Hard choices need to be made to keep healthcare sustainable, says PM Lee Hsien Loong

Prime Minister Lee Hsien Loong, assisted by Senior Physiotherapist Ma Shi Min, tries out a high-tech treadmill at Sengkang General Hospital, on March 23, 2019.
Prime Minister Lee Hsien Loong, assisted by Senior Physiotherapist Ma Shi Min, tries out a high-tech treadmill at Sengkang General Hospital, on March 23, 2019.ST PHOTO: ALPHONSUS CHERN

SINGAPORE - Singapore's healthcare receipts already exceed $9 billion and is rising faster than GDP, with a certainty it will rise even further.

Eventually, this will be unsustainable, Prime Minister Lee Hsien Loong said on Saturday (March 23).

In the medium-term, the country will have to find new ways to fund healthcare spending.

"But at the same time, we have to think hard about what we must spend on, and which drugs and procedures are cost-effective," he said at the official opening of Singapore's biggest new hospital, Sengkang General Hospital (SKH), and the companion Sengkang Community Hospital, which provides rehabilitation services.

"And we have to make hard choices, and I hope we will have the support of Singaporeans in making them," he said.

PM Lee's comments come as the Health Ministry said it will take a pause to plan future healthcare needs after the next public general hospital opens in Woodlands in 2022.

Since 2010, the government has been steadily building more facilities to meet growing demand as the population ages.

The Sengkang integrated campus in the north-eastern part of Singapore will add 1,000 acute hospital beds and 400 community beds when it opens fully. Currently, it operates about 500 acute and 150 community hospital beds. More beds will be opened progressively to meet rising patient demand.

On Saturday, PM Lee noted that Singapore spends less on healthcare than most other developed countries, yet has better outcomes.

One reason for the lower expenditure is the relatively younger population, which has only recently begun ageing.

"But the main reason is because we have structured our system properly, and built in the right incentives to guard against overconsumption of healthcare," he said.


This is not easy to do because it is difficult to tell people that some treatments they want are not necessary or cost-effective, he added.

"Yet we have to watch how heavily the Government subsidised healthcare," he said, noting that in countries with high health subsidies, doctors tend to prescribe more unnecessary and expensive treatments.

In his speech, PM Lee also talked about how the healthcare system must adapt to Singaporeans living longer, with more chronic diseases like diabetes and hypertension, and in smaller families but a larger proportion of seniors overall.

One way it is doing this is shifting to a more patient-centric, multi-disciplinary approach, he said.

That is why SKH and SKCH are located in the same campus and operate as a single entity, just as the authorities have done with Ng Teng Fong General Hospital and Jurong Community Hospital.

PM Lee noted that SKH patients can receive a wide range of medical services - they can be treated at SKH and smoothly transferred to the community hospital, with staff from both hospitals working together as one team. The administrative procedure for such a transfer has also been simplified.

Patients will also get access to specialist services more easily, through tie-ups with the National Heart Centre, Singapore National Eye Centre and the National Cancer Centre, among others.

PM Lee also emphasised the importance of primary care, and noted how SKH is partnering almost 30 general practitioners in Sengkang and Punggol to provide chronic disease management, for one thing.

Even as these measures are rolled out, he reminded people that the "best thing we can do for ourselves is to take care of our own health".

While accidents or injuries cannot be helped, many diseases are preventable if we watch our diet or lead healthy lifestyles, he said.

Check out ST's Health Check podcast series: