OVERCHARGING/OVERPRESCRIPTION BY DOCTORS (Publication of guidelines on medical services and charges)

Mr Yeo Toon Chia asked the Minister for Health (a) what action is the Ministry taking against doctors who overcharge or overprescribe treatments for their patients; (b) how his Ministry protects the interests of patients; and (c) whether his Ministry will consider publishing, as guidelines for the public, the various medical services and charges which government hospitals/restructured hospitals/polyclinics are charging.

The Minister of State for Health (Dr Aline K. Wong) (for the Minister for Health): Mr Speaker, Sir, my Ministry believes that patients are in the best position to protect themselves from being overcharged when they can make an informed choice.

We therefore require all hospitals to, firstly, provide their patients with information on the estimated total bill sizes prior to their hospitalisation, so that they can choose the hospital and class of ward according to their ability to pay. Secondly, provide information about the amount of Medisave which can be used for payment of the hospital bill and whether any additional cash payment is necessary.

We also require GP clinics to display their range of charges for consultation and treatment.

For restructured hospitals and institutions, information on their charges for various treatment services is freely available at all the A&E Departments, Admission Rooms, Specialist Outpatient Clinics and information counters.

My Ministry is currently looking into the possibility of making available information on hospitalisation fees and charges on Teleview.

My Ministry takes a serious view of doctors who overprescribe treatment or investigation procedures. Under the Private Hospitals and Medical Clinics Act, hospitals are required to conduct regular medical audits of the treatment or investigation procedures to ensure their appropriateness.

However, patients can also ensure that they minimise risks to themselves by ensuring they always consult their family doctor with whom they can build up trust and confidence and on whom they can depend for advice. They should also seek a second specialist opinion if there is any doubt. This is particularly important before undergoing any major surgical operation or investigation procedures.

Finally, if the patient feels strongly that he has been overcharged or over-prescribed with unnecessary treatment or investigations, he can lodge a formal complaint with the Singapore Medical Council which is a statutory body established to maintain standards in the medical profession.

Dr Tan Cheng Bock (Ayer Rajah): Sir, with regard to charges, I just want to ask why NUH, having been given a subvention grant by Government, is not displaying C class bed charges.

Dr Aline Wong: The answer, Sir, is NUH does not have C class beds.

Dr Tan Cheng Bock: If they have been given a subvention grant, they should also provide C class beds. The subvention grant is given by this House.

Dr Aline Wong: There are B2 subsidised beds in NUH. These provide subsidised care for patients who require treatment at a tertiary level hospital like NUH.

Dr Tan Cheng Bock: Can I ask the Ministry to ask NUH to reconsider having more C class beds since they are given a grant?

An hon. Member: They do not have C class beds.

Dr Tan Cheng Bock: They do not have. So they must provide C class beds.

Dr Aline Wong: The Ministry is working with the NUH to provide C class beds so that NUH consultants can in fact give treatment to subsidised C class patients at Alexandra Hospital.

Dr Toh Keng Kiat (Nominated Member): Sir, I understand that some doctors who are required to sit in audit committees to look into the activities of their colleagues are not prepared to do so for fear of litigation and other action. Will the Ministry extend some kind of immunity to these doctors who sit in audit committees?

Dr Aline Wong: I am afraid this is a rather legal matter on whether immunity can be granted. Among the members in the medical profession they have the responsibility to provide peer review of each other's performance and they do tend to raise their standard through this peer review process.