SPEECH BY DR KOH POH KOON, SENIOR MINISTER OF STATE, MINISTRY OF HEALTH, AT THE LAUNCH OF TEMASEK FOUNDATION-SINGHEALTH PRE-HOSPITAL EMERGENCY CARE PROGRAMME IN SOUTHEAST ASIA

Professor Kenneth Kwek, Deputy Group CEO, Innovation and Informatics, SingHealth,
Mr Stanley Lee, Senior Director, Temasek Foundation,
Professor Marcus Ong, Chairman, Pan Asian Resuscitation Outcomes Study,
Professor Tan Hiang Koon, Group Director, International Collaboration Office, SingHealth,
Distinguished Guests – both online and also, physically here with us,
Ladies and Gentlemen,

Introduction

1. A very good morning. It is my pleasure to join you here this morning for the official launch of the Temasek Foundation-SingHealth Pre-Hospital Emergency Care Programme in Southeast Asia, organised in collaboration with the Pan Asian Resuscitation Outcomes Study (PAROS) group.

2. Now, the international community of emergency care professionals, many of you are here with us today, has a very strong conviction that “It takes an entire system to save a life”, and that’s the reason why we are gathered here today to do this together. An optimised system of care involves the community, first responders, dispatchers, ambulance crew, ambulance services and finally, also emergency departments. Each and everyone along this entire chain plays a crucial role. Together, they provide a critical sequence of rapid responses during medical emergencies, such as stroke or cardiac arrest. And you heard Professor Marcus Ong earlier, every second counts in managing the outcome. The efficiency of this Pre-Hospital Emergency Care (PEC) systems are essential and can make a big difference to save lives and ensuring better patient outcomes. This is especially so since many such emergencies actually occur outside of the hospital, in our homes, in our workplaces.

3. The Ministry of Health (MOH) therefore recognises the importance of pre-hospital emergency care and in 2014, MOH set up the Unit for Pre-hospital Emergency Care (UPEC). This is a national unit to provide clinical oversight and operational support for PEC initiatives in Singapore. The Ministry of Home Affairs (MHA) and Singapore Civil Defence Force (SCDF) are our key partners in Singapore’s PEC system.

4. MOH and UPEC work closely with MHA and SCDF to improve community responsiveness to medical emergencies by widening the public’s access to Cardiopulmonary Resuscitation (CPR) training or dispatcher-assisted CPR training. One example of this is UPEC’s Dispatcher Assisted First Responder (DARE) programme. Through the Save a Life initiative, we have also increased the number of Automated External Defibrillators (AED) in our public places. Since January 2022, MOH has also taken steps to regulate the provision of private ambulance services under the Healthcare Services Act (HCSA) to ensure minimum standards of care for the safety and welfare of patients using private ambulance services. So we are doing a lot by equipping our public places with the necessary equipment, by ensuring standards of service delivery, but it really means that actually the whole community, not just the hardware, but the software, have to come together to make an impact on survival rates.

Singapore’s OHCA Data

5. These efforts to raise awareness and improve early pre-hospital interventions can save more lives. Now, more than 3,000 persons had out-of-hospital cardiac arrests (OHCA) in Singapore in 2020, which is much higher than in 2011, when there were about 1,300 OHCA cases. As you’ve heard from Professor Marcus Ong, it could be a combination of just an ageing population alone, perhaps an increase in incidence of chronic diseases. Whatever the case, that trend may continue to increase over time, and I think it is important that we put together collective efforts to address this. So with our collective efforts to raise awareness and improve our PEC systems. Fortunately, we see a positive trend in bystander intervention rate. Based on the 2020 “Singapore OHCA Data Report” by UPEC, bystander CPR rates improved from 22% in 2011 to 56% in 2020, a doubling of the response rate. The bystander AED rate improved from 2% in 2011 to 9% in 2020. Clearly, a lot more headroom for us to grow here. Over the same time period, OHCA survival rate has also risen from 3.5% in 2011 to 4.3% in 2020. The Utstein survival rate, which is the survival rate among people who had a witnessed, shockable cardiac arrest, rose from about 12% to 22%. So these are all very encouraging statistics, indicating doubling and in fact, more than doubling of some of these key indicators. And we hope that with some of the work that we do together, especially with the programme that we are launching today, we can actually raise such outcomes to a much higher level for over the years to come. 

Temasek Foundation-SingHealth Pre-Hospital Emergency Care Programme

6. So I am glad to see that Temasek Foundation, SingHealth, Asian Association for Emergency Medical Services (AAEMS), and the PAROS network have developed the three-year Temasek Foundation-SingHealth Pre-Hospital Emergency Care Programme to develop the capability of PEC agencies and professionals in Southeast Asia. 

7. Beyond training alone, the Programme will promote collaboration and sharing of international best practices among the partner countries. It also provides a platform for partner countries to develop joint initiatives to reduce mortality and morbidity, for research collaboration, and also share ideas to strengthen their respective PEC systems. Ultimately, these efforts will enhance the PEC research and Emergency Medical Services (EMS) treatment capability within our region.

Everyone Can Save A Life

8. Now, life-saving work is not limited to healthcare professionals only. In fact, as we heard earlier, the larger community plays an important part in the PEC system too. So I want to encourage everyone, if you have not done so, to attend CPR training or join the DARE training programme, and volunteer as a first responder. Remember, all of us are potential beneficiaries of a good PEC system and all of us, certainly, can be a first responder.

9. Later, you will hear from a cardiac arrest survivor, Mr Raymond Balakrishnan Prabahaka, who will be sharing his survival story about how his son, Mr B P Jackson, who had no prior knowledge of CPR, worked with the emergency medical care services to save his life. A young volunteer first responder, Mr Darryl Lee, will also share his experience of saving lives in the community. And to date, Darryl has responded to and assisted in about 10 situations that are of medical emergencies out in the community, making a big difference to many lives in his very own way. And I hope their stories will inspire many more of us, especially those who are online joining us here today. Share these stories with your circle of friends, and to encourage them to also be a first responder and contribute to the PEC ecosystem wherever you are.

Closing

10. So in closing, I would like to congratulate Temasek Foundation, SingHealth, the AAEMS and the PAROS network on the launch of the Pre-Hospital Emergency Care Programme. I wish you and your partners every success in your journey of advancing Pre-Hospital Emergency Care in your own countries in the region. Once again, I want to urge everyone to volunteer, to be a first responder, to get yourself trained if you have not done so, and to encourage those around you to do so. You can all play a vital part to save a life in your own ways.

11. And I wish you all a successful and a very engaging meeting this weekend. Thank you very much.