Rejection of Referred Patients whose Residential Addresses Fall Outside Healthcare Cluster
Ministry of HealthSpeakers
Summary
This question concerns whether public hospitals reject polyclinic referrals based on residential addresses and how patient choice is preserved under Healthier SG. Dr Lim Wee Kiak and Dr Tan Wu Meng raised concerns about accessing specialist care outside one’s cluster for reasons like proximity to work or caregivers. Senior Minister of State Dr Janil Puthucheary clarified that hospitals do not reject patients based on addresses, but may redirect them for clinical appropriateness or capacity. He confirmed that residents retain the right to choose their preferred Healthier SG clinic and specialty care institution if the required service is available. Additionally, he assured that there are established appeal routes for patients and Members of Parliament to address any referral-related issues.
Transcript
The following question stood in the name of Dr Lim Wee Kiak –
24 To ask the Minister for Health (a) whether public hospitals are allowed to reject patients referred by polyclinics because their residential addresses fall outside the healthcare cluster and, if so, what percentage of referrals are rejected for this reason; and (b) how will the Ministry assist such patients, including hospital staff, who may be denied access to their workplace's outpatient benefits due to their residential addresses.
25 Dr Lim Wee Kiak asked the Minister for Health (a) how does the Ministry plan to improve the triage process for patients referred to public hospitals by polyclinics, ensuring transparent justifications for rejecting referrals; and (b) what plans does the Ministry have to ensure effective communication in cases of rejected referrals, while establishing appropriate channels for follow-up and resolution.
Dr Tan Wu Meng (Jurong): Question No 24.
The Senior Minister of State for Health (Dr Janil Puthucheary) (for the Minister for Health): Mr Deputy Speaker, may I have your permission to answer Question Nos 24 and 25 from today's Order Paper?
Mr Deputy Speaker: Yes, please.
Dr Janil Puthucheary: Public hospitals do not reject patients referred by polyclinics based on their residential address. Public hospitals may occasionally reject patients if the referrals are inappropriate, such as to a specialty that the hospital does not provide.
Patients are also prioritised based on their medical condition and need. In rare situations, if the hospital is not able to provide an appointment within the time demanded by the urgency of the case, then the hospitals will then inform patients and referring polyclinics to direct the referral to a more appropriate institution, for example, one where there are more timely slots available. The polyclinics will discuss alternative arrangements with the patient, including making a referral to another institution where applicable.
Patients may also contact the polyclinic, hospital or the cluster's main appointment centre to seek clarification and assistance for their referrals.
Mr Deputy Speaker: Dr Tan Wu Meng.
Dr Tan Wu Meng: I declare that I am a medical doctor at a public hospital. I raise this in my capacity as Member of Parliament (MP), as I have Clementi residents who are concerned about the matter on this Parliamentary Question. Can I ask the Senior Minister of State if he can reassure the House that based on the Minister for Health's commitment last year during the March 2022 Committee of Supply on the Healthier SG concept. Minister at the time said individuals will have choice – you can choose whether to enrol or not in Healthier SG, you can choose who to enrol with, even doctors who are far away from your home, there are a variety of reasons why some Singaporeans decide to do that; because the clinic may be nearer to your workplace, near your parents' place.
So, my first supplementary question is, can the Ministry of Health (MOH) confirm that this choice will still be available to persons seeking to enrol in Healthier SG because someone may seek care with a family doctor nearer to their workplace or with their caregivers?
Secondly, can I also draw the Senior Minister of State's attention to the points I raised during the Healthier SG debate last year on 4 October 2022? At the time, I had raised Clementi residents' concerns whether it will become harder to seek specialist care in a hospital outside their own geographical cluster because sometimes, residents may seek to see a specialist at a hospital not next to their home but where they are going to be cared for by a family member during their illness. Can the Senior Minister of State assure us that this freedom of choice will still be available to patients seeking referral for specialist care from polyclinics?
Lastly, if there are situations arising that need appeal, can the Senior Minister of State assure us there will be options available for patients to raise the matter to MOH for further study?
Dr Janil Puthucheary: Sir, I thank Dr Tan Wu Meng for his three questions. The answer to all three is yes. Yes, residents can continue to exercise choice about where they enrol for Healthier SG. Yes, resident can exercise choice about where they seek specialty care at the public hospitals, with the caveat that the service is available at that hospital. Sometimes, that is not widely known, how sub-specialty services are divided amongst our public healthcare institutions. And three, yes, if there are any issues with this, there are routes for appeal that residents and MPs on their behalf can pursue.