Speech By Mr Chee Hong Tat, Minister Of State For Health, At The Singapore Trauma Conference Opening Ceremony

Good morning.

1 It is my pleasure to join you this morning at the annual Singapore Trauma Conference 2016. First held in 2007, the Singapore Trauma Conference has grown in scale and scope over the past 10 years.

Trauma Trends – Traffic Accidents and Falls

2 Trauma affects countries all over the world. In Singapore, trauma is the number one killer amongst those under the age of 45, which is largely attributable to road traffic accidents. Although road traffic accidents have been on a declining trend from 2012, it still causes the second-most common injury at about 25% in 2014^[1].

3 The most common cause of injury is falls, accounting for more than 60% of serious injuries. The elderly is the largest age group, constituting almost two-thirds of all fall cases. As Singapore’s population ages, incidences of falls are on a gradual increase. Correspondingly, almost half of trauma deaths occur in those aged above 65 years old, which underscores the correlation between frailty and mortality rates.

Strengthening System Capabilities

4 Having understood the major contributing factors in trauma cases, strategies for trauma prevention and improvement in trauma care can be identified.

5 To facilitate coordination of trauma services and advise on the development of trauma care, the National Trauma Committee for Singapore was started by the Ministry of Health in 2008. The Committee has since developed the ‘Minimum Standards of Acute Care for Trauma Patients’ to ensure that every public hospital in Singapore has the necessary range of medical capabilities to effectively deal with acute trauma cases. With standardised clinical expertise and medical protocol for trauma management, trauma mortality rates decreased from 2012^[2]. To date, all public hospitals in Singapore have met these Standards, including the newest hospital, Ng Teng Fong General Hospital. I encourage the private hospitals to do likewise, to provide better care for patients.

6 A critical area in Singapore’s trauma care is how we deal with hip fractures. Over the last 30 years in Singapore, cases of hip fractures have increased 5 times in women aged 50 and above, and 1.5 times in men of the same age group^[3]. It is a potentially debilitating injury which can diminish life expectancy and quality. Patient outcomes can be greatly improved with surgery and early rehabilitation. To facilitate and expedite overall care processes, hospitals such as Tan Tock Seng Hospital, Khoo Teck Puat Hospital and Changi General Hospital have launched an integrated care pathway for hip fracture.

7 Under the care pathway, surgeries will commence in a timelier fashion, with corresponding shorter hospital stays. Early rehabilitation can then be initiated, with patients continuing their rehabilitation in the community. This will provide a smoother transition back into the community, successfully returning hip fracture patients to independent living.

Falls Prevention

8 We must also invest upstream to minimise the risk of falls and injuries. Together with the Health Promotion Board, we are introducing a National Seniors’ Health Programme under the Action Plan for Successful Ageing. Through a series of health talks conducted in the community, we want to raise awareness among seniors on topics such as falls prevention, nutrition and physical activities. Tan Tock Seng Hospital will also organise an annual Falls Awareness Day to educate seniors and their caregivers on how to minimise the risk of falls.

9 We are bringing preventive health services closer to our seniors. For example, Alexandra Health System is piloting a falls risk assessment protocol. Seniors can identify their risk factors and undertake preventive measures to reduce these risks. Madam Seah is a 70 year old lady who was feeling unsteady on her feet. Madam Seah had initially thought that this was caused by her weak knees. Through the assessment, she found that it was not her knees but her back that was making her feel unsteady. She is now going through physiotherapy sessions to strengthen her back muscles to reduce her risk of falls.

Conclusion

10 In closing, I am heartened to see so many trauma care professionals, from both local and international communities, gathered at this Conference. By learning from one another, through collaboration and sharing of best practices, common challenges can be addressed in the exchange of ideas and peer discussion. This will help raise the standards of trauma and critical care to benefit our patients. I congratulate Singapore Trauma on your 10th anniversary, and wish you well as you continue your good work in the years ahead.

Thank you.

^[1] The rate of road traffic accidents resulting in serious injuries are as follow: 27% in 2012, 25% in 2013, 24.9% in 2014.

^[2] Not including ‘died at scene’ trauma cases, 8.7% of trauma cases (376 out of 4314) died in hospital in 2012, compared to 7.5% (357 out of 4769) in 2014

^[3] Source: HPB health portal http://www.hpb.gov.sg/HOPPortal/health-article/7468