Interview with Cheng-Ho Tsai, Superintendent, Mackay Memoral Hospital

Cheng-Ho Tsai, Mackay Memorial Hospital has a unique background and origins. How has this endured through the different stages of the pharmaceutical sector in Taiwan, and how do you see the continuity of it?

Indeed, our institution is 130 years old. Our medical centre, which is one of the largest in Taiwan, has the capacity of 3000 beds and employs about 7,000 people. The Mackay Memorial Hospital was constructed in the memory of Dr. Mackay, who came from Canada to Taiwan carrying a mission of Christianity. We are today under the jurisdiction of the Presbyterian Church and it is our duty to perpetuate Dr. Mackay’s mission: we integrate the spirit of gospel into the medical care. This makes this hospital very different from the others. As a Christian hospital, our work is both evangelical and medical. We are expected not only to take care of the people in terms of physical concerns, but also to preach the spirit of the gospel. We want to integrate the values of Christianity in the patient care.

What is your scope of operations in 2010?

We operate very actively as a hospice. Since 1990, we are the first and still largest hospice centre in Taiwan. The hospital administration launched the new Mackay Memorial Medical College two years ago. Thus our areas of focus today are research, education and social service. As we want to become one of the best medical centres in Taiwan, we introduce regularly new technology, not only in the research, but also in the patient service. The hospital is also a centre to prevent suicide.

The healthcare sector as one of the six key areas for economic development highlighted by the Executive Yuan, along with the Biotech sector; what are the implications for the MMH, now that it is a government priority?

The government encourages us to take part in the Biotechnology. Mackay Memorial Hospital has a special section to operate with the Ministry of Economy to help the local Biotech companies any kind of new products. In June 2002, we established the Mackay Memorial Hospital Innovative Enterprise Centre in cooperation with the Ministry of Economic Affairs to promote the development of small and medium sizes businesses.

Chuangye Huang from Wan Fang Hospital was saying that being private made it easier to function as a business – what’s your opinion?

Wan Fang medical centre is focused on international medical services overseas, especially with China. As a Christian hospital, we have a mission. Running a hospital as a business is for us secondary. Our concerns are the patients’ services, research and Education. All our efforts in these areas allow us to say that we have today an outstanding health care centre where we can do very complicated medical examination: this ensures us to survive in a fierce competition.

Apart from that, our mission is focused on the Taiwanese people. That was Mackay’s spirit and we want to make this spirit last. In addition, we have a mission of Christianity. We have today the ability to achieve the mission that we had been given a hundreds years ago. Medical Research and Christianity are for us the key areas to take care of our people. Business comes second. In this regard, our approach is different from that of Wan Fang hospital.

However, our mission goes beyond the borders of Taiwan, and we want to expand in South East Asia and Africa.

According to M. Ming-Fong Chen, superintendent of the National Taiwan University Hospital (NTUH), there are today two different ways of looking at China. The first one consists in playing the second role, referring to the obvious size difference between both markets. The other way is to see China as a potential market in which Taiwan can be really competitive, but only if its level of innovation is high enough. Taking into consideration your current affiliation with the China Medical College (CMC) in Taiwan, what is the scope of this collaboration and what your ambitions to further enter into this promising land?

We have already received medical staffs from hospices in China and work closely with China in many areas. To respond to Dr. Chen’s statement, I believe we have in Taiwan a more advanced health care system. In terms of technology and medical services, both countries are very competitive, but our system is better. Our understanding of the human body and spirit is a significant advantage to cure people, especially as a Christian hospital. In this perspective, China can benefit from our experience. Moreover, In Taiwan, our medical schools are excellent, and the students are very talented. Ideally, Taiwan and China will be willing to share their respective research and experience, instead of putting them in competition.

To what extent is Taiwan considered as global Centre of Excellence for clinical trials?

After the International Conference on Harmonization (ICH) published the international criteria of clinical trials, immediately Taiwan government streamlined the rules of domestic clinical trials to be in accordance with the international criteria, where all clinical trials can be conducted in the same standard internationally. In addition, Taiwan’s unique environment is that people can have medical treatments in many convenient ways. The medical centres which can conduct clinical trials are able to provide service to more than half of the population who require medical service. In fact, these medical centres are almost the place for all the latest drugs to be executed for clinical trials. Consequently, Taiwan has gained abundant international experience and developed many organizations and specialists for international accreditation, such as laboratory facilities, clinical trial centre, Institutional Review Board, clinical trials professionals etc. As a result, Taiwan has become a good clinical trial environment with complete regulation review, strict trial execution and expertise with great experience. Most importantly, the industry can understand and get linked to the capacity of the clinical trial of Taiwan much more easily.

What is Mackay Memorial Hospital commitment to encouraging clinical trials in Taiwan and what are the strategies to increase the number of studies being conducted at the hospital?

Around ten years ago, the clinical trial of a new drug in Taiwan took one to two years from application to execution. Moreover, the quality of the review board was questioned. In order to solve both problems, Mackay was the first pioneer in Taiwan to offer a complete scheme for examination, policy and principals. Besides that, the hospital updates the information on the website for the public and follows the internal regulations and ICH regulations to set up an Institutional Review Board standard procedure, where the quality of the examination can be in accordance with internal regulations. The institutional Review Board has changed the meeting frequency from every three months to every month, and two years ago, it set up two human clinical trials committees. Currently, it has one clinical trial institutional review board every two weeks. Besides increasing the efficiency for administration procedures, Mackay continuously hold training courses with the industry, legal department of the government as well as the academic specialists.

What are the strengths of the Mackay Memorial Hospital over other hospitals in this country for clinical trials?

The Mackay Memorial Hospitals are located in four different places. In northern Taiwan, our two hospitals located in Taipei and Tamsui area are ranked top three among all hospitals in Taiwan in terms of number of patients. The Mackay Hospital has complete medical service, ranging from the internal medicine to surgical, gynaecology, paediatrics , dermatology, neurology, and home nursing departments, as well as and hospice care ward. Therefore, there are many kinds of fields to work with the industry. The Mackay Memorial Hospital is the first hospital to standardize the procedures of clinical trials. With our cooperation with the Protech Pharmaservice Corporation (PPC), Mackay will provide more professional and multiple services to the industry.

Hospitals in Taiwan are in the position to connect the Taiwanese people to the latest innovations from pharmaceutical companies through clinical trials. How do you feel about this position, and how are you working to increase your work in Clinical Trials?

In the recent years, Mackay has not only spent a lot on research and development (about 3% of the total revenues, which represents about ten million US dollars), but it also established the first hospital-based incubator centre in Taiwan. By fostering collaboration with the industry, Mackay encourages the innovation results to be shared mutually in rapid ways. By providing with a mature clinical trial environment, Mackay helps the big scale pharmaceutical industry to develop new drug, and also helps the small scale and new innovation enterprise to take clinical trials rapidly and safely. Furthermore, our hospital is working with the industry (e2Joy) and is planning to establish ten Good Tissue Practice (GTP) laboratories which are in accordance with the American and European specifications, in which cancer vaccine and stem cell therapy can be taken by the research staffs. We also provide eight laboratories to the industry to research the development of the cell therapy, hoping the latest medical technology can be soon applicable clinically in strict specifications, safely and efficiently.

How does the hospital look for partnering with pharmaceutical companies and forge long-term links with the industry?

As mentioned earlier, we have worked with PPC for several years. Currently, we are planning to provide the most beautiful floor facing to the sea in the Tamsui hospital to our partner. Indeed, we established a clinical trial ward with PPC, which will be able to execute Phase I study, and under our preliminary plan, the offices of our new floor in Tamsui will be offered to the industry who are required to work there. Besides that, the GTP lab cooperated with e2Joy will be open to the industry and different biotech manufactures. It is expected that through our endeavour, the industry will be convinced that the Mackay Memorial hospital has the capacity and ability to work in collaboration with them in specific fields. Actually, there are many manufactures that are already looking forward to collaborating with us.

Cheng-Ho Tsai, you came in 1974 to Mackay Hospital and dedicated your life to it; to what extent have your personal achievements and objectives put a stamp on the hospital’s philosophy?

Dr. Mackay’s mission has to be perpetuated. I managed to do it so far and will keep working on the same basis. As our hospital is becoming larger, there are more possibilities for me to achieve this task. With our affiliate local hospitals and colleges, we train constantly future doctors and nurses to maintain a high level of education at Mackay and further expand our services. Recently, the hospital has put more emphasis on suicide prevention, patient care for old people, and hospices for charity.

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