How is healthcare development incorporated into Oman Vision 2020?

AL-SAIDI: You have mentioned Vision 2020, which was set many years ago. Let me give you an updated piece of information, that is, the Health Vision 2050. As far as I am aware, we are the first country to have put a strategy in place for healthcare for 2050. We started in late 2010. We looked at Oman’s Vision 2020 in which there were many parts dedicated to the healthcare sector. However, we considered ourselves a dynamic and young team in the healthcare sector. I have an excellent team, who has worked for a full year to analyze the healthcare situation in Oman. This is a local team composed of both members of the Ministry of Health and other government agencies. Within less than a year they completed a full analysis on healthcare, from A to Z, from the infrastructure, to the human resources, to the equipment, etc.  After analyzing the data, we planned what to do from now until 2050. We sent this data to international experts from all corners of the globe, such as New Zealand, the United States, Canada, Europe, our neighbours, the near subcontinent, and the Far East. We invited groups of experts from all over the globe, and in the first week of May 2012, just last year, we had the first international conference called Health Vision 2050 for Oman. I can tell you right now how many pharmacists, how many dentists, how many nurses, how many doctors we will need in 2049. I can tell you what the Omani population is going to be in 2049 or 2050 or 2048, etc. From 2011 to 2050, I have all the data to tell you what is required in the healthcare sector in Oman; that is, the number of hospitals, primary healthcare, human resources, equipment etc. This is a long and ambitious plan. We are not waiting for 2050, we are already working and acting upon this data. Thus, whatever the Ministry of Health plans today, it should be valid and suitable for the years to come, up to 2050. We are now in possession of highly accurate statistics. Our birth rate is known, our death rate is known, our life expectancy is known. Our life expectancy, for example, is increasing, meaning that it is going to be more expensive to look after elderly patients, who, at the moment, only account for 4% of the population. The amount of work and effort put into the Health Vision 2050 is great. For everyone’s information, on 5th and 6th of May this year, we reviewed what is happening with Oman Health Vision 2050 and as a recommendation from this conference, we are forming an International Advisory Board for the Ministry of Health so experts from different corners of the globe will advise us on how to move forward with our healthcare. The international experience will be shared and modified according to what we need and what we can afford. So 2020 is almost over, but we have 2050, which is a new baby.

The GCC healthcare market is on track to grow 11.4% annually to $44bn by 2015. What is Oman’s overall contribution to the GCC healthcare market? How do you see this evolving over the next 2-5 years?

AL-SAIDI: Let me start from a different angle. Healthcare in Oman is provided free of charge. The private sector in the neighbouring countries has grown significantly, is competitive there, and is adding value. The private healthcare sector in Oman is still in its early stages. What I am looking for is a private sector that can come to Oman, compete with my institutions, and provide services that the public feels the public sector is not providing them with, either because they are not happy with our services or because such services are not available. The healthcare budget in Oman is only 2.4% of GDP. About 5% of the government expenditure is on health, whereas the international average is 13%. We spend only 5%, yet the outcomes of our healthcare is comparable to, if not better than, countries that spend approximately 9% of their GDP and where the government’s expenditure is 12-13%. There is scope to increase the expenditure in healthcare, as we have just invested in the development of specialized healthcare, which is extremely expensive. At the moment, we only provide organ transplants for kidneys and, for very limited bone marrow transplants. However, for liver transplants, we still send our patients abroad, meaning that we are spending money elsewhere because we are not providing this service locally. Oman’s contribution to these millions or trillions in the GCC’s healthcare market is not huge yet.

In a recent Gallup Poll, 43% of Omanis have indicated that they prefer to receive medical treatment abroad. What policies or programs are being put into place in order to improve the country’s overall quality of healthcare and to ensure that certain medical specialties are being offered?

AL-SAIDI: I do have a bit of reservation about that 43% statistic. That questionnaire was based on a very small sample. I can tell you it was 1,700 out of a population of 3m Omanis, which is definitely not a representative sample. This does not mean that tens of thousands of Omanis do not go abroad for treatment. However, coming from a statistic and scientific point of view, I would challenge that number as being inaccurate. Nevertheless, I am aware of this phenomenon. I am still a practicing physician and I know that being in a hospital as a patient, you will unfortunately not always be faced with good experiences. I can tell you that one of the major issues with our healthcare system is not lack of excellent drugs, equipment, or doctors. These are challenges that we have, but the major challenge is the way we communicate with our patients, the way we inform our patients and their families about their diseases. Let me go back to your question, 43%, I must say, I am not happy with that number, but there are patients who go abroad. The reason for that is partly because some of the facilities are not provided in Oman as yet. Another reason that can explain this trend is that if you go to any other country, the United States for example, and if you look at the number of Americans who go to Mexico, or Cuba, or elsewhere for treatment, these are hundreds of thousands or tens of thousands. Does this mean that the healthcare in the States is not good? It is excellent. European countries, they have waiting lists. We do have a problem with waiting lists too. However, I can assure you that it is much less an issue than any European country and you have to consider that this is for government services, not private services. The other issue, which we already touched on, is non-communicable diseases, which are chronic and for life. Imagine telling a person that he has a disease for life. It is a shock and you will be looking for any glimpse of hope for somebody to tell you something different. So where do you go? You go to the private clinic and they will tell you the same thing. Then you go to X country or Z country, thinking their medicine is better, but they come back, unfortunately, with the same story. So, yes, I am not happy with the amount of money that Omanis spend in many countries for healthcare. If they need to be sent abroad for treatment, we do send patients abroad. Last year alone, in 2012, we as the Ministry of Health sent 1,280 patients to be treated in different countries. This is for services that cannot be provided in Oman. If we talk about cardiac surgery, for example, we have a large waiting list, so we do send patients who need cardiac operations abroad. Of course, everything is paid for by the Omani government, from their tickets, to their food expenditure, to their operation, to their return ticket back home. Another example is the liver transplant, which we do not carry out in Oman. However, since 2010, we’ve contracted a centre in one of our neighbouring countries and we are sending Omani patients who require liver transplant there, free of charge. We are against the sale or purchase of organs. Trafficking of human organs, in whichever form, is absolutely prohibited by the Omani government. We are definitely against it and those who opt to go abroad to X or Y country to buy a liver or a kidney, we absolutely dissociate from that, we do not participate in it, we do not fund it, and we do not refund those who go at their expenses. But anyone who requires treatment abroad will go through a process, that is, the recommendation from the physician, which then goes to the Committee for the Treatment Abroad, who shall approve it, so that ultimately the government pays for the treatment abroad.