Kuwait Healthcare Snapshot A summary of Kuwait s Government and Private Healthcare sectors in 2009 Ali Boshehry Global Markets Monitor 6/6/2010 Healthcare globalmarkets.com.kw
Global Markets Monitor Contents Global Markets Monitor... 3 About the Author... 3... 4 General... 4 Population... 4 Economy... 6 Healthcare... 7 Government Healthcaree Sector... 8 Private Healthcare Sector... 10 Page 2 of 12
Global Markets Monitor Global Markets Mon nitor Global Markets Monitor was established in 2010 in Kuwait. Despite its new establishment, the founding team is regardedd highly professional and experienced in the fields of Project Management, Research, and Consultancy. Global Markets Monitor aims at delivering professional market information to individuals and corporations for better investment decisions and outcomes. We mainly target emerging markets in the Middle East such as Iraq and Iran where we have local teams that worked in many fields obtaining facts and figures that built successful projects. Global Markets Monitor strives in delivering quality and professional services to its clients. Our team has been able to complete different projects successfully with the highest satisfaction and is always looking for more challenging tasks in challenging markets. Our teams in Iraq make every effort to be recognized as one of the best and finest consultancy teams contributing to clients needs throughout the different projects and developments stages. About the Author Ali Boshehry is the Managing Director of Global Markets Monitor. Mr. Boshehry has worked in many challenging projects in the commercial and hospitality markets. Ali Boshehry has worked and managed several projects for major developers and firms in the Gulf Region that enabled him to develop his skills in market research, project management, feasibility studies, operator contracts, etc. Mr. Boshehry holds a Bachelor s degree in Engineering Vanderbilt University (Tennessee, USA), a Hotel Real Estate Investments and Asset Management from Cornell University (New York, USA) and is currently perusing his MBA degree from Kuwait University. Page 3 of 12
General Kuwait is a small oil rich country with 102 billion barrels of oil reserves - about 9% of world reserves 1. Kuwait is situated strategically between Iraq, Iran, and Kingdom of Saudi Arabia and occupies 20,000 square kilometers of land. Kuwait declared its independence from the British Empire on the 19 th of June in 1961 under Al-Sabah Family ruling. The country has developed since then to be positioned as one of the major oil exporters in the world. Kuwait is divided into six governorates to facilitate the control and the management of the growing population in Kuwait. The governorates are; 1. Al Asimah 2. Hawalli 3. Farwaniya 4. Mubarak Al Kabeer 5. Al Ahmadi 6. Al Jahra Map 1 Kuwait map Population The population in 2009 reached a total of 3,484,881 people; 1,118,911 are Kuwaitis and 2,365,970 are expats 2, Graph 1. The total population has increased dramatically in recent years in response for the local demand for skilled and unskilled labor in alll fields. The wealth generated from the oil sector enabled Kuwait to start and develop other sources of income to provide luxury to its local residents. One of the major reasons for the increased foreign labor in Kuwait is the lack of higher education population that can respond to the country s, Graph 2. Local citizens with higher education are only 11% of the working population in Kuwait 3. Furthermore, local citizens are unwilling to perform basic job duties that fit their educational levels because the government has taken the responsibility of hiring them despite their qualifications. 1 CIA The World Factbook 2 The Public Authority for Civil Information 3 The Public Authority for Civil Information Page 4 of 12
2,500,000 Kuwait Population 1965-2009 2,000,000 1,500,000 Population 1,000,000 Total Kuwaitis Total Expats 500,000-1965 1975 1985 1995 2005 2009 Year Graph 1: Kuwait Total Population 1965-2009 200,000 Working Population Educational Level in Kuwait - 2009 180,000 160,000 Working Population 140,000 120,000 100,000 80,000 60,000 illiterate Literate Elementry School Middle School High School Diploma Undergraduate Postgraduate N/A 40,000 20,000 - Educational Level Graph 2: Kuwaiti working population in Kuwait in 2009 Page 5 of 12
Economy Kuwait s economy is heavily dependent on oil where the oil sector contributed 59% of Kuwait s Gross Domestic Product in 2008 4. The Gross Domestic Product (G.D.P.) 5 has been increasing higher than normal since 2004 due to the massive global energy demand. As a result, the Year to Year Change in Adjusted Series of G.D.P. reached 10% in 2004 but dropped again to an average 4.8% in 2006 and 2007, Graph 3. 25,000,000,000 Kuwait's Gross Domestic Product - 2004-2008 20,000,000,000 Agriculture and Fishing GDP in KWD 15,000,000,000 10,000,000,000 Extraction of Crude Petroleum and Natural Gas and Service Activities Incidental to Oil and Gas Manufacturing Electricity, Gas, and Water Construction Wholesale & Retail Trade, Hotels and Restaurants Transport, Storage, and Communications Finance, Real Estate and Business Services 5,000,000,000 Financial Institutions Community, Social, and Personal Services - 2008 2007 2006 2005 2004 Year Graph 3: Kuwait's Gross Domestic Product 2004-2008 Economic growth at the activity level shows the lack of diversity of Kuwait s G.D.P. the oil sector is dominant with 59% of the total G.D.P. then it is followed by the Finance, Real Estate, and Business Services sector with 15.7% which leaves a large gap between the first and second activities. Kuwait continual dependence on the oil sector to fund its national projects has halted any noticeable improvements to local facilities and services except for the oil sector until 2010. A development plan was approved by the National Assembly which shall change the face of Kuwait s economy. If the Kuwaiti government is serious about implementing the national development plan, we shall witness major changes to the current G.D.P. 4 Kuwait Central Statics Authority 5 The Gross Domestic Product is a measure of a country's overall economic output. It is the market value of all final goods and services made within the borders of a country in a year. Page 6 of 12
Healthcare Kuwait s wealth enabled it to provide free Healthcare to its local residents and collect minimal fees from expats. The Kuwaiti government also sends local citizens abroad for treatment if no applicable resources are available locally. The Healthcare system contributed 1.07% of the G.D.P. in 2008 which is relatively low among the other activities in country s economy 6, Graph 3. The government of Kuwait spent a total of KWD 598,500,000 on healthcare in 2008/2007 which is a 9% increase from the 2007/2006 amount spent, KWD 547,200,000. On the other hand, the government generated a total of KWD 77,554,000 in 2008/2007 which is an increase in revenue by 74% compared to the previous year, Graph 4 7. The increase in revenue is correlated with the increase in foreign population which is the main source of revenue. 700,000,000 Kuwait Government Healthcare Services Revenue vs. Expenditure - 2008-2006 600,000,000 500,000,000 Amount in KWD 400,000,000 300,000,000 Revenue Expenditure 200,000,000 100,000,000-2008/2007 2007/2006 Accounting Year Graph 4: Kuwait Government Healthcare Revenue and Expenditure comparison- 2006-2008 The Kuwaiti government represented by the Health Ministry currently operates 15 general and specialized hospitals containing approximately 5,500 beds across the country as of 2008. The private sector on the other hand operates 8 hospitals containing approximately 700 beds as of 2008 8. 6 Kuwait Central Statics Authority 7 Ministry of Health 8 Ministry of Health Page 7 of 12
Government Healthcare Sector Kuwait government currently operates 15 general and specialized hospitals 9. As of 2007, the government Healthcare system in Kuwait employed 36,377 employees. The number of medical staff (physicians, dentists, and nurses) is lower than the number of non-medical staff, Graph 4. 25,000 Government Medical Staff vs. Non-Medical Staff - 2003-2007 20,000 Number of Staff 15,000 10,000 Medical Staff Non-Medical Staff 5,000-2003 2004 2005 2006 2007 Year Graph 5: Government Healthcare Medical vs. Non-Medical Staff Comparison in Kuwait - 2003-2007 The Healthcare facilities are distributed geographically all over the country to serve all the commercial and residential areas. There is at least one major general hospital in every governorate; # Governorate 1 Al Asimah 2 Al Asimah 3 Hawalli 4 Farwaniya 5 Al Ahmadi 6 Al Jahra Table 1: Kuwait General Hospitalss 2007 10 Hospital Al Amiri Hospital Al Sabah Hospital Mubarak Al Kabeer Hospital Fawaniya Hospital Al-Adan Hospital Al-Jahra Hospital Total Beds Beds 374 438 409 523 557 621 2,922 9 Kuwait Ministry of Health 10 Kuwait Ministry of Health Page 8 of 12
The government also operates specialized hospitals as exhibited in Table 2 below; # Hospital Specialization 1 Al-Razi Orthopedic surgery 2 Physical Med. & Rehabilitation Physical Med. & Rehabilitation 78 3 Maternity Hospital Maternity 4 Chest Diseases Hospital Chest Diseases 5 Infectious Diseases Hospital Infectious Diseases 6 Psychological Medicinee Psychological Medicine 7 Ibn Sina Hospital Spinal Surgery 8 Kuwait Cancer Control center Cancer Control 9 Allergy Center Allergy Center Total Beds Table 2: Kuwait Government Specialized Hospitals - 2007 11 Beds 267 375 131 151 749 363 112 128 2,354 Moreover, The Kuwaiti Government has been increasing the number of clinics consistently to provide the basic healthcaree services to the local residential areas; Graph 6. 90 Government Healthcare Facilities in Kuwait - 2008 80 70 Number of Hospitals and Clinics 60 50 40 30 Hospitals (General& Specialized) General Healthcare Centers Dental Care Centers Maternal Care Centers Childhood Care Centers Preventive Care Centers Diabetes Clinics 20 10 0 2000 2001 2002 2003 2004 2005 2006 2007 Year Graph 6: Government Healthcare Facilities in Kuwait - 2008 11 Kuwait Ministry of Health Page 9 of 12
The Government has not developed any new major Healthcare facilities since the completion of the above mentioned hospitals leaving the hospitals get more congested with the fast growing population. The Kuwaiti government announced in 2008 Jaber Al Ahmad hospital to be completed in 2013 covering an area 469,370 m². The hospital will include 36 operation rooms and other major facilities that would serve up 600,000 people in the surrounding residential areas. The project since Figure 1: Jaber Hospital Model announced has been facing major delays where actual work on site did not start until November of 2009 12. Private Healthcare Sector Unlike the government sector, the Private Healthcare Sector has been developing in a much faster pace. New clinics and hospitals have been established and continue to appear in the different areas of Kuwait. A good indication of how well this sector is doing is the number of staff being employed by the different establishments. The private healthcaree sector increased its employment share of the market by 11% in 2007 and 34% in 2006. 4,000 Total number of staff Private Sector - 2008 3,500 3,000 2,500 Number of Staff 2,000 1,500 Physicians Dentists Nurses 1,000 500-2000 2001 2002 2003 2004 2005 2006 Year 2007 Graph 7: Total Physicians, Dentists, and Nurses in Private Sector - 2008 12 Alqabas Newspaper 11/5/2009 Page 10 of 12
The private sector is expected to grow further in the upcoming years. Patients are avoiding the free government healthcaree services and are paying a premium for private healthcare due to some of the following reasons; Criteria Government Healthcare Services Time Longer waiting time Appointments Patients should schedule many appointments to complete a single treatmentt Prestige No Prestige Table 3: Government vs. Private Healthcare Services in Kuwait Private Healthcare Services Less/no waiting time Patients can complete their treatments in fewer appointments Local patients are paying extra for the social statuss associated with the hospitals visited especially in the Gynecology field The Kuwaiti government has organized the private healthcare establishments based on their size and functionality 13 : 1. Private Hospitals: the Ministry of Health divides the Private Hospital into two categories; a. General Private Hospital: is a private hospital that has a minimum of 60 beds where patients can be admitted for treatment. The General Private Hospital must at least provide all the following medical practices; i. Internal Medicine ii. General Surgery iii. Pediatrics iv. Gynecology & Obstetrics v. Anesthesiology b. Specialized Private Hospital: is a private hospital that has a minimum of 40 beds where patients can be admitted for any specialized medical practices such as Pediatrics, Ophthalmology, E.N.T., etc. c. Private Dispensaries: are medical establishments that must at least one of the below mentioned medical practices. i. General Practice ii. Dentistry iii. Medical Labs and Bacteriology iv. Radiotherapy v. Physiotherapy The Dispensary should have at least 3 General Practice clinics and no more than 2 specialized clinics. The Manager of the dispensary must be a Kuwaiti General Practitioner with at least 5 years of experience and not retired. The manager is required to be full time employee for the dispensary. 13 Ministry of Health Medical Licensing Department Page 11 of 12
2. Private Clinics: are one room medical facilities that are managed by a doctor with any medical specialty. The clinic shall provide waiting areas and an examination room for patients. 3. Private Healthcare Centers: are medical facilities that can provide all the following practices; a. General Surgery b. Internal Medicine c. General Surgery d. Pediatrics e. Gynecology & Obstetrics The license is only given to Kuwaiti doctors with at least 10 years of continual experience. The Healthcare Center should have a minimum of 6 general or specialized clinics. The clinic cannot provide overnight admission. On a final note, with the rapid increase of the population in Kuwait and the high demand for the free government healthcaree services, the private sector can provide and benefit more from such causes. Many factors play into the success of any project including a healthcare facility; selecting the right location, providing good services, studying the market research, and keeping in touch with your client base. Page 12 of 12