Prescription for change: Dr Hanan Al Kuwari

Unlike many of the gulf’s corporate suites, Dr Hanan Al Kuwari’s office isn’t on the top floor of a tower with impressive views over the sea, nor is it filled with wall-to-wall mahogany panelling or expensive artwork. Instead, it is hidden on the ground floor in the corner of a small building tacked onto the side of the Women’s Hospital in Doha. One wall is almost entirely covered with a bookcase packed to bursting with research manuals and folders, while two shelves next to the window struggle to contain a series of awards and trophies.

The office speaks volumes about Al Kuwari, who was appointed managing director of the non-profit Hamad Medical Corporation (HMC) in 2007, and who runs one of Qatar’s largest and most complex organisations. Relaxed, confident and personable, it’s a little surprising that she hasn’t done an interview before, but then again, HMC’s performance has done most of the talking in the past.

“I’m an optimist, I always believe we can achieve whatever we put our minds to,” Al Kuwari says simply, when asked whether she ever envisaged reaching her current position when she started out in the business.

Perhaps best described as the Qatar’s version of the UK’s National Health Service, HMC is the main public healthcare provider, providing free services at the point of need for the entire population, whether expatriate or local.

Al Kuwari is certainly not your standard government apparatchik, parachuted in from another sector. Prior to joining HMC as a junior administrator at the Women’s Hospital in 1996, she had worked at the World Health Organisation (WHO) and Reuters as a healthcare journalist. Since then, she has risen up the ranks, becoming executive director at the Women’s Hospital in 2003, and assistant managing director for operations in 2005.

“I’ve always known that I would end up in healthcare, I’ve known that from day one,” she says. “As far as I can remember, I was always drawn by healthcare and hospitals, and was inspired by the patients themselves.

“Throughout my childhood and adolescence, every patient that passed by me, every person that was ill, drew me closer to the sector.

“That’s really where the passion comes from: seeing the strength and character of patients, people who go through an illness and recover from it, and the role that the clinical team plays in helping them recover.”

Al Kuwari cites her family as one source of inspiration, as well as the vision and leadership of the Emir of Qatar, Sheikh Tamim Bin Hamad Al Thani, who previously served as chairman of the Supreme Council of Health, as well as Sheikha Mozah Bint Nasser Al Misnad.

Founded in 1979 with two hospitals, HMC now has eight hospitals across the country and also runs Qatar’s ambulance service. The nerve centre of the operation lies in Hamad Bin Khalifa Medical City, a sprawling complex that houses Hamad General Hospital (Qatar’s biggest), along with the Women’s Hospital, a brand new Heart Hospital, the Rumailah Hospital for continuing care and a new National Centre for Cancer Care and Research.

Last year, the organisation treated more than two million patients — which roughly equates to the size of the country’s population. HMC also conducted 850,000 emergency visits, carried out 40,000 surgeries, delivered 20,000 babies and arranged over a million outpatient appointments. The emergency department at Hamad General Hospital is believed to be one of the busiest in the world, with roughly 1,500 people passing through every day.

“It’s a very rapidly evolving system, and well-recognised across the region and internationally,” Al Kuwari says, adding that HMC is the first organisation outside the US to receive Joint Commission accreditation across all its hospitals simultaneously, one of the first to gain American College of Graduate Medical Education accreditation, and also the first outside the US to receive the CAP [College of American Pathologists] accreditation.

“Many of the international accreditations that our system has achieved over the last five years are focused on quality and delivering the right level of care at the right place for our patients,” she continues. “We view ourselves as being responsible for the entire population; we have an obligation to care for everyone who comes under our roof, whether they can afford it or not.”

Despite the fact the fact that HMC has expanded rapidly in recent years, the fast- growing population, as well as increased incidence of non-communicable diseases and growing numbers of elderly patients, mean that it is finding it tough to keep up with demand. In a September research note, Qatar National Bank (QNB) estimated that Qatari real GDP growth would hit 7.8 percent in 2016, up from 6.8 percent this year. That, in turn, is fuelling rapid population growth; QNB thinks this will rise by an annual average of 8.2 percent between 2012 and 2016.

According to Alpen Capital, the rapid rise in Qatar’s population means that the country now has the lowest hospital bed ratio per capita in the Gulf (12 beds per 10,000 members of the population in 2011, down from 25 in 2006).

“The population is increasing and that’s a challenge, but that’s also a good thing,” says Al Kuwari. “That shows we are a thriving economy that’s growing, and for us as a health centre we are also thriving.

“We’ve doubled our bed capacity over the last five years, and we’ll be doubling that again. We’ve just opened a new skilled nursing facility and we’ll soon be opening a second one. We’ll also be opening a number of residential complexes across the system where patients can sit in a home environment and be cared for by our professional team of clinicians.

“So not only we’re building new facilities, we’re also going beyond our walls and boundaries to get closer to where our patients are.”

Those plans form just part of HMC’s ambitious 2013-2018 five-year strategy, which includes adding a new accident and emergency department, new operating theatres, another new cancer hospital, and the second phases of both the Heart Hospital and Al Khor Hospital, in the north of the country. Also in the works are an Infectious Diseases Hospital and a Specialist Mental Health Hospital, as well as a Translational Research Institution.

“Really the strategy revolves around providing the safest, most effective care for our patients,” Al Kuwari adds. “We’re not saying that lightly, we truly mean it.

“What is the best care that’s being provided around the world, and how can we provide that to our patients? How can we ensure that the outcome here is equal if not better than the best elsewhere? The key is to provide care in the right place and the right time.”

In line with more facilities, HMC is also working to attract more medical professionals to the country. In this respect, Qatar is already outperforming its peers in the GCC. By 2011, according to Alpen Capital, the nation boasted more healthcare personnel per head of population than any other Gulf country.

“One of the major projects that we are really proud of is our journey to become an academic medical centre,” says Al Kuwari. “It not only adds value to Qatar, but also adds regional value by attracting the best doctors.

“We are now become recognised as an academic teaching hospital and we are getting a large number of regional requests to come and work for us. Young doctors always seek to work in a place that is recognised and accredited, as that will be of value to them on their CV.”

Alongside attracting foreign doctors to come and work in Qatar, the onus is also on organisations like HMC to galvanise local interest in the sector. Al Kuwari says that there is a “very strong cadre” of Qatari clinical, administrative and support professionals, and that the company has rolled out programmes to sponsor and train would-be doctors and nurses that include scholarships and career paths that will expose them to other healthcare systems and international training sites. Local students are also helped by the presence of the Health Sciences Department at Qatar University, as well as Weill Cornell Medical College in Qatar, which is based in Education City.

A major focus for HMC is non-communicable, or lifestyle diseases. Like the rest of the Gulf states, Qatar has high obesity rates, and diabetes and cardiovascular illnesses are particularly prevalent. Al Kuwari says that the organisation is doing what it can, including opening up a new diabetes centre last year, but stresses that the onus also lies with the patient.

“The patient has as big a responsibility as we do in managing their health, and that is the evolution we see in healthcare worldwide,” she says. “We are spending a lot more on partnering with our patient and educating our patient, and working with them on prevention and awareness building.

“The diabetes centre is a good example of the model of care we are following with regard to lifestyle diseases. It’s a one-stop clinic, where you get your curatives, your diabetic counselling and your preventative programming all in one location, so you don’t have to navigate multiple sites or teams.

“That’s the approach we have for cancer, for the Heart Hospital. And whichever site you present yourself in our system — say, for example, you are a stroke patient — you’ll be treated the same way, with the same protocols and the same system of healthcare across the system. That’s really important.”

Under Al Kuwari’s watchful eye, HMC has already hit several ambitious targets. Its ambulance response time is between 7-10 minutes 80 percent of the time — not bad, considering the state of Doha’s traffic at the moment. HMC’s stroke teams’ response times are well above international norms, and its response to emergency and trauma is above global standards of 48 hours. Still, as Al Kuwari herself would be the first to admit, there is still plenty of hard work to do.

“We operate from morning until evening, and our theatres run all night,” she says. “We don’t stop for the evenings or the weekends — that’s the nature of the service. There’s no reason why we should not be up there with the top percentile of the global healthcare system — and that’s a target I’m very confident we will achieve.”