Singapore has three healthcare clusters: The National University Health System (NUHS), which runs hospitals and polyclinics in the west; the National Healthcare Group (NHG) in the central region; and Singapore Health Services (SingHealth) in the east.
“As a regional health manager, the mission of a cluster is to look after the health of the geographical segment of population it is looking after,” said Mr Ong. “It goes far beyond running hospitals and polyclinics.”
“Clusters are already implementing health interventions in the community today, but this role will now expand in the coming years, from a relatively small proportion of a cluster’s effort to quite a significant proportion in the future.”
Mr Ong said the Ministry of Health (MOH) would need to work with the clusters to take a “strategic, holistic and system-level perspective” to improve the health of Singapore’s population.
He said this meant identifying the “social determinants of health”, or the various factors in people’s lives that can affect their physical, emotional and mental well-being, including their physical living environment, education, employment and food choices.
“We need a far better grasp of available information as well. That’s the second point, to be able to link point of care data with community health data. We need to use research to connect the datasets and draw insights on which social interventions drive better health or overcome poorer health.”
MOH and the healthcare clusters would then have to engage community partners to “go upstream” and guide the development of population health, said the minister.
He added that these concepts were not new to the healthcare clusters, which have already been doing this, but that MOH was formalising and expanding the work.
“This includes evolving your key performance indicators, to feature population health and preventive care much more strongly,” Mr Ong told an audience of healthcare professionals at the annual National Medical Excellence Awards.
He noted that residents may have established relationships with doctors in clusters and hospitals outside their residential region.
“For such cases, MOH will do budget transfers between healthcare clusters at the backend at the end of every year to account for residents’ different usage patterns.
“Residents therefore do not need to be limited to hospitals under the cluster that looks after the geographical area they live in,” he said.
Mr Ong added that COVID-19 had stressed Singapore’s healthcare system “severely, but the system did not collapse”.
“But this may well be a rehearsal for a much larger challenge coming our way, which is an ageing population of deteriorating health.
“It is not an epidemic curve that lasts several weeks, that we can ride through, but an inevitable trend of health deterioration lasting a couple of decades.”
