Kuwait’s health system faces growing pains despite major investments

• Kuwait has built a world-class health infrastructure with well-distributed centers, but despite significant resources, services still fall short of expectations.

• The creation of the Supreme Council of Health aims to transform Kuwait’s health system by developing stable strategies, eliminating duplication, and streamlining responsibilities between the Ministry of Health and separate entities for financing, insurance, and services.

• Cost and bureaucracy in Kuwait hinder progress, requiring bold reform to replace outdated systems with modern, competence-based administration, while integrating AI, strengthening infrastructure, and updating legislation to drive innovation and enhance telemedicine.

The wise decision by the Council of Ministers and the Minister of Finance to cancel health insurance contracts in government institutions deserves commendation. This decision is a crucial step towards curbing waste and eliminating the duplication of resources, as reported by Al Jarida newspaper.

Kuwait has established a world-class health infrastructure, with a well-distributed network of integrated health centers across every region, reflecting the commitment of successive governments since independence to provide accessible healthcare services. However, despite these significant resources and substantial budgets allocated to the health sector, services still fall short of expectations. This is largely due to the health system’s inability over many decades to adapt to the rapid developments seen in the Gulf countries and worldwide.

Development of health system in Kuwait

It is unfair to place the blame for this historical backwardness solely on the current health administration; previous administrations have also played a role, and we too have contributed to some of these shortcomings. However, it is now the responsibility of the current administration to seize the historic opportunity presented by the new era of reform.

From this perspective, we urge decision-makers to conduct a comprehensive study of the health system and the need for a radical transformation.

As the full operation of the expected health insurance hospitals approaches within the next two years, we believe this historic opportunity should be leveraged to develop and reformulate the health system.

In this regard, we intend to submit a comprehensive proposal to the government for consideration by officials in the ministries of health, planning, and finance, aiming to ensure a qualitative leap in health services, improve governance, and rationalize spending.

First Axis: Health insurance services

Al-Daman Hospitals are crucial not only for transferring two million expatriates to health insurance services, easing the Ministry of Health’s financial and administrative load, but also for creating the ideal conditions to restructure and modernize Kuwait’s entire health system.

Completion of health insurance hospitals

It is worth commending the government’s role, especially that of the First Deputy Prime Minister, in resolving this issue after the Ministry of Health’s reluctance and delay in taking serious steps towards activating the project.

This decisive intervention ended the delay and paved the way for prioritizing the activation of work on the completion of health insurance hospitals.

By leveraging the expertise of qualified consultants in the Ministry of Health, the following can be achieved:

1. Hiring qualified medical, technical, and nursing staff.
2. Equipping hospitals with modern equipment and technologies.
3. Accelerating the hospital opening program with specific timelines.

Second axis: Comprehensive change in health system

Creation of the Supreme Council of Health: The establishment of the Supreme Council of Health is key to transforming Kuwait’s health system. Reporting directly to the Council of Ministers, with the General Secretariat under the Ministry of Health, the council includes relevant ministries and institutions.

Functions:

1. Develop stable plans, strategies, and policies that remain consistent despite changes in ministers, and coordinate with all stakeholders, including the private sector and civil society.
2. Eliminate duplication by integrating all health sectors within a unified regulatory framework.
3. The Ministry of Health will focus on supervision, organization, and quality control, while financing, health insurance, and direct services will be handled by separate entities.
4. Summary of the proposed health system:

Completing the operation of health insurance hospitals will ease financial and administrative pressure on government hospitals, as around two million expatriates move to Daman Hospitals.

Key steps:

1. Establish national companies to manage hospitals and health centers, each overseen by the Investment Authority.
2. Transform health district departments into branches of the Ministry of Health for regulatory oversight.
3. Create the National Health Insurance Center, under the Ministry of Finance, to finance health companies via comprehensive insurance policies, later transitioning into an insurance company within the Investment Authority.
4. Establish the Supreme Council of Health to develop a stable, long-term strategy.

Control in the new system:

• Financial control: Managed by the National Insurance Center, ensuring transparency and reducing waste.
• Technical control: Overseen by the Ministry of Health to ensure service quality.
• Beneficiary control: Monitoring satisfaction with services provided.

Towards an advanced and sustainable health system: This proposed system is a bold step toward transforming Kuwait’s health sector, separating regulatory and operational roles, and relying on comprehensive insurance. This will improve service levels and citizen satisfaction, offering a historic opportunity for reform to ensure a healthier future.

Third axis: Professional and quality standards

• Achieve international quality standards in government institutions.
• Implement unified electronic health records and referral systems to ensure service integration and avoid duplication.
• Develop operational policies for technical departments with periodic performance reviews.
• Activate quality and safety management systems, drawing from successful programs like Saudi Arabia’s “Health Performance.”
• Restructure training and scholarship programs to meet the health system’s and community’s needs.

Fourth axis: Achieving International Recognition for Hospitals and Health Centers

International recognition ensures hospitals meet global medical quality and safety standards, covering diagnostic, therapeutic, technical, administrative, and clinical aspects. Steps include:

• Choosing an accredited body (e.g., JCI, TUV, ISO15189).
• Evaluating compliance and creating corrective plans.
• Developing the workforce and operational systems.
• Implementing quality management systems with internal audits.

Fifth axis: Health economics, rationalizing spending, and stopping waste

Kuwait’s health sector faces economic challenges requiring a comprehensive response:

1. Transition to a universal health system reduces unplanned spending and guides resource use.
2. Establish an integrated system for monitoring health resources and prioritizing projects based on feasibility studies.
3. Achieve quality through international recognition, rationalizing consumption, and optimizing resources.
4. Embrace digital transformation with AI, unified health files, drug inventory management, and telemedicine.

Sixth axis: Strengthening financial governance

• Establish a unified national body for medical procurement to reduce prices through bulk purchasing.
• Coordinate with Gulf countries for expanded unified purchasing.
• Develop a comprehensive health insurance system for governance and auditing.
• Use performance indicators and balanced scorecards.
• Address job inflation and restructure the workforce.
• Launch a new hospital operating program.

Seventh axis: Pharmaceutical security and industries

Pharmaceutical security is crucial for national security, as shown during the COVID-19 pandemic. Localizing pharmaceutical industries offers job opportunities, reduces costs, and enhances crisis readiness.

Strategic recommendations:

• Establish an integrated industrial zone for pharmaceuticals and medical supplies, and this project was presented by Dr. Abdulaziz Al-Jadaan.
• Stimulate private sector investment through incentives and legislation.
• Attract international companies to transfer technology and localize production.
• Develop specialized competencies to support the pharmaceutical sector in Kuwait.

Eighth axis: Health promotion, community medicine, and clinical education

Focus on prevention, healthy lifestyles, and modern education tools like digital health and AI to tackle chronic diseases such as obesity, smoking, and cancer.

Key initiatives:

• Implement clinical health education programs based on patient data and risk factors.
• Launch the “Lifestyle Physicians” program to train doctors in preventive medicine.
• Use WHO mobile health initiatives, including AI and smart apps for health tracking.

Ninth axis: Digital health and artificial intelligence in health systems

Artificial intelligence and digital health are key to improving healthcare systems globally, requiring the adoption of an integrated national strategy.

• Reduce operational costs: Optimize inventory management.
• Enhance patient satisfaction: Ensure quick responses to complaints.
• Reduce medical errors: Monitor drug interactions.
• Develop human competencies: Use performance data for skill development.
• Epidemiological management: Predict disease spread and identify vulnerable areas.
• Increase productivity: Automate routine tasks.
• Quality improvement: Monitor performance and ensure compliance with standards.

To achieve this, we need both short- and long-term plans to integrate AI into health systems, strengthen infrastructure (including unified electronic records and connections between public and private sectors), and focus on workforce training. Updating health legislation to encourage innovation, while ensuring compliance with international laws, and enhancing telemedicine and community awareness is also vital.

International recognition of hospitals boosts health system efficiency and ensures patient safety.

In conclusion, the current system is a barrier to progress, leading to waste, inefficiency, and increased spending. Reforming it with a modern, comprehensive system is essential to overcoming these challenges.

In an upcoming article, we will detail the legislative axis, the stimulation of the private sector, and the completion of some tactical axes, based on Kuwaiti, regional, and international experiences. I am confident that, in this new era, the Ministry of Health can achieve a radical transformation that will enhance the efficiency of health services.

Cost and bureaucracy major challenges in Kuwait

Cost and bureaucracy are major challenges in Kuwait, with government projects often exceeding private sector costs. The entrenched documentary cycle and deep state influence, fueled by nepotism and personal interests, hinder progress.

To drive radical reform in the health system, we must boldly tackle this challenge by replacing bureaucracy with modern administrative systems rooted in competence and professionalism.