Main Complaints from Cardholders in Community Health Assist Scheme

Er Dr Lee Bee Wah asked the Minister for Health (a) over the past three years, how many complaints have been received from CHAS cardholders against the clinics listed under the programme, especially that relating to medical fees; and (b) whether the Ministry can give a breakdown of the main complaints received and the action taken.

The Minister of State for Health (Dr Lam Pin Min) (for the Minister for Health): **** Mdm Speaker, we have received about 300 complaints against CHAS GPs and dental clinics from 2013 to 2015, or about 100 a year. In comparison, about 5.8 million CHAS claims were made over the same period. About half of the complaints were related to charges at the CHAS clinics, including incorrect billing and high fees. Other complaints included operational issues resulting in incorrect subsidy, refusal by the clinic to provide itemised billing, customer service issues, and concerns over the professional practice of the doctor or dentist.

In each case, the AIC had engaged the clinic involved to seek clarification on the issues raised by the patient. For example, for complaints on fees, AIC would obtain and review the bill breakdown from the clinic and explain to the patient whether the fees were due to the length of consultation or type of medication prescribed. If there was a need to correct the bill, AIC would work with the clinic to effect it. Where the complaint was related to professional misconduct, or professional ethics and standards, the patient would be advised to lodge a complaint with the Singapore Medical Council (SMC).

Some of these complaints could be avoided with clearer communication between the clinics and patients. Clinics are strongly advised by MOH to prominently display common charges in their clinics, and provide itemised billing to patients. Patients can also seek clarification from their clinics and request for itemised receipts which will show them their bills before and after subsidy. Patients can also check how much CHAS subsidies their clinics have claimed for them, by logging into the CHAS website or calling the CHAS hotline.

I would like to encourage all Members to inform MOH of any complaints or feedback by residents on CHAS clinics, and we will look into each case to address their concerns.

Er Dr Lee Bee Wah (Nee Soon): Thank you, Mdm Speaker. I would like to ask Minister of State is it compulsory for a clinic or for a doctor to issue invoices with the itemised breakdown. If it is not compulsory, I would suggest to make this compulsory with itemised breakdown so that the residents can check.

And the second question is though there is a CHAS hotline, can it be made more prominently displayed, maybe in front of the registration counter of clinic so that the residents know where to address their grievances?

Dr Lam Pin Min: At this point in time, it is not mandatory for clinics to issue itemised receipts to their patients. We do encourage patients to request for it as well as for doctors to issue it whenever possible. MOH is in the process of looking into whether it is necessary to make it compulsory in the future. As for the CHAS hotline, I take the Member's suggestion that we shall encourage clinics to put up clearer signages or even the CHAS hotline number so that patients will be aware and can actually gain access to the information easily.

Er Dr Lee Bee Wah: May I ask why is it that is not compulsory to issue the itemised invoice? Why is it so difficult giving so many feedback on this over-charging?

Dr Lam Pin Min: Like I have mentioned, MOH is actually in the process of looking at it and we are seriously considering making it compulsory and once the details are out, we will announce it very soon.

I just want to reiterate that the medical profession has been a noble profession, and I want to believe that it still is. Many patients hold doctors in high esteem and expect a high standard of professionalism from them. Since we are talking about CHAS over-charging and the perceived misconduct, I would like to remind all doctors that they are affirmed to the SMC's Physicians Pledge and they are also bound by the SMC's ethical code and ethical guidelines. I also want to reiterate in this House that MOH will not hesitate to take errant doctors to task if they are found to be engaged in professional misconduct or in contravention of the guidelines.