Mix of public and private support expanding Abu Dhabi's health offerings

Helped in part by some significant examples of international investment, the health care sector in Abu Dhabi has made huge strides over the last four decades. Based on these foundations, the agencies responsible for planning future provision in the emirate are currently focused on improving, reshaping and expanding the services offered to its residents and citizens, and balancing the resources provided by both the public and private sectors.

In 2015, 52% of all inpatient care and 31% of outpatient cases were dealt with in government-owned hospitals, while the remaining care was provided by the private sector, which has seen its role increase since 2011, when government hospitals handled 65% of all inpatients and 40% of outpatients. In 2017, 8.6% of the federal budget, or Dh4.2bn ($1.1bn), is earmarked for health care across the UAE. Health officials in Abu Dhabi are anticipating significant private sector investment, as 10 new hospitals are currently under construction in the emirate alone.

Administration

Bodies at both the national and emirate level share the regulation and administration of the health sector in Abu Dhabi. At the federal level, the Ministry of Health, renamed the Ministry of Health and Prevention in early 2016, was established pursuant to Federal Law No. 1 in 1972, and is mandated with licensing companies and individuals that provide health care services, building and managing health facilities, and regulating the practice of medicine, nursing, pharmacy and dentistry. The ministry has responsibility for the Northern Emirates, while Dubai and Abu Dhabi have their own administrative bodies.

In Abu Dhabi, the General Authority of Health Services was established in 2001. Its functions were later divided in 2007, with Health Authority - Abu Dhabi (HAAD) tasked with health regulation and administration, while Abu Dhabi Health Services Company (SEHA) became the operator of most public health care assets, which in 2015 included 13 hospitals, equivalent to 25% of the total number of hospitals operating across the emirate.

Providers

SEHA hospitals had a total capacity of 2576 beds in 2015, ranging from the 682-bed Sheikh Khalifa Medical City in Abu Dhabi to the 15-bed Al Wagan Hospital in the Eastern Region of the emirate. Among the larger infirmaries are the 455-bed Tawam Hospital, Al Ain Hospital (368 beds), Mafraq Hospital (363 beds) and Corniche Hospital (255 beds). Occupancy rates ranged from 12% at 23-bed Delma Hospital in the Al Dhafra Region, to 86% at the 163-bed Al Rahba Hospital, which is located 30 km from Abu Dhabi city. Johns Hopkins Medicine International manages two of SEHA’s hospitals. The agreement to manage the Tawam Hospital, the regional referral centre for specialist care and national referral centre for oncology services, dates back to 2006. Tawam’s specialities also include emergency medicine, neonatal care and fertility services, as well as cardiac care.

In 2008 Johns Hopkins signed an agreement to manage Al Rahba Hospital. The facility has four operating rooms and nine adult and paediatric dialysis units, and offers general surgery, obstetrics, gynaecology, internal medicine, paediatrics and emergency care. Joint Commission International, a US non-profit health care accreditation organisation, accredits both hospitals.

Mubadala Investment Company has also developed two hospitals and a number of medical facilities. This includes the 364-bed Cleveland Clinic Abu Dhabi, a flagship medical centre developed in conjunction with Cleveland Clinic in Ohio, as well as a collaboration with South Korea’s Wooridul Hospital to create Healthpoint, a 47-bed speciality facility, which houses the Abu Dhabi Knee & Sports Medicine Centre, the Bariatric and Metabolic Surgery Centre, and the Wooridul Spine Centre. Its 21 clinical services include paediatrics, cardiology, dentistry as well as family medicine. Mubadala’s health care portfolio falls under the company’s newly formed alternative investment and infrastructure platform, and will be led by Waleed Al Muhairi. The restructuring came about because of Mubadala’s $122bn merger with the International Petroleum Investment Company, announced in 2016.

Both Mubadala Healthcare institutions operate as public hospitals outside the SEHA umbrella, in addition to Imperial College London Diabetes Centre (ICLDC), which employs 63 doctors, 37 nurses and 20 pharmacists. ICLDC was the busiest clinic or medical centre in the emirate in 2015, according to HAAD, which showed that it handled 186,316 treatment episodes. Mubadala also operates the Abu Dhabi Telemedicine Centre with the Swiss firm Medgate; the Capital Health Screening Centre; the Tawam Molecular Imaging Centre; and the National Reference Laboratory. The Zayed Military Hospital, a 360-bed infirmary serving military personnel and their families in Abu Dhabi, is not included in HAAD data, nor is the military hospital in Al Ain.

Private Providers

There were also 37 private hospitals in Abu Dhabi at the start of 2015, with a combined total of 2056 beds ranging in size from the 159-bed Burjeel Hospital to Gulf Diagnostic Centre, which has eight beds. There are some significant private sector players in Abu Dhabi’s health sector.

NMC Healthcare began in Abu Dhabi in 1975 as a small clinic and pharmacy, and has grown to 30 health care facilities in six countries, with 1200 doctors treating 11,000 patients per day. In 2012 NMC Healthcare was listed on the London Stock Exchange. It reported revenues of $880.9m in 2015, and in August 2016 it hit revenues of $578.3m, up 46.9% year-on-year.

In June 2015 it purchased ProVita International Medical Centres in Al Ain and Abu Dhabi for $160m, and subsequently acquired the Dr Sunny Group of six health centres and three pharmacies in Sharjah, as well as Americare group, a provider of in-home care in Abu Dhabi. The latter two acquisitions were valued at $100m. NMC Healthcare has speciality hospitals in Abu Dhabi and Al Ain which have 92 and 93 beds, respectively, and built the $70m Brightpoint Royal Women’s Hospital with 27 beds, which opened in 2014. The company’s flagship hospital in Abu Dhabi is the 250-bed, $200m NMC Royal Hospital in Khalifa City, which opened in September 2015.

In February 2016 two of the other major private health care providers in Abu Dhabi and the UAE combined forces in a reverse takeover by Al Noor Group of Mediclinic International, a health care company with hospitals and clinics in Switzerland and South Africa as well as in the UAE. At the time, Al Noor had seven facilities in Abu Dhabi City, two in Al Ain and one located in the Al Dhafra Region. Prior to this $2.2bn takeover, Mediclinic had five hospitals in the UAE, including two clinics that opened in Abu Dhabi and Al Ain in 2014 and 2015, respectively.

Another international provider with a prominent footprint in Abu Dhabi is VPS Healthcare, which has six hospitals with a range of prices and 335 beds, including its flagship Burjeel Hospital, which has 159 beds. VPS Healthcare announced in June 2014 that it would be spending $1.5bn over three years, with $1.4bn to be put into the development of a 400-bed tertiary hospital – Burjeel Medical City – in Mohammed bin Zayed City, which is due to open by the end of 2017. UEM edical, formed in 2007, partnered with Singaporean provider ParkwayHealth to operate the 150-bed Danat Al Emarat Women and Children’s Hospital in Abu Dhabi, which opened in August 2015.

A few months later UEM edical partnered with Moorfields Eye Hospital in London to open the Moorfields Eye Hospital Centre in Abu Dhabi’s Marina Village. The company also runs a number of clinics dealing with family health, children’s health, diabetes and fertility under its HealthPlus brand.

Growth Drivers

HAAD data indicates that much of the recent growth in health care provision in Abu Dhabi has been due to private sector investment. By 2015, 73% of non-acute care (NAC) beds, 67% of outpatient consulting rooms and 53% of same-day care beds were provided by the private sector, according to its 2015 Capacity Master Plan (CMP) (see analysis). However, the authority is also keen to ensure the best and most cost-effective use is made of existing government facilities to minimise a wasteful overlap in provision in some areas, while some capacity gaps remain in coverage, either by location or by speciality of treatment. HAAD is keen to attract investors, but is also prepared to point out and restrict duplication of existing services where necessary.

On the demand side, there is continued growth in outpatient treatment for non-communicable, lifestyle-related diseases such as diabetes, cardiovascular disease and cancer. On the supply side, between 2003 and 2013 there was a 17% compound annual growth rate (CAGR) in the number of licensed clinicians and a 12% growth rate in the number of medical facilities. The private sector’s success in achieving sustainable occupancy levels in these new facilities will, to some extent, depend on the services being offered, and HAAD has indicated that there are shortages of specialist physicians in emergency care, psychiatry, obstetrics, neonatology, specialist paediatric care, orthopaedics and transplant surgery.

The authority also envisages increased demand for health care services beyond the flagship tertiary hospital setting, with significant capacity gaps in primary care, NAC and long-term care beds.

HAAD’s CMP also takes into account facility expansion planned by SEHA. Therefore, it emphasises there is no additional requirement for acute overnight beds in Al Ain and Abu Dhabi, as construction work is being completed on two new SEHA facilities with a combined capacity of 1451 beds.

These two projects include the new 719-bed Dh4.4bn ($1.2bn) Al Ain Hospital, which will be handed over to SEHA when work is completed by Abu Dhabi General Services Company (Musanada), the public joint-stock company established in December 2007 to deliver public sector projects. In July 2016, 32% of the work on Al Ain Hospital had been completed. Musanada is also building the 732-bed Sheikh Shakhbout Medical City, a Dh4bn ($1.1bn) public health project in Al Mafraq, and had completed 90% of the work as of February 2017.

Demographics

Another key growth driver in Abu Dhabi is its population. From 2010 to 2015 the number of people living in Abu Dhabi grew by a CAGR of 6.3%, driven in part by the arrival of new foreign workers, but also by growth of the Emirati population. In 2015 the population of Abu Dhabi reached 3.15m, according to HAAD. One factor is that citizens can expect to live longer. Data from Statistics Centre - Abu Dhabi (SCAD) and HAAD show that, at birth, Emirati males could expect to live to 76 years in 2015, compared to 74.9 in 2010, while women’s life expectancy at birth increased from 77 to 79.8 years over the same period.

However, the demographic structure of Abu Dhabi creates challenges in both the short and longer term for those attempting to plan health care or compare the emirate’s performance against international benchmarks. Among UAE nationals, who constitute 16.7% of the total population of Abu Dhabi, 68% are under the age of 30, while 60% of all 2.6m foreign residents are workers between the ages of 20 and 40.

International Comparisons

HAAD has attempted to factor in these anomalies in its reporting of data by giving an actual figure and an adjusted figure when reporting its health care provision. The adjustment is made by mapping the population age structure of Abu Dhabi to the average OECD country. For example, the actual number of hospital beds per 1000 is 1.6, but the adjusted figure is 3.65. By comparison, Germany has 8.2 beds, the UK and US each have 2.9, and Kuwait has 2.2 beds. However, it could be argued the rationale for such an adjustment is not as sound when making comparisons with other GCC countries, as their populations all include large numbers of temporary, young, foreign workers.

Even without this factor built in, Qatar has higher numbers of physicians and nurses per 10,000 people than any of the OECD countries. Abu Dhabi has 26.9 physicians per 10,000 people, or 52.44 adjusted, compared to 77.4 in Qatar, 38.9 in Germany, 28.1 in the UK and 24.5 in the US. The ratio per 10,000 people for nurses is 69.1, or 134.71 adjusted, in Abu Dhabi, compared to 118.7 in Qatar, 114.9 in Germany, 98.2 in the US and 88 in the UK. SCAD data shows there was a 16.5% increase in the number of physicians per 10,000 in Abu Dhabi and a 40% increase in the number of nurses per 10,000 people between 2011 and 2015.

Strategic Focus

Performance in the provision of health care is mapped out against a matrix of long-term plans drawn up at the federal level for the UAE and the emirate level for Abu Dhabi. The UAE Vision 2021 makes delivering high-quality health care a national priority measured against 10 key performance indicators, which include comparisons with other countries in indices that were drawn up by the World Health Organisation and the International Diabetes Federation (IDF). The Abu Dhabi Economic Vision 2030, which was published in 2008, foresaw a premium health care system for the emirate’s residents, and opportunities to contribute to the diversification of the economy through the development of the health care equipment and services sector. In June 2016, following three years of consultation, the comprehensive five-year Abu Dhabi Plan was unveiled, providing a blueprint for development including 25 key objectives and 83 programmes. In August 2016 HAAD published its CMP, which includes a detailed supply, demand and gap analysis of current provision at both the emirate and regional level as well as projections for the future.

Planning Aid

In publishing the CMP, HAAD encouraged health care operators and providers to use its data to plan future developments, and to engage with HAAD at a strategic level to ensure planned developments meet the needs of the population, both in terms of the specialities offered and the region covered by each proposed new facility. The document also reminds developers to adhere to Abu Dhabi Urban Planning Council regulations and standards in planning new facilities. Underpinning the CMP are HAAD’s seven main priorities for creating a healthier Abu Dhabi: quality enhancement, recruitment and retention of staff, preventive medicine, sustainability, improvements in informatics and e-health, emergency care and integrated health care providing residents with a continuum of lifelong care. The CMP was devised to enable health care stakeholders to help achieve the objectives of Abu Dhabi’s health sector strategy.

Insurance Pioneer

One of the central factors supporting the sustainability of Abu Dhabi’s health sector is insurance, and the emirate became an early pioneer in instituting mandatory health insurance for all residents when it issued Law No. 23 of 2005. This required all employers to provide insurance to their employees as well as any dependants of their employees. This was followed two years later by Resolution 83, directing HAAD to give comprehensive coverage to all UAE nationals living in Abu Dhabi under the Thiqa (“trust”) programme, which allowed them to claim 100% of the cost of treatment at public or private hospitals in the emirate, and 90% of the cost for treatment outside the emirate. The Thiqa programme is managed exclusively by Daman, a public joint-stock company in which the government of Abu Dhabi owns an 80% stake, with the remainder held by Munich Re. Daman also manages the basic plan for low-income expatriates. The employers of wealthier expatriates and those expatriates themselves can buy enhanced insurance packages with a wider range of benefits from almost 40 private insurance companies. HAAD data shows that Thiqa covered 15% of all policyholders in 2015, while 42% had basic insurance and 43% had enhanced insurance. There were 517,144 people enrolled in the Thiqa programme, 1,458,406 with basic cover and 1,458,989 with enhanced cover. Daman had a 39.5% market share of all paying members of schemes. In 2015 Thiqa accounted for 35.14% of all claims. Basic insurance accounted for 28.41% of claims, while enhanced insurance came to 36.44% of the total.

Health insurance policies, including the Thiqa programme, saw a series of changes over the course of 2016 and 2017, culminating in April 2017 when the government waived a 20% co-pay that had been established the previous year for Thiqa customers at private health care facilities. “It takes time to gauge the impact of health policy benefits changes on patient behaviour,” Dr Michael Bitzer, CEO of Daman Insurance, told OBG. “You need a long period of claims history, and without this it is pure speculation. Our role as Daman is to monitor what we see, and to advise HAAD accordingly.” While the immediate results are uncertain, changes around Thiqa are expected to improve the outlook for private players by giving patients a choice of facilities in which to receive treatment.

Private Sector Influence

The introduction of mandatory insurance, along with average annual population growth of 6.3%, acted as a catalyst for the expansion of private health care provision in Abu Dhabi. From 2009 to 2015 the number of facilities grew at a CAGR of 12%, with the number of hospitals rising from 39 to 52, and the number of licensed clinicians expanding at a CAGR of 17%.

The bulk of that growth came from the private sector; in 2015 government health facilities run by SEHA accounted for 8% of the total, including 25% of hospitals, 10% of health centres and 10% of pharmacies. The exception to this trend is the 12 dialysis centres in the emirate, of which 92% are SEHA facilities, with 98% of nurses in the centres working for SEHA along with the only dedicated physician. In total, 38% of physicians in Abu Dhabi were working for SEHA in 2015, along with 19% of dentists, 34% of nurses and midwives, 32% of allied health professionals and 21% of pharmacists. Abu Dhabi continues to welcome the involvement of the private sector, and the strategic role it plays in improving access to high quality medical facilities, illustrated by healthy competition and the series of high profile investments in recent years.

Jawda

A major focus of HAAD’s work is measuring the performance and outcomes at public and private hospitals across the emirate in order to give clinicians comparative data, but also to enable patients to make more informed choices when they seek treatment. HAAD has been working with health care providers and insurance companies, which collect data on the number and types of treatments, to produce measures of quality or excellence, Jawda in Arabic.

The authority will bring together the results of 200 separate metrics of performance covering diverse aspects of care such as waiting times, morbidity rates, patient complaints and complications arising from a range of surgical procedures. Providers will offer some of their data to HAAD, but the authority will collect its own statistics and will also examine the figures gathered from insurance claims. The programme has been running since 2014, and currently measures over 100 indicators of hospital performance across four segments: patient safety, care effectiveness, patient experience and timeliness. The idea behind Jawda is that will evolve to work as a quality index, which will impact performance by rewarding high-quality providers and punishing those that fail to meet the standards established by the authorities.

More Satisfied Customers

In June 2015 HAAD announced the results of a Jawda-related patient satisfaction survey. The authority hired an outside auditor to interview patients and assess their happiness with the health care services they were provided with in Abu Dhabi. Nearly 56,000 interviews were recorded, with a total of 38,000 of these considered valid. Approximately 40% of the survey’s responders were UAE nationals, with the remainder coming from abroad. The results were markedly higher than those recorded in a similar survey conducted five years earlier, with 83% of patients expressing satisfaction with their care; this figure is higher than many countries, including Singapore, the UK and the US.

By developing and implementing Jawda, Abu Dhabi will be able to measure gains in health care as well as progress in patient satisfaction in a more clear and measurable way. The first results of the Jawda exercise are likely to be published during the course of 2017. HAAD hopes that the data gathered in the exercise will enable its staff to spot anomalies or issues and take proactive action to correct any documented shortfalls or problems in the provision of care.

Major Merger

In 2015 Mediclinic joined forces with Al Noor Hospitals Group to create the world’s eighth-largest health care operator, with combined revenues of $4bn as well as 73 hospitals with 10,200 beds, along with 37 clinics and a combined staff of 32,000 in Southern Africa, Switzerland and the UAE. Revenues from the group, based on performance in FY 2014/15, were divided among Switzerland (46%), Southern Africa (31%) and the UAE (23%).

The merger also propelled Mediclinic into the FTSE 100 Index. Prior to the combination of the two companies, Mediclinic had just two clinics in Abu Dhabi; Mediclinic Clinic Corniche in the World Trade Centre Mall and Mediclinic Al Hili in Al Ain. In the prospectus that was issued by the company prior to the merger, Mediclinic said that it was working “to bring the Abu Dhabi clinics to profitability”. The company’s existing operations were focused on Dubai, where it has two acute hospitals and eight clinics with a total of 382 beds. Al Noor, in contrast, was heavily focused on Abu Dhabi, although it also operates some medical centres and other facilities in Dubai and Oman.

According to the Mediclinic prospectus, in 2013 Al Noor’s facilities dealt with 29% of all private outpatients in the emirate and 30% of inpatients. By June 30, 2015 it had two hospitals and eight medical centres in the Abu Dhabi region; one hospital and six medical centres in the Al Ain region; and four medical centres in the Al Dhafra Region. The company employed 4190 staff, including 684 physicians and 426 other medical staff. In 2014 Al Noor had revenue of $449.1m and a net profit margin of 18.4%. Across the group, outpatient visits had expanded from 1.5m in 2012 to just short of 2m in 2014, and inpatient admissions increased from 36,000 to 42,000. Over the same period average revenue from outpatient visits and inpatient admission rose from $154 and $2343, respectively, to $170 and $2415. In the risk assessment included in the prospectus, Mediclinic did note that changes in Abu Dhabi or UAE health care laws and regulations might materially affect its business in the Middle East.

With regard to the Thiqa scheme, it noted; “The government of Abu Dhabi provides this insurance plan, and could elect to restrict access of its members to the enlarged group’s (Mediclinic and Al Noor) and other private facilities in the future.” Meanwhile, bed occupancy rates rose from 59% to 76%, and in the first half of 2015 reached 81%. The prospectus pointed to a number of expansion plans in the pipeline at the start of 2016 at Al Noor facilities, but it also acknowledged the role mandatory insurance, and particularly Thiqa, had made in the company’s success, adding, “The Emirati population has become more accustomed to using health care services that are paid for by virtue of having insurance.” It noted that for the first six months of 2015, Thiqa patients accounted for 25% of its inpatient volume and 21% of outpatients. In 2012, 2013 and 2014 reimbursements from insurance companies accounted for 91%, 92% and 93% of revenues, with the remainder accounted for by out-of-pocket cash payments.

Mubadala Health

As the variety and scope of health care services in Abu Dhabi continue to further expand and improve, a broadening range of advanced services is being offered under the auspices of Mubadala Healthcare, a specialist division of Mubadala Investment Company. Its seven health care businesses contributed 3.27% to Mubadala’s revenues of Dh34.1bn ($9.3bn) in 2015, amounting to approximately Dh1.1bn ($299.5m).

Also under the Mubadala umbrella is ICLDC, which is seeing 30-50 new patients every week in a country that has one of the highest rates of Type 2 diabetes in the world. ICLDC is treating patients, but with an illness that is often lifestyle-related, there is also a focus on education, prevention and research. With this in mind, the centre has also started up an innovation fund that will invest in companies that focus on diabetes.

Cleveland Clinic

One of the most prominent assets within the Mubadala Healthcare network is Cleveland Clinic Abu Dhabi, which is a 364-bed hospital on Al Maryah Island that provides more than 30 medical and surgical specialities, including heart and vascular, neurological, digestive diseases, eye, respiratory, and critical care. In 2017 work began on preparing transplant facilities, in line with the proposed changes in transplant legislation in the UAE. The hospital opened in March 2015. In 2016 the facility received 285,492 outpatient visits and completed 70,575 same day visits. Physicians performed 11,786 procedures during the year. The Emergency Department received 39,852 visits and nearly 500 patients were transferred to the clinic from other national and international facilities. By offering specialist treatments previously unavailable in the UAE, such as robotic heart surgeries, Cleveland Clinic Abu Dhabi is bringing more high-quality care to Abu Dhabi. It is also saving residents the expense and inconvenience of seeking treatment in Europe or the U.S. for complex and critical care requirements.

Dr Tomislav Mihaljevic, CEO of Cleveland Clinic Abu Dhabi, told OBG that the hospital is part of Abu Dhabi’s growing focus on providing high-quality health care in a domestic setting, and that this trend has led to a growing number of international patients travelling to the UAE capital for specialist care.

“The majority of our patients are Emirati nationals, but we also treat expats and visiting nationalities from all around the world,” said Mihaljevic. “We have catalogued 1149 international patients coming to Cleveland Clinic Abu Dhabi from more than 40 countries specifically for care in 2016,” he added.

Healthpoint

Mubadala also owns Healthpoint Hospital at Zayed Sports City, which treated 185,000 patients in 2015 including 150,000 Emiratis. The hospital was opened to meet specialised needs, which include – but are not limited to – sports medicine, plastic/reconstructive surgery, paediatrics, family medicine and women’s wellness. It serves as the home of Abu Dhabi Knee & Sports Medicine Centre, as well as the Wooridul Spine Centre. The hospital is looking to expand in 2017, with an eye towards attracting more medical tourists. The hospital is also expecting to enlarge its capacity in the first quarter of 2017; currently the hospital hosts a total of 44 inpatient beds, but has announced that it is looking to increase this number to 78, with 10 of these new beds expected to open in the obesity wing of the hospital. As of August 2016 Healthpoint employed 380 medical personnel, including 85 physicians. Occupancy rates for the hospital ranged between 90% and 100% in the first half of 2016, and the facility welcomed between 1000 and 1200 patients per day in this period.

Laboratories

Regardless of the location or region, health care tends to lag behind other sectors. However, in the UAE there has been a marked shift from subsidised public health care towards private sector-driven advancement, assisted by strategic guidance from the government. Despite health care typically conjuring up images of hospitals and physicians, 70-80% of physician decision-making comes in the laboratory. The National Reference Laboratory (NRL) was created by Mubadala in partnership with Laboratory Corporation of America Holdings, one of the world’s leading health care diagnostics companies. The NRL can perform more than 5000 clinical tests and has a wide range of national and regional clients. It also serves some of its sister companies in Mubadala Healthcare by providing laboratory services to Health-point Hospital, ICLDC and Cleveland Clinic Abu Dhabi, including the technical wing of the Anatomic Pathology Laboratory, which focuses on surgical pathology. In November 2016 the NRL reached a major milestone, when it announced that with six labs accredited by the College of American Pathologists (CAP), it had become the largest CAP-accredited laboratory network in the Middle East. The NRL offers a comprehensive range of services. As a result, only approximately 2-3% of tests are sent outside the UAE, which encourages greater levels of trust in the domestic health care sector.

Telemedicine

Mubadala has also entered into a joint venture with the Swiss company Medgate to run the Abu Dhabi Telemedicine Centre (ADTC), the only HAAD-licensed centre for telemedicine. Using an app and a toll-free phone number, Daman policyholders can speak to a doctor about any non-emergency medical concern at any time of the day or night. Medical staff can diagnose, provide advice and treatment plans, evaluate symptoms and recommend a choice of up to three doctors for face-to-face appointments if deemed necessary. The telemedicine centre has diagnosed more than 2600 medical conditions since its inception in October 2014; the majority of its callers have been parents expressing concern about young children. As of February 2016 service was extended to 1.3m residents, with almost 30% of calls coming from rural areas, which makes the facility strategically important to the government. There have been calls to incentivise calling the service as opposed to in-person visits. With the number of calls increasing every month, the scope of the service could be expanded to allow for prescriptions to be granted over the phone; however, as of 2017 this is pending the enactment of a number of necessary government regulations. “Telemedicine has the potential to fill the gap in access to care arising from the rollback of health policy benefits as part of further rationalising of health care provision,” Mina Abdulla Hamoodi, CEO of ADTC, told OBG. “Where people are looking to cut costs, telemedicine can provide a highly cost-effective care mode at scale. It also empowers patients to make a phone call first, and then progress based on the sound advice they receive.”

Outlook

Although the health care sector in Abu Dhabi has expanded rapidly and matured notably in recent years, there remain many areas in which it is seeking to innovate and improve. Balancing business aspirations of private providers with the most cost-effective mechanisms to make the best use of state facilities is a complex juggling act, but one that regulators appear determined to handle. “With a growing population, more health consciousness, and mandatory insurance, it is a no brainer,” Salem Al Noaimi, CEO and managing director of Waha Capital, told OBG. “However, high growth causing inflationary pressures, lots of hot money flows, overvaluations, and attracting and retaining the right employee base are all challenges faced by investors.” With the CMP having been released at the end of 2016, investors and private health care providers can more easily identify any existing gaps in provision and better pinpoint the opportunities to develop and offer services, as the emirate strives to deliver its citizens and resident an ever more effective and advanced health care.