Guidelines and Autonomy Given on Disbursement Amounts for MediFund Applications

3 Mr Leon Perera asked the Minister for Health (a) what are the recommended guidelines used to assess MediFund applications, including the quantum of assistance to be provided; (b) what degree of autonomy do MediFund Committees have to make decisions on such applications; and (c) what measures are in place to ensure consistency of interpretation of these guidelines by MediFund Committees across the MediFund-approved institutions.

The Senior Minister of State for Health (Dr Koh Poh Koon) (for the Minister for Health): To apply for MediFund, applicants must be Singapore Citizens who are subsidised patients and are receiving treatment from a MediFund-approved institution. As long as patients meet these eligibility criteria, the MediFund Committees (MFCs) have flexibility and discretion over the assessment, approval and assistance quantum of MediFund applications. They work with the medical social workers (MSWs) to assess applications holistically, taking into account patients’ socio-economic and health circumstances, as well as bill sizes.

MOH provides operational guidelines to MediFund-approved institutions to facilitate their management of MediFund and to provide some consistency for decision making, although MFCs retain full discretion over assessment of applications.

Mr Speaker: Mr Perera.

Mr Leon Perera (Aljunied): I thank the Senior Minister of State for his answer. Just one supplementary question, which is to confirm the understanding that MOH provides guidelines as to the quantum, the way in which you do the means testing for MediFund, but those guidelines, if I understand it correctly, are not binding on the different MediFund Committees, so they have the discretion to deviate from those guidelines, depending on their case-by-case assessment.

The second supplementary question is, if that is the case, then what process is in place to ensure that there is a basic degree of consistency? Because otherwise, you could get some MediFund Committees being more generous than others, depending on the hospital or the healthcare provider.

Dr Koh Poh Koon: Sir, the Member is correct that the MediFund Committees do have discretion and MOH provides guidelines regarding means testing criteria, the amount of assistance as a benchmark so that they can have those as a reference. The full discretion is given to these committees to actually deviate from these suggested guidelines.

In terms of the outcomes, I think that is the fundamental and most important thing. Despite all the guidelines, are we able to assist most of these people and patients who are in need. In fiscal year 2020, 98.3% of the total number of MediFund and MediFund Silver applications that were received were approved and 87.6% of the approved applications received the full assistance. So, I think the outcome speak for itself that regardless of the guidelines, most of these applications actually receive the assistance they require and most of them in full, as well.

Let me also add that MediFund assistance is also automatically extended to needy patients under MSF's social assistance schemes, for example, the ComCare Long-Term Assistance recipients, who fulfil the MediFund eligibility criteria without requiring them to go through the application process. So, those who are already on our radar, who are in need, will receive the necessary support, without further application.

In terms of auditing some of these outcomes and making sure that the spirit of MediFund is complied with, the MediFund accounts and administration for each preceding financial year are audited annually, either by Auditor-General's Office (AGO) or an external auditor appointed by MOH in consultation with AGO.

So, I think there are robust processes in place to make sure that the MediFund Committees perform their roles well and the outcomes, in terms of the numbers that have been assisted, also validate this observation.