Mr David Ong asked the Minister for Health (a) if he can provide an update on the sufficiency of hospital beds for the critically ill; and (b) whether the hospitals can cope with the current number of beds in the event of a surge in the number of chronic cases turning critical.

The Minister for Health (Mr Gan Kim Yong): Sir, the Ministry of Health has over the years built up high dependency and intensive care capacities to meet the needs of critically-ill patients. As of end of 2011, High Dependency (HD) and Intensive Care Unit (ICU) beds constitute approximately 9.4% of beds in service. Bed occupancy rates for HDs and ICUs vary across different hospitals and time periods. The bed occupancy rate in 2011, up to the end of the third quarter of 2011, for HD was 60% while the bed occupancy rate for ICU was 73.1%.

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We recognise that the demand for such facilities would increase as our population ages with increasing prevalence of chronic diseases coupled with advances in medical treatment that enable treatment of increasingly more complex cases. We would thus be increasing the number of high dependency and intensive care beds even as we increase the overall number of public hospital beds. At the same time, we need to use these facilities appropriately and ensure right siting so that only patients who need HD and ICU beds are warded in such facilities.

Mr David Ong (Jurong): I thank the Minister for the response to the question. Indeed, I am concerned about the shortage in capacity in view of the fact that we are a fast ageing population and there is a significant rise of people suffering from chronic illnesses, such as diabetes. Our specialist outpatient clinics, which are a prelude to hospitalisation for many of our chronic sick, are now seeing a waiting time of about six months or more, and this long waiting time can lead to further complications, such as eye, limb and kidney problems. So, I would like to ask the MOH whether the Ministry can look at quickening the pace in shortening the waiting time and whether our restructured hospitals can be better prepared to take care of this sudden surge of cases turning from chronic to urgent and critical.

Mr Gan Kim Yong: Mr Speaker, Sir, Mr Ong has raised a very important point. As part of our healthcare strategy, I would share more about our overall capacity plan during the Budget Debate as well as during the Committee of Supply (COS). What is more important as we progress is that we must recognise that as our population ages, we will see an increasing prevalence of chronic diseases, as Mr Ong has pointed out. But if we do nothing, these diseases will progress and we will end up with many of the patients developing multiple morbidities, and many of them will end up in hospitals and putting a stress on our hospital system as well as our healthcare system overall. But to address this problem, while we continue to add hospital beds, we must also look at how we can manage these chronic diseases better and more effectively.

It is for this reason that we have introduced recently the Primary Care Master Plan. Through this Master Plan, we hope to be able to transform the primary care sector to deliver patient-centric, team-based, holistic care to manage the chronic diseases more cost-effectively. At the same time, we have also enhanced our Primary Care Partnership Scheme, or what we now call Community Health Assist Scheme (CHAS). Through this scheme, we tap on the capacity in the private sector (the private GPs) to help us manage the chronic diseases in the community so that we can prevent these diseases from progressing into multiple morbidities. And we hope that through this Primary Care Master Plan as well as CHAS, we will be able to be more effective in managing these diseases and reduce the load on the hospital beds. This will be beneficial to the society as a whole and, more importantly, this will be beneficial to the patients themselves. I hope to be able to share more with Members during the COS.

Mr Speaker: Dr Lily Neo, keep it short.

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Dr Lily Neo: Thank you, Mr Speaker. May I ask the Minister, apart from what he has just mentioned earlier, is his Ministry looking into other measures or new options to ease the demand of the expensive, acute hospital beds to cope with this ageing population and more and more chronic cases, and what are these measures?

Mr Gan Kim Yong: Mr Speaker, as I mentioned earlier, we would like to share more details during the COS. But I think it is probably appropriate for me to stress at this moment to Dr Neo as well as the rest of the Members that for us to be able to manage the hospital beds, it is not just about building more beds. We will continue to build more hospitals. We talked about Jurong Hospital. We will be bringing forward Sengkang Hospital, and we will share more about our plans and capacity expansion.

But more than just building beds, we also have to look at various measures to manage the demand in the hospitals. For example, right siting is very important. We want to make sure that only those who need to be hospitalised will be hospitalised. Patients who can be cared for in community hospitals, in nursing homes or even at home, we should find ways to encourage them and facilitate better care in the community as well as at home.

These are the various measures that we will be discussing during the COS. In the short term, while we build more capacity in the hospitals, the various healthcare institutions also look at measures to increase effective capacity. One example is to shorten the length of stay. If we are able to shorten the length of stay, manage it better, then, effectively, you create more bed space for patients.

Secondly, we are also looking at whether we can decant some of the administrative facilities or spaces to convert them into medical facilities that can provide additional space. We are also looking at how we can manage the process more efficiently, such as discharge processes, so that it is more efficient for us to discharge patients when they are ready rather than to have to wait for administrative procedures to be completed. And if we are able to discharge patients more efficiently, then we will also be able to create more space to cater for the increasing needs.

3.00 pm

Mr Speaker: Order. End of Question Time.

[ Pursuant to Standing Order No 22(3), Written Answers to Question Nos 16-17, 22-23, 26, 29 and 32-34 on the Order Paper are reproduced in the Appendix (Pg 1149-1155). Question Nos 18-21, 24-25, 27-28 and 35 have been postponed to the next sitting of Parliament on 17 February 2012. ]

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