Health & Education
Cure, Prevent, Live
Events over the past year have defined the future for Qatar’s healthcare sector, with the government indefinitely suspending its national health insurance service in December 2015 and instead resolving to rely on private insurers to provide coverage. If healthcare spending is any indication, however, the government remains committed to the development of a world-class healthcare system. In 2015, spending hit QAR19 billion ($5.2 billion), up from QAR17.5 billion ($4.7 billion) in 2014, and the country’s considerable reserves should allow it to continue this level of spending for the foreseeable future.
Back in July, BMI Research published a report suggesting that sizable expansion projects, growing private-sector engagement, and increasing health insurance projects would all contribute to strong growth over the coming years. Just a few months later, though, and the government’s national health insurance scheme, run by the National Health Insurance Company (Seha), was suspended just two months after the Minister of Public Health announced that the program would be expanded to expatriates in 2016. Through Seha, which was being rolled out in stages, the government covered medical costs under a mandatory insurance scheme. Many Qataris who believed that private hospitals were abusing the program had criticized the system; others, however, slated the cancellation, suggesting that private companies could have been brought on board through outsourcing instead of pulling the plug entirely. Either way, the private sector now stands ready to pick up former Seha policyholders, clear in its new task of ensuring coverage to the entirety of society.
While the results of this move are yet to be seen, it comes toward the end of the National Health Strategy, which set out the vision for the sector over 2011-2016. The six-year strategy is in turn a part of the Qatar National Vision 2030, which has a clear human development pillar to provide commitment to a healthy population through a world-class healthcare sector and the promotion of sport in society. Developed by the Supreme Council of Health, the National Health Strategy stands on three pillars; moving from a focus on treatment to prevention, the provision of affordable services, and the integration of high-quality research. And while access to affordable services has been cast into doubt following the end of Seha, the emphasis is still very much on developing the right tools to boost preventative healthcare.
According to the latest World Health Organization (WHO) data, 13% of Qatar’s population is under 13, while just 2% is over 60. That puts the average age at a spritely 32. Urbanization is rampant, at 99%, while the fertility rate is 2. The leading cause of death is heart disease (nearly 15%), followed by diabetes (nearly 9%), and then road traffic deaths (just over 7.5%). And looking at the system in more detail, back in 1984 Qatar had 13.7 physicians and 35.3 nurses for every 10,000 people. Of these, private-sector doctors accounted for just 0.7 per 10,0000 people, and there were no private-sector nurses. By 2008, just prior to the establishment of the Supreme Council of Health, the overall numbers of medical professionals had increased substantially in Qatar to 31.8 doctors and 58.2 nurses for every 10,000 people. And of these, 12.6 doctors and 7.2 nurses per 10,000 were engaged in the private sector. Now, according to Ministry of Development Planning & Statistics data from April 2014, levels have remained stable with the number of doctors per 10,000 head of population down marginally to 31.6. For nurses the ratio has fallen marginally to 58.1 per 10,000 people. Over this same period of 2008 to 2014, the population of Qatar has gone from around 1.5 million to 2.2 million, meaning that in real terms the ratio of doctors and nurses caring for the public is currently keeping pace with the country’s population growth. The picture is similar for hospital bed numbers. In 2008 there were approximately 14 hospital beds available for every 10,000 people, and now the figure is around 12 beds per 10,000 people. For its part, the Hamad Medical Corporation (HMC), the main public healthcare provider in Qatar, has the goal of doubling its bed capacity by 2022 to meet the sector’s increasing needs.
BMI Research suggested pharmaceutical spending would hit QAR2.12 billion ($582 million) in 2015, up from QAR1.9 billion ($521.7 million). One of the key challenges of recent years has been the difficulty of importing medicines. Leading private hospitals have petitioned the government to review the entire importation system to allow better access to life-saving drugs in a timelier manner. Challenges aside, Qatar’s pharmaceuticals market is considered low risk compared to other countries in the region, although the small market size and suspension of the national health insurance service reduce potential reward. The high prevalence of lifestyle diseases and urbanization, however, mean the sector is only likely to grow. As an indication of the growth of the sector, Qatar Airways Cargo introduced two new dedicated pharmaceutical routes from India to Doha in 2015, as the Gulf state looks to become a hub for distribution in the region. To better streamline the system, and as part of the National Health Strategy, the Department of Pharmacy and Drug Control is working toward a series of new policies, processes, and legislation to regulate incoming products. At the same time, the Department is set to begin work to understand what is required from a national formulary for pharmaceuticals in Qatar. In order to educate local healthcare practitioners, the Department will also be developing launch training and education programs for clinicians on the most appropriate use drugs. All of this should go a long way to make Qatar’s reliance on the import of medical devices and pharmaceutical products more sustainable going forward.
Sport and the importance of maintaining a healthy lifestyle have graced many a government memo in recent years, with the authorities keen for an inclusive sporting mentality to both reduce the growing prevalence of lifestyle diseases as well as foster a new generation of athletes and sports stars, especially as the country gears up to host the 2022 FIFA World Cup. Liberal estimates suggest that the country may have spent $200 billion by the time the first kickoff whistle is blown, meaning that the government has a lot riding on its vision for a healthier, sportier Qatar. One initiative has been the promotion of National Sport Day, held on the second Tuesday of February. Established in 2011 by Former Emir Sheikh Hamad bin Khalifa Al Thani to encourage more physical activity, the current government has taken up the baton with enthusiasm. In 2016, the Ministry of Culture and Sports discouraged organizations from handing out free gifts in an effort to avoid the commercialization of the day. Instead, events such as the Doha Dash, including runs of varying distances along the Losail International Circuit, and sailing and water skiing along the Corniche, to mention only a few, were the highlights of the day.
Moving forward, and legacy, a term popularized thanks to the desire by the London Olympics organizers to see the event have a long-term impact on the sporting culture of the UK, is likely to become a buzzword in Qatar as it begins to look beyond the 2022 FIFA World Cup and at what its lasting impact will be. With lifestyle diseases the biggest killer in the country, getting people to embrace sport as a way of life could be crucial if the authorities wish to avoid unnecessary strain on the healthcare sector in the future. And while it is unclear how successfully private insurers will be able to provide medical coverage to all members of Qaari society, the onus is now on the private sector as a whole to ensure that the sector is ready for anything.
A HEALTHY INVESTMENT
As articulated in Qatar National Vision 2030 (QNV2030), Qatar’s long-term development strategy, one of the four pillars of advancing Qatar’s development is human development. A key aspect to human development is advancing the healthcare of the nation, an issue that affects many aspects of the economy, from social productivity to economic competitiveness. As such, in 2011, Qatar’s leadership rolled out the National Health Strategy 2011-16 in order to propel Qatar toward the health goals and objectives outlined in the QNV2030. A number of important national projects have been implemented in this regards, most notably the development of a regulatory framework for health facilities, pharmaceuticals, and medical devices. In April 2014, the Supreme Council of Health (SCH) made headway into the regulatory and accountability of healthcare facilities by launching the Health Service Performance Agreement. This agreement stipulated that primary healthcare hospitals had to report multiple performance indicators to the SCH on a regular basis. In October 2015, Prime Minister Sheikh Abdullah bin Nasser bin Khalifa Al-Thani announced details of a new scheme to introduce quality standards across private and public hospitals as well as clinics. By March 2016, all public and private health service providers will be covered by the National Program for the Licensing and Accreditation of Healthcare Facilities scheme. Importantly, this means that one singular regulator will handle all the administrative processes in accordance with this scheme.In addition, this initiative will standardize how facilities are monitored and measured. Sheikh Abdullah said, “It allows decision-makers effective use of the results of these indicators in developing policies and legislation that improve the quality of corporate performance.“ Both of these initiatives combine to form a key step toward the increasing of transparency and quality of healthcare in Qatar. In addition to this, it will afford private health investors clear and standardized information on the requirements for their projects in Qatar.
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