On Sunday, Shawwal 29th, 1433H, corresponding to September 16th, 2012, His Excellency the Minister of Health, Dr. Abdullah bin Abdulaziz Al-Rabeeah, delivered a speech before the Shura Council, in which he expressed his gratitude that he was granted the opportunity to meet with the esteemed council, which plays an essential and pivotal role in our beloved Kingdom.
In his speech, the Minister underscored the importance of communication and transparency among regulatory authorities and commissions, as well as the constructive criticism and recommendations proposed by the council, mass media or forums. The Ministry of Health (MOH) lends an attentive ear to all propositions, in an effort to keep a close eye on all that has to do with the problems and challenges facing our citizens.
Dr. Al-Rabeeah affirmed the Ministry's keen interest in launching and empowering the quality, measurement and development programs. This by no means indicates that the Ministry of Health, considering the extensive diversity of health services it provides throughout the Kingdom, is completely immune against errors and shortcomings. We pay colossal attention to redressing such errors, and taking the necessary action against those proven to be delinquent, as well making good use of such indicators, so as to evade their recurrence, and develop the entire health performance, within the framework of the comprehensive conception of quality and integrity.
According to Dr. Al-Rabeeah, the Ministry of Health, along with its employees, have no doubt a momentous paradigm shift in the health sector is ahead. This wouldn't be achieved without the generous support of the Custodian of the Two Holy Mosques and His Royal Highness the Crown Prince, May Allah protect them, and without the colossal efforts exerted by our dear citizens.
Dr. Al-Rabeeah delivered his address before the 52nd Regular Session, presided over by Sheikh Dr. Abdullah bin Mohamed bin Ibrahim Al Al-Sheikh, with the aim to discuss the MOH's performance and achievements, answer the inquiries of the council members, as well as the inquiries and propositions submitted by citizens, emanating from our staunch confidence of the importance of people's participations in discussing their issues and problems.
Following is the text of the Minister's address before the Shura Council:
In the Name of Allâh, the Most Gracious, the Most Merciful
Praise be to Allah, the Lord of the worlds, and peace and blessings of Allah be upon the noblest of the Prophets and Messengers, our Prophet Mohammed, and upon his family and companions.
Your Excellency Sheikh Dr. Abdullah bin Mohammed Al Al-Sheikh,
Your Excellencies,
Brothers and Sisters,
Peace be upon you and Allah's mercy and blessings.
On my behalf, and on behalf of the MOH employees, I would like to express my gratitude that I am granted the opportunity to meet with the esteemed council, which plays an essential and pivotal role in our beloved Kingdom. I am here today to present the MOH's plan, review the programs and services accomplished so far, and lend an attentive ear to the visions and proposed of your esteemed council, in an endeavor to pursue whatever serves our Kingdom and people.
On this occasion, allow me to take the opportunity to make clear that the Ministry of Health (MOH) is a service ministry, which caters for people's health-associated needs, and cares for their health throughout their lives, through its health facilities, numbering about 251 hospitals and 2109 primary healthcare centers, in addition to specialized centers, medical cities, specific health programs, staffed by over 250.000 employees of both genders, according to last year's statistics. To date, primary healthcare centers have received about 55 million patients, whereas the outpatient clinics of hospitals received about 11.5 million patients. Emergency sections received 20 million patients. About 430.000 surgeries and 256.000 births have been conducted.
Brothers and Sisters,
The Ministry of Health has been always cherishing the principles of transparency, justice and integrity, and boasting its commitment to caring for patients and gaining their satisfaction, under the slogan: “Patient first”. The Ministry has launched and empowered the quality, measurement and development programs. This by no means indicates that the Ministry of Health, considering the extensive diversity of health services it provides throughout the Kingdom, is completely immune against errors and shortcomings. We pay colossal attention to redressing such errors, and taking the necessary action against those proven to be delinquent, as well making good use of such indicators, so as to evade their recurrence, and develop the entire health performance, within the framework of the comprehensive conception of quality and integrity the Ministry relentlessly seeks to achieve in compliance with the directions of the Custodian of the Two Holy Mosques and His Royal Highness the Crown Prince, May Allah protect them.
The Ministry, besides, has a staunch belief of the importance of communication and transparency among regulatory authorities and commissions, as well as the constructive criticism and recommendations proposed by the council, mass media or forums. It was one of the first ministries to contact these authorities seeking to maintain the state's right, and, in the meantime, preserve citizens' rights and dignity.
Honorable Audience,
The Ministry of Health, while catering for its important service role, has been still keeping a close eye on other as important aspects. It has embarked on encouraging health researches, and putting them into action. It has also carried out large research programs, such as measuring the proportion of morbidity, in addition to proceeding on the development of health information, and communicating with the relevant authorities to unify such information and ensure its precision.
There is still another essential role upheld by the Ministry, which is the transfer of health technology, and entrenching robust pillars for the health industry, as well as fostering the strategic participation and partnership between the private and public sectors on the one hand, and the international corporations seeking to provide medicine and promote the national health industry. It didn’t escape our notice, also, that we have a considerable role to play in the Gulf, Arab and international arenas, thus effectively contributing to the science-based decision-making process.
Your Excellencies,
Allow me to sum up, hereafter, some of the MOH's achievements over the past three years.
1. The MOH Strategic Plan (1431 – 1440H):
The Ministry's strategic plan was formulated by its sons and daughters, to ensure its viability, guided by the visions and visions and recommendations of experts and national and international consulting firms. It is gratifying for us that the Ministry has already taken practical steps towards the implementation of the plan as it should be. It includes an overview of the MOH's situation before 1431H, and enumerates the major obstacles facing the Ministry, how to overcome them, and ways to make success of the efforts driving to that end. The National Project for Integrated and Comprehensive Healthcare, in which a number of the members of your esteemed council participated, culminates our efforts to achieve justice and comprehensiveness throughout the Kingdom.
This ambitious plan places a particular emphasis on primary healthcare, which is reckoned one of the basic pillars upon which the concept of modern public health relies.
It also sets forth certain scientific and equitable standards for the distribution of health services, in concordance with the directives given by the Custodian of the Two Holy Mosques, and His Royal Highness the Crown Prince, underscoring the accomplishment of justice and equality among all citizens. The Ministry, emanating from these directives, has been paying close attention to the equitable distribution of referential and specialized health facilities, in an endeavor to alleviate the suffering of travel, in accordance with scientifically approved standards and criteria.
Based on this, the Ministry has set certain standards and criteria for the establishment of health facilities, concordant with and emanating from the national and international standards. It adopts the latest developments in respect of the international health code standards, seeking to bring into effect the directions of the Custodian of the Two Holy Mosques, to maintain citizens' health, safety and privacy, by dedicating a room for every patient, or two patients at most, in the MOH's new facilities.
2. Bed Crisis:
The Ministry of Health is aware of the difficulties facing citizens with regard to the lack of beds, which resulted from the projects not coping with the actual needs over the previous years. This in turn pushed the Ministry to set a package of urgent solutions to overcome this crisis until the projects underway are completed, including the following:
- Full operation of the available beds, especially at Intensive Care Unit (ICU).
- Great expansion in outsourcing from the private sector in terms of critical and emergency cases when there are not sufficient beds in the MOH hospitals, in the sense that the patients are referred to the private sector hospitals. And the total of what has been spent in this regard, since the beginning of the year, has reached SR 319 million, and it is expected that such a sum will exceed more than SR 500 million.
- Developing several programs of one-day surgery and treatment. The proportion has reached about 35% of the total surgical operations.
- Hiring the dialysis treatment service and long-term care from the private sector. The outsourcing program has been developed (phase 1) at SR 200 million, and the followed procedures for such a phase have initiated, and as far as the outsourcing of long-residing patients, such a program has been introduced at SR 40 million, and the procedures of tendering and awarding are being taken in order for the service presented to meet the global standards.
- Providing the Home Medicine Service; which is provided to patients suffering from chronic diseases at their homes in order to lessen the need of such patients to be hospitalized, in line with the modern healthy approach. And such a program has benefitted more than 17,000 patients to date.
3. Projects:
The Ministry is interested in fair distribution for the health services, built upon the scientific approach and the accredited standards by the Ministry. The projects of the Ministry of Health have achieved the following:
As of 1430 to 28/10/1433H, a number of 621 primary healthcare centers have been delivered, and the establishing of 706 health centers is underway. Also, 47 hospitals have been operated, with a total bed capacity of 4770 beds. Besides, 124 hospitals are being established and equipped. In addition to this, King Khalid Medical City is being established and equipped in the Eastern Region, along with King Faisal Medical City, with a view to serving the Southern Region, and Prince Mohammed Bin Abdulaziz Medical City to serve the Northern Region. Besides, the expansions and bed additions at both King Abdullah Medical City in Makkah and King Fahd Medical City in Riyadh. Hence, such projects which are being established and equipped will – Allah willing – bring the number of beds at the Ministry of Health as twice as it was in 1430H, to reach 66,000 beds over the next seven years; taking into account the quality and international standards for such buildings. However, modifying some of such projects to meet the global standards and the patient's privacy have stalled some of these projects, which is in the best interest of our dear citizens.
4. Specialized Hospitals and Medical Cities:
The programs have been developed in the MOH's medical cities and specialized hospitals. They are: King Fahad Medical City (Riyadh), King Abdullah Medical City (Makkah), King Fahad Specialist Hospital (Dammam), and King Khalid Eye Specialist Hospital (Riyadh). This is in order to present high level specialized services, and in conformity with the world's highest standards, such as organ-transplantation, oncology and advanced surgeries. King Abdullah Hospital (Makkah) is best known for oncology, open-heart surgeries and retinal diseases. King Fahad Specialist Hospital (Dammam) is known for oncology and organ-transplantation surgeries and is regarded as one of the biggest centers all over the Kingdom. Also, it is the only center all over the Kingdom that undergoes Pancreas-transplantation surgeries. As for King Fahad Medical City, it is distinguished with oncology and heart surgeries and its remarkable nerve injuries treating and their surgeries center; establishing a proton therapy center is underway, which will be the first of its kind in this region of the world. And this has made such medical cities and specialized hospitals treat a great deal of the complicated cases referred to them, which in turn reduced the number of patients referred to be treated abroad.
Furthermore, establishing, equipping and inaugurating specialized centers in different regions of the Kingdom have been expanded in Riyadh, Al-Qassim, Makkah, Jeddah and the Eastern Region; and heart centers in Riyadh, Makkah, Medinah, Dammam, Jeddah, Al-Ahsa, Assir, Al-Qassim, the Northern Border, Al-Baha, Najran and Hail. Also, 20 centers have been established and equipped to treat diabetics in different regions and provinces of the Kingdom. Opening such centers has led to limit the treatment to the places where the patients reside, and to reduce the need to have them moved to the big cities for treatment.
5. Preventive Medicine and Health Awareness:
The Ministry's efforts have continued in the field of preventive medicine and health awareness programs. This was particularly manifested in introducing 5 new vaccines to the basic vaccinations program for children: staphylococcus, rotavirus, meningitis, chickenpox and hepatitis. Hence, this is expected to lead to reduce the morbidity and mortality of such diseases. The Kingdom is one of the pioneer countries in this domain.
6. National health laboratory:
Raising the level of the National Health Laboratory (now under construction) to the fourth standard has been adopted; to be one of the few laboratories which presents such a level of service in all over the world.
7. Manpower:
- New standard rates have been approved for the health work force at hospitals and primary healthcare centers.
- A new payroll for health practitioners has been enacted, based upon justice and equality, seeking to raise the level of health services provided throughout the Kingdom's regions.
- The full-time allowance has been approved, aside from other allowances, for the physicians enrolled in the health job list.
- The over-time allowance has been approved for the non-medical technical workers.
- The scarcity allowance, excellence allowance, supervision allowance and training allowance have been approved for those included in the health job list.
- Within the framework of the Ministry's keen interest in Saudization, a number of 24772 of the graduates of health institutes and faculties have been employed over the period from 1/1/1430 to 28/10/1433H.
8. Specific Programs:
The Ministry of Health has launched a number of medical programs meant to raise the level of health services, including:
Patient Relations and Rights Program:
This program has been adopted by all MOH hospitals throughout the Kingdom's regions. It is followed up by the MOH senior officials to provide the necessary guidance. Besides, the Citizen's Voice Services has been launched through the MOH Portal, thus reiterating people's roles in the development process.
Internal Audit and Control:
The Internal Audit and Control programs have been set to work with the aim to ensure transparency, integrity, performance development and unification of specifications.
The central department is directly followed by the Minister of Health.
The department, as well as its subsidiaries at health directorates, has been supported with qualified and specialized health cadres, so as to effectively assume its responsibility. The department is encompassing now 294 jobs, after it had been staffed by only ten jobs three years ago.
Over the two years (1432 – 1433H), about 600 tasks have been accomplished, through which about 4000 errors and failings have been found out, and instantly addressed.
The Visiting Physician Program:
This program has been introduced to fill the gap of qualified health cadres in some peripheral regions, especially in rare specialties, with the aim to treat patients at their regions. The program was launched to overcome the challenges of permanently providing such cadres in such regions. Therefore, the Ministry, by way of this program, has attracted over 1700 physicians so far, from within and without the Kingdom, including the United States and America.
Referral Program:
The Ministry is currently conducting the final tests on the National Automatic Referral Program, which harnesses advanced technology in referring patients, according to certain medical accurate standards and scientific methodology. The program will be overseen by hierarchical levels of responsibility.
9. Central Emergency and Control Room:
The Ministry of Health is now preparing for launched an easy and unified number for the emergency room, equipped with control monitors, to provide apt answers for questions and inquiries, and adeptly address emergency cases. The number will be launched soon.
10. IT Program
The Ministry has attracted more than 200 experts, of both national and foreign competencies, to develop the concept of health and e-governance. Also, several specific programs have been launched, in an effort to serve patients and enhance MOH's services with state-of-the-art technologies.
11. Upholding Institutional Work and Administrative Development:
The Ministry has reviewed its administrative structure, in the light of the numerous changes emerging in the management of the Kingdom's health services, seeking to cope with the international health-associated developments. To that end, the Ministry has adopted a new organizational structure, including several changes, such as introducing an agency for public health, an agency for support and medical affairs, an assistant agency for primary healthcare, an assistant agency for the private health sector affairs, an assistant agency catering for supportive health cadres, and an assistant agency for employment. The Ministry has embarked, also, on embrace the institutional work, by way of its executive boards and their subsidiary committees, thus ensuring reviewing plans and decisions on an institutional and collective base, in a way that ensures continuance and impartiality. In addition, all the procedures related to the financial and administrative systems are currently reviewed by renowned national and international consulting firms, in an endeavor to reach at a financial and administrative methodology, harnessing ERP systems.
12. Quality and Measurement Programs:
The Ministry of Health is keen to entrench the culture of quality, measurement and performance monitoring. In this context, a program for the detection of critical medical errors has been adopted by the Ministry for the first time, and the private health sector has begun to adopt it as well. The Ministry developed this program the view that it will be a model for analyzing errors, taking the necessary actions against those proven delinquent, and evading the recurrence of such errors in the future. The Ministry, in addition, has begun to adopt the Clinical Audit Program, meant to monitor the performance indicators (KPIs) approved to ensure quality (49 indicators). The Ministry has also formed committees for the documentation of health practitioners' certificates and assigning their clinical authorities.
It is worth mentioning, in this regard, that ten MOH hospitals have been accredited by the Joint Commission International (JCI), and thirty other hospitals have been granted the national accreditation certificate. The remaining hospitals are in their way to accreditation, according to a certain timetable.
13. Development and Unification of Guides and Procedures:
The Ministry has issued a number of guides and directories, including: the Physicians' Work Regulation Guide, the Medicine Development and Unification Guide, the Consumable Directory, and the Contracting Guide, in addition to many other developmental guides.
14. Training and Scholarships:
The Ministry has paid much attention to training and scholarships, as manifested in raising the budget allocated to that purpose from SR 150 million, to SR 350 million over the past three years. Training and scholarships programs have covered all the medical, technical and administrative cadres. The number of those on scholarships is 1424, whereas the number of those studying by the past year inside the Kingdom is 2898. The number of those who received training last year is 132802 employees of both genders.
15. Employment:
The Ministry has made every effort to raise the level of its employees (both Saudis and non-Saudis). In doing so, we are proceeding from our staunch belief of the pivotal role of these cadres in the promotion of the health level and reduction of proportion of errors. All the standards, criteria and requirements of employment have been thoroughly reviewed to ensure quality and ongoing development. Meanwhile, the Ministry has not relinquished its responsibility in Saudization, with a view to achieving the sought-after objectives: quality, safety, and patients' satisfaction.
16. Medical Errors:
In its quest for the reduction of medical errors, the Ministry of Health has taken the following steps:
- Obligating the accreditation process on all health facilities.
- Obligating all health cadres to obtain the occupational registration from the Saudi Commission for Health Specialties.
- Providing continuing medical education for all health cadres, and considering it an indispensable condition for the re-registration.
- Applying a program for detecting and measuring critical medical errors taking place at hospitals.
- Adopting the Clinical Audit Program.
It is noteworthy, in this respect, that the number of cases related to medical errors received by the Kingdom's forensic authorities over the year 1432H is 1547 cases. In 507 cases (32.7%), health practitioners were convicted, whereas the number of cases in which health practitioners were not convicted was 1041 cases (67.3%). The forensic authorities are independent forensic courts headed by a judge (A), chosen by the Ministry of Justice. The Ministry of Health cannot interfere with the decisions and judgments issued by these authorities. Complaints of such decrees shall be submitted to the Ombudsman.
17. Private Health Sector:
Within the framework of the inspection over the private health sector, the Ministry's field teams throughout the Kingdom's regions have recorded 2352 violations committed by private health institutions and health practitioners working for them, and 140 health facilities have been closed since the onset of this year.
Your Excellencies,
All what I have just mentioned is no more than the tip of an iceberg; it is just a part of the strenuous efforts underway in the Ministry of health seeking to fill the gaps, develop performance, and provide safe healthcare services abiding by modern scientific and occupational standards.
Your Excellencies,
The Ministry of Health keeps a close eye on all the challenges facing citizens, and all the constructive criticism and recommendations proposed by your esteemed council and the mass media and forums. I would like to make clear that we are making every effort, and working day and night, guided by Allah, with a view to overcoming all such challenges, fill gaps, readdress errors, and adopting modernization and development, in light of the available human and financial resources, and the large health challenges facing the entire world.
The Ministry of Health, along with its employees, have no doubt a momentous paradigm shift in the health sector is ahead. This wouldn't be achieved without the generous support of the Custodian of the Two Holy Mosques and His Royal Highness the Crown Prince, May Allah protect them, and without the colossal efforts exerted by our dear citizens. The development of the health systems and facilities requires effort, time, right approach, and, above all, qualified national competencies, that embody the true and permanent investment of this beloved country.
I pray for Allah to confer health and prosperity upon us, and to guide us to whatever good and benevolent. Peace be upon you and Allah's mercy and blessings.