presented by: dr. junaid ahmad advisor to dha on ccmc july 30, 2011 slide 1 creek city medical...

Presented by:Dr. Junaid Ahmad

Advisor to DHA on CCMC

July 30, 2011 Slide 1

CREEK CITY MEDICAL COMPLEX (CCMC) Phase VIII, DHA, KARACHI

July 30, 2011

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AGENDA1.0 INTRODUCTION2.0 MARKET NEED ASSESSMENT

- Field Survey- Survey Findings

- Conclusions3.0 CCMC: THE CONCEPT4.0 TECHNICAL EVALUATION

- Location- Land Development & Zoning

5.0 CCMC AERIAL VIEW6.0 CCMC: DEVELOPMENT STRATEGY7.0 CCMC: SUPPORT FACILITIES8.0 CCMC: INVESTMENT MOBILIZATION STRATEGY 9.0 FACILITIES AT CCMC9.1 CDCL: OWNED FACILITIES9.2 FACILITIES OWNED by PRIVATE PARTIES10.0 EACH HOSPITAL UNIT WILL BE SELF-CONTAINED11.0 CCMC FOUNDATION

July 30, 2011

Feasibility Study of CCMC at DHA, Karachi



1.0 INTRODUCTION

DHA has been desirous of setting up world class health care facilities at DHA Karachi for the past over a decade.

Attempts have been made in the past to:

a) Setup a fully owned hospital financed by DHA in late 1990s but it was abandoned due to various strategic reasons.

b) Later on a 320 bed super tertiary CCH built by consortium of IHG of UK and Mass Group of Pakistan was planned. This effort did not succeed because of procedural issues and deteriorating law and order situation in the Country because of which the foreign investors lost interest.

Now DHA has planned to built a world class Medical Complex comprising of at least 10 specialized hospitals / health care facilities of 30-50 beds each on Joint Venture basis.

July 30, 2011


1.0 INTRODUCTION (Cont.)SCOPE OF STUDY

Market / Need Assessment Conduct Market Survey of hospitals, clinics and diagnostic facilities in DHA, Clifton,

etc. Conduct survey of medical and health related facilities and services in DHA and

Clifton. Identify market needs for different types of hospitals, clinics and other related

facilities.

Technical Evaluation Land and land development. Zoning Plan for selected facilities. Facilities at CCMC to be arranged by DHA. Facilities to be set up by private investors. Infrastructure. Support Services. Business Model. Financing Deserving Patient s.

Governance & Management Identify the most suitable governance model for setting up the CCMC, alongwith an

optimum management structure and manpower plan.

Slide 4


July 30, 2011


2.0 MARKET / NEED ASSESSMENT

Areas covered include DHA, Clifton and Ghizri. FIELD SURVEY

Slide 5

S. No. Name Location

1 National Medical Center NMC DHA

2 Sir Syed Trust Hospital SSTH DHA

3 Health Care Hospital HCH DHA

4 Parklane Hospital PLH CLIFTON

5 Sindh Medical Center SMC CLIFTON

6 South City Hospital SCH CLIFTON

7 Ziauddin Medical Center ZMC CLIFTON

8 Clifton Medical Services CMS CLIFTON

9 Hilal-e-Ahmar HeA CLIFTON

10 BHY Hospital BHY GHIZRI / CLIFTON

11 DHA Clinics DHAC DHA


July 30, 2011


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Cardiologists were available in all the 11 hospitals & clinics surveyed.

Cardiac Surgery facilities were only available in 5 hospitals.

Only conventional open-heart surgery for coronary bypass is available.

Valvular heart diseases surgery is not available.

Pediatric Heart Surgery is missing.

Long waiting times and over crowded.

World class Cardiac Center is needed at CCMC.

Slide 6


2.0 MARKET / NEED ASSESSMENT….Cont.

SURVEY FINDINGS

CARDIOLOGY & CARDIAC SURGERY

March 25, 2011


March 25, 2011 Slide 7

Diseases of respiratory tracts are increasing rapidly in the City.

Doctors in all the 10 hospitals surveyed were treating diseases of Chest in the conventional manner.

A modern facility is desperately needed.



SURVEY FINDINGS

CHEST & PULMONOLOGY

None of the 10 hospitals have neuro surgeons on a full-time basis.

Very basic facilities are available for treatment of the Brain and Central Nervous System.

Little expertise existed in areas such as treatment of Parkinson’s disease, dementia, Alzheimer, neuro rehabilitation, behavioral neurology, etc.

Psycho-neurology services were not available for conditions such as schizo phrenia, post-stroke depression, denertia, etc.

A modern state-of-the-art facility is needed.

NEUROLOGY


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SURVEY FINDINGS

PSYCHIATRY & PSYCHOLOGY

It deals with prevention, diagnosis and treatment of adult diseases. The specialist of this field is a physician and is heavily over-burdened in

all the 10 hospitals. This facility will also look after the growing diseases of diabetes. A large facility at CCMC for this field is required.

INTERNAL MEDICINE INCLUDING DIABETES


The science of the mind and behavior was not available in its entirety at any of the 10 hospitals.

Very basic facilities and services were available in only 5 hospitals. These areas are not serviced properly and modern facility is needed to be

setup at CCMC.





SURVEY FINDINGS OPTHALMOLOGY

ENT – both medicine and surgery were found at all 10 hospitals by consultants on call.

Advanced surgery facilities are needed for burns, facial plastic and reconstructive surgeries which are not available.

Services are highly crowded at all hospitals.

Modern ENT facilities need to be setup at CCMC to deal with all the above.

ENT & OTOLARYNGOLOGY

Treatment of medical and surgical eye problems is available in almost all the 10 hospitals through OPD and general consultancy only.

However, delicate surgery facilities are not available such as Anterior Segment Surgery, Cornea, Ocular and External Eye Surgery, Glaucoma, Retinal problems, neuro ophthalmology, ocular oncology, ocuplasties, etc.

Some of the above facilities are only available in one surveyed hospital. However, other hospitals at distant locations form DHA/Clifton have the above facilities.

A modern ophthalmology facility is badly needed at CCMC.


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SURVEY FINDINGS FAMILY MEDICINE

It deals with promoting health and well-being through occupation. The primary goal is to enable patients to participate in the activities of

daily life and in their respective professions. No facility for occupational therapy was available in the 10 hospitals. Occupational deprivation is increasing due to social, political, economic

and environmental factors. Needs to be setup at CCMC.

OCCUPATIONAL THERAPY


Family physicians deliver a range of acute, chronic and preventive medical services to the whole family.

Only 3 of the hospitals have this facility. Patients in large number crowd this facility. A modern large facility is badly needed at CCMC.


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SURVEY FINDINGS UROLOGY & NEPHROLOGY

It is available at all hospitals but heavily over-crowded. May be grouped with Family Medicine and offered at CCMC.

GASTRO ENTOROLOGY


Almost all hospitals surveyed had urologists and nephrologists on call. Only two hospitals have the facility for laparoscopy to treat prostrate,

kidneys and uretors. Surgical treatment of malignant cancer of the above were also not available. Facilities for renal replacements, dialysis and revat transplants were also not

upto the mark. A modern Urology & Nephrology Center is badly needed at CCMC.


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◘ Found in all hospitals but overcrowded.

◘ Essential and should be offered at CCMC.



SURVEY FINDINGS OBSTERICS & GYNAECOLOGY

PEDIATRICS


◘ Available at all hospitals in conventional form.

◘ Complex surgeries were not available for hand, shoulder and elbow surgeries, total joint reconstruction, pediatrics orthopedics, spine surgery, orthopedic trauma, etc..

◘ All these facilities need to be setup at CCMC.

ORTHOPEDICS

◘ Also available in all hospitals but heavily over crowded.

◘ Complex pediatric surgeries are not available.

◘ Pediatric cardiac and neuro surgeries are badly needed.

◘ Should be setup alongwith Ob, & Gynae facilities at CCMC.


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SURVEY FINDINGS DIAGNOSTIC & IMAGING SERVICES

It was revealed that there is a perpetual shortage of beds in all the hospitals surveyed.

Very high rates of occupancy and over crowded. All the units at CCMC would need to have their own wards and rooms

for patients.

HOSPITAL BEDS / BEDS RATIO


Pathology labs are available at all hospitals plus others e.g. Sind Lab, AKUK collection pts. etc.

MRI, CT Scan were only available in 3 hospitals and that too basic and under installation.

No modern hospital complex can exist without these. A modern state-of-art facility is needed for CCMC.


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SURVEY FINDINGS NON CLINICAL SERVICES


Clean drinking and potable water facilities are available using mineral and municipal water. Quality of municipal in particular is questionable.

No treatment of liquid wastes / effluent by any hospital.

No incinerators for disposal of hospital waste at any hospital.

Standby generators are available in most hospitals.

All hospitals have pharmacy, ambulance service, Masjid, cafeteria, laundry services.

A few hospitals have arrangements for parking.

CCMC will need its own:

– Power Plant plus standby generators for each unit.– Effluent Treatment Plant.– Hospital Solid Waster Incinerator.– RO based water treatment plant for water supply.– Security services.

Proposed Medical Super Market for pharmacy, gift shop, flower shop, surgical and hospital instruments and supplies, etc.


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There is perpetual shortage of hospitals. There is over crowding and very high rates of occupancy. All hospitals use Municipal Water for washing & cleaning whose

quality is questionable. They do not treat their liquid or solid waste. Poor parking facilities in most hospitals. Poor ambulance services in most hospitals. Many modern diagnostic services, eg MRI, CT Scan etc. are not

available in DHA, Clifton Area. No Trauma Center. Non availability of medical equipment & aids in DHA Clifton. Serious problem of residential facility for doctors, nurses, paramedics

(either visiting or long term).Slide 15



SUMMARY

July 30, 2011




CONCLUSIONS

1. Diagnostic Center with MRI, CT Scan, Sonology and all other services.

2. Cardiology & Cardiac Surgery (Valuvalur, Pediatrics, etc.).

3. Chest & Pulmonology

4. Neurology (Neuro-surgery, Pediatric neurology, Parkinson, Alzheimer, Dementia, Psycho Neurology, Behavioral Neurology etc.).

5. Internal Medicine (Highly overcrowded and ever growing need)

6. Ophthalmology (Anterior Segment Surgery, Cornea, Ocular, External Eye Surgery, Retinal Problems, neuro ophthalmology, etc.).

7. ENT & Otolaryngology (burns, facial plastic & reconstructive surgeries, plus all needed services).

FOLLOWING STATE-OF-THE-ART FACILITIES ARE NEEDED FOR RESIDENTS OF DHA & CLIFTON.

July 30, 2011




CONCLUSIONS

8. Family Medicine (Highly overcrowded, essential for any hospital)

9. Urology & Nephrology (renal replacement, dialysis, revat transplant surgical treatment of cancers of kidneys, prostrate, etc.).

10. OB & Gynae (Essential for all hospitals).

11. Pediatrics (Cardiac & neuro surgeries, complex surgeries and a specialized facility is needed).

12. Orthopedics (Complex surgeries not available).

13. Trauma Center (Name is available) for handling emergencies.

July 30, 2011



3.0 CCMC: THE CONCEPT CCMC is proposed to be a Medical City, having 10 different specialized

hospitals, each owned and operated by a carefully selected private party. Each hospital will be of 30 – 50 beds, more easily manageable as OMI,

Tabba Heart Center, Cardex Clinic, O & A Clinic and many others. CCMC will generate its own power, water through RO plant, Effluent

Treatment, Solid Waste Management, Apts. for doctors, paramedics, nurses, serviced apts., etc. owned and operated by carefully selected private investors.

Large hospitals require huge investment, mobilization of which is very difficult as seen earlier twice before by DHA.

Large hospitals are very complex to manage and very few are successful. Large hospitals generally take 5 -7 years to become profitable.

July 30, 2011


Located on 18 acres in Phase VIII bordering Shaheen, Faisal Street 2 and 80’ wide road.

Ideal location for resident of Phase IV, V, VI, VII and VIII. Wide roads and growing residential, commercial and recreations areas.


4.0 TECHNICAL EVALUATION

LOCATION

LAND DVELOPMENT & ZONING

Town planning to be done by experienced town planners & architects. Plots of 1,2 acres, 1000, 2000 & 4000 Sq. yds to be created. Detailed zoning plans / rules / regulations to be framed for adherence

concerning façade, use of building materials, elevators, parking, public amenities, waste disposal (both liquid & solid), standby generators, etc.

Detailed building codes will be developed for adherence by all allotees.July 30, 2011



5.0 CCMC AERIAL VIEW

4

5 6

712

3

8

910

14

15

16

11

1213

17 1819

20

HOSPITALS

8 Skin, Nails, Hair & Cosmetic Surgery 13 Poly Clinic & Orthopedic Center 9 ENT & Eye Center 14 Family Medicine10 CDCL Offices 15 OB & PED Center11 Diagnostic Center & Blood Pressure 16 Cardiac Center12 Urology Center 17 Neuro Psycho Center

SUPPORT FACILITIES

1 Mosque 6 Solid Waste Incineration2 Medical Super Market 7 Effluent Treatment Plant3 Medical & Health Club 18 Nurses Apt. 4 Power Plant 19 Serviced Apt. 5 Water Treatment Plant 20 Doctors Apt.

July 30, 2011


6.0 CCMC: DEVELOPMENT STRATEGY

Slide 21


CCMC Development Company (CDCL) has been established as a special purpose company by DHA.

CDCL has prepared the Master Plan, Zoning Regulations, Building Code, Marketing Plan, Investment Mobilization Plan and other plans to launch the project.

CDCL invites EoIs through press for the 10 hospitals EoIs for Power Plant, RO Plant, Incinerator, the 4 Apt. blocks, Medical Super

Market and Medical & Health Club etc. will be invited at a later stage. Private Investors will be carefully prequalified as per a pre-set transparent

criterion. Prequalified investors (local and NRPs) will be asked through an RFP document

to submit technical and financial proposals. Selection will be done on a pre-set transparent criterion.

Standardized Agreements will be signed with each party. CCMC is a Golden Opportunity for those NRPs (Doctors & others) in UK, USA,

Canada, EU, Australia and Rest of the World who have plans to return back and serve the Country.

July 30, 2011


7.0 CCMC: SUPPORT FACILITIES

Slide 22


1. 10-15 MW Power Plant for cheaper and reliable power supply.

2. 80,000 litre / day RO Plant for supply of clean drinking water essential for hospitals – Shortage in DHA.

3. Incinerator for hospital solid waste. Needed in all world-class facilities.

4. Sewerage Treatment Plant for hospital and domestic waste water, Treated water to be used for safe horticulture in CCMC and surrounding.

5. 100 Apts. (2 bedrooms) for doctors who prefer to live near their work place.

6. 100 Studio Apartments for nurses.

7. 100 Studio Apts. for Paramedics. Foreign/Expats to be hired from Sri Lanka, Philippines etc. to meet local shortage.

8. 100 Studio Apts. (fully serviced) for visiting doctors, long term patients and their attendants.

9. Medical Super Market for all medicines, drugs, hospital supplies, medical instruments & aids, etc. None in Karachi.

10. Medical & Health Club for water treatment, O2 treatment, health foods, health restaurant, etc.

11. Bank (selected Financial Service Provider)

12. Insurance Cos. for health coverage.

July 30, 2011


8.0 CCMC: INVESTMENT MOBILIZATION STRATEGY

Slide 23


A separate Public limited company ‘CDCL’ is being established to manage CCMC.

CDCL will invite private parties under Joint Venture Arrangement for establishment of the following;

• 10 Hospitals of 30-50 bed each

• 25 MW power plant

• R.O. Plant

• Incinerator

• 3 Apt. Blocks

• Medical Super Markets

• Medical Health Club CDCL will carry out all development works through collection of

development charges from the investors/allotees

July 30, 2011



9.0 FACILITIES AT CCMC

1. OWNED & OPERATED BY CCMC DEVELOPMENT COMPANY.

2. OWNED & OPERATED BY PRIVATE PARTIES.

July 30, 2011



9.1 CDCL: OWNED FACILITIES

CDCL will have its offices near the main gate of CCMC including reception and information desk. Additionally, the company shall be responsible for:

Telephone Exchange (PABX).Standby Generator of capacity 150 KVA for common areas lighting only.Effluent treatment plant for all the units of CCMCParking area only for CCMC Development Co. offices and guests.Masjid available in the vicinity to be managed by DHA.Security & safety of CCMC (Main Gate plus periphery wall).Common Ambulance Service (Each hospital to also have its own Ambulances).

July 30, 2011



9.2 FACILITIES OWNED by PRIVATE PARTIES

PRIVATE PARTIES will be carefully selected to setup complete hospital units on 1 or 2 acres of plots or even on 1000 – 2000 sq. yds.

Following hospital units / healthcare facilities will be setup at CCMC.

1. Cardiac Center.

2. Neuro Spinal & Psycho Center.

3. Urology Center.

4. ENT & Ophthalmology.

5. OB & Pedriatics.

6. Family Medicine.

7. Poly Clinics including Orthopedics.

8. Skin Hair Nail, Cosmetic Surgery.

9. Diagnostic Center & Blood Bank.

10. Trauma Center

July 30, 2011



Following Support Facilities will also be developed and managed by private parties.

Apts. for Doctors. Apts. for Nurses & Paramedics. Serviced Apts. RO Water Plant of atleast 80,000 ltrs / day capacity. Power Plant of 25 MW Capacity to supply uninterrupted power. Hospital Solid Waste Incinerator. Medical Super Market Medical & Health Club Bank(s) Insurance Companies.

9.2 FACILITIES OWNED by PRIVATE PARTIES

July 30, 2011



10.0 EACH HOSPITAL UNIT WILL BE SELF-CONTAINED

OPD Finance & Accounts

Patient Wards / Rooms Marketing & Outreach

OTs Laundry & Housekeeping

ICUs / CCUs Cafeteria & Kitchen

Doctors Clinics Tel. Exchange & PA System

Nurses & Paramedical Staff Rooms Staff Standby Generator

Medical Records Ambulance Service

Administration Internal Security

July 30, 2011



11.0 CCMC FOUNDATION

CCMC Development Co. will setup a CCMC Foundation for collecting donations, Zakat, Fitra and Kherat for financing deserving patients.

The CCMC Foundation will be managed by a Board comprising of highly credible individuals as a Section 42 Company (not-for-profit entity).

The CCMC Foundation will develop and implement a transparent system of collecting and distributing funds.

Its accounts will be audited annually and copies provided to all donors.

DHA & Clifton house the richest in the Country who can and do contribute large amounts to charity.

All hospitals and other units of CCMC will help in generating funds and their patients will also benefit from these funds.

July 30, 2011


THANK YOU

Slide 30


July 30, 2011


presented by: dr. junaid ahmad advisor to dha on ccmc july 30, 2011 slide 1 creek city medical...

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