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‘Healthcare Global Enterprises is growing at 20-22 per cent currently and will further focus on expansion of its centres’ HealthCare Global Enterprises (HCG) has been one of the fastest growing cancer care network in India is very soon going to launch around five new centres. After the IPO, the companies has scaled up its expansion and has plans to set up its cancer care centre in Africa. Dr BS Ajaikumar, Chairman & CEO, HealthCare Global Enterprises shares the company's growth story and plans for 2017-18 in an interaction with Raelene Kambli You launched your first hospital in 2005. What did it take to finally make that decision? Once you had made it, what were some of the steps you took to learn the business skills? Back in the early 2000s, we realised that the delivery of cancer care was poor in India, and so were the clinical outcomes because of low use of technology. We were aware that India was a poor country, unable to afford quality cancer care – all of which created a perception amongst people that cancer was a disease to be feared. To me, these reasons were unjustifiable. The growing number of cancer patients required more attention to make cancer care both accessible and affordable, and we felt that the government alone was not in a position to deliver such care in India. It was clear to us that private enterprise had a big role to play and could penetrate most markets. Around 2003-04, I returned to India and set up the hub and spoke model shortly after that, in 2005. From a business angle, we had to make our model viable and we turned to private equity. There is always the concern that equity is more expensive than debt – which is true. Debt, however, is like a sword hanging over your neck, while in the case of equity, value is created for the investor. Keeping this in mind
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we chose equity. Although dilution is a fear with equity, it did not matter to us because our goal was not to make it a business but a social enterprise, by using our business acumen. These are some of the bold steps we took to make HCG a successful venture. We then opted for more private equity to expand across the country, got ourselves a good name, increased our transparency and were able to successfully go public as a cancer care provider – something that was completely unimaginable a decade ago. You’ve built a fast-growing business- India’s largest cancer care network. What was your strategy in building a business so rapidly, especially in cancer care? What were some of the steps you took? Some of these steps I have partly explained above, our main strategy was that the business can and should go ahead based on the need and the opportunity. Cancer in India was increasing significantly, and from our experience it was clear that cancer, as a lifestyle disease, would increase to epidemic proportions. So, we decided to build a hub and spoke model, the hubs being centres of excellence and the spokes in partnership with doctors and experts, in big
cities as well as in tier II and III cities, extending cancer care expertise to a larger public. In just 10 years, we have been able to set up over 20 comprehensive cancer centres in India and make cancer care affordable even in tier II and III cities like Vijayawada, Ranchi and Kanpur. This kind of expansion hasn’t been done globally, and has been possible through our hub and spoke model, centralisation of services, and our partnership model with doctors.
We have always been interested in creating doctor entrepreneurs especially in niche areas – IVF is one of these areas
What have been some of the most strenuous challenges that you have faced? How did you overcome those challenges, and what did you learn from them? The first challenge for us was to create a model with the knowledge and the technology needed to address a disease as complex as cancer. Some of our questions back then were: how do we bring in the funding finance, and how do we create a hybrid financing model where there is equity and debt, which as I have explained earlier, is a challenge we overcame. The next challenge was to identify where in the country we wanted to be and at what point. The third challenge was to create a model of partnership with doctors, a new model for India. This last step required a lot of awareness building amongst doctors, financial investors, banks and private equity in-