Kuwait in Dh21bn health sector boost

Eight hospitals and nine towers are in works but some professionals are questioning the expansion plan, arguing that more buildings may not mean better treatment.

KUWAIT CITY // As Kuwait attempts to emulate the infrastructure booms of other Gulf Cooperation Council countries with a wide-ranging development plan, the health sector has emerged as a prime target for investment.

Kuwait plans to build eight new hospitals and add nine towers to existing facilities in the next few years. When combined with the giant Sheikh Jaber al Ahmad al Sabah Hospital, which is under construction, the healthcare sector could see 1.62 billion Kuwaiti dinars (Dh20.6bn) of projects under way soon. The upgrades could give Kuwaitis access to the world's best medical technology, but health experts warn that infrastructure does not always mean better service. Plans to segregate foreigners from locals could lead to an inequality of care.

"You drive an old Mercedes, but it's nicely conditioned and in good shape, you can travel anywhere you want," said Dr Mohammed Shamsah, the secretary general of Kuwait Medical Association, at Adan Hospital's intensive care unit recently. "You get a nice new Cadillac, and it can break down." By way of comparison, Dr Shamsah said one may go to any Victorian hospital building in England and it is an old building, but the quality of care is much better than Kuwait. "You improve your efficiency by providing better quality."

Dr Shamsah said he recently told an official at the ministry of health: "You guys are expanding like crazy and never thinking about the running costs of these expansions. If you build 10 hospitals and then find that half of them are hardly occupied, then you've just burdened the economy with further costs." Kuwait could provide better quality of care by putting armies of staff who "do nothing but drink tea and eat falafel in the morning" to better use, he said. "It's about getting your troops in the right field, the right frontier."

The ministry of health is in charge of building the nine new expansions to Kuwait's existing hospitals. Hashem al Hassan, a ministry engineer, said the new towers would cost 120 million dinars and would add 2,240 beds, along with intensive care units, X-ray machines and facilities for physiotherapy. "People are complaining that you don't find beds or private rooms and we need to account for Kuwait's growing population," Mr al Hassan said. "With the new equipment and technology, the standard of health care is increasing."

The construction of the eight planned hospitals, with an estimated 600 beds each, is the responsibility of the ministry of public works. The minister, Fadhel al Safar, recently estimated that the projects could cost up to 1.2bn dinars. The ministry is also building Sheikh Jaber al Ahmed al Sabah Hospital, an ultra-modern, 1,168-bed facility scheduled to open in 2013. Ali Nodoom, one of the ministry's project engineers, called the 304m-dinar project "the mother of all hospitals", at the construction site in South Surra recently. He said the hospital's new technology, high-quality rooms and slick marble design will be "cleaner and healthier" for patients and "improve the psychological environment" for care.

If all of the planned projects are finished, Kuwait's bed capacity in government hospitals could nearly triple to almost 13,000 from around 4,700, matching a trend of growth in other Gulf countries. A recent report by Kuwait Finance House Research said 200 hospital projects have been announced or are under way in the GCC, which could add 27,009 beds to the region's hospitals. Dr Nadeem al Duaij, the chairman of Kuwait Health Initiative, a group of more than 50 health activists who promote research in public health and advocate policy, said he has "mixed feelings" about the new buildings because even though Kuwait's health sector is in need of investment, "not everyone will be served by the new towers".

Kuwait is increasingly treating foreign workers and citizens separately by segregating intensive care units and setting distinct treatment hours in primary care clinics, Dr al Duaij said. "We stand against this very strongly because it's inequitable and a move towards more separation." Mr al Duaij said he attended a meeting of parliament's health committee in April, and its members were "going back and forth" on designating some of the new hospitals specifically for foreigners.

He said a white paper that was circulated in the ministry suggested three of the new hospitals should be used for that purpose. Members of parliament's health committee were not available for comment, but Mr al Duaij said a draft law they are working on makes a distinction between Kuwaitis and foreign workers in health insurance. He said this could create a "two-tier" system that would negatively affect the entire country's health.

If one does not immunise an entire group in society against a certain disease, then even those who have been immunised are at risk, he explained. "If expats get less healthy, this will affect the entire population." Dr al Duaij said he believes that Kuwaitis have been frightened by false reports in the media suggesting that expatriates have put citizens at risk of diseases like hepatitis, HIV and tuberculosis. He said candidates seeking election have campaigned with nationalist ideas.

Kuwait suffers from some of the worst rates of diabetes and obesity in the world, and an alternative solution to the country's health problems could be found by concentrating on preventative medicine, such as diet and exercise programmes and measuring blood pressure, he said. "There is not a sustained screening programme in the country despite having a massive burden of disease." @Email:[e-mail]