Time to get tough on regulation

Since the grand launch of Dubai’s healthcare reforms back in June scrutiny has centred on the radical overhaul of the funding system.

However, it became clear last week that another, and until now largely ignored, arm of the changes to develop a single regulatory system, will bring with it equal, if not more important changes.

Plans to establish a one-stop regulatory shop that will license, inspect, quality approve and manage complaints of all health care providers and health care professionals, to a set of strict standards, is a significant move. And one that, unlike the move to mandatory health insurance for all expatriate workers, will impact directly on the day to day working lives of doctors, nurses, pharmacists and allied health care professionals, as it is expected to demand continuing professional development.

Yet, as with the whole reform program, details on how the new regulatory system will work are still sparse. But, in principle, getting tough on regulation is a welcome and long overdue move. In fact, looking at the issue from a patient’s point of view, it seems inconceivable that the healthcare industry in Dubai has been allowed to grow so large, without the issue being addressed before.

At present a jaw-dropping 10 regulatory authorities exist in the Emirate - each working to their own set of licensing standards and inspection guidelines. And a disturbing half has no clear inspection and clinical complaints procedures. What that means is that a doctor working for a private primary healthcare provider will be subject to completely different licensing, inspection and complaints standards, than one working in the free zone of Dubai Healthcare City, for example.

Employees at government hospitals were not even issued with a separate license until last year - as part of moves to become JCI accredited - because it was presumed to be part and parcel of being an employee of the Department of Health and Medical Services (DoHMS).

Of course, the current situation does not provide grounds enough to say that standards of facilities, or clinical practice, vary widely or dangerously between the 10 authorities. The point is that at present no-one knows what the true level of performance and safety is, because there is no universal bar with which to measure, and monitor providers and professionals. And that is dangerous.

Another essential strand of the new regulatory system will be the establishment of a comprehensive, and independent, complaints and enforcement procedure. A move that will finally put an end to the absurd situation whereby DoHMS was responsible, in a regulatory capacity, for managing complaints against itself, and its employees, as well as complaints about the private sector.

Consultation on how the new regulatory scheme will work in practice is currently underway, but it will be imperative to its future success, that everyone affected by the changes is involved in drawing it up. So far, 50 technical briefings and a ‘Big Talk’ of 55 experts in the field have been undertaken by the Dubai Health Authority. The plan is to start rolling out the new system within the coming year and to complete the initiative in four years time. For everyone’s peace of mind it won’t be a moment too soon.

Joanna Hartley is the editor of Medical Times Middle East.

RELATED ARTICLE: Half of health inspectors have no clear protocols

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