Hiring delays slow Gulf health plans

30 October 2008

Partnerships with leading international clinics are helping to attract skilled professionals and improve healthcare across the region, but hurdles to recruitment still need to be overcome.

Healthcare is a global profession, meaning hospitals and healthcare facilities in the Gulf face strong competition from all over the world when it comes to recruiting staff.

The good news for the region is that reports from recruitment specialists and the professionals placed are positive in terms of the facilities and training on offer.

“However, both groups say the region’s hospitals are slow to recruit staff, and competition from more established markets, such as the UK and US, is increasing.

“Many private and public healthcare providers in the region rely on recruits from the Far East and the Indian subcontinent because of the availability of people and resources [in these regions],” says Taysir Khatib, regional director of the private Mayo Clinic in Dubai.

“Because the competition for staff is increasing after Europe and the US entered the game with better offers, especially for allied health personnel, many regional institutions are
unable to compete.

“As a result, qualified professionals will emigrate to Europe or the US rather than work in the region. This makes it harder to recruit and, more importantly, to retain what you recruited.”

Expanding sector

The Mayo Clinic is one example of the healthcare facilities that are being set up around the Gulf. A specialist in cardiology care and research, the facility in Dubai is its first outside the US.

“We have to remember that people come to the region to financially support themselves, their families and to build for their future” says Khatib.

“So in addition to financial benefits, many look into how much they are improving themselves professionally.

“Therefore, institutions that offer professional and educational advancement will have a better chance of retaining staff and can compete better in today’s open market.”

London-based Moorfields Eye Hospital is another international healthcare provider that has established operations in the region.

Chris Canning, chief executive officer of the hospital’s clinic in Dubai, tells MEED that the establishment of the facility is raising the standard of treatment available in the region as the specialists can carry out complex procedures that would otherwise be done overseas.

“We take lots of patients that would previously have been sent abroad, which creates major savings for the government,” he says.

The hospital is also looking to pass on its expertise. “We have a long track record in teaching and research in the UK,” says Canning.

“We intend to bring this over and are looking for opportunities. To date, we have been more successful in research than in teaching.”

One research project involves the identification of the genetic mutation that is responsible for a retinal defect leading to blindness.

“There are more than 300 genes responsible for it and we have only found half of these,” says Canning.

“Here we have a new population that has not been studied. We are finding new genetic causes. The gene defect can be different to that seen before.”

Research is being done collaboratively with laboratories in London.

Canning says teaching is a different issue. “To do this requires a critical mass of teachers,” he explains. “We have three consultants so there is a limited range of issues to teach on.

“We have given a range of presentations and have carried out ad hoc training as we bring people out here.

“But we are more keen to move on to a systematic fellowship, curriculum-style teaching with a structured training programme.”

Growing opportunity

Fortunately, the opportunity to bring in more consultants and offer residency placements for trainee doctors is not far away.

Moorfields has signed a memorandum of understanding with the University Hospital, which is backed by state-owned development company Tatweer and is currently under construction in Dubai Healthcare City.

“We are teaming up with University Hospital, which is a major 450-bed hospital costing $500m,” says Canning.

“The memorandum of understanding suggests that Moorfields will run and staff the ophthalmology department, and this will bring us closer to the number that we need to run residency programmes.

“A critical mass of consultants is six or seven. We do not have the work for six, we have the work for three, nearly four. But the University Hospital will add patients and allow us to bring in more consultants.”

Ensuring that world-leading specialists are training local staff is the best way to create a self-sufficient healthcare sector, and partnerships with international providers are the best way to achieve this, says Khatib.

“Self-sufficiency can be accomplished by creating an association with world-known healthcare institutions that can help in the training and education programme by having these professionals/recruits trained in this institution before returning to their home country for service,” he says.

Recruitment consultants say professionals who are planning to move to the region are impressed by the facilities and training on offer. But there are concerns over the length of the recruitment process.

“Every hospital has a long list of vacancies and we have the candidates, but matching the two can take five to six months, which is too long,“ says Steve Twelftree, director of international recruitment at medical staffing firm Pulse.

“The key in recruitment is to process jobs quickly so that you do not lose candidates.

“Most staff are on a three-month notice period and there is no reason why the process cannot happen during this time. We are trying to help hospitals improve their processes.”

So far this year, Pulse has placed 100 nurses and 50 doctors in jobs, but says this is nowhere near where it would like to be.

Twelftree says prejudice over where staff come from is still a problem. “It is a global playing field,” he says.

“About 80 per cent of the region’s nurses come from the Philippines but there is a two-tier economy.

“Clients believe that Western nurses are of a higher quality and so will come to us for more senior [staff]. I have had a client say to me ‘we want a Western candidate with blue eyes’.”

Key fact

Dubai’s University Hospital will have 450 beds, at a cost of $500m

Restricting recruitment

According to Twelftree, there are rumours that the UAE might place restrictions on staff from the Philippines and India, but no such restrictions are being considered in Kuwait.

Kuwait’s Health Minister Ali al-Barrak met with the Philippines’ Secretary of Labour & Employment Marianito Roque in early October to discuss improving mutual co-operation in the health sector.

The minister also visited Singapore and Thailand as part of a tour of the region.

He praised the level of training of medical staff in the region and said that doctors from Singapore would be visiting Kuwait to give lectures and conduct medical procedures.

But recruiters say although the level of demand is high in Kuwait, this is due to crippling bureaucracy in the public system.

“We no longer place into Kuwait,” says the managing director of another international recruitment firm.

“It took more than a year to place staff despite us having a waiting list of candidates. It is not worth the effort involved.”

One area where a lot of effort is being made is in governmental reform of health services. Experts say this will also improve the quality of care on offer and make the region more attractive for professionals.

“I expect to see an increasing requirement to meet external international benchmarking and monitoring standards, with more requirements to improve empirical data collection and reporting, and using that to help improve service delivery,” says Linda Marshall, director of operations for Dubai-based private health company Enaya Healthcare.

This could include information such as patient survival rates following major procedures, the number of those procedures carried out or the length of time patients stay in hospital for treatment.

“Clinicians find this data useful,” says Marshall. “To date, there is not a lot of transparency but the UAE is in a prime position to take the best examples from other countries and create a better regime.”

Alongside the reforms in the professional sector, much is being done by regional gov-ernments to invest in educational facilities to help more nationals enter the healthcare profession.

Harvard Medical School has established a centre in Dubai Healthcare City, Weil Cornell Medical College is up and running in Qatar, and more world-class universities are on the brink of announcing tie-ups with GCC governments.

Promoting education

Local educational institutions such as UAE University and Sharjah University are continually investing in their facilities and report that student numbers are rising.

But sources say the government could go further by promoting the sector in high schools and at a younger age.

“The healthcare industry will face great difficulties in the near future recruiting and retaining good, qualified professionals in all aspects of the industry because demand exceeds by far what is available,” says the Mayo Clinic’s Khatib.

“Therefore, healthcare institutions must think of creative plans to generate what is needed in this field.

“This can be accomplished either by starting to recruit from the high-school level or attracting local graduates who are willing to enter the healthcare field.

“Failure to start planning for the future now will result in a severe shortage of well-educated and qualified personnel, which will compromise the healthcare industry and, more importantly, the health of the population.”

  • Taysir Khatib, Chris Canning and Linda Marshall will present at MEED’s Middle East Healthcare conference on 2-4 November.

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