Speech by Minister for Defence Dr Ng Eng Hen, at the Inauguration of the Medical Simulation Training Centre

Senior Minister of State for Defence and Acting Minister for Community Development, Youth and Sports, Mr Chan Chun Sing,
Senior Parliamentary Secretary, Dr Maliki,
Chief of Defence Force,
Chief of Services,
Chief of Medical Corps,
Chief Army Medical Officer,

I see a lot of old friends so it is a delight to be here to officiate the opening of the Medical Simulation Training Centre (MSTC). I think for those of you who study military history, enough has been written about how it is important to fight battles with superior combat power. But in parallel, much has been written about how service, or how you clothe your soldiers, how you feed them, how you take care of them, how you deliver medical care to them, is actually just as crucial. And the SAF's medical support system that provides medical care to our NSmen and NSFs both in peacetime and in war is a critical element in the SAF. If you think about it, in peacetime, we have almost 40,000 full-time National Servicemen - each one someone's precious son, husband, brother. And during those two years, we subject them to rigorous training so they must be able to maintain their individual physical and mental well-being during their two years in the SAF. So whenever something happens, questions are asked, and rightly so. Sometimes when something happens and it is not physical injury but he may be depressed, we ask ourselves if we had detected it, could we have done something. And indeed in incidents, we ask ourselves that. After the two years, they must be able to maintain their fitness and health for the next 10 to 15 years, to fulfil their roles as operationally ready NSmen. Singapore is renowned for its high standards of medical care; foreigners come here for medical care and rightly so - as NSmen and their families expect equally high standards of medical care within the SAF, particularly because NSmen put aside, some, their studies, their careers, to spend time within the SAF. And that expectation not only includes acute care for emergency treatments, but also their general health such as those related to preventive medicine and psychological assessments. So even if someone is not sick or does not have disease, in the traditional sense of the word, you want to be healthy enough so that they can perform well in their NS duties and we ask ourselves, obviously, how can we help them to maintain a healthy attitude towards their well-being, how can we, in the sense, make them fit. A robust medical support system would be crucial because it provides confidence and upholds the morale for our soldiers and the public if they are convinced they are well taken care of.

In operations, this need is no less. In fact, some will say the SAF has to maintain high standards of medical care benchmarked against established militaries. For example, our medical and surgical teams have deployed early for Humanitarian Assistance and Disaster Relief (HADR) missions. And each time there is a conflict, the Ministry of Defence (MINDEF) recognises, and I assure you, that there is a much higher chance that we will mobilise the medical teams first, because in a sense, they are the least politically sensitive. Each time there is a conflict we do not think of mobilising the Special Forces first, I assure you. This sends a different signal. So if you look at our history, it has been the medical teams that has been mobilised more often. Like the Asian Tsunami in 2004 and the Padang Earthquake in 2009. We have also deployed to peace support operations frequently in Timor Leste and Afghanistan. And there our medical personnel worked closely and were highly valued by our coalition partners, whether they are from the United States, Australia, New Zealand and the Netherlands. I recently visited our deployments in Afghanistan in Tarin Kowt, where they run a hospital and they were working with the Dutch initially, and then the Australians. They run very good facilities.

The labs nowadays have shrunk. So you go into a lab, it is not a huge one, but it has everything you actually need. When I speak to the medics or the doctors who return, and they tell me about their exposure to war injuries, they do it with a quiet sense of confidence that they have seen battle action, battle injuries. And that if ever, we were so unfortunate to have to require their expertise here, they would be able to do a good job. How do we, in Singapore, keep pace with this kind of expectations from the public, whether it is in peacetime or the real needs of operations? Because we know that medicine advances very fast. In order for us to do this, the SAF collaborates and integrates with the larger national healthcare systems so that we can bring high quality care to our servicemen. The SAF works closely with the national pool of specialist doctors and scientists, many of who have taken precious time out to be here - I know you are very busy in hospitals, and we thank you for taking time to be here. And many, like you, are NSmen or volunteers, and you serve in a number of capacities, whether on Advisory Boards because your expertise is required. You advise and provide policy guidance to the SAF in the areas of clinical governance, benchmarking of clinical care, as well as medical screening and classification guidelines. The SAF is also working closely with the National Heart Centre to deliver timely and quality advanced cardiac investigations and medical screening to SAF servicemen. In the area of musculoskeletal injury prevention and management, we partner medical specialists at the Changi General Hospital to enhance the care for our soldiers.

These collaborations are necessary because they help augment the limited numbers of regular doctors within the SAF, just as we have done in other areas such as defence research and development (R&D). I use this analogy because it is a useful one. In defence R&D, despite 5000 engineers being generated each year from our tertiary institutions, no single R&D agency in Singapore had the wherewithal to provide us with the required capabilities needed for the SAF. That is the truth, and I am willing to say it because all countries face the same limitation. We always need things that can fly further, look better or look more precisely and hit the target more accurately. We can only achieve this by building a defence ecosystem, which means that we have a number of agencies, DSO, DSTA, and the private defence industries. So if you look at our platforms, whether they're the frigates or our Terrex, or even refurbished Leopards, it has been always a joint collaboration between all these different agencies. So this need to use multiple resources of NSmen, the public and even the private medical sector applies to the medical expertise required by the SAF, because in contrast to the 5000 engineers that are produced every year. Singapore only produces 300 medical graduates and it is not possible for us to be domain experts in all areas. We have to attract top medical talent as regulars into our service to provide leadership and to oversee the system.

MINDEF and the SAF Medical Corps have recognised these limitations long ago, and is now reviewing our medical support system so that we can provide even better care for our national servicemen. Included in this review is the need to optimise the contributions of NS medical professionals to play larger and more important contributory roles in the daily operations of the SAF. The SAF Medical Corps is looking to deploying more experienced doctors, partnering NSF doctors, to provide better medical care in our camps, provide better supervision and timely care, especially in our training institutions. The review also seeks to find ways to enhance our emergency medical support system in the SAF by working with the Emergency Medicine Departments of our hospitals because we recognise that the medical personnel working in the hospitals day in day out, for example, in the Accident and Emergency Department, would just have more experience as they see larger numbers of patients. For us, the SAF, to upgrade our medical care, we really ought to be utilising their resources or working with them to learn from them. The SAF Medical Corps is therefore exploring ways to tap this expertise for the SAF.

Crucial in this review and in these endeavours is the goal to raise standards of medical care for SAF soldiers. We are doing this so that we can serve our NSFs and our NSmen better and take better care of them. Medicine is dependent on technology. Better medical care can only be achieved if the medical personnel are well trained. For example, in 2009, the SAF introduced the Emergency Medical Technician (EMT) Course - this was a 12-week entrance-level course conducted by SMTI and developed in collaboration with the Justice Institute of British Columbia (JIBC), one of the world’s leading educators for training pre-hospital care paramedics. And to ensure that every soldier can administer immediate life-saving procedures, we implemented the Cardio Pulmonary Resuscitation (CPR) and Automated External Defibrillator (AED) training since 2010 for all recruits. In addition, the SAF has been the stalwart of the Advanced Trauma Life Support (ATLS) training for the past 20 years. All SAF doctors are trained in the ATLS, so that they can provide acute trauma care in an effective way, whether it is in peacetime or operations.

We had to do more of these to take better care of our soldiers. The SAF will continue to upgrade the proficiency of our medical personnel. To this end, the SAF has been at the forefront in using medical simulation to provide realistic and value-added training. Simulation models were first introduced in the SMTI in 2005. But the first models were fairly basic. They looked like humans but they had basically features like breathing, pulse and oxygen saturation. And, if you remember, they were connected to wires. They were not quite remote. But today, the new MSTC is equipped with state-of-the-art technology, and I am sure you will have a look at it later. Human-like simulators now can play back various medical scenarios to train more realistically, comparable to the other advance militaries in the world, and reflects our commitment to utilise all available expertise and technology to build a world class medical system and support our soldiers through the toughest training and operations. But we can build these institutions, at the end of it, critically, it is human resource, people like yourselves. I know that many of you, even though you are very busy professionals, find it very important to give back your time and I want to thank you. I also want to thank our MPs who have been taking part in constructive feedback.

So I have just a few words to say, to thank you, and to also give support and I am hereby pleased to declare the Medical Simulation Training Centre open. Thank you.

More Resources

• SAF Unveils State-of-the-Art Medical Simulation Training Centre