Speech by Prime Minister Lee Hsien Loong at the Opening of Ng Teng Fong General Hospital & Jurong Community Hospital

10 October 2015

 

Distinguished guests, ladies and gentlemen, I am very happy to join all of you for the opening of Ng Teng Fong General Hospital and Jurong Community Hospital.

We have been eagerly awaiting the opening of these two hospitals for a while.  On the 30th of June this year, they commenced operations, and now, as the CEO has just told you, they have opened 500 acute and 175 community hospital beds.  When it is fully open, they will have 700 acute beds and 400 community hospital beds, which will add much needed capacity to our healthcare system.

These hospitals are an important part of our Healthcare 2020 master plan.  Over the last five years, we have been steadily expanding and building hospitals, and increasing the number of hospital beds.  We opened Khoo Teck Puat Hospital in 2010 and now Ng Teng Fong General Hospital, as well as the Jurong Community Hospital.  We will open more hospitals in the years ahead – Yishun Community Hospital by end of this year, Sengkang General and Community Hospital in three years’ time, Outram Community Hospital in five years’ time, and Woodlands General and Community Hospital in 2022, which is seven years’ time.

We need more hospitals and capacity because the patient numbers have been rising steadily.  And the number has been rising mainly because our population has been aging, and aging very rapidly.  If you look at our old age dependency ratio, which measures the number of people 65 years and above, compared to the people who are in the working ages, 20 to 64 years old, the number has been gradually increasing over the years until 2010, then there was a sharp kink, and started increasing very rapidly.  From 2005 to 2010, the dependency ratio was 12 per cent, over five years, it went up to 13 per cent.  We can manage these numbers.  But from 2010 to 2015, it went from 13 to nearly 18.  In five years.  So today, for every 100 working persons, we have 18 people who are aged 65 and above.  If you look forward, over next five years, the increase will be even faster.  Over the five years beyond that, faster still.  That is including immigration, and all that we are doing to have our population grow, more babies born.  With this older population, our healthcare needs are bound to expand further.

So I am happy that we now have Ng Teng Fong General Hospital and Jurong Community Hospital built and operating.  Because these are new developments, we had the chance to design the buildings from a fresh start, around the patient.  As Mr Foo has just told you the wards here are unlike the wards in any other hospitals – fan-shaped, with lots of natural light and greenery outside, at least when there is no haze; every patient with good ventilation, and a good view, for all of the wards, whether it is C, B2, B1 or A class.  There also outdoor terraces complete with equipment and supply points, designed with patients in mind.  Patients can take short walks, enjoy a little sunshine and fresh air, lift their spirits and recover faster.  In Jurong Community Hospital, we even have a mock-up three-room HDB flat, not for sale, but just to help patients ease back into their home environment while they are recuperating – learn how to work, manoeuvre around grab bars, ramps, steps, kitchen equipment, and get back to a home environment safely.  The two hospitals – the General Hospital and the Community Hospital, are just next to each other, and they operate together as a single integrated development, physically and also in terms of clinical services and operations which they provide.  A patient who completes his surgery here in Ng Teng Fong General Hospital and needs rehabilitative care can be transferred smoothly to Jurong Community Hospital to recuperate.  He does not need an ambulance, he just get wheeled along the corridor.  He will continue to be looked after by care teams from both sides, the General Hospital if necessary, the Community Hospital which most of the time will be adequate.  When he is discharged, he will get just one bill for his stay.

When people think about healthcare, first and foremost what comes to mind is hospitals, because that is the most direct association, and the most vivid image they have.  But hospitals are actually just one piece of an overall healthcare system.  They have to fit in well with all the other components, which also have to be properly developed, resourced, organised, and linked together, which is what we have been trying to do for healthcare in Singapore, in particular in Jurong.  We have been building up our primary healthcare care facilities.  Polyclinics.  We are building a new polyclinic in Jurong – Pioneer Family Healthcare Centre by 2017.  Then we have a family medicine clinic coming up.  JurongHealth has worked with a group of family doctors to set up the Lakeside Family Medicine Clinic, which can give you a check-up, and refer you to hospital if necessary.  It is more than a polyclinic can do, because you can do tests and you also have a link to the hospitals, and it can also provide follow-up care after you are discharged from the hospital.  We also have the Jurong Medical Centre which has been operating a couple of years now, which gives specialist outpatient care like eye services and early childhood intervention.  Patients who need specialist care do not have to think about the hospital as the only possible place they can go to.  There is specialist care available within the community, more convenient, more responsive, and I believe also more economic.  

Downstream from the hospitals, we are building nursing homes.  Recently we opened All Saints Home in Jurong East.  NTUC Health has opened in Jurong West.  And we are expanding our eldercare centres so that seniors who live at home can take part in day activities and interact with others, stay active, stay engaged, stay cheerful and well.  We even have in Jurong a Blood Bank at Westgate, so that after you shop, you can donate blood.  You should do it in that sequence.  

We are putting all the pieces together in Jurong, designing the whole around the patients, to be patient-centric, not just the hospitals, but also the primary care, after care, nursing homes, outpatient treatment, making sure that they all work together.  And that the patient gets the right treatment at the right place.  Overall, the system delivers better care for the patient, in a cost-effective way.  That is what we will be doing this all over Singapore.

That is the healthcare system.  But of course, the best thing you can do is to take care of yourself, keep healthy, and not have to go to the healthcare system because that way, you really have the best quality of life.  That is our own responsibility.  So I encourage all of you to exercise regularly, keep active and fit, and stay well.  I know that in Jurong, the grassroots organisations are very active.  They have many active aging clubs, they organise popular activities like brisk walks, and I was just talking to the Mayor, Dr Teo Ho Pin the other day and he said they even taught some senior citizens in their 50s and 60s, to learn to swim, from scratch.  Their requirement is, “Please do it very early in the morning, so that we are not bumped around by the rest of the swimmers in the swimming pool.”  But they learn to swim, as very mature adults.  That is the attitude which we want.  Each of us should look after our health, monitor our own medical conditions, and take it seriously.  Because things like high cholesterol, high blood sugar, or high blood pressure are silent malfunctions of our system.  They are silent until it show up, and then it is too late.  It is much better to deal with them early, when they are there and before they cause trouble, than to wait for them to become undeniable and very difficult to treat, and harm is done.  

JurongHealth has been working hard with grassroots leaders to do health screening for the community in the void decks.  Today for this opening ceremony, I see that we have a few hundred residents come and doing health screening.  In fact there is a health carnival as well.  I suppose if you passed your health screening, you are allowed to go to the carnival.  But I hope you go for the screening, I am talking to residents in general but also all of you who are here, because doctors and nurses can get sick too.  And be sure to follow up if the screening shows up something that needs to be checked or treated.  I say that because I know a lot of people go to health screening, I know quite a number get picked up with conditions, like maybe one-third, one condition or another, and I also know that many of the people who get found to have conditions and are sent a note – “Please go and see your doctor, or go to the polyclinic”, do not follow up after that.  So if you are going to get a health screening, and not going to follow up after that, really it is wasted effort and really you are sitting on something that can cause a lot of trouble later on.  There is really no reason not to follow up because with CHAS and the PG package, there is support to deal with chronic conditions, and affordability should not be a problem.  If you need blood pressure drugs, it will be prescribed, it can be affordable.  If you need statins, you can have statins.  If you need diabetes drugs, you can change your dietary habits, have less Chendol and Ice Kachang, and will improve the blood sugar.  We need to keep active, watch our health closely.  We have a good healthcare system, so we can have a good quality of life, live well and age well.

Today, we have a very good healthcare system in Singapore.  Without blowing our own trumpet, I think we can say as a fact that it is one of the best in the world.  We spend less on healthcare than others, yet we have better health outcomes.  Infant mortality is one of the world’s lowest; longevity is one of the world’s longest.  I just looked at the latest number.  On average, we are now 82.7 I think.  That means men live till 80 and women live till about 85.  If you are born today, I am quite sure your life expectancy by the time you reach that point will be close to 90.  Medical coverage brings in nearly everybody.  So whether you are rich or poor, the medical care is accessible to you.  Waiting times are not too long.  Some of them we want to bring down but compared to other countries, overall, not too long.  Keeping such a good medical system depends not just on having more doctors and more hospitals or nurses, but also on getting the system right, making sure healthcare is delivered properly – right care at the right place, making sure healthcare is paid for properly – so that the patients pay something, the Government pay something, the insurance pay something, and each party has an incentive not to overuse the system, not to overprescribe, not to over demand healthcare services, to watch the cost and make sure it is effective.  We have been able to do that so far but it is not easy, and it depends on our political support, because ultimately, Singaporeans must be willing to support the system, and support the Government when it tries to keep the system efficient, accessible, and sustainable.  

But we have to continue to improve our system because our needs are growing – I described to you how our population is aging – our healthcare expenditure will grow.  In fact it is one of the major reasons why our budget spending will grow over the years.  We must make sure we keep on getting the system right, and value-for-money, even as we provide better protection through MediShield Life for Singaporeans, even as we increase Government support through CHAS and the PG Package for lower and middle income Singaporeans in particular, and for the PG Package, for all of the pioneer generation.  We have to make sure that the patients do not overuse resources, and doctors do not over-treat patients.  This is always going to be hard because the more support we give, the less patients have to worry about healthcare costs, the less doctors have to worry – “If I prescribe you this procedure or this drug, the patient will have to pay some of it, why don’t I just go ahead and prescribe?”.  Then the greater the incentive to overuse healthcare services, and the more pressure we will have on our resources, on our budget, and on the professionals – the doctors, nurses, and staff running the system.  

Furthermore, apart from the incentives and the cost, we must all realise what a huge and complicated system our healthcare network is.  This year, we have nearly 400,000 inpatient admissions and the number is growing, which means every day, 1,300 off-the-cuff inpatient admissions, therefore, so many more procedures, interventions, prescriptions, diagnoses, assessments to be made.  Our challenge is: even as it becomes more complex, to maintain the highest quality of medical care – of diagnosis, of treatment, and of patient care.  That means a whole team has to work together.  You can have the best surgeon in the world, but without good nursing care, without good hospital administration, without a reliable pharmacy, and just cleanliness and administration of the hospital, you can survive the operation, you will die of the recovery.  It happens, that is why people come to Singapore in order to have the operations, not that there are no very good surgeons and specialists elsewhere, but in Singapore, they can be confident of the whole system.  The whole team has to work together to make this happen.  

And once in a while, unfortunately, something will go wrong.  As something evidently did in SGH, some months ago, resulting in the recent Hepatitis C outbreak.  When something like this happens, our approach must always be to first put things right, to find out what is wrong, to safeguard the health and well-being of patients.  Establish what happened, learn from the experience, improve and do better in future.  We also always have to be open and transparent with the public and with the patients about what has happened, because we must maintain public confidence, and trust in the healthcare system.  In case of the Hepatitis-C outbreak, MOH is still investigating the case, we have an independent investigation going on.  I cannot say yet what has happened, how it happened, but I can tell you that is the approach MOH is taking and which we will take for any similar cases in future.  

Ultimately, how good our healthcare system is depends on the healthcare workers.  The thousands who give of their best every day – slogging, long hours patiently, sometimes under very difficult conditions, making sure that even if you cannot cure a patient, you can relieve his pain, his discomfort, his anxieties, treat and take care of the patient.  This week, Minister Gan Kim Yong launched a book that documented our healthcare story from independence.  Quite a number of healthcare workers turned up but I am sure many were still on duty and could not go.  Today, I would just like to thank you in person, you and all the healthcare workers who all played a part in the story, caring for patients through the years – the doctors and nurses, allied health professionals and IT staff, medical social workers, hospital administrators, and so many others – all of our Singapore healthcare team.  

The new hospital here has just started operating in June, but already, in these last few months, it has made an impact in the lives of patients.  We watched a video just now about Mr Tan, who lost his hearing through meningitis, and now with a cochlear implant, with the care and the ministering of the staff of the hospital, is able to hear again.  I am very happy that Mr Tan and Mrs Tan are here together with the hospital team, and able to share our joy on the occasion.  I am confident that the hospital will care for many more patients, as professionally, competently, and compassionately, for many more years to come.  I would like to thank the Board and the management team for their hard work in preparing the hospital to serve patients and the wider community.  I would like to thank the family of Mr Ng Teng Fong for their very generous donation, which has enabled us to improve and build up the facilities in this hospital.  I look forward to visiting the hospital when you are more settled, seeing how it is operating, seeing patients being treated well, recovering and benefitting from the investments which we have put in.  Congratulations once again.

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