SPEECH BY MR ONG YE KUNG, MINISTER FOR HEALTH AND COORDINATING MINISTER FOR SOCIAL POLICIES, AT THE 3RD SINGAPORE PRIMARY CARE CONFERENCE, 15 MAY 2026

Mr Cheng Wai Keung, Chairman of SingHealth  

Professor Ng Wai Hoe, Professor Joe Sim, Group CEOs of our healthcare clusters 

Dr David Ng, Associate Professor Karen Ng, Associate Professor Lew Yii Jen, CEOs of our clusters’ Polyclinics 

Dr Wong Tien Hua, President, College of Family Physicians Singapore 

Associate Professor Joanne Quah - thank you for organising this event. 

Colleagues, friends, ladies and gentlemen 

I am very happy to join you today at this year’s Singapore Primary Care Conference 2026, or SPCC 2026. 

2        This is our first SPCC since Family Medicine was formally recognised as a medical specialty and so this is more than symbolic. It affirms the vital work of family physicians and provides a clear pathway to specialist accreditation for those with advanced training. 

3        Since 1 November last year, more than 220 Family Medicine Specialists have been accredited by the Specialists Accreditation Board. This is about 80% of all Fellowship-holders in Singapore, and it is an encouraging start. 

4        I hope more family physicians and GPs will get accredited as specialists over time. But recognising Family Medicine as a specialty is one of many changes in the primary care system.  

5        As David has mentioned, you are at the tipping point of the transformation. But tipping point seems to suggest you tip over and suddenly it changes everything. I think it is more an inflection point, so not so sudden as tipping over. The primary care system is indeed changing fast and it has to change, because of shifting demography. As our population ages, we must build a healthcare system that lasts and is sustainable. So we are shifting care upstream – towards prevention, and anchored in the community and closer to where people live. Primary care is at the heart of this transformation and this shift.  

6        Today I would like to talk about the key changes needed of the primary care system.   

One System, Two Sectors?  

7        Historically, primary care in Singapore functioned like “one system, two sectors”. While government-run polyclinics held about 10% of our primary care doctors, they shouldered close to half of the chronic workload. Conversely, private GPs which comprised the bulk of primary care doctors, handled most of the acute cases such as coughs, colds and fevers. 

8        It was not a satisfactory situation, and over the years we have worked hard to rebalance the respective patient profiles. For example. we set up the Community Health Assist Scheme (CHAS), and through CHAS, we extended government subsidies to GP clinics, so that the cost of seeing a GP would be more affordable and comparable to going to a polyclinic. We also established Primary Care Networks, where GP clinics band together to share resources, build capabilities, and support patients with more complex needs. Then, 2023 was a watershed year, as we launched Healthier SG, which depends strongly and actually primarily, on GP clinics to deliver primary care to the population. 

9        So today, the situation has improved and it continues to improve. Compared to before Healthier SG was launched, our surveys show chronic patients accounting for a higher proportion of GPs’ total workload. You can feel a real shift is underway – it is encouraging and we will have a clearer picture after our more comprehensive survey this year. The system is on the move, to become a more integrated primary care system where public and private providers work in concert and closely together.  

A Different Business Model 

10        As this shift gathers pace, it will affect GP clinics and I think at least in two significant ways. First, how GP clinics are sustained financially. Second, how care is being delivered. Let me start with the first aspect, the financial aspect.  

11        GP clinics are commercial entities, GPs need to earn a living and need to have enough revenue to cover their expenses. Under the old model, where GP clinics saw mostly acute cases, clinics sustained operations through consultation fees and medication mark-ups. 

12        This model is getting more challenging. As people become more health-literate, many will self-medicate with support from retail pharmacies. Those who are cost conscious may seek alternate sources for lower-cost medications. More employers also accept occasional sick leave without insisting on Medical Certificates (MCs); and where MCs are needed, telemedicine increasingly provides them. So a significant revenue source for GPs – medication mark-ups – is being squeezed and eroded without any government policy. It just happened because it is a market phenomenon.   

13        At the same time, the demand for preventive and complex chronic disease management is rising, and honestly the polyclinics cannot cope by themselves even as we build more of them and increase their capacity.  

14        As mentioned earlier, to mobilise the help of GP clinics, the Government introduced CHAS and Healthier SG, to encourage GPs to take on more preventive and chronic care. Under these schemes, MOH pays grants and service fees directly to GP clinics. These are a growing stream of revenue, for services that are making a real meaningful impact to the population.   

15        In 2022, Government payments to GP clinics were $230 million. In 2025, after Healthier SG was implemented, this grew to almost $350 million. This works out to an average of over $140,000 per GP clinic. 

16        Looking ahead, as we press on with preventive and population health, I believe this trend will continue and it needs to continue. This means that as revenue from medication mark-ups comes down and gets squeezed because of competition and other factors, it can be made up, or more than made up, by Government payments and service fees for population health.  

17        But to deliver more preventive and chronic care, clinics will need new capabilities – and new ways of working. 

An Improved Care Model 

18        This leads to the second area of major change, which is that GP clinics will have to deliver care differently. Many GPs are “solopreneurs”, with one clinician delivering most of the care. But chronic care – especially for patients with more complex needs – takes a team. 

19        Polyclinics realised this and have moved towards the “teamlet” care model, where chronic patients are cared for by a team of doctors, nurses, and care co-ordinators.  

20        A recent MOH internal study found that with teamlets, chronic patients were more likely to keep up with recommended screenings and follow-ups, leading to fewer complications over time. I don’t know why, but there’s a teamlet, I suppose more people nag them, and it works. Primary care costs rose slightly. So by running a teamlet model, the primary care costs per patient rise up slightly, but savings from fewer hospitalisations and specialist visits more than offset this. The study team will be making a fuller presentation of their findings later. 

21        GPs can also raise the quality of care by working in teams – which is why we established PCNs. PCNs can simulate a teamlet through GPs collaborating or hiring additional healthcare staff. But without major capital investment, it is difficult to access equipment that polyclinics have, such as X-rays, ultrasound, or retinal cameras. 

22        MOH will strengthen support for Healthier SG clinics by widening access to such services and equipment. We will have to explore ways to enable the GP clinics’ Healthier SG enrolees to better access subsidised ancillary and diagnostic services. We will think of ways, for example, could be through Community Health Posts (CHPs) or through polyclinic services, but this will have implications on workload, and we’ll have to phase in these changes progressively and over time.   

23        Beyond teams and equipment, and leveraging AI which has been mentioned in the earlier speech, GPs can also improve chronic care by tapping on stronger support in the community. This is in fact what we envisaged when we embarked on Healthier SG. GPs can show patients the pathways to better health. In many countries, there's also the concept of enrolees, but you enrol into a GP clinic, so that the GP clinic become a gatekeeper to hospital services. In our context, GP clinics, as they enrol a Healthier SG patient, is the pathway to community support rather than a gatekeeper. 

24        Over the past few years, MOH has invested in CHPs and Active Ageing Centres (AACs), where seniors can stay active, build social ties, and receive lifestyle counselling as well as frailty assessment and interventions. Agencies such as the Health Promotion Board and People’s Association are also rolling out more healthy lifestyle activities in the community. 

25        And GPs should make full use of these support systems, be part of these efforts, connecting residents to these healthy lifestyle activities. GPs can coordinate care with AACs or CHPs. It is not unimaginable. GPs can help to operate a CHP, or partner with a CHP to enrol residents in Healthier SG, conduct health screening and frailty management for seniors at an AAC. It’s a captive audience. AACs are always full of seniors. If you cooperate or to collaborate with an AAC, we can deliver care to all the seniors at an AAC. 

26        To unlock such possibilities, MOH has worked with HDB to rethink how we tender out new GP clinics in HDB estates, moving away from an approach that was only based on price, to one that gives significantly greater weight to quality of the care model.  

27        Over the past year, we have tendered out eight clinics through a Price – Quality Model, with a heavy emphasis on quality, and we received very strong proposals from bidders. Most of them had a clear understanding of multi-disciplinary chronic care and demonstrated commitment to doing so alongside community partners such as the AACs. This helps channel resources into providing better quality care, and dampens rental price competition. We all know there was a record bid some time ago, I think it was Tampines. But in the last eight tender, the winning price bids have been relatively stable – and at only a fraction of the record high price bid registered last year. 

Closing 

28        The future of healthcare is not in hospitals alone nor polyclinics alone. It is in the community. It is in prevention. It is in population health. And it is in the relationships you build with patients over time. There is a great opportunity to anchor more patient care in primary care, and especially amongst our GPs.  This is a foundation that we need to lay, for a healthier Singapore and a more sustainable healthcare system. And there is still a lot to do.  

29        Let me end by thanking all our healthcare workers here, all our family physicians, for your commitment and compassion. Your mission is noble. Your work is getting more, but we count on all of you. You are a steady, trusted presence in all our patients’ journeys. 

30        I wish you a fruitful conference.