Saudi Arabia's Vision 2030 is the government strategic plan for economic diversification. It has defined healthcare as one of its key pillars for development and has set the goals and strategy for improved healthcare access and quality. Building a world class infrastructure is key and the government has turned to the private sector to achieve this with a $66 billion investment, making Saudi Arabia the most promising healthcare market in the Middle East.
Saudi Arabia, like its GCC counterparts, has experienced growing demand for quality healthcare services as its population grew quickly, lived longer and developed diseases associated with a sedentary lifestyle, obesity and diabetes. Vision 2030 has pledged to provide solutions and the government is addressing this with digital technologies and privatisation. Accessibility, quality and affordability of healthcare are key.
In April 2021, a report authored by Frost & Sullivan, a global research and consulting firm, and Mashreq Bank announced that the kingdom of Saudi Arabia plans to invest $66bn in healthcare infrastructure, scaling up private sector participation from 40 per cent to 65 per cent. Around 40-50 per cent of the total investment is likely to be on infrastructure until 2025 with the focus on digital solutions and medical consumables and implants after 2025.
Between 2010 and 2020, the GCC had some of the highest healthcare infrastructure investments in the world. This included an increase of the number of hospitals and hospital beds. The number of hospitals nearly doubled in most countries and around 80 per cent of the hospitals and clinics built were financed from government initiatives and funding.
In 2021, the government announced a formal law for public private partnerships, which clearly directs all sectors to develop privatisation strategies. The result has been some very promising deals in the health sector. But ensuring greater involvement of the private sector requires authorities to introduce necessary policies and collaborative platforms.
The ministries of health and finance of Saudi Arabia have developed a virtual platform which functions as a single location for relevant information about healthcare entities, certifications and regulations with the aim of improving investor experience. This platform brought together more than 120 hospitals and clinics in Jeddah and around the kingdom. Major investors fall into three categories - sovereign wealth funds, family offices and institutional investors.
Major private healthcare companies including Saudi German Health, Dr Sulaiman Al-Habib Medical Group and King’s College Hospital have announced plans to open or expand services in the kingdom, forecasting a growth in demand over time.
Through Vision 2030, the Saudi Health Ministry has taken the bold step to shift from being both the regulator and the operator of hospitals and clinics to being just a regulator and gradually assigning the operations to the private sector with the adaptation of a transformation strategy that separates the providers, payers and regulators, and the decision to have three government entities in the space – one focused on paying, another on regulation and one on operations.
The factors listed below are expected to drive demand for healthcare facilities and services and create lucrative business opportunities for companies involved in hospital operations, private medical insurance, medical equipment and technology.
The Saudi Arabian government aims to reduce the burden of financing universal health care by the public sector and a key component of this is the expansion of the private medical insurance sector. Formerly all residents of the country, citizens and expatriates, were permitted to use the public hospitals free of charge. This has changed. Private healthcare insurance is now compulsory for expatriates working and living in Saudi Arabia and for Saudi nationals (and their dependents) working within the private sector. Employers of foreign workers must provide private health insurance as a benefit.
There also appears to be a move towards the provision of healthcare for public sector employees through private healthcare insurance with the expectation that eventually 100% of the Saudi population will be privately insured. It was recently announced that four government ministries have entered into, or are in the process of entering into, arrangements with specialised companies to provide medical insurance services for their employees. These are the Ministry of Finance, Ministry of Commerce, Ministry of Tourism, and Ministry of Economy & Planning. It is only a matter of time before other government ministries and agencies follow suit in order to reduce the burden on the public health system.
The Implementing Regulations of the Co- operative Health Insurance Law 8/05/1430H were recently amended to state that private healthcare insurers must provide coverage within their insurance provision for telemedicine services, a clear indication of the importance of this method of providing healthcare within the Kingdom. The use of remote consultation will increase, and this is especially so following on from the COVID-19 pandemic.
A study by consultant PwC highlights that, since the establishment of a National Digital Transformation Unit, the kingdom’s public and private sectors have invested almost $15bn into information and communications technology infrastructure.
Ranking second out of the top three digital risers in a report by the World Economic Forum, Saudi Arabia is noted to have “continuously invested in its digital infrastructure”, for instance through its efforts in deploying 5G networks. Catalysing the rate of change was the Covid-19 pandemic, during which technology was used to a large scale. The number of applications used to manage healthcare during the pandemic quadrupled.
Telemedicine and teleconsulting (collectively ‘Telemedicine’) is now a regulated activity in Saudi Arabia. Previously, it was a tolerated practice before a licensing regime was introduced in December 2018 and Telemedicine Regulations (‘Regulations’) were published in June 2019. The Regulations state that telemedicine is available for screening, triage, consultation, diagnostics, obtaining a medical opinion from a healthcare practitioner, treatment support, and the monitoring of a medical condition.
Telemedicine can be practised by foreign investors in the Kingdom and all legal requirements and protocols that are applied to healthcare practitioners in physical practice in Saudi Arabia equally apply to the practice of telemedicine.
The MOH, through its public health services section, now provides telemedicine services through patients calling a designated telephone number (937) to obtain an initial medical consultation, and there is no need for an appointment to utilise this service and seek medical consultation. If the patient’s health query can be resolved and if medication is required, the MOH will send a text message to the patient with a prescription number to get free medication from designated pharmacies. If further investigation or treatment is required after the initial consultation, patients can book appointments through the Sehha application, which then informs the patient of the nearest healthcare institution (public) to attend the required appointment. A number of private healthcare centres now provide a telemedicine service to complement their physical healthcare service, and in some cases this is a partnership with an overseas, high profile healthcare provider.
In summary Saudi Arabia's financial investment, Vision 2030 strategy and National Transformation Programmes will lead to three major trends in the healthcare sector:
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