On old school giving: Susmita and Subroto Bagchi, and Radha and NS Parthasarathy

The Bagchis are also independently involved in a massive project to help build a 750-bed cancer hospital and palliative care centre in their home state, Odisha, spread across 20 acres of land given free by the government, which they say is the largest such initiative in the country to enable the poor from not only the Eastern states, but also the rest of India to access “high quality, affordable health care”, according to Susmita. They have invested close to ₹500 crore of their personal money in this project, which is likely to provide employment to about 2,500 doctors, nurses, researchers and support staff.

Pritha Venkatachalam, partner and co-head, Asia and Africa at The Bridgespan Group, says that unlike earlier, when philanthropists like the Tatas and Birlas built large institutions as part of their personal philanthropy, there are fewer examples now of large institutional giving by philanthropists, with them opting for other ways to channelise their altruism. This could be through their own operating or grant-making foundations (like the Swades Foundation by Zarina and Ronnie Screwvala or the Rohini Nilekani Philanthropies), retail giving to causes or collaborative philanthropy like the ACT grants (set up by startup founders, venture capitalists and social sector leaders to fund Covid-19 relief measures and innovations).

In this context, the Bagchis and Parthasarathys giving large sums of money to set up institutions that are likely to impact generations is “significant”, she says, particularly in a country like India, where many people are still unable to access basic health care needs either due to lack of access to health care centres or high out-of-pocket costs, and where research into health care and capacity-building still has a long way to go. Global research shows that patients treated in a teaching hospital have a higher probability for survival, she adds, and “when philanthropy is looking at both hospital care and research together, it has potential to improve overall medical education and patient care”.

“I think it’s time to revive philanthropy for building institutions,” says Parthasarathy. “Within that, we don’t always need to build new institutions, but support existing ones that are doing good work.” Their philanthropic strategy, he explains, is to identify the cause, identify an institution or people who you can trust, who will be transparent and have accountability in terms of what happens, and then write a cheque and let them take over the project completely.

Subroto adds, “We do not want to have a foundation or trust, and want to liquidate everything in our lifetime. Our principle is, instead of trying to make a difference yourself, go help people on the ground who are trying to make a difference.”

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Nuts and Bolts

Post his “four days of retirement” from Mindtree in 2016, Subroto decided to do pro bono work with the Odisha government to bolster their skill development initiatives, while Susmita has since started working with the government schools in the state. The hospital project started sometime in 2021.

It was around the same time that the Parthasarathys, well into their retirement too, decided it was time to do something more significant with their money and time. “We have led a very ordinary life. We were lucky to come into money, but how much of it do we need?” says Parthasarathy, an alumnus of BITS Pilani and IIT-Kharagpur, who was looking for a good project to fund when he was introduced to the director of IISc, Govindan Rangarajan, by a mutual friend.

Radha, a retired banker who worked with the State Bank of India (SBI), recollects that they had a non-agenda meeting with Rangarajan on December 30, 2021, when he showed them a presentation about a project that combined science, engineering and medicine through a medical school and hospital. The idea was to foster a “bench-to-bed approach”, which will bring together research, clinical discovery, education, manpower training and patient care to improve health care outcomes.

In India, spending towards health care is less than 2 percent of the government’s Budget outlay. The target, as per the National Health Policy 2017, is to increase government’s health expenditure to 2.5 percent of India’s gross domestic product (GDP) by 2025. But the Bagchis and Parthasarathys believe it is unfair to leave the responsibility entirely to the government, and that private individuals with the means and networks to make a difference must also step up.

According to the India Philanthropy Report 2023 by Bain & Company and Dasra, released in March, India’s social sector funding stood at ₹22.6 lakh crore in FY22 or 9.6 percent of the GDP. About 95 percent of this funding comes from the government, both Centre and states.

The richest in the country give away merely 1 percent of their wealth to philanthropic and social causes, which is less compared to their counterparts in other countries of the world. “Indian UHNIs (ultra-high-net-worth individuals) could boost their total contribution by 8 to 13 times if they matched their counterparts in China, the UK, and the US,” the report says.

Subroto explains that he was born in a government hospital, the government helped him get his inoculation as an infant, he was educated in government schools, and even his two daughters were born in a government hospital. “The government, through whatever rudimentary health care system, has brought me to where I am today, but after that, what? You just walk away?”

He says the Covid-19 pandemic laid bare the need for India’s public health care system to be strengthened. “But you can’t just leave it to the government. All of us have to pitch in,” he says. “If the nation has to be somewhere in the next 20 to 30 years, you need to take care of the health of the people. But the size of the problem is often not discussed by capable, entitled and resourceful people.”

Rangarajan, IISc director, says under the medical school, construction of the hospital and academic/research block is “progressing well”. The timeline is to complete the construction by the end of 2024 and start the hospital operations. “We hope to admit PG medical students in 2025,” he tells Forbes India over email.

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In November 2022, Rangarajan had told Forbes India that this philanthropic contribution will strengthen clinical research and medical technology, and “create a cadre of physician-scientists that is currently missing in India”. The medical school will have dual degree MD-PhD programmes. Research focus areas, he had said, will include infectious diseases, metabolic disorders (including diabetes), cancer, neurology and cardiology.

The Bagchi-Parthasarathy Hospital will be spread across 12.6 lakh square feet. The academic and research block will occupy two lakh square feet and the residential complex about six lakh square feet. The cost of the hospital, including biomedical equipment, is expected to be around ₹1,000 crore, Rangarajan had told Forbes India in November.

“The hospital will be a not-for-profit entity. We will be treating poor patients under various government schemes like Ayushman Bharat. The hospital will have payment beds which will provide additional revenue,” he says.

The medical school will have a similar cost, primarily for endowments to fund chair professorships, visiting professorships, student internships etc. The residential complex will cost around ₹250 crore.

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The contribution by the Bagchis and Parthasarathys has resulted in more philanthropists coming forward with their donations for the project. “Among those who have consented to make their names public are Ajit Isaac (Quess Corp), Kiran Mazumdar-Shaw (Biocon) and Prashanth Prakash (Accel),” Rangarajan says.

Even for the Odisha hospital project, just the individual contribution by the Bagchis is not going to be sufficient, and they are hoping others will come forward. “One hospital bed costs ₹2 crore on an average. So, a 750-bed hospital will require around ₹1,500 crore. It is very capital-intensive,” Subroto says. “We are basically giving the institution a push to take off and progressively it will be in a position to cross-subsidise and meet its future expenses.”

Right now, patients in Odisha flock to the Acharya Harihar Regional Cancer Institute in Cuttack. Susmita explains that patients have to stay at or near the hospital for months during the course of treatments—surgery, chemotherapy or radiation. “People of the bottom of the pyramid suffer multiple dislocations,” she says. “And for every cancer patient, an entire family moves.”

And to make sure patients and their families do not have to worry about anything other than the treatment itself, there is a hostel for families of patients, who can live there for free. This hostel will have the capacity to accommodate about 300 people. “So when the poorest come in for treatment, they do not have to stay under a flyover,” says Subroto, adding that they will also take care of their food requirements.

Called Bagchi-Sri Shankara Cancer Centre and Research Institute, the idea is to make sure that the overall base cost of treatment is affordable-to-nil for people from social and economically vulnerable backgrounds, says Dr BS Srinath, a surgical oncologist and the head of the Sri Shankara Cancer Hospital and Research Centre, which will run the Odisha hospital. Patients of the hosptial will include people who are very poor, for whom treatment and other related expenses will be free; people who have a higher level of affordability, but need highly subsidised treatment, and third, those who can afford it.

“You can treat some poor free, but you can’t treat everybody free. If you want to treat the poor free with high quality care, somebody will have to bear the cost. The money from the paying patients will be used to treat the poor,” says Dr Srinath, claiming that the hospital will particularly benefit the poor from East and Northeast India, who find it difficult to otherwise access such treatments. The palliative care centre is being set up in collaboration with Bengaluru-based hospice trust Karunashraya.

Venkatachalam of Bridgespan believes this hospital will plug a critical gap, particularly towards palliative care, which does not attract much philanthropic funding. “This is an important investment. Philanthropic contributions in these niche health segments will provide an uplift for the country and contribute tremendously towards social good,” she says.

Susmita, a published author, informs that the work on the hospital began in February 2021, and the inpatient department with about 200 to 250 beds should be functional by October. “We’ll hit the 750-bed mark in two to three years,” she says.

The first phase will see the inpatient and outpatient departments, apart from accommodations for doctors, staff and patients. The second will see the construction of an auditorium, a cancer museum and research centre, which, she says, will look into the data analysis and research into the economics, sociology and psychology of cancer. “We want youngsters to visit this museum, and you never know, some might be inspired to work in the area of cancer treatment or research.”

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Inter-generational Impact

Venkatachalam says if there is one thing history has taught us in India, it’s the fact that institutional giving is valued as long as both the ‘hardware’ and the ‘software’ components of an initiative come together. “We do know of many cases where philanthropic giving has supported the ‘hardware’, which is literally the building of the institution itself. But the challenge is in the ‘software’, which in this case is to get health care workers, researchers, doctors, support staff etc,” she says. “A hospital without the right qualified doctors, nurses, staff and research support will not take the philanthropic giving to its impact potential.”

Even for the medical school, “it is always a challenge to get good faculty members”, agrees Rangarajan, but adds that given the stature of IISc, and the “unique nature of the proposed medical school”, they hope to recruit “high-quality faculty to combine both clinical and research expertise”.

Parthasarathy understands this is a concern, and says the proof of the pudding is for this philanthropy to see the light of the day. “It’s not about the recognition or writing the cheque. It has to fructify,” he says, adding that they have volunteered to spread the word. “The next big challenge is to get the right kind of talent. I get resumes from doctors, which I forward to IISc. I have told them to create a portal and publicise the openings.”

Radha says their aim was to always do that “one big thing”, and then learn from the process. “And then use this process to do something else or help others who want to be next in line to do this kind of activity,” she says.

Subroto is of the belief that for him, being a philanthropist is not just about giving money, but also bringing your experience, network and reputation into the projects and causes you back, in order to make sure it has “inter-generational impact”. He counts the Tatas and Wipro Founder-Chairman Azim Premji, Nandan and Rohini Nilekani among his role models, and is inspired by Mother Teresa.

Susmita and he say that when they present their hospitals and medical school to the world, the hope is that it will awaken other people’s ambitions. “You can create a legacy only when you make your work an open book, open source. This is something like that. There are so many startups and young entrepreneurs who make so much more money than we did. Those kids should say, ‘750 beds are not enough. I want to take this to the next level’,” says Subroto. “We want to be outdone.”