Dual Practice on Health Service-Should it be Promoted in Qatar?

Abstract

Dual Practice (DP) is a widespread phenomenon of public healthcare employees working concurrently both within and outside the public-sector environment for personal profit. The impact of dual practice varies in its potential for access, quality, cost and equity of healthcare services. Unregulated growth of the private sector, low salaries and poor working conditions in the public sector have made an attractive opportunity for healthcare workers to work simultaneously at both public and private facilities. This generates additional income for healthcare workers which are minimising the budgetary burden of the public sector to retain skilled staff, especially at the scarcity of resources. However, its negative impact far exceeds the positive impact, which includes the rise of detrimental and predatory behaviour, ethical issues and migration of healthcare workers. Also, there are limitations for time and resources that compromises the service delivery, where healthcare workers who are engaged in dual practice are available only for a limited time at public facilities; many times found as absenteeism, tardiness, inefficiency and lack of motivation. In many countries, the health sector managers are forced to accept dual practice to retain their highly skilled employees, sometimes detrimental to health service provision. Though several reasons for dual practice such as a wide gap between physicians’ income expectations and their wages, long waiting lists and unsatisfactory working conditions prevail in the public sector of many countries, none of these factors is reflecting in Qatar. Most of the healthcare professionals in Qatar are expats and dual practice may further inflate substantial workforce shortfall in the public healthcare sector. Hence policymakers should pursue strict policies to prevent dual practice of healthcare workers in Qatar.

Keywords

• dual employment
• ethical issues
• migration of healthcare workers
• moonlighting
• public-on-private