Invest & Strengthen GP System – Dr Tan Hui Ling

We need to step back and look at the bigger picture.

Recent news highlighted our government’s concern of the healthcare system, from congestion in our public hospitals, limited resources to escalating healthcare expenditure. We also hear the public’s concern of increasing medical bills stressing the cost of living.

At the same time, the medical fraternity has also raised concerns of the recent announcement of price control on medication, as well as that there would be no revision for the private General Practitioner (GP) fees which has been in place since 1992.

To manage the rising costs in our healthcare system, current measures to control drug prices and no revision of GP fees will only achieve short term gains, and likely to create long term negative consequences.

First and foremost, we need to take a step back and look at the bigger picture of what we want to achieve in our healthcare system and consider the long term goals.

It is unquestionable that primary healthcare is the foundation for a sustainable, cost effective healthcare delivery system. Our government has also declared the commitment to the World Health Organisation’s call for Universal Health Coverage and enhancing our primary healthcare system.

Thus, what we should focus on is to strengthen and encourage GP practice in the community:

  • Include private GP on top of government health clinic doctors as part of our national primary healthcare provider system. Involving GPs in the Peka B40 health screening programme is not enough to see a long term positive impact in our healthcare system, especially as we work towards universal health coverage.
  • Invest and develop primary healthcare doctors (including private GPs) as a family medicine specialty. This is to ensure all practising primary healthcare doctors are trained and competent to cater to the evolving healthcare needs of our population, including health prevention, acute illness to chronic disease management, as well as post-acute care and end-of-life care.
  • Involve private GPs as gatekeeper to reduce congestion in our public hospitals. A lot of medical conditions do not need to be treated or follow-upped in acute hospitals. Recent initiative by Tengku Ampuan Rahimah Hospital (HTAR) that collaborate closely with private practitioners for referral is a good start (Reported in The Star, 13 May 2019). GPs can also be recruited for post-discharge transitional care in the community. All these will contribute to reduced healthcare cost for the country.
  • Review the GP remuneration to encourage more doctors to practise as GP. Keeping the GP fees at 1992 rate in order to control healthcare cost is not a wise long term solution. The fee revision based on 2010 detailed market study should not draw fear of further increasing healthcare cost nine years later. Market force itself will influence how GP charge patients as well as how much patients are willing to pay for a GP visit. Supply and demand itself will affect market rate, and the last thing we want is to have lack of GPs in the community.
  • Incentivise GPs who practise in areas where there is lack of healthcare access, especially in the rural areas. The incentive can be in the form of tax rebate or even remuneration. We can also refer to how Australian government promote and incentivise rural GP practice.

We all need to take a step back and look at the long term bigger picture.

Dr Tan Hui Ling, MBBS, MPH is a reader of CodeBlue.

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of Code Blue.

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