ALEXANDRA HOSPITAL (Service and staffing level)

Dr Wang Kai Yuen asked the Minister for Health what is his appraisal of the service level at Alexandra Hospital and whether he is satisfied with the service provided to the public at the present staffing level in the hospital.

The Minister for Health (Mr Yeo Cheow Tong): Mr Speaker, Sir, Alexandra Hospital (AH) is a medium sized 400-bedded acute general hospital. It has departments of general medicine, general surgery, orthopaedics and paediatrics. It also has a 24-hour accident and emergency service.

Alexandra Hospital has been able to improve its facilities and level of service in recent years. It is now comparable to the other Government hospitals.

Let me list out some of the improvements. Alexandra Hospital now has 89 doctors, compared to only 66 doctors five years ago. This is an increase of over 35%. Patients, especially those with complex medical problems, can now obtain a much higher level of medical care. Alexandra Hospital has a total staff strength of 882, giving a staffing ratio of 2.2 per bed. This is comparable to the other general hospitals as well.

The hospital has also been upgrading its equipment and operating systems. It recently installed new X-ray equipment costing $0.5 million. This has resulted in a shorter waiting time for patients.

Alexandra Hospital has computerised its patient registration, billing and appointment scheduling. It has also improved its Accident & Emergency and Specialist Outpatient Departments.

Sir, all these improvements have enabled Alexandra Hospital to provide a more efficient and faster service to patients. For example, at the A&E Department, 75% of all patients were seen within 53 minutes in 1989. In 1991, this was shortened to only 27 minutes. A&E patients have to generally wait longer in the other hospitals.

Similarly, in the Specialist Outpatient Clinics, 75% of all patients are now seen within 40 minutes, compared to 50 minutes in 1989. In the other hospitals, the waiting time varies from 40 to 70 minutes.

The median waiting period for patients requesting for an appointment to see a specialist has been reduced from 11 days in 1990 to 3-6 days in 1991. In the other hospitals, the median waiting period varies from 7 to 14 days, which is much longer.

Patients are now happier with the medical and nursing care, meals and ward accommodation provided by Alexandra Hospital. Patient surveys show that 74-94% of patients rate these services as excellent or good, compared to only 60-88% in 1987.

As a result, more patients are now using Alexandra Hospital. In 1991, the number of hospital admissions increased by 4% to 19,700, while the Specialist Outpatient Clinic attendances increased by 8% to 64,100.

Sir, my Ministry is continuing to upgrade Alexandra Hospital. We are now undertaking major physical upgrading works in Alexandra Hospital costing $18.2 million. This will enable us to provide more B2 wards, and better ward facilities. We will upgrade the operating theatres, add a day surgery suite, and expand the Intensive Care Unit. There will also be facilities for geriatric patients. All these will help to improve the level of service to patients in Alexandra Hospital even further.

Dr Wang Kai Yuen: Sir, would not the Minister agree that if there are reported cases of patients who are prematurely discharged, even in Alexandra Hospital, with all these improvements, there is still room for improvement?

Mr Yeo Cheow Tong: Sir, there is always room for improvement in any hospital. The question is to what extent. Normally, the doctors will vet all patients carefully and ensure that they are suitable for discharge. Of course, patients may prefer to stay longer in the hospital, especially in the Class C wards where the charges are very low, rather than be discharged home or into a nursing home where they may have to pay even more. They will then consider themselves to be prematurely discharged, but actually they are well enough and do not require to be kept in an acute hospital which is really meant to cater for people with acute illnesses.