SOLUTIONS FOR SINGAPORE
The initiative NHCS implemented aligns with
something the Ministry of Health has been working
on across Singapore. “They have started an initiative
where certain subspecialties would open their tests
or services to primary care doctors without having
to go through a specialist gatekeeper,” Terrance
says. “For example, someone with a backache could
see a physiotherapist without going through an
orthopaedic surgeon if the criteria were met.”
Looking more broadly at Singapore’s healthcare
sector, Terrance sees the biggest issue as its ageing
population. Not only are patients ageing faster and
living longer but families are getting smaller. And
fewer children means there will not be enough
caregivers for the elderly.
“The government has recognised that our
problem is how we don’t have enough people in
healthcare, particularly nurses, and to some extent,
doctors and other allied health professionals, to
cope with a larger number of the elderly who will
inevitably have more conditions,” he says. “Heart
disease and heart attacks become more common
as you get older. In general, people above the ageof 65 have a much higher risk of developing
a condition that requires admission, and it can be
for much longer. So we are gearing up to try to
meet this demand.”
Around 30 per cent of NHCS patients are
aged 65 and over. While the natural solution might
be to increase facilities and recruit more people
into healthcare – something NHCS has already
done – it isn’t the only solution. Terrance
emphasises the urgent need to change the way
medical practitioners provide care so that it is not
so labour intensive.
“Even if you have the budget to get healthcare
staff, you cannot find enough people,” he explains.
“Eventually, there’s going to be even fewer people
to manage our resources. There’s a keen interest
to see how much more care can be delivered
with patient education, healthy lifestyle and
self-empowerment.
“People are better educated, there is potential
of leveraging on IT, with lots of tools that allow
patients to track their own outcomes. And so
perhaps the solution will lie in patient
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