'Sick' citizens abuse free health trips

Doctors say that only a fraction of patients taking advantage of the country's generous healthcare provisions actually need treatment abroad.

Kuwait's healthcare system is generous, but open to abuse.

KUWAIT CITY // Get sick in Kuwait and the government might send you on an all-expenses-paid trip for treatment in the West - not an ideal holiday for some, but for many Kuwaitis it is an offer that is too good to refuse. The state's guarantee to send ill citizens who cannot be treated locally to the world's best hospitals is a pillar of Kuwait's generous social welfare system. The journeys for medical care to countries such as the United States, the United Kingdom, France and Germany have saved and improved the lives of thousands, but doctors say many are signing up for superficial treatment or a free trip.

"If you analyse them, you will find about only 15 per cent deserve to go abroad," Dr Mohammed Shamsah, 41, the secretary general of the Kuwait Medical Association (KMA), said recently between tending to critically ill patients in Adan Hospital's intensive care unit. "They have been sending people with eczema. They have been sending people with psoriasis." Some Kuwaitis are flying to Europe's top tourist destinations during the summer months for plastic surgery, Dr Shamsah said. The applications "don't say it's for aesthetic reasons, they say, 'reconstructive surgery of the breast'".

Dr Shamsah blamed politicians, who use their influence, or wasta, in the country's treatment abroad centres. "If you're a member of parliament and you can get me treated abroad for a cold, and I can take my family for a holiday, I feel obliged to give you my vote," he said. Other cases are genuine. Three years ago, Khaled al Ali's father, Ali, 60, was sent to the US for seven months to receive treatment for bowel cancer at the University of Texas MD Anderson Cancer Centre in Houston. Mr al Ali and his sister accompanied his father, the three received a plane tickets and a daily allowance of $126 (Dh463) each.

"It's probably the best centre to treat the disease in the world," Mr al Ali said while sorting through paperwork at the department for treatment abroad in Al Sabah hospital, where Kuwaitis who want treatment overseas apply. "The doctors and nurses were so humane and my father was eventually cured." The operation his father would have received in Kuwait would have left his father needing incontinence pants for the rest of his life, but this outcome was avoided by the more advanced surgery in the US. "He is now as healthy as anyone else," Mr al Ali said.

Mr al Ali's family received more bad news recently when his mother, Aisha, 58, was found to have pancreatic cancer. She applied for treatment overseas, but the hospital's committee refused her request because they believed her disease can be treated locally. The family is now appealing against the decision. "If they say no again, I will pay for her to be treated overseas myself," Mr al Ali said. The ministry of health said it spent about 200 million dinars (Dh2.55 billion) to send about 2,100 Kuwaitis to hospitals overseas last year. Thousands more are sent by similar programmes run by the military, the police, the Kuwait Oil Company and the Emiri Diwan.

Seriously ill patients, along with care-seeking women or children, can travel with up to two family members. On top of a daily allowance and plane tickets, the package can include a private aeroplane ambulance at the cost of about $25,000. Patients waiting for transplants can stay in their host country for years waiting for an operation. Waleed al Tabtabae, an MP, blasted his counterparts for lobbying on behalf of their supporters and ministers for approving their requests. "I was told by an MP's secretary that he had issued 900 decisions [for treatment overseas] for the MP during the election year of 2006. The majority of these decisions were undeserved and allowed the applicants to travel for tourism at the expense of the state, pocket money included," Mr al Tabtabae said on his website.

An official at the ministry of health's department for treatment abroad, who spoke to The National on condition of anonymity, admitted that the system has been abused in the past, but argued that reforms implemented last year by the current minister, Hilal al Sayer, are preventing MPs from exploiting the rules. The new system requires committees in hospitals and a higher committee at the department for treatment abroad to approve all applications.

"In 2006, when too many people travelled because there were no rules, no laws, it cost around 600 to 800 million [dinars]," the official said. "MPs can't influence the decisions anymore. That's why you don't see them here and don't see their secretaries." Dr Shamsah agreed that Dr al Sayer's reforms have cleaned up the ministry, but he believes the other institutions that send Kuwaitis abroad, such as the military and police, "are now even worse".

Kuwaitis travel overseas for treatment because both the ministers and the parliamentarians bend to their wishes, and because they do not trust the country's medical system, he said. He estimated that about 80 per cent of the locals in his hospital's intensive care unit will try and get treated overseas even if it will not help. "You cannot just come with a 90-year-old who has been in bed all year, not moving, has had multiple strokes and is demented, and ask for a miracle to happen. And then send him abroad so a Brit can tell the family he is a hopeless case," he said.

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