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Singapore polyclinics will reserve slots for urgent walk-in patients and elderly amid online booking challenges

Senior Minister of State for Health, Dr. Janil Puthucheary, assures Members of Parliament that Polyclinics will allocate slots for walk-in patients with urgent medical needs and elderly patients with mobility issues as several MPs addressed the Minister with supplementary questions during the parliamentary session on Tuesday (4 July), highlighting feedback from residents, particularly seniors, who encountered challenges while attempting to book appointments online.

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1 year ago

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SINGAPORE — Polyclinics will reserve slots specifically for walk-in patients with urgent medical needs, as well as elderly patients who are frail or have mobility issues, as announced by Senior Minister of State for Health Dr Janil Puthucheary.

Dr Puthucheary was addressing Parliamentary Questions in Parliament raised by Dr Tan Wu Meng, Member of Parliament (MP) for Jurong GRC, and Ms He Ting Ru, MP for Sengkang GRC, on Tuesday (4 Jul).

Dr Tan inquired about the safeguards in place to ensure access to polyclinic care for seniors aged 65 and above who face challenges in booking appointments online or repeatedly encounter fully booked slots. Meanwhile, Ms He questioned the possibility of releasing next-day appointment slots in fixed tranches throughout the day instead of a single release at 10 pm.

In response, Dr Puthucheary highlighted the increasing demands on Singapore’s healthcare system as the population ages and requires more primary care. He also mentioned that the completion of planned New Polyclinics had been delayed due to the pandemic.

“As a result, some polyclinics have greater demand and less easy availability of appointments.”

Consequently, in the interim, the polyclinics have implemented short-term measures to address the situation. They will set aside specific slots for walk-in patients with urgent medical needs, particularly elderly individuals who are frail or have mobility issues.

“To do so, non-urgent cases may be given an appointment for another day or advise to seek treatment at a nearby community Health Assist scheme (CHAS) General Practitioner (GP) Clinic.”

“Polyclinics will also try to leverage telemedicine as much as possible and contract private groups to help deliver the service, ” Dr Puthucheary added.

Regarding Ms He’s question, Dr Puthucheary acknowledged that some polyclinics already release appointments in tranches.

“However, this does not solve the issue of capacity constraint and in fact may frustrate patients more if they are repeatedly unable to book appointments.”

In response to Dr Tan’s inquiry about obtaining monthly data on the speed of online booking slot reservations and the number of patients who logged into the polyclinic appointment system but did not proceed to book, Dr Puthucheary clarified that the Ministry of Health (MOH) did not possess the requested data.

MPs shared seniors’ feedback who were troubled by the polyclinic booking system

During the parliamentary session, several MPs addressed the Minister with supplementary questions, highlighting feedback from residents, particularly seniors, who encountered challenges while attempting to book appointments online.

They emphasized the need for improved solutions and greater convenience for elderly patients.

Dr Tan, MP for Jurong GRC, expressed concerns to the minister regarding two residents from Clementi, particularly seniors, who were troubled by their experience with the polyclinic booking system.

“One resident tried to make an online booking for her elderly mother four days in a row, logged in at the booking time, couldn’t get a slot. Another senior, not IT-savvy, can go online went to a polyclinic, and was told to book online. He can’t go online. ”

Dr Puthucheary reassured that MOH will continue to explore various measures to enhance healthcare accessibility for seniors 

Dr Tan raised two points: exploring the possibility of a hotline for seniors unable to use smartphones or computers for online bookings, and enhancing subsidies for consultations at GP clinics to be on par with those at polyclinics.

In response, Dr Puthucheary reassured that the Ministry of Health (MOH) will continue to explore various measures, including hotlines, to enhance accessibility and user-friendliness of polyclinic appointments and services, particularly for seniors.

Regarding subsidies at CHAS GP clinics and their relation to polyclinic charges and costs, Dr Puthucheary emphasized the importance of ongoing review.

“This is something that we are constantly reviewing on an ongoing basis we will have to constantly review the conditions as well as the level of subsidy that we provide for the chest GP clinics and indeed take into account the relationship with what happens in the politics.”

Liang Eng Hwa, MP for Bukit Panjang SMC, supported Dr Tan’s suggestion and shared feedback from seniors who find it nearly impossible to secure online appointments at the NUHS Bukit Panjang Polyclinic.

He further inquired whether health facilities could allocate dedicated walk-in appointments, especially for seniors who face difficulties with online booking.

Additionally, he expressed puzzlement over the inability to meet the demand despite increased efforts by MOH to build new polyclinics.

In response, Dr Puthucheary clarified that polyclinics reserve a portion of appointment slots for walk-in patients.

“So not all the appointment slots at a given polyclinic on a given day are only for online appointments. There are slots that are set aside for walk-in patients.”

He explained that the walk-in patients or potential patients are assessed, and so sometimes they will be given advice to come back on another day or to seek help at a GP clinic, depending on what it is they present with.

Regarding capacity constraints, Dr Puthucheary acknowledged the impact of various factors.

Delays in polyclinic construction and operationalization, caused by the COVID-19 pandemic, have played a role. The ageing population with increasing frailty and comorbidities has also contributed to rising demand for care.

“Recently in the news we’ve had the Khatib and Sembawang Polyclinics timings talked about, but there is also an increasing demand as our population ages and the agent have increasing frailty and comorbidities that will require further care.”

He emphasised that the government is working diligently to catch up and expand services to address capacity challenges resulting from the combination of growing demand and pandemic-related constraints on projected supply.

Leader of the Opposition proposes expanding walk-in slots for senior patients at polyclinics

Pritam Singh, Leader of the Opposition, raised concerns about the difficulties faced by seniors in accessing the online system and requested an increase in the number of walk-in slots at polyclinics.

He also asked the Minister to provide information on the percentage of slots allocated for walk-ins and inquired about the number of complaints received by MOH regarding the inability to book slots online.

Although Dr Puthucheary did not have specific data on the feedback received by MOH, he emphasised the possibility of increasing the proportion of walk-in slots.

“I would point out that that doesn’t change the overall capacity available at the polyclinic, and that is actually the heart of the issue,” Dr Janil reminded.

“I understand there is frustration with the online system for seniors, but there are also people who are able to use the online system and as a result, the availability of the resources and the capacity for the services at the polyclinic are better matched to those patients.”

“So I think we have to have a balance. If we went to a full-on walk-in system, that would have an implication on the ability for the care teams to deliver the service that they are used to delivering.”

“If we went to a fully online system, indeed, the frustrations that members in this House have highlighted will become worse.”

“The question then is what is the best way of determining that balance? And this is left to the operational teams running the polyclinic to take into account their capacity, the services that they deliver, the demographics of their population, and it can vary over time.”

Nevertheless, he assured Pritam Singh and other MPs that MOH will continue to collaborate with cluster management and operational teams to optimize the right balance of online appointments, advance bookings, same-day appointments, and walk-ins.

Suggestion on training Active Aging Center staff to assist seniors with polyclinic appointments

Yip Hon Weng, MP for Yio Chu Kang SMC, inquired about the number of senior patients resorting to A&E for non-emergency cases due to difficulties in booking polyclinic slots. He also suggested training Active Aging Center staff to assist seniors with polyclinic appointments, considering their community proximity.

In response, Dr Puthucheary acknowledged the lack of specific data on senior patients who were unable to book polyclinic appointments.

However, he agreed with Mr Yip’s suggestion and expressed the Ministry’s willingness to explore alternative resources to improve access and utilisation of services.

Jamus Lim: some Sengkang resident mentioned long waiting times of up to two and a half hours

Jamus Lim, Workers’ Party MP for Sengkang GRC, highlighted the significant difficulties faced by residents in accessing online services, mentioning long waiting times of up to two and a half hours.

He suggested that the health system could direct more online bookers towards telemedicine options, considering that those who can navigate online booking might be comfortable with telemedicine consultations.

Additionally, he mentioned the discrepancy in recognising valid medical certificates (MCs) from different providers, which falls under the Ministry of Manpower’s jurisdiction. Nonetheless, he proposed exploring guidelines that allow for MCs from a wider range of providers.

In response, Dr Puthucheary mentioned that the MOH is actively exploring the use of telemedicine to enhance polyclinic services.

He emphasised that the decision of whether a patient requires an online consultation or an in-person appointment should be based on clinical judgment rather than a policy position.

MOH aims to support healthcare teams in optimizing telemedicine usage and improving the overall capacity of polyclinics.

Polyclinic walk-in patients experience median waiting time of 17 minutes, with 95th percentile reaching 164 minutes for doctor consultations

During a parliamentary session in March, Mr Saktiandi Supaat raised a series of queries regarding the waiting time, turn-away rates, and age proportion of affected individuals at Polyclinics.

Dr Puthucheary, then responded that the overall median and 95th percentile doctor consultation waiting time for walk-in patients was 17 minutes and 164 minutes, respectively.

He added that the Ministry does not currently track the number of patients turned away or the proportion above 55 years of age.

Suggestions to prioritise walk-in patients who are seniors were also raised by Members of Parliament in May, considering the challenges they face in accessing general practitioners.

Dr Puthucheary affirmed that patients’ age and mobility are considered in their assessment, but the urgency of their needs is the primary factor in determining care.

Dr Paul Tambyah calls for comprehensive review of Singapore’s healthcare system amid long wait times

Just last month, Dr Paul Ananth Tambyah, Chairman of the Singapore Democratic Party, already highlighted the growing issue of long waiting times at Singapore’s Polyclinics, as he called for a comprehensive review of the nation’s healthcare system.

Dr Tambyah cited the current online system as a case of “digitalization for the sake of digitalization,” as many elderly individuals find the digital processes challenging to navigate.”

“While statistics from a parliamentary reply show that the median waiting time at Polyclinics has been reduced to about 17 minutes, it was reported that about 5% of individuals, equating to nearly 1,000 patients daily, wait for more than 160 minutes.”

“This lengthy waiting time often results in individuals returning home without receiving the necessary medical attention, which may lead to further health complications and additional pressure on the already strained healthcare system.”

 

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Singapore to offer Mpox vaccine to high-risk healthcare workers and close contacts

Singapore will offer free mpox vaccines to high-risk healthcare workers and close contacts of confirmed cases, amid concerns over the deadlier clade 1 strain. The Ministry of Health stated mask-wearing is unnecessary for the public, as the virus primarily spreads through close contact.

Published

2 weeks ago

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4 September 2024

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Singapore has announced new measures to combat the spread of the deadlier mpox clade 1 strain, as concerns mount over its potential impact.

At a press conference on Wednesday, Health Minister Ong Ye Kung revealed that the mpox vaccine JYNNEOS will be offered to two key groups: healthcare workers at high risk of exposure and close contacts of confirmed cases.

The announcement comes as the World Health Organization (WHO) declared mpox a global public health emergency for the second time in two years due to the resurgence of clade 1 cases in Africa.

Minister Ong emphasized that while there is limited data on the virus, the government has sufficient information to implement precautionary measures. “We do not have full information on the characteristics of this virus, but we have good information on how it behaves,” he said. Ong added that Singapore’s response plan would remain flexible and adapt as the global understanding of the virus evolves.

Response Measures and Border Controls

As part of a whole-of-government approach, the Ministry of Health (MOH) has coordinated a comprehensive public health strategy to prevent the spread of mpox clade 1 in Singapore.

While no direct flights connect Singapore to countries experiencing mpox outbreaks, temperature and visual screening measures have been put in place at Changi and Seletar airports for travellers and crew arriving from affected regions. Screening at sea checkpoints has also been implemented for ships from mpox-affected areas.

Travellers are required to report any mpox-related symptoms (such as fever or rash) and provide travel history via the SG Arrival Card. Those displaying symptoms will be assessed by medical professionals at the borders and referred to hospitals if necessary.

Vaccination Strategy and Quarantine

The JYNNEOS vaccine, previously approved in Singapore for both smallpox and mpox, will be offered to two key groups. Healthcare workers at the National Centre for Infectious Diseases (NCID) and other high-risk facilities will be provided with pre-exposure prophylaxis, in addition to existing infection control protocols. Close contacts of confirmed mpox cases will receive a single vaccine dose within 14 days of exposure during their 21-day quarantine period. The MOH has assured that the current vaccine supply is sufficient to meet the needs of these priority groups.

MOH highlighted that a “significant” portion of the population—those born before 1981—may already have some immunity due to mandatory smallpox vaccinations administered in Singapore until that year.

Detection, Isolation, and Treatment

MOH has instructed all healthcare providers to be vigilant and promptly report any suspected mpox cases, especially those involving clade 1.

Suspected cases will be referred to designated hospitals for further assessment and testing, with paediatric cases directed to KK Women’s and Children’s Hospital and adult-child family groups to National University Hospital. Confirmed clade 1 cases will be isolated in healthcare facilities until they are no longer infectious to prevent further community spread.

Testing for mpox involves polymerase chain reaction (PCR) testing conducted at the National Public Health Laboratory. While there are no rapid point-of-care test kits available, cases are managed through supportive care. For severe cases, antivirals such as Tecovirimat may be used, aligning with treatment protocols in other countries.

Community Measures and Mask-Wearing

Based on current data, the virus spreads mainly through close physical contact, such as within households. Therefore, mask-wearing for the general public is not recommended unless there is significant evidence of respiratory transmission. MOH has stated that if respiratory spread becomes a concern, measures such as mask-wearing on public transport or in crowded indoor spaces may be considered.

In settings such as preschools and schools, existing infectious disease protocols—such as visual screenings for symptoms and hygiene measures—will continue to be implemented to control any potential spread. Additionally, MOH, in collaboration with the Ministry of Manpower and the National Environment Agency, has begun wastewater testing at migrant worker dormitories and the Onboard Centre to detect any presence of mpox.

Ongoing Surveillance and Preparedness

MOH will continue to work closely with international counterparts to monitor the evolving mpox situation. Border measures, detection protocols, and vaccination strategies will be adjusted as needed to safeguard Singapore’s public health.

As of now, Singapore has not detected any clade 1 cases, with all 14 mpox cases this year involving the less severe clade 2 subtype. However, Minister Ong stressed the importance of vigilance, particularly in protecting vulnerable groups such as children and the immunocompromised, should clade 1 reach Singapore.

“Our best course of action is to suppress the spread, provide proper treatment, and have an effective vaccination strategy in place,” Ong said. Despite the concern surrounding mpox, Ong reassured the public that it is unlikely to cause the level of disruption seen during COVID-19.

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Health

Baby born with 26 fingers and toes in India, considered reincarnation of Hindu deity

A baby in Bharatpur, India, was born with 26 fingers and toes, believed to be a reincarnation of a Hindu deity.

Published

12 months ago

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22 September 2023

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A baby was born with an astonishing 26 fingers and toes in a hospital in Bharatpur, a city in the northern Indian state of Rajasthan.

While medical experts describe the condition as a genetic anomaly known as polydactyly, the baby’s family is rejoicing, believing that their child is the reincarnation of a revered Hindu deity.

The baby, whose name has not been disclosed, entered the world with 14 fingers on its hands and 12 toes on its feet, leaving medical professionals both astounded and intrigued.

As reported by the Daily Mail on Tuesday (19 Sep), doctors described it as a genetic anomaly known as polydactyly, where someone is born with one or more extra fingers or toes. It can occur on one or both hands or feet.

However, the family is reported to be happy and openly refers to it as a reincarnation of Dholagarh Devi, a famous local deity whose temple is located near the girl’s birthplace. The deity’s statue depicts a young girl with multiple hands.

The baby’s mother, Sarju Devi, aged 25, expressed immense joy at the birth of her child. Sarju Devi’s brother, whose name was not disclosed, spoke to local media, proudly stating, “My sister has given birth to a baby with 26 fingers, and we consider it to be the incarnation of Dholagarh Devi. We are overjoyed.”

The baby’s father, Gopal Bhattacharya, a Central Reserve Police Force officer, is also reported to be ecstatic about the birth.

Dr BS Soni, a medical practitioner at the hospital where the baby was born, offered a medical perspective on the condition, saying, “Having 26 fingers is not harmful, but it is a genetic abnormality. The little girl is perfectly healthy.”

The big question now is whether the family from Bharatpur, in the northern Indian state of Rajasthan, plans to undergo surgery to reduce the number of fingers and toes on their newborn baby.

This decision is yet to be disclosed as the family continues to bask in the belief that their child is a divine reincarnation.

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