Practice of Engaging Foreign Agents to Bring Overseas Patients to Singapore Public Hospitals

The following question stood in the name of Miss Cheng Li Hui –

4 To ask the Minister for Health (a) how long have public hospitals been engaging foreign agents to bring in overseas patients; (b) whether the Ministry is aware of these practices; and (c) whether the foreign patients crowd out Singaporeans in our healthcare services.

5 Mr Pritam Singh asked the Minister for Health whether the Ministry will reschedule or bring forward the specialist appointment dates of subsidised Singaporean patients arising from the Ministry's decision to stop referral contracts for foreign patients in public hospitals.

Mr Murali Pillai (Bukit Batok): Question No 4, please.

The Senior Minister of State for Health (Dr Lam Pin Min) (for the Minister for Health): Mr Deputy Speaker, may I have your permission to take Question Nos 4 and 5 together?

Mr Deputy Speaker: Yes, please.

Dr Lam Pin Min: The priority of MOH and public healthcare institutions, or PHIs, is to serve Singaporeans' healthcare needs. Our PHIs are not allowed to actively market themselves to foreign patients. MOH has also recently asked PHIs to cease any contracts with service providers to assist foreign patients referred for medical treatment in Singapore. Today, none of our PHIs have contracts with such service providers anymore.

There are foreign patients who travel to Singapore to seek medical treatment on their own accord. Between 2013 and 2017, such patients make up about 1.5% of the total inpatient and day surgery attendances at our PHIs. Those whose referrals were supported by contracted service providers constituted about only 0.4% of attendances in PHIs that had such contracts.

Singaporeans remained the majority of patients treated in the PHIs. Foreign patients have not impacted our PHI's delivery of services and subsidised appointment slots given to Singaporeans. In fact, the median waiting time for new subsidised specialist appointments has improved steadily from 28 days in 2013 to 22 days in the first half of 2018. MOH will continue to work with our PHIs to ensure that meeting Singaporean's healthcare needs remains our priority.

Mr Deputy Speaker: Mr Pritam Singh.

Mr Pritam Singh (Aljunied): I would like to thank the Senior Minister of State for the reply. My Parliamentary Question was actually prompted by a resident who saw me in late August. He had been referred by a polyclinic for a specialist appointment for a colonoscopy procedure. These were the resident's words and I narrated this to SGH. One of the hospital's staff told him that only one day of the week is set aside for subsidised patients for colonoscopy procedures and that is the reason why his appointment was scheduled six months later.

So, I shared this information with SGH. SGH came back a couple of weeks later. They contacted the resident and they pushed forward the appointment by three months, and so, he only had to wait three months. So, that is reason why I actually asked the question whether, firstly, there is any truth to this assumption or allegation that there are specific days set aside for non-subsidised patients and other days for subsidised patients, be it for inpatient procedures or other procedures not limited to colonoscopies?

The second question I have is pertaining to a reply that the Senior Minister of State gave that between the years 2013 and 2017, 1.5% of foreigners were registered for inpatient or day surgeries in our public hospitals. But what is the number, the absolute number of that as opposed to a percentage? I believe earlier in October, there was a MOH's reply to The Sunday Times clarifying that this number is actually lower than what it was in 2008. At that time, it was 2.4% if I remember correctly. Just to get a sense of the absolute numbers, I would appreciate if the Senior Minister of State could share the total number of foreign patients, vis-a-vis both percentages.

Dr Lam Pin Min: I would like to thank Mr Pritam Singh for the two clarifications. On the first clarification, many hospitals do have a protocol to prioritise the appointment given to patients according to the severity of the conditions. If the condition is deemed to be urgent, then the appointment given will be much shorter or almost immediate. And if the condition is assessed to be not urgent, then appointment date given can be much further away. It could be a few weeks or a few months, depending on the type of condition.

As to the feedback given by one of his residents, I would find it hard to believe that only one day in a week will be assigned for colonoscopy for subsidised patients, considering the fact that the department in SGH is actually a large one with multiple specialists performing such procedures. But I think that needs to be clarified with SGH.

With regard to the second question on the number of foreign patients that were being seen in 2017, the number is actually 10,900 attendances which actually constitutes only about 1.5% of the total attendances seen in Singapore.