SINGAPORE - When the pandemic blows over, Singapore's most important national healthcare agenda will be a major strategy to shift the city-state away from hospital-centric care to a more patient-centred preventive model, said Health Minister Ong Ye Kung on Sunday (April 10).
Dubbed Healthier SG and announced last month during the Ministry of Health's (MOH) budget debate, the initiative aims to get general practitioners, family physicians and the community to play a larger role in spotting diseases earlier and keeping people out of hospital as much as possible.
This focus is necessary because after Covid-19 has passed, Singapore needs to tackle a far more challenging pandemic of longer-term, chronic illnesses - of which diabetes is a significant one, said Mr Ong. He was speaking at the official opening of a National Kidney Foundation (NKF) dialysis centre at Yishun Community Hospital (YCH) - the first to be located within a hospital compound.
Singapore leads the world in diabetes-induced kidney failure, with about 5.7 new patients diagnosed with the condition daily. There are currently more than 8,500 dialysis patients here.
Commending NKF for saving lives every day throughout the pandemic, Mr Ong noted at the start of his speech that despite a significant easing of Covid-19 measures since March 29, the number of infections has been falling - from more than 13,000 then to around 4,000 in recent days.
"So far, my prediction has been wrong, because I expected that once we ease up, cases will have an uptick but it continues to go down," he added. "So I'm very glad to say that I was wrong. But we still have to watch next week."
He noted that for issues like diabetes where individual dietary habits and preferences are involved, a movement mobilising some 2,000 GPs trusted by families could prove more effective at changing mindsets.
In a private setting where the GP advises the patient and says "these are your readings, you need to do something about it for your family, for your children, for your parents, for your loved ones", and after the patient sees the GP numerous times, "then there may be enough trust" for the person to change his mind, said Mr Ong.
Some time in the middle of next year, MOH will start inviting residents aged 40 and above to enrol in a national programme to commit to seeing one GP of their choice, he added.
Much of the GPs' advice would be based on lifestyle and include recommendations that would require community support, be it brisk walking or other forms of exercise.
The Government would have to think about "positive nudges" to help the patient along, said Mr Ong, as he reeled off potential incentives such as lowered healthcare insurance premiums and vouchers for watching one's diet.
A detailed plan for Healthier SG will be released in a White Paper in the fourth quarter of this year and Parliament will discuss the strategy at length, he added.
NKF chairman Arthur Lang said that aside from providing dialysis treatment and care, the foundation's greater mission - to prevent or delay kidney failure, including by working with GPs to focus on early intervention - is very much aligned with the Healthier SG strategy.
NKF's vision over the next two decades is to stop opening dialysis centres altogether, he added.
There are 40 such centres islandwide, including the one officially launched on Sunday at YCH, though it started operations in December 2020. It was established with the help of a $2 million donation from the philanthropic arm of Singapore conglomerate Keppel Corporation.
The dialysis centre is adjacent to Khoo Teck Puat Hospital (KTPH) - an acute hospital for short-term treatments and operations, in contrast to YCH's focus on recovery.
"This allows for timely and seamless transfer of patients," said Mr Lang. "Patients do not need to travel to other centres for dialysis. Patients discharged from KTPH can come over to YCH to have their dialysis at this centre... Patients will benefit from the seamless continuity of care through connected networks of healthcare teams, information flow and treatment care plans."
NKF's YCH centre is also the first to offer peritoneal dialysis, a typically home-based treatment where a cleansing fluid is introduced into the abdomen through a tube. The centre also conducts training, troubleshooting and counselling for patients, among other services.
NKF's other centres concentrate on haemodialysis, which involves inserting two needles - one to remove blood and the other to return cleansed blood to the body - during treatment sessions that take place thrice a week for about four hours each time.
