Healthcare is one of the sectors still expected to see growth in the downturn. However, Dr Azad Moopen, founder and chairman of DM Healthcare Group, believes there are still some obstacles that the UAE government needs to identify and address in order to sustain this rise.Like many expatriates who arrive to Dubai, Dr Azad Moopen was not planning to stay in the emirates for the long-term. The physician began life in the emirate working in a local college and after about two years had planned to return home and retire in the Indian sun. Luckily, from the region's healthcare point of view, his plans didn't work out.
From one clinic in 1987 his company, DM Healthcare Group, now has one of the largest healthcare networks in the GCC. By 2015 it plans to have 300 establishments and 10,000 staff across the Middle East and India. Not bad for someone who says they didn't have a long-term goal.
"I always believe in destiny and that you have to work hard," he says. Both appear to have paid off as the week before we met he had just returned from India where he received the ‘Pravasi Bhartiya Samman' - a top award given by the President of India for achievements by Indians overseas.
The accolade has clearly given the healthcare chief an extra sense of vigour; he is forthright in his views on the sector in the Middle East, especially in relation to the responsibilities of both employers and the government. The firm's slogan is ‘Healthcare for All' and Moopen firmly believes that employers and the UAE government must continue to fund healthcare for their employees.
"I feel that somebody has to spend. I do not know whether it has to be the government or the employer, but definitely not the employee.
"For the population who are natives of this country it is the responsibility of the government to take care of them. For expatriates it is the responsibility of the employer to make sure they have coverage through insurance to make sure their healthcare is taken care of when they are here.
"I strongly feel it has to be included as part of the cost for the employer. If someone can pay AED10,000 to stamp the visa of an employee I think they can add another AED1000 to provide healthcare," he says.
The large number of expatriates, which make up nearly three quarters of the UAE population aged fifteen to 64 years old, has a direct impact on healthcare requirements in the country. Figures from industry researchers RNCOS show that the UAE has one of the lowest hospital bed ratios by international standards and in 2007 it was less than two beds per 1000 of the population, around half what it is in most developed economies.
However, Moopen defends this by saying the demographics mean that the region generally has a lower healthcare requirement than other developed nations. For example, in the UAE figures show that those aged 65 years old only make up 0.9 percent of the population, compared to maturing populations such as Germany, where the age group accounts for 20.3 percent.
There are also two other important factors says Moopen: expatriates are generally within the healthy age group of 25 to 55 years old, and they have a tendency to return home to their own countries if they require long-term care.
"That is important for us when planning as we have to look more at acute illnesses, rather than chronic illnesses, because immediate care is usually given here. The primary care [in the UAE] is as good as in any other country as it has to be taken care of immediately," he points out.
However, no matter how healthy a population is, he believes healthcare is something they cannot cut back on, even in a recession. "We have found that even in the very bad, supposedly recession-hit years, in 2009 we had grown by increasing our establishments and increasing our employees.
"Healthcare still has a supply demand gap... It is something that is essential. It will be one of the last areas to be affected by recession," says Moopen. In fact, the RNCOS research backs this up and has forecast that the healthcare sector in the UAE alone will grow at an annual rate of more than thirteen percent until 2012.
As part of their ‘Vision 2015' plan, Moopen plans to see the group increase its facilities to 300 within the next five years. It plans to have 175 pharmacies and 75 clinics, of which they currently have 50 and 25 respectively."It is easier to increase the number of pharmacies as we do most of it through acquisitions," he says. At present, up to 75 percent of the company's revenue comes from Dubai, therefore much of its expansion plans are outside the emirate and the UAE, with Saudi Arabia being its main focus.
"One major country we have not covered so far is Saudi Arabia - a huge country with a big population. Once you enter there and start establishing [the business], the numbers will be easily achieved."
While his growth plans may be focused outside the UAE, Moopen still has some advice for the UAE government and staffing is one of the biggest issues he sees facing the healthcare sector.
"When you look at healthcare one of the most important things is manpower. Getting qualified people and good people is an issue, especially in healthcare. It is a challenge which we have to live with."
Previously, a lot of the doctors and nurses were recruited from India. However, the growth in the Indian economy has meant that the differentiation between wages in India and the GCC has now changed and it is harder to persuade Indian staff to uproot and move to the Middle East.
There is also the issue of retention of staff when they arrive in the UAE as nurses often leave the private sector and move to the government sector, where wages are generally higher. Moopen also believes the government could do more to speed up the licensing process for staff.
"I find sometimes it is extremely difficult. It is important that their qualities are looked at - but there are certain situations where you have people who have been qualified for many years - they come here and can't get a license.
"I think the authorities should look at it much closer and help the private sector to come into healthcare," he adds.
Two other areas that Moopen believes the region's government should loosen up its regulations are in vitro fertilisation (IVF) and organ transplants.
"We would like to, if it was opened by the government, to go into areas like in vitro fertilisation," he says.
At present, IVF treatment is only offered in government operated hospitals.
"They want to have more controls on that. They don't want people to play around," Moopen added. UN research has found that fertility in the UAE is already a big issue and over the last three decades the UAE fertility rate has dropped from 5.7 children per woman to less than two. Moopen believes "it is time for the authorities to look at providing such avenues for the private sector".
"The government should look at the individual organisations and establishments and those who have accreditation and [a] good reputation - the government should allow such establishments to take care of these areas," he says.
In terms of worldwide organ transplants, he says"it is something that needs to be looked at in detail, from a cultural, religious as well as a social angle."
All of DM Healthcare Group's facilities are private operations but Moopen has not ruled out private-public partnerships with the UAE government and is looking into opportunities to manage government run hospitals.
The group's headquarters are currently in Dubai Healthcare City (DHC) and while Moopen says the healthcare sector has not been impacted by the credit crunch he believes it has been impacted by the downturn in the real estate sector.
He says the DHC development "has not matured yet" and still requires a lot of investment. Many projects have been put on hold in Dubai, including some in DHC. The group currently has no clinics in DHC, only administrative offices. Therefore, the only impact that Moopen is hoping they will see in DHC is that their rent may come down.