UK’s top hos­pi­tal brands plug a gap at home with UAE push

Im­pe­rial Col­lege Lon­don Di­a­betes Cen­tre has three units here, Moor­fields has two and King’s Col­lege Hos­pi­tal is build­ing it­self up just as Dubai pushes to be­come a global health­care des­ti­na­tion. Pa­tients will not need to travel far, Anam Rizvi re­ports

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The UAE is in­creas­ingly be­com­ing a draw for UK health­care providers to set up cen­tres that serve as hubs to at­tract pa­tients both lo­cally and from over­seas while bring­ing in rev­enues for their hos­pi­tals in Bri­tain. Im­pe­rial Col­lege Lon­don Di­a­betes Cen­tre (ICLDC) has three units in this coun­try, while the more than 200-year-old Moor­fields Eye Hos­pi­tal has a branch in Dubai and one in Abu Dhabi. King’s Col­lege Hos­pi­tal (KCH) has a clinic in Abu Dhabi and a 100-bed multi-spe­cial­ity hos­pi­tal com­ing up in Dubai.

Each of these brands came here for a host of rea­sons in­clud­ing ex­pand­ing their pa­tient base, di­ver­si­fy­ing rev­enue streams and con­duct­ing re­search. For some, step­ping into the UAE marked their first global ven­ture.

Dubai is push­ing to be­come a global lead­ing health­care des­ti­na­tion and in 2015, ac­cord­ing to the Dubai Health Author­ity, Dubai’s 26 hos­pi­tals re­ceived 632,000 med­i­cal tourists, of whom 53 per cent were from the UAE and 47 per cent from abroad. As part of its Health Strat­egy 2021, Dubai aims to at­tract 500,000 for­eign pa­tients a year within four years.

The UAE pro­vides UK hos­pi­tals with the chance to in­crease in­come as costs soar at home. Ana Ni­cholls, a health­care an­a­lyst at the Econ­o­mist In­tel­li­gence Unit, points out that “many UK hos­pi­tal trusts – and par­tic­u­larly the Lon­don ones – are run­ning big deficits be­cause of over­spend­ing on NHS treat­ment. KCH, for ex­am­ple, had a deficit of £80 mil­lion (Dh376.3m) in the first nine months [to De­cem­ber last year].” KCH Lon­don opened a clinic in Abu Dhabi in 2015 and by the end of 2018 will have a hos­pi­tal in Dubai Hills in Mo­hammed Bin Rashid City. The hos­pi­tal is a joint ven­ture with Al Tayer Group, Dubai In­vest­ments and the UK-based Ash­more Group and the to­tal project cost is es­ti­mated at US$200m. Open­ing hos­pi­tals in In­dia and Pak­istan is also on the cards.

Lon­don hos­pi­tals in to­tal had a deficit of £409m in the nine months to De­cem­ber, ac­cord­ing to NHS Im­prove­ment, which is re­spon­si­ble for over­see­ing foun­da­tion trusts and NHS trusts, as well as in­de­pen­dent providers of NHS-funded care.

“UK hos­pi­tals’ pri­vate health­care arms are one of their few money-earn­ing ven­tures,” says Ms Ni­cholls. “Ac­cord­ing to the In­ter­na­tional Med­i­cal Travel Jour­nal in 2015, Lon­don’s pri­vate and NHS hos­pi­tals make sales of about £275m a year to in­bound med­i­cal tourists. By build­ing hos­pi­tals out­side the UK, in key mar­kets, they can prob­a­bly in­crease those earn­ings be­cause pa­tients will no longer have to travel so far.”

Ac­cess to a wide range of po­ten­tial pa­tients, the abil­ity to re­cruit from a pool of well-trained staff and a rel­a­tively sta­ble busi­ness en­vi­ron­ment where reg­u­la­tions for med­i­cal tourism are al­ready in place, are some of the rea­sons Bri­tish hos­pi­tals are turn­ing to the UAE.

“The UK has tra­di­tion­ally been a ma­jor med­i­cal tourism cen­tre but it has strug­gled in re­cent years, partly be­cause coun­tries have seen their economies slow as global oil prices fall and partly be­cause there is more in­ter­na­tional com­pe­ti­tion,” says Ms Ni­cholls.

Neil Buck­ley, the chief ex­ec­u­tive of KCH Dubai, says: “[The UAE] was seen as a location where pa­tients from all over the world come. In the past three years nearly 600 pa­tients from the six Arab GCC coun­tries were treated in King’s Pri­vate [in Lon­don], the pri­vate pa­tient ser­vice of King’s Col­lege Hos­pi­tal NHS Foun­da­tion Trust.”

His­toric links be­tween the UAE and the UK also pro­vide im­pe­tus for Bri­tish hos­pi­tals to open branches here, says Mr Buck­ley, adding that there is also a sig­nif­i­cant num­ber of pa­tients who travel to Lon­don for treat­ment from the UAE.

“The national strat­egy that the govern­ment wants – to de­velop health care as a med­i­cal tourism hub” is an­other fac­tor en­cour­ag­ing UK hos­pi­tals’ push into this coun­try.

In ad­di­tion, “there is a drive with the NHS that trusts are look­ing for al­ter­na­tive rev­enues”, Mr Buck­ley says. “The in­come that goes from here to King’s will ben­e­fit the UK pa­tients. There is a flow of some of the prof­its and a small per­cent­age of the prof­its go to them.”

With doc­tors and nurses com­ing from the UK to the UAE, med­i­cal pro­fes­sion­als in both coun­tries stay in touch while also shar­ing treat­ment ex­pe­ri­ence.

How­ever, there are also chal­lenges for UK hos­pi­tals op­er­at­ing in this coun­try.

In June last year, Health Author­ity – Abu Dhabi an­nounced Thiqa card­hold­ers would need to pay 20 per cent of the cost of treat­ment at pri­vate hos­pi­tals. Pre­vi­ously the plan fully cov­ered the cost of all pro­ce­dures for Emi­ratis at pri­vate health cen­tres. Govern­ment-owned hos­pi­tals were not af­fected.

“In Abu Dhabi the co-pay came in and that reduced the pa­tient num­bers. A lot of ex­pats have left. Dubai is a hugely com­pet­i­tive mar­ket. Now, with Brexit, we have to get se­ri­ous and get out there into the world,” says Mr Buck­ley.

Mar­i­ano Gon­za­lez, the com­mer­cial direc­tor at Moor­fields Eye Hos­pi­tal, Lon­don, says the pri­vate sec­tor here was suf­fer­ing un­der the co-pay rule as the busi­ness model changed and “the mar­ket had be­come less at­trac­tive for in­ter­na­tional health­care in­vest­ment”.

Moor­fields Eye Hos­pi­tal’s An­nual Re­port 2015-16 stated that in­come from its pri­vate and over­seas pa­tient ac­tiv­i­ties in Lon­don and Dubai, where it opened in 2007, in­creased dur­ing the year by £1.7m to £23m. It also said since 2007 the hos­pi­tal has had a steady year-on-year growth in rev­enues and in the num­ber of pa­tients it treats. In eight years there were more than 100,000 vis­its from pa­tients of 179 na­tion­al­i­ties and the hos­pi­tal per­formed more than 9,000 sur­gi­cal pro­ce­dures. It is now plan­ning to ex­pand to China and South Asia.

Its Moor­fields Eye Hos­pi­tal Abu Dhabi is a joint ven­ture be­tween United East­ern Med­i­cal Ser­vices and Moor­fields Lon­don. “We were pi­o­neers in the NHS when we opened Moor­fields Dubai. It was the first over­seas branch of any NHS hos­pi­tal,” Mr Gon­za­lez says. “At the end of the day hav­ing units in the UAE ben­e­fits the NHS pa­tients and im­proves the NHS ex­pe­ri­ence of the UK pa­tients.” Last month, Sheikh Mo­hammed bin Zayed, Crown Prince of Abu Dhabi and Deputy Supreme Com­man­der of the Armed Forces, re­moved the 20 per cent co-pay for Emi­ratis seek­ing med­i­cal treat­ment at pri­vate health cen­tres. Mr Gon­za­lez be­lieves that has helped to make the mar­ket at­trac­tive again for in­ter­na­tional op­er­a­tors that wish to set up or con­tinue ac­tiv­i­ties in Abu Dhabi.

“It’s a big change and its very wel­come from our side and we are look­ing for­ward to pro­vid­ing ser­vices in Abu Dhabi for the Emi­ratis and for ev­ery­one,” he says.

“Def­i­nitely it’s a change again in our pro­jec­tions and in our busi­ness model. In this case we are ex­pect­ing to have a pos­i­tive one com­pared to the pre­vi­ous one. This will be a process. Now the Emi­rati pa­tients have an op­tion of where to go with­out pay­ing from their pock­ets. We re­ally ap­pre­ci­ate the de­ci­sion of the rulers,” says Mr Gon­za­lez.

“It’s a more fair mar­ket as the de­ci­sion lies with the pa­tient. We want to move our busi­ness model step by step. We are ex­tremely happy with the cur­rent sit­u­a­tion.

“This changed the sce­nario and from think­ing of leav­ing … Abu Dhabi, we are think­ing of stay­ing. Based on the per­for­mance of our fa­cil­ity in the next one to two years, we will de­cide if we will in­vest fur­ther.

“Def­i­nitely in­ter­na­tional op­er­a­tors will be more com­fort­able to in­vest cap­i­tal,” Mr Gon­za­lez says.

Majd Abu Zant, the chief op­er­at­ing of­fi­cer at United East­ern Med­i­cal Ser­vices, points out that the Moor­fields fa­cil­ity’s location in Abu Dhabi makes its ser­vices ac­ces­si­ble for more Emi­ratis and means lo­cally-based pa­tients do not have to cover the cost of travel to and from Dubai.

And there is room for fur­ther ex­pan­sion, the Moor­fields an­nual re­port said. “Moor­fields has the road map to ex­pand its pres­ence re­gion­ally and in­ter­na­tion­ally. Moor­fields con­tin­ues to pro­vide com­plete clin­i­cal over­sight for both fa­cil­i­ties.”

Aside from treat­ing pa­tients, there are other col­lab­o­ra­tions be­tween UK hos­pi­tals and the UAE. The af­fil­i­a­tion be­tween ICLDC in the UAE and Im­pe­rial Col­lege Lon­don, for ex­am­ple, is founded on com­mon in­ter­ests in re­search and academia.

ICLDC has two branches in the cap­i­tal and one in Al Ain. It was es­tab­lished in 2006 in col­lab­o­ra­tion with Mubadala and was Im­pe­rial Col­lege’s first med­i­cal fa­cil­ity out­side the UK.

“This re­la­tion­ship right now is purely re­search based,” says Dr Saf Naqvi, the med­i­cal direc­tor at ICLDC Abu Dhabi. “We have a very good part­ner­ship pro­gramme with Im­pe­rial Col­lege and they have very ac­tive in­volve­ment in our projects. We have doc­tor­ate stu­dents from Im­pe­rial Col­lege in Lon­don who are do­ing re­search here for a pro­gramme on di­a­betes and obe­sity.”

Satish Ku­mar / The National

Neil Buck­ley, the CEO of King’s Col­lege Hos­pi­tal Dubai, says his­toric links also pro­vide im­pe­tus for Bri­tish hos­pi­tals to open branches here.

Cour­tesy Moor­fields hos­pi­tal

Moor­fields Eye Hos­pi­tal Abu Dhabi is a joint ven­ture with United East­ern Med­i­cal Ser­vices.

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