Healthcare services will be streamlined into 3 clusters
Each will have full range of services, from polyclinics to general and community hospitals
By Poon Chian Hui, Assistant News Editor, The Straits Times, 19 Jan 2017
Singapore's public healthcare will undergo a major shift in the coming year, bringing the entire suite of medical services closer to people's homes.
The six regional health systems of today will be streamlined into three "integrated" clusters.
This will be done by merging three of the current clusters with larger ones, based on geographical location. Between them, the three new, beefed-up clusters will cover the entire island.
Every cluster will then boast a fuller range of services, encompassing general hospitals, at least one community hospital and several polyclinics. Each cluster will also have a medical school.
The move is meant to address future healthcare challenges, such as a greying society and more people with chronic ailments, said Health Minister Gan Kim Yong.
With each new cluster looking after more than a million Singapore residents - and offering the full range of medical services - people will find their healthcare needs being met closer to where they live.
This will mean mergers and consolidation within the existing six-cluster system that took shape between 2007 and 2009.
Singapore Health Services (SingHealth) will join forces with the Eastern Health Alliance, which oversees Changi General Hospital, to offer services in the east.
The National Healthcare Group (NHG) will merge with Alexandra Health System, which runs Khoo Teck Puat Hospital and Yishun Community Hospital, to handle the central region.
In the west, the National University Health System (NUHS) will be paired with Jurong Health Services, which manages Ng Teng Fong General Hospital and Jurong Community Hospital.
The three merged clusters will thereafter be known as SingHealth, NHG and NUHS respectively.
In line with the changes, the polyclinics will be regrouped.
Currently, SingHealth and NHG run nine polyclinics each. This would leave NUHS without any polyclinics. That is why a polyclinic group called National University Polyclinics is being formed. It will be operated by NUHS.
The move involves several polyclinics changing hands.
Two SingHealth polyclinics will be transferred - Geylang Polyclinic to NHG and Queenstown Polyclinic to NUHS.
Another four polyclinics, located in the west - Bukit Batok, Choa Chu Kang, Clementi and Jurong - will move from NHG to NUHS.
The public healthcare system has improved over the years, noted Mr Gan.
"Nevertheless, we cannot afford to stay still as there remain many challenges ahead, such as our ageing population, increased chronic disease burden and the need to manage future growth in healthcare manpower and spending."
The reorganisation will optimise resources, he said.
It is expected to be completed by early next year and will not disrupt existing services for patients.
"Patients will not need to make any changes, and can continue with their existing healthcare arrangements and appointments," said the Health Ministry (MOH).
No healthcare staff will be retrenched.
The building of new facilities will also carry on as planned. Some projects in the pipeline include Sengkang General Hospital and Bukit Panjang Polyclinic.
A medical school in each cluster may also offer more training op- portunities.
In the long run, patients can expect more seamless care.
A diabetic patient could be more easily linked up from a hospital to a primary care provider in a cluster or an external service provider, offering care closer to home.
"As with any reorganisation, change can understandably be uncomfortable and unsettling for some," said Professor Philip Choo, group chief executive of NHG. "That said, I strongly believe our patients will benefit."
Coming soon to a cluster near you: Seamless healthcare
Delivering integrated, comprehensive care a key focus in new geographical-based system
By Poon Chian Hui, Assistant News Editor, The Straits Times, 19 Jan 2017
Patients may find more comprehensive healthcare services anchored closer to their homes after the public sector transitions into a new three-cluster system.
The beefed-up healthcare group in their neighbourhood will also bring health promotion, disease prevention and rehabilitative care within their reach.
Singapore's public healthcare sector will be reorganised into three clusters, down from the current six.
Facilities across the country, including general hospitals and polyclinics, will be grouped based on their locations, so that each cluster oversees a specific area of the island.
Singapore Health Services (SingHealth) will merge with Eastern Health Alliance and take charge of services in eastern Singapore, including Changi General Hospital.
The National Healthcare Group (NHG), which will take Alexandra Health System under its wing, will cover the central region.
National University Health System (NUHS), to be paired with Jurong Health Services, will helm the west. The new clusters, to be known as SingHealth, NHG and NUHS, will cover about 1.1 million to 1.5 million Singapore residents in each region.
Several polyclinics will be transferred across the groups, so that every cluster has primary care services.
After the changes, the different types of public healthcare facilities near one's home are more likely to come under the same management, compared with now.
Healthcare adviser Jean-Luc Butel said that the mergers should make it easier to strategise and implement decisions across the various institutions.
"You can now make decisions over broader areas of the system," said Mr Butel, who is president of consultancy firm K8 Global.
"For example, the application of best practices across the system should go more easily."
Staff will also be able to respond more quickly and decisively, such as when implementing new programmes for patients.
The transition is expected to be completed by early next year.
In outlining their visions, the leaders of the new clusters said that one key focus is on delivering integrated care for patients.
Professor John Wong, who will lead the merged NUHS as its group chief executive, said that the reorganisation allows longstanding partners in the west to come together to provide "seamless care from prevention to home care".
The six regional health systems each have their own strengths.
Some have formed strong primary care networks, while others are stronger in education or research.
The new entities can tap the combined strengths of the original clusters, said MOH.
Professor Ivy Ng, group chief executive of SingHealth, said: "Changi General Hospital's leadership in disciplines like geriatrics, sports medicine, emergency medicine and others will complement SingHealth's range of clinical services."
Similarly, NHG group chief executive Philip Choo said there will be more concerted efforts in wellness and preventive care.
Some hospitals also have existing tie-ups with service providers, such as voluntary welfare organisations, to run programmes for patients.
Such services could be scaled up under the expanded cluster, so residents in a wider area can tap them.
Dr Lee Chien Earn, who heads the Eastern Health Alliance, noted that the cluster has worked on disease prevention and early detection and treatment to help keep people in the community healthy.
A scheme, called Eastern Community Health Outreach, helps residents detect and manage chronic diseases early. It is currently available only in neighbourhoods in the east such as Tampines Central and Bedok.
With the merger, Dr Lee said that such successful programmes could be expanded "at pace and scale as part of a larger health cluster".
Additional reporting by Linette Lai
No changes to roles and salaries for most staff: MOH
By Linette Lai, The Straits Times, 19 Jan 2017
The vast majority of healthcare staff will remain in their current roles after the mergers of regional clusters, the Health Ministry (MOH) said yesterday.
It also said it did not expect to see any changes made to the monthly salaries for most employees.
"Almost everyone within the public healthcare sector will continue in their current roles, within their current teams," said a ministry spokesman. He noted that the public healthcare groups are already "broadly aligned" where pay is concerned, so salaries are unlikely to change.
However, "a small number may eventually be redeployed, as the merged clusters better optimise their manpower", he added.
"In such cases, staff will be offered jobs that match their experience and skill sets without any changes to their current salaries. The clusters will consult with the union and staff on these changes."
The reorganisation will see the existing six regional health systems streamlined into three clusters, and also see the National University Health System take over the management of five existing polyclinics.
All 18 polyclinics are now managed by either Singapore Health Services or the National Healthcare Group.
Dr Lew Yii Jen, who will be stepping up to be the chief executive of the new National University Polyclinics, said he would ensure "minimum disruption" to workflow as the polyclinics are handed over, and make sure staff have opportunities to raise any concerns.
The ministry did not say how many public healthcare staff will be reporting to a new employer by early next year, when the entire transition is completed.
What is known is that three of the current six group chief executives - Mr Liak Teng Lit, Mr Foo Hee Jug, and Dr Lee Chien Earn - will no longer hold their current positions. MOH said they have all been offered senior positions in public healthcare.
In a separate statement yesterday, Ms Diana Chia, general secretary of the Healthcare Services Employees' Union, said it would work to make sure that workers' terms of employment are not adversely affected by the changes.
"The union will continue to hold engagement sessions with our members to address their concerns and clarify queries regarding the change," Ms Chia said.
"We will also continue to work with the relevant stakeholders to facilitate the transition of the affected healthcare workers."
Yishun Community Hospital chief executive Pauline Tan, as well as other senior executives in the sector, said that the changes would give employees more opportunities for learning and professional development.
The community hospital will soon come under the National Healthcare Group.
"The larger cluster, with its combined strengths and resources, will provide wider career options, professional development and learning opportunities for our staff," Dr Tan said.
"This will enhance our appeal as an employer of choice."
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Reorganisation of healthcare system into three integrated clusters to better meet future healthcare needs