When Egypt built the first phase of its universal health insurance system, it wanted private hospitals inside the tent — but it got fewer than planned. The obstacle was not money. It was certification. Before a facility can treat an insured patient, the accreditation authority has to sign it off — which means a stack of approvals down to civil defence permits. The process moved slowly enough that the state built new public hospitals instead of using private beds that already existed. Phase two now assumes private providers supply up to 40% of beds — which turns accreditation into a licence to build. Joining me is Professor Dr. Ihab Othman, Professor of Ophthalmic Surgery, investor, and CEO of Eye World Hospital. Professor, welcome to Fintech TV.
Thank you for the invite. I am very pleased to be with you.
Three years ago you argued that accreditation would shift value away from famous individual names toward institutions and quality. You have since put your own hospital through that same system. What does accreditation actually cost a private hospital in real terms?
The shift toward a universal health insurance system covering 120 million people by 2030 has driven dramatic change in how we look at the future of health in Egypt. The expenditure is actually a significant hurdle — between 15 million and 120 million Egyptian pounds, depending on the specific requirements of the General Authority for Healthcare Accreditation, which mandates not only infrastructure but also documentation and personnel standards built around patient safety. For hospitals built before 2010, the infrastructure changes required are sometimes simply not feasible — fire systems, corridor widths, clean and dirty utility cycles, all of it. Newer hospitals that were already built with those standards in mind have better chances. We are currently in our third year of accreditation and in the process of renewing for another three years.
Was the accreditation gate too narrow, or were too many facilities simply not good enough to pass?
It is not just about being good enough or not. You can build a hospital in 18 months, but you cannot build a specialised physician in 18 months. The point is not the buildings or the equipment — it is the human resources. Phase two requires neonatal ICUs, cardiac ICUs, tertiary care level capabilities. The resistance from the private sector comes from two points. First, cost — if the tariff falls below 70% of a hospital's costs, the private sector will not participate. It has to cover at least 90 to 100% of cost to be viable. Second, the delay in getting reimbursed — currently 90 to 120 days. For a 100-bed hospital you need approximately 50,000 staff hours dedicated to the accreditation process alone. And in phase one, 40% of hospitals that applied received only conditional accreditation — a six-month review period before the full three-year certification could be granted.
Banque Misr has signed a protocol with the accreditation authority to lend specifically for equipment needed to meet accreditation standards. Does that mean accreditation is now becoming bankable collateral?
It will be perfect if we know clearly what the return will be. It has to be linked to a bigger system — we need clarity on the volume of patient referrals and surgeries that private hospitals actually receive in exchange for meeting all the requirements. The system is becoming clearer as the portal develops, decentralising patients from governorates and directing them toward more specialised hospitals. If the banking system now provides low-interest loans for accreditation-related investment — at the infrastructure, IT, and equipment level — that will definitely encourage more hospitals to integrate. The loans will provide whatever the business needs to meet the accreditation requirements.
As CEO, you are being offered volume at a price and payment cycle you do not control. What would have to be true for you to say yes?
If the tariff falls below 70% of our cost, we simply do not accept it. Either we say no to the system, or we slow down the volume we accept to protect viability. It is not only about the tariff — it is also the payment cycle. 90 to 120 days is something that for individual doctors is quite impossible to withstand at high volume. For hospitals with good capital, we can manage 3 to 4 months. But according to WTO specifications, if the cycle comes down to 60 days — which is currently being evaluated as part of the phase one review — that would be significantly better for everybody. And it would make the universal health insurance system genuinely attractive for the private sector, which constitutes about 40% of Egypt's healthcare capacity.
This is a step that a lot of people are waiting for. Thank you very much for joining us today.
Thank you. Very pleased to be here.
