The Singaporean Ministry of Health (MOH) announced on 18 January that the healthcare system will be reorganised into three integrated clusters, from the existing six regional health systems. This is said to better meet Singaporeans' future healthcare needs.

"Over the last few years, MOH has significantly improved the accessibility, affordability and quality of healthcare in Singapore under our Healthcare 2020 Masterplan," said Health Minister Gan Kim Yong.

"Nevertheless, we cannot afford to stay still as there remain many challenges ahead such as out ageing population, increased chronic disease burden and the need to manage future growth in healthcare manpower and spending.

"This reorganisation of the public healthcare clusters will enable us to meet our future healthcare challenges. I am confident that we will be able to better optimise resources and capabilities, and provide more comprehensive and patient-centred care to meet Singaporeans' evolving needs," he added.

Polyclinics will also be reorganised

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Currently, the healthcare system is organised into six regional health systems: Alexandra Health System, Eastern Health Alliance, Jurong Health Services, National Healthcare Group, National University Health System (NUHS) and Singapore Health Services (SingHealth).

In the upcoming reorganisation, the six regional health systems will merge to form three clusters - the Central region, comprising the National Healthcare Group and Alexandra Health System to form the National Healthcare Group (NHG), the Eastern region, comprising the SingHealth and the Eastern Health Alliance to form a second cluster under SingHealth and the Western region, comprising the NUHS and Jurong Health Services to form the third cluster called NUHS.

NHG Group CEO Professor Philip Choo will head the Central region, SingHealth Group CEO Professor Ivy Ng will head the Eastern region and NUHS Group CEO Professor John Wong will head the Western region.

The polyclinics will also be re-organised into three groups: NHG Polyclinics, SingHealth Polyclinics and the new National University Polyclinics. This will include some transfers of polyclinics across groups.

For example Bukit Batok, Choa Chu Kang, Clementi and Jurong polyclinics will be moved from NHG to NUHS. Geylang Polyclinic will be moved from SingHealth to NHG, and Queenstown Polyclinic will be moved from SingHealth to NUHS.

National Specialty Centres and specialised hospitals such as the Institute of Mental Health and KK Women's and Children's Hospital are unaffected and will remain with their existing clusters.

The reorganisation of the clusters is aimed to be completed by early 2018, said MOH.

Reorganisation in preparation for Singapore's future state of health

"The current system works quite well, and the clusters have done a good job catalysing initial care transformation efforts," said Dr Lee Chien Earn, Group CEO of Eastern Health Alliance. "However the changes announced by MOH are meant to position us for the future, as our challenges are long-term ones."

For example, MOH said that primary care, which is offered by GPs and polyclinics, will play an increasingly critical role in providing patient-centred care in the community. Integration of care in instances such as patient referrals will be streamlined as all three clusters will have primary care capabilities.

Each merged cluster will have a fuller range of assets, capabilities, services and networks across different care settings. This means that patients of all the public healthcare institutions will not be affected and they can continue with their existing healthcare arrangements and appointments. Fees are also unaffected.

Healthcare professionals have more developmental opportunities

There will be no changes to healthcare infrastructure building projects and no retrenchments due to reorganisation. The MOH said that almost everyone would continue in their current roles within their current teams and only a "small number" will be re-deployed to allow the clusters to optimise their manpower.

The reorganisation will also enable public healthcare institutions to deploy their resources and capabilities more efficiently. This means that healthcare professionals will have better access to a variety of career options and professional development opportunities.

The Healthcare Services Employees' Union (HSEU) said it will "work closely with stakeholders to ensure that (its) workers will not be adversely affected by the terms and conditions of employment after the reorganisation".

Healthcare analyst Jeremy Lim of global consultancy firm Oliver Wyman said that even though many will criticise the latest move, "the intent is probably deeply strategic".

"What's different this time is that the public healthcare system has fully embraced its mission of health rather than simply healthcare, and hence the focus is equally on preventive health and community well-being, as it is on acute medicine in the clinic or hospital setting," said Dr Lim. MIMS

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Sources:
https://www.moh.gov.sg/content/moh_web/home/pressRoom/pressRoomItemRelease/2017/reorganisation-of-healthcare-system-into-three-integrated-cluste.html
http://www.businesstimes.com.sg/government-economy/singapores-public-healthcare-system-to-regroup-into-three-clusters
http://www.todayonline.com/singapore/moh-consolidate-healthcare-clusters-three-regional-groupings
http://www.channelnewsasia.com/news/singapore/moh-to-reorganise-healthcare-system-into-three-integrated/3443040.html
https://www.moh.gov.sg/content/dam/moh_web/PressRoom/Press%20releases/Press%20Release%20on%20Reorg%20(Annex%20A).pdf