The Business Year

Dr. Faleh Mohamed Hussein Ali

QATAR - Health & Education

Pulling Together

Acting CEO, the National Health Insurance Company (NHIC)

Bio

Dr. Faleh Mohamed Hussein Ali is Acting CEO of NHIC and Assistant Secretary General for Policy Affairs at Qatar’s Supreme Council Of Health (SCH). He also serves as the Chair of several national committees within SCH, such as the National Health Accounts Committee and the National Health Strategy Steering Committee. His earlier public sector roles include positions at the Ministry of Interior, as well as posts at Hamad Medical Corporation, Qatar’s main public secondary and tertiary healthcare provider. He also served as the CEO of the Cuban Hospital, a joint project between the Governments of Qatar and Cuba. He graduated from the Royal College of Surgeons in Dublin, Ireland in 1993. He also holds a Master’s in Health Management from the Tanaka Business School at Imperial College London.

"The establishment of the NHIC is a significant component in realizing the National Vision 2030."

What is the role of National Health Insurance Company (NHIC)?

The NHIC was established by the Social Health Insurance law in 2013 to manage and operate the National Health Insurance Scheme, better known as Seha. The project itself stems from the human development pillar of the Qatar National Vision 2030. A key element of this human development pillar recognizes that a productive society needs to be a healthy one. There are several initiatives that revolve around this pillar of the strategy. On the healthcare front, this led to the development of the National Health Strategy (NHS), which evolved into around 40 projects, each of which tackles a necessary development for the transformation of Qatar’s healthcare sector. One element of the NHS focuses on the establishment of a social health insurance scheme to provide equitable access to healthcare services for people living in the country. In turn, it also targets bringing greater efficiency and transparency to the operation of the Qatari health care sector. Seha acts as a catalyst for change across both the NHS and other initiatives within the healthcare sector in the country. Additional benefits are, for example, an increase in transparency and data collation from all providers. This, in turn, allows for better planning of the types of issues that are prevalent in the country, trend spotting, and overall planning of the types of facilities, and geographical placements for these efforts. On the macro level, this leads to greater transparency and efficiency in the allocation of healthcare spending by the government.

When fully implemented in 2015, what will be the impact of Seha on the healthcare sector when looking at the balance between public and private healthcare providers?

A key point to note is that we do not discriminate between public and private healthcare providers. All licensed providers, be they public or private, are welcome to join the scheme. Having said that, Seha is, if anything, more of a boost to the private sector. Healthcare in Qatar has traditionally been dominated by public providers, with only those who could afford it or who had private health insurance seeking out treatment at private facilities. With Seha, the playing field is leveled to a great degree and our members now have access to great quality and choice when selecting a healthcare provider. The competition this creates should over time lead to better quality service. Moreover, giving people access to private healthcare through Seha opens up new opportunities that could spur new private investment in the country’s healthcare sector.

“The establishment of the NHIC is a significant component in realizing the National Vision 2030.”

After the completed implementation of Seha, will there still be a role for the private insurance companies in the field of healthcare?

The system we are implementing in Qatar is not dissimilar to what you see in many parts of the world, where you have a mandatory scheme that guarantees a minimum level of healthcare for the citizens of a country, with private health insurance available as a supplementary service for those who want it. Private health insurers will therefore have an important role to play in providing supplementary and complementary and potentially quite lucrative coverage for additional services not included under Seha.

How does Seha fit in the national objective of elevating standards in Qatari healthcare services?

For the insured, Seha offers more choice by providing access to both public and private healthcare providers. This creates competition among providers to attract members, ultimately resulting in higher quality care and better service. Moreover, with more people having access to private healthcare, we should see more private investment in the healthcare sector over the long run, which brings benefits to both individuals and the state. As such, we could see newer, more modern facilities, a wider range of specializations, and better healthcare access in towns and cities across the country. More broadly, Seha plays an enabling role for many of the goals set out in the NHS. The NHS constitutes some 39 projects that seek to transform the healthcare sector in Qatar in a comprehensive and holistic nature, bringing greater efficiency and transparency to the operation of the Qatari healthcare sector. Seha will also be a vehicle to implement international and national standards of care delivery set by the Supreme Council of Health. This will affect the whole pathway of patient care from, amongst other care pathways, prevention to rehabilitation. Seha will lead to the better management of healthcare costs through the implementation of internationally accepted healthcare management systems.

What challenges do you expect to arise during the process of full implementation of the Seha program?

We are now one year into the scheme. Stage one was launched in July 2013 to cover Qatari national females aged 12 and above for maternity and women’s health issues. This was in many ways a pilot, giving our providers and us a chance to ease into the new system with a smaller population group and a restricted set of services. In April 2014 we introduced stage two of Seha, expanding the scheme to cover Qatari nationals of all ages and both genders for the full spectrum of basic healthcare services. The rollout has gone remarkably smoothly thus far, which is a testament to the high levels of cooperation by all parties involved. As of August 23, 2014, we had just over 300,000 doctors and hospital visits by Seha members, 266,000 of which have taken place since the launch of stage two. So in terms of challenges, the hardest part is now behind us. The learning curve for the system itself for future stages will not be as steep as for that of stages one and two. With each stage we learn and improve for the next one, and when we come to future rollout we will be at a point where the requisite systems have been up and running for some time, where providers have become used to the workings of the scheme, and the main challenge boils down to the logistics of accommodating greater numbers.

How do you foresee the role of foreign investors in the future of Qatari healthcare?

Seha opens up access to private healthcare for its members. This should be a boon to private providers, whose customer base has been limited to those few who can afford private healthcare or who had private insurance, estimated at around 17% at end-2012. As such, over the long run, I would anticipate increased private investment, both foreign and local, in the Qatari healthcare sector.

How does the Qatar National Vision 2030 inspire you in managing the NHIC?

The establishment of the NHIC is a significant component in realizing the Qatar National Vision 2030. I and the rest of the NHIC team are very conscious of this in everything we do and it does in fact inspire us to do the best job we can to make the vision a reality.

© The Business Year – November 2014

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