Easier now for Singapore doctors to do family-based care

SINGAPORE - The lifting of age restrictions on private-clinic subsidies will allow more households to be cared for as a family unit, rather than as individuals.

This will allow them to enjoy the benefits of "family medicine", said doctors who welcomed the Government's latest move to keep health care affordable.

When the age floor of 40 is removed in January, half of all Singaporeans can tap the Community Health Assist Scheme (Chas), which subsidises care at more than 800 private practices.

Two weeks ago, the Health Ministry also raised the qualifying monthly income from $1,500 to $1,800 for each family member, which means more households can qualify for the scheme.

Dr Koh Hau Tek, medical director of Parkway Shenton which has 20 clinics under Chas, said the expansion gives doctors better access to a family's medical history, which allows them to focus more on prevention.

A child whose parents have high blood pressure due to being overweight, for instance, can be advised at an earlier age to exercise and eat healthy to avoid a similar problem.

Even mental ailments can be better diagnosed and treated if a doctor has a better insight into the family situation.

For example, relationship problems with family members may be behind a person's depression, a Chas-covered condition that is getting more common even at primary care level.

"It enhances the value of family medicine," said Dr Koh of the expansion of the scheme.

Agreeing, Dr Tan Tze Lee, who runs a clinic in Choa Chu Kang, added that families who go to the same clinic can also be treated "more consistently".

"We don't have to tell them that one person can pay less, but not the other person," he said.

When cashier Han Qin Qing signed up for Chas two years ago, she was hoping her two children could use it too. Her son had asthma and is prone to falling sick. But only she was eligible.

"Now that my children can also join, Chas is more meaningful," said Madam Tan, who earns $1,200 a month.

The scheme is gaining in popularity. Chas cardholders made 252,000 visits in the first half of this year, up from 85,000 over the same period last year. This is set to continue, with more patients expected to turn to private clinics, where queues are shorter and opening hours longer.

Chas, which originally covered 10 chronic diseases, has also been expanded to cover five more, including anxiety disorders. Patients can claim up to $480 a year for these conditions.

Government Parliamentary Committee for Health chairman and Sengkang West MP Lam Pin Min said the "very generous" changes to Chas will help reduce crowding and cut waiting times at polyclinics, now that more middle-income families have another option for affordable care.

Official figures on the country's 18 polyclinics show that the median waiting time in June to see a doctor after registration ranged from nine to 40 minutes. This does not include time spent queueing to register, to collect medicine and to pay.

Already, some are considering making the swop, said Dr Lo Mun Kid. Over the last few weeks at her Lorong Ah Soo clinic, she has seen more patients collecting application forms for Chas.

"More will be switching to GPs, especially those who could not afford it before," said Dr Lo.

But even if more patients opt for private GPs, health policy expert Dr Jeremy Lim of Insights Health Associates feels that the patient load at polyclinics will not change much. The growing and ageing population means there will be more patients overall.

Last year, polyclinic visits rose to 4.614 million from 4.315 million in 2010, a 7 per cent increase. He said: "There is just so much pent-up demand."


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