SME profile: Good care equals capable staff

The chief executive of the long-term care hospice ProVita in Abu Dhabi says that of the biggest challenges he faces, finding and retaining quality healthcare staff is near the top.

Michael Davis, the American head of Abu Dhabi-based ProVita, says the task of finding nurses is made even more difficult by the fact that his company’s speciality of mechanical ventilation for victims of car accidents, strokes and birth defects was not widely practised in the UAE before ProVita established itself in the UAE.

Not to mention that the Abu Dhabi government sets the bar high for entry into the profession, which includes at least two years’ experience in home countries, he says.

“We are not a frozen yogurt franchise here,” Mr Davis, 51, says at a coffee shop near the hospice.

“We are not a fast-food chain. We are dealing with people’s lives. The service we provide is long lasting and very personal. You cannot just come in and put a shingle on the wall saying that I provide long-term care and people trust you.”


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At stake for the UAE is saving on costs, especially at a time when revenues from oil are starting to decrease amid a plunge in global commodity prices. But more importantly perhaps, it is also about finding enough beds to meet the needs of its citizens who require long- term assistance.

Already, the supply of hospital services in the UAE is struggling to meet demand with many of the country’s citizens going abroad to countries such as England for complicated treatments, often with their families in tow at the expense of the Government. There are about 500 Emiratis worldwide who are on mechanical ventilation, according to Mr Davis.

“That is very expensive,” he says. “The cost of that care to the government is outrageous. What I find amazing is the degree to which the UAE government is willing to care for their citizens. The government has a very passionate commitment to providing care to local families.”

So successful has ProVita become that the private equity company TVM Capital Healthcare Partners and its partners sold ProVita last week for US$160.6 million to NMC Health, a London-listed UAE healthcare company. Private equity companies typically buy businesses with the aim of selling five to seven years down the road after developing them. TVM Capital had about a 40 per cent stake in ProVita. It would not disclose how much it paid for the stake in 2010.

Despite efforts to make the profession more desirable by offering more incentives, a shortage of nurses in the UAE persists. The World Health Organization’s 2015 World Statistics Report found the UAE lagging behind with 31 nursing and midwifery personnel for every 100,000 of the population. This compares with 88 per 100,000 in the UK, 114 in Germany and 173 in Switzerland, the report states.

Mr Davis says that it takes time to find healthcare workers but that he has managed to provide enough incentives for career progress to be able to hang on to them. The annual turnover rate is less than 5 per cent compared to a rate of 18 to 21 per cent in the United States for similar positions, he says.

Since taking over as the chief executive of ProVita in June 2013, the workforce has more than doubled to 390 from 157, with most of them coming from emerging markets such as Asia.

ProVita has two facilities in the UAE, one in Abu Dhabi with 42 beds, and one in Al Ain with 50 beds, with both facilities often operating at full capacity. Another 30 beds will be added in Abu Dhabi.

Demand for such services in this country have grown, and are projected to increase by 20 per cent by next year, when 2,241 patients are expected to take up home healthcare services, up from an estimated 2,136 this year, according to a 2012 Abu Dhabi Health Authority report.

While those above 65 years form the majority of recipients of such services, children up to nine years form the next largest group of recipients. Diabetes, cardiovascular diseases and neuropsychiatric conditions are among the common conditions for which patients seek such services.

There was a capacity shortfall of 93 beds in 2011, with 598 critical care beds, including 146 intensive care units, Haad said. It estimated that 216 additional critical care beds will be required by 2031, according to the authority.

In 2007, ProVita was invited by the Abu Dhabi government to set up healthcare facilities in the emirate. Because of the financial crisis the following year and the long process of getting licensing, it was only in 2011 that ProVita began to accept its first patients.

“Bureaucracy is such a strong word, I do not want to sound pejorative,” Mr Davis says.

“There was nothing like this that existed in the UAE, so it was not necessarily a resistance, it was a bureaucracy. It was also being able to articulate the need, the regulatory environment, to understand what we were about. What type of licence we needed. It was defining it, classifying it, to make everything fit in the right box. Once that happened, it was still not easy to obtain a licence.”

The high incidence of road traffic accidents, birth defects and strokes in the UAE has generated a stream of patients that have suffered traumatic brain injuries, he says.

“The business replicates itself because every day in the UAE there is a child born that needs services like ours for rehabilitation as the population ages. Some data suggests that one person per day in the UAE suffers from a stroke,” he says.

As a result, ProVita is expanding its business in the UAE as well as looking at the possibility of setting up in Saudi Arabia and Qatar to tap demand for mechanical ventilation services.

Mr Davis says it took him time to adjust to the way business is done in the Middle East, but when he finally settled in to the UAE he found the country similar not only in climate to his last residence in Houston, Texas but also in its customs.

“I often tell people in the US and they are sometimes shocked by it – the southern culture in the US is very much like the Arab culture,” he says.

“It centres around family, it centres around food. It centres around your friends and the unit as a whole and I have really been accepted by my patients and their families.”

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