United Arab Emirates Dubais healthcare market

Juha Wiln
2008

Table of contents
1. SUMMARY ............................................................................................................................ 3

2. HEALTH CARE POLICY, REGULATION AND SERVICE PROVISION IN DUBAI............................................................................................................................................ 5 3. 4. 5. 6. 7. DEPARTMENT OF HEALTH AND MEDICAL SERVICES ................................. 6 PRIVATE HEALTH CARE IN DUBAI....................................................................... 10 DUBAI HEALTHCARE CITY (DHCC) ...................................................................... 11 SAUDI GERMAN HOSPITAL GROUP ..................................................................... 13 SOURCES ............................................................................................................................ 14

Juha Wiln Finpro ry Firstname.lastname@finpro.fi + 358 40 3433 325

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1.

SUMMARY
There is great and increasing demand for healthcare in Dubai. The main reasons for this are the fast population growth and the increase of non-communicable, lifestyle-related diseases. There were 1.32 million people in the emirate of Dubai in 2006. The population is growing c. six per cent per year and will likely exceed 1.6 million in 2010 due to large immigration and high birth rate. This has created not only a housing shortage but also a healthcare service shortage. Health care services in Dubai are provided mainly by Dubai Department of Health and Medical Services (DOHMS), UAE Ministry of Health and private companies. Besides, Dubai Municipality and Dubai General Police provide services to their staff only. Government has so far provided c. 75 per cent and private sector c. 25 per cent of health care funding in Dubai. The purpose is to invert these shares in five years (by 2013). DOHMS will continue investing in new facilities. It will build a new 800-bed hospital at the site of present Rashid Hospital and another hospital in Jebel Ali District. DOHMS will also open three new health centres by 2010. However, health care service capacity and provision will increase mainly in the private sector. There were 18 private hospitals in Dubai in the first half of 2007. According to Dubai Healthcare Provision Report (June 2007) eight private hospitals will be opened in 2008 or 2009. One of these projects - American Hospital - is an expansion. Some new players will provide with a large spectrum of services and some players specialized services in special hospitals. Some newcomers like Saudi German Hospital Group will build both a general hospital and six special units. Companies will get clients if their health care services are of good quality. International companies which have a wellknown brand (e.g. Harvard Medical School, Mayo Clinic, Johns Hopkins Medicine and SGH Group) will most likely succeed best. However, there is so much demand for services in Dubai (and other emirates) that also smaller players can thrive. Representatives of Saudi German Hospital Group said that the turnover of health care services is forecast to be 60 billion USD in the Gulf Co-operation Countries in 2010. Of this, 8-9 billion USD comes from the United Arab Emirates alone. 70 per cent of the sales growth will be in the private sector. The turnover of medical tourism in the UAE grows 15 per cent a year and is forecast to be 2 billion USD in 2010. Medical tourists are attracted by the high quality of hospitals and hotels and vast amount of free-time activities. These features also allure foreign businessmen who can have treatment during business trips. Besides, there are plenty of foreigners who spend winters in Dubai and want to have health care while staying there. A very important means to meet the demand for health care (and increase the demand) is Dubai Healthcare City, the worlds first integrated health care free zone. DHCC consists of Academic Medical Centre, 2) Medical cluster, 3) Wellness cluster, 4) Supporting services and 5) Center for Healthcare Planning and Quality (CPQ) in charge of regulation and licensing in the zone. DHCC is being developed in two phases. The first phase is c. 4.1 million square feet in size. The second phase, with 19 million square feet of land, will allow DHCC to offer the complete healthcare continuum, including hospitals, wellness

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and clinical centres. Phase I will be 80 per cent complete by 2010. The University Hospital in the Academic Medical Centre will open in 2011, though. According to Dubai Strategic Plan 2015 every resident of the emirate, including expatriates, is to be covered by health insurance. A health insurance scheme has been planned but the plan has not yet been approved by the Executive Council. When implemented, the scheme will have a big positive effect on private health care provision. The United Arab Emirates, especially Dubai, is a land of experimenting new ideas and solutions. It is a gateway to the Middle East, Africa and Asia. As the UAE is compact in geographical size and regulation in Dubai does not differ much from regulation in the other emirates, investors often treat the markets of seven emirates as one. Demographic indicators in 2006 Population of Dubai 1 321 453 Natural increase of population 15 088 persons (11.4 % from 2005) Number of babies born alive 16 929 Crude birth rate in 2006 12.8 per 1000 people Number of registered deaths 1 841 Crude mortality rate 1.4 per 1000 people Neonatal mortality rate 5.8 per 1000 people Infant mortality rate 9.2 per 1000 people Child (1-4 years) mortality rate 0.5 per 1000 people Child (1-4 years) mortality rate 10.6 per 1000 live birth Source: Dubais Department of Health and Medical Services (DOHMS)

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2.

HEALTH CARE POLICY, REGULATION AND SERVICE PROVISION IN DUBAI Situation in May 2008
Health care policy and strategy in Dubai is made by the federal Ministry of Health (MOH) and Dubais Department of Health and Medical Services (DOHMS). The Ministry of Health defines the broad framework and DOHMS acts on a more detailed level. Healthcare regulation in Dubai is divided between three authorities: the federal Ministry of Health, DOHMS and Center for Healthcare Planning and Quality (CPQ) of Dubai Healthcare City (DHCC). The Ministry of Health regulates health care provision units it owns in Dubai: two hospitals (Al Bahara and Al Amal), nine primary healthcare centres and a smoking cessation clinic in Jumeirah. Department of Health and Medical Services regulates its own health care provision units and those of private companies outside DHCC. DOHMS has four hospitals (Dubai, Rashid, Al Wasl and Trauma Centre) and 16 operating health centres (in May 2008). Center for Healthcare Planning and Quality (CPQ) of Dubai Healthcare City is in charge of regulation of hospitals and clinics in DHCC. Dubai Healthcare City is the worlds first integrated health care free zone. There is one hospital in DHCC at the moment (May 2008). Later this year another one is due to start operations. A total of eight hospitals have been approved to date. Health care services are provided mainly by federal Ministry of Health, DOHMS and private companies. Besides, Dubai Municipality and Dubai General Police provide services to their staff only.

Situation in the future

As the Department of Health and Medical Services has been in charge of both policy & strategy, regulation and service provision (together with other actors), it has had a very central position in Dubais health care system. The role of DOHMS is, however, changing significantly due to restructuring started by the government of Dubai. The most important aspects are the separation of policy & strategy, regulation and service provision from each other and the foundation of new organizations that will be responsible for these functions. Policy and strategy The government of Dubai created the Dubai Health Authority in June 2007. The DHA will gradually take all policy and strategy functions from DOHMS. The new authority starts to function in phases and will be fully operational by 2012. This means that after a couple of years the federal Ministry of Health and DHA are responsible for health care policy and strategy in Dubai.

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According to Dubai Strategic Plan 2015 every resident of the emirate, including expatriates, is to be covered by health insurance. A health insurance scheme has been planned but the plan has not yet been approved by the Executive Council. Regulation The present system of three health care regulators in Dubai will be transformed to a system of only one regulator. A new governmental agency will be founded to regulate all public and private hospitals, health centres and clinics everywhere in the emirate of Dubai, including Dubai Healthcare City. MOH, DOHMS and Center for Healthcare Planning and Quality will divest their regulatory functions as soon as the new agency starts to work. The name of the regulatory agency has not been decided, yet. At present, staff licensed by the Ministry of Health is not allowed to work in public and private hospitals under DOHMS regulation without satisfying its requirements. Besides, medical workers with DHCC license cannot practise with DOHMS or the Ministry of Health, unless licensed to do so, even though DHCC has the strictest requirements, accepting only doctors with qualifications from certain, mostly Western countries. This will change; in the future, all medical workers will get a license from the new regulatory agency and be entitled to practise in all sectors. Service provision The federal Ministry of Health will continue providing health care services in Dubai. MOH is content with its present scale and will not open new facilities in the emirate. As for private companies, the existing ones will stay in the market and many new will enter. DOHMS will provide medical services for a couple of years more. In the next decade service provision will be taken over by a new organization. After DOHMS will have divested its policy, regulatory and service provision functions it will be dismantled.

3.

DEPARTMENT OF HEALTH AND MEDICAL SERVICES

Hospitals and health centres Dubais Department of Health and Medical Services is the biggest service provider in Dubai. DOHMS has four hospitals (Dubai, Rashid, Al Wasl and Trauma Centre) and 16 health centres and clinics (in May 2008). Rashid Hospital is a 454-bed general medical/surgical hospital. Built in 1973, it is one of Dubais oldest hospitals. In July 2006, DOHMS announced a 1 billion AED (272 million USD) plan to build a new 800-bed hospital within available space at the site. The new hospital is expected to be ready by 2010. The existing building will subsequently be demolished. The investment expenditure does not include medical equipment and devices. Their cost is estimated at 40 per cent of the building cost. If the estimate is exact, c. 109 million USD will be spent on equipment. DOHMS is also building an Accident & Emergency hospital in Jebel Ali district. The estimated expenditure on construction is 600 million AED (163 million USD) excluding medical equipment and devices. Their cost is estimated at 40 per cent of the cost of the building (c. 65 mln USD). There will be 400 beds in Jebel Ali Hospital. DOHMS will

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open three new health centres by 2010: Al Barsha, Nad Al Hamar and Al Mizhar. Building cost of one health centre is estimated at 30 million AED (8.2 million USD). Procurement of services and equipment Department of Health and Medical Services manages its own hospitals and does not buy management services from private companies. On the other hand, the Health Authority Abu Dhabi (HAAD) contracts hospital management. If Dubai started to copy Abu Dhabi, foreign companies would have chances to offer management services to DOHMS or the successor of DOHMS in service provision. DOHMS uses foreign consultants and other experts in health care units. North European companies have chances to sell consulting services. When DOHMS (and the coming organization which will run hospitals and health centres) wants to purchase services from private companies, it looks at skills of individuals and companies and is not interested in the nationality of service providers. DOHMS (and its successor in service provision) is willing to buy equipment from North European companies. The manager in cardiac surgery has been trained in Sweden and knows Swedish offering. Extending the perspective to other Nordic countries is quite easy. DOHMS health care units need all kind of things. In demand are especially rehabilitation facilities and equipment. As DOHMS will be replaced by a new organization in service provision in a couple of years, it is not yet known what equipment and devices will be purchased and for what sums in the 2010s. The purchasing process will anyway change from the present. Tendering procedure by the Purchasing Department may also change. Health care indicators for DOHMS DOHMS had 17 health centres in 2006 (16 in May 2008). There were c. 78 000 people per one DOHMS-operated health centre and c. 6000 people per one general physician. The number of visits in hospitals and health centres per 100 people was 101. Average length of stay was 5.2 days and average bed occupancy rate 56.2 per cent. Basic healthcare indicators for DOHMS in 2006 Population per health centre Population per general physician Population per specialist Number of visits / population Number of patient care days Annual discharges / 1000 people Average length of stay Average bed occupancy rate Bed turnover rate Number of beds per doctor Number of beds per 1000 people Source: DOHMS Finpro
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77 733 6 062 1 590 1.01 218 44.42 5.2 days 56.20 % 41.76 % 1.70 1.06

Employees in DOHMS The number of employees in Department of Health and Medical Services was 9540 in 2006. The number grew 13.2 per cent from 2005. Nationals constituted 26.2 per cent and females 58.2 per cent of the staff. The number of employees in DOHMS hospitals and health centres was 6798 in 2005 and 7620 in 2006. The number of doctors (excluding dentists) was 1049, dentists 81, nurses 3338 and pharmacists 155 in 2006. As for doctors, there were 218 general physicians and 831 specialists. Number of patients and surgical operations in DOHMS The number of out-patients (patients who go to a hospital or clinic for treatment but do not have to stay overnight) in DOHMS hospitals and primary healthcare was 1 330 656 in 2006. The number grew 6.5 per cent from 2005. Nationals constituted 65.7 per cent of all out-patients and female nationals 59 per cent of national out-patients. The number of out-patients in DOHMS health centres and clinics (including emergency units) was 637 655 in 2005 and 669 698 in 2006. The number of in-patients in DOHMS hospitals (including Trauma centre) and primary healthcare was 69 652 in 2006. Nationals constituted 32 021 of them. The total number grew 7.4 per cent from 2005. The number of surgical operations in DOHMS hospitals was 20 560 in 2004, 19 988 in 2005 and 22 463 in 2006. The number of major operations was 12 060 and that of minor operations 10 403 in 2006. Most operations are obstetric & gynaecological, general surgery and trauma & orthopaedic. Operations in DOHMS hospitals by type Trauma & orthopaedic General surgery Cardiac surgery Neurological Obstetric & gynaecological Paediatric Urological Extracorporeal shock wave lithotripsy (ESWL) Ophthalmology Ear, nose, throat (ENT) Dental Circumcision Others Total Source: DOHMS 2005 2 825 4 177 209 309 4 969 1 249 521 99 912 1 040 424 2 944 310 19 988 2006 4 020 4 852 206 482 5 396 1 203 497 127 1 022 962 513 3 131 52 22 463

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There were 5653 cases of notified infectious diseases in 2006. The most common diseases were chicken pox with a 61.4 per cent share, hepatitis B (392 cases, 6.9 % share) and pulmonary tuberculosis (312 cases, 5.5 % share). The number of malaria infections was 147, that of salmonellosis 33 and that of food poisoning 98. Notified infectious diseases by type in 2006 I.C.D Disease A 01 Typhoid & paratyphoid A 02 Salmonellosis A 15 A 16 Pulmonary tuberculosis A 38 Scarlet fever B 01 Chickenpox B 02 Herpes zoster B 15 B 17 Hepatitis A, B and C B 26 Mumps B 50 B 54 Malaria G 00 G 01 Bacterial meningitis J 12 J 18 Pneumonia R 75 HIV + VE T 61 T 62 Food poisoning Other infectious diseases Total Source: DOHMS Mortality and non-communicable diseases Socio-economic development, improved sanitation and consequent reduction in the occurrence of communicable diseases along with cultural changes have led to increasing life expectancy, changing nutritional habits, decreasing habitual physical activity and the emergency of non-communicable diseases as the dominant feature of ill health in Dubai and other emirates. Non-communicable diseases amounted for three-fourths of all deaths in Dubai in 2006. There is a Plan of Action for the prevention and control of non-communicable diseases in Dubai. The plan of action which is intended to guide DOHMS work focuses on cardiovascular diseases, cancer, chronic respiratory diseases and diabetes which are responsible for half the deaths worldwide. Many of these deaths could be prevented through known and cost-effective interventions that focus on non-communicable diseases and their shared risk factors. The long-term goal of the action plan is to direct comprehensive and coordinated action in order to meet the target of reducing death rates from non-communicable diseases by two per cent annually over and above existing trends. DOHMS tries to achieve this goal by placing the growing burden of NCD on the development agenda and strengthening capacity of health systems to prevent and control such diseases. The action plan will set out priorities, actions, a time frame and performance indicators for prevention and control of non-communicable diseases. As for actions, Dubai Health Authority (which takes policy and strategy functions from DOHMS) will strengthen efforts aimed at preventing and controlling NCD by: strengthening advocacy; generating Finpro
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No of cases 63 33 312 25 3 472 107 603 72 147 38 182 207 98 294 5653

Share, % 1.1 0.6 5.5 0.4 61.4 1.9 10.6 1.3 2.6 0.7 3.2 3.7 1.7 5.2 100.0

and disseminating evidence-based information; fostering implementation on Tobacco Control, and strategies, plans, programs and charters that strengthen prevention and control of NCD; building partnerships for prevention and control; and measuring and improving performance at all levels in order to assure accountability and transparency. Time frame: The action plan would be implemented within the framework of the strategic plan, 20082013 and other existing schedules at all levels of DHA. Results should be measurable by 2013.

4.

PRIVATE HEALTH CARE IN DUBAI

There were 46 057 in-patients and 1 061 109 out-patients in the private health sector in Dubai in 2006. Nationals constituted 16.4 per cent, other Arabs 18.5 per cent, Asians 46.4 per cent and other nationalities 18.6 per cent of the total number of in-patients. Males accounted for 45.1 per cent of in-patients. Private sector had 17 hospitals in 2006. The number of beds in these hospitals was 828. Days of care to patients discharged including death was 106 399 in 2006. Average length of stay was 2.3 days in 2006. Bed occupancy rate rose from 31.9 per cent in 2005 to 55.8 per cent in 2006. Private sector carried out 30 478 surgeries in 2006. The number of private hospitals grew to 18 and the number of beds to 913 in the first half of 2007 when Medcare Hospital opened its doors and some hospitals were expanded. Medcare Hospital is a 60-bed premium general hospital located in Jumeirah adjacent to Safa Park, between Sheikh Zayed and Al Wasl roads. The number of private hospitals and clinics is growing fast. Domestic and foreign investors are attracted to Dubai (and other emirates) by the growing resident population (both nationals and expatriates), growing demand by residents for health care and growing demand by foreign health tourists for services. Incentives given by the government of Dubai to private investors also affect positively. Some new players will provide with a large spectrum of services and some players specialized services in special hospitals. Some newcomers like Saudi German Hospital Group will build both a general hospital and six special units. According to Dubai Healthcare Provision Report (June 2007) eight private hospitals (including SGH) will be opened in 2008 or 2009. One of these projects - American Hospital - is an expansion. It is easy for foreign companies to start operating in Dubai if they have knowledge and skills, get support from local businessmen and co-operate with the authorities. Companies will get clients if their health care services are of good quality. Naturally, some companies will succeed better than others. International companies which have a well-known brand will most likely be very profitable. Examples are Harvard Medical School, Mayo Clinic, Johns Hopkins Medicine and SGH Group. However, there is so much demand for services in Dubai and other emirates that also smaller players can thrive. Representatives of Saudi German Hospital Group said that the turnover of health care services is forecast to be 60 billion USD in the Gulf Co-operation Countries in 2010. Of this 8-9 billion USD comes from the United Arab Emirates alone. 70 per cent of the sales growth will be in the private sector.

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The turnover of medical tourism in the UAE grows 15 per cent a year and is forecast to be 2 billion USD in 2010. Medical tourists are attracted by the high quality of hospitals and hotels and vast amount of free-time activities. These features also allure foreign businessmen who can have treatment during business trips. Besides, there are plenty of foreigners who spend winters in Dubai and want to have health care while staying there. Government has so far provided c. 75 per cent and private sector c. 25 per cent of health care funding in Dubai. The purpose is to invert these shares in five years (by 2013). Government expects healthy competition between the companies. It continues regulation, improves regulation and makes sure that all hospitals have a certain quality. Low price of private services is not the only important thing. Health insurance scheme which is coming to Dubai will have a significant effect on private health care provision. As every employee (expatriates included) has to be insured, everybody will have the chance to go to a good clinic or hospital. Health insurance is already in use in Abu Dhabi, and other emirates are following suit. The United Arab Emirates, especially Dubai, is a land of experimenting new ideas and solutions. It is a gateway to the Middle East, Africa and Asia. As the UAE is compact in geographical size and regulation in Dubai does not differ much from regulation in the other emirates, investors often treat the markets of seven emirates as one.

5.

DUBAI HEALTHCARE CITY (DHCC)

Dubai Healthcare City is the worlds first integrated health care free zone. It has been developed by Tatweer, a subsidiary of Dubai Holding, a holding company set up by the government of Dubai to manage it assets and investments. The purpose of DHCC initiative is to provide the highest quality health care and wellness services to people from Dubai, other emirates, the whole Middle East and even people from other continents. DHCC aims at filling the gap between Europe and South East Asia and establishing a regional gateway for customers and patients to receive world-class health care, medical and wellness services. Dubai Healthcare City site is located in Bur Dubai alongside Rashid Hospital, a short distance from the Dubai Creek. DHCC lies in the heart of the city four kilometres from Dubai International Airport. In the near future, Dubai Metro will allow access to DHCC patrons via the Green Line with its own designated stop. This state-of-the-art railway system will allow easy access in and out of DHCC for the patients, their families and staff. DHCC consists of: 1) Academic Medical Centre which comprises a) Harvard Medical School Dubai Center (HMSDC) Institute for Postgraduate education, b) Dubai Harvard Foundation for Medical Research (DHFMR) and c) 400-bed University Hospital 2) Medical cluster which comprises e.g. private hospitals and clinics, a transplantation centre and pharmaceutical & equipment suppliers 3) Wellness cluster which comprises e.g. a wellness centre, nutrition centre, health farm and resort and spa. This cluster is not yet operational.

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4) Supporting services such as hotel and bungalow accommodation and telemedicine. 5) Center for Healthcare Planning and Quality (CPQ) in charge of regulation and licensing in DHCC. (Licensing and general regulative functions will be taken over by the new governmental organization in charge of all health care units in Dubai in a few years.) DHCC is being developed in two phases. The first phase, located behind Wafi City, is approximately 4.1 million square feet in size. The second phase, with 19 million square feet of land, will allow DHCC to offer the complete healthcare continuum, including hospitals, wellness and clinical centres. Phase I will be 80 per cent complete by 2010. The University Hospital will open in 2011, though. The first hospital in DHCC, The American Academy of Cosmetic Surgery Hospital (AACSH) opened in October 2007. It has 25 beds. The second one, the City Hospital (General Hospital) will start operating in 2008. It has 210 beds. A total of eight hospitals with 1068 beds have been approved to date (May 2008). Harvard Medical School Dubai Center (HMSDC) is the first Harvard Medical School facility of its kind to be established outside of the United States. The Dubai Harvard Foundation for Medical Research (DHFMR) will support a partnership between Dubai Healthcare City and Harvard Medical School to create and sustain a Regional community of leaders in medicine and the life sciences to advance new scientific knowledge for the benefit of people. The Al Maktoum Harvard Medical Library will be accessible to all the health care providers and professionals in DHCC and the UAE. The Dubai Harvard Foundation will share its research elements to all health care providers as DHCCs aim is to improve the health care scene. The Harvard Medical School Dubai Center will provide educational services to its registered students only. Harvard Medical International and DHCC have jointly established the Center for Healthcare Planning and Quality (CPQ), as a regulatory body implementing rigorous high quality clinical standards to ensure safe and quality patient care. CPQ also plays a major role in planning to ensure an appropriate balance between clinical services within DHCC to meet patient needs, demands, and expectations. There are North-European healthcare organizations that have established business operations in DHCC. Besides, there are North-European healthcare organizations that have expressed interest in leasing premises and starting business operations in DHCC. There are still free sites in DHCC where private companies could construct buildings for their medical or wellness business. Investment applications will need to be part of the clinical plan and any approval will be based on the proposed business. There is also still free space in some of the buildings that private companies could use for their business operations. As above, any new application will need to be part of the clinical plan and approval will be based on the proposed business. DHCC clinics (and the AACSH hospital) were visited by c. 36 000 out-patients (and zero in-patients) in 2007. The number of out-patients will grow, and there will be plenty of inpatients in the near future, when rest (most) of the hospitals open their doors.

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The significance of DHCC for Dubai and the whole United Arab Emirates is tremendous due to the fast population growth (c. 6 % in the UAE per annum) and to the gap in specialised health care services. DHCC plans to meet the needs by providing opportunities for health care providers to start up and easily set their facilities in the free zone environment. By targeting and receiving patients from both home and abroad, DHCC (and Dubai in general) will be a hub for health care in the near future.

6.

SAUDI GERMAN HOSPITAL GROUP

Saudi German Hospital Group has five hospitals four of which are in Saudi Arabia (Jeddah, Assir, Riyadh and Medina) and one in Yemen (Sanaa). According to SGH strategy, there will be 30 hospitals in the Middle East and Northern Africa in 2015. Projects in Dubai, Cairo, Hail in Saudi Arabia and one in Ethiopia will be completed soon. SGH Group constructs its own hospitals by means of 1000 construction staff and finances its developments with the support of local governments and development banks. SGH Group is or at least will soon be the largest private health care supplying group in the Middle East and North Africa. SGH has competition in individual cities, but not serious competition from other groups on a regional level. The group is a multi functional company which is regarded as a health care developer and not just a hospital operator. The group has a medical college in Jeddah, Saudi Arabia, which is the largest private medical college in the region. According to strategy, there will be five medical colleges in the MENA region in 2015. In Arab countries medical universities have been run by governments, but now private universities are coming. SGH will also build fitness and wellness facilities and spas, and non-profit hospitals for poor countries (social business). SGH Group is building a general hospital in Dubai Healthcare City which will be ready in early or mid-2009. The new hospital is a huge investment. There will be 300 beds. Later SGH will build six 50 bed-special units (300 beds in total). All these seven units will be situated in one area in DHCC. The SGH Dubai hospital will cover all medical treatment areas (cardiology, diabetes, orthopaedics etc.) but is a leader in orthopaedic and trauma treatment. The vice president of SGH, Dr. Khaled A. Batterjee, is the best-known orthopaedic physician in the Gulf region. Trauma patients have been taken care by Department of Health and Medical Services, but private companies are now entering the field. As the only way to compete in Dubai is to have excellent equipment and people, all advanced equipment are bought from Germany, other European countries and the USA, and most physicians are recruited from Germany and other European countries. Nurses come mostly, circa 80 %, from abroad. The small number of emirate and other Arab employees in present hospitals and in the coming SGH hospital is explained by the fewness of Arab medical students and physicians and the relatively low confidence of locals in their countrymen. Nationality matters, but probably less in the future. As the number of medical schools grows and quality improves in the region and as an increasing amount of Arabs enrol and graduate from the schools, locals will believe more in their skills. The numbers of physicians, nurses and other employees in the SGH Dubai hospital are still in planning phase. They will not be strictly fixed as market needs are decisive. The

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numbers of in-patients and out-patients in the hospital are also in planning phase; anyway, due to SGHs good brand there will be heavy demand and the hospital will be full. Representatives of SGH said that the biggest health care group in the region had to come to Dubai, show its level and quality of service and set (unofficial) standards for others. SGH will relocate its corporate headquarters to Dubai and cover the entire Middle East from there. The group has embraced best practices from other industrial sectors and uses balanced scorecard. One competitive advantage is the group structure itself: insurance companies prefer to work with groups rather than individual hospitals. In addition, SGH expects to be one of the main beneficiaries of medical tourism in Dubai. In addition to health care, SGH is also in wellness business. It is the master franchisee for Golds Gym in the Middle East. Representatives of SGH accentuated that they have maximum corporate social responsibility. They organize scientific seminars and provide training for non-profit purposes. They also have Childrens club, Womens club and Anti-smoking club.

7.

SOURCES
Interview with Mr. Ezza Kazim, Assistant Director General, Dubai Department of Health and Medical Affairs (DOHMS), on the 21st of April 2008. Interview with Mr. Mohammed Al Yousuf, Executive for Sales & Leasing and Mr. Khamis Al Nuaimi, Senior Executive for Sales & Leasing, Dubai Healthcare City (DHCC) on the 22nd of April 2008. E-mail correspondence with Mrs. Amal Hussain Mourad, Marketing and Communications Department, Dubai Health Care City, in April and May 2008. Interview with Mr. Tanweer Ahmed, Project Coordination Manager, Mr. Joy Donald Gomez, Corporate Marketing Manager and Mr. Saheem Ahmed, Assistant Corporate Marketing Manager, Saudi German Hospital Group on the 22nd of April 2008. http://www.dohms.gov.ae/default Department of Health and Medical Services http://www.dhcc.ae/EN/Pages/Default.aspx Dubai Healthcare City http://www.sghgroup.com/ Saudi German Hospital Group Dubai Healthcare Provision Report, June 2007 Wikipedia Article on Rashid Hospital

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