Speech by Mr Gan Kim Yong, Minister for Health, at the Singapore Health & Biomedical Congress (SHBC) 2017, 12 Oct 2017

Prof Philip Choo, Group CEO, National Healthcare Group

Dr Lee Eng Sing, Chairman, Organising Committee, Singapore Health and Biomedical Congress 2017

Distinguished speakers and delegates

Ladies and gentlemen

1.            Good afternoon, and a very warm welcome to the Singapore Health & Biomedical Congress (SHBC) 2017.    

Transforming our Health Ecosystem

2.            Over the two and a half days, you will have an opportunity to establish network and discuss an important subject, namely “Transforming our Heath Ecosystem”.  In Singapore’s context, a system-wide transformation of our healthcare system is needed to meet the future challenges arising from a fast greying population, shrinking workforce, and growing chronic disease burden such as diabetes.  We need to change. As the landscape changes, our needs will change, the ecosystem will change, and we will need to change our solution. If we continue to provide the same solution, we will get into trouble in no time at all. We started the journey earlier with the reorganisation of our six healthcare clusters into three.  This congress provides a timely platform for us to take a deep dive into our transformation strategy and efforts so as to evolve a sustainable healthcare solution in Singapore and give our people good health.

3.            At the Ministry of Health (MOH), we are taking healthcare transformation very seriously to ensure that we are future ready.  Since rolling out of the Healthcare 2020 Masterplan in 2012, we have been making considerable changes and implementing new initiatives to improve the affordability, accessibility and quality of healthcare to Singaporeans.  Some of the more notable ones include the Community Health Assistance Scheme (CHAS) to encourage the lower and middle-income groups to seek primary care outside of Polyclinics, and the Medishield Life to provide better protection for all and for life.

The Three Beyonds Enabled by Research

4.            Underlying these efforts is our push to make three key shifts in our healthcare system, as part of our long term planning beyond Healthcare 2020.  The three shifts, which I am sure by now, many of you know well, are to move beyond the hospital to the community to enable Singaporean to receive appropriate care in the community and closer to home, beyond quality to value to give every Singaporean best value while keeping our system sustainable in the long term, and beyond healthcare to health to help and support Singaporeans to lead healthier lives. 

5.            I am heartened to see the National Healthcare Group (NHG) responding to the call to shift beyond hospital to community.  On this special occasion, I would like to congratulate you on your new partnership with the Nanyang Technological University and Dover Park Hospice to launch the Palliative Care Centre for Excellence in Research & Education (PalC).  A memorandum of understanding will be inked later this afternoon, to form a tripartite collaboration that will marry the delicate skill of caring for those in their final days with research and evidence-based practice.  The aim is to bolster capability and capacity to support end-of-life care in Singapore at the community level.  The subject of death has always been a sensitive subject to discuss with the terminally ill patient or their family members.  Hence, there is a need to encourage more meaningful dialogue about end of life matters.  Hopefully, with training, healthcare professionals, caregivers, and volunteers will be better enabled to support families with loved ones who wish to spend their last days at home.  

6.            Health and biomedical sciences research is critical in our efforts to improve the prognosis, diagnosis, and treatment of diseases as well as healthcare services, that can bring value, beyond quality to patients.  For example, the Adult Dengue Platelet (ADEPT) Study conducted under the STOP Dengue Translational and Clinical Research Programme provided evidence to support the World Health Organisation (WHO)’s present guidelines on dengue, which recommends against prophylactic platelet transfusion in patients with low platelet count.  This conclusion is important in improving patient care especially in dengue endemic areas and during large dengue outbreaks when the demand for platelet transfusion increases, and thus limited platelet supply can be appropriately reserved for therapeutic use in severe bleeding.  This will also save cost for patients by avoiding unnecessary treatment.

7.            Nonetheless, beyond doing research to identify new and innovative ways of doing things, we also need to be mindful whether the new innovations deliver outcomes that matter to patients.  New tests, drugs and devices are becoming more expensive.  Assessed against the additional value they deliver, not all are necessarily worth the higher costs.  To this end, the Ministry set up the Agency for Care Effectiveness (ACE) in 2015 to determine the relative value of technologies, like drugs, devices, medical services through health technology assessment (HTA).  HTAs can help us evaluate their likely costs and benefits, so we know which ones should be encouraged or adopted,   as well as how to use these technologies to improve patient outcomes and at the same time, provide cost-effective healthcare.  Since May this year, ACE started to publish guidances and appropriate care guides. Drug guidances provide doctors and healthcare professionals with evidence to support optimal ways of using specific drugs evaluated, while Appropriate Care Guides address targeted areas of practice where there may be significant variation in practice or gaps in knowledge.  Next year, ACE will also be releasing guidances in the medical technology areas.

8.            Lastly, in moving beyond healthcare to health, research has also helped to prevent the onset of disease.  For instance, the Developmental Origins of Singapore Translational and Clinical Research Flagship Programme found that the recommended high-risk screening criteria had led to the under-detection of gestational diabetes mellitus cases.  Mothers with gestational diabetes have a very high risk of developing Type 2 Diabetes; and even in the absence of such condition, higher fasting glucose levels can affect infant adiposity and neural development.  As such, the programme has called for universal screening and lifelong post-diagnosis follow-up, to provide an early window of opportunity to improve the long-term health of mother and child.  Today, universal screening is instituted at three main public hospitals- the KK Women’s and Children’s Hospital, Singapore General Hospital and the National University Hospital.

Improving Patient Outcomes

9.            I am glad to see that our research efforts lead to improved patient outcomes which is a key end goal of our efforts.  For example, the National Health Innovation Centre Singapore is supporting Dr Rinkoo Dalan from Tan Tock Seng Hospital to commercialise a cost-effective, non-invasive diagnostic device that is able to detect radial artery endothelial dysfunction and assess the risk for macrovascular disease in diabetic patients.  These are two predictors of cardiovascular disease.  If successful, stratification and clinical management of at-risk patients, and in particular diabetic patients who have a higher risk of heart disease, can be carried out earlier.

CONCLUSION

10.         To tackle the new challenges that we face in healthcare, we need to think and plan ahead and our healthcare ecosystem must transform to be future ready.  Research has been and will continue to be key to this, and I hope, over time, to see more research outcomes that will benefit our healthcare system and our people.  NHG has put together an excellent programme for this congress.  Congratulations on a job well done, and I wish you a fruitful conference ahead.

Thank you.