Report of the Study Course on ICPD and Health Care 21-24 October 1998 Singapore

AUICK Study Course on ICPD and Health Care 1998

Lecture 6: "Health Care Systems in Singapore Compared to Other Health Care Systems"

(Summary of the Lecture)

Dr. Goh Lee Gan
Associate Professor, Department of COFM, National University of Singapore

To meet the increasing health care demand, the Ministry of Health, Singapore, aims to promote good health and reduce illness, to ensure that all Singaporean have access to good and affordable health care and to promote medical excellence.

Singapore's health care services are provided by both the public and the private sectors. The government runs 17 polyclinics, each serving 100,000 to 150,000 people. About 900 private clinics are run by about 1250 medical practitioners. The private sector provides about 80% of primary health care service, with the government polyclinics providing the remaining 20%. There are a total of 10,800 beds in 22 hospitals in Singapore as of March 97. Eight public hospitals have the minimum 160 to the maximum 3,100 beds, while 14 private hospitals have the minimum 20 to the maximum 500 beds.

Singapore provides primary health care designed for different age groups from womb to preschool, adulthood and old age.

Chart: Health Care - "Womb to Tomb"

Age	Main problems	PHC Sections
Womb	Antenatal care Postnatal care Infant care	Maternal and child
Preschool	Child development Communicable diseases	Maternal and child
School	Communicable diseases Nutrition Development Behavior problems	School health services Outpatient clinics Child Psychiatric clinic
Adolescence	Puberty adjustments Psychological adjustments Illnesses	Psychiatric clinic Medical Social worker Family planning clinic Outpatient clinics
Young adult and adulthood	Illnesses Illnesses related to work Social relationship	Outpatient clinic Industrial health department Medical social worker Counselling
Old age	Degenerative diseases Psychosocial problems	Outpatient clinics Community support services Home nursing foundation Psychiatric clinic

Singapore also provides care for categorized groups such as children, women, elderly and people with chronic diseases. The polyclinics provide outpatients with such services for the elderly as stroke ehabilitation, health screening, training of family members to provide home care and transport services. Voluntary Welfare Organizations are closely involved in the care of the elderly, providing facilities and day care services in various communties.

To maintain a healthy lifestyle for Singaporeans, drives for disease prevention and health care promotion are carried out by the National Health Education Department and the Department of Nutrition. Health Lifestyle Decade and National Sports Centre and People's Association work together to prevent disease and promote health.

Figure 1: The Shrinking Continuum

Nations in the world have chosen different approaches to health care needs. While the United Kingdom implements government-run national health service, in the United States the majority of population depends on private. voluntary health insurance (Figure 1).

In the U.S. the rate of total health expenditure to Gross Domestic Product increased over thedecades, reaching 12 % in 1990, while Japan remained steady at about 6.5%, and the United Kingdom at about 6.2% (Figure 2).

Following the lecture, comparison and discussion on Japanese Health Care system were made.

Figure 2 Total Health Expenditures As a Percentage of Gross Domestic Product (in percent)

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