Official Opening of the International College of Surgeons, Singapore Congress

01 Apr 2006

By Dr Balaji Sadasivan, Senior Minister of State for Information, Communications and the Arts And Health

Venue: Shangri-La Hotel, Singapore

Professor Nadey Hakim

World President, International College of Surgeons;

Professor Christopher Chen,

Corporate Secretary and President,

International College of Surgeons, Singapore Section;

Professor Peter Lim,

Organising Chairman,

International College of Surgeons, Singapore Congress 2006;

Distinguished guests, colleagues,

Ladies and gentlemen,

Good morning. It gives me great pleasure to join you at the official opening of the International College of Surgeons, Singapore Congress 2006. The International College of Surgeons, or ICS, is a world federation of general surgeons and surgical specialists. Founded in Geneva, Switzerland, in 1935 by Dr. Max Thorek, it now has over 70 organized national sections around the world with more than 8,000 surgeons and surgical specialists in over 110 countries. Singapore is proud to be home to one of these sections. Established through the efforts of Professor Christopher Chen and Professor Peter Lim about 16 years ago, the Singapore section has grown from strength to strength, organizing a number of ICS meetings through the years, including the ICS World Congress in the year 2000.

ROLE OF INTERNATIONAL PROFESSIONAL BODIES

The founders and early leaders of ICS were visionaries in that they could forsee the need for an international organisation of surgeons when most twentieth century clinicians were usually more parochial. The ICS is today an important international organisation in a globalised world. It serves as an invaluable resource and opportunity for scientific and professional exchanges. With the aim of improving the lives of patients throughout the world through the development and education of ICS members, the presence of ICS in Singapore serves to make our local and regional surgeons better clinicians. Singapore is honoured to play host to the ICS.

The ICS Singapore Congress 2006 is an outstanding international meeting bringing together local, regional and international surgeons of all specialties. Participants will be able to tap into the wide variety of expertise available at the congress to stimulate their own learning. Furthermore, collegiality between surgical professionals the world over will be enhanced, promoting understanding, trust and mutual respect. Lasting friendships will also be forged between surgical professionals from various countries.

THINK GLOBALLY, ACT LOCALLY

As the globalisation of medicine and healthcare progresses, it is inevitable that surgery too will become more international. We are at the start of a dramatic evolution of surgery in the 21st century. I will give two examples of this phenomena.

In September 2001, the world???s most expensive surgery costing about a million dollars was performed, when the gallbladder was removed from a 68 year old lady in Strasbourg, France. But the surgeons were not in France, they were in New York. The operation was done through a robot controlled from thousands of miles away. This was the first case of trans-Atlantic tele-surgery made possible by the use of high-speed broadband fibre-optic service of 10Mbits per sec. Today, 5 years later, the speed of 10Mbits per sec soundss slow because we will soon have 100Mbits per sec broadband speeds in Singapore this year and 1 Gigabit speeds in 2-3 years. So with increases in broadband speeds, more and better telesurgery will become possible.

Another example of the internationalisation of surgery was the Iranian conjoint twin operation performed in Singapore. The surgical team consisted of top surgeons from the US, Europe and Japan. They came together to give the Iranian twins their best chance of success. I am not aware of such an international cast of surgeons being assembled for a surgery before this case.

Although the two examples are dramatic, there are many less dramatic but more far-reaching changes occurring in medicine with the globalisation of healthcare. These changes cause healthcare workers, patients and healthcare services to cross national borders.

There is a global shortage of well qualified doctors, nurses and allied health workers and the market for this manpower is global. Trans-national recruitment is common. Our hospital nurses are given brochures at bus-stops enticing them to work in developed countries. There are advertisements for Medical officers to work in Australia. A UK team was in Singapore 2 years ago to recruit consultants. To staff our hospitals we have to pay globally competitive wages. Singapore, too, has to tap into the global market for well trained doctors. The Singapore Medical Council is progressively recognising more degrees from good medical schools. With this change, we will have more foreign-trained doctors working in Singapore. The ability to recruit more doctors internationally will allow our public hospitals to provide better care.

Patients now have more choices in a globalised world as they can seek treatment across national borders. Just as in the past, when some Singapore patients used to go abroad for cutting edge treatment, last year more than 300,000 patients from the region came to Singapore for treatment. Some surgical services like cataract and cosmetic surgery are becoming commoditised and sold as part of tourist vacation packages. This will increase the traffic in surgical patients across borders. Sometimes it is governments that move patients across borders. This occurs when it is more cost-efficient for countries to send their patients abroad for surgical procedures. For example, in order to cut the waiting lists, the NHS in UK sent patients to Europe for surgery.

The healthcare industry is becoming globalised. The adoption of common standards like the Joint Commission Hospital Accreditation standards by hospitals across the world facilitates this process. To keep the cost of healthcare affordable, healthcare providers often outsource parts of their operations to low cost centres in other countries. By doing this, they are able to pass the savings to their patients in terms of lower costs. Information technology, billing, transcription and record keeping services were the first services to be outsourced. But the outsourcing revolution continues. Since the start of the year, Radiology X-ray reporting in the NHG cluster in Singapore has been outsourced to India. This reduces the cost to the NHG hospitals. Eventually the patients will benefit because their bills will be lower.

Adjusting to globalisation can be difficult. In the year 2000, a famous heart surgeon in Argentina, Dr Favaloro, shot himself through the heart. A brilliant surgeon, he returned to Argentina from the Cleveland Clinic and started a heart foundation to provide heart surgery for everyone including the uninsured poor who could not pay for their treatment. Naturally such a foundation was not financially viable and it collapsed in debts. He blamed globalisation. Unable to stop free market economics, in despair, he committed suicide.

I hope none of you are contemplating such a drastic response to the effects of globalisation. An International professional college like ICS can provide its members with an intimate understanding of global issues affecting healthcare and surgery and help members adapt to change. In a sense, the presence of the international college of surgeons in Singapore will help engender amongst our local colleagues a ???think globally, act locally??? outlook. Such an outlook would be crucial for the future of the surgical profession in the ever changing field of surgery in an ever changing globalised world. And in the globalised world, surgeons will look to international organisations like the ICS for leadership in determining the future of surgery.

CONCLUSION

I am are especially honoured to have Professor Nadey Hakim and the ICS Council members here in Singapore and I thank the ICS for bestowing upon me the prestigious the Honorary Fellowship of the College. I am proud to be a fellow of such an august body.

In closing, I wish to congratulate Professor Christopher Chen, World Corporate Secretary of the ICS, President of the Singapore Section, as well as Congress President of the Singapore Congress 2006 for his efforts in making this Congress possible. I also congratulate Professor Peter Lim, Congress Chairman for his hard work and magnificent organisation to make this Congress a resounding success. The Singapore Section of the ICS and all members of the Committee of the Singapore Congress 2006 have done a magnificent job in organizing this congress. On this note, I am very happy to declare the Congress open.

Thank you.