MINISTRY OF HEALTH

Health Policy

The overall quality of the Medical Services will be raised to provide increasingly sophisticated treatment to the population. Singapore will be developed into a centre of excellence for specialist medical service. Major Developments in the Hospital Service

The hospitals are the pivot of the medical services. There is at present a shortage of hospital beds.(i)( (i) See Appendix I, cols. 51-2.)

The Outram Road General Hospital will be replaced by a new 1,900-bed hospital. This new hospital estimated to cost $125 million will be Singapore's premier hospital and specialist centre, housing for a start the five selected medical specialities of neurosurgery, cardiovascular surgery, plastic and reconstructive surgery, paediatric surgery and nephrology. Also planned is a teaching hospital at Kent Ridge to be completed during the decade.

A team of hospital planners and architects are now drawing up a plan for a comprehensive development and modernisation hospitals. Their recommendations are expected to be made soon.

Interim Plans

Meanwhile interim plans to reorganise and improve the Service are being implemented.

The interim plans include the development of the four selected specialities of Neurosurgery, Plastic and Reconstructive Surgery, Cardio-Thoracic Surgery and Nephrology. Progress on them is well advanced. Millions of dollars have already been spent on building and new equipment.

New Medical Institutions Planned

Four different institutions are being planned: -

(1) A polyclinic with hospital beds at Changi for the civilian and military population there.

(2) A similar centre at Jurong, mainly `for the treatment of industrial accidents.

(3) A "half-way-home" at Sembawang for the care of the mentally-ill who do not require close medical attention.

(4) An Institute of Urban Health which will be a conglomerate of various departments, certain sections of the University Departments of Social Medicine and Public Health, the Department of Parasitology, the Vector Control Unit, the evaluation unit of the Family Planning and Population Board. It is being established in conjunction with SEAMEO. It is primarily a research and graduate teaching institute.

Rehabilitation Centre for the Paralysed and Chronic Sick

Institutional care for special categories of the disabled and chronic sick will be improved.

A rehabilitation centre with 82 beds at Mandalay Road for the treatment of the disabled, paralysed and the chronic sick will be completed in January 1973.

Outpatient Services

The existing network of outpatient dispensaries will be extended to render more comprehensive service.

Priority placed on Health of our Young People

More will be invested to promote the health of our young people.

Maternal and Child Health and School Health Services

The Maternal and Child Health Services will be expanded with more comprehensive and better pre-natal and post-natal care.

The School Health Service will also be expanded, to provide a wider health screening service. The service will include hearing, eye-sight and mental screening tests.

Eradicating Malnutrition

To ensure that the mental and physical development of our very young are at optimum levels, attention will be focused on pockets of malnutrition now existing.

Malnutrition is mainly the result of parents not feeding their children with a proper diet, or having many more children than they can afford. It will be combated with more health education and nutritional demonstrations to mothers. The Nutrition Unit is being enlarged to implement feeding schemes for undernourished children. Family Planning and Population Control

But all these are palliative measures. The basic solution is a lower birth rate. Then we can raise our standard of life and quality of the environment. Accouchement fees, maternity leave, priority points for homes will be so adjusted that they will bring about the ideal of the two children per family. For the Singapore of the 1970's the third child is a luxury. The fourth and fifth are anti-social acts. These charges will take full effect after 9 1/2 months from today, i.e., 1st August, 1973. Housing Board priorities will also be changed. The highest priorities are for those who have two or less children, whether for their first flat, or for transfer to a better flat. Families with three will drop slightly in priority. Families with four or more will have little priority. This will be implemented so as not to be harsh to those who already have large families. But after 9 1/2 months from today, 1st August, 1973, any addition to two children means declining priority in balloting for purchase or rentals of flats. Any increase in family size beyond two will mean lower priority in transfers to bigger flats, either for purchase or rentals.

The second 5-year National Family Planning Programme (1971-1975) is directed at two main target groups: -

(1) The between 15 per cent to 18 per cent of married women known as the "hard core" belonging to the low income and high parity groups who have not taken to family planning.

(2) The newly weds whose numbers have increased significantly. Even if the relatively low fertility level of 1970 remains constant the crude birth rate will actually increase to 24,5 per thousand in 1975 and 25.7 per thousand in 1980. (See Appendix II, cols. 53-4.) This is because the number of women of reproductive age will have increased by about 170,000 a 25 per cent increase. (See Appendix III, cols. 55-6.) The aim is to further dampen fertility, so that the crude birth rate will fall to about 18.4 per thousand in 1975 and 14.8 per thousand in 1980. Then the rate of natural increase will be less than 1 per cent by 1980.

More use of sterilization as a means of family planning for those who have completed their families will be advocated.

Dental Health

The present scheme to give priority to comprehensive dental coverage to all primary schools will continue. This service is being extended to kindergarten children. It will then be extended to all secondary school pupils and pregnant mothers at Maternal and Child Health Clinics. More than 90 School Dental Clinics will be added to the 68 already established. (See Appendix IV, cols. 57-8.) Two major dental health centres to complement the existing two at Pegu Road and Institute of Health will be built.

Combating Drug Addiction

All outpatient clinics and centres have been organised to provide for treatment of drug addicts. A referral clinic has been established at the Outram Road Hospital. A second one is planned for Alexandra Hospital. A special ward for the hospital care of addicts will be opened within the year.

Increasing costs

With the new general hospital at Outram Road costing about $125 million and increased costs of medicines and medical equipment nearly all of which are imported, and the extension of more sophisticated medical facilities, costs of medical treatment have been going up. They will continue to do so.

Further with wage revisions of Government servants, doctors, nurses, and other medical workers, the budget of the Ministry of Health must go up.

The Government will have to meet the increased budget from increased taxes on spending and revenue. But the user will have to pay a relatively token increase to remind him to use these medical services only when really necessary.