TBY talks to David Hadley, CEO of Mediclinic Middle East, on preventative care, medical tourism in Dubai, and ongoing research projects.

What is the overall contribution of Mediclinic Middle East to the company's operations?

We have 54 hospitals in Southern Africa, 18 in Switzerland and we own a 30% stake in Spire Healthcare in the UK with 39 hospitals, while here in the Middle East we have seven hospitals and 20 clinics. We contribute around 26% of Mediclinic revenue worldwide. We are the third or fourth largest in terms of market share and are a listed company in London.

What is your assessment of sector related policies in Dubai?

When you consider the past 14 years, which is how long we have been present in the UAE, regulations have certainly improved and ensured that the healthcare environment has more governance over it and more control. More regulations have come into effect, such as the introduction of mandatory health insurance, and a more ethical market has taken shape. In 2019, the government has also created the Dubai Health Post Office, which is a portal through which all our payments are processed. It has created the ERX where all pharmacies seek approval and where payments go through, while additionally e-authorization for all healthcare services is obtained. In Abu Dhabi they created the new Department of Health which has a healthcare advisory board that I sit on. The plan is to eventually have one national unified medical record, which will be fantastic.

In that mid to upper market, has there been a shift behavior such as a move toward preventative care?

That seems to be a more observable trend globally, where probably almost half of healthcare expenditure goes on preventative health and wellness. Executive medicals are a large business line, and people are trying their best today to stay healthy and out of the doctor's surgery. In our business we do executive medicals and are starting a precision medical laboratory where you take the gene sequencing of an individual and give them specific medication based on what their genes indicate a shortage of. The next step is called microbiome where bacteria in your stomach are looked at to determine what is missing so that you do not need antibiotics and probiotics. This can tell you specifically which bacteria are required to ensure that you maintain a healthy lifestyle.

Is Dubai becoming a hotspot for medical tourism?

People effectively travel for healthcare for three reasons: lack of access, price and quality. So, if you look at the globe, it is going to be difficult to attract people that struggle to have access. The second consideration is price, probably the biggest reason why people travel for healthcare. So where you see that the local economy and salaries amount to 70% of your own costs, you cannot compete with the likes of India and Thailand for the same reasons, or with those cheaper countries. Therefore, the aspect to focus on is quality. The reputation behind a quality healthcare destination like the UK's Harley Street, Germany, Switzerland and the US takes long years to develop. I do believe that this is the area we to focus on, even though it will indeed take time to establish that reputation.

What are your priorities for the next two years?

First, it is important to note that the economic environment of the UAE is under strain. The economy has certainly changed over the past three to four years, as has the mix of the people in the UAE. The reality is that Dubai has already diversified and Abu Dhabi will diversify still further. There are big attractions to bringing in major manufacturing companies and huge incentives in place. The UAE has become a country where receivables are on the rise. We have obviously been here for a long time, we are positioned in a certain way, have a strong balance sheet and are listed on the London Stock Exchange. While we are not committing to major new investments currently, we do have a significant number already being worked on. The first one is Mediclinic ParkView Hospital which we finished in September of last year, and which is doing very well. We opened that because we felt that we needed a hospital on this side of town nearer to the world Expo 2020 site, which will require ready access to healthcare services. Rashid Hospital is the main trauma hospital.. We are working on numerous little projects and our other major one is Mediclinic Airport Road Hospital in Abu Dhabi, which is under expansion to double in size: the new extension should open early next year. These two projects alone, Parkview and Airport Road, will have added 40% capacity to our business over the past two years. We do expect some consolidation in the industry due to regulatory changes and prevailing economy conditions. We are well positioned to embrace this. We bought the Majid Al Futtaim clinics last year, and also Bourn Hall, the original pioneers of IVF over 40 years ago. They invented that technology and are present in the UAE under a franchise arrangement. We are focusing more and we are moving our business toward preventative and precision medicine. That will be a key focus for us over the coming years, as well as embracing other innovations.

Do you see a future for research and development here?

We run a huge research program with our doctors. We have 52 research projects running at the moment in conjunction with the Mohammed Bin Rashid University. Another gap in the market is healthcare teaching facilities and we have addressed that too. Also, with the Mohammed Bin Rashid University, we now have teaching facilities in the UAE. We have about 50 students that will be joining us in September and rotating throughout our facilities over the next three years, which increases the number to 180 students, effectively making our hospitals and clinics teaching facilities. Research and education within healthcare is certainly the way forward and we are already participating in that.