Interview: Dr Haitham Alfalah
Given comparatively reduced health budgets, how are sector players allocating their resources in a more cost-efficient manner?
DR HAITHAM ALFALAH: The past decade has seen a year-on-year rise in health care spending, fitting within the strategy to face the huge demand rising in the Kingdom’s health care services. The government is currently working on developing a new health care vision for the country that can provide better services to our communities with the best utilisation of resources aligning with Saudi Arabia’s 2030 vision. There is a need to consolidate health care services and create specialised centres. Improved information collection systems and a smarter investment strategy can decrease duplicated services and be instrumental in implementing cost-effective projects. The Kingdom is aware of the myriad expenses that have accumulated over the years and projects that can be classified as underperforming. Programmes seen as cost ineffective will be cut to open room for improved solutions. Optimisation is the new strategy of the ministry, creating change in the sector by focusing on the core competencies of specific institutions. From a human resources perspective, staffing at all levels is a challenge. The Kingdom has made progress on the education and training front. The number of medical schools has jumped from four to 20, but there is still a gap and more training facilities are needed to close it.
What role can the private sector play to help reduce the burden on hospitals in the Kingdom?
ALFALAH: Private sector involvement in health care has been limited, accounting for less than 20% of health services. However, changes in the government’s health care vision will open new possibilities for public-private partnerships. There is a wide spectrum of opportunities for private involvement, ranging from the administration of public hospitals to the privatisation of specific services offered within a public hospital to improve the efficiency of service, or to larger private involvement in the construction of private facilities and medical centres. Moreover, there are opportunities for investment in the area of postacute care. Patient rehabilitation services are in high demand, and we have yet to see significant public or private initiatives to supply this growing demand.
To what extent should hospitals focus on specific care, such as trauma or oncology, to reduce duplication and enhance the system’s efficiency?
ALFALAH: What we see on the ground, and particularly in large cities, are government facilities that have duplicate services. The advantages of consolidating services should not only be seen from a cost-efficiency perspective. It has been shown that there is a patient volume threshold that enhances the expertise and treatment quality of the medical department, which also enhances patient safety. By creating stronger centres for specialised services, we are also improving patient outcomes and creating large fields for training and research.
The sector’s regulatory structure needs more flexibility to make certain that patients are not affected by the consolidation of the sector’s services. Ensuring a smooth process for patient transfers between institutions is of the utmost importance. We need to ensure there is a streamlined process for patients to receive complete care within a time frame that corresponds to their needs. At King Saud Medical City, we are focusing on trauma services, which is our core competency. With several nearby facilities offering cancer treatment services, there is no need to duplicate a service that requires significant investment with marginal contributions to the system as a whole. Injuries from traffic accidents are high in the Kingdom and we are well positioned to serve in this area. Our trauma department provides care to 92% of patients transferred by helicopter in the Riyadh region.
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