Be Like the Ox

By Khaw Boon Wan

Mr Baey Yam Keng, Mr Tan Chin Siong, Members of Parliament, Tanjong Pagar GRC
Mr Bernard Chen, Chairman SingHealth
Distinguished guests, ladies and gentlemen

1. This event marks the 46th year of the establishment of Queenstown Polyclinic and its re-opening after being rebuilt on a new site. I am pleased to see how much polyclinics have evolved over the years, to serve Singaporeans better.

2. Together with GPs, our polyclinics have kept our standard of primary healthcare high. This is not easy as Singaporeans have ready access to affordable specialists in hospitals. Many have tended to bypass GPs and polyclinics by going straight to the hospitals and the Emergency Departments.

3. GPs and polyclinics have therefore to work harder to reach out and to explain their roles better to the public. You are there to look after the total health of the patients you serve; not just for the occasional coughs and colds.

4. Chronic sickness, for example, is best managed by GPs, in consultation with hospital specialists. This is the lowest cost solution with best results. If chronic sickness is largely managed at the hospital specialist clinics, the cost will be unnecessarily high for the patients. Hospitals, unlike GP clinics, may also be more inconvenient as they are not within walking distance of most Singaporeans.

More innovation

5. Within the primary healthcare system, our polyclinics play an important complementary role: besides looking after the poor, polyclinics break new ground by piloting new delivery systems. For example, managing chronic diseases or electronic health records which hopefully can be the industry standard for the GPs to adopt.

6. I congratulate Dr Tan Chee Beng and his team on establishing valuable partnerships with both the hospitals and the GPs. Hospitals, Polyclinics and GPs serve the same customer pool and it is important to keep the healthcare sector tightly-knit; this will serve our patients more effectively and at lower costs. There is still much that polyclinics can do to innovate and to try out new delivery models.

7. This new Polyclinic, for example, has incorporated a Community Wellness Centre to allow it to take on larger roles in supporting mental wellness within the Queenstown community. I am also encouraging experimentation at the Jurong Medical Centre to see how far we can go in reshaping healthcare at the community level. The Alexandra Hospital team led by its CEO, Liak Teng Lit, is trying out various ideas there. Some may prove unsuitable, but others may turn out useful.

8. We should not be afraid to try new things and to innovate. Or there will be no progress. My vision is that we will have a diverse range of polyclinics and other alternatives to meet patients’ diverse needs, but all competing to raise standard of care while keeping charges affordable.

9. Just like our libraries, each new polyclinic must be better than the one they replace. Or we would have missed the opportunity to bring about improvements. I expect the rebuilt Queenstown Polyclinic to be very different from the old Queenstown Polyclinic I visited 25 years ago, and also to be a further improvement from the Woodlands Polyclinic which I recently re-opened. I look forward to the tour later on.

Facing economic downturn

10. Meanwhile, I know the recession is on the minds of many Singaporeans. This has cast fears of pay-cuts or worse, retrenchment. Many are worried about the burden of supporting their loved ones should they fall ill. The chronic sick are concerned about being able to cope with the costs of long-term medication.

11. I am mindful of these concerns. Let me assure Singaporeans that basic healthcare in Singapore is affordable to all, in both good and bad times. Our 3Ms healthcare financing model is designed specifically for this: we save in Medisave regularly and build up Medifund during good times, so that we have the funds to pay for healthcare during bad times. In this way, essential healthcare services do not have to be postponed or cancelled because of financial hardship. Singaporeans therefore do not need to worry.

12. In bad times, my Ministry work even harder to deliver on this promise. In recent months, we have implemented a series of new initiatives to particularly help Singaporeans cope with healthcare costs during these difficult times. Let me highlight some of them.

More financial aid

13. First, we have enlarged Medifund so that it can help more needy patients. This year’s budget for Medifund disbursements is $74 million. This is a very substantial increase of nearly 50% from last year’s allocation. I have also asked our various Medifund committees to be on the look out for deserving cases. They are compassionate people with a big heart and I am confident no needy Singaporean will fall through this safety net.

14. Second, we have relaxed the eligibility criteria for the Primary Care Partnership Scheme (PCPS). Patients with monthly household income of $800 per capita are now eligible for PCPS. Previously, the threshold was set at $700 per capita. With this change, 80,000 Singaporeans can potentially benefit from PCPS.

15. Third, we have expanded the scope for PCPS to cover three common chronic diseases – Diabetes, Lipid disorders and Hypertension. Previously, PCPS only covers acute illnesses, like coughs and colds. With this change, needy elderly Singaporeans can now receive subsidised care from their GP, and being charged at rates similar to those charged in polyclinics.

16. As there are many more GPs than polyclinics, the patients will find this convenient, besides saving on transport cost as most GPs are within walking distance of their homes. MOH will in turn subvent the GPs and effectively help pay the bills incurred by the patients.

More job opportunities

17. Fourth, MOH will help create job opportunities for Singaporeans. Last year, I have announced our plan to significantly raise the staff to patient ratio in the restructured hospitals so that patients will have more consultation time with their doctors and waiting can be reduced. We had committed to expand our pool of doctors, nurses, pharmacists and allied health professionals by 40% by 2012. This means an additional 4,700 well paying jobs. We have decided to bring forward this plan as fast as what the labour market can support. The political will is there, the budget is there. What is missing are people with appropriate skills. We will accelerate and intensify recruitment.

18. In addition, we are expanding our capacity, adding new hospital beds and clinics. KTPH is opening next year, while AH will stay open until the new Jurong General Hospital opens latest by 2015. This means an additional 1500 jobs to man the new capacity. In total, we are talking about 6,200 jobs to be filled. Of these, 4,500 jobs have to be filled within the next 2 years. Many are for healthcare professionals like nurses and pharmacists. But many are also for administrative and ancillary staff such as counter staff, accounting staff and telephone operators which staff from other sectors can fit in, after relevant skills upgrading.

19. Fifth, MOH will expand mid-career conversion opportunities for those who are retrenched or have been working in the other sectors. They may want to make healthcare their career instead. We have been working with the Workforce Development Agency (WDA) on this for mid-career switch to nursing. We will now expand the scheme to include other professions, especially those in the allied health sector, like therapists, radiographers, pharmacy technicians and healthcare assistants. Their training costs will be heavily subsidised and they will also receive allowances during training. Upon graduation, they will have a job waiting for them. For 2009, we have budget to fund about 250 mid-career conversion opportunities. But we hope there will be stronger demand than this and if so, we are prepared to support more.

More training opportunities

20. Sixth, we are increasing the number of scholarships for students interested in healthcare. This year, we are offering 250 local and overseas scholarships for various allied health disciplines. This is a significant increase from the previous year and includes the new scholarship we introduced last year for polytechnic graduates to pursue a one-year degree conversion course overseas. Again, we are prepared to do more, if there is stronger demand.

Staying healthy and united

21. We are monitoring the situation closely and if necessary, will launch other initiatives to help Singaporeans cope with these trying times. Several ideas are being discussed within my Ministry. For example, I am actively studying how Medisave can be further liberalised to help reduce patients’ out-of- pocket cash expenses. We can discuss this further during the upcoming Budget Debate.

22. But Singaporeans too have important roles to play. They should keep fit and stay healthy. They should certainly stay away from harmful habits such as smoking, over-eating and excessive drinking.

23. The year of the Ox will be challenging. But like the Ox, we should have the patience and the perseverance to endure the trials of this economic slowdown. During this difficult time, some people may find themselves suddenly out of a job. Quite naturally, some fall into despair, become withdrawn and even fall sick from worrying. Don’t. The economy will improve with time. We have been through this several times before.

24. I was very inspired to hear of people who in the worst of times, took opportunity to reappraise their lives, use their suddenly, unplanned and unwanted, available free time to get in shape physically and intellectually and came out even better from the ordeal.

25. Last month, the Straits Times told such a story of 58-year old Mr Michael Chong. He spent thirty years of his career working in the bank, “thinking that it was an iron rice-bowl”, but was suddenly retrenched 6 years ago. Instead of lamenting his fate, he went to a job fair and the orientation at the HMI Balestier Hospital got him interested in nursing. He signed up for a 3-month basic nursing course, fully paid for by Spring Singapore. Mr Chong is now a senior healthcare assistant in the renal ward of NUH, “counting pills instead of money” as he joked about his career change.

26. He told the Straits Times: “It has been 5½ years and I am still loving it. I think I will definitely stay on until I retire.” He offered this advice to Singaporeans: “I kept an open mind and found that there is life after that golden handshake … My advice is don’t dwell on having lost your job, then you will be able to ride that second wind. I did”.

27. The recession will not overwhelm us. Sooner or later, it will pass. We will emerge from the crisis, stronger and more resilient, just as we did in past crisis like the SARS of 2003. This, I am absolutely confident.

28. Finally, let me congratulate the management and staff of SingHealth Polyclinics on the re-opening of Queenstown Polyclinic. I wish all of you a very Happy and Healthy New Year.