ABU DHABI // There are severe gaps in healthcare services in Al Gharbia, Abu Dhabi’s western region, health chiefs admitted on Wednesday.
Out of 28 medical specialties, there are shortages in 21. The gaps include vascular surgery, invasive cardiology and the treatment of infectious disease.
By comparison, in Abu Dhabi city there are only two specialities with gaps, and seven in the east of the emirate.
The shortfall is “telling” and “painful”, said Dr Maha Barakat, director general of the Health Authority Abu Dhabi.
“We have analysed it – we have definitely not ignored this. It is a high priority for us to resolve and we are working as effectively as possible to try to cover these gaps.”
Dr Barakat said the authority had identified 10 rural areas that needed health clinics, and had put them out to tender to the private sector in January. She did not say what the response was.
“We’re still in the development phase for fulfilling these 10 services,” she said.
The authority’s chairman, Dr Mugheer Al Khaili, said investors sought profit and would not invest unless they had incentives. In such cases the Government should step in, he said.
“This is our role as a health authority to provide this service,” Dr Al Khaili said.
He said he had visited Liwa Hospital and found an excellent level of service but few patients.
Supporting every medical specialty in every hospital might not be feasible, he said. There was a programme in place with Seha, the Abu Dhabi health services company, to provide doctors in local hospitals during events such as Al Dhafra Festival.
Providing coordinated services in Al Gharbia was a challenge because of its low population density, said Amer Al Kindi, a health policy expert.
“This is an area of improvement for Abu Dhabi, and the fact that it’s on the plan means the Government is taking a good step.”
Another priority for the health authority – attracting and recruiting UAE nationals – was essential for Al Gharbia’s development, he said.
“You need Emiratisation in health care if you want to ensure the needs of rural areas.”
He said it could be difficult to maintain highly trained medical staff in rural areas. In Australia, for example, the government offered citizenship to foreign doctors in exchange for working in rural areas, but found that doctors left after the minimum time.
“In rural areas, especially in primary care settings, one way to ensure quality provision of primary care is to use people in those areas to work there,” Mr Al Kindi said.
While Emiratisation was important for sustainability, it would take longer than five years to see the results, he said, especially in health care, in which professional development took many years.
“To start today means that you see results in 10 to 15 years, and this happens in every country, not only in the UAE.”
The health authority has planned 58 initiatives in seven priority areas of healthcare reform over the next five years.
The priorities are continuation of care, improving quality, attracting and retaining the workforce, emergency preparedness, wellness and prevention of disease, cost effectiveness and electronic health information.
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Key changes
Commission caps
For life insurance products with a savings component, Peter Hodgins of Clyde & Co said different caps apply to the saving and protection elements:
• For the saving component, a cap of 4.5 per cent of the annualised premium per year (which may not exceed 90 per cent of the annualised premium over the policy term).
• On the protection component, there is a cap of 10 per cent of the annualised premium per year (which may not exceed 160 per cent of the annualised premium over the policy term).
• Indemnity commission, the amount of commission that can be advanced to a product salesperson, can be 50 per cent of the annualised premium for the first year or 50 per cent of the total commissions on the policy calculated.
• The remaining commission after deduction of the indemnity commission is paid equally over the premium payment term.
• For pure protection products, which only offer a life insurance component, the maximum commission will be 10 per cent of the annualised premium multiplied by the length of the policy in years.
Disclosure
Customers must now be provided with a full illustration of the product they are buying to ensure they understand the potential returns on savings products as well as the effects of any charges. There is also a “free-look” period of 30 days, where insurers must provide a full refund if the buyer wishes to cancel the policy.
“The illustration should provide for at least two scenarios to illustrate the performance of the product,” said Mr Hodgins. “All illustrations are required to be signed by the customer.”
Another illustration must outline surrender charges to ensure they understand the costs of exiting a fixed-term product early.
Illustrations must also be kept updatedand insurers must provide information on the top five investment funds available annually, including at least five years' performance data.
“This may be segregated based on the risk appetite of the customer (in which case, the top five funds for each segment must be provided),” said Mr Hodgins.
Product providers must also disclose the ratio of protection benefit to savings benefits. If a protection benefit ratio is less than 10 per cent "the product must carry a warning stating that it has limited or no protection benefit" Mr Hodgins added.
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