Health care is essential for any economy regardless of its size since it directly affects the workforce. The workforce in turn influences output and income earned by the government from taxes and foreign exchange. The health care sector should thus receive a substantial proportion of the budgetary expenditure if a country is to achieve high growth and development levels. The UAE is one of the most influential countries in the Middle East and it shapes the economic and political sphere in this continent. Although it is a dominant country in the Middle East, it faces many challenges in its health care system which threatens to undermine its growth and development. Several interventions should be taken to ensure that this nation does not lose its influence in the Middle East due to problems in the health care sector, which may affect its growth and development.
This paper will show that UAE faces challenges such as limitation in the number of specialists and nurses, low skills possessed by nurses and poor remuneration of employees who work for government hospitals. In order to address these concerns, more health care professionals should be trained and schools build for students who are interested in the medical field. In addition, foreign workers in health care facilities should be thoroughly vetted to ensure that they possess skills needed by patients. In order to motivate employees in the health care sector, their salaries and allowances should be increased, and their working environments improved through equipping hospitals with drugs, equipment and health care specialists. This will improve the overall quality of health care provided in the UAE.
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The health care sector is one of the most important sectors in any nation and it directly affects the economic growth and development of all nations. This is due to the reason that if the population has poor health, the productivity from individual workers decreases and this in turn reduces output from industries and firms. This in turn results in lower GDP, lower taxes earned by government and lower income earned from exports. Many health care systems across the world face challenges due to an increase in number of people who seek health care and the limitation of resources available. There has been an increase in diseases, both communicable and terminal illnesses. In addition, unhealthy lifestyles and poor dietary habits have led to an increase in diseases such as diabetes, heart illnesses and high blood pressure, across the world. It is therefore important that different health care systems are assessed and their weaknesses exposed in order to improve the quality of health care provision.
The UAE faces some challenges in its health care service delivery. These weaknesses include a shortage of specialists and nurses. Others include low quality of skills by nurses and low motivation levels among health care stakeholders. This has led to poor service delivery and man patients are opting to pursue health care services abroad. Many specialists are also taking jobs abroad since they perceive remuneration in UAE to be low. These factors have an economic impact of loss of revenue by the government, increase in cost of health care and opportunity costs of seeking local health care services. This paper will analyze the health care industry in the United Arab Emirates. Various weaknesses inherent in the system will be discussed from an economic point of view. These weaknesses will be compared to other successful hospitals across the world in order to develop effective interventions to solve them. Recommendations will then be made on actions which the UAE government, in collaboration with the private sector and international partners, has to take to improve the quality of health care provision. The incentives which should be given to change the behavior of UAE health care stakeholders will also be given at the end of the paper. The discussed issues will be summarized.
Problems and solutions
There are various problems which are present in the UAE health care system as earlier stated. These problems include inadequate distribution ratio of nurses to patients and the presence of low skilled nurses. These problems lead to dissatisfaction with service provision amongst the UAE population, and this results in many patients seeking treatment overseas. Over 70% of residents in UAE seek treatment overseas when faced with life-threatening ailments. This leads to losses to both health care providers and the government, which loses a substantial income from taxes. In addition, sometimes the government supports patients who seek treatment overseas and this increases the costs incurred by the government. For instance, in 2009, the UAE government spent over 280 million dirham to cover overseas costs of 530 patients (Porter & Teisberg, 2006). This figure is even higher when military patients are included. When the government spends this amount of money on overseas treatment, economic losses include opportunity costs of payment from patients to health practitioners, loss of tax revenue by the government and direct expenses paid for the medical cost. It is therefore imperative that steps are taken to restore the confidence which nationals of the UAE have in the health care system. This part of the paper will discuss individual problems in the provision of health care in the UAE. The solutions to the problems faced will be discussed after discussing the problems.
Inadequate distribution ratio of nurses to patients
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The international acceptable standards in health care provision advocates for a bed capacity to nursesââ‚¬â„¢ ratio of 1:1 in areas which are considered critical to health care. The current ratio present in the UAE is in fact 1:5. This means that one nurse takes care of four patients simultaneously. According to Zain and Libo, (2008), although the internationally recognized nurse to patient ration in the ICU is 1:5, there are several hospitals in Dubai which have higher nurse to patient ratios. For instance, the Al Baraha hospital has a nurse to patient ratio of 1:10 in general wards, and in the ICU, this ratio is 1:4. In addition, it has 100 doctors and 200 nurses yet it receives 13 new born babies, 250 emergency patients and 650 outpatients in a daily basis. This shows the problem facing the hospital as far as the shortage of nurses is concerned.
This is not acceptable, especially in critical areas of health care. This is due to the reason that increasing the workload of nurses has adverse impacts on health care provision. These include increasing risk of spread of infection as nurses urgently try to complete tasks, increasing risk of error due to fatigue, increasing occupational injuries due to rush to complete tasks, increasing risk of error when filling incident reports and increasing turnover rate due to excessive work and few promotions. This would eventually reduce the overall quality of health care, which adversely affects the health of the population and workforce. This would in turn reduce productivity and economic growth and development in the UAE. In addition, inadequate staff may make patients lose confidence in the health care provision and seek alternative health options such as over the counter medication, herbal medicine and others. Some of these methods may further aggravate their illnesses.
In order to solve this problem, the UAE government should increase its investment in health care. The current proportion of budget spent on health care in the UAE is approximately 9%. For a sector which has a huge impact on a countryââ‚¬â„¢s growth and development, UAE spends too little on health. It should increase this proportion to over 15% in order to cater for the needs of hiring new nurses and expanding health care infrastructure. The US, which is a larger economy, spent 17% of its GDP in 2009 on health care. More nurses should be hired to improve the nurse to patient ratio. In addition, more medical schools would be built to train more health care practitioners who would cater for the expanding health care needs. This will reduce the risks earlier discussed and improve the overall quality of health care in the UAE.
Low skilled nurses
Many nurses who work in the UAE are either under qualified or in possession of little experience, which affects their health care provision. This is caused by many factors and one of them is the shortage of nurses and the unfavorable nurse to patient ratio. Due to this shortage, cheap labor is sought from foreign countries such as Philippines and India. When this happens, it is difficult to fully ascertain the levels of skills held by these professionals, and most end up having low nursing skills. In addition, little or no professional training in nursing is given to such health care professionals. As a result, the few nurses present in the UAE do not possess the skills required to deal with the many health care needs of the population. This leads to provision of poor and low quality health care, which makes the population unhealthy. Nurses with poor professional skills are more prone to errors, which may even end up being fatal to patients.
In order to deal with the problem of low skills among nurses, several interventions ought to be taken. The first is a review of skills and experience possessed by nurses who come from overseas to work in the UAE. Their academic qualifications and experience should be corroborated, and the quality of health care institutions they worked for assessed before they are employed in UAE hospitals. In order to develop superior nursing skills among UAE residents, the government ought to increase its budgetary allocation to the health care sector in order to build more nursing institutions which would develop more nurses (Oxford Business Group, 2008). The private sector and international partners should collaborate when building these nursing schools and training new nurses in order for improve the quality of skills possessed by nurses. According to City data website (2010), this strategy has already proved to be successful in Bangkok. Due to investment in training of nurses and use of technology, the health care delivery has improved and this has translated into direct benefits to the population. The life expectancy has increased by over 10 years during the last three decades.
Inadequate number of specialists
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This is a third problem which faces the UAE health care industry. There are a large number of general doctors but few specialists amongst the population. Most large hospitals have over 100 doctors but the number of specialists is usually less than 10. This limits the effectiveness of health care provision since many patients nowadays require specialized health care needs. The increase in chronic diseases such as cancer, heart problems and brain disorders has made it necessary to increase the number of specialists in these fields. In the current case, where there are few specialists, the specialist to patient ratio is very large. This may cause similar problems caused by overburdening nurses with responsibilities. In addition, it increases the costs of treating illnesses which require specialized care since the few specialists may charge high prices due to their high demand. The overall effect of having few specialists is increase in cost of health care, inability of the population to access specialized care and increase in errors made by specialists due to high work load. All these factors undermine the UAE health care provision industry.
In order to solve this problem, training of specialists is required, so that they may offer their services to patients who require them. The government should collaborate with international partners and the private sector to build more schools where health care specialists are trained. These medical schools should be well equipped in order to ensure that specialists have the expertise and knowledge needed to perform their duties effectively (Crichton, 2000). Since the cost of training health care specialists is high, the government should subsidize the costs of pursuing education on certain areas of health care. The population should be encouraged to pursue knowledge on certain areas which have very few specialists such as neurology.
Incentives which should be given to health care practitioners
There are various incentives which should be given to doctors and nurses in order to increase their motivation levels. These incentives enable them to be well motivated and to increase their output as far as caring for patients is concerned. These incentives will be discussed below;
There have been complaints from many health care practitioners in the UAE that the salaries and benefits they receive are not commensurate to the efforts they put in their assignments. As is common in many countries, many government health practitioners have complained that professionals working in private practice are earning significantly higher salaries and benefits than them. This lowers their morale and productivity since according to the expectancy theory by Vroom, employees only work harder when they are sure that their expectations regarding remuneration and other needs, will be realized (Beach, 2007). This can be seen by the large number of health care specialists who are moving to the US and Europe to offer their services to these countries. In order to increase their motivation levels, their salaries and benefits should be increased and matched to those of specialists in private practice. This will ensure that health care professionals are motivated and they will increase the quality of services they give.
Better working environments
In order for doctors and nurses to be able to work effectively, they should be provided with the latest equipment, drugs and training. This enables them to provide high quality health care to the population. The government should ensure that all hospitals have enough staff in order to improve the nurse to patient ratio. There should also be enough specialists and equipment and drugs used by patients. In any organization, organizational culture plays a role in motivating employees (Murray, 2005). The organizational culture should be therefore conducive for employees, since this will motivate them into increasing their output. The management should ensure that employees are involved in decision making, are given independence when working and that they are encouraged to work as a team. There should be an uninterrupted flow of information between the lower level employees and the management. The management should use the democratic leadership style since this is the most effective in achieving employee motivation (Bratton, et. al., 2004). This style involves employees in making decisions which affect their duties. Finally, there should be conflict resolution mechanisms which will avoid workplace conflicts. This will ensure that the quality of service provision improves.
Incentive for patients
It has been discussed that due to the challenges which the health care sector in the UAE faces, many patients are beginning to lose confidence in the health care system. It is therefore necessary to provide certain incentives which will restore confidence in the health acre system. One way of doing this is improving the patient to nurse ratio. This has been discussed in detail above when dealing with challenges in the UAE health care industry. Increasing the number of nurses will ensure that patients receive better quality of health acre and this will restore their faith in the system. Another incentive is the increase in quality of skills possessed by nurses. This will enable nurses to provide better services to patients, and this can be achieved through re-training them and vetting them before they are employed. Finally, patients should be provided with score cards which reveal their satisfaction with service provision in hospitals. This measure will enable hospitals to acquire feedback from their patients and they will be able to improve upon areas which they are considered to be weak (Carver & Scheier, 2001). It has proven to be successful in many hospitals in Thailand and it is bound to be similarly successful in the UAE. This measure will increase the quality of health care provided.
Summary and conclusion
There are various aspects of the UAE health care system which have been discussed in the paper. UAE has been seen to have challenges such as few number of specialists, low nurse to patient ratio, lower remuneration of health care stakeholders and poor skills by nurses. These effects have been discussed to lower the motivation of employees and as a result, they are likely to make errors or perform poor quality assignments. This in turn makes patient lose confidence in local health care provision and some seek health care services overseas. Some health care professionals also look for employment overseas as a result. When this happens, the UAE government loses tax revenue. It also ends up paying for patientsââ‚¬â„¢ overseas treatment which leads to economic losses such as lost opportunity costs of payment from patients to health practitioners, loss of tax revenue by the government and direct expenses paid for the medical cost.
In order to solve these problems which are affecting the UAE healthcare service provision, several steps should be taken by the UAE government in collaboration with the private sector and international partners. The first involves better remuneration of employees in the health care industry. The stakeholders in the health care industry should set new remuneration which matches that from the private practice. The second step involves building of medical schools and paying for educational needs of students to enable them pursue various medical fields. This will increase the skills and number of health car professionals, which is a major challenge in UAE. The third intervention is screening all health care professionals from foreign countries before they begin working in the UAE in order to ensure that they have adequate skills.
Although these interventions are important in improving the overall quality of healthcare provision in the UAE, it is similarly useful to provide incentives to stakeholders in the health care sector in order to improve service provision. Health care employees should receive higher remuneration in order to increase motivation. Their work environment should also be conducive and the organizational culture should feature teamwork, independence, communication, conflict resolution and other important factors (Mugisho, 2007). Patients on the other hand can be motivated through improving the skills and increasing number of nurses and specialists since this will encourage them to have faith in the health care system. Feedback should be sourced through score cards, where patients rate service provided to them. This will enable the management improve the weaknesses of the processes. These interventions will encourage patients to seek local health services and this will increase government income and tax revenue thereby leading to higher economic growth and development.