From Heritage to Healthcare: Should Traditional Medicine Have a Stake in Singapore's Public Healthcare System?

Rushil Srinath and Lan Sin Yu
5 hours ago
8 min read

Credits to Unsplash: Igor Miske (https://unsplash.com/photos/photo-of-teacup-with-coffees-CwVE4xCAA8Y)

In this Explainer, find out...

How is Traditional Chinese Medicine (TCM) currently regulated and used within Singapore’s healthcare system?
Why is TCM being increasingly integrated into public healthcare, and how can this work in practice?
What risks and trade-offs could arise from expanding TCM’s role in healthcare, and how should Singapore manage them?

Introduction

Traditional Chinese Medicine (TCM) and Western Medicine

TCM is a healthcare system that began in ancient China. It views health as a state of balance between Yin and Yang in the body, and the smooth flow of Qi (vital energy). Common TCM treatments include herbal medicine, acupuncture, cupping and dietary therapy. Instead of treating a single illness, a TCM diagnosis looks at the body as a whole to assess a person’s health.

In contrast, Western medicine is perceived to be more heavily based on modern science and biomedical research. It focuses on identifying specific diseases using tests like blood work and medical imaging, and treating them through medication and surgery. Western medicine places strong emphasis on evidence-based practice, meaning treatments must be scientifically tested and proven to be safe and effective.

In short, a key difference lies in their respective approaches. TCM takes a more holistic view on health, while Western medicine is more focused on diagnosing and treating specific illnesses.

TCM Usage in Singapore

Western medicine is the main form of healthcare in Singapore. However, TCM is also popular, especially among elderly Chinese Singaporeans. Studies show that TCM makes up 88 per cent of complementary and alternative medicine use in Singapore. This may be because many seniors grew up using TCM, so it is more familiar to them. In addition, treatments are commonly viewed as more “natural” and less invasive, appealing to those who are cautious about medications or side effects.

Given TCM’s increasing importance, this Policy Explainer considers recent efforts to integrate TCM into the mainstream healthcare system. In turn, we evaluate both possibilities and challenges associated with integration.

TCM’S STANDING IN SINGAPORE

To begin, we consider the position of TCM within the healthcare system today. Currently, TCM is recognised, regulated and commonly used. However, it operates separately from the main Western, evidence-based medical framework.

Despite not being fully integrated into the mainstream healthcare system, TCM is formally regulated in Singapore. For example, practitioners are required to register with the Traditional Chinese Medicine Practitioners Board (TCMPB). The TCMPB sets basic standards for training, professional conduct, and accountability. Additionally, TCM products such as herbal medicines are regulated by the Health Sciences Authority (HSA). This reduces risks related to safety issues and misleading claims. Such regulations reflect the government’s recognition of TCM’s popularity and continued use amongst some groups.

Despite the above regulations, TCM remains largely outside Singapore’s mainstream public healthcare system. It is not a routine part of care in polyclinics and is mainly provided through private clinics. Hence, most TCM services are paid out of pocket. There are limited subsidies and little coverage under national healthcare financing schemes.

However, in recent years, Singapore’s public hospitals such as Tan Tock Seng Hospital and Sengkang General Hospital have been trying to integrate TCM into patient care. This reflects growing clinical interest in applying and evaluating TCM using evidence-based methods.

Promoting Further Integration of TCM in Public Healthcare

Currently, Singapore prioritises Western medicine as the foundation of public healthcare. This is because of Western medicine’s strong evidence base and ability to deliver standardised outcomes. TCM is viewed as complementary or alternative care, rather than a core component of national healthcare. Nevertheless, TCM is being gradually integrated into public healthcare due to its popularity among Singaporeans.

Three particular methods of integrating TCM into the mainstream healthcare system are explored below:

Integrating TCM into the Healthier SG programme;

Creating more pathways for TCM practitioners to be formally accredited; and

Promoting collaboration between TCM and Western medicine practitioners.

Bringing TCM into Healthier SG

First, one way that TCM is entering public healthcare is via the Healthier SG programme. Healthier SG is a national preventive healthcare strategy launched by Singapore’s Ministry of Health (MOH). Its core aim is to shift healthcare away from just treating disease in hospitals to preventing illness in the community. Singaporeans are encouraged to register with a primary care clinic or general practitioner (GP) who will work with them on long-term health plans. This includes lifestyle advice, screenings, vaccinations, and chronic disease management. The goal of Healthier SG is to keep people healthier for longer. In the future, it is possible for patients to register with TCM practitioners under the expanded Healthier SG programme.

TCM fits well into the Healthier SG framework because it is particularly suitable for preventive care. For example, TCM is used to prevent diseases like diabetes, hypertension and high cholesterol. As Health Minister Ong Ye Kung says, TCM can help patients adopt healthier lifestyles through advice on diet and daily routines. This aligns with Healthier SG’s goal to promote long-term healthy living.

TCM Accreditation Opportunities

Second, the Government is creating more ways for TCM practitioners to be certified. For example, MOH and TCMPB are working on an optional accreditation framework. This means TCM doctors can get formal validation for the quality of their care. When rolled out in 2026, this framework will allow qualified practitioners to take part in Healthier SG activities. These could include helping patients adopt healthier lifestyles and participating in community health outreach programmes.

Additionally, there are more formal TCM education and training options. For example, Nanyang Technological University introduced a new Bachelor of Chinese Medicine degree in 2023. This is the first local undergraduate programme in Chinese medicine by TCMPB, designed for Singapore’s healthcare needs. The four-year degree teaches both traditional diagnostic and treatment methods as well as foundational biomedical concepts. The curriculum includes regular clinical training and internships to build practical skills. This prepares graduates for a system where TCM and mainstream healthcare work alongside each other.

TCM working closely with Western Medicine Providers

Third, the Government is exploring collaborative models where TCM practitioners work alongside mainstream primary care. MOH has launched a TCM Integrative Sandbox initiative. It tests how TCM treatments can work together with Western medicine in public healthcare settings. Under this programme, 18 proposals from healthcare clusters are being tested in a controlled environment over one to two years.

During the sandbox phase, specific use-cases (such as acupuncture for migraines or stroke rehabilitation) are implemented in public hospitals and clinics to collect clinical data. This evidence will guide future decisions. It will determine which TCM treatments can be offered more widely and how they may be incorporated into mainstream practice.^,

In addition, consultations with GPs and TCM practitioners are being planned. These discussions will focus on collaboration, roles, and workflows that support preventive care. This includes referrals from TCM to GPs for screenings and vaccinations, while continuing TCM care.

Potential Challenges

The integration of TCM into Singapore’s national healthcare framework involves balancing cultural heritage with clinical safety.

In this regard, at least four main challenges emerge:

Ensuring consistent standards;

Filling information gaps;

Avoiding over-reliance on TCM; and

Enhancing collaboration between TCM and Western medical practitioners.

Product Integrity and Standardisation

First, a major difficulty in integration is that standards for TCM practices vary vastly. Unlike the highly standardised pharmaceutical industry, TCM has mostly been self-managed by practitioners. This lack of consistency might lead to product tampering. Harmful ingredients (such as steroids or banned weight-loss substances) may be added to “all-natural” TCM medicinal products to produce faster results. Such practices pose severe risks, such as internal bleeding or even organ failure.

To address this, Singapore uses a measured approach. HSA applies stricter controls for ready-made medicine while maintaining lighter oversight for raw herbs. Stricter rules could mean product registration, standardised labelling, scientific safety standards, and zero-tolerance for tampering.

This is further supported by TCMPB, which enforces minimum standards of ethics and competence.^, Without over-policing the heritage aspect of the practice, this balance ensures that safety is enforced.

That said, the variation in practices may not simply give rise to a risk of product tampering. Variation may also affect the type of diagnosis and treatment methods. Indeed, American medical researcher Ted Kaptchuk has observed that patients with stomach ulcers could be diagnosed with six different unique syndromes in TCM. Each of those diagnoses may have its own herbal remedy. If this is so, TCM may produce significant inconsistencies that make it difficult to assess its treatment efficacy. This may seem to suggest that greater standardisation must be pushed for.

However, some may also argue that the value of TCM lies in its flexibility. Such flexibility means that treatment can be tailored to the needs of the particular individual. Hence, Kathryn Muyskens, a researcher at the National University of Singapore’s Centre for Biomedical Ethics, has questioned whether standardising TCM practices may come at the cost of diluting a core strength of the medical practice. The tension between preserving consistent standards while striving for consistency is therefore a conflict any TCM-related policy has to continue to grapple with.

Bridging the Information GapSecond, many patients are hesitant to disclose TCM use to their biomedical doctors, fearing they might be “shamed or scolded for being ‘backward’”. This lack of communication creates a dangerous blind spot for clinicians and raises safety concerns.

The risk of herb-drug interactions is perhaps the biggest concern. For instance, certain herbs with blood-thinning properties can cause life-threatening complications if combined with Western anticoagulants during surgery. As TCM institutions operate outside of the National Electronic Health Record (NEHR), this risk is exacerbated by data fragmentation and the lack of care continuity.^,

Under the 2025 Health Information Bill, TCM practitioners must now contribute to national health records. This shifts the focus away from debating medical beliefs and toward the practical task of sharing data to ensure patient safety. Digitising TCM prescriptions allows for automated cross-checking against Western medications. This safeguard reduces the burden on the patient to disclose their habits and provides doctors with a complete view of a patient’s health profile, regardless of their personal views on alternative medicine.

Clinical Efficiency

Third, questions remain over the clinical efficiency of TCM treatment. For example, doctors have warned that exclusive reliance on TCM may lead to delayed treatment. This is because patients who rely exclusively on TCM treatment forgo objective and standardised monitoring of their conditions. In turn, these patients may potentially develop a false sense of security while their condition worsens.

In turn, a question arises: how should the state determine the scope and scale of subsidies for TCM? This question is important. Without a clear evaluation framework, there is a risk of subsidies being provided for ineffective treatment.

In response, the Ministry of Health (MOH) utilises Integrative Clinical Sandboxes as described previously. This sandbox approach functions as a structured evaluation mechanism, allowing the Government to:

Identify which TCM treatments offer objective clinical value;

Signal to patients which therapies should be used as complements (and not replacements) for essential medical care; and
Maintain public trust by ensuring that taxpayer-funded healthcare remains rooted in evidence.

Collaboration between TCM and Western Medical Practitioners

Fourth, for TCM to take root as a complement to mainstream options, there must be collaboration between TCM practitioners and Western medicine practitioners.

However, this is arguably lacking today. For example, as recently as 2019, 70 per cent of Western medical practitioners in Singapore felt that improving their knowledge of TCM could allow themselves and their patients to discuss TCM more comfortably. The same study revealed that only 10 per cent of these Western medical practitioners have personal experience in using TCM. In turn, this may explain why even in hospitals where acupuncture is offered, there is a perception that TCM is a second-class treatment option. This suggests that for the recent efforts to succeed, what is required is not merely regulations, but indeed a cultural and mindset shift amongst medical practitioners.

Conclusion

Ultimately, the evolution of TCM in Singapore reflects a pragmatic shift from historical coexistence to intentional integration. As Singapore grapples with an ageing population and the rising prevalence of chronic diseases, Singapore is moving beyond merely permitting traditional practices, towards actively synergising them with the national healthcare agenda.

The success of this integration should not be measured by the wholesale adoption of TCM, but by the creation of a dual care model. In this future, a patient can be referred by their TCM physician to a GP for subsidised screenings while continuing their holistic maintenance, all within a single, transparent financial and data framework.

That said, real challenges remain, both at the technical level, and in relation to how TCM is perceived and understood. Addressing these risks will be essential to ensure success in truly integrating TCM into Singapore’s healthcare model.

This Policy Explainer was written by members of MAJU. MAJU is a ground-up, fully youth-led organisation dedicated to empowering Singaporean youths in policy discourse and co-creation.

By promoting constructive dialogue and serving as a bridge between youths and the Government, we hope to drive the keMAJUan (progress!) of Singapore.