1

INDEX
Sl Description Page No.
Preamble
Write-up
1.00 Introduction - Health Care Scenario In India 2-6
2.00 Scope Of A Eye Clinic 7,8
3.00 Objective Of The Project 9 - 11
4.00 Promoters’ Details 12
5.00 Salient Features Of The Project 13
6.00 How The Eye Clinic Will Be Built 14 , 15
7.00 Disease Profile and Eye Diseases 16 , 17
7A West Bengal Scenario 18 - 20
8.00 Automation 21 , 22
9.00 Activities 23 - 25
Financials
10.00 Capital Expenditure And Means Of Finance Table – A,B,B1
11.00 Projected Balance Sheet Table – L
12.00 Projected Profitability Estimates Table – F
13.00 Projected Cash Flow Statement Table – K
14.00 Details Of Income From Operations Table – E
15.00 Details Of Expenses Table – C,G,H
16.00 Interest and Term Loan Repayment Schedule Table – I, I1
17.00 Depreciation Schedule , Taxation Table – D , J
18.00 Ratio & Sensitivity Analysis , BEP & DSCR Table– N,P,O,M
19.00 Details Of Equipment Table – B2
20.00 Conclusion
Annexure - Floor Plans
Space For Notes

1.0 INTRODUCTION

1.1 HEALTH CARE SCENARIO IN INDIA

With a rapidly expanding population of around 1050 million, India has a very
inadequate health care system. World Health Organization shows a figure of 0.7 beds
per 10,000 population, a level well below many less developed nations. Even though
quality of medical education is quite good, and by and large health care

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professionals are competent, public hospitals managed through government subsidy

are too overburdened and understaffed to maintain quality standards. While most of
them are not equipped enough, the quality of care is quite substandard.
Consequently, with changing demographics and rapidly expanding middle and upper
income groups, those who can so afford it, turn to Private Nursing Homes and
Hospitals. Considering the tremendous demands, such Nursing Homes have sprouted
all over both large and small cities. Local physicians see it as a channel to practice
independently and it is indeed a good source of income to most. As the market place
privatizes, and healthcare comes to be considered an industry by the Government of
India, corporate health-care emerges as a lucrative investment to many. Of late,
some large private tertiary care hospitals have even successfully raised money
through public offerings.

The CII-Mckinsey report (2002) on India’s Healthcare industry states that India
would require 750,000 beds by 2012 and estimates that a fresh investment of US$25
billion is needed to establish quality health facilities in the next 8-10 years .

Estimates say that while the proportion of households in the low income group has
declined significantly , middle and higher income group has increased from 14 to 20
percent . With the demand for healthcare far exceeding supply , the industry has
transformed to a USD 23 billion industry , which is surging ahead with a growth rate
of 13 percent a year . While the general belief is that private healthcare spending in
India contribute 60 percent of the country’s healthcare service , the World Bank
Report , 2004 has pegged it at 82 percent .

Also allowing 100 percent FDI subject to approval by the Foreign Investment
Promotion Board under the Department Of Industrial Policy And Promotion in the
Ministry of Commerce and Industry is a sign of market opening up for international
investors .

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The proposed modern Eye Clinic ( SHUVAM NETRALAYA ) would differ from
other facilities in the quality of its equipment and its staff. Latest equipment will be
provided and the Clinic will provide quality service .

1.2 Per Capita Health Expenditure of a Few Countries

India’s health spend as percentage of GDP (5.2%) matches that of other developing
countries but on a per capita basis it is low.

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800

600

400

200

0
Korea Brazil Thailand China India

Healthcare per capita expenditure

1.3 Ne ed For A Speciality Clinic

5%
IN FAVOUR OF GOOD CLINIC
25%
FEELS NOT USEFUL WITHOUT
DEDICATED DOCTORS

70% CAN'T SAY

Source : Business Today

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1.4 Existing Health Care Facility In and Around Kolkata

AWARENESS 30

REASONS FOR DISSATISFACTION

80 70
70
60 50
50 40
40 30
30
20
10
0

S
S

S
R

IE

E
TO

IT

IE

N
IL

E
N
C

R
C

E
O

A
FA

V
D

W
N
O

A
C

1) Doctors : In various disciplines and specialization.

2) Facilities : Hospital facilities viz., waiting arrangement,

flow of information, Accounts, public
utilities, night stay arrangement, etc.

3) Convenience / Communication : Location, Public Information and Transport.

4) Awareness : Majority of general public are not aware

of the medical services provided by the hospitals.

The above chart is based on a local survey conducted by the consultants on more than 250 persons of
different status and economic category .

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1.5 Source-wise Health Expenditure

6% 2%
8%
Self Paid
Government
Municipal Bodies
25% 59% Employers
Foreign aid

1.6 Average Cost Of Medical Treatment

500
400
300 Private Service
200 Government Services
100
0
t B sh
U mil an
M rna at

aj ra

W Pra u
h

l
ar ka
G i

ga
h

ad
es

R sht
el

es de
h
ah ta
Ka uj

en
Ta ast
tt a N
ad

a
Pr

r
ra
dh
An

Source : Business Today

2.00 SCOPE OF A SPECIALTY EYE CLINIC

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India, with it’s ever expanding population, needs more & more medical facilities to
cater to it’s huge population. The central and the state Governments have
emphasised on this aspect since independence and a lot of investment has gone into
this sector. Still, a lot more remains to be done. It is now quite apparent that the
Government hospitals, health centres and clinics lack the proper infrastructure in
doctors and equipment to cater to our immense population. Though a few good
private hospitals, having good eye-care facilities have come up in and around
Kolkata over the last few years but in the fringes and districts of West Bengal there is
no / negligible quality eye-care facility and the trend among patients is to go to South
India or even outside India for treatment.

The Government facilities are inadequate to cater to the patients of West Bengal and
also to the patients who come here for treatment from Bangladesh . As a result, the
few good clinics and private hospitals are doing roaring business.

Hence, we can infer, that West Bengal needs more state of the art hospitals / nursing
homes / specialty clinics so that the patients get good quality healthcare and service
and the gap between supply and demand is shrinked . And, this organisation,
proposes and promises to do justice to this demand.

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ESTABLISHED
LOCAL PHYSICIAN’S
SUPPLY
INVESTOR
GOVT. BODY’S DESIRE TO SET
UP CLINIC IN
S COOPERATIO MASLANDAPU
N R

SHUVAM NETRALAYA

DEMAND
GREAT DEMAND
INVESTMENT FOR QUALITY
OPPORTUNITY IN EYE-CARE IN
HEALTHCARE WEST BENGAL

3.00 OBJECTIVE OF THE PROJECT

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The main promoter of this project Dr. Prabir Kumar Bhakta has a dream of setting
up of a good quality eye-care clinic . He had built up his profession in Maslandapur
by sheer hard work and today can boast of a big name in his field in that area.
Backed by the same desire and zeal , Dr. Bhakta felt that even after six decades of
independence , the health sector has hardly improved to the desired extent . There are
many things like health education , basic check-up programmes , awareness and
prevention of dreaded diseases etc . which are yet to find a place in the common
man’s life . The idea to develop an eye-care clinic with mass based awareness
programme inspired Dr. Bhakta to look deep into the matter .

GENESIS
Inspired by the great teaching of Swami Vivekananda “Service to man is service to
God” SHUVAM NETRALAYA was born and started its journey in setting up the
centre in Maslandapur .

SHUVAM NETRALAYA will be firmly committed to achieve the following aims and
objectives :

• Build up a most modern state-of-the-art eye-care centre with special emphasis

on Blindness Control along with general preventions .
• The entire centre which will boast of a series of world class equipment and
will be run on self generating system so that the charges are kept to the
affordable limits of general public .
• Primary healthcare programmes through its team of doctors for rural masses
on basic awareness against diseases of the eye .

• Contacts with district level hospitals will be established through a wide

Telemedicine network at a later date .

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• The best doctors in the field of ophthalmology will be made available in the
Centre so that people in general can complete both diagnostic , curative and
surgical treatment in the centre .
Main Objective :
In the fast changing modern technological environment of sophisticated medical
equipment and instruments, it is indeed difficult to keep pace with the latest
developments taking place all over the world. To overcome this dynamic situation,
the selection of state-of-the-art equipment and instruments has been carried out after
an intensive in-depth study and analysis of the medical care needs of the community
by a select team of reputed doctors, professionals, managers and bio-medical
engineers who are updated in knowledge of their respective fields. Thus the Centre
shall enjoy the support of the world’s latest equipment currently available to aid
accurate diagnosis and therefore appropriate complete treatment under one roof.
SHUVAM NETRALAYA shall keep updating the latest technology out of its own
resources without losing any time.
SHUVAM NETRALAYA may tie-up with all other major Hospitals in Kolkata as
well as other places in Eastern Region for recommendation of patients and vice
versa. In order to meet the stringent aseptic quality standard, the Centre shall be
meticulous in every aspect of it’s maintenance, including pollution control, selection
of staff, etc. The Centre will have a smiling reception and a loving nursing care.
It may be stressed here that quality equipment and instruments by themselves do not
make a Centre or a Hospital unless backed by equally capable and qualified Doctors,
Technicians, Nurses and Paramedical Staff.

Therefore, while formulating the project, care has been taken to select appropriate
personnel with dedication, professional knowledge, integrity and humane touch.
Prime attention to the patients along with highly dedicated and personalized service
will be the main orientation of the team, comprising both medical and management
staff.

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In brief , we might say that the following objectives will be the guiding principles for
the project :
1. Availability of state-of-the-art equipment and world class quality service will
be the standard practice .
2. Low cost competitive pricing will be ensured .
3. Certain percentage of care will be available on a minimal cost to the neediest.
4. Liaison with WB government and Indian Government will be maintained for
ensuing social responsibility in view of the need for the poor and uninsured
patients .

Apart from the above , the main aim of this project is to establish a self
generating medical project with its resources and revenues being utilized for
further growth and expansions .

4.0 PROMOTER’S DETAILS

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Dr. Prabir Kumar Bhakta , MBBS , DO

DOB : 23.06.1960.
Address : CJ – 82 , Sector – II , Salt Lake City , Kolkata – 700 091 .
Telephone : 98361 88241

Medical School :
1978 to 1983
N.R.S. Medical College , Kolkata .

Post Graduate Diploma :

1988
Diploma In Ophthalmology
University of Calcutta

Service Life :
1987 – 1990
As GDMO in M.A.M.C. hospital , Durgapur .
1990 – 1995
As a visiting eye specialist in N.B.M. Eye Hospital , Garia .

Private Practice :
Solo Practice – Since 1995
Ophthalmology ( Invasive & Non Invasive )

5.00 SALIENT FEATURES OF THE PROJECT

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Name SHUVAM NETRALAYA

Location Maslandapur , 24 Parganas ( North )

On Maslandapur – Basirhat Road
Registered Office As above – to be opened

Constitution To be constituted as a proprietorship

Company

Line Of Business Clinic , Diagnostics and Hospital

Type Of Business OPD and Daycare

Employment Potential 5 + other contractual employments

Power Requirement 12 KVA

Cost Involvement
Land and Building Rs. 27.47 Lakhs
Equipment Rs. 18.56 Lakhs
Other Contingencies Etc. Rs. 09.82 Lakhs
Project Cost Rs. 55.84 Lakhs
Financing Pattern
Capital Rs. 11.96 Lakhs
Term Loan Rs. 41.88 Lakhs
Others Rs. 02.00 Lakhs
Total Rs. 55.84 Lakhs

6.00 HOW THE HOSPITAL WILL BE BUILT

The Hospital with far-reaching benefits is projected involving around Rs.56.00

Lakhs with the break up of :

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Sl Description Amount Rs.

(In Lakhs)
A Land and Building 27.47
B Equipment 18.56
C Contingencies , etc. 9.82

Total Cost of the Project 55.84

The Dreamers who want to make it happen :

The team of people who have been planning a Eye Care Centre on such a scale are
not idle dreamers. Inspired by the ancient Indian concept of a joint family where the
better placed brother extends the helping hand to the less fortunate brother, they are
top notch professionals – Ophthalmologists , Cost Accountants and Architects. They
are pragmatic too – knowing, it can be done – an ideal Care and Cure Centre – with
their own dedication and active co-operation for achieving the objectives .

Infrastructure Of The Proposed Centre

The Promoter is set to buy a three storied house of 2500 sq.ft. built up area in
Maslandapur . The condition of the house is excellent and is recently repaired
extensively and painted .

The ground floor and the first floor ( total 2000 sq.ft. built up area )will cater to the
proposed centre and the second floor will serve as a residential unit for the time
being . It may be used in case of future requirement .

The ground floor will contain examination rooms , a septic operation theatre and a
day care ward along with reception , patient waiting , toilets and utility services .

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The first floor will boast of an excellent aseptic operation theatre ( with air curtain ,
dehumidifier , UV lamps and A.C. with hepa filter ), Doctors’ lounge , a day care
male ward , a day care female ward , toilets , stores etc.

The time schedule is nine months from Day 0 , when the construction will start .

CLINICAL FACILITIES VIS-À-VIS LOCATION

S OPD OPD OPD SEPTIC OT COMPLEX G

T RECEPTION WAITING WASH DAY CARE WARD FL.
A
I DAY CARE WARD DOCTORS ASEPTIC OT COMPLEX 1ST
R STORES WASH LOUNGE DAY CARE WARD FL
S

The structure of consultant participation in the centre will be as follows :

1. Full Time Consultant Physicians

• Will dedicate their practice exclusively to SHUVAM NETRALAYA
• Will be provided with practicing and operating facilities within the centre
2. Part Time Consultant Physicians
• May maintain practice outside the Hospital
• Will provide consultation at specific hours assigned to them
• Will be provided with practicing and operating facilities within the Centre
3. Visiting Consultants
• Will utilize the Centre Facilities on ad-hoc basis
• Physicians from other States who wish to practice in West Bengal on
visiting basis

7.00 DISEASE PROFILE AND EYE DISEASES

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The past few decades have witnessed a marked shift in the disease profile in India .
Unfortunately , the burden of non-communicable diseases is expected to climb sharply
from 39% in 1990 to 57% in 2020 . Some of the factors leading to such a change are :

1. Environmental degradation ( eg. Increased pollution level has increased the

incidence of pulmonary disease and asthma )
2. Emergence of new diseases such as AIDS
3. The proliferation of slums , resulted in poor hygiene conditions and an increase
in related ailments and
4. Increasing stress levels leading to higher incidence of coronary diseases etc.

The change in disease profile has led to :

1. Increasing focus on tertiary care and hence need for acute care facilities and
2. Increased expenditure on treatment of new disease , requiring protracted and
expensive treatment .

Trends In India

Extremely high share of cardiovascular disease in terms of overall burden of disease for
India and the trends in coming years is evident from a study done by World Bank . It
must be noted that the projections for the year 2005 are based on an arithmetic mean of
figures for 1990 and 2020 . DALY data for different causes are also being provided in
the following table :

BURDEN OF DISEASE – PROJECTED TRENDS FOR INDIA

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(figures in %)

CAUSE 1990 2020 CHANG 2005

E
Infectious & parasitic diseases 28.09 17.3 -40 23.1
Respiratory Infections 11.9 3.2 -73 7.6
Maternal Conditions 2.6 0.3 -88 1.5
Prenatal conditions 8.8 2.4 -73 5.6
Nutritional Deficiencies 4.2 1.2 -71 2.7
Communicable & others 56.4 24.4 -57 40.4
Cancer 2.5 7.1 184 4.8
Diabetes 0.8 0.8 0 0.8
Neuropsychiatry conditions 7 12.6 80 9.8
Glaucoma and cataracts 1 2.7 170 1.9
Cardiovascular diseases 8.1 18.4 127 13.3
Respiratory Diseases 2.6 6.4 146 4.5
Digestive Diseases 2.2 2.5 14 2.4
Muscular – skeletal 0.5 1.1 120 0.8
Congenital anomalies 2.9 3.2 10 3.1
Oral conditions 0.4 0.8 100 0.6
Other non-communicable diseases 0.9 0.9 0 0.9
Non-communicable diseases 28.9 56.5 96 42.7
Injuries 14.7 19.1 30 16.9
Total 100 100 0 100
Total DALYs (10000) 287739 23674
1

Burden of disease data has been expressed as share (expressed in % ) of disability –

adjusted – life – years ( DALY ) for a particular cause in relation to the total DALYs .
[ Source : Health Nutrition and Population Indicators (1999) , World Bank ,
Washington]

7A WEST BENGAL SCENARIO

7A 1 BURDEN OF DISEASES OF WEST BENGAL

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Percentage share of Burden Of Diseases by Rural & Urban , All age Group .

Leading Causes Rural Urban Combined

Group I : Communicable , Maternal , 59.26 56.60 58.75
Prenatal , Nutritional Deficiency
Group II : Communicable Disease 24.89 31.52 26.15
Group III : Injuries and Accident 15.85 11.88 15.10

7A 2

Data Source : Health On The March 2007

Source : Health on The March 2007

7A 3 PERCENTAGE DISTRIBUTION OF HOSPITALISED CASES

BY MAJOR CAUSES 2001

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DISEASE MEDICAL COLLEGE DISTRICT HOSPITALS

HOSPITALS ( % AGE) ( % AGE)

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Cerebrovascular / 15.59 11.13

Cardiovascular
Diarrhoea 9.08 19.31
Cataract 8.63 1.88
Obstructive Labour 7.86 4.75
Injuries due to falls & fire 8.91 2.94
Poisoning 4.26 5.21
Abortion 4.16 3.38
Road Traffic Accident 3.9 4.14
Mental & Behavioural - 2.40
Disorders
Malignant Neoplasm 3.73 3.80
Chronic Obstructive 3.56 5.05
Pulmonary Disease
Respiratory Infection 3.45 7.10
Tuberculosis 3.36 2.25
Asthma 2.68 2.50
Meningitis 2.62 1.16
Peptic Ulcer Diseases 2.34 1.81
Hepatitis 2.11 -
Anaemia 1.95 2.81
Diabetes Mellitus 1.78 3.03
Malaria 1.67 -
Eclampsia 1.56 1.57
Cirrohosis 1.49 -
Nephritis & Nephrosis 1.00 -
Hypertension (Maternal) - 1.32
Haemorrage ( Maternal) - 3.56
Others 4.31 8.90
Total 100.00 100.00 *

* Based on a study of 115652 hospitalised cases in different districts of West Bengal in

2001 .

Infrastructure of NPCB in West Bengal

No. of Eye Care Units Established 1472

Ratio with State Population per 58,000 people 1

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State Ophthalmic Cell 1

State Health & F W Samiti 1
Regional Institute of Opthalmology 1
Tertiary Eye Care Unit (Medical College & Hospital) 9
Secondary Level Hospital (District Hospital, SD Hospital & SG Hospital) 94
Primary Eye Care (Rural Hosp., BPHC, PHC) 1256
Central Mobile Unit (RIO, BSMCH, NBMCH) 3
District Mobile Unit(North 24 Parganas,Murshidabad, Kochbehar,Uttar 6
Dinajpur,Bardhaman, Paschim Medinipur
Vision Care Centre (established 1905 - 1907) 100
Total no. of Opthalmologist in Govt. sector 196
Toal Number of PMOA 464
Total Number of Licentiate Eye Bank 12
Total Number of Eye Donation Centers 10
Total Number of hospitals running with HCRP Programme 16

Source : Health On The March 2007

8.00 AUTOMATION

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This Hospital will maximize the efficiency of all the activities with the help of
computers . The INTERNET will be the driving force through which the healthcare
record fragments (encounters) can be accessed , with various operating systems like
Microsoft’s Windows and also access to information records through IDN
( Integrated Delivery Network ).

The Automation will result in :

Comprehensive :
Clinical summary , Imaging , Document Management , Medications , Diagnosis /
Procudure coding and Clinical Templates , Laboratory results , Preventive care
Alerts ,Reports , Data security , Centralised Data repository , enterprise growth .

Workflow :
Process flows with branching logic , focused on complaint , diagnosis and treatment ,
Integrated E-mail and Fax server .

Data :
Discrete data capture , Graphing and trending , Outcome analysis , Utilization
review , Order tracking and prescription monitoring .

Integrated :
Outside information such as new transcription or lab data , links to billing and
scheduling .

Besides the above , the other areas of usage of automation are :

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Patient Management

Equipment Maintenance Management

Service Dealer Management

Film / File room Management

Sales , Marketing and Public Relations Management .

The patients will have easily accessible Computerised Medical Records (CMR) , Lab
Results , Messaging and To-do’s , Patient Information Handouts , Patient Health
Maintenance , Prescription writing with Medication Tracking , Patient Appointment
Scheduling and Patient Registration and data retrieval .

9.00 ACTIVITIES

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This Centre will be built following the latest amendments and criteria of The West
Bengal Clinical Establishment Rules, 2003.

It will be proactive towards the patients, serving them at reasonable prices keeping in
mind the per capita income factor of people in and around Maslandapur . The Centre
will have transparent fee structure and will also treat deserving patients at subsidized
rates.
The unit will tie-up with different doctors, who are expert in their own field, to share
their time, knowledge and expertise with it. Hospicon Services and Management
Consultant , CJ - 240 , Sector – II , Salt Lake , Kolkata-700 091, Technical
Consultant in hospital planning and with working experience in building similar
centres and hospitals will provide the right resources.

The unit will also have referral tie-up with other major hospitals in case of
emergency. Hence, all the necessary technological support which the unit might need
has been thought of and arrangement made thereof. Latest and state of the art
medical equipment with cost effective redundancy & support planning will help
clinicians to deliver best treatments for the serious disciplines.

The centre will be supported by modern on-line Hospital Management Information

System through its LAN. This will enable up-to-date information, patient records,
clinical treatments, inventories, billings and internet connection to other clinical
sites. Fully trained bio-medical and software team will provide necessary back-up for
round the clock operation.

9.1 Marketing Strategy

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Hospitals are indeed becoming important industry . Intricate planning of patient care
and resources round the clock is important for the well being and clinical success . To
help in such planning , a proper marketing team backed by accurate market data base
will be implemented by the management .

A three – pronged addressal of the supply – demand issues will be made in the following
lines :
1. Coverage of referrals and remote centers , territory wise .
2. Coverage of general public through camps and awareness programmes .
3. Addressal of centre facilities / image building through intensive sales
promotional schemes / advertisements .

To provide technology support in building the right supply – demand chain and to
facilitate the marketing team with right information , following measures will be
undertaken :
a) Promotion of Centre facilities / image building / technology update
through one-to-one technical presentations by marketing personnel with
referrals .
b) Promotion of Centre Facility Cards for cost effective medical supports
directly and through existing networks .
c) Detailed on-line HMIS ( Hospital Management Information Systems )
with customized parameters and data base for day to day monitoring /
guidance .
d) Professional tie-ups with marketing agencies with experience in same /
similar fields . M/S Hospicon Services and Management Consultant , CJ
- 240 , Sector – II , Salt Lake , Kolkata-700 091 , our existing technical
consultants will coordinate on the subject with effective and timely
inputs .
e) Satellite treatment centers within realistic journey time limits will be
established in adjoining areas .

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LICENSES TO BE OBTAINED FOR THE PROPOSED CENTRE

OLD BUILDING IN
POSSESSION

Building Plan (for extension ) West Bengal Pollution Control

Sanction From Respective Board – NOC for consent to
Panchayet establish

Fire Clearance From Fire Service CMOH – Building Plan Clearance

As per Clinical Establishment Act

Other Permissions From Relevant

Authorities Clearance certificate from respective
Panchayet with clearance for water
Building Construction Complete

Clearance from WBSEB for

electricals

Health clearance from CMOH

Equipment Installed

Trade License From Panchayet

Bio-medical waste disposal

agreement with municipality /
agencies

NOC for consent to operate from

WBPCB

INAUGURATION

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