Parliament: Big rise in healthcare spending not sustainable, individuals must also try to stay healthy, says Gan Kim Yong

Since 2010, Singapore's national healthcare spending has almost doubled, from $11 billion to $21 billion in 2016 while government health expenditure increased even faster, by 2.4 times, from $3.9 billion to $9.3 billion. ST PHOTO: KUA CHEE SIONG

SINGAPORE - Singapore is pumping in more money than ever on healthcare, but raising spending at current rates is becoming unsustainable.

In the end, the most effective way to keep healthcare affordable is to stay healthy, as unhealthy lifestyles are taking a toll on the system and affecting the quality of life as Singapore ages.

Speaking on the debate of his ministry's budget allocation for the year on Wednesday (March 6), Health Minister Gan Kim Yong shared that since 2010, Singapore's national healthcare spending has almost doubled, from $11 billion to $21 billion in 2016. Government health expenditure increased even faster, to 2.4 times, from $3.9 billion to $9.3 billion.

"However, it is unsustainable for us to continue increasing our national healthcare expenditure at this current rate," he said.

Healthcare manpower and infrastructure has been ramped up, said Mr Gan. Since 2010, the number of doctors here has gone up by 52 per cent and nurses by 44 per cent. Medical school intake has gone up from 300 to 500 a year and the latest nursing intake of more than 2,100 students is a record high.

Seven new hospitals have been built, adding a total of 3,800 beds when fully opened.

But this trajectory cannot be sustained, said Mr Gan. Individuals have to do their part in keeping healthy and the healthcare system has to transform the way it delivers care.

An ageing population is only one part of the problem.

People are living longer, but "for every 10 years we live, we spend more than a year in illness", said Mr Gan.

He said life expectancy here has gone up to 84.8 years in 2017. The years lived in good health have also increased to 74.2 years.

"These figures also show that we are living about 10 years of our life in ill health," he said.

Dr Chia Shi-Lu (Tanjong Pagar GRC), head of the Government Parliamentary Committee for Health, had earlier expressed disappointment that Singapore, once ranked the healthiest country in the world, had fallen to 8th place this year.

Mr Gan acknowledged that Singapore needs to work harder in its fight against chronic diseases. Deaths from cancer, stroke and heart diseases have fallen by 16 per cent between 2010 and 2017 as a result of "early prevention, better treatment and disease management, which have contributed to our increase in life expectancy".

But research shows the prevalence of diabetes, high blood pressure and high cholesterol levels here has gone up by 4 per cent, 14 per cent and 33 per cent respectively among adults aged 18 to 69 years, between 2010 and 2017.

He said: "This is partly due to an older population, but also to unhealthy lifestyles and habits."

And while individuals get their acts together, healthcare institutes have also been changing the way they treat patients.

An experiment by the National Healthcare Group polyclinics, where a team of medical personnel looks after about 5,000 patients with chronic diseases, has resulted in improved outcomes, he said.

Polyclinics in the other two clusters are now also following suit.

New ways to manage patients are also being tried out at the hospital level. About 4,000 patients have benefited from Alexandra Hospital's integrated model. The hospital is now moving into the next phase where it integrates hospital care with community services.

To keep people healthy, the ministry will also offer free cervical cancer vaccines to young girls, better screening for cervical cancer and non-fasting screening for diabetes and cholesterol to encourage more people to screen for problems.

Said Mr Gan: "But the most effective way to keep healthcare affordable is to stay healthy."

Correction note: The story has been edited for clarity.

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