8 must-knows about health care in 2012

8 must-knows about health care in 2012

The new year has begun and there's no better time than now to embark on a healthier, happier you.

Here are eight upcoming health care changes that all Singaporeans should know about, compiled by The Straits Times (ST):

1. Extension of subsidies to cover chronic diseases

What's going to happen?

Singaporeans aged 40 or older with a per capita monthly household income of $1,500 or less will be eligible to sign up for the Primary Care Partnership Scheme from January 15.

Under this scheme, patients can get subsidies for the treatment of 10 chronic ailments when they visit their general practitioners (GPs).

The 10 ailments are diabetes, hypertension, lipid disorders, stroke, chronic obstructive pulmonary disease, asthma, schizophrenia, major depression, dementia and bipolar disorder.

This scheme was previously only available for Singaporeans aged 65 or older, with a per capita monthly household income of $800 or less.

The extension of subsidies is expected to benefit about 710,000 people, up from the current 87,000.

Additional significance

Aimed at narrowing the difference in the fees of seeing a GP to that of going to a polyclinic, the scheme is expected to lower the current load of polyclinics by shifting a significant number of patients towards GPs.

This would "rebalance" the patient load between the public and private sectors, said Health Minister Gan Kim Yong, when he announced the extension last August.

Currently, doctors in the public sector make up 14 per cent of all Singapore primary care doctors, but see 45 per cent of patients with chronic diseases here.

Besides shorter waiting times, seeing a GP also boasts of other advantages, such as being able to see the same doctor and make medical appointments after office hours.

Medisave changes

2. Higher Medisave withdrawal limit for outpatient treatment

What's going to happen?

Starting from this month, the Medisave annual withdrawal limit for outpatient treatment of 10 chronic diseases will be raised from $300 to $400.

Under Medisave400, which was renamed from the old scheme Medisave300, the money can be used to offset bills at polyclinics, GPs and specialist outpatient clinics.

Patients can also use their Medisave savings to pay for certain vaccines and mammogram screenings for breast cancer.

Medisave is primarily used to help Singaporeans offset their hospitalisation bills.

This liberalisation of Medisave is part of the government's efforts to make health care more affordable for Singaporeans, the Health Ministry said.

It has been suggested that the previous withdrawal limit of $300 for the treatment of chronic ailments is insufficient, and a third of the accounts which used the scheme had the full $300 drawn out.

The Health Ministry is currently monitoring the situation, and the new cap for the Medisave withdrawal limit may be adjusted further if the need arises, said Mr Gan.

Palliative care, cheaper medicine

3. Palliative care to be available in more hospitals

What's going to happen?

A programme which improves the quality of life of terminally ill patients will soon be available at Singapore General Hospital (SGH), Khoo Teck Puat Hospital (KTPH) and Changi General Hospital (CGH).

The Holistic Care for Medically Advanced Patients (Home) programme, run by the Agency for Integrated Care, is currently available at NUH and Tan Tock Seng Hospital (TTSH).

The programme includes regular home visits by a nurse in charge of caring for the patient and delivering updates to a doctor. A counsellor will also make house calls to facilitate discussions on advance care planning and provide caregiver support.

Home is available for patients suffering from advanced chronic obstructive pulmonary disease and end-stage heart failure. There are plans to expand the programme to include patients with other conditions.

One in four of the 17,000 people who die in Singapore each year receive palliative care in a hospice, nursing home or at home.

ST reported that Singapore has been moving towards giving people a "good death", with more being done to boost the importance of palliative care.

Palliative medicine was recently designated a sub-speciality in Singapore, with the first specialists officially recognised in February 2011.

4. Cheaper medicine

What's going to happen?

The Health Ministry announced last year that the subsidies on drugs is to be increased, as medicine costs form a large chunk of a patient's bill.

This is in line with the government's push to make health care more affordable for Singaporeans, the paper reported.

At the moment, more than 500 types of drugs are under the list of subsidised drugs.

For drugs which are subsidised by 50 per cent, the quantum of subsidy is to be increased to 75 per cent at polyclinics and public hospitals by early 2012.

Those who qualify for the Primary Care Partnership Scheme will also qualify for these subsidised drugs - namely those aged 40 and above, with a per capita monthly household income of $1,500 or less.

The additional drug subsidies are expected to cost an additional $45 million a year.

Most expensive private hospital

5. Parkway Novena Hospital to open

What's going to happen?

The second half of 2012 will see the opening of the most expensive private hospital to be built in Singapore in the last 30 years.

Parkway Novena Hospital, built at the approximate cost of $2 billion, is said to house 333 single bed wards and will focus on the treatment of heart and vascular diseases, orthorpaedics, neuroscience and general surgery.

The hospital is under Parkway Pantai, the biggest private hospital chain here. Parkway Pantai also runs Gleneagles Hospital, Mouth Elizabeth Hospital and Parkway East Hospital.

Additional significance

The government is looking into borrowing ward space from private hospitals to meet the high demand for hospital beds in the public sector.

The number of patients being warded in public hospitals has been growing exponentially in the recent years, growing 4.3 per cent in the first nine months of 2011, which is up from the 3.8 per cent hike of the year before.

The National University Hospital (NUH) is already renting ward space from West Point Hospital.

The opening of the new hospital is expected to increase the number of beds available for rental by Parkway Pantai hospitals, ST reported.

Currently, Parkway Pantai's three open hospitals have average occupancy rates of 65 to 75 per cent, which are the optimal rates aimed for by most private hospitals to strike a balance between flexibility in dealing with patient influx and profitability.

'Makeovers'

6. Local nursing homes to get makeovers

What's going to happen?

Three nursing homes are to move into new and larger premises by 2013.

The nursing homes - Villa Francis Home for the Age, Singapore Christian Home for  the Aged and Bright Hill Evergreen Home - will also improve their productivity and add value to lower-level jobs here.

Erst & Young Advisory has been appointed by the Agency for Integrated Care (AIC) to help these homes.

AIC is in charge of looking at the health care needs of Singapore's aging population.

Additional significance

ST reported that nursing homes are currently facing difficulties in recruiting local staff, as there is a negative image and renumeration gap between those working in nursing homes and those working in hospitals.

It is hoped that the makeovers will improve the image of nursing homes, by removing the stigma of having outdated and inefficient procedures, manpower-intensive work and poor technology.

7. New guidelines on sedation during surgery

What's going to happen?

Doctors with patients who require sedation during surgery will have to refer to a set of guidelines, to kick in by this year.

The guidelines provide details including what type of training doctors administrating sedation should have and the monitoring devices that should be used by clinics to ensure patient safety.

An expert committee of 10 specialists in anaesthesiology and other surgical disciplines was created by the Ministry of Health late last year to draw up these guidelines.

Public hospitals and most private hospitals have strict safety measures for the use of anaesthesia. However, there has been a rising  trend of non-anaesthesiologists performing the sedation process at clinics, ST reported.

The guidelines are expected to improve the safety of patients during sedation in clinics, as they can be used against a doctor when there is complaint to the Singapore Medical Council.

Guidelines from other countries, such as the US, Britain and Australia, will considered.

Community health centres

8. More community health centres to support GPs

What's going to happen?

At the moment, there is only one community health centre (CHC), which is located in Tampines and run by CGH.

The services offered at the centre include foot and eye screenings for diabetics and counselling by nurses, among many others.

GPs in the area can refer patients to the centre, and the reports are then sent to the GPs to review the results with the patients.

At least three more such centres are to be set up this year, preferably by the private sector with government help, the Health Ministry said.

However, the services offered by the centres may differ, as they depend on what GPs in the area want, the ministry added.

Aimed at boosting Singapore's medical capabilities to deal with the country's aging population, the centres will allow GPs to cater to more patients with chronic illnesses and provide holistic health care the conditions require.

GPs represent 86 per cent of all primary car doctors, but handle only 55 per cent of such patients, said ST.

yamadak@sph.com.sg

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