Disjointed thinking is dangerous

The internationalisation of healthcare is proving itself to be a strong force for change, even blowing new life into the most long-standing medical education and regulation systems in the region.

Yet, in the rush to boost standards of post-registration training and professional regulation to Western levels, healthcare systems are in danger of developing duplicate and unworkable new schemes.

Take the news of the demise of the Arab Board of Medical Specialisations, which was set up in 1979. The plan is to replace the old board with the new GCC Council for Health Specialisations that will work to streamline specialist training and the granting of board certificates across the Gulf countries.

The commendable move will raise the quality of post-graduate education and allow doctors who train in the region to work anywhere in the world. Moreover, the GCC health ministers are not stopping there, they also plan for the new board to turn its attention on specialist courses for nurses, pharmacists, dentists and allied health care professionals too.

But, what the ministers seem to have overlooked is the fact that there is a strong movement within nursing in the region already, to go down the self-professional regulation route. This means the professions will determine their own post-registration training needs.

Just last month it was announced that a Nursing and Midwifery Council is to be set up in the United Arab Emirates (UAE), which will work in parallel with similar councils in Jordan and Oman, to steer the professional development of nurses and midwives.

Each of the councils has royal support, and are working with local Universities, health authorities and healthcare providers to determine the educational needs for specific specialist nursing roles and to accredit training providers.

Meanwhile, in October the Emirates Medical Association (EMA) also revealed that it was gearing up to take on a stronger self-regulatory role for all medical professionals, including doctors, pharmacists and allied health care professionals, working in the UAE.

Although plans have yet to be formalised the EMA sees itself as having an important part to play in setting levels of post-registration education, as well as being in charge of licensing and the continuing development of medical professions.

At the same time, however, local health authorities in the country are making moves to step up their regulation of all healthcare professionals. Dubai Health Authority (DHA), for one, is in the process of rolling out a comprehensive new licensing and regulatory plan.

When Medical Times recently asked how the DHA’s plan fitted in with the EMA’s, the answer came with a heavy sigh:. “That’s between them and the Ministry of Health.”

This is worrying, for such disjointed working can surely only lead to a heavily fragmented system, which instead of facilitating improved healthcare, will simply become another barrier to it.

What is taking place may be a simple case of the left hand not knowing what the right hand is doing. If this is true, then at least in theory, it should be easy to remedy.

But if it’s more than that, and power mongering behind the scenes is having a role to play, then healthcare professionals and providers should prepare themselves for confusing and frustrating times ahead.

Joanna Hartley is the editor of Medical Times Middle East.

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