Healthcare in Singapore needs to change, and in a drastic manner, if it is to remain effective and affordable as the population ages.
Otherwise, it can be overcome by three major threats: The provision of healthcare services would be inadequate to meet the needs of Singaporeans, cost of healthcare would shoot through the roof, and people would suffer more years in poor health as they age.
In short, the current business model cannot sustain itself, said healthcare adviser Jean-Luc Butel of a global consultancy. He was among five panellists in the fifth of The Straits Times Future Economy Roundtable series on healthcare.
The major problems they see looming on the horizon are:
- The fast-ageing population, in which the number of people aged 65 and older will more than double from 430,000 today to above 900,000 in 2030. By then, one in five persons will be older than 65, an increase from one in nine today. It will weigh heavily on the medical services as older people generally require more such services.
- Healthcare costs have been rising faster than general inflation, and is likely to continue. Dr Kelvin Loh, head of Parkway Pantai's Singapore operations, attributes the rise to newer treatments which are costlier but give better outcomes. As a result, Singaporeans enjoy one of the longest lifespans in the world.
- Healthcare manpower cannot keep up with growing needs. The shortage is already a problem. Said the president of the Healthcare Services Employees' Union, Ms K. Thanaletchimi: "In the future it'll be even more dire because many of our current generation are not going into healthcare."
While the problems are daunting, they are not insurmountable, said the panellists.
Central to their solution is a major mindset change among healthcare providers and the public, as well as a general willingness to adopt technologies and practices that increase the efficiency of the services and their effectiveness on the patients.
The change can be a powerful force in overcoming the two
major issues in healthcare: the increasing demand for healthcare services by an ageing population, plus manpower
shortage and rising costs.
AGEING POPULATION WITH GREATER HEALTHCARE NEEDS
Although older people generally need more healthcare services, the demand need not soar as long as people stay healthy and keep at bay their "disability years".
Ms Thanaletchimi favours educating the young so that they grow old knowing how to prevent diseases caused by poor lifestyle choices.
Dr Loh advocates delivering healthcare in a "smarter way" by using technology to monitor chronic conditions and react swiftly when a person's health deteriorates. This would keep the person healthier and, in turn, reduce the need for hospital care. "In the end, we can change the cost curve," he added.
Tetsuyu Home Care director Tan Li Lian said general practitioners need to be better trained to care for the chronic sick in the community. Too many deal with coughs and colds rather than more serious medical problems, and may not be up to caring for a stroke patient, she said.
MANPOWER SHORTAGE AND RISING HEALTHCARE COSTS
The shortage of trained nurses and therapists is acute, said Ms Thanaletchimi. The nurse shortage could be resolved by redefining the scope of a nurse's job to exclude non-nursing chores, like bathing a patient.
Dr Loh said 10 per cent of a nurse's time is spent looking for things, which can be reduced by applying process engineering to their work. He called for hospitals to use technology "to get the diagnosis quickly ... the correct treatment quickly and then discharge the patient quickly".
At the end of the day, keeping healthcare effective and affordable also requires a buy-in by both the healthcare providers and the people they provide for. So if everyone pulls together and in the same direction, people need no longer worry that they "can afford to die but not to get sick" in Singapore.