Speech by Mr Gan Kim Yong, Minister for Health at the National Medical Excellence Awards Ceremony

05 Jul 2011

By Mr Gan Kim Yong
Venue: National Medical Excellence Awards Ceremony, Pan Pacific Hotel

Ladies and gentlemen, good evening. It gives me great pleasure to be here today for the fourth National Medical Excellence Awards (NMEA). The NMEA recognises our healthcare personnel who have made outstanding contributions in clinical quality, mentorship, education and research. I am delighted to be among such distinguished company this evening.

2.          Healthcare is a highly complex subject, with many challenges and few easy answers. I was made fully aware of this when I was appointed Deputy Chairman of the Government Parliamentary Committee for Health in 2002. I worked with the government on healthcare affordability, an important issue for all Singaporeans. I had also looked into coverage of our elderly under ElderShield, which was introduced for those who need long-term care, especially during old age. Almost ten years hence, ensuring affordability and meeting the healthcare needs of our ageing population continue to rank among our foremost priorities.

3.          Over the past month or so, I have been visiting various hospitals and healthcare institutions. In fact, I have just visited SGH this morning, and shall be making more visits in the forthcoming weeks, including to community hospitals and nursing homes. The medical and service excellence that I have seen is impressive. More importantly, I have come away from these visits with deep respect for the many men and women in our hospitals and healthcare institutions – doctors, nurses, pharmacists, allied health professionals – whose dedication and professionalism they demonstrate day after day in service of Singaporeans. What I have seen so far has reinforced my view that our fundamentals are sound.

4.          However, it is clear that there are still many challenges confronting us today. As I mentioned earlier, affordability of healthcare is a perennial issue. Many Singaporeans, including the middle-class, are worried about whether they can afford to pay for the care they may need in the future, or whether there will be beds in our hospitals or nursing homes when they or their loved ones need it. The demands on our healthcare system will only grow with our rapidly greying population. More than that, the nature of these demands is also more challenging than what we have had to deal with erstwhile. At the same time, advances in medical science and the development of new care models are changing existing paradigms of how healthcare services are best delivered and managed.  These issues are set against a national backdrop of growing societal, economic and political maturity in Singapore. Expectations are higher than ever before.

What MOH is doing to strengthen the healthcare eco-system

5.          MOH is undertaking a thorough policy review to see how we can strengthen our healthcare ecosystem to better address these challenges. Medical service is critical in meeting our national healthcare needs. The quality of such service is in turn dependent on our having dedicated educators and mentors who train and inspire our clinicians. While a strong educational foundation is necessary for medical research and innovation to harness new technologies, develop cutting-edge healthcare solutions, and adapt such solutions for mass adoption, the tracking of health outcomes provides valuable data and information that facilitates teaching and research.

6.          The policy review that MOH is undertaking will take some time, as the issues are complex and require close study. Among other things, we will look into the key issue of affordability, and how we can strengthen and widen our safety net in an effective and sustainable way for Singaporeans. A key area will be how we can fine-tune our existing 3Ms framework to make healthcare costs more affordable. At the same time, we are continuing with our efforts to enhance medical service. I will touch on three areas today – the expansion of our infrastructural capacity, ensuring sufficient and good quality manpower, and our ageing population.

7.           First, healthcare infrastructure. We have a network of highly regarded hospitals and healthcare institutions, many of which have achieved Joint Commission International accreditation. But what we need to do more is to make sure that we have sufficient capacity and also the right type of capacity. This means building more hospitals and increasing the number of hospital beds. However, it would be simplistic to assume that we can simply keep building hospitals as a long-term solution. This is neither feasible nor desirable. This is why MOH has also been working towards expanding our community hospitals, nursing homes and homecare; in other words, growing our intermediate and long-term care (ILTC) sector as a whole. Providing a range of step-down options will allow Singaporeans to obtain the care they need at appropriate settings while keeping healthcare costs affordable. We will need to work closely with the private sector and VWO sector. This would require the right regulatory and funding model to ensure that such institutions are viable and provide affordable services while maintaining the high standards of care that we expect from them. Caring for our sick and elderly is a demanding task; we need people with passion, the right skills, training and temperament. We are therefore also looking at how we can fund the upgrading of ILTC manpower.  This brings me to the next point.

8.           Sufficient and high quality medical talent. This requires the right programmes for education and training, as well as good career opportunities to attract and retain healthcare professionals. Let me touch first on education. The cornerstone of medical education is our institutions - to train the next generation of healthcare professionals.  We have anchored new institutions in Singapore such as Duke-NUS Graduate Medical School, and plans are underway for our third medical school and the new Geriatric Education and Research Institute. We will also strengthen continuing education for our healthcare professionals. In the area of research, MOH will continue to work with the National Medical Research Council to fund worthy clinical research projects, and build up our talent pool of clinician scientists.

9.         We have implemented the new residency programme to provide supervised and structured training to our medical graduates in the crucial formative years of their career, as they pursue specialisation. To cater to our ageing population, more specialist training in disciplines such as Geriatrics and Internal Medicine will also be needed. In addition, we are reviewing the compensation framework to better retain our top doctors and healthcare professionals in the public sector, as part of our wider efforts in talent attraction and retention. In terms of careers, we are expanding nursing career tracks and making new investments in allied health training.

10.         Third, our ageing population. As I mentioned earlier, we will be stepping up our infrastructural and manpower capacity to address the healthcare needs of our ageing population. Over and above these efforts, we will press on with our strategic goal of integrated care under the Regional Health Systems (RHS). Our long-term vision is for the RHS to provide seamless healthcare services and raise overall population health within their respective geographic areas. In this regard, service planning must be improved. This means that national and regional healthcare needs must be assessed more carefully, with a view toward translating such needs into clinical service plans based on integrated care pathways. For this to work, the RHS must be financially sustainable. Additional incentives to fund preventive care, care integration and right-site patients to the most appropriate healthcare setting will need to be in place. We will also need to enhance the governance and regulation of healthcare providers, including those in the ILTC sector.

Working Together

11.         Clearly, there is much work ahead of us. All of us must work closely together if we are to succeed in ensuring that Singaporeans continue to have access to good quality and affordable healthcare in the decades ahead. And by “all of us”, I am referring to clinicians, educators, scientists, nurses, pharmacists and allied health professionals in both the public and private sectors as well as policy-makers – each of whom has a role to play in our evolving healthcare eco-system. It is imperative that we work in a close and collaborative partnership, for the healthcare challenges today are simply much too complex and multi-faceted for any one of us to address adequately on our own. It is only by cooperating closely and leveraging on our collective strengths that we can achieve more together, as a team.

12.         Policies and structures are important, but ultimately, our healthcare eco-system is only as good as our people. The NMEA is a timely reminder of this, as we come together to celebrate the achievements of some of our most accomplished clinicians, including in the areas of mentorship, education and research. The constant pursuit of excellence is a key driving force in the robustness of our healthcare eco-system.

Ethos and Values

13.         Yet such achievements mean little if they are not underpinned by the core values and ethos of medicine. Doctors have traditionally held a special place in society for the life-saving, life-preserving work that they do. Medicine has long been seen not so much as a mere occupation, but a higher calling that goes beyond monetary rewards. There is justifiable pride in the good work that doctors do in healing patients. As we honour the winners of the NMEA tonight, let us also remember that at its best, medicine is about helping our fellow human beings with compassion and empathy. The German physician, philosopher and humanitarian Albert Schweitzer once said that ethics is nothing more than reverence for life. I think this encapsulates rather neatly the basic values and ethos of medicine. Ultimately, medical excellence as well as values and ethics should drive all that we do in medicine and in our healthcare eco-system.

14.         My warmest congratulations once again to this year’s NMEA winners. Well done indeed. I am certain that our healthcare eco-system will have many more achievements to celebrate in the years ahead, as all of us work closely together toward our shared goal of a healthy Singapore.

Thank you.