Opening speech by A/prof Benjamin Ong, Director of Medical Services, Ministry of Health, at the 10th Asian Society of Cardiovascular Imaging Congress On 5 August 2016

Prof Choe Yeon Hyeon, President of Asian Society of Cardiovascular Imaging (ASCI)
A/Prof Tan Swee Yaw, Chairman of ASCI 2016
Dr Lynette Teo, Co-Chair of ASCI 2016

Distinguished guests and fellow medical professionals,
Ladies and Gentlemen

1.     It gives me great pleasure to join you here at the opening of the 10th Asian Society of Cardiovascular Imaging Congress.

Rise of cardiovascular diseases in Singapore

2.     Singapore’s healthcare system has made good progress over the past decade, with increased Government spending to support the needs of an ageing population and improve health outcomes, while keeping costs affordable for patients. These efforts have received international recognition. In 2014, Bloomberg ranked Singapore first among 51 countries in having the most efficient healthcare system.^[1] The Economist Intelligence Unit (EIU) also ranked Singapore second in the world for healthcare outcomes overall.^[2]

3.     But closer to home, like in many countries, MOH continues to focus on tackling diseases of high burden among Singaporeans. This includes cardiovascular diseases. It is encouraging to see that the mortality rate of cardiovascular diseases has fallen significantly – from 95 per 100,000 adult Singaporeans aged 35 to 64 years in 2001, to 77 in 2014^[3]. However, cardiovascular diseases still account for a large proportion of deaths in Singapore. In 2014, 1 out of 3 deaths was due to either heart disease or stroke^[4], and ischemic heart disease was the third cause of hospitalisations from 2012 to 2014.^[5] All in all, cardiovascular diseases were responsible for one-fifth of the total disease and injury burden in Singapore in 2010, with the total cardiovascular burden per resident population increasing exponentially with age from age 40 years onwards.^[6]

4.     This is a significant cause of concern for Singapore’s greying population, as we will potentially see a growing number of seniors living with health problems and disabilities caused by cardiovascular diseases. It is important therefore to arrest this problem early, through preventive health, the appropriate application of medical research and technology advancements. This includes the proper use of cardiovascular imaging, to improve the diagnosis and guide the management of cardiovascular diseases.

Advancements in multimodality cardiovascular imaging

5.     The theme for this year’s Congress is “Cardiac Imaging: Guiding Therapies For Better Clinical Outcomes”. The emphasis on better clinical outcomes is fully in line with my ministry’s priority to deliver quality patient care that is cost effective. Advances in cardiovascular imaging have helped us to better diagnose and manage cardiovascular diseases. Newer computed tomography (CT) technology reduces radiation exposure without sacrificing accuracy and can reduce radiation exposure by up to 90% in some cases. This improved CT technology has been widely employed in both restructured and private hospitals in Singapore.

Continued innovations through medical research

6.     Imaging has become a crucial element in cardiovascular healthcare delivery, by allowing early detection of the disease and identification of the cardiovascular phenotype. But there is still room for improvement. For example, MOH is funding a study led by Prof Mark Richards (Director, Cardiovascular Research Institute, NUHS) to improve the prediction of post-myocardial infarction (MI) ventricular remodelling, to minimise post-MI heart failures and death. Hopefully in the near future, we will be able to identify new biomarkers and imaging indicators predictive of post-MI ventricular remodelling, and help innovate a sustainable model of care that significantly improves long-term outcomes.

7.     Even while these developments occur, we also need to ensure that the technologies we employ are cost effective. MOH has set up the Agency for Care Effectiveness which will develop guidance on the proper use of high cost technologies. The goal is to help to ensure that advanced imaging technologies are used appropriately, will be of high quality, and contribute to outcomes that are commensurate with cost and are meaningful.

Prevention is the best medicine

8.      It is useful to remember that medical and technological advancements alone are not enough to address the problems caused by cardiovascular diseases. Prevention remains paramount. Leading a healthy lifestyle and maintaining a healthy weight will reduce the risk of chronic diseases such as hypertension, hyperlipidaemia and diabetes, which are the major risk factors for cardiovascular disease. These risk factors need to be addressed early and will likely yield the best results.

9.     In recognition of the gravity of this problem, MOH has declared War on Diabetes in April this year. In collaboration with the Health Promotion Board (HPB), MOH has intensified our efforts to focus on obesity control, enhancing screening and tightening follow-ups. For instance, HPB partnered supermarket chain NTUC FairPrice to provide a 5 per cent discount on its house brand wholegrain rice items from June to August to improve the nutritional quality of the meals consumed. Besides diet, HPB is also encouraging residents to weave physical activity into their daily routines through initiatives such as the National Steps Challenge, Sunrise in the City and the Sundays @ the Park (SATP) programme. These efforts, we hope, will encourage Singaporeans to lead a healthier lifestyle, so as to reduce the obesity-related risk factors of cardiovascular diseases.

10.     Singapore is ageing rapidly. As part of the Action Plan on Successful Ageing, we are rolling out the National Seniors’ Health Programme which aims to bring preventive health services and programmes closer to seniors in our communities. This year, we will roll out the stroke awareness programme to educate seniors on the signs and symptoms of stroke, so that stroke patients can be recognised early and receive prompt medical care.

11.     To help seniors better take charge of their own health, we have also developed toolkits for seniors and their caregivers. This includes topics such as simple exercises to do at home, nutrition tips, as well as preventing falls. By empowering seniors to better take care of their health, we can improve their quality of life and enable them to lead more active and fulfilling lives. Preventive care is of paramount importance, because it not only reduces morbidity and mortality but reduces disabilities, enhances quality of life, ultimately reducing healthcare cost and burden.

Closing

12.     In closing, let me thank the organisers – the Singapore Cardiac Society and Singapore Radiological Society, for jointly organising this event. I hope that you will have a wonderful Congress; with engaging exchanges between the cardiology and radiology experts, and learning from the line-up of experts from around the world.

13.     On this note, let me wish all of you a fulfilling time at the Congress. Thank you.

^[1] Sharon Chen and Sterling Wong. Singapore Beats Hong Kong in Health Efficiency: Southeast Asia. Published in Bloomberg on 18 Sep 2014. The ranking evaluates healthcare costs as a share of GDP and per capita, as well as life expectancy and improvements from the previous year.

^[2] Singapore ranked world No. 2 for healthcare outcomes: EIU. Published in The Straits Times on 27 Nov 2014. The report was assessed the efficiency of healthcare systems globally, specifically looking at value-for-money.

^[3] Data from Ministry of Health.

^[4] Singapore Heart Foundation. Last accessed on 22 Jul 2016.http://www.myheart.org.sg/article/about-the-heart-and-heart-disease/statistics/singapore/75

^[5] Published on Ministry of Health website. Last accessed on 21 July 2016.

^[6] Singapore Burden of Disease Study 2010