The Graduation Ceremony Of The Institute Of Chinese Medical Studies

11 Apr 2004

By Mr Khaw Boon Wan

Venue: The Meritus Mandarin Hotel

"BEYOND ACUPUNCTURE"

Mr Sia Bak Chiang

President, Association for Promoting Chinese Medicine

Ms Kwek Mei Lin

Principal, Institute of Chinese Medical Studies

Distinguished Guests

Ladies and Gentlemen

Last month, I was in Nanjing to launch the inaugural SIA flight between Nanjing and Singapore. I took the opportunity to visit the Nanjing TCM University at its brand new campus. I was especially glad to meet the 30+ Singaporean students studying TCM there.

What struck me was that some of our students there study TCM for personal health interest. They have no plan to become a TCM practitioner but they are attracted to this ancient practice. As they probe deeper into the philosophy and try it on themselves, they discover a whole new world and along the way, find their health improving.

One Singaporean student there told me that he intends to pursue a Master Degree, and then PhD in TCM, purely in pursuit of the knowledge and the health benefits he has experienced. I was struck by this insight and his positive experience. I cheer him on.

I too hope that I would have an opportunity to learn about TCM as a student. Dr Hong Hai pursued this after he retired from politics. That is something for me to think about in due course.

In Singapore, public interest in TCM goes back many years. Take your Institute as an example. The Institute of Chinese Medical Studies was established in 1972. I am told that the founding of the school was a result of public interest in acupuncture after it became popularized during the visit of President Nixon to China that year. The Nixon visit stimulated an overnight global awareness of the amazing ability of using acupuncture in anaesthesia for surgery.

Mixing East and West?

China, post-Nixon visit, has undergone a transformation. Along with it, TCM has developed by leaps and bounds. The Principal of the Nanjing TCM University told me that they had initially thought that the key to further progress was to integrate east and west. But their experience has shown that such artificial integration would destroy both.

The reason is that the basis and approach of TCM and Western medicine are fundamentally different. There are many things about TCM that we have no answers to, and we may not be able to get the answers via the western approach.

This is also the reason why all healthcare regulators, both in the East and the West, find it challenging to regulate TCM. In Western medicine, the operating principle is evidence-based medicine. If we say that a particular drug or a particular treatment works, it is backed by clinical trials and research findings which have been subject to international scrutiny.

Although TCM is increasingly subject to evidence-based tests in countries like China and Japan where leading universities teach and conduct research in TCM, the level of rigour has not reached that required by Western medicine.

Should we then accept a lower standard of evidence for TCM? Or should we apply the evidence-based principle strictly? A strictly conservative approach would however make it difficult for the practice to continue, let alone grow. This will deprive consumers of a service which has provided much relief and comfort to generations of Singaporeans.

In 1995, MOH appointed a TCM Committee to look into this subject. The Committee, under the able leadership of Dr Aline Wong who is with us here today, recommended, and MOH agreed, a cautious, step-by-step approach to the regulation of TCM.

That same year, we set up an acupuncture research clinic in Ang Mo Kio Community Hospital. A year later, we started to upgrade the training of TCM practitioners. In 1999, we tightened the control of Chinese proprietary medicine. In 2001, we registered acupuncturists. In 2002, we registered TCM physicians. The registration process has been smooth and we now have about 2,000 TCM practitioners on the register.

I will continue this step-by-step approach to the regulation of TCM.

One thing remains clear. This is an area where regulation will have to be light, for the simple reason that regulators do not know enough. The main focus of regulation is to ensure safety of the TCM products, such as by checking for contamination of herbs with heavy metals and the adulteration of Chinese proprietary medicines with Western pharmaceutical agents.

However, regulators are unable to assess such products for efficacy as is done for Western pharmaceutical drugs. So consumers must not equate TCM with Western medicine and will have to be sensible and careful. At the same time, it is incumbent on the TCM practitioners to regulate themselves seriously and to continuously upgrade their standards of practice. This is the only way to earn consumer confidence and along the way, enable TCM to gradually join mainstream healthcare.

Into Mainstream

The trend is positive. TCM is increasingly accepted and practiced in mainstream healthcare, especially for pain control, palliative care and rehabilitation medicine. A recent study in the UK published in the British Medical Journal in March this year showed that acupuncture may benefit patients with chronic headache and migraine.

In Singapore, acupuncture is now available at Ang Mo Kio Hospital, National University Hospital, Singapore General Hospital and Tan Tock Seng Hospital.

Beyond Acupuncture to Tuina

I asked the medical community if we could now move beyond acupuncture to consider including other forms of TCM therapies. They suggested that tuina could be the next modality. My Ministry has proceeded to form an expert committee to look into the suggestion.

It is being chaired by Prof Lee Tat Leang. One of your graduates, Dr Hong Hai, is a member of this committee.

The committee is in the midst of its deliberations. They are studying the effectiveness of tuina in several areas, including pain control, the rehabilitation of patients with stroke or spinal injury.

As part of their assignment, they are consulting doctors and physiotherapists and the local TCM community to assess how tuina can complement care delivered in our hospitals in a safe and effective way.

I look forward to the committee's recommendations, on how tuina can be included in our healthcare facilities. I hope that their recommendations will help take TCM to a higher level and a brighter future.

Conclusion

In closing, let me congratulate all those who are graduating today. Apply all that you have learnt to serve your patients, even as you apply it on yourself to better your health.

Thank you for this opportunity to join you at the Combined 23rd and 24th Graduation Ceremony of the Institute of Chinese Medical Studies.