Speech by Dr Amy Khor, Minister-of-State for Health, at the 1st Singapore Rehabilitation Conference, 10 February 2012

Introduction

Good morning, ladies and gentlemen.

1          I am delighted to join you today at the opening ceremony of the First Singapore Rehabilitation Conference hosted jointly by the Singapore General Hospital and Tan Tock Seng Hospital.

Challenges for Rehabilitation Medicine

2          Rehabilitation medicine has come a long way since it started in 1973 as a unit in Tan Tock Seng Hospital treating spinal cord injuries.  Today, we have rehabilitation services available in acute hospitals, community hospitals and 48 day centres. Much has been done and I would like to acknowledge the efforts of doctors, nurses, therapists, and administrators in raising the level of rehab services in Singapore. Yet, much more needs to be done to meet the challenges that lie ahead.

3          With an ageing population and the increasing prevalence of chronic conditions such as stroke, hip fracture and heart failure, Singapore will face an increasingly heavy social, fiscal and economic burden. There is also a group of younger patients afflicted with traumatic brain injury or spinal cord injury who, with advances in medical care, survive these injuries but have a poor quality of life.  For all these patients, rehab plays a critical role in improving functional outcomes and the quality of life, reducing dependence, and enabling integration back into the community.

Transformation in the Rehabilitation Landscape

4          In the acute hospitals, there is a growing move to start rehabilitation early in the recovery process, such as initiating rehab at the intensive care unit (ICU) with the aim of achieving better outcomes and shortening the duration of inpatient care. Our hospitals are also leveraging on technology such as tele-rehabilitation, robotics and gaming as force multipliers in patient care. 

5          Recently, when I visited the SGH and TTSH Rehab departments, I was heartened to see very committed multidisciplinary teams managing a wide spectrum of rehab patients. At the same time, I was amazed by the use of robotic and virtual reality technologies which assisted the patients in their recovery process in a very engaging and interactive way which reduces the challenge and chore that patients may feel while undergoing therapy with repetitive movements and exercises. 

Efforts to enhance community rehabilitation

6          My Ministry is also keen to work with partners to enhance rehab in the community. 

7          In 2011, we introduced new service requirements [1] to improve the standards of rehabilitation care in terms of staffing, needs assessment, individualized care plans and monitoring of outcomes in MOH-funded day rehab centres. Centres that meet these service requirements will be accredited to receive higher government subsidies and be allowed the use of Medisave for community rehab services. I am glad that currently 31 centres have met these new service requirements and have been accredited. The Agency of Integrated Care (AIC) is working to get more centres to qualify for accreditation. To encourage wheelchair-bound, needy and elderly patients to attend their scheduled rehabilitation sessions regularly at fully accredited MOH-day rehab centres, we have also extended transport subsidies through the Senior’s Mobility Fund to them.

8          We have also introduced a new type of facility  known as the Transitional Care Facility (TCF) for patients who require slower-stream, lower intensity rehabilitation for 3-6 months after discharge from acute or community hospitals, before they can return home.  The Eastern Health Alliance has started to pilot this TCF care model at a 32-bedded ward within Peacehaven Nursing Home. Beyond the first pilot at EHA, we are working with 2 more providers to set up TCFs.

9          MOH has also taken steps to enhance the competency of healthcare workers delivering rehab services. Measures include introducing and integrating rehab components into our undergraduate medical curriculum, developing local degree upgrading programmes with the Singapore Institute of Technology and Trinity College Dublin for Occupational therapists and Physiotherapists; and introducing regulation of allied health professions to raise standards of the therapy workforce.

Conclusion

10        Indeed, these are exciting times for rehab medicine. It is therefore timely that the first-ever national rehabilitation conference with its most apt theme of “State-of-the Art Advances in Clinical Rehabilitation” is taking place today as the quality of rehabilitation delivered is as critical as the quantity. I congratulate the organizers for putting together a comprehensive programme, which not only addresses the main fields of rehabilitation but is also tailored to our country’s specific needs. I am glad to see many healthcare professionals involved in rehab work here at this conference -- physical, occupational, and speech therapists, medical social workers, nurses, doctors, rehabilitation scientists, engineers and health administrators. I wish you an enriching and fruitful conference ahead.

Thank you.

[1] The new service requirements for community rehabilitation services focus on six key aspects of rehabilitative care provision: (i) Professional certification of rehabilitation needs; (ii) Professional staffing; (iii) Individualised care plans; (iv) Care outcomes and regular reviews; (v) Outcomes monitoring and reporting; and (vi) Clear discharge criteria.