Gleneagles Hospital 9th Annual Seminar

05 Aug 2007

By Prof K Satku

Venue: Sheraton Towers, Singapore

Dr Goh Jin Hian

Chief Executive Officer, Gleneagles Hospital

Dr Calvin Fones

Chairman, Organising Committee

Colleagues

Ladies and Gentlemen

It gives me great pleasure to be here with you today at the 9th Annual Seminar of Gleneagles Hospital.

Sudden and Unexpected Deaths

The theme for the seminar – Dealing with Sudden and Unexpected Deaths is a distressing one, on the surface. However if we look beyond this and study the causes and events leading to these incidents we may learn to anticipate and even prevent them. When we are not so fortunate, we must instead prepare ourselves to cope with them. Running through the program I note that the seminar this afternoon deals with many issues pertaining to the theme.

A sudden unexpected death is traumatic to the families involved and can cause anxiety to the general public as people ponder on the possibility that such events could also happen to them or their loved ones.

The public is naturally concerned about the seeming randomness of such events and whether they can do anything to protect themselves or their loved ones, be it through screening or other preventive measures.

Although there is a general sense that our ability to predict and prevent such events will always be limited by the complexities of the human body’s functioning and the vagaries of life, advances are being made. We now know that most sudden deaths are caused by cardiovascular conditions and only 3 to 4 percent remain of unknown aetiology.

I will not go into the specifics but in general as healthcare professionals, it remains our duty to explore the strategies that can be employed to minimise such occurrences. We should also comfort those affected and be a calming influence to the public at large. I commend you for having taken the time today to explore this issue.

Private Sector Playing a Bigger Role

May I now seek your indulgence to discuss another issue that is relevant to all present - how the private sector can play a bigger role in the overall national healthcare system.

There is often a perceived chasm between the public and private sectors within our healthcare system. We might view the other with a degree of suspicion and hold each other at arms length as though we were functioning in totally independent domains.

I think Singapore is too small for that and this approach is not efficient in view of our limited healthcare resources.

Let me explain further using specialist manpower as an example. The pool of good specialists in any available field is limited. No matter what the issue is, the same few names always crop up. So, for issues that are of national strategic importance, it will make sense to ensure that the private sector is fully engaged. This is especially so given the fairly large size of the private healthcare sector in Singapore.

Let me suggest some strategic areas in which I think the private sector can play a bigger role.

Training

Firstly, the nurturing of the next generation of medical professionals. Very often, only those in public practice are involved in teaching of some sort. When they leave for private practice, many consider it incompatible with continuing to teach.

The current mind-set amongst many is to “write-off” those who leave for full-time private practice. We cannot and must not. It is a tremendous loss to the nation as many of those who leave are senior clinicians with a wealth of knowledge and who are excellent teachers and role models. We need them to mentor the next generation of doctors and inculcate the correct professional values and ethos.  Leaving for the private sector is not synonymous with loss of such values and I would add that remaining in the public system is not synonymous with virtue either. What counts is how each individual conducts himself or herself, how each individual internalises the ethos of the medical profession and how he demonstrates it in his practice.

I will urge you, especially those who have been teaching prior to joining the private sector, to consider devoting part of your time to teaching and mentoring our residents and medical students.

Of course, this involves a certain amount of sacrifice on the part of individual clinicians. However, I hope you agree with me that one of our fundamental obligations as healthcare professionals is to help train our younger colleagues, just as we have benefited from the previous generation who trained us. Besides being an obligation clinical teaching builds collegiality and strengthens our profession. The Private sector doctors have a great capacity to contribute in this area and I will be proposing plans for significant engagement. I look forward to your support.

Giving Professional Input

Another area where the private sector can contribute is in giving professional input on issues which affect the health of Singaporeans. The public sector certainly does not have a monopoly on expert opinions and the private sector also has a role in shaping the national health agenda.

One way in which this can be done is to have the Academy of Medicine function as the common ground since specialists from both the private and public sector belong to the Academy.

MOH has recently engaged the Academy of Medicine through a Memorandum of Understanding to provide input on professional matters. I urge the specialists in the private sector to give your full support to this initiative.

Emergency Preparedness

Finally, private hospitals can play a bigger role in emergency preparedness. The events of the past few years in places like New York, Bali, London and Madrid have raised the spectre of possible terrorist attacks on Singapore soil. Even in the absence of terrorist threats, accidents resulting in mass casualties can also occur. Should such events befall Singapore, the preparedness of our healthcare institutions will be crucial in limiting the health impact on our society.

In such events, we have to depend on both the public and private healthcare infrastructure to cope with the sudden surge in patients. In addition, the proximity of a healthcare facility to the event site might make a critical difference in the health outcomes of those affected, making participation of all healthcare institutions essential in our national emergency preparedness planning.

Once activated, the emergency response team should be able to implement its emergency disaster plan to handle a sudden influx of casualties and victims, such as setting up a triage area, clearing non-emergency patients and visitors, and activating of doctors accredited with the hospital to support the increased manpower needs.

To ensure that such plans are indeed practical and feasible, healthcare institutions including the private hospitals must develop emergency preparedness plans and participate in relevant exercises.

Last year, some private hospitals participated in Exercise Sparrowhawk to test out their hospital influenza pandemic plans. We greatly appreciate the efforts taken to ensure that the exercises were a success.

We are in the midst of making emergency preparedness a licensing requirement for all hospitals under the Private Hospitals and Medical Clinics Act. This is because we recognise the critical need for all hospitals to maintain a certain level of preparedness in case of unforeseen emergencies.

I urge you to support such efforts so that our healthcare system can be in the best possible state of preparedness.

Conclusion

I am currently looking for a colleague from the private sector to spend a couple of sessions with me at the Ministry to bring the agenda that I have just articulated to fruition.

It is my sincere hope that all medical professionals, whether in public or private practice will be able to see and identify themselves as part of the greater national healthcare system.

I know that time is valuable for many of you, especially since this is a Sunday. I’ll end here and wish you a very fruitful learning experience this afternoon.

Thank you.