S'pore to spend more than $1 billion to get Healthier SG preventive care strategy up and running

In making these investments, the primary motivation is to reduce the burden of disease and the suffering of people. PHOTO: ST FILE

SINGAPORE - To get the new preventive care strategy Healthier SG off the ground and running, Singapore will spend more than $1 billion over the next three to four years in set-up costs, such as new IT systems and support to get general practitioner (GP) clinics ready for the scheme.

It will also spend an estimated $400 million a year on recurrent costs, such as annual health screenings for residents and the annual service fee for GPs, Health Minister Ong Ye Kung told Parliament on Tuesday.

"We spend about 6 per cent of our healthcare budget on preventive care annually, such as to fund HPB," he said, referring to the Health Promotion Board.

"With Healthier SG in the coming few years, we will, and we want to, grow this – perhaps to double the share of total healthcare spending," he said.

In making these investments, the primary motivation is to reduce the burden of disease and the suffering of people and their loved ones, he added.

Mr Ong was speaking at the start of the debate on the White Paper on Healthier SG, which outlines a major shift in the healthcare system and was published on Sept 21 after six months of consultations with more than 6,000 residents, GPs, employers and others.

Healthier SG seeks to shift the gravity of care from the hospitals to the community.

The aim is to get residents to build a long-term relationship with one family doctor, who will help them to take charge of their own health and wellness.

In his speech, Mr Ong acknowledged that these investments in preventive care will take time to produce results.

Any impact in people's health will not happen immediately, but perhaps be discernible eight or 10 years down the road.

And with an ageing population, reversing the rise in healthcare spending will not be possible. "What we can hope for is to slow down the rate of increase," Mr Ong said.

Singapore's total healthcare spending could rise by up to threefold in the coming 10 years to about $60 billion a year by 2030, from about $22 billion a year at present, he noted.

"If this national medical bill doubles instead of triples in 10 years – we would have saved much more than what we are planning to spend on preventive care," he said.

"At the heart of Healthier SG is a philosophy of how we choose to live our lives. If we put in a small effort every day, a bit of discipline every week, a bit of restraint every week, we can avoid big life-changing suffering later."

Mr Ong said: "We are making a big effort to support you because it is almost human instinct to not do the right thing because of instant gratification."

Under Healthier SG, once residents sign up with a family doctor, the Government will fully fund the annual check-ins with doctors and nationally recommended health screenings and vaccinations for residents.

The screenings will include common chronic conditions such as Type 2 diabetes, hypertension and hyperlipidaemia, as well as for breast, cervical and colorectal cancers.

Those using MediSave to treat chronic illnesses will no longer be required to co-pay 15 per cent of the bill using cash, and can fully use their MediSave. Subsidies for common chronic disease drugs at private GPs will also be enhanced.

For this to happen, the support of family doctors is key.

"GPs will continue to attend to their existing patients and prescribe medication to them. What Healthier SG does is to enlarge their client pool, through enrolment for preventive and chronic care consultations," said Mr Ong.

The GPs will be paid an annual standard fee per enrolled patient, for maintaining a long-term relationship with him or her.

This fee will cover regular doctor consultations, ensuring residents adhere to their health plans, the associated administrative work and a review of the health plan annually – over and above subsidies for health screenings and medication, which are separately funded, added Mr Ong.

The minister said it is not a new concept for GPs, as those who assist the healthcare clusters to manage complex chronic patients get a "Care Plus" service fee payment of $100 per patient.

"Healthier SG will broaden such schemes to cover preventive care for large segments of the population. The fee will be similar or higher than the current Care Plus fee, depending on the health conditions of the enrolled residents," said Mr Ong.

"We estimate that in the coming few years, Healthier SG service fees and revenue from subsidised services can grow as more residents enrol and become a significant component of a GP's annual revenue – maybe a quarter, maybe a third."

A total of 28 MPs had indicated that they plan to speak during the debate on the White Paper.

Among the 18 MPs who spoke on Tuesday, Dr Tan Wu Meng (Jurong GRC) highlighted the need to look into the challenges faced by those who are not digitally savvy and those who are less mobile, and said that holistic care takes time.

Ms He Ting Ru (Sengkang GRC) asked about the support for GPs, including training in handling mental health cases, and if the barriers for foreign-trained Singaporean doctors to come home to practise can be lowered.

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