India Visit report

Eddie McCaig

Professor of Surgery,

College of Medicine Nursing & Health Science, Fiji National University

There had been intended a group of 11 delegates to undergo a week-long visit to India’s Largest

Hospital Network, 2 withdrew prior to leaving.

The Fortis Healthcare is India’s second largest and fastest growing hospital chain. The Fortis

group comprises a 76 hospital network. The Fortis Centers of Excellence focus on high-end

treatment in critical illnesses across Asia and has a capacity of 12,000 beds.

We visited 6 Hospitals and an Undertaker in the 3 cities of Delhi, Kolkata and Chennai.

Declaration.

• SSCSiP paid my airfares.

• Transport and Accommodation in India was catered for by Medical Service Company

and its Managing Director Mr. Deepak Singh.

• No cash payment was received in any form: consultancy or per diems.

Transport

• The Transport To/from and within India was very well organized BUT It took about 24

hours of travel and airport waits to get from Fiji to India.

Accommodation.

• We stayed in 3 excellent Hotels whilst in India.

• Hotel Vivanta by Taj in Gurgaon, Delhi.

• The Park Kolkata Hotel, Kolkata

• Accord Metropolitan Hotel Chennai.

The Hospitals.

• Fortis Memorial Research Institute, Gurgaon

• Fortis Fit. Lt. RajanDhall Hospital, Vasant Kung, New Delhi

• Fortis Hospital, Nordia

• Fortis Escort Heart Institute, Delhi

• Fortis Hospital, Anandpur, Kolkata

• Fortis Malar Hospital, Adyar, Chennai

These were of a standard that would match the best I had ever seen in Australasia, Europe or the

Americas. If one were to class these hospitals I would rate them as being 4 star Hotel standard to

7 star, this was the level of The Fortis Memorial Research Institute in Gurgaon. It was described

in a Brochure as “the Mecca of Health Care” for Asia and beyond and it aims to be the “next

generation Hospital”. I believe them.

John Pinto International, funeral Directors.

The group had said that their involvement in recent times that they had on average a death a year

that needed repatriation. During our stay we told of a death from the PIC and the problems faced

were discussed.

The Staff.

• There were staff presentations at all Hospital visited, the staff were all internationally

qualified and were of a very high standard.

• The Fortis group had obviously recruited the best from within India, Europe and the

USA.

• The staff presentations were of a very high standard and there CV’s were impressive.

• The population size was reflected in the extensive experience of the staff.

Problem list.

1. Travel time, it toke on average 24 hours from home to India. We could not hope to send a

“sick” person this distance.

2. All the Hospital within the Fortis group is solely vegetarian. This I feel must be related to

all; patients and agreed to prior to departing.

3. Communication between all stake holders must be improved significantly. We must be

realistic with our expectations and not send patients to die in India.

Recommendations

1. I have no hesitation in recommending that our patients who are referred abroad use of the

Hospitals that we had visited. The standard of both Staff and the Hospital were of a high

level.

2. I would also recommend that PIC should utilize the services of Medican Service

Company Ltd to facilitate patient referral abroad.

…………………………………………………………………………………………….

Rajat Gyaneshwar

Professor of Obstetrics and Gynaecology

College of Medicine Nursing & Health Science, Fiji National University

Dear Colleagues,

I concur with Eddie in his summation. What we saw was impressive. Apart from excellent

clinical infrastructure, well credentialed staff and impressive hotel services the Fortis group bring

a cooperate management which is responsive to senior clinician needs.

Fortis are relatively new as a group but have taken over some established hospitals such as

Escort which has an enviable national record in cardiothoracic surgery. They have also achieved

recognition for many of their facilities with national boards auditing compliance with

international standards in health care delivery.

The operations are managed using 2 governance tools. The FOS ie Fortis operations systems

which ensures management efficiencies and the MOS ie the medical operations systems which

ensures broad clinical quality measures including lengths of stay, unplanned readmissions, return

to OT and ICU admissions. They also monitor complications such as post procedural infections.

The data is used for comparisons across the Fortis group and the reporting includes senior

management. They have mechanisms in place to use the data for quality improvement strategies.

The clinical governance strategies have been adopted recently and are being developed with

strong backing from senior administration.

A weakness in the system is that unexpected deaths e.g. intraop or immediate post op deaths are

not reported to a coroner. All serious incidents are managed internally and external review is not

mandatory.

Recommendation

I think the PICs need to be encouraged to ensure a robust triaging system to ensure appropriate

referrals. The referrals need to include a consultant to consultant discussion and not merely an

admin process. There have been isolated cases where the management would have been different

e.g. a case for a renal transplant where the diagnosis did not warrant a transplant.

There is also a need to develop a post treatment follow up mechanism to ensure sustained

benefits for the individual pt.

Mr Deepak Singh has an excellent relationship with Fortis, has credibility with senior

management and clinicians. I found him to be very professional and ethical.

Regards,

Rajat

SSCSiP’s Clinical advisors in India on a fact-finding trip

Prof Rajat Gyaneshwar (second from the left) and Prof Eddie McCaig (behind the two ladies)