Hospital Shame

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The Independent Singapore did an interview with Dr Tan Lip Hong on the bed crunch at some of our hospitals, with the Changi General Hospital setting up an air-conditioned tent to accommodate patients. Dr Tan has worked as a GP in the heartlands for the past 19 years. He is also one of the authors of the Singapore Democratic Party’s healthcare plan.

What was your first reaction when you read this?

I am not surprised by this report.

Why?

The Singapore government has been under-investing in healthcare infrastructure for decades. Our hospital bed to population ratio is way below that of developed country standards. And these standards are calculated based on resident population. Given that our non-resident population is 30% of our total population, this would mean that the our problem is even more dismal.

The total population of Singapore has increased by at least 35 per cent in the last decade, yet the total number of hospital beds has remained more or less constant.

The Health Minister has said that the ministry is aware of the situation, but said the extra beds will only come on-line in 2020 – in seven years’ time!

What can be done in both the short term and long term to prevent a similar situation from happening?

The government has started to build more hospitals. If there are no delays, the Ng Teng Fong hospital (700 beds) will be operational in 2014 and the Sengkang Hospital (500 – 600 beds) will be ready in 2018. These are very long lead times (Mount Elizabeth@Novena; a $2 billion 333-bed private hospital was built in just 3 years. Even with these two new restructured hospitals built, our hospital bed : population ratio will still be way below OECD norms.

We clearly have to put in more resources on increasing the number of our hospital beds. The SDP Healthcare Report has recommended about $1.5 billion a year to be spent on expanding infrastructure and manpower until sufficient capacity is achieved. Realistically, we need to almost double the number of hospital beds to reach an acceptable number.

I was at the Changi hospital, where the tent stands as a sore thumb, over the past week visiting a relative, and the A and B1 class beds were only about half filled. To fill A class beds, our restructured hospitals actually send missions to Myanmar, the Middle East and Africa to advertise our services.

At the out-patient level, appointments for B and C patients can take months, whereas those for A class patients only take a week.

There is clearly a very inefficient use of our current resources.

In the shorter term, taking into account our severely-stretched resources, restructured hospitals should no longer be in the medical tourism business and should concentrate on providing care for citizens. There should be only one standard of care. Private healthcare should be provided by private hospitals. This would leave our public hospitals with increased capacity to deal more efficiently with over-crowding.

However, the longer term solution for our bed crunch problem is to recognise the fact that we do indeed need more hospital beds urgently and the commitment has to be there to pour sufficient resources to providing these beds urgently.