The masterplan for the massive makeover of Singapore General Hospital (SGH) is an ambitious attempt to keep pace with demographic and medical change. It will not be easy to keep Singapore's oldest and largest hospital running smoothly while making extensive changes at its Outram site. But the redevelopment over 20 years has to be undertaken if SGH is to retain its special position in the country. Its healing role in contemporary Singapore, a history which began just two years after the founding arrival of Stamford Raffles, will be amplified as the amount of space devoted to patient care at the SGH campus, which includes five speciality centres, is progressively tripled.
Inevitably, some of the particular plans for SGH's relocation and expansion will change over two decades. This has occurred before, as when its redevelopment plans changed direction to focus on high-rise construction in order to maximise the use of space in land-scarce Singapore and also in line with shifts in thinking on how best to operate hospital services most efficiently.
Critically, medical and support services must not be compromised during the logistical transition demanded by a massive revamp. The fact that the Accident and Emergency Department will acquire a new interim building, to cope with rising demand, reveals an eye for immediate detail in the midst of the gigantic effort to remake SGH. That the Cancer Centre will occupy a central place in the makeover attests to the expected rise in demand for cancer care as better treatment translates into longer lives for patients who will depend on follow-up care. Balancing the insistent needs of the present against the emerging needs of the future will be an important part of SGH's mandate.
Patients, visitors and staff might find temporary moves somewhat challenging during the different stages of redevelopment. However, that is a necessary price of change seen at major hospitals everywhere as they strive to keep up with new times. Some have used rebuilding opportunities to employ design strategies to reduce stress and safety risks, and improve on the efficiency of conventionally designed, modern hospitals. SGH too should innovate to justify its historical pre-eminence and to better fulfil its vital role as a teaching hospital.
As the population grows, and people live longer because of medical and economic advances, both the young and old alike will expect higher and yet affordable standards of medical care. New treatments will be found for old ailments, but new diseases will appear. Medicine, as one of the most important sources of physical succour available to mortals, will be drawn increasingly into the competing orbits of a material profession and a moral vocation. SGH must strike a viable balance between these forces as it grows physically.