Speech by Minister of State for Health, Dr Lam Pin Min at the 36th Asian Medical Students’ Conference on 6 July 2015

Professor Hooi Shing Chuan, Vice-Dean (Education), Yong Loo Lin School of Medicine, National University of Singapore

Distinguished Guests

Ladies and Gentlemen

1.        Good morning. I am pleased to join you this morning at the 36^th Asian Medical Students’ Conference. To our friends from all over the world, a warm welcome to Singapore!

AN AGEING ASIA

2.        Asia is ageing rapidly. Many developed countries such as France, Australia and Canada took more than 60 years for its proportion of seniors aged 65 years and above to double from 7% to 14%.  On the other hand, countries in Asia such as Sri Lanka, Thailand and South Korea will see the same demographic change in less than 25 years.

3.        Singapore will also age rapidly. The proportion of seniors aged 65 years and above is expected to double from 7% to 14% by 2020. By 2030, about one in five residents will be above the age of 65.

EMBRACING AN AGEING POPULATION

4.        An ageing population can have a significant impact on our society. On the one hand, the demand for healthcare services is likely to rise as our population ages. In many societies, an ageing population is increasingly straining healthcare financing as well as social security systems.

5.        On the other hand, we should recognize that population ageing is also a result of advances in medicine, science and technology that has allowed us to live longer.  Ageing need not only be associated with sickness and disability. It can also be associated with longer, more productive lives.

6.        As medical professionals, we can play very critical and important roles in helping our societies respond effectively to an ageing population. First, in advocating for and participating actively in delivering preventive health, so that we can expand “health spans” even as “life spans” expand. Second, we can transform the delivery of care to be more person-centric and more appropriate for seniors.  Let me elaborate.

WORKING TOGETHER TO EXTEND ‘HEALTH SPAN’

7.        As a health system, one of the key strategic shifts we need to make is to place a greater emphasis on preventive health, and not just be concerned with sickness care.

8.        With early investment in good preventive health and sustained efforts to encourage a healthy lifestyle from young through to adulthood, it is possible to defer the onset of diseases and disabilities.  If our seniors continue to stay physically healthy and cognitively active, there is no reason why they cannot continue to be a driver of our social and economic development.

9.        It is for this reason that the Ministry of Health in Singapore has stepped up our efforts to outreach to seniors to promote early health screening, eye checks and falls risk assessment. We promote health screening and healthy lifestyle systematically in each region, as well as in workplaces.

10.      I am heartened to note that students from the Yong Loo Lin School of Medicine at the National University of Singapore (NUS) are already playing their part in promoting preventive health in Singapore. Take the example of the Public Health Service (PHS), an initiative by medical students from NUS. The PHS was started 11 years ago and is a comprehensive, free health-screening event for all Singapore residents.  This programme targets residents in mature estates such as Clementi, in order to reach out to more elderly residents.

11.      Medical students who are part of the PHS provide health screening to residents of mature estates for conditions such as hypertension, diabetes, high cholesterol and colorectal cancer. The PHS also initiated a special segment that provides an added geriatric focus for participants above the age of 60. These seniors will go through various stations like medication reconciliation through a pharmacist consult, a urinary incontinence test and a falls risk assessment.

12.      To date, about 15,000 participants were successfully screened in the PHS. Through the PHS, the students were able to identify residents early who may be at risk and may need early medical attention. This is also a good platform to educate residents on what they should do to keep themselves in good health. I applaud the efforts of our passionate medical students from the Yong Loo Lin School of Medicine, and I encourage more of you to play a part in this effort of expanding healthy years in our senior population.

FUTURE READY AGED CARE SYSTEM

13.      The way we organise our healthcare delivery system in Singapore will also have to change in response to population ageing. Seniors often have multiple conditions and their chronic conditions cannot be totally addressed within an acute hospital stay.

14.      Delivering care to a senior with multiple conditions cannot be a summation of discipline-centric care.  Rather, we should take a holistic view of the senior’s conditions and deliver person-centric care that is appropriate and holistic. This means that we will require more “generalists” in our system, such as geriatricians and internists, now and more so, in the future. We need future doctors like you, to be opting to join these disciplines.

15.      We also need to transform our healthcare delivery to bring care beyond the acute hospitals to “home”. An acute centric care model will not be able to sustainably support an ageing population with chronic conditions. Rather, we should build up a good primary care and a strong intermediate and long term care sector, and be able to join up care across settings for our elderly patients.

16.      In recent years, Singapore has sought to grow the primary care sector by developing Family Medicine Clinics (FMCs) and developing shared care models between acute hospitals and FMCs. We are also extending access to subsidised primary care at participating private providers through the Community Health Assist Scheme (CHAS) and training more family physicians.

17.      MOH has also ramped up the capacity of intermediate and long term care services, such as nursing homes, day care and home based care services. We are engaging aged care providers to set higher care standards, and improving the affordability of aged care services through enhancements in subsidies for long term care.

18.      At the systems level, we have reorganised our public healthcare system into six Regional Health Systems (RHS) to facilitate local care integration. Each of these RHSes serves a particular geographical region in Singapore and aims to orchestrate holistic, patient-centred care across the entire healthcare continuum within the population it serves.

19.      I am pleased to note that students from NUS are also involved in the delivery of care in the community. The Tri-Generational HomeCare project is one such project comprising Medicine, Nursing, Pharmacy and Social Work students from NUS, in partnership with secondary school students. These students work closely with a multi-disciplinary team from Khoo Teck Puat Hospital to look after seniors who are frequent admitters to hospital, in the community, so that they can reduce their readmissions. They provide medical care by monitoring the blood pressure and capillary blood glucose of patients, and look after their social needs by linking them to the relevant community partners through community nurses. Students gain first hand exposure to team-based care and work to provide medical, psychosocial support and holistic care over a period of 6 to 12 months for seniors. Through this initiative, they are able to reach out to our seniors in the community and support them to age in place.

CONCLUSION

20.      Let me end by commending you for a very positive theme to this conference – to embrace a silver tsunami. However, let me also encourage you to see ageing not as a natural disaster, but also an opportunity to live longer and more fulfilling lives. Together, we can unlock the potential in longevity and provide good care for our seniors to age gracefully in place. This can be the future of ageing and it is for you, the younger generation, to create it.  

21.      Thank you.