Growing population needs twice as many doctors

Abu Dhabi // The number of doctors and nurses needs to double over the next decade to cope with an ageing and rapidly expanding population, new figures have revealed. A report from the Health Authority-Abu Dhabi (HAAD) estimated that the capital would need up to 102 per cent more doctors, from the current 5,300 to as many as 10,700. The number of nurses will need to rise by as much as 101 per cent, from 6,900 to 13,900.

The report also pointed to shortfalls in fields including paediatrics, gynaecology and orthopaedics. The transience of the UAE's expatriate population is an additional hurdle. Some 16 per cent of doctors quit their jobs each year - so to increase numbers by just five per cent hospitals would need to hire more than a fifth of their workforce each year. Some 13 per cent of nurses quit each year. "If churn rates remain at their 2009 level, this will require some 1,600 doctors and almost 1,800 nurses to be recruited annually," the HAAD Statistics 2009 report stated.

Although the number of hospital beds has been rising, it will need to rise much further to cope with an expected doubling of the expatriate population by 2019. To cope with this, the report estimates that bed capacity must rise by 55 per cent. Many wards are already overcrowded. Intensive care units for children and babies were consistently more than three quarters full throughout last year. Increases in diabetes and cancer in particular require "aggressive growth" in services over the next decade.

Although services are generally adequate for the emirate's relatively young population, they will need to adapt and grow significantly to cope as that changes. The population is expected to grow from the current 1.9 million to a maximum of 3.5 million over the next decade. People aged between 25 and 29 are the largest group in the emirate; rates of diabetes, heart disease and cancer all increase with age.

Abu Dhabi lags behind the GCC in its provision of hospital beds. It has just 1.3 beds per 1,000 people, compared with 2.7 in Bahrain, 2.5 in Qatar and 2.2 in Saudi Arabia. However, the younger population makes Abu Dhabi's figure equivalent to three beds per 1,000 in a more age-balanced population. Demand for inpatient services is still expected to warrant a further 2,000 beds, on top of the current 3,642, within the next decade.

Some 4,280 new beds are planned, 1,000 of them on Abu Dhabi island. However, only 2,700 of these are considered "likely" to materialise, with 1,782 to be completed by 2011. HAAD also expects "aggressive growth in inpatient services relating to both diabetes and cancer". The number of doctors and nurses will need to more than double if the population expands at the maximum rate predicted. A breakdown of the specialities shows gaps in paediatrics, orthopaedics, ophthalmology and gynaecology, among others. Patients wait up to six days for an appointment with an obstetrician or gynaecologist. Other areas with shortages include paediatric surgery, psychiatry, endocrinology, urology, intensive and critical care, internal medicine and rehabilitation.

Dr Saleema Wani, a consultant obstetrician and gynaecologist at the Corniche Hospital, said staff at the capital's only dedicated maternity hospital had very high workloads. "Having more doctors means we will be able to reduce the waiting time for the patient, which is what we ultimately want," she said. The rising population and developments in the industry, she said, created the need for "more talent" who should be employed with "better packages".

There are just 31 licensed psychiatrists in Abu Dhabi, meaning patients wait two or three days for an appointment. There are more alternative therapists - 36 - than psychiatry professionals. Dr Yousef Abou Allaban, a consultant psychiatrist at the American Centre for Psychiatry and Neurology in Abu Dhabi, said there is a "serious need" to employ more. "Ideally, we need around 300 to 500 of them for the capital alone," he said, citing World Health Organisation estimates.

"A total of 31 registered psychiatrists for a population of 1.7 million is a terrifying lack of doctors in a much needed speciality that is not given enough importance." Some doctors, however, took issue with HAAD's findings. Dr Maurice Kallas, orthopaedic specialist and head of the emergency department at Al Noor Hospital in the capital, was unconvinced of the need for expansion in his field. "We have more than we need at the hospital," he said. "This is a reflection of the numbers of doctors in these specialities in the entire emirate. Specialists applying to work in the UAE from the region find there are no vacancies."

Instead, emergency specialists, nurses and subspecialties in fields such as pulmonology, rheumatology, nephrology and endocrinology need to be attracted to the UAE. "Even more than that, we need more nurses," he added. "The entire world needs more nurses." Alison Ramsay, the director of nursing and quality at Abu Dhabi German Hospital, said employing more Emirati nurses might be part of the solution. The hospital has yet to open, but Mrs Ramsay needs more than 400 nurses.

The Ministry of Health reports that just one in 25 nurses are UAE nationals. Ideally, said Mrs Ramsay, that should be closer to one in four. "Nursing is not an attractive career choice for Emiratis, and there are not enough basic training programmes in the country," she said. "There is a real dependence on recruiting from abroad." @Email:munderwood@thenational.ae hkhalaf@thenational.ae