“PPPs can reduce costs, improve care, and attract regional patients”

Hélène Echevin, CEO of C-Care Group

• “Healthcare quality is often a question of volume – the more you do, the better the outcomes”
• “Mauritius must move toward a single-route registration system for specialists”
• “The demand for qualified healthcare professionals will only increase”

Mauritius’ ambition to emerge as a regional hub for specialised healthcare hinges on policy reforms, strategic investments, and cross-sector collaboration. Hélène Echevin, CEO of C-Care Group, one of the country’s leading private healthcare providers, argues that public-private partnerships can reduce costs, enhance clinical outcomes, and attract regional patients. In this interview, she outlines the structural bottlenecks, including the cumbersome registration of specialists, the urgent need for workforce development, and the untapped potential of medical tourism from East Africa and beyond.

Can you briefly describe your clinic’s key services and specialties?

C-Care is a prominent and diversified private healthcare group in Mauritius, known for its strong commitment to delivering high-quality, patient-centered medical services across a wide spectrum of specialties. Our presence spans multiple facilities in Mauritius – C-Care Darné, C-Care Wellkin, C-Care Grand-Baie, and C-Care Tamarin – as well as two hospitals in Uganda: C-Care IHK and IMC. Our reach extends further with C-Lab’s 29 collection centres, three C-Pharma retail pharmacies, and DentCare, a dedicated dental division.

In 2023, we strategically expanded into Madagascar with the full acquisition of Centre Technique Biomédical (CTB), a leading biomedical service provider in the region.

C-Care Darné and C-Care Wellkin are the flagships of our network. These hospitals not only offer the most advanced infrastructure and broadest range of services in Mauritius, but also set a regional benchmark for private healthcare. Our latest addition, the C-Care Cancer Centre at Darné, inaugurated in March 2024, exemplifies our integrated approach to oncology by combining advanced technology – such as the Varian TrueBeam radiotherapy machine – with compassionate, personalised care.

We are proud to be the only private healthcare provider in Mauritius accredited by the Comprehensive Health Knowledge System (CHKS), reinforcing our commitment to excellence in patient safety and international standards.

How many medical staff are currently employed across your facilities?

At C-Care Wellkin, we employ over 190 medical specialists supported by more than 900 staff members. C-Care Darné brings together over 200 doctors and multidisciplinary teams across more than 30 specialties. C-Care Grand Baie operates with 18 professionals (nine clinical and nine non-clinical), while DentCare employs 36 clinical and 21 non-clinical staff.

What is your average annual patient intake, both outpatient and inpatient?

Annually, our facilities manage approximately 260,000 outpatient consultations. For inpatient services, we register an average of 34,000 admissions when daycare cases are included, demonstrating strong trust in our capabilities from patients both locally and regionally.

Are you currently facing a shortage of healthcare professionals?

Yes, the shortage of healthcare professionals, and particularly of nurses, is one of our most pressing challenges. We currently require over 400 nurses – including registered nurses and healthcare assistants. The rapid growth in private healthcare facilities has intensified this demand.

Although we actively recruit foreign nurses, we believe sustainable solutions lie in expanding local training. This requires urgent investment, as it takes at least three years to train a qualified nurse.

Shortages also extend to certain medical specialties. As Mauritius positions itself as a regional healthcare hub, we support a more flexible recruitment framework that includes welcoming qualified foreign nursing professionals and temporarily easing regulatory quotas.

What are your views on the registration process for foreign specialists?

The current process is lengthy and complex. Specialists must obtain an Occupation Permit, register as general practitioners, and then apply for specialist registration with the Medical Council, which often takes months.

We advocate for a simplified, single registration process with digital tracking and transparency, similar to frameworks in the UK or New Zealand. For short-term engagements like health camps or specialised surgeries, a temporary, streamlined registration process should be extended to the private sector, not just public hospitals.

Do you support subsidised nursing education and partnerships with training institutions?

Absolutely. We actively invest in workforce development. In addition to in-house training and partnerships with institutions like Polytechnic Mauritius and Charles Telfair Institute, we recently launched the C-Care Training Institute. The Institute offers specialised training – such as phlebotomy, in collaboration with C-Lab – and is developing new certification programmes in key healthcare fields. We are open to further partnerships with public institutions to support the next generation of healthcare professionals.

Has your clinic participated in government outsourcing schemes?

Yes, notably in dialysis services. However, this agreement – established over a decade ago – needs revision to better reflect today’s operating costs and realities. We believe PPPs should be expanded into areas such as cancer diagnosis and care, medical imaging, and transplant services.

What value can PPPs bring to healthcare?

Contrary to popular belief, higher volume leads to higher quality. Increased patient throughput enhances skills, improves outcomes, and optimises the use of medical equipment. PPPs can help achieve this, while reducing costs and improving access.

We worked closely with the Ministry of Health during the COVID-19 pandemic and continue to support regular public-private dialogue. We are also part of the Joint Public-Private Dialogue platform and support the government’s move to revise the Human Tissue Act, which will reduce dialysis costs and enable reallocation of resources to other critical areas.

Would you support a volume-based or fixed-subsidy PPP model?

Yes, we support a volume-based model. With clearly defined service-level agreements and periodic reviews, it ensures transparency and cost control. Such models can be implemented for radiology, cataract surgeries, and other elective procedures.

What challenges do you face working with the public sector?

The Overseas Treatment Scheme, while well-intentioned, lacks transparency and structured timelines. Clinics often receive incomplete information and insufficient time to respond. More proactive consultation and data-sharing are needed before rolling out new policies.

Would your clinic support a PPP model for a national Cyclotron unit?

Yes. A Cyclotron is crucial for advanced cancer diagnostics and treatment. This project should be developed at a national level, adhering to IAEA standards, and implemented through a PPP model. C-Care would fully support and invest in such an initiative.

“We must simplify the process of welcoming foreign patients and specialists”

What other infrastructure priorities should be addressed through PPPs?

Cancer diagnosis and treatment, as well as transplant capabilities, should be top priorities for joint investment over the next five years.

Does your clinic have the capability to perform transplants?

Yes. Prior to 2018, we successfully conducted renal transplants. Our infrastructure is ready for renal, corneal, and bone marrow transplants. However, implementation guidelines are currently lacking.

How has the absence of clear guidelines affected operations?

Since 2018, we’ve been unable to proceed with transplants, as we are awaiting Ministry guidelines for institutional approval and specialist authorisation. The Human Tissue Act empowers a Board to oversee and approve transplant activities, but operational clarity is still missing.

What are your recommendations?

Enabling the private sector to resume transplant procedures will help ease the burden on the public sector and offer patients faster access to care. This would significantly improve patients’ quality of life while reducing long-term dialysis costs. Proper guidelines and approvals would enable life-changing care for many Mauritians.

Is your clinic receiving international patients?

Yes. We receive patients mainly from Madagascar, Comoros, and Seychelles. With our recent acquisition of CTB in Madagascar and our collaboration with Healthcare Global Enterprises (HCG) India, we are strengthening our regional influence and improving access to advanced oncology services.

What are the barriers to expanding medical tourism from East Africa?

Key challenges include:

• Lack of fast-tracked medical visas: Many of our direct foreign competitors are processing such visas at a much faster pace.
• Limited direct flights.
• Perceived cost comparison with India.
• Limited awareness of Mauritius as a medical destination.

Would you support a Medical Tourism Taskforce?

Definitely. A national taskforce comprising the Ministry of Health, the EDB, and private providers could develop a robust Medical Tourism Strategy and improve coordination, marketing, and implementation.

What incentives would encourage your clinic to invest further in medical tourism?

Government-led promotional campaigns, inclusion of healthcare in tourism expos, and cross-border marketing would significantly boost Mauritius’ credibility and attract more international patients.

What top three measures would you recommend to the government?

• Simplify the recruitment process for foreign healthcare professionals.
• Enhance collaboration between public and private healthcare providers through PPPs.
• Promote medical tourism, especially from East Africa and Indian Ocean islands.

How do you assess the government’s engagement with the private sector?

Post-COVID, collaboration has improved. However, long-term planning and structured consultation are essential to address complex challenges in the healthcare sector.

Would you participate in drafting a National Healthcare PPP Framework?

Yes. We are ready to contribute, especially on projects involving dialysis, cancer treatment, and advanced diagnostics, such as Cyclotron technology.

How important are foreign doctors and visiting surgeons to your operations?

They play a critical role in delivering niche and high-end medical services. Their presence helps build local expertise, improve outcomes, and raise the country’s profile as a regional hub.

Have you experienced difficulties with registration under the Medical Council Act?

Yes. The dual-route system – requiring general practitioner registration before specialist status – is a major bottleneck. We propose a single-route registration system for specialists in general – foreign and local – and a digital platform for greater efficiency and transparency.

Do you support a temporary registration scheme for visiting specialists?

Yes. For short-term assignments and health camps, a streamlined registration process would allow us to bring in specialists quickly and efficiently, improving patient access to rare treatments. This would significantly benefit Mauritian patients by improving access to specialized care, helping reduce treatment costs, and boosting Mauritius’ status as a regional medical hub.

What steps would strengthen Mauritius as a regional medical hub?

• Invest in advanced infrastructure and training.
• Develop robust medical tourism partnerships.
• Simplify administrative processes for specialised professionals.
• Promote Mauritius as a destination for specialised, high-quality healthcare.