Present Issue 
Past Issues 

Present Issue 
Past Issues 

SMA Editorial Board 

Letters to the Editor 


This site is supported by Health ONE


The Ministries of Health, National Development and the Environment released their addenda to President SR Nathan’s address to Parliament on Monday, 4 October 1999 (ST, 6 October 1999). The full text of the Minister of Health Mr Lim Hng Kiang’s speech on policy directions is reproduced below.

Health: Focus is on right lifestyles and good care

“The Ministry of Health aims to promote the health of Singaporeans by encouraging healthy lifestyles and preventing disease while ensuring access to good and affordable basic health care in the event of illness. We will improve the quality of our clinical services and professional manpower, and control costs to patients and the government.

Nurturing a healthy nation

Over the next five years, we will build the new Rehabilitation Centre and Communicable Disease Centre at the Tan Tock Seng Hospital campus. The National Heart Centre will be rebuilt at the Singapore General Hospital campus. Alexandra Hospital will be redeveloped to become the regional hospital in the western part of Singapore. The restructuring of public health care institutions has given hospitals more management and operational autonomy, and made them more responsive to patients’ needs. We will complete the restructuring process by vertically integrating primary, secondary and tertiary health-care services in the public sector. Woodbridge Hospital, Alexandra Hospital and the polyclinics, will be restructured and included in the integrated system. This will help to maintain the right balance between competition and cooperation among our public healthcare institutions. It will minimise wasteful duplication, ensure optimal development of clinical capabilities and deliver care seamlessly.

Implementation of Casemix

MOH will introduce the Casemix classification system which categorises the output of hospitals into clinically meaningful groups that require similar amounts of resources to treat. This will improve the measurement of hospital performance and strengthen our quality assurance and medical audit processes. This will allow us to benchmark our hospitals against one another and against those in the developed countries. Casemix will also provide a more accurate and equitable basis for subventing health care services in the restructured hospitals. This will be implemented by the end of this year. In three to four years’ time, Casemix will also be used to moderate health care costs in the private sector through limiting the charges borne by private hospital patients who pay with Medisave.

Health care for the elderly

Apart from acute primary and hospital care, many elderly patients can be more appropriately cared for in “step-down” settings, such as community hospitals, nursing homes, day rehabilitation and day care centres, and home medical and nursing care. As our population ages rapidly, the demand for step-down care will increase. To meet these needs, we will work with voluntary welfare organisations and the private sector to build community hospitals and nursing homes. We will also put in place a financing framework to help individuals and their families pay for their share of step-down care costs, with government subsidies and community assistance going to those who need financial help. We will introduce an insurance scheme to defray the high cost of long-term step-down care required by those elderly who suffer from severe disabilities. The ministry is also studying a means test for all step-down care services to target government subsidies at those who deserve financial help.

Professional competence

The ministry will strengthen formal education and training at undergraduate and postgraduate levels to ensure the highest quality of medical manpower. We will work with the relevant professional bodies to ensure that health-care professionals take part in continuing medical education, to update them on the latest health-care developments and to renew their skills and knowledge. We will also study the need to introduce regular re-certification of doctors, taking into consideration the trends in developed countries.

Nurses play a critical role

To develop our nursing service, we will provide more opportunities for training and speciality development, expand and develop career opportunities and improve nursing education.

Pursuit of clinical quality

We will uphold health-care quality in Singapore through a two-pronged approach of quality assurance and medical audit. Hospitals are required to establish quality assurance programmes. The ministry will monitor their clinical performance at hospital and speciality level and benchmark them against national and international standards. We will also formulate a National Medical Audit Programme to create a culture of self-regulation and continuous quality improvement in our hospitals, clinics and nursing homes, and to enforce accountability of providers for health care.”