The Comprehensive Integrated Era: Towards Comprehensive Coverage, Specialisation, and Quality Assurance
Chapter (4/5) from the series of articles on "The Evolution of Healthcare Facilities in Saudi Arabia"
By the mid-2000s (1426H onwards), Saudi Arabia’s healthcare system entered a phase marked by rapid growth in infrastructure, a broader range of services, a strong private sector, and major improvements in workforce numbers and service quality. Healthcare services became more integrated, linking primary and specialised care, and there was a strong commitment to improving healthcare standards across all regions of the Kingdom.
In the latter half of the 20th century, Saudi Arabia’s healthcare landscape changed significantly. The focus moved beyond basic services and tackling public health issues to managing chronic diseases, improving preventive care, and designing hospitals that centred on patient needs and efficiency. Under King Abdullah bin Abdulaziz Al Saud (2005–2015), the Kingdom modernised its healthcare facilities. Designs now considered patient comfort, flexibility, and the ability to handle a wide range of health challenges.
Widespread Expansion of Ministry of Health Facilities
During this era, the Ministry of Health (MOH) launched large-scale projects to increase the number and capacity of hospitals and other healthcare institutions. More than 79 new hospitals were built and put into service. Besides adding general hospitals, the MOH established specialised hospitals and centres for more complex medical needs.
Between 1426H and 1435H, the number of MOH hospitals and beds grew substantially. By 1431H, there were 249 MOH hospitals and 34,370 beds. By 1435H, these numbers had risen to 270 hospitals and over 40,300 beds. This expansion improved both capacity and the geographic spread of services, ensuring that major cities and remote areas alike gained better access to healthcare.
Primary Healthcare Centres (PHCs) became a cornerstone of the national health strategy. Over 824 new PHCs were opened, and work began on 827 more. By 1431H, Riyadh alone had 399 PHCs, Makkah 84, and Jeddah 93. PHCs delivered about 70% of MOH services, focusing on prevention, maternal and child health, immunisations, health education, and early treatment. Their numbers rose from 2,109 in 1427H to 2,282 by 1436H, reflecting a commitment to easily accessible, community-focused care and reducing pressure on secondary and tertiary hospitals.
A key feature of this era was the creation and upgrade of specialist centres for complex conditions such as heart disease, kidney problems, cancer, diabetes, and dental care. By 1430H, many specialist units were operational, including centres for organ transplants, advanced cardiac care, and oncology. These centres improved patient outcomes, reduced the need to travel abroad for treatment, and encouraged medical research and innovation.
Growth of the Private Healthcare Sector
This period showed a collaborative model of healthcare delivery, where public initiatives and private investments worked together. While the MOH remained the main provider, private hospitals and clinics covered service gaps, provided specialised care, and introduced market competition that encouraged improved quality and efficiency.
Moreover, The private healthcare sector grew rapidly. By 1427H, there were 127 private hospitals with a total of 12,590 beds. Jeddah had the highest number of private hospital beds (3,892), and the Riyadh region had the highest proportion of private-sector beds compared to its population. Along with private hospitals, 1,057 private dispensaries and 416 private polyclinics created a more diverse healthcare landscape. This growth complemented public efforts, gave patients more options, and relieved pressure on government facilities.
The Shift from Public Health to Preventive Care
In earlier decades, Saudi Arabia’s healthcare system mainly addressed public health issues like infectious diseases and improving overall access. Facilities were designed to treat acute illnesses and handle emergencies. As the Kingdom modernised, non-communicable diseases like diabetes and heart disease increased. Healthcare facilities had to adapt, placing more emphasis on long-term care and prevention.
Growing Burden of Chronic Diseases
?? With urbanisation and changing lifestyles came a rise in chronic diseases. Hospitals had to focus on preventive measures and long-term management, not just treating acute illnesses. They needed spaces for outpatient services, rehabilitation, and chronic disease management clinics. Emphasis on early intervention meant hospitals required flexible spaces for screenings, check-ups, and health education, as well as inpatient and emergency services.
Preventive Healthcare Facilities
?? Many new hospitals and clinics included areas dedicated to preventive care, such as health education centres, wellness clinics, and screening units for chronic diseases. PHCs served as the first point of contact for preventive services or minor conditions. Designed with modular layouts, PHCs could expand as needed to meet increasing demands.?
Patient-Centred Design: A New Era in Healthcare Architecture
There was a shift from purely functional hospitals to patient-centred environments that supported healing, comfort, and reduced stress. Hospitals began focusing on creating surroundings that promoted well-being.
Incorporating Healing Environments
?? Research shows that natural light, nature views, and quiet areas can aid patient recovery. Hospitals built during this period, such as King Abdullah Medical City (KAMC) in Mecca, included healing gardens, green spaces, and large windows. These features improved patient satisfaction and created a calming setting for both patients and staff.?
Private Patient Rooms and Family Involvement
?? Instead of large, shared wards, hospitals moved toward private rooms. This approach lowered infection risks, offered a quieter and more comfortable space, and allowed family members to stay close, reflecting the importance of family support in Saudi culture. Facilities also included family waiting areas and family-friendly amenities, especially for patients needing long-term or intensive care.
Wayfinding and Accessibility
?? Hospitals improved signage, colour-coding, and lobby design to help patients and visitors find their way easily. They also prioritised accessibility, adding ramps, wide corridors, and accessible restrooms, making hospitals more welcoming for all.
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Flexibility and Adaptability in Hospital Design
As healthcare needs diversified, hospitals had to be flexible enough to handle new challenges. Designs had to accommodate population growth, new medical technologies, and emerging health threats.
Modular and Flexible Layouts
?? Hospitals adopted modular designs and flexible floor plans to easily reconfigure spaces for new departments, technologies, or patient loads. Multi-purpose rooms could serve various functions. This approach meant hospitals could adapt without costly structural changes.
Expanding Outpatient and Day Surgery Facilities
?? As preventive care and chronic disease management took centre stage, outpatient clinics and day surgery units became vital. They allowed patients to receive care without full hospital admission. These areas had to support high patient turnover, provide efficient diagnostic and lab services, and minimise waiting times.
Emergency Preparedness and Crisis Response
?? Hospitals were also designed to handle public health emergencies and surges in patient demand. Features included emergency departments with flexible layouts, isolation rooms, and negative pressure units for infectious disease control. This ensured hospitals could respond effectively to everyday needs and large-scale crises.
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Laying the Foundation for the Future
By the end of this era, Saudi Arabia’s healthcare system was more integrated, balanced, and able to address a wide range of health needs. Public and private facilities were widely available, specialised services had multiplied, and quality standards had improved. With an expanded network of PHCs and hospitals, supported by a larger, well-trained workforce, the Kingdom was ready for future technological advances, policy changes, and public health challenges.
These developments during King Abdullah’s reign demonstrated Saudi Arabia’s commitment to improving healthcare services and patient outcomes. From embracing patient-centred design to integrating advanced technologies and sustainable practices, Saudi hospitals became modern examples of architectural innovation.
For healthcare architects and planners, the evolution of Saudi hospitals during this period provides lessons in creating facilities that are not only functional but also adaptable, patient-focused, and environmentally conscious. As the Kingdom moves toward the goals of Vision 2030, these design principles will shape the next generation of healthcare facilities, prioritising patient well-being and environmental responsibility.
In the next and final chapter, we will see how these foundational improvements led to digital transformations and innovative care models that continue to shape Saudi Arabia’s healthcare land