Commissioner Eric Yap
Mr Loh Ngai Seng, Second Permanent Secretary MHA
Colleagues from the Home Team
Partners and Friends
1. A very good morning to all of you. As SCDF looks back on another year, I think they can look back with satisfaction as it had performed extremely well. There was a public perception survey conducted at the end of last year - 99 percent of the respondents, which is nearly everyone, said that they were confident in SCDF's capabilities to deal with emergencies.
2. Let me give you an anecdote. Last week, I was in the US for a working trip. I was speaking with my counterpart, Secretary John Kelly, Department of Homeland Security. I laid out the context for some serious discussions. In that context, I talked about the public confidence in our Home Team. I said that 90 percent of our people expressed confidence in our Police Force, and 97 percent felt confident walking alone near a neighbourhood, and he was astonished.
3. It comes through years of hard work, discipline, and appropriate use of force. Here, the Police, Prisons, SCDF, are part of the solution, part of the partnership between the people and the Home Team.
4. For SCDF, really, this is testament of the professionalism, the standards and the sense of duty of our SCDF officers. Today, I will touch on four areas. First, the Emergency Medical Services (EMS), second, the new capabilities that SCDF is building, third, SGSecure and finally, national service, this year being NS50.
Transforming Emergency Medical Services
5. We are transforming the EMS frameworkSince the year 2000, the number of '995' calls has been increasing at about 6 percent. Last year, SCDF handled about 180,000 calls, 500 every single day, and our population is ageing. We have 12 percent elderly now, which will be 25 percent by 2030. However, 40 percent of our EMS calls relate to the older population. So you can imagine how it is going to explode in thirteen years.
6. SCDF has been planning ahead.I It has been putting in resources to increase EMS resources. But really, increasing resources alone to meet that demand is not a sustainable approach. So, we have to review the EMS framework. We will revise our approach, the speed at which we respond, the type of situations to which we respond. These will be calibrated depending on the nature of the case so that the resources can be best channelled to respond to the cases which actually need the response immediately.
7. These changes will be implemented in a few places over the next few years. From 1 April this year, two changes have been made. First, the triaging of '995' calls, we have been doing that but there will be better triaging to assess immediately the severity of cases. The call centre operators are supported by staff nurses from hospitals, who can provide medical advice and instructions to callers on how to perform CPR remotely even before the emergency ambulance arrives.
8. Second, for critical emergency cases, our firefighters are now trained to double up as Emergency Medical Technicians (or EMTs), on the bikes.They are on the spot before the ambulance arrives. They will be deployed to augment SCDF paramedics.
9. In the subsequent phases as we roll this out, we will make changes to the way which we respond to critical cases. We have to prioritise resources for the most severe, most critical cases. Let me give you an illustration – take three types of cases.
10. You have a cardiac arrest or stroke where effectively every second counts and the resource has got to be there in the fastest possible time. If that resource or the ambulance is attending to someone else, for example with chronic cough, then you are taking away that resource from someone who may be suffering a stroke and that is a life lost. We have to be firm about this and give critical cases top priority.
11. In these sorts of cases, in the most critical cases, SCDF will dispatch paramedics in an ambulance as well as a firefighter who is trained as an EMT, who will respond on a fire bike. The fire bikes can reach the incident site faster, and try to stabilise the casualty in the first few minutes. That is critical, even before the ambulance gets there. In life-threatening conditions, those few seconds could make a difference.
12. The second scenario, which often happens, require basic first aid treatment, such as cuts with bleeding, or accidents with bruising. They are not going to die from these situations and we do not need to give the same priority as we would to the first type of cases. We can dispatch our EMTs, they are on the bikes, they are trained to give first aid and independently manage those situations and assess if an ambulance is needed. If an ambulance is not needed, we will not need to dispatch an ambulance.
13. Third type of situation, we get a lot of calls, for example for chronic coughs and constipation. How many calls? 10% of our '995' calls fall under this category. Last year, there were 19,000 such calls. That is a lot and it is putting a strain on resources. Every time we respond to this, it takes away our ability to deal with an actual emergency. For these, under the revised EMS response framework, we will advise them to seek outpatient treatment. If they insist on visiting a hospital, they can make their own arrangements, call for a private ambulance or other sorts of medical transport services.
14. The public may not immediately understand why we are making these changes. So I think it is incumbent on the Home Team, SCDF, to really get the message across. I've asked the Commissioner and SCDF to put in resources and focus on communicating this. A lot of this depends on proper communication, why we are doing this. When I explain it this way, people will understand. That explanation has got to come across to those 10% of callers, those 19,000 calls where people are calling and expecting SCDF to respond. The 99% of people who have confidence in the SCDF also then references back to the fact that they expect you to solve all their problems so that is why they have confidence. So, there is a reverse side to it as well, and we have to manage that, without affecting the mind-share. We have to try and say, look there is a way in which this has to be managed.
15. We are expanding our EMS manpower and fleet. However, if we do not manage the demand side of it, I think it will overwhelm us as the years come. No amount of resources we put in will help us handle this.
16. We will put in safeguards. The triaging and assessment framework is developed by a team of senior emergency medical doctors. We will train the call centre officers, enhance the capabilities of the call centres, put in place proper, advanced IT systems, and supervision by experienced medical staff. That will allow the triaging to be done as accurately as possible.
17. Where there are uncertainties over the exact condition of the patients, SCDF will take a cautious approach, deploy their resources on-site, better assess the severity and not take the chance and render the treatment where required. That is on our recalibration of emergency response.
Building New Capabilities
18. Let me now turn to building new capabilities. SCDF is constantly innovating and has been recognised for its innovation. Two years ago, in 2015, it was awarded the Singapore Quality Award with Special Commendation. Last year, SPRING awarded SCDF the prestigious Innovation Excellence Award. It is the first public sector agency to win prestigious Business Excellence Awards in two consecutive years.
19. That high tempo of innovation has been continued and today, they will be launching the New Fire Medical Vehicles, as well as the Rapid Response Fire Vessels. It will enhance the ability to deal with land-based firefighting and maritime firefighting capabilities. They have been designed by SCDF. The Fire Medical Vehicles are purpose-built and they combine firefighting capabilities with patient cabins. So it provides SCDF the additional operational flexibility to take the victims to the hospital, without having to call for an ambulance.
20. If you look at the new Rapid Response Vessels, they can reach speeds of more than 40 knots, so it allows SCDF to respond much faster to maritime fires and also conduct rescue operations in a maritime environment.
21. Beyond that, SCDF will embark on a manpower transformation plan. Over the next few years, significant resources will be invested to revamp our training facilities and build new training facilities at the Civil Defence Academy (CDA). This will give our officers the possibility of enhanced, realistic training, to really yield different types of emergency situations on the ground.
Supporting SGSecure
22. Let me now turn to the third point, SGSecure. We have talked about the threat of terrorism, and the need to prepare our population, psychologically and also training them so that they feel they can do something when they are caught in a situation. Even as SCDF and Police respond, no matter how quickly, we are still better off if people on the ground are able to help themselves and help others in those few minutes before the security forces and SCDF forces arrive. Therefore, we have been conducting these massive, islandwide exercises, bring the message of SGSecure across and train as many people as possible.
23. In that context, SCDF has worked with MOH to introduce a new programme called DARE, "Dispatcher Assisted first Responder". DARE is a short, concise, 40-minute training programme that teaches the community how to perform CPR and use the AED, to revive cardiac arrest victims. The pilot phase, the Save-A-Life initiative, was in six constituencies<[1], and about 2,000 people have been trained.
24. Later this year, SCDF will partner MOH and make it DARE Plus. It will be a one-hour programme and include the 'Run, Hide, Tell' advisory that we have rolled out, improvised first-aid skills and also how to handle fire extinguishers.
25. SCDF targets to train at least 300 residents from every constituency within the next three and a half years, by end 2019 – 300 in every constituency. That is on top of about 40,000 people who are trained annually in CPR and AED by SCDF, as part of its community programmes.
26. The messaging on SGSecure will be constant on the ground, getting our officers to walk the ground, knocking on doors, over and over again, community events and outreach events. I think over time, we will have a population that is more aware and hopefully, more prepared.
Creating a More Meaningful NS Experience
27. Finally, let me turn to NS50. This year is a critical year, the 50th anniversary of NS. Our NSmen play an important role, right next to our regular officers. SCDF is looking at enhancing the roles that our NSmen will play by deploying more and more of them in frontline positions.
28. SCDF will enhance the roles that NSFs will play in the Special Rescue Unit. The Special Rescue Unit was formed after 9/11, with its main role to provide mass casualty incident support. The unit will now be trained to deal with a wider range of incidents – it could involve fires at vegetation, warehouses and oil tanks.
29. Secondly, apart from training them to handle a wider range of challenges, SCDF will also create more leadership positions for NSFs. Those who perform well can expect to take on supervisory roles. Operationally-ready NSmen will also be given opportunities to assume senior leadership appointments, including being Deputy Division Commanders. That would be challenging and also encouraging, and something that they can aspire to.
30. By doing this, and better tapping on our NSmen, both full-time and operationally-ready, SCDF's operational capabilities will be sharpened significantly and our NSmen will also find it a more meaningful NS experience.
31. This year being NS50, the Home Team is organising a series of events throughout this year to commemorate NS50, and pay tribute to generations of SPF and SCDF NSmen who have served the country with utmost dedication and professionalism.
32. We kick off today with the Home Team Show and Festival at the Singapore Sports Hub, with the finale at the end of this week. The five-day event will showcase how Home Team officers, including NSmen, work together with key stakeholders, with people, to keep our homes and communities safe and secure. That's what this Home Team show will bring across, hopefully, to a very large number of persons. We hope to achieve that.
Conclusion
33. The coming year will be quite exciting, quite challenging, lots of work. SCDF will embark on a series of initiatives to prepare itself for the challenges that it faces. You have heard about the transformation journey. It's going to be a long one, but we have started it, and this is something that unless you keep working at, it will stall. So you will have to keep pushing, and we will keep pushing, partnering the community, changing the way we work, to really make it succeed.
34. I get the sense that there is buy-in, we now all accept that there has got to be this transformation. People on the ground, officers on the ground, are waiting to see what it actually means, and as they see the transformation being rolled out in tangible terms, I think there is greater and greater acceptance.
35. I am confident that our officers in the Home Team will rise to the challenge. They have always done so, and will continue to uphold the Home Team values of Honour and Unity to safeguard the safety and security of Singapore.
36. Thank you very much.
[1] Bedok, Bukit Panjang, Choa Chu Kang, Radin Mas, Pasir Ris West and Tampines West.
