Long lines and months of waiting: patients question long delays at Qatar’s public healthcare months after decrease in Covid-19 pressure.
When Sara* had her second miscarriage in May 2021, a friend advised her to go to the hospital for help, hoping to figure out if something was wrong with her body.
“I was excited to have my first baby, but then I had my first miscarriage in October 2020, three months after I got married. My husband and I wanted to try again and see if something was wrong,” the now 32-year-old recalls.
She scheduled a visit to Sidra Medicine, a private women’s clinic in Qatar. Her insurance, however, did not cover anything related to reproductive health. Her doctor at Sidra Medicine referred her to Hamad Medical Hospital, a public hospital where she could complete all of the necessary medical exams for free.
Sara presented her referral letter to Hamad Hospital for the first time in July 2022. She said she was told that she would have to wait three months to see a doctor.
“They didn’t even read the letter properly to understand the doctor I needed,” she recalls.
When she finally went to the appointment after three months, Hamad had assigned her to the wrong doctor, who did not understand her condition.
“The doctor looked at me and said ‘we are an infertility clinic here and you are having miscarriages this means you don’t have fertility issues. We can’t help you here,” she said.
Sara, who had suffered her third miscarriage during the three months she waited, was forced to wait an extra month for another doctor, who later cancelled her physical appointment at the scheduled time.
When she finally had her blood test in November 2022, she was told she would have to wait two more months for a genetic test, and then another five months for a follow-up appointment with a doctor to understand the results.
Currently, Sara’s next appointment at Hamad hospital is in May 2023.
“I can’t do these tests somewhere else because it would cost approximately QAR 6000, which I can’t afford,” she told Doha News, adding that her insurance would not reimburse the money since it doesn’t cover issues related to women’s reproductive health.
Sara has had three miscarriages since July 2022, when she first attempted to schedule an appointment with Hamad Hospital. In total, she has had 5 miscarriages over the past two years.
“I just want to know why this keeps happening to me. I would have felt less anxious if I had received medical care earlier. Going through miscarriages is very exhausting mentally, and it is even harder when you can’t seek the medical help you need,” she said, emphasing that this long wait has traumatised her, making it hard to cope with the loss of her pregnancies.
She will not fully know the results of her medical procedures until May 2023, almost a year after her first visit to Hamad.
Sara’s experience is not an isolated occurrence. Qatar’s healthcare system has faced an increasing amount of issues over the past years, but one seems to relentlessly echo concerns from the public: the long appointment wait and questionable oversight for some cases.
On average, the waiting time for an appointment in the main state hospital, Hamad Medical Corporation (HMC), can take up to a year, with specialties like dentistry and cardio most overloaded.
According to Doha News’s recent poll, almost 40 percent of people who took part in the survey said they had to wait for more than 6 months to get an appointment at HMC or PHCC facilities.
Responding to a question on whether they were made to wait for an appointment despite having a medical emergency, 73 % said they could not get time slot to see a doctor at public facility in Qatar, though 27% disagreed.
Oftentimes, patients find themselves waiting to be treated for months, which – in some cases – can lead illnesses to transpire into more serious or sometimes life-threatening diseases due to delayed treatment.
Asmaa*, a teacher at a private school, told Doha News that when she contracted Covid-19, she faced “heavy weight on her chest and difficulty breathing.” In spite of this, HMC told her she would have to wait five months to see a doctor.
But after a day of waiting, her condition worsened, and she had to be rushed to a private hospital’s emergency section with an ambulance.
“I don’t have private insurance and cannot afford to pay. I went to the emergency and they told me I need an appointment if I don’t have a fever. So many complications can happen in six months. How is that okay?” she explained.
“This is not the first time [this happens]. The last time I wanted to book a dental appointment because I was experiencing severe pain, they told me the wait is seven months. They said there was nothing they could do. But that was three years ago, and it seems like things have not gotten any better.”
Another resident echoed Asmaa’s sentiments, adding that a lack of immediate access to urgent care can sometimes result in severe illnesses.
“My mum was suffering from a stone in her adrenal glands. Hamad Hospital kept delaying her appointment till the stone had enlarged and she had to have immediate surgery to remove it. If she waited longer, the stone would have erupted,” she said.
Healthcare workers call for help
Patients are not the only ones frustrated with the healthcare system.
In the past couple of years, the pressures of the pandemic coupled with World Cup stress has taken a tremendous toll on doctors, nurses, and other essential workers on the front line who say they’re risking their lives while living in a constant state of uncertainty.
Doha News spoke to a doctor who works for PHCC who preferred to remain anonymous. He stated that after the pandemic, dozens of his colleagues started leaving.
“We gave so much up to save lives, and we were ‘rewarded’ with cuts and no bonuses. So many left,” he explained.
During the four years Dr. Andrew* worked in Doha, his schedule has remained fully booked for at least three months. It is hard, he said, to prioritise more ‘critical’ cases when others have been waiting for months for their check-up.
“It is out of our hands. We even feel bad even to take vacations because we know it will make people wait for more.”
The medical expert explained that several of his patients have to wait months to get an appointment, with most needing to pay for a visit in the private sector due to a long time.
“It is out of my hands,” he kept saying. “We sometimes work even when we are very sick.”
With few benefits and a a stressful overload of work, Andrew explained that many have left to work in the private sector, however this has in turn led to more pressure on public facilities, according to the doctor.
“Many leave and then the load gets worse. It is nothing new, but it is happening more now.”
Other doctors also seem to share the same concerns.
Lara*, a doctor who has been working at Hamad hospital for five years, told Doha News that some departments are understaffed, and some doctors have to work long shifts which are still not enough to accommodate the large numbers of patients.
“Doctors are doing what they can with the resources we have,” she said, adding that her salary has not been raised since Covid-19 pay cuts.
Public healthcare, but not for all?
However, after years of backlash and complaints from the public, Qatar seems to be leaning toward taking some of the load off the public healthcare sector with new regulations– most of which will switch the wait to private hospitals.
In 2021, authorities introduced a new mandatory health insurance system for all non-Qatari nationals living in or visiting Qatar.
This means that all residents and visitors will have to obtain private health insurance, whether from their workplace or independently, in order to receive healthcare. The Gulf nation has recently also made medical insurance mandatory for all visitors, including those with a ‘Hayya’ permit.
Such a move could possibly divert health traffic towards private hospitals and clinics, leaving more space for HMC to receive more patients and thus lessening the waiting time.
While two-tiered health systems are not uncommon, particularly in Gulf countries, the move has raised eyebrows by those questioning whether the country is looking to nationalise public healthcare for citizens only.
Speculations surfaced further after the health ministry allocated four health centres to Qataris only in June 2022, including Leabaib Health Centre, Muaither Health Centre, Al Thumama Health Centre, and South Al Wakra Health Centre.
Though this appears like an easy fix for the complaints on waiting times, questions over whether the private healthcare system is ready to take on hundreds of thousands of residents arise – particularly as the country’s population continues to grow.
It also means thousands of migrant workers will be likely be unable to afford the ‘reimbursement system’ or ‘excess cover’ certain companies offer, leading to a significant number of residents not receiving the healthcare they need due to high costs.
The law, however, has not yet come into practice and no announcement has been made regarding the change. Authorities say they are currently focusing on implementing mandatory private insurance for visitors and will later expand to residents and companies.
For now, public healthcare remains open for all though with questionable expectations until new healthcare laws are properly implemented.
In an effort to clarify some of the issues raised by the public in Qatar, Doha News reached out to the Ministry of Public Health but did not receive a comment by the time of publication.
As it stands, the increasing stress felt by healthcare professionals and the public – be they Qatari or non-Qatari – remains up in the air until a system is announced to address their concerns and help in adapting to the new ‘normal’.
* Names have been changed or omitted to protect identities.