Speech by Dr Amy Khor, Senior Minister of State for Health, at the 4th Japan-Singapore Inter-Professional Collaboration Symposium, 1 July 2017

His Excellency Kenji Shinoda, Ambassador of Japan to Singapore,

Associate Professor Lee Kheng Hock, President, College of Family Physicians Singapore,

Distinguished speakers and guests,

Ladies and Gentlemen, 

A very good morning to all.

1    I am delighted to be here at the 4^th Japan-Singapore Inter-Professional Collaboration Symposium, jointly organised by the College of Family Physicians Singapore (CFPS) and Bright Vision Hospital, and supported by the Embassy of Japan in Singapore and the Japan Primary Care Association.

2    This event once again brings together regional experts, healthcare teams and professionals from Singapore and Japan, for the exchange of ideas and to promote inter-professional collaboration. I would like to extend a very warm welcome to our overseas visitors. 

Singapore’s War on Diabetes

3    Over the years, advances in medical knowledge and technology have enabled us to achieve increasing life expectancy. Both Japan and Singapore face challenges associated with an ageing population. These include higher demand for healthcare services, and greater chronic disease burden, as well as increasing case complexity. To ensure that our healthcare system remains sustainable in the long-term, while keeping services affordable for patients, we need to emphasize maintaining good health. To nurture a healthy nation, we need to empower individuals to take good care of their health and arrest the causes of ill health early, so as to reduce the progression of long-term chronic diseases. In doing so, they will be able to reap the benefits of healthy ageing.

4    Among the common chronic diseases, diabetes has become a major healthcare concern in Singapore, as well as globally. The World Health Organization estimates that the number of adults living with diabetes has almost quadrupled over the past 35 years. Locally, about 440,000 Singaporeans have diabetes. One in three Singaporeans have a lifetime risk of developing diabetes. This is contributed by various modifiable risk factors, such as an unhealthy diet and a sedentary lifestyle.

5    Last year, the Ministry of Health, Singapore (MOH) declared a multi-year war on diabetes to create a supportive environment for Singaporeans to lead lives free from diabetes, and for Singaporeans with diabetes to manage their condition well. As prevention is better than cure, a major part of our efforts is focused on upstream prevention to promote a healthier lifestyle to reduce the incidence of new cases of diabetes. It is apt, therefore, that the theme of our symposium this year is “Diet, Health and Ageing”.

Healthy Living

6    To tackle the risk factors of an unhealthy diet and physical inactivity in Singapore, and reduce the risk of chronic diseases, we have adopted a twin food-and-exercise strategy. We aim to improve dietary quality, discourage overeating and encourage active lifestyles in the population.

7    With 60 per cent of Singaporeans eating out for lunch or dinner at least four times a week, it is important to ensure the availability, accessibility and pervasiveness of healthier food options. The Health Promotion Board (HPB) has worked with food and beverage outlets to offer healthier meal options such as 500-calorie meals. In Singapore, quite a number of hawker centres offer these 500-calorie meals. Under the Healthier Dining Programme, food outlets including even McDonalds have started to provide wholegrain options with lower calories labelled with a Healthier Choice Symbol. This makes it easier for consumers to identify and choose the healthier options. We also recently launched the Healthier Ingredient Development Scheme with an investment of $20 million over three years, to incentivise food manufacturers to innovate and develop products with healthier ingredients for the local market.

8    It is heartening to see that some of these initiatives have yielded positive results. For example, through our partnership with the food industry on food product reformulation, we have seen the median sugar level of pre-packaged beverages decrease from 9.5 per cent to 6.5 per cent over the past ten years. The healthier meals sold under the Healthier Dining Programme also tripled from 7.5 million meals in 2014 to 26 million in 2016. HPB shared that when healthier meals were first offered at some canteens in industrial parks, they launched a spin the wheel promotion to raise customers' attention to these meals. This resulted in a 20% increase in demand for healthier meals. All these efforts aim to create new norms for healthier eating among the population. When consumers make healthier food choices, more food businesses will be encouraged to provide healthier options.

9    Physical activity is another important component of healthy living. However, many people today lead a sedentary lifestyle, with around 39 per cent of Singaporeans having insufficient physical activity^[1]. To encourage individuals to move more, we have introduced the National Steps Challenge, the world’s first population-level pedometer-based initiative which encourages participants to take more steps daily by making small changes to their daily routine. The first season in 2015 has successfully mobilised 156,000 people to move more, and four in five participants who were previously inactive became sufficiently active after joining the Challenge. The second season garnered over 350,000 adult sign-ups, and over 40,000 children and youth participants. By leveraging behavioural insights and technology, we hope to empower more Singaporeans to lead a more active lifestyle, and reduce their risk of diabetes

Role of Family Medicine and Primary Care

10    Lifestyle modification, however, may not be easy to initiate and sustain for some individuals. This is where general practitioners and family physicians in primary care have an especially important role to play, as a healthcare partner to their patients.

11    Our vision for primary care is ‘One Singaporean, One Family Doctor’, with primary care as the first and continuous line of care for patients. By forging a longstanding, trusted relationship with their patients, general practitioners and family physicians have a deeper and more holistic understanding of the biomedical and psychosocial needs of their patients. This places the primary care doctor in a better position to provide better patient-centric care, including timely advice on lifestyle modification, early disease screening and detection, and effective management.

12    To better support our primary care doctors in chronic disease management, we are developing Primary Care Networks. Under this initiative, general practitioners come together and organise themselves in virtual networks to deliver care as multi-disciplinary teams which include doctors, nurses and other supporting staff. MOH provides funding for nurse counsellors and care coordinators, as well as support to establish chronic disease registries, to enable GPs to manage patients with chronic diseases, including diabetes, more holistically. We had a recent PCN application call and I am pleased to know that the response has been positive, with 14 applications involving over 200 GP clinics.

13    At the same time, MOH recognises that continued professional up-skilling of our primary care doctors is a key enabler for primary care transformation. MOH will continue to enhance postgraduate Family Medicine training by working with key stakeholders, such as the College of Family Physicians Singapore which runs the Graduate Diploma programme in Family Medicine, as well as the Sponsoring Institutions which run the Family Medicine residency training programmes. Building up our primary care manpower capabilities will help strengthen the sector and better anchor chronic disease management within the community. 

Conclusion

14    This symposium is an excellent opportunity for healthcare professionals from Singapore and Japan to share your different experiences and perspectives in promoting good health and facing the common challenge of an ageing population. I am positive that the knowledge exchange and sharing today will be invaluable in helping us to deliver good healthcare and enable good health in both Singapore and Japan.

15    Thank you, and I wish all of you a fruitful day ahead. 

^[1] Source: 2010 National Health Survey