‘Incoming Administration Must Waive Custom Duties on Medical Equipment, Incentivise Healthcare Entrepreneurs’

The Managing Director and Chief Executive Officer, Grover’s Hospital, Dr. Grover Anil, in this interview shared his thoughts on how to make Nigeria’s healthcare sector compete with its counterparts across the globe. Gilbert Ekugbe brings the excerpts

Tell us about the journey so far 

Grover’s hospital is the subsidiary of Grover medicals and diagnostic limited. We started Grover’s medicals six years back with a humble journey of small GP clinic in Adetokunbo Ademola street and by the grace of God, the initial response was very good and then we upgraded from the clinic, to the multi specialist hospital in this current building we are in since 2019. Although, I am not new to Nigeria, my wife and children have been living in Nigeria for more than 20 years. I have spent almost 22 years of my life in this country and I love Nigeria so much. I am a very passionate person when it comes to Nigeria and I always carry a Nigerian flag on my chest. Somehow when we came to this country initially we came for a short project just to live here for four years, that was the initial plan, but at that time, our children were very young schooling in Lagos and just because we love Lagos,  love Nigeria and gradually, when we started living here, we found out that this country is a God blessed country. Nigeria is a blessed country with great people, a very peaceful place and weather wise, it is excellent. Socially, when we started moving around, we made very good friends and professionally also. We were happy and so we decided to stay back. After the initial project, 15 years back, I got a very big assignment. I was the first pioneer Chief Medical Director of one of the largest diagnostic center in Nigeria where I worked in a medical diagnostic industry for almost seven years before we started our own hospital in 2016. It was sheer coincidence actually around 2016 during my 50th birthday celebration in our temple, it was a turnaround in our life story because me and my wife actually wanted to go back to India at that time in 2016 when I achieved 50, but I think God had destined something else for us. My son came back from India, after finishing his engineering course as a software engineer, it was his idea who actually inspired and motivated us to set up our own small enterprise which is Grover’s medicals and diagnostic limited, the parent organisation of Grover’s hospitals. We thank God that the journey so far has been very rewarding. It has been very successful, in spite of few challenges here and there, which is part of any business and any country as I mentioned to you from a simple ordinary GP general practice clinic, we gradually moved to a bigger multi specialist hospital, but when we came to this building in 2019 immediately after that, unfortunately, Covid 19 struck in 2020 to 2021, I want to use this opportunity to express my gratitude to our medical team who rendered brilliant services to the community and to the people for saving lot of lives during Covid 19 pandemic. Our hospital rendered free ambulance services in collaboration with our Indian community and rotary club at that time, the period was tough, people were afraid, lots of people were dying during this period. We were among the selected private hospitals by the Ministry of Health in Lagos State to render Covid 19 management services in our Intensive Care Unit (ICU) for critically ill patients and after that, post COVID in 2021, we realised that there are certain areas in medical field where there is a lot of gap where we thought we should do strategic investment. Our board of directors and management decided to invest into the healthcare infrastructure aggressively mainly in three areas. Number one, critical care management. There are not many facilities available in Lagos state, where you have ICUs. So, in 2021, first thing what we decided was upgrade and invested into the critical care ICU for adult patients, as well as for newborn babies. We have even one of the most advanced, ultra modern, highly advance critical care unit for newborn babies called Neonatal Intensive Care Unit (NICU). The NICU is for newborn babies, premature babies to give them critical care for survival of those babies. We have a very well highly advanced eight bedded NICU unit available in our hospital. The second area which we thought we should invest after 2021, is urology, because there are not many centers or many hospitals where you can do laparoscopy or endoscopy urology surgeries. So, we invested heavily into setting up new urology department. Our urology department is equipped with all laser and everything related to the laparoscopy surgery for urology problems. There are many people who used to travel abroad for prostate surgeries, stone removal surgeries, kidney related issues, but now all those problems can be treated here in Nigeria. We have all the technology and equipment in Grover’s hospital. It is a heavy investment we have done into technology, into the infrastructure to set up a laparoscopy, endoscopy, urology unit. Then the third area, which is also a big challenge in the medical field, we realised that a lot of Nigerians travel abroad for various types of orthopaedic surgeries, joint replacement surgeries, spine surgeries. So we invested into our orthopaedic joint replacement unit. We now have arthroscopy, arthroplasty, joint replacement orthopaedic spine surgery unit at Grover’s hospital and conducted by medical professionals, experts and well trained surgeons, so these are the three areas where we invested into the healthcare infrastructure as responsible medical entrepreneur in Nigeria, a country which I love most, but I treat Nigeria as my second home. It is a wonderful country blessed with great people.

In terms of employment opportunities, how many Nigerians have been gainfully employed by Grover’s Hospital?

I mentioned initially when we started the clinic with a very small number of only 10 or 11 people in 2017, but over the years now, we have grown into a big multi specialist hospital. At the moment we have almost 75 staff working in our hospital, out of which eight are expatriates while the remaining are all Nigerian professionals and Nigerian colleagues. Not just about job employment opportunities, we also give a lot of importance to the training. We impart a lot of training to our Nigerian professionals with the help of expatriates or from senior Nigerian doctors, clinical meetings are done, technical trainings are given

Tell us about your plans for Grover’s Hospital in the next five years

Grover’s hospital is a well established name in Lagos state, going forward, we have two projects we want to set up. We want to set up a 100 bedded surgical and trauma center at Ibeju Lekki very close to Dangote refinery and Lekki seaport. This area will be like new Lagos very soon with lots of new development coming up in Ibeju Lekki area. The second future project is that we want to also set up one branch in the mainland. A lot of our clients have been requesting for a branch in the mainland for the past two years. So, we are in the process of looking for a suitable place in mainland this year, we want to have at least the second branch in mainland to start with but in future by the grace of God, if everything being equal, we also want to open branches in places like Abuja, Port Harcourt, Ibadan and Kano. These are the cities where we will open our branches and that is the plan in the next five years. We are also planning to set up our own pathology labs because diagnostic services also need more players.

What are some of your Corporate Social Responsibility (CSR) activities over the years?

Right from the beginning of my earlier days when I came to Nigeria, I have always been passionate that wherever I work, I must give something back to the society. So as a passionate alumni of Lagos Business School (LBS), this is one of our philosophies in LBS that we must incorporate CSR in whatever business or whatever job we do. I have been actively associated doing few CSR activities in collaboration with Kirti’s Kare Foundation (KKF), Rotary Club, Lagos Business School as well as our Shane Punjab Association, which is our Indian community association. So we regularly participate and commit ourself to do CSR programmes like organising free health checkup camps. We organise free medical outreach camps regularly in collaboration with KKF and Rotary Club. We organise free cancer screening camps for women, especially cervix cancer screening, breast cancer screening and last year, we did the cancer screening camp by our rotary club also in collaboration with Redeemed church. So we fix up a place either at a church or a community center like 1004 estate where the poor women around that area, the underprivileged women  in that local government area and other parts in Lagos. Two years back, our collaboration with the Rotary Club, even the free cervix cancer vaccination was also provided by our hospital. One more project where I am quite closely associated is the problem of cataract in the eyes and this is very common in Nigeria. So as a Rotarian,  I have been associated with Rotary Club of Lagos Island for many years and our club in collaboration with our hospital, also organise free cataract eye surgery camps also. These are the areas which we want to focus in the future and now we have a strong tie up and collaboration with our foundation partners. I want to specifically mention this part now that going to 2023, we have decided that we have joined hands with KKF who are our CSR partners. Officially, Grover’s Hospital is now partners as a medical healthcare partners with KKF. We have also that one thing that a lot of Nigerians are not aware of is how to prevent lifestyle diseases. Lifestyle diseases is the biggest problem for any society, for any country. Lifestyle diseases like diabetes, hypertension, kidney disease, stroke, cancer, are called lifestyle diseases. Now, these lifestyle diseases, there are some of the diseases which are preventable and during those health checkup camps, we also organise health talk. We organise awareness campaign for the people for the public of Nigeria, on how to avoid these lifestyle diseases and treatment. In fact, when we started the clinic, six years back the name of our clinic was Grover’s Lifestyle clinic. Earlier, the name was Grover’s lifestyle clinic. So from lifestyle clinic, we upgraded ourselves to Grover’s hospital, multi specialist hospital because lots of people have problems of diabetes, hypertension, kidney diseases, stroke, cancer, and now this year, I am very happy to inform you for the knowledge of the public that our hospital has now set up a very big dialysis center so those people who have kidney failure can come to our hospital for dialysis treatment. We have a 24/7 round the clock ambulance services. We have a well equipped emergency and casualty development that runs 24/7 any kind of emergency medical or surgical emergencies. We render medical services, emergency medical services 24 hours and seven days all through the year

What are some of the challenges hindering development of Nigeria’s healthcare infrastructure?

As far as healthcare infrastructure is concerned in Nigeria since I have been living here for more than 20 years, I would say we have a long way to go. If we have to compare ourselves with the Western world or with India or Asian countries, we have a long way to go. We are still lagging behind in terms of technology or in terms of expertise. There is a lot of gaps, but I would say if you look at the other side of the mirror, this is an opportunity also, since there is a gap, it is providing an opportunity for a lot of new young healthcare entrepreneurs like me to invest money into the sector. I have seen one thing in Nigeria that a lot of people, Nigerian or foreign investors do not invest into this sector. Why do the people do not invest into healthcare infrastructure in Nigeria? I would say there are three or four major challenges and the biggest challenge we face as a hospital owner or a healthcare entrepreneur, is that we do not get regular or constant uninterrupted power supply and you know we have a lot of sensitive equipments in the hospital. Just imagine if we have ICU patients inside and advanced surgeries are going in the operation theatres and power trips off, you can imagine the damage that would be caused. You are also aware that last year, the prices of diesel went up almost three times and the biggest challenge today is that hospitals majority of the time are running on generators so, uninterrupted clean power is one of the biggest challenge. The federal government must direct Power Holding Company of Nigeria (PHCN) to make some special concession for 24/7 uninterrupted power supply to the hospitals so that we do not need to depend on generators. They must make some kind of special provisions for hospitals because hospitals are life saving centers. This is not an entertainment place. Hospitals are life saving centers, where some of the critical patients emergency patients come for health support. The second biggest challenge which we face here in Nigeria in last few years is that there is a lot of brain drain and I know many of Nigerian doctors, biomedical engineers, well trained nurses that have left Nigeria in the last five to six years and this is the biggest challenge I would say we are facing in our medical sector. You hire a well trained doctor, you train them further and when he is ready to give you the results, he leaves the shores of Nigeria and lands up in UK, Canada, Dubai, Saudi Arabia and instead of professional gain, it is more like a brain drain. They are being trained here, they schooled here, they do their residency programme here, the doctors and once they are supposed to serve the Nigerian community as passionate medical professionals, some of them they prefer to leave and same is the case with laboratory scientists, nurses, biomedical engineers and this trend has been increasing recently. The trend in recent years is increasing drastically. We are losing many world trained Nigerian medical professionals and if something is not done in this area or some palliative measures are not taken by the government, It will be very difficult to find good doctors in the future in Nigeria. The federal government and medical professionals healthcare entrepreneurs,  all of us have to sit down together at a common platform to solve this problem. The third challenge which healthcare infrastructure or healthcare sector is facing is the non availability of forex. If you want to import new medical equipments, if you want to import some advanced machines, you will need forex, but majority of the time forex is not available at the CBN rate in your banks and if you want to buy from the parallel market, it will not viable for the business and then it is not cost effective. So this is a very big challenge the healthcare sector or medical field people are facing which is the non availability of forex at the CBN rates, but we all know another challenge which our medical healthcare industry is facing which is medical tourism, because of some of these gaps, and some of these challenges, a lot of Nigerians  prefer to travel abroad for the medical treatment or surgeries whereas it should be reversed medical tourism. Now we are at that stage, Nigeria is at that crossroad where we should be talking about a reversed medical tourism. People from African countries within West Africa from the neighboring countries should be actually coming to Nigeria to do the surgeries here and even the Nigerians should encourage that Nigerian should do the surgeries and treatment in Nigeria. As I mentioned to you earlier, for example in our hospital Grovers hospital, all types of advanced orthopaedic surgeries can be done here. Joint replacement surgeries can be done here, all type of advanced laparoscopy or endoscopy, urology surgery, nephrology surgery procedures can be done here. All types of advanced ENT surgeries can be done here in our hospital. So majority of the surgeries are now possible in Lagos or in Nigeria, in so many good hospitals. So if people themselves, stop going overseas, it will save a lot of forex for Nigeria as a country because billions of dollars are being spent every year on medical tourism when people travel abroad for the surgeries whereas some of these surgeries can be done here. Technology is available now in Lagos and Abuja. Doctors are available surgeons are available we should try to embrace and encourage Nigerian hospitals, local doctors to do the surgeries here and I would suggest one thing that we can bring in some experts from overseas to come here and do the surgeries here and train the Nigerian doctors that should be the trend. If there is any special kind of surgery which is not being done here, at Grover’s hospital, we will try to bring some expert surgeons from abroad so that those surgeries can be done in our hospital in Lagos. It will give an opportunity for Nigerian doctors also to learn and train and this is our emphasis for the future.

Do you have the capacity to meet high surgical demands?

Yes, we have it. As I mentioned to you now, our hospital is almost 50 bedded multi specialist hospital, where various advanced surgeries can be done. We have well trained medical professionals, doctors, nurses, lab scientist, biomedical engineer on ground here, dialysis professional on ground here. So those surgeries can be done here and we have that infrastructure available here.

What advice do you have for the incoming administration on how to develop the nation’s health sector

My only piece of suggestion or recommendation, I don’t want to call it an advice, because I am a small boy in terms of advice. I will say I can make a small suggestion or a recommendation to the people in top  government authorities that if our State and federal governments can create some special channels in collaboration with the commercial banks to offer some special low interest rate loans, which can help healthcare entrepreneurs to set up more facilities and also to allocate forex at the CBN rate for the healthcare sector and if these two things are done, it will really go a long way. It will facilitate the health care infrastructure, healthcare entrepreneurs to upgrade the technologies and to do the business smoothly. If special loans are provided, and if forex allocation is given on priority to the healthcare sector at CBN rate, it will bring about some significant development in the nation’s healthcare space and the second suggestion, which I also gave during our last economic conference at LBS and I will repeat that recommendation again, if possible, the federal government or the authorities should look into this,  this was the model adopted by government of Thailand, government of Singapore Government of Dubai, government of India many years back. So same suggestion I want to give we should completely waive off the custom duty on the medical equipments. If you want to improve our technology, since those machines and technology equipments advanced technology equipments are not available or manufactured in Nigeria and majority of them are imported. So if we can waive off the custom duty in this sector, it will encourage people to invest more and tomorrow if you want to set up some for example IVF lab or if you want to set up oncology cancer treatment center or if you want to import certain advanced machines and equipments first of all, the interest rates are very high and on top of it forex is not available and the third part if you are able to bring in those equipments, the custom duties are very high. If government can waive of those custom duties for the healthcare sector to encourage medical entrepreneurs, it will go a long and investors would invest happily and within few years you will find that we are at par with Dubai or Saudi Arabia or South South Africa or any other advanced country in healthcare. There should be a special emphasis given to the healthcare industry and the last suggestion which I want to give or my advice would be there should be some set of special incentives for local Nigerian healthcare investors or foreign direct investors into the healthcare field. Some kind of tax benefits some kind of tax holiday, some special incentives should be given to serious healthcare investors and with this approach the healthcare industry and healthcare infrastructure can boom and come up to international standards at par with other advanced nations. Those are my suggestions