MINISTRY OF HEALTH

The primary aim of the Ministry of Health will be to provide basic health care to the maximum number of people and to educate the population on how to remain healthy.

Disease patterns have changed with Singapore's rapid industrialisation and urbanisation. While infectious diseases like malaria and diphtheria have been effectively controlled, diseases precipitated by personal habits and stresses of modern living are increasing. The incidence of lung cancer, coronary heart disease and hypertension, and mental illness is steadily rising. Last year 22 out of 1,000 people died of lung cancer, a 37% increase over 1973; 72 out of 1,000 died of coronary heart disease, a 41% increase over 1973. Similarly, hospital admissions for mental illness rose from 2,707 in 1973 to 4,229 in 1977, an increase of 56%. Psychiatric outpatient attendances increased from 28,138 to 62,214 over the same period, an increase of 121%.

Changes in our population size and age structure will influence the planning of future health services. The number of elderly persons is already increasing faster than the rate of increase of the general population. The present number of 160,000 old people aged 60 years and above, will rise to about 190,000 (7% of total population) in a decade and 270,000 (9% of total population) in 20 years' time. They will impose greater demands on health care as the 1977 National Morbidity Survey showed a steep rise in ill health amongst Singaporeans from 45 years upwards. Focus on Primary Health Care

A reorganised Division of Primary Health Care Services and Health Education was recently set up to give added direction to an integrated programme of health education, and preventive and basic curative health services. A feature of this programme is the establishment of modern and well equipped polyclinics at major HDB new towns combining general curative treatment, screening, immunisation, dental, and family planning services under one roof. The first of such polyclinics, Kelantan Road Polyclinic, was opened on 3rd July 1978. Similar polyclinics have been earmarked for Bukit Merah, Clementi, Bedok and Ang Mo Kio New Towns in the next two years. Some of these polyclinics will have facilities for X-ray examination and minor surgery.

The extensive immunisation programme against infectious diseases will continue. This programme has been extended to Primary 6, Secondary 4 and Pre-University 2 pupils to consolidate immunity against infectious diseases.

The Home Nursing Foundation, which was launched in December 1976, has stepped up its activities, with its nurses attending to nearly 1,400 chronic sick patients in 1977. Most of these chronic sick would otherwise be occupying expensive hospital beds. Home nursing will be expanded to look after the mentally ill who are discharged from Woodbridge Hospital.

Health Education

Health education must be made universal like literacy. There will be more regular health education talks, film shows and exhibitions at community centres, clinics and schools. A National Health Campaign is planned for 1979. It will highlight diseases induced by urbanisation and harmful life styles.

Family Planning

The Family Planning and Population Programme must be sustained. Although replacement level with an average of two children per couple has been achieved, it is expected that over the next 10 years births will increase as more women enter the reproductive age group. Family planning information, education and communication activities will be aimed particularly at youths. This will be done through seminars for school principals and teachers, and talks and exhibitions for young factory workers.

Hospital Development

The redevelopment of the Singapore General Hospital, which will cost $238 million, will be completed in stages over the next three years. When fully completed early in 1982 it will have 1,659 beds.

Major improvement schemes for four major hospitals include the extension and upgrading of X-ray Departments in Tan Tock Seng, Toa Payoh and Alexandra Hospitals; a new Class A ward for Alexandra Hospital; additional Class A beds and a day observation area for the Accidents and Emergency Department at Toa Payoh Hospital; and conversion of TB wards to Medical and Surgical wards at Tan Tock Seng Hospital.

The Ministry is planning to introduce a new ward class, intermediate between the existing 'B' and 'C' classes. It will provide more privacy than in Class 'C'.

Pharmaceutical Development

The Manufacturing Division of the Pharmaceutical Department is unable to meet the increasing demands for pharmaceutical products from government hospitals because of its physical limitations and inefficient equipment. It is important that the government's pharmaceutical manufacturing capacity keep up with the improvements in medical care. The Ministry is therefore planning to transfer the Manufacturing Division from Silat Road to larger and more suitable premises at Norris Block in the existing Singapore General Hospital when it is vacated in 1980. Automatic and semi-automatic production lines will be installed. World Health Organisation technical advice has been sought for the project. Arrangements will be made for local professional staff to be given overseas training in pharmaceutical production.

DR TOH CHIN CHYE Minister for Health