2024年3月6日，新加坡衛生部長王乙康在國會發言，「健康SG」計劃在實施中，越來越多人已經加入。通過建立健康SG計劃，要實現醫療的三大目標。

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以下內容為新加坡眼根據國會英文資料翻譯整理：

主席先生，陳有明醫生強調，醫療需要跨越時間和空間進行，我們同意這一觀點。事實上，這是我們正在努力實現的轉型的一個關鍵方向。有疾病需要在診所和醫院進行治療，但醫療需要在社區和家中建立起來。衛生部一直在推動這一轉型，過去幾年我們已經進行了一些戰略性的政策調整。

患者數據需要在醫療系統中流動，從醫院到診所，再到老年護理和康復中心。這項工作幾乎已經完成，尚待完成的是一項新法律，我希望能在今年晚些時候提交到這個議會。監管需要從以醫療場所為中心轉變為以服務為中心，因此，我們不再對醫院或診所進行監管，而是對提供的服務進行監管，無論其環境如何。因此我們修改了法律，頒布新的《醫療服務法案》（Healthcare Services Act ）。

財政支持必須是中立的。但我們不能簡單地基於這個原則去規劃，因為這很可能導致濫用和意外行為。相反，我們逐步識中立性應該適用的情況和環境，然後進行調整。去年，我們對保健基金計劃的相互承認和通過遠程醫療延伸保健儲蓄支持以管理慢性疾病做出了一些改變。今年，我剛剛宣布了進一步的措施，包括社區醫院、居家病房和遠程醫療的保健儲蓄支援。

最重要的是，在預防保健和保障人口健康方面，我們需要做出果斷和審慎的投資。我們經常聽到要增加醫院能力和醫療人力資源的呼聲。這是合理的。但更重要的是從長遠來看，社區和社會的能力擴展，以預防疾病並建立健康。我們通過「健康SG」計劃正在做到這一點。我們開始看到變化，更多的居民開始參加鍛鍊、騎自行車、跑步或快走，大家正在關注糖攝入量。

鈉的改變需要更長一段時間。食品飲料（F&B）從業者正在改用低鈉鹽。克里斯汀·洛克（Christine Lock）在武吉坎貝拉小販中心是第一個這樣做的人，她賣的是咖喱飯。她是自願這樣做的，因為她的愛人曾經患過心臟病。她說：「我想照顧好我的顧客。」

梁智強導演在疫情期間發起了一個為老年人舉辦的快步走團體，名為「趴趴走」。這個名字的英文意思是為了樂趣四處走走。這個活動每周舉行一次，吸引了近1000名來自新加坡各地的參與者，包括年輕人和老年人。如果他們聚集在社區的某個地方，你會立即注意到。對於他們來說，快步走已經成為了一種新習慣，而且還可以結識新朋友。導演和他的團隊甚至為「趴趴走」創作了一首歌，並將更健康的新加坡的信息融入其中。他們沒有徵求我的意見。所以，兩周前我加入了他們，每個人都唱了那首歌。除了我，每個人都知道這首歌。

我也想分享一下 Cynthia Phua女士的故事。許多議員都認識她，她曾是一名前國會議員。她同意我今天與大家分享她的故事。去年底，她加入了健康SG計劃，選擇了一個離家近的家庭醫療診所。這位醫生注意到她已經三年沒有做乳腺X光檢查了，並提醒她去做檢查。最後，她在去年底做了乳腺X光檢查，發現自己可能患有乳腺癌，後來通過活檢確診了。幸運的是發現得很早，她後來接受了手術切除腫瘤，而且她的身體中沒有發現新的腫瘤。

Cynthia Phua女士現在正在休養並接受治療。她精神狀態良好，我們祝願她一切順利。她想讓我告訴大家：請參與社區推動的健康SG計劃。她堅持不懈的呼籲大家參加，因為這可以改變生活，也可以挽救生命。

英國樂格塔姆研究對世界上的醫療系統進行了全面的排名。他們不僅考慮到醫生與人口比例或醫療保健能力，或者使用的先進設備的種類，而且還評估人口健康和預防保健系統。他們在2023年將新加坡評為世界上最佳的醫療系統，這個評選結果非常寶貴，它鼓勵我們做得更好。

據說在醫療領域存在一個不可打破的鐵三角。醫療的三大目標是：醫療准入、 成本控制和醫療質量。它們之間相互權衡的，其中一方面的改善總是以犧牲其他兩個方面為代價的。

我已經概述了通過使用「居家病房「和正確安置的方法，我們可以增加病床的容量，而不一定需要建造更多的醫院床位。換句話說，在不影響醫療質量的前提下，降低醫療准入門檻。通過將保險和自付相結合，我們降低了患者的醫療成本，同時抑制了對醫療的過度需求。因此，在不影響醫療准入的情況下，提高了負擔能力。更重要的是，通過建立健康SG計劃，我們同時實現了這三個目標，使人們能夠過上更長、更健康和更有意義的生活。

健康SG計劃不是一個政府計劃或融資方案。它是一個針對新加坡人的運動，一種新的生活方式，國民、社區和政府之間的新協議。我們還沒有打破鐵三角，去往醫療健康更簡單的道路。但我們已經取得了良好的開端，並開闢了自己的道路，為我們自己、我們的家庭和我們的國家實現更大的幸福和可能的繁榮。

以下是英文質詢內容：

Mr Chairman, Dr Tan Wu Meng urged that healthcare needs to be delivered across time and space, which we agree. This is, in fact, a key aspect of the transformation we are striving for. Whereas sickness often needs to be treated in clinics and hospitals, health almost exclusively has to be built up in communities and in our homes. MOH has been working on this transformation and we have made a few strategic policy changes over the last couple of years.

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Patient data needs to flow across care delivering settings, from hospitals to clinics, to senior care and rehabilitation centres. This piece of work is almost done. What remains is a new law, which I hope to table in this House in the later part of this year. Regulation needs to move from being premises centric to services centric. So, we do not regulate hospitals or clinics, but the services delivered, regardless of settings. That is why we revamped our legislation to enact the new Healthcare Services Act (HCSA).

Financial support needs to be settings and premises neutral. But we cannot simply apply this based on first principles, as it is bound to lead to abuse and unintended behaviour. Instead, we progressively identify the situations and circumstances where premises-neutrality should apply, and then make deliberate rule changes. We made a few changes last year on the mutual recognition of MediFund and extension of MediSave support to manage chronic illnesses via telehealth. This year, I just announced further moves on community hospitals, MIC@Home and MediSave support for telehealth.

Most importantly, we need to be decisive and deliberate in making investments in preventive care and health of our population. We often hear calls for investment in hospital capacity, in our medical manpower. This is valid. But what is more important for the long term is capacity expansion in communities and society, in its ability to prevent sickness and build health. We are doing so via Healthier SG, and we are starting to see a change. More residents are coming forward to exercise, cycle, run or brisk walk. People are watching their sugar intake.

Sodium takes a while more. Food and beverage (F&B) players are switching to lower-sodium salt. Christine Lock, who sells Nasi Lemak, she was the first to do so at Bukit Canberra Hawker Centre. She did so voluntarily, because she had a loved one who suffered a heart attack. She said, "I want to take care of my customers."

Film Director Jack Neo has started a brisk walking group for seniors, started during the pandemic. It is called "趴趴走". In English, it means walking around for fun. His event is every week, and it will attract almost 1,000 participants, young and old, from all over Singapore. If they descend on one of your communities, you will immediately notice. A thousand people gathering somewhere. For them, brisk walking has become a new habit, and they made new friends. Jack and his team even composed a song about "趴趴走" and incorporated messages of Healthier SG. They did not consult me. So, when I joined them two weeks ago, everyone sang the song. Everyone knew the song except me.

Let me also share the story of Ms Cynthia Phua. Many Members will know her, she was a former Member of Parliament. She agreed to let me share her story with you today. She enrolled into Healthier SG late last year, with a GP clinic near her home. The GP noticed that she had not done a mammogram for three years. So, repeatedly reminded her to do. Eventually she did, late last year. That was when Cynthia found out that she might have breast cancer, and it was later confirmed through a biopsy. Fortunately, it was discovered early. She has since gone through an operation to remove the tumour, and no further tumors were discovered in her body.

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Cynthia is now resting and undergoing treatment. She is in good spirits. We wish her all the best. She wants me to tell everyone – Please push for Healthier SG in your communities. You know how persistent Cynthia can be when she calls for action, because it can change lives and it can save lives.

The UK Legatum Institute ranks healthcare systems in the world in a holistic manner. They do not just take into account of your doctor to population ratio or your healthcare capacity, or what kind of state of the art equipment you use, but they also evaluate population health and preventive care systems. They ranked Singapore as having the best healthcare system in the world in 2023. This is a valuable vote of confidence in our system. It encourages us to improve and do better.

It is said that there is an unbreakable iron triangle in healthcare. The three aims in healthcare: affordability, quality and accessibility. They are also trade-offs, such that improvement in one area always comes at the expense of the other two areas.

I have outlined how, by using MIC@Home and right-siting, we can increase capacity without necessarily building more hospital beds. In other words, improve accessibility, without compromising quality of care. By weaving insurance and co-payment, we reduce out-of-pocket payment for patients, while containing excessive demand for healthcare. Hence, improving affordability, without undermining accessibility. And more importantly, by building better health through Healthier SG, we achieve all three aims at the same time and enable people to lead longer, healthier and more meaningful lives.

Healthier SG is not a Government programme or a financing scheme. It is a movement for Singaporeans, a new way of life, a new compact between people, the community and the Government. We may not have broken the iron triangle to open a straight and easy line to good health. But we have made a good start and carved our own path to achieve greater happiness and probably prosperity, depending on how you look at it, for ourselves, our families and our nation. [Applause.]

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