Singapore spends less on healthcare than the UK, and achieves remarkable health outcomes. Yet it is often unclear how far these lower costs are due to the design of their healthcare system as opposed to wider societal and cultural factors. This paper focuses specifically on primary care, and argues that Singaporean-style polyclinics and telemedicine could help drive efficiency in the UK, as they have done in Singapore.
KEY POINTS
- There is no simple reason why Singapore spends less than other developed countries on healthcare:
- Singaporean public hospitals do not deliver markedly lower unit costs than peer countries.
- Singapore charges patients to access healthcare services, and while this moderates demand, it cannot fully explain Singapore’s low hospital utilisation.
- Low demand is largely determined by population health and culture, which are difficult to emulate.
- Hong Kong and Taiwan spend more than Singapore on healthcare, but much less than Western countries. All three East Asian states have very low levels of obesity, high life expectancy, and low health inequality.
- Health experts should not uncritically cite parts of Singapore’s system to justify their favoured programme of reform. Instead, they should provide evidence that a specific part of Singapore’s healthcare system works better than the NHS. This paper applies this method to primary care.
RECOMMENDATIONS
- The NHS should grant prescribing rights to Singaporean doctors, building on an existing EU Directive. Demand for private GP appointments is growing as patients struggle to access timely care. An appointment on a Singaporean telemedicine app costs half as much as private UK providers, and British patients are already using this service. The government should formalise this process, and make it accessible to more people.
- NHS England should trial Singaporean-style polyclinics in areas of England with too few GPs. Singaporean polyclinics deliver lower unit costs, and pay their doctors more than NHS GP practices.
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