UK’s top hospital brands plug a gap at home with UAE sites

Imperial College London Diabetes Centre has three units here, Moorfields has two and King’s College Hospital is building itself up just as Dubai pushes to become a global healthcare destination.

Neil Buckley, chief executive, Kings College Hospital. Satish Kumar / The National

The UAE is increasingly becoming a draw for UK healthcare providers to set up centres that serve as hubs to attract patients both locally and from overseas while bringing in revenues for their hospitals in Britain.

Imperial College London Diabetes Centre (ICLDC) has three units in this country, while the more than 200-year-old Moorfields Eye Hospital has a branch in Dubai and one in Abu Dhabi. King’s College Hospital (KCH) has a clinic in Abu Dhabi and a 100-bed multi-speciality hospital coming up in Dubai.

Each of these brands came here for a host of reasons including expanding their patient base, diversifying revenue streams and conducting research. For some, stepping into the UAE marked their first global venture.

Dubai is pushing to become a global leading healthcare destination and in 2015, according to the Dubai Health Authority, Dubai’s 26 hospitals received 632,000 medical tourists, of whom 53 per cent were from the UAE and 47 per cent from abroad. As part of its Health Strategy 2021, Dubai aims to attract 500,000 foreign patients a year within four years.

The UAE provides UK hospitals with the chance to increase income as costs soar at home. Ana Nicholls, a healthcare analyst at the Economist Intelligence Unit, points out that “many UK hospital trusts – and particularly the London ones – are running big deficits because of overspending on NHS treatment. KCH, for example, had a deficit of £80 million (Dh376.3m) in the first nine months [to December last year].”

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At a glance

What: Well-known British hospitals and medical institutions and opening units in the UAE.

Why: As fewer patients come to the UK from abroad, sites here diversify revenue streams while expanding the patient base.

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KCH London opened a clinic in Abu Dhabi in 2015 and by the end of 2018 will have a hospital in Dubai Hills in Mohammed Bin Rashid City. The hospital is a joint venture with Al Tayer Group, Dubai Investments and the UK-based Ashmore Group and the total project cost is estimated at US$200m. Opening hospitals in India and Pakistan is also on the cards.

London hospitals in total had a deficit of £409m in the nine months to December, according to NHS Improvement, which is responsible for overseeing foundation trusts and NHS trusts, as well as independent providers of NHS-funded care.

“UK hospitals’ private healthcare arms are one of their few money-earning ventures,” says Ms Nicholls. “According to the International Medical Travel Journal in 2015, London’s private and NHS hospitals make sales of about £275m a year to inbound medical tourists. By building hospitals outside the UK, in key markets, they can probably increase those earnings because patients will no longer have to travel so far.”

Access to a wide range of potential patients, the ability to recruit from a pool of well-trained staff and a relatively stable business environment where regulations for medical tourism are already in place, are some of the reasons British hospitals are turning to the UAE.

“The UK has traditionally been a major medical tourism centre but it has struggled in recent years, partly because countries have seen their economies slow as global oil prices fall and partly because there is more international competition,” says Ms Nicholls.

Neil Buckley, the chief executive of KCH Dubai, says: “[The UAE] was seen as a location where patients from all over the world come. In the past three years nearly 600 patients from the six Arab GCC countries were treated in King’s Private [in London], the private patient service of King’s College Hospital NHS Foundation Trust.”

Historic links between the UAE and the UK also provide impetus for British hospitals to open branches here, says Mr Buckley, adding that there is also a significant number of patients who travel to London for treatment from the UAE.

“The national strategy that the government wants – to develop health care as a medical tourism hub” is another factor encouraging UK hospitals’ push into this country.

In addition, “there is a drive with the NHS that trusts are looking for alternative revenues”, Mr Buckley says. “The income that goes from here to King’s will benefit the UK patients. There is a flow of some of the profits and a small percentage of the profits go to them.”

With doctors and nurses coming from the UK to the UAE, medical professionals in both countries stay in touch while also sharing treatment experience.

However, there are also challenges for UK hospitals operating in this country.

In June last year, Health Authority – Abu Dhabi announced Thiqa cardholders would need to pay 20 per cent of the cost of treatment at private hospitals. Previously the plan fully covered the cost of all procedures for Emiratis at private health centres. Government-owned hospitals were not affected.

“In Abu Dhabi the co-pay came in and that reduced the patient numbers. A lot of expats have left. Dubai is a hugely competitive market. Now, with Brexit, we have to get serious and get out there into the world,” says Mr Buckley.

Mariano Gonzalez, the commercial director at Moorfields Eye Hospital, London, says the private sector here was suffering under the co-pay rule as the business model changed and “the market had become less attractive for international healthcare investment”.

Moorfields Eye Hospital’s Annual Report 2015-16 stated that income from its private and overseas patient activities in London and Dubai, where it opened in 2007, increased during the year by £1.7m to £23m. It also said since 2007 the hospital has had a steady year-on-year growth in revenues and in the number of patients it treats. In eight years there were more than 100,000 visits from patients of 179 nationalities and the hospital performed more than 9,000 surgical procedures. It is now planning to expand to China and South Asia.

Its Moorfields Eye Hospital Abu Dhabi is a joint venture between United Eastern Medical Services and Moorfields London.

“We were pioneers in the NHS when we opened Moorfields Dubai. It was the first overseas branch of any NHS hospital,” Mr Gonzalez says. “At the end of the day having units in the UAE benefits the NHS patients and improves the NHS experience of the UK patients.”

Last month, Sheikh Mohammed bin Zayed, Crown Prince of Abu Dhabi and Deputy Supreme Commander of the Armed Forces, removed the 20 per cent co-pay for Emiratis seeking medical treatment at private health centres. Mr Gonzalez believes that has helped to make the market attractive again for international operators that wish to set up or continue activities in Abu Dhabi.

“It’s a big change and its very welcome from our side and we are looking forward to providing services in Abu Dhabi for the Emiratis and for everyone,” he says.

“Definitely it’s a change again in our projections and in our business model. In this case we are expecting to have a positive one compared to the previous one. This will be a process. Now the Emirati patients have an option of where to go without paying from their pockets. We really appreciate the decision of the rulers,” says Mr Gonzalez.

“It’s a more fair market as the decision lies with the patient. We want to move our business model step by step. We are extremely happy with the current situation.

“This changed the scenario and from thinking of leaving … Abu Dhabi, we are thinking of staying. Based on the performance of our facility in the next one to two years, we will decide if we will invest further.

“Definitely international operators will be more comfortable to invest capital,” Mr Gonzalez says.

Majd Abu Zant, the chief operating officer at United Eastern Medical Services, points out that the Moorfields facility’s location in Abu Dhabi makes its services accessible for more Emiratis and means locally-based patients do not have to cover the cost of travel to and from Dubai.

And there is room for further expansion, the Moorfields annual report said. “Moorfields has the road map to expand its presence regionally and internationally. Moorfields continues to provide complete clinical oversight for both facilities.”

Aside from treating patients, there are other collaborations between UK hospitals and the UAE. The affiliation between ICLDC in the UAE and Imperial College London, for example, is founded on common interests in research and academia.

ICLDC has two branches in the capital and one in Al Ain. It was established in 2006 in collaboration with Mubadala and was Imperial College’s first medical facility outside the UK.

“This relationship right now is purely research based,” says Dr Saf Naqvi, the medical director at ICLDC Abu Dhabi. “We have a very good partnership programme with Imperial College and they have very active involvement in our projects. We have doctorate students from Imperial College in London who are doing research here for a programme on diabetes and obesity.”

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