The Opening Ceremony of the 6th Asia Pacific Nurses Convention

12 Jul 2006

By Ms Yong Ying-I, Permanent Secretary (Health)

Venue: Meritus Mandarin

Dr Hiroko Minami,

President, International Council of Nurses,

Ms Tan Wee King,

President, Singapore Nurses Association,

Mr Melvyn Chiang,

Chairman, Organising Committee,

Ladies and gentlemen,

Good morning.

It gives me great pleasure to be here today to open the 6th Asia Pacific Nurses Convention (ASPAN). I would like to congratulate the Singapore Nurses Association for bringing together nurses from 19 countries to participate in the ASPAN Convention. I would particularly like to welcome the international participants who have taken the time to come to Singapore to attend this convention.

The theme for the convention: "Globalisation - Nursing Sans Borders" is timely and well-chosen. Globalisation has profoundly impacted the nursing profession precisely because nursing transcends boundaries, race, religion and culture - this convention itself is an example.

Globalisation and the rising demand for nurses

The global demand for healthcare services is increasing because of aging populations in developed nations, and rising incomes in developing nations. As a result, there is growing international demand for healthcare professionals, including nurses.

Globalisation, coupled with the global demand for nurses, has translated into the increased movement of nurses, especially from developing countries to developed countries. The international recruitment and migration of nurses is an issue of global concern as it strips developing nations of scarce nursing manpower.

It is not sustainable for developed nations to rely on foreign nurses for their healthcare manpower needs. Instead, developed nations should build up capacity to train enough nurses to satisfy their local demand for nurses. Taking this one step further, it would be even better if developed nations helped to train nurses from other countries, as part of international collaborations, so as to alleviate the global shortage of nurses.

I would like to share with you what Singapore is doing to fulfill our demand for nurses. Before 2005, Singapore only had one nursing school offering a diploma programme in nursing. We recognised the urgent need to increase our nursing manpower and started a 2nd diploma programme and will be offering a nursing degree course this year. Besides increasing the intake of local nursing schools, we are also looking into ways to reduce the attrition rate of nurses, offering re-entry programmes for nurses who previously resigned, and running a manpower conversion programme for mid-career workers who are interested in nursing. Together, these measures have improved our self-reliance for nurses.

The changing role of nurses

Beyond increasing the quantity of nurses, we also have to relook the role of nurses. As healthcare evolves, the job scope of nurses has grown in breadth and complexity. It is crucial for nurses to keep up with the rapid advancement of medical science and technology so that standards of care can continue to improve. At the same time, the cost of healthcare has been rising and we need to find creative ways to deliver more with less, and remove system wastage. Nurses can deliver better care while reducing system costs by going beyond their traditional roles to take on new roles.

In Singapore, we started the Masters in Nursing programme three years ago so that nurses keen to acquire more expertise could become Advanced Practice Nurses. With their increased skill set, APNs can effectively manage common acute illnesses and stable chronic conditions, promote better patient compliance with treatment, and encourage disease prevention. Many studies have shown that as APNs assume these new roles, patients receive comparable, if not better, care while doctors are freed up to manage other patients.

I personally saw how APNs increased system efficiency and reduced system costs when I visited the Veteran's Administration in the US in April this year. At the VA, patients with stable chronic conditions need not make a trip to the doctor for routine check-ups. Instead, patients self-manage their illnesses from home and send relevant medical information, such as blood pressure measurements, electronically to the clinic. At the clinic, it is not the doctor, but the APN who tracks the condition of chronic patients and provides relevant medical advice to patients.

Another example is the Aravind Eye Hospital in India which is doing outstanding work restoring sight to tens of thousands of patients, at a fraction of the cost in developed countries. One of the reasons behind their success is because the large number of highly-trained nurses in the hospital allows doctors to focus on what they do best - diagnosis and surgery.

Through higher education and professional development, nurses can take on new duties which were previously the sole domain of doctors. We must embrace the changing role of nurses in order to realise its potential benefits.

Nursing standards in a globalised world

In addition to embracing new roles, nurses have to understand changing expectations that patients have of them. In a globalised world, patients are well-informed and can travel freely to receive medical treatment. We can no longer benchmark our performance locally and need to compare ourselves against the best in the world. Globalisation compels us to raise nursing standards because an increasing number of patients expect to receive world-class care.

Fortunately, I believe that one aspect of nursing that transcends borders is our desire to achieve clinical excellence. However, in a globalised world where many hospitals treat significant numbers of foreign patients, it is no longer adequate for nurses to focus solely on delivering clinical excellence. Additional skills and traits such as fluency in a foreign language and a service mindset will prove to be increasingly important to nurses.

Not only are patients seeking treatment abroad, nurses are also seeking to work overseas, as mentioned earlier. To allow the free flow of nurses between countries, some countries have signed bilateral or multilateral mutual recognition agreements (MRAs). Singapore, too, will be signing a MRA on Nursing Services with ASEAN in August this year. Singapore and India are also working out a MRA as part of our governments' Comprehensive Economic Cooperation Agreement. In line with globalisation, international standards for nursing practice and nursing education should be established and recognised.

Conclusion

Nurses have been indispensable to healthcare teams. For the nursing profession to remain valuable partners in healthcare delivery, the profession must continue to upgrade and keep in step with global developments.

We share many common challenges and the ASPAN Convention is an excellent platform for you to exchange ideas, discuss experiences, network, and develop new initiatives. I would like to wish you an enriching and stimulating convention.

Thank you.