THE Kingdom's seventh minister of health in as many years, Tawfiq Al-Rabiah is set to encounter an unusual test shortly when he faces existing challenges to the future of healthcare in the country. Visibility in this sector is still foggy and no clear vision for its future is on the horizon. Perhaps his background as former minister of commerce is another test for the healthcare profession's ethics. This profession turns into a ferocious monster when profit becomes its main goal and health institutions are run on the basis of profit and loss. The privatization of the health sector is one of the most important challenges for the new minister. Announcing the project might be easy, but implementing it may turn out to be almost impossible because of the very high cost of healthcare. In their current financial state, citizens by and large will be unable to bear the cost of the "commercial" health insurance. Therefore, there should be a study before converting hospitals into companies, enabling the private sector to own government hospitals. The study should come before announcing the privatization project because unlike cosmetic procedures, the high prices for essential services like treatment for diabetes, high blood pressure and heart diseases in private-run hospitals could be catastrophic for the majority of patients. One of the anomalies in private health sector is that the businessman is always waiting to make a profit from society's health crises. This is at a time when the private sector is supposed to be close to becoming a nonprofit institution. What was never expected has taken place. Chaos has spread in the specialist sector after the Health Affairs Administration closed its eyes to government doctors working in the private sector, despite a ban in place. The reason is that doctors want to be compensated for the losses they incurred over the past six years. This has had a negative impact on the standard of medical services. What is strange is that the decision to ban Saudi doctors in government hospitals from working in the private sector is still in force. A greater loss was incurred by those who were brought up since childhood to respect the law. The challenge before the minister of health is to find a solution so as to end corruption of working culture in the medical field. This can be achieved either by nullifying the decision forbidding work in the private sector, opening the way officially before all to work in private sector hospitals, or reviving the medical cadre system in health institutions. Then the Health Affairs can implement the decision banning work in the private sector by doctors in government hospitals. A greater challenge in the medical field is a lack of ongoing scientific research. Researchers have realized they are losing financially if they continue to contribute to this important field. They have also come to the conclusion that publishing distinctive scientific papers in reputable fields leads to poverty and need. Therefore, it is necessary to draw up special packages for those who have chosen to work in vital research areas. Any society that does not contribute to scientific research lags behind and lives on the margins of 21st century civilization. Another chronic challenge is the centralization of administration in the Ministry of Health, as it is supervising thousands of hospitals and health centers. The solution may be to distribute powers among local health administrations in the provinces to supervise hospitals and health centers in their area, and take them to task for any negligence. Among the other challenges is unifying the occupational regulations in different health sectors. There ought to be a unified occupational and legal authority for all sectors. The objective is to put a limit to playing with the rights of employees and health practitioners in some sectors that are run through absolute centralization. The existence of an impartial authority would help put a limit to the arbitrary sacking of employees and administrative authoritarianism in health institutions.
