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The health care system in Saudi Arabia can be classified as a national health care system in which the government provides health care services through a number of government agencies. In the meantime, there is a growing role and increased participation from the private sector in the provision of health care services.
The Ministry of Health (MOH) is the major government agency entrusted with the provision of preventive, curative and rehabilitative health care for the Kingdom’s population. The Ministry provides primary health care (PHC) services through a network of health care centers (comprising 1,925 centers) throughout the kingdom. It also adopts the referral system which provides curative care for all members of society from the level of general practitioners at health centers to advanced technology specialist curative services through a broad base of general and specialist hospitals (220 hospitals). The MOH is considered the lead Government agency responsible for the management, planning, financing and regulating of the health care sector. The MOH also undertakes the overall supervision and follow-up of health care related activities carried out by the private sector. Therefore, the MOH can be viewed as a national health service (NHS) for the entire population.
There are also three other mini-NHS which finance and deliver primary, secondary and tertiary care to specific enrolled security and armed forces populations: the Ministry of Defense and Aviation (MODA), the Ministry of Interior (MOI) and the Saudi Arabian National Guard (SANG). In addition to these agencies, there are several autonomous government agencies which are responsible for the delivery and financing of health care services in the KSA. The Ministry of Education provides immediate primary health care to students. The Ministry of Labor and Social Affairs operates institutions for the mentally retarded and custodial homes for orphans. These facilities provide their guests a certain amount of medical care. The General Organization for Social Insurance and General Presidency of Youth Welfare provide health services for certain categories of the population in connection with its management of sport facilities. The Royal Commission for Jubail and Yanbu provides health facilities for employees and residents at the two industrial cities (Jubail and Yanbu). The Saudi Arabian Airlines operates its own health care facilities with the aim of providing health care services to its employees. The Kingdom’s universities provide, through their medical colleges or hospitals, specialist curative services and medical education and training programs, while they also conduct health research in collaboration with other research centers.
The Government also finances and provides care on a referral basis in its major specialized national tertiary care referral hospitals King Faisal Specialist Hospital and Research Center and King Khalid Eye Specialist Hospital. The King Faisal Specialist Hospital and Research Center uses highly advanced technologies and act as a reference hospital for cases that require advanced and specialist treatment, while it also conducts research on health issues in general and those related to the Kingdom in particular. The King Khalid Eye Specialist Hospital is designed to be a large health facility offering high quality specialized services for ophthalmology and eye surgery and medicine as well as being a regional research center in the area of ophthalmology. The hospital also has a cornea bank in which imported corneas are stored.
Budget allocated to the health sector by the Ministry of Health was in:
The Saudi Red Crescent Society undertakes an important and effective role in providing emergency services at the pre-hospital stage, either at the scene of accidents or during the transportation of patients to hospitals. The society also undertakes a unique task by providing such services for pilgrims during Hajj and Umrah at the Holy Places of Mecca and Medina.
Moreover, the private sector provides health services through its health facilities including hospitals, dispensaries, laboratories, pharmacies and physiotherapy centers throughout the kingdom. The following are the major indicators provided by the private sector by the end of the year 2000:
Saudis and public sector expats are eligible for a comprehensive package of benefits including, public health, preventive, diagnostic, and curative services and pharmaceuticals with few exclusions and no cost sharing. Most services including state of the art cardio-vascular procedures, organ transplants, and cancer treatments (including bone marrow transplants) are covered. Sponsors/employers are responsible for paying for an extensive package of services for private sector expatriates.
The health sector during the past two decades, like all other sectors shared a great deal of support and attention to improve their level worker's performance in its facilities on the basis of quality assurance. In 1983, before the application of primary health care, health services were in the form of "e-medical" services in hospitals and clinics. Prevention programs also involved through limited health care centers offices and Maternal and Child Health (MCH) centers.
The beginning of emphasis on prevention and environmental health was in 1925 by establishing a public health department. It was made by a royal decree from King Abdul Aziz Al-Saud. By 1926 the first school of nursing was opened and followed by the school of heath and emergencies in 1927.
The health services expanded in 1951 by establishing the ministry of health. A ministerial ordinance in 1980, led to the establishment of the administration integrating the existing dispensaries, health centers, health offices and maternal and child health (MCH) centers into one unit. By the end of the 1980s there were 253 hospitals, 38,955 hospital beds and 1,640 primary health centers. The proportion of these positions filled by Saudi nationals is very low. Saudi nationals represent 13% doctors (22,633 doctors), 11.2% nurses (45,840 nurses) and 38% health technicians (25,192 health technicians). In 1993, the total number of hospitals was 281, 41,789 hospital beds and 1,707 primary health centers and the positions filled by Saudi nationals increased to 22.7% doctors, 24.5% nursing staff and 41.8% health technicians.
In the end of the 2000, the major indicators provided by the private sector were:
In 2002, The Saudi health system was established by a Royal decree to insure the provision of comprehensive and integrate health care to all population in Saudi Arabia in a fair minded, organized and affordable manner. In 2004, there were 1848 primary health care centers and the total number of hospitals was 200. The Ministry of Health (MOH) budget increased from 2.8% of the total National budget in 1970 to 6.4% in 2004. In 2006, there were 20.4 doctors and 35.4 nurses per 10.000 population. In 2008, health care centers were 1925 centers throughout the kingdom and 220 hospitals which adopted the referral system which provided curative care for all members of society from the level of general practitioners at health care centers to antecedent technology specialist curative services through a broad base of general and specialist hospitals.
Currently, health services in Riyadh have passed several stages until it reached to the image that we find it today which included the development of the manpower, hospitals, primary health care centers, emergency services, ambulance, and also included the development of the private sector (profit and non-profit).
In 2005, health insurance was made compulsory for all non-Saudi nationals working in the country under the Cooperative Health Insurance Act. In 2008, this act was extended to include Saudi nationals working for the private sector. Enforcements of this compulsory coverage include fines for non-compliant companies and a refusal to renew working permits without insurance. There is also the Arabian Shield Cooperative Insurance Company.