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Book Review

State of Health' 97
The report of the Director of Medical Services.
Published by the Ministry of Health, 111


This is the "first of a series of reports to be published on the state of health of our nation", said Dr Chen Ai Ju, the Director of Medical Services, in her Foreword to the publication.

This book is readable but is by no means meant to be superficially read. Between its covers are much information, revelations and hints of the direction and thinking of senior health professionals working in the Ministry of Health. This publication needs to be a "must read" item for anyone connected with Public Health and Health Policy in Singapore.

This book is more than a simple corporate report of the Ministry of Health. The emphasis is on Healthcare and Health of Singaporeans from the medical professional’s perspective. This is a welcome development given the insidious creep of consumerism into healthcare. Patients are thankfully called "patients" and not "customers". The emphasis of the Report is on improving healthcare indicators, strengthening professionalism and identifying population healthcare needs. The Report quietly gets back to the basics of good, sound health care delivery: patients, disease, services and healthcare professionals. With the separation of the offices and responsibilities of Permanent Secretary and Director of Medical Services in recent years, this "professional" Report is a needed information resource from the professional arm of the Ministry of Health.

The book is divided into 10 chapters. The first chapter gives an overview of the state of health of Singaporeans today and includes trends of major healthcare indicators. The next two chapters describe the health prevention and promotion programmes of the Ministry. The next two chapters are concerned with the provision of services.

Chapter 6 describes, possibly for the first time in some detail, the various health laws administered and regulatory activities conducted by the Ministry. It describes recent developments in regulatory work, such as the revision of the Medical Registration Act and control of Chinese Proprietary Medicines etc. Medical Audit and Accreditation is highlighted in this chapter. It is heartening to note that various establishments such as termination of pregnancy clinics and renal dialysis centres have been audited recently and most have been found to be providing acceptable standard of services.

To the reader, Chapter 7 can be quite a revelation. We get to know how many specialists there are in the various major disciplines in medicine and dentistry. We also are able to find out the number of nurses with post-basic qualifications. Other interesting facts include little known information such as 17% and 18% respectively of trained nurses and pharmacists do not practice nursing and pharmacy.

The Report ends with Chapter 10, aptly titled: "The Way Ahead". It highlights the major issues facing us, doctors, in the future: CME, aging of the population and the emergence of some infectious diseases.

(The Report is available at the MOH HQ at the College of Medicine Building, Level 2, Reception Counter at S$20.)