Preparing for the future
Dr Azad Moopen shares 30 years of insight and knowledge on the UAE healthcare sector
Dubai’s medical landscape was a very different place when Aster DM Healthcare chairman and managing director Dr Azad Moopen opened his first clinics in 1987. Nearly 30 years and an entire chain of clinics later, much has changed as the landscape shifted from government-owned facilities to a vast network of private sector providers. Now, employing more than 13,000 members of staff, including 1,500 doctors, Moopen has helped drive Aster’s evolution to one of the country’s biggest healthcare providers within this large field.
Upon his arrival in the United Arab Emirates, the healthcare infrastructure in the country was “rudimentary,” Moopen says. “The government hospitals provided only primary and secondary care, and very little tertiary care was available. But now, the healthcare landscape has completely transformed and has a huge variety of services delivered by world-leading expertise.”
Indeed, such is the UAE attractiveness to the top medical professionals, it has led to phenomenal growth within the sector over the last 20 years. And, within that short space of time, it is now ranked among the world’s best. However, according to Moopen, it’s not all sunshine and roses.
“There is an essential difference between the Gulf Cooperation Council and other markets,” he says. “That difference is the availability of trained manpower. For example in India, unlike the UAE, new hospital staff can all be recruited from the local market. In the UAE, there simply aren’t enough trained professionals. The ideal situation is of course that we hire staff from the local population.”
While neighbouring Oman and Saudi Arabia have their own wealth of home-grown talent, in the UAE the vast majority of those working in healthcare at all levels come from abroad. “Ultimately if you look 10, 15 or even 25 years down the line [hospitals] have to be run by the people that are available here,” says Moopen. “There is light at the end of the tunnel as the local workforce grows. But given the slow uptake, a large staffing gap will remain for a good while yet.”
In order to get to the point where the local workforce can make up a significant portion, the government must invest even more heavily in medical education, believes Moopen. “Unlike much of the world, medical education in the UAE is a relatively new development, only having emerged within the last 50 years,” he says. “The UAE, then, should turn its efforts to educating people both from the local population and from abroad in order to provide a well trained work force, adapted to local needs and ready to work in the UAE.”
Moopen’s own passion for education has fostered a desire to personally help develop the country’s medical talent by establishing a medical college in the UAE. He hopes to work with either the government or a local partner to collaborate on the project. Moopen is no stranger to education, having given a number of medical lectures at Calicut Government Medical College, India. Aster has even established a number of medical schools there training nurses, paramedics and doctors to feed into their growing business.
“Seven years ago, the company started thinking both strategically and morally about the fact that it was such a large consumer of medical graduates,” he explains. “The colleges are a direct line from there to us and provide not just skilled employees but employees who are already familiar with the company and the way it operates.”
The absence of talent in the UAE is,
”THE UAE, THEN, SHOULD TURN ITS EFFORTS TO EDUCATING PEOPLE BOTH FROM THE LOCAL POPULATION AND FROM ABROAD IN ORDER TO PROVIDE A WELL TRAINED WORK FORCE, ADAPTED TO LOCAL NEEDS AND READY TO WORK IN THE UAE.”
however, offset to a very large extent by the fact that the country provides ample opportunities to access capital to fund new projects. Egypt, for example, is a market where, despite having a huge local workforce already trained there is a very real lack of capital in the market to fund new hospitals and clinics. And with the rollout of mandatory insurance in Dubai – giving healthcare access to nearly 95 per cent of the population – the city may soon see a huge upswing in demand for medical services. Such a dramatic increase in the numbers of those insured could create what Moopen describes as a “problem of plenty”. As a result, this could lead to a mismatch between the demand for services and the supply of hospitals and clinics – commissioned to meet the new demand. But as Moopen readily concedes, from the point of view of a healthcare company, it is a nice problem to have from a professional vantage point. Although it still leaves many clinics with a deteriorating staffing problem. And as Aster DM Healthcare continues to expand rapidly more will need to be done to meet the upsurge in demand, says Moopen.
Currently the majority of Aster DM’s nurses hail from India and the Philippines. And while recruitment from new markets in Africa and elsewhere in the Middle East such as Syria and Iraq will help in the short term, Dubai will need more innovative solutions to help in the long term. “With innovation being a key focus of the government this year, new technologies can be something to really help reduce the staffing gap,” says Moopen. “For example, in radiology, a scan can be interpreted from anywhere on the planet. Radiologists now no longer need to be tied to a single hospital. Indeed, the rise of tele-radiology is something that will usher in a new level of efficiency in hospital practice. Technology can certainly reduce the manpower requirements of hospitals and ought to be a key focus moving forward.”
Aster DM is certainly making use of the technology available: the company has recently received approval from the Dubai Health Authority to pilot a telemedicine service named ‘Aster MyHealth’ and is hoping to partner up with a regional mobile provider to roll out the scheme. The programme gives chronic disease patients home monitoring equipment that automatically uploads the patient’s results to a central system, where they can be monitored by their care team. As a result, if there is any variation or anomaly in the results, the patient’s care team is made aware as quickly as possible, allowing them to intervene in the manner they deem fit. Moopen adds: “Aster My Health is an example of a technology that, if it is rolled out, can have a huge impact on the lives of patients – improving their outcomes as well as allowing doctors to care for a much larger patient pool. This, therefore, reduces the manpower requirements to care for the population.”
Any cost-consolidation is much-needed at the moment as falling oil prices put the regional economy under pressure. On that subject, Moopen remains optimistic. “Healthcare is the least and last hit in the event of a recession,” he says. “The region’s economy has seen fluctuations over the last 25 years but the government of the UAE knows what it’s doing and has the right vision.
“The current doom and gloom about the region’s economy is just temporary. In healthcare especially, the spend in the UAE is 3 to 4 per cent of the country’s gross domestic product whereas in Europe it can reach 10 per cent of GDP. As such, there is still a great deal of room for growth in the market due to a still sizeable gap between what’s required and what is currently in place.” He adds: “Coupled with the introduction of health insurance, such factors will have a salutary effect.”
Another issue troubling many as well is the region’s ageing population, something else Moopen is keen to put into perspective. Though Saudi Arabia will have to face the effects of its population’s longevity, the same cannot be said for the UAE, he says. “Given the small portion of the UAE’s population that are citizens – 15 per cent citizens versus 85 per cent expat – the problem of ageing populations experienced in much of the western world shouldn’t come to affect the UAE as most expats leave the country at a relatively young age with almost none staying past the age of 65.”
And finally, looking ahead what does Moopen see in store for the country? “Medical tourism,” he says simply. “This has been a huge boost to the country’s healthcare market, making the case for Dubai as an ideal destination for medical tourism given the huge array of amenities it offers as well as its increasing ability to attract some of the worlds best doctors to practice in the emirate.”