Critical condition

While fees are set to rise, clinics and hospitals are coming under increasing pressure to treat rising patient numbers according to Advet Bhambhani, the CEO of Dubai's Jebel Ali Hospital.

"Before it was an employers' market. Now it's an employees market for medical staff. The doctor to population ratio is below what it should be and needs to be addressed," he says.

"Over the last 12 to16 months we have seen a real shortage of doctors, nurses and trained paramedic staff. As a result we are seeing salary increases anywhere from 35 percent to 100 percent, especially for specialists who are now earning double what they used to - we are reeling from that."

Bhambhani says the most difficult health professionals to recruit are consultant-level doctors, particularly open heart surgeons, cardiologists and neurologists. He says it is forcing the hospital fees higher while recruiting is becoming harder.

"We cannot rely on our own human resources department to find people now. We are increasingly outsourcing recruitment to agencies, and going abroad for recruitment, which is an additional expense. We just can't find people locally."

Medical recruitment consultant Paul Johnson, of Dubai-based Outsourcing Consultants, says the public hospitals are in a far more precarious position than privately-run institutes because salary flexibility is non-existent.

"It is increasingly difficult to find staff for any specialty hospital because salaries haven't moved up, while the cost of living has gone out of control.

"Medical salaries have fallen well behind in inflation - some are the same as they were 10 years ago.

"We struggle to recruit nurses and medical staff from the UK, the US, Australia. Our specific shortages would be neonatal intensive care unit nurses and super-specialties where these professionals will now be paid more in their own countries.

"Treatment fees are still low, so hospitals can't afford to increase the salaries, even the top regional hospitals are still not charging as much as Western hospitals do."

Johnson says as long as the health system is controlled by insurance companies, hospitals will not be able to hike their fees, therefore preventing any salary increases for staff.

"Hospitals who charge more will get penalised by insurance groups, hospitals aren't good at sticking together but insurance groups are. It's wrong but that's how it works. Unless something changes hospitals cannot charge more and are going to scramble for staff. But as accommodation prices continue to rise, the problem is going to get worse."

Dr Prem Jagyasi, a healthcare management consultant, believes the medical industry's problems could be assisted by uniform medical licences.

"We need regional cooperation. If we had a uniform medical licence, doctors could avoid the burden of bureaucracy in having to gain different licences to practice in different emirates and states."

Additionally, doctors are discouraged by being forced to come in on visit visas, sit exams, and then seek employment.

"It's not encouraging for them, especially when they can go elsewhere and the process is made much easier."

Meanwhile, despite the perceived problems facing the health industry, Dr Ali Al-Numairy, president of governing body Emirates Medical Association, refutes the notion of a staff shortage in Dubai.

"There is not really a shortage, yes maybe for paramedics, and some specialties, but I don't fully agree. I feel the shortage of staff by hospitals is because of the salary offerings," he says.

"The UAE is a destination for everyone; we have applicants from Iraq, Syria, Palestine," he continues.

"I am confident the private health sector's medical services can cope with the growth in population, and incoming health problems."

But Dr Al-Numairy does concede doctors in the region are generally under-paid. The GCC is currently unable to produce sufficient numbers of clinical staff to provide healthcare for its population, according to McKinsey. It says the region will continue to rely on imported physicians and nurses for some time.

The question is whether Dr Malek and the thousands of other expatriate doctors and nurses working across the Gulf, will still want to come.

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