The Annual College Of Family Physicians Singapore Convocation Dinner

04 Nov 2006

By Mr Heng Chee How

Venue: College of Medicine Building Auditorium

A/Prof Goh Lee Gan,

President,

College of Family Physicians Singapore

Distinguished guests, ladies and gentlemen

I am delighted to join you at this convocation of 104 primary care doctors who have attained post-graduate qualifications awarded by the College of Family Physicians, some jointly with the National University of Singapore.  To our graduates, I offer my heartiest congratulations.

This is a significant step in your career as Family Physicians. By pursuing this post-graduate training in Family Medicine, you have demonstrated your commitment to continuous improvement for the sake of your patients. It is a noble undertaking.

With your enhanced knowledge and capabilities, you are set to embark on the next phase of your careers, one which promises to be both exciting and opportune.  It is exciting because you will not just be more skilful versions of yourselves, but would be key partners in the national quest for better health with peace of mind.   And I say opportune because this invitation to partnership is not an empty statement.  The stars are aligned for you to now make a real and big difference.

Medisave for Chronic Disease Programme

Let me explain.  As you know, MOH has since 1st October this year introduced the Chronic Disease Management Programme. Under this programme, patients can use Medisave to pay for outpatient treatment of selected chronic diseases. We are doing this for 2 reasons. 

First, we want to do more to right-site care.  Ailments that can best be treated and managed at primary care level should be treated and managed at primary care level.  As Family Physicians, you know your patients better, and they trust you more than any doctor elsewhere.  Seeing you is probably more convenient for your patients than seeking treatment from a different provider.  At the other end, this would also allow acute and specialist care resources to be used for their intended purposes.  It benefits everybody.

Why do it for chronic disease?  In the context of an aging population, we know for sure that the incidence of chronic disease will tend to rise.  A patient stricken with a chronic disease will have to live with it for life.  That itself is expensive and upsetting. If not well controlled and managed, premature and unnecessary complications and deterioration will cost the patient even more in money and loss of quality of life.

So it makes sense to activate and energise Family Physicians to tackle this emerging health need in the population.  With the help of a structured treatment programme and well qualified Family Physicians who are committed to continuous improvement, patients will benefit from improved outcomes.

The second reason for our rolling out the initiative this way is a practical one.  As we want to encourage people to seek treatment for chronic diseases early and to manage their conditions systematically, we help them work the sums.  For many people, the out-of-pocket cash outlay is a big factor that affects their willingness to seek treatment, and their stamina in following up.  This is why we allow Medisave to be tapped for this, subject to safeguards against early depletion of such savings.  It makes life easier for many.

Here, I return to my earlier point about this invitation to partnership.  As you can see, the pieces and policy are now in place.  To bring the idea to life, to let the population enjoy the intended benefits, we must have the support and participation of Family Physicians.  This is why MOH and the College of Family Physicians have worked hard to reach out to Family Physicians to join this programme.

I am told that the Continuing Medical Education (CME) events organised to explain and promote the use of Medisave under the Chronic Disease Management programme were very well-attended. So too the structured programmes to update doctors on the latest in chronic disease management.

Doctors' Response to the Challenge

How are we doing so far?  Since the launch of the programme for diabetes a month ago on 1 October 06, half of all Family Clinics have already joined the scheme.  More Clinics are joining these early adopters each week.  This response is most encouraging.  It shows that when doctors see the benefits for their patients, they will step forward to help. 

We believe that when treatment for hypertension, lipid disorders and stroke are added to the list in January 07, the vast majority of Family Clinics would be active partners in the programme. 

Supporting the Physician

On MOH's end, we are doing some more things to nurture conducive conditions for the Programme.  A national public awareness and education effort has been launched. The key messages are: everyone should first see his family physician, follow treatment instructions closely, and be proactive about managing one's illness.  We hope that over time, patients' understanding of and participation in the care that they receive would grow.

Then, to simplify matters for the patient even more, a booklet to help him monitor his progress has been specially developed.  This booklet lets him record key information about his condition. The patient tracks his own progress and brings the booklet with him each time he sees the doctor. This allows the layman to become an active partner in his own care.

Conclusion

We will learn from experience, and see what else needs to be done or fine-tuned to get us ever closer to the goal of a nation of healthy Singaporeans.  Whatever we may do, I know that Family Physicians and primary care will play a crucial part.  And so I hope that you will rise to the occasion again and again as we make progress together. Society will recognise and thank you for your efforts and contribution.  

I wish you a pleasant evening.  Thank you.