SINGAPORE – Mr Ng Wing Kee, 67, goes to Bukit Merah polyclinic three or four times a year for medicine to keep his diabetes controlled.

He also recently went there for the Government-subsidised pneumococcal vaccine, which protects against some types of bacterial infections that can cause serious illnesses like meningitis, sepsis and pneumonia.

His daughter Jessica Ng, who is in corporate communications, visits the same polyclinic on the rare occasion that she is sick, and to get her annual influenza vaccine.

Her son Jadon Lai, aged 17 months, is probably the family member who has to go to the polyclinic most frequently, since that is where he gets his childhood vaccines to protect him against a host of infectious diseases such as whooping cough, diphtheria, hepatitis, measles and chicken pox.

Jadon will be going to the polyclinic again soon for his booster shots and his 18-month development screening, where he will be checked for things like vision and squinting, and get his head size, height and weight tracked.

It is not uncommon for whole families to use polyclinic services.

Today, polyclinics are a far cry from the first one, which opened in Queenstown 60 years ago – although even then, it provided free immunisation services which were immensely popular.

It took 15 years from the time then Prime Minister Lee Kuan Yew opened the Queenstown polyclinic for the second one in Marine Parade to be opened in 1977.

Since then, 23 more polyclinics have been added, with nine more to be opened by 2030 – meaning there will be more than one new polyclinic opening a year going forward.

The country’s 25th, Sembawang Polyclinic, was opened on Nov 25 by Health Minister Ong Ye Kung and boasts a Health and Wellness Studio where yoga and healthier cooking classes will be held.

Not surprisingly, the minister told The Straits Times: “Polyclinics are great!”

Polyclinic attendance rose from 4.9 million in 2015 to 6.7 million in 2019. The number dropped to around six million a year during the two pandemic years, but went back up to 6.6 million in 2022.

Today, polyclinics are no longer regarded as places that cater only to the poor who are willing to endure long waits for cheap care, with overworked doctors rushing patients through the system.

Instead, they are now the go-to place for many people because of the range of services they provide. People requiring primary care can get all their needs seen to in one place, including getting blood tests and X-rays done.

Polyclinics offer a wide range of services for everyone, from infants to seniors, such as vaccinations, some of which are free or subsidised; health screenings; pre- and postnatal care; and treatment for acute and chronic illnesses. They even help new mothers overcome postnatal blues.

A spokesman for the Ministry of Health (MOH) said: “We are working to anchor care in the community, through the provision of a more comprehensive range of services in our polyclinics.”

Polyclinic services can be divided into four rough categories: acute care, chronic care, mother and child health, and preventive care such as screening and immunisation. Some polyclinics today also offer services such as mammography to screen for breast cancer, dental treatments and podiatry services.

Over the past five years, the number of polyclinic doctors has gone up by 18 per cent – from 530 in 2018 to 624 in June 2023, resulting in a better doctor-to-patient ratio.

Doctors used to see as many as 60 patients a day, but now attend to about 40 a day, which is on a par with the patient load of general practitioners (GPs) in private practices.

The doctors are well trained, with 85 per cent having postgraduate qualifications such as a Master of Medicine in family medicine or a graduate diploma in family medicine.

MOH said: “With postgraduate family medicine training, (the doctors) are equipped to manage a wider range of common acute and chronic conditions, including patients with multiple comorbidities or more complex conditions.”

Between 2018 and 2023, the number of nurses has also gone up by 22 per cent, from 720 to 875, and the number of allied health professionals such as dieticians and podiatrists has increased by 45 per cent, from 163 to 236.

MOH said: “The significant increase in allied health professionals was driven in part by efforts to provide a more comprehensive range of services in the polyclinics, such as physiotherapy to support the national One-Rehab initiative, and pharmacists who can help to manage common chronic conditions through the pharmacist-led clinics.”

Having more staff at polyclinics means they can spend more time with patients, especially those with complex problems involving more than one chronic condition.

Forty per cent of polyclinic patients are being treated for chronic conditions such as diabetes, asthma, kidney disorders and heart disease. All chronic patients are treated by a team which may include, where necessary, pharmacists, dieticians, nurses and podiatrists, in addition to doctors. Patients see the same team during every visit.

People in their 60s form the largest proportion of polyclinic patients. Since the launch of Healthier SG – which promotes having one doctor to one patient for lifetime care, with significant government subsidy – 210,000 people have signed up with polyclinics, while 336,000 have signed up with GPs.

Those seeking acute treatment for an immediate medical problem, such as conjunctivitis or diarrhoea, make up 25 per cent of patients – down from 30 per cent in 2018.

Preventive care, such as screening and getting vaccinated, has become increasingly popular and now accounts for 10 per cent of all visits, while the rest comprise appointments with a pharmacist, at nurse-led clinics, or for lab tests, among others.

“This trend is in line with our messaging for Healthier SG – to shift our focus from reactively caring for those who are sick, to preventing individuals from falling ill,” the MOH spokesman said.

As we continue to ramp up Healthier SG, we will likely continue to see a rise in such attendances, as our population becomes more aware of the importance of preventive care.

Some polyclinics are moving into areas like mental health and frailty screening and, where there is a need, providing care within the community.

Frailty is particularly important, given Singapore’s rapidly ageing population. Left unchecked, it could lead to more serious problems, such as falls and fractures.

Another new scheme, which is now available at 10 polyclinics with more coming in the future, is joint mother-and-child service, in which mothers can be helped when they take their infants for appointments, without needing a second appointment for themselves. Mothers can receive services including breastfeeding and lactation support, and maternal mental health screening for conditions like postnatal depression.

The new Sembawang Polyclinic, like those in Choa Chu Kang and Punggol, offers the Family Nexus scheme, which lets families with young children access health and social services. For example, if a family has difficulty getting a child into childcare because of financial constraints or other reasons, the Family Nexus will link them with relevant agencies. It also helps with conditions like postnatal depression.

A previous major complaint about polyclinics was the long time patients needed to spend there – the bulk of which was spent waiting to register, waiting to see a doctor, waiting to get their medicine and waiting to pay the bill.

But that is no longer the case today, thanks largely to technology.

Patients can now use their mobile phones to book an appointment, register up to an hour prior to the appointment, and check the number of patients ahead of them in the queue. They are alerted when there are three patients ahead of them.

After they see the doctor, there are three ways for them to get their prescribed medicine:

• Locker service (available at selected polyclinics): The pharmacist collates the medicine and places it in a locker, then sends a message to the patient’s mobile phone telling him the medicine is ready for collection, as well as the combination number to open the locker.
• Home delivery: This takes several days, but delivery is currently free.
• Pick-up at the pharmacy: This is mandatory for patients using a medicine for the first time as the pharmacist needs to explain its usage. With the introduction of the other two options, the number of patients doing this has gone down, resulting in a shorter wait.

Payment can be made at the polyclinic counter, at an automated payment machine using a bank card, or online after leaving the polyclinic.

Polyclinics play an important role in training the next generation of healthcare professionals. The new Sembawang Polyclinic, for example, has a dedicated consultation room with a video camera, allowing a group of doctors to observe – with patients’ permission – how more senior doctors interact with patients.

Medical students spend three to eight weeks, nursing students one or two weeks, pharmacy undergraduates 11 weeks and polytechnic pharmacy students 20 to 24 weeks at polyclinics, during which their mentors are given protected time to supervise and guide them.