Dr Devi Shetty’s Narayana “health city” in the Cayman Islands is the launch pad for the Indian physician’s wider ambitions to bring affordable medical care to the rest of the world.

“We intend to build medical health cities in India, Asia and Africa, and will build large numbers of hospitals in these areas,” he said yesterday in a British Broadcasting Corporation interview.

Cayman, he said, would prove that healthcare can de delivered at a fraction of the costs in the developed world, and “if all goes well,” he said, “we’ll start in Africa.”

The Cayman Islands Narayana Centre would be the first venture outside of his Bangalorer, India-based Narayana Hrudayalaya complex, the Indian physician said, and would serve as a model for the next steps.

The rising costs of healthcare, in the face of rising demand, would be controlled through his “health city” concept. This would achieve economies of scale, train medical personnel and make affordable services available to consumers everywhere.

Dr Shetty (right), on a four-day George Town visit last week, said groundbreaking would occur in eight months for the initial, 140-bed phase of East End’s Narayana centre, with the first patients admitted in August 2013.

Modelled on the Bangalore complex, Dr Shetty’s medical group plans a $2 billion, 15-year prgramme, ultimately creating a 2,000-bed tertiary-care hospital, specialising in pediatrics, cardiology, neurology, gastroenterology and a range of other disciplines, as well as after-care facilities and a medical school.

Performing nearly 15,000 surgeries on patients from 25 countries, the Bangalore operation is known for efficiency, earning after-tax profit margins of 7.7%, more than most US private hospitals

“America,” with more than 40 million uninsured, “has the highest [medical] costs in the world.” Dr Shetty told the interviewer: “Across the world it’s the same problem of delivering healthcare, where 70% of revenues is for salaries alone. What other industry has that? It’s just not sustainable. It’s a disaster waiting to happen.

“We would like to show America, just outside their waters, that you can build and provide healthcare for less than half of the costs in the US. The economy of the 21st century is going to be driven by this industry, which is already US$4.5 trillion worldwide, and while the state can provide healthcare with taxpayer’s money, the taxpayers themselves cannot pay. It just can’t work anymore. The costs are too high.

“We have partners from the US in the Cayman Islands, prestigious hospital chains that are not-for-profit, not even listed. We will prove this can be done,” he said.

He addressed fears about medical standards, saying staff were consistently working “operating from morning till night”, and that “as you get bigger, it is actually easier to maintain standards.

“If a patient is unhappy,” he said. “He just presses the speed dial to connect to the patient complaint system.”

Doctors were also involved in financial decisions, meeting daily to review records and options: ”If a doctor does not understand the financial implications of providing health care, then you can forget about reducing costs. Doctors have to be at the centre of financial management or they won’t get any patients,” he said.