Ministry of Health Addendum to the President's Address (20 May 2009)

20 May 2009

By Mr Khaw Boon Wan

Our mission is to help Singaporeans live well, live long and with peace of mind.  We promote preventive healthcare and champion an active, healthy lifestyle among Singaporeans.

2. Our healthcare system is universally accessible and of high standard. It is affordable because of the 3Ms framework: Medisave, MediShield and Medifund, plus Government subsidies.

Helping Singaporeans stay healthy

3. Effective healthcare starts with prevention. We formulate and implement preventive programmes in schools, workplaces and the community, including wellness programmes for the elderly.  We put priority on health screening and follow-up corrective programmes, especially those tackling smoking and obesity. 

4. We will continue to subsidise immunisations that are clinically recommended for population-wide protection. Our National Integrated Screening Programme will be expanded to cover more conditions, including colorectal cancer.  We will develop better functional assessment tests to help seniors detect potential problems early, when intervention is most effective.

5. We will strengthen capabilities of family physicians, especially in chronic disease management, mental health, palliative and home medical care, and provide support through organising shared services to reduce their operating costs.  We will promote best practice guidelines for family physicians and in our polyclinics.   

6. We will continue to improve the management of common chronic diseases, to prevent them from developing into more serious illnesses. Medisave will be extended beyond the six chronic diseases, to include outpatient treatment of schizophrenia and major depression.

7. We remain vigilant to the threat of infectious disease outbreaks and will work closely with the World Health Organisation and neighbouring countries to keep this region safe.  We will continue efforts to control communicable diseases such as tuberculosis and HIV. 

Preparing for “Silver Tsunami”

8. As our population ages, we need to strengthen the long-term care sector to help meet the healthcare needs of our seniors. We need to ensure that Intermediate and Long-Term Care (ILTC) – which includes community hospitals, nursing homes, hospices, home care - is adequately funded and provided well.   

9. We will develop, akin to the 3Ms, a 3Es (Eldersave, ElderShield and Elderfund) framework to help meet needs for ILTC.  Medifund Silver plays the role of Elderfund, and we will grow it whenever the budget position allows.  Basic ElderShield and ElderShield Supplements have been launched and we will expand these to provide greater coverage for those who are willing to pay more.  We will look into ways to build up Medisave to play the additional role of Eldersave and help young and working Singaporeans set aside sufficient savings to meet their healthcare needs when they grow old.  We will increase our subventions to ILTC providers to help them meet growing patient needs.

Enhancing capabilities and capacity for ILTC

10. We will enhance ILTC capacity and capabilities.  We will facilitate expansion of ILTC services, including releasing land for new providers and building new community hospitals in Yishun and Jurong by 2016.  We will work with private and Voluntary Welfare Organisations (VWOs) to expand nursing home capacity from 9,200 to 14,000 beds over the next decade. We expect to build five new nursing homes in the next two years, including one catering to the special needs of psychiatric patients.

11. MOH will step up manpower training to improve ILTC and support the professional development of staff in the VWO sector.  We will also build up capabilities on end-of-life care and expand the pool of palliative care specialists. We will work with partners on education and awareness so that Singa¬poreans can make more informed decisions about end-of-life care.

Transforming Healthcare Delivery

12. We are expanding public healthcare infrastructure to meet growing needs.  Khoo Teck Puat Hospital will open next year. We are planning to open a new general hospital in Jurong by 2014.  Beds are being added in existing hospitals.  Major facilities being developed include the National Heart Centre, and the Pathology and Research Centre at Outram; the second Heart Centre and the Cancer Centre at Kent Ridge; and a new Communicable Disease Centre in Novena.  We also plan to expand the NUHS Dental Centre and build new capabilities in geriatrics and rehabilitation. 

13. Manpower expansion must precede infrastructure expansion.  We are stepping up the recruitment and training of 4,500 doctors, nurses, pharmacists, therapists, administrative and other staff.  We will improve the way we work, with multi-disciplinary teams to deliver effective care, including new roles for Advanced Practice Nurses, Nurse Educators and Allied Health Professionals (AHPs).  We will also strengthen the training and deployment of healthcare staff in the public sector. 

14. MOH and MOE will study the need to expand local training of healthcare professionals, including the setting up of a third medical school and a degree programme for AHPs. We will provide scholarships for scarce skillsets, such as clinical psychology, biostatistics, bioinformatics and healthcare management. We will also continue to recruit suitable foreign healthcare professionals to augment the local manpower pool.  

Facilitating Integrated Care

15. We will facilitate integration of care services so that patients can be cared for at the most appropriate settings.  Otherwise patients may end up in the inappropriate acute setting, and incur unnecessarily higher costs. We will expand the Agency for Integrated Care to facilitate this and advise patients on options. We are developing a National Electronic Health Record (NEHR) system, so that patient medical information can be shared across healthcare providers nationwide.  The NEHR will be supported by legislation with robust safeguards to ensure patient confidentiality.

Pursuing Medical Excellence

16. We will continue to invest in clinical and translational research. Outram and Kent Ridge Campuses will transform into academic health sciences centres and translate research into better and more cost-effective treatment. We will redevelop the Communicable Disease Centre, as the current H1N1 outbreak has reaffirmed the need for strong capabilities in infectious diseases research and treatment.   We will grow new capabilities through upgrading, and set up new specialty centres of excellence when needed.

17. We will regularly review and enhance our healthcare regulatory framework, to ensure that it remains robust and relevant.  MOH and the Health Sciences Authority (HSA) will work actively with partners to build up surveillance, investigation and enforcement capabilities.  These efforts will help to maintain continued trust and excellence in Singapore’s healthcare system.