Libya’s General Peoples Committee (GPC) for Health released a report in February this year highlighting some vital statistics for the health sector, according to the Pan African News Agency.

It reported that Libya has 10,230 doctors of which 8,612 (84%) were Libyan and 1,618 (16%) were foreign. This statistic meant that Libya has 17 doctors for every 10,000 citizens.

The report also indicated that Libya has 96 hospitals, with 20,289 beds, with 25 specialised units which had 5,970 beds, as well as 1,355 Basic Health Centres, 37 clinics and 17 quarantine units.

However, while on the face of it, these statistics may sound good, the reality of Libya’s health sector to those who know it is far from it. In fact the GPC for Health’s own website - www.health.gov.ly – carries an attachment of a United Nations World Health Organisation (WHO) 2007 report on the Libyan health sector which is very critical.

The report which engages in a detailed analyses of Libya’s health sector informs that ‘in comparison to its MENA (Middle East North Africa) peers, Libya spends much less on health care as a % of GDP - about 3.3% - but a similar amount in absolute terms. When adjusted for purchasing power differences across countries, Libya spends only USD 222 per person per annum’.

It goes on to reveal that ‘the Government spends 60 million Libyan dinars (LD) annually for medical treatment of Libyan citizens abroad. More is spent out-of-pocket (privately) by Libyans traveling for treatment to Arab countries and Europe’.

‘Despite guaranteed free medical care in the public sector, Libyans are opting to purchase private medical care, in order to receive a higher level of service. This money is spent in two main areas. There is a small but growing private health care sector in Libya.

This mostly provides primary and basic secondary care through 431 outpatient clinics and 84 inpatient clinics, with the bed capacity of 1361’.

However, the report concludes that this ‘small but growing (Libyan) private health sector continues to be hampered by the lack of an overall policy approach to the sector from the health authorities.’

Moreover, the report reveals that ‘for more serious procedures, Libyans travel abroad for treatment in Tunisia, Jordan, and Egypt or further’.

The WHO report was aware that ‘headline health system indicators show Libya’s human resources and level of health service delivery to be in line with that of MENA peers’.

However the report stressed that ‘the number of health professionals varies considerably across Shabiat, from 6.3 doctors per 10000 in Jdbaya to 28.5 per 10000 in Ben Ghazi and from 19.4 nurses per 10000 in Misrata to 275.8 per 10000 in Ghat’. This variation, the report concludes ‘stems from the absence of central guidelines on correct ratios or control over appointment’.

With regard to quality as opposed to quantity, the WHO report says that ‘medical education in Libya has expanded massively, placing enormous pressure on scarce resources, with an ensuing decline in quality.

At present (2007) Libya has 15,000 students in medical faculties, compared to just 9000 practicing doctors, and a total population of around 6 million’.

Hence with regards to the issue of producing quality doctors, the UN report concludes that Libya, ‘simply does not need to educate this many doctors. At the same time, there is a major lack of other health workers- pharmacists, medical technicians and trained paramedics’.

Furthermore, regarding Libya’s education and training of medics, the report goes on to say that ‘the expansive funding of Libyan doctors perusing postgraduate specializations abroad has also been inefficient, as Libya has not derived from their skill.

Faced with low salaries, they have chosen to make their careers abroad and Libya has been forced to import expensive foreigners to replace them.’

Finally, the United Nations WHO report concludes that despite the expenditure on overseas education and the numbers of doctors that the Libyan system produces, ‘ Libya still finds itself lacking in specialists in a number of key areas such as anesthesia, cardiology and radiology, despite enormous number of medical students, and the funds spent on scholarships for doctors to specialize abroad’.

This equally applies to the area of nursing as the report concludes that ‘the standard of nursing care of Libya is also inadequate due to poor quality nursing education Nursing practice is dependent on expatriate staffing.

Most qualified nursing staff is not Libyan. Libya remains dependent on expansive foreign nurses for almost all quality and specialized nursing care, and for midwifery.’

In conclusion, it is quite clear from this authoritative and respected UN WHO report that Libya needs to seriously reform its health sector. Libya must move on to modern up to date qualitative indicators of performance and assessment.

It is not a matter of the volume of doctors or hospitals – but the quality of all round health care that the system delivers to the average Libyan citizen that counts.

As the UN report indicated, Libya needs to work on its health policy with regards to the quality of education, the average spend per student, the number of doctors that graduate and their salaries.