ON THE SPEND

Oman 2014 | HEALTH & EDUCATION | INTERVIEW

TBY talks to Dr. Ahmed Mohammed Obaid Al Saidi, Minister of Health, on the role of the Ministry and the public-private balance.

HE Dr. Ahmed Mohammed Obaid Al Saidi
BIOGRAPHY
Dr. Ahmed Mohammed Obaid Al Saidi has a BSc from Park College, Kansas City, an MB ChB from the University of Glasgow, and studied General Management at Harvard Business School, in addition to a number of other diplomas. His career has included senior medical, administrative, and academic positions in both Oman and the UK, including as Under Secretary for Health Affairs and Senior Consultant Rheumatologist at the Omani Ministry of Health, Deputy Director General (Medical), Head of Medical Division and Senior Consultant Physician/Rheumatologist at The Royal Hospital in Oman, and Consultant Rheumatologist and Senior Lecturer at the Bristol Royal Infirmary in the UK.

What role has the Ministry of Health (MOH) played in the development of healthcare provision in Oman?

Prior to the 1970s, Oman's health services were extremely inadequate. From the beginning, the government made a commitment to develop a modern welfare state, including the promotion of health among Omani people. Oman's current health indicators compare well with those of many developed countries. Thanks to considerable economic and social development and progress in healthcare over the years, the Sultanate has achieved a life expectancy of over 76 years. This has been achieved despite a relatively high fertility rate and the consequent large share of the population under 15 years of age (34%). The health indicators show a remarkable reduction in mortality, especially childhood mortality. Remarkable achievements have been made in controlling other communicable diseases such as respiratory infections, diarrheal diseases, tuberculosis, and leprosy. Control of malaria, once a deadly disease in Oman, has been a great success. The annual number of cases declined from over 30,000 in the early 1990s to only 1,531 cases in 2012. Almost all cases reported in the last decade were imported. The MOH is the country's main agency responsible for the health sector. It develops policies and plans and implements these in coordination with all constituents of the health sector. The public sector runs 83% of the hospitals and 92.5% of hospital beds, and employs most doctors and nurses. The MOH runs about 75% of the hospitals and 78% of hospital beds, with about 70% of doctors and 77% of nurses. The MOH is also the principal provider of preventive, promotion, and rehabilitative services. It provides ambulance facilities and emergency medicine services. Drug control, bulk procurement, and the distribution of drugs are managed by the MOH. It runs educational institutions for nurses and allied professionals, and collaborates with Sultan Qaboos University (SQU) and the Oman Medical Specialty Board (OMSB) for undergraduate and post-graduate medical education.

How is the Ministry dealing with the challenges associated with a rising population?

Oman spends 2.4% of GDP on health. That is considered high compared to the average of 0.5% for developed countries and 1.6% for less developed countries. It is also high compared to the rates in a number of countries in the Eastern Mediterranean region. Considering the country's limited resources, the consequences of population growth will certainly affect the governments' policies for economic and social development. It is noteworthy that successive years of relatively rapid population growth have given Oman an overwhelmingly young demographic profile. Governmental spending on health accounts for about 82.5% of total health expenditure. In 1976, Oman devoted OMR9 million to the health sector. By 2012, the budget of the MOH had only grown to OMR482 million. Estimates show that by the year 2025, the MOH alone would require almost double its current spending on health to ensure the maintenance of sustainable national health development, a situation that would be far beyond the capacity of public financing.

What is the role of the private sector?

Although Oman has a very good public healthcare system and the services are free to nationals, the private sector has survived and even grown over the past decades. The private sector healthcare providers currently deliver both primary healthcare and specialized medical services through clinics, medical centers, polyclinics, or hospitals. Also, the private sector plays a major role in the pharmaceuticals sector and in providing dentistry services. The numbers of private hospitals and clinics are now 11 and 973, respectively. The number of hospital beds has increased to 488 in 2012 from just six in 1995. The number of private pharmacies has also grown over the same period from 254 to 476. Indeed, the private healthcare sector is complementing public healthcare reasonably well.