Kathy Harvey (00:05):
Welcome to the application, the podcast series from Saïd Business School, featuring some of the extraordinary personalities who were offered a place on the Executive MBA here at Oxford University. I'm Kathy Harvey. As Associate Dean, I've been involved with the people who've embarked on this journey for over half the 20 years since the programme was established. This is my chance to reconnect with them and to hear more about their struggles and their achievements, personal and professional.

Hasmukh Patel (00:38):
So I took my young family from London, England to Empress, Alberta. A dramatic move to say the least. My wife followed about two months after I went, and I don't think she spoke to me for three weeks.

Kathy Harvey (00:55):
Hello. It's a pleasure to welcome Hasmukh Patel to this latest episode of the application podcast. Hasmukh was born in Kenya, but trained as a doctor in Scotland in the UK, and then made a decision with his young family to immigrate to Canada where he settled in the province of Alberta. From then on, he did what all entrepreneurs do. He seized an opportunity to solve a big problem and risked everything to make it work. Now he's chairman of Agecare, a residential care home business, which he founded in 1998 with revenue of over $700 million looking after thousands of elderly people in Canada and now in the uk. It's changed the model for elder care in Canada, and we can talk about that humic in a little while. But first of all, I'd like to start by asking you about what it was like coming over from Kenya to live in the UK and how you felt about that transition.

Hasmukh Patel (01:59):
So Kathy, as you said, I was born in Kenya. My parents were first generation immigrants from India. My father did not have much of a formal education, but he was very ambitious and he worked hard to provide for his family and he ensured that we attained good education and encouraged us to do well at school. After my O levels in Kenya, he sent us to England to study on my own, and I did my A Levels in North London before moving to Aberdeen for medical school. I finished my training as a family practitioner and did my residency in family medicine in Luton and Dunstable Hospital.

(02:49):
It's a very different life, leaving your parents, leaving your family, coming to live in London, did you live with relatives or entirely on your own?

(02:58):
It was very difficult. Was 1974 and I was staying as a paying guest with the family. Had never been to the UK prior to that. So extremely different environment.

Kathy Harvey (03:13):
How different was it? What did it feel like to be a teenager, no doubt, very concerned to fulfil your family's ambitions, but with nobody else in the UK

Hasmukh Patel (03:25):
It was a challenge, but the college I went to in North London had other students from Kenya, so that made it a little easier to be with people from the same country. The biggest challenge was the weather, found it extremely cold the first six, eight months that we were here.

Kathy Harvey (03:45):
Well, the challenge in Canada is often the weather too, so perhaps we can discuss that later. But Aberdeen is certainly not similar to where you grew up in Kenya, one of the coldest parts of the UK. How did you end up studying medicine there?

Hasmukh Patel (04:03):
So as you know, basically I applied to med school after my A Levels and I was accepted at Bristol University and Aberdeen. I had a friend who went from my college to Aberdeen, so I followed suit again just because I had somebody to be with. Aberdeen was interesting, I had a lot of difficulty understanding the accent, but I survived. And I have to say I had a wonderful five years in Aberdeen.

Kathy Harvey (04:36):
So you became qualified and then you went down the route of general practise. At that point, how did you see your future career?

Hasmukh Patel (04:46):
So I finished my training in 1987, as I said in lieutenants table. And the idea was always to stay in England and work here .In the late eighties it was kind of difficult for physicians in the UK and I made a decision to immigrate to Canada. A number of my peers had moved to the US but I chose to go to Canada. Again I did not know anybody in Canada, but made that move. And the reason I chose Canada was it was one country that recognised the UK training, so I didn't want to go back to school. So I applied in Canada, in Alberta and was offered a job in rural Alberta, a small town called Empress. The population of Empress was 210 people and it was a small farming community with a surrounding population of probably about 6-700 people. So I took my young family from London, England to Empress Alberta, a dramatic move to say the least, but I spent my next four years in Empress.

Kathy Harvey (06:05):
Did it take them a while to speak to you again after you'd done that?

Hasmukh Patel (06:08):
My wife followed about two months after I went, and I don't think she spoke to me for three weeks. She was not happy.

Kathy Harvey (06:16):
So you settled down there for a while. You saw yourself, I remember you talking to me about this before as staying in general practise. So what led to the change in starting care homes

Hasmukh Patel (06:29):
Started at Empress and after staying in Empress for four years, I moved to Medicine Hat where I practise family medicine

Kathy Harvey (06:36):
Very appropriately named must have said

Hasmukh Patel (06:38):
Very, yes. So I moved to Medicine Hat in 1991 from Empress, and in 1998 I had this idea of starting a care home, a seniors care home. And the idea came for two reasons. Number one was that as a physician, I had patients in the existing care homes in Medicine Hat and they were built in the sixties, very institutional, cold, depressive. I had a smell to it when you enter, and you know I felt there's better way of caring for seniors. And number two was that there was a lack of long-term care beds in the community and this resulted in seniors occupying hospital beds, which were obviously needed for acute care and much more expensive. So the solution was simple, build a new care home in the community, move the residents, the seniors from the hospital beds to the community. So that's where the idea came about to build a new purpose, design purpose-built modern senior care home.

Kathy Harvey (07:55):
It's still quite a long way though from being a general practitioner to being a business owner and an entrepreneur. I'm just trying to get a sense of how you felt you could make that leap.

Hasmukh Patel (08:12):
I don't think I was thinking that far. I think I saw a problem and I thought of a solution. So what I did was I went to the Health authority board and discussed my observation that we have a lot of seniors in our hospital beds and we need to build a new community, long-term care centre. I said to them, I would build it, I would fund it, I would own it, but we have to partner whereby you'll provide the funding and the residents. This was an idea. I had never done this before, but it was something that I presented after many, many months of discussion with the board, they finally agreed to the idea. So here I was told to build 86 bed long-term care in medicine hat. And that's what I did. Obviously I knew nothing about seniors care, I didn't know how to operate the regulations for services to offer staffing, but I have this, I can do attitude. So I did a lot of research. I read books. In those days there was no internet or computers, so I would go to the library and read and understand the sector in the province. I attended some conferences in the US to again understand the business and I found a contractor to help me build a home. I learned about fundraising, capital structure, and in two years we built the first care home.

Kathy Harvey (10:02):
So if I were looking for a care home for my mother, my partner, a member of my family, and I was to go into that care home, your very first care home, what would've been different? Why would I have considered that to be different? And what were you most proud of yourself?

Hasmukh Patel (10:19):
It was very different from the existing homes. So the existing homes were institutional, there were wards. So 2, 3, 4 seniors in one room, a common tub room where 10 15 would go for their personal hygiene. So the homes that I built was single rooms with en suite bathroom carpet and stuff, linoleum wall paintings, stuff like that made it look like very residential features. And it was a quite eye-opener for the health authority. And when they saw the first one, it is actually they came to me and said, would you build a second one in another community within a very short time, within a year. So I did that and then another health authority came and saw what we had done and asked me to go to their health authority, which is about 300 kilometres away to build the third one. So the model was obviously appealing to the health authority in the sense that they did not have to come up with the capital, they just had to provide for the operations dollars, which they were doing anyways. So I think the model was unique and it seemed to create a lot of value for both parties.

Kathy Harvey (11:43):
So your vision for these homes was a home from home as it were, and that probably was more expensive to provide. So for the residents and residents families, did they have to pay more or was it the same as before?

Hasmukh Patel (11:58):
The funding in Alberta is regulated by a government, so there's two source of funding for the operators. One is from the resident and the other is from the government. The government funds for the care services is the same for every operator in the province, whether you are operating a government owned facility or a private facility. The second is the resident and the residents do pay a copay for room and board, but that fee is again regulated by government. It's the same for everybody. So for a resident it does not matter where you reside, private facility or government facility. The fee is exactly the same.

Kathy Harvey (12:47):
And is that the same throughout Canada?

Hasmukh Patel (12:49):
It's the same throughout Canada.

Kathy Harvey (12:52):
So now how many homes are there run by Agecare?

Hasmukh Patel (12:55):
So we operate in three provinces, Alberta, British Columbia, and Ontario. Today we have about 55 homes across the three provinces, about just under 9,000 beds and over 11,000 staff.

Kathy Harvey (13:13):
So by the time you started to grow, being a general practitioner, being a doctor would've probably been very difficult alongside running the business. What were the family discussions like around how you were going to spend your time and the kind of person you were going to become in the future?

Hasmukh Patel (13:35):
I think that's a good question. I think I have a very close knit family. I have two young children. They were probably nine and 10 by the time we were doing this. And it's interesting, they actually helped me with some of my thought process and my wife was extremely supportive of what I was doing. Obviously there's a downside to this. I spent a lot of time away from home and the responsibility of raising the young family relied mostly on my wife. But yeah, with her support and the support of the kids, we did. Okay.

Kathy Harvey (14:13):
Well, certainly how we look after our older generation is a worldwide problem. There's so much discussion amongst many nations, amongst many governments across the world about how we deal with the ageing population. In your view, what are the key things that we really need to think about?

Hasmukh Patel (14:38):
I think any publicly funded senior care sector, there are four or five principles that you must have. One, it needs to be affordable. I two, it needs to be accessible. Three, the focus needs to be on quality and care services. Four, I think you need well-trained staff and five, I think the focus needs to be on improving. So those are the key, I think, principles that you need.

Kathy Harvey (15:14):
But these are very difficult principles to stick to because finding care workers who are often paid a very low rate anywhere across the world is extremely hard.

Hasmukh Patel (15:27):
That's our biggest challenge today, Kathy, is staffing. There's a shortage of frontline staff across the healthcare sector, not just in Canada, but across most of the western world. We need to train more frontline staff. It's a problem we've had for years. We've talked about this in Canada. Unfortunately we haven't pursue the solution.

Kathy Harvey (15:49):
Is that the next business?

Hasmukh Patel (15:52):
No, I think for me, I think my focus now is really to, well, in a way is to transform the sector, right?

Kathy Harvey (16:02):
Well, along the way you built up a construction company so that you could build more residential homes. I think you built a pharmacy services company so that you could dispense from your care homes and private equity acquired a stake in your business. So it's a very different business from the business you set up all those years ago. Private equity isn't always known as the most caring of professions. Have you had to change things in a way that you haven't been happy with?

Hasmukh Patel (16:34):
So this private equity fund is slightly different. It's an infrastructure fund. So they actually invest in asset for long-term. They typically invest in roads, ports, solar panels, wind farms. They saw what we did as a social infrastructure. We have long-term contracts with government. So their mandate is not to exit, but to grow and stay. So that's why I think we were a good fit. We managed the portfolio, but they are majority investor in our business now.

Kathy Harvey (17:13):
Now you made the decision, I think you were in your I early sixties, if you don't mind me saying, so, to come to Oxford and study for an Executive MBA, you were already very successful with a long career behind you. So why did you do that and what did you learn from it?

Hasmukh Patel (17:33):
I think education has always been important, and I think continuous education is in my DNA instilled that in my children and everybody that I know. So it was part of my DNA to continue to learn. Having been in the UK for many years, Oxford is always a place that I would've loved to come. So when I had a chance, I took it. I think it's one of the best things I've done, to be honest with you. Although I knew a lot about business, it actually gave me a lot of confidence after spending the two years here. I did our acquisition after my MBA because we've completed the acquisition or the partnership with our PE in 2019 December. I graduated long before that. So it actually gave me a lot of confidence to talk to a PE fund.

Kathy Harvey (18:25):
I think it's a humbling thought that even after being very successful, many of us still feel we need confidence. What was it like being in that class?

Hasmukh Patel (18:39):
I think it was all, it was good and bad. It good in the sense that I was amongst very bright and very bright students and often I felt academically I didn't belong. But I think the networking was fantastic. I met some awesome friends. I still, I'm very connected to them. The challenging bit was the travel, flying in on a weekend, doing the course for the week and then going back while still running the company. So a lot of pressure in terms of time and travel and family, but very happy that I did it.

Kathy Harvey (19:22):
Well. It worked out okay. It worked out. I believe you did well. You became a lox Sonian graduate, and you have very generously donated money for a scholarship to the programme which you graduated from, and you asked for that money to go to an African candidate. Can you tell me a little bit about that, why you focused on Africa?

Hasmukh Patel (19:49):
Well, obviously I was born in Africa, spent my foundational years in Africa. So Africa has always been very close to my heart. And the reason I chose to do the scholarship is in my cohort, there were a number of students from Africa, and a common thread when talking to them was how challenging it was for them to come to Oxford financially. Most of them were just working people and didn't have the means to attend. So that was the impetus to say, if I have the ability to create a scholarship for Africa and students and these are bright, bright leaders, and that was the impetus to do it. My hope is that they will go back to their country and create jobs, be leaders in their field. So the scholars that we've had to date have absolutely been fantastic.

Kathy Harvey (20:47):
So when they meet you, they see you as an example of success and a role model of success, but I'm sure there'd be many moments of failure in your career, in your professional and personal life. What have you learned from failures yourself?

Hasmukh Patel (21:05):
I think I've learned that I'm quite resilient and I don't get stressed that often. At least I don't appear to get stressed from my failures. I have learned. So I'll give you an example. So one of the failures I had in the business was we were growing too fast in the early stage of our business to the point that we had tremendous cashflow issues and the learning was obvious, don't grow too fast, have managed growth, be well capitalised, be patient. So those first four or five years were exciting, but I think quite challenging because we just didn't have that patience. So I learn a lot from my mistakes on personal note. I think if there is a regret is that I was not there for my children when they're growing up. I spend a lot of time on my business, but I think end of the day, I think if you teach your kids good values and work ethic ethic and they see what you do, I think it's what we do as parents is all you can do is teach good values.

Kathy Harvey (22:14):
And you took your business through the pandemic care homes in the pandemic all over the world in crisis. What was that experience like?

Hasmukh Patel (22:24):
That was extremely challenging times. I think there were four different groups that were impacted in four different ways, obviously. One was the residents of the care homes, many of them had preexisting medical conditions, and when they contracted covid, the symptoms and the outcome was quite poor. Many of them were in isolation for days and there was no human contact. So the mental anguish was quite painful. The second is the families. The families could not go visit and support and care for the loved ones when they most needed it. And this brought a lot of anger to the families,

Kathy Harvey (23:16):
Which your staff had to deal with.

Hasmukh Patel (23:17):
And often I was just going to say, and then the anger was actually let out on the staff. The third is a staff. And for me, this is the biggest eyeopener. It takes a lot of courage to go to a place of work, which is in an outbreak, and they go back after the shift home with the risk of contracting the virus and giving it to their children, their spouses. And lastly, the operators. We were in crisis. We were not trained for this kind of management. The whole logistic of supplies, PPE, food, very challenging, so very difficult two years, but we survived like everybody else. And the vaccine had a tremendous impact, tremendous positive impact on the pandemic.

Kathy Harvey (24:15):
You got through it and onto the next stage of your business. And of course, you've expanded and you have some homes in the UK now as well. We talk a lot at business school in particular about different styles of leadership and successful leadership and less successful leadership. What does good leadership mean to you?

Hasmukh Patel (24:38):
I think the leadership styles have changed over the years in this environment, in this current era. I think a human-centric leadership, someone who is empathetic and has integrity is important. In the seventies and eighties, we should just talk about stakeholder, shareholder value creation. Things have changed. So I think a much more broader, impactful leadership is what I would admire now.

Kathy Harvey (25:09):
Well, when you applied to join the executive MBA at Oxford, you had to write an application form and you had to tell us what your ambitions were, what your hopes were for the future. I want you to imagine you are writing an application form for the next challenge in your life. What would it say?

Hasmukh Patel (25:28):
I think I would go back to my grassroots of education and continuous learning. The scholarship is a big thing. I think the next thing I would do in terms of aspiration is to look at education at preschool, early learning. So preschool, kindergarten, grades one and two, because I think those are foundational years for growing child, and I think that would, my next aspiration is to create some kind of a high quality early learning centres in developing countries.

Kathy Harvey (26:04):
Sounds to me like you are still a very driven entrepreneur, has looked. So we can look forward to seeing that vision being realised, I hope in the near future. Thank you so much.

Hasmukh Patel (26:16):
Thank you, Kathy. Thank you.

Kathy Harvey (26:23):
You've been listening to the application from Oxford University's Saïd Business school. You can catch up with all our episodes wherever you get your podcasts. If you'd like to know more about Saïd Business School, take a look at the Oxford Answers section on our website or check out the programme pages for more inspiring stories about our Executive MBA alumni. The application is produced by Philippa Goodrich and Oxford Digital Media. I'm Kathy Harvey, associate Dean at Saïd Business School. Thank you for listening.