Raffles Medical Group's 25th Anniversary Dinner

28 Jul 2001

By Mr Lim Hng Kiang

Dr Loo Choon Yong, Executive Chairman, Raffles Medical Group

Distinguished guests

Ladies and Gentlemen

It is my pleasure to join you this evening at the 25^th Anniversary Dinner of the Raffles Medical Group (RMG).

RMG has grown steadily over the past 25 years. When RMG was first founded in 1976, it consisted of only 2 clinics in the busy Central Business District. Today, the group comprises a network of more than 60 clinics distributed throughout the island and a 400 bed acute care hospital. The group provides medical services that span the entire healthcare spectrum, ranging from primary healthcare to specialised tertiary care. It also provides ancillary healthcare services such as health screening and diagnostics, international medical assistance and healthcare management consultancy.

The role of the private sector

Singaporeans enjoy good health today. For example, the life expectancy of Singaporeans has increased from 66 years thirty years ago to 78 years today. This is the result of our economic success and a healthcare delivery system that provides good and affordable health care to all Singaporeans.

The private sector has had an important role in Singapore's healthcare system, complementing the public sector by providing a full range of personalised, quality clinical services for patients in Singapore. The private sector currently provides about 20% of acute hospital beds. We encourage the private sector to continue to develop and grow.

Today, however, like their counterparts in most other sectors, private specialists are facing increasing competition. New clinical facilities in neighbouring countries are offering clinical services at lower rates. At the same time, due to the difficult economic conditions in the region, fewer foreign patients are coming to Singapore for medical treatment. The majority of these patients are treated at private hospitals. The number of foreign patients admitted to Singapore hospitals has dropped by 25% from the peak in 1997. Private specialists and private healthcare providers need to respond to these challenges by actively upgrading their capabilities and by exploring new ways to re-position themselves. This would also help us to maintain our standing as a centre of medical excellence.

Maintaining medical excellence in the private sector

Specialists have to hone and upgrade their skills constantly to be able to provide the highest standards of care. This is achieved through effective continuing professional development programmes. I am happy to note that there is a high level of such activity today. All our major private hospitals have active continuing professional development programmes. These include regular lectures, updates and seminars as well as hands-on skills training for proceduralists. I would like to urge private specialists and hospitals to do even more so that the public will remain confident that our specialists are keeping up to date with the latest medical advances.

Another approach to improving care provision is through the adoption of an institutional model of private specialist practice. This is what RMG is doing. It has organised itself as a multidisciplinary group practice which incorporates best practices from both the public and private sector. An institutional model of clinical care delivery which adopts team-based care and structured protocols of treatment will help ensure that patients receive well-integrated treatment. At the same time, it will allow for more structured clinical quality assurance to ensure that care delivered is of a high quality.

A third approach is for private specialist hospitals and groups to link up with centres of excellence elsewhere. For example, RMG's collaborative arrangements with the Memorial Sloan Kettering Cancer Centre in New York will allow RMG to further strengthen its medical expertise. However, private specialists should not just look overseas for such partnerships, since there are many mutual benefits to be gained through a closer working relationship with our own public sector institutions.

Closer public-private sector collaboration:

Closer collaboration between the public and the private healthcare sectors can yield important benefits for both sectors as well as for Singaporeans as a whole. Let me elaborate.

First, GP-cluster networking. General practitioners (GPs) in the private sector handle more than 80% of primary healthcare in Singapore and play a pivotal role in the provision of primary healthcare. In recognition of this, both the National Healthcare Group (NHG) and Singapore Healthcare Services (SingHealth) have set up networks with GPs. Under SingHealth's GP Empowerment Programme and the NHG's Partners Club Programme, affiliated GPs are able to refer patients to the clusters' hospitals and specialist outpatient clinics directly and more quickly. There are closer and more formal professional linkages between GPs and hospital specialists through CME and shared care programmes.

In these programmes, the primary physician works closely with the institution as a team to provide patients with integrated care. Examples of joint programmes include the NHG Cancer Programme and KK Hospital's Shared Care Programme for the Management of Childhood Asthma. Such a network allows for the seamless care of patients. In the NHG Cancer Programme, GPs play key roles in areas such as providing for the early screening for cancer and delivering public health education programmes. They also co-manage the complications of cancer therapy and the provision of palliative care. The institutions on the other hand are able to facilitate easy and quick access to referrals and diagnosis and to focus on acute multi-disciplinary team-based care.

Second, specialist public-private sector collaboration. At the tertiary healthcare level, we already have private specialists who make major contributions to programmes in our public hospitals. This includes the liver transplant programme at NUH and the heart/lung transplantation programme at the National Heart Centre. There is definitely room for more of such joint programmes. Having only a limited pool of clinical expertise, we need public and private sector physicians to work together.

For solo specialists in private practice, because of the nature of private practice work, the opportunity to sub-specialise and to keep up with the latest medical techniques may be limited. At the same time, medical students and specialists-in-training lose the opportunity to learn from such top specialists. In recognition of this, my Ministry introduced the Faculty Practice Plan (FPP) in January this year.

The FPP not only provides a scheme that allows public sector physicians to participate in private practice, but it also provides a mechanism for private sector doctors to return to institutional practice. This in turn provides opportunities for exposure to teaching and research, and facilitates greater exchange between public and private sector doctors on the latest clinical advances in treatment and cutting edge medical technology.

The SNEC Eye Associates, which began operations at Mount Elizabeth Hospital in May this year and the SingHealth Specialist Centre which is to be situated in Gleneagles Hospital are two recent examples of public sector participation in private practice. At the same time, private sector specialists have been invited to offer their services in public hospitals and specialist outpatient clinics on a sessional basis. To date more than 200 such specialists have taken part in this part time scheme.

Third, research. Medical research provides an added opportunity for public and private sector collaboration. Such combined efforts will help to strengthen Singapore as a research hub and as a leader in clinical research. It allows for the pooling of resources and the sharing of expertise. An example of collaborative research would be in the area of multicentre clinical trials. To facilitate multicentre clinical trial research in Singapore my Ministry has set up the Clinical Trials Coordinating Committee. The private sector should take full advantage of such opportunities to collaborate in medical research.

Conclusion

In the pursuit of medical excellence, I am happy to see that the less fortunate have not been forgotten. RMG's pledge to set aside half a percent of its annual profits for charitable causes over the next five years and its plan to raise $250,000 for charity in its 25^th anniversary donation drive is indeed a step in the right direction.

Finally, I would like to congratulate Dr Loo Choon Yong and the doctors and staff of Raffles Medical Group on your 25^th Anniversary. I wish you every success in your future endeavours as well as a pleasant and enjoyable evening.