Singapore Physiotherapist Association 6th National Congress 2006

19 Aug 2006

By Mr Khaw Boon Wan, Minister for Health

Dr Margot Skinner,

AWP-WCPT President

Dr Celia Tan,

President Singapore Physiotherapy Association

Ms Mahadevi Barathi,

Chairperson, Organising Committee

Ladies and Gentlemen

Welcome to the 6th National Congress organized by the Singapore Physiotherapy Association.

Raising Standards

Your congress has set its focus on the changing role of allied health professionals in the Ergonomic Era. I am heartened to see your profession keeping pace with developments. This forward-looking attitude is vital among all healthcare professionals if we are to meet the changing needs of Singaporeans.

On Government's part, we will continue to upgrade healthcare professionals across the entire eco-system. Let me mention a few major initiatives.

For doctors, we are starting a second medical school. The Duke-NUS Graduate Medical School will accept its first intake next year. We are also putting in place a structured post-graduate training programme to help Family Physicians better manage their patients' needs.

For nurses, our new nursing degree programme at the NUS started 5 days ago. I was struck by the overwhelming response to this course, some 2,000 applicants for 50 places. This seems to confirm a trend of reviving interest in nursing as a profession. I am very much cheered by this. We must be doing something right in this initiative, enhancing the nursing career, making it challenging and satisfying to the nurses. In particular, I think we are on the right track to promote and develop the Advance Practice Nurse programme to enable the better skilled nurses to take on greater clinical responsibilities. The further empowerment of our nurses, in turn, will mean better care for our patients.

Allied Health Professionals

Allied health professionals play a very important role in our effort to deliver good quality healthcare to all Singaporeans. As we tackle the chronic diseases that come with an ageing population, allied health professionals will become vital players in disease prevention, disease management and disease rehabilitation.

For example, dieticians are crucial in teaching the public on eating right. Occupational therapists and physiotherapists are instrumental in helping our elderly remain mobile and able-bodied. Just this week, I read in ST's "Mind Your Body" supplement, heart-warming stories of how one physiotherapist helps her patients regain their mobility after a traumatic experience, be it stroke or accident. Full recovery may not be always possible, but to the patient, even a 25% recovery is dramatic. In this congress, you are promoting ergonomics, for example to avoid unnecessary backaches or injuries arising from poor posture among our many office workers.

The Government will continue to work with you to help raise professional standards.

Higher Degree for Locals

Recently, my Ministry has worked with the NUS to introduce a new Master of Science in Speech and Language Pathology. This programme, based on local conditions and incorporating knowledge of local languages such as Mandarin, Chinese dialects, Malay or Tamil, will begin in Jan 2007. It will help to ensure that the assessment and intervention programmes provided by our speech therapists will be more effective for our local patients. Like the nursing degree programme, it has received a strong response, with 150 applicants contending for the 20 places being offered.

Qualifying Examination for Foreigners

Meanwhile, we will continue to attract and recruit allied health professionals from overseas to augment our local supply. We take a global approach to foreign recruitment. But we must ensure that the standard of care is not compromised. That is why my Ministry has decided to introduce qualifying examinations from Oct 2006 for foreign-trained physiotherapists, occupational therapists, radiographers and radiation therapists recruited from non-traditional sources. The qualifying examinations, which comprise written and practical tests, will be held quarterly. Only persons who pass the assessments will be allowed to practice here.

Ensuring Affordability

As we work to raise the standard of our medical services, we work even harder to ensure that good medical care remains affordable to all Singaporeans. Our system of subsidy and 3Ms (Medisave, MediShield and Medifund) is fundamentally sound. But we must continue to recalibrate and refine it, to ensure its continuing relevance.

Last July, we implemented the MediShield reform. The reform was necessary. Prior to the reform, private insurers focused on cherry-picking, leaving basic MediShield to look after the poor and the sickly. As a result, basic MediShield paid out more in benefits than the premiums it collected. In 2004, for example, it incurred a deficit of $15 million and was operationally insolvent. The problem needed to be solved.

One year after the MediShield reform, we are pleased with the results. We set three objectives for the reform and we did well in all three.

First, we have restored Basic MediShield to financial health. We did this by fixing the flawed industry structure and eliminating cherry-picking. As a result, MediShield premiums are now able to cover the claims, with sufficient surplus set aside for future claims.

Second, patients with large hospital bills now get better financial protection. For Class B2 and C patients with bills between $5,000 and $10,000, the average MediShield payout used to be 48%. Based on the past several months' experience, it has now gone up to 60%, significantly reducing the financial burden on such patients. Co-payment by patients has dropped from 52% to 40%.

Third, MediShield reform has resulted in a more vibrant and competitive private health insurance market. Singaporeans now have more choices. There are 5 insurers providing Medisave approved products in the market now, instead of the earlier 3. Insurance products have doubled from 9 to 18.

Competition among the insurers has brought benefits to consumers. For example, NTUC IncomeShield and GE's Supreme Health have increased their daily ward and treatment claim limits, surgical limits, annual and lifetime limits. And there was hardly any increase in premiums.

As a result, more Singaporeans have subscribed to medical insurance. Significantly, 90% of working Singaporeans are now on MediShield or a Medisave-approved private insurance plan.

The major reform for MediShield is done. But the work is never finished. There will always be scope for occasional refinements.

Meanwhile, we will be implementing the Medisave scheme for the outpatient treatment of four chronic diseases. We are starting with diabetes and we expect to announce the implementation details for diabetes outpatient care soon.

Conclusion

On this note, I wish all of you a fruitful congress. Thank you.