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How the Idea of ‘Tagging’ 1 Person to 1 Family Doctor in S’pore Will Work from 2023

2022-03-10 , 10:26 am

Do you doctor-hop, or do you only visit one doctor for everything?

From 2023, you’ll be invited to enrol with a general practitioner or polyclinic doctor of your choice, who will support you throughout life and help with preventive care.

There’ll also be more widespread sharing of health data across different healthcare providers so that your doctor can have a more holistic assessment of your health.

Here are all the details about this new initiative.

Regular Doctors Help To Focus on Preventive Care

During the Ministry of Health’s (MOH) Committee of Supply debate, Health Minister Ong Ye Kung said that this initiative is part of a new strategy called Healthier SG.

It would be a huge reform of the healthcare sector, and aims to include GPs into the public healthcare system. Healthier SG will also have the healthcare system focus more on preventive care.

Currently, only 60% of Singaporeans have a regular doctor, while others tend to doctor-hop.

However, if everyone has a regular doctor, it could actually lead them to be healthier and have fewer visits to the hospitals.

A regular doctor would be able to know you better, and can detect the early signs of any problems more accurately. They’ll also have a better understanding of your overall health condition and health history, to be able to spot any relation between different visits to the doctor.

This would allow doctors to better provide preventive care.

Enrolment from 40 and Above, Based on Where They Live

The enrolment will likely start with people in their 40s and above.

That’s because chronic illnesses usually start to set in then, so they’ll be the ones who would benefit the most from this programme. MOH will build up the participation rate progressively.

Enrolment will be based on where residents live, as 90% of residents visit doctors near their homes.

However, you can choose to enrol with a doctor far away from home, like people who continue to visit their childhood doctors. You can also make changes to your enrolled doctor when needed, such as when moving houses.

MOH to Partner with Healthcare Groups To Integrate GPs into Health System

MOH will be partnering with three healthcare clusters, namely National University Health System (NUHS), National Healthcare Group (NHG) and Singhealth. Each cluster will be in charge of a region of up to 1.5 million residents.

Together, they’ll support the GPs within their region and integrate them into the health system. This would be done by enabling data sharing and building up team-based care.

For instance, GPs may work with the polyclinics or hospitals to jointly manage patients with more complex needs. Hospitals could also refer patients to their family physicians to ensure that patients still get the care they need, even after discharge.

Upgrades in Manpower and Technology To Support Reforms

MOH will be investing in manpower and technology to support these reforms.

They’ll be exploring more measures to ensure new graduates have more broad-based experiences. They’ll also be strengthening post-graduate training in family medicine.

MOH will also see how they can better provide data support for family physicians. This includes giving them access to medical records, and tools like clinical dashboards to track their patient’s health over time.

The National Electronic Health Record (NEHR) system, which MOH has been developing, will be crucial to this reform. It’ll help to synchronize and enable access to information across different providers.

New legislation will also be put in place to govern the greater access and handling of shared data. A Health Information Bill will ensure and facilitate secure data sharing, and heighten the responsibility for those accessing such data.

Healthcare Groups’ Financing System To Be Adjusted, Provide Incentives for Preventive Care

The groups are now funded based on a workload-based model. This means that funding is based on the number of services provided, like the number of operations or patients seen.

MOH will be moving to a capitation model of funding, where the three healthcare clusters will receive a pre-determined fee for every resident in the region they’re caring for.

This new model will give hospitals more incentive to keep residents healthy via preventive care, and allows for more room to decide how they’ll best support each resident.

Giving clusters control of the funds will also incentivise them to think of how they could best save the funding and cut costs. This could include measures like moving patients into other care settings that could cost lower, for both the clusters and the patients.

The healthcare providers will also need to hit a set of key health outcomes, like the quality of care, uptake of healthy lifestyles, and cost-effectiveness of treatments.

However, the absolute budgets of each cluster won’t be affected, and might even increase a little. It’s just the basis of calculating the budgets that’ll change.

If you’re confused, here’s your TLDR: different ways of calculating healthcare budgets may possibly lower healthcare costs for us, and will lead to the healthcare system focusing more on stopping us from falling sick in the first place.

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Details Still Being Worked Out, Will Be Up For Debate in Parliament Once It’s Done

The details of Healthier SG are still being worked out. MOH will consult various stakeholders over the next few months, which includes the public, GPs, healthcare workers and community partners.

More details of public consultation plans will be shared when ready.

The details of this initiative will be shared in a White Paper and it’ll be up for debate in Parliament.

You can watch Minister Ong’s short video on this initiative here: