DPM Heng Swee Keat at the SGH200 Rooted in Excellence Event

Mr Gan Kim Yong,
Minister for Health

Mr Peter Seah,
Chairman of SingHealth,

Professor Ivy Ng,
Group Chief Executive Officer, SingHealth,

Professor Kenneth Kwek,
Chief Executive Officer, Singapore General Hospital,

Mr Khaw Boon Wan,

Staff of the Singapore General Hospital,

I am delighted to join you this afternoon to commemorate the bicentennial of the Singapore General Hospital.

Preamble

The Singapore General Hospital, or SGH, traces its roots to 1821. It started as a general hospital in the cantonment for troops. After several relocations, it finally settled at the Sepoy Lines in Outram Road in 1882. Many older Singaporeans still refer to SGH in Hokkien as “see-pai-poh”, which is derived from the term “sepoy hill”.

The modern chapter of SGH began in 1926, when three blocks – Bowyer, Stanley and Norris – were constructed to create an 800-bed hospital. Today, only the Bowyer Block Clock Tower – which is where we are at – remains. This clock tower has kept watch with generations of healthcare workers, and also patients and their families, as they go through critical moments in life. Today, it continues to bear witness, to another historic moment – SGH’s bicentennial.

Singapore Healthcare Story

As our oldest hospital, the SGH story mirrors the growth of public healthcare in Singapore. Back in 1821, healthcare for the local population was scant. Public health efforts then were narrowly targeted at infectious diseases, such as smallpox and tuberculosis. Following Independence, the Government took a more comprehensive approach towards public health. The provision of public housing led to better living conditions. Compulsory vaccination programs, public cleanliness campaigns, and health promotion efforts led to better health outcomes.

As we progressed as a nation, we built up our healthcare system and invested more in healthcare – Meeting the needs of a growing population, raising the quality of care, while keeping care affordable. To meet these growing healthcare needs, SGH was redesigned to house a wide variety of medical specialties and sub-specialties. The Government set up specialist centres within the Outram Campus for cancer, heart, eye, neurological and dental conditions. We made rapid improvements in our healthcare system over a short span of a few decades. Today, Singapore is ranked first in the World Bank Human Capital Index. Our life expectancy is 85 years, among the best in the world. We achieved this not by spending the most money on healthcare, but by making the most of our investment, and with the dedication of our healthcare teams. Our hospitals today are well-regarded in Singapore and abroad, with SGH ranked among the top ten best hospitals in the world by Newsweek.

Future of Our Healthcare

What will the future of SGH, and indeed the future of healthcare in Singapore, look like? The future of healthcare in Singapore will be shaped by our people, and by the basic commitment of this Government to help all Singaporeans to keep active and healthy, and to have access to affordable, appropriate and quality healthcare should they need it. This is a core tenet of our social compact, which we must continue to uphold as our population ages. By 2030, one quarter of our population¹ will be aged 65 and above. We have already provided additional healthcare support for our Pioneer Generation and Merdeka Generation. But as our population continues to age, we will need to redouble our efforts in health promotion, and expand our healthcare capacity. This includes expanding our polyclinic network, and building more acute and community hospitals. We are also redeveloping the SGH campus in Outram.

To provide quality and affordable healthcare in a sustainable way, everyone has a part to play. All Singaporeans, including our seniors, must place greater emphasis on staying active and healthy, both in body and mind. As a society, we must also take greater collective responsibility, whether it is through social risk pooling, such as Medishield Life and Careshield Life; or through the taxes that we each contribute, so that we can build a fairer and more equitable society for all.

Healthcare Transformation

Looking to the future, healthcare institutions, like SGH, also have a major role to play. Around the world, societies have found it challenging to achieve healthcare that is of quality, and yet affordable. But we have achieved both objectives so far, by making the most of our spending. And we can continue to do so by pressing on with the healthcare transformation efforts that Minister Gan Kim Yong has been embarking on. Let me reinforce how we can transform.

The first area of transformation is the shift from healthcare to health. The good health of our seniors rests on the foundations laid when they are younger. In Singapore, we have seen an increase in the number of people living with chronic illness. If chronic conditions are not managed well, it could result in more serious conditions down the road, and severely impact one’s quality of life. This is why we must continue to focus on preventive health and healthy living, and shift the focus from treating ill health only when it occurs, to promoting health and vitality. One of our biggest challenges is with diabetes. Minister Gan declared a national “War On Diabetes” in 2016, focused on raising awareness, promoting a healthy lifestyle, and early detection. There are some early indications that our efforts are yielding results. For example, more than 800,000 people took part in the National Steps Challenge in 2019. This is four times the number of participants in 2016. SGH has been very active in promoting preventive health and healthy living. For example, the community nursing network set up by SGH and other SingHealth partners, provides services such as health screening, chronic disease education, as well as care and case management in the heart of the community. This will empower our elderly residents to keep well, age well, and get well. We must continue to press on with our health promotion efforts.

The second area of transformation is the shift towards greater integration of care. We must take a systems approach to ensure the right-siting of healthcare, including shifting more care from acute hospitals to the community setting. Within each institution, we must take a holistic and multi-disciplinary approach in caring for our patients. Teamwork in healthcare is critical. And we must strengthen collaboration among institutions, across primary, acute, intermediate and long-term care; and across healthcare clusters. As we focus on healthy living, we must go beyond healthcare institutions to partner with the community and private sector. The Community Network for Seniors and the close partnership with ActiveSG are good examples of how we collaborate across the social and healthcare sectors. SGH is also partnering private providers such as Guardian Pharmacy to extend their Medication Delivery Service, so that patients can more conveniently order and collect their medication.

SGH’s bicentennial is an appropriate time for SGH, and other healthcare institutions, to reimagine and create new models of care for our people. A good example is the SGH Diabetes and Metabolism Centre. This is a one-stop, comprehensive care centre for patients with diabetes, many of whom have multiple chronic conditions. The Centre organises services and support around the patients’ needs. For patients with stable chronic conditions, SGH has also offered remote care as an option, by harnessing technology and introducing video and phone consultations. The rebuilding of Outram Campus also anticipates these needs and is based on the latest models of care which are more holistic, multi-disciplinary and team-based, across the entire spectrum of care.

The third area of transformation is through the continued pursuit of healthcare innovation. Much of the improvements to health outcomes and cost efficiency in past decades, are due to our investments in science and technology. These investments have also contributed significantly to the fight against COVID-19. For example, we developed the Fortitude PCR test kits, which is now used by more than 45 countries, and cPass, the first serology test for neutralising antibodies to be authorised for use by the US FDA. To further our healthcare transformation efforts, we must continue to innovate. The Government has committed $25 billion over the next five years to support research and innovation under RIE2025. One key area is in maximizing health and human potential.

SGH has been a key partner in the RIE journey. You have undertaken many research projects, working in collaboration with researchers from around the world. One example is the decade-long research led by Professor Marcus Ong on out-of-hospital cardiac arrest. The research findings have helped to improve the delivery of emergency care, and significantly improved survival rates.

Through these transformation efforts, we can achieve both quality healthcare and affordable healthcare.

But COVID-19 has brought a fourth area of transformation to the fore – the resilience and robustness of our healthcare system. We can never fully anticipate what the next pandemic will look like, and the capabilities need to combat it. But the lessons from SARS put us in a better position for COVID-19. And we must learn from COVID-19 to better prepare for Disease X. We must continue to strengthen our systems and capabilities, and our frontline workers must remain nimble and adaptable in responding to this virus and future crises.

COVID-19

COVID-19 has in fact exemplified the teamwork, resilience and spirit of innovation of our healthcare teams across Singapore. In the SGH family, all of you stepped up when the pandemic struck. The initial months were particularly difficult – the nature of the virus was not known to the world, cases were increasing rapidly, and the healthcare system was stretched. Your dedication to patients and commitment to help Singapore overcome the pandemic is commendable. I am glad that you also faced the uncertainties with courage, and adapted and innovated as the situation evolved. SGH came up with innovative solutions to increase the capacity to care for infectious patients. For example, in 50 days, SGH converted a car park into a full-fledged COVID-19 isolation ward. SGH also created a portable anteroom system, which when fitted behind the entrance of a ward or Intensive Care Unit (ICU), is able to convert it within hours into a negative pressure isolation space. On behalf of all Singaporeans, I thank all you for your unwavering commitment and dedication in the fight against COVID-19.

Helping you grow

Your dedication to patients goes way beyond COVID-19. Even as medical science and technology advance, the focus on caring for our patients with empathy and a strong human touch, will always remain a critical part of our healthcare system. A simple gesture of kindness or going the extra mile, often leaves a lasting impact on patients and their families. So I am glad that as part of your bicentennial celebrations, SGH started the One Kind Act movement, not only to commemorate SGH’s legacy of caring to heal, but also encourage all to give and show kindness, especially to patients in need. Over the weekend, SGH CEO Professor Kenneth Kwek, Chief of Medical Board Professor Ruban Poopalalingam, and a group of colleagues rode 200km around the island, to raise funds for SGH’s Needy Patients Fund. Not everyone can cycle 200 km. But I hope each of you can show kindness and make a difference in our own ways.

At the same time, we will also ensure that you – our healthcare professionals – are well supported at the workplace. Emotional and mental health are important in every line of work, Even more so for healthcare, especially during COVID-19. So even as you give your best, I urge you to pace yourself, take care of your well-being, and of those around you.

The Government is also committed to make a career in healthcare attractive. Recently at Budget 2021, I announced that nurses, allied health professionals and pharmacists in our public healthcare institutions can look forward to a salary increase. MOH is working with SGH and all healthcare employers to further enhance the career pathways for healthcare staff, and to broaden your options for further development. So I hope you will continue to care for your patients, look after yourselves, and find a career in healthcare meaningful and rewarding.

Conclusion

Two hundred years ago, infectious diseases were the top public health concern. Today, as we commemorate your bicentennial, another infectious disease – COVID-19 – is topmost on everyone’s mind. As we learn to live with the virus, we must continue to press on with healthcare transformation and innovation. The pandemic will end at some point, but there is no stopping our ageing demographics. Your ability to adapt and innovate, while showing care for your patients, will determine whether we can deliver quality healthcare care, while keeping cost affordable. Today, we also start a new chapter in your history. With a culture that is firmly rooted in excellence, I trust that each and every one of you would continue to care to heal, educate to empower and innovate to advance. I wish you all the very best as you progress in the next centennial.

Thank you very much.

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[1] Refers to citizen population