Healthcare funding: bridging the private investment gap

ARTICLE

Healthcare funding: bridging the private investment gap

Director of Investment and Public Private Partnership at Dubai Health Authority, Dr Ibtesam Bastaki examines the key factors stimulating growth in the emirate’s rapidly changing healthcare sector

As a family physician, I’d be the first to tell you that a well-balanced diet can positively impact health. But our lifestyle trends are rapidly influencing the focus of healthcare investment in Dubai. And we need to keep abreast of that change to stay on top.

Throughout my decades-long career I have gained hands-on experience working with patients across a number of primary and secondary healthcare facilities.

I crossed over from a government position into the private healthcare sector several years ago. My mission was, and continues to be, bringing the world’s best healthcare services to patients in the UAE. For me, that change came at an exciting time.

Dubai had successfully secured the Expo 2020 bid, and that brought with it a host of new opportunities. The most obvious being job creation and an increase in visitors. This placed a new demand on the healthcare sector, so investment in the right areas became a need not a want.

In 2016, Dubai welcomed more than 326,000 health tourists, generating over AED 1 billion in total healthcare revenue. The emirate plans to become a major centre for medical tourism by 2020, and the DHA’s objective is to attract more than 500,000 health tourists by the end of next year. Now working with the DHA, fostering Public-Private Partnerships (PPPs) to help achieve this is my priority.

Key factors stimulating healthcare market growth

To move with the emirate’s continuing transformation and emerge as a leading hub of healthcare, we must respond and act on the key factors that are stimulating the growth of the region’s healthcare market. Among others, an ageing population and innovations in the way patients receive care is where investment priorities should lie.

Ten to 15 years ago, Dubai was quite different. The government was taking the lead on the majority of services across the city, including the healthcare sector. Back then, it served 60 to 70 per cent of outpatient and inpatient services. But growth of population, increased infrastructure, maturity of health regulations and the mandate of health insurance, changed things. Autonomy became the private sector’s buzzword.

Now, private sector healthcare providers account for 79 per cent of outpatient services and 74 per cent of inpatient services. And the data doesn’t lie. In 2014, Dubai was home to 2,800 licensed medical facilities. Today, that number has grown to 3,100, marking a growth of four per cent year on year. Private healthcare investment is helping to develop a strong health ecosystem in the emirate. We want that to continue.

Last year, the DHA launched the Dubai Health Investment Guide 2018-25. As part of its strategy, it outlined eight objectives, of which ‘providing attractive infrastructure for investments’ is a key element.

Identifying gaps in the market is the first step to a brighter future. That's what this guide does. There are certain areas in Dubai lacking health services, and it’s those areas that we need to focus on. The Dubai Health Investment Guide basically maps out the ABCs of where to go next. It’s a high-profile conversation that includes ideas, innovation, research and education to help solve tomorrow’s healthcare challenges as a nation and worldwide.

Though still a young country, the UAE has made big strides in healthcare over the past decade. Dubai has led that growth. Initiatives spearheaded by the government and government-related entities have opened up huge opportunities for private sector providers. This has resulted in the UAE being able to position itself as an attractive destination for innovation and talent. Not one to rest on its laurels, the government has made it clear that those strides need to continue making pace.

The investment guide states that growth in Dubai’s healthcare sector has been “mostly articulated around primary and secondary care, to cope with the Emirate’s dynamic demography”. But despite this favourable environment, there remains room for growth in the healthcare provisioning market. Private investment is at the forefront of that mission.

Over the next two to three years, DHA’s private investment focus centres on the supply-gap demands in specific types of services. We need more centres of excellence in tertiary care; rehabilitation, physical therapy and long-term care; chronic disease management; mental health; and ambulatory care.

Looking longer term, focus areas for investment include prevention and pharmacy beyond the pill; precision medicine and genetics; and population health management.

Keeping up with demand for specialised care

We need to create a more robust sector, which promotes healthcare, not sick care. In 2014, curative care accounted for 59 per cent of expenditure in the healthcare sector, with rehabilitative care, ancillary services, and preventive care each accounting for one per cent, 15 per cent and five per cent, respectively.

While general hospitals are catering to the needs of the majority of Dubai’s current population, lifestyle trends are paving the way for a tailored approach to healthcare.

If facilities here don’t keep up with that demand for specialised care, citizens and residents will look overseas for treatment. And that’s an alternative Dubai does not want.

If you look at the top three causes of death among the UAE population, cardiovascular disease ranks number one, with cancer and trauma cases ranked two and three, respectively. To tackle each proactively requires specialised care.

Specialist centres for cardiology and oncology will not only ease the burden on general hospitals here, it will harness a reputation that, in the long run, will attract medical tourists to the city for treatment for these diseases.

Similarly, an increase in population is directly impacting the demand for urgent and emergency care. As more cars take to the roads, accident rates will be impacted. As more infrastructure takes hold, injuries in the workplace will likely increase. The launch of more urgent care clinics across the city will carve out a niche, which responds to this demand for trauma-centric care.

The investment needs and priorities for outpatient care units and acute inpatient beds for 2018, 2020 and 2025 have all been highlighted in the Healthcare Investment Guide. Based on comprehensive analysis of demand and supply projections across specialties for the emirate of Dubai, it will give you a more detailed view of where the needs lie.

The vital role of primary healthcare physicians

Close to 100 per cent of Dubai’s population now benefits from health coverage, following the introduction of mandatory health insurance law in 2014. That has brought with it an influx in demand across hospitals and clinics in Dubai.

While blue-collar workers seek intervention from primary healthcare facilities, white-collar workers are seeking more specialised treatment at secondary healthcare levels.

That mandate for health insurance has changed the investment segment. But to reduce healthcare costs and to encourage better quality of care, we need to emphasise the important role primary healthcare physicians hold within the emirate. They need to become the gatekeepers for better health.

This year, His Highness Sheikh Mohammed bin Rashid Al Maktoum, vice-president and prime minister of the UAE and ruler of Dubai laid down a new road map to ensure the emirate continues to prosper and grow in the coming 50 years.

Article Five of the nine-point charter cites a ‘Doctor to Every Citizen’. It aims to provide citizens with medical consultations 24/7 through hundreds of thousands of doctors, specialists and medical consultants across the globe. This will be facilitated by smart government application.

The goal is to bring doctors closer to individuals, which in turn will enhance awareness among the patient population.

While telehealth plays a huge role in the success of this vision, I believe better familiarisation is needed across primary healthcare centres, locally.

By extensively developing each physician for certain catchment areas within one population, it will build a better rapport between doctor and patient. And when each physician knows a family well, the opportunity to implement screening programmes will become a mandate. That could lead to early screening for cardiovascular diseases from the age of 18 onwards, as well as diabetes. And screening leads to prevention.

Age is more than just a number

Government reform has the ability to influence change in any sector within a country’s economy. The share of UAE Nationals aged 60 years and over is expected to increase by eight per cent by 2030.

Recent legislation pertaining to the introduction of retirement visas for long-term expatriates has also borne a new population-centric demand for Dubai’s healthcare sector.

Starting this year, expatriates in the UAE aged 55 or over will be eligible to secure a five-year retirement visa, if they meet certain requirements. For private investors, this has shone the spotlight on the emirate’s ageing residents.

With a relatively young population (aged 16-65 years), the supply-demand for geriatric medicine has never been a priority here. But as more expatriates choose to retire in the UAE, that supply-demand ratio will be under supplied. As such, I would definitely encourage private companies to invest in this area of business.

How technology is generating new investment opportunities

Telehealth is a new speciality in Dubai, but telemedicine is changing the game. This is another area that needs investment.

A clear licensing process exists for telehealth companies in Dubai. That means there is scope, which enables the emirate to take a share of the global telehealth market, which is estimated to reach six billion people by 2025.

But currently, Dubai has just a handful of facilities licensed with telemedicine. We need to dramatically increase that number. The use of more advanced technology can minimise risks and maximise positive outcomes in the workplace. It can be used as a visual aid guide for better education, and it can speed up surgery time too.

But to encourage more private investors to take a leap in this direction, we at the DHA need to pilot more services first.

Shows like ArabHealth are very important for knowledge transfer. Networking with industry experts from around the globe brings more know-how to the market and that face-to-face interaction often paves the way for lucrative private investment opportunities, that otherwise would not have come to be.

The conferences and exhibitions hosted at Dubai World Trade Centre (DWTC) are a hive for activity. And when I look forward, I know many of the healthcare successes of the future, as far as Dubai goes, will be a result of these networking events. I believe the industry will be far removed from the one I joined decades ago, and for me that is nothing short of exciting.

Topics

  • Healthcare
  • Investment
  • Medical