SINGAPORE - Singapore's three healthcare clusters are working on strengthening the support structures around general practitioners (GPs) to help them deliver preventive care under the country's new one-resident-one-doctor plan known as Healthier SG.


Their comments come after the Ministry of Health (MOH) submitted the White Paper on Healthier SG to Parliament on Sept 21.


Healthier SG is a major transformation of the healthcare system to get people to take charge of their own health to keep diseases at bay. It is slated for launch in the second half of 2023 for those aged 60 and above, but first needs the buy-in from GPs.


The GP onboarding process to Healthier SG has not begun, but work to facilitate it has started.


"The SingHealth Partners Primary Care Network (PCN) is currently recruiting GPs in the eastern region to join the PCN, which is a prerequisite for GPs to come on board Healthier SG," said Professor Lee Chien Earn, SingHealth's deputy group chief executive of the regional health system.


"We are also working with MOH and AIC (Agency for Integrated Care) to gather feedback from GPs on the types of support they need."


GPs had earlier voiced concerns about the fees, workload and work involved in Healthier SG. Singapore has about 1,800 GP clinics, of which 670 have formed PCNs.


The clusters said they will strengthen their relationships with GPs and community partners such as social service agencies and schools, as well as work closely with government agencies, such as the Health Promotion Board and Sport Singapore, in order to connect residents to a whole host of activities and interest groups.


SingHealth will set up integrated community care teams to deliver care in the east and anchor primary care in the community, said Prof Lee.


Called the SingHealth Healthier SG Teams, they will comprise care providers in a particular geographical area, such as primary care providers, community nurses, well-being coordinators and social care partners, he said.


These teams will provide preventive care to the well population, as well as care coordination and chronic disease management to those who are at risk or have chronic conditions.


Under Healthier SG, MOH will give the three healthcare clusters an annual budget based on the total number of residents under their care.


At the National Healthcare Group (NHG), which takes care of residents in the central-north region, Professor Eugene Fidelis Soh, the deputy group CEO for integrated care, said it will develop with its GP partners' relevant resources, shared care protocols and care pathways for enrolled patients, and have its IT systems enhanced and linked progressively.


"The family doctor is key to the implementation of Healthier SG," said Prof Soh.


In the long run, when residents feel confident about owning their heath, they can also, as a community, care for their families, neighbours and society.


This "'gotong-royong spirit' will uplift our physical, psychological, social and spiritual well-being collectively," he added.


Healthier SG builds on years of work that Singapore has put in to construct a healthcare system to help keep the population healthy and away from hospital care as much as possible


Mr Chua Song Khim, deputy CEO of the National University Health System (NUHS), said it has been working, for instance, with community partners to improve the health literacy of residents, encourage them to go for relevant health screenings and vaccinations, and guide them towards better management of health issues through GPs and National University Polyclinics.


He said NUHS has launched the My Health Map, a personalised preventive health plan for individuals, among other efforts. There is much to be done and NUHS will work on reaching out to more residents in the west, especially those who have not had the opportunity to seek medical care, he said.


Associate Professor Jeremy Lim, director of the Leadership Institute for Global Health Transformation at the National University of Singapore's Saw Swee Hock School of Public Health, said: "If it is still the single GP seeing patients in the clinic and in between, sending WhatsApp messages to other patients to urge them to exercise to eat more healthily... Well, then it is a fool's errand and we are doomed to fail.


"But if the doctor is supported by a care team, a lot of technology and community partners, then it is not one person looking after thousands of people, but a properly structured and trained team."