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SPEECH BY DR ALINE WONG, SENIOR MINISTER OF STATE FOR HEALTH, AT THE OPENING OF THE 6TH SCIENTIFIC CONFERENCE AND 7TH MEDITECH EXHIBITION ON 24 MAY 97 AT 2.30 PM
Ladies and Gentlemen
It is a pleasure for me to be here to officiate at the opening ceremony of the 6th Scientific Conference and 7th Meditech Exhibition of the College of Family Physicians. Family Medicine is a discipline that is close to my heart.
Primary health care is first line medical care. It is an essential or fundamental health care provision that should be easily accessible to all. In Singapore, primary health care is heavily subsidised in the public sector, which caters to approximately 20% of all the patients. The private sector caters to 80% of the patients and the GPs' charges are highly affordable to the population.
The College of Family Physicians is the organisation concerned with the professional health or the professional competence of its members, the family physicians. You, therefore, have an important role to play, to ensure that primary health care provided in Singapore is of a high standard.
For many years now, the College has played an important role in the training of family physicians, and in their continuing education. In recent years, the College has been conducting a 64-session modular course leading to a Masters in Family Medicine. I have been informed that this programme will be further modified and upgraded, and will include some hands-on clinical components. I commend the College for its dedicated efforts in improving the standard of practice of family physicians through this programme, as well as through the many continuing education programmes it has been conducting.
It is right and good to be internally driven, to continuously look for ways to improve your profession. For it is through increasing the numbers of well-trained family physicians, both in the public and private sectors, that primary health care in Singapore can be upgraded to compare with the best in the world. Good primary health care has been said to be capable of handling 90% of medical problems. It is one good way of controlling health care costs, as good primary health care doctors can be effective gate-keepers to the more expensive secondary and tertiary health care services.
Of course, controlling health care costs is only one reason why we should do primary health care better. All forms of medicine should have as their central goals the curing of diseases, alleviating suffering and improving the quality of life of the patients. Under these objectives, specific health programmes and medical services can be targetted at different sectors of the population.
Women constitute half of the population. Their health and well-being are an integral part of the health of the nation. When women are in good health, not only will they become more productive persons, enjoying a higher quality of life, but the next generation will also be healthier, more productive and have a better quality of life.
By international standards, Singapore women's health is good. Their expectancy of life at birth is 78.7 years and the maternal mortality rate is 4 per 100,000 live and still births. Women here have equal and ready access to the whole range of medical services
Similarly, antenatal care, postnatal care and family planning services are widely available at GP clinics, O&G clinics in both public and private sectors, and at government polyclinics. Babies are all delivered in hospitals by trained medical personnel. Polyclinics have well-women clinics that provide general health screening as well as special screening services, such as cervical cancer screening for women. Health education specially for women is provided not only by the Ministry, but also by the media such as radio programmes and women's magazines, as well as by civic organisations, such as community centres.
However, with a better educated female population, there is greater expectation for more health programmes focussed on women. In addition, there are certain women's health issues which are currently a cause of concern. For example, the incidence rate of breast cancer, which is the No 1 cancer among women, has increased from 19.9 per 100,000 women 30 years ago (1968-72) to 38.7 per 100,000 women (1988-1992). Another is cervical cancer. Its rates have only declined slightly, from 18.1 per 100,000 women 30 years ago (1968-72) to 15.2 (1988-92). By comparison, some places like British Columbia and Finland have cervical cancer rates which are about one third of ours. Moreover, there are still women coming late for treatment when the cervical cancer is already advanced.
Other problems concerning women here are: insufficient intake of iron and calcium that can lead to anaemia, particularly in pregnancy, and osteoporosis among elderly women; late antenatal care, particularly among women from the lower income groups; high abortion rate at 25% of all pregnancies; hip fractures and senile dementia among elderly women and stress and fatigue among working women who have to shoulder multiple work and family responsibilities.
To tackle these problems, I have initiated a Women's Health Programme within the Ministry and formed a committee on Women's Health to oversee the implementation of the programme. The Committee will identify specific issues concerning women's health in Singapore, prioritise them and set up the approach to be taken to address each issue. It will review the existing programmes and services for women, streamline and repackage them and recommend new programmes to fill in any significant gaps identified. It will also monitor the progress of the programmes, including harnessing public support and women's participation.
Apart from Ministry officials, I have invited representatives from the College of Family Physicians, the Women's Committee of People's Association, and NTUC Health Care to be members of this Committee. Together, we will formulate strategies to further improve the health of women in Singapore. These activities need not be expensive. Much will be carried out at the primary health care and health promotion and education level. It is thus essential that the community be involved, including the family physicians who are at the front of primary health care. I am confident that all of you will give this programme your heartiest support.
I would like to wish you a successful Conference.