HSC1003 - Health Systems
The World Health Organisation (WHO) has defined health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
This definition has not been amended since 1948.
Official healthcare was introduced in Singapore in the 1860s, traditional health practices and home remedies were common among non-European communities.
In the 19th century, infectious diseases like smallpox and tuberculosis were the main causes of mortality. Smallpox vaccination was only made mandatory in May 1869.
The first hospital to be build in Singapore was the Singapore General Hospital, near Bras Basah Road and Stamford Road. Today, Chijmes stands at the site.
In the 1900s, the colonial government introduced Maternal and Child Health Service, School Health Service, etc.
At this time, the only existing hospitals were military hospitals, located at Alexandra, Sembawang and Changi. Alexandra Hospital was the largest and best-equipped hospital in the British Far East Command.
More recently, several public health campaigns were launched:
- 1960: Dental Health Campaign
- 1970: National Heart Week
- 1980: National Smoking Control Programme
Quite possibly the most successful family planning campaign in the world was the Two is Enough policy introduced in the 1970s. It was so successful that fertility rates in Singapore fell from more than 4 per female in 1965 to less than 2 in the 1980s.
Below is one of the posters that were used in the campaign:
From 1980s onwards, strategies to keep healthcare affordable were launched.
- MediSave (1983)
- MediShield (1984)
- MediFund (1993)
In 1990s, specialist centres were also centralised: - Singapore National Eye Centre (1990)
- National Heart Centre (1994)
- National Dental Centre (1997)
- National Cancer Centre SG (1999)
Now, on to something a little more relevant to my course:
Radiography services began in Singapore in 1913.
Radiotherapy was set up as part of Department of Radiography in 1926, and the School of Radiography was started in Singapore General Hospital in 1963.
A health system must aim to achieve 3 main things:
- Health
- Responsiveness
- Fairness in Financial Contribution
It is challenging to quantify health because of its imprecise definitions. However, certain qualities are definitely not healthy, like lower life expectancy, mortality or disability.
Responsiveness refers to the prompt attention to health needs and the accessibility to basic amenities. It can also refer to the access to social support networks for individuals receiving care. It may also refer to respect for patients, their dignity, individual autonomy and confidentiality.
Fairness in financial contribution is the most controversial factor. The goal of this is to achieve a fair and sustainable contribution system. By fair, we mean that household incomes should not be compromised in order to receive the necessary healthcare, and the contribution to healthcare should be proportional to either the household income or disposable income.
As previously mentioned, this is a rather dry module, and pretty content heavy in terms of various theoretical models, history and the like.
More of this to come next week. Thank you for reading my Messy Workings! :)
