Table of Contents
Security and External Relations
Ministry of Health
MINISTRY OF HEALTH (MOH)
MOH’s vision is “Championing a healthy nation with our people—To live well, live long & with peace of mind”. MOH’s mission is to be an innovative and people-centred organisation, to promote good health and reduce illness, ensure access to good and affordable healthcare that is appropriate to needs, and pursue medical excellence.
A total of $4.7 billion is allocated to MOH in FY2012 to achieve this mission.
Outcomes of Ministry
MOH has identified the following desired health outcomes in line with our mission:
- Healthy Singaporeans
- Good quality and accessible healthcare
- Affordable healthcare
- Appropriately resourced healthcare system
To build a nation of healthy Singaporeans, MOH begins with focusing on health promotion and education, as well as building up a strong public health system that is resilient against communicable disease threats and civil emergencies.
Building a Healthy Population
As our population ages, we face the challenge of an increasing burden of non-communicable diseases (NCD), similar to the situation in developed countries. Heart disease, cancer, stroke and chronic respiratory diseases are major health problems in Singapore today. We can reduce the burden of these NCD by tackling lifestyle-related risk factors like smoking, unhealthy diet, physical inactivity and obesity from young; and by screening for and managing chronic conditions like high blood pressure, high blood cholesterol and diabetes well.
The Health Promotion Board (HPB) is the main driver for national health promotion and disease prevention programmes targeted at increasing the years of healthy life and preventing illness, disability and premature death. HPB aims to develop high quality programmes and platforms for healthy living that are customised to meet local community needs, and to leverage social capital to influence and motivate people to lead healthy lifestyles. Its programmes are focused on three areas - healthy children and youth, healthy adults, and healthy ageing. For FY2012, $203 million is set aside for various programmes that work on obesity, prevention, tobacco control, preventive health services for children and youth, chronic disease management, awareness and education of AIDS, Tuberculosis, other communicable diseases, and mental health. Considerable effort is also being channelled into building up a Health Ambassador Network, a programme where ordinary citizens are equipped with skills to be health advocates to their peers.
MOH and HPB are also working closely with the industry, trade unions, community organisations, healthcare partners and schools to promote healthy lifestyles and build capacity for health promotion. We will continue to grow this network to create a supportive environment and ecosystem that makes the healthier option the default choice for Singaporeans. We will make a push to empower individuals and to enable them to better care for themselves by providing them with the right information, technology and devices.
In addition to physical health, MOH also coordinates and drives initiatives that promote the mental well-being of Singaporeans, through the National Mental Health Working Group. These initiatives have strengthened mental health care in the community using customised approaches for children, youths, adults and the elderly, and increased awareness among Singaporeans of the importance of mental well-being through public education campaigns. In the coming year, we will be expanding professional resources and mental health services in the community, closely integrated with primary care and intermediate and long-term care services, so that patients can receive appropriate care and support in the community.
Maintaining Vigilance Against Emergency Health Situations
Even as we tackle the challenges of the rising burden of non-communicable diseases, our healthcare system must continue to remain vigilant and prepare against public health threats and potential emergency health situations such as flu pandemics and mass casualty events. MOH will strengthen its close partnerships with the World Health Organization (WHO) and the international community to improve surveillance and to counter emerging global infectious diseases and other threats in a quick and robust manner. We will also sharpen our national research strategy for infectious diseases and health services research, particularly with the new Saw Swee Hock School of Public Health in the National University of Singapore (NUS).
Good Quality & Accessible Healthcare
MOH is committed to ensuring that all Singaporeans have access to good quality healthcare that is appropriate to needs. This is achieved through the following:
Managing Patients Holistically through Integrated Healthcare Services—Strengthening Primary Care, Intermediate & Long-Term Care and End-of-Life Care.
MOH aims to evolve a healthcare system that is patient-centric and for patients to be cared for in settings that are most appropriate for their condition.
MOH will work towards fostering greater integration between healthcare providers in the primary, step-down, and acute care sectors. To do so, we have reorganised the healthcare delivery system into networks of providers along regional lines. These integrated networks of providers comprise general hospitals working in close partnership with community hospitals, and other providers in the community such as nursing homes, polyclinics and private General Practitioners (GPs), to provide seamless care for patients. One example of this is the Eastern Health Alliance (EHA) which was formed in FY2011 and comprises of Changi General Hospital, St Andrew’s Community Hospital, the Salvation Army’s Peacehaven Nursing Home and SingHealth Polyclinics.
MOH will continue to work with stakeholders to upgrade capabilities in the Primary Care Sector, especially in the management of major chronic diseases in the community. We will work with private GPs to transform primary care through the development of new primary care models, Family Medicine Clinics (FMC) and Community Health Centres (CHC) so that Singaporeans can tap on the expertise of a team of healthcare professionals, including nurses and allied health professionals to help them manage their chronic conditions.
As our population ages, the demands on aged care will increase. Under the guidance of the Ministerial Committee on Ageing (MCA), we will expand the scope of intermediate and long-term care (ILTC) in Singapore, to facilitate ageing-in-place so that our seniors can grow old in the company of their family. We will expand and enhance home-based care, and develop a wider network of day care centres that provide both social and healthcare services, within the heartlands, so that our seniors and their caregivers can have better access to quality care, close to home. We will also work with aged care providers on manpower and financing initiatives that can help build up their capabilities. This will in turn make home and community-based care a more viable option for Singaporeans.
Information Technology is an important enabler of integrated care. The National Electronic Health Record (NEHR) will provide national health informatics infrastructure to enable relevant patient information to be shared amongst healthcare providers to improve the standard of care. The NEHR is being implemented in phases, with the deployment of NEHR Phase 1 to early users from the healthcare sector implemented from July 2011. We will continue the roll-out of NEHR to all providers participating in integrated care, including GPs, aged care players and private sector acute care institutions.
Investing in Knowledge-driven Healthcare
The pursuit for medical excellence ensures that our national healthcare system keeps pace with global medical advancements. Clinical research and knowledge-driven care will help develop new standards in medical excellence and raise the quality of medical care for Singaporeans. Under the Health Services Development Programme, funds have been set aside to develop new clinical services. These initiatives will augment Singapore’s medical capabilities in our public healthcare system and help position Singapore as the premier regional medical services hub.
Strengthening Regulatory and Professional Standards, and Ensuring Patient Safety
MOH licenses healthcare institutions such as hospitals, medical / dental clinics, clinical / X-ray laboratories and nursing homes to ensure that these institutions maintain safe standards of healthcare for all Singaporeans. We also conduct regulatory surveillance, periodic compliance audits and investigations into breaches of relevant healthcare laws to safeguard the public against unethical and wrongful healthcare practices such as illegal organ trading. MOH works closely with all the professional boards and councils, such as the Singapore Medical Council, Singapore Nursing Board, and Singapore Dental Council, to ensure proper registration of key healthcare professionals and establish ethical codes and guidelines to uphold high standards of professionalism and conduct among our healthcare professionals.
MOH has governance agreements with the Restructured Institutions and tracks achievement of priorities and desired outcomes in healthcare provision, facilitated by benchmarking exercises to drive performance improvement. Healthcare institutions are required to establish quality assurance systems to evaluate and learn from clinical errors and incidents so as to seek improvement in their systems of care on a continuing basis. MOH constantly monitors clinical quality and performance of all licensed hospitals and clinics, and ensures that our healthcare performance is comparable to or aims towards international performance benchmarks.
MOH has augmented knowledge translation of quality improvement and patient safety through Healthcare Quality Improvement and Innovation Funding to pilot evidence-based practices and solutions for local suitability and for adoption as new standards of practice. We work closely with stakeholders to ensure that the best and most up-to-date information and knowledge is available for sharing and learning in the healthcare fraternity. To promote and recognise clinical quality improvement activists and projects, and celebrate their achievements, national forum and awards were commissioned. We have also implemented national patient safety strategies in the areas of medication safety, correct site surgery and to reduce healthcare-associated infections by formalising and standardising practices and outcome measurements across healthcare institutions.
The Health Sciences Authority (HSA) is MOH’s main driver to protect and advance public health and safety in its regulation of health products to meet appropriate standards of safety, quality and efficacy; securing Singapore’s blood supply through its operation of the national blood bank; and supporting the administration of justice with its forensic science and analytical chemistry testing expertise.
In FY2012, the Health Products Regulation Group of HSA will build up its capacity to focus on the smooth roll-out of regulatory requirements for medical devices, under the Health Products Act, by keeping stakeholders well informed and engaged regarding the regulatory changes taking place. The Blood Services Group of HSA will continue to extend its broader strategy of providing more fixed blood collection centres, with the aim of bringing blood donation to the community and providing blood donors more convenience. The Applied Sciences Group of HSA will build on its strong collaboration with the Ministry of Home Affairs’ Home Team Departments by further improving the scientific scope and timeliness in the delivery of its forensic science analytical services.
Singapore adopts a balanced approach to the financing of healthcare, with the aim of providing peace of mind to individual Singaporeans through our framework of heavy Government subsidies as well as the 3Ms (Medisave, MediShield and Medifund). This multi-tiered healthcare financing framework has served us well thus far in ensuring that the vast majority of hospital bills remain affordable for Singaporeans. In FY2012, a series of enhancements will be introduced to further enhance the affordability of healthcare services, especially for middle income households with elderly.
In FY2012, a total of $2.2 billion is set aside as subsidies for Singaporeans seeking medical care at the restructured hospitals and institutions, polyclinics, community hospitals, and institutions in ILTC sector e.g. nursing homes, community hospitals, day rehabilitation centres for the elderly and hospices, for the provision of subsidised medical care.
Government subsidies will be extended to all community hospitals patients and there will be an increase in the subsidy level across the board, with the middle income experiencing the largest increase. We will also raise subsidies for nursing homes, day care and rehabilitation facilities and home care so that more in the middle-income group can benefit. Two-thirds of Singaporean households will now qualify for ILTC subsidies. In addition, MOH will be absorbing the 7% GST charged for healthcare services consumed by subsidised patients in MOH-funded ILTC institutions.
We have also enhanced the subsidies for outpatient care. From 15 January 2012, the eligibility criteria for the Community Health Assist Scheme (CHAS), formerly known as Primary Care Partnership Scheme (PCPS), was expanded to allow more Singaporeans access to subsidised primary care and basic dental care at private GPs and dental clinics near their home. Under the Medication Assistance Fund (MAF), which is an assistance scheme to help Singaporeans with selected high-cost medications, the level of subsidy for eligible patients was increased to 75% from 50% since October 2011. MAF was also expanded to cover non-standard, but clinically necessary drugs on a case by case basis.
Apart from enhancements to the subsidy framework, we are continually refining the 3Ms financing framework. For example, the withdrawal limits for outpatient expenses was raised from $300 to $400 on 1 January 2012, to help patient manage chronic diseases. The Medisave scheme has been extended to cover mammograms and colonoscopies since June 2011.
As our population ages, we will be extending the MediShield maximum coverage age from 85 to 90. This will ensure that Singaporeans are able to remain covered for almost all of their lives. We will also be reviewing other possible changes to MediShield, including an extension to cover treatment for congenital conditions. As premiums have to be adjusted to take into account these changes and the on-going claims experience, the Government will provide a one-off Medisave top-up in FY2012 for all Singaporeans insured under MediShield to help offset these premium increases. This will be on top of the Medisave top-ups provided through the GST Voucher scheme that was announced recently in the Budget speech.
The use of Medifund will be expanded from 1 April 2012 to include non-residential ILTC services such as day rehabilitation, home medical and home nursing. In FY2012, there will be a top-up of $600 million to the Medifund capital sum and this will increase the payouts from Medifund by over 20%. This will help those who need extra assistance, including those middle-income Singaporeans faced with high medical expenses.
Apart from the 3Ms framework, we also have ElderShield, which is an affordable severe disability insurance scheme to provide insurance coverage for elderly Singaporeans who require long-term care. MOH is studying the possible changes to ElderShield to enhance coverage for the cost of long-term care. For Singaporeans who are not eligible to join ElderShield due to the age limit or pre-existing disabilities, they may apply for the Interim Disability Assistance Programme (IDAPE) for the Elderly, to help defray some of the cost associated with long-term care. MOH will be raising the qualifying per capita household income for IDAPE, from the current $1,000 to $2,200 per month. The IDAPE payouts will also be increased from the current $100 and $150 per month to $150 and $250 per month.
With a rapidly ageing society, MOH will improve access, affordability and quality of aged care. MOH will continue to empower Singaporeans to make better decisions on their choice of doctor or healthcare provider.
Appropriately Resourced Healthcare System
Augmenting Healthcare Manpower and Improving Infrastructure
With the ageing population, healthcare needs will increase even as they change in nature. By 2030, 1 of 5 Singaporean residents will be aged 65 and above. As our society becomes more developed, Singaporeans’ expectations of healthcare and our healthcare professionals continue to rise. Our manpower and infrastructure capacity must grow in tandem with the growing and evolving healthcare needs of Singaporeans.
- In FY2012, we will continue to increase the intakes of local educational programmes, including for doctors, dentists, nurses, pharmacists and allied health professionals. We will work on expanding the capacity of and raising the quality of medical education and clinical training, and to upgrade the capabilities of healthcare professionals.
- To retain good healthcare professionals in the public sector, we will also provide additional funding to ensure competitive salaries for doctors, specialists, nurses, allied health professionals and pharmacists in the public sector. We will continue to seek to improve career development opportunities for our public sector healthcare professionals. We will also provide additional funding to enhance staff attraction and retention in the long-term care sector, and work on strategies to build up capabilities and raise productivity in the sector.
- With the ageing population and the increasing burden of chronic care, MOH will continue to invest in healthcare infrastructure, with the development of new facilities and improvements and expansions to existing facilities, in both the public acute and ILTC sectors.
- New facilities under development: On the Outram Campus, new buildings for Pathology Education and Research, and the National Heart Centre are expected to be ready by 2013 and 2014 respectively. The new Ng Teng Fong General Hospital is on track for completion in 2014, while the adjoining Jurong Community Hospital is will open the following year in 2015. Other projects in the pipeline include the new Sengkang General Hospital and Community Hospital and two more Community Hospitals in Yishun and Outram. We will also build a new integrated building for Changi General Hospital and St Andrew’s Community Hospital which will be ready in 2014. These new facilities will increase the number of beds in acute hospitals by more than 30%, or 1,900 beds by 2020, and more than double the number of Community Hospital beds, by adding another 1,800 by 2020.
- Existing facilities undergoing upgrading: We are in the process of enhancing capacity at some of our existing facilities. More generally, our restructured hospitals constantly seek to improve the delivery of care for patients, and conduct periodic improvements works to enhance patient experience and operational efficiency.
- To facilitate “right-siting” of patients in a setting which is more appropriate to their care needs, MOH will also expand services in the ILTC sector. In addition to our efforts to improve access by seniors to home-based healthcare services, or community-based day facilities, we will continue to work with VWO partners to expand the number of nursing home beds. In total, we will increase the supply of Nursing Homes beds by about 70%, from about 9,000 today to 15,600 by 2020. This will be done by redeveloping existing Nursing Homes, such as the Singapore Christian Home for the Aged, Bright Hill Evergreen Home, Villa Francis Home for the Aged, Ren Ci Nursing Home, Lions Home, and through the construction of new nursing homes.
Ng Teng Fong General Hospital
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