Doctor’s ORDERS

Contributing 26% to Mediclinic International’s revenues worldwide, Mediclinic Middle East office is prepared to handle the region’s growing medical needs with two hospital projects ready.

What is the overall contribution of Mediclinic Middle East to the company’s operations?

We have 54 hospitals in southern Africa, 18 in Switzerland, and own a 30% stake in Spire Healthcare in the UK with 39 hospitals. Meanwhile we have seven hospitals and 20 clinics in the Middle East. We contribute around 26% to Mediclinic’s revenue worldwide. We are the third or fourth largest in terms of market share.

What is your assessment of sector-related policies in Dubai?

Looking at the past 14 years, which is how long we have been in the UAE, regulations have certainly improved and ensured that the healthcare environment has more control. More regulations have come into effect, such as the introduction of mandatory health insurance, and a more ethical market has taken shape. In 2019, the government also created the Dubai Health Post Office, which is a portal through which all our payments are processed. It has created the e-Prescription initiative, where all pharmacies seek approval, payments are processed, and e-authorization for healthcare services is obtained. Abu Dhabi has a new Department of Health, which has a healthcare advisory board that I sit on. The plan is to eventually have one national unified medical record, which will be fantastic.

In that mid- to upper market, has there been a shift toward preventative care?

That seems to be a more observable trend globally; almost half of healthcare expenditure goes to preventative health and wellness. Executive medicals are a large business line, and people are trying their best today to stay healthy and out of surgery. In our business, we do executive medicals and are starting a precision medical laboratory where you take the gene sequencing of an individual and give them specific medication based on what their genes indicate a shortage of. The next step is called microbiome, where bacteria in your stomach are looked at to determine what is missing so that you do not need antibiotics. This can tell you specifically which bacteria are required to ensure you maintain a healthy lifestyle.

First, it is important to note that the economic environment of the UAE is under strain. The economy has certainly changed over the past three to four years, as has the mix of the people in the UAE. The reality is that Dubai has already diversified, and Abu Dhabi will diversify still further. There are big attractions to bringing in major manufacturing companies and huge incentives in place. The UAE has become a country where receivables are on the rise. We have obviously been here for a long time; we are positioned in a certain way, have a strong balance sheet, and are listed on the London Stock Exchange. While we are not committing to major new investments currently, we do have a significant number already being worked on. The first one is Mediclinic ParkView Hospital, which we finished in September 2018 and is doing well. We opened it because we felt we needed a hospital nearer to the Expo 2020. Our other major project is Mediclinic Airport Road Hospital in Abu Dhabi, which is under expansion to double in size. The new extension should open early 2020. These two projects alone, Parkview and Airport Road, have added 40% capacity to our business over the past two years. We do expect some consolidation in the industry due to regulatory changes and prevailing economic conditions. We are well-positioned to embrace this. We bought the Majid Al Futtaim clinics last year and Bourn Hall, the original pioneers of IVF over 40 years ago. They invented that technology and are present in the UAE under a franchise arrangement. We are focusing more on and moving our business toward preventative and precision medicine. That will be a key focus for us over the coming years, as well as embracing other innovations. ✖

considerable growth since beginning in 2013. In 2017, we were among the top three hospitals in Dubai in terms of patient activities. This remarkable achievement illustrates the diversification strategy we actively pursue. Fundamental to this diversification strategy is the development of excellence centers in different specializations. Our fully fledged program for obesity includes surgical and medical bariatric services. In Dubai, some services are notably overserved while others remain underserved. In particular, more beds need to be added for adults and pediatrics who require critical care services. Long-term care, palliative care, and rehab services are also underserved. These challenges are exacerbated by labor challenges such as the acquisition, onboarding, and retention of overseas talents. To counter this, Al Zahra has implemented a system that efficiently manages, supports, and engages with our employees. This has been instrumental in reducing our staff turnover to below 3%. Adopting a healthy people management system ensures we have the healthcare professionals we need to meet the growth of key services.

WE HAVE EXPERIENCED

over 200,000 patients, a significant achievement for a specialized hospital. Despite the evolving regulations in the healthcare sector and Middle East markets, we have retained our high quality standards, governed by our parent hospital in the UK. We have also built an excellent reputation across the UAE. We provide the full spectrum of eye care services, from basic screenings to complex eye surgeries through a team of visiting and permanent doctors. We extended our reach beyond our base and successfully establish strategic alliances. In addition, our net profits have grown exponentially. We have seen a substantial growth in medical tourism to our hospital and the Dubai market; 20-30% of our market share includes medical tourists, and we expect this to grow. On the ground, acquisitions will continue; large hospitals with financial backing will continue to acquire smaller organizations. But the future sustainability of healthcare players revolves around quality. The new rating system announced by regulators will have a strong focus on quality, safety, patient experience, care excellence, and financial outcomes.

WE HAVE SEEN

was our core business for almost 15 years, and our experience gave us the courage to spread our wings. Now 32 years on, we have 2,000 doctors and almost 20,000 staff. We take the best of the world’s expertise and provide local patients access to these experts. Within the GCC, we must find a balance in terms of the payment model. Before, the patient went to the provider in search of service and paid the provider. Now, it is moving toward being fully insurance led. Whilst that is a huge advantage for the population, it creates imbalances across the broader ecosystem. Insurance companies are interested in the best care at the lowest cost, while the providers are interested in providing the best care for the patient. To ensure the patients’ best interests, guidelines must be set for each stakeholder. Dubai’s vision is oriented toward creating this equilibrium, and we can see this in its move toward outcome-based payments for providers. This will ensure that everyone is incentivized according to the correct model.

THE UAE

in Dubai have significantly contributed in building SGH brand name in general, regionally, and globally. Our brand name benefits from increased trust here in Dubai, and we maintain a good position here in the healthcare market in the UAE and Dubai in general. Since the beginning, our hospital has been a tertiary level hospital, providing all medical services under one umbrella. We are the only hospital providing all specialties and sub-specialties medical care including dialysis, nephrology, urology, transplants, open heart surgery, nuclear medicine, oncology, cancer treatment, chemotherapy, and radiotherapy. Mandatory insurance was announced in Dubai two years ago, which forced us to look at who will cover our patients. At that time, 80% were insured and 20% were uninsured. Our patients were already part of the working population and were often insured under their work contracts, so it did not affect us significantly. So from the beginning, the uncovered percentage was low. Even though it was mandated, the practice of having insurance was already present.

OUR HOSPITALS

Abdul Razaq Ameri

DIRECTOR, AL KUWAIT HOSPITAL DUBAI

What have been the key drivers for the establishment of The Priory Group in Dubai, and how do your key services fit within the context of the UAE's health system?

As the largest independent provider of mental health services in the UK, we attract many service users worldwide. It was a natural progression for us to look at how we could grow internationally. We chose the UAE because of the ease of establishing a business, its excellent location to serve and support our service users across the GCC, and the dynamic nature of operating here. Our research showed a gap in the provision that we could address. Mental health services are an integral part of any healthcare system, and this is no different in the UAE. We see a fantastic proactive approach from the UAE government toward mental health. In 2018, Dubai launched Happy Lives are Healthy Lives, its first mental health strategy. In November 2018, it was announced that Dubai's mandatory health insurance would cover mental healthcare. The government actively wants to do something about the increase in mental health issues. Additionally, we have engaged with the Emirate's health authorities to talk about mental health. There is a real appetite to implement Dubai's first mental health strategy.

Social media can lead to living a virtual life, with limited face-to-face interaction, avoidance, and often misconstrued reality. This may lead to mental health-related issues such as depression, loss of individual value, low confidence, and anxiety. An interesting study on mirror neurons, which help us understand emotions and behaviors, suggests that, with an increased online presence, our mirror neurons are not developing as they should. It is essential to have a balance between time spent online and socially interacting in-person. ✖