Numbers don’t lie – especially not in healthcare.
This is the case Singapore is currently in as recent national surveys report how chronic diseases have become a major health challenge to the country.
Driven by an ageing population and lifestyle risk factors, Singapore’s health stats have painted a clear picture of rising chronic disease rates that demand urgent attention:
- About 1 in 3 Singaporean adults between ages 18-74 (37.0%) has hypertension (high blood pressure)
- Roughly 1 in 3 (around 32%) have hyperlipidaemia (high cholesterol)
- Diabetes, a key concern of Singapore’s “War on Diabetes,” affects about 1 in 12 residents – roughly 8.5% of adults aged 18 to 74
- Obesity rates have also risen, with about 1 in 9 Singaporeans (11.6%) classified as obese.
Notably, many chronic conditions in Singapore remain under-diagnosed or poorly controlled.
For example, among those with high blood pressure, more than half (53.5%) had not been previously diagnosed before a health survey, indicating a large pool of “silent” hypertensives in the community. Similarly, nearly 1 in 5 diabetics in Singapore are unaware of their condition, and among those diagnosed, a significant proportion do not meet recommended blood sugar targets.
These gaps highlight the need for stronger chronic disease management at the primary care level, where regular monitoring, patient education, and early interventions can make a big difference.
As it is, there seems to be a solution hiding in plain sight—one that’s already embedded within our communities and may hold the key to more sustainable chronic care.
Private Clinics and Their Role in Singapore’s Chronic Care Eco System
In the intricate scaffolding of Singapore’s healthcare system, private general practitioner (GP) clinics are the quiet constants.
Nested in HDB void decks, tucked beside bakeries, across from wet markets – by sheer presence, these clinics outnumber the 26 government-run polyclinics many times over.
With this, private GPs have been crucial players in the Ministry of Health’s (MOH) Healthier SG initiative. As of early 2024, over 1,000 GP clinics have signed up to participate in Healthier SG, out of roughly 1,300 eligible Community Health Assist Scheme (CHAS) clinics.
Public response has been positive – more than 700,000 residents enrolled with a primary care clinic in the first months of the rollout. Notably, seniors are the first to be enrolled for preventive care and chronic follow-ups under the Healthier SG framework.
Private GP clinics also possess inherent strengths that make them valuable assets in chronic disease management:
- Shorter Waiting timesPrivate clinics typically offer faster access to consultations. Appointments are easier to secure, and walk-ins rarely stretch into hours, making it a more practical option for patients with limited time.
- Flexible operating hoursMany private clinics operate beyond the standard 9-to-5, with evening and weekend slots built into their schedules. For working adults and family caregivers, this flexibility isn’t a luxury—it’s the only way chronic care fits into a packed week.
- Continuity of CareContinuity of care is one of the defining features of private GPs. Unlike in polyclinics, where rotating rosters mean you may not see the same physician twice, private doctors often serve the same patients over years, building familiarity and trust that’s critical for chronic disease management.
- Longer consultation durationsPrivate GPs often have the bandwidth to offer longer consultations, which gives room for meaningful conversations around symptoms, medication adherence, and lifestyle adjustments. It’s not just more time—it’s better use of time, for both patient and physician.
However, until recently, their place in the narrative of chronic disease management has been oddly understated. Despite this widespread accessibility, private GP clinics have historically played a smaller-than-expected role in chronic disease management.
Although they represent over 80% of Singapore’s primary care providers, they have been responsible for managing just over half of the nation’s chronic care cases. Public polyclinics, meanwhile, which account for less than 20% of primary care doctors, have taken on a disproportionate share of chronic disease patients.
Limitations of Private Clinics in Chronic Care
Why the imbalance? The answer is part perception, part infrastructure. Polyclinics have historically offered affordability and a kind of clinical convenience.
Cost has been a traditional sticking point. Polyclinics are heavily subsidised by the government – Singapore citizens pay only a nominal fee for consultations and enjoy subsidised medication rates.
Private GPs set their own fees, which historically made chronic management at a GP more expensive out-of-pocket for patients without insurance or subsidies. Many lower-income patients simply could not afford regular GP visits for chronic care before subsidy schemes matured.
Thus, while GPs offer convenience and potentially higher satisfaction, the affordability gap drove many chronic patients to polyclinics.
Additionally, patients, especially retirees and seniors managing multiple prescriptions, are drawn to one-stop access: lab tests, medication refills, eye screenings—all within the same building, under the same roof.
In contrast, private GPs have not always had the space or staffing to support that model. This often means referring patients to external providers, adding steps to the care journey and reducing convenience—especially for patients managing multiple conditions.
To discuss, here are some other barriers that continue to limit the full participation of private clinics in Singapore’s chronic care efforts, despite their accessibility and patient-centred strengths:
- Administrative and reporting burden
Participating in initiatives like Healthier SG and Primary Care Networks (PCNs) requires clinics to implement additional reporting, documentation, and care planning processes. For solo or small-practice GPs with limited staff, this can create operational strain, particularly in managing chronic disease registries and compliance requirements. - Limited cross-setting care coordination
While continuity of care is a strength, private clinics can struggle with cross-setting coordination—especially when patients need to transition to specialists, hospitals, or government support services. In contrast, polyclinics often operate within integrated health clusters, enabling smoother referrals and shared patient records. - Technology and systems integration challenges
Many private clinics still operate with legacy systems that are not fully integrated into the National Electronic Health Record (NEHR). This limits real-time data sharing and can complicate chronic care tracking across providers, which is critical for coordinated, long-term management.
What Private GPs Need to Strengthen Their Role in Chronic Care
Private GP clinics in Singapore are no longer operating at the fringes of chronic care. With Healthier SG and other reforms ushering in a more community-based approach, these neighbourhood practices are being invited to take on a far more central role.
But as with any system shift, responsibility cannot rest solely on the shoulders of practitioners. The question isn’t just what GPs can do—it’s also what they need, and how the system must evolve around them.
1. Lean Into Healthier SG, but With Support
The Healthier SG initiative is already changing the equation: Now, GPs receive an annual service fee per enrolled patient (adjusted by health risk), a capitation approach that rewards preventive care and regular follow-up instead of only episodic visits.
GPs who leverage such schemes can close the cost gap with polyclinics, enabling patients to receive sustained chronic care in the familiar GP setting without financial barrier. In short, by embracing Healthier SG’s framework and subsidies, private clinics can proactively expand chronic care services while the government shoulders part of the cost burden.
But maximising the impact means more than signing up. Clinics must build workflows around this model—recall systems, medication synchronisation, and health planning conversations. They also need technical and funding support to do so. When structured properly, Healthier SG becomes not just a policy—it becomes practice.
2. Scale Smarter Through Networks and Shared Resources
Team-based care is the only sustainable way forward. Private clinics, often operating solo, can’t match the breadth of services polyclinics provide. But through Primary Care Networks (PCNs), they don’t have to.
PCNs are an important enabler for private GPs to manage chronic patients more holistically as joining one can give them access to government-funded support staff and shared resources such as nurse counsellors, care coordinators, and allied health services, turning small clinics into full-service chronic care providers.
This team-based approach ensures that patients with chronic conditions receive ancillary services like nurse-led education, diabetic foot screenings, and retinal photography which individual GP clinics may not offer alone.
Participation is now a Healthier SG requirement, but the opportunity is larger than compliance. PCNs, if used well, allow GPs to focus on clinical care while a central team manages follow-ups, data entry, and allied services. It’s not just scale—it’s smart scale.
3. Use Technology to Optimise, Not Overwhelm
Technology is often seen as an administrative burden, but used right, it’s a lifeline. To manage a larger chronic patient panel, clinics should then leverage technology and innovative staffing solutions that streamline workflows.
Digital tools such as electronic medical records (EMR) and the National Electronic Health Record (NEHR) integration help GPs access hospital reports and update chronic care plans seamlessly, improving continuity.
This is also where virtual staffing comes in. Services like Outpost’s virtual medical receptionists can handle reminders, calls, and appointment logistics. By using such services, clinics can ensure no chronic patient “falls through the cracks” in between visits, as the virtual assistant can call patients to remind them of upcoming reviews, coordinate referrals, and prompt patients to go for their screenings or lab tests.
This not only improves operational efficiency but also enhances patient adherence to care plans.
4. Move from Reactive to Preventive Care
Traditionally, many private GPs were oriented towards acute, episodic care, but expanding into chronic care means adopting a proactive, preventive mindset.
Thus, under Healthier SG, GPs are expected to co-develop personalised Health Plans with patients. These aren’t just checkboxes, they’re conversations about setting targets, medication goals, and lifestyle changes.
In fact, a recent MOH survey found that 3 in 4 Singaporeans believe a personalised plan would help them stay healthy, and most trust their GP to guide them with such. In this case, private GPs can build on this trust by actively engaging patients in goal-setting and education during consultations.
Clinics might also consider expanding manpower dedicated to chronic care: hiring a nurse educator or care manager, even on a part-time basis or shared within a PCN, can greatly enhance patient counseling and follow-up. This then helps the clinics embed preventive care into their chronic care workflows.
5. Help Educate Public Understanding That Private Doesn’t Mean Premium
Finally, one of the most overlooked enablers of a stronger GP role is public perception. Many patients still assume private clinics are costly, transactional, or out of reach. Even with subsidies in place, uptake may lag unless the narrative changes.
A coordinated communication effort—co-led by MOH and GP associations—can help reposition private clinics as not just accessible, but central to national care. That shift in perception may be just as critical as any policy reform.
Final Thoughts
The future of chronic care in Singapore is not too limited now, not when private GPs now have opportunities to fill the gap the public health care system has for its patients.
They have been the touchpoints closest to patients’ lives, and if supported well, they are where continuity, trust, and real prevention can take root. But to play a bigger role, private GPs need the infrastructure, incentives, and integration that match the complexity of the expectations of long-term care bestowed on them.
Ultimately, it’s not about adding more to the GP’s plate, but redesigning the table entirely. When private clinics are empowered as frontline partners in chronic care, what we build isn’t just a system—it’s resilience, at scale.
About the Author: kate
