The major role played by the private sector in Saudi Arabia’s health sector is reflected in the proliferation of polyclinics. “They are mushrooming very rapidly, almost a new one in some corner of the Kingdom every week,” says Muhammad Ali, who has established himself as a leading polyclinic entrepreneur.
“There is so much demand for polyclinics, especially to deal with some of the routine health problems faced by the lower and middle strata of society or expatriates, that whatever number exists now may not be enough,” says Ali who owns or part-owns or manages a string of polyclinics across Jeddah.
One attractive feature of a polyclinic is that it has all the necessary departments to deal with most routine health problems. “It is only when a polyclinic finds it difficult to deal with a serious health problem that it refers the case to a specialist hospital,” says Ali who has also ventured successfully into a fully-fledged hospital in central Jeddah.
Some of the polyclinics are licensed by the local municipality to provide workers with health certificates. “In the interests of public health and hygiene, every six months municipalities require such certificates from any employee working in restaurants and eateries, supermarkets or wayside stores where they handle food items,” says Abdul Karim Hafiz, a municipal official.
Expatriates, who number more than six million out of an estimated total population of 27 million, are all contract workers who need to renew their iqamas (residence permits) every two years. They require a health document certifying that they do not suffer from HIV or any other communicable disease. Expatriates can obtain such certifications from the polyclinics or hospitals licensed by the General Directorate of Passports (GDP). “This in itself is big business for polyclinics, so there is a constant effort on their part to get such recognition from the Passport Office,” says an official at the GDP. Polyclinics usually charge a minimum fee of SR40 to issue such certificates.
Some polyclinics have, however, been accused of issuing certificates for a consideration without even conducting a health check-up. Abdul Salaam, managing director of the 250-bed Al-Noor Medical Center at Sharafiya, who manages a polyclinic in Hail, rebuts the allegation. “Such charges are baseless and malicious. Of course, there are black sheep in every business, but no polyclinic can risk doing this because if it is found indulging in malpractice or irregular activities, it is not only blacklisted by the authorities but also it runs the risk of losing its license permanently.”
When so many polyclinics exist, for instance six in a one square kilometer in Jeddah’s central district of Sharafiya, how do they compete to get a share of the business? M. Shuaib, manager of a polyclinic in the district, explains: “We market ourselves among the health insurance providers in a bid to get their recognition. Once this is done, half the battle is won, because obtaining this recognition itself adds to the prestige and stature of a polyclinic. Like a hospital, we too charge a minimum fee of SR20 for a patient holding the health insurance card from an insurance company. Such insurance companies are many, but the notable players are BUPA, MedNet and MedGulf. “We polyclinics also get a number of patients who are not covered by such insurance companies. They are workers engaged by small establishments who do not provide insurance cover. These employees cannot afford to go to hospitals, so they come to us. Sometimes, we take pity on them and charge them according to their financial status,” says a management executive of Abeer Polyclinic, which runs a chain of polyclinics.
Moiz Chaudhry, a Bangladeshi worker feels polyclinics are indeed a boon to workers like him. “I am a building haris (watchman). I cannot afford to have an insurance cover, nor does my sponsor who owns the building I work in, have any interest in providing me such insurance. So whenever I am sick and cannot be treated by self-medication or home remedies, I visit a polyclinic. Going to a private hospital is out of the question for me as it is expensive and a government hospital is a taboo for non-Saudis unless it is a life-threatening medical problem.”
A spokesman for the Ministry of Health says its teams conduct surprise raids on polyclinics and other medical institutions, including hospitals, medical laboratories and pharmacies, across the Kingdom. “Whenever they are found violating regulations, they have been closed down. In just three months in the recent past, the MoH detected violations as a result of more than 3,500 surprise inspections,” says Abdul Aziz ibn Abdul Mohsen Al-Dakheel, director general of health affairs in the Riyadh region. “Our department has not shown any leniency toward health institutions that violate the ministry’s rules and instructions. We give top priority to the health of citizens and residents and our inspectors will continue to check violations,” he says. At the same time, the ministry initiates investigations as part of a national strategy to protect integrity and combat corruption.
In a recent statement, the MoH said it had fired three Saudi employees on the grounds of administrative corruption. The ministry has also dismissed some foreign workers for stealing vaccines from public health centers and selling them to private clinics. The MoH is in the process of linking all public hospitals, health centers, pharmacies and other medical facilities with an advanced information network, as part of its efforts to facilitate services and prevent corruption. Meanwhile, the insurance market is poised for a major leap forward. It is estimated that the market will be worth SR20 billion to SR30 billion within the next eight years. “That’s why so many insurance companies are making desperate bids to get into Saudi Arabia”, says a financial consultant. “It’s an enormous market”. He adds that the Kingdom’s fast-growing pharmaceutical sector is contributing to the success of insurance company investments.
A report from the Gulf Organization for Industry Consulting notes that Saudi Arabia tops the list of GCC countries in the number of pharmaceutical factories (nearly 30) and the volume of investment in the industry (more than $600 million). In health insurance products, the entry of the private sector has given a fillip to the establishment of new hospitals and polyclinics as well as expansion of existing facilities.
The insurance sector is growing with the implementation of the new labor law. Saudis are also coming within the scope of the health insurance scheme. Some 16 million citizens are to be covered under a phased program. In addition, more than 50 percent of the expatriate population in the Kingdom is already covered by the mandatory health insurance scheme. The MoH is working on a project with the General Directorate of Passports to link iqamas electronically with health insurance.
Health care specialists point out that with the Kingdom’s population growing at 3.2 percent annually, privatization in the sector will gain momentum and will further boost the proliferation of polyclinics. The very fact that new polyclinics keep on opening demonstrate it is a profitable business.
