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To Ban or Not to Ban? Regulating Dual Practice in Palestine.

Jumana Alaref1, Jawad Awwad2, Edson Araujo1

  • 1World Bank Group , Washington , DC , USA.

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|September 14, 2019
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Summary

Banning dual practice in Palestine may cause a brain drain of specialists and is unlikely to improve public healthcare quality or reduce patient costs. Enforcement and financial sustainability are also major concerns.

Keywords:
Palestinedual practicehealth marketsmonitoring and accountabilityprivate sectorquality of care

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Area of Science:

  • Health Policy and Systems Research
  • Public Health
  • Health Economics

Background:

  • Dual practice, where health professionals work in both public and private sectors, is often linked to concerns about healthcare quality.
  • Policy options exist to regulate dual practice, but their impact on care quality remains under-researched.
  • Effective policy depends on national health systems, labor markets, private sector monitoring, and regulatory enforcement.

Purpose of the Study:

  • To evaluate the potential impact of banning dual practice in Palestine.
  • To assess the enforceability, implications, and sustainability of such a ban within the Palestinian context.

Main Methods:

  • Analysis of theoretical evidence and international experiences.
  • Application of context-specific primary and secondary data for Palestine.
  • Assessment of policy feasibility, including financial and enforcement aspects.

Main Results:

  • A ban risks a brain drain of rare specialists from the public sector, with low risk of losing general health workers.
  • Poor quality in public facilities, due to resource shortages and management issues, is unlikely to improve with a ban.
  • The proposed ban is fiscally unsustainable and difficult to enforce due to weak monitoring systems.

Conclusions:

  • An outright ban on dual practice in Palestine is unlikely to reduce patient financial burdens or improve public sector service quality.
  • The policy faces significant challenges regarding specialist retention, public facility improvements, and fiscal/enforcement sustainability.