Call for pool of specialists to share expertise with hospitals’ intensive-care units in UAE


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ABU DHABI // Health experts have called for a pool of rehabilitation specialists to share their expertise with many hospitals to help ease a crisis in intensive-care units (ICU).

There is a severe shortage of experts in speech therapy, cardiac rehabilitation and neurological care, which are crucial for those suffering from acute trauma, they say.

This means critically ill patients take longer to recover, filling badly needed beds, said Dr Sabahat Wasti.

“We would like to see more expertise sharing in the country,” said Dr Wasti, chief executive and consultant at the Berlin Medical and Neurological Rehabilitation Centre in Abu Dhabi.

“I think a good practice would be to allow rotating visiting of ICUs by early rehab teams to cover several hospitals – to see patients, develop their care plan and oversee the implementation of the plans.”

Many of those in an ICU have suffered an acute trauma or require complex care. They need experts in areas including speech, occupational and neurological therapies and cardiac rehabilitation.

There is also a great need for specialists in treating children with complex developmental disorders.

Dr Wasti, 56, said world-class intensive-care hospitals were being built in the UAE, but he warned that not enough local experts were being trained to work in them and patients were still being forced to go abroad for treatment.

Most rehabilitation specialist services are lacking compared with Europe and America, he said.

“Post-critical illness rehabilitation here is not readily available,” Dr Wasti said. “The resource is limited, so you have to widen the scope and share the expertise.

“It would make infinite sense that people could work across facilities, especially in certain areas where the resource is very tight.”

Countries including the United States are focusing heavily on rehabilitation services, he said.

“ICU rehabilitation is a rapidly upcoming field in Europe and America. There is emerging and accumulating evidence that with early rehabilitation you can reduce the length of stay in hospital and you can improve the outcome.”

The Health Authority Abu Dhabi (Haad) published statistics last year showing that severe capacity gaps exist in medical rehabilitation.

A rotating team of specialists would help to meet the demand until more staff were employed, said Dr Wasti.

Insurance companies could help to foot the bill, he said, once they realised it was more economically viable to have visiting experts rather than pay for patients who stayed in hospital for longer.

Dr Wasti said while new rehabilitation centres were cropping up in Abu Dhabi, more needed to be done to tackle the lack of trained specialists.

“A lot of people are jumping on the bandwagon in developing rehabilitation services,” said the British expatriate. “While it is very welcome, it is equally concerning the way these services are being developed either on spec or with imported expertise who do not know the lie of the land.

“We are not homing in to the specialist rehabilitation. We invest too much in the structure and not in the professional development. So we are left with good buildings and good places to work but not a good quality of clinicians to operate in places.”

The lack of rehabilitation services means residents are still travelling oversees for specialised treatment, he said.

“The demand to go overseas is real but we may, in part, at least be able to offset this demand if it was possible to share expertise in-house.”

Dr Wasti will address the Emirates Critical Care Conference in Dubai in April.

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Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.

Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.

Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.

Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.

“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.

Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.

From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.

Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.

BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.

Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.

Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.

“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.

Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.

“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.

“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”

The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”

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