Ministry of Health's Addendum to the President's Address

13 Jan 2005

By Mr Khaw Boon Wan , Minister for Health

Venue: Parliament

The Ministry of Health aims to ensure that good and affordable healthcare, appropriate to needs, is available to all Singaporeans, in addition to protecting public health. New challenges, including emerging diseases and rising lifestyle illnesses, demand fresh and bold ways for delivering and financing healthcare. The Ministry will pursue its objectives in collaboration with all healthcare partners. We will focus on the following initiatives.

STRETCHING THE HEALTHCARE DOLLAR

The affordability of healthcare is a major concern for Singaporeans.

Strengthening the 3M Framework

The Ministry will strengthen our 3M (Medisave, MediShield and Medifund) framework to help Singaporeans pay for their share of hospital bills after Government subsidy. In particular, the Ministry is reviewing MediShield and the role of insurance in paying for healthcare costs. This will relieve Singaporeans from the financial burden of large hospital bills.

Medifund provides a safety net to help Singaporeans who are unable to pay for their medical expenses despite heavy subsidies, Medisave and MediShield. Its capital sum has been steadily built up to $1 billion. We will periodically top it up when conditions permit, so that Medifund remains adequate for our needs.

Managing Medical Inflation

New scientific advances are improving medical care but driving costs up. The Ministry will help contain medical inflation without compromising the quality of patient care. We will use market forces, where appropriate, to manage medical costs, for example through publishing bill sizes and quality indicators. This will allow Singaporeans to make informed choices on where to seek treatment and provide transparent benchmarks on the comparative efficiency of healthcare providers.

Our public healthcare providers will review and standardise clinical practices. They will raise labour productivity and streamline operational processes to eliminate waste, such as cutting down unnecessary visits and tests. Patients, on their part, will need to moderate their expectations as there are limits to improving standards without cost increase.

Means Testing

Currently, the Ministry subsidises large portions of Singaporeans' hospitalisation bills, especially for B2/C patients. To better target our subsidy dollar for those in greatest need, we will implement simple means testing for inpatient services, while ensuring that all Singaporeans will be able to access and afford healthcare if they need it.

DEVELOPING A PATIENT-CENTRIC HEALTHCARE SYSTEM

Healthcare must be centred around the patient. This ensures the most appropriate care for the patient, and helps contain healthcare costs.

Building a Healthy Population

The first priority is to ensure that Singaporeans stay healthy, thus avoiding costly treatment. The Ministry will intensify its national programmes to prevent diseases, and to educate and encourage Singaporeans to take personal responsibility for their own health - to eat wisely, exercise regularly, manage stress, maintain good public and personal hygiene, and not smoke.

Managing Patients Holistically

The Ministry will promote the holistic management of patients instead of episodic illness care, through early detection, intervention and proper control of risk factors for chronic diseases like diabetes and hypertension.

Primary care providers play a crucial role in this effort. Our GPs and polyclinics must serve as the first point-of-contact and be the main gatekeepers to ensure proper and right-siting of care. The Ministry will, through improved training, build up their capabilities to more effectively manage chronic diseases, including diabetes, obesity and asthma. Singaporeans benefit when they have good family physicians who help them actively manage their own health.

The involvement and integration of other healthcare providers in the community, including nursing homes and community hospitals, are key to the right-siting of care and the holistic management of patients. The Ministry is launching Jurong HealthConnect, a community-based healthcare delivery model in Jurong. We are also planning a new hospital in Yishun to be the central node for a comprehensive and user-friendly health ecosystem in the north.

IT - A Key Enabler

Information Technology (IT) will be a key enabler. The Ministry will accelerate IT adoption to integrate our various healthcare providers through the seamless flow of information. This will improve efficiency, co-ordination and care delivery.

Towards Medical Excellence

Beyond IT and systems integration, striving for medical excellence and safeguarding medical standards remain fundamental to the success of any healthcare system. The Ministry will develop its healthcare manpower, ensuring that training is up to date, while increasing the supply and quality of medical and paramedical talent from local and foreign sources.

To raise the supply of talent, the Ministry will work with the National University of Singapore to start a second medical school. We will further free up the recognition of medical degrees from established foreign universities.

Nurses can play a larger professional role. The Ministry is transforming the nursing profession, through job re-design, local nursing degree programmes, and expanded responsibilities for nurses with higher qualifications. We will continue to recruit foreign nurses to meet local shortages. For those who are deserving, we will grant accelerated PR status or citizenship.

The Ministry will also develop our clinical capabilities and improve the quality of patient care. Through our Health Services Development Programme, we will continue to pilot new health services and medical capabilities.

TACKLING INFECTIOUS DISEASE OUTBREAKS

SARS highlighted the dangers of infectious diseases. Our success in dealing with the outbreak reflected the resilience of our public health system. The Ministry will stay vigilant to respond to infectious disease outbreaks, even as we formulate new measures to control the rise in communicable diseases like HIV.

While HIV has not struck our population in a big way, the number of new cases has steadily risen. At present, the infection is mainly confined to small groups of individuals who engage in high-risk behaviour. We must not allow these individuals to infect their spouses, children or others. The Ministry will strengthen is prevention and control efforts, to ensure that HIV does not become a major public health problem.

SINGAPORE MEDICINE

With rising demand for quality healthcare across the region, and given our reputation, there is significant potential for Singapore to be a medical hub. Through SingaporeMedicine, we will partner EDB, IES and STB to realise this economic potential.