Speech by Mr Gan Kim Yong, Minister of Health at St Andrew’s Mission Hospital Centenary Celebration and Dedication of St Andrew Nursing Home, 18 Oct 2013

Bishop Rennis Ponniah, President of St. Andrew’s Mission Hospital,

Board of Management of St. Andrew’s Mission Hospital,

Board of Management of Singapore Anglican Community Services,

Distinguished Guests,

Good evening. I am happy to join you today in celebrating St. Andrew’s Mission Hospital (SAMH)’s 100th anniversary, and the dedication of St. Andrew’s Mission Hospital’s newest institution—St. Andrew’s Nursing Home.

A Century of Community Service

2.            Today marks a momentous milestone in St. Andrew’s Mission Hospital’s history. For a young nation like Singapore, we do not have many organizations with a hundred years of history. SAMH therefore stands out as a shining icon of community service in Singapore.

3.            The history of SAMH is an inspiring one. It started as a small medical dispensary for impoverished women and children at Bencoolen Street one hundred years ago. It subsequently expanded to provide inpatient care as well as nursing and midwife training for locals.  During the Japanese Occupation, SAMH provided outpatient services for those in need, and post-World War II, it expanded its services to provide paediatric care for children, including the establishment of St Andrew’s Mission Hospital for Children at Tanjong Pagar.

4.            Today, SAMH continues its good work through a number of community care services – the St Andrew’s Community Hospital, St. Andrew’s Autism Centre in Elliot Road, St. Andrew’s Lifestreams, the care and counselling service in Potong Pasir, and now, the St Andrew’s Nursing Home.

5.            Over the last century, SAMH has contributed tremendously to the development of healthcare services in Singapore especially in the early years of nation building, when our healthcare system was yet to be developed. True to your vision, you have been “a light in a dark place” and touched the lives of many by bringing comfort and healing to the sick. I salute you and thank you for your contribution to Singapore.

Ageing and Healthcare Transformation

6.            Today, we are witnessing a fundamental shift in the national healthcare needs. Ageing is driving major changes in the demand pattern for healthcare services. In the past few years, we have seen a clear increase in the demand for healthcare services and many patients being treated at our hospitals and Specialist Outpatient clinics are elderly.

7.            The trend will become even more pronounced as the pace of ageing picks up over the next twenty years. By 2030, the population of seniors above 65 years old will nearly triple to reach over 900,000, enough to fill nine Toa Payoh towns. By then, one in five residents will be over 65 years old, compared to fewer than one in ten today.  As rapid ageing sets in, the needs of aged care will increase in tandem. By 2030, 117,000 seniors may be semi or non-ambulant, more than double the number we have today.

8.            Apart from the impact on healthcare capacity, ageing also challenges us to effect a more fundamental transformation in healthcare delivery. To effectively support an ageing population, having a well develop and efficient acute care sector is not enough. For senior citizens with multiple chronic illnesses, the key to good care is to strengthen primary as well as the community and long term care sectors to keep them healthy in the community. This will reduce the need for frequent visits to the hospital that are not only costly but also stressful to patients and caregivers.

9.            We need good primary care services to help the elderly manage their chronic diseases well; we need good rehab services and post discharge support services for the elderly who may be hospitalised with a stroke or fall; we need day care  and dementia day care services to help seniors age gracefully in place when frailty and dementia sets in; we need good home care and nursing home care to support seniors with severe disability and we need good palliative care to provide dignified support for the elderly and their families.

10.         A key focus of the Healthcare 2020 Masterplan is to build up primary and long term care services to support a much older population by 2020. First, the government will be ramping up the hardware development of nursing homes and community care facilities. Second, MOH through the Agency for Integrated Care, has been engaging the intermediate and long term care providers to articulate higher standards of care and to chart strategies to build up skills and capabilities of the sector. Third, we have increased government subsidies to help elderly patients and their caregivers better afford intermediate and long term care services.

11.         Good care for our senior citizens goes beyond good medical treatments. It is also about addressing the psychological and social wellbeing of our seniors. Therefore, we also need to build up community and long term care through partnership with the people sector. The outreach and human touch of community organizations and volunteers are irreplaceable. In fact, many of our public hospitals are evolving into “hospitals without walls”, by forming strategic partnerships with community voluntary welfare organizations to provide seamless care to elderly patients from hospital to home.

The Next 100 Years -  Long Term and Community Care

12.         In this context, SAMH can continue to play a critical role in healthcare in the next 100 years. While it has focused on looking after children and mothers in the initial years of nation building, going forward, SAMH can play a valuable role in supporting a rapidly ageing population in Singapore.

13.         SAMH can consider playing a bigger role particularly in the provision of community and long term care in Singapore—such as in the provision of nursing home care, home care services, as well as dementia care services.  It can also play a useful role in capability building and supporting community partners in caring for the elderly.

14.         St. Andrew’s Community Hospital has already been ramping up its capabilities to care for persons with moderate-to-severe dementia by renovating and converting one of its wards into a dedicated dementia ward.  Scheduled to start admitting patients next week, its facilities, programmes and staff will focus solely on providing good person-centered dementia rehabilitation and care.  

15.         St. Andrew’s Community Hospital has also been working with my Ministry to start an integrated home healthcare, comprising case management, home nursing, home medical and home therapy. In 2013 alone, it is projected that close to 5,000 home visits would have been made to homebound patients in the east, helping them to recover and age-in-place.   I am also pleased to note that by early 2014, St Andrew’s Community Hospital will work with MOH and Kandang Kerbau Women and Children’s Hospital to start a Paediatric Home Care programme that will care for 500 children annually.

16.         The Hospital’s in-house Day Rehabilitation Centre, together with its collaborations with St. Hilda’s Community Services Centre and Peace-Connect Seniors Activity Centre, will have provided close to 23,000 rehabilitation sessions in 2013 to elderly patients recovering in the community. 

17.         In the community, St. Andrew’s Community Hospital has also been providing free health care to lower income residents living in rental flat through its Mobile Clinic services.

18.         It is thus most meaningful that SAMH is making its centennial birthday with the dedication of St. Andrew’s Mission Hospital’s newest institution—St. Andrew’s Nursing Home. The Institute for Mental Health will be closely collaborating with the home in terms of medical support and clinical training. I am heartened that the nursing home will not only provide essential mental and medical care to some 300 patients, but will also provide job opportunities for able-bodied persons recovering from mental illness, in areas such as laundry and cleaning.

Conclusion

19.         In closing, I would like to congratulate SAMH again on 100 years of service, and we look forward to partnering SAMH to deliver good and compassionate care to a fast ageing population, in the years to come.

20.         May I wish everyone a joyous and fruitful celebration, and an enjoyable evening ahead.

21.         Thank you.