Incidence of People Refusing Conveyance to Hospitals via SCDF Ambulances
Ministry of Home AffairsSpeakers
Summary
This question concerns the rising number of people refusing SCDF ambulance conveyance, with Mr Dennis Tan Lip Fong asking for studies on refusal reasons and health risks. Minister K Shanmugam noted that refusal rates remain stable at 10% to 12% of total calls, with absolute increases aligning with overall call-load growth. He stated that SCDF respects patient autonomy and does not track refusal reasons, except in cases where a patient is assessed as mentally incapacitated. Officers counsel patients and families on medical risks, advising those who still refuse to seek alternative care or call 995 again if necessary. These protocols balance the respect for patient rights and informed consent with the duty to provide information on the consequences of declining hospital conveyance.
Transcript
5 Mr Dennis Tan Lip Fong asked the Minister for Home Affairs in view of the increasing number of people who refuse conveyance to hospitals via SCDF ambulances in recent years (a) whether SCDF will consider (i) doing a study to understand the different reasons given for refusal, (ii) determine the proportion of such people whose lives or health may be compromised by their refusal; and (b) what can be done to reduce the number of such incidents.
Mr K Shanmugam: As mentioned in our earlier reply to the Member on 5 July 2023, over the last five years, the number of people who refused conveyance was about 10% to 12% of the total number of calls received for the Singapore Civil Defence Force (SCDF)’s emergency medical services (EMS). [Please refer to "Persons Refusing Conveyance via SCDF Ambulances to Hospitals", Official Report, 5 July 2023, Vol 95, Issue 107, Written Answers to Questions section.]
While the absolute number increased annually, this increase was in line with the increase in the overall EMS call-load. We had also explained to the Member that SCDF does not track the reasons for refusal of conveyance.
Ambulance services and healthcare institutions worldwide are guided by the same set of medical ethics, which includes patient autonomy and informed consent. As such, SCDF respects the patient’s right to refuse conveyance. As mentioned in our earlier reply to the Member on 5 July 2023, the only exception is when the patient is assessed to be mentally incapacitated.
Our officers will counsel patients who refuse conveyance on the potential medical consequences. This includes engaging their family members or next-of-kin, where possible. For patients who continue to refuse conveyance, SCDF will advise them to seek medical treatment on their own or call 995 again, if necessary.