PUBLIC AND RESTRUCTURED HOSPITALS

PUBLIC AND RESTRUCTURED HOSPITALS:

(Class downgrading of wards): 7 .

Dr Fatimah Lateef asked the Minister for Health if the process of class downgrading for wards in public and restructured hospitals can be streamlined and hastened as there are too many steps and appointments which make the workflow process very time consuming.

The Minister for Health (Mr Khaw Boon Wan): Mr Speaker, Sir, public hospitals offer different classes of ward at different levels of subsidy so that patients can choose according to their budget. While clinical care is the same, comfort and other non-clinical service levels do differ.

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Before admission, hospitals will advise the patients on the estimated bill sizes so that they can make an informed choice. There is no means-testing at this stage and patients are free to choose.

Subsequently, a higher-ward class patient may seek a downgrading to a subsidised ward. At that stage, we will require means-testing. It takes about two days to process the application. But sometimes it takes longer, not because the procedures are cumbersome, but because the patients are unable to produce relevant documents to support their applications.

We will continue to streamline the process. Unfortunately, the necessary step of getting income information and family particulars cannot be avoided in any means-testing process.

Dr Fatimah Lateef (Marine Parade): Sir, this is also for outpatient or SOC patient where the downgrading actually may take up to eight to 10 weeks. I have had several cases who had actually come to me to appeal because they need to make several appointments with the medical social worker and also to get approval of the doctor for the downgrading. So if this could be streamlined further, it would be so much helpful for the patient because, in the interim, they have to pay the non-subsidised rate while waiting to be downgraded for the eight to 10 weeks.

Mr Khaw Boon Wan: As I said earlier, we will try to streamline. But, sometimes, the difficulties are that patients are unable or unwilling to disclose the necessary information. Dr Fatimah works in SGH. So I specifically asked SGH's medical social workers about the processes for outpatient downgrading, and they said by and large they are able to do it smoothly. They make sure that the decision is made before the follow-up appointment. So if the follow-up appointment is in a few

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weeks' time and so long as it is done in time for the next appointment, I think that should be adequate. But if a patient is unable or unwilling to provide the information, I hope the doctor can help counsel the patient to do so. He has to cooperate with the medical social worker, and we will try to facilitate it as much as we can.

Mr Speaker: Mdm Halimah, last question.

Mdm Halimah Yacob: I think the difficulty for patients who are seeking downgrading is also because the process of means-testing sometimes requires them to produce the salaries of all their children. Sometimes, you have elderly patients who do not even know where their children are staying because their children do not visit them, and they may be too scared. I have a case of a resident who is too scared even to ask his children for their payslips. So these are the difficulties. If the hospital could exercise some flexibility and humanity in such cases, I hope the Minister would consider that also.

Mr Khaw Boon Wan: Yes, we work in a humane industry and we would try to be as compassionate as we can. I think hospitals do exercise flexibility. I did ask for some data from SGH, in particular, on applications and what is the success rate. By and large, they said that for outpatients, about two-thirds have a successful downgrading. For inpatients, about 1% of Class A and B1 patients have successfully been downgraded. By and large, the hospitals do try to assist as much as they can, but they really need the help of the family members to cooperate. Where children are not forthcoming in providing information, or worse, in helping to pay the bills for their parents, I think society as a whole must encourage the children to do so because

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the failure of them to do so means that you and I have to look after their parents, which I do not think is the right way society ought to be organised.