“Building ahead of demand” for airport, but “nothing” for healthcare?

The rhetoric – “building ahead of demand” for Changi airport, but “building nothing’ for healthcare (decrease in total hospital beds for 10 years) is “laughable”?

I refer to the article “Building ahead of demand is key for Changi Airport’s success, says Khaw Boon Wan at T4’s opening” (Straits Times, Aug 3).

Quoting the Transport Minister Khaw Boon Wan who was at the official opening of the airport’s Terminal 4 (T4), the article states that the minister said that forward planning and building ahead of demand are important to ensure that Changi Airport keeps ahead of its rivals.

He said, “But building ahead of demand requires sound judgment. It is not simply ‘build and they will come’. The aviation industry is unpredictable, subject to many disruptions, including oil prices and, at times, unhelpful governmental interventions,” and added, “Adhering to straightline projections may end up in tears. We must be sensitive to potential disruptions and be ready to make strategic changes promptly when warranted,”

Since the Transport Minister was the Health Minister from 2004 to 2011 – did we “build ahead of demand” for healthcare?

In fact, according to the Department of Statistics’ Yearbook of Statistics 2012, the total number of hospital beds in Singapore declined from 11,936 in 2001 to 11,394 in 2011 despite the number of hospital admissions increasing from 384,054 to 469,445. Against this backdrop, there was an increase in the population from 4.1 to 5.2 million over the same period.

In 2003, then Acting Health Minister Khaw Boon Wan launched SingaporeMedicine, a national initiative to establish and enhance Singapore's position as the medical hub of Asia. The initiative aimed to attract one million foreign patients a year by 2012. Today, medical tourism has increased from 200,000 a year to about 850,000 medical tourists a year now, all the while when the number of hospital beds was not significantly increased.

This may explain the historical spate of letters and media reports about the shortage of hospital beds and longer waiting times in public hospitals.

You may think that along the way, there had been a rethink of the initiative given the complaints of the lack of beds. But in 2008, Mr Khaw in the capacity of the Health Minister said longer waits in the public sector are inevitable if costs are to be kept low. "We will always run very crowded clinics. That's the only way to keep costs down. But for emergency cases, don't worry, you'll be seen to immediately."

So, arguably, which is more important – “building ahead of demand” for Changi airport, or “never build anything at all” for healthcare (hospital beds)?