Saleh Al Tamimi, CEO, King Saud Medical City: Interview

Interview: Saleh Al Tamimi

What needs to be done to fulfil the growing staffing needs of the Kingdom’s health sector?

SALEH AL TAMIMI: This is certainly our biggest risk and challenge. The health sector still depends significantly on foreign workers while experiencing substantial growth. We have to come up with a comprehensive plan to provide the necessary skilled workers. This means investing in Saudis.

Over the years, Saudi Arabia has been a training centre for many foreigners, especially from India and the Philippines, who often come for a few years and then move to North America or Europe. We are unable to have a safe future without changing the equation so that most of our workers are Saudi. However, working out how to do that is challenging for a number of reasons. Nursing is not a popular job among young Saudis, particularly because it is a profession dominated mainly by females, and Saudi women would much prefer an eight to four job than to do shift work. That is a huge challenge, because hospitals need to operate 24 hours a day.

What we need to do is continue to provide advanced training opportunities for Saudis, be it locally or internationally. The King Abdullah Scholarship Programme is very important in this regard. One major change that has occurred in the past few years is the establishment of new universities across the kingdom. Previously, there were only four medical schools; now there are twelve. The intake, year to year, is increasing too. Training and ongoing professional development in the different hospitals is also crucial. At the same time, we need to continue to be an attractive place for skilled foreign workers and find ways to keep them here longer.

In which areas do you see most room for the public and private sectors to collaborate?

AL TAMIMI: There is a lot of common interest in public-private partnerships and plenty of room for collaboration. We would love to see more involvement from the private sector in chronic care, home care, rehabilitation, senior homes and medical transport. These are important services, and ones in which the public health care system has not performed well. Public hospitals deal mainly with acute care. We have invested heavily in this area, but much less in rehabilitation, step-down facilities, chronic care and senior homes. Such facilities are largely unavailable in the kingdom, meaning we need acute care to keep patients in hospitals after they have received treatment. This clogs the system by reducing bed turnover, which is one of the main challenges in improving access to health care. There are great opportunities for the private sector to supply these kinds of facilities and, in doing so, increase the quality and accessibility of health care in the kingdom.

How can the Saudi health system better meet the needs of the community?

AL TAMIMI: As health care leaders, the first thing we need to do is identify patients’ priorities. Often we think for our patients and imagine we know what they want, when this is not always true. We need to engage with the community and study our society so as to know where their priorities lie. Second, we must acknowledge that our health system is fragmented, and work on developing a more integrated system that can help our patients find the right care at the right place at the right time. Our hospitals tend to work in silos so integration is crucial.

To solve this, we need to start with hospitals complementing each other at different levels, and then extend that to the primary care system. This requires both more and smarter investment in primary care, an area that so far remains weak, despite much effort. Our health system currently has an inverse pyramid, with most people seeking care right away from the big hospitals and bypassing primary care centres. The creation of an efficient, integrated system can build trust, improve outcomes and cut costs.