Tawfig AlRabiah

As part of a wider move towards increased business regulation in the Kingdom, the Minister announced major changes for a number of regulations. The Kingdom wanted to more closely align its practices and regulations with the World Trade Organization standards and many new regulations were implemented to assist with this strategy.[9] Companies across the Kingdom began to adopt International Financial Reporting Standards, often known as IFRS, to promote transparency. The introduction of this new system has been further developed by the new Minister and other governing bodies.[10]

Another major regulation change in the Kingdom was the introduction of new intellectual property laws. The registration process was completely updated and implemented. The stricter laws meant that patent laws were much tighter in the country and rule breaking would be more obvious. As part of the same move, Saudi Arabia introduced a new system for trademark applications. Prior to Al Rabiah's tenure, trademark applications could take up to eight months to be processed. By 2015, applications could be processed in a single day in the majority of cases. The reason for the dramatic time reduction was due to making the application digital, so many processes were streamlined. Some aspects of the process were also automated, which helped shorten the entire process. As part of the move to online applications, the traditional paper applications were quickly phased out, within two years the majority of trademark applications were completed online.[11] Other applications such as Sole Enterprise were also streamlined using similar techniques. The system of submitting documents was also improved during this period, which included electronic submissions for industrial licensing and financial statement.

Stealth taxation was identified as a problem for consumers in Saudi Arabia by Al Rabiah. In order to solve this problem, various regulations were implemented for restaurants to create a consistent tax system for services and commercial items. As part of this improvement on services, Al Rabiah also implemented new regulations on products. This included new standards for plug and play and also improved standard warranties on products manufactured in the Kingdom. It was hoped this would improve the standard of manufactured products in the country.[12] To further protect consumers, a new call centre was constructed for consumer rights to assist citizens. The enforcement of price tags was also introduced, reducing consumer issues for customers.

New plans were drawn up by Al Rabiah and his team to create off-plan sales for the property. The benefits of this were that it would allow investors to buy during the construction phase, which aimed to promote further growth and larger plans would be submitted by developers.[13]

Under Al Rabiah's leadership, various new organisations were formed under the umbrella of the Ministry. In 2007, The Saudi Export Development Authority was formed to develop the export market.[14] Other business-related organisations were formed during Al Rabiah's tenure including, Small and Medium Enterprise SME Authority, Business-to-Business Credit Bureau (Bayan) and Thiqah for IT solutions.[15][16] Finally, he also launched a non-profit ASAS to maintain and manage industrial cities.[17]

As part of the restructuring, Al Rabiah and other members of the Department of Health announced the creation of a national health insurance agency. The move was welcomed in the Kingdom as Saudi Arabia would be one of the first countries in the Middle East to offer national health insurance for its people. The government made the official announcement in late 2018, with the Saudi financial newspaper Argaam suggesting that the healthcare sector would be regulated by a central body, while medical services would be independently provided. The article by Argaam suggested that the development of its healthcare will have a focus on digital innovations, according to a quote from Al Rabiah at a healthcare conference in Riyadh.[22]

The Kingdom's new focus on innovative digital services led to the creation of Saudi eHealth Analytics, abbreviated to Seha. A new platform is a digital tool which allows Saudi citizens to connect to a physician digitally. The main method of connection is through a smartphone, where face-to-face discussions can take place remotely between patient and physician. Following discussions or medical consultations, electronic prescriptions can also be raised, if required. As part of the same strategic developments, the 937 healthcare number was expanded, which allowed healthcare professionals to speak with citizens with health issues over the phone. The development of the 937 number was a huge success and in 2017 reached a million annual medical calls for the first time. The satisfaction rating grew by nearly 25% of all the calls processed. By late 2018, the call centre was processing 80,000 calls a week.[23]

The call centre can also process and book appointments with a medical professional should it be required, which can be now done digitally since the introduction of a centralized booking system, known as Mawid. The system can also be used for referrals for the first time, so physicians can refer patients to a hospital for a specific reason using the system. The most notable thing about this isn't the technology, but that it is provided free of charges to Saudi Arabian citizens. When compared to US services, many similar offerings are privatized and operated by for-profit companies, such as WebMD.[23]

As Minister of Health, Al Rabiah wanted to create competition between the various medical services and hospitals. This vision resulted in the creation of a Kingdom-wide project known as "Ada’a". The new national system focused more heavily on key performance indicators for individual services and hospitals, which in turn identified problems, while creating friendly competition between the various services. This is not too dissimilar to NHS league tables in the United Kingdom. According to the regional press, once the new system was implemented, waiting times and other indicators improved dramatically over a short period of time.[23]

Al Rabiah has also spoken about his focus on AI technology and how it could transform the Kingdom's healthcare system in the medium to long-term. Trials and developments have indicated it could be one of the pioneering countries in medical AI, with the involvement of companies such as Siemens. This also included the signing of a contract with Babylon Health in the United Kingdom.[24]

Al Rabiah has achieved a number of major milestones during his tenure. In 2017, he established the Saudi Patient Safety Center (SPSC) with the purpose of enhancing healthcare in the Kingdom, given that it is the primary reference for all matters related to patient safety and prevention of medical errors. He oversaw the development and establishment of the Saudi Center for Disease Prevention and Control, often abbreviated to CDC. The Council of Ministers made the announcement in 2013, following internal discussions and became the first centralized disease facility of its kind in Saudi Arabia. The aim of the facility would be to conduct research and practical experiments to aid the overall health of the Kingdom, but also boost the country's health sector.[25] The World Health Organization announced that two Saudi Arabian cities had received the classification of a Healthy city, as part of the WHO Healthy Cities Program. The cities were Diriyah and Jalajil.[26] The MOH was awarded with Healthy City certificates for the cities of Unayzah and Riyadh Al Khabra as 4th. and 5th. Healthy Cities in Saudi Arabia. The cities were qualified after successful evaluation by the World Health Organization (WHO) and external experts in March 2019.[27]

Following a number of reports into obesity in the Kingdom, the Minister began to introduce a number of new methods to limit the impact of obesity. The strategy by Al Rabiah was named Diet and Physical Activity Strategy or DPAS for short.[28] The problem was also tackled at the source by the Minister, who suggested a number of tax increases on unhealthy food and drink products. The aim would not only stop poorer citizens from buying unhealthy food, but also the additional tax could be used to contribute to any healthcare costs associated with obesity in the Kingdom.[29] Other initiatives included adding calorie labels to a number of food and drink products. The Kingdom also implemented ingredient lists for some food types, which made it easier for people with health issues to shop and eat with more care.[30] As part of a move toward healthier citizens of the Kingdom, the Minister announced that there would be an expansion in the number of clinics to treat tobacco addiction. In order to reduce the number of people taking up smoking, the Kingdom also created a number of initiatives to take a stricter view on smoking as a whole. This included a tax increase on the sale of cigarettes.[31] The University of Massachusetts also became involved in the initiatives, signing a partnership with the Kingdom to assist in the research of the treatment of tobacco addiction.[32]

Al Rabiah played a major part in the opening of women-only gyms in the Kingdom. It had been suggested that many women in the Kingdom struggled to exercise enough, which was causing issues with obesity. The move allowed women to get involved in bodybuilding, running and swimming to maintain higher standards of health.[33] This was also included in the wider Saudi Vision 2030 initiative.[34]

A major health issue that occurred each year in Saudi Arabia was the health of pilgrims traveling to the country. International Health Regulations were applied to pilgrims, in line with the World Health Organization. These new guidelines and checks would be applied to 1.6 million people annually.[35] As part of the same strategy, a new contingency and emergency planning was introduced by the Minister, with the creation of the Saudi Disaster Medical Assistance Team (S-DMAT). The newly formed relief team would be used during pilgrimage season, but could also be deployed to neighbouring countries in times of crisis.[36]

A new commission was formed in 2016 to aid the treatment of Hepatitis C in the country. The aims of the commission are to eradicate the disease from the domestic population in the Kingdom. This also coincided with the creation of a new Saudi-made medicine that would be used to treat the virus.[37] Wider initiatives on the treatment of disease were also implemented, with flu vaccinations becoming a focus. Between 2016 and 2018, vaccinations in the country quadrupled.[38] The vaccinations were made possible with the launch of rural medical care in the country. Mobile primary care became a new initiative under the Minister's guidance, which meant rural citizens in the Kingdom could access health-related services more easily. The care industry in Saudi Arabia recognised that more people required home visits as part of a wider initiative to help the elderly and those less mobile. The Minister increased the number of services that could be implemented during home visits. It was estimated that 250,000 home visits were conducted by the end of 2018.[39]

Until Al Rabiah became the Minister of Health for Saudi Arabia, healthcare in schools fell under the stewardship of the Ministry of Education. It was decided by the Council of Ministers that the health of children in schools throughout the Kingdom should be managed by the Ministry of Health. In 2018, this was transferred across to the Health Ministry. Following this move, a thorough check was carried out into the processes at schools for children's health. It was decided that reform on health checks was required and subsequently implemented that all pupils in chosen grade intervals would have health checks.[40]

As a wider move to improve health infrastructure in the Kingdom, the Minister opened a number of new Cardiac centers, both for operations and research. The new facilities totalled six by the end of 2018, with performance indicators suggesting heart operation success was up to 96%.[41]