SPECIALIST CLINICS IN PUBLIC HOSPITALS AND POLYCLINICS

Mr Low Thia Khiang asked the Minister for Health (a) what is the standard of service that patients can expect from specialist clinics in public sector hospitals and polyclinics; and (b) whether doctors at these clinics are overworked.

Mr Lim Hng Kiang: Polyclinics provide a comprehensive range of preventive and primary care services. They are able to manage acute illnesses like the common cold as well as the more chronic problems such as diabetes and hypertension. Other services include health education, family planning, antenatal and postnatal care, childhood immunisations and developmental assessment of children. We have about 200 doctors manning 17 polyclinics. About one-third of them have postgraduate qualifications in family medicine.

For patients with more complicated medical problems, a full range of specialist outpatient clinics are available in the various restructured hospitals and specialty centres. We have about 640 specialists covering the 29 specialties with outpatient clinics, ensuring a high quality of clinical services.

Apart from professional standards, my Ministry also recognises the importance of service quality such as waiting time and good communications.

Polyclinics are well-used by residents as fees are affordable. The majority of the patients are walk-in cases who do not have prior appointments. The waiting times can therefore be longer because of the bunching effect. During the morning peak hours between 8 and 11 am, patients may have to wait up to 90 minutes to see a doctor. Waiting times could be improved if patients were to visit the polyclinics during non-peak hours. My Ministry is monitoring this situation closely, and the polyclinics are also working to ensure that their patients do not have to wait unnecessarily long.

For the specialist outpatient clinics, our target is for at least 50% of our patients to be seen within 30 minutes of their appointment times, and for 95% of the patients to be seen within 75 minutes of their appointment times. Currently, not all specialist outpatient clinics are able to achieve these targets. My Ministry commissioned an Operations Research study in April 2001 to look into the causes of this, and to recommend measures needed for the clinics to achieve these targets. The study is expected to be completed soon.

In ensuring clinical and service quality standards, the Ministry and hospitals monitor and ensure that doctors are not unnecessarily overworked. At polyclinics, doctors work 45 hours a week, excluding lunch hours. This is comparable to a private-sector General Practitioner who works an average of 43 hours a week. Doctors in hospitals work an average of 60 hours a week. The working hours are longer because most hospital doctors, as part of their work, perform night calls. However, the working hours of our doctors are comparable to those of doctors in other developed countries. While public-sector doctors generally see more patients than a General Practitioner every day, hospitals and polyclinics also ensure that their doctors have sufficient time with patients so that quality of care is not compromised.