First International Medical Travel Conference

14 Dec 2006

By Mr Khaw Boon Wan, Minister for Health

Venue: Grand Hyatt Hotel

Ladies and Gentlemen

MEDICAL TRAVEL 

When the term "medical tourism" was first coined, it was frowned upon by some people. That patients could be like tourists seemed to be a strange idea. Patients are often in pain and misery, while tourists are in search of fun and pleasure. The two just do not seem compatible.

But over time, people got used to the concept of seeking medical treatment across borders. Eventually, the term has been replaced by "medical travel" which I agree is a more appropriate description. While the first flow of medical tourists were largely for cosmetic treatment, patients with serious illnesses are now crossing international borders regularly. When you are sick, you want to be treated by the best that you can afford. Many patients now travel exclusively for medical care. It is no longer a subset of tourism but rather an extension and internationalization of healthcare. With easier travel and global competition, medical travel as a trend will continue. And even more people can afford cross-border medical treatment now with the many low-cost carriers operating in the region.

Today, more than 1.3 million people travel to or within Asia for medical services every year. As the middle class in China and India expands, we can expect this number to grow. One study projects a total annual expenditure of $7 billion for the Asian medical travel market within the next 5 years. 

SINGAPOREMEDICINE

Singapore has been serving foreign patients for decades. But as the numbers grew, we could not simply leave the market to develop by itself. To serve the patients better, we decided that we should be more proactive in organizing ourselves. In 2003, I launched the SingaporeMedicine initiative in response to this need. It is an inter-Ministry initiative to facilitate the foreign patients' entry and exit and to ensure that they receive good value for money. Do they have visa problems? How can we speed up visa approval? Do they know which hospitals to go to? How do they know if they are getting value for money? What are the needs of the family members who accompany the patients? How can we facilitate their hotel accommodation and shopping needs? Do they have a problem communicating in their own languages? All these require a systematic and professional approach.

Our proactive efforts have been useful. In 2002, 200,000 foreign patients came to Singapore for treatment. Last year, the number doubled. This is an average growth rate of 20% per year. Patients come from a wide region. Besides the traditional ASEAN market, we also receive patients from the Middle East, Russia, Africa, Europe and US.

This is a competitive business. Foreign patients now have many choices. From our foreign patients, we gather that they appreciate our quality of care. They said that we have good hospitals, not just one or two hospitals or specialties but we provide good care across a wide spectrum. We are still learning and benchmarking ourselves against the best in the world. Almost all our hospitals have obtained Joint Commission International accreditation, even though we do not impose such a requirement. Some CEOs told me that they did it just to benchmark and to learn from others. One CEO said he did it just for the fun of it. By upholding international safety standards, we can assure our patients that the doctors and nurses are competent, our blood supply is safe, medical devices are reliable and so on. Above all, we pride ourselves in delivering a high ethical standard of medical treatment. We frown upon over-servicing and profiteering at the expense of unsuspecting patients. We encourage transparency and regularly publish hospital bill sizes so that patients can make informed choices.  We have also begun to publish quality outcome data.

We will continue to build on our strengths and make ourselves better. I am confident that SingaporeMedicine will succeed because we have been tracking our clinical performance. Our results match the best centres in the US and Europe. Yet, our costs are but a fraction of those charged in the West. Combined with the fact that Singapore has a very organized and safe environment and is well-connected to every major city in the world, it is very attractive and easy for patients to come here for treatment.

Actually, we push SingaporeMedicine, not solely for the purpose of attracting foreign patients. We do this for the good of our own Singaporean patients. Singaporeans will continue to expect a high standard of care and at an affordable rate. To meet their expectations, we have to continue to raise our medical standards while keeping cost affordable.

This morning, let me focus on two major strategies.

ENHANCING OUR CAPABILITIES

First, we will continue to leverage on medical advances to better serve our patients. Patients' primary objective is speedy recovery. They want to know what is wrong with them and how to be healthy again if it is medically possible. This requires a professional team to be able to make a speedy and accurate diagnosis, followed up by competent, effective treatment.

Modern hospitals and clinics and other hardware investments play a role, but what is critical is medical talent and consistent nursing care. That is why we have always invested in medical capabilities. We have sent almost all our specialists, and many nurses, administrators and other staff for training and attachment in some of the best centres in the world. Our investment has served us well as manpower development is the key to good healthcare.

This has given us a strong foundation to enter the next phase of development whereby our medical teams should also be active players in the development of medical advances. We are moving SingaporeMedicine in this direction. This is a natural follow-up development to our Biomedical Sciences (BMS) Initiative. Recently, we reviewed our progress in biomedical sciences and decided that in the next phase of the BMS Initiative, we will pay particular attention to translational and clinical research. The strategic intent is to bring the discoveries from basic sciences in the laboratories and translate them into effective treatment for our patients - "from bench to bedside". In this way, we hope to bring our multi-billion-dollar investments in biomedical sciences to directly benefit our patients, resulting in good diagnosis and effective treatment.

Over the next 5 years, the Government will invest $1.5 billion in translational and clinical research. This is a major investment in new clinical capabilities. Along the way, we shall transform the culture in our hospitals. While patient-care will remain the key preoccupation, there will be a growing culture on clinical research and teaching.

This is why we have started a second medical school, in cooperation with Duke University, to produce more clinician-scientists. This is why our National University Hospital is collaborating with St Jude Children's Research Hospital to enhance its capabilities in cell-based therapy and leukemia. This will bring hope to children suffering from cancer in the region.

This is also why we have re-organised our National Medical Research Council to more strategically oversee the implementation of the clinical research programmes. We have to make sure that the new investments are put to good use and research grants are efficiently and effectively awarded to the most deserving teams. We are fortunate to have Prof Edward Holmes chairing our revamped NMRC. He brings with him immense expertise and experience in this field.

Last week, our Biomedical Sciences International Advisory Council (IAC) had a very productive discussion here. They were pleased with our progress in biomedical sciences and fully endorsed our decision to focus on translational and clinical research in the next phase of development. They believed that Singapore had the necessary ingredients to succeed in becoming a leading biomedical hub.

To realize this vision, the IAC advised that it would be important for Singapore to establish academic medical centres (AMCs) that would foster stronger integration between our medical schools and hospitals, with joint governance by the relevant stakeholders. They believed that this was essential to the success of the next phase of our Biomedical Sciences Initiative. We will not be able to reap the full benefits of our investments in Biopolis if we do not have a world-class AMC to support the translation of new knowledge and technologies arising from our academicians and scientists into new drugs and treatments to improve patient care in our hospitals.

The IAC was so convinced of this move that a select panel of the IAC members led by Co-Chairmen Sir Richard Sykes (Rector, Imperial College) and Dr John Mendelsohn (President, M.D. Anderson Cancer Centre) agreed to help us translate this recommendation into reality. We are grateful for their assistance and are actively following up with them on this.  

EXPANDING OUR CAPACITY

Second, we are gearing up for the expansion in foreign patients to Singapore. We are ramping up the training and recruitment of doctors, nurses and allied health professionals. 

We have invested heavily in hardware development. Our hospitals have all been rebuilt and continuously upgraded with the latest technologies. At the same time, we need more hospitals to meet the expanding needs. Last month, I witnessed the ground-breaking ceremony of our next public hospital, AH@Yishun. This is a major investment, costing more than $550 million for 550 beds. It will open in 2009.

Private hospitals will need to expand too. They are bullish about the outlook of the medical travel industry here. They have given us feedback on the need for land to allow them to expand, to build new hospitals and day surgery centres. 

My Ministry is working closely with the Ministry of National Development and the Urban Redevelopment Authority to identify sites for new private hospitals, medical suites and other supporting facilities. To meet the target of 1 million foreign patients by 2012, we will need URA's help to release more sites for private hospital development over the next few years. Otherwise, Singapore will be missing out on such opportunities. 

CONCLUSION

This conference provides an opportunity for the various stakeholders in the international medical travel industry to network and discuss the latest ideas. I am glad that you are forming the International Medical Travel Association in Singapore to bring together the leading agencies and decision-makers in your industry.edical travel is growing and its potential is huge. You are pioneers in this industry and there will be many teething problems and obstacles to your growth. A platform like the IMTC provides an opportunity for you all to share experiences and collaborate on new opportunities.

On this note, I declare the inaugural International Medical Travel Conference open.