Speech by Mr Chee Hong Tat, Minister of State for Health at the Healthcare Infrastructure Technology & Engineering Conference (HI.TEC 2017), 7 Mar 2017

Mr Goh Aik Guan, MD/MOHH

Excellencies, Distinguished Guests

Ladies and Gentlemen

            Good morning and happy to join you today at the fifth Healthcare Infrastructure Technology & Engineering Conference (HI.TEC). I am pleased that this year’s conference partner, the Australian Government and the Australia Trade and Investment Commission or Austrade, will be sharing their experiences on trends and technologies that are shaping the Australian healthcare landscape. I hope this win-win partnership will extend into other domains such as healthcare infrastructure planning, construction methodologies and workforce capability development. Earlier, the Finnish Ambassador (Ms Paula Parviainen), shared that Finland has one of the fastest ageing populations in Europe. There are also opportunities for us to work together with Finland to share best practices because we face similar challenges when it comes to ageing, healthcare, and how to improve productivity so that we are better able to provide quality care to our people.

2.           Here in Singapore, we face a double-challenge in healthcare as our population ages.  On the demand side, we will see an increase in demand for hospital beds and aged care services.  On the supply side, an ageing population means that we have fewer Singaporean healthcare workers in the future.  

3.           So what can we do?  MOH has increased healthcare capacity over the past few years. Since 2012, we have opened the Changi General Hospital Integrated Building (CGH-IB), Ng Teng Fong General Hospital (NTFGH) in the western part of Singapore, Jurong Community Hospital (JCH) – which is linked to Ng Teng Fong Hospital, Yishun Community Hospital (YCH) – which is linked to Khoo Teck Puat Hospital, and the new Sengkang General Hospital and Community Hospital will be ready in 2018. Woodlands Hospital is next on the list.  We have also added seven new Family Medicine Clinics (FMCs) and seven Community Health Centres (CHCs), 3,400 nursing home beds and 5,600 day care and home care places over the last five years. In tandem with this capacity expansion, we have also been increasing our healthcare workforce, by about 23,000 from 2011 to 2016.

4.           We put in place this capacity expansion because it is necessary to meet our future healthcare needs, and we need to start planning ahead, planning early, so that we will be ready for the future. Building the infrastructure is, of course, challenging, and we would need to find ways to do so in a productive way, but even more challenging is finding the skilled and trained manpower. If we want to expand capacity, we need to focus on both – infrastructure and manpower. But we cannot continue to grow on this current trajectory. The current pace of expansion, this current trajectory, it is simply not sustainable.  At some point we will run out of space, and even before that, run out of people. We must focus on productivity improvements, so that we can deliver better value to our patients while managing the increase in our overall healthcare costs.  

Improving Productivity

5.           Since 2012, HI.TEC has been a useful platform to share and learn from one another how we can develop our healthcare facilities better, cheaper and faster.   I am pleased that MOHH has been constantly looking at ways to improve productivity in the construction of new healthcare facilities. In line with the Public Sector Productivity Gateway Framework spearheaded by BCA, MOHH has developed a productivity blueprint for infrastructure development, known as the Master Productivity Plan (MPP) for healthcare. Through the MPP, we aim to achieve between 2% to 3% annual productivity growth from 2010 to 2020.

6.           One of the key thrusts under the MPP is a greater push towards off-site manufacturing for on-site assembly. We have already piloted the Pre-fabricated, Pre-finished, Volumetric Construction system, or PPVC for short, at the new Woodlands Crescent Nursing Home project. Modularised patient rooms were pre-fabricated, complete with internal finishes, fixtures and fittings, and delivered to site for assembly like Lego. This is something that we will do at more locations for more projects.

7.           Such game-changing technologies helped us to shorten the construction by three months and achieved productivity savings of up to 35% in man-days.  As the bulk of the construction activities and manpower were moved off-site to a factory, dust and noise pollution at the nursing home site were kept to a minimum – it also benefits the residents in the vicinity as we keep most of the noisy more pollutive activities away from the site. MOH will extend the use of such prefabrication technologies to other healthcare infrastructure projects.

8.           The MPP also promotes the implementation of alternative, time-saving procurement methods. One of our goals for healthcare infrastructure projects is to get contractors to plan upstream to come up with designs that are labour-efficient and easy to build. The Early Contractor Involvement (ECI) procurement approach has resulted in cost and time savings for projects with a protracted development timeline. It taps on contractors' understanding and experience of the construction process and brings this to the forefront of the design process, so to not retrofit after building as that is often time-consuming and costly, but to build it upfront into the design. This has helped facilitate the adoption of labour efficient designs and construction methods, which also benefits our construction industry, also benefits our engineering companies and designers. Using the ECI method for Changi General Hospital-Medical Centre project has yielded cost savings of about $5 million or 2.5% of main construction contract cost. Some people may say that it is only 2.5%, but 2% for one project and another project, if you add it all up, the cumulative savings can be quite significant and very substantial. More importantly, it is the mindset – of always trying to look for ways to do things better, trying new ideas, improving as we go along, extracting value, and cutting waste. These are important steps that we need to take, not just for infrastructure but for operations and policy.

9.           In short, embracing productive construction technologies has been a plus for MOH and MOHH, as it has enabled us to speed up the development of our healthcare facilities, while retaining quality and managing our costs.  It has also been beneficial for the industry, particularly companies which are seeking to develop a competitive edge in construction technologies.  Most importantly, it has been beneficial to patients, who can now access care more conveniently, nearer their homes.

10.       We need to go beyond building facilities faster and cheaper. Last year, when I attended this conference, I spoke about the need to continuously look for innovative ideas to optimise design, workflows and improve productivity in our healthcare infrastructure.  As the saying goes, “we shape our buildings and then they shape us”. 

11.       This year, we want to build on these earlier discussions to innovate in the areas of healthcare infrastructure design and construction, so that our healthcare facilities can support productivity enhancement efforts and improve patient experience.  This is what today’s conference ‘Smart Healthcare Infrastructure for All Ages’ aims to achieve. 

12.       I understand that one highlight of this year’s HI.TEC conference is the InnoShow exhibit, which showcases smart technology solutions from companies across Asia Pacific. The exhibit features a range of technological solutions including automated cleaning and disinfection systems, humanoid robots and predictive tools. I encourage our healthcare providers to partner with industry players, to learn what new technologies and approaches are available, and where feasible, to adopt them for use in our healthcare facilities. 

13.       We need to look beyond healthcare, to find solutions that can improve the healthcare sector. Many of the things that we can benefit from solutions that are already adopted in other sectors - whether it is design, engineering, IT, manufacturing, and service industries. I know many of our healthcare institutions are doing that. They are linking up with partners outside the healthcare industry, so that they can learn the best practices, and also linking up with partners from overseas. I am very happy to see many overseas guests here today. The solutions that we need to tackle the challenges we face would not be unique to any particular country or society. It is something that we can all benefit if we are able to share best practices, learn from one another, and innovate together, to do better.

Conclusion

14.       In this spirit of learning and collaboration, I wish you all a fruitful and productive conference.

15.       Thank you.