Saudi Arabia will need an additional 10,000 doctors by 2020 and twice that many by 2030 to tackle critical bed shortages and meet the needs of its growing population, experts have warned.
A significant increase in nurses, technicians and medical staff is essential to plug the Kingdom’s chronic bed shortfall — with more incentives, such as easing visa regulations, being suggested as ways of attracting and retaining overseas expertise.
Earlier this week, Arab News revealed that a study by the consultancy firm Oxford Economics showed Saudi Arabia will need an extra 5,000 hospital beds by 2020 and 20,000 more by 2035, as its population rises.
Now Mansoor Ahmed, director for health care, education and PPP at Colliers International, has unveiled exclusive figures showing this will result in a parallel shortage in medical professionals, unless that issue is also addressed.
“There is a direct correlation between number of beds and medical staff,” he said. “Based on a Colliers estimate, by 2020 KSA will require an additional 10,000 doctors and by 2030 another 20,000 doctors on top of that.
“There are two ways of filling this gap producing more doctors and nursing staff locally, and attracting medical staff from other Arab and Asian countries. However, to do this, KSA needs to look easing its visa rules and regulations.”
Ahmed said that one of the main challenges faced by private operators in the region, including KSA, is attracting and retaining quality staff, prompting health-care providers to “poach” doctors from the local market rather than hiring from abroad.
“Operators desperate to recruit qualified specialized staff have prompted a trend of poaching physicians from competitors,” he said. “With a limited pool of established physicians, their salaries have witnessed exceptional growth, to an extent that it is negatively affecting the profitability of hospitals/clinics in KSA.
“A large number of doctors, nurses and paramedical staff in KSA migrate to Western countries after a few years due to better opportunities and training facilities. In addition, the current Saudi regulations for recruitment further increase the staff cost due to limited available resources.
“The government’s role is extremely important in establishing career-focused educational institutions, such as medical and nursing colleges, to increase the supply of local medical professionals and to drive qualified Saudi talent into jobs. Moreover, to overcome the supply gap, the government needs to provide funding to the private sector and improved employment regulations to be able to attract qualified resources from abroad.”
Ahmed believes that the Oxford Economics study’s estimates are conservative.?Based on the current annual KSA population increase of 2.65 percent per annum, he points to analysis carried out by Colliers showing the Kingdom will need an additional 7,800 beds by 2020 and 32,000 beds by 2030.
The real- estate costs of this alone would equate to between $1.3 billion (SR4.9 billion) and $2.6 billion by 2020 and $5.3 billion and $10.6 billion by 2030. Once fitout and medical equipment costs are added, the figures rise to $2 billion- $3.6 billion by 2020 and $7.9 billion- $14.3 billion by 2030.
“The growing population is the key driver, but you also have to look at the changing composition of the population which will dictate the types of bed required,” he said. “Between 2015 and 2050, about 21 million children will be born in KSA, creating demand for health-care facilities and services relating to mother and childcare, such as obstetrics, gynecology, and pediatrics.”
Life expectancy in KSA has also increased. “These changes will lead to increasing requirement for a larger number of long-term care facilities,” Ahmed said.
“Saudis have traditionally gone oversees for health care, and it is Colliers’ opinion that they can be targeted if the same hospital brands where they have this treatment can establish branches in KSA.”
Ahmed said that the focus should be not simply on increasing the number of beds, but in creating more centers of excellence dedicated to daycare surgery, which will reduce demand for bed space.
Dr. Camille Sirgi, deputy CEO of the Abu Dhabi’s Bareen International Hospital, described KSA’s bed shortage crisis as “worrying”, and agreed the Oxford Economics study paints “a real picture” of the situation both in KSA and across the GCC.
“Saudi has a greater population than the rest of the GCC, so this problem is heightened,” he said. “And it does not just affect a certain societal segment — it has a real impact on every person in the short and long-term future.”
Efforts should go beyond infra- structure and additional beds, due to the shortage of nurses, physicians and hospital technicians that will emerge unless measures are taken.
Sirgi said that the Kingdom should adopt similar measures to the UAE, which last month announced long-term residency visas for up to 10 years for investors and specialists, including doctors, which would attract oversees talent to make a more permanent move. The Kingdom also needs more medical colleges and universities to train homegrown talent, and to offer financial incentives or subsidiaries for those studying in health care.
Prasanth Manghat, CEO and executive director of the UAE’s largest private health care provider NMC Health, which is expanding into Saudi Arabia, said: “The Kingdom is working overtime to bring social, economic and cultural change. It is moving beyond the realms of the hydrocarbon-based economy. Talking in terms of health care, the details of the report are no surprise to us as we have entered the geography some time back and are present in four cities with more than 800 beds.
“There is not only a huge demand and supply (capacity) gap but also a definite capability gap. The short- to-medium term areas are mother and child health, geriatrics, oncology and long-term care. These four focus areas are well within the statistics.”
Manghat said that more demand will require more skilled profes- sionals, especially the development of local talent.
An Australian expatriate working as a nurse in Saudi, who declined to give her name, believes a lack of primary health-care facilities — especially outside metropolitan areas — exacerbates the bed shortage issue, as people in need of early-stage medical care are not seen until their condition requires immediate and more urgent medical attention in larger city-based hospitals.
“There is also a lack of long-term care facilities and a health-care system that hasn’t been refined to suit the needs of Saudis — especially those who live rurally and don’t know how to access services provided for them by the government,” she said.
“I would like to see more programs targeting difficult-to-reach areas, and developing health care in remote areas and smaller cities, so only those requiring specialist care have to come to Riyadh.”
However, Hamish Clark, partner at Middle East Health Industries at PwC, believes a drive by the Kingdom to educate its citizens to adopt healthier lifestyles may mean the bed shortage will be less critical than the study suggests.
“One of the most exciting things about Vision 2030 and the Ministry of Health’s transformation program is the ambition to do things differently,” he said. “In many ways, this old way of thinking that hospital beds equal health may apply to older health systems, but in Saudi Arabia that is not the case.
“The Minister of Health unveiled a new Model of Care in April 2017, and this described a new way of delivering health care that puts much more emphasis on individuals looking after themselves, on the importance of virtual care and how much greater investment is needed in primary care. Keeping people well, treating them at home and providing virtual care services mean that reliance on hospital beds will be far less important.”
Nevertheless, Clark emphasized that chronic bed shortages in ICUs need urgent attention, and foreign investment and private health care companies will be needed to close the care gap.
“In a young and dynamic country, with leadership that is committed to rolling out the new Model of Care, the focus on bed numbers will reduce, and quality and value will increase. There is the distinct possibility that KSA will leapfrog other health systems, like the UK’s NHS, by 2030.”