Healthcare in Singapore is supervised by the Ministry of Health of the Singapore Government. It largely consists of a government-run universal healthcare system with a significant private healthcare sector. In addition, financing of healthcare costs is done through a mixture of direct government subsidies, compulsory savings, national healthcare insurance, and cost sharing.
Singapore generally has an efficient and widespread system of healthcare. Singapore was ranked 6th in the World Health Organization's ranking of the world's health systems in the year 2000. Bloomberg ranked Singapore's healthcare system the most efficient in the world in 2014. The Economist Intelligence Unit placed Singapore 2nd out of 166 countries for health-care outcomes. Bloomberg Global Health Index of 163 countries ranked Singapore the 4th healthiest country in the world and first in Asia. Singapore is ranked 1st on the Global Food Security Index. In 2019, Singaporeans have the world's longest life expectancy at 84.8 years. Females can expect to live an average of 87.6 years with 75.8 years in good health. The averages for men are lower.
According to global consulting firm Towers Watson, Singapore has "one of the most successful healthcare systems in the world, in terms of both efficiency in financing and the results achieved in community health outcomes". This has been attributed to a combination of a strong reliance on medical savings accounts, cost sharing, and government regulation. The government regularly adjusts policies to actively regulate "the supply and prices of healthcare services in the country" in an attempt to keep costs in check. However, for the most part the government does not directly regulate the costs of private medical care. These costs are largely subject to market forces, and vary enormously within the private sector, depending on the medical specialty and service provided. However, Towers Watson has claimed that the specific features of the Singapore healthcare system are unique, and have been described as a "very difficult system to replicate in many other countries." Many Singaporeans also have supplemental private health insurance (often provided by employers) for services not covered by the government's programmes.
Public health system[]
Since the 1990s, all public hospitals, polyclinics, and specialty centres have been restructured as government-owned corporations, and operate under three healthcare groups or "clusters":
- National Healthcare Group
- National University Health System
- SingHealth
The 10 public hospitals comprise 8 general hospitals (AH, SGH, NUH, CGH, TTSH, KTPH, NTFGH & SKH), a women's and children's hospital (KKH), and a psychiatric hospital (IMH). In addition, there are 9 national specialty centres for cancer (NCCS & NCIS), cardiac (NHCS & NUHCS), eye (SNEC), skin (NSC), neuroscience (NNI) and dental care (NDCS & NUCOHS).
As of 2012, Singapore had a total of 10,225 doctors in its healthcare system, giving a doctor-to-population ratio of 1:520. The nurse-to-population ratio (including midwives) was 1:150, with a total of 34,507 nurses. There were 1,645 dentists, giving a ratio of 1 dentist to 3,230 people.
Approximately 70–80% of Singaporeans obtain their medical care within the public health system. Overall government spending on public healthcare amounts to 1.6% of annual GDP. This amounted to an average of $1,104 Government Health Expenditure per person. Health-related spending is the third largest expenditure item, after defence and education expenses. As the median age of the population increases, Singapore's healthcare spending is expected to rise. Healthcare spending has risen from $4 billion in 2011 to $9.8 billion in 2016.
Singapore has an incredible reputation for health services and healthcare systems; in 2000, the country was ranked sixth in the world by the World Health Organization. Public hospitals have autonomy over management decisions, and compete with one another for patients. General hospitals have a variety of functions and services; they mainly represent multi-disciplinary acute inpatient and specialist outpatient services, have 24-hour emergency centers, and often specialize in a specific field of medicine (cancer research, neuroscience, dental care, cardiac care, etc.). Singapore has an array of hospitals and health services available, as well as community hospitals that exist as an intermediate form of healthcare for people who do not require the services of a general hospital but cannot cope at home. The funding behind Singapore's public health sector can be broken down into the Ministry of Health of Singapore, MediSave, MediShield Life, and MediFund.
Emergency Medical Services[]
Emergency medical services (EMS) in Singapore are provided by the Singapore Civil Defence Force. SCDF operates a fleet of ambulances, "fast response paramedics" on motorcycles as well as first responder fire-bikers. SCDF is characterized as a nationally funded, multi-tiered, fire-based EMS system. SCDF responded to 150,155 calls in 2013, of which 96.1% were classified as emergency calls.
Community Health Assist Scheme[]
In 2012 the Community Health Assist Scheme was introduced. This provides subsidies for Singapore Citizens from lower-to-middle income households, and the Pioneer generation, born before 1950, who need treatment for common illnesses, chronic health problems and specific dental issues. Beneficiaries get a blue or orange Health Assist card, depending on household income. From 2019 the scheme is to be extended. Orange cardholders who only got subsidies for chronic conditions will get subsidies for common illnesses. All Singaporeans will be covered for chronic conditions, and the subsidies for complex chronic conditions will be increased.
Private sector[]
The increasingly large private sector provides care to those who are privately insured, foreign patients, or public patients who are able to afford what often amounts to very large out-of-pocket payments above the levels provided by government subsidies. The private sector consists of private healthcare, and private insurance.
The government uses the capacity of the private sector to reduce waiting times in the public sector. In 2015 it plans to use the Raffles Medical Group
Private healthcare[]
The private healthcare sector in Singapore has a huge market, with a more exclusive clientele. Private healthcare often attracts individuals in search of more advanced and complicated treatments such as stem cell therapy, or specialized cancer treatments. Private healthcare is more appealing and preferred by expatriate citizens as opposed to public for the short wait times, and greater availability of services.
Two hospital groups operate the majority; Parkway Pantai and Raffles Medical Group. These private hospitals are typically smaller, offer patients more privacy, and typically specialize in certain procedures or surgeries.
Parkway Pantai[]
arkway Pantai is Southeast Asia's largest private healthcare provider with hospitals in several countries such as Singapore, Malaysia and Brunei. It is a wholly owned subsidiary of IHH Healthcare and owns four hospitals in Singapore: Gleneagles Hospital, Mount Elizabeth Hospital, Mount Elizabeth Novena Hospital and Parkway East Hospital.
Raffles Medical Group[]
Raffles Medical Group (RMG) is one of the largest private healthcare providers in Asia, with hospitals and clinics located in several cities, including Singapore. RMG owns Raffles Hospital in Singapore, which specializes in obstetrics and gynecology, cardiology, oncology, and orthopedics.
Private health insurance[]
There are a variety of choices for private health insurance in Singapore, known as Integrated Shield Plans which supplement Medishield Life coverage. Depending on an individual, or families level of income, lifestyle, location, and medical history, there are monthly insurance plans ranging from $75 SGD to $400 SGD. Companies include but are not limited to AIA, Aviva, AXA, Great Eastern, NTUC Income and Prudential.
Financing[]
Singapore's healthcare system uses a mixed financing system that includes nationalised life insurance schemes and deductions from the compulsory savings plan, or the Central Provident Fund (CPF), for working Singaporeans and permanent residents. This mechanism is intended to reduce the overuse of healthcare services.
Medisave[]
Medisave is a medical savings account under an individual's CPF account that is used for payment of future medical expenses as well as premiums of medical insurance policies. Funds can be pooled within and across an entire extended family.
The Central Provident Fund Board, a social security system, allows the citizens of Singapore to put aside funds for a variety of expenses including retirement, healthcare and mortgage. Citizens can make monthly contributions to three different accounts: 1) ordinary accounts for housing, insurance, investment, and education, 2) special accounts for retirement, and investment, and 3) MediSave accounts for hospitalization expenses and medical insurance.[1] MediSave contributions are usually between 8-10.5% of an individual's wage, and is capped at a $52,000 limit.[1] This form of a health savings account is required by all workers; those below the age of 55 are required to deposit 20% of their earnings. This contribution is almost matched by the employer who contributes 17% of the workers earnings.
Medishield[]
Launched in 1990, Medishield is a low cost basic insurance scheme intended for those whose savings are insufficient to meet their medical expenses. Premiums can be paid out of Medisave accounts. A new scheme, Medishield Life, replaced the Medishield in November 2015. Co-insurance payment rates are to be reduced from 10–20% to 3–10% and the lifetime claim limit is to be removed. The scheme helps to pay for hospital bills and selected outpatient treatments. The government provides premium subsidies to lower- to middle-income residents, the elderly and new policyholders transitioning from cheaper policies.
The Integrated Shield Plan (IP) includes both the MediShield Life component and an additional private insurance coverage component run by private insurers, to cover for optional benefits in public hospitals and private hospitals. Premiums for the IP can be paid by the Medisave funds.
Eldershield[]
Eldershield is a severe disability insurance scheme which insures against the cost of private nursing homes and related expenses. Since 2002, members with a CPF Medisave account will automatically be enrolled in the scheme at the age of 40, unless they choose to opt out. Three private insurers, Aviva, Great Eastern and NTUC Income were chosen to manage ElderShield. The Ministry of Health will run ElderShield from 2021 on a not-for-profit basis, taking over from the three private insurers. This arrangement will allow a smoother upgrade to CareShield Life.[2] It has 1.2 million policyholders as of 2015, with $2.6 billion collected in premiums, and around $100 million in payout claims and $130 million in premium rebates between 2002 and 2015.
Medifund[]
MediFund is Singapore's safety net program, which covers only the lowest class of hospitalization fees and services. This form of coverage and insurance is only available to citizens of Singapore once they have depleted their MediSave and MediShield funds. The amount of funding and coverage is dependent on the individuals' income, health condition, and socioeconomic status.
It is a government endowment fund for those who are unable to meet their assessed contribution. Risks are not pooled, so an individual may be exposed to catastrophic expenses. A total of $155.2 million was allocated to patients in 2015.
Subsidies[]
Singapore citizens and Permanent Residents warded in public hospitals receive government subsidies for their medical fees, which scale according to their chosen class of ward as well as their income. Since 1 January 2009, patients warded in B2 and C class wards in public hospitals undergo means testing to determine the level of subsidy they are entitled to, based on the average monthly income received over the last available 12-month period including bonuses for salaried employees. However, patients receiving services such as Day Surgery, A&E services, Specialist Outpatient and polyclinic visits receive standardised subsidies regardless of income without requiring means testing.
People with no income, such as retirees or housewives, will have their subsidy rate pegged to the value of their homes, whereas all unemployed residents of HDB flats excluding those in executive condominiums (EC) will be entitled to the highest tier of subsidy.
The following table details the subsidies available:
| Means testing in public hospitals as of 1 January 2009 | ||||
|---|---|---|---|---|
| Average Monthly Income of Patient (SGD) |
Citizens Subsidy | Permanent residents Subsidy | ||
| Class C | Class B2 | Class C | Class B2 | |
| $3,200 and below1 | 80% | 65% | 70% | 55% |
| $3,201 – $3,350 | 79% | 64% | 69% | 54% |
| $3,351 – $3,500 | 78% | 63% | 68% | 53% |
| $3,501 – $3,650 | 77% | 62% | 67% | 52% |
| $3,651 – $3,800 | 76% | 61% | 66% | 51% |
| $3,801 – $3,950 | 75% | 60% | 65% | 50% |
| $3,951 – $4,100 | 74% | 59% | 64% | 49% |
| $4,101 – $4,250 | 73% | 58% | 63% | 48% |
| $4,251 – $4,400 | 72% | 57% | 62% | 47% |
| $4,401 – $4,550 | 71% | 56% | 61% | 46% |
| $4,551 – $4,700 | 70% | 55% | 60% | 45% |
| $4,701 – $4,850 | 69% | 54% | 59% | 44% |
| $4,851 – $5,000 | 68% | 53% | 58% | 43% |
| $5,001 – $5,100 | 67% | 52% | 57% | 42% |
| $5,101 – $5,200 | 66% | 51% | 56% | 41% |
| $5,201 and above2 | 65% | 50% | 55% | 40% |
|
1. No income declare and property with AV below $11,000. | ||||
Government initiatives[]
National Electronic Record Programme[]
The National Electronic Record Programme was launched in 2011 and is used by more than 280 institutions to support telehealth and telemedicine.
Pioneer Generation Package[]
The Pioneer Generation Package (PGP) is a S$9 billion package launched in 2014 aimed at helping approximately 450,000 Singaporeans born on or before 31 December 1949 and obtained citizenship before 31 December 1986 through a series of healthcare and social support schemes over an estimated 20-year period.
Hospitals[]
Public hospitals[]
Acute hospitals[]
These are the public acute hospitals in Singapore.
| Acute hospital | Healthcare cluster | Planning area |
|---|---|---|
| Alexandra Hospital | National University Health System | Queenstown |
| Changi General Hospital | SingHealth | Tampines |
| KK Women's and Children's Hospital | SingHealth | Kallang |
| Khoo Teck Puat Hospital | National Healthcare Group | Yishun |
| National University Hospital | National University Health System | Queenstown |
| Ng Teng Fong General Hospital | National University Health System | Jurong East |
| Sengkang General Hospital | SingHealth | Sengkang |
| Singapore General Hospital | SingHealth | Bukit Merah |
| Tan Tock Seng Hospital | National Healthcare Group | Novena |
Psychiatric hospitals[]
These are the public psychiatric hospitals in Singapore.
| Psychiatric hospital | Healthcare cluster | Planning area |
|---|---|---|
| Institute of Mental Health | National Healthcare Group | Hougang |
Community hospitals[]
These are the public community hospitals in Singapore.
| Community hospital | Healthcare cluster | Planning area |
|---|---|---|
| Bright Vision Hospital | SingHealth | Hougang |
| Jurong Community Hospital | National University Health System | Jurong East |
| Outram Community Hospital | SingHealth | Bukit Merah |
| Sengkang Community Hospital | SingHealth | Sengkang |
| Yishun Community Hospital | National Healthcare Group | Yishun |
Not-for-profit hospitals[]
Acute hospitals[]
These are the not-for-profit acute hospitals in Singapore.
Community hospitals[]
These are the not-for-profit community hospitals in Singapore.
- Ang Mo Kio - Thye Hua Kwan Hospital
- Ren Ci Community Hospital
- St. Andrew's Community Hospital
- St Luke's Hospital
Private hospitals[]
These are the private acute hospitals in Singapore.
- Concord International Hospital
- Farrer Park Hospital
- Gleneagles Hospital
- Mount Elizabeth Hospital
- Mount Elizabeth Novena Hospital
- Parkway East Hospital
- Raffles Hospital
- Thomson Medical Centre
Upcoming hospitals[]
- Woodlands Health Campus
Defunct hospitals[]
- British Military Hospital (predecessor of Alexandra Hospital)
- Changi Hospital (Template:Coord, (a former Royal Air Force hospital located at Hendon Road, Changi and affiliated to RAF Changi until 9 Dec 1971): Merged with Toa Payoh Hospital to form the Changi General Hospital on 15 February 1997.
- Toa Payoh Hospital (Template:Coord): Merged with Changi Hospital to form the Changi General Hospital on 15 February 1997.
- View Road Hospital (Used to be a subsidiary of Institute of Mental Health (Singapore), but ceased operations in 2001.)
Polyclinics[]
A polyclinic is a clinic or health care facility that provides both general and specialist examinations and treatments for a wide variety of diseases and injuries to outpatients and is usually independent of a hospital. When a polyclinic is so large that it is in fact a hospital, it is also called a general hospital.
The term was rare in English until recently and is still very rare in North America, but examples include the polyclinics in England (large health care centres able to provide a wider range of services than a standard doctor's (GP) office) and The Polyclinic in Seattle, Washington, US.
Polyclinic has been and is however often used in English to refer to similar, usually large institutions in many other countries that are called "poliklinik" or similarly in other languages (and whose etymology is different).
The term policlinic (spelled similarly to and pronounced the same as polyclinic) is a very rare term in English sometimes used by American medical professionals for the outpatient clinic or outpatient department of European hospitals.
NHG[]
National Healthcare Group Polyclinics is the primary healthcare arm of the NHG. It has six polyclinics in the central and northern parts of Singapore. They provide treatment for acute medical conditions, management of chronic diseases, women and child health services and dental care, as well as health promotion and disease prevention, early and accurate diagnosis, and disease management. It is also a training centre for family medicine physicians.
- Ang Mo Kio
- Geylang
- Hougang
- Toa Payoh
- Woodlands
- Yishun
SingHealth[]
In November 1999, then-Minister for Health Lim Hng Kiang announced that Singapore's public healthcare institutions would be reorganised into two delivery networks, or clusters. In October 2000, the formation of the two clusters - National Healthcare Group and SingHealth - were officially completed.
On 3 November 2009, Singapore General Hospital and SingHealth Group launched the inaugural issue of Singapore Health – a newspaper reporting on health-related matters affecting Singaporeans.
On 18 November 2011, Changi General Hospital left SingHealth and formed the Eastern Health Alliance along with St. Andrew's Community Hospital, SingHealth Polyclinics and The Salvation Army Peacehaven Nursing Home.
On 20 January 2017, SingHealth announced that it would be merging with the Eastern Health Alliance, bringing Changi General Hospital back into the SingHealth cluster.
- Bedok
- Bukit Merah
- Kaki Bukit
- Marine Parade
- Outram
- Pasir Ris
- Punggol
- Sengkang
- Tampines
National University[]
The NUHS operates National University Polyclinics, a network of primary care polyclinics largely situated in the west of Singapore. They provide primary care services to the population in those areas, and also provide training for family medicine physicians.
- Bukit Batok
- Choa Chu Kang
- Clementi
- Jurong
- Pioneer
- Tengah
| Polyclinic | Group |
|---|---|
| Ang Mo Kio | NHG Polyclinics |
| Bedok | SingHealth Polyclinics |
| Bukit Batok | NUHS Polyclinics |
| Bukit Merah | SingHealth Polyclinics |
| Bukit Panjang | NUHS Polyclinics |
| Choa Chu Kang | NUHS Polyclinics |
| Clementi | NUHS Polyclinics |
| Eunos | SingHealth Polyclinics |
| Geylang | NHG Polyclinics |
| Hougang | NHG Polyclinics |
| Jurong | NUHS Polyclinics |
| Kallang | NHG Polyclinics |
| Marine Parade | SingHealth Polyclinics |
| Outram | SingHealth Polyclinics |
| Pasir Ris | SingHealth Polyclinics |
| Pioneer | NUHS Polyclinics |
| Punggol | SingHealth Polyclinics |
| Queenstown | NUHS Polyclinics |
| Sengkang | SingHealth Polyclinics |
| Tampines | SingHealth Polyclinics |
| Toa Payoh | NHG Polyclinics |
| Woodlands | NHG Polyclinics |
| Yishun | NHG Polyclinics |
Eastern Health Alliance[]
Eastern Health Alliance (Abbreviation: CGH; Chinese: 东部医疗联盟; Template:Lang-ms) was a regional health system in the East of Singapore.
History[]
The Eastern Health Alliance was officially launched on 18 November 2011 by founding members Changi General Hospital, St. Andrew's Community Hospital, SingHealth Polyclinics and The Salvation Army Peacehaven Nursing Home.
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Integrated care programmes[]
The Eastern Health Alliance was focused on delivering a range of healthcare services, from early detection, disease prevention and management, through to ongoing care. It developed a range of integrated care programmes for the people of eastern Singapore.
Eastern Community Health Outreach[]
A community-based chronic disease prevention programme offered in partnership with grassroots organisations. The programme included health screenings, health coaching and healthy lifestyle activities, which aim to intervene early to delay the onset of chronic diseases such as diabetes, high blood pressure and cholesterol.
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Health Management Unit[]
Set up to assist patients who need help to manage their long-term conditions. These patients received advice from nurse tele-carers on medication, diet and lifestyle, how to monitor their condition and look out for signs of deterioration, helping them stay healthy for as long as possible. Those who needed more help would receive further guidance and support in between medical visits.
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Community Health Centre[]
It supported general practitioners by providing services for patients with long-term conditions. Services included eye screening, foot screening, health monitoring and education about diet, lifestyle and medication. The first centre, located in Tampines, was helmed by senior nurses and allied health professionals with experience in caring for patients with chronic conditions.
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Changi General Hospital-St. Andrew’s Community Hospital partnership[]
The positioning of St. Andrew's Community Hospital (SACH) right next to Changi General Hospital (CGH) enabled a transfer of care for more than 4,000 patients since 2005. Patients who no longer require acute care were transferred to SACH for rehabilitation and continuing medical care. SACH and CGH are connected by a covered link bridge. This close proximity helps facilitate better coordinated and integrated care for SACH patients through the sharing of medical records and clinical support services, and consultations by visiting CGH specialists.
Transitional Care[]
Transitional Care helps to bridge the gap between hospital and home for patients with complex or multiple care needs. It aimed to stabilise, rehabilitate, and help patients and their caregivers cope with care at home. It also aimed to reduce unnecessary re-admissions to the hospital. The Transitional Care team comprised doctors, nurses, therapists, dietitians, pharmacists and medical social workers.
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Grace Corner[]
A facility set up in The Salvation Army Peacehaven Nursing Home to provide rehabilitation services for patients with long-term debilitating conditions, and training for caregivers. Medical and nursing services, as well as lifestyle activities are provided. The aim was for patients to be fit enough to return home and integrate back into the community.
Home Care Service[]
St. Andrew's Community Hospital's Home Care Service attended to the nursing needs of patients residing in the east. These patients were discharged from acute care hospitals or community hospitals and usually have medical histories of strokes, fractures and multiple diseases. Common nursing care provided to them included changing their urinary catheters; nasal-gastric tubes for feeding, wound care, dressings, and removal of stitches after a surgery.
Hospital Policy[]
| Overview | Group A | Group B |
|---|---|---|
| Note | Visited for the first time since the COVID-19, or pass by through bus services | Visited before COVID-19 |
| Hospitals | Alexandra Hospital Gleneagles Hospital Institute of Mental Health Khoo Teck Puat Hospital Ng Teng Fong General Hospital Sengkang General Hospital Singapore General Hospital Tan Tock Seng Hospital |
Changi General Hospital KK Women's & Children's Hospital Mount Alvernia Hospital Mount Elizabeth Hospital Mount Elizabeth Novena Hospital National University Hospital |
| Polyclinics | Ang Mo Kio Polyclinic Bedok Polyclinic Bukit Batok Polyclinic Bukit Merah Polyclinic Clementi Polyclinic Geylang Polyclinic Hougang Polyclinic Jurong Polyclinic Outram Polyclinic Pasir Ris Polyclinic Pioneer Polyclinic Punggol Polyclinic Queenstown Polyclinic Sengkang Polyclinic |
Tampines Polyclinic |
| Visiting Policy | Maximum of one accompanying person per patient Do not sit at the seats that are marked as "This seat is blocked for social distancing". You will be fined up to $300. |
Up to 5 visitors are allowed. Do not gather in groups of more than 5. |
At the vaccination centre, do not gather in groups of more than 2.
References[]
External links[]
- Official list maintained by the Ministry of Health
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