TREATING THE HEALTHCARE SECTOR

Saudi Arabia 2017 | HEALTH | INTERVIEW

TBY talks to Dr. Khalid Bin Mohammed Al Shaibani, Deputy Minister for Planning and Health & Director of the Vision Realization Office, on reforms within the Ministry of Health, the corporatization of healthcare provision, and transformations in care delivery.

 Dr. Khalid Bin Mohammed Al Shaibani
BIOGRAPHY
Dr. Khalid Bin Mohammed Al Shaibani attended medical school in Saudi Arabia as well as the UK. He has a bachelor’s of medicine, a bachelor’s of surgery (MBBS), and a professional qualification of Fellowship of the Royal Colleges of Surgeons (FRCS). He retains full General Medical Council registration in the UK and is a member of the Royal College of Physicians and Surgeons, Glasgow, the Arab Society of Nephrology and Renal Transplantation, and the Saudi Society of Nephrology & Renal Transplantation.

Vision 2030 is a massive project, with sweeping goals for the health sector. What has been accomplished toward achieving these goals since they were announced?

Our health sector has not had a substantial or significant reform since the Ministry of Health's inception. We have traditionally supported building more hospitals, more primary care centers, and more care delivery. Clearly, we now need to shift the focus to the prevention of disease. The concept is a far-reaching transformation that engages almost every component of how we provide care, from how we finance it to how we actually deliver care on the patient side. One of the themes of our transformation is collaboration with the private sector. We have identified more than 40 PPP opportunities. We have looked at imaging, laboratory facilities, and the pharmacy segment as well as at some of the services we have seen a large shortage in: rehabilitation, long-term services, and home care. We have also looked at issues like the large number of hospitals that are being completed, but have problems commissioning and operating. We look to the private sector to help us with that. Two hospitals have been released to financial, legal, and business consultants who will develop the complete package.

Do you intend to take the road of corporatizing assets on the way to privatization, for example as done by the General Authority of Civil Aviation?

Currently, the MOH has a conflict of interest. It provides care through a network of more than 365 hospitals and 2,500 primary care centers but is, at the same time, the governor and regulator. We have plans in 2018 to separate this process so that the MOH will no longer provide care. The provision of care will be given to multiple corporates that will then compete on the basis of quality of services and patient care, experience, and safety. We have started what we call the “pathfinder" engagement, in which the Health Minister initiated the road to corporatization. We hope that by 2030 we will have corporatized them and granted them autonomy. Doing so would reduce the level of decision-making to as close to the patient as possible and allow them to develop competitiveness. We hope that by 2030 it will be left to the decision makers to decide on whether to privatize that asset or keep it as a government-owned asset. It would be completely corporatized by then, but still a government entity.

How will this change transform care?

We will integrate the different silos that currently exist in the system. Now, a patient goes through the system in a horizontal manner; we always have the problem of patients going to a primary care facility and being unable to get a referral to go to hospital. Instead, they skip the first step and go to a hospital directly, and that creates a huge burden on hospitals and does not utilize our primary care appropriately. Through a series of workshops over a period of five months, healthcare workers have designed six main pathways for our patient population. One of them is the chronic disease pathway. There is also emergency care, maternal and childcare, elective care, mental care, and end-of-life care. Corporates will be asked to roll out this model of care in different locations. This is the concept of the integrated new model of care that we want to use. Technology will also transform care. A private firm will provide a complete solution, including the health permission systems, hardware, software, data center, cloud, and infrastructure, to our ailing primary care network that has no connectivity. There are 2,300 primary care centers today, and most of them lack internet access. Our goal is the accessibility of 70% of the population to e-medicine by providing the internet access to the primary care centers.