Speech by A/Prof Kenneth Mak, Deputy Director of Medical Services (Health Services Group), at the Opening Ceremony of the 6th Asia Pacific Primary Care Research Conference (APPCRC), Friday, 22 September 2017

Professor Ivy Ng, Group CEO SingHealth,

Dr Adrian Ee, CEO SingHealth Polyclinics,

Dr Tan Tze Lee, President College of Family Physicians Singapore,

Distinguished guests,

Ladies and gentlemen,

Good morning to all.

            I am pleased to join you this morning for the opening ceremony of the 6th Asia Pacific Primary Care Research Conference (APPCRC), held in conjunction with the Family Medicine Symposium.

2          These two platforms have been integral to the exchange of knowledge and developments in primary care. Coming together for the first time, they bring a wider range of topics and bright ideas from clinicians across the public and private primary care sectors in Singapore and the Asia Pacific region. To our overseas friends and distinguished speakers, a very warm welcome to Singapore.

Family Physicians as key players in primary care

3          In Singapore, the number of Singapore citizens aged 65 and above is projected to double to 900,000 by 2030. This means that one in four Singaporeans will be in that age group, up from one in seven today.^[1] Furthermore, the Singaporean Burden of Disease Study 2010 found diabetes, ischaemic heart disease and stroke as leading contributors of chronic disease burden.^[2]

4          Primary care plays an increasingly significant role in care transformation in view of the ageing population and increasing chronic disease burden. To meet the healthcare needs of Singapore in a sustainable manner, we need clinically and cost-effective interventions, careful health policy planning and prudent allocation of resources.

5          A key strategic thrust of MOH is to transform our healthcare delivery model from one built around the hospital to one that can meet the needs of more Singaporeans closer to their homes. We see primary care as the bedrock to enable a shift to bring healthcare beyond hospitals into the community. Our vision for primary care is ‘One Singaporean, One Family Doctor’, with primary care as the first and continuous line of care for patients.

6          In addition to improving our delivery of care to those who are ill, a more critical approach is to nurture a healthy nation, where we focus on early interventions and healthy lifestyle choices to keep our people in good health. This is also in line with one of MOH’s shifts to go beyond healthcare to health. As part of effective chronic disease management, there is also a need to go beyond treating the disease and provide health counselling and lifestyle management advice.

7          To enhance the support for private GPs in chronic disease management, we are developing Primary Care Networks (PCN) which allow GPs to share resources and deliver better chronic care through a multi-disciplinary team of doctors, nurses and allied health professionals. 

8          General practitioners and Family Physicians play a vital role as healthcare partners to their patients by providing comprehensive care, integrating health promotion and advocating disease prevention. 

Research in primary care and evidence-based medicine 

9          With holistic and continual care as key defining features of Family Medicine, the day-to-day practice of primary care physicians enables them to identify and be involved in appropriate research domains based on daily encounters. By being the community healthcare provider, they engage in more frequent patient encounters through longitudinal follow-up, and are well-placed to provide patient-centred care, including timely advice on lifestyle modification, early disease screening and detection, and effective management. 

10        This approach provides Family Physicians the opportunity to highlight outcomes that are meaningful to patients, such as decreased morbidity and improved quality of life, rather than disease-oriented outcomes which tend to describe changes in physiologic variables or lab markers such as blood sugar levels or kidney function. 

11        I am pleased to note that SingHealth Polyclinics (SHP) have made significant efforts in research – with close to 80 research partnerships established since 2014, and translating research to improve patient outcomes. One such example is the research collaboration between SingHealth Polyclinics (SHP) and Institute of Technical Education (ITE) College West, which recently developed a first-of-its kind digital smoker-analyzer that could strengthen existing methods to quit smoking. Named “STEADES”, the digital smoker-analyzer uses visual tools to display the smoker’s carbon monoxide (CO) levels in real-time and connects to a digital social support platform to motivate them to quit smoking. 

12        To boost Family Medicine research, the SingHealth Duke-NUS Family Medicine Academic Clinical Programme (ACP) recently launched a Family Health Research Fund. The Family Medicine ACP will be increasing its philanthropic efforts in the coming years to support research in Family Medicine for better patient care and health outcomes. 

Developing and evolving Family Medicine as a discipline 

13        In recent years, Family Medicine education and training have seen encouraging gains in momentum and scope. The College of Family Physicians Singapore (CFPS) plays a key role in the professional development of Family Physicians through its various training programmes. 

14        There has been a significant increase in enrolment for the Graduate Diploma in Family Medicine (GDFM), from about 100 trainees in 2014 to over 200 trainees this year. The Family Medicine residency programmes have also seen an increase in uptake, from about 40 in 2014 to about 60 this year. The increase in the number of doctors choosing Family Medicine as a discipline is encouraging as we move towards our vision of ‘One Singaporean, One Family Doctor’. 

15        In view of the changing primary care landscape, CPFS is currently looking at enhancing the GDFM programme structure and course content to strengthen key areas of national priority such as chronic disease management, mental health and geriatric care. Future trainees will be more proficient in managing the evolving needs of our patients as family physicians. I am happy to note that the GDFM Enhanced Programme will be launched in the next academic year in July 2018. 

Closing 

16        With the growing emphasis on evidence-based medicine and value-based outcomes, research and education in primary care are the twin propellers that will push the boundaries of knowledge and competencies of Family Physicians in Singapore. Family Physicians have a vital role in research and education to enhance the practice of Family Medicine, as well as its development and standing as a discipline that is patient-centred, evidence-based, family-focused and problem-oriented. 

17        I would like to thank the SingHealth Duke-NUS Family Medicine Academic Programme and College of Family Physicians Singapore for putting together this conference. I encourage you to take the opportunity to learn from and collaborate with one another to improve the quality of primary care in the region. I wish you a fruitful conference. Thank you. 

^[1] Department of Statistics Singapore – Population Trends www.singstat.gov.sg/statistics/visualising-data/storyboards/population-trends

^[2] Ministry of Health Singapore – Singapore Burden of Disease Study 2010