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CSR in Indian hospitals: A changing panorama

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CSR is gaining prominence and popularity in Indian healthcare with hospitals seeking to move away from traditional notions and accept responsibility for the community as a stakeholder in corporate activity By M Neelam Kachhap

The perception of corporate social responsibility (CSR) in India is changing. It is slowly moving away from philanthropy to a process of sustainability, where the company and community have an ongoing engagement. We live in the millennium age, where boundaries mean little to the organisations turning global. Today, business is not only a profit-making proposition but also a personified image which can think, leap, rebel and emote. It is this character of business that has brought CSR to the limelight. An offshoot of globalisation, CSR has gained immense prominence and popularity in the decision-making world.

The healthcare industry, particularly private hospitals are yet to make CSR an integral part of their business. For the corporate hospitals in India, CSR exists more in the form of traditional philanthropy. A reflection of which can be seen in the society but the effect are not profound. There is a need for greater visibility, education and awareness of the concept so that the hospitals can turn small efforts into larger benefits for the society.

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Jasbir Grewal

“Corporate hospitals should be responsible and accountable in their functioning – whether it be through performance or interactions at every level of society. The principal philosophy of a hospital should be driven by the need to save lives, create strong preventive health mechanisms and earn trust among the stakeholders about best practices in healthcare. Social and environmental stability will follow. It cannot be the other way round,” says Jasbir Grewal, Head, Fortis Charitable Foundation and Executive VP, Fortis Healthcare.

In the last 20 years, healthcare industry in India has witnessed rapid growth and development. Multinational corporations as well as hospitals have played key roles in defining healthcare market in India and influencing the behaviour of a large number of consumers. With the explosion of information technology (IT) and medical tourism in healthcare, a new model of business and corporate governance has been created. But this new generation of hospitals have failed to capitalise on the response of the community and sustainability of the environment — the two important aspects of viability in business.

Conduction free health check-ups as a form of passive philanthropy no longer constitutes CSR. The new age corporate hospitals need to understand what CSR means.

The primary difference between CSR and traditional philanthropy is that CSR accepts the community as a stakeholder in corporate activity.

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Suyash Borar

“Corporate responsibility is achieved when a hospital focusses all its practices to ensure that it operates in ways that meet, or exceeds, the ethical, legal, environmental, commercial and public expectations that society has of a healthcare institution,” says Suyash Borar, Director Xceptional Health and Wellness, Kolkata.

“The difference between CSR and traditional corporate philanthropy is that in traditional corporate philanthropy you give money to NGOs or support causes for the poor people and in CSR you build an organisation to solve the social problem,” says Dr Huzaifa Khorakiwala, CEO, Wockhardt Foundation.

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Dr Huzaifa Khorakiwala

“You build an internal organisation which either implements or monitors or implements and monitor both on social issues and solve the social problems. So an entire organisation is build for that and that is CSR,” he explains.

Further, the emerging perspective on CSR focuses on responsibility towards stakeholders (shareholders, employees, management, consumers and community) rather than just on maximisation of profit for shareholders. There is also more stress on long-term sustainability of business and environment and the distribution of well-being. Says Borar, “The continuous commitment by corporations towards the economic and social development of communities in which they operate amounts to CSR. This means being participative and creating independent communities and also taking care of the underprivileged.”

According to management gurus, there is an increasing recognition of the triple-bottom line: people, planet and profit, among the corporates. The triple-bottom line stresses on the following:

  • The stakeholders in a business are not just the company’s shareholders
  • Sustainable development and economic sustainability
  • Corporate profits to be analysed in conjunction with social prosperity

Triple-bottom line is a very good guideline, which can be adopted to create a conducive environment for business as well as the society.

Defining CSR for hospitals

Our society still has to come to terms with the idea of healthcare as a business. Corporate hospitals are viewed as profit making institution that benefit from peoples’ suffering.

Can CSR change this image? Yes, it could if corporate hospitals understood the benefit of being socially responsible and were conscious about the interest of the key stakeholders.

However, a hospital is very different from other business and has unique operational issues.

Patients demand the best care regardless of economic justification and are more often unable to pay for it. In addition successful treatment reduces the number of patient visits and does not try to maximise loyalty or retention, unlike business.

So, how does a hospital define its CSR with such operational challenges?

CSR in terms of corporate hospitals can be regarded as a form of capital stock renewal, reflecting the need to preserve natural capital (by minimising the hospital’s environmental pollution), to improve social capital (by supporting the institutional framework of laws and acceptable business practices) and to invest in human capital (by empowering and training staff).

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CSR: The feel good factor

By incorporating CSR in their forte, hospitals can retain patients and their demand for services provided, because patients will not feel ‘scalped’. This ensures consumer loyalty for the hospital. Further, experts opine that adopting CSR affects the entire hospital value chain and ensures public acceptability and acceptance, thus ensuring the long-term success. Good CSR activity retains and conserves the supply of willing and motivated staff because employees will feel the hospital is doing what is ‘right’ to patients and staff. This helps the hospital run ‘by the law’ and avoids political repercussions.

New breakthrough: PPP

Leading corporate houses have discovered that working together with non-profit and government organisations to solve social problems can give them new insights and approaches to create business opportunities as well. Says Borar, “CSR and industry’s partnership for inclusive growth are one and the same.” The new wave of CSR advocates the integration of concerns and commitments for a cause into the core competency of an organisation’s goal.

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Vishal Bali

Says Vishal Bali, Co-founder and Chairman of Medwell Ventures, “Today’s business leaders no longer want to be loosely associated with a cause or partnership with an NGO. They would rather initiate cohesive working model to work with the government machinery and other variables.”

From running primary health centres to creating public awareness platform, corporate hospitals in India have many avenues to partner with the government.

“At Wockhardt Foundation we have a partnership with government where government funds the programme and we implement it. We have worked in Tamil Nadu where we did hospital on wheels with the Tamil Nadu state government. We monitored 420 mobile medical units and we are going to start our operations with the government in Jharkhand,” reveals Dr Khorakiwala.

“Fortis foundation is collaborating with several non-profit organisations such as – the Needy Heart foundation, Aishwarya Trust, Being Human foundation, Rotary Club, and government of punjab among others, as a health partner. On an average, we conduct 80-100 congenital heart defect surgeries per month for children referred to us by our partners. We have linkages with NGOs, government agencies and other corporate CSR foundations to carry out awareness programmes, health camps and disaster relief initiatives in case of natural calamities,” shares Grewal.

Congenital heart defects surgery is also performed at various Apollo Hospitals, Narayana Health City, Bangalore and Kokilaben Dhirubhai Ambani Hospital, Mumbai.

The way forward

There is a need to develop a more rational and ethical debate on CSR. CSR should go beyond tokenism to a vital priority in healthcare of tomorrow. If hospitals expect better understanding from the community about the challenges that this sector faces it has to look at CSR. It will help improve their image and enhance the stakeholder engagement by making their performance indicators available to public in a transparent and sincere way.

CSR indeed has a strong foundation and is bound to gain momentum in the coming years. For all the attention it is now receiving, it is yet to be seen when CSR would become integral to the goal of the Indian healthcare sector.

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