SINGAPORE — Primary care will be strengthened and healthcare professionals will get a wider and deeper range of career opportunities as a result of the six regional health clusters merging into three, said senior healthcare officials on Wednesday (Jan 18) following the Ministry of Health’s announcement.

Since 2000, even as the number of regional health clusters grew from two to six, the polyclinics here remained under two clusters, SingHealth and National Healthcare Group (NHG). With the re-organisation, the National University Health System (NUHS) will manage polyclinics for the first time.

This means all three clusters will each oversee several polyclinics, as they continue the partnerships already forged with other players including nursing homes, social service providers and private doctors.

Dr Lew Yii Jen, the incoming chief executive of the new National University Polyclinics group, has set his sights on developing and strengthening primary care for residents in western Singapore. Currently senior director of clinical services at NHG Polyclinics, Dr Lew said: “Over the years of working as a family physician at NHG Polyclinics, I have come to realise the importance of delivering care on a team-based approach. This approach is especially effective in the care of chronic patients as regular and consistent follow-ups can be done by our family physicians, care managers and allied health professionals according to the specific needs of this group of patients.

“I will continue to drive and improve this team-based approach at National University Polyclinics.”

Dr Lew also wants to upgrade the skills and capabilities of the primary care teams to meet growing healthcare challenges.

Asked how he would harmonise the different payment systems and operations of the five polyclinics that NUHS will be taking over from NHG and SingHealth, Dr Lew said the immediate priority is to ensure patients are not affected by the re-organisation and that operations continue to run smoothly.

The different systems and structures will be harmonised over the longer term and will be worked through “in the coming months”, he said. National University Polyclinics will oversee two upcoming polyclinics in Pioneer and Bukit Panjang.

Group chief executive of Eastern Health Alliance (EHA) Lee Chien Earn said he would continue as chief executive of Changi General Hospital after his cluster is merged with SingHealth. He will concurrently be part of SingHealth’s senior leadership to drive expansion of programmes that have been successful in the EHA. The cluster’s programmes include the Eastern Community Health Outreach that helps detect and manage chronic diseases early, and Neighbours for Active Living, which enables ageing-in-place. It has also been at the forefront of healthcare innovation, such as in assistive robotics technology, said Dr Lee.

EHA and SingHealth have already collaborated in recent years, through initiatives such as the Singapore National Eye Centre Eye Clinic @ CGH. EHA staff were informed of the merger through one-on-one discussions, small group dialogues and town halls, said Dr Lee. Their questions centred mainly on human resource and development, and Dr Lee said the merger will provide a platform for more career options and career development.

Member of Parliament Chia Shi-lu, who is on the government parliamentary committee for health, said some feedback over the years was that some of the regional health clusters were “a bit too small”, and it was better to have critical mass when building up a primary care network.

Polyclinics currently provide about 20 per cent of primary care services, while private general practitioners provide the remaining 80 per cent.

The Government has tried to leverage private general practitioners to a greater extent, such as through the Community Health Assist Scheme which subsidises visits to a private GP. But GPs also need resources and support, which bigger clusters can better provide, said Dr Chia, an orthopedic surgeon at SingHealth’s Singapore General Hospital.

For patients, there should be little apparent change in the short term, said Dr Jeremy Lim, who leads the health and life sciences and public sector practices of consulting firm Oliver Wyman in the Asia-Pacific.

In the longer term, there should be much better flow of information amongst healthcare and social care providers, he said. Patients should be able to receive the care they need within the cluster, appropriately divided across inpatient care, outpatient services, and even community and home care offerings.

And the three clusters will each have a world-class medical school partner — the National University of Singapore’s Yong Loo Lin School of Medicine for NUHS, Duke-NUS Medical School for SingHealth and the Nanyang Technological University’s Lee Kong Chian School of Medicine for NHG, noted Dr Lim. This means innovations can be “rigorously studied by the academics so that we know what works and what doesn’t”.