Healthcare System Accessibility in the Face of Increasing Privatisation in Saudi Arabia: Lessons From Australia

BACKGROUND: The Kingdom of Saudi Arabia (KSA) is a developing nation with significant resources to improve the nations population health and a planned objective to do so with its Vision 2030 plan. Nonetheless to achieve national strategic goals in health policy and outcomes, the structures and methods necessary to do so must first be elucidated, and outcomes of proposed actions must be appropriately predicted. The primary purpose of this literature review is to compare and critically analyse the structural and policy aspects of the Australian and KSA health systems to offer insights into the potential mechanics of developing further health system accessibility within the KSA. Importantly, this review addresses the issue of accessibility in the context of the recently proposed privatisation of hundreds of services throughout the KSA as a major component of the Vision 2030 plan.

METHOD: 43 peer-reviewed articles were identified using the PRISMA approach and systematically analysed to determine the effects of policy changes in the 2030 Vision to the accessibility of healthcare, in particular the effect of privatisation, as observed in other nations such as Australia.

FINDINGS & DISCUSSION: the literature review demonstrated that privatisation can, but does not always, lead to productivity and efficiency gains, however privatisation also leads to increasing administrative costs and service cost inflation. Health outcomes or service quality indicators are not significantly affected by privatisation. It is probable that privatising health services will reduce accessibility to health services in some subsets of the population.

CONCLUSION: according to the international evidence, the proposed plan to privatise health services in the KSA will probably have a negative effect on the accessibility of health services and downstream improvement in population health outcomes. If inappropriate governance is not implemented, the plan to privatise services also carries the risk of decreasing access to vulnerable populations and threatens health equity and needs-based health care.