Devi Shetty's Narayana Hrudayalaya can perform heart surgery for US$800

Cardiac surgeon Devi Shetty's pre-fabricated facility in India performs about 30 operations a day, and poor are treated free

PUBLISHED : Monday, 22 April, 2013, 12:00am
UPDATED : Monday, 22 April, 2013, 5:17am


What if hospitals were run like a mix of Walmart and a low-cost airline? The result might be something like the chain of "no-frills" Narayana Hrudayalaya clinics in southern India.

Using prefabricated buildings, stripping out air-conditioning and training visitors to help with post-operative care, the group believes it can cut the cost of heart surgery to US$800.

"Today healthcare has got phenomenal services to offer. Almost every disease can be cured and if you can't cure patients, you can give them meaningful life," says company founder Devi Shetty, one of the world's most famous heart surgeons.

"But what percentage of the people of this planet can afford it? A hundred years after the first heart surgery, less than 10 per cent of the world's population can," he said in Bangalore.

Already famous for his "heart factory" in Bangalore, which does the highest number of cardiac operations in the world, the latest Narayana Hrudayalaya ("Temple of the Heart") projects are ultra low-cost facilities.

The first is a single-storey hospital in Mysore, two hours drive from Bangalore, which was built for about 400 million rupees (HK$57.7 million) in 10 months and recently opened its doors.

Set amid palm trees and with five operating theatres for cardiac, brain and kidney procedures, Shetty boasts how it was built at a fraction of the cost of equivalents in the rich world.

"Near Stanford [in the US], they are building a 200-300 bed hospital. They are likely to spend over US$600 million," he said.

"There is a hospital coming up in London. They are likely to spend over a billion pounds," added the father of four, who has a print of mother Teresa on his wall - one of his famous patients.

"Our target is to build and equip a hospital for US$6 million and build it in six months."

The Mysore facility represents his vision for the future of healthcare in India - and a model likely to burnish India's reputation as a centre for low-cost innovation in the developing world.

Air-conditioning is restricted to operating theatres and intensive care units. Ventilation comes from large windows.

Relatives or friends visiting in-patients undergo a four-hour nursing course and are expected to change bandages and do other simple tasks.

In its architecture, Shetty rejected the multi-storey model, which requires costly foundations and steel reinforcements as well as lifts and complex fire safety equipment. Much of the building was pre-fabricated off site and then quickly assembled.

The Mysore facility will be followed by others in Bhubaneswar in the southeast Odisha state and West Bengal's Siliguri.

Each will owe its existence to Shetty's original success story, his pioneering cardiac hospital in Bangalore that opened in 2001.

About 30 heart surgeries are performed there daily, the highest in the world, at a break-even cost of US$1,800. Most patients are charged more, but the poorest are treated for free.

Its success has made Shetty wealthy and famous.

In the crammed waiting room, families from across South Asia wait for appointments with the boss who juggles them between stints in the theatre.

"We saw him on TV recently and we could see his commitment to poor people and middle-class people like us," said Ranjan Bhattacharya, a civil servant who brought his ill wife 2,000km by train from northeast India.

In its dealings with suppliers, the hospital group works like a large supermarket, buying expensive items such as heart valves in bulk. By running the operating theatres from early morning to late at night, six days a week, it is inspired by low-cost airlines that keep their planes in the air as much as possible.

The British-trained surgeon sniffs at the output of Western counterparts who might do a handful of operations a week. His surgeons do up to four a day on a fraction of the wages.

"Essentially we realised that as you do more numbers, your results get better and your cost goes down," he said.

From 6,000 beds now in 17 clinics, he aims to expand to 30,000 beds in the next five years.

"The current regulatory structures, the current policies and business strategies [for healthcare] that we have are wrong. If they were right, we should have reached 90 per cent of the world's population," he said.