Dr. Abdullah Al-Rabeeah, who became the minister of health in the Cabinet reshuffle in February, has pledged that the health care services will meet the demands of both citizens and expatriates. To ensure not only the best possible service to the public but an integrated health service, his ministry is to embark on a number of new projects. These include family health and home health care programs.
The Health Ministry (MoH), with a network of 1,925 primary health care centers providing the overwhelming bulk of primary health care services throughout the country, is responsible for the provision of health services carried out in public hospitals and clinics as well as the regulation of health care provided by the private sector.
It is not, however, the only ministry to provide health care services. A large number of Saudis access government-provided health care through institutions unconnected to the Health Ministry.
Three other ministries provide a full range of medical services, all the way through to tertiary care if needed. These are the Defense and Aviation Ministry, the Interior Ministry and the National Guard, serving their respective branches of the security and armed forces with hospitals and clinics across the country. In addition, the Education Ministry provides immediate primary health care to students.
The Ministry of Labor and Social Affairs operates institutions for the mentally retarded and custodial homes for orphans; these facilities provide their residents a certain amount of medical care. The General Organization for Social Insurance (GOSI)and General Presidency of Youth Welfare also provides health services for certain categories of the population in connection with its management of sport facilities. Likewise, the Royal Commission for Jubail and Yanbu provides health facilities for employees and residents in the two industrial cities of Jubail and Yanbu. Saudi Arabian Airlines operates its own health care facilities for its employees. The Kingdom’s universities also provide a degree of coverage through their medical colleges and hospitals. The government also finances and provides care on a referral basis in its major specialized national tertiary care referral hospitals King Faisal Specialist Hospital and Research Center and King Khaled Eye Specialist Hospital.
Additionally, there is the Saudi Red Crescent Society (SRCS). It provides emergency services at pre-hospital stage, either at the scene of accidents or in the transportation of patients to hospital. The society also undertakes the unique task of providing such services for pilgrims performing Haj and Umrah at Makkah and at Madinah. During the last Haj, it set up 93 first-aid centers, used 492 ambulances and deployed a large number of doctors, nurses, paramedical staff and drivers to serve the pilgrims.
Under a recent agreement with the MoH, Red Crescent ambulances will now transport patients to both government and private hospitals in the Kingdom. According to SRCS president, Prince Faisal bin Abdullah, the primary aim of this new arrangement is that all emergency patients receive medical treatment as quickly as possible. It follows an instruction from Custodian of the Two Holy Mosques King Abdullah that, in an emergency, patients should be taken to the nearest hospital.
Saudis and expatriates employed by the public sector are currently eligible for full, free health care, no matter the cost, whether it is a visit to the doctor for backache or a baby’s cough or state-of-the-art cardiovascular procedures, organ transplants and cancer treatment (including bone marrow transplants). All are covered.
Sponsors/employers are responsible for paying for an extensive package of services for private sector expatriates, usually through insurance.
After education, health care is the government’s top priority. In last year’s budget, a record SR44.4 billion (almost 11 percent of total government spending) was allocated to it and social services (the two always go together). It represented an increase of 12.4 percent over the 2007 figure. Most of that increase went to pay higher salaries in hospital and clinics.
Under that budget — public health care accounts for 80 percent of all health spending — the ministry signed agreements for a number of new hospitals in addition to the 79 being built at the time. The new ones included a 200-bed hospital in Al-Ahsa at a cost of SR204 million and two 100-bed hospitals at a cost of SR173 million in Al-Laith on the Red Sea coast north of Jeddah and at Mekhawah in Baha region. There were also allocations to install computer systems in some 50 hospitals and 300 health care centers. The ministry also started work on further nursing accommodation at a cost of SR370 million.
This year, the budget allocation is even higher: SR52 billion; again, around 11 percent of the total. As well as covering the ever-increasing costs of the health service, a proportion has been allocated for several completely new hospitals, ongoing work on 86 hospitals providing a further 11,750 beds, a large number of new primary care centers and the upgrading and expansion of many existing hospitals.
Currently, there are 379 hospitals in Saudi Arabia (256 public sector, 123 private sector) with some 52,000 beds, in addition to the 4,000 clinics owned and operated by Saudi and foreign partners. It works out at around 22.5 beds per 10,000 of the population, the same as in China but well down on levels in most industrialized countries. In France, for example, there are 73 beds per 10,000 people and in Australia 40 per 10,000. However, the extra beds in the pipeline — 16,453 in both government and private sector hospitals in the next six years — may alleviate the situation, although the increase will be offset in part by growing demand from a growing population. According to the latest Annual Statistical Report of the Ministry of Health, the estimated population in the Kingdom was put at 24.2 million with an annual growth rate of 2.2 percent. Fertility rate was 3.1 percent, and life expectancy has increased to 73 years of age.
Hospitals in the Kingdom — both governmental and private — reportedly employ over 31,402 doctors, 6,218 of them Saudis, (although this figure is disputed). They also employ over 66,000 nurses and pharmacists. The Kingdom currently provides a doctor for every 673 people. The recently implemented private health insurance scheme covers foreign workers in the Kingdom. It is now mandatory for every foreign worker to be covered by a health insurance scheme to look after his or her illness and hospitalization expenses.
A total of 123 million patients have visited the private and public health institutions throughout the Kingdom for medical treatment during the year 2007, according to the latest Health Ministry’s annual report. The most potential significant statistic, however, is that less than half (around 48 percent) used public sector facilities.
As a result of persistent efforts taken by the ministry, there was a remarkable decline in infectious diseases. Only 13 positive cases for meningitis were detected out of 300,000 suspected patients, which was 0.05 percent, against the previous number 0.09 percent. Diseases such as measles and polio was successfully controlled thanks to planned vaccination programs.
Under a new system, each hospital will have a suggestion box to enable the patients to submit complaints to those running the institution. Additionally, the ministry has established a toll free number 920020024 for suggestions and also the patients could text their complaints to the same number.
The ministry also plans to unify the salary structure of 150,000 health officials working in government and specialized hospitals. It was announced last week that King Abdullah had approved plans to put salaries of doctors and others in government hospitals be on par with their counterparts in specialized hospitals such as National Guard Health Affairs and Riyadh Armed Forces Hospital.