World News Day: A look at how medical tourism has not improved the lives of Singaporeans

World News Day is meant to celebrate the positive impact of professional journalism on their communities and subscribes to the catch-phrase “Real News Matters”. On this day, the Straits Times chose to publish an article entitled “Health Ministry clamps down on medical tourism in public hospitals”(Sep 28, 2019)

Contrast this with another Straits Times report last Septmber which reported on parliamentary questions being raised by opposition MPs about our public hospitals giving kick-backs to foreign agents recommending foreign patients to public hospitals in Singapore. This resulted in displacing local patients for hospital services and, not surprisingly, ignited a wave of criticisms against the Ministry of Health. Names of specific hospitals were mentioned in the media report and this led to the Ministry of Health issuing a directive to these hospitals to cease the malpractices.

This malpractice was in existence for many years – it is unbelievable that the Health Minister Mr Gan Kim Yong and his predecessors were not aware of it. In fact, the concern about foreigners crowding out Singaporeans in restructured hospitals (they were privatised and became Pte. Ltd. Companies) is not new and was raised in Parliament in 2010.

As usual, the government always has a nice answer to make a bad situation look good. “Responding, Senior Minister of State for Health Lam Pin Min said public hospitals treated 10,900 foreign patients in 2017. Those referred by contracted service providers made up about 0.4 per cent of attendances in public health institutions.”

It is difficult to determine the extent that foreign patients in public hospitals had contributed to the long waiting time for appointments in Specialists’ Clinics. However, the Jakarta-based hospital agent HCM Medika said that since it was established in 2007, it had facilitated medical visits for 15,000 patients in Singapore and Malaysia.

If the Straits Times truly believes “Real News Matters”, the journalists could easily have got to the bottom of the matter. By making a few visits to SGH’s Singapore National Eye Centre and the National Heart Centre would be sufficient to determine whether or not the number of foreign patients caused the long waiting time for subsidized Singapore patients, and whether our public hospital resources are not unduly deployed to treat foreign patients.

My personal experience tells me that as a subsidized patient, I would invariably be attended to by a junior doctor or even foreign doctor. If I opt to become a private patient, I could obtain an early appointment and be attended to by a Consultant or Senior Consultant.

In Sept 2018, when the issue of public hospitals paying agency fees for referral of foreign patients to Singapore exploded, NUH spokesman said, “NUH’s foremost priority is to provide care for Singaporeans.” and “MOH told Sunday Times following the report in Sept last year that the priority of public healthcare institutions was to serve Singaporeans’ healthcare needs.”

If that was true, why, in the first place, did the Health Minister allow public hospitals to carry on such malpractice for so many years? Where was the oversight by his Health Ministry?

The Straits Times had played its part in exposing this malpractice but the continued influx of foreign patients into public hospitals remains unresolved.

One year on, the number of foreign patients seen by Consultants and Senior Consultants in SGH’s Singapore National Eye Centre and National Heart Centre is anything but decreased. These foreign patients can easily be distinguished from local patients. Almost all of them were attended to by Consultants and Senior Consultants. Quite obviously, these private foreign patients had taken their place in the queues and local subsidized patients are pushed further backwards. This probably explains the long waiting time for a subsidized local patient to get an early appointment.

There is a simple solution to this unfair treatment of subsidized Singaporean patients in seeking specialist medical care. Not all Consultants and Senior Consultants want to go to private practice. The MOH could contract these consultants for a 3-day or 4-day week to attend to subsidized Singaporean patients. These consultants can, on the other day/days of the week, attend to their private patients who (both local and foreign) join a different queue. In this way, subsidized Singaporean patient have an equal chance to be attended to by a Consultant or Senior Consultant in a public hospital. Otherwise, MOH’s assurance of giving Singaporean patients priority in public healthcare institutions does not make sense.

Further, this new contract agreement will help public hospitals to retain their experienced senior doctors who are happy to stay in public hospitals and still be able to earn a handsome income like their counterparts in private hospitals.

I view this whole episode of opening the doors of public hospitals to private-fee paying foreign patients as a sign of poor governance in the healthcare sector. For this as well as numerous other failures attributed to MOH, the Health Minister must bear the full responsibility for the lack of oversight and duty of care for Singaporean patients.

 

Cheang Kok Ming

 

 

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12 Responses to “World News Day: A look at how medical tourism has not improved the lives of Singaporeans”

  • RDB:

    Profit and money minded ministers will be concern for Singaporean’s first policy? What do you think.

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  • TruBlu:

    Its still more acceptable to allow private sector to do medical tourists business.
    But to allow our limited govt hospitals to do medical tourists business when our own sgs have got to take long queues to receive treatment is Unethical.

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  • DavidNeo&IreneVanessa:Bastards:

    I had my eye op at SNEC. Appoitment in July. Op in September. I noticed as a private patient, I was always served last or nearly the last for the doctor’s consultations. But the skill of the doctor was very good. A minute and the cataract op was over. After that I requested him to operate my left eye, But was flummoxed by his answer:”It depends whether we want to do it or not.”

    Following the first doctor’s refusal to do the second op, I went the fully subsidised route. Meaning the op can be paid fully by medisave but doctor’s consultations still chargeable by cash. But it was a subpar experience, very unsatisfactory. I mean I still pay right? Doc don’t want to answer questions, some nurse clumsy as hell. Well that’s the SNEC’s Balestier branch. Thank Q you, doc Lim for giving my double vision. Got one elderly Malay woman said she could not see after the op!

    Well in both cases have to pay fully in cash or sign medisave forms. They make sure all monies collected before doing the op.So there’s really no recourse for refund. Tell them your dissatisfaction anf they all become yaya papaya. Very poor after sales service.

    I don’t think they can compare to the real private hospitals in terms of service.

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  • Proof of the pie in the eatin:

    So if it’s true what Chee Soon Juan has alleged: that PAP’s Medisave Fund has collected a hefty S$89 billion from working citizens since the 80′s why has only $2 billion been released to our costly medical expense claims?

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  • Rabble-rouser:

    The Medical Tourism factor are declining for S’pore! The bread ‘n butter medical procedures are being done in Thailand & in M’sia. The reason: S’pore healthcare are simply too expensive & uncompetitive!

    The 2nd factor is that S’pore’s healthcare quality are no longer that advanced when our Regional neighbour’s hospitals have caught up with S’pore. Why pay a high premium when you can get a similar quality of healthcare with better service to boot but at a better price (currency differential)!

    S’pore & the PAP govt practised Corporate Medicine. It is the chase for profits that determined their focus of medical care & healthcare priorities. And that is why they focused on Medical Tourism rather than domestic clientele!

    The PAP govt are synonymous with greed & revenue collection! Talk is useless! Voters in Gan Kim Yong’s constitutuency should vote him out like George Yeo in GE 2011.

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  • Even Simpler Solution:

    Kick out the self entitled greedy Pappies.

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  • Singapore Fooled Again n Again:

    It’s all about money, KPI, etc. Simple and short.

    Why cater to foreigners and have them given express or immediate attention whereas Singaporeans who are given subsidies have to wait for 6 months or more than 1 year to be attended to?

    You get what you vote for. Remember to vote wisely, for all Singaporeans and our future generations

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  • NotMyProblem:

    Just to wake you Singaporeans up, do you truly think those hospitals built like a 5-stars hotels are meant for you cheapskate subsidized patients. They are for foreign private patients.

    For Singaporeans you can die but please don’t get sick. Doctors are not for you! There is not many Dr Tan C B. And don’t think you can get a $8 heart operation.

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  • Taleban:

    Just go back to the old way.
    Government Hospitals (restructured) look after Singaporean and foreign workers at reasonable/subsidized price.
    Foreign patients and those who can afford go to private hospitals like Mt. Elizabeth Hospital, Gleneagles Hospital, Mt. Alvernia Hospital etc.
    Government (restructured) Hospital should not be jealous of private hospital making money. They are commercial entities and they should be making money.

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  • Asddd:

    Complain complain complain typical sinkie rather than go do something about it… shut up la…

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  • truly 3rd world now!:

    many people hasten to visit thd doctor due to hefty consultation n medication costs.
    just return our medisave n cpf money. stop hoarding the reserves for future or future generations,when the people who are living now need it and cant even afford a doctor.
    true whats being said in sg ” you can afford to die , but cant afford to get sick”.
    MINISTER in charge, are you awake and listening at all?

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  • Harder Truths:

    This facade of giving $G citizens a subsidy – this is such a big lie and the 70% think they are given a freebie.

    The fact is – you pay for this through the back pocket – not the front.
    Next time you go to hospital – look at the unsubsidised rate – this is what you are actually paying.

    What are you paying for? That $5000/- per head to Europe to learn cooking by a civil servant. Or the $47000 ‘artistic’ bin center. This is where the money goes. No? Then why are you waiting 4 hours to see a doctor at SGH?

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