Health

Care system largely in place, time to consolidate

Perhaps the most important work next year will be the "war on diabetes" that Health Minister Gan Kim Yong announced in April. One of the major causes of diabetes is a sedentary lifestyle coupled with consumption of unhealthy food and drinks.
Perhaps the most important work next year will be the "war on diabetes" that Health Minister Gan Kim Yong announced in April. One of the major causes of diabetes is a sedentary lifestyle coupled with consumption of unhealthy food and drinks.ST FILE PHOTO

As 2016 draws to a close, with many notable events shaping what has been called by many a year of change, 2017 looks set to be just as significant. The Straits Times looks at what to expect for health, defence and technology. Up next: Seamless care transitions, enhanced ElderShield, anti-diabetes efforts in action

Many of the pieces in Singapore's healthcare system are already in place, including insurance coverage for everyone against big bills which can be incurred even with subsidised care.

More hospitals and nursing homes have also come online to meet rising needs. Members of the pioneer generation, who might not have enough savings to meet healthcare needs as they age, have also received more help.

Next year should see a consolidation of the different levels of care, so that the transition from one level to the next is seamless.

This would include more help for those who prefer to age in the community, especially in the homes that they have lived in with their families, instead of spending their last years in a nursing home.

This will be made possible partly with the revamp of ElderShield, the severe disability insurance. The revamp will mean better financial help for people who are no longer able to live unaided.

The hope is that with sufficient disability insurance to offset the cost of care, more people can afford to live the life they prefer. The care can include hiring a maid to help the elderly with basic daily activities such as eating, using the bathroom and getting out of bed.

Consultation on how to enhance ElderShield will start in January and the new revised product should take shape by the end of next year.

  • 2016: Notable events

  • War on diabetes

    Health Minister Gan Kim Yong declares a "war on diabetes" during the parliamentary debate on his ministry's budget in April.

    He said the disease is one of the biggest drains on the healthcare system, costing the country more than $1 billion a year.

    It is estimated that there are more than 400,000 diabetics here today and one in three does not even know he or she has the disease.

    Of those who do know, one in three has poor control.

  • Zika outbreak

    The mosquito-borne disease that affects the development of unborn babies surfaced here in August.

    Forty more people were found to be infected with the virus within days of the first person being identified.

    The National Environment Agency went into overdrive to clear mosquito breeding in areas where Zika had surfaced.

    To date, 457 people have been diagnosed with Zika, with the latest case reported on Wednesday.

  • Genetic screening

    Dr Amy Khor, Senior Minister of State for Health, announced the decision to allow for genetic screening of embryos in a pilot at the National University Hospital.

    This is to see if screening can identify those with chromosomal abnormalities, thereby improving the chances of getting a live birth through in-vitro fertilisation.

    Last year, women here went through more than 6,000 assisted reproduction cycles, but fewer than one in four resulted in live births.

    Salma Khalik

Meanwhile, more step-down facilities - such as nursing homes and homecare, daycare, eldercare and rehabilitation centres - will be added to provide recovering patients or the frail elderly the support they need to continue living at home.

Perhaps the most important work next year will be the "war on diabetes" that Health Minister Gan Kim Yong announced during the Budget debate in April this year.

The first steps have been taken, including the setting up of several committees to target the prevention and control of diabetes for different groups, such as children, working adults and the elderly.

The new year should see the various committees turning their plans into action.

Diabetes is both a disease and a risk factor for many other serious illnesses. One in two people who suffer a heart attack here is diabetic, as are two in five people who get a stroke. Diabetes is also the major cause of kidney failure, blindness and limb amputations.

Among developed countries, Singapore has a higher-than-average prevalence of diabetes, coming second only to the United States.

One in eight adults aged 20 to 79 is diabetic. The prevalence is higher among older people.

In Europe, it is one in 11 adults and in Japan, only one in 13.

The annual cost of diabetes here is huge, at more than $1 billion today, and is expected to exceed $2.5 billion a year by 2050 if nothing is done to curb the rise of the disease.

The cost comes not only from treatment for the disease itself, but also the associated complications, such as gangrene, amputations and care for those who are severely affected. There is also a cost to lost man-hours of work.

Diabetes is a highly preventable and treatable disease if tackled early, since one of the major causes is a sedentary lifestyle coupled with consumption of unhealthy food and drinks. If the disease can be controlled or, better still, prevented, it would significantly reduce the cost of healthcare.

Without diabetes, more people can also age in better health and be able to enjoy their twilight years.

But the war on diabetes should not be a one-off battle and cannot be the responsibility of the Ministry of Health alone.

It is something society as a whole has to take on, and tackle together.

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A version of this article appeared in the print edition of The Straits Times on December 31, 2016, with the headline 'Care system largely in place, time to consolidate'. Print Edition | Subscribe