Healthcare in the United Arab Emirates

Guiding Principle

The UAE has emerged as one of the fastest growing healthcare markets in the Middle East, resulting from increased government spending during strong economic years. The UAE Government plays a central role in providing public healthcare services, however, it is rapidly promoting the involvement of private sector in all areas of medical services to deliver a high standard of healthcare to the population. The UAE lucrative pharmaceutical market and the high standard medical facilities are reflecting the country’s rapid development over recent years, although these markets are heavily dependent upon imports. There is no federal law regulating the subject-matter of health insurance in the UAE. Some years ago all employees in the UAE could acquire a public heath card for a small amount. Now the rules became more diversified. Abu Dhabi introduced compulsory health insurance. A new unified health insurance system in Dubai for nationals and non-nationals is under consideration and it is expected that the scheme will eventually be extended across the country.

I.    Federal Medical Liability Law No. 10/20081

Federal Law No. 10/2008 concerning medical liability sets out duties and obligations of the physician, urging him/her to act accurately and honestly and to take into consideration the applicable scientific and technical practices so as to achieve the required level of patient care. This law defines medical errors as errors resulting from ignorance of technical matters, which every person who practices in the medical profession would know or from negligence or failure to exercise due care and diligence.

Under this Law, the physician is prohibited from using non licensed or unlawful means to treat the patient. The physician is also prohibited from disclosing the patient’s confidential medical information to unauthorized third parties.

With regard to surgical operation, the Law requires that the physician is qualified to perform operations in accordance with his/her practice and experience. The place of the operation should be adequately equipped and prepared such that the proposed surgery can be successfully performed.

Under the Law, the physician is prohibited from performing an abortion or prescribing anything that may cause an abortion unless it is evident that the continuation of the pregnancy is either dangerous to the life of the woman, or if it is evident that the embryo is deformed (provided that the embryo is no older that 120 days and seriously deformed beyond any treatment).

II. Federal Law No. 7/1975 Concerning the Practice of Human Medicine Profession 2

The said law regulates provisions on the licensing and registration of physicians. Under this law it is prohibited for any person to practice the profession of human medicine in companies or clinics or private hospitals in the State of United Arab Emirates, unless he has a licence to practice this profession from the Ministry of Health (abbrev. “MoH”).

This Law also defines the specific requirements for establishment the medical laboratories, clinics and private hospitals. No person has the right to establish medical laboratories for bacterial, chemical, organic or food analysis or alike, as well as the X-Ray, ionized isotope, physiotherapy clinics or private hospitals unless having a licence from the MoH.

A.  Rules and Regulations related to Healthcare

III. The UAE Labour Law

1.   Basic Principles

Many relevant provisions for the healthcare are included in the UAE Labour Law (abbrev. UAE-LL) applicable in all Emirates3 . UAE Labour Law is based on French Law, has 193 articles, which are supplemented by various Ministerial Decrees.

An employment contracting the Labour Law is null and void to the extent that it purports to erode rights the Labour Law has conferred upon an employee. Foreign employers  may not by-pass the application of the UAE Labour Law by referring to a foreign law in an employment contract.

2.   Sick Leave

Full wage has to be paid for the first 15 days of sickness and half wages for the next 30 days per year. Periods of sickness over 90 days are a “justifiable reason” for dismissal. In accordance with Art.83 UAE-LL, a sick employee is entitled to continue his contract for a period of 90 days provided that he has completed more than three months after the probation period in continuous service of the employer. For the first two weeks the employee may claim full payment, for the following thirty days payment will be reduced to 50%. For the remaining period up to 90 days the sick employee is not entitled to any payment unless stipulated otherwise. The employee may not claim any payment, if his disease is caused by the consumption of alcohol or drugs (Art. 84 UAE-LL).

Art. 85 UAE-LL stipulates that the employer may terminate the labour contract, if the sick employee fails to appear after the expiration of the 90 days period. Nevertheless, the employee shall receive his end of service gratuity.

At the earliest, the termination of the labour contract is effective with expiration of the 90 days sick leave according to Art.124 UAE-LL, notwithstanding the fact, that the disease of the employee results in a temporary or permanent disability exceeding the period of 90 days.

With the knowledge of the disability of the employee to work, the employer may terminate the labour contract. The employment ends after the period of restraint of 90 days at the earliest, if the employer complied with the period of notice in accordance with Art.117 UAE-LL. The employee will receive his end of service gratuity including the period of 90 days for the sick leave without any reduction due to his sick leave.

3.   Maternity Leave

According to Art. 30 UAE-LL, a working woman shall be entitled to maternity leave with full pay for a period of 45 days, including the period preceding and that following her confinement, on condition that she has been in her employer’s service for a continuous period of no less than one year.

If she has not completed that period of service, she shall be entitled to maternity leave with half pay.

On the expiry of her maternity leave, a woman worker may be absent from her work without pay for a maximum period of 100 consecutive or non-consecutive days if such absence is due to an illness preventing her from resuming her work and if the illness is confirmed by a medical certificate issued by the medical service specified by the competent health authority, or if the latter authority confirms that the illness was caused by the woman’s work or confinement.

The leave provided for in the preceding paragraphs shall not be deducted from other periods of leave.

IV. Healthcare Insurance Law

There is no federal law regulating the subject-matter of health insurance in the UAE. The Emirate of Dubai and Northern Emirates have not passed any specific regulations on health insurance. Only health cards are applied in these emirates. The Abu Dhabi Health Insurance Law No. 23/2005 came into effect and applies to all expatriates living or residing or working in the Emirate of Abu Dhabi after January 2007. A new unified health insurance system in Dubai for nationals and non-nationals is under consideration and it is expected that the scheme will eventually be extended across the country.

The health insurance scheme based on the Abu Dhabi Health Insurance Law offers 3 kinds of policies for coverage:

Basic Health Insurance Policy – for individuals with monthly salaries less than AED 4.000 or AED 3.000 plus housing allowance. The premium has been set at AED 600 yearly. The policy is valid for 1 year and is to be renewed annually. The insured is not entitled to claim back the premium.

Enhanced Health Insurance Policy – for all other individuals. These policies will include basic coverage plus additional covers as per the agreement between the beneficiary and the insurance company.

Emergency Health Insurance Policy – for all visitors to the Emirates in the event of an emergency. The premium will be set according to the duration of the visit and in consideration of the prices in the market.

The insurance policies generally are valid for 1 year from the date of issuance and are to be renewed annually. Shifting from one policy to another is flexible provided the insured pays the difference. The policies contain basic healthcare services, excluding special services, additional services, maximum coverage, procedure of complaints guidelines and a co-payment to be paid by the insured.

According to Abu Dhabi Health Insurance Law, the authorized healthcare provider shall provide – in the case of a medical emergency – healthcare to any injured party, whether or not their insurance covers the treatment. The costs may be recovered from the health insurance company if insured, or from the employer / sponsor if not insured. In the case of work related injuries, the health insurance scheme will not cover any medical treatments. These will be covered by the Work Compensation Insurance.

There are several obligations of the employer and sponsor to provide health insurance. All employers and sponsors are responsible for the procurement of health insurance coverage and possession of valid health insurance at all times for their employees and their families (1 spouse and 3 children under 18), inclusive of registration fees, as well as the cost of the policy and for the cost of all healthcare services that are provided to persons on his sponsorship in the event that such a person is not covered by a valid health insurance policy.

V.  Federal Medical Liability Law No. 10/20084

Federal Law No. 10/2008 concerning medical liability sets out duties and obligations of the physician, urging him/her to act accurately and honestly and to take into consideration the applicable scientific and technical practices so as to achieve the required level of patient care. This law defines medical errors as errors resulting from ignorance of technical matters, which every person who practices in the medical profession would know or from negligence or failure to exercise due care and diligence.

Under this Law, the physician is prohibited from using non licensed or unlawful means to treat the patient. The physician is also prohibited from disclosing the patient’s confidential medical information to unauthorized third parties.

With regard to surgical operation, the Law requires that the physician is qualified to perform operations in accordance with his/her practice and experience. The place of the operation should be adequately equipped and prepared such that the proposed surgery can be successfully performed.

Under the Law, the physician is prohibited from performing an abortion or prescribing anything that may cause an abortion unless it is evident that the continuation of the pregnancy is either dangerous to the life of the woman, or if it is evident that the embryo is deformed (provided that the embryo is no older that 120 days and seriously deformed beyond any treatment).

VI. Federal Law No. 7/1975 Concerning the Practice of Human Medicine Profession 5

The said law regulates provisions on the licensing and registration of physicians. Under this law it is prohibited for any person to practice the profession of human medicine in companies or clinics or private hospitals in the State of United Arab Emirates, unless he has a licence to practice this profession from the Ministry of Health (abbrev. “MoH”).

This Law also defines the specific requirements for establishment the medical laboratories, clinics and private hospitals. No person has the right to establish medical laboratories for bacterial, chemical, organic or food analysis or alike, as well as the X-Ray, ionized isotope, physiotherapy clinics or private hospitals unless having a licence from the MoH. 

B.  Healthcare in the Day to Day Life

The UAE has emerged as one of the fastest growing healthcare markets in the Middle East. It has been found that the UAE healthcare sector is one of the most developed in the GCC region after Saudi Arabia with a strong demand for best-in-class healthcare. Standards of healthcare are considered to be generally high in the UAE, resulting from increased government spending during strong economic years. According to the World Health Organization, in 2004 total expenditures on healthcare constituted 2.9 percent of gross domestic product (GDP), and the per capita expenditure for healthcare was US$ 497. The World Bank ranked Dubai and Abu Dhabi as being the second and third, respectively, most popular medical tourism destinations in the region. The number of doctors per 100,000 (annual average, 1990–99) is 181.

The UAE Government plays a central role in providing healthcare services and accounted for around 70% of the total healthcare spending in 2007. However, with increasing pressure on the public healthcare system, the Government is rapidly promoting the involvement of private sector in all areas of medical services ranging from diagnosis to treatment.

Citizens of the UAE are provided healthcare by the Government’s Federal Ministry of Health. Healthcare currently is free only for UAE citizens. The MoH requires all citizens to obtain a health card. As of 2001, governmental medical facilities no longer provide free medications to expatriates; instead, expatriates must obtain medications from private pharmacies. Also in 2001, the Government announced that expatriate workers and visitors without health cards must pay the full costs of medical treatment received in the UAE. These efforts signalled a shift towards greater private sector involvement in the UAE healthcare system.

Generally, a very good coverage of Primary Healthcare (PHC) has been achieved throughout the country so that no more than 200 people live in an area 30 km away from a health service or without a PHC clinic. All PHC clinics provide curative and preventive services with a small percentage of rehabilitation services.

In UAE most of the infectious diseases like malaria, measles and poliomyelitis that were once endemic have been eradicated, while pre-natal and post-natal care is on par with the world’s most developed countries: the new-born (neonate) mortality rate has been reduced to 5.54 per 1000 and infant mortality to 7.7 per 1000. Maternal mortality rates have dropped to 0.01 for every 100,000. Cardiovascular disease is the main cause of death in the UAE, constituting 28 percent of total deaths. Other major causes are accidents and injuries, malignancies, and congenital anomalies.

As the UAE has a vast healthcare sector, its pharmaceutical and medical device markets are quite big. In fact, the country has the largest pharmaceutical market after Saudi Arabia in the GCC. Both of these markets depend on imports with low local participation.

The UAE pharmaceutical market is considered as the most lucrative market in the Middle East region, growing at double digit rate over the past few years. The growth can be attributed to a number of factors such as rapidly escalating population, liberal trade policies and adaptation of international standards in healthcare. This market remained unaffected by the economic crisis.

Pharmaceutical drugs import will continue to dominate the country’s growing demand for domestic drug consumption. Countries such as the UK, Germany, Switzerland and France serve as the most important sources for pharmaceutical imports for the UAE.

The UAE is home to eight pharmaceutical factories with investments reaching $64.2 million. Leading players in the pharmaceutical manufacturing business include Globalpharma, Gulf Inject and Medpharma, Neopharma, Pharmacare.

The medical facilities in the UAE are of a very high standard, reflecting the country’s rapid development over recent years. The UAE medical device market like pharmaceutical market is heavily dependent upon imports. In recent years, the UAE medical device market has been buoyed by some of the lowest import duties in the region. In vitro and diagnostics equipments are exempted from import tariffs, while capital equipment and instruments carry a 5% levy.

As a consequence of this high standard of care at all stages of the healthcare system, life expectancy at birth in the UAE, at 78.3 years, has reached levels similar to those in Europe and North America. To date, healthcare in the UAE has, by and large, been funded by the Government. As with other sectors, this emphasis is evolving and public-private partnerships are becoming more important.

The UAE is working with leading global institutions to develop its healthcare system. The UAE seeks to become a major centre for world-class healthcare in the Middle East, for its own residents, as well as those in the region. A number of the partnerships are with US-based institutions:

The Harvard Medical School Dubai Centre is a joint project of Harvard University and the Dubai Healthcare City;

The Cleveland Clinic Abu Dhabi is in development and will be a world-class specialty hospital and clinic;

The Johns Hopkins Medical School manages healthcare systems in Abu Dhabi, including the 469-bed Tawam Hospital.

C.  Healthcare in the Public Sector

The UAE has a comprehensive, government-funded health service and a rapidly developing private health sector that delivers a high standard of healthcare to the population.

Public policy focuses on developing organizational and legal frameworks based on best practice, to upgrade the private and public sector health service capabilities. In addition, public policy action will set priorities for health services within the sector. The MoH is undertaking a multimillion-dollar program to expand health facilities and hospitals, medical centres, and a trauma centre in the seven emirates.

Healthcare services are offered by 6 different authorities:

Ministry of Health – A wide range of public health facilities are run by the MoH, it manages 22 hospitals, 88 PHCs, school health and maternity and child health all over the UAE;

General Authority of Health, Abu Dhabi – established in 2001 to manage hospitals and PHC’s in the emirate of Abu Dhabi;

Army Directorate of Medical Services runs 3 hospitals and several field clinics;

Department of Health and Medical Services, Dubai – established in 1972, manages 4 hospitals and 20 PHC’s in the emirate of Dubai;

Dubai Healthcare City- established in 2002 is an autonomous entity with 3 clusters: University Medical complex, Medical and Wellness; Private sector.

D.  Healthcare in the Private Sector

Private initiative in healthcare in the UAE has been subdued largely due to free availability of government healthcare services to citizens. Now, the private sector has become an important partner in providing comprehensive healthcare. This sector accounted for around 30% of the total healthcare funding during 2007. It is now contributing effectively to curative, preventive and health promotion services through hospitals, diagnostic and medical centres and clinics. The number of private sector hospitals surged by more than 100% in 2007 to total 51, while the number of hospital beds reached 1864, up by around 62% compared to 2006. The private sector is far more active in the provision of primary care than hospital services.

The UAE currently has nine major hospital projects underway. To attract wealthy UAE nationals and expatriates who traditionally have travelled abroad for serious medical care, Dubai is developing Dubai Healthcare City, the world’s first healthcare free zone that offers international-standard advanced private healthcare and provides modern medical services in the disciplines relevant to the health issues facing the region and internationally. These include cardiology, oncology, diabetes as well as providing a basis of other preventive, health maintenance and rehabilitative services. It also provides an academic medical training centre. Dubai Healthcare City is a paradigm project that plans to cluster over 300 healthcare providers, 10 hospitals with 1,300 beds and a range of related businesses in a “Healthcare Free Zone”.

Dubai Healthcare City is an AED$1.8 billion (US$490 million) development backed by the Government of Dubai. Dubai Healthcare City will work closely with the Government of Dubai Department of Health and Medical Services and the UAE Ministry of Health to improve the overall healthcare system and facilitate delivery of healthcare. But it is not a government entity. Dubai Healthcare City is described as a self-regulated environment for high-quality healthcare, medical education and research, which has a mission to create a platform for the provision of healthcare, education and research services within an informed regulatory framework. The aim is to complement the existing facilities in Dubai and the United Arab Emirates, and to provide higher quality healthcare services where necessary.

Another ongoing project is the establishment of a $400 million Dubai Biotechnology and Research Park (DuBiotech). DuBiotech features a 300-hectare biotech science park that attracts a mix of biotechnology and pharmaceutical companies active in research and development, scientific discovery, testing, production, storage, sales and distribution.

1.    On 16th December 2008, H.H. Sheikh Khalifa bins Zayed Al Nahyan, the president of the United Arab Emirates, issued Federal Law No. 10/2008 concerning Medical Liability. The law is comprised of 39 articles over 6 chapters. 

2.    Federal Law No. 7/1975 Concerning the Practice of Human Medicine Profession is issued by H.H. Sheikh Khalifa bin Zayed Al Nahyan, the president of the United Arab Emirates on 21.10.1975. The law is comprised of 35 articles over 5 chapters. 

3.   The UAE-Labour Law, (abbrev. UAE-LL) Law No. 8 of 1980, published in the UAE Official Gazette, Vol. X, No. 79 on 30.04.1980, as been amended by Federal Law No. 24 of 1981, published in the UAE Official Gazette No. 98 in November 1981, Federal Law No. 15 of 1985, published in the UAE Official Gazette, Vol. XV, No. 158 in December 1985 and Federal Law No. 12 of 1986, published in the UAE Official Gazette, Vol. XVI, No. 168 in October 1986 with Resolutions and Ministerial Decisions pertaining to Federal Law No. 8 of 1980 from 1980 to 29.02.1997.

4.    On 16th December 2008, H.H. Sheikh Khalifa bins Zayed Al Nahyan, the president of the United Arab Emirates, issued Federal Law No. 10/2008 concerning Medical Liability. The law is comprised of 39 articles over 6 chapters. 

5.    Federal Law No. 7/1975 Concerning the Practice of Human Medicine Profession is issued by H.H. Sheikh Khalifa bin Zayed Al Nahyan, the president of the United Arab Emirates on 21.10.1975. The law is comprised of 35 articles over 5 chapters. 

January, 2010 Elena Schildgen & Zahra Tahsili
  Meyer-Reumann & Partners – Dubai & Tehran Office