Dubai: The symptoms are there — a rash of new health care facilities is being created across the Gulf to meet the needs of the population. These capacities — as well as new ones constantly being added — can just as well serve the needs of the growing number of people in the future, with a little bit of care.
In the UAE, the projection, at least among some health care professionals, is that the next five to ten years will see additions that could even equal the present capacity built over 40 years. Clearly, in an industry not given to hyperbole, that is saying a lot.
But could it be that by doing so they are not addressing the symptom, i.e., the actual need, and taking more of a pre-emptive step? And by doing so isn't the health care industry losing sight of the here and now?
"What I think the local health care industry needs is reorganisation and redistribution," said Dr Hayder Al Zubaidy, CEO of the Canadian Specialist Hospital. "The problem that's happening here is simply that people are trying to build hospitals which are similar to each other and not covering the whole set of needs of the local population.
"Elsewhere in the world health care systems are based on the population — for a certain number of primary-care centres, you have a secondary-care and it's the same with tertiary-care facilities. This way there is a better utilisation of time and resources and that works to the benefit of the patients as well."
Dr Al Zubaidy's prescription of specialisation being the need of the hour finds an echo within the industry. According to a new report by Alpen Capital on the state of the Gulf's health care sector, GCC governments continue to spend significant amounts on health care imports each year due to a lack of sufficient services.
"In 2009, the UAE spent $2 billion (Dh7.34 billion) on overseas medical treatment for its nationals," the report added. "Health care spending in GCC depends excessively — over 70 per cent of the total — on government finances. This has become a major challenge with soaring health costs and there is a need for increasing private sector participation."
Slow returns
This is exactly what the private sector health care operators have set out to do and becoming ever more visible with the announcement of super-specialty hospitals in every possible neighbourhood or community. But they better have the deep pockets and the gumption to sit out the long payback period, the Alpen Capital report warns.
A more optimal use of resources by the private sector would be to give more attention to the primary-care centres. By doing so, it would create a tamper-proof filtration system whereby only those needing treatment end up going to the hospitals. In one stroke, it removes the current clogging of the secondary-care network in the country.
"It's a sort of vetting process and clinically the right way of doing things; it's also financially the right way," said Mark Adams, CEO of Gulf Healthcare International. But a lot of homework needs to be done before the more acceptable way becomes the norm here.
"In the Middle East it's a relatively low attendance at a primary-care or an outpatient facility and they go to a doctor about once a year," Adams added. "Half the population doesn't even have health insurance and they're not sure they can afford the treatment."
Better management of existing health care resources would go some way in addressing the rising cost of seeking treatment. As against the current 2.5 to 4.5 per cent of GDP, the region's health care costs could soar to double-digit territory over the next 10 to 20 years, in line with levels in the US or the UK.
Rising costs
According to the Alpen Capital report, "Health care costs in the GCC are on the rise due to increasing use of new and advanced technologies as well as high pharmaceutical costs. Studies reveal that new medical technologies lift health care costs by 38-62 per cent."
Globally, health-related costs could have shot up by 10.5 per cent this year, as per research conducted by Towers Watson and quoted by in the Alpen Capital report.
With the individual governments set on reducing their exposure as health care providers, the responsibility now rests on the private sector operators to stay in touch with the advances and provide the same to their patients without breaking their backs by passing on all of the costs. If that happens, it would only be another incentive for the region's vast expatriate base to seek treatment in their home countries.
If it reaches that stage, it could have devastating results for the new capacity in the pipeline. "As per our estimates, the GCC health care market is projected to grow at an annual rate of 11 per cent to $43.9 billion by 2015 from an estimated $25.6 billion in 2010," the Alpen Capital report said.
"The demand for hospital beds is expected to be 93,992 in 2015, which is in line with the expected supply looking at the number of projects in the pipeline. The number of beds remain in line with the current GCC average and below the US and European averages."
So, how can the resources and capacities — existing and future ones — be put to better use? It again brings the debate right back to the need to create a vetting process for treatments and the treated.
"There is no doubt in my mind that such a filtration process can be implemented successfully in the UAE… but it will not be soon," said Dr Al Zubaidy, who adds there are only three privately-owned tertiary facilities operating in Dubai now. "First, surveys have to be done; this will then set the stage for regulations and the classification of the providers."
He added: "I am sure a step-by-step approach would prompt more residents to seek treatments here than in the US or the UK — already the pricing in Dubai is much better. Making the changes won't be easy, but I think Dubai will be able to apply these in two years."
It will also be the cure that answers to the gaps in the health care system.
