A Brief Review on The Health Care Framework in The United Arab Emirates

18 Jan 2023

The seven emirates that make up the United Arab Emirates (UAE) are united. The most popular ones are Abu Dhabi and Dubai. The remaining emirates are Ras al-Khaimah, Sharjah, Ajman, Fujairah, Umm al-Quwain, and Ajman, which are frequently referred to as the "Northern Emirates" collectively. The UAE operates within a constitutional framework at the federal level that includes provisions for the population's health and welfare, specifically that "the community shall provide all the citizens with medical care and means of prevention and treatment from diseases and epidemics and shall promote the establishment of public and private hospitals, clinics, and treatment houses. In addition to working with all other health authorities to ensure that all public and private hospitals are accredited in accordance with precise national and international quality standards of medical services and staff, the Federal Ministry of Health and Prevention (MOHAP) is responsible for overseeing the federal government's implementation of policy relating to the provision of comprehensive healthcare for all citizens and residents of the United Arab Emirates.

The Department of Health (DOH), the Dubai Health Authority (DHA), and the Sharjah Health Authority, respectively, have been established in the emirates of Abu Dhabi, Dubai, and Sharjah. These three emirates have the most developed rules and regulations regarding healthcare issues among the seven emirates. By creating healthcare sector-free zones like the Dubai Healthcare City (DHCC) and the Sharjah Healthcare City, the emirates of Dubai and Sharjah have also created provisions for healthcare investment. The MOHAP serves as the primary regulator for the remaining Northern Emirates, which rely on it to regulate the provision of healthcare services. 

The UAE has consistently consulted other jurisdictions while developing a legal framework for the healthcare industry. Priorities include ensuring adherence to global best practices and assisting in providing the general public with high-quality medical care. In addition to reducing the need for people to travel abroad for specialised treatment, the drive to improve healthcare services across the UAE also aims to promote medical tourism, expand the range of services offered, and create a healthcare sector supported by the private sector and insurance investment. There are well-known healthcare attorneys who provide guidance to entities and individuals practising in the healthcare sector on corporate, employment, dispute resolution, insurance, medical malpractice, intellectual property, and public policy issues

The arrival of the COVID-19 pandemic in 2020 has had a significant negative impact on the healthcare industry. As we move into the post-COVID-19 environment, we look at how some of those actions have sped up the health sector's transition into the digital era. The health regulators issued various directives to public and private sector operators on how to handle the situation. Although some of these strategies are covered in this chapter, the overall campaign to combat COVID-19 is not fully described here.

 

The Medical Industry In General

The state of the healthcare industry in the United Arab Emirates is closely related to the state of the overall economy and the government's strategy of diversifying away from the oil and gas industry. According to the IMF's general economic forecast released in April 2021, the UAE's economy would expand by 3.1% in 2021. The goal of the National Agenda 2021 is to establish a world-class healthcare system in the UAE. A variety of policies are being discussed to accomplish this goal and enhance fundamental health outcomes, health infrastructure and preventative care, and physical and mental health satisfaction. The United States now ranks 42 in the Healthcare Quality Index.

 

Health Insurance's Function

Health insurance is now required in the UAE thanks to the Insurance Authority, which was set up in accordance with Federal Law Number 6 of 2007 (as amended).

4 The government-sponsored "Thiqa" program, which is run by the UAE national insurance company Daman and offers a wide spectrum of health insurance coverage, covers the UAE national Emirati people (and those of comparable status).

By passing Law Number 23 of 20055, which offers a fundamental level of coverage for all employees and their families, Abu Dhabi became the first emirate to fully implement mandatory health insurance for the expatriate community. According to Law Number 11 of 2013,6 a similar program is presently being implemented in Dubai. It was started in February 2014 and finished in three phases based on the size of the employer's employees, with the last phase ending in June 2016. Every emirate in the United Arab Emirates has not yet implemented mandatory health insurance for ex-pats. The function of health insurance is essential to the ability of the remaining expatriate community to purchase and access private medical services and medications as the government diminishes its commitment to publicly funded treatments, which are generally accessible only by the Emirati population.

 

Funding and Compensation for Particular Services

Not all healthcare requirements are covered by health insurance. Although the Thiqa coverage for Emiratis is rather broad, recent budget cuts have made it necessary to withdraw access to some Thiqa services. In a similar vein, expatriates who only receive a minimal level of coverage must pay for various services that are not covered by most insurance. Due to the vast list of uninsured services, international patients are often forced to pay out of pocket and occasionally travel abroad to receive care, where costs may be much lower.

 

Primary/family medicine, hospitals and social care

Primary/Family Medicine

Patients in the UAE can consult medical specialists immediately without going via a primary care facility first. Since consumers "search" for services and seek advice from multiple specialists for the same ailment, direct access to specialized services is to blame for driving up healthcare expenses for the government and insurance.

Direct access is currently being restricted, and primary care is gaining more attention from healthcare regulators in an effort to improve the coordination of care across the continuum. The aim is to provide healthcare throughout a person's whole life cycle, in a procedure that lasts from the patient's first appointment with a primary care doctor through the referral process and up until the end of the course of treatment.

These kinds of initiatives ought to lead to advancements in the use of primary care practitioners' skills through care pathways and in the coordination of primary, intermediate, and tertiary healthcare services.

The DOH recently released a guideline for basic healthcare services in 2016, recognizing the necessity for primary care gateways as part of the emirate's master strategy for healthcare service delivery.

7 In a same vein, the DHA has granted licenses to 20 medical facilities offering primary healthcare services throughout the emirate.

Insurance companies are increasingly taking the initiative to change the terms and conditions of health insurance policies so that consumers must attend primary care services and receive the proper recommendations from primary gateway providers before expenses are approved. In terms of upcoming changes, we anticipate that patients will have access to teleconsultation channels as the UAE begins to license telehealth services.

 

Hospitals Public Sector

The DHA (together with its subsidiaries the Healthcare Corporation and the Dubai Healthcare Insurance Corporation (DHIC)), the Abu Dhabi Health Services Company (SEHA), and the MOHAP are the principal state agencies that regulate the provision of high-quality healthcare services. Trauma centres, obstetrics and gynaecology, orthopaedic, surgical, and the treatment of lifestyle disorders fall under the umbrella of secondary care services offered by public hospitals. The goal of the policy is to provide additional specialized services on top of this.

The public hospitals in Dubai, including Dubai Hospital, Rashid Hospital, Latifa Hospital, and Hatta Hospital, are run by the DHA. It is currently constructing additional facilities and broadening its offering of services, which now includes a kidney transplant center, specialized pediatric services, and gastroenterology.

All public hospitals and clinics in Abu Dhabi are owned and operated by SEHA, an independent public joint stock company. These facilities include 12 hospitals, 46 primary healthcare clinics, 10 disease prevention and screening centers, mobile clinics, a school clinic, blood banks, dental clinics, and a vaccination center.

A significant player in the delivery of public healthcare services, Mubadala Healthcare, a branch of the Abu Dhabi government investment vehicle Mubadala Development Company, also caters to customers with private insurance or high net worth who choose to pay out of pocket. The Imperial College London Diabetes Centre, Health point Hospital, the Abu Dhabi Telemedicine Center, and other initiatives are among them.

The MOHAP is in charge of managing the Northern Emirates' public healthcare system, which includes 16 hospitals and more than 60 clinics. Although MOHAP has traditionally served the Emirati community, it will soon offer services to all locals, for example, through Ras al Khaimah's Sheikh Khalifa Specialist Hospital, which is now managed by Seoul National University Hospital and provides specialized cancer services.

 

Private Industry

Due to recent amendments to Federal Law Number 4 of 2015 (on Private Health Facilities) and Law Number 22 of 2015 (Regulating Partnership between the Public Sector and the Private Sector in the Emirate of Dubai), the private sector is expected to play a significant role in the provision of healthcare in the future.

 

Social Assistance

For the most part, development programs for Emirati families and people with special needs are the focus of the Ministry of Community Development, which was established to manage social care in the United Arab Emirates. The idea of social care has remained in its infancy since the introduction of social care regulations in the 1970s. An inadequate network enabling the transfer of old or vulnerable patients from hospital treatment to home care with proper social care assistance has resulted from the lack of focus on geriatric or dementia care services. Normally, families were left to carry this burden, but now that a Community Development Authority and Department of Community Development have been established in Dubai, families will benefit from additional support that is being made accessible through new programs by this Ministry. The transition to home care is now supported by a number of initiatives, such as a partnership in Abu Dhabi that transfers patients from Cleveland Clinic Abu Dhabi to Amana Home Care services, enabling high-quality home care.

 

Information About Patients' Health and Data

There is no comprehensive data protection law in the UAE. Legal duties under the Penal Code regarding the use or disclosure of "secrets" without the authorization of the person to whom the secret pertains give rise to privacy obligations. However, there have been changes made to new laws that only apply in the context of healthcare.

The Use of Information and Communications Technology in Health Fields, Federal Law No. 2 of 2019 (with Implementing Regulations), governs how ICT is used in health-related fields across the nation.

The following goals are among those the law attempts to accomplish

  • mandate that health authorities establish guidelines for the control and confidentiality of electronic patient records; 
  • establish a central system for storing medical records; and
  • prohibit the export of patient health information unless an exemption applies or approval has been obtained by the relevant health authority.

Along with the new law, the following statutes continue to exist and provide for patient confidentiality.

According to Federal Law Number 5 of 2019 (concerning the Practice of Human Medicine Profession), which regulates doctors licensed in the UAE, no doctor has the right to disclose a private secret without the patient's consent, regardless of whether the patient directly confided it to him or her or if he or she learned of it independently while performing their duties.

Medical professionals, pharmacists, and other healthcare professionals licensed in the UAE are subject to the MOHAP Code of Conduct 1988, which mandates complete patient information confidentiality and forbids disclosure without the patient's prior informed consent.

The use and dissemination of Patient Health Information (including personal information and medical information about a patient's physical or mental health) by entities regulated in the DHCC is governed by DHCC Regulation Number 7 of 2013 (on Health Data).

Healthcare providers in the emirate of Abu Dhabi must create and implement policies and procedures relating to confidential health information, which includes information that can be used to identify a patient, in accordance with the DOH Data Standard 2008, which was released in 2008. Only the bare minimum of staff members may access confidential health information, and such information must be protected from unauthorized access, according to the policies created in accordance with the Data Standard.

The Salama Electronic Medical Record System was unveiled by the DHA in 2017. Currently, a single electronic medical record system links the public hospitals. This program will eventually be extended to all hospitals in the emirate of Dubai. The DOH has finished implementing MALAFFI, a centralized electronic medical record database, and has ordered that all Abu Dhabi-licensed medical facilities sign up for the system and input patient health data to it.