Speech by Senior Minister of State for Health, Mr Edwin Tong, at the Asia Pacific Heart Rhythm Society Public Education Forum 2018, 8 September 2018, 10:15am

Dr Teo Wee Siong, Board Member, Asia Pacific Heart Rhythm Society (APHRS) and Organising Chairman, APHRS Public Education Forum 2018

Adjunct Associate Professor Ching Chi Keong, Board Member, APHRS and Organising Chairman, APHRS Public Education Forum 2018

Dr Tan Yong Seng, Board Member, Singapore Heart Foundation (SHF)

Dr Chee Tek Siong, Board Member, SHF

Distinguished Guests,

Ladies and Gentlemen.

Introduction

           I am glad to be here today, as we bring into focus an important but perhaps not so well-known health issue in Singapore – atrial fibrillation.

2.     Atrial fibrillation is the most common serious heart rhythm disorder, affecting millions of people around the world. The risk of the condition increases with age and affects as many as 1 in 20 people over the age of 65. Symptoms of atrial fibrillation may range from mild chest discomfort to palpitations, breathlessness and fainting. However, a proportion of people with atrial fibrillation may not experience symptoms at all. Studies suggest that two-thirds of those with atrial fibrillation do not know that they have the condition.

3.     If left untreated, atrial fibrillation can lead to other serious conditions. Atrial fibrillation can increase the risk of a potentially deadly stroke by up to eight times and is associated with 15% of all strokes in Singapore. It is important that all of us are aware of its symptoms and seek help from a doctor when feeling unwell. Early diagnosis and treatment can help establish control and reduce the risk of complications. 

4.     Atrial fibrillation is also a concern because Singapore has a rapidly ageing population and it is likely that there will be more patients with the condition in future. The number of seniors aged 65 and above in Singapore is expected to increase from about 1 in 7 now, to around 1 in 4 by 2030.

Better Support and Access to Care

5.      Better access to care in the community is important, and the Ministry of Health (MOH) has been working to ensure that patients can receive adequate support for various conditions, including cardiovascular-related illnesses, beyond the hospitals. In 2017, we worked with our Regional Health Systems to pilot geographically-based Community Nursing teams to support patients in the community. Under the pilot, community nurses support different needs in the elderly population. They provide post-discharge care and conduct home visits for patients with complex medical needs or who require end-of-life palliative care. They also train caregivers and coordinate care for patients. These are examples of the holistic suite of services that community nurses provide, to help patients recover well at home and reduce hospital readmissions.  

6.      MOH has also launched the Primary Care Networks (PCNs), to ensure that patients with chronic conditions are better cared for in the community.  As part of the PCN scheme, more than 300 general practitioner (GP) clinics have organised themselves into virtual networks to deliver holistic care in a team-based care approach. Patients receive care through a multi-disciplinary team, comprising GPs, nurse counsellors and care coordinators in a setting closer to home for more effective and holistic management of their chronic conditions.

Early Detection and Maintaining a Healthy Lifestyle

7.         Even as we do more to shift care beyond the hospital and into the community, all of us can and should do something for our own health by adopting a healthy lifestyle. Some of the modifiable risk factors for atrial fibrillation include high blood pressure, being overweight and chronic conditions, like diabetes. Maintaining a healthy lifestyle can help to lower the risk of developing such illnesses. 

8.      The Health Promotion Board (HPB) has been enhancing efforts to encourage Singaporeans to take charge of their health. HPB’s Healthier Dining Programme (HDP) was introduced in 2014 to help consumers choose healthier options, improving Singaporean’s eating habits and dietary quality when they dine out. As of 31 July 2018, there are more than 1,140 food and beverage operators with 8,700 outlets on board the HDP. HPB aims to ensure that by 2019, at least 40% of stalls across all hawker centres and coffee shops will have at least one healthier option on their menu.

9.        The National Steps Challenge is the world’s first population-level physical activity initiative. Across three seasons of the National Steps Challenge™, HPB successfully motivated over 1 million Singapore residents to become more physically active. The fourth season will be launched in October 2018.
 
10.     Early detection can also go a long way in helping to treat and manage many cardiovascular-related illnesses and other conditions, as well as reduce the risk of further complications. Regular health screening is therefore important, and this is why the government has enhanced subsidies for the national Screen for Life programme to encourage more Singaporeans to go for evidence-based screening and follow-up at Community Health Assist Scheme (CHAS) GP clinics. Eligible Singaporeans can have access to subsidised health screenings at $5 or less, and this includes the first post-screening consultation with a doctor. CHAS cardholders pay $2, while the package is free for our Pioneers.

Conclusion

11.       In closing, I would like to thank the Organising Committee, the Singapore Heart Foundation, the Asia Pacific Heart Rhythm Society and the Singapore Cardiac Society for raising awareness of atrial fibrillation. I wish all of you good health and a fruitful discussion ahead. Thank you.