The 6th Annual Seminar Of Gleneagles Hospital

23 May 2004

By Dr Balaji Sadasivan

Venue: Sheraton Towers

Dr Timonthy Low, General Manager, Gleneagles Hospital

Dr Leong Keng Hong, Chairman of the Organising Committee of the 6th Annual Seminar of Gleneagles Hospital

Ladies and Gentlemen

I would like to thank the organising committee for inviting me to speak at your annual seminar. It is always a pleasure to meet with my fellow colleagues in medicine. I would also like to commend Gleneagles for taking the effort to organise these annual seminars to enable doctors to share their knowledge and learn from each other.

Technological improvement and innovation is proceeding at an unprecedented pace. What had been thought of in science fiction is becoming science fact. In the 1960s, there was a movie entitled 'Fantastic Voyage' in which a group of scientists are miniaturised and travel inside a patient. The movie had imagined scenes of what we might see from that point of view. Today, endoscopy is a standard procedure that enables us to visualise internal structures of the body, and recently miniaturisation has given us wireless capsule endoscopy, where a patient swallows a small pill containing a video camera which travels through the gut and allows us to see its entire length. More recently, Star Trek movies have an alien race, the Borg, which uses tiny machines at the molecular level to affect the physiology of other races. In real life, engineers are working to develop the field of nanotechnology, and perhaps one day we will have 'nanobots' that we can use to treat disease at the molecular level.

What all this means for doctors is that we have to keep up with advances in technology. We need to ensure that we are offering our patients the most effective and efficient treatments that are available. In addition, Singapore's economy as a whole would also benefit when doctors take an active role in upgrading their skills and knowledge. Medical tourism is a growing sector that Singapore can develop. The Healthcare Services Working Group of the Economic Review Committee proposed that Singapore aim to increase the number of foreign patient visitors to one million a year by the year 2012, thereby contributing some $2.6 billion of value-add to our GDP.

SingaporeMedicine is a multi-agency government initiative aimed at making Singapore's world-class healthcare services easily accessible to international patients. Since the launch of SingaporeMedicine, the Singapore Tourism Board (STB) has been working hand-in-hand with healthcare providers to market and promote their services overseas and establish Singapore as a regional medical hub.

As part of STB's strategies, they have been organising road shows and taking part in health tourism tradeshows in Indonesia, Malaysia, and the Middle East, inviting healthcare providers to join them on such road shows. Awareness of Singapore's healthcare services and that of the hospitals are further reinforced by print and TV advertising campaigns in various markets. STB has also been inviting overseas journalists and doctors to Singapore to showcase our facilities and expertise, creating opportunities for our hospitals and doctors to network and build relationships with potential referral sources.  To further help our hospitals, incentive schemes were developed by STB to encourage our hospitals to do more in foreign patient-centred market, business and product development.

I am glad to say that Parkway Group Healthcare is one of the most active private healthcare players which has been heeding the call to leverage on the various initiatives of SingaporeMedicine.

However, I must warn you that we are not alone in trying to attract foreign patients. For example, an article in the Sunday Times earlier this month featured the Bumrungrad Hospital in Bangkok and how it is successfully marketing itself to foreigners as a venue for cheap but good quality healthcare. The article highlighted that one day's stay in a four-bed ward costs only US$20, and that Bangkok's private specialists earn between US$30,000 and US$60,000 a year. It takes them a year to earn what an equivalent specialist here would make in just two months.

What does such competition mean for us? It is difficult for us to compete on price; so we need to focus on the quality of care that is provided. We must ensure that the quality and standard of medical care in Singapore is the highest in Asia and one of the highest in the world.  It is all the more important that we are not seen as lagging behind others in health technology. This is where seminars such as this one come in useful: by educating doctors on the latest advances in health technology. The theme of this seminar is very appropriate in that respect: "New Tests & New Treatments: Facts & Fallacies".

If Singapore is to emerge as a medical hub and the venue of choice for medical treatment in the region, we must not lag behind in using innovations that work. Here is where the discipline of Health Technology Assessment can help us to identify new technologies that work.

Health Technology Assessment, or HTA, is the comprehensive evaluation of existing and emerging medical technologies in regard to their medical, economic, social and ethical effects. The technologies referred to can be drugs, devices, procedures or services. This evaluation asks four fundamental questions:

(1) Does the technology work?

(2) For whom?

(3) At what cost?

(4) How does it compare with the alternatives?

Knowing the answers to these questions will help us more clearly decide if a technology is worth adopting or not. A useful subset of HTA is Horizon Scanning. This is the activity of keeping an eye on the cutting edge of medical research to identify new technologies that may have significant impact on health services.

The capability to perform HTA and horizon scanning needs to be developed. We should develop our capability of evaluating technology and become first movers in the medical marketplace.

To conclude, Arthur C. Clarke, the astrophysicist and science fiction writer said that "Any sufficiently advanced technology is indistinguishable from magic". The challenge for us is to understand and master technology so that we can wield the "magic" for the benefit of our patients. I wish you all an enjoyable annual seminar.