Those 60 and above can enrol with GPs for personalised lifelong care under Healthier SG from second half of 2023

SINGAPORE — From the second half of next year, Singapore residents aged 60 and above will be able to enrol in a national programme where they get to choose a family general practitioner (GP) to stick to and who would then manage their health throughout the rest of their lives.

The ultimate aim of the programme, named Healthier SG, is to prevent people from falling ill in the first place, and to improve the overall health of Singaporeans by forging stronger patient-doctor relationships. 

People aged between 40 and 59 will get to enrol in the programme in the next two years.

The plan was first announced in March by Health Minister Ong Ye Kung. Since then, the Ministry of Health (MOH) has consulted more than 6,000 Singapore residents and stakeholders such as private GPs, employers and community partners to design the key features of Healthier SG.

A White Paper was then submitted to Parliament on Wednesday (Sept 21) and will be debated next month. 

Under the proposal for Healthier SG, residents will be encouraged to choose and enrol with a family doctor, who will then serve as a first point-of-contact to holistically manage their health. 

Those who choose to enrol in the initiative will receive their first onboarding health consultation for free. 

Once enrolled, residents will develop a health plan with their doctor and discuss how to improve their health, such as by making lifestyle adjustments, having regular check-ins on their health and taking up the recommended health screenings and vaccinations.

Singapore citizens who have enrolled can then receive fully subsidised nationally recommended screenings and vaccinations. 

They will also no longer have to make a cash co-payment when using MediSave from their Central Provident Fund account for chronic care management.

And MOH will introduce a new drug subsidy tier under the Community Health Assist Scheme (Chas) for a list of drugs that are used to manage chronic diseases, so that their prices at private GP clinics are comparable with those at polyclinics.

For chronic conditions covered under the Chronic Disease Management Programme, Singapore citizens who are eligible for subsidies may be referred by GP clinics under Chas and the Healthier SG programme to go directly to specialist outpatient clinics for subsidised care, without going through a polyclinic. 

Beyond helping patients manage their diseases, these family doctors will also be able to make "social prescriptions", which are referrals to community partners, to support residents in leading healthier lives.

They will be able to do this as Healthier SG will help to connect residents to a wide range of activities organised by agencies such as the Health Promotion Board, Agency for Integrated Care, People’s Association, Sport Singapore and community partners.

Seniors will also be given more support via eldercare centres, which will be expanded and enhanced by 2025, MOH said. 

"We will expand the number of centres from the current 119 to 220 by 2025; and provide more services, such as connecting seniors with community programmes and helping them with monitoring vital signs," Mr Ong said on Wednesday.

Residents would be free to choose any doctor or clinic who is enrolled in the Healthier SG programme. This could be a clinic located near their home or workplace or a doctor whom they have known for many years.

Those who wish to switch to a different GP under the programme may do so up to four times upon initial enrolment in the first two years, and once a year for the subsequent years.

To ensure a consistent level of care and guide family doctors in providing screenings and vaccinations, as well as to manage key conditions, MOH has developed 12 care protocols, with more of such protocols to be developed in future covering areas such as mental health. 

These protocols, developed with GPs and polyclinics, identify key components of care and key processes and  data needed, which would then guide those participating in the Healthier SG programme to provide the same consistent level of care to patients.

Care protocols will be rolled out first for diabetes mellitus, hypertension and lipid disorders, the three most common chronic conditions. 

Other protocols to be launched will cover other common chronic conditions and end-of-life care. 

MOH said that the progress and outcome of Healthier SG will be monitored via short-term indicators such as rate of resident and GP enrolment, medium-term ones such as level of physical activity among Singapore residents and long-term outcomes such as the prevalence of chronic diseases and healthcare costs.

"Healthier SG will be a long-term, multi-year effort, as it takes time, probably eight to 10 years, to see the initial results of a healthier population," MOH said.

"We are investing in and changing the healthcare system, to support individuals to chart their own journey towards better health."