PRELIMINARY SCREENING OF PATIENTS BY 24-HOUR MEDICAL SERVICES CENTRE IN PUBLIC HOSPITALS

Mr Low Thia Khiang asked the Minister for Home Affairs whether the imposition of higher charges is an effective solution to curb the increasing number of calls for ambulance for non-emergency cases.

Mr Wong Kan Seng: The Singapore Civil Defence Force's Emergency Ambulance Service (EAS) is primarily intended to respond to life-threatening emergencies. For this reason, SCDF ambulances are well equipped and the crews are specially trained.

SCDF has mounted sustained public education efforts over the years to educate the public on the proper use of the EAS. In February this year, 850,000 pamphlets and posters were distributed to households and public buildings to further reinforce this message. In April 1997, SCDF helped private ambulance companies to get together to set up a hotline service (777-0000) operated by CISCO to cater to non-emergency cases. The public is encouraged to call the 777-0000 hotline for non-emergency cases. The hotline is a 24-hour service provided by CISCO and is supported by Heng-Gref Medical Supplies and Services, Civic Ambulance Service and Econ Nursing Home Services. SCDF also continued its publicity drive on the hotline through the mass media and TCS has assisted in incorporating the appropriate educational messages in local entertainment programmes and documentaries. These programmes included "Under One Roof" on TCS5 and "Comedy Night" on TCS8.

Despite these efforts, the EAS has been increasingly abused for non-emergency cases. While the number of emergency calls has hovered around 40,000 per year over the last 5 years, the number of non-emergency calls has nearly doubled from the 11,000 in 1992 to 20,000 last year. As a percentage of all calls received by SCDF, the number of non-emergency calls has risen from 20% in 1992 to 32% in 1996 and to about 40% in the first 8 months of 1997.

We must take decisive steps to stop this misuse of the EAS. This is because each time the EAS attends to a non-emergency call, it is less able to respond in time to a real emergency.

The previous charge of $50 for each non-emergency call was lower than what some private ambulance operators charge. It is therefore hardly surprising that the number of non-emergency ambulance calls has increased steadily. In any case, the new fee of $75 barely covers three-quarter of the operating cost of the EAS. We intend to further increase the charge for non-emergency calls to recover its full cost of about $100, with effect from October 1998. Many countries such as the United States, Canada and Australia already charge full cost for non-emergency users of their ambulance services so that critical resources are properly allocated. In fact, even emergency cases have to pay for the ambulance services in these countries.

With continued publicity on the new 777-0000 non-emergency hotline and SCDF's increased fees for non-emergency cases, the number of non-emergency calls to SCDF should be checked. In any case, we will monitor the situation closely.

Mr Yeo Guat Kwang asked the Minister for Health whether he will request public hospitals to consider the establishment of a 24-hour Medical Services Centre to do preliminary screening of patients before directing them to either the Accident and Emergency Departments (A&E) or to other non A&E doctors.

Mr Yeo Cheow Tong: All the A&E departments already conduct preliminary screening, or triage, to determine if a patient is a true emergency case. At the triage station, patients who are assessed to be non-emergency cases are advised to go to the walk-in clinics if the hospital has one, nearby polyclinics or GP clinics. There is, therefore, no need to set up a 24-hour Medical Services Centre for this purpose.