Just 19 per cent of diabetic patients had all the necessary tests done, while no stroke patients followed the recommended after-care regime, MOH said in a paper released on Monday.

It looked at 35,221 patients - mostly aged above 50 with more than one chronic disease - who used their compulsory medical savings to pay for treatment. Of these, only 28 per cent had undergone all the checks.

MOH loosened the Medisave purse strings in 2006 to allow people with four chronic conditions - diabetes, high cholesterol, high blood pressure and stroke - to use up to $300 a year from Medisave for treatment.

'The low compliance rate is a cause for concern,' said Madam Halimah Yacob, chairman of the Government Parliamentary Committee for Health.

'It shows that people still look upon treatment as merely taking medicine, and not as a holistic programme which requires them to go through regular tests and observe things such as weight control or quitting smoking.'

Left unchecked, diabetes can lead to blindness, kidney failure and heart disease, while stroke victims can suffer another attack.

The report card on high blood pressure and high cholesterol was better. About 62 per cent of hypertensive patients and 77 per cent of patients with high cholesterol got all the required checks.

The Health Ministry is 'encouraged by the first-year results', said its spokesman.'We see this as a learning experience and expect further improvements over time.'

The ministry could not say why so many diabetics did not get all the checks.

Madam Halimah linked the shortfall to patients' complacency and ignorance.

Some patients also find it troublesome to visit different clinics for tests on their eyes and feet, said general practitioner C.C. Lim.

Dr Lam Pin Min, a member of the Government Parliamentary Committee for Health, said some general practitioners might not be trained to perform the most common types of missed tests, like eye and foot checks.

Dr Wong Weng Hong, chief executive officer of Healthway Medical Group, whose 60 GP clinics have more than 600 patients on the programme, said the Government's data collection could be inaccurate and more patients may be going for tests than the numbers show.

He said most GPs get assistants to manually submit patients' test results by typing them via the Health Ministry's online portal, and this could result in some results being omitted.

A system that could automatically draw the required information from the GPs' databases and feed it into the ministry's database could be the solution, he said.

For diabetic Mohd Nasruddin Asmawi, sticking to treatment was never in doubt.

He paid $300 for a year-long treatment package with Raffles Medical Clinics after being diagnosed in 2006.

The 43-year-old technologist said: 'I told myself to be disciplined because I have three children to take care of and bills to pay.'

From next month, Medisave can also be used for asthma and chronic obstructive pulmonary disease.

huichieh@sph.com.sg