Photo of A&E of Singapore General Hospital (Terry Xu)

Citizen’s two cents to Ministry of Health on the three clusters of medical group in tiny Singapore

by Yvonne Leng

I sent my mom to Accident &Emergency (A&E) at the National University Hospital (NUH) on 25th Feb due to acute pain in her knee, resulting in her inability to walk.

She lives in the East but I admitted her to NUH because I reckon the waiting time at Changi General Hospital (CGH) & Singapore General Hospital (SGH) might be too long over a weekend.

At the point of consultation with the doctor during A&E visit at NUH, I had conveyed my interest to send my mom to do Physio at CGH instead.

I was told that CGH & NUH run independently so I will have to do the arrangements myself, so I told him to issue me a referral letter which he did.

After contacting CGH, I told them the episode and only to be told that my mom will not be entitled to the subsidized rate because she will be charged as a private patient as she was not attended to by the doctors there.

I asked if that is the case, do they want me to admit my mom one more time to A&E at CGH just to get around the system so as to allow her to get the subsidy moving forward?

CGH then asked me to send the referral letter over which I did, only to realize the letter I was issued is also not valid because they need a referral letter to see an Orthopedic, while my letter from NUH indicated to see a Physio. (Because you can only see a Physio only after you see their Orthopedic)

I was further being explained that NUH is not part of SingHealth group as they belong to NUHS which make up primarily of the healthcare groups in the West.

So if any patient like my mom who had seen a doctor from NUHS, which shockingly includes Polyclinics, they will not be able to see any doctor/specialist from SingHealth group, or rather they can but at the cost of the private patient.

Upon further reading on my own, I found out there is a third healthcare group – National Health Group (NHG), which I assume the same (senseless) above policy applies. How big only is Singapore to have 3 different clusters of medical group under the government?

While the healthcare system seems obviously flawed to me in this context, the next best thing you can do is to educate your doctors, who can give us the correct advice from the beginning to get around the system.

Rather than making me go back and forth between myself, NUH and CGH, doing rounds of “investigation” and explanation via calls and emails just only get my mom to be eligible as a subsidized patient which she was entitled to begin with. It was not even much of a complicated case to begin with.

After a handful of emails and calls for the past 2 days, as I am writing this feedback, I am still pending for someone from NUH to revert and re-issue me with the (correct) referral letter, while at the same time NUH had hinted to me that I might need to take my mom down to NUH (again) so as to allow them to access in person so they can pen the referral letter (correctly) this time.

How further flawed can your system get?

Not only these actions are causing delay treating my elderly mother, you are wasting everybody’s resources, including taxpayers’ money (who partially fund the hospitals).

I had read your press release and it claimed the reorganization of healthcare system into these 3 clusters is to better meet future healthcare needs – like really?

In my humble opinion, you are creating competition within different clusters, running hospitals like a profitable organisation, do not prioritize your patients’ needs and therefore not giving them the flexibility to “cross clusters” freely – and probably many more scenarios which I yet to came across. We all know government spending on healthcare has burgeoned and surely more can be done to bring higher productivity and optimization on the whole, as a group not individual clusters.

I have grave concerns how this system will work in future in view of our aging population and how many patients out there, who are not as fortunate as me to have the capacity to voice this out, not just to the public but also to the hospitals so as to fight for themselves, just to get around the system that is obviously flawed.