PM Lee Hsien Loong at the Official Opening of Sengkang Hospital Campus

Distinguished Guests

Ladies and Gentlemen

I am very happy to be here this morning for the opening of Sengkang General Hospital and Sengkang Community Hospital. This is my second visit to the Sengkang Hospitals. I came informally last December just for jalan jalan, to take a look around the new facilities and meet the staff who are starting up these new hospitals. I was happy to find them in good spirits, gearing up progressively, and getting used to their new surroundings.

I met some patients too. Most of them were residents living nearby and they were glad that a hospital had opened in their neighbourhood, and they no longer had to travel all the way to Tan Tock Seng Hospital or Khoo Teck Puat Hospital to get treatment. But there were also a few visitors not from Sengkang or Punggol, but curious Singaporeans who have come from other towns like Yishun and Pasir Ris and were also welcomed here.

Indeed, all of us have been eagerly awaiting Sengkang Hospitals’ opening, since we started planning it eight years ago. This hospital is part of our Healthcare 2020 Master Plan, to steadily build and expand medical facilities across the island, and to bring healthcare closer to our homes. 

In 2010, Khoo Teck Puat Hospital opened in the north, and about four years ago, Ng Teng Fong General Hospital and Jurong Community Hospital opened in the west. Today, we formally open Sengkang Hospitals, SKH and SKCH, and these will serve residents in the Northeast, especially in Sengkang and Punggol. And next year, Outram Community Hospital will open. And then around 2022, Woodlands General Hospital as well as Tan Tock Seng’s Integrated Care Hub will also open.

We are building these new facilities because we need additional capacity. Our total patient numbers have been rising steadily and there are a few reasons for this.

Firstly, Singaporeans are living longer. Average life expectancy of a baby born today is about 85 years - one recent study puts that as number 1 in the world. But even if we are not number one, number two, number three. And I am quite sure in the next 85 years, with new medical advances, that baby born today can expect to live 87, 88, maybe even 90 years. It is completely possible. In fact, even today, 1 in 7 of the babies can expect to live to at least 95!

So that is good news. But unfortunately, the additional years of life are not additional years of health. Because on average, although the life expectancy is 85 years. The healthy life expectancy is only about 75 years, which means we can expect to experience about ten years of ill health in our lives. And mostly, it will be when we have grown old. So we need more hospital beds to take care of the growing numbers of elderly who need medical care. That is the first reason, because people are living longer. 

The second reason is we are all getting more chronic diseases, like diabetes, hypertension, high cholesterol. Their prevalence has increased. If you go back and compared from 2010 to 2017. It has gone up 4% for diabetes, 14% for hypertension and 33% for high cholesterol. It is partly because our population is older, and older people are more prone to these conditions. But it is also because of unhealthy lifestyles and habits – not eating properly, not exercising enough, and becoming more sedentary, more overweight. Worse, if the conditions are not managed well, more serious complications will set in, and quite likely, the patient will see more hospitalisation. 

The third reason is that we not only have more seniors, but also smaller families and therefore a larger proportion of seniors in the population. So there are fewer family members to look after each aged sick person at home. And with less family and social support, chronic medical conditions are likely to worsen, which will result in more admissions to hospitals.

So our healthcare system must adapt to all these changes in our population and our healthcare needs. It is not just building more capacity, but also about using this capacity more efficiently and effectively.

One major shift we are making is towards a more patient-centric, multidisciplinary approach. For hospitals, this means putting together more services at one location. Which is why we have co-located the Sengkang General Hospital and the Sengkang Community Hospital. Just as we have done with Ng Teng Fong General Hospital and Jurong Community Hospital. Because, this allows the General and Community hospitals to operate as one single integrated entity, especially in the services that they provide. 

Patients at Sengkang Hospitals can receive a wide range of medical services, from initial diagnosis and treatment, to recuperation. For example, a patient who has been treated at Sengkang General Hospital can be smoothly transferred from this side to that side, to the Community Hospital for rehabilitation and continuing care.

This is especially helpful for older residents who need longer to recover. The doctors and staff in both hospitals can work together as one team to look after the patient comprehensively and holistically. And administration is also simplified.

The National Cancer Centre, National Dental Centre, National Heart Centre, Singapore National Eye Centre, National Neuroscience Institute and KK Women’s and Children’s Hospital, they all operate satellite clinics here at Sengkang Medical Centre. So that patients who need more specialised services can readily access the clinics here – they do not have to go all the way to all these different centres all over Singapore. 

Of course, improving hospitals is only one aspect of improving our overall healthcare system. Primary care plays a crucial role, for example, the network of GPs and polyclinics. SKH and SKCH, as a new and modern hospital campus, can drive improvements in this network.
For example, SKH is partnering almost 30 GPs in Sengkang and Punggol to provide general chronic disease management. It is also supporting the Punggol and Sengkang Polyclinics to manage more complex diabetes cases. 

These two hospitals also lead the integration of social and healthcare services in the community. Sengkang Hospital organises regular health screening together with GP and community partners. And after screening, the patients can immediately follow-up at CHAS GP clinics, which is very important because if they do not follow up, not only is the screening wasted effort, but worse if the condition get worst later, it will become much harder and more expensive to treat.

SKCH also partners the National Heritage Board to conduct reminiscence therapy for elderly patients with dementia. Brings them to historic places like the Sun Yat San Memorial, and making traditional goodies like “huat kuay”.

Of course, the best thing that we can do for ourselves is to take care of our own health, stay healthy, and avoid going to the hospital at all. Because if you have an accident or injury and need to go to hospital - well that cannot be helped. But many diseases are preventable if we watch our diet, and lead healthy lifestyles.

SKH runs community programmes to encourage residents, young and old, to stay healthy, eat well and exercise regularly. You saw some of the activities they organise this morning and we participated in them too. I think if we do that every day, we will feel better every morning. 

Sengkang Hospital staff give talks on childhood obesity and diabetes prevention to primary schools. They teach parents and teachers how their children can practise healthy living from young. And the programmes have been effective, because while we are not always careful with our own health, we love our children and are much more concerned about theirs.

Conclusion

Improving our healthcare system is a collective effort. The Government is building more and better facilities, staffed with well-trained doctors and nurses. We are structuring our system correctly so that people get the right type of treatment, at the right place, at the right cost. The healthcare community needs to work together to deliver this. And at the same time, each one of us must take responsibility for our own health.

Singapore spends less on healthcare than most other developed countries, and yet we have better outcomes. We have needed to spend less partly because our population was younger, and has only recently begun aging. But the main reason is because we have structured our system properly, and built in the right incentives to guard against overconsumption of healthcare services.

This is not easy to do. Because it is very difficult to tell people that the treatment they want is not really necessary, or not cost effective. And yet we have to watch carefully how heavily the Government subsidises healthcare. Not just to save taxpayers’ money, but to avoid encouraging over-treatment by doctors and over-consumption of healthcare services.

In countries with very high subsidies or free healthcare, people worry less about their healthcare costs, and doctors correspondingly prescribe more unnecessary and expensive tests and treatments.

Already our Government’s healthcare expenditure exceeds $9 billion a year, and it is rising faster than our GDP. And it is certain to rise further. Eventually, we cannot sustain this.

So in the medium term, we have to find new ways to fund this healthcare spending. But at the same time, we have to think hard about what we must spend on, and which drugs and procedures are cost-effective. And we have to make hard choices and I hope we will have the support of Singaporeans when we make them.

This healthcare system is one of the best in the world. For this, we owe much to the thousands of healthcare workers, who work day and night to keep it going. To make sure it delivers good healthcare and takes good care of the patients. 

The doctors and nurses, the allied health professionals, the medical social workers, the hospital and polyclinic administrators, the IT support staff, and many others. You give your best every day, working hard, often under difficult and stressful conditions. You make all the difference, when we are hospitalised, or are unwell and need help.

So on behalf of Singaporeans, I would like to thank you for being patient, committed and competent, and for taking good care of Singaporeans who need medical help, which is all of us at some time or other.

Once again, let me congratulate Sengkang General and Community Hospitals on their opening. I am confident that they will care for many patients, professionally, competently and compassionately, for many years to come.

Thank you very much.