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SPEECH BY DPM LEE HSIEN LOONG AT OFFICIAL OPENING OF CHANGI GENERAL HOSPITAL
Our challenge going forward is to balance the pursuit of medical excellence and affordability of healthcare to individuals, their families and the community.
Ladies and Gentlemen,
I am happy to be here this morning to declare the opening on the new Changi General Hospital.
Changi General Hospital is the first of our new-generation regional hospitals. Developed at a cost of $380 million, it replaces two of our old hospitals, Changi Hospital which was built in the 1930s, and Toa Payoh Hospital which has been operating for 37 years. It will provide high quality medical care across a wide range of specialities, wider than what Toa Payoh Hospital and the old Changi Hospital used to provide. The types of medical care provided include general medicine, general surgery, orthopaedic surgery, geriatrics, rehabilitation medicine and psychiatry, ENT and eye, plus two sub-specialities: gastro-enterology and urology.
Changi General Hospital is part of the Ministry of Health’s master-plan to build a modern hospital network of developed-country standards, to meet the needs of the Singaporean population for the 21st century. In the past decade, the Health Ministry has built or redeveloped 5 hospitals, 4 national centres and 8 polyclinics. The upgrading programme will continue. The Government is committed to provide Singaporeans with excellent and affordable health care. This is part of our vision of Our Best Home for Singaporeans.
Changi General will be the main hospital serving the eastern part of Singapore. We have decided to rename it Changi General Hospital rather than New Changi Hospital. The new name better reflects its role as a regional hospital offering a broad range of services, and also the main provider of hospital services for the 750,000 Singaporeans living east of Kallang Basin.
Acute Hospital Network
The national network of acute hospitals comprises of regional hospitals such as Changi General Hospital, tertiary hospitals such as Singapore General Hospital and National University Hospital, and national centres such as the National Heart Centre, the National Neuroscience Institute, or the National Cancer Centre. These three levels of the hospital system serve different segments of the patient population according to different medical needs. Together, they enable patients to enjoy the best care possible at the best value.
Regional Hospitals
Regional hospitals like Changi General are the main providers of hospital care in the acute hospital network. We envisage three regional hospitals in Singapore: Changi General in the east; Tan Tock Seng Hospital serving the central sector; and eventually a new hospital serving the west. They have the appropriate levels and mix of medical, nursing and paramedical personnel. They are equipped with modern facilities and equipment. They have the resources and the professional capability to manage most patients efficiently and effectively.
For most medical conditions, Singaporeans should regard the regional hospital nearest them as the hospital of their first choice. For all but the most complex problems, regional hospitals will provide good quality and affordable care. Should they need to be referred to a tertiary hospital or a national centre because of their medical condition, the regional hospital will do so. Regional hospitals, tertiary hospitals and national centres will cooperate closely to handle referrals smoothly. They share the goal of quality service.
The Government encourages each regional hospital to excel in one or two specialities or sub-specialities. This will enhance the professional standing and public reputation of the hospitals. It will help them to attract and retain good staff. It will also encourage Singaporeans living in the vicinity to use regional hospitals as the hospital of their choice. For example, Changi General Hospital has capabilities in gastro-enterology and urology. The Government will also consider allowing Changi General to develop other clinical services, if there is high demand from the catchment population of the hospital, and if it can successfully do so
Regional hospitals can build closeness to the communities they serve, and can reach out more to the communities than a national-level institution can. Since moving into these new facilities, Changi General has been conducting health education talks, health screenings for common diseases, and training for residents in CPR and first aid. You have been running patient support groups and helping patients to learn self-care skills after being discharged from hospital for conditions such as diabetes, stroke and incontinence. You have also been working closely with other caregivers like general practitioners, and plan to establish links with nearby nursing homes and community hospitals, including offering them training and assistance. I commend the staff of Changi General on your efforts to make this the hospital of first choice for residents of the eastern part of Singapore.
Regional hospitals allow Singaporeans to enjoy good quality medical care at affordable prices. They should avoid competing head-on with tertiary hospitals and national centres. Their value lies in precisely that they can provide at lower cost the best care for a large proportion of medical needs, by referring the minority of cases needing more expensive facilities and complex treatment to tertiary hospitals and national centres. At the same time, tertiary hospitals and national centres should not expand into those areas which are better met by regional hospitals.
On their part, Singaporeans needing medical services should use the level of care appropriate to their needs. If they make unnecessary or excessive use of specialist services in the tertiary hospitals and national centres, they will drive up medical costs. It will also mean longer waiting times for appointments and hospital beds, physical overcrowding and long queues in these tertiary centres. Many patients now managed in the tertiary hospitals and national centres can be just as well managed in regional hospitals, and at lower cost.
It is understandable that Singaporeans who need medical treatment want to the best treatment possible. But if everyone looks for a specialist to do an MRI scan every time he has a headache, we will never have enough specialists or MRI machines, nor are we able to afford them. I urge Singaporeans to use these expensive facilities only for complex medical conditions that cannot be adequately treated elsewhere. In many developed countries, patients must be referred by a general practitioner before they can see a specialist. Fortunately we do not need to do that yet. If we can convince Singaporeans that regional hospitals provide as good care as the tertiary hospitals, that should help reduce the problem
Tertiary Hospitals and National Centres
Tertiary hospitals manage patients with more complex problems across a broad range of specialties. The two tertiary hospitals _ SGH and NUH _ have the specialised expertise and facilities required to care for such patients properly. KK Women’s and Children’s Hospital is a specialist hospital, catering to the special needs of women and children.
We have 5 national centres of excellence: for skin, eye, heart, cancer and neuroscience. These cover the most important specialised areas to meet our present and future healthcare needs. Three of the centres _ National Heart Centre, Singapore National Eye Centre and National Skin Centre are well established. The National Cancer Centre and National Neuroscience Institute will open in 1999.
I understand that the regional hospitals are concerned that the tertiary hospitals will take patients away from them, and the tertiary hospitals are similarly worried about the national centres. They should not worry. The regional and tertiary hospitals will continue to manage the majority of patients within their capabilities, and refer only the difficult cases to the national centres. The different types of hospitals are meant to collaborate with and complement one another. Specialists with the appropriate qualifications, expertise and experience, no matter where they may be practising, should participate actively in clinical service, training and research activities at the national centres. Specialists in the relevant departments in the public hospitals will be offered concurrent appointments to the national centres. Those in the private sector will be invited to participate on a part-time basis.
Conclusion
We already have a first class healthcare system. Singaporeans have ready access to a wide range of preventive, curative and rehabilitative health programmes. We enjoy high quality medical care at affordable prices. We have managed to achieve this by complementing Government subsidies with our philosophy of promoting personal responsibility for one’s own health, and requiring co-payment of at least part of the medical expenses when one falls ill.
Our challenge going forward is to balance the pursuit of medical excellence and affordability of healthcare to individuals, their families, and the community. We need to optimise the use of the acute hospital network. The regional hospitals will play a crucial role in providing high quality care to the large majority of patients.