Push for more doctors in community care: Gan Kim Yong

Health Minister sees family docs, broad-based specialists helping those with more issues as they age

Mr Gan Kim Yong said another key to better healthcare is to step up screening efforts.
Mr Gan Kim Yong said another key to better healthcare is to step up screening efforts. ST PHOTO: LIM YAOHUI

Singapore is building up the number of family physicians and broad- based specialists who will be able to provide holistic care to patients with multiple medical ailments.

This comes as the nation shifts its focus towards preventive and community care, said Health Minister Gan Kim Yong in an exclusive interview with The Straits Times last month.

While there is still a need to continue building more hospitals and nursing homes, he said there is also a need to "strengthen the community part so there is a balance, so that more patients can be taken care of in the community".

This shift is crucial with the rapidly ageing population requiring more healthcare services. By 2030, the number of people aged 65 and older will double to 900,000.

Mr Gan said: "Planning has to be done now, some of the pieces have to be put in place now before the ageing challenge hits us. We have a window to do what needs to be done."

He said the recent announcement of restructuring the public sector into three clusters, each with one or more hospitals, a medical school and several polyclinics, provides "stronger infrastructure to allow us to implement some of these shifts in a very decisive way".

One key shift, he added, is for primary care to play a bigger role.

This in turn means Singapore will need a lot more of such doctors and it does not matter if they are from private general practitioner (GP) clinics or government-run polyclinics, noted Mr Gan.

"Chas (Community Health Assist Scheme) is designed to allow more seamless co-management of patients between polyclinic and GPs, and if they are looked after by GPs in Chas, I'm quite happy."

About half the population qualify for Chas, where Singaporeans enjoy government subsidies when they see a private GP or dentist.

The Ministry of Health is encouraging more primary care doctors to become family physicians. These physicians are GPs with more training so that they are better able to care for patients with chronic conditions.

The plan is to add 300 family physicians between last year and next year. At the end of 2015, there were 1,659 family physicians out of more than 8,200 non-specialists, the majority of whom were GPs.

"Beyond a doubt, primary care will play a very crucial role going forward as we transform our care model, whether in anchoring care in the community so that there is less reliance on hospital specialist care, or in reaching out to the population in the community to keep them healthy," Mr Gan said.

Specialists will also be encouraged to take on broad-based specialities, like internal or geriatric medicine. Between 2011 and 2015, 390 such specialists were added, with another 317 who have or will come on board between last year and next year.

As people get older, they tend to develop more than one medical condition and, as such, specialists should be able to handle all the different ailments the patient suffers from, to minimise the need for multiple referrals, said Mr Gan.

Another key to better healthcare, he added, is to step up screening efforts and to keep the population healthier so there is less need for hospital care.

The Health Promotion Board, which provides screening, education and opportunities for people to stay healthy, has seen its expenditure go up by more than 8 per cent a year for more than five years, and this is likely to exceed $225 million this financial year.

Its Sundays@The Park programme, which boasts a variety of fun physical activities such as zumba, kickboxing and Bollyrobics, had 14,000 participants across 72 parks islandwide by the end of last year - up from 9,000 in June.

The plan is to make an active lifestyle the norm, since exercise is key to keeping healthy. Although people here are living longer, they spend the last 10 years of their lives on average in ill health, according to Ministry of Health statistics.

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A version of this article appeared in the print edition of The Straits Times on March 06, 2017, with the headline Push for more doctors in community care: Gan Kim Yong . Subscribe