Speech by Mr Gan Kim Yong, Minister for Health, at the Inaugural National Seminar on Productivity in Healthcare, 9 Oct 2014

Distinguished colleagues and guests,

Ladies and gentlemen,

Introduction

Good morning and I am delighted to be here at the inaugural National Healthcare Productivity Seminar organised by the Ministry of Health and the Agency for Integrated Care.

Singapore’s Changing Healthcare Landscape and Need for Quality and Productivity in Healthcare

2.           One of our key objectives under Healthcare 2020 is to be able to deliver quality yet affordable care.

3.           We have done reasonably well so far but there are challenges ahead. As Singapore’s population ages, our healthcare needs will increase. More manpower will be required to staff and operate the new healthcare facilities that we are building across the acute, primary and intermediate and long-term care (ILTC) sectors. Medical advances and higher demand for healthcare services will contribute to rising cost pressures. Patients’ expectations of more affordable and better quality care will also increase.

4.           We must step up our efforts to enhance the quality and efficiency of our healthcare services to meet these challenges. To maintain a high performing healthcare system, we must nurture and sustain a culture of productivity and quality improvement in our public healthcare institutions. Befittingly, the theme for this year’s combined productivity and quality event is “Enhancing Care through Quality and Productivity”.

Productivity Efforts on the Ground

5.           Productivity is the ability “to do more with the same" or "to do same with less" or even better, "to do more with less”. It is not something new to the healthcare sector. Our public healthcare institutions have been building a culture of continuous improvement, for example, through adopting lean management practices. However, we need to do more on this front. While we recognise that the human touch is an important factor in healthcare, there are nevertheless many areas where there is potential for us to improve on efficiency and optimise use of resources.

6.           Since 2012, the Government has set up the Healthcare Productivity Fund to support productivity efforts in the healthcare sector. Institutions can tap on the Fund for their initiatives in areas such as shared procurement, job redesign and process redesign. This funding also helps them invest in new technology and equipment, and in training and skills upgrading for their staff. All the six public healthcare clusters and 87 ILTC institutions have tapped on the Healthcare Productivity Fund for productivity-related projects and training.

Productivity at Three Levels

7.           We aim to achieve higher healthcare productivity at three levels. First, we are working to transform healthcare at the systems level to achieve better, more seamless, and more appropriate care for our patients. We are working with our public healthcare institutions to help patients receive the care that they need at the appropriate care setting. For example, patients with chronic conditions such as diabetes and hypertension can be managed at the primary care level by a team of doctors, nurses, therapists, dieticians, case managers and other healthcare workers. Patients benefit by receiving more convenient and personalised care and regular advice on managing their conditions. With better control upfront, we avoid or delay the deterioration of the chronic conditions and this reduces hospital admissions and avoids higher healthcare costs downstream.

8.           Our public healthcare clusters are working with their Regional Health System partners to provide more integrated care. For example, Khoo Teck Puat Hospital (KTPH) piloted an Ageing-in-Place (AIP) programme in 2012 for patients with chronic conditions who had registered frequent hospital admissions. They leveraged on a network of community nurses to look after four hundred patients within their homes and communities, through regular home visits and health reviews over the phone. This has yielded positive results, with the average number of hospital admissions reduced by more than 60%, and about $11 million saved per year.

9.           Second, we aim to increase productivity at the institutional level, so that we can improve our operational efficiency and provide our patients with a higher quality of care while doing things faster, better and safer. We can do this in various ways, including training and developing our healthcare workers so that they can contribute at the highest possible level, and standardising and streamlining our processes.

10.       A good example is Tan Tock Seng Hospital (TTSH)’s Value Added Cataract Surgery Process. By standardising the cataract surgery process and streamlining the number of key steps from 45 to 27, the average procedure time was reduced by nearly one third.  Patient satisfaction also increased.

11.       Third, we are tapping on new technology as a workforce multiplier. This is about working smarter, not just working harder or longer. One example is the use of tele-conferencing in the National Healthcare Group Eye Institute. Through the use of tele-conferencing, it is now possible for patients in polyclinics to have consultations with eye specialists in the Eye Institute. What this means is that ophthalmologists do not need to physically examine the patient with this remote consultation. This not only facilitates more timely and convenient access to care, it also saves travelling time for patients to the Eye Institute. We intend to scale up such tele-health efforts to include more healthcare institutions, so as to benefit more patients.

Concluding Remarks

12.       Ultimately, unlocking the productivity potential of our healthcare system will require the commitment, passion and ingenuity of our healthcare staff at all levels. Fostering the right mindset and culture will be key.

13.       I hope that the exchange of ideas and sharing of best practices over the next two days will provide a catalyst for new and innovative ways to bring our productivity and quality of care to the next level, for the benefit of our patients.

14.       I wish everyone a fruitful conference. Thank you.