Public hospitals facing severe bed crunch?

20140110-114146.jpg

“Prominent blogger, Leong Sze Hian wrote on his blog [Link], “In my opinion, the obvious reason for the beds’ crunch, to the best of my knowledge, has never been highlighted in the media – that the total number of hospital beds in Singapore has seen zero increase over at least the last 12 years or so, despite an increase in the population by more than 1 million.”

Actually, the government did increase the number of hospital beds but the problem is they also expanded the population in Singapore considerably over the same period.” Link

The latest serious hot topic in cyberspace now – other than the multi-million kidnapping case or some unhappy cinema patrons at Rex Cinema, is the dearth of beds in government run public hospitals. Many citizens have expressed outrage on this latest worrisome situation. We are talking about NOT one but all the government run public hospitals in our Singapore. How could it be? What happened to our legion of planners and scholars taking huge salary and yet fail to deliver this basic service to our citizens which we have always taken for granted until recently? It seems that this is one of the latest trends happening in Singapore where “Things Are Falling Apart!” Realy langgar!

I do not agree with Uncle Leong’s statement. I only subscribe partially to the second statement. Let me substantiate what I say here.

Back then in 1990 when I was an investigation officer (IO) on duty, I had to visit and interview patients in all the public hospitals across the island. We rotated between IO(R) – Routine or IO(C) – Crime every 4 or 5 days. All routine cases reported to the police between 6am to 6am the next day would come under my preview if happened in my divisional boundary. For example if patient had a fall at home and got warded, I’d need to investigate to rule out foul play. As such, I usually commenced my hospital rounds after 2am after a quick supper. Before 8am, I would need to go through all the reports of the day and prepare a summary of main cases. After a short break, it’s time to review all cases with all the Heads in the conference room. In those days, they called it ‘morning prayers”. Usually, I would plan my route by shooting to the old Changi Hospital, Toa Payoh, TTSH, SGH, AH. Sometimes, I would go to NUH, East Shore or even Mt Alvernia hospitals. Common cases referred to the police then were patients had a fall, drugs overdose usually taking sleeping pills. It’s my job to find out exactly what happened to them. Usually there were 3 to 8 or even 10 cases during my tour of duty. If something was amiss, follow- up investigation would ensure.

Back then when I went on my hospital rounds, there were hardly any foreigners in our public hospitals. Even the nurses were mainly locals. I could see that there were always few empty beds next to the patients in the common ward. In those days, the hospitals were more simple and less advanced. Toa Payoh and Changi Hospitals then were certainly not as big as the current ones. There was no Yishun hospital also. Raffles hospital was also not in existence. So called community hospitals were unheard off also.

Fast forward to today, more than 20 years later we are witnessing a severe shortage of hospital beds in all the government run hospitals. With bigger, better and more properly equipped hospitals and yet we are facing this unthinkable nightmare. Why? It just does not make sense at all. I’m bewildered by this latest incompetency.

I was discussing this sad state of affairs with my good friend. He alerted me to the news report.

“Today’s papers say hospitals are putting tents to put patients in and even getting to sleep in corridors. This is worst than 3rd world countries. You must blog about it. There are too many PRCs taking advantage of our healthcare? Or is it poor planning? Disgusting!!!”

20140110-114442.jpg
There are few facts we need to consider. The fact that there are much more bigger and better equipped hospitals than before effectively demolished Uncle Leong’s opinion that there is “no increase in hospital beds.” The second argument that with influx of foreigners – not local population increase in my opinion – the government run hospitals not able to cope is only partially true.

The problem lies with the deployment of public hospitals to non citizens resulting in the current severe shortage. Public hospitals are strictly meant for natives and should not be strained by non-natives. It is as simple that. All non natives should seek private medical services in the private hospitals. But then, the government is running public hospitals with strong profit motive up to the optimum level. They are taking in non natives cuz they pay more than locals. Foreigners will definitely seek medical attention in public hospitals since they are much cheaper than private ones even though they pay higher than locals. Those public servants turned-entrepreneurs running public hospitals simply cannot resist the urge to take in foreigners cuz of more profits and huge revenue. That is the kind of mindset adopted in all the public hospitals leading to such an embarrassing fisaco.

Again our Singapore brand name has taken another downward dive when the MSM splashed pictures of tents in hospital compound with hospital common corridors sprawling with beds overflowing from the sardine packed wards. When I visited those hospitals back in the 1990s, it was unheard of. Even in the old run down Changi hospital with limited space constraints, there was no such thing as lacking of beds for locals.

The root cause is that our public hospitals are heavily used by non natives. With the influx of foreigners especially there is a new trend of “medical tourists” and our serious aging population, public hospitals just cannot cope. Of course, government spending was also not generous. It did not keep pace with galloping demands! They would prefer to buy more F35s – the world’s most expensive toys where only the filthy rich with tons of money to throw liberally!

If only public hospitals cater exclusively to locals, I am sure that there will be no shortage of beds for citizens. Let the private hospitals handle non-citizens’ healthcare. But then, no CEO in a public hospital will take this approach simply because foreigners are paying more than locals whom are “heavily subsidized” by govt for their medical treatment. But then, medical treatment for locals are also not cheap either. With such high medical costs and yet there is still so much demand for medical services certainly seems ironical. I will bet to the last dollar no one would want to get warded in a public hospital due to the extremely high costs. An extended stay with few operations in a public hospital will definitely wipe out your CPF MediSave savings. Who wants to go there for the fun of it?

Now that the problem has exploded into the open with tents pitching up in public hospital compound, the truth is out. Why did they not foresee such a problem? Current measures as reported in the press are only fire fighting ad hoc remedies but do not solve the root cause of it. They need to really get into the root cause of it instead of putting up so much talk in damage control saying that so many or how many hospitals are being built. Our population aging, due to the holiday season etc. How many hospitals can you build to put a brake on straining our limited resources on public hospitals?

In short, the answer is not to build more but how do you manage? What is the government’s priority when it comes to healthcare for natives and non natives? Natives first than followed by non natives or what? Public hospitals run by the government for citizens only or to be shared by the tons of foreigners? That is the crux of the matter. Bottom line of public hospital costs vs basic citizens’ entitlements to a reasonable subsidized medical treatment is another angle that the government of the day will need to reconcile. Let’s hope that they get their acts together fast and don’t be blinded by rich paying foreigners leading to such a pathetic state of affiars. I’m sure our late Dr Goh KS and pioneer founding leaders would never let such thing happen if they were still around.

20140110-114603.jpg

Look at the picture below. Do we need to come to this stage where citizens are required to queue to get a place in a public library (hospital beds)? They are more than 1,000,000,000 people and we are only 5.3 million. They got better excuses and pretexts if they fail their own people but can we afford to make more blunders? Have we breach the margin of tolerance? Time is running out cuz it’s getting nearer to the finishing line.

20140110-114638.jpg

PS: I just got this list of 10 solutions or suggestions from our brilliant Lohcifer.

1.) Increase number and quality of local specialists.

2.) Study demographics of surrounding/foreign countries to determine which countries likely to come here for healthcare and what the anticipated numbers are (looking into aging population there, etc.

3.) Build bigger hospitals with perhaps separate wings for medical tourists. Build extensions to existing hospitals.

4) Implement patient flow management process.

5.) Refer non critical cases to GPs.

6.) Incalcate culture of home care, providing training to household members teaching them how to provide care at home for the sick.

7.) Incentize those who self-medicate.

8.) Introduce programs enabling patients to help themselves thru online self-assist and such.

9.) Educate public to develop mindset that a hospital visit is only necessary if life & death.

10.) Income tax discounts & other incentives for those who stay away from hoslitals for fixed number of years.

Just some thoughts.

– Lohcifer of Loh & Behold.

About Gintai_昇泰

I'm a Chinese Singaporean living in the Eastern part of Singapore. I tweet on current affairs & inspirational quotes. I blog on issues or events if they interest me. I write for pleasure. I also write mainly for my family and friends. At least they know I'm still alive and well. It's a free country. No one is forcing you to read if you don't like what I write. I'm entitled to my own opinions. Having said that, there are still retards, morons and losers out there hiding behind anonymity hurling all kinds of insults and wicked remarks on my blog. I guess we'll just have to live with these cowardly mangy dogs found in any society. Sigh!
This entry was posted in Langgar. Bookmark the permalink.

21 Responses to Public hospitals facing severe bed crunch?

  1. Sgcynic says:

    //The fact that there are much more bigger and better equipped hospitals than before effectively demolished Uncle Leong’s opinion that there is “no increase in hospital beds.” //

    Your “fact” about the ‘size’ of hospitals says nothing about the number of beds. Uncle Leong had stated the number of beds in our hospitals back in 2012:

    “according to the Department of Statistics’ Yearbook of Statistics 2012, the total number of hospital beds in Singapore declined from 11,936 in 2001 to 11,394 in 2011, although the number of hospitals increased from 29 to 30.”
    http://leongszehian.com/?p=1814

    We all have our opinions. Let the figures speak for themselves.

  2. Sgcynic says:

    From the same link above.

    “Increase in hospital admissions
    The number of hospital admissions increased from 384,054 to 469,445.

    Increase in medical tourists
    Medical tourism has also increased to about 850,000 medical tourists a year now.

    Population increase by 1.1 m
    Against this, there was an increase in the population from 4.1 to 5.2 million over the same period.

    Shortage of hospital beds
    This may explain the recent spate of letters and media reports about the shortage of hospital beds and longer waiting times in public hospitals.”

  3. patriot says:

    Build more hospitals, extend and expand current ones
    are good suggestions. But, if there are shortages of medical
    staff, it will still be pointless. And if more aliens have to be imported
    to fill up the vacancies, then there is going to be more foreigners who
    will also need medicares themselves from time to time. Should there be
    a highly contagious disease outbreak, what will be the Next Solution? Cant
    just be solving a present problem and creating more and bigger ones for future.

    patriot

    • patriot says:

      Like to add that there are some very bad
      and vicious cycles been created in housing,
      healthcare, transportation and importation of
      alien to improve on the GDP.
      There got to be a stop to the Madness in pursuing
      economic growth or at least have more considerations
      for the social impact and the livelihoods of the Current
      Population.
      Singapore is afterall a tiny barren dot, it will reach its destiny
      much faster than other better endowed lands. It is the Decree
      Of Nature that no man can change.

      patriot

    • Patriot,
      Thanks for your comments. Many share your views.

    • bernie quah says:

      He did say as the number one item to increase number and quality of local doctors and specialists.

    • Anonymous says:

      Heys, Patriot. Remember me? Gemami. I’m now Gem SG. I believe we do have a disease outbreak contingency with the upcoming National Center for Infectious Disease coming up. Don’t ask me how effective or useful the center will be though.

      If you’d pm me, I’ll tell you what I’ve been up to. Miss your sharing at TOC, but that’s history. I’m active at The Alternative View. Go like page will you? Cheers, my ol’ buddy.

      • Anonymous says:

        Hi Gemami;

        hard to forget You and Observer Sg/Hkg.
        Was wondering how the Two of You disappeared at the same time.
        Had emailed You twice but to no avail. Good to know that You are still active in Cyberspace. Will visit Your Site and communicate with tge Folks there.

        Cheers.

      • Anonymous says:

        Hi Gemami;

        good to see You here. Had been wondering how both You and Observer Sg/Hkg disappeared together suddenly. Thought both eloped and left Sin.
        Missed much of tge interactions with both of You.

        Me am sure there are all sorts of plans for contingency as well as strategy for everything imaginable. Maybe there are too many plan, theory, strategy and schemes. So much so that Rulers and Planners have not been able to cope up with all the plans (in paper/theory) when actions are imperative. Effective execution is the Equivalence of walk the Talk, else it is all talk and rod.

        Missed much of the vigorous and substantial contributions from You and Obseever. Do hope to meet You Guys at the many Cyber Highways that me tends to gallivant.

        How could I pm You?

        Cheers.

  4. Alan says:

    Not only is there a shortage of beds, appointments to see specialists doctors at public hospitals seems to stretch longer & longer. If I remember correctly, previously a few years back it takes about 2 weeks to make the next appointment. Now it seems for certain ailments, it has stretched as long as 4 months. And you can shorten the wait if you tell them if you want to pay as private patient.

    Their motto now seems to be “Got money can talk”. I mean the PAP.

    • Sgcynic says:

      If you ask for a postponement due to exigency, it’s easily another month wait despite calling the hospital one month in advance of the appointment date.

  5. “They are taking in non natives cuz they pay more than locals. Foreigners will definitely seek medical attention in public hospitals since they are much cheaper than private ones even though they pay higher than locals. Those public servants turned-entrepreneurs running public hospitals simply cannot resist the urge to take in foreigners cuz of more profits and huge revenue. That is the kind of mindset adopted in all the public hospitals leading to such an embarrassing fiasco.”

    “…But then, no CEO in a public hospital will take this approach simply because foreigners are paying more than locals whom are “heavily subsidized” by govt for their medical treatment”

    Actually, the above quotes show you misunderstand the idea of subsidy. Simply put, it means the Govt pays the difference. If a hospital stay costs $X, a local pays $y and the Govt subsidises $X-y. On the other hand, a foreigner who enjoys no subsidy pays $X. The net revenue to the hospital is the same. Hence the hospital is indifferent to whether the patient is local or foreigner.

    Medical tourists also do not really patronise public hospitals because such hospitals do not have the best doctors. Honestly, if you can afford to come to Singapore for treatment, you’re looking for the best plastic surgeon you can afford, and those are in private practice.

    • M Tye says:

      Not really true. Some of the so-called “public” hospitals have the best doctors, these are the ones on the verge of leaving for private practice. NUH for example has a mirror or alternate website entirely in Arabic, do you know? So that the oil-rich middle-eastern sheikhs can come and they – together with the wealthy Indonesians, Thais and Filipinos – are all here. Also lots of the good doctors in so-called “public hospitals” work in several hospitals – a prof could be lecturing at NUH (after all, it is a teaching hospital), then in the afternoon go to Khoo Teck Puat for surgery, and then go to Mt E to do another consult, ending the day at SGH. They move around, and are not stuck in one place. Generally, to be honest, health care quality isn’t too bad here in Singapore, that’s why we are having the problems Gintai blogs about!

  6. Anonymous says:

    Alan,

    is this your 2014 resolution? Fist of all, if you go to Google and and simply search ‘UK + hospital + out of bed’, at least one such news will popped out. (http://www.telegraph.co.uk/health/healthnews/9261908/Nurses-say-NHS-patients-treated-in-corridors-as-beds-run-out.html). This is England hor, in 2012 reporting that beds are running out and pateitns need to be treated in corridor. They are not third world country.

    The conclusion? Every countries wil ahve problem with overcrowding. One simple explaination as people becomes more advance and richer, they are more worried about their health.

    Honestly, this has GOT NOTHING TO DO WITH OUR COUNTRY. It’s a problem to be found anywhere in the world.

    What has gotten into you Alan? You are far from being a politician you know, by just being a keyboard warrrior here. Just ranting, raging and blame Singapore for everything … about everything you don’t know.

    Sure, go ahead everyone, go give me thumbs down; go ahead, delete this reply. If one day Alan gets into trouble, see if any of those who enoucrage you to speak bad abut our country will be there to help you.

    Good luck.

    • Of course I rant because I pay tax and I voted for highly-paid experts to provide solutions. I’m only a common man, what answers do I have? By ranting I am already providing pointers that things are not right. At least I put my name to my opinions and not hide behind nicknames like some cowards who post stupid comments. You will also find that there are 10 suggestions to solve the problem we are facing. I love my country so much to just shut up when things are not right.

    • patriot says:

      Indeed it got nothing to do with the country.
      However, it got everything to do with the Rulers competency, vision and wisdom.

      patriot

  7. Neena Beh says:

    I cannot understand the logic of mongoloids who say we should be contented because even first world countries have overcrowded hospitals so we should shut up or trains breakdown in London all the time so we should be contented. Hello we Singaporeans were taught to expect the best, that to compromise is to become laggards and losers.

  8. patriot says:

    国家安危,匹夫有责。
    人民康安政府有责。
    The People and the Rulers are one in the safety and wellbeings of the People and the State. The Government is duty bound to provide its’ utmost for the health and wellbeings of its’ citizens. The People on their parts, are to help their leaders to ensure the security and prosperity of the State.

    I laud Gintai for his concerns for the
    Wellbeings and health of the People.
    And his on the Ground Observations
    and personal experiences are shared
    by most citizens.

    When citizens are concerned for his or
    her fellow countrymen and the State, I
    see no reason for him to be warned of
    consequences, unless he is expected or
    suspected to be targetted for reprisal
    and or victimization for speaking out his sincere views.

    Gintai deserves to be applauded for his
    civic consciousness, kudos to him.

    patriot

Comments are closed.