Coronavirus Singapore
New primary healthcare system for migrant workers
One medical centre in each sector; active surveillance to reduce risk of disease outbreaks
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Workers at a construction site at Dakota One earlier this month. Under the new healthcare system, each sector will be anchored by a medical centre for migrant workers complemented by on-site centres in larger dormitories, at least two mobile clinical teams, round-the-clock telemedicine consultations, and ambulance and special transport services.
ST PHOTO: DESMOND WEE
From as early as November, a new system will be rolled out to provide primary healthcare for migrant workers here and reduce the risks of future disease outbreaks through active surveillance.
Tender documents published by the Ministry of Manpower (MOM) on Monday reveal that the new system will deliver healthcare in six geographical sectors, with each sector housing at least 40,000 migrant workers both in and out of dormitories.
Healthcare providers may submit proposals to operate in one or more sectors.
Each of the six sectors will be anchored by a medical centre for migrant workers, which will be complemented by on-site centres in three larger dormitories, at least two mobile clinical teams, round-the-clock telemedicine consultations, and ambulance and special transport services.
The centre in one of the sectors, covering areas in the west like Bukit Batok and Jurong, will be operated by a non-governmental organisation, which documents did not name.
The sector has about 54,800 workers, of whom more than 82 per cent reside in dorms.
Tender documents said healthcare should be provided in a way that "minimises any cultural and language barriers to access healthcare services". This may include having doctors on-site from workers' home countries and multilingual translation capabilities.
Providers must also keep workers' out-of-pocket expenses low.
Under the new system, each of the six medical centres for migrant workers will be the first-line outpatient facility. The centres will have X-ray machines to facilitate diagnoses.
They will also be used for public health surveillance, and equipped with testing capabilities and isolation facilities to halt the spread of diseases like Covid-19. They will be staffed by at least one doctor as well as nurses, administrative personnel and a radiographer.
On-site medical centres, to be located in three large dormitories for a start - PPT Lodge 1B, Sungei Tengah Lodge and Tuas View Dormitory - will have similar capabilities but without X-ray facilities.
Meanwhile, mobile clinical teams will be activated by MOM in the event of an emerging outbreak, where they will help execute public health interventions like swabbing and contact tracing.
Telemedicine consultations will cater to non-urgent needs like mental health counselling or medication refills, which will be delivered.
The new healthcare system for migrant workers follows the roll-out of 13 regional medical centres for workers since August 28 last year.
Tender documents did not state how or if these centres will fit into MOM's plans come November.
About 87 per cent of Singapore's 62,563 Covid-19 patients were dorm residents, although no new cases have been detected in dorms in the past two weeks.
Dr Jeremy Lim, vice-chairman of migrant workers' non-profit organisation HealthServe, said it has been approached by several private healthcare groups to be part of a consortium for the tender.
"We have not made any commitments. We are guided by what is in the best interest of migrant workers," he said.
Dr Lim, who is also an associate professor at the National University of Singapore's Saw Swee Hock School of Public Health, said MOM's request for proposals has a strong element of proactive care, including preventive health screenings and education for workers.
Infectious disease physician Ling Li Min said the pandemic showed the healthcare needs of migrant workers had been neglected, with many suffering from chronic conditions not seeking treatment here as costs are prohibitive.
Dr Ling said it will be important for doctors running the new medical centres to work together across sectors to recognise outbreaks.
Dr Lim said any future outbreaks should also be easier to manage because interactions between workers and healthcare providers should be limited to more specific geographic areas.
Mr Johnathan Cheah, managing director of S11 Capital Investments, which operates PPT Lodge 1B, said that the current medical centre at the dormitory in Punggol has served its residents well.
"The biggest benefit is that the centre ensures early detection and isolation of those with acute respiratory symptoms and there is no need for the worker to go into the community," he said.
Note: This story has been updated for clarity.