The healthcare sector in Qatar remains heavily dominated by the public sector but a gradual shift in favour of private clinics and hospitals is expected to happen with full implementation of the National Health Insurance Scheme (Seha).
Questions have been raised as to what extent private clinics and hospitals are prepared to take up challenges lying ahead. The other side of the issue is whether they have been given a free hand to effectively compete.
The Peninsula spoke to doctors and officials from private healthcare facilities to know their views on problems and challenges facing them.
Almost all admitted that there are issues that need authorities’ immediate attention.
A major problem pointed out by most respondents is the severe shortage of some life-saving (emergency) medicines in the market and their non-availability in private pharmacies, which often makes treatment difficult.
They cited Sorbitrate, a tablet commonly used to provide temporary relief to patients suffering from chest pain and heart problems. It should be kept under the patient’s tongue.
“This tablet is not available in private pharmacies. As per rules, doctors are not permitted to stock medicines. Non-availability of such drugs could be a real problem for doctors while treating patients.
“Suppose a heart patient with chest pain is waiting in a clinic for a Hamad Medical Corporation (HMC) ambulance. The doctor can give him temporary relief if required medicines are available,” said Dr Sameer Kalandan, who runs a private clinic in Doha.
Metoclopramide and Stemetil to treat nausea and vomiting were also cited as examples.
“The problem is that licensed dealers do not import such medicines, probably because they are not profitable. This should not be allowed to happen. Authorities should ensure sufficient supply of such life-saving drugs,” said Dr Kalandan.
Dr Sameer Moopan, CEO, Aster DM Healthcare that runs six polyclinics in Qatar, went further and said, “We are required to keep an ‘emergency cart’ in clinics but what is the use of it without the essential medicines? We are forced to buy them from HMC at higher prices, in limited quantities.”
For many other medicines, only limited versions/options are available in the local market.
“A wide range of eye drops are used in ophthalmology but only five or six are available in Qatar. The same is the case with antibiotics. We cannot import them directly because the medicines have to be registered in Qatar,” he added.
Dr Moopan said the problem is likely to aggravate with a major reduction in the prices of medicines recently imposed following a GCC decision to unify import prices.
“Reducing prices is a good move but authorities should ensure that dealers do not stop importing medicines they may find not profitable,” said Dr Moopan.
Apart from the shortage of drugs, some clinics have problems with some private insurance providers which are “selective” in their approach. They allegedly choose some clinics and refuse to serve others.
“Why are they selective? The Supreme Council of Health (SCH) has not graded any clinics for such purposes,” Dr Kalandan said, expressing dismay.
He said some international medical insurance companies operating in Qatar are resorting to such practices.
“This practice may continue even if national insurance is implemented because these companies would be providing additional insurance as a rider to basic insurance under Seha,” he added.
He said there are some private and semi-government companies that refuse to accept sick leave certificates from certain clinics.
“If they have a complaint against any clinic issuing bogus certificates, why can’t they go to SCH? Why discriminate against clinics,” he asked.
Dr Kalandan hoped authorities would intervene to address such issues.
Most officials praised rules and regulations being imposed by SCH to raise the standards of private clinics and hospitals.
However, some complained about “procedural delays” in issuing licences to newly-recruited doctors, nurses and paramedical staff.
“We are facing problems in getting licences. We have been trying to obtain a licence for a new doctor for several months now but we are still waiting,” said an official of Qatar Medical Center.
He said such delays could cause major losses to healthcare providers because new recruits are not permitted to start work until they have a licence from SCH.
“Licensing procedures for new staff take a long time. We have been asked to produce some documents again and again. There is also a communication problem in this regard,” said an official of Al Shefa Polyclinic.
According to Dr Moopan, talents and experiences of some doctors cannot be fully utilised due to the different criteria adopted by SCH in defining the functions of general practitioners, specialists and consultants.
“The coding system under Seha requires defining the job of each of these categories clearly. But some criteria used for this classification need to be reviewed. For example, under the current system, an ENT specialist cannot treat a disease like sinusitis,” he said.
He felt that some highly experienced doctors are denied surgical privileges because they are not members of Arab Board of Medical Specialities or similar bodies recognised by SCH.
SCH continues to revise and update rules and regulations but decisions are not properly communicated to healthcare practitioners and providers.
He said some private health facilities are also facing problems in getting visas to bring qualified people, especially technicians and paramedics from other countries.
He said finding qualified professionals is a major challenge for private clinics and hospitals due to the increasing costs.
Isam Al Ajji, Director, Human Resource, Al Hayat Medical Center, highlighted the issue of the Qatari ID.
“Every time a patient visits a clinic he/she has to produce the ID, even if we have recorded it in our files. They may be denied treatment for failing to produce the ID and it is difficult to convince them about the reason,” said Al Ajji.
He said the clinic has been receiving 400 to 500 patients daily since it joined the Seha network.
“We still are not able to solve the issue of long waiting list for appointments. We should also be extremely cautious about making mistakes,” said Al Ajji.
He, however, feels that National Health Insurance Company is working with facilities to help address such issues.
“We have a good communication with authorities in this regard,” he added.
Despite problems and challenges, all officials sounded optimistic about a better future for private healthcare facilities, especially with the introduction of Seha.
Scores of private clinics have come up in the country in the past few years and many more are in the pipeline.
No new private hospital has been opened for several years but this is going to change with SCH giving the green signal to private investors to go ahead with their projects.
The Seha network includes three private hospitals, more than 40 clinics and several specialist dental facilities.
The launch of Seha that covers all citizens in the current phase has given a boost to private facilities in terms of the number of visitors.
Seha may not have helped reduce crowding at Hamad General Hospital, the largest healthcare provider, but several private clinics and hospitals in the network are also struggling to cope with the rush created by a sudden surge in the number of Qatari patients.
As a policy shift, Qatar’s healthcare strategy is giving high importance to the private sector, reflected in the rapid rise in the number of facilities. SCH has also announced plans to involve private companies in the management of some primary healthcare centres.
A main challenge identified is to develop the required infrastructure and provide quality care, as mandated by Seha.
“Seha will be a boon for the private sector that is going to play a vital role in the health sector.
“However, HMC would continue to be the leading player,” Dr Kalandan said, adding his clinic has applied to join Seha and is waiting NHIC’s approval.
“We have joined Seha recently and are ready to take up challenges with our expanding network. We are getting full support from SCH,” said Dr Moopan.
He said in the long run private healthcare facilities will be able to meet the needs of the burgeoning population, working side by side with public facilities.
Some doctors refused to express views or to be quoted for fear of falling foul with authorities.
The Peninsula
