Keynote Address by Mr Masagos Zulkifli, Minister for Social and Family Development, and Second Minsiter for Health, at the Singapore Health and Biomedical Congress

Professor Philip Choo,

Group CEO, NHG

Assistant Professor Lambert Low,

Chairman, Organising Committee,

Singapore Health and Biomedical Congress 2021

Distinguished speakers and delegates,

Ladies and gentlemen,

1.     A very good morning to all. It is my pleasure to join you today at the Singapore Health and Biomedical Congress 2021.

2.     Before I begin my address, I would first like to express my deepest gratitude and appreciation to all our healthcare workers present. The past two years have been extremely challenging for our healthcare family – all of you have been at the forefront of our nation’s fight against COVID-19. I have personally seen and witnessed the selfless dedication of many of our healthcare workers, often going beyond the call of duty, making countless sacrifices, in order to keep our people safe. Thank you!

3.     Despite the current evolving situation, I am confident that our resilience and collective social responsibility as a nation, will serve us well, as we move towards COVID-resilience. This is also linked to this year’s theme on ‘The Brave New World of Healthcare’, charting out our journey towards a COVID-19 resilient nation, as we brave new frontiers together as one healthcare family.

Changing Operating Environment
4.     The pandemic has taught us two lessons – first, that the resilience of a country’s healthcare system is key to its success in containing the virus; and second, pandemics are fought not only at the frontlines of our healthcare systems, but also on the social front. Whether countries succeeded, depended on how robust their social systems were, and how much people trusted their governments.

5.     Fortunately, in Singapore, we have built our health and social systems on strong foundations and fundamentals. We have a renowned healthcare system, delivering one of the highest standards of healthcare and outcomes globally. Our healthcare system is also a core part of our Social Compact, where we ensure that all Singaporeans can access affordable and quality healthcare services. Providing them with a peace of mind and certainty against life’s vicissitudes. And where we unite our society, across public, people and private sectors, to uplift those with less among us. We have seen this during the crisis – as individuals, family members, neighbours, businesses banded together with our healthcare workers, government agencies – to care for those affected.

6.     However, our operating environment will become more challenging going forward. COVID-19 will not be the last health crisis and we will also face new social challenges. Our society is ageing, and this will bring about new challenges. While our people may have one of the longest life expectancies, about 10 years of our lives are spent in poor health. An ageing population, coupled with unhealthy lifestyle behaviours associated with modern living, such as unhealthy diet and physical inactivity, will lead to an increase in the prevalence of frailty and chronic diseases. This will in turn drive up healthcare costs. If left unchecked, it will be unsustainable in the longer term.

7.     While we have made significant progress in tackling some of these issues, such as in our community health programmes, we can do more as an entire system. I am heartened to know that this year’s Congress will be looking into transformative efforts, that can bring us closer to a more sustainable healthcare system and healthy population. Let me elaborate on three key areas.

Innovation and digital transformation for quality care

8.     First, we need to transform our healthcare system in the area of digitalisation, and leverage digital tools for care delivery. COVID-19 has accelerated this need. In response, we had to speedily put in place several applications and systems to augment our public health surveillance. For instance, the TraceTogether application enabled early identification of individuals who might have exposure to COVID-19 to prevent further transmission. The COVID-19 Vaccination Appointments System has also supported the mass roll-out of vaccination exercises across Singapore, enabling clinicians to access medical records to ascertain patients’ suitability for vaccination.

9.     We also saw greater up-take of telehealth consultations. During the Circuit Breaker, the NHG provided over 42,000 tele-consultations – a 20-fold increase from 2019. This was also precipitated by time-limited extension of the CHAS Chronic subsidies and MediSave usage, covering video consultations for all chronic conditions under the Chronic Disease Management Programme. Research show that telehealth can be equivalent, and even more clinically effective at times, than conventional care delivery in specific areas. Going forward, telehealth consultations will become a definitive feature of our care delivery, complementing traditional face-to-face medical consultations.

10.     Another related area is data-enabled care. To provide seamless and continued care across settings and domains, clinicians will require access to reliable data. There have been several efforts by different agencies to do this. In this regard, I would like to commend NHG‘s institutions for their efficient Command, Control and Communications systems (or “C-cube”). It has helped to smoothen out coordination of patient care across settings in meaningful ways. For example, by providing visibility on frontline operations and prompts for key decisions, such as in manpower deployment and capacity management. It has helped to weather through periods of surges due to COVID-19. As our healthcare needs evolve, our investments in digitalisation for clinical care need to grow in tandem.

Strengthening our social compact to address health inequalities 11.     Second, as I mentioned earlier, our healthcare system is a core part of our enabling Social Compact in Singapore. Our success as a nation in overcoming future pandemics and health crises, rests not only on the resilience of our healthcare systems, but also the togetherness of our nation. COVID-19 has heightened the awareness that everyone has a role to play in achieving good health and well-being. Since last year, individuals took efforts to observe Safe Management Measures to stay well. Different parts of the community stepped up, to support each other and those who were vulnerable. This is the Singapore spirit.

12.     We have seen how the pandemic has affected various groups in society, especially the vulnerable. Research have also shown that the Social Determinants of Health, such as social, economic and environmental factors, can influence up to 80% of health outcomes. If we want to achieve and sustain a healthy population, we need to continually strengthen and sustain an enabling Social Compact. We can contribute to this national goal, as one healthcare family, through closer social-health integration.

13.     I will share one tangible example of how we have done so, through Community Link (or ComLink), which MSF leads. We started ComLink to provide more holistic support for families with children living in rental housing, serving 14,000 families over the next two years. It is different from our typical ways of programming. Through ComLink, we unite the various partner organisations in the community and volunteers, to work with us to achieve holistic outcomes for the family, like stability, self-reliance and social mobility. These tend to be cross-cutting and cannot be addressed by one agency or organisation alone. Hence the need for back-end coordination. In essence, ComLink shifts the design approach from being one run by multi-agency programmes to being client-centric. So I am glad that since healthcare too, is a key need of these families, our Regional Health Systems are involved with this effort – specifically the Woodlands Health Campus. They have partnered MSF on a social-health integration pilot to address the health needs of families through ComLink Marsiling in a holistic manner. I look forward to further collaborations between the health and social sectors, as we continue to strengthen and sustain our Social Compact.

Achieving good health in the new normal14.     Third, prevention is the best medicine. The pandemic has led to a rise in obesity and physical inactivity in the population. These are known risk factors for chronic conditions, such as diabetes, hypertension and high blood cholesterol levels. We can reduce our risk of these chronic diseases through healthy habits and health screenings.

15.     There is also emerging evidence supporting the need to go further upstream, as early as during preconception, to promote population health. This is important, as we want to give every Singaporean child the best start in life, and to provide an enriching environment, where they can flourish and achieve their fullest potential.

16.     To this end, we have set up the Interagency Taskforce on Child and Maternal Health and Well-being. One goal is to see how evidence can be translated into tangible policies and programmes to achieve better health outcomes for our young. I am glad that NHG has worked with MOE to roll out the Living Well@School pilot. Under this programme, parents and teachers are co-opted as partners and role models to enable our primary school students to embrace healthy living early in life.

Closing17.     In closing, let us press on ahead, as one healthcare family and one nation, as we journey towards a COVID-resilient Singapore. To tackle the challenges beyond COVID-19, we must also continue to transform our healthcare systems, strengthen social-health integration, and address problems upstream. This will put us on a path of building a more sustainable healthcare system and healthy population for generations to come. This requires a collective effort, from all parts of society and the healthcare system. I wish all of you an enriching and meaningful Congress ahead. Thank you.