Foreign Medical Treatment - Health Care Sidetracked

The recent disputes over the responsibilities of the Foreign Medical Treatment Department at the Ministry of Health are further highlighting the misguidance of our health care system. While we focus on getting our patients out of the country to more capable providers, time has deepened our homeland’s health care crisis. Indeed, misinformed decision-makers and erroneous popular belief have shifted resources away from many of the basic foundations of a sound health care system. The solution is not to “outsource” health care but to establish our very own state-of-the-art system by training and recruiting leaders, launching nationwide prevention programs, building quality hospitals, reinforcing medical education and rendering the workplace safe for both providers and patients alike. We must set aside our pride, accept the harsh reality of the declining quality of care, and reallocate resources to reverse this. We cannot bow to misinformation that attributes our low death rates to a flawless health care system in a nation with a pyramidal population structure. Our neighbors have understood this and have now outpaced us owing to their forward-thinking and risk-taking behavior.

Let us analyze the shortcomings of our decision-making.

Historically, and quite understandably, our society has been a proud one. Our economists have set an example in the region by establishing world-renowned financial institutions, seeking key foreign investments and securing our economic prosperity for years to come. Our educational system was our national pride that provided the best in secondary and higher education accessible to each and every one of us. And, yes, even our health care system was looked upon as being one of the best in the Gulf with its grand medical centers, free care for all and early institution of prevention programs such as vaccination schemes, and so on and so forth. Yes, once.

Our health care has succumbed to political strife and national crises. A vicious circle of poor recruiting habits, stubbornness, fear of criticism, mismanagement of funds, public distrust has settled in and precipitated the failing of a once flourishing structure. Seeing the health of our nation slip us by, we now seek a costly and unproductive means of meeting our patients’ needs. With that naturally comes abuse which, as highlighted in the recent Al-Qabas article, has become common practice. It is acceptable that in certain, select cases, for which our Nation is unwilling to provide local resources (I say willing as opposed to able as many of us believe it to be inadmissible for a nation like ours to lack state-of-the-art care easily attainable through recruitment or training), care be offered abroad in more specialized centers.

To give you an idea of the financial burden our country is bearing to treat patients abroad, Dr. Massouma Al-Mubarak recently exposed figures for the past years during her speech at the National Assembly. During the fiscal year of 2004-2005, our government spent KD 102 million (USD 355 million) on the foreign medical treatment of patients sent by agencies other than the MOH. When analyzing the evolution of this practice over the years, we make a worrisome realization. In 2000-2001, the MOH sent 483 patients abroad at a cost of KD 9 million (USD 31 million) whereas in 2004-2005 a total of 1452 patients were flown out of the country costing our nation KD 28 million (USD 98 million)! This could either mean that our health services are deteriorating, that corruption within the MOH has grown rampant or that our patients are sicker requiring more specialized care. I suspect that the latter has little to do with this problem…

Instead, let us stop for a second to revise our priorities and start by recruiting qualified health care professionals to better the care provided and reach, at the very least, regional standards. A plethora of job offers for U.S., Canadian or European-trained personnel can be found on web sites of multiple international headhunting corporations for Saudi, Emirati, Qatari, or Bahraini medical centers. Strong educational and public health initiatives have spawned from such recruitment and led to the improvement of their national health care. The partnerships of leading institutions such as Harvard University, Johns Hopkins University, University of Pittsburgh, Cornell University, and a slew of medical facilities with the various ministries of health have resulted in self-sustainable developments throughout the region.

Also, rather than strengthen our oversees health offices, as suggested, we ought to consolidate our network of contacts at these elite institutions through our Cultural Offices to negotiate access to training programs for our junior physicians, nurses and other allied health professionals as well as engage in drastic health sector reforms by utilizing their expertise and vast experience in health policy and management. The creation of incentive by offering attractive packages and improving work conditions may even encourage our own to return to Kuwait or, perhaps, prevent an exasperated workforce from fleeing the nation for more stimulating employment opportunities.

Finally, educating the people through rigorous campaigns on key public health issues will precipitate change by acting as an eye-opener ultimately leading to healthy competition for a more demanding customer. In an upcoming article we will expose various means by which we believe our public health services could and should be restructured to better serve our people’s interests.

The bottom line is that it is unacceptable for us to sit back and watch a grim future unfold to our children. We cannot waste time reinventing the wheel while our nation beats deplorable records in prevalence of diabetes, obesity, heart disease, road traffic injuries and other major causes of mortality. We must stay informed and reach out for the help we so desperately need.

The Kuwait Health team applauds the efforts of our new Health Minister, Dr. Massouma Al-Mubarak, to steer the focus of attention towards internal improvements in this particular matter.