HEALTH-CARE SERVICE (Plans for lower-income group)

[Mr Deputy Speaker in the Chair]

Dr S. Vasoo asked the Minister for Health whether there are any further specific plans to provide affordable health-care service for the lower-income group and which hospitals will be retained as Government hospitals.

The Minister for Health (Mr Yeo Cheow Tong): Mr Deputy Speaker, Sir, the Government will continue to ensure that basic health care is accessible and affordable to all Singaporeans, by providing subsidies to the lower income groups and waiving charges for the needy.

My Ministry has taken the needs of lower-income Singaporeans into consideration when planning the development of the new hospitals and clinics. For example, the three new hospitals being built now, namely, the new Tan Tock Seng Hospital, Kandang Kerbau Hospital and the new hospital in Simei, will have a total of about 3,550 B2 and C class beds, as compared to the existing total of 3,300 beds.

A new Community Hospital was opened in Ang Mo Kio in June this year. The Community Hospital provides low cost intermediate level hospital care. More than 80% of its beds are B2 and C class beds. We will build more community hospitals in future if the need arises.

The Ministry will also continue to provide affordable primary health care and will develop further our network of polyclinics. New polyclinics will be opened in Bukit Batok, Geylang and Choa Chu Kang within the next two to three years.

The Alexandra Hospital will be the only Government hospital and there are no plans to restructure it for the time being. My Ministry is currently renovating Alexandra Hospital at the cost of $27 million to upgrade the facilities and services. The renovations will result in an increased capacity of about 100 B2 and C class beds when they are completed in 1994.

Dr S. Vasoo (Tanjong Pagar GRC): Sir, if there are more demands for B2 and C class beds, would the Ministry consider increasing the number of such beds?

Mr Yeo Cheow Tong: Sir, my Ministry monitors regularly the demand for all classes of beds and we make adjustments to meet the demand as and when required.

Mr Loh Meng See (Kampong Glam GRC): Sir, will the renovation cost of $27 million be reflected in the new prices to be charged to patients or can the Minister show us that the fees charged by the hospital will remain the same notwithstanding the renovation cost?

Mr Yeo Cheow Tong: Sir, the costs of building and renovation are normally reflected in the capital cost of the hospital. In the case of Alexandra Hospital, they pay a rental to the Government for the use of the land and building and the subsidy provided by the Government is more than adequate to cover the rental cost for the subsidised patients.

Dr Tan Cheng Bock (Ayer Rajah): Sir, may I ask the Minister whether there is a fixed percentage of C class beds in the various hospitals?

Mr Yeo Cheow Tong: Sir, as I have explained to Dr Vasoo just now, we monitor the demand for C class beds and if the need goes up, we will make available more C class beds. But the demand for C class beds in the past few years has actually been declining and, therefore. it is not feasible to impose a fixed limit on the number of C class beds.

Dr Toh Keng Kiat (Nominated Member): Sir, actually my question has been partly asked by Dr Tan. I note from the Annual Report of Singapore General Hospital last year that occupancy of C class beds was 106%. What is the actual ratio of B class to C class beds? Does this mean that the demand for C class beds will be more than B2 beds?

Mr Yeo Cheow Tong: Sir, the demand for the subsidised beds - B1, B2 and C classes - in SGH has always been very high. In fact, quite often, patients have to wait for admission to all these three classes of beds. The answer is very simple as to why the demand is so high. I think Singaporeans do see SGH as being the premier hospital and, therefore, from all parts of Singapore, patients go to SGH and it is not possible for one hospital to meet the medical needs of all the people in Singapore. So we have to keep on explaining to the patients that in actual fact the other hospitals do give equally good service. In some cases, the waiting time for admission into the hospital is much shorter if they had gone to an alternative hospital and very often we do explain that to the patients going to SGH.

Dr Tan Cheng Bock: Sir, I believe that in C class there are five modalities of care that are not made available to patients. I would like to ask the Minister whether a patient, for example, a cardio-thoracic patient, would be charged C class rates if he has that particular ailment, and he has to move up to B2 class because he needs that modality of care.

Mr Yeo Cheow Tong: Sir, this question has been asked several times and I have answered it several times. I would like to explain again. In the five disciplines where there are no C class beds, the patient is admitted as either a B2 class patient or above. Where the patients find that they are unable to afford B2 bills, they can ask for the bills to be reduced either to a C class bill or for complete remission. The hospital will then review on a case by case basis.

Dr Tan Cheng Bock: They were admitted into C class first and then they discovered that they need this particular care, so they have to move to B2. Under these circumstances, do you still charge them B2 rates or C class rates?

Mr Yeo Cheow Tong: Sir, in the first place, these are very specialised facilities like, for example, the Burns Unit. In most cases, the patients are admitted directly into that unit, for example, the Cardio-thoracic Unit for those with heart attacks. In the unlikely instance where they are admitted first as C class patients in another ward, and then they are put in a B2 ward, they are still charged as B2 patients. But if they have any problems paying the bills, the hospital will always be very flexible in remitting them.

Dr Tan Cheng Bock: But they cannot afford it, in the first instance, and that is why they went into C class.

Mr Yeo Cheow Tong: Sir, in many cases, many of the patients in C class can very well afford C class and B2 rates. But they have chosen to go into C class because they are very prudent in the use of their funds and we should respect that. But when they can afford to pay B2 charges and they do not wish to be downgraded to C class, we should also respect their wishes.

Dr Tan Cheng Bock: I am giving a case where a person really can only afford going to C class. While in the hospital, it was discovered that he has this particular condition that needs B2 treatment. There must be some consideration.

Mr Yeo Cheow Tong: Sir, as I explained just now, if he only can afford C class charges, then the patient can let the hospital know and the hospital will be very happy to remit the bill.

Dr Tan Cheng Bock: He is already in B2 class so he is charged B2 rates.

Mr Deputy Speaker: Dr Tan, can you please let the Minister finish his reply?

Mr Yeo Cheow Tong: There are only B2 wards for those five specialties. If the patient really cannot afford, whether he was first admitted as a C class patient or otherwise, he should let the hospital staff know and the rest follows automatically. There is no difficulty or complication in the appraisal process.