Abstract
Cost containment is likely the single most important influencer of health restructuring in all parts of the world. Regardless of the types of economy, all governments, including that of Saudi Arabia, are under increased pressure to build sustainable health models. Irrespective of the abundant oil based financial resources and a relatively small population size, the Government think-tank in the last 5 years slowly realized the need to develop an improved and more sustainable economic health model. Public–Private Partnerships (PPP) are the suggested face of privatization and were proposed in the early 1990s; PPPs which have legal sanctity over the transfer of function and ownership of any services to the private sector, were created with the aim of delivering goods including health services. This remodeling from the conservative regulator-pay or-deliver (all in one) model to the new model of care has huge potential but is constrained by many challenges. As a result, the Ministry of Health plans to develop more inclusive PPP sustainable models. This chapter reviews the various issues dealing with the benefits, lacunae, challenges of implementation of privatization in the healthcare sector as well as scope of growth for private players in the near future. A detailed description of these new private sector participation models of care is provided along with a discussion of the impact of the various components of privatization such as corporatization, clustering, purchase program, e-Health, and implementation of health services. This chapter will improve the understanding of not only the transactional aspects of privatization but also their execution, and the means by which different privatization arrangements can be incorporated as well as sustained within the existing healthcare system in Saudi Arabia. In the present communication we have highlighted the prominent benefits along with cost benefit analysis of the proposed PPP model over the existing one by presenting a case study of the obesity management model as an example, which will help to improve the understanding of the PPP footprints across the Middle East.
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References
Abudahish AR (2019) New era of HHC; using technology I communications and Diagnosis of HHC Patients, Privatisation of HHC. International Conference on Family Medicine and Home Health Care (ICFM 2019) Hilton Riyadh Hotel & Residences, 23–25 April 2019
Abusaaq HI (2015) Population Aging in Saudi Arabia. Economic Research Department. SAMA Working Paper, p 14
Agampodi SB, Amarasinghe DA (2007) Private sector contribution to childhood immunization: Sri Lankan experience. Indian J Med Sci 61:192
Akinci F (2002) Privatization in health care: theoretical considerations and real outcomes. J Econ Econ Educ Res 3(2):62–86
Al Asmri M, Almalki MJ, Fitzgerald G, Clark M (2019) The public healthcare system and primary care services in Saudi Arabia: a system in transition. East Mediterr Health J 25:1–18. https://doi.org/10.26719/emhj.19.049
Al Hanawi MK (2017) The health care system in Saudi Arabia: how can we best move forward with funding to protect equitable and accessible care for all? Int J Health care 3(2):78–94. https://doi.org/10.5430/ijh.v3n2p78
Al Hanawi MK, Qattan AMN (2019) An analysis of public-private partnerships and sustainable health care provision in the Kingdom of Saudi Arabia. Health Services Insights 12:1–10
Al Hanawi MK, Khan SA, Al-Borie HM (2019) Healthcare human resource development in Saudi Arabia: emerging challenges and opportunities – a critical review. Public Health Rev 40:1
Al Jazaeri A, Ghomraoui F, Al-Muhanna W, Saleem A, Jokhadar H, Al Jurf T (2017) The impact of healthcare privatization on access to surgical care: cholecystectomy as a model. World J Surg 41(2):394–401
Al Juaid M, Mannan F, Chaudhry Z (2016) Quality of care in university hospitals in Saudi Arabia: a systematic review. BMJ Open 6:e008988. https://doi.org/10.1136/bmjopen-2015-008988
Alkhamis AA, Miraj SA (2016) Association between demographic characteristics and health status of uninsured expatriate workers in Saudi Arabia. Biosci Biotech Res Commun 9(4):587–595. https://doi.org/10.21786/bbrc/9.4/3
Alkhamis AA (2017) Critical analysis and review of the literature on healthcare privatization and its association with access to medical care in Saudi Arabia. J Infect Public Health 10(3), 258–268.
Alkhamis AA, Cosgrove P, Mohamed G, Hassan A (2017) The personal and workplace characteristics of uninsured expatriate males in Saudi Arabia. BMC Health Serv Res 17(1):56
Al khamis AA, Miraj SA (2018) Links between employment-related factors and physical and mental health among uninsured expatriate males in Saudi Arabia. Int J Health Sci 12(1):50–58
Al Mazrou Y, Al Ghaith T, Yazbeck AS, Rabie TS (2017) How labor laws can transform health systems: the case of Saudi Arabia. Health Syst Reform 391:26–33
Al Mutairi AG, Al Shamsi HS (2018) Healthcare system accessibility in the face of increasing privatisation in Saudi Arabia: lessons from Australia. Global J Health Sci 10(7):111–121
Al Saghier M (2019) FM in 2030 vision, the new model of care. In: International Conference on Family Medicine and Home Health Care (ICFM 2019) Hilton Riyadh Hotel & Residences, 23–25 April 2019
Al Shamsan R, Leslie H, Majeed A, Kruk M (2017) Financial hardship on the path to universal health coverage in the Gulf states. Health Policy 121(3):315–320
Albreht T (2009) Privatization processes in health care in Europe – a move in the right direction, a ‘trendy’ option, or a step back? Eur J Pub Health 19(5):448–450
Alrabiyah OA, Alfaleh F (2010) The Saudi health system reform: initiation, development and the challenges facing it. Science Press and Publishing, Riyadh
Al-Salem AA (2018) Renovation of financing health care services in Kingdom of Saudi Arabia, by implementing National Health Insurance (NHI). Eur J Pharmaceutical Med Res 5(9):439–448
Ashraf A (2019) Role of health care private sectors in national transformation. In: International Conference on Family Medicine and Home Health Care (ICFM 2019) Hilton Riyadh Hotel & Residences, 23–25 April 2019
Barlow JG, Roehrich J, Wright S (2013) Europe sees mixed results from public-private partnerships for building and managing health care facilities and services. Health Affairs (Project Hope) 32:146–154. https://doi.org/10.1377/hlthaff.2011.1223
Barraclough S (2000) The politics of privatization in the Malaysian Health Care System. Contemp Southeast Asia 22(2):340–359
Basu S, Andrews J, Kishore S, Panjabi R, Stuckler D (2012) Comparative performance of private and public healthcare systems in low-and middle-income countries: a systematic review. PLoS Med 9(6):e1001244
Berendes S, Heywood P, Oliver S, Garner P (2011) Quality of private and public ambulatory health care in low and middle income countries: systematic review of comparative studies. PLoS Med 8(4):e1000433
Boardman A, Vining A (2010) Assessing the economic worth of public-private partnerships. In: Hodge G, Greve C, Boardman A (eds) International handbook on public-private partnerships. Edward Elgar, London, England, pp 159–186
Bustreo F, Harding A, Axelsson H (2003) Can developing countries achieve adequate improvements in child health outcomes without engaging the private sector? Bull World Health Organ 81:886–895
Christine A, Christoph H (2008) Privatisation of health care in Europe. Research paper. Working Life Research Centre, pp 1–27
Colliers International Health care (CIH) Report (2018) Kingdom of Saudi Arabia: Health care Overview. Available from: https://www.colliers.com/-/media/files/emea/uae/case-studies/2018-overview/ksa-healthcare-overview-thepulse-8th-edition.pdf?la=en-gb
Doring A, Paul F (2010) The German healthcare system. EPMA J 1:535–547. https://doi.org/10.1007/s13167-010-0060-z
Einarson TR, Annabel ACS, Ludwig C, Panton UH (2018) Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007–2017. Cardiovasc Diabetol 17(83):2–19
Elachola H, Memish ZA (2016) Oil prices, climate change – health challenges in Saudi Arabia. Lancet 387:827–829
Eskandari M, Abbaszadeh A, Borhani F (2013) Barriers of referral system to healthcare provision in rural societies in Iran. J Caring Sci 293:229–236. https://doi.org/10.5681/jcs.2013.028
Fantom N, Serajuddin U (2016) The World Bank’s classification of countries by income, policy research working paper. World Bank Group, Developmental Economics, Data Group, pp. 1–50.
Farquharson E, Mastle CT, Yescombe ER, Javier E (2011) How to engage with the public-private partnerships in emerging markets. PPIAF and the World Bank, Washington, pp 3–4
Fielding JE, Rice T (1993) Can managed competition solve the problems of market failure? Health Aff (Supplement):216–228
Fleming C (2012) Health policy brief: improving care transitions. https://doi.org/10.1377/hblog20120921.023379
Folland S, Goodman AC, Stano M (2001) The economics of health and health care, 3rd edn. Prentice-Hall, Inc, New Jersey, p 47
Forde K, Malley A (1992) Privatisation in health care: theoretical considerations, current trends and future options. Aust Health Rev 15:269–277
Frakt A (2019) The huge waste in the U.S. health system. The New York Times Report. Retrieved from https://www.nytimes.com/2019/10/07/upshot/health-care-waste-study.html
Gwatkin DR, Wagstaff A, Yazbeck AS (2005) Reaching the poor with health, nutrition, and population services: what works, what doesn’t, and why. Health Nutrition and Population. Department World Bank, Washington DC
Harding AS, Preker AS (2000) Understanding organizational reforms: the corporatization of public hospitals. In: Preker AS (ed) HNP discussion paper. The World Bank, Washington, DC, p 76
Health Expenditure Report (2019) Global spending on health: a world in transition. WHO Global Report; Retrieved from https://www.who.int/health_financing/documents/health-expenditure-report-2019.pdf?ua=1
Herwartz H, Strumann C (2014) Hospital efficiency under prospective reimbursement schemes: an empirical assessment for the case of Germany. Eur J Health Econ 15(2):175–186
Holden C (2009) Exporting public–private partnerships in healthcare: export strategy and policy transfer. Policy Stud 30:313–332
Hurk MVD (2018) Public–private partnerships: where do we go from here? A Belgian perspective. Pub Works Mang Policy Sage J 23(3):274–294. https://doi.org/10.1177/1087724X18757534
Jahan S, Al-Saigul AM (2017) Primary healthcare research in Saudi Arabia: a quantitative analysis. Int J Health Sci 11(2):9–15. Saudi Insurance Sector, Year 2016, March 12, 2017. Sector Reports, Albilad capital. [cited 2017 Oct 25]. Available from: http://www.albiladcapital.com/Research_EnglishReport/InsuranceSectorQ416EN.pdf
Ko M, Derose KP, Needleman J, Ponce NA (2014) Whose social capital matters? The case of US urban public hospital closures and conversions to private ownership. Soc Sci Med 114:188–196
M. Berer Editorial (2010) Who has responsibility for health in a privatised health system? Reprod Health Matters 18(36):4–12
Maarse H (2006) The privatization of health care in Europe: an eight-country analysis. J Health Polit Policy Law 31(5):981–1014
Mahmood FM (2018) Prevalence and prevention of lifestyle-related diseases in Saudi Arabia. Int J Health Sci 12(5):1–2
Mercille J, Murphy E (2017) What is privatization? A political economy framework. Environ Plan 49(5):1040–1059. https://doi.org/10.1177/0308518X16689085
Mbonye AK, Hansen KS, Wamono F, Magnussen P (2009) Increasing access to prevention of mother-to-child transmission of HIV services through the private sector in Uganda. Sex Transm Infect 85:534–539
McKinsey Global Institute Report (2015) Saudi Arabia beyond oil: the investment and productivity transformation. McKinsey Global Institute
Ministry of Health (MOH) (2010) Strategic Plan 1431–1440 (2010–2020). MOH, Riyadh
Ministry of Health (2017) Annual statistical book. Riyadh: Ministry of Health. (cited 27 Sept 2018). Available from: https://www.Moh.Gov.Sa/En/Ministry/Statistics/Book/Documents/Annual-Statistical-Book-1438H.pdf
News Report (2018) Ministry of Health to establish holding company to separate delivery of health services from its other functions. Albilad Arabic. Jan 16. Accessed from http://www.albiladdailyeng.com/ministry-health-establish-holding-company-separate-delivery-health-services-functions/
NTP. Saudi Arabia’s Vision 2030. National transformation program 2020. http://vision2030.gov.sa/sites/default/files/NTP_En.pdf.Up-dated2016. Accessed 11 Sept 2019
Rahman R, Al Sharqi OZ (2018) What drove the health system reforms in the Kingdom of Saudi Arabia? An analysis. Int J Health Plann Manag 34(1):100–110. https://doi.org/10.1002/hpm.2584. Epub 2018 Aug 26
Ramamonjiarivelo ZH, McRoy L, Epané JP, Hearld L, Maldonado RW (2015) The impact of privatization on efficiency and productivity: the case of American Public Hospitals. Acad Manag Proc 16073–16073. https://doi.org/10.5465/AMBPP.2015.16073abstract
Raman AV, Björkman JW (2008) Public-private partnerships in health care in India: lessons for developing countries. Routledge, Adingdon, UK
Roehrich, Lewis J, George M, Gerard (2014) Are public-private partnerships a healthy option? A systematic literature review. Soc Sci Med 113C:110–119. https://doi.org/10.1016/j.socscimed.2014.03.037
Saudi Arabian Monetary Agency (SAMA), 48th Annual Report, 2013. Available from: http://www.sama.gov.sa/. (Last accessed on 2019 June 5).
Saudi Arabian Monetary Agency (SAMA), 54th Annual Report, 2018. Available from: http://www.sama.gov.sa/. (Last accessed on 2018 December 4).
Scarpaci JL (1989) Introduction: the theory and practice of health services privatization. In: Scarpaci JL (ed) Health services privatization in industrial societies. Rutgers University Press, New Brunswick, pp 1–23
Smith SR, Lipsky (1992) Nonprofits for hire: the welfare state in the age of contracting. Harvard University Press, Cambridge, MA
Stuckler D, Basu S, Wang SW, McKee M (2011) Does recession reduce global health aid? Evidence from 15 high-income countries, 1975–2007. Bull World Health Organ 89:252–257
The Pulse (2018) Kingdom of Saudi Arabia overview health care, 8th edn. Colliers International, Riyadh
The Sustainable Development Global Report (2019) UN, New York
The World Bank (2018) World development indicators database. World Bank. Available from: http://www.databank.worldbank.org/data/download/GNIPC.pdf (Last accessed on 2019 June).
Tiemann O, Schreyögg J (2012) Changes in hospital efficiency after privatization. Health Care Manag Sci 15(4):310–326
Tracy S, Welsh A, Hall B, Hartz D, Lainchbury A, Bisits A, Tracy M (2014) Caseload midwifery compared to standard or private obstetric care for first time mothers in a public teaching hospital in Australia: a cross sectional study of cost and birth outcomes. BMC Pregnancy Childbirth 14(46):46. https://doi.org/10.1186/1471-2393-14-46
Tullock G, Seldon A, Brady GL (2002) Government failure: a primer in public choice. Cato Institute, Washington DC
Tuohy CH, Flood CM, Stabile M (2004) How does private finance affect public health care systems? Marshalling the evidence from OECD nations. J Health Polit Policy Law 29(3):359–396. https://doi.org/10.1215/03616878-29-3-359
Villa S, Kane NM (2013) Assessing the impact of privatizing public hospitals in three American states: implications for universal health coverage. Value Health 16(1):S24–S33
Vision 2030. Health sector transformation strategy Kingdom of Saudi Arabia: national transformation program 2020. Available from http://www.vision2030.gov.sa/sites/default/files/NTP_ En.pdf. (Last accessed on 18 2019)
Walshe K, Smith J (2011) Introduction: the current and future challenges of healthcare management. In: Walshe K, Smith J (eds) Healthcare management, 2nd edn. The Open University Press, Buckingham, UK, pp 1–12
Welch PJ, Welch GF (1992) Economics: theory and practice, 4th edn. The Dryden Press, Orlando, FL
World Bank Report (2018) Washington (District of Columbia)
WHO African Health Report (2018) Retrieved from https://www.afro.who.int/sites/default/files/201808/The%20Work%20of%20WHO%20in%20the%20African%20Region%20%20-
World Bank (2005) Comparative advantages of public and private health care providers in Bangladesh. World Bank, Dhaka
Yiranbon E, Zhou LL, Asante Antwi H, Nisar N (2016) The impact of privatisation of healthcare equipment and technology SOEs on productivity in Africa. Int J Eng Res Afr 26:195–205. https://doi.org/10.4028/www.scientific.net/jera.26.195
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Alkhamis, A., Ali Miraj, S.S., Al Qumaizi, K.I., Alaiban, K. (2021). Privatization of Healthcare in Saudi Arabia: Opportunities and Challenges. In: Laher, I. (eds) Handbook of Healthcare in the Arab World. Springer, Cham. https://doi.org/10.1007/978-3-030-36811-1_177
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