Atiesh Mishra, aviation consultant at AJM Jet Management and aircraft sales representative at Boutsen Aviation, explores the potential market for an air ambulance operation in India.
The sheer geographical size of India and presence of more than 200 airports make a strong business case for the introduction of a dedicated air ambulance service provider.
In India, traffic jams in urban areas have been a long-standing problem, making it impossible for patients to reach a medical facility during an emergency. Access to a reliable air ambulance charter could cut travel time by as much as 90%.
There is a high demand for air ambulances in India, particularly due to the fact that over 75% of the rural population has limited access to good healthcare facilities. With new advances in transportation technologies and access becoming more affordable, the widespread deployment of air ambulance services is expected to be a more feasible option in the future.
At present, there is only one company with a dedicated helicopter fleet for emergency medical services (EMS) in South India. The other charter operators providing air ambulance services through fixed-wing aircraft are operating under mixed operations of both passenger charter and aeromedical transportation. This, at times, results in delays for the deployment of the aircraft, which is a crucial factor for emergency services.
When patient demand arises from a remote location, the aircraft is required to be ferried from the its base airport due to the limited availability of such planes, which results in high positioning fees and charter costs.
There can be three categories of aircraft that would be possible to deploy to the Indian market. In broad terms, the first category would be a light/mid-size jet like a Hawker 400/800, Cessna Citation XLS/CJ2 or Phenom 300, with a range profile of 1800 nautical miles.
The second category would be the turbo propellers and piston engine aircraft like King Air 200, Piaggio Avanti Evo, King Air C90, Pilatus 12, Cessna 310, Piper Chieftain and Piper Cheynne, which have a range profile of 600 nautical miles.
The third option would be helicopters such as a Bell 407, Bell 206 and EC120. The helicopters and turboprops are very popular for organ transfer, for which market demand is strong.
Making it happen
At present, mediclaim insurance companies in India are unable to provide coverage for air ambulances. This is mainly due to a lack of service providers and reliability in services, and the high cost of operation.
This can be resolved if serious aircraft medevac charter players set up an efficient fleet of aircraft placed in strategic locations across India, so that most areas were covered. There may be a space for an insurance company or an international medevac operator to collaborate with an Indian charter operator to provide such services. There would be a first-mover advantage for such a company.
Some state governments have been proactively supporting aircraft operators to set up air ambulance services. In the past, the Maharashtra government had signed a memorandum of understanding (MoU) with city-based MAB Aviation in February 2016. However, due to a lack of funding, progress on the project has been slow.
New entrants in the market should choose their aircraft base by identifying cities where there are developed medical hospitals. Patients are predominantly flown to Delhi and Mumbai, where there are specialty hospitals for cardiac ailments, cancer treatments and other specialized treatments. Choosing the right aircraft is also important for business viability, in addition to the support of hospitals and ground crew.
Looking to the future, the market has all the key drivers for the growth of air ambulance services and may see the entry of foreign players in this market.