H1N1-2009

H1N1-2009:

(Impact on medical tourism): 5.

Dr Lam Pin Min asked the Minister for Health (a) whether he will provide an update on medical tourism in Singapore for 2009; (b) how has the Influenza A (H1N1-2009) pandemic affected medical tourist arrivals; and (c) what is the Ministry's plan in boosting medical tourism in Singapore?

The Minister for Health (Mr Khaw Boon Wan): Sir, the number of medical tourist arrivals is estimated through annual surveys by the Singapore Tourism Board. The 2009 figures are not yet available.

Given the global economic slowdown, we should expect a drop in the number of medical tourists this year. The H1N1 outbreak has further dampened medical travel demand, especially during the initial months of the outbreak.

Nonetheless, our major private hospitals experienced only marginal changes in revenue for the second quarter of this year, as compared to the second quarter of last year. This suggests that the impact of the downturn and H1N1 so far is not as bad as originally projected.

As the region recovers from the recession, our healthcare system should be able to capture the upturn in medical tourism. We have a competent healthcare system, with world-class facilities and a well-deserved reputation for high medical and ethical standards. We continue with our efforts to expand the capacity and to raise the capabilities of our healthcare services, in both the public and the private sectors.

Two new private hospitals are slated to open in 2012 and will give us additional capacity to cater to both locals and foreigners. Professional manpower will continue to be expanded, through increased local training and foreign recruitment.

Let me add that SingaporeMedicine should not be narrowly defined and measured by the number of foreign patients coming here. That is only one part of the larger biomedical science sectoral development which we have embarked upon. Beside traditional pharmaceutical investments, a growing area is in medical technology investments, healthcare informatics, healthcare innovations and effective preventive healthcare programmes. The world is hungry for practical solutions to help people stay healthy, manage their chronic illness and reduce their medical bills. Attracting the sick to come here for treatment is one component of SingaporeMedicine. Contributing to the research and innovation that can yield useful solutions to the global healthcare problems is another major component. That is why we invest in clinical and translational research, support clinician-scientists and offer our hospitals and healthcare providers as test sites for such innovative ideas. This is part of the joint MOH and EDB "Health and Wellness" initiative, where we are positioning Singapore as a future-oriented Living Lab, for the industry to work with the public sector in co-creating, conceptualising, test-bedding and adopting innovative solutions, which could subsequently be exported. While we are still at the early phase of this development, there are opportunities for Singapore to be a leader in addressing global healthcare challenges. The prospects are promising and exciting.

Dr Lam Pin Min (Ang Mo Kio): I would like to ask the Minister in view of the current financial crisis and the ongoing H1N1 pandemic, will our target of one million medical tourists per year by 2012 still be achievable? Secondly, how many of our hospitals, both the restructured as well as the private hospitals, have been JCI accredited and if MOH has any intention for all our hospitals to attain JCI accreditations? Lastly, whether MOH has any statistics on the number of Singaporeans who sought medical treatments overseas because of the more competitive prices elsewhere?

Mr Khaw Boon Wan: I have addressed that point some time ago. Our original target of one million patients by 2012 – we have acknowledged, when we declared it, is a stretched target. It helps mark the goalpost that we want to work towards. When I addressed this point a few months ago, I said that 2012 is probably unrealistic a target. Nevertheless, we will do our best to try to reach this goalpost. Part of the reason is that our domestic demand has also grown a lot. There was actually a shortage, up till last year, of capacity. Our demand is bigger than what we can cope with. We were turning away patients because when supply is below demand, prices adjust themselves, and we probably priced ourselves out at the margin. That is why we got the URA land sales activated and we have now two new projects coming on-stream. But yes, I think 2012 target of one million foreign patients is probably not realistic.

How many hospitals are JCI accredited? I believe all public hospitals are JCI accredited. Some private hospitals are. I do not intend to make it mandatory. Private hospitals will respond to market signals. If the patients demand JCI standards and JCI accreditation will help in their marketing, I am sure they will pursue it. I think the private sector CEOs are all pursuing in this direction.

On the number of Singaporeans who are medical tourists, I do not have such data. Anecdotally, our counterparts in, for example, Bangkok or Malaysia/Melaka, mentioned that many Singaporeans go there for elective surgeries at substantially lower rates. This is part and parcel of globalisation. Many foreign patients will come here and some of our own patients will go across to Johor Baru, for example, for cheaper-priced treatments. We should allow it as consumers would benefit through such increased competition across the border.

Assoc. Prof. Paulin Tay Straughan (Nominated Member): Thank you, Mr Speaker. May I follow up on that last point, Minister? Can you comment on the implications of medical tourism on healthcare cost for Singaporeans? What I am worried about in particular is in the allocation of scarce resources. Where are the checks and balances? What mechanisms are in place to ensure that our medical professionals are looking after the healthcare needs of Singaporeans as their primary concern?

Mr Khaw Boon Wan: For us in public hospitals, our mission is very clear. Our primary objective is to look after Singaporeans' health, particularly those in the bottom half of the population who have no choice. If you are in the upper half, you can consider going to private hospitals or even foreign hospitals. But for the bottom half, we are the only provider for them. That is why our priority or mission is crystal clear; we would always go that way. There are mechanisms in place as our departments are all peer- reviewed. CEOs and departmental heads regularly review work performance and if some professionals neglect their subsidised patients, that will show up in their performance appraisal. Let me assure Members that we will never neglect local patients and simply chase the foreign patient load; we do not. I have repeatedly clarified that medical tourism is never an objective. As far as MOH is concerned, it is an outcome. If we continue to raise our medical standards and keep prices affordable for all Singaporeans, our reputation will spread and foreign patients will naturally come to our shores. And I see no reasons why we should reject them just because they are foreigners. We will treat them within our capabilities and capacity. When we do long-term planning – whether it is manpower or capabilities – we will have to factor in foreign patient load. In practice, the percentage of foreign patient load in public hospitals is not huge.

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