Online doctors from Singapore should consult patients to ease burden on NHS, think tank says

NHS online GP
NHS online GP

Online doctors from Singapore should consult patients to ease the burden on the NHS, a think tank has suggested.

Permitting Singaporean clinicians to prescribe medicines to British patients could ease pressure on local GPs and help poorer people access medical care, the Social Market Foundation has argued.

A paper published by the think tank identified key lessons the NHS could learn from Singapore’s famously efficient healthcare regime.

It argues that ministers should permit doctors in Singapore to virtually prescribe medications to British people unable to access GP appointments.

The briefing document also proposes that Singaporean “polyclinics” could provide a cost-effective solution to the post-pandemic backlog.

Promoting the model, the Social Market Foundation claims the island country only spends 4.4 per cent of its national income on healthcare – less than half that of the UK – but still enjoys much better outcomes.

It states that Singapore’s infant mortality rate is half that in the UK and that its population also has lower levels of obesity and a greater life expectancy.

Singaporean approach could ‘rescue NHS’

In a foreword to the briefing paper, former health minister Lord Warner argues that these benefits mean ministers ought to look to Singapore for inspiration.

With NHS England reporting that less than half of British patients can “easily” secure a GP appointment, he argues that Singapore’s setup could “help rescue our beleaguered NHS” from its “serious decline”.

Given one in eight people in the UK have already sought out private healthcare - which can involve telemedicine - the paper suggests that it would be a “natural” next step for doctors based in Singapore to be permitted to prescribe medication to patients in the UK.

If this proves successful, the NHS could commission such services for rural areas with limited access to local GP practices, it proposes.

In addition to telemedicine, the paper also proposes that Singaporean “polyclinics” could be set up in parts of England with poor access to primary care services.

These super clinics would combine GP services with labs able to carry out diagnostic tests, and multidisciplinary teams who can care for those with chronic health conditions.

“Polyclinics” became a buzzword in 2008 when Lord Darzi, then a health minister under Gordon Brown, attempted to set up “one-stop shops” across the country.

But the British Medical Journal soon branded them “costly white elephants” when they failed to deliver value for money, and they were decommissioned under the coalition government.

But in a brave reimagining of a near-identical scheme, parliamentary researcher Max Thilo, who authored the paper for the Social Market Foundation, maintains that such clinics could still be cost-effective.

Funds would be saved as care for chronically ill patients would be shifted away from acute hospitals, which are always the most expensive part of any healthcare system due to their fixed overheads, he claims.

The multidisciplinary “team” structure and flexible clinic layout – with consultation rooms connected by sliding doors –  would also allow doctors to see multiple patients at once.

Lord Warner writes in a foreword to the paper: “The NHS is in serious decline, struggling to recover from the devastating impact of the pandemic, Brexit and over a decade of austerity.

“Politicians know radical change is necessary but are fearful of explaining what’s needed to their electorate. Part of the trouble is they lack models they can draw on and cite as a way forward.

This pamphlet provides valuable service delivery ideas that would help rescue our beleaguered NHS.”

However, a recent report from The King’s Fund, another think tank, offers a note of caution for any minister tempted by an innovative solution to address the country’s struggling healthcare services.

It argues that there is “little evidence that one “type” of health care system or health care financing model achieves consistently better results than another. And the costs of transitioning from one system to another can be significant.

“As a result, countries predominantly try to achieve better health outcomes by improving their existing model of health care, rather than by adopting a radically different model.”

In addition to working for Bernard Jenkin MP, Mr Thilo is a recipient of a “Polaris Fellowship” from Entrepreneur First, where he is “working to introduce Singaporean-style polyclinics in areas of the UK with poor access to primary care services”.

Entrepreneur First, an international talent investor, was established by former management consultants Alice Bentinck and Max Clifford, who chairs the government’s Advanced Research and Invention Agency (ARIA), an initiative of Dominic Cummings.