C AND B2 CLASSES IN PRIVATE HOSPITALS

Mr Steve Chia Kiah Hong asked the Minister for Health if his Ministry will accept the private hospitals' offer to treat subsidised C class and B2 class patients.

Mr Lim Hng Kiang: The Ministry of Health acts as the purchaser of medical services for lower and middle income Singaporeans. Public sector hospitals and institutions are set up to provide good and affordable basic healthcare to them. The Ministry has put in place various safeguards to ensure that Singaporeans continue to enjoy good healthcare and to moderate cost increase. Amongst these are:

a) Setting up two healthcare clusters as not-for-profit entities and imposing revenue caps on them. Each cluster has a tertiary hospital, regional general hospitals and polyclinics to ensure integrated and seamless care for patients at the lowest cost setting appropriate to needs;

b) Specifying the number of Class B2+, Class B2 and C beds to be provided by our public hospitals to ensure that the needs of lower and middle income Singaporeans are met;

c) Setting clinical and service standards to ensure quality in the medical services delivered; and

d) Coordinating the introduction of high-cost and high-technology medicine and equipment to avoid wasteful duplication and manage increases in healthcare cost. All these safeguards are to make sure that our public sector hospitals and national centres keep cost down.

Today, subsidised patients choose the public hospital and ward class they want to be treated in, and the appropriate Government subsidy is given based on the choice of ward class. The Ministry will not be able to extend this arrangement for private sector hospitals. There is no mechanism to determine who is eligible for treatment at private hospitals, and we would end up subsidising those who can and should pay for their own healthcare expenses. There is also no compelling reason for the Ministry to run a dual system where we now select subsidised patients for certain treatments in private hospitals, as suggested by the Parkway group. The public hospitals are providing acceptable standard of care to subsidised patients. The Ministry has allowed subsidised patients to be treated by private sector general practitioners and dentists under the Primary Care Partnership Scheme, but those eligible have to undergo a means test.

The Ministry would be happy to contract the service from the private sector if it can offer lower costs at the same or better service quality with the proper framework in place. We are putting in place such a framework for the step-down care sector, with means testing, accredited private sector facilities, properly audited norm costs, revenue caps, and so on. If the private sector is keen to help keep healthcare costs down, they are welcome to provide step-down services within this framework for a start.