This week, we heard that a well-known UK NHS Trust is pulling out of Abu Dhabi, UAE, highlighting that exporting healthcare abroad is not for the faint-hearted. Successful or not, HBI thinks that public healthcare operators embarking on such ventures face a moral quandary.

NHS Trusts and US academic medical centres have been going abroad for years, especially to the GCC, to leverage their brand, bring a higher quality of healthcare to immature systems but also – and NHS operators are not shy of saying this – to make profits which will be invested back on home turf.

But we think that going into a region like the GCC poses a dilemma for these groups who are not normally profit-driven. Patients and payors might be willing to pay top-dollar for healthcare services delivered by British NHS consultants and nurses, but a ruthless executive could then combine this with an environment of over-treatment and over-testing. Tidy profits, at the expense of local payors, could then be re-invested in free at-the-point-of-use healthcare back home.

If you stick to your guns, refuse to overtreat, provide NHS-levels of quality and outcome-driven healthcare you may risk losing money in what are highly competitive markets. You could argue this is the more ethical approach, but is it ethical to risk losing taxpayers’ money for ventures abroad, potentially further straining already-tight budgets?

Hopefully, once local payors mature and start to think seriously about quality, you can provide both outcome and quality-driven healthcare and be handsomely remunerated for doing so. But until then, we wish them luck.