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.”