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‘Ventilation and HVAC, especially, are significant considerations’

Mohammed R Alyemeni, Senior Advisor at TVM | Capital Healthcare Partners for Saudi Arabia & the GCC Countries, and former Deputy Minister of Health in Saudi Arabia for Planning & Health Economics, speaks with Fatima de la Cerna of Climate Control Middle East about the projects the Ministry of Health in the Kingdom has lined up for the next few years and the challenges involved. Excerpts…

| | Aug 2, 2015 | 4:00 pm
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What is the update on Saudi Arabia’s Ministry of Health? I understand that it has undergone several leadership changes in the past few months.

We’ve had six ministers in 13 months. Of course, the changes in leadership have resulted in some delays, because when you have a new guy stepping in, everything has to be suspended to allow him to understand and assess the situation. But, then, things resume and now, we’re hoping that there will be stability. Everything should take off quickly once we have that.

I have heard that the changes have resulted in projects, like medical cities, being shelved. Could you confirm if this is true?

I doubt if those reports are true, certainly not about medical cities. They’re more likely just delayed, because the master plans are already there. As long as the current Minister doesn’t do major changes and adopts the plans as they are now, projects should take off in a couple of months.What people need to understand is that these are huge projects. We’re not moving a whale here, but a tankful of whales. Allocating the land for one medical city, for instance, is a big challenge because it will need to be a huge piece of land. Selecting the right organisation to build the project is also not going to be easy, because only a few companies in the world can take on the job and do it right. There are other challenges, such as appointing medical staff, but they are not impossible to overcome or address.

In light of what is happening, how would you describe the state of the country’s healthcare sector?

A bit of background: For 20 years, we didn’t have many healthcare services, in terms of building and allocation, because of the oil glut or because oil prices were down. That’s why, we had trouble meeting the benchmark identified by the United Nations, which is 3.5 beds per 1,000 capita. That’s the low average, but Saudi’s was at 1.8. However, oil prices started going up, and money was available, so the government began investing in the healthcare sector. Only, the healthcare sector is not easy to develop, because hospitals are not administrative buildings. As per international standards, it takes between five and seven years, on average, from the time you break the ground to the time the first patient walks into the hospital.

Now, we stand at about 2.1 beds per 1,000 capita. The good news is the Ministry of Health is building 150 hospitals over the next few years, and the private sector is adding around a hundred. Other government services are also said to be planning around 50 more. If all those plans push through, by 2020, we should end with the targeted 3.5 beds per 1,000 capita. In terms of spending, this means that we are more than doubling the capacity.

I was in France for a meeting with the Saudi-French Business Council, and I had people there asking me about healthcare business opportunities in Saudi. And I said that there are so many, we might as well establish another Ministry of Health. But I warned them that it’s not easy to do business in Saudi Arabia, because when it comes to critical services like healthcare, the country is very serious, particularly in terms of licensure and approving interested participants. The Ministry and the government, in general, want to see to it that everything is done the smart way and that return on investment is ensured.

On the topic of investment, some people from the HVAC industry claim that, in some cases, no matter how advanced a hospital is, there are deficiencies that can compromise the quality of care given to patients. Are HVAC solutions among those the Ministry looks into when deciding on investment matters?

Yes, definitely. For a long time, we didn’t have outbreaks of diseases. But then, about six years ago, we had an outbreak of H1N1, and though we were able to contain it, we were concerned it would develop into a pandemic. We had not been building hospitals in preparation of such cases. Our hospitals were not equipped; we didn’t have the required double isolation rooms, for example. So we had to fly in expensive equipment to set them up – a serious investment made by the Ministry.

That was a lesson learnt. Now, the healthcare sector, in general, is treated as a serious investment by the Ministry of Health. It looks at major hospitals to make sure that they have the equipment and the systems necessary to receive patients with infectious diseases, that special isolation rooms are airtight and won’t allow the spread of airborne viruses. Ventilation and HVAC, especially, are significant considerations. And I’m not talking about small babies. I mean very expensive ventilators and chillers that meet standards for not only operational capability but also healthcare suitability.

Sustainability has been a buzzword in the Gulf region in the last few years. Sustainability measures like going green. How can they be applied to the healthcare industry?

When it comes to sustainability in the healthcare industry, the most important part is the ability to continue to pay. The healthcare tag keeps going up, and it’s breaking the back of every country in the world. Sustainability should come from diversifying the economy, by changing one’s healthcare organisation from being totally cost-centred to being partially profit-centred, as a way of achieving some return on investments. In terms of being green, it’s very difficult – difficult, not impossible – to adopt that in the healthcare industry, because the services will be affected. Just to give you an example, today, hospitals use disposables to minimise the risk of spreading infections. That is not a green practice, but it is necessary, for now. I don’t know if one day we’re going to go back to how it was before the time of disposables. But healthcare is certainly never going to be a sector that will become economically easy to manage.

One should remember, however that the strain imposed by costs and the need to control expenses will always push people to find ways and innovate. That can be both a good and a bad thing because one of the biggest influences of healthcare costs and healthcare quality is new technology. Like I said, it can be a bad thing, a good thing or both; it depends on how one looks at it.

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