JEDDAH – Clinical governance, the systematic approach to maintain and improve quality of patient care within a health system, plays an increasingly significant role with medical costs steadily on the rise. A large part of this increase is due to market dynamics such as implementation of the new mandatory health insurance coupled with an expanding population requiring medical care. Both the public and private sectors, especially in the field of health insurance, have taken a pro-active approach to meet the surging demand. The government allocated SR87 billion of the SR702 billion in the 2012 national budget to health and social affairs, which amounts to an increase of 26 percent over the fiscal year 2011. Most of the allocated budget will be invested in projects such as new primary care centers and hospitals which will have a positive impact on the Kingdom's citizens as they will have better access to more medical facilities and services. The budget represents an additional boost for the Saudi economy, which will be reflected in benefits for the insurance sector. As an indicator, Saudi insurance companies dominated the IPO market in the first half of 2008. However, the sheer presence of health insurance companies will have no impact if the insurance companies are not led by clear guidelines guaranteeing the service quality that patients in the kingdom require. When interviewed about the importance and necessity of clinical governance as a quality insurance tool to protect the rights of patients, Dr. Hani Jokhdar, Medical Director at Bupa Arabia, a university staff at Umm Al Qura School of Medicine, and a Certified Hospital Accreditation Surveyor at the Central Board Accreditation for Healthcare Institution, said: “The driving force of Bupa Arabia's operations is the wellbeing of our members. As the highest medical authority I am responsible for clinical governance and building a governance framework to insure that our members receive the required service for their treatment. “Accordingly, we have built in various check points within our system. For example, when medical providers approach us for an approval, a team consisting of 150 doctors from the entire spectrum of clinical specialties assesses each case to guarantee that our members receive the appropriate treatment for their condition. The medical expertise and experience that we employ as the Kingdom's first dedicated medical insurance provider is crucial to the decision making process. “Furthermore, Bupa Arabia has a dedicated unit of medical professionals that ensures the health and wellbeing of its members at hospitals. The Roving Doctors visit the medical providers and check on the quality of service ranging from assuring admittance, right treatment, and ensuring that the treatment plan is implemented to timeliness. “At the core of Bupa Arabia's corporate governance stands customer satisfaction. In order to achieve this, we have developed a quality check methodology and quality assurance in order to continue implementing the practice. Our primary role is to ensure clinical safety and effectiveness. Therefore we set a strong focus on the professional development and management of our health professionals to ensure that all the decisions are in accordance with relevant legislation, regulations, specifications, underwriting codes of practice, policy and national standards." Dr. Jokhdar concluded the interview by saying: “Bupa Arabia is ready to take the lead for the road ahead. I consider true leadership to be when you have the tools to penetrate society with your capabilities. Bupa Arabia has these tools along with its medical expertise and experience to utilize them. The key is to look at how to make our members healthier. This happens by directing and providing them with the best services, the finest medical expertise, being there for them when they needs us, and educating them about their health. “People have come to see the benefits of Bupa Arabia as a healthcare partner committed to help its members live a healthier and happier life. Looking to the future, we will continue to intensify our relationship with health care providers, taking a bilateral approach for the benefit of the patient."
