SGH's 180th Anniversary Launch Ceremony And Exhibition

30 Mar 2001

By Mr Lim Hng Kiang

Theme: Enhancing patient care, training and research in the new millennium

Introduction

Good evening ladies and gentleman.

It is my pleasure to be here with you at this very special event - the 180^th anniversary of the Singapore General Hospital (SGH). SGH has a long and distinguished history. Its humble beginnings can be traced to a wooden shed by the Singapore River. SGH has come a long way. Since its founding in 1821, SGH has developed over the years to become the sophisticated and modern health care institution that it is today, with an illustrious tradition in medical service, teaching and research.

In medical service, SGH has scored numerous firsts not only in Singapore but in the region and the world - first kidney transplant, heart transplant and lung transplant in Singapore, first cochlear implant surgery in South East Asia, first computer-aided neurosurgery and virtual reality surgery in Asia and first peripheral blood stem cell transplant from a matched unrelated donor to a Thalassaemia Major patient in the world.

In the area of research, SGH has several outstanding research groups doing competitive research. SGH has also played an important role in medical education in Singapore ever since the first medical school was established on SGH's premises in 1905.

Today, we not only celebrate SGH's contributions over the past 180 years but we also mark its entry into a new millennium of healthcare in Singapore. An important trait that should be preserved as SGH moves into this new era in healthcare is its tradition of service to the public. The designation of the clusters as "Not-for-Profit" entities provides SGH and the other public healthcare hospitals and institutions, with the organisational culture to remain true to this tradition of public service.

With the organisation of the public healthcare delivery system into two clusters, SGH is not just an independent institution but also a member of a family of healthcare hospitals and institutions, the Singhealth family. As the tertiary hospital in the cluster, SGH serves as the flagship hospital for Singhealth. Both in terms of age and capacity, SGH can be regarded as the older sibling to the other hospitals in the cluster.

Integrated patient care

Vertical integration within the clusters is to ensure that patient care is co-ordinated across the whole continuum, from primary to tertiary care. There should be good collaboration and co-operation among all the service providers within the cluster to ensure seamless care to the patients. Patients should be cared for at the appropriate level and receive the appropriate care they need.

SGH should develop strong links with the regional hospitals and the primary care institutions not only to receive the more complex patients from them, but also to nurture and support the regional hospitals and primary care institutions so that they can enhance and develop their services at the respective levels of care.

Training

The training of healthcare professionals is of utmost importance. At the end of the day, the single most important determinant of the quality of healthcare that we can deliver to Singaporeans is not physical buildings, technology or infrastructure, but the competence, skills and dedication of our healthcare professionals.

While we have a very good training system for doctors, with dedicated teachers and a strong tradition that emphasises the importance of training of junior doctors, we have to recognise that training takes place in busy hospitals and clinics which are also committed to providing good clinical services in a timely manner. We therefore have to put in place measures to ensure that the quality of training and the priority it receives will be continually enhanced even as clinical service demands increase.

Measures to strengthen training

To address this, my Ministry has been working closely with the National University of Singapore (NUS) and the Singapore Medical Council (SMC) to systematically institutionalise measures to strengthen the training of doctors at all levels. We have defined more explicitly the roles of the various agencies involved in the training of the major categories of doctors, developed more structured training programmes and processes for educational quality assurance and provided specific funds for training.

Training of houseofficers

For new medical graduates, the one year housemanship period is critical for providing the on-the-job-training necessary to become independent doctors. Over the past 2 years, we have spelt out the standards for housemanship training more definitively. The SMC has also established a system of accreditation and audit for all departments involved in the training of houseofficers. MOH will reimburse the Restructured Hospitals the cost of the houseofficers' salaries, amounting to $10.7m, to reinforce the point that training is the primary objective in the deployment of the houseofficers. These measures will help ensure that houseofficers will receive adequate and appropriate training as they work as part of the clinical teams in our hospitals.

Specialist training

The specialist training system is also being streamlined through the Specialist Accreditation Board. The Joint Committee on Specialist Training, comprising the NUS Graduate School of Medical Studies and the Academy of Medicine, Singapore, has been established to oversee and direct the 35 Specialist Training Committees involved in specialist training. My Ministry will be providing the Joint Committee on Specialist Training with a development grant over three years to help it meet the costs of developing, overseeing and auditing the implementation of specialist training standards.

My Ministry also recognises that specialist trainees currently spend a good deal of their time providing clinical service in the hospitals. In order to ensure that trainees are given sufficient protected time for training activities, the funding for postgraduate training will be increased to $23m with effect from 1 April 2001. The increased funding is to be used to employ additional doctors to meet the hospitals' service needs, so that specialist trainees can have sufficient protected time to attend conferences, carry out research and participate in other training activities.

Cluster Research Fund

Besides training, the Ministry recognises that research is also an integral component in delivering quality healthcare to Singaporeans. In order to support this important function and to give the clusters some autonomy in the direction of the research efforts of their respective institutions, from April 2001, the Ministry will provide a research grant, the "Cluster Research Fund", to each cluster directly. The grant for this year amounting to $5m for each cluster is in addition to the NMRC grant. The NMRC grant for the five year period from 1997 to 2001 was $232m. From next financial year, the grant for the NMRC will be increased. For financial year 2002, NMRC will receive a grant of $75m.

The Cluster Research Fund is to be used for building up research manpower capabilities for example funding support for young or first-time investigators who may have difficulty competing for funds through the National Medical Research Council. It will also be used to support research that contributes directly to improved patient care for instance establishing key departmental or hospital databases or for employing research assistants and statisticians so as to facilitate research and support patient-focused clinical types of research.

Conclusion

SGH has a long and proud tradition of leadership in the healthcare arena in Singapore. I would like to congratulate all the past and present staff of SGH for the past 180 years of contribution to the people of Singapore and wish you even more success in the years ahead.