Addressing the gaps in India’s paediatric care system

Paediatric speciality care in India continues to be concentrated in a few tertiary hospitals. What are the biggest structural gaps that need to be addressed to improve access to specialised care for children?

There are three gaps, and they compound each other.

The first is numbers. India simply does not have enough trained paediatric super-specialists, and the few we do have are clustered in a handful of tertiary centres in large cities. A family in a smaller town, or even in parts of the NCR, can end up travelling hours for something as fundamental as a paediatric pulmonology or endocrinology consultation. That should not be happening today.

And the shortage will not fix itself, because we have never really built the pipeline. DM and fellowship seats in paediatric super-specialities are a fraction of what the country needs, and even doctors who do train in them often drift towards adult practice or general paediatrics, simply because there are so few places where a paediatric super-specialist can practise their craft full time. If we want more of these specialists, we have to build the institutions where such a career makes sense. The discipline cannot grow ahead of the places it is practised in.

The second gap is coordination. Even where specialists exist, they are often spread across different departments, sometimes different hospitals entirely. So parents are left stitching together a treatment plan on their own, at the worst possible moment in their lives to be doing that.

The third gap is one that rarely makes it into policy conversations. Our spaces were never built for children. A five-year-old walking into an adult-oriented hospital is already anxious before a single doctor has seen them. That anxiety is not incidental. It affects how children respond to examination, to treatment, to the entire experience of being unwell.

Fixing access is not only about training more specialists, though we desperately need that too. It is about bringing those specialists together, physically and structurally, around the child, rather than asking every family to navigate a system built for someone else.

Many clinicians are choosing to take on entrepreneurial roles alongside their medical practice. What factors are driving this shift, and what does it mean for the evolution of India’s healthcare ecosystem?

Most of us who make this shift are not doing it because we stopped wanting to practise medicine. It is almost the opposite.

After years in clinical practice, you see the same gaps repeat themselves, the same frustrated families, the same coordination failures, the same structural problems that no individual doctor can fix from inside a ward. Large institutions move slowly, especially those with significant legacy infrastructure. At some point, you either accept the gaps, or you try to build something that closes them. For me, it was never a business decision first. It was a clinical frustration that eventually needed a business vehicle to solve.

What this means for India’s healthcare ecosystem is genuinely significant. Clinicians bring something that investors and administrators often cannot: direct, repeated, first-hand exposure to what patients and families actually experience at their most vulnerable. As more of us step into these roles, I would hope it shifts the entire ecosystem toward care that is designed around patients first, and financially structured second, rather than the other way around.

As specialised healthcare providers expand outside large hospital networks, what operational and financial challenges are proving the most difficult to overcome while maintaining quality and affordability?

The hardest challenge is that quality in paediatric super-speciality care depends almost entirely on people: senior specialists, trained paediatric nurses, experienced support staff. That talent is scarce, and it is expensive, particularly outside the large hospital networks that can offer both scale and institutional prestige.

Beyond talent, building in-house diagnostics and a dedicated paediatric pharmacy, which we considered non-negotiable, adds significant capital cost upfront, well before patient volumes can support it. There are no shortcuts there that do not eventually show up in care quality.

Then there is affordability. Families are already under enormous financial strain when a child is seriously unwell. I refuse to build a model where a parent is handed a surprise bill at discharge rather than an honest estimate before a procedure begins. Balancing senior talent, in-house infrastructure, and transparent pricing, without the cost-absorption that a large hospital’s scale provides, means every operational decision has to justify itself twice: once clinically, and once financially.

What has made it workable is the model itself. Lavender Lane is a specialist child care centre built on what is known internationally as a day hospital. The concept is simple. A child comes in the morning, receives treatment that would traditionally require an admission, whether that is chemotherapy, a transfusion, an infusion or a minor procedure, under the supervision of a senior specialist, and goes home the same evening. Day hospitals are well established in paediatric care in the UK and much of Europe, but India has barely begun to build them. A day hospital is genuinely leaner to run than inpatient infrastructure, and the savings that creates are what allow us to protect both quality and affordability at the same time.

Investor interest in speciality healthcare has grown in recent years. From your perspective, what are investors looking for in healthcare ventures today, and where do you see the next wave of opportunities?

From the conversations I have had, investors today are looking well past clinical credentials or a good location. They want to see genuine structural differentiation, a model that is not simply a smaller version of an existing hospital. And they want to see a clear path to recurring trust with families, not just one-time transactions.

Unit economics matter enormously, particularly in paediatrics, where treatment cycles and family relationships can run for years. The lifetime value of a family’s trust is at least as important as the revenue from any single visit, and the most serious investors understand that clearly.

The next wave of opportunity in Indian healthcare, in my view, sits precisely where the large networks have been slowest to go: focused, speciality-led care built around a specific patient group, delivered outside the traditional multi-speciality hospital format. Paediatric super-speciality care sits squarely in that gap. The need is enormous, the existing supply is genuinely thin, and the model is structurally different enough to defend.

I would also say that investors are increasingly rewarding ventures that can show measurable, public commitments to quality, not just growth projections. That is something we built into Lavender Lane from day one, and it has shaped every conversation we have had with serious partners.

You chose to establish Lavender Lane as a standalone paediatric super-speciality centre rather than within a multi-speciality hospital ecosystem. What informed that decision, and what lessons have emerged during the journey from concept to launch?

Inside a multi-speciality hospital, paediatric care almost always becomes one department among many, competing for space, design priority, and operational attention with everything else the institution runs. I did not want a children’s wing. I wanted a specialist child care centre built entirely around a child, from the ground up: the lighting, the waiting areas, the way appointments are structured, the way a family is spoken to when they first call. That level of intentionality is very difficult to achieve as a smaller piece inside a much larger adult-focused system.

The biggest lesson from concept to launch has been about patience. Building in-house diagnostics, a paediatric pharmacy, and day hospital infrastructure from scratch takes real time, and I had to resist the pressure to cut corners simply to open sooner. Every shortcut in healthcare has a patient at the end of it.

The other thing I did not fully anticipate was how central the care navigator model would become. It was not the headline idea when we started, but it turned out to be the thing parents responded to most. Families navigating a serious diagnosis do not just need excellent doctors. They need one person who knows their child’s story and stays with them through the whole journey. Once that became clear, we built around it.

Every stage of this has confirmed the same thing: building slowly and correctly matters more than building fast.

As Lavender Lane begins operations in the NCR, what metrics will you use to evaluate the success of the model, and what factors will determine whether it can be replicated in other markets?

Our Noida centre opens this August, so these questions are about to stop being theoretical for us. And success, for me, is not primarily a volume or revenue question, though both matter for sustainability.

The metrics I watch most closely are clinical and relational. How many families are we keeping out of hospitalisation through day hospital treatment? How quickly does a care navigator respond to a first call? How often do families return to us for ongoing care rather than seeking a second opinion elsewhere? These tell me whether the model is actually working for the people it was built for.

We also publish the Lavender Lane Standard quarterly, a public set of specific, measurable commitments across clinical quality, response times, and family experience. That public accountability is not a marketing exercise. It is a discipline we hold ourselves to, and I treat it as a metric in its own right.

On replicability, the honest answer is that it will depend on three things. Whether we can find and retain senior specialists willing to work this way in a new city. Whether there is enough local awareness of paediatric super-specialities for families to actively seek us out. And whether we can build the same in-house infrastructure without compromising on it to cut costs or timelines.

Our Delhi centre, already under fit-out for 2027, is our first real test of that. If it can hold the same standard as Noida, that tells me the model travels, not just the idea behind it.

But the outcome I am most invested in is bigger than any one centre. I want the day hospital to become a recognised category in Indian paediatric care, something families ask for by name and health systems plan for, the way the best children’s health systems in the world already do. If, a few years from now, a parent in any Indian city simply expects that their child can receive specialist treatment in the morning and be home by evening, Lavender Lane will have done its job.