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Clinical Care & Innovation – the past, present and future (Part 1)

Today, Singaporeans enjoy world-class, multi-disciplinary healthcare… but how did we get here?

Tests of Resilience

Early Singapore was rife with infectious and communicable diseases due to poor public sanitation and food hygiene. There were frequent outbreaks of cholera, smallpox, polio, tuberculosis and human plague – one cholera outbreak lasted 24 years, from 1899 to 1923! This spurred the government to focus on improving sanitation and public health, before going on to develop and enhance health services.

The journey to building a robust health system was not all smooth-sailing, as there were challenges along the way:

Explosion on the Greek tanker S.T. Spyros

Patients with severe burns arriving at the Burns Unit in SGH
Photo: The Straits Times

In 1978, Singapore experienced its first post-war mass casualty disaster – the explosion on the Greek tanker S.T. Spyros, which left 76 people dead and 69 others injured. Many of the injured were sent to Singapore General Hospital (SGH) – the only hospital with a fledgling burns unit. The lessons learnt from this tragic disaster would lead to the further development and upgrading of what we know today as the SGH Burns Centre. Today, the Centre has become the major burns referral centre for Southeast Asia, providing specialised and multidisciplinary care, from point of injury to post-hospital rehabilitation.

Collapse of Hotel New World

Rescue efforts at the Hotel New World collapse site
Photo: The New Straits Times Press (Malaysia) Berhad

In 1986, the Hotel New World collapsed due to structural defects and poor construction. This would be Singapore’s worst civil disaster since the Spyros explosion, with 33 people perishing and 17 survivors rescued. With the rescue efforts coordinated by the Singapore Civil Defence Force (SCDF), Singapore Fire Service, the Singapore Armed Forces (SAF) and SGH, many of the survivors and the bodies of those who perished were airlifted or brought to SGH for treatment or post-mortem examinations. The helipad atop SGH’s Block 1 was instrumental in aiding the transfer of victims quickly from the accident site to SGH, and the Emergency Department played an instrumental part coordinating the medical field teams and determining the supplies needed.

Overcoming Severe Acute Respiratory Syndrome (SARS)

In 2003, SARS hit our shores and spread rapidly, infecting 238 Singaporeans and claiming the lives of 33. KK Women’s and Children’s Hospital (KKH) was given the mandate to run the paediatric facilities in Tan Tock Seng Hospital (TTSH), the designated SARS hospital – with just 24 hours to set up and be operationally ready. SARS would put a strain on our healthcare system and workers, leading us to develop more sharpened crisis preparedness and response plans.

KKH staff in full PPE at the TTSH paediatric SARS ward

Photo: KK Women’s and Children’s Hospital

In later years, we would also face outbreaks of Dengue, Hand Foot and Mouth Disease (HFMD), Nipah Virus and H1N1. Each healthcare crisis gave us the opportunity to further enhance our preparedness for the challenges ahead.

The battle against COVID-19

Photo: The Straits Times

In 2020, the unprecedented battle against COVID-19 landed on our shores. We were quick to join global forces and head into war against the virus. With safe management measures, the redeployment of medical staff and resources, and the need to reduce face-to-face interactions, we had to adapt quickly and turned to the use of technology as a primary mode of care to keep our staff and patients safe. The war wages on in 2021, but there are silver linings – not only have we made strides forward in advancing healthcare technology, our sense of unity and duty as healthcare workers has also strengthened. Together with the wider healthcare fraternity and fellow Singaporeans, we will surely prevail over COVID-19.

These tests of resilience were major turning points for our public healthcare system that undoubtedly sparked shifts in our response to crises and new diseases. They not only sharpened our response plans to civil emergencies, but spurred fundamental changes in our public health strategies, led to expanded health services and were the genesis to the setting up of specialised units in our hospitals.

Transforming Healthcare

From the 1990s, we would see the birth of more public hospitals to serve communities in other regions of Singapore – Changi General Hospital (CGH) in 1998, Khoo Teck Puat Hospital in 2010 and Sengkang General and Community Hospitals (SKH, SKCH) in 2018.

In addition, to address the growing need for specialised treatments, specialist centres were established – Singapore National Eye Centre (SNEC) in 1990, National Heart Centre Singapore (NHCS) in 1994, National Dental Centre Singapore (NDCS) in 1997, National Neuroscience Institute (NNI) in 1999 and National Cancer Centre Singapore (NCCS) in 2000.

The SGH Campus Master Plan was unveiled by Prime Minister Lee Hsien Loong in 2016, marking the start of a series of major developments to the Campus in the coming years, to enhance facilities and increase capacity for Singapore’s growing healthcare needs. Since then, the Outram Community Hospital (OCH) has started operations, and the construction of the new Emergency Medicine building, the SGH Elective Care Centre, and new NCCS and NDCS buildings are underway!

In 2020, MOH also announced the building of a new integrated hospital in the eastern region that would help manage the patient load at CGH.

Aside from infrastructure, the models of care our patients now enjoy, as well as the “heart-ware” of medicine – the healthcare workers who treat our patients – have also evolved and grown.

Today, we have specialists in over 50 disciplines leading the charge in clinical care, education and research. Our nurses and allied health professionals (AHPs) are also at the forefront in the delivery of our health services, playing integral roles in care teams at our hospitals and clinics. Gone are the days when medical specialties existed in silos – we now offer holistic, patient-centric care, such as through the SingHealth Duke-NUS Disease Centres (SDDCs), which bring together specialists from across disciplines to offer our patients multi-disciplinary and integrated care.
In our continued pursuit of excellence, we also seek out ways to expand and enhance the responsibilities and career tracks of our healthcare professionals.

At SingHealth, we have more than 5,000 AH staff. Invaluable to the care teams they are part of, AHPs are experts in their specialised fields of practice, supporting the diagnosis, assessment, treatment, rehabilitation and/or prevention of diseases or illnesses, to enhance or maintain physical, sensory, psychological, cognitive and/or social functions of patients. With over 30 specialties, our AH workforce contributes to the Academic Medicine landscape through delivery of care to patients, educating the next generation, and pursuing high-impact research and innovation.

Ms Loh Peh Rong, Cardiac Technologist at the National Heart Centre Singapore (NHCS)

Photo: Singapore Health

At the heart of our care teams are our over 11,000 nurses, all highly committed to delivering quality patient care. Highly skilled and critical members of our care teams, they are empowered to shape care practices through innovation and research. Our nurses enjoy career development in five career tracks and training opportunities in over 30 diverse specialties.


The Road Ahead

We remain steadfast in our commitment to keep our patients at the heart of all we do. Through the many tests of the resilience of our nation and healthcare system, we have taken many strides and grown from strength to strength to build the world-class public healthcare system we enjoy today.

So, what does the future hold for healthcare? What will care look like in the years to come?

Find out in Part 2!