Hotel 'Hospital'ity with a Difference

It's "hospital"ity with a difference! Hyderabad is witnessing a real estate revolution as two arms of the service sector -- hotels and hospitals come together. An increasing number of hotels are converting into hospitals, with more and more renowned physicians and health experts looking at a quick conversion of their dreams of setting up corporate hospitals.

The escalating cost and time barriers in setting up a hospital as it's conceived and envisioned, is driving more and more healthcare experts to look to quick-fix solutions to providing medicare to the people.

Constructing hospitals in populated areas of a city doesn't seem possible as land for such spaces is simply not available. The nearest land you can get is 30 kms off the city, which can't be accessed by masses. A 100-bed hospital requires at least 2 acres of land. And converting existing infrastructure seems to be the only solution.

"Health care involves huge costs. Converting dreams and visions about setting up hospitals involves a lot of time, money and infrastructure. When it's all in short supply, you look at existing buildings that might be feasible enough to be converted. These could be departmental stores, a villa, or government offices, or then hotels. The nearest that comes to a hospital is a hotel, though you need to strip off the glamour, fancy mirrors and chandeliers, and bring in convenience catering to the sick," says Prof Arun K Tewari, director, Care Foundation.

Hotels offer the facilities required for a hospital -- rooms, parking, housekeeping, kitchen, laundry, and all need to replace is entertainment areas like bars, banquet halls and swimming pools, with health infrastructure like critical care units, operation theatres, etc. There is minimal adaptation in such conversion, he adds.

The trend began with the Share Medical Care Trust converting Hotel Sarovar near Tank Bund into the Mediciti Hospital more than eight years ago. The latest to join the bandwagon is Care Foundation, which has begun work at the Bhaskara Palace in Banjara Hills to convert it into a multi-speciality hospital. Care did a similar project with Hotel Sampoorna in Nampally in 1997.

Sampoorna was converted into a predominantly cardiac neuro 200 bed hospital with four operation theatres, one cath lab, and one ICU. The Bhaskara Palace is being converted into a multispeciality 300-bed hospital, with 10 operation theatres, two cath labs, and four ICUs.

There are three major requirements of a modern hospital: firstly, infrastructure -- civil, electrical and utilities, second medical -- diagnostics, intervention and care, and third personnel -- doctors, paramedics, technical or housekeeping.

A modern hotel provides most of these necessities. By altering what is not required into what's missing, a hospital can be made.

In terms of the civil infrastructure, guest rooms can be utilised as patient rooms. The banquet halls, convention centres, lobbies, swimming pools, restaurants etc can be converted into patient waiting areas, ICUs, operation theatres and R&D and testing labs. The electrical and utilities infrastructure like firefighting equipment, air conditioning are already present.

The medical requirements -- ICUs, operation theatres, cath labs, nuclear medicine, endo/laproscopy, cardiac care, neuro, ortho, pulmonary and oncology department, labs and radiology consisting of biochemistry, microbiology, pathology and CT Scan, ultrasound, colour doplar, X-Ray machine, can be added.

Also, the technical and housekeeping personnel can be utilised, while a team of doctors and paramedics can be assembled.

The advantages of converting are many. First being the prime location. Second is saving on time. A hospital normally requires three years to get constructed and equipped, and if converting, half the construction is done, in turn getting a lead time of 18 months. The third advantage is in terms of reduced investment and nil interest costs.

"A modern 250-bed hospital requires Rs 50 crores and a gestation period of three years. We save interest costs of borrowing for paying for the assets, and getting a prime location, well accessed and well populated. So getting assets without interests," he adds.

But, the only downside could be if you don't have the requisite personnel. Care Foundation has taken care of this. Dr Soma Raju, CMD Care, has grouped under him the single largest team of cardiac specialists in the country. There are a total of 2,000 cardiac specialists in India, of whom 25 are with Care, Prof Tiwari says.

"Necessity and obligation are the main drive for this model. Necessity and obligation to bring health care to the public in the shortest time possible. We want to duplicate the model. Work is in progress to start similar hospitals in Amalapuram and Rajamundry, says Dr Raju.

But, entrepreneurs and hoteliers can't use the same model to outsource hotel buildings to hospitals, they warn. "Doctors are a very egoistic herd and can't be controlled by anybody except their own tribe. This model works only for established physicians with a team. Hospitals are not profit-driven, so it's not a revenue model for hoteliers," says Prof Tiwari. Agrees Mr Manik Arke, secretary of Mediciti Hospital's Share Medical Care Trust: "Healthcare delivery needs special skills. The similarity ends with both being servicing industries. It's not easy to convert as those being served in hospitals are much more demanding than guests in hotels."

You need to provide for wheelchair entrances, convert lobbies as waiting rooms, lifts need to be slow and non-jerky and should accomodate stretchers etc. The healthy stay in hotels on some business while the sick are treated at hospitals, so many commonalities in terms of services such as security, canteen and laundry, but with added services of medicare, he says.

The Mediciti in Shamirpet is their main hospital, but the trust wanted a location in the city that could do initial diagnosis and transport patients there in case of further treatment and acute care. It found the right choice in Hotel Sarovar, for its pleasant and prime location facing Tank Bund. The hotel was converted into a 164-bed hospital.

But, nothing can beat a hospital constructed according to its inception, he rues. Converting is overall a compromise, but it's fine as long as it's all for the patient's good. Amen to that!