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The Rediff Interview/ Dr Pratap Reddy

'Apollo had done everything that was possible for Ranga'

Dr Pratap Reddy, chairman, Apollo Hospitals You mean to say the general public has no faith in Apollo now? Did you see the crowd outside?" an agitated and visibly irritated Dr Pratap Reddy asked.

Yes, it is true that the Apollo Hospital looks like a railway station with people milling all around even on the day Rangarajan Kumaramangalam passed away. In an exclusive interview with Shobha Warrier, Dr Reddy brushes aside all the allegations hurled at the hospital and argues his case with pertinent points. It is clear that he holds the press responsible for all the controversies that surround the hospital today.

Immediately after P R Kumaramangalam went into a coma, the Union health minister told the press that one went to big hospitals not only for good treatment, but also for proper diagnosis. He further added that in Kumaramangalam's case, Apollo had failed.

I think the minister was not completely informed then. I am quite happy because so many members showed their concern and emotion in Parliament; they wanted a probe to see whether anything had gone wrong in the management of Kumaramangalam when he was in Apollo. My answer is straightforward -- no, nothing went wrong. Apollo has infrastructure which is comparable to the best in the world. It is unfair to make such allegations.

There are three components in medical treatment. The patient comes first, the hospital next and finally the doctors. To repeat, Apollo has the best infrastructure and we select only good doctors who have good credentials. More than 50 per cent of the doctors who work in our Delhi hospital are trained in the UK and in the US. The doctors who looked after Kumaramangalam are highly qualified. Dr Prasad Rao has 20 years experience in internal medicine. He was backed by Dr Lalitha Sekhar who has been working with us as a consultant for ten years now. Dr Ajay Lal is acknowledged as a good pulmonary physician. So we had a good team of specialists to look after Ranga.

I must tell you, when the controversy was going on, Apollo in Delhi did a marvelous thing, which is not done in this part of the world at all. A two-year-old girl received a liver from her mother. Such a surgery in the US would have cost $ 400,000! If a hospital can do a liver transplant, it can do anything. That is the kind of infrastructure we have developed in all the Apollo Hospitals.

Didn't the Apollo Hospital make a wrong diagnosis in Kumaramangalam's case? After he was admitted to AIIMS, he was diagnosed as suffering from myeloid leukemia.

When he came to us, Ranga had been running a fever for two weeks. He was already on antibiotics and we continued the antibiotics. We did several investigations and the results did not reveal any specific infection because he was already on antibiotics. Because there was a patch in the lung and because of his age, we tested him for TB and cancer too. Those tests were also negative.

Did you test him for leukemia?

Why should we have tested him for leukemia? There was no indication of it at all.

I spoke to some doctors and they told me that if a person had prolonged fever, he should be tested for leukemia.

For leukemia, the first indication is that there will be abnormal cells in the blood picture. In his case, there were no abnormal cells at all. We made a number of blood pictures. The WBC (white blood corpuscles) count will be very high if you have leukemia. His count was between 5,000 to 7,000. The platelets were also adequate. In his case, there were one-and-a-half lakh platelets. When you have leukemia, the number will drop. You also bleed if are suffering from leukemia, from your punctures, and in his case, we did a lung biopsy but he didn't bleed. He showed none of these four symptoms. So how could we have suspected leukemia?

He was discharged on April 23 and he came to the hospital on May 5 for a blood test. The results were better than those of the previous test. His haemoglobin count had gone up to almost 12 and his blood count and platelets were normal. Unfortunately, he didn't see the doctor. But he said he felt so much better. So, there was no indication of leukemia in all our tests in the hospital.

Remember, there was a 100 days gap from the time he saw us till he got hospitalised in AIIMS. What I think is that if he was at all suffering from leukemia, he might have got an acute leukemia blast. That is why the attack was so severe.

Madan Lal Khurana said he gave the land to Apollo in Delhi on the presumption that it would help poor patients too.

He did not give the land. The land was given by Rajiv Gandhi because he wanted me to build an Apollo Hospital in Delhi and land was given to 23 more hospitals in the city. Normally Apollo charges patients three per cent for management. Rajiv Gandhi had told me, Dr Reddy, you charge Re 1 for your management. You also take the land for Re 1. Escorts got the land for Rs 5,000 an acre. I too could have paid that money but that one rupee business came into the picture. One rupee was the consultation fee collected for running the hospital.

Khurana also said that instead of earmarking beds for poor patients, the hospital was charging exorbitant rates for all the facilities.

I think this controversy regarding poor patients has been going on for a long time. The press has misrepresented the whole issue. We are the only hospital amongst 22 who have developed facilities for the poor. Let the press show one other hospital to have done so. All hospitals have given an undertaking in Delhi that they would separately build 25 per cent free facilities. But Indraprastha Apollo Hospital is the only one to have built this facility.

But the politicians and the press are still blaming us because politicians want me to supply medicines and materials free of charge. Indraprastha Apollo Hospital provides all facilities for the poor, which cost me Rs 11 crore a year. I told them that my doctors would treat the poor free; my operation theatres would be available for the poor. I am the only one doing this, and still the press attacks me.

In Rangarajan's case too, they are holding a trial. Star TV telecast Khurana's statement every half-an-hour without even asking us what the true facts are. In this case, it is absolutely clear that we are right. Any sensible medical person would understand that Apollo had done everything that was possible for Ranga. I am very confident of this fact because apart from the other experts handling his case, I too have personally gone through his case because Ranga is a good friend of mine. At the time of discharge, he shook hands with me and said, please leave me as the Parliament session is going on. Otherwise, we would have kept him for another three days.

Do you feel that if you had kept him for some more time he could have been saved?

I don't think so. I don't think those three days would have made any difference. Like I said, on May 5, when he had the blood test, the results were better than those in the previous test. If he had come for periodic follow-ups then perhaps it might have been different. I don't think the illness he had when he was in our hospital had anything to do with what happened to him in the end. This is my opinion as a medical man.

The doubt in the minds of the general public is that if something like this can happen to a high profile person, what about them?

Who is the general public? The general public is unfortunately lead by the media, which is indulging in total false propaganda about us. The media is publicising false news without finding out the facts. The press has completely killed us in the first few days of Ranga's illness coming to light and only day-before-yesterday did they publish our statement. It is very unfair.

Kushabhau Thakre, the former BJP president, has also said that the Apollo is minting money and is not interested in patients.

Let me tell you one thing: we treat an average of 20,000 patients a year. In these 20,000 patients, there will always be some amount of medical complications and some of these patients may even die. We accept every single patient who comes to the hospital. Regarding Kushabhau Thakre, the hospital gave a rejoinder that complication with hematoma occurs in every 20 patients in a government hospital but in a private hospital, it occurs in one in 200 patients. Nobody published the rejoinder.

The press should realise its responsibility. They should understand the damage they are doing because in India, Apollo and other hospitals have brought in some standards into the medical field. But instead, all of you are doing grave injustice to the people. Because of the media, doctors are not going to perform their very best.

We also received quite a few mails complaining about your hospital, like negligence, over-billing, etc.

What is over-billing? A delivery at the Apollo Hospital, Delhi, costs Rs 17,500. In a nursing home in Delhi, it costs Rs 25,000 to 30,000. Are we over-billing?

I know of a hospital where a patient did not survive a bypass surgery but the bill was Rs 19,50,000! I don't think this would have ever happened in Apollo. You don't write about such things. But you punish us because ours is a private hospital, which pays taxes to the government. A calculated disinformation campaign about Apollo Hospital is going on in Delhi in some parts of the media, which is unfortunate and unfair.

But I am sure people still believe in us. You see, our hospitals, they are all full. Even today, there is no vacant bed in Apollo because that is the kind of service we provide. But you have created some suspicion in everybody's minds. Why do hospitals ask patients to sign forms? Because something can go wrong too just as, in all probability, things might go right.

Let me go back to one of Khurana's criticisms. He asked whether Apollo Hospital was a five star hotel-like commercial venture or a hospital.

I refuse to answer such unnecessary comments. It has no bearing on the problem. A five star hotel charges Rs 9,000 to 14,000 for a room without any service. For the same room, we charge Rs 3,000, and we provide all the meals for the patient, his relative as also round-the-clock service. How can you call this five star? Only an ignorant person will make such statements. And this has been happening in the press continuously -- comparing Apollo to a five star hotel! No other hospital has been called thus. I think it is because we are doing so much for the people and we are in the limelight.

Is it not true that only the elite in India can avail the facilities that you offer in the Apollo Hospitals? Is it not true that the ordinary citizens of India cannot afford to treat themselves here?

Is that a statement or a question?

It is a question.

You just go and look at the people in the lobby. Do they look like the elite of India? They are all ordinary citizens of India. That is why I have been struggling all these years to get health insurance so that ordinary people can come here.

I am a man with a human heart. I am not like the media. I have got my village covered. I have the Thambaram village also covered. We give free treatment to the people in these two villages.

Let me ask you something about what had happened to the table tennis champion, Chandrasekhar.

It was the press who blew up that case too. The newspapers showed him paralysed when the fellow was betting on the racecourse.

You mean he was not affected at all after a surgery?

An anesthetic accident happened and he was saved because of Apollo. That nobody depicted. Because every doctor here did everything possible for him, he was saved.

You mean in Chandrasekhar's case too, there was no negligence.

What is negligence? Let me ask you, why does a doctor want to be negligent? When somebody comes to me, why do I harm him? You are also a human being. Tell me, if somebody comes to you, will you harm the person? Yes, sometimes complications occur. That is why we explain to people that there is a two per cent or three per cent chance of mortality and five per cent chance of morbidity.

One former prime minister called me the day-before-yesterday and told me, "I feel so sorry for the ignorance of people. You have done so much for this country, sacrificing everything. You came back 30 years ago to this country when you could have been a multi-millionaire abroad. Here, they are trying to hang you for nothing." I won't name him. He spoke to me for 15 minutes over the telephone.

In any hospital, there will be a mortality rate of three patients. But I have a rule not to refuse admission to any patient in whatever state they come. I tell my doctors that if the same thing happens to your father or mother, what will you do? What if we don't give admission to a patient and he dies on the way to his home or to another hospital? So there will be deaths in a hospital.

The press is one-sided, criticising only Apollo, not only today but throughout. They have taken on Apollo, especially the Delhi hospital. There is a bias behind this.

Why do you feel there is a bias?

Because otherwise these things would not happen. In Delhi, there are other hospitals too. There are infections in other hospitals too. We are not gods. We are human beings. And, Apollo is not a temple. I don't think a temple can cure everybody. But we try to do everything possible for everybody.

You blame the media but the media attacked you only after the politicians started the tirade. Why is it that the politicians are making such a big noise against Apollo?

Do Khurana and four others make up the entire Parliament? Khurana has his own reasons for speaking out against us. He still thinks he is the chief minister of Delhi. He asks us to treat this guy free, treat that guy free. How can I do that? Whose money am I giving? It is the shareholder's money. If I had the government's money, I could have thrown it anywhere I wanted. But my people and I are accountable to our shareholders.

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