MENA Healthcare NewsletterNovember 2017

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MENA Healthcare Newsletter – November 2017

As one of the region’s few genuine full service law firms, our combination of skills, expertise, experience and network of connections allow us to act as a ‘one-stop-shop’ for healthcare clients for all of their legal needs in the MENA region. We feel this is reflected in our recent Merger Market M&A Award for Middle East Pharma, Medical & Biotech Legal Advisor of the year 2017.

In this edition of the healthcare newsletter we have explored current topical issues and market trends to give you an insight into the challenges facing the healthcare sector.

The content ranges from Medical Malpractice, Healthcare Financing and two of the articles have a particular focus on the Kingdom of Saudi Arabia (KSA). We are thrilled to see so much interest in the KSA as a result of Vision 2030 which seeks to reshape the Kingdom and boost what is the Arab world’s largest economy. It is an exciting time for KSA and the interest displayed in the market has grown over the last 12 months. We have included a short video of our Saudi Arabia Symposium which gives key insights on KSA from market experts with a real focus on opportunities provided by the privatisation programme.

We do hope that you find this interesting and enjoy the read, please feel free to contact any of our team members directly to discuss further.

Kind regards

MENA Healthcare team

They are excellent – responsive, knowledgeable and business savvy. They were able to give us insights into not just the law but also the way business is conducted in the region. Chambers Global Corporate, Middle East-wide

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Personnel aspects of Medical Malpractice in the UAE

According to the Dubai Health Authority (DHA), the body that regulates and licenses the private and public sectors of the medical services industry in the Emirate of Dubai, Dubai’s medical tourism market was worth AED 1.4 billion in 2016, marking a 9.5% increase over previous years.

The DHA is expecting a 12% rise of medical tourists this year. The DHA’s statistics, however, also show an increase in the number of complaints alleging medical malpractice, ranging from minor grievances to gross medical failures. It is therefore important that institutions are properly prepared for such incidents. This article explores some practical ways of managing the personnel issues surrounding complaints.

Defining medical malpractice and the requirement for medical liability insurance Federal Law No. 4 of 2016 concerning Medical Liability (the Medical Liability Law) came into effect on 15 August 2016 and includes the following as the definition of medical error:

• ignorance of technical issues that every practitioner of the same profession of the same degree and specialisation should be familiar with;

• failure to follow the recognised professional and medical standards;

• failure to act with necessary due diligence; and

• negligence and failure to act carefully and with precaution.

The DHA indicated that common complaints they have received concerned misdiagnosis of patients; performing wrong surgery and procedure; mismanagement resulting in complications; unsatisfactory service or result; and negligence by healthcare professionals.

Under the Medical Liability Law, medical liability insurance is mandatory for all practitioners. Institutions are responsible for the payment of all premiums to cover its employed practitioners. Institutions are also required to provide insurance for civil liability for any visiting doctors as well as insuring them against the risks resulting from the practice of the profession which could include criminal liability.

What should institutions do to mitigate the risk of medical malpractice / negligence?Whilst this list is by no means exhaustive, set out below are some ways in which institutions can mitigate the risk of medical malpractice to the extent possible:

• Complaints procedure – it is recommended that institutions appoint and train a few members of the management to deal with complaints and have in place a procedure to follow in order to investigate complaints that are filed.

• Guidelines and protocols of medical management and policies– consideration must be given to how this will be communicated to medical practitioners and staff, whether this is in the correct language and format given the nationality and literacy levels of the practitioners and staff and who will manage and update the guidelines and policies as and when required. Junior staff and nursing staff should constantly be made aware of common malpractice incidents.

• Training – senior, junior and nursing staff should be regularly trained on medical malpractice issues. Such training should be tailored to the relevant employee’s role and responsibilities and should be repeated for every new staff intake. Staff will need to be made aware of the Medical Liability Law and its implications as part of staff training programs. The trainings should be clearly documented so that, in the event of a dispute, the employer can evidence that such training took place.

• Effective communication and documentation – the DHA has indicated that more than 60% of medical errors can generally be attributed to: (i) ineffective communication between healthcare professionals, (ii) ineffective communication between healthcare professionals and patients, and (iii) ineffective documentation.

• Emergency response procedure – prompt action is key in the event of malpractice, particularly with incidents that have resulted in a severe consequence or fatality due to the staff’s malpractice. It is important that senior staff are clear on the emergency response procedure to be followed (for example, who should the incident be reported to? Who should liaise with the authorities?) in the event such an incident occurs.

• Regular review and audit of records is vital. Positive and negative findings should be documented and notes should be adequate as these can be used as evidence in the event of a dispute.

• Data protection is increasingly important and adequate measures must be put in place to maintain records as well as document patient consent. Protection from cyber crime is also paramount in light of increasingly targeted attacks.

What are the legal issues to consider prior to termination of employment? Under Federal Law No.8 of 1980, amended (the UAE Labour Law), termination of employment must be for a valid reason or it would be considered as arbitrary dismissal. The UAE Labour Law sets out a minimum disciplinary process which, if followed, will limit the risk of a potential successful arbitrary dismissal claim against the institution. It is therefore prudent for institutions to adhere to the following procedure, as a minimum, prior to dismissing any medical practitioner or staff associated with the malpractice incident or breach of procedure and protocol.

1.) Investigation

As previously indicated, it is recommended that institutions have in place an internal policy or procedure to follow in order to investigate complaints that are filed. If possible, witnesses should be interviewed and witness statements should be signed. The investigation process should be well documented and the outcome of the investigation should be clearly noted, including whether the management has decided if the error committed warrants a disciplinary action against the practitioner / staff involved. Employers have 30 days from the date of discovering the potential breach to start an investigation. Care will need to be exercised in terms of who is aware of the investigation and who is involved. The UAE has strong defamation laws and the subject of the investigation is entitled to protection in so far as the regulatory process permits.

2.) Disciplinary process

Broadly speaking, an adequate disciplinary process involves:

• Notifying the relevant medical practitioner / staff involved (in writing) of the allegations against them within 30 days of discovering the offence.

• Inviting the medical practitioner / staff to a disciplinary hearing where the employee is given an opportunity to respond to the allegations. Minutes should be taken of the hearing.

• Investigating any explanations provided by the medical practitioner / staff.

• In response to the hearing and investigation process, issuing a decision in writing, including the reasons for the decision. Any sanction should be fair and reasonable.

• Complying with any additional requirements contained in any internal disciplinary procedure (if applicable).

• Care should be taken to mark all documentation produced in the process as ‘Private and Confidential’ with the company stamp and the appropriate signatures. However, anonymity cannot be guaranteed for any witnesses as regulatory reporting obligations may apply.

As the UAE government continues to be proactive in expanding the healthcare sector, medical tourism will continue to boom. Dubai anticipates targeting more than 500,000 medical tourists by 2020, thereby generating around USD 710 million per annum. The UAE, generally, is aiming to place itself among the top 5 destination for medical care by 2020. In order to reach this target it will be crucial for the UAE to maintain a standard regulatory framework and practice in order to avoid accumulating further cases of medical malpractice.

Sara KhojaPartnerT: +971 4 384 4689 E: Sara.Khoja@clydeco.ae

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Across the region there is an increased focus on ensuring citizens and residents have access to quality healthcare. According to healthcare projections the value of the region’s healthcare market will reach between US$90 billion and US$130 billion by 2020 1. In the GCC, it is expected to reach US$69 billion by 2020, representing almost 48% of the MENA region 2. Certainty around who will pay for healthcare services is a key factor for those investing in the sector.

A priority for governments is ensuring that economically viable healthcare funding models are in place for public and private sectors. We take a look at the Sultanate of Oman, the latest country to announce healthcare financing reform with the introduction of compulsory health insurance and other developments in the GCC countries.

Until recently government funded public healthcare systems have been the dominant form of institutionalised healthcare financing in the region. Governments in the GCC bear the majority of healthcare costs, around 65% to 80% of the total healthcare expenditure. Private sector healthcare has traditionally been funded through voluntary health insurance schemes or ‘out of pocket’ expenses. The old financing models are evolving as governments take steps to institute healthcare financing reform.

The adoption of compulsory health insurance schemes is a common theme in the region. The regimes generally operate on a ‘pay per service’ model with mandated basic benefits (schedule of benefits); private sector employers are mandated to fund the basic benefits for their employees with the state funding schemes for their citizens. Private sector employers may face fines and hiring freezes if they fail to comply.

OmanDr Ahmed Mohammed Obaid Al Saidi, Oman’s Minister of Health (the Minister) announced at a recent health insurance conference hosted in Oman in September that compulsory health insurance has been approved for Oman and that the first phase will commence on 1 January 2018.

According to the Minister the aim of implementing compulsory health insurance is not to cut costs, rather it is part of the government’s wider commitment to ensuring an efficient and effective quality healthcare system. Spending on healthcare in Oman increased to 6% of the government spend in 2016. Between 2007 and 2016, government spending on healthcare has reached an annual average growth of 14%, with the average investment spend in the healthcare sector at around 25%3.

The Oman Chamber of Commerce and Industry have announced that mandatory health insurance will be introduced in Oman for all private sector employees. However, it is anticipated that the mandatory health insurance scheme may extend in some form to Omani nationals at a certain stage.

The scheme is currently in its final stages and it is anticipated that it will be rolled out to the private sector in phases based on employer size. The first phase is expected to involve companies with over one hundred employees, with the second phase extending mandatory health insurance requirements to companies with between fifty to one hundred employees.

Although eagerly awaited, no form of legislation has been issued to date. With only a couple of months until the end of 2017, it remains to be seen how implementation will be rolled out from 1 January 2018.

Health insurance has been a growing line of business in Oman, accounting for 26% of the market GWP in 2016, with a CAGR of around 34% over the past five years4. Currently only 9% of both the expatriate and the local workforce in Oman are insured . The introduction of compulsory health insurance will significantly increase growth in the insurance sector and it should have positive knock on effects for the healthcare sector generally.

Saudi Arabia The Kingdom of Saudi Arabia introduced a mandatory health insurance regime in 2004, which requires private sector employers to provide basic health insurance benefits for their employees and dependants (citizens and expats). At present the Saudi national population (>31 million) (outside of those employed in the private sector) are still being served by the public sector system which is ripe for financing reform.

Unified Policy Regulations were issued in 2016 by the health insurance regulator (CCHI) to implement a one policy per employer rule. The regulations were aimed at closing loopholes to ensure that all employees in the private sector are provided with genuine basic health insurance benefits.

On 5 October 2017, CCHI issued a Circular to clarify the scope of benefits available under the Unified Policy. The Circular was issued following numerous complaints filed by beneficiaries with CCHI regarding restrictions being imposed on coverage under the Unified Policy which do not comply with the regulations. The Circular clarified the scope of cover for eleven benefits under the Unified Policy.

The Circular required licensed insurance companies to take affirmative action to confirm compliance with the CCHI within a ten day period (i.e. by 19 October). CCHI have made it clear that they will be actively monitoring the market for compliance and that they will take action where breaches are identified.

Saudisation targets are continually being increased in the market. SAMA (the Saudi Arabian Monetary Authority) issued a resolution on 8 October 2017, targeting the insurance industry and requiring that all jobs related to the sale of insurance products to individuals must be held by Saudi nationals from 1 February 2018. Employers in the industry will continue to face recruiting challenges as they adapt to the changes in regulation.

United Arab EmiratesThe UAE is a federation of seven emirates. Compulsory health insurance has been imposed by standalone health authorities only in Abu Dhabi and Dubai. There are currently no compulsory health insurance regimes in place in the northern emirates.

Abu DhabiThe Emirate of Abu Dhabi rolled out a compulsory health insurance model in 2006, which includes private schemes for low income and white collar employees and, Thiqa, an exclusive scheme for Emiratis in Abu Dhabi. Although private insurers are permitted to participate the dominant player is the government owned National Health Insurance Company (Daman). The Abu Dhabi scheme is one of the most mature regimes within the GCC countries.

Last year the Health Authority of Abu Dhabi (HAAD) announced the imposition of a ‘co-pay’ for Emiratis in Abu Dhabi when utilising private sector healthcare services. The aim was to curb over-use of private sector providers. The consequences for the private and public sector healthcare providers were more complex and far reaching than anticipated. The issue was reversed within a short period with the announcement of a waiver of the co-pay arrangement.

Spotlight on Healthcare Financing

1. Source: Middle East Insurance Review, October 2017.2. Ibid.3. Source: Asia Insurance Review, Oman: Mandatory national medical cover scheme to start in Jan 2018, 27 Sep 2017.4. Ibid.

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The move to reform the system highlighted the continuing challenge that all regulators face in managing the financing of healthcare in an economically sustainable manner. These issues are not going away, insurers have reported in 2016, around US$1 billion lost due to fraud and misuse; including issues such as identity fraud and a culture of over prescription by doctors with financial incentives do so.

HAAD has begun implementing further reforms in order to reduce medical spending and reduce insurance costs. Effective 1 September 2017, patients seeking second or subsequent outpatient appointments for the same specialty within twenty one days, without a doctor’s referral, will only be covered if they obtain pre-approval from the insurer. The new rules are intended to curb the common practice of visiting one consultant after another for the same symptom, with no referral from a GP, a time consuming and expensive exercise.

HAAD have also announced developments for healthcare providers. The Jawda Quality program (HAAD quality metrics) is being integrated with pricing (‘Pay-for-Quality’). Healthcare providers with low rankings may face reductions in approved pricing for services. This is part of Abu Dhabi’s vision to be recognised as a world leader in healthcare quality improvement. The system should reward good-quality providers and incentivise lower-quality healthcare providers to recognise and improve poor performance. HAAD have committed to offering specific quality improvement mentoring to assist healthcare providers.

DubaiThe Emirate of Dubai introduced a similar regime to Abu Dhabi in 2014; the final phase was implemented on 31 March 2017. The Dubai Health Authority (DHA) has started to take action for violations of the law. Earlier this year the DHA announced that it had fined twenty five market participants including health centres, clinics, insurance brokers and insurers for violating the health insurance law and that it has referred six clinics for prosecution for alleged fraudulent activities. This recent action has sent a strong message to the market regarding the consequences of breaching regulation.

The DHA and the General Directorate of Residency and Foreigners Affairs (GDRFA) (the part of the UAE’s Ministry of Interior tasked with regulating the entry/exit of foreigners to the UAE through the Emirate of Dubai) are now connected. The DHA has issued a number of General Circulars related to the uploading of information to the members’ register to ensure that insurers and TPAs are aware of their responsibilities and common issues. Insured members must be able to purchase a policy and immediately go to GDRFA to renew their visa without issue. If an insurer or TPA causes a policyholder to incur fines and delays in visa issuance/renewal, the DHSA will launch a full investigation. Fines of AED 10,000 may be applicable per policy, as per Executive Council Resolution No. 7 of 2016. In addition, if the insurer/TPA is at fault, the DHA will hold the insurer/TPA responsible for any fines levied on members.

QatarQatar’s social health insurance scheme was introduced in 2013. It mandated a single national insurer to provide basic benefits to all Qatari nationals and expatriates. The Qatari scheme was based on a single national insurer being the sole provider of basic benefits for all Qataris and expatriates. The potential opportunities for private insurers were significantly reduced. The scheme was rolled out to Qatari nationals and later withdrawn in 2015 following mounting pressure from the private insurance sector.

Qatar Cabinet Decision No. 27/2016 was issued on 11 October 2016 to provide the foundation for the implementation of a new compulsory health insurance regime. The expectation is that the new regime will be similar to the regimes in Abu Dhabi and Dubai.

Bahrain and KuwaitBahrainIn Bahrain, the Supreme Council of Health has indicated that healthcare financing reform will be implemented in 2019.

KuwaitAll expatriates in Kuwait have to pay a basic mandatory tariff to the government in order to obtain residency status. Under the existing system, Kuwaiti citizens and residents have access to the Kuwait’s public healthcare system.

In December 2016, the Minister of Health for Kuwait approved a new scheme for expatriates to be introduced in phases commencing in early 2017. The new scheme anticipated the introduction of compulsory health insurance for expatriates, which would be provided by the national insurer; the Kuwait Health Assurance Company (KHAC); along with the exclusion of expatriates from the public sector system (in an effort to reduce the overcrowding in the public sector). As a part of Kuwait’s National Healthcare Expansion Plan three 700-bed hospitals will be built to provide integrated medical services to foreigners in Kuwait.

However, the proposed arrangements with KHAC were cancelled in January 2017. This has left uncertainty in the market, it is expected that an employer funded health insurance scheme will be mandated to cover expatriate healthcare costs; however the form of the scheme is not yet clear.

Future TrendsThe reform of the healthcare financing systems in the region is vital to the development of equitable and sustainable healthcare systems. We expect in the next few years to see a continued trend towards the introduction of compulsory health insurance regimes. Other solutions will inevitably emerge as governments engage with the challenges inherent in healthcare financing. For the moment we await with interest the unveiling of the compulsory health insurance regime for Oman.

I like their approach–they are very pragmatic and go right to the answer. They are consistent in terms of quality and efficiency.Chambers Global Corporate and Commerical

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Medical malpractice laws & processes in the Kingdom of Saudi ArabiaAs the Kingdom of Saudi Arabia (KSA) sees a change of culture quickly taking place, the medical malpractice landscape continues to develop with claim frequency and severity gathering apace. In this article, we look at the current medical malpractice regime in the KSA and the sorts of medical malpractice claims and trends that are emerging.

The 2005 Law & Executive RegulationsThe key relevant legislation in the KSA relating to medical malpractice is Law No 276 of 1426, the law of Practising Healthcare Professions that was issued on 6 December 2005 (the 2005 Medical Malpractice law) and the executive regulations 39644/1/12 passed in 2006 (the Executive Regulations).

This provides that medical malpractice liability insurance is compulsory for medical professionals. The obligation to take out insurance is on the professional. This is a different approach to other GCC countries, where the obligation is on the employer (i.e. hospital / clinic).

However, the 2005 law also provides that where there is no or insufficient insurance cover for the claim, the employer is liable to pay compensation and can seek a right of recovery against the employee.

There is also specific provision under the law relating to the liability of doctors who are employed by visiting doctors i.e. one healthcare provider but who work at multiple clinics/ hospitals.

Key provisions of the 2005 Medical Malpractice LawThe 2005 Medical Malpractice Law sets the standards to be observed by any person licensed to practise within the healthcare profession in the KSA. This law applies not only to liability for medical errors, but also to licensing requirements, duties and professional responsibility.

Article 26 provides that a healthcare practitioner “shall exert due care in conformity with commonly recognised professional standards”.

Article 27 gives examples of failures which will constitute malpractice. These include “error in medical treatment” and “lack of knowledge in technical matters”.

The 2005 Medical Malpractice Law also provides for fines and punishments in respect of criminal liability which can be imposed in certain cases of medical malpractice. A healthcare professional can be subject to imprisonment (not exceeding six months) and/or a fine not exceeding SAR100,000 for breaches of the law including:

• Practising healthcare without a license;

• Providing false information or using unlawful means resulting in obtaining a license to practise healthcare; and

• Unjustifiably declining to treat a patient.

The processes for bringing a claim or complaintThe 2005 Medical Malpractice Law sets out the process available to injured parties, should they wish to make a complaint or a claim alleging medical malpractice.

In advance of bringing formal proceedings, a patient can ask that an investigation is conducted by directing a complaint to either (i) the medical facility where the malpractice occurred and/or (ii) the Ministry of Health (the MOH).

In practice, whilst Claimants may submit a complaint to a hospital, they will often submit a complaint directly to the MOH, the administrative and regulatory body responsible for the regulation of healthcare in KSA.

Following receipt of a complaint, the MOH usually assigns an internal committee to investigate the complaint. That committee should include a specialist in the same specialisation of the defendant doctor, from a government hospital in Riyadh. The committee’s role will include reviewing the relevant medical file, meeting with and examining the patient, requesting patient’s files and records, as well as interviewing the doctors and other members of the medical team involved in providing the treatment.

Following the committee’s investigations, a report will then be issued by the committee. The committee will either recommend that the MOH:

• Refers the case to the Sharia Medical Panel; or

• Refers the case to the medical violation committee; or

• Discontinue the case as no malpractice has occurred.

The committee will submit its report to the MOH who will decide whether to act in accordance with the committee’s recommendations. Experience shows that the committee’s recommendations are usually followed.

Both parties are usually informed of the committee’s decision and will have the right to appeal this within 60 days of receiving the decision. In accordance with Article 40/13 of the Executive Regulations, an appeal can be progressed by either the complainant or the defendant before the Board of Grievances or the MOH.

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If an appeal is progressed via the MOH route, and the conclusion of a medical error is upheld at any appeal, the matter will be referred by the MOH to the Sharia Medical Panel for further review.

The Sharia Medical PanelShould Claimants opt to proceed directly by civil litigation, or where the MOH refers the matter pursuant to the 2005 Medical Malpractice Law, the case will proceed before the Sharia Medical Panel, a specialist panel established to consider claims in respect of medical malpractice.

The Sharia Medical Panel has the following jurisdiction:

• Consider claims of medical malpractice in cases brought before it regarding private rights (Diyah, indemnity or compensation); and

• Consider cases of medical malpractice leading to death, damage of an organ or loss of total or partial use thereof, even in the absence of a claim for a private right.

The Sharia Medical Panel is a judge led process and is made up of legal and medical experts who assist the judge.

Decisions from the Sharia Medical Panel may be appealed before the Administrative Courts (Board of Grievances) within thirty days from the date of notification thereof. An appeal can involve a total re-hearing of the matter and new evidence may be adduced.

Police complaints can also be progressed, especially where the claim is for blood money. In those circumstances the matter will be referred to the Sharia Medical Panel for determination but expat doctors should be aware that travel bans can be issued against them.

It is also important to note that whilst an investigation is ongoing, expat doctors who are the subject of any investigation may be banned from leaving the country.

Claim examples and trendsWith regard to the levels of claim values, claims are often inflated, but will typically lack evidence in substantiation. This often makes it difficult to anticipate the damages that may potentially be awarded to a claimant.

Unfortunately, as judgments of the courts are not always published it is difficult to gauge accurately the nature of awards and trends in this regard. Historically, the KSA courts (like most courts in this region) are still far more conservative in awarding damages than may be the case in other jurisdictions. However, claim values are increasing.

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In our experience, historically, the tendency with damages awards was that the courts did not award significant awards over and above the statutory blood money payments (Diyah and Arsh) although the position is slowly changing. Diyah is the remedy prescribed for wrongful death; Arsh is prescribed for loss of an organ or bodily injury. Diyah payment is presently capped by statute at SAR300,000.

We set out below a few examples of awards and fines which have been made publicly available:

• Two doctors were found guilty for causing death of a child and fined SAR112,000;

• Two doctors found guilty for death of a baby and fined SAR330,000;

• A doctor was found guilty for causing total disability to a child and an award of SAR1.6 million was made.

• A doctor was found guilty for causing death to a patient and ordered to pay SAR 310,000 being the Diyah as well as SAR 10,000 for the committed violation.

Conclusion The 2005 Medical Malpractice Law implemented in the KSA was in many respects ahead of its time in the region when it was issued.

Unlike most other legislation at that time in the GCC region, the law and regulations contained specific provisions relating to issues such as where liability rested in the case of visiting doctors, and also created a specialist tribunal to handle medical malpractice litigation. Twelve years on, the Sharia Medical panel is an established and active body that combines legal and medical input in arriving at its determinations.

Whilst claims in KSA have historically been low both in volume and quantum in the region, the KSA is going through a period of change, with greater awareness by the population of the remedies available, and the regulatory mechanisms in place to prosecute claims.

Practitioners and healthcare providers will need to keep abreast of developments and carefully review their insurance and risk management protections, to ensure compliance with the laws and regulations, and to ensure they have adequate cover in place in the developing claims environment.

Medical Malpractice Breakfast briefing 13 September

Clyde & Co held a breakfast briefing in Dubai on topical issues facing the healthcare sector in the GCC region, with a specific focus on the UAE.

The sessions covered a variety of risks faced by healthcare providers, including malpractice claims, employee performance issues and cyber risks. Our expert speakers provided an analysis of how to manage such risks and any adverse events that may occur. The event was a great success and we achieved some really useful insight in to real life situations and challenges our clients manage on a day to day basis.

We believe that being in touch with our clients needs and having regular communication allows us to offer the best practical advice across all healthcare matters.

Shabnam KarimSenior AssociateT: +971 4 384 4373 E: Shabnam.Karim@clydeco.com

Prospect of full foreign ownership in the healthcare sector in the Kingdom of Saudi ArabiaIt has recently been announced that the Saudi Arabian General Investment Authority (SAGIA) has declared that foreign investors may be able to have full ownership of companies within the healthcare sector in the near future.

This is a preliminary announcement but is the latest in a series of measures aimed at attracting foreign investors into the Kingdom of Saudi Arabia’s key market sectors.

Although the date for implementation of the foreign ownership initiative has not yet been confirmed, such initiatives are aligned with the Kingdom’s ‘Vision 2030’ strategy, through which the Kingdom plans to decrease its dependency on the oil industry. Other sectors which are already open to 100% foreign ownership in the Kingdom are wholesale and retail as of 2015 and, as of August 2017, engineering service companies. Should this proposal come to fruition, it will result in the Kingdom becoming one of a few countries in the region that permits 100% foreign ownership within the healthcare sector.

Market analysts in the region consider that the initiative will significantly improve the healthcare sector within the Kingdom. They believe the easing of ownership restrictions within the healthcare sector, along with the privatisation of governmental institutions, may lead to increased competition within the sector. It is understood that the Kingdom’s government hopes that the privatisation programme will raise more than $200 billion for the country. The implementation of the full foreign ownership framework will require legal and regulatory reforms, but it presents an attractive opportunity for both healthcare providers and investors alike.

Saudi Arabia SymposiumOn Thursday 19 October we held our first Saudi Arabia Symposium

Saudi Arabia’s Vision 2030 and the National Transformation Plan 2020 present significant opportunities for the private sector. However, the key to success in the Kingdom is understanding the current legal climate, the rapidly changing regulatory environment, and the practicalities of operating there.

Vision 2030 seeks to reshape Saudi Arabia and boost what is the Arab world’s largest economy. This video provides key insights from market experts on how to capitalise on the growth opportunities provided by the privatisation programmes, highlighting the trends and challenges to look out for, along with the solutions on how to best operate in Saudi Arabia.

Naji HawayekPartnerT: +971 4 384 4619 E: Naji.Hawayek@clydeco.ae

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Our team

Abhi JalanPartner, DubaiT: +971 4 384 4537 E: abhi.jalan@clydeco.com

Lee Keane Partner, QatarT: + 974 4 4967 315 E: lee.keane@clydeco.com

Alain SfeirPartner, RiyadhT: +966 11 253 2112 E: alain.sfeir@clydeco.com

James Marriner Associate, DubaiT: +971 4 384 4142 E: james.marriner@clydeco.com

Naji Hawayek Partner, DubaiT: +971 4 384 4619 E: naji.hawayek@clydeco.com

Abdulaziz AlBosailyPartner, KSAT: +966 11 253 2110 E: abdulaziz.albosaily@clydeco.com

Munisha Khatwani Senior Associate, DubaiT: +971 4 384 4844 E: munisha.khatwani@clydeco.com

Rajiv Nawbatt Senior Associate, DubaiT: + 974 4 4967 315 E: lee.keane@clydeco.com

Corporate

Michael DuckerSenior Associate, DubaiT: +971 4 384 4277 E: michael.ducker @clydeco.com

Alexandra Lester Senior Associate, DubaiT: +971 4 384 4356 E: alexandra.lester@clydeco.com

Dispute Resolution

Louise McDonaldParalegal, DubaiT: +971 4 384 4637 E: louise.mcdonald@clydeco.ae

Shabnam KarimSenior Associate, DubaiT: +971 4 384 4373 E: shabnam.karim@clydeco.com

Dispute Resolution - Medical Malpractice

Mark BlanksbyPartner, DubaiT: +971 4 384 4553 E: mark.blanksby@clydeco.com

Heather NevinPartner, Abu DhabiT: +971 2 494 3521 E: heather.nevin@clydeco.com

Ben CowlingPartner, RiyadhT: +966 11 253 2111 E: ben.cowling@clydeco.com

Geoffrey WhiteAssociate, DubaiT: +971 4 384 4385 E: geoffrey.white@clydeco.com

Projects and Construction

Joycia YoungPartner, DubaiT: +971 4 384 4589 E: joycia.young@clydeco.com

Saba Al SultaniSenior Associate, DubaiT: +971 4 384 4564 E: saba.alsultani@clydeco.com

Rob DeansPartner, DubaiT: +971 4 384 4538 E: rob.deans@clydeco.com

Commercial/IP

Sara KhojaPartner, Abu Dhabi/Dubai/RiyadhT: +971 4 384 4689 E: sara.khoja@clydeco.com

Yasser ShabbirAssociate, DohaT: +974 4496 7434 E: yasser.shabbir@clydeco.com

Rachael SmithAssociate, DubaiT: +971 4 384 4141 E: rachael.smith@clydeco.com

Employment

Wayne JonesPartner, DubaiT: +971 4 384 4106 E: wayne.jones@clydeco.com

Allison BeirneLegal Director, DubaiT: +971 4 384 4107 E: allison.beirne@clydeco.com

Insurance/Regulatory

www.clydeco.comClyde & Co LLP

Clyde & Co* accepts no liability for loss occasioned to any person acting or refraining from acting as a result of material contained in this document. The content of this document does not constitute legal advice and should not be relied upon as such. Advice should be taken about your specific circumstances. No part of this summary may be used, reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, reading or otherwise without the prior permission of Clyde & Co.

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