SPEECH BY MR ONG YE KUNG, MINISTER FOR HEALTH AND COORDINATING MINISTER FOR SOCIAL POLICIES, AT THE OPENING CEREMONY OF THE SINGAPORE GENERAL HOSPITAL EMERGENCY/NATIONAL NEUROSCIENCE INSTITUTE BUILDING

Mr Cheng Wai Keung, Chairman, SingHealth Board of Directors

Professor Ng Wai Hoe, Group CEO, SingHealth

Associate Professor Tan Hiang Khoon, CEO, Singapore General Hospital (SGH)

Associate Professor Au Wing Lok, CEO, National Neuroscience Institute (NNI)

Distinguished guests, ladies and gentlemen

1.             I am happy to join you today for the official opening of this building in the Singapore General Hospital campus. And as you know, it will house the NNI at SingHealth, as well as the SGH Emergency Department (ED).

Evolution of NNI

2.              Let me start by saying, because we have two co-located institutions, I will say something about NNI and something about the ED. Let me start by saying something about NNI. When NNI was first established in 1999, it became the apex, or should I say, the neuro centre, for brain, spine, nerve and muscle conditions. Its establishment marked an important milestone in the development of neuroscience services in Singapore.

3.             NNI is special, and I mean it. It is one of the things I learnt after becoming Health Minister. It is special as a specialty centre because of its longstanding dual-campus model, located at both NHG Health’s Novena Campus and SingHealth’s SGH campus. Because of this, NNI has been in a unique position to directly support two healthcare clusters from the beginning. Later, NNI clinicians became IT ambidextrous, being able to operate the Electronic Medical Record systems of two different clusters.

4.              The ability to collaborate and operate across clusters is now wired in NNI’s DNA, and something I feel all the other specialty centres can take reference from. Today, even as we officially launch the NNI building at the SGH campus, NNI has developed satellite centres across multiple hospitals.  

Evolution of the ED

5.              And this building also houses SGH’s ED.

6.              In 1948, SGH established its Casualty and Outpatient Service, operating out of the Red House, a two-storey red-brick building that was part of the General Hospital. It became Singapore’s first 24-hour Emergency Unit.

7.             It responded to major incidents such as the Spyros industrial accident in 1978 and the Hotel New World collapse in 1986, shaping how Singapore prepares for and responds to civil disasters. It continues to play a pivotal role in producing clinicians, educators and leaders in Emergency Medicine in Singapore.

8.             Today, we have a bigger and better equipped ED in SGH. Having been operational for several months, it has ironed out most of the initial kinks and teething issues. Some of you may know, after I became Health Minister, I always insist we will do opening ceremonies on the first day of operations. But I do that for polyclinics. I think for the ED, better not. Let you iron out the teething issues first.

9.              What has not changed is that the ED continues to be the frontline of a healthcare institution and the bridge between what is happening inside the hospital and the outside environment. The ED is that bridge. When there is an external influenza infection wave or worse, a pandemic crisis, the ED is the first place to attend to an incoming wave of patients. As Hiang Khoon put it, you discovered the first COVID-19 patient here. Internally, if bed occupancy shoots up for whatever reasons in the hospital wards and admissions slow down, the choke is immediately felt in the ED as well.

10.          So, by looking at the ED, we can immediately gauge the health status of the community and the hospital. It is like the Traditional Chinese Medicine practitioner feeling your pulse. The pulse of the system is in the ED. Needless to say, running an ED is a very complex task.

11.          This is further complicated by today’s patients being very different from those in the past. In the early years – this is what I found out as we researched and prepared this speech – many emergencies involved casualties from gang and secret society fights. Those are the kinds of patients you had to tend to. And they came to the ED mostly for wound treatments. Today, ED patients, I think very few are injured due to gang fights, but they are older and many have multiple chronic conditions. Emergency care requires thoughtful clinical judgement and careful assessment, with several specialties working together. From time to time, I still get complaints from Singaporeans who write to me, who say: “In the past, when I went to the ED, attention was so swift. One doctor saw me and everything was resolved. Now I get referred all over.” But I do not know how to explain to them that their conditions today, compared to the past, are much more complex.

Running an ED

12.          There are a few aspects to a well-run ED.

13.          First, we must be able to triage effectively. An ED cannot operate on a first-come, first-served basis. A delay of 30 minutes for a stable fever could be an inconvenience. But for someone with a stroke or heart attack, that same thirty minutes are life and death.

14.          Shortly after joining the Ministry of Health (MOH), I learnt that the measurement of whether an ED is running at full capacity is not whether the ambulance bays are filled but the question is whether the resuscitation rooms are filled.

15.          On an average day, the SGH ED sees over 300 patients. Triage enables healthcare staff to quickly assess who requires immediate attention and who can wait safely. Typically, about 15% of patients need immediate attention and are given priority.

16.          This means less urgent cases will have to wait. The wait can be frustrating, but it is essential for emergency care to work properly. This way of working ensures that if a patient who is waiting today ever needs emergency care, he or she will be given priority. So again, sometimes when I walk along the streets, members of the public will come to me and say, “Mr Ong, I went to the ED and I waited quite a while, a few hours.” I say, “Good. It means it is not serious.” Conversely, sometimes I do get praises. People come to me and say, “I went to the ED, I was attended to immediately.” And then I say, “That is not so good. What is your condition that is so urgent?” So I hope more people can appreciate that unique operational environment of the ED. I seek the understanding of Singaporeans when there needs to be a longer wait.

17.          Second, we have to keep patients flowing through the system. This means moving patients efficiently from triage assessment to, depending on their condition, observation, diagnostic tests and scans, treatment, admission or discharge. The new building provides significantly expanded capacity at each stage of this patient journey. The number of triage and resuscitation rooms has more than doubled, from 10 to 22 rooms. The critical care area capacity has more than tripled, from 15 to 53 cubicles.

18.          One recent innovation in ED operations, is to provide beds for short-term monitoring. This is to cater to a situation that is becoming more common with an ageing population, where the patient is stable, but we want to observe him or her a while longer just to be sure. And for these patients, SGH ED has tripled its Extended Diagnostic & Treatment Unit capacity, from 13 to 38 beds. And moving around the three clusters, I do not know whether the Group CEOs compare notes, but I have the sense that all three clusters, without coordination, came to the same conclusion that you need these short-term observation points.

19.          As for patients who need a longer period of recovery and observation, there is a new 152-bedded Acute Medical Ward, where they typically stay for about three to four days before discharge.

20.          These features and facilities create a smoother patient journey at the ED, reducing bottlenecks and delays, and improving care for ED patients and the pulse of our healthcare system.

21.          Third, we have to bring the right expertise together and to the patient quickly. The co-location with NNI is by design, to provide a faster response to stroke patients, where a blocked blood vessel needs to be cleared within the “golden hour”. The co-location allows specialists in emergency medicine, neuroradiology and vascular interventional radiology, as well as other disciplines to work more closely and respond more promptly. Technology such as AI further expedites diagnosis, reducing the duration for brain scans from up to an hour to just six minutes.

22.          For the fourth aspect, we need to provide alternatives for non-emergency cases. So a good ED design is not just this ED, but the entire ecosystem. Managing pressure also means recognising that not everyone who comes to the ED requires emergency care. Telehealth platforms provide a convenient alternative to in-person visits for less critical conditions. The SingHealth Primary Care Network of GPs and GPFirst partners can be the first port of call for patients with mild to moderate medical conditions, to assess whether an ED visit is necessary.

23.          These efforts are making a difference, and we know they will make a difference. Recently, we have been suffering from the haze. We can see more acute respiratory conditions going up. Many come to the ED. So MOH, on 12 October, activated the Haze Subsidy Scheme (HSS). Immediately after we activated the HSS, ED attendances dropped. So alternatives are very important, and these efforts will make a difference. Over the last three years, wait times for 95% of serious but not life-threatening emergency cases have improved from 217 minutes in 2023 to 141 minutes in 2025. This reflects the concerted efforts across our healthcare system to ensure that when emergencies happen, patients receive timely care. Just in case, when you hear 217 and 141 minutes, it can sound very long, but these are for the non-life-threatening emergency cases. For the emergency cases, we aim for zero minutes.

A Tribute

24.          I thank everyone who has worked hard to make this new building possible. SGH has embarked on a 20-year implementation of its Campus Masterplan. The SingHealth Tower and Outram Community Hospital were completed in 2019 and are now fully operational; the National Cancer Centre Singapore was completed in 2023, also fully operational; and today we mark another important milestone with the official opening of SGH ED and NNI.

25.          There is more to come – the Elective Care Centre, the new National Dental Centre Singapore, and not forgetting the new Health Sciences Authority Building and also not forgetting the MOH Building. This campus will be the heart of Singapore’s healthcare system.

26.          We will continue to invest in our healthcare infrastructure and our people, so that we can all look forward to a rejuvenated health campus, and a stronger healthcare system that can provide even better care to Singaporeans. Thank you, everyone.