Singapore will have a new cancer centre to help tackle the rapidly rising number of cancer patients.
Called the National University Cancer Institute Singapore or NCIS, it's the second such centre here after the National Cancer Centre.
But what does it mean to patients to have another similar facility?
Will this mean patients now have greater access to better and cheaper care?
Join Claire Huang as she finds out more from Professor John Wong, Director of NCIS who starts by explaining why there's a need for a second facility.
This is largely because of the significant cancer burden that Singapore has to deal with. It’s unfortunately the most common cause of death in Singapore and because of the aging population, we expect the number of cancer cases in Singapore to continue to rise. Now, because of the large population at risk as well as the need for trying to focus its resources, I think the Ministry of Health feels that time has come for a second national cancer centre to be created.
When the National University Health System, NUHS was formed, NUHS already had certain strengths and one of the strengths of the university as well as NUH, has been in cancer for many, many years. So this allows the institution to build the formation of NCIS.
So what will NCIS bring to the table for cancer patients here? What does it mean in the end?
Well, NCIS allows an institution to be created, which brings the strengths of both the National University Hospital as well as the National University of Singapore. Both institutions have tremendous strengths in cancer, in terms of cancer care, cancer education, and cancer research. So creating this allows us to leverage on the synergies of both institutions for the benefit of Singapore.
So how different is it from NCC, the National Cancer Centre?
I think what NCIS has, perhaps, is that it does have all the specialties in cancer in one facility. So for instance, NCIS does have pediatric oncology onsite, it also has gynaecological oncology onsite and it also allows us to work with many departments in cancer care in the University. For instance our Department of Epidemiology and Public Health.
You mentioned there are nine tumour groups in NCIS. So when a patient comes to NCIS, what kind of scenario would it be? How would you go about treating (the patient)?
So our nine tumour groups are clustered because one whole approach of NCIS is to really look at approaching cancer based on, not by department, but based on the actual tumour. So the nine tumour groups cover all the common cancers in Singapore. So when a patient comes in to NCIS, that patient’s care will be discussed by the tumour group. So the patient’s care will be discussed by our multi-disciplinary team, consisting of all the various medical specialties. It also involves input from nursing oncology, from pharmacy oncology and also, it has input from public health experts also.
The multi-disciplinary groups allow us to approach cancer care, cancer research and cancer education holistically. The actual delivery of care to the patient, some of the groups feel that it’s best for them to see the patient collectively, because of the need for the patient to get combined treatment.
Some of the tumour groups will be seeing the patient sequentially because again, it makes better sense for the patient to be seen sequentially. So we’re going to leave it to the tumour groups to decide "what’s the optimal way to manage the patient?" from the patient’s perspective, as well as for us improving the already good care that we deliver.
But from a patient’s perspective, does it mean it’ll be faster care for them, better quality care for them, and better outcome for them in the end? And in terms of cost effectiveness, how does it impact?
So I’ll say yes to all of those. Our goal is to improve both the efficiency and the speed of care; our goal is to improve on the quality of care, and our goal is to try and look at the total cost of care and determine how to allocate resources.
Our quality of care and all our data banks we have in terms of how our quality of care, be it in complex procedures like bone marrow transplants, or if it’s in multi-disciplinary care such as in colon cancer where you need multiple specialties working together, our outcomes are comparable to the United States. But what we want to do is see how we can study this and how can we improve on this.
But for the hospital itself, for NCIS itself, costs will go up.
Well, it may not. So this is a very interesting issue. We do know that the cost of medical care is increasing. I mean, the cost of most things in Singapore does go up with time. What we want to do is to manage this cost and we want to take a look at this cost of care, of a patient's condition, through the whole journey of that condition. If we have the whole team that's involved in the care of this patient's cancer, come together and map out the whole journey, then we can be in a much better position to say "where should we allocate the cost?". Perhaps we may save the system in the long run if we spend more initially.
Let me give you an example for instance. If patients have to wait to get decisions because of the need to get the different doctors coordinated, we may be able to cut down the costs by getting the doctors together at the start, to have that discussion. So I think that if it means that patients have to be on treatment for a certain period of time before we know whether that treatment is working or not, and if we say we bring in the research that we do, to determine whether the treatment can be changed much earlier, because of special tests we want to introduce, or through some of the new findings that come up through research, that may save the overall costs to the patient.
Do you have enough doctors and medical staff to handle the increasing workload?
Manpower is always a big challenge. We definitely have more doctors and nurses and pharmacists than before and especially when you focus, when you allow these people to focus in one disease, ie cancer, the ability to optimize their skills and knowledge becomes better. Both NCC and NCIS, together are looking what are the manpower norms for Singapore and discussing this with the Ministry of Health.
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