Prof Satku, Director of Medical Services, Ministry for Health, 

Dr Adela Tow, Chairperson Tetraplegia Work group
Mr See Cher, President, The Society for the Physically Disabled

Ladies & Gentlemen

Good morning.

Introduction

Welcome to the workshop on spinal cord injury, appropriately titled “Re-integration, Let’s Make it Happen”.

On behalf of the Tetraplegia Workgroup, The Society for the Physically Disabled and all the participants, we would like to thank Prof Satku, Director of Medical Services for taking time off his busy schedule to be present at today’s workshop. Your presence, Sir, reaffirms the Ministry of Health’s broad direction to better tap into community resources to augment the whole healthcare delivery system.

This Workshop is made possible by a team of representatives from the Tetraplegia Workgroup and SPD staff. It is also made possible with the support from Ministry of Community Development, Youth and Sports. We would like to express a big thank you to the Ministry.

This morning, we will also see the launch of the public education material on spinal cord injury. With the variety of breakout sessions planned, the Workshop is certainly going to be informative and useful for the clients, professional and administrative staff working with people with spinal cord injury.

Community Rehabilitation

SPD is committed to develop its professional therapy service as a step down facility to complement acute care hospital services. The traditional acute and sub-acute rehabilitation services are largely carried out in the hospitals (acute/community). We saw the need to develop a quality rehabilitation service to complement the healthcare system.

In 2002, we set up our rehabilitation centre with the help of Singapore Power. In 2004, SPD bid successfully to be a Therapy Hub to support community service providers. SPD rehabilitation service is staffed by professional therapists. With the Therapy Hub we are able to have economy of scale to have a good training curriculum and supervision to maintain a strong team of professionals. This will certainly lead to better service standard and outcome.

To further streamline our programme to better serve our clients, we decided to have special tailored programmes for our key groups of clients; spinal cord injury is one of the key programmes. We are glad to work with the Tetraplegia Workgroup on this programme.

Hospitals can have the confidence that the rehabilitation services in SPD are comparable to that in the restructured hospital. In fact, 60% of our rehabilitation clients are direct discharge from the hospital; where in the past these patients would be placed on the long waiting list of the hospital outpatient rehabilitation.
Step down facilities provided by community service organisations such as SPD can help to free resources at hospitals for more acute patients and also reduce the length of stay for the patient in the hospital. This leads to saving of cost for both the patient and the hospital.

Spinal Cord Injury: Reintegration

Having quality therapy service is important but the real value add is to have fully integrated community rehabilitation service that takes care of the social, mental and physical rehabilitation of the client. Community service providers carry a host of other related services to provide a holistic rehabilitation plan for the patient which will lead to better integration.

In SPD, we are able to provide this. Besides the rehabilitation services, we provide social support, financial support, assistive technology services, work training centre, sheltered workshop and employment/placement all under one roof. Clients with spinal cord injury will require all the above services.

Thus full service centres like SPD can certainly complement the healthcare delivery system of rehabilitative care especially for clients with spinal cord injury, stroke and even diabetes amputees.

Case example: Norsilawati

I wish to quote an example of how community service providers can complement our healthcare system.

Miss Norsilawati’s life changed drastically during an ill-fated trip in Australia in 2001. She was a backseat passenger in a car driven by a friend when the car skidded and overturned on the road. She was admitted to a hospital in Australia before being transferred back to Singapore and warded in SGH. From there, she continued with TTSH rehabilitation centre for a prolonged period of 9 months.

She was referred to SPD Rehab Center in 2003 where she received physiotherapy and occupational therapy to help her improve her upper limbs and hand functions, independence in daily activities such as wheelchair transfers, bed mobility.

With the improvement in rehabilitation aspects, she was placed at the SPD Multi Media Centre (MMC) for vocational training. SPD MMC provided her with various computer courses during her attachment in MMC in order to upgrade her knowledge in computer usage and today she is part of the SPD Web design team.

She had certainly benefited from SPD Rehabilitation services and Vocational Training in MMC, which will prepare her for a possibility of open employment when the opportunity arises.

You probably have read of the recent Straits Times report on shortage of beds and resources in Tan Tock Seng Hospital, and you will agree that Norsilawati could have received equally quality care at a step down community facility immediately after her condition had stabilized. This would have allowed the scare resources in hospital to treat more acute and critical cases.

In fact from our experience, people with spinal cord injury or any of the more complex physical disabilities are better integrated into society/community if they receive more comprehensive support early. There is a need to rehabilitate the clients early and more intensely in the early stage. Thus SPD would like to propose to MOH to consider tapping on professional therapy step down facility to complement the hospitals especially the hospital outpatient rehabilitation services.

At this juncture, I am happy to share that SPD is in the midst of working out a joint care plan and case management with hospitals starting with Singapore General Hospital.

Conclusion

Norsilawati has demonstrated the determination and strength to make the best of her life. This spirit really spurs the community service providers to do more and to better support patients who require physical rehabilitation including the elderly and especially those with complex physical disability like spinal cord injury.

Finally, we hope all participants will have a good morning ahead. And we thank Prof Satku again for gracing our workshop and hope he will also consider seriously our proposal to complement the healthcare delivery system to better serve people who require physical rehabilitation.