Speech by Mr Amrin Amin, Senior Parliamentary Secretary, Ministry of Health, at the Singapore-International Physiotherapy Congress 2018, 19 May 2018

Ms Lee Sin Yi, President of the Singapore Physiotherapy Association

Mr Er Beng Siong and Asst Prof Dawn Tan, Co-Chair, Organising Committee for the Singapore-International Physiotherapy Congress 2018

Distinguished guests,

Ladies and Gentlemen,

1.    Good morning. It is very nice to join you today and of course a pleasure to meet many friends from overseas, from the region, to come here to discuss how we can further strengthen skills, expertise, and grow professional networks.

Need to Transform Singapore’s Healthcare System

2.    Singapore’s healthcare system is undergoing a transformation. As you know, there are a number of challenges. The population is fast ageing, and we are facing a growing burden of chronic diseases. Approximately three in four Singapore citizens aged 65 and above have either diabetes, high cholesterol, or hypertension, or a combination of the three. At the same time, our resident labour force growth will slow, as workers retire and fewer young Singaporeans enter the workforce.

3.    To create a sustainable healthcare system, we need to change our approach to ageing and health with three key paradigm shifts. Firstly, we want to empower the nation to be healthy, and move beyond healthcare to health. That means we have to develop early interventions and promoting healthy lifestyle options so more people can enjoy many years of healthy living. The second aspect is we are going beyond hospital-provided acute care, to delivering care in the community. This will enable convenient access, enhance the recovery process and health outcomes for Singaporeans. The last part is, providing healthcare that offers value to patients.

Role of Physiotherapists in Care Transformation

4.    In these shifts, Physiotherapists (PTs) are critical partners. I am glad to note that this year's congress theme is Movement for Health, Physiotherapy Across All Ages. This highlights the many opportunities that PTs can play in to enhance health through movement for all ages. 

Beyond healthcare to health: Physiotherapists in preventive health and education

5.    We want Singaporeans stay healthy. Through rehabilitation, through education, PTs empower individuals to take charge of their health, allowing individuals to cope better and manage their conditions. The Ministry of Health (MOH) is engaging stakeholders, including PTs, to design more effective and tailored approaches to the care and management of diabetes. One example is, MOH is working with stakeholders, such as the Singapore Physiotherapy Association (SPA), to develop the Patient Empowerment for Self-care framework. This is an initiative under our War on Diabetes. Under this framework, SPA is working with Active Health SportsSG to develop reference materials and resources to encourage physical activity and exercise among individuals across all levels of physical capability. There will be materials targeted towards patients and individuals, as well as healthcare professionals and community-based providers to allow them to more effectively support their patients and clients. The first tranche of materials will be rolled out later this year.

Beyond hospital to community: The role of physiotherapists in the community

6.    We are also moving beyond hospital to community, and this is where you can play an important role so that patients can recuperate and recover in a familiar and conducive setting. To do so, MOH has initiated a ‘One-Rehab’ Implementation and Co-ordination Committee comprising representatives across acute hospitals, community hospitals and community care providers such as polyclinics, nursing homes and day rehab centres to anchor rehab within the community sector itself. The committee will identify gaps and develop care models to support rehab care journeys that are centred around the patients’ care goals. The committee will also develop the roadmap for training and the development of capabilities needed to augment the current capabilities of our system.

7.    You play a critical role in ensuring that care transitions from hospital to community, such as patient transfers, discharges and the coordination of care from healthcare institutions to home, are well managed. You also play a key role in optimising and maintaining the function of individuals in community. For example, PTs can refer patients for subsidised physiotherapy, occupational therapy and speech therapy at senior care centres, day rehabilitation centres, and even at home. This will shift the scope and roles of PTs from being defined by their workplace, to one that ensures that their patient care and rehab needs continue to be coordinated and met, wherever they are in their care journey.

8.    Atiqah and her colleagues are one of many examples of how multi-disciplinary teams work together to help patients in the community. To fulfil the wish of a resident at Ren Ci Hospital to return home to attend his daughter’s matrimonial ceremony, Atiqah, who is a physiotherapist, assisted her patient with cardiopulmonary physiotherapy to ensure that he could breathe properly. She conducted strengthening and endurance exercises to build up his ability to endure the long hours out of bed for the ceremony. This was done together with other healthcare professionals, including an occupational therapist who ensured that the patient’s wheelchair could enter his home. As a team, Atiqah and her colleagues were able to grant his wish to be home to witness the ceremony.

9.    We need more of our physiotherapists to work alongside multi-disciplinary teams to deliver quality care in the community care sector so that patients can transit back home seamlessly.

Beyond quality to value: PTs’ contributions in innovation and transformation of healthcare industry

10.    Beyond quality to value - this is where you can play a part in contributing in innovation and transformation of the healthcare industry. Looking beyond quality to value means ensuring care for patients that is affordable and appropriate for their needs. We must innovate and utilise technology effectively to achieve better outcomes and convenience for patients.

11.    One example is Tele-rehabilitation, which has the potential to greatly increase convenience for patients and caregivers. The National University of Singapore, IHiS, and local startup T-Rehab have co-created Smart Health TeleRehab. Through wearable sensors and guided videos, patients can perform therapy exercises in the comfort of their homes. Physiotherapists can remotely prescribe customised exercises and monitor the progress of patients at their convenience.

12.    Another example is the use of robotics to further enhance patient outcomes and productivity. In 2016, St Luke’s Hospital introduced ‘The G-EO System’, a robot-assisted gait retraining system. This robot provides better physical support to patients during exercise and increase the effectiveness of each session. With ‘G-EO’, a patient can achieve about 900 steps per 30-minute session, which would previously require almost 7 sessions without the robot’s assistance. It also means less manpower-intensive to conduct gait retraining with the robot, requiring one staff to manage the robotic system, instead of two in conventional gait retraining. Since its introduction, over 230 patients, stroke and non-stroke, have benefitted from the robot-assisted rehab. Among these, stroke patients who were able to follow the instructions showed an overall improvement of 43% in their Functional Ambulation Category, improving their potential to walk with less assistance and to have greater independence in walking. I hope to see more of such innovation and the use of technology to improve our productivity and better deliver care to patients.

Closing remarks

13.    Everyone here can play a part in the transformation journey to build a sustainable healthcare system in Singapore and beyond. I look forward to seeing our PTs enabling our people to attain better health, better care and a better life.

14.    To all congress participants, I hope that this congress will inspire meaningful discussions that will help the PT profession better enhance health, through movement.

15.    I wish everyone a fruitful congress and I hope you get to enjoy our beautiful city too. Thank you very much.