Speech by Deputy Prime Minister and Minister for Finance Heng Swee Keat at St Luke's Hospital Charity Dinner 2019, Saturday, 20 July 2019, at St Regis Hotel

Dr Peng Chung Mien, Chairman, St Luke’s Hospital

Associate Professor Tan Boon Yeow, Chief Executive Officer, St Luke’s Hospital

Distinguished Guests

Ladies and Gentlemen

1. Good evening. I am happy to join so many dedicated healthcare professionals and generous individuals like yourself who have come together this evening to support the St Luke’s Hospital’s Charity Dinner. St Luke’s Hospital has been serving, loving and healing patients, this is very meaningful. 

Ageing Population and Investments in Healthcare

2. Singapore is ageing rapidly. By 2030, one in four Singaporeans will be aged 65 years and above, compared to one in seven today. Singaporeans also have one of the longest lifespans in the world at 83 years^[1]. It is good that we are living longer. But it is not just about adding years to life, but also life to years. 

3. Over the years, the Government has been strengthening our healthcare system to make it more accessible, more affordable and to maintain high standards. Since 2010, we have 

a. completed seven new acute and community hospitals. 

b. built and re-developed five polyclinics. 

c. expanded home and centre-based care services by more than 9,500 places. 

d. We made healthcare more affordable for all.

i. We introduced MediShield Life, a universal healthcare insurance, to provide all Singaporeans with lifelong protection against large hospital bills. 

ii. The Pioneer Generation Package and the Merdeka Generation Package provide our seniors greater assurance for their healthcare expenses. 

iii. We are enhancing the Community Health Assist Scheme to cover all Singaporeans with selected chronic conditions, regardless of their income levels.
    
4. Our healthcare expenditures have been growing. 

a. Between 2010 and 2016, our National Healthcare Expenditure almost doubled from 11 billion to about 21 billion dollars.^[2]  

b. We have also more than doubled the amount of direct government subsidies given to Singaporeans from 2.6 billion to 5.6 billion dollars over the same period^[3]. 

c. Therefore, we need to plan ahead to ensure that our healthcare expenditures are sustainable. We have embarked on a journey to transform our healthcare system for the future.

Transforming our Healthcare System

5. First, we need to empower Singaporeans to take charge of their health, and lead active and healthier lifestyles. 

a. The Ministry of Health (MOH) launched the War on Diabetes to mobilise a whole-of-nation effort. Diabetes shares the same risk factors with other chronic diseases. Hence, preventing and managing diabetes will be beneficial to the management of other chronic diseases. 

i. Our efforts are beginning to bear fruit. Early indications suggest that many Singaporeans are adopting healthier lifestyles. Based on the 2018 National Nutrition Survey, Singaporeans’ diet quality has improved. We are eating more wholegrain, fruit and vegetables, as well as substituting saturated fat with unsaturated fats. However, high sugar and salt consumption is still a cause for concern. We will continue our efforts to encourage Singaporeans to eat healthily. 

ii. The National Steps Challenge has also seen good results. More than 800,000 Singaporeans participated in season four of the National Steps Challenge which started from October 2018. This is four times more than in season one. 

b. We have also expanded the Community Networks for Seniors nationwide to provide a strong community care system for seniors. 

i. The Community Networks for Seniors brings together government agencies, partners and volunteers to promote active ageing among seniors, befriend seniors living alone, and bring together health and social support for seniors with needs. 

6. However, despite our best efforts to stay healthy, we may still fall ill. Over the years, we have increased acute hospital capacity to meet demand. However, episodic care provided by acute hospitals cannot adequately address the rising incidence of chronic diseases. We need to shift from short, episodic care to person-centric care over a longer term. 

a. With rapid advancements in medical technology and drug discovery, we have also renewed focus on the value of care delivered to patients, especially in acute hospitals. 

i. MOH has set up the Agency for Care Effectiveness (or ACE). ACE evaluates health technologies to inform decisions on funding for medical technologies and subsidies for drugs. ACE also produces guidelines on the use of health technologies to support healthcare professionals. ACE’s work helps us to make the best use of health technologies, while managing cost effectively. 

7. We are also shifting the focus of healthcare delivery beyond hospitals to the community. Our aim is to deliver care closer to homes and in an environment that patients are familiar with. 

a. To anchor care firmly within the community, we are building up our community care sector and widening the range of services from primary care to intermediate and long term care.

b. For primary care, we are growing public primary care infrastructure and tapping on private primary care capacity. 

i. Our network of polyclinics will grow from the current 20 to about 30 by 2030.

ii. We started the Primary Care Networks (or PCNs) in 2018 to support like-minded General Practitioners (or GPs) to form networks to achieve economies of scale and optimise resourcing to deliver team-based care for chronic disease management. There are now 450 GP clinics on board the PCN scheme. This is a 50% increase from 300 GP clinics last year.

c. We are expanding options for aged care services, through new models such as the Integrated Home and Day Care programme to meet more complex needs of seniors. 

d. Caregivers are often unsung heroes who enable our seniors to age with dignity. To strengthen support for senior caregiving, MOH launched the Caregiver Support Action Plan this year. 

i. The Plan outlines initiatives to provide financial and workplace support, improve respite options, and support caregivers with their socio-emotional needs.

Community Hospitals are Integral to Our Healthcare Transformation Journey 

8. Community hospitals, which provide intermediate care will continue to be an integral part of our healthcare system. All Community Hospitals, including those operated by our community partners such as St Luke’s Hospital, will play an even larger role in the future.  

9. Community Hospitals support patients’ transition back to the community and to return home. To achieve this, Community Hospitals work in close partnerships with acute hospitals to identify patients who require a longer recovery to receive continuing care.

a. The Community Hospitals work through a team-based approach. The care team, which may include doctors, nurses, rehabilitation therapists and social workers, seeks to better provide holistic care for patients.

b. Community Hospitals also provide appropriate facilities to help patients in their recovery process. 

i. These include rehabilitation gyms, therapy areas, communal areas for patients to participate in activities, and mock-up home environment. 

10. Even as Community Hospitals remain true to its mission in providing continuing care and rehabilitation, Community Hospitals can be a catalyst in transforming the way we care for patients.

a. In 2018, MOH implemented direct emergency department admissions to Community Hospitals for medically stable patients who will benefit from a short period of medical, nursing or rehabilitation care. 

i. For example, conditions suitable for direct admissions include urinary tract infection, non-surgical wound care, or inpatient rehabilitation to improve patients’ ability to perform daily activities.

ii. MOH also extended MediShield Life coverage for direct admissions to Community Hospitals.

b. In this way, care can be provided at the most appropriate setting without admission to an acute hospital. Since July 2018, we have seen more than 300 patients benefitting from such direct admissions.

Supporting Community Partners and Care in the Community 

11. The theme of this evening’s charity dinner, “Meeting A Need”, is very apt. Over the years, Community Hospitals, have been addressing the healthcare needs in the community. 

a. Community Hospitals have addressed care gaps, even before the Government started building up the intermediate and long-term care sector. 

b. Some examples include Ang Mo Kio-Thye Hua Kwan Hospital, St. Andrew’s Community Hospital and Ren Ci Hospital.

12. Another good example is St Luke’s Hospital. You have been supporting the care needs of the community, especially in the western region.   

a. As Dr Peng shared with us just now, a group of Christian leaders conceived of the hospital. They were driven by the passion to meet the needs of the elderly in Singapore, regardless of race or religion. 

b. It was the first hospital in Singapore dedicated to the elderly sick. 

c. In 1996, St Luke’s Hospital admitted its first patient. 

13.  Over time, St Luke’s Hospital remains unwavering in responding to the needs of the community. Dr Peng spoke passionately about this just now. Please allow me to add a few words.  
a. You are one of the pioneers in introducing the family physician-centric model in Community Hospitals 

i.  The family physician plays a central role in delivering holistic care through leading a multi-disciplinary team, and providing clinical oversight for patients. 

b. Over time, you treat patients beyond the elderly.  

i. You provide inpatient rehabilitation for patients with conditions such as stroke.

ii. To further help patients improve their functional ability, you provide outpatient rehabilitation services such as physiotherapy and occupational therapy.

c. You have also expanded your range of services to meet evolving needs. 

i. You started a purpose-built dementia ward to help patients manage their symptoms and support their caregivers. 

ii. You are known for your expertise in wound care. 

1) Take for instance, Mr Pang Jui Min who suffers from diabetes. He had accidentally stepped on a nail. The wound became infected, and he had three of his toes amputated. Mr Pang approached St Luke’s Hospital, and received dedicated wound care service and post-surgery rehabilitation. His wound healed and this saved him from having to undergo further amputation of his limb.

iii. To better care for the needs of end-of-life patients, you started a dedicated palliative care ward in 2017. 

d. You also actively form new partnerships and pilot new programmes. 

i. You go upstream to conduct annual health screening and follow-ups for seniors under the Project SilverCare programme, in collaboration with NUS.

ii. In April this year, you worked with the Agency for Integrated Care to pilot the Community Response Team programme. This programme provides early intervention and clinical support for persons with mental health conditions. A multi-disciplinary team visits these clients to conduct assessments and behaviour management interventions. This will enable them to be better supported at home for as long as possible. 

14. Your patients also make a difference to the lives of other patients by helping one another. 

a. For example, Mr Cheong Hon Kee benefited from your rehabilitation services. He is paying this forward by volunteering and supporting other patients who need speech therapy. 

b. Another example is Mrs Gwee Kwee Eng. She contributed four art pieces to raise funds at the auction. 

c. As you can see, St Luke’s Hospital had since its founding been evolving your services to meet the changing needs of our people. I am confident that you will continue to inspire your patients and improve their lives. 

15. The Government will continue to play an enabling role to support philanthropy and Singaporeans in need. 

a. This year, Singapore commemorates our Bicentennial. It marks 200 years since Sir Stamford Raffles arrived in Singapore. The values that have evolved with us, such as multiculturalism, self-determination, care for one another, have shaped Singapore’s history and society. To quote the words of the Bicentennial Experience, ‘From Singapore, to Singaporeans’. I know that many of you want to help fellow Singaporeans in need. 

b. I had announced the Bicentennial Community Fund, which will provide dollar-for-dollar matching for donations made to an Institution of Public Character (IPC), such as St Luke’s Hospital, in this year.  

i. Donors will continue to enjoy 250% tax deduction on qualifying donations to IPCs. 

c. In addition, the Community Silver Trust has been supporting our community partners since 2011.

i. This dollar-for-dollar matching grant has benefited more than 80 community partners in the intermediate and long-term care sector. 

d. Under the Business and IPC Partnership Scheme, businesses will also enjoy a 250% tax deduction on qualifying expenditure incurred when they send their employees to volunteer and provide services to IPCs. 

e. These initiatives will help Singaporeans in need. 

f. I also spoke about building our future Singapore together last month, and how the Government will work with you, for you. I encourage all of us to actively help one another. I want to thank thousands of volunteers who have helped St Luke’s Hospital over the years. Together, we can build a democracy of deeds, where everyone contributes in one way or another. Let us build a more caring and inclusive society. 

Conclusion

16. To conclude, Community Hospitals such as St Luke’s Hospital, play an important role in our healthcare transformation. Community hospitals can transform patient care. St Luke’s Hospital has embarked on several initiatives to respond to the evolving needs of the community over the years.

17. The support of everyone – from public healthcare institutions, private care providers to community partners – have enabled Singapore to achieve a world-class healthcare system. The Government will continue encouraging Singaporeans in leading active and healthy lives, and in developing a sustainable healthcare system for our future generations. 

18. In closing, I wish St Luke’s Hospital every success in your fundraising efforts. May you continue to grow from strength to strength, and inspire Singaporeans with your vision to ‘Transforming Community Care’. 

19. Thank you. 

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^[1] Department of Statistics (DOS). 

^[2] Source: MOH COS 2019

^[3] Source: MOH COS 2019