Qatar and other GCC countries are spending an enormous amount on healthcare, what kind of return are they receiving?

AL-MAWLAWI: The emphasis over the past 3 decades has been on capital-intensive projects in healthcare. But as it is known, healthcare has four pillars: preventative, rehabilitative, promotive, and curative. The emphasis in the past decades has been on the curative through building hospitals and infrastructure. If we take the wonderful model of healthcare in the Scandinavian countries, their health indices are consistently the highest in the world because they emphasize the other pillars. They start with preventative and with promotive; health education for mother and child, and promoting nutrition and exercise. That can save a lot of money. So if the emphasis is on the curative, which has been the case in most of the Gulf region, then if we focus on primary healthcare not primary medical care, then I think that will get us a wonderful return on investment in the healthcare systems.

What is the role of the private sector in healthcare in Qatar?

AL-MAWLAWI: We have a lot of questions hanging over private healthcare in Qatar. How far are the government services going to expand? There is no clear-cut road drawn for the private sector in the 5-year healthcare strategy. The ambiguity of that role has made it very difficult to truly invest in the healthcare system in Qatar. So we need more light shed on this issue. Whatever we do in the private sector is not based on scientific feasibility studies because we do not know where the government will go and what the role of the private sector is vis-à-vis the government. So this makes it very difficult to plan ahead.

How will a more active health insurance industry impact healthcare in Qatar?

AL-MAWLAWI: It will create higher volume for private healthcare because private healthcare and government healthcare will not be free anymore. So we will all be on equal footing, which will provide plenty of choices for the people of Qatar. However, there could be a downside and that is that we need years of trial and error to grasp the proper makeup and the proper matrix of a national health insurance scheme. So we have to go through it and understand the pilot. We look forward to this, but there are still many unknowns, which will be clarified as we go along implementing the whole thing. I do not know if the cumulative result of all of this will be for the benefit of all. I was a member of the national committee that set this scheme and our work was approved by the cabinet. But there are many unknowns just as there were with many other countries that adopted national health insurance schemes. Every country has its unique conditions and in the committee we did look at the different models including the Canadian, Ghana, Saudi, Dubai, and Abu Dhabi schemes and tried to avoid the pitfalls of these systems. Luckily, we have adopted a flexible system in Qatar so the main feature in it is that you can rectify without huge costs as you go along.

What needs to be done to improve preventative care in Qatar?

AL-MAWLAWI: The role that preventative health is playing is less than it should be. What most health care systems in the world lack is adopting the true definition of health. This is stated in the constitution of the World Health Organization, which has been ratified by all nations on earth and states that health is not the absence of disease, it is the complete mental, psychological, social, and physical well being of a person. So that puts a heavy emphasis on preventative health and the promotion of rehabilitative health. This is still lacking in most of the world. For me, health starts with the individual and what happens in the family. Healthcare should start before conception because a woman should follow a certain diet to ensure that when conception takes place, that her womb is healthy and ready. During pregnancy, there is a whole gambit of nutritional advice and even musical advice for the baby. Preventative medicine is the most cost effective approach to healthcare, but it is not emphasized because it is does not bring a great deal of profit to different entities.

What can be done to address HR shortages in healthcare in the region and the lack of national healthcare professionals?

AL-MAWLAWI: This issue of health manpower is a huge issue all around the world. There are many countries that are suffering from a lack of specific doctors, technicians, or nurses. What we are witnessing is that there is an emergence of an international pool of medical health expertise. Even looking at the United States of America or Germany, they are becoming net importers of nurses. Their nursing schools cannot graduate the required number of nurses and the same is true of doctors. When you have a small population like Qatar, Kuwait or Bahrain, you cannot have all of the specialties and sub-specialties from the national reservoir. There is not enough population anyway to cover all the different types of specialties and sub-specialties in different fields. A third issue is that the economic difficulties now faced by the capitalistic countries in Europe and North America is now availing a lot of expertise at a more competitive price tag. This is a blessing in disguise for a lot of us. Lastly, we find there are very good investment opportunities in the establishment of medical schools and training schools for auxiliary medical professionals. That will help in the next 5 to 10 years. However, in the small Gulf countries, we can never expect to be self-sufficient when it comes to health and medical manpower.

Is the current share price of Medicare Group fair?

AL-MAWLAWI:It is way too low. In fact, I was a banker for many years and I was running Commercial Bank of Qatar. From my financial background, I can tell you that if anyone does a real financial analysis of the performance of Medicare Group, the parent company of Al Ahli Hospital, you find that it is way undervalued. All you need to do is look at our financial results over the past 5 years and any financial professional will bet on us. We do have a stock market in the Middle East that is mainly psychologically moved, so it does not really rely on technical analysis. It is basically based on word of mouth and we pay a price for that. I hope it matures into a more professional market.