Cases Referred by Polyclinics to Hospital A&E Departments

8 Miss Cheryl Chan Wei Ling asked the Minister for Health (a) from 2013-2016, what is the number of cases referred from the polyclinics to the Accident and Emergency departments (A&E) of the public hospitals; (b) how many of the referred cases are due to simple procedures that cannot be performed at the polyclinics; and (c) what are the reasons that those simple procedures must be referred to A&E.

The Senior Minister of State for Health (Dr Lam Pin Min) (for the Minister for Health): Mdm Speaker, the numbers of cases referred from polyclinics to Accident and Emergency (A&E) departments at public hospitals were 55,000 in 2014, 57,000 in 2015 and 64,000 in 2016. Comparable figures for 2013 are not readily available.

The proportion of such referrals to total polyclinic attendances has been fairly small and constant at about 1% in each of the three years. Likewise, the proportion of such cases to total A&E attendances has been quite small and stable at about 4% over the same period.

We do not have statistics on how many of such referrals are for procedures that cannot be performed at the polyclinics. Today, polyclinics are able to attend to patients requiring minor procedures if the condition can be appropriately managed at a primary care setting. Patients with high-risk factors, or patients presenting with conditions that require more specialised assessments, treatments or monitoring would, however, need to be referred to a hospital's specialist outpatient clinic. Patients who require such services on an immediate basis may be referred to the hospital's A&E.

The Ministry of Health will continue to work with the polyclinics to build up capabilities to offer more treatments and procedures to Singaporeans at primary care settings.

Mdm Speaker: Miss Cheryl Chan.

Miss Cheryl Chan Wei Ling (Fengshan): Madam, I have two supplementary questions for the Senior Minister of State. The first one is whether there is a list of these simple or minor procedures that is available at the different polyclinics and can that be made available to the public. The second one is: if the patient goes to the polyclinic and the situation is not an emergency, can they not be referred to A&E but given the option to visit or consult a specialist at a public hospital on a later date for the procedures?

Dr Lam Pin Min: Mdm Speaker, I would like to thank the hon Member for the two supplementary questions. The answer to the first supplementary question is yes, the polyclinics do publish a list of minor surgical procedures that they are able to perform in the polyclinics and this information is available on the SingHealth polyclinics' as well as the National Healthcare Group polyclinics' websites. However, I would like to qualify that these minor surgical procedures may not be available in every polyclinic every day due to infrastructure and manpower constraints. Moving forward, all the new polyclinics that will be developed will have dedicated space catered for minor surgical procedures.

As to Miss Cheryl Chan's second supplementary question, today, polyclinics would conduct the necessary triage and assessment process to ensure that only urgent cases are referred to A&E. In fact, we do not encourage polyclinic doctors to refer non-urgent cases to A&E. Non-urgent cases should preferably be referred to the Specialist Outpatient Clinics instead. We have noted Miss Cheryl Chan's feedback and will continue to work with the polyclinics to ensure that patients are referred appropriately to the right care settings, taking into consideration accessibility and affordability for the patients.