Interview: Mohamed Elmandjra
What key changes have you observed in Morocco’s health care sector in recent years?
MOHAMED ELMANDJRA: Operators in Morocco’s health sphere have always followed the dynamic of answering needs, not creating new ones. Growth in the sector is natural and organic, and increasing demand is being answered by both public and private providers. Still, the sector remains relatively underdeveloped compared to other industries. Morocco manages to attract major global firms in telecoms and automotives, but lags behind in education and health provision. Nonetheless, there have been some significant changes recently, with a noticeable trend towards more sophistication and reducing fragmentation, as small, disorganised structures can no longer cater to patient needs. The sector is also changing in a way that has increased its attractiveness to financial investors. Before 2015 only doctors could buy shares in a clinic, however, as this is no longer the case, it has positively impacted the development capacity of health providers. Companies now have the capital to invest in larger structures with modern equipment. The average number of beds in a standard clinic used to be around 30, which is very low compared to the rest of the world. From a regional perspective, operators are starting to show interest in developing health infrastructure outside of the Casablanca-Rabat axis. There is not as much purchasing power in Oujda as there is in Casablanca, but there are far more health care needs there.
How can the government foster more public-private partnerships (PPPs) in the health sector?
ELMANDJRA: The health sector is central to greater development nationwide, but it is not a business like any other. For ethical and moral reasons, success in the sector is not based solely on key performance indicators – patients are not clients. Therefore, it makes sense that some segments stay under public sector oversight. However, with interest from private institutional investors growing, a number of opportunities have arisen for PPPs that can significantly enhance the quality and capacity of care. There are certainly some roles that are more suited for the private sector. While emergency services, epidemiology and infectious diseases are segments better left in the public sector domain, some specialisations requiring expensive equipment can be better served in the private sphere, such as oncology, medical imagery and nuclear medicine. In these cases, private operators have more capacity to offer higher-quality services. Contrary to popular belief, development in the private sector is not a result of public sector failure; rather, when taken together, they complement each other. By modelling what has been done in the education sector, there will be space for all health care providers to succeed.
What is the outlook for Morocco’s health sector in the near to medium term?
ELMANDJRA: I think we will see an increasing number of PPPs enhancing patient care. For example, those benefitting from the Medical Assistance Regime could be treated faster and for a lower cost if there were some agreements between public and private clinics. For example, the waiting time for an appointment in Radiotherapy could be reduced to a week or two and not necessarily at incur a higher total cost of treatment. We should also see developments in telemedicine, not to mention the possibilities offered by teleradiology. Already, approximately 15% of the patients treated in Morocco come from abroad, mostly from other African countries. From a business standpoint, there will be more opportunities for medical device providers. However, for the sector to expand, there will need to be a clear emphasis on training doctors and nurses. Qualified professionals remain hard to find, especially in key specialisations.
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