Hot Seat

Strategist Par Excellence

Daljit Singh, President-Strategy, Fortis Healthcare Ltd, speaks to Rita Dutta about the recent Escorts controversy and his searing strategies to propel the Group’s expansion plans.

Be it the controversy surrounding the Escorts takeover, then later the Dr Naresh Trehan imbroglio in May, this year, its IPO or ambitious expansion plans, Fortis Healthcare Ltd is always in the news. And the man charting and executing all crucial strategic decisions is the flamboyant 54-year-old Daljit Singh.

The Trehan Episode

My interview with Daljit at Escorts Heart Institute, New Delhi kickstarts with the much-criticised method of expelling former Executive Director Dr Trehan. In hindsight, does he think the situation could have been handled in a more dignified and less hasty manner? Was it necessary to simultaneously announce a few promotions during this chaos? "That was the only option left open at that time. It was too serious a matter to have been an act of impetuosity," he asserts.

And did Fortis seriously engage with Dr Trehan to arrive at a logical solution to resolve the "conflict of interest"? "Of course! We were in regular dialogue with him over a period of about 20 months. There were three clear choices discussed: to extend existing partnership to cover Medicity; continue partnership with Escorts only, with Dr Trehan making an exit from Medicity; break up the partnership, leaving Fortis to focus on Escorts and Dr Trehan to focus on Medicity. However, the talks led to a statement and we had to take a call," he elaborates. What about the issue of neglecting patients during this chaos? "No patient was neglected. We would see some people impersonating as attendants/patients and being a nuisance in the hospital lobby, but when questioned, they would vanish mysteriously," he reveals. About forcibly taking away Dr Trehan's mobile number, which reportedly caused major inconvenience to patients, Daljit says, "There was no question of use of force; all telephone numbers belong to Escorts, and this policy was laid down by Dr Trehan himself. We just went by the book."

Inking New Ties

After clearing the air on the Trehan controversy, he delves into his liaison with Fortis, which began in September 2002 as the CEO (Operations) of Fortis Healthcare. Prior to Fortis, for 28 years he was with ICI India Ltd where he was Executive Director, Human Resources, Manufacturing, External Relations, Communications and SHE. His decision to leave ICI was prompted by the fact that the company did not have am aggressive growth strategy for India, since the parent company was restructuring. He joined Fortis, as according to him "the promoters wanted to create a world class integrated healthcare system known for clinical excellence and patient care."

When he joined Fortis, the Group had just one Hospital at Mohali. Today, he is part of the senior management that boasts of running 12 hospitals with about 2,000 beds and still growing. With Fortis planning to add another 4,000 beds by 2010, Daljit definitely has his hands full.

His early days at Fortis were a period of constant learning as he was coming to terms with the nuances of healthcare delivery and medical terminology. "The cardiac surgeon would tell me he had performed a 'tetrology of fallot' and I would ask him to explain what that meant. That would lead to a short class wherein the doctor, using the white board on my office wall, would seek to explain the intricacies of the human heart and the marvellous surgeries that provided relief to the patient!" he says. The Mohali facility was his training ground. He claims that when one is genuinely interested, a lot of learning can happen; this not only enhances knowledge but also leads to a deeper appreciation of how medical problems can be alleviated.

The Flamboyant Punjabi

Daljit spearheaded a cultural change in Fortis with fresh strategies. Some of them are:

Team Building: One of his strengths is building high-performance teams. His amicable and charming personality, not to mention his zest and high sense of integrity, endears him to his colleagues and makes him a good manager. As his former colleague Dr Ravindra Karanjekar, Associate VP, Wockhardt Hospitals, says, "One of his greatest strength is his social and warm persona. At the same time, he is honest and loyal."

Patient Centricity: Daljit also improved efficiency in operations. Like a good Punjabi host, he constantly emphasises on the importance of 'hospitality' in healthcare delivery. "I put in a lot of effort to build upon the concept of patient centricity, a term that literally means 'putting patients first'. This involved designing a relevant 'patient/attendant feedback' system, which would constantly provide us vital feedback on patients' and their attendants’ views about our services. The feedback is then put to use by improving services. It also meant putting in effort in training and developing the patient-facing staff to sensitise them to patient requirements,” he says. All touch points were identified and worked upon viz security services, front desk operations, counselling services, F&B, housekeeping services, nursing etc. Specially-trained Patient Welfare Officers (PWOs) were appointed to interact with patients on a daily basis and resolve their issues.

"Complaints like long waiting periods for admissions, brusque behaviour of front office staff, improper counselling, inaccurate billing, deficiencies in food services, or the doctor/nurse not coming on time are common complaints in any hospital. Through a focus on patient-centric initiatives, we are continuously seeking to create a culture of service across our organisation. How a patient feels about Fortis is of utmost importance to us,” he asserts.

FOS: He is also spearheading a project of creating the Fortis Operating System (FOS). This project, when completed, will ensure that all key patient-facing processes in a hospital are understood, manualised and implemented. "This will ensure consistency in operations so as to deliver high service levels and performance. FOS will facilitate replicability and scalability across the Fortis network, thereby ensuring that patients can expect to get a similar level of service across the network hospitals," says Daljit.

Quality: This is another area that Daljit feels passionate about. Fortis Hospital, Mohali, recently had its final survey for JCI quality accreditation in mid-June, 2007. "The journey which commenced in the second half of 2005 required much effort, and pretty much involved each one of the over 1,000 staff at Mohali," he says. Daljit wants quality to become an integral part of Fortis culture. "It must become a habit and be woven into every activity that is critical to sustainable development." The journey took somewhat longer than he had anticipated, but he is ecstatic about the roll out now. "Two of our other hospitals are ready for the final NABH accreditation surveys," he proudly states.

Resource Management: "We have achieved significant success in managing the cost of energy; through judicious use of innovative methodologies. We actually managed to reduce costs over a two-year period, despite seeing a doubling in hospital occupancy," he says.

He also steered to reduce inventories by about 60 per cent over a span of a year. "There have been many other initiatives which succeeded in reducing variable costs, leading to improved margins. Continuous focus in driving productivity and reducing costs is essential to the running of a successful business," he says.

Some Key Concepts

Centre of Excellence: He has divided the hospitals as centres of excellence and high-end multi-specialties. According to him, all hub hospitals of Fortis (about 200-bed capacity) will have a centre of excellence in one or more speciality and additionally a backbone of multi-speciality. "By centre of excellence, we mean a centre of quality and expertise that not only draws the local populace, but also patients from afar. The high-end super-specialities serve in a comprehensive manner all the medical needs of the local population," he explains. The Mohali facility, for instance, has a centre of excellence in cardiac and a strong backbone of multi-speciality services.

Another upcoming facility in Gurgaon's Sector 44 will be a centre of excellence in seven super-specialities like cardiac sciences, orthopaedics, gastroenterology, renal sciences, oncology, neurosciences, mother and child. This facility, to be built on a sprawling 11-acre campus, is expected to come on stream by 2009 at a cost of Rs 500 crore. Fortis is also in the process of commissioning a 300-plus-bed project in Jaipur.

The Boutique Hospital: Besides working on developing the hub and spoke model, popularised by Fortis, Daljit explains how the Group has introduced the concept of boutique hospitals—like the recently launched high-end facility for women and children, Fortis La Femme. It has been positioned as an exclusive facility for birthing and womens' medical issues like gynaecological surgeries, cosmetic surgery, breast cancer screening, women's wellness, etc. "We are also planning a sports medicine centre," he says.

Land banks: Fortis has tied up with leading builders to set up hospitals as part of the colonies proposed to be built by them. "Good hospitals and schools as part of large housing projects enhance the value of the projects. It is clearly a win-win for both parties," says he.

Dealing with Disappointments

Not all ventures have kissed success, though. An example is the software implementation project that was considerably delayed. "We took almost twice the time to implement a state-of-the-art HIS at one of our hospitals. This indeed was an eye-opener," reveals Daljit.

So how does he deal with failure? After months of planning, when a project fails to take off, does it depress him? "Of course, I feel bad about it, but one has to move on; learn from the failure and come out strong," he philosophises.

According to him, any good strategy must be backed by an equally rigorous 'execution strategy' which is sufficiently detailed, so that rapid implementation is facilitated. Execution requires senior management attention and cannot be delegated.

Daljit Unravelled

The car he drives: Black and beige Pajero. The books he loves to read: Major HPS Ahluwalia's 'Higher than Everest'; Jon Krackauer's 'Into Thin Air'; and Mark Shand's 'The River God'. Favourite food: A year-and-a-half ago, he turned vegetarian. He enjoys all kinds of food, from sambar to sarso da saag. He relishes Kashmiri Pandit food. He loves making barbeque for his friends and family, an art that he learnt from the master chef of Bukhara. His favourite holiday destination: He enjoys nature destinations. He dabbles in white water rafting and trekking. He has trekked across the Rohtang, Leh and Ladhak; Mt Kailash and Manasarovar Lake, the base camp of Mount Everest in Tibet, Sangla valley etc. How important is money to him: It is important to take care of your basic needs. It should not reach a level of greed.

On Fortis's Expansion Plan

"It all began with the CII-McKinsey Report in 2002, which charted the huge opportunity for the Indian healthcare market," he states. Daljit is crystal clear about Fortis' plans. "Ours is a differentiated growth strategy. We work on a hub and spoke model, with the hubs being centres of excellence in one or more specialities. When we enter a region, we desire to become dominant and have a strong presence; our belief is that people should not travel long distances to access facilities. We have a dominant position in Northern India and have only recently forayed into Navi Mumbai. We will, over a few years, have a pan India presence and occupy the tertiary care space. Primary care is not our focus," he asserts.

For a population of over 33 million in Delhi NCR, for instance, Fortis has five facilities and is planning more. "We have just commenced construction of a 500-bed facility, spread over 7.5 acres in Shalimar Bagh in North West Delhi at a cost of around Rs 250 crore," he informs.

So, how does the key strategist see himself five years from now? "I hope to be recognised as somebody who has made some significant contribution to the shaping of the corporate healthcare sector of our country," he says.

The Challenges Ahead

No prizes for guessing. Yes, the major challenge is to make Escorts work post Dr Trehan. "Whilst we continue to focus on rapid growth, we need to simultaneously retain focus on improving our operating performance. Attracting, retaining and growing talented people are constant challenges in a sector bursting with opportunities. As our network expands, one's ability to attract good talent also improves," he says. To build capability, the company is developing the Fortis Institute of Enhanced Leadership Development and is tying up with top management schools for that.

It would be no exaggeration to say that Daljit, as part of Fortis, is playing a crucial role in bringing order to a hitherto unstructured and seemingly chaotic healthcare industry.

rita.dutta@expressindia.com