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DELOITTE: RAPID HEALTH CARE MARKET GROWTH ANTICIPATED IN THE MIDDLE EAST

- Deloitte: ME health spending driven by population expansion and rising wealth in ME
- Deloitte: Gulf countries drive health tourism to diversify their economies.
Change is the new normal for the global health care sector, according to Deloitte’s recent report entitled “2016 Global health care sector outlook – Battling costs while improving care”. As providers, payers, governments, and other stakeholders strive to deliver effective, efficient, and equitable care, they do so in an ecosystem that is undergoing a dramatic and fundamental shift in business, clinical, and operating models.
This shift is being fueled by aging and growing populations; the proliferation of chronic diseases; heightened focus on care quality and value; evolving financial and quality regulations; informed and empowered consumers; and innovative treatments and technologies — all of which are leading to rising costs and an increase in spending levels for care provision, infrastructure improvements, and technology innovations.
“It’s expected that the dip in health care spending in the GCC in 2015 is temporary. Spending growth is anticipated to resume in 2016, topping four percent, and rise to over six percent a year in 2017 and 2018,” said Abdelhamid Suboh, partner and Life Sciences and Health Care industry leader at Deloitte Middle East. “Driven by population expansion and rising wealth, growth in Asia and the Middle East markets will be particularly rapid as public and private health care systems develop in some countries; in addition, the trend towards universal health care is likely to be a growth driver in numerous markets. However, the pressure to reduce costs, increase efficiency, and demonstrate value will continue to intensify.”
While most people associate increasing health care costs with negative situations — such as administrative waste, rising insurance premiums, expensive care for chronic diseases — increasing costs can also signal positive developments such as amazing new medical treatments and innovative technologies that may one day cure diseases that were formerly incurable.
The way forward for the global health care sector is clear. Stakeholders must look for ways to decrease costs, given the consensus that the current upward trajectory is unsustainable and several macro issues are framing the cost discussion as shown in the following areas:
Population health – Stakeholders are seeking to address the cost curve with innovative approaches to managing the health of a population and health and social care systems will need to join forces, and the public and private sectors will have to transition financial incentives from the “break-fix” model of care to prevention, predictive maintenance, and outcome optimization.
Chronic and communicable diseases – The proliferation of chronic diseases is having serious repercussions in both developed and emerging countries. Meanwhile, the fight against communicable diseases continues, especially in developing countries. Also, population access to health care clinicians, facilities and treatments varies widely around the globe – from simplistic as infrastructure basics, to complex as issues with cost containment.
Access – Today’s consumers are also more informed, involved in, and financially responsible for their health care decisions and therefore have higher expectations for the services and products they receive.
Government spending – Health care is one of the largest industries in the world. However, challenging economic conditions are making it difficult for governments in many of the world’s regions to devote the necessary financial resources needed to handle expanding health care demands—especially when they are coupled with ever-rising costs.
Drug price controls – Amid the reform-driven shift to outcomes focused, value-based payment and reimbursement systems, numerous countries are instituting reform-driven drug price controls. Drug manufacturers will continue to be pressured to justify the cost of their products42 based on, among other things, the product’s comparative effectiveness against similar offerings.
Waste – Stakeholders are continually trying to identify ways to drive waste out of the system. At the same time, cost pressures, changing staffing models, technology advancements, and consumer preferences are creating a business case for “everywhere care” through alternative care delivery and operational models such as retail clinics, home care, telehealth, and medical tourism. But as their populations and health care needs grow, countries all over the world struggle to match the demand for trained medical professionals.
Medical advancements – Medical innovation comes with a high price tag. Widespread adoption of personalized/precision care, shifting clinical offerings from mass generalization to mass customization, will likely be made possible through public and private investments in offerings that integrate drugs and devices with low-cost diagnostics, disease management programs, and clinical decision support. Personalizing care based on genetics and individuals’ health information also has the potential to generate new therapies that may radically improve outcomes.
Digital connected health – The demand for value and an increasingly competitive environment are prompting health care organizations to find new and more effective ways to improve care delivery including telehealth, mHealth, electronic patient records, wearables, and social media – which are growing rapidly in use and influence and, thus, hold considerable implications for the health care sector.
Data and analytics – As health systems continue to face shrinking margins, tightening budgets, and evolving payment models, the combination of data and analytics is also being touted as a possible missing key to unlock new sources of value.
To view the whole report, go to: http://bit.ly/2cvLtbh
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Seven lessons from 2020

Rebeca Ehrnrooth, Equilibrium Capital and CEMS Alumni Association President
Attending a New Year’s luncheon on 31 December 2019, we played a game that involved predicting the world in 2020. Some of the questions included: would Uber become profitable? Would the three-decade bond rally finally come to an end? Would the US hit a recession?
Unlike any of our predictions based on a traditional approach to business and predicting, we now know that 2020 became the year where business, professional and personal plans were turned upside down, reshaped and put-on hold. The proverbial black swan had arrived.
As revealed in a new CEMS Guide to Leadership in a Post-COVID-19 World, to which I contributed, the COVID-19 pandemic has exposed deficiencies in the 20th Century vision of leadership, giving a rare opportunity to question the status quo.
So, what are the main lessons from 2020?
- Humans are enormously adaptive. This is not an extinction scenario. The world is getting used to dealing with global human disaster which may become a recurring event. Life continues guided by new parameters.
- No sector or country is immune to rapid change. Just as the leveraged finance and equity markets ground to a halt during the Global Financial Crisis, we have seen a disruption in the financial markets (including M&A) in 2020, including a significant redistribution of wealth between sectors; think tech vs airlines and the hospitality industry. When a market is disrupted it has secondary and tertiary effects such as less work for accountants, lawyers, financiers etc.
- Location is not as important anymore. The belief that finance staff need to be based in one of the financial capitals to be effective has been forever altered. Pursuing a career in finance from anywhere is becoming possible. However, it’s likely that over time, financial controls and human interaction will move the work model back towards the traditional office approach, as work is a critical sanctuary for people. While working from home may allow more time for family, chores and sports, it is mainly effective for people who already have their internal and external networks. For junior employees it presents a notable challenge as they may be forced to spend their formative years without a chance to really build their networks.
- Change is likely to be lasting. The opportunity for alternative finance and tech focused providers is enormous and 2020 will accelerate this shift. For example, many retail banks are providing rather poor customer service, blaming the pandemic. Even the most loyal customers will be heading elsewhere. For recent graduates and current students this is a major shift; future winners and key employers may not be names we are used to seeing in the headlines.
- There will be a spotlight on leaders with visionary strategy and understanding of the operations. 2020 showed many politicians and business leaders behaving like they were playing a game of snakes and ladders, rather than executing a thought-out strategy. The next wave of thoughtful leadership is urgently required.
- Collaboration leads to success. The definition of a pandemic is an infectious disease prevalent worldwide. A global problem requires a collaborative solution rather than each country and industry on their own. Quoting Steven Riley, professor of infectious disease dynamics at Imperial College London: “Once you have the knowledge and you share the knowledge, then you are able to take measures to push transmission much lower”. This principle is transferable to management education. In a world more complex than ever, investing in a degree is hard currency. Combined with the full global alumni network, corporate partners and schools, CEMS is capital that doesn’t depreciate.
- Resilience has become a watch word. Saint-Exupéry’s quote resonates with me: “If you want to build a ship, don’t drum up people to collect wood and don’t assign them tasks and work, but rather teach them to long for the endless immensity of the sea.” We are in a new paradigm – so prepare for the next change. For COVID-19, while we hope that the vaccine will soon upon us, the broader long-term positive challenge remains.
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Data after Brexit: How does the end of the transition affect GDPR?

By John Flynn, Principal Security Consultant at Conosco
The UK has officially left the European Union now that the transition period has ended on January 1st 2021. But this could raise issues with one of the biggest bugbears for many companies – the international transfer of personal data.
Businesses can relax, somewhat – GDPR, which took businesses months to get their heads around, is not being replaced. It will continue as the UK GDPR 2018, and will still be based on the criteria of the Data Protection Act of 2018. However, the UK will retain the right to change the UK GDPR as it sees fit in the future.
The main changes apply to those who receive data coming into the UK from Europe. Transfers from the UK to other countries can continue under existing arrangements.
We know it can be difficult to cut through the legal jargon, so we have simplified what you need to know to protect yourself and your data:
1 – Update your privacy notice
Most businesses do not have the correct clauses in place ahead of January 1st, potentially exposing their liability, should something happen to their data. All company privacy notices online will need to be updated to specifically state ‘UK GDPR’, as opposed to ‘EU GDPR’. You will also need standard contractual clauses in place, which cover both parties – those transferring and those receiving the data.
The Information Commissioner’s Office (ICO) has a list of what needs to be included in the standard contractual clause here. The ICO will remain the UK regulator for data protection, regularly liaising with each EU member state.
This also applies to Multi Corporate Groups who operate in multiple countries, who need to update their documentation and privacy notice to expressly cover the data transfers. The UK has applied for an adequacy assessment, which would negate the need for contractual clauses, however this has not yet been approved by the EU.
2 – Data privacy assessments
Any company which runs applications and software should always perform a Data Privacy Impact Assessment. This was also in the guidelines before, but these assessments are now more important for those who outsource their IT operations internationally.
For example, when using a service such as a cloud-based system, the company must be sure that its service provider adheres to UK GDPR and stores the data within the European Economic Area (EEA), or has a binding corporate agreement with the company, where data is stored outside of the EEA. You should also, as mentioned above, make sure that a contractual clause is in place.
3 – Review local legislation
Contracts should now have contractual clauses that specify the responsibilities of the data controller and the data processor. If you are receiving personal data from a country territory or sector covered by a European Commission adequacy decision, the sender of the data will need to consider how to comply with its local laws on international transfers. You should check local legislation and guidance in this case.
4 – Cyber Security health check
The ICO is increasing its capacity and efforts to crack down on data breaches, post-Brexit. Now is a great time for all companies to have a health check to understand their Information Security posture and GDPR compliance. Nobody wants to be caught handling data improperly and fined when it could have been prevented with education and training.
A gap analysis performed by an expert is money well-spent. It’s also a fact that companies that have cybersecurity and Information Security controls are not only able to better defend against attacks but are also far better placed to recover from an attack.
Looking forward
It’s important that all businesses – large and small – are properly preparing their data storage and transferring for the 1st January. ICO has been busy setting examples by fining large, high-profile companies for failing to keep millions of customers’ personal data safe.
It will continue to come down hard on the data breaches of personal identifiable information and special categories of data. The saying ‘prevention is better than a cure’ rings truer than ever this year, and you will thank yourself if you make the efforts to properly store your data now, and not when it’s too late.
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2020 reflections and 2021 outlook

By John Hunter, Head of Banking and Fiduciaries, Finance Isle of Man
Reflections on the most surreal year
The Covid-19 pandemic has completely changed the world as we knew it, resulting in catastrophic loss of life and fears of a downturn hang over global economies like a sword of Damocles. In the UK, the new strain has further exacerbated the situation. As I am sure many have already said we are living in what could be called the most surreal times. People have been trying to cope with this “new normal”, by changing their lifestyles and evolving behaviours.
The Isle of Man responded swiftly to the pandemic by closing its borders and enforcing social restrictions which everyone respected and adhered to. Socially and culturally the Island demonstrated all the good things that come from living on a relatively small Island where community still means so much.
The Isle of Man’s financial services sector adapted quickly, seamlessly transitioning to working from home. The banks too adopted flexible remote working practices and continued to support clients around the world helping them navigate the challenging situation and making the most of any opportunities that arose.
Although there is no substitute for face-to-face interactions, we all embraced web-conferencing platforms like Microsoft Teams and Zoom to stay connected with contacts around the world and build and nurture business relationships, whether it was with financial services firms or high net worth individuals looking to relocate to the Island.
Furthermore, a priority for the Isle of Man has been to reinvigorate the business and cultural ties with South Africa. In a normal world, we would have travelled to the country, held in-person meetings with businesses and industry representatives and talked about building on our wonderful historic ties. However, because of the scale and breadth of disruption we had to change all our plans! We hosted a virtual roadshow which comprised a series of webinars exploring why it has never been more important for South African businesses and individuals to choose the right jurisdiction for long term financial planning.
Looking ahead to the future
We are all hoping that the global rollout of vaccines will provide the pathway to some form of return to normality and all the things people are missing will be back. Like amidst all periods of immense turmoil, interesting, new possibilities have emerged such as the revolution in work culture and a renewed importance of being close to nature and green spaces is. And these possibilities can help reshape society for the better.
The global economic recovery and rebuild might seem further away in the current environment especially amidst the new lockdowns. But we are confident in the resilience of economies and are hopeful that different industrial sectors and governments working together would result in green shoots.
The financial services industry has an important role to play in getting the world economy back on its feet. It is a core component of the solution to continue facilitating the financing of corporates, as well as to develop sustainable finance and nurture digital technologies which have proven to be vital during the pandemic. The sector should continue its cooperation and collaboration with governments and regulators to ensure efficient capital flows and financial stability for businesses and individuals.
Banks too have a crucial role to play as they are instrumental to the effective transmission of monetary policies and stimulus packages. As mentioned in a report by EY: “Financial insecurity in the wake of COVID-19 will require banks to boost consumer confidence and help build a more resilient working world.”
We expect the Isle of Man’s financial services sector and banks to continue navigating the situation with resilience as they have been doing thus far and contributing to the global recovery process. Also, we truly hope this will be our busiest year ever (subject to our ability to travel), with an extensive global schedule of planned activity to promote the Island as an international financial centre of excellence and innovation. Personally, I had planned to be in South Africa for the British & Irish Lions tour, but regrettably, it might not take place and as such we will look forward to catching up with friends there as and when we can.
Conclusion
No doubt, there are significant challenges for the world ahead but as Albert Einstein said: “in the midst of every crisis lies great opportunity”. And it is this opportunity that we all need to work together to identify and make the most of. We are confident that in 2021 the Isle of Man will continue to support financial services businesses help their clients, employees, and the wider society through these surreal times. We are all in this together.