MOH steps up disease prevention amid ramp-up of primary care

Singapore

THE government is stepping up disease prevention by urging people to adopt healthier diets and proposing new law to raise the minimum age for tobacco sale, even as it moves to beef up the country's primary and community care network in the face of a rapidly ageing population.

This comes as the Ministry of Health (MOH) shifts its focus beyond hospitals to community care, beyond quality to value, and beyond health care to the individual's health, a point made by Health Minister Gan Kim Yong on Thursday in Parliament during the Committee of Supply budget debate of about S$10.7 billion for the year.

In terms of facilities, Mr Gan said Changi General Hospital will open its new medical centre next year, Sengkang General and Community Hospital by end-2018, the new National Centre for Infectious Diseases will open progressively from end-2018, and Outram Community Hospital will open by 2020.

He added that Woodlands General Hospital and co-located Community Hospital will break ground in April and be opened progressively from 2022.

From 2017 to 2020, the government will add another 4,200 nursing home beds, 2,200 day care places and 2,500 home care places, Mr Gan said, adding that MOH has already added seven new family medicine clinics and seven community health centres.

"But adding capacity alone is not a sustainable solution in the long term if we do nothing else. Our capacity growth must be coupled with efforts to transform our care model to leverage on strong primary and community care, and keep our people healthy with better disease prevention and healthier lifestyle choices," said Mr Gan.

On the issue of affordability, Mr Gan said MOH will consider the proposal to extend MediShield Life coverage to patients who are suitable for direct admission to community hospitals.

More attention is channelled towards the war on diabetes. To this end, the Health Promotion Board (HPB) will invest S$20 million over three years on the Healthier Ingredient Scheme (HIDS) to incentivise food ingredient manufacturers and suppliers to develop better quality and greater varieties of healthier staples, and promote adoption among food and beverage businesses and consumers.

Minister of State for Health Chee Hong Tat on Thursday said HIDS, to be rolled out from July 1, builds on HPB's earlier Healthier Ingredient Scheme pilot.

Healthier catering guidelines will also be implemented in the public sector from April 1 to encourage healthier food options, he said, adding that reducing Singaporeans' sugar intake is another area MOH is looking into.

To stub out chances for youths to smoke, Senior Minister State for Health Amy Khor told Parliament that MOH will propose changes within the year to raise the minimum legal age for the purchase, use and possession of tobacco products to 21 years from 18. The change will be implemented in phases over the next few years.

She added that mental health services will be strengthened over the next five years through early identification of mental health symptoms, faster response to mental health needs in the community and expansion of mental health services in polyclinics, among other measures.

Various prevention initiatives are also in the pipeline, key of which is the Diabetes Risk Assessment (DRA) tool to help Singaporeans aged 18 to 39 assess their risk for undiagnosed diabetes. It will be available online on HealthHub from Sept 1.

Minister of State for Health Lam Pin Min also shared that MOH will roll out a scaled-up primary care network (PCN) scheme this year to provide more support for more general practitioners (GPs) to get started on the initiative. The PCN was piloted in 2012 to improve chronic disease management through team-based care.

Under the scheme, GPs will form virtual networks and deliver care through a multi-disciplinary team of doctors, nurses and allied health professionals to better manage patients' needs. MOH will launch the PCN application call on April 1 for a period of two months.

Beyond the PCNs, MOH will open more primary care facilities, Dr Lam added. Keat Hong and Tampines family medicine clinics are to open this year, so will polyclinics in Pioneer, Punggol and Bedok. New polyclinics in Bukit Panjang, Eunos, Sembawang and Kallang/Balestier are slated to open by 2020, while those in Yishun and Ang Mo Kio will be re-developed in 2018.

Along with the growth in healthcare sector comes the need for some 9,000 additional staff for new facilities and services in the public healthcare and aged care settings.

To this end, Dr Khor said MOH will invest an additional S$24 million in the next three years to beef up its health conversion and training programmes so as to enable more mid-career Singaporeans to join the sector.