A long wait for certainty

Andrew Loh

Mr Joseph Lee (not his real name) had his bi-annual medical check-up on 13 February this year. The doctor, a general practitioner (GP), found blood in his urine and scheduled him for a second test – on 27 February. Thereon, he was asked to return for a third test on 14 March.

Mr Lee, 57, was told that blood in the urine may indicate a presence of kidney stones, or cancer. However, he was also told that the chances of it being indicative of anything serious were slim. Mr Lee felt it was best to be certain. He then made an appointment with the polyclinic to get a referral to the hospital because it would be cheaper as he would be able to make claims for the cost with his company. Such referrals also entitle him to receive subsidized rates for his medical needs.

Mr Lee went to see the polyclinic doctor on 6 April and was given an appointment with Tan Tock Seng Hospital (TTSH) for the 29th of June – some two and a half months later.

At his consultation with TTSH on the 29^th, he was told by the attending doctor that he will have to have an x-ray done. He may also have to have an endoscopy performed to determine the seriousness of his condition. Mr Lee returned the next day to have his x-ray taken.

His endoscopy is scheduled for the first week of September.

All in all, from the first detection of blood in his urine in February to the endoscopy in September, the entire process would have taken seven months.

According to a check with TTSH, we were told that the average waiting time for such tests was “one month plus”. This, we were told, was because of the long queue for subsidized patients. For “private patients” (non-subsidised patients) the queue was shorter. Does this mean that those who were willing to pay more would receive not just better but also faster treatment? Our query with TTSH seemed to indicate so, which was also what a nurse at TTSH had told Mr Lee.

“The waiting time is too long,” he said. When he asked the nurse at TTSH about this, he was told that it was because he was a “subsidised patient”.

While the medical cost is not a worry for Mr Lee as he receives government subsidy and is able to make claims with his company, it is the length of the waiting period which upsets him.

Mr Lee’s case throws up several questions about Singapore’s healthcare system.

One, how do hospitals prioritise patients’ needs?

Two, are patients who have more serious medical conditions also made to go through similar lengthy waiting periods like Mr Lee?

Three, are hospitals advised by the governing authorities to delay treating “subsidised patients”?

Four, is it true that hospitals have to collect enough fees from non-subsidised patients to cover the costs of subsidised patients?

Five, has Singapore’s spending on healthcare at about four per cent of GDP, which is one of the lowest in the world, contributed to the above issues?

Six, with the share of private spending to public spending on healthcare ratio at about 75: 25, which I understand is also one of the highest in the world, will the burden of healthcare affordability continue to be transferred gradually to individuals?

It is not hard to imagine the anxiety someone in Mr Lee’s position would go through, waiting – for months – to find out if his condition is a serious one which would warrant further treatment.

While it may not be easy or simple to resolve the problem of long waiting periods, it is nonetheless imperative that our hospitals look into this. With Singapore being one of the fastest ageing nations in the world, the healthcare needs of senior Singaporeans must be a priority. And this should not only apply to the area of affordability but also, perhaps more importantly, in providing peace of mind for them through a more efficient processing system.

In 2003, Minister Mentor Lee Kuan Yew said this of Singapore’s healthcare system:

“In Singapore, within half-an-hour, you would be in SGH, TTSH and within one-and-a-half to two hours flat, you’d know what went wrong.”

While MM Lee may have been referring specifically to emergency services, one hopes the same standards will also be set for other aspects of our healthcare system.

Mr Joseph Lee would certainly welcome them.

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With thanks to Leong Sze Hian.

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