Average Waiting Times at Polyclinics for Walk-in Patients and Plans to Redistribute Patient Load

19 Mr Vikram Nair asked the Coordinating Minister for Social Policies and Minister for Health (a) what are the average waiting times at polyclinics for walk-in patients during peak and off-peak hours; and (b) whether there are plans to redistribute patient load across off-peak hours.

The Senior Minister of State for Health (Dr Koh Poh Koon) (for the Minister for Health): In 2025, for walk-in patients, the median and 95th percentile doctor consultation waiting times were eight minutes and 72 minutes respectively. However, the Ministry of Health (MOH) does not track waiting times by peak versus off-peak hours, but it is likely that 95th percentile waiting times happened during peak hours.

That is why it is important for us to operate on an appointment basis as much as possible, to optimise capacity and patient waiting times and to spread out patient arrivals across the day. That said, we always schedule fewer appointments than full capacity to accommodate walk-in patients with acute medical needs.

Mr Speaker: Mr Vikram Nair.

Mr Vikram Nair (Sembawang): I thank the Minister of State for the answer. I think it is an improvement from the last time this question was asked two years ago, which was 17 minutes and 164 minutes. So, there is improvement. But a one-and-a half-hour waiting time is still quite long. I am wondering whether there are any plans to maybe introduce more capacity for polyclinics.

Dr Koh Poh Koon: Sir, I thank the Member for his question. I think that is a question that many patients also ask.

Let me explain what exactly happens in a clinic because it is not such a straightforward issue as trying to stick to increased capacity. Because in the midst of increasing capacity, we also want to optimise the use of that capacity. We could actually leave a lot of empty slots just in case there are walk-in patients, but that means there will be a lot of time wasted that will not be used if there are no walk-in patients. In the sense, there will always be a trade-off there.

When we do schedule appointments, we hope that we can stick to the time. When the patient arrives, we then serve the patient within that allocated time. But as you can imagine, it is often not so straightforward to determine ahead of time how that conversation and the consultation with each particular patient will go. Even if we allocate, say, 15 minutes for what we think is a reasonable consultation time, sometimes the patient that comes in that time slot may have a very complex issue or multiple medical problems that takes a far longer conversation and examination to complete. In which case, it may take half an hour and, therefore, it eats into the next patient's consultation time. In a busy clinic, sometimes, such long conversations, on a particular day, you may have quite a few complicated patients that come in sequentially. That means that there will, therefore, be a snowball effect and patients who are seen at the later part of the session, of the morning session or afternoon session, will therefore end up experiencing a longer waiting time, even though they have been given a scheduled appointment.

So, there are quite a lot of complicated dynamics happening in a clinic on a day-to-day basis and it is very hard to predict ahead of time how each day will pan out.

What we are trying to do is to stick as much as possible to more scheduled appointments, so, we minimise that variance as far as we can. We see that for scheduled appointments, the median waiting time in 2025 for a scheduled appointment is about 10 minutes. So, you can see that the medical staff tries as far as they can to complete a consultation and conversation within an allocated timeframe so that they minimise the snowballing effect.

But the 95th percentile waiting time in 2025 for a scheduled appointment can go as high as 52 minutes. Again, like I said, if you are towards the end of that morning session where the prior patients before you had longer conversations, that snowballs into a much longer waiting time for those at the end of that session.

This is what a healthcare clinic usually goes through and we will try our very best to resource with more consultation slots to actually meet all those demands. What the clinic tries to do is that, for those who turn up in a walk-in manner and for which the staff triage that this is actually not something that is an emergency or extremely urgent, they will try to schedule the next day's appointment for this resident, so that he or she can come back the following day without having to be subjected to a long waiting time as a sudden walk-in patient.

I hope that kind of gives the Member a sense of how complicated it is, but how the efforts are still being made to try and reduce waiting time.

Mr Speaker: Mr Pritam Singh.

Mr Pritam Singh (Aljunied): Thank you, Speaker. I am empathetic to the arguments of efficiency and ensuring that patients can see a polyclinic doctor or consultation as quickly as possible.

I understand the Senior Minister of State mentioned it is important to try and make a make an appointment so that your waiting time is within a certain period. But can I ask the Senior of Minister, is the Ministry taking note of how many people are actually walking in vis-a-vis making scheduled appointments?

I ask this in the context of a super aged society, because there is also the added problem of difficulty in making appointments for certain individuals, especially those who live alone, for example. So, over the longer term, does the Ministry have a datapoint for us to understand whether there are individuals who are making appointments or is that really going to be an extant problem that the healthcare system has to deal with and has to accept?

Dr Koh Poh Koon: Sir, I thank the Member for his question. I do not have the numbers for the percentage of walk-in versus scheduled appointments. But I think, in general, most patients who do not have pressing issues will try to fix an appointment because they want certainty of time and to also reduce their waiting time.

But healthcare being the way it is, there will always be a sudden onset of discomfort and unwellness that will prompt a walk-in appointment.

That is why we do not work just based on polyclinic resources alone and we have resourced many of our general practitioner (GP) clinics with Community Health Assist Scheme (CHAS), so that patients have an additional option to go to a nearby GP clinic and get subsidised treatment at the GP clinics as well, even if it is a walk-in situation.

It is about actually working with the entire resources of what we have in the entire healthcare ecosystem and not just focusing on polyclinics per se. And I think, over time, as we improve on our Healthier SG enrolment, there will be better relationships between the patient and their enrolled GP so that that stronger nexus and better understanding between the patient and the GP will hopefully also spread the load out for each individual patient to the GP clinics where they also have easier access to care and nearer their homes as well.

12.30 pm

The Chairman: Order. End of Question Time. The Clerk will proceed to read the Orders of the Day.

[Pursuant to Standing Order No 22(3), provided that Members had not asked for questions standing in their names to be postponed to a later Sitting day or withdrawn, written answers to questions not reached by the end of Question Time are reproduced in the Appendix.]