Regulatory and Supervisory Failures by the Ministry of Health on Private Hospitals

· Episode No. (28)

· The State Audit and Administrative Control Bureau (SAACB) conducted a performance audit during the years 2022–2023, which was issued on 29-9-2025.. to assess the effectiveness of the institutional arrangements and procedures relied upon by the Ministry of Health in exercising its regulatory and supervisory role over private hospitals as of December 2024, in light of the orientation toward the public–private partnership approach, and with the aim of ensuring that health services reach all citizens efficiently and fairly, the following are included the most substantive observations clarified by the above SAACB report:

1- Planning and distribution of private hospitals

• There are signed agreements with the private sector, yet the report pointed to a lack of sufficient planning that takes into account the geographical and specialty distribution of private hospitals!
• Private hospitals are concentrated in specific governorates, which has led to a distortion in distribution, and a failure to achieve equity in the provision of health services!
• Failure to make optimal use of these hospitals in localizing specialized services, and rationalizing referrals, including referrals to the Israeli side!

2- Procedures for licensing and renewing hospital licenses

• The norm is that a license be renewed immediately upon its expiration, yet the report recorded cases of renewal of some hospitals retrospectively...., to conform with the expiration date of the old license, a procedure that is improper!
• The absence of a central updated database at the Licensing and Permits Unit showing the expiration and renewal dates of licenses!
• Weak coordination between the Ministry and its directorates in monitoring license dates!

3- Compliance with controls and standards

• Failure to fully comply with the administrative and technical instructions stipulated in the Private Hospitals Licensing Instructions No. (4) of 2020!
• Failure to consistently verify the financial clearance (براءة الذمة المالية) of hospitals and their owners!
• Deficiencies in verifying the availability of internal policies and regulations that govern work within private hospitals!

4- The supervisory role after granting the license

· The absence of a clear and systematic supervisory program that covers all private hospitals.

· Field inspections are often carried out only at the request of licensing or renewal, and not as part of a periodic plan!

· Weakness in documenting the results of field inspections, and in preparing comprehensive reports, and failure to use approved forms that cover all aspects!

· Deficiencies in following up the rectification of violations that are detected during visits!

5- The SAACB report meanwhile presented substantive recommendations to correct the violations mentioned above, and among the most prominent of these recommendations are the following:

· Documenting and organizing cooperation agreements with the private sector in a way that clearly defines roles and responsibilities.

· Preparing a national plan for the geographical and specialty distribution of private hospitals, in a manner that achieves health equity.

· Activating the legal framework to require financial clearance (براءة الذمة المالية) at the time of licensing or renewal.

· Including the policies regulating the operation of private hospitals among the tasks of the Licensing, Permits and Compliance Monitoring Unit and ensuring adherence to them.

· Preparing periodic supervisory plans that include all private hospitals, and conducting regular field inspections.

· Adopting unified and comprehensive supervisory forms, and preparing periodic reports on the results of committees’ work and field inspection tours.

· Strengthening the Ministry’s supervisory and oversight role to ensure full compliance with technical and administrative standards.