Speech by President Halimah Yacob at the International Council of Nurses Congress

Mr Gan Kim Yong, Minister for Health, Singapore

Ms Annette Kennedy, President, International Council of Nurses

Associate Professor Lim Swee Hia, President, Singapore Nurses Association

Distinguished Guests

Good evening. Firstly, thank you for the wonderful display of your national costumes. I am pleased to join you at tonight’s International Council of Nurses (ICN) 2019 Congress, hosted by the Singapore Nurses Association (SNA).  Let me first take this opportunity to congratulate the ICN on its 120^th anniversary.  I wish you many more years of strong leadership and contribution to the international nursing community.

Singapore is honoured to play host to this largest international gathering of nurses across national and regional borders.To all the nurses who are with us during this week’s Congress – welcome to Singapore!I hope you will find your learning experience and stay here fulfilling and enjoyable.

Nursing lies at the core of healthcare. In all healthcare systems, nurses typically make up the largest profession. Nurses play a wide range of important roles, including caregiver, care manager or coordinator, patient advocate and educator.To the patients and families, you are also their friend, confidant and informal source of advice and emotional support.

While the core role of nursing in healthcare will not change, the practice of nursing will continue to evolve in tandem with changing needs and developments in healthcare.In particular, three major driving forces will have a major impact on nursing in the coming years - demographic changes; shifts in healthcare delivery and financing systems; and technology advances. Let me elaborate.

It should come as no surprise that many nurses are seeing older patients. The phenomenon of longer life expectancies and ageing populations is a common one across the world today. According to the World Health Organisation, by 2020, the number of people aged 60 years and older will outnumber children younger than five years.While longer lifespan is something worth celebrating, we also know that as people age, they will have a greater need for healthcare, especially for chronic diseases.Countries will need many more nurses.Especially nurses who understand the conditions and issues faced by older patients and are able to communicate with and help them.

Here in Singapore, this situation is even more acutely felt. According to a study on “The Burden of Disease in Singapore, 1990-2017”, Singaporeans are living longer but not necessarily healthier lives. This is why we have gone on a major effort to recruit nurses.In 2013, the Ministry of Health launched a campaign named “Care to Go Beyond” to raise public awareness of the wonderful work that nurses do and elevate the profile of the profession in our society. From outreach activities at schools and community events, to social media publicity and a local television drama series on nursing, the campaign illustrated the impact and possibilities of a career in nursing.Beyond looking at the young, the Ministry also introduced Professional Conversion Programmes to help mid-career professionals to make a switch to nursing, especially for those who are retrenched from their jobs.

I am pleased to note that these efforts have borne some fruits.In the five years, we have seen a 30 percent increase in the nursing student intakes.As the demographic shift and increase in demand will march on, we must continue with our efforts.I am certain that other countries have similar examples to share.

In the face of changes in demographics, disease patterns and citizen expectations, many countries are transforming their healthcare delivery and financing systems so as to provide accessible, affordable and effective healthcare to citizens in a sustainable way.As the backbone of healthcare systems, nurses will play a big part in any such transformation.The practice of nursing will inevitably be affected.

Singapore for example has set out to transform our healthcare system in three ways.

First, we want to move “Beyond Healthcare to Health” and invest more in health promotion and disease prevention.I notice that this is incidentally the theme for this Congress. Second, we are working to move “Beyond Hospitals to Community” and deliver more care in community settings closer to our citizens’ homes. And finally, we are looking “Beyond Quality to Value” to encourage evidence-based practice, appropriate care and productivity improvements.

We see our nurses playing critical roles in bringing about each of these shifts.For example, new and innovative nursing services will be required.Many of these services will be more community and home-based; more holistic and person-centred; and more focussed on health promotion and disease screening.

For this reason, we have been developing more nurses in the community care sector in Singapore.Some of our efforts include piloting new community nursing services, developing a systematic competency framework for community nursing, and inculcating community nursing exposure in nursing schools and nursing leadership development efforts.

Technology can be an enabler for nurses and nursing.For example, effective patient monitoring and information recording devices can relieve their burden, and enable them to focus on more critical care tasks.The use of electronic patient records has not just made patient information much more readable, but also made team-based and continuity of care possible.Advances in telehealth technologies can bring nursing care closer to patients’ homes.

Based on my observation however, nurses in many healthcare institutions still find much of their time consumed by tasks related to documentation, patient transport, inventory management and ancillary services.More thus can be done. I urge all healthcare and nursing leaders to encourage more pervasive use of technology and redesign work to enable our nurses to focus their time and skills on core nursing care roles.You can also share with and learn from one another’s experiences through events such as this Congress.

In a changing world marked by structural demographic shifts, ongoing healthcare system transformations and rapid technology advances, nurses deserve more than a pat on the back. We must support our nurses in rising up to the challenges and seizing new opportunities. I would therefore urge all of you, whether you are representing a state, a healthcare system or an employer, to commit to nurturing your nursing workforce. Help them acquire new knowledge and skills.Create new career development and progression pathways.Invest in developing the next generation of nursing leaders.

To the nurses amongst us, I encourage you to play a part in shaping the future direction for the nursing profession. Contribute to the many national level nursing taskforces and future nursing career reviews, so that you can add to depth of the deliberations and robustness of solutions.

Each year in Singapore, the President confers the President’s Awards for Nurses to recognise the most outstanding nurses who have gone far beyond their call of duty.This is one event which I personally look forward to. I recall that I used to serve on the selection panel for the Award years ago and the interviews were always very memorable.The stories behind each year’s awardees and their nursing colleagues, which are by no means atypical, never fail to move me.

They reinforce to us the essential role played by nurses in our lives.They reinforce to us that nursing requires not just deep skills and well-rounded personal attributes, but also passion, resilience and stamina.That being a nurse requires a strong and caring heart.So to all the nurses amongst us this evening, thank you for putting your heart into serving us each day!

In closing I would like to paraphrase this quote whose origins are unknown. “Save one life, and you’re a hero. Save a hundred lives and you MUST be a nurse”. It is an honour to be among so many heroes this evening. I salute you and wish you all an enriching experience at this international superhero congress.

Thank you.