With an impressive portfolio of 18 hospitals with more than 5,000 beds, over 4,000 doctors, 2,500 medical students and more than 250,000 patients per year in emergency room services, Italy’s Gruppo Ospedaliero San Donato (GSD) has firmly cemented its position as the largest private healthcare group in the country. With three of their institutes classified as IRCCS (Scientific Institute of Recovery and Care) - a recognition distinguishing those institutions within which the research activity has a direct and immediate impact on the quality of the cure delivered to patients – the result is 4 million patients treated each year.
The history of GSD is tied to the history of Luigi Rotelli, a physician and founder of the first hospital in 1957 - the Istituto di Cura Città di Pavia, followed by the Policlinico San Donato - from which he went on to lay the grounds for the Group as it is known today.
With its foundations rooted in science and research, and the central belief that the patient is primarily a human being and should be cared for on a personal level, research, cooperation, and transformation of results into cure are the three activities that have accompanied GSD throughout their more than half a century history.
“Our way of curing and caring, with paths that we personalise in all respects, is inspired by this fundamental belief,” says Paolo Rotelli, who took over as President of GSD in 2015 from his father. “As a family-owned Group, this belief has remained at our core and was a particular point of pride as we celebrated our 60th anniversary in 2017. My grandfather was the founding father of the Group and, after him, my father used his lawyer’s acumen to build a further 16 hospitals and make the Group the success that it is today.”
Focus on the UAE
Last year, GSD Healthcare (the UAE arm of GSD International) opened its first office in the United Arab Emirates, based in Dubai Healthcare City. In 2018, the focus for GSD Healthcare is to offer medical training courses to regional medical professionals looking to develop their medical skills and to earn Continuing Medical Education (CME) accredited by the Dubai Health Authority (DHA).
Hosted in partnership with international medical device companies, GSD brings out their top chief surgeons and medical officers from their various institutes and hospitals in Italy to teach the latest techniques on the most cutting-edge medical devices. To date, they have successfully carried out two training courses that were fully booked and well received by the attendees.
“What sets us aside in the training world is that all of our teaching and training is done by those at the very top of their medical professions,” says Rotelli. “Secondly, people don’t pay to listen to a lot of theory presented through a slideshow; we focus solely on hands-on, practical training that attendees take back to their practices and apply them immediately. During the training course, we teach particular skills, we allow them to practice these skills using the latest medical devices and we assess each of our participants individually at the end of the course.”
All GSD Healthcare training courses in the UAE are certified by the Vita-Salute University in Milan, which has been ranked by TIMES Higher Education list as the No.1 University in Italy.
“For us, these training courses are a means to understand the needs of the market – what the physicians really want to learn. Our two-day courses are just the beginning of what we have to offer in the UAE and we are extremely flexible with how and what training opportunities we are able to customise for those that have the passion to keep learning,” Rotelli explains. “If any of the participants want to apply for further training in a specific field, they can apply to attend more in-depth, certified training courses at our university in Milan.”
According to Rotelli, these UAE-based training courses are a first step in creating a network of cooperation and knowledge sharing between the healthcare facilities, healthcare professionals and local patients in the UAE and with those in the GSD network in Italy.
“Our country is traditionally known around the world for our food, fashion and, of course, the Ferrari brand. We want to change this perception of our country. For example, the fashion industry is worth 70 billion euros of our GDP while healthcare is worth 180 billion euros. The healthcare industry in our country is a much stronger product and we want the world to become more aware of our brand of healthcare.”
Once their network in the UAE is sufficiently strong, and they have achieved strong brand awareness within the local medical community, Rotelli explains that their ultimate goal is to open a healthcare facility in the UAE. “This is our long term goal, but right now, our focus is on building connections and introducing ourselves to the region and making our name synonymous with over half a century of medical excellence.”
“While we are now concentrating our main efforts on creating partnerships within the UAE, we are keen to utilise these connections to eventually begin to explore opportunities in the wider regional healthcare market such as in the Kingdom of Saudi Arabia.”
Trust in science and research
In Italy, GSD has a stellar reputation for scientific research, especially molecular medicine and gene therapy. Ranking second only to CNR (National Research Council) among the Italian institutions, GSD produces more than 1,600 publications, many of which have a wide resonance inside the international scientific community.
Through the three IRCCS institutes (Scientific Institutes of Recovery and Care), GSD has achieved an important position in the international arena of scientific research. The high number of publications, the training of young physicians and scientists, and the new treatment options offered to patients testify to the results achieved in highly interesting disease areas.
It is within the Ospedale San Raffaele shelter for science, which is the educational centre of the Vita-Salute University in Milan, in which researchers focus their efforts on understanding the molecular processes underlying the diseases, and has reached excellence in the field of molecular medicine. Meanwhile, the focus of the Policlinico San Donato institute is on the study and treatment of heart and large vessels diseases. Founded in 1969 and with an extension of 50,000 square metres in the south-east of Milan, the Policlinico is a multi-specialised healthcare institute renowned for cardiovascular excellence and carrying out the largest number of cardiac surgeries in Italy (over 1,500 per year).
While the IRCCS institutes have been credited with discovering workable cures for some of the world’s rarest genetic conditions, today, they have turned their attention towards discovering a cure for a genetic diseases that is much more prevalent in the Middle East – Thalassemia.
“Within the same modalities, our researchers are now working in collaboration with pharma giant GlaxoSmithKline to find a cure for Thalassemia,” explains Rotelli. “Although this is a rare disease, there are tens of thousands of patients, especially in this region, who could benefit from a more effective treatment for this genetic disease.”
The Ospedale San Raffaele institute has also made considerable advancements in the treatment of leukemia. They have the latest Phase 1 drugs and treatment options, much like in the US. The institute also has an experimental treatment for Diabetes Mellitus Type 1 in the form of a stem cell transplant.
“All of this was made possible because, for the last 30 years, the Italian government continued to allocate huge amounts of funding into medical and scientific research,” says Rotelli. “Today, due to fiscal deficit in the country, this funding has been significantly reduced.”
“This is why we are increasingly focusing our efforts on showcasing our medical technologies and specialist research capabilities to the global medical community in order to find funding that will enable us to continue to develop these techniques that are changing the face of medicine.”
GSD is willing to enter into partnership with medical laboratories in the UAE in order to co-develop some of these revolutionary techniques that are bringing hope to so many patients around the world. “We know that the UAE government is one of the largest donors worldwide and that they are committed to making the world a better place through medical research. We are fully aligned with this vision and we would like to share our know-how and expertise on how to make it possible to go from the research stage, all the way to being used on real patients in a clinic setting.”
International expansion
GSD is a family-owned private hospital group operating for profit; however, the funding for over 80% of their patients comes directly from the national health system in Italy. This is a form of Public-Private Partnership (PPP) which works under a “checks and balances” system to ensure that the government does not overspend and exceed their budgets. Each private hospital in the country can only generate a maximum of 80% of their revenue from patients that are referred by the government and each type of treatment is charged at the same fixed rate, regardless of if you are treated in a public or private hospital. GSD generates 1.25 billion euros per annum from the national health system and this figure is capped at its maximum capacity.
“The remaining 20% of our business comes from out-of-pocket (OOP) payments or from health insurance companies. While Italian patients are traditionally reluctant to pay OOP, or to invest in private health insurance for themselves, we are still seeing that this figure is growing year-on-year. This is one of the reasons why we are setting our sights on the international market,” Rotelli explains.
Last year, GSD welcomed more than 1,600 international patients from countries such as Canada, Australia, Romania and The Maghreb. Due to ongoing humanitarian efforts where surgeons from GSD travel abroad to train local surgeons in specialist paediatric cardiac procedures, particularly in countries such as Tunisia, Morocco and Egypt, GSD continues to receive hundreds of paediatric patients whose treatment is paid for by the respective governments.
Similarly, GSD receives a large number of paediatric cardiac patients from Romania due to a bilateral agreement signed by the Government of Italy and the Romanian government to treat Romanian nationals in Italian hospitals. “As a result of this, if we receive a patient from Romania, we will get reimbursed for this by the Italian national health system,” Rotelli adds.
In 2017, GSD opened their doors to a brand new market of international patients from ex-Soviet countries such as Ukraine, Moldavia and Russia. This was as a direct result of the establishment of two GSD offices in the region and the in-bound flow of patients initially began because surgeons and physicians from GSD hospitals were willing to accept the impossible cases.
“These were the cases that no one else would take on,” says Rotelli. “For example, last year we successfully carried out the first ever organ transplantation on a foreign patient, with a foreign (living) donor, in Italy. It took nine months to get all the appropriate approvals from the government but once the ethics part of the process was taken care of, our patient from Russia was able to go ahead a receive a kidney transplant in our hospital.”
From over half a century of cutting-edge medical research, to training an army of Italy’s future surgeons and physicians, the Gruppo Ospedaliero San Donato certainly has the pedigree to make a statement in the global healthcare arena. With their international expansion plans well under way, and their ambitions to begin to collaborate with the UAE government on finding a cure for some of the region’s troubling diseases, the future certainly look interesting for this successful family Group.
