The news that newly arrived expatriate workers will soon be screened for contagious diseases has come despite the current strain on the national health service - and has reminded many of plans for its privatisation. Government schemes for contracting out the provision of health services for non-Qataris have indeed been on the agenda for a while and are moving forward.
Currently, work or residence visas are not stamped without clearance from the Medical Commission, while those with certain contagious disease have to leave the country for good.
Once in Qatar though, expatriates are looked after by the comprehensive medical care that is provided by the state. The care is provided by the state for nominal fees. However, with a rapidly expanding population due to the demand for more expatriates to participate at all levels in Qatar's rapid economic expansion, the strain on the services has prompted plans to privatise healthcare provision for non-Qataris.
The Hamad Medical Corporation (HMC) is the instrument of state healthcare and was established in 1979. It is currently the largest provider in Qatar and has a market share which exceeds 98% of inpatient services and 95% of outpatient services.
HMC currently supervises three hospitals. Hamad General Hospital has 660 beds distributed among all sections; the Women's Hospital comprises 332 beds, an assisted conception unit and a 71-bed neo-natal intensive care unit; and Rumailah Hospital was opened in 1957 and comprises 338 beds - it is currently in the process of being converted into a general hospital whence it will provide comprehensive diagnostic services.
However, major expansion of government facilities has been underway for some years as the construction of the new Hamad Medical City is well advanced in central Doha. The new facilities will mean three new hospitals opening their doors to patients. These will be a 320-bed children's hospital, a 200-bed trauma/orthopaedic hospital, and a 200-bed physical medicine hospital. These will double the inpatient capacity of government hospitals from 1346 to 2596 beds. The Medical City will also include a 300-bed nursing home for long-term care.
This is only one part of the expansion plans though. Further facilities will include a 112-bed cardiology hospital, a 200 bed general hospital at al Wakrah and a 50-bed community hospital at North City with a similar facility to follow at Dukhan.
The new expansions will relieve some of the demand on facilities, but keeping pace with the population expansion still requires more private healthcare facilities, according to some.
The Ministry of Public Health plans to privatise the sector by introducing compulsory health insurance for non-Qataris. Plans to implement this service are being made in coordination with the concerned employers in both the public and private sectors.
The mechanism for providing health insurance is largely in place. A firm is being created that involves all the national insurance providers in co-operation with major firms such as Qatar Airways, and this will come into being subject to an Emiri Decree expected later in 2005.
The impact of this is expected to be more than just taking pressure off HMC's capacity and the Ministry of Public Health's budget; it is expected to stimulate the rapid development of the state's embryonic private health care market.
"They are determined to make the insurance compulsory and this will improve the private sector," explained Turki al-Khater, managing director of HMC and undersecretary at the Ministry of Public Health, when speaking to OBG recently. "We don't see it as competition; we hope it will take the load of us because we currently have a shortage of space. It will take time for our facilities to expand to meet demand."
One of the principal effects of the plans is expected to be improved quality as consumers seek to optimise the investments they have made in their health.
"Once you are insured and the insurance company is paying it means you want to get the best for your money," continued al-Khater. "It's for the good of the country to have competition for the delivery of the best service."
Private health services are however relatively un-developed in Qatar. However, the tide has turned with the opening of the first private general hospital in November 2004. Al Ahli Hospital is a 250-bed multi-specialty hospital managed by Aus Health International, an Australian subsidiary of New South Wales health, the largest healthcare provider in Australia.
"Insurance presents an opportunity for establishing the market," explained Lynette Lewis, CEO of Al Ahli Hospital to OBG recently. "When it is compulsory, people are forced into health schemes and they become more discerning, hence they will seek quality."
The strategy at Al Ahli is to develop a set of services that compliment HMC and that can also attract those seeking treatment from abroad. As well as hi-tech equipment though, the hospital intends to really focus on the value-added aspects of the service delivery and hence dubs itself a six-star hospital. The expectation is that quality will attract those who appreciate the high levels of service on offer, regardless of their national status.
"The insurance scheme will help but we expect those who can afford it to come here anyway," continued Lewis. "The market is undeveloped at the moment but by targeting certain groups and developing high quality services over the next year we expect to establish a strong reputation as a centre of excellence; although tertiary referrals, for example, will not come overnight."
With Qataris currently enjoying one of the highest levels of GDP per capita in the world, it is sure they can afford to opt out of government healthcare. It seems that the development of the private healthcare sector will not just take budgetary pressure off the Ministry of Public Health, but could be the basis for a line of luxury healthcare to serve the whole region.
