A meeting with Dr. Ahmed Taha, “President of the General Authority for Health Accreditation and Control”
Meeting with Dr. Ahmed Taha"Head of the General Authority for Health Accreditation and Control"
Currently, the global scene has increased interest in the goals of sustainable development. To ensure a sustainable future for current and future generations, and for this reason, Earth Guards stands out in this momentum as a leading platform in spreading environmental and development awareness. Therefore, the magazine seeks to shed light on the efforts made by various bodies and institutions to achieve these development goals.
Hence, Homat Al-Earth presents to its dear readers this special dialogue with Dr. Ahmed Taha, “President of the General Authority for Health Accreditation and Control,” in which she discusses the vital role with which the Authority strengthens the Egyptian health system, in a way that reflects the concrete steps achieved regarding the Sustainable Development Goals (SDGs). So, to the lines of the dialogue.
The Egyptian health system has developed in recent years within the framework of achieving Sustainable Development Goals (SDGs), and one of the most important pillars of this development has been: the General Authority for Health Accreditation and Control; What are the roles of this body, and what are the accreditation standards by which it evaluates health facilities?
First, I would like to talk about the reality of the comprehensive health insurance system. In order to understand the Authority’s role in this; Comprehensive health insurance is the national project adopted by the state in order to reform the health system in general. If we took a look at the Egyptian health system, we would find that it was suffering greatly from the difficulty of its governance.
This is due to the fragmentation of the health system, as there were many health facilities affiliated with the Ministry of Health and Population, and there are other facilities affiliated with the Ministry of Higher Education, or facilities affiliated with the Armed Forces, and others affiliated with the Ministry of Transport, or the police. There were also health facilities belonging to civil society organizations and the private sector. Each of these sectors had a different work system, and here comes the question: Did this benefit the Egyptian citizen?
The reality of the fragmentation of medical facilities only reflects the confusion among the recipients of medical services - as well as the providers of these services - due to the difference in the quality of service in each sector, and the change in their own standards. Therefore, it was necessary to have a health sector that adopts a system that governs all these disparate sectors.
The health system before 2019 was suffering from a prevailing social pattern, where the patient preferred to go to the hospital for very simple reasons. Therefore, the health system was burdened at that time by the number of people requesting health services in a way that exhausted it, so the quality of health services became the subject of many questions. Because the citizen needs a good health service that guarantees that medical errors do not occur, which are the third leading cause of death worldwide!
If the health service is not good, the citizen will go to the private sector; Because he is not confident about the quality of health services in the government sector; Therefore, health service providers in the private sector will make their facilities have a good reputation and distinguished medical quality. Consequently, this placed a financial burden on the Egyptian family, to the point that more than 90,000,000 citizens around the world have gone from middle-income to poor. There was a threat of poverty for the sake of treatment.
Everything I described to you confirmed to us that the Egyptian health system was in need of a strong, comprehensive project, sponsored by the state and ensuring its implementation, as every citizen must have insurance coverage that preserves his health at an affordable, fair, and comprehensive cost; This project was comprehensive health insurance.
Comprehensive health insurance is a project based on the concept of comprehensiveness in medical services, and the comprehensiveness and diversity of service providers such as the private sector and the entire private sector. In order to achieve this, the health system must be based on solidarity between Egyptians. Every citizen pays a known amount from his salary in exchange for providing health services to himself and his family. Which means that there is no exit as was the case in the old health system. This comprehensiveness in providing medical services does not mean that the new health system must bear the burden of services such as cosmetic dentistry, orthodontics, or joint implantation. What we mean by comprehensive medical services are those necessary medical services that are not accessible to everyone.
With regard to the Health Accreditation and Oversight Authority, it is the gateway to entering this field. Whoever wants to enter the new health system - individuals or governmental and non-governmental institutions - must comply with the standards of the Health Accreditation and Oversight Authority. These are standards that ensure that health facilities are compatible with the comprehensive health insurance system. Not only that, but we had to adopt these standards internationally, which is a legal requirement. In order for the Authority’s standards to be compatible with the standards of health services around the world.
These standards accompany the patient on his journey, starting with feeling sick and heading to the hospital. So the standards become a medical plan that tells us who must receive the patient, who is allowed to examine him, what are the qualifications of this examiner, in addition to the qualifications of the supporting medical staff, and how will the health facility itself deal with him?
The standards also intervene in the steps of the medical examination, through the diagnosis stage, until the specialist doctor presents to the patient the dimensions of the problem, the method of treatment, and other alternatives. The standards also require that the patient’s opinion be taken into account in choosing between different treatment methods and their alternatives.
The standards also require that the medical facility’s rooms and corridors be of a certain level of health, and that any potential infection within the facility be controlled, in addition to procedures for recording and following up on the patient’s history inside the facility, such as monitoring the effects of medication doses, while confirming the times of its administration to the patient. This medicine must be part of a very precise tracking strategy, as the facility must store it in accordance with the storage requirements followed for the medicine from its purchase until it reaches the patient.
The facility must also work carefully to prevent disasters such as fires from occurring in the facility, as the facility’s staff must be trained to deal with fires and all emergency crises, with evacuation strategies and firefighting systems in place. In addition to the above, the management of the medical facility must have a plan to manage its hazardous waste in a sustainable manner.
The standards also include surgical cases, and this includes how the specialist doctor deals with surgical operations, and determines their location, after confirming the necessary tests for the operation, with attention and focus on possible scenarios inside the operating rooms, such as forgetting a machine inside the patient’s intestines, or giving him a medication that conflicts with the doses of anesthesia. Regarding this last standard, the anesthesiologist must meet safety standards.
All of these 274 standards are implemented by the General Authority for Health Accreditation and Control. Among these standards are what fall under the national safety standards, which amount to 28 standards, and the basic quality standards, which amount to about 30 standards. These are very important standards. If it had been absent from the health oversight process, catastrophic medical errors would have occurred. We do not say that applying these basic standards will completely prevent medical errors, but rather will make the rates of these errors proportional to global rates. There are acceptable medical errors and others that cannot be avoided.
After that, we must work to rehabilitate health facilities so that they are prepared and able to actually implement these standards. That is, the General Authority for Health Accreditation and Supervision trains the cadres of health facilities within the scope of the authority, and then we work to evaluate these cadres. In order to qualify for entry into the comprehensive health insurance system, they will be given certificates indicating their readiness for this. The matter does not stop there, but the Authority has a role subsequent to the training and qualification processes, which is the supervisory role. To ensure the sustainability of the application of quality standards within the health system.
The comprehensive health insurance law was issued at the end of 2018. Can you explain to us the extent of what has been achieved regarding this law, and what are the most important features of the second phase of the comprehensive health insurance project?
This law has a number of stages. The first stage included six governorates, starting with Port Said Governorate, since His Excellency President Abdel Fattah El-Sisi issued the starting signal to implement this system in November 2018. Then we moved from Port Said to Ismailia, Luxor, Aswan, Suez, and South Sinai. These are the governorates in which the system has been implemented so far, and we are preparing to cover five other governorates, namely - Damietta, Marsa Matrouh, Kafr El-Sheikh, Minya, and North Sinai. Therefore, by the end of 2025 or the beginning of 2026, we will have covered 11 out of 27 governorates, and we still have a good opportunity - God willing - to continue the path under the presidency of His Excellency President Abdel Fattah El-Sisi.
This innovative health system has been supported - personally - by the President of the Republic since we began conducting the necessary scientific studies in 2014, until implementation was in 2018. In general, the Authority is subject to the direct supervision of His Excellency the President of the Republic. So that we remain consistent with the state’s strategy, I mean “Egypt Vision 2030”.
In addition to the above, the General Authority for Health Accreditation and Supervision, among other bodies, works to monitor the health system, namely: the Comprehensive Health Insurance Authority, which represents the financial aspect, and is concerned with collecting subscriptions from citizens. And the Health Care Authority, which represents the arm of the state.
The private sector has a strategic role, especially since we live in an era of digital transformation and development partnerships. What is the philosophy of health reform projects regarding integration between private sector participation and the provision of a competitive health service for the benefit of all categories of people?
We believe that there is no successful comprehensive health system except in partnership with the private sector, whether in Egypt or other countries of the world. The private sector provides between 40% and 50% of health services in Egypt. Therefore, excluding the private sector from this vital system dooms the project to failure from the beginning.
The private sector is capable of providing basic care services and advanced care services, and it is allowed - like the government sector - to join the comprehensive health insurance system by obtaining the accreditation of the General Authority for Health Accreditation and Control, and by contracting with the Comprehensive Health Insurance Authority. So that he can receive compensation for providing services, just like the government sector. This reflects the meaning of strategic and development partnerships, which express the truest expression of the concept of “sustainability.”
As for digital transformation, it is extremely important. Because when the patient goes to receive service in a basic care unit, then other options are presented to him, such as government or private hospitals, or private sector hospitals; If the patient chooses the private sector - for example - what will connect him from the place of primary care to the private sector is an electronic link, where the medical record for this patient and his medical history are within an electronic system, which is in the form of a smart card - a smart card - on which all his data is uploaded; Because there cannot be a good comprehensive health system except through digitizing the entire health system, starting with the patient, passing through the facility, and then the medical personnel.
Regarding the societal challenges that stand in the way of the efforts of the General Authority for Health Accreditation and Control, tell us about the most important of these challenges?
There are two challenges facing the health system. The first: changing people’s prevailing culture; Because the citizen must realize what we are doing for him, and this will require a change in behavior, and I previously indicated that the general culture is to go to the hospital for any reason; Which places a burden on the energy and capacity of these hospitals.
The other challenge is our readiness to implement digital transformation in a comprehensive manner. The problems of this transformation are represented in saving time, effort, training, and money. It also requires what is called the “Learning Curve.” So people have to be patient; Since the comprehensive health system cannot be implemented at once in all governorates, the experiment must mature quietly.
A country like England implemented a comprehensivehealth insurance systemin about 30 years, and if we say that the matter requires a radical change in behavior and the prevailing culture, this must take time through societal awareness spread by the media, in addition to the important role of awareness programmes, initiatives and seminars, in addition to Marketing.
The General Authority for Health Accreditation and Supervision follows an approach that combines the essence of “Egypt Vision 2030” with the concept of transparency and enhancing the efficiency of government institutions. How was the Authority able to implement this in reality?
By sustainability, we mean that the Authority establishes what is called the requirements for the transformation towards green health facilities. The Authority has begun this transformation since 2022, as this coincided with Egypt’s hosting of “COP27”. The manifestations of this transformation were represented in the carbon footprint, reducing carbon emissions resulting from health facilities, optimal use of new and renewable energy, responsible use of water, recycling of some waste such as solution containers, and handling Safe with hazardous waste coming out of health facilities.
We have worked in these facilities to transform them into green health facilities, and through the approvals of the General Authority for Health Accreditation and Control, we have developed important health facilities, such as Shefaa El Orman Hospital in Luxor, as this has created a unique sustainable transformation of its kind.
This green sustainability, which is the most important feature of the work of Earth Guards, is in the interest of societal progress and progress in the Egyptian medical field, ensuring that the Egyptian citizen has a healthy and sustainable life. Therefore, the Egyptian state is interested in this transformation, especially with the presence of major climate problems such as global warming and increasing carbon emissions.
Among the values governing the Authority’s work are: teamwork; What are the aspects of cooperation between the General Authority for Health Accreditation and Supervision and the international “TEMOS” body, which is responsible for accrediting health facilities to provide medical tourism services?
It is known that Egypt is one of the countries that is highly qualified to have a large share of global tourism. Because of its strategic geographical location in the middle of the entire world, in addition to the moderate climate most of the year, it is also a tourist attraction, as it contains a third of the world’s antiquities.
Among the types of tourism in Egypt: hospital or therapeutic tourism, and we find this type in places such as Oyoun Musa, and the oases; Therefore, Egypt is qualified to provide this type of tourism, and after implementing the comprehensive health insurance system, the health facilities will have a very good infrastructure and apply international quality standards. This is what will make the tourist reassured about the quality of the health service he wants, not only through the presence of international quality standards, but also in addition to dissolving the language barrier between the doctor and the patient coming to Egypt, all of which is a competitive advantage at a very low cost.
But, the problem lies in Egypt’s need to market this type of tourism. Therefore, Jahar - the General Authority for Health Accreditation and Control - worked to conclude an agreement with the German international accreditation body “TEMOS”. There we worked to implement a cooperation protocol between us and this international body so that our standards would be able to meet the requirements of the international patient, through good medical care and comfortable accommodation. Indeed, our journey with the patient arriving in Egypt begins from his arrival at the airport, where we work to facilitate visa procedures, all the way to the hotel, while developing a distinguished tourism program.
All of this is the content of the agreement betweenJahar and Timos, and this was approximately two and a half years ago, and we are currently working on implementing the outcomes of this protocol in EgyptAir Hospital, and we are targeting other hospitals, and in the near future we will issue standards specifically for hospital tourism, which is a new precedent of its kind in the whole world.
