Speech by Dr Lam Pin Min, Minister of State for Health, at the 22nd Singapore General Hospital Annual Scientific Meeting, 7 April 2017

Professor Ang Chong Lye, Chief Executive Officer, SGH

Professor Fong Kok Yong, Chairman, Medical Board

Associate Prof Koh Tse Hsien, ASM Organising Chairman

Professor Venkat Narayan, Emory University, Atlanta

Distinguished speakers and guests

Ladies and Gentlemen 

1.     Good morning. I am pleased to join you at today’s opening ceremony.

2.     Singapore’s healthcare needs are changing, and innovation and research have important roles in transforming care management and delivery to meet our long term healthcare challenges. By 2030, one in four Singaporeans will be aged 65 years and above, up from one in seven today. The growing prevalence of chronic conditions, such as hypertension and diabetes, will further add to the demand on healthcare services.

3.     To address this change in healthcare demand, there is a need to transform the way we deliver care in Singapore. Doing more of the same will not be sufficient to adequately address the changes in healthcare burden, and we need to make fundamental “shifts” to the way care is delivered. We are working to move beyond hospital to the community, beyond quality to value, and beyond healthcare to health. These are significant shifts which require mindset change, manpower re-allocation and also organisational adjustments. In addition, research plays a role in assisting these “shifts”. 

Beyond hospital to community

4.    With the changes in Singapore’s healthcare needs, it is not sustainable or desirable for healing and care to continue to be centred in hospitals. Hospital care is resource intensive, and is not the right site for a person-centred approach to manage chronic diseases, which is best done in the community and closer to home. It is necessary to examine how care can be provided in the community. The Ministry of Health has established the National Innovation Challenge (NIC) on Active and Confident Ageing to facilitate this. We have launched grant calls to look into translational ideas in lengthening health span, unlocking the talent and productivity in longevity, as well as leveraging on science and technology to overcome disabilities to help Singaporeans age-in-place. I encourage SGH and its collaborators to continue to use this platform and others to look into ways to move care from the hospital into the community.

Beyond Quality to Value

5.     Another area of focus is for us to go beyond quality and offer patients good value in healthcare provisioning. In this regard, I am pleased to note that SGH has some encouraging results in piloting a new model of care to improve cost-effectiveness and right-siting of patients. SGH, through the use of a transitional care programme with discharge strategies and follow-up plans for high-risk patients, was able to bring about a 20 to 30 percent reduction in hospital readmission risk and length of stay. These initiatives would help lessen the burden of healthcare costs to patients, and more of such innovations are required in the system.

Beyond Healthcare to Health

6.     Even as the first two prongs of the Ministry’s plan – of translating care from hospital to the community, and bringing about good value - are for patients, there is recognition that as a nation, we need to move upstream in our efforts to ensure that Singaporeans have good health to begin with, and not only focus our efforts on ensuring they receive good healthcare when they are ill.

7.     The focus on prevention, and early detection and management, in the War on Diabetes, is one example where we want to maintain the population in as good a state of health, for as long as possible.

8.     Diabetes is a serious health issue in Singapore. One in three Singaporeans has a lifetime risk in developing diabetes; a 30% lifetime risk. Poor control of diabetes can lead to debilitating conditions such as heart attack, stroke, kidney failure, blindness, and even lower limb amputation. The statistics are startling. Each day on average, our hospitals conduct 4 amputation procedures as a result of diabetes. In 2014, 2 in 3 of the 1,600 new kidney failure cases are caused by diabetes.

9.    Appropriate interventions can arrest the development of the disease, and early detection and management can slow its progression and prevent complications. Realising these, SingHealth has chosen to focus on populations at-risk for diabetes, namely, those with pre-diabetes, and women with gestational diabetes. Through its “One Stethoscope for Diabetes” project, SingHealth has mapped out patient journeys for pre-diabetes and gestational diabetes, and identify critical chokepoints that typically lead to a loss in follow-up. For instance, by providing patients with more care options at natural touch points in the community, it will make it easier for follow-up to take place.

10.     In addition, the project considered the development of strategies to incorporate patient empowerment and self-management as integral to the care journey. At the heart of it, is the recognition that healthcare providers form one part of what constitutes care and support for a person to regain health. To move beyond healthcare to health, we need to collaborate and involve other players in the spectrum, such as health coaches, caregivers, patient volunteers, and patients themselves – to empower individuals to take charge of their health.

Closing

11.     SGH has a long history of clinical research, and continues to be one of the most important healthcare providers which contributes to the medical and scientific discussions nationally. This commitment of calling together various disciplines and professions within the SGH Campus, and partners, through a research focused conference – to collaborate on important areas, and to recognize different research contributions – is yet another testament to the commitment SGH has towards research.

12.     Different expertise is required for the work on healthcare and the work on research. Today, you have internationally renowned clinicians and researchers who will speak to you on using research to improve patient outcomes, and using new therapy to address current healthcare challenges. You will also celebrate the many different professions which have contributed to research. I encourage you to continue to tap on different resources to collaborate, to learn, and to derive new solutions for our healthcare system and for the patients who are the focus of our healthcare delivery. Thank you.