I commend senior health correspondent Salma Khalik for highlighting the issue of rising healthcare costs ("Make cheaper healthcare in nearby countries an option"; last Sunday).

Disease prevention, such as reducing smoking-related conditions by reducing tobacco use, requires a multi-pronged approach.

Picking up the smoking habit is linked to largely social influences. Thus, efforts in schools focused on educating the younger generation against smoking require a coordinated effort by teachers, parents and role models.

Disease prevention is a systematic effort made possible only with a shared vision and joint collaboration with key stakeholders.

While screening may offer benefits in some disease conditions, this outcome is not universal, but dependent on the choice of screening tool and disease condition.

A prostate-specific antigen (PSA) test to detect early prostate cancer, for example, may be beneficial to some people. But it may lead to additional diagnostic tests in others, as abnormal PSA levels may also be due to benign conditions. Thus, there is a need to establish medical benefits before implementing national screening programmes.

While the nation may have a system in place to facilitate the exchange of patient-related information among public hospitals, there is a relative disconnect with private hospitals.

Coordinating expertise and resource allocation among all hospitals here will provide maximal gains for the national healthcare budget and, ultimately, keep a lid on overall costs.

In addition, a focus on empowering primary healthcare in Singapore will reduce the unnecessary utilisation of tertiary services, without compromising the quality of care delivery.

Tapping cheaper drugs and services available across the Causeway, and the easing of manpower costs as a result, may yield limited advantages.

Instead, for the long term, why not consider a reduction in duplication of manpower needs. For example, where possible, focus on hiring and retaining capable individuals (especially in nursing) with a drive and vision for systems improvements.

Therefore, it is possible to contain costs, which should occur in tandem with efforts fixed on championing a healthy nation.

Lee Lui Shiong (Dr)