Speech by Deputy Prime Minister and Coordinating Minister for Economic Policies Heng Swee Keat at RehabWeek 2023 on 25 September 2023.
Mr Zen Koh, General Chair of Rehab Week 2023
Professor Philip Choo, Group CEO, National Healthcare Group
Prof Yu Yuping, Vice-Chair, Ruijin Hospital, Shanghai JiaoTong University School of Medicine
Dr Thierry Keller, President, International Consortium for Rehabilitation Technology
Ladies and gentlemen, a very good morning to you, and to our friends who have come from afar, a warm welcome to Singapore! I am delighted to welcome 1,000 delegates and nine associations to the 7th edition of Rehab Week, which is held in Asia for the first time.
Amongst our audience today, there are clinicians, researchers, engineers, and businesses. You bring a wide range of expertise – from healthcare and social care, to robotics, neurotechnology, AI and other emerging fields. This conference is an excellent platform to share your findings and innovations, exchange ideas, spark new collaborations, and collectively push the boundaries of rehabilitation practices and technology. We are especially pleased to bring such a distinguished group together in the year where we are marking the 50th anniversary of rehabilitation medicine in Singapore. In 1973, Tan Tock Seng Hospital established the first dedicated rehabilitation medicine service in Singapore. We have since built upon its pioneering efforts to offer rehab medicine in every public acute hospital, as well as in most community hospitals. As we mark this Golden Jubilee, let us move with renewed energy to bring everyone together, to innovate and harness the possibilities of technology and community, and advance rehab together!
Rehabilitation services has grown in importance over the years. Rehab enables a person – a child, adult, or older person – to function as independently as possible, and to participate meaningfully in daily activities. The demand for rehab services is growing swiftly, worldwide. As people live longer, the incidence of chronic disease and disability will also increase. Globally, the World Health Organisation estimates that around 2.4 billion people, or 1 in 3 people, are living with a health condition that may benefit from rehab. At the same time, rehab offerings have expanded. Rehab is now routinely incorporated into the care plans of cancer patients or patients with chronic conditions. Technology-enabled rehab, such as robotics and virtual reality, is also becoming more common. The availability of rehab services has implications on social, economic, and health outcomes, especially in ageing societies. First and foremost, rehab services are important for individual well-being. Beyond that, rehab enables productive longevity, when individuals are able to participate in and contribute to society for longer. Rehab can also reduce downstream medical costs, when offered upstream as part of a holistic care plan. This is why WHO considers rehab as a key strategy for achieving the UN Sustainable Development Goal of “healthy lives and well-being for all at all ages”.
Some of you may know that I am a grateful beneficiary of rehab. I suffered a stroke seven years ago. I am blessed to have made a full recovery, and am very grateful to the many people who had supported my journey. I collapsed during a Cabinet meeting, and fortunately, my Cabinet colleagues who were doctors rendered first aid immediately. I received excellent care from the doctors and nurses at the National Neuroscience Institute and Tan Tock Seng Hospital. Therapists played a very important role in my recovery. I did not know then, but I was already receiving rehab while I laid unconscious in the ICU! I later learnt that the practice of early rehab reduced the debilitating effects of lying flat in an ICU bed. Afterwards, there was a long road to relearning daily activities, such as speaking, walking, standing, eating, writing. My therapists were patient, encouraging, and professional. With caring therapists and intensive rehab, I was able to regain my full functions, and live fully. I have also met other stroke patients who, under the good care of our doctors and therapists, have been able to recover most, if not all of their functions. You do important work, and we are all grateful beneficiaries.
I’m glad that rehab is growing more inter-disciplinary in its practice and offerings, and drawing on technological trends to innovate and achieve better outcomes for patients. Through my role as Chairman of our National Research Foundation, I have had the opportunity to experience some of these innovations first-hand. My observation is that cross-disciplinary teams, by integrating different perspectives and expertise, are best placed to develop novel solutions and breakthroughs. So given the wide range of expertise in this room, there is great potential to collaborate, innovate and develop new approaches to rehab!
Innovations in rehab have tapped on broader trends like robotics and digitalisation. Today, robotics-assisted physiotherapy and games-based cognitive exercises have become more common. Technology-enriched rehab can provide “precision rehab” – developing unique and customised plans for every patient. Used appropriately, it is also helpful in augmenting human effort and thus mitigating manpower constraints. We have also developed new capabilities in virtual rehab, as a result of COVID-19. This has increased convenience for patients, and empowered them to take charge of their rehab journey at home.
Many societies are ageing, and facing a declining population. So while the demand for rehab services is rising, the supply of staff to provide such services is declining. It is therefore critical for us to harness the appropriate technology to augment our efforts. With innovations making rehab more effective, it is important that we organise rehab services in a way that is accessible and convenient for patients, so that they are most likely to follow through with, and reap the full benefits of rehab.
In Singapore, our acute hospitals offer excellent rehab care services and conduct research to improve care. Tan Tock Seng Hospital, as I mentioned, is a pioneer in rehabilitation medicine. It offers a comprehensive range of integrated rehab services for conditions ranging from brain and spinal cord injuries, to geriatric and surgical care. Changi General Hospital houses the Centre for Healthcare Assistive and Robotics Technology (or CHART), which ensures a tight linkage between clinical needs and technological innovation. Over the years, we have also been working to right-site care, including rehab, into the community. After all, the goal is always to support patients to reintegrate into the community. Many rehab services are offered at the community level, from community hospitals to day rehab centres. However, having many service providers on the ground also results in a fragmented landscape, making it difficult to devise and implement holistic care plans.
As such, one recent innovation in Singapore is our One-Rehab Framework, a nationwide initiative to ensure that our population has timely access to the right level of rehabilitation care. Through a common IT portal and harmonized clinical outcomes, we can now track a patient’s rehab journey and support seamless care across different settings and different members of the care team. It enables different care professionals and providers to share relevant information with one another conveniently, and coordinate rehab care plans that are customised, harmonized, and structured. We also design our financing policies to nudge patients to right-site their care within the community and ease the load of acute hospitals. I share this example to make the point that if we want patients to be able to reap the full benefits of the technological and clinical innovations that we have made in rehab, we must pay attention to the last mile delivery. Rehab offers the uplifting prospect of enabling every person to live well and maximise their potential. In turn, this keeps society vibrant. We must therefore do our best to collaborate, innovate, and deliver well.
I am glad that RehabWeek is convening so many delegates with diverse expertise and a shared commitment to advancing rehab care. Some of you will be visiting our clinics and research labs to see first-hand how we organise and deliver rehab care in Singapore – we welcome your feedback, and also look forward to learning from you. It is important that we share good practices and useful technology, so that whatever has worked well, regardless of where it was created, can be scaled. This is how we can strengthen our collective impact, particularly when tackling challenges on a global scale. Beyond this conference, Singapore would be happy to be one of your bases to explore new opportunities, or build new ventures. We have a strong ecosystem across research, innovation and enterprise, and have set aside S$25 billion for a range of research and innovation activities. We hope our compact size and linkages to global and Asian nodes can be useful, as we push to collectively advance the frontiers of rehab, to benefit people around the world.
On this note, I wish you a fruitful week ahead, and hope that you also set aside some time to discover and enjoy Singapore! Thank you.
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