How far along is the integration of Al Noor Group into Mediclinic's structure?
Approximately 18 months ago we acquired the Al Noor group in Abu Dhabi, making us one of the largest healthcare providers across the UAE, with facilities in Abu Dhabi, Al Ain, the Western Region, and Dubai. We spent most of the year working on that integration. There were many challenges during that phase, most especially the sudden changes within the regulatory framework. The economy across the UAE is not growing as it used to during the boom years of 2011-2014. Despite the challenges of living within the constraints of the new oil price, we have confidence in the future of the UAE and are still growing. In Dubai, we opened our comprehensive cancer center in September 2016, which has been performing ahead of expectations since then.
What are the differences between the regulatory framework in Abu Dhabi and Dubai?
In Dubai, the regulator, on top of setting policy, also manages the government hospitals. They are not really growing these hospitals, as they want the private sector to invest and take on this responsibility, so they support the private sector and competition through policy. The insurance sector is also competitive. When mandatory health insurance was introduced in Dubai, there were initially seven providers that could provide the basic package to the market, whereas in Abu Dhabi there is just the one provider. This means that this one provider comprises two-thirds of the market. The rest of the companies are fighting for that remaining one-third, so it is not as competitive as Dubai. In Abu Dhabi, the regulator also sets policy but does not operate the public hospitals directly, and thus, the onus is not left to the private sector to take on this responsibility.
What effect does medical tourism in the region have on your business?
The statistics for medical tourism can be misleading. For example, emergency room visits from a normal tourist could be considered as medical tourism, so statistics need to be read in context. There is a medical tourism visa now available for healthcare specifically, and there is potential for growth in the medium to long term. It is important to understand that medical tourism includes three deciding factors for patients. Firstly, the person does not have access to such services in their home countries. Second, the quality of facilities in the source country is not as required. And third, people are looking for healthcare at a cheaper price. When it comes to price, the UAE cannot compete with lower income countries such as India and Thailand, but we can compete on quality.
In what areas do you see the most potential for growth?
Whilst the healthcare spend per capita is fairly high at USD2,200 per capita, the UAE is a high-income country. Expenditure on healthcare in the UAE is actually still fairly low as its percentage of GDP sits at around 3.5%. That will inevitably increase over time as quality improves and less people travel abroad for their healthcare needs. Also, there is an ever-ageing population, and the burden of disease is increasing with an increasing prevalence of diabetes, obesity, heart disease, and cancer. All of these factors will hike up the cost of healthcare and required expenditure over time.
What are the most important trends you see coming into healthcare?
The regulations will increase, and I hope that there will be a larger focus on ethics and the subsequent cost of over-utilization. Improved technology, especially artificial intelligence, will also make a more significant impact on services within healthcare. The patient to doctor relationship will also change; we will have mobile health such as video and telephonic appointments, and wearables will become a more significant part of healthcare monitoring. Healthcare is an exciting and an ever-changing environment, and the UAE is at the forefront of these changes.