Strengthening Long-term Healthcare Workforce Sustainability while Maintaining Care Standards

3 Dr Choo Pei Ling asked the Coordinating Minister for Social Policies and Minister for Health in light of global competition and rising domestic demand for healthcare manpower (a) how Singapore is strengthening long-term workforce sustainability while maintaining care standards; and (b) whether workforce planning assumptions are being reviewed to ensure resilience amid tightening regional labour markets.

The Senior Minister of State for Health (Dr Koh Poh Koon) (for the Coordinating Minister for Social Policies and Minister for Health): Sir, ensuring an adequate healthcare workforce to meet rising healthcare demand is a foremost priority for the Ministry. We adopt a multi-pronged workforce strategy to ensure sufficient healthcare manpower while maintaining care standards and regularly update our plans as circumstances change.

Our focus continues to be to build up the local core of our healthcare workforce through diversifying training pathways, increasing local intakes for healthcare programmes and ensuring that job roles are attractive and salaries are competitive. We bring in qualified foreign healthcare workers in areas of shortfall. And to ensure resilience, we diversify the sources of foreign recruitment and secure government-to-government bilateral manpower cooperation agreements with regional countries.

We will continue to invest in good preventive health and right-site patients to appropriate care settings to keep our healthcare system sustainable.

Mr Speaker: Dr Choo.

Dr Choo Pei Ling (Chua Chu Kang): Thank you, Mr Speaker, and thank you to the Senior Minister of State for the response.

Beyond expanding training capacity and recruitment, how is the Ministry redesigning care models and workforce structures so that productivity gains translate into more sustainable workloads? Beyond that, how are we strengthening retention of experienced mid-career and senior healthcare professionals whose institutional knowledge is critical to long-term resilience? And finally, as demographic and disease trends evolve the next decade, how is our workforce planning being aligned with broader healthcare transformation efforts to ensure that sustainability is present beyond immediate capacity expansion?

Dr Koh Poh Koon: Sir, I thank the Member for her three supplementary questions. As I will be giving a more holistic treatment of this subject on healthcare manpower in my Committee of Supply speeches, I will be brief on the three supplementary questions.

For the first supplementary question on how we are redesigning care models to ensure the workloads are sustainable, I would just briefly say that we are shifting from more team-based care to a more shared care model, in which we allow more cross training among the healthcare professionals in adjacent domains, so that they can provide more shared care for patients who may need a lower acuity of care outside their area of expertise. For example, in the allied health professionals, a physiotherapist and occupational therapist may share the same patient, for which they can provide some degree of support or guidance to a patient who needs an adjacent sector of care. So, that would not require an overburdening of another fellow professional, for which they can give simple advice in their own capacity.

We will also be doing care team transformation. So, one idea is to then change the idea of a specialist being always the principal doctor in charge of a patient to having someone else who can coordinate the care other than a specialist, so that the workload can be better distributed and care is less fragmented.

On the second supplementary question on strengthening retention of more senior or mid-career professionals in the healthcare sector, as I said in my main reply, we looked at making sure the salary is competitive compared to other sectors so that there will be a good reason to retain them, but also making sure that they are able to practise at the top of their licence. So, through redesigning the job and making the career progression pathway a lot more seamless and more fluid, we allow these professionals to practise at the top of their licence so that they actually have satisfaction in their professional career.

But beyond their own professional satisfaction, we also want to make sure that the work environment is one which is inclusive and supportive. So, each of our healthcare clusters have a Chief Welfare Officer that looks at the welfare initiatives to encourage and support our healthcare staff who work under reasonably stressful situations.

And finally, we also have systems in place to prevent harassment and abuse at the workplace of our healthcare professionals and we take a zero tolerance stance. So, we also send a signal that we are protecting their workspaces and supporting them in the work that they do.

The third supplementary question on how the workforce planning is being aligned with care transformation, I will briefly say that we are also creating new career tracks. For example, in the hospital setting, we are creating a new category of career track for doctors. We call them hospital clinicians. These are pegged similar to how a specialist would progress in the hospital and, by doing so, we open up pathways for doctors even within the hospital setting to have fulfilling careers. And in the primary care sector, we have also announced that we will grow the pool of family medicine specialists, designating family medicine as a specialty itself, so that we actually can then grow the pool of general practitioners (GPs) who are prepared to train at a higher level and deliver care at a higher level of acuity in the community, and thereby aligning that with our overall transformation to community care settings and helping patients to accept their care in the community.

Mr Speaker: Mr Cai Yinzhou.

Mr Cai Yinzhou (Bishan-Toa Payoh): Thank you, Speaker. Thank you, Senior Minister of State for the reply. I have a question regarding foreign domestic workers in Singapore. I understand we have 300,000 foreign domestic workers who form about one-fifth of our foreign workforce. Many of them work in the homes in the care settings at home, taking care of seniors with a range of conditions as well, some more severe than others.

May I ask the Senior Minister of State if we are considering having a professionalised track for foreign domestic workers to specialise in the aspect of palliative or geriatric care, considering that is part of what they are already doing at home, in order to professionalise our home care setting?

My second question is also for foreign domestic workers who are really good in taking care of seniors. Sometimes, after the seniors pass on, they are unable to continue taking care of another senior in another home setting. Do we have options for these foreign domestic workers to progress to also join the community care sector as a care staff, or even nurses as well?

Dr Koh Poh Koon: Sir, the short answer to that is that we have no plans to turn foreign domestic workers into healthcare professionals in the formal sense.

Mr Speaker: For those who want more details, stay back for the Ministry of Health Committee of Supply taking place in the next two days.