SINGAPORE - The transitional care facilities (TCFs) set up during the Covid-19 pandemic to prevent hospitals from being overwhelmed have proven so valuable that they will be retained as a key part of Singapore’s healthcare system, Health Minister Ong Ye Kung told Parliament on Tuesday.

They are for medically stable patients from public hospitals waiting for long-term care arrangements, such as home or nursing home care.

As there is currently no TCF in the west, a new one – in close proximity to Ng Teng Fong General Hospital – will be set up in the next few months, Mr Ong said during the debate on the White Paper on Singapore’s response to the Covid-19 pandemic. The paper was released on March 8, and the Government is drawing lessons from it to better prepare Singapore for the next pandemic.

A key one relates to strengthening the Republic’s hospital capacity. During the pandemic, Singapore set up 500 TCF beds in five sites, and they were run by private operators.

“It is as good as adding 500 more beds to our acute hospitals,” said Mr Ong. “We have therefore decided that TCFs will become a medium- or even long-term feature of our healthcare system.”

Singapore will also continue to expand the community and step-down care sector, such as community hospitals and nursing homes, he said.

These moves will help meet the increasing demand for hospital beds. Public hospital bed occupancy has risen from a pre-Covid-19 level of 87.6 per cent in 2019 to 93.1 per cent in 2022. This is largely due to the higher number of older patients with complex conditions, who require longer hospital stays.

Mr Ong said the percentage of senior patients aged 65 and above has risen from 39 per cent in 2019 to 43 per cent in 2022, and many of them are frail and have underlying medical conditions.

Singapore is determined to learn from the crisis and improve various aspects of its healthcare system to make it more resilient, said Mr Ong.

Elaborating on the plan for a public health centre that Deputy Prime Minister Lawrence Wong had mentioned on Monday, Mr Ong said a new Communicable Diseases Agency (CDA) will be set up to oversee disease preparedness, prevention and control, surveillance, risk assessment and outbreak response in Singapore.

It will consolidate the relevant public health functions that today reside in the Ministry of Health (MOH), the National Centre for Infectious Diseases (NCID) and the Health Promotion Board. In addition, the National Public Health Laboratory will be transferred to the CDA, which will maintain oversight of the clinical facilities in NCID.

Mr Ong also said MOH will separately retain a permanent Crisis Strategy and Operations Group, or CSOG, in the ministry to maintain surge readiness for a mid-sized outbreak and other health emergencies. In peacetime, the CSOG will help operationalise Healthier SG, Singapore’s major preventive health strategy that will start enrolment in July.

Singapore will boost its pandemic preparedness with a national research and development plan known as Prepare, or Programme for Research in Epidemic Preparedness and Response, which was launched in November 2022.

It also wants to amend the Infectious Diseases Act to allow it to use a situational tier system – instead of the current Disease Outbreak Response System Condition (Dorscon) colour coding – to tell the public that there is an outbreak, threat or emergency.

Singapore will also seek to ensure that it has early access to effective vaccines for future pandemics. The Republic’s vaccination strategy enabled it to keep Covid-19 mortality rates relatively low, but it came with an inevitable financial cost, given how small the market here is, Mr Ong said.

“To date, expired vaccines are about 15 per cent of the doses we ordered, with a total value of $140 million,” said Mr Ong. “In the coming months, this is likely to rise to close to 25 per cent, as more vaccines expire. After that, it should stabilise.”

Singapore had tried to donate the spare vaccines but there have been no takers due to an oversupply of spare vaccines around the world and declining demand, he added.

Singapore is now negotiating agreements to secure early access to vaccines against other pathogens with pandemic potential.

Going forward, lest a dangerous Covid-19 variant of concern emerges, the Republic will keep a stock of vaccines and maintain a network of vaccination centres, including five to 10 joint testing and vaccination centres, so it can administer a booster to those aged 50 and above as well as the medically vulnerable, within three weeks, if needed.

MOH has estimated that more than 3,700 people here have died of Covid-19 infections, including 2,000 deaths not recorded in the official death toll as they may have died of undiagnosed Covid-19 infections or Covid-19 could have worsened some other underlying illnesses, said Mr Ong.

A key call that the Government had to make during the pandemic was on when to open up once a high population immunity had been achieved, said Mr Ong. Many people had urged the Government to open up quickly, like some other countries did. “The desire is understandable, but they overlooked the key difference between us and them – they had paid the price in human lives, which we refused to pay,” Mr Ong said.

He was among 12 ministers and MPs who spoke on the second day of the debate on the Covid-19 White Paper. They included DPM Wong, who said: “We can see this is what happened in so many other places: If there is little trust, public health becomes politicised and individualised, and that compromises and impairs the country’s pandemic response.

“Fortunately, social capital and trust have been high in Singapore over the decades, and the silver lining in this terrible crisis is that social capital and trust have increased.”