Plan to ape Singapore to ease GP shortage

Opportunities for private GP work in some areas could be frustrated under a think-tank’s blueprint to ease NHS pressures by allowing Singaporean doctors to prescribe medicines to British patients.

In a paper published by the Social Market Foundation, with a foreword from former health minister Lord Norman Warner, healthcare researcher Max Thilo identifies lessons for the UK’s health­care system from Singapore’s ‘famously efficient and effective regime’. 

As demand for GP services grows, he argues, the UK Government should consider liberalising prescribing rights for Singaporean telemedicine providers and introducing Singaporean-style polyclinics in areas of England with poor access to primary care services.

Mr Thilo also calls for a shift from delivering acute services in hospitals to follow Singapore’s investment in polyclinics and low-cost telemedicine. 

‘Teamlet’ model

The polyclinics combine GP services with other healthcare offerings – such as diagnostic tests. Singaporean polyclinics operate a ‘teamlet’ model, where patients with long-term conditions are cared for by a team comprising the same doctor, two nurses and health co-ordinator. 

Polyclinics have been explored in the past in the UK. Lord Darzi, a health minister in the Gordon Brown government, introduced polyclinics combining primary and some acute care. But the plans were abandoned in the early stages. 

In his foreword, Lord Warner, health minister under Tony Blair, argues that the ‘time has come to revisit these ideas and draw on the experience of Singapore’.

Singapore-style polyclinics separate acute and chronic patients. This allows them to operate at higher volumes. Doctors that cater for walk-in patients see 56 acute patients a day, during regular working hours. Polyclinics also drive down costs, it is said, by staffing the urgent care clinic with junior doctors. 

Singaporean polyclinic doctors earn slightly more than the average English GP, but cost per appointment is lower in Singapore than in England. 

The paper says Brits have increasingly been seeking out private care, as well as using international telemedicine apps to reach out to Singaporean GPs.