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Vietnam and Canada – Partnership In Healthcare
Canada and Vietnam have much to celebrate internationally – Canada’s natural resource management, for example, has prompted world recognized innovation in mining and processing for mined material, Canada is a leader in banking innovation and it is also recognized worldwide for its expertise in healthcare. Canada, however, is more widely known for being understated when promoting achievements. Vietnam, in direct contrast, has emerged in recent years as the engine in ASEAN (Association of South East Asian Nations) and has fast become a go to investment market from other Asian and western markets. Canada has been tacitly interested in Vietnam – until recently. Much has been noted in Canada about the emerging opportunity in Vietnam and the hyper-growth that is being realized there as a result of investments in certain sectors – now including healthcare.
 From left to right Marc Kealey, principal Triple Eye Corp; His Excellency Le Sy Vuong, Ambassador; David Tsubouchi, principal Triple Eye Corp and Co-Chair CVBC; Danny Leung, Principal Triple Eye Corp and Co-Chair  |
The government of Vietnam recognized early that outreach and collaboration with western economies is the life-blood for growth and economic stability. One initiative in recent years that capitalized on the special relationship shared between Canada and Vietnam is the establishment of the Canada Vietnam Business Council, an initiative of the government of Vietnam. Vietnam’s government and business community realized, too, that Canada is a country that should have stronger and longer term economic relations with Vietnam. This was demonstrated when Canada’s Governor General, the Rt. Hon. David Johnston visited Vietnam in 2012 and recently Canada’s Minister of Foreign Affairs, Hon. John Baird visited the nation to promote more trade between the two countries. This past February, Canada’s Prime Minister, Stephen Harper, celebrated “Tet” among Canada’s largest Vietnamese-Canadian community in the Greater Toronto Area, officially signalling the importance of the relationship between Canada and Vietnam.
From a more tangible perspective, healthcare in Vietnam is one of the more important public policy issues facing the country. At a 2010 meeting in Toronto, Canada between His Excellency Le Sy Vuong Ha, Ambassador to Vietnam and members of the Canada Vietnam Business Council the topic of healthcare was the focal point.
Specifically, the Ambassador recognized that Vietnam and Canada have a special relationship. He pointed out that Vietnam’s understanding of Canadian healthcare and, particularly, its knowledge of the structure of Canada’s healthcare system – publicly funded and privately delivered – place Vietnam uniquely in a position to exploit opportunities to promote private sector investment in healthcare in their country. Canada’s healthcare system, by virtue of its funding mechanism(s) make it one of the most unique systems in the world. That noted, however, Canada – specifically trade organizations and government, must do a better job to promote its healthcare system to and in emerging markets like Vietnam and by extension ASEAN, but that is a topic for another day.
Today, the Vietnamese economy continues to strengthen and Vietnamese citizens in urban areas reap the economic benefits of this growth – specifically Hanoi and HCM City. Social and lifestyle issues continue to improve as the Doi Moi (the renovation policies) unfold. However, for some Vietnamese there remains a disparity in health equity and, as such, health quality and access to health services available in Vietnam have not kept pace. “There is tremendous stress on the public system in Vietnam and alternative, private sector based opportunities have to be unlocked. There is, however, one immutable benefit of the Doi Moi – a segment of the population of Vietnam are becoming wealthier. As such, the opportunity to access quality healthcare for those with means in the country is terribly limited so most Vietnamese with economic means, seek personal healthcare outside Vietnam”, said Marc Kealey, a principal at Triple Eye Corporation of Canada – a health infrastructure company.
Ambassador Ha cited numbers as high as six billion dollars ($6 billion) a year that is spent outside of Vietnam by its citizens seeking healthcare services in countries like Singapore, Malaysia, Japan, Australia and China. Those countries reap the benefit of Vietnam’s developing healthcare system, while Vietnam struggles through its renovation policies. Ambassador Ha, through myriad meetings with the Canada Vietnam Business Council and Triple Eye Corporation, expressed the desire and rationale of his government to repatriate that capital, encourage direct foreign investment in healthcare in Vietnam and encourage more private sector investment in healthcare services.
One such company that has risen to the challenge to invest in healthcare opportunities in Vietnam is Canada’s International Infrastructure Inc (better known as Triple Eye), one of the founding members of the Canada Vietnam Business Council (CVBC). Senior partners in the company took up Ambassador Ha’s challenge and travelled to Vietnam in 2010 to answer the call on health care investment opportunities. On the first visit, with other members of the CVBC, Triple Eye participated in an historic signing of a cooperation agreement on developing healthcare opportunities there.
With considerable experience in developing and designing emergency medical services, Triple Eye executives have worked in Latin America, Eastern Europe and other Asian countries. On the visit in 2010, members of Triple Eye – Marc Kealey and Danny Leung met with the Chair of the Dai An Joint Stock Company (JSC), Madame Phuong Truong Tu ,whose organization operates one of Vietnam’s largest economic free trade zones – one is located in Hai Duong province, east of Vietnam’s capital city, Hanoi. At meetings in Hai Duong, Madame Phuong made it apparent that her vision matched the vision of Ambassador Ha’s with respect to the necessity of repatriating Vietnamese healthcare dollars in Vietnam. She also offered ideas to improve and provide quality care services for Vietnamese citizens who might otherwise seek their care in foreign jurisdictions – her idea was to look to countries like Canada, Japan, Taiwan and other such places. After an initial qualification process in Vietnam, Triple Eye presented its bona fides and outlined how working together for a protracted period of time (25 years) rather than, say, a five year payback would encourage public policy decision makers in Vietnam to endorse the model of greater participation with Canada in healthcare investment. Triple Eye and Dai An immediately began to negotiate.
Months later and several trips back and forth to Vietnam and Canada (for both parties), agreement was reached on a site for a hospital to be built at the Dai An Industrial Zone along Hwy 5 in Hai Duong province – east of Hanoi. The intention to build the hospital, a first between Canada and Vietnam was announced in media after a visit by a large delegation to Canada from Vietnam in June of 2012 and shortly after that Triple Eye spent considerable time in the summer and fall of 2012 in Hai Duong to prepare pre-feasibility on the proposed hospital site.
The Hospital project
Recommended and located on several hectares of serviced land in Hai Duong, the proposed site for what has become known as “Madame Phuong’s hospital project” is strategic for the provision of private sector health services for ex-patriates living in that area of Vietnam and for those in Vietnam with means and for employees and their families who are employed at plants located at the Dai An Industrial zone.
The prefeasibility study, conducted by a team of health specialists led by Marc Kealey of Triple Eye in 2012 determined if the land for siting the hospital was suitable for building a hospital and other practical issues – like sizing – environment and ease of access for patients and their families to the proposed site. Preliminary economic issues were discussed too, including costing and planning. It was determined after considerable study the project is viable and that the overall cost for a 200 bed hospital in Hai Duong would be $265 million dollars.
Site for proposed hospital project at Dai An Industrial Zone, Hai Duong province, Vietnam
Triple Eye delegates Marc Kealey and Danny Leung and officials from Dai An JSC negotiated the terms of reference for the relationship between Triple Eye (the project manager for the proposed hospital) and Dai An JSC. Agreement was reached to proceed as a corporation to build a hospital and that milestone was announced in late summer of 2012 after considerable meetings with government officials in Vietnam including at the most senior of levels at the national government like the Vice Chairman of the country and the Minister of Health. Triple Eye delegates Kealey and Leung also met with senior decision makers at the provincial government in Hai Duong Province. In late summer of 2012 a signing ceremony was held and the cooperation agreement between Dai An JSC and Triple Eye was ratified. A celebratory dinner was held in Hai Duong and attended by hundreds of government, business and Canadian Embassy officials.
The meeting with the Minister of Health in Vietnam bore particular fruit for the proposed hospital project and credibility for the relationship between Dai An JSC and Triple Eye. Of note was the discussion between the country’s Minister of Health and Marc Kealey of Triple Eye where Minister Tien gave endorsement and support for private sector investment in healthcare in her country. The Minister endorsed the agreement between Triple Eye and Dai An JSC and gave an impassioned plea that private healthcare investment was needed for the country because health care policies have not kept pace with the expansive growth in the economy.
The Minister made it clear in her remarks that the government encourages private sector investment in healthcare and her aspirations for such an investment meshed perfectly with that of Ambassador Ha’s about repatriating capital from Vietnamese seeking healthcare in foreign jurisdictions.
Kick-starting health care policy aspirations for any developing nation accrues to the government , she noted, and in the case of Canadian investment in healthcare, like the proposed project to be built by the Dai An Vietnam Canada International Hospital Corporation, there is, seemingly active interest and immediate results for Vietnam. The Minister offered her unqualified support.
Marc Kealey, pictured left meets with Vietnam Minister of Health Nguyễn Thị Kim Tiến at their meeting in Hanoi in late summer 2012 to discuss investment in hospital project
The delegation from Canada meeting with members of the Hai Duong province legislature in fall 2012 at a special meeting to discuss the hospital project considered for at Di An Industrial zone in Hai Duong province. Pictured beside Marc Kealey (centre) to the right are Madame Phuong, Chair of Dai An JSC and partner to Triple Eye Corp
The business case for a private hospital
A private hospital corporation developed by agreement between a Vietnamese Corporation like Dai An JSC and Canadian company Triple Eye Corporation could be of significant benefit to Vietnam says Marc Kealey, principal of Triple Eye Corporation. “It behooves us as Canadians to try and find alternatives within our own system to help Vietnam realize her potential in a global world where health dollars should stay close to home” he says. He noted that options for healthcare are being considered in Vietnam by other countries like Malaysia, China, France and the United States and they are being closely examined to see how they can work. The benefit of a Canadian proposal is that the policy framework for private sector hospital projects or PPPs has worked in Canada and may be adopted in Vietnam.
“Private sector investment in healthcare is the way to go in country’s like Vietnam as the country matures – state run systems without adequate capitalization are never good. And as economies grow, so too, does choice for those with means who live there”, says Kealey. “There is a lot of talk from foreign companies who claim to have all the answers, we aim to have all the pieces in place, make a full contribution and realize the potential we set out to provide with our partner in Vietnam.”
The agreement between Triple Eye Corporation and Dai An JSC has prompted the establishment of a corporation in Vietnam called the “Dai An Vietnam Canada International Hospital Corporation”, which, is now in the throes of achieving its investment certificate. It is anticipated that the certificate will be granted when all the paperwork has been signed off. There have been hurdles and some bureaucracy from both Canada and Vietnam that have slowed things a bit, but the path is clear that a certificate will be granted and the project will begin.
For its part, Triple Eye Corporation of Canada is actively interviewing Canadian companies with who it will partner for the engineering, design, construction and staffing of the 200 bed hospital slated for completion in late 2015.
In the meantime, Triple Eye continues to lecture and promote the project widely across Canada. In recent months it has sought and garnered Canadian medical staff and a recognized Canadian university to work alongside in education and staffing for Vietnamese workers. There continue to be many emails and letters from interested Vietnamese health workers to Triple Eye about employment opportunities and Triple Eye is actively promoting the project to funding partners for financing the project – interest is high.
One of the greatest challenges facing Triple Eye in Canada comes from funding sources who inquire as to how to mitigate risk in Vietnam. This fear, Triple Eye believes comes largely from of lack of practical knowledge of the current Vietnam. “I personally believe that Canadians have to visit Vietnam if they are interested in that market and see for themselves the potential that exists there” says Kealey, “once Canadian business people and those available to deploy finance for large projects like our hospital corporation, well see how the economy is shifting and they will see the enormous opportunity that also exists there. Once that’s realized, the appetite for investment will increase and the fears for risks will be minimized. We have the right partner in Dai An JSC, the right economic environment, the right policy directives set from the highest levels of government in Vietnam and the Canadian Embassy in Hanoi is extremely helpful. Our job is to demonstrate the viability of the project to deploy funding from the finance sector and risk management organizations in Canada to see what we see in Vietnam”, said Kealey.
Time is of the essence for projects of this magnitude and Triple Eye and its partner Dai An JSC is striving to have all its papers in order by the end of summer 2013 to begin construction as soon as possible and have this, the first such hospital, ready for patients in 2015.
Canada celebrates growing importance of Vietnam
The Vietnamese Lunar Celebration TET is an annual event worldwide. In Canada, Prime Minister Stephen Harper visited Mississauga mid-January to celebrate the growing influence of the Vietnam community in Canada by attending TET this year.
The growth of interest about Vietnam in Canada is likely borne from the growing influence of the community in Canada – nearly 350,000 strong – many being professionals and business people across Canada, with quiet effectiveness.
Vietnam boasts one of the fastest growing economies in the Association of South East Asian Nations (ASEAN). What’s not known is that the risk profile favours foreign direct investment (FDI) and stable returns for that investment. We, as Canadians, just need to learn more about Vietnam and its aspirations for the future. Vietnam is tiny country geography-wise, but is home to ninety (90) million people- where practicality and innovation are a characteristic. For example, Vietnam encourages FDI through industrial zones – areas where there is ample land to grow foreign manufacturing facilities. Its workforce is skilled, educated and innovative.
In 2012, Prime Minister Harper challenged Canadians to innovate. Our group took up the challenge, travelled to Vietnam to explore opportunities with one of our most unique selling propositions – health care.
Healthcare in Vietnam is evolving. Most people with means in Vietnam seek their healthcare in places like Japan, Singapore, Malaysia and China. K&A through Triple Eye Inc signed an historic partnership agreement with a local partner to build a Canadian branded hospital in a province (close to Hanoi) where thousands of workers who need health care close to home live and work. Expatriates living in the area are delighted because they believe that Canadian healthcare is the best in the world and they won’t have to travel to other countries to get better healthcare. In fact, Vietnam’s Minister of Health (pictured above – taken in Hanoi September 2012) along with her colleagues in the ministries Foreign Affairs and Foreign Investment see Canadian healthcare as a brand on which to build its new model for domestic healthcare. Other government officials like the project because they believe that repatriating dollars spent outside of Vietnam could be in the billions. Media reports about our particular projects have surfaced and excitement is palpable. We are presently in the process of securing our financing for the project, identifying the EPC partners and getting ready to deploy there in 2013. K&A will be project manager and have agreed to manage the hospital, train Vietnamese healthcare workers and hopefully expand the model to other places throughout Vietnam. It truly is a call action for Canadians taking up the challenge of innovating by exporting our know-how.
Look for more attention from the government of Canada specifically in Vietnam where our hospital project and other opportunities abound and are sure to be celebrated.
- Marc KealeyTriple Eye Agreement to Build New Hospital in Hai Duong, Vietnam
Is Canada on sleeping medication?
I’m here in Hanoi, Vietnam – again. This is my second trip in the last two months. It’s interesting, the last time I was here at the beginning of September; the former Ambassador to Canada and now a noted advisor to the Central Government scolded us by saying “Canada is asleep on Asia Pacific”. I think he’s right!
Our trip this month was to sign a cooperation agreement between the Vietnamese Chamber of Commerce and Investment, which, as many who do international business know, is the government’s external link to other countries seeking business opportunity.
Our signing ceremony was historic, it is the first such agreement between private sector enterprise in Canada and the government of Vietnam. There were noted dignitaries from Vietnam at the event, including the current Vietnamese Ambassador to Canada, who spoke glowingly about Canada and the opportunity that exists between the two countries. There was decent media coverage too, but the meeting was cut short. Why? Because the US government, with a large business contingent, was in the same building as we were to celebrate the 10th anniversary of the trade cooperation agreement between the two countries.
As I reflected on that, I wondered why our Canadian Embassy wasn’t at our event. Why no one from the Canadian government showed up. It’s not as if either wasn’t given ample notice. In fact, on our last visit, we specifically met Embassy commercial counsel to brief up on the event to happen in the ensuing months.
This leads me to my point – Is Canada asleep when it comes to Asia Pacific?
I’d say it has one eye closed. The sum total of Canada’s interest in Asia Pacific lays, in my opinion, with China. Why? Because I believe we think we have a better opportunity there because of the strained relations China shares with the USA.
If the former Ambassador is right about Canada being asleep, and I believe he is, then the opportunity for Canada is the fact that Vietnam is the gateway to ASEAN (Association of South East Asian Nations) – some 680 million people strong. Countries like Cambodia, Laos, Thailand, Indonesia, etc. all of whom need healthcare innovation, quality education, high technology industry and good manufacturing processes and natural resources like oil, gas and minerals.
Canada has traditional north-south dialogue (witness recent free trade agreements with Chile and Colombia).
But what about a dialogue with ASEAN countries?
The Keystone XL fiasco from Obama’s chicken-hearted approach to dealing with environmental lobby groups in Washington is a case in point. Let’s take advantage of his misstep by helping develop ASEAN by putting an elbow bend in the Oil Sands pipeline and having a terminal on the west coast of Canada to deliver our oil to energy developing ASEAN countries.
With this beach-head, we can lay to waste the notion that Canada is asleep and we can use large-scale exports as a means to deliver on other expertise in healthcare, education, hi-tech and other natural resources.
And maybe, just maybe, the Canadian embassies and their commercial counsels in ASEAN countries might wake up and help Canadian business flourish there.
Canada Vietnam Business Council signing ceremony
