Hospitals held back as building costs rise



ABU DHABI // Medical projects are being postponed, reduced in scale or are running over budget as the price of building increases. The Ministry of Public Works has asked the Ministry of Health to re-evaluate all planned healthcare and hospital projects in the northern Emirates. The Health Ministry plans to build as many as 13 primary healthcare centres and increase the number of hospital beds in Ras al Khaimah. Al Qassimi hospital is also establishing a heart centre.

Dr Abdullah al Nuaimi, the director general of public works, said construction costs had increased so much that the ministry could no longer afford to continue with plans as they were. He said his ministry had asked health officials to "reconsider downscaling or reducing some of their requirements? to look into what pieces could be saved and what pieces should be postponed for another phase". He added that projects had been put through feasibility studies to determine whether all elements of each plan were necessary, and in some cases the scope of the project had been reduced.

Projects that were due for early 2009 have been pushed back until later in the year. Dr Nuaimi would not say which projects have been delayed or how they have been scaled down. The budget problems have been blamed on a lack of qualified contractors, high steel prices over the past year and a shortage of concrete. While prices and supplies have recently returned to normal, the damage has already been done.

"2008 is abnormal," said Dr Nuaimi. "Construction costs increase every year due to inflation but the increase is within five or six per cent." The medical system in the UAE is expanding every year, and the Government is attracting private investors to help meet demands. The exact scope of the problem is not known as many medical projects that have been planned are private arrangements. "I've heard that people who were planning on coming online in 2010 or 2011, are now saying 2012 or 2013," said Richard Larison, the chief executive officer of the American Hospital Dubai. "Nobody is really coming out and saying there is a problem but there is a lot of anecdotal evidence out there about things being pushed back."

He said the plans already being executed for the expansion of his hospital are not affected, but that the inflation is something to bear in mind for future endeavours. "There are situations that, before the project has begun, people are asking if they can make it into a viable business model. People are asking whether they can raise the prices high enough to be able to get a return." Both health authorities, in Abu Dhabi and Dubai, say the increase in prices has not affected them in a significant way, and that no projects have been stopped. The Ministry of Public Works is proceeding on the basis that this situation was a blip and will not be repeated.

Brian de Francesca, the chief operating officer of Tawam Hospital in Al Ain, said the budget of its expansion project had soared from Dh10 billion (US$2.7bn) to "Dh12bn or Dh14bn". "Generally we were always very conservative both on the timing of the project and the inflation rate, which I'm glad we did. If we had estimated 10 per cent inflation over three years [similar to other countries] then we would have been sunk.

"Everyone sees the UAE and the Middle East as an endless bucket of money and people are coming out of the woodwork to get involved on projects," said Mr de Francesca. "There are a lot of very good organisations but there are a lot of questionable ones as well. That is one of the greatest challenges, to weed out who is what." amcmeans@thenational.ae

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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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