Saudi Gazette report When seeking treatment, patients in Saudi Arabia usually go through a process that begins with a visit to a primary health center, and if treatment is unsuccessful, doctors will refer the patient to a general or specialist hospital and finally to a medical city. However, poor services offered at primary healthcare centers, where specialists are not always available, leads many people to seek treatment at specialist hospitals and medical cities directly, resulting in long waiting periods for appointments and an increased burden on doctors, Al-Riyadh daily reported. Medical cities in the Kingdom, the most famous of which is the King Fahd Medical City in Riyadh, are made up of several hospitals where patients receive state-of-the-art care from renowned specialists. Experts have said in order to ensure smooth operations at medical cities, the services and infrastructure at primary healthcare centers must be improved so patients with easily-treatable conditions can be treated and discharged, freeing doctors to concentrate on more complex cases. Former Shoura Council member Dr. Mohammed Al-Zulfa said while clinics and primary healthcare centers play an important role, many patients have lost confidence in them, especially in ones located in small cities and rural areas where inferior medical care is provided. “These health centers are inadequately equipped and lack the services of specialists, causing delays in the early stages of treatment, which has prompted many citizens to ask where they should go to seek specialist treatment,” he said. Al-Zulfa explained that the infrastructure at primary healthcare facilities is rarely upgraded and although the Ministry of Health has established many health centers, years pass between construction of these centers and their actual operation. “Many of the buildings were constructed decades ago and are in need of renovation and proper equipment and staff. This points to an obvious problem and the Ministry of Health should hold regular meetings with officials in regions and cities to address this problem. Perhaps the Ministry of Health suffers from a lack of qualified medical staff, as the Ministry of Finance places a cap on doctors' salaries,” he noted. Admitting that additional medical cities need to be constructed in various regions of the Kingdom, Al-Zulfa said medical staff must be trained ahead of time, through scholarships and extensive training, to work in the cities. “The Ministry of Health should also coordinate with university hospitals in different regions to prepare students to work in these medical cities. The ministry should be aware of the increasing population and the diversity of diseases,” he added. Shoura Council member Dr. Abdulrahman Al-Haijan said that the government has exerted efforts to upgrade health services and although the Kingdom has the resources to do more to improve its healthcare system, it lacks a system that allows physicians to provide services to patients in a timely and thorough manner. “Healthcare services in villages lack qualified doctors and equipment, and when patients are referred to hospitals, they often discover that they were wrongly diagnosed. Some doctors even accuse patients of suffering from psychological conditions if they are unable to correctly diagnose them,” he said. Nursing consultant Dr. Sabah Abu Zanada said the management of the health sector should be entrusted to hospital management specialists and not to doctors. She explained that specialist doctors should not be entrusted with administrative duties as they lack the necessary knowledge and said doctors in developed countries have to take a management course before they are entrusted with any administrative duties. “Officials believe that the greater the number of hospitals, the better the health services, but the fact is that specialists in healthcare planning can create an integrated health sector, which only health planners and administrators can appreciate. There is a lack of such specialties and any graduates who have specialized in this are neglected,” Abu Zanada said. “Our patients remain in hospitals for weeks without a real need. Citizens under 15 years of age represent 50 percent of the population and those above 65 represent 5 percent. There are more than 400 hospitals in the Kingdom, yet no beds are available to patients. The solution lies in establishing rehabilitation and nursing centers for the elderly, who account for 60 percent of patients occupying hospital beds,” she added. Lawyer and former Shoura Council member Dr. Ibrahim Al-Sulaiman claimed the government is planning to build 3,000 primary healthcare centers, a number he said was unsustainable if the proper equipment and medical staff are not available to run them. His solution: “Build an educational medical city. “There needs to be an educational medical city to qualify medical staff in various specialties to work at these centers,” Al-Sulaiman said.
