Health Profession Localisation in Saudi Arabia: Eight Decrees with Different Rates

Health profession localisation in Saudi Arabia is not one decree. It is several ministerial decisions from the localisation family, each with its own number, date, percentage and the wage floor at which the Saudi worker is counted. Their percentages are different, and some of them reach their percentage over two stages or more.

This guide covers eight decrees from this family, and it treats two questions: what each decree lays down on the private health establishment, and when the Saudi worker is counted in the percentage at all. Counting here is suspended on something beyond recruitment: the wage floor, and professional accreditation where the decree requires it. The shared architecture of localisation decrees, from the level of measurement to the rounding rule to the higher-percentage rule, is not set out here.

1. The eight decrees: the percentages, the dates and the counting floors

The dates are presented as the documents print them, in Hijri and Gregorian where both were printed together. This guide has made no conversion between the two calendars in either direction. The Ministry’s page for the dentistry decree prints its issuance date on a day following the one printed on the signed decree, in both calendars, so both readings are given here as the two sources print them: 26/7/1446 AH · 26 January 2025 on the decree, and 27 Rajab 1446 AH · 27 January 2025 on the page.

The grace period of the pharmacy decree 103111 is 6 months from its date of issuance, and its date of application is 27/7/2025.

The medical laboratory decree 51267 runs over two stages six months apart. As for the distribution of the percentage across the two stages, that is, what is required in the first and what in the second, this guide did not come across it. What is read is the decree’s percentage and the dates of the two stages.

Read across the table, the rates are different rather than graduated. Four of the eight state a single flat figure: 51273 at 65%, 208837 at 50%, and 51270 and 51277 at 80% each. The two stages in 51270 and 51277 are geographic rather than rate stages: they decide which establishments the decree reaches and when, not what percentage is required of them, as section 5 sets out. A fifth, 103111, states no single figure at all: its rate varies by the pharmacy activity rather than by a stage, at 35%, 65% and 55%. Whoever reads this family as one rising ladder has imposed a shape on it that five of its eight decrees do not have.

2. The scope of application: the health establishment in four decrees, and a wider scope in pharmacy

The scope of application does not run on a single pattern in these decrees. In four of them it is narrower than “the private sector” taken absolutely, because it names the health establishment and is satisfied with one worker. Its wording, as read in the guides for the radiography professions (51273), the medical laboratory professions (51267), the physiotherapy professions (51270) and the therapeutic nutrition professions (51277), is:

“This decree applies to all health establishments in the private sector operating in the Saudi market, in which one worker or more is employed” in the targeted professions.

On this text, a non-health establishment employing, say, a nutrition specialist is not within the scope of application.

As for the pharmacy profession decree (103111), it departs from this formula in both of its descriptions. Its scope of application as read is “private sector establishments”, not “health establishments”, so it is not constrained by the description of a health establishment. And its threshold is 5 workers or more in the pharmacy professions rather than one worker, and it is stated in two places in its guide. The effect of that is practical rather than verbal: a community pharmacy employing four pharmacists is outside the scope of application of its own decree, while a clinic employing one worker in the radiography professions is inside the scope of the radiography decree. So a single formula is not read across the eight decrees, and the scope of application of each decree is read from its own procedural guide.

3. The wage floor: a counting condition, not a minimum wage

These decrees suspend the counting of the Saudi worker in the percentage on a minimum for his wage. It is a counting condition and not a minimum wage: a Saudi whose wage falls below it does not enter the reckoning of the percentage, and there is no prohibition in that on contracting below it.

The measure is the contribution wage registered at the General Organization for Social Insurance, not the basic wage and not the total wage in the contract. What goes into that figure and what stays out of it is set out in the contribution wage at GOSI.

The floors in most of these decrees separate into two tiers: SAR 7,000 for the specialist and SAR 5,000 for the technician in radiography, medical laboratories, physiotherapy and therapeutic nutrition. In the medical devices and supplies sector it is 7,000 for the specialist holding a bachelor’s degree and 5,000 for the technician holding a diploma. In dentistry it is SAR 9,000, and in the optics sector SAR 5,500.

As for the pharmacy profession (103111), its floor is a single tier: SAR 7,000, with no “technician” grade in it. This is not a gap in its guide. The table of targeted professions in this decree lists eleven job titles in all, and there is no title of “technician” among them. For that reason, someone working in a pharmaceutical technical occupation not named in that table is not a worker whose wage fell short of the floor. He is outside the table of targeted professions: he does not enter the percentage, and no wage floor excludes him from it. So it is not said of pharmacy that “the technician floor is 5,000”, and it is not said that “the technician floor is 7,000” either, because the decree lays down no grade for the technician at all.

The effect of this condition is that it separates two figures: the number of Saudis on your file, and the number of them who enter the percentage.

4. Professional accreditation: another counting condition in five of these decrees

Five of these decrees require, for counting, professional accreditation from the Saudi Commission for Health Specialties: the radiography professions (51273), the medical laboratory professions (51267), the physiotherapy professions (51270), the therapeutic nutrition professions (51277), and the pharmacy profession (103111). The body is one across the five and the effect of the condition on counting is one, but what the text describes differs: in the first four it is “the worker … in the targeted professions”, and in pharmacy it is “the pharmacist”. For that reason each decree’s text is carried in its own wording. The text of the four in their guides:

“The worker is required to obtain professional accreditation from the Saudi Commission for Health Specialties, in accordance with what is provided in the Health Professions Practice Law and its implementing regulation … and unaccredited workers are not counted within the imposed localisation percentages.”

And its text in the guide for the pharmacy profession (103111):

“The pharmacist is required to obtain professional accreditation from the Saudi Commission for Health Specialties, in accordance with what is provided in the Health Professions Practice Law and the implementing regulation of the Health Professions Practice Law, and unaccredited pharmacists are not counted within the imposed localisation percentages.”

It is therefore a counting condition like the wage condition: the unaccredited worker does not enter the percentage. These five are what this guide came across in this family, not an exhaustive account of what is in their decrees. And a decree in which no body is named among the others is not thereby shown to be free of an accreditation condition.

As for who falls within “the pharmacist” among the remaining titles in the table of targeted professions in the pharmacy decree, this guide did not come across it, and it is not settled here. What is stated is the table’s total; no number is asserted for that subset.

Beyond the naming of the body, this guide came across nothing: which professions inside each family require accreditation, on what conditions, by what deadline, and what it entails. The Health Professions Practice Law and its implementing regulation, referred to in this text, were not come across by this guide, so what is in them is not described.

5. Two geographic stages in physiotherapy and therapeutic nutrition

The decrees on the physiotherapy professions (51270) and the therapeutic nutrition professions (51277) do not reach all establishments at one time. Their text on this is identical:

The first stage at 19/10/1446 AH, six months after the date of issuance of the decree: “it applies to all establishments in the main cities, and to the giant and large establishments in the remaining regions (according to the classification of establishments in Nitaqat and according to the workers at the establishment’s actual site).” And the second stage at 25/4/1447 AH, twelve months after the date of issuance: “it applies to all establishments in all regions.”

And “the main cities means (Riyadh, Makkah, Madinah, Jeddah, Dammam, Khobar).”

The classification in Nitaqat here decides when the decree reaches the establishment, not how its percentage is computed. The Nitaqat side is treated separately in attesting employment contracts on Qiwa and its effect on the establishment’s classification, a guide that states the required Saudization percentages and their variation by activity and establishment size are outside its own scope.

6. The denominator in these decrees: what this guide did not come across

The percentage in most of these decrees is laid down at entity level, and that is the level of measurement. As for the denominator of the percentage, that is, the number it is divided by, its wording in the guides of these decrees was not come across by this guide.

And here a rule from the wider family must not be carried across. That the denominator is the workers in the targeted professions is established for the cross-cutting profession decrees. It is not a rule of the family as a whole: the decree on the sales outlets of seven economic activities (208819) states 70% of the total workers in the outlet, and the decree on real-estate activities and professions (212535) states 70% of the total number of workers at the establishments. Both compute on total headcount rather than on the targeted professions.

The distinction that keeps this straight is that “applies to” is not “is calculated on”. A decree may apply to the workers in the targeted professions while dividing by a population its scope sentence never names. The two are separate sentences in a guide, and one is not read off the other.

For that reason no worked example is built in this guide for any of the eight decrees: an example entails fixing the denominator, and the denominator is not read. The question of the denominator in a particular decree is referred to its own procedural guide and to the competent authority.

7. The breach: the trigger is laid down and the amount is not published here

The trigger of the breach as laid down in the guides: failing to reach the required percentage, or assigning any task of the tasks of the localised profession to a non-Saudi, directly or indirectly, under any other job title.

As for the amount of the fine, it is not published here. The decrees do not carry their penalties in their own texts but refer to the table of violations and penalties, and the decrees of this family refer to decrees 75913 and 44558, while the page of the table of violations and penalties published by the Ministry today carries decree 112377. The relationship between a decree’s reference and the table published today was not come across by this guide in a source, so no fine amount is attributed here to any of these decrees.

What the text does not address

• The denominator of the percentage in the guides of these decrees: the number the percentage is divided by.
• A worked example for any of these decrees: none is built while the denominator is not read.
• The scope of application in the decrees on the dentistry profession (103107), the medical devices and supplies sector (48081) and the optics sector (208837): this guide did not come across it, so neither the health establishment formula nor the private sector establishments formula is carried across to them.
• The tables of targeted professions in the seven decrees other than pharmacy: this guide did not come across them, so no title is named here as inside or outside them. As for the table in the pharmacy decree, what is read from it is the number of its titles and their being free of a “technician” grade, not an enumeration of them title by title.
• The distribution of the percentage across the two stages of the medical laboratory decree (51267): what is read is the decree’s percentage and the dates of the two stages.
• The conditions of professional accreditation beyond the naming of the body in the five named decrees: which professions it binds, on what conditions, and by what deadline. Among that is who falls within “the pharmacist” among the remaining titles in the table of the pharmacy decree.
• The Health Professions Practice Law and its implementing regulation referred to in the accreditation condition.
• The amount of the fine following a breach of one of these decrees, and the outcome of the reference to decrees 75913 and 44558.
• The earlier decrees that these decrees may be updating: this guide did not come across them, and the absence of a naming is not a denial of existence.
• The support and employment programmes mentioned in the guides in general wording: no programme name, no eligibility condition, no amount and no channel.

Each one of these matters is a matter to be referred to the statutory text and the competent authority. And a caution that has to be added: a health profession this guide did not come across is not thereby outside localisation. It may be reached by an activity decree, or a regional decree, or a decree whose guide has not been published.

What your system should record

The figure the Ministry sees in localisation decrees is read from the GOSI registration rather than from your file. So what is useful to hold in the employee’s file with you is what you can match against that registration:

• The occupational title registered at GOSI for every worker in a targeted health profession, and its code in the Saudi Standard Classification of Occupations.
• The worker’s grade: specialist or technician, since the counting floor separates the two in most of these decrees.
• The contribution wage of every Saudi in a targeted profession, so that it can be measured against the floor of his own decree. What the two shares of that contribution are and how they land in the payroll run is treated in GOSI in the payroll run, and the rate in force is treated in the two parallel systems at GOSI.
• The professional accreditation and its expiry date for every worker in the professions whose decree requires it.
• The establishment’s actual site and its classification, for whoever falls under the physiotherapy and therapeutic nutrition decrees.
• The stage dates in the decrees that run in stages: dentistry, medical laboratories, medical devices and supplies, and, as geographic stages, physiotherapy and therapeutic nutrition.
• The registered title as it appears on the contract itself, which the mandatory particulars of the Saudi employment contract sets out, and the contribution base defined in GOSI contributions.

Checklist

• Does the establishment description in the scope of application of the decree that reaches you apply to you, and the threshold of worker numbers in it (a health establishment with one worker or more, or a private-sector establishment employing 5 workers or more in the pharmacy professions, and the scope of application of each decree is read from its own procedural guide)? And from which procedural guide did you read it?
• Do you know which of the eight decrees reaches your professions, and its percentage, and its date of application?
• Does the contribution wage of every Saudi in a targeted profession reach the floor of his own decree, at his grade as specialist or technician where his decree separates the two grades?
• Does every worker in radiography, medical laboratories, physiotherapy or therapeutic nutrition hold a valid professional accreditation, and every pharmacist likewise?
• If the decree that reaches you runs in stages, do you know which stage you are in today?
• Did you read the denominator of the percentage from your own decree’s guide, or did you borrow the denominator of another decree?
• Do you have a profession reached by two decrees?

Why this turns into a problem

The two counting conditions separate two figures you see as identical. A Saudi appointed in a targeted profession appears on your file as within the percentage, and he drops out of it in the reckoning if his contribution wage is below the floor of his own decree, or if he is not accredited where his decree requires accreditation. So the shortfall does not show in the number of employees. It shows in the number counted.

Added to that is that some of these decrees run in stages, and the dates of their stages are written in their own procedural guides.

This is where it pays to have an employee’s facts in a single file. That is what Qoyod HR provides: a single employee file holding the contract, the documents and their expiry dates with an alert before them, an attendance record for each employee, and their leave, salary and end-of-service entitlements. End-of-service, overtime and leave-balance calculations are built into the system. It is a standalone HR system with its own subscription, and the link with Qoyod accounting is available now. As for the percentage laid down in your decree and the denominator it is divided by, both are read from its procedural guide, and no system reckons them.

For more guides and templates, browse the HR Resource Centre.

Frequently asked questions

What are the health profession localisation percentages in the private sector?

The percentage differs by decree. In the guides read: the pharmacy profession (103111) 35% for community pharmacies and medical complexes, 65% for hospitals and 55% for the remaining activities; the dentistry profession (103107) 45% from 27/7/2025 then 55% from 27/1/2026; the radiography professions (51273) 65%; the medical laboratory professions (51267) 70%; the physiotherapy professions (51270) and the therapeutic nutrition professions (51277) 80%; the medical devices and supplies sector (48081) 40% then 80% for the sales, promotion and product introduction professions and 30% then 50% for engineers and technicians; and the optics sector (208837) 50%. The percentage of each decree is read from its own procedural guide.

When is a Saudi worker counted within a health profession localisation percentage?

The wage floor is a counting condition: a Saudi whose contribution wage registered at the General Organization for Social Insurance is below the floor of his own decree does not enter the reckoning of the percentage. Professional accreditation is another counting condition where the decree requires it: an unaccredited worker does not enter the percentage. Both are counting conditions, not a minimum wage and not a prohibition on contracting.

What is the wage floor at which a worker is counted in the health profession decrees?

In the guides read: SAR 7,000 for the specialist and SAR 5,000 for the technician in radiography, medical laboratories, physiotherapy and therapeutic nutrition; in the medical devices and supplies sector 7,000 for the specialist holding a bachelor’s degree and 5,000 for the technician holding a diploma; SAR 9,000 in the dentistry profession; and SAR 5,500 in the optics sector. As for the pharmacy profession (103111), its floor is a single tier of SAR 7,000 with no “technician” grade in it, because the table of targeted professions in its decree contains no title of “technician”. The floor of each decree is read from its own guide.

Which body grants the professional accreditation in the health profession localisation decrees?

Five of these decrees name the Saudi Commission for Health Specialties as the body for professional accreditation: the radiography professions (51273), the medical laboratory professions (51267), the physiotherapy professions (51270), the therapeutic nutrition professions (51277) and the pharmacy profession (103111). The text of the first four reads “and unaccredited workers are not counted within the imposed localisation percentages”, and the text of the pharmacy decree reads “and unaccredited pharmacists are not counted within the imposed localisation percentages”. These five are what this guide came across in this family, not an exhaustive account, and a decree in which no body is named among the others is not thereby shown to be free of an accreditation condition.

Whom do the health profession localisation decrees apply to?

It differs by decree. In the guides for the radiography professions, the medical laboratory professions, the physiotherapy professions and the therapeutic nutrition professions: “This decree applies to all health establishments in the private sector operating in the Saudi market, in which one worker or more is employed” in the targeted professions, so a non-health establishment employing, say, a nutrition specialist is not within it. As for the pharmacy profession decree (103111), its scope is “private sector establishments” rather than “health establishments”, and its threshold is 5 workers or more in the pharmacy professions rather than one worker, so a pharmacy employing four pharmacists is outside its scope of application. The scope of application of each decree is read from its own procedural guide.

Do the physiotherapy and therapeutic nutrition decrees apply to all regions at one time?

No. The first stage at 19/10/1446 AH applies to all establishments in the main cities and to the giant and large establishments in the remaining regions, according to the classification of establishments in Nitaqat and according to the workers at the establishment’s actual site, and the second stage at 25/4/1447 AH applies to all establishments in all regions. The main cities are Riyadh, Makkah, Madinah, Jeddah, Dammam and Khobar. The classification here decides when the decree reaches the establishment, not how its percentage is computed.

Statutory references

This guide rests on the procedural guides published by the Ministry of Human Resources and Social Development for the decrees on the pharmacy profession (103111), the dentistry profession (103107), the radiography professions (51273), the medical laboratory professions (51267), the physiotherapy professions (51270), the therapeutic nutrition professions (51277), the medical devices and supplies sector (48081) and the optics sector (208837), and on the signed ministerial decisions attached to them, as to the percentages, the dates, the wage floors for counting, the professional accreditation condition and, where it was read, the scope of application; and on the page of the table of violations and penalties published by the Ministry, as to the table carried on it today being decree 112377.

No denominator of a percentage that was not read from the guide of its own decree is published in this guide, nor any worked example built on one, nor any job title attributed to a table of targeted professions, nor any fine amount attributed to a decree. Decrees that are updated from year to year have their dates reconsidered from their page at the Ministry before anything is built on them.

This guide is an organisational explanation and not legal advice. In a live dispute or a particular case, the statutory text and the competent authority remain the reference.