Scaling Up Polyclinics' Capacity to Accommodate More Walk-in Patients with Urgent Conditions

The following question stood in the name of Ms Joan Pereira –

16 To ask the Minister for Health whether polyclinics can scale up their capacity to accommodate more walk-in patients with urgent medical conditions, such as those experiencing acute or severe pain, and to avoid turning away senior citizens.

Mr Saktiandi Supaat (Bishan-Toa Payoh): Question No 16.

The Senior Minister of State for Health (Dr Janil Puthucheary) (for the Minister for Health): Sir, our polyclinics take in all patients with appointments. As for walk-in patients without appointments, those requiring urgent medical attention will be attended to, those not requiring urgent medical attention may be asked to book an appointment or seek treatment at a nearby general practitioner (GP) clinic.

We are continuing to expand our network of polyclinics. We opened Bukit Panjang, Eunos and Kallang Polyclinics in end 2021 and another two polyclinics in Sembawang and Tampines North are slated to open later this year. Khatib Polyclinic will open in 2024 and Serangoon and Tengah Polyclinics in 2025. At the same time, we will work with GP clinics, which play an important role in treating acute diseases at the primary care level, too.

Mr Deputy Speaker: Mr Liang Eng Hwa.

Mr Liang Eng Hwa (Bukit Panjang): Sir, I share the concern expressed by Member Joan Pereira on the polyclinics and the Senior Minister of State mentioned about Bukit Panjang Polyclinic. We do have situations where residents have not only not been served as a walk-in – they could not get a place for walk-in – but even for online booking, where the night before they could not get a slot. I just want to ask the Senior Minister of State whether the Ministry of Health (MOH) is looking at improving this situation.

Secondly, there is also Community Health Assist Scheme (CHAS) GP Clinic scheme, which is meant to take some load off the polyclinics. But it seems that is not helping much. May I ask the Senior Minister of State is the Ministry looking at what are the impediments do that? Why is it so? Is there a need to change the scheme or the policy so that it becomes attractive for patients to use the GP clinics as well, and not all going to the polyclinics?

Dr Janil Puthucheary: Sir, I thank the Member for his questions. On both his questions, he has highlighted the direction in which we are moving, which is for the polyclinics to work in partnership with the GP clinics and family practitioners in the area that they serve. We do want our residents to understand that these are part of a continuum of primary care services.

For the polyclinics, if the patient turns up without an appointment, wants to walk in and if they have an urgent need, they will be attended to. There will be triage, they will be assessed and, if there is an urgent need, they will be attended to. If it is something elective and there are no appointment slots left, the recommendation will be that they seek care electively in a planned way, make an appointment with the GP within the vicinity.

I am not sure whether there are specific details about how the Member feels the CHAS scheme is not helping much. Perhaps if there are specific cases, we could look into that and see how we can assist. In general, we are trying to find ways to help the GPs, the family physicians, as a community, upskill and deliver these types of cares in partnership with the polyclinic teams as well. In general, the GPs and the family physicians are more than willing and able to do so.

Mr Deputy Speaker: Mr Ang Wei Neng.

Mr Ang Wei Neng (West Coast): Thank you, Deputy Speaker. I would like to ask a supplementary question of the Senior Minister of State. For the residents in the west, especially in the Nanyang ward, they go to Pioneer Polyclinic. They really have difficulties getting appointments online and, even so, when the residents go to the polyclinic early in the morning to queue for the appointment, they cannot get an appointment.

So, my supplementary question is, one: when they queue, if they cannot get an appointment, can they get the next day's appointment? Two, we also understand that most of the polyclinics and the MOH building are in other parts of Singapore, in the north-west part or the western part, and not in the Jurong area. So, how are we going to alleviate the situation at Pioneer Polyclinic?

Dr Janil Puthucheary: Sir, I thank the Member for his questions. We will look at his suggestion in terms of the queuing system and the appointment booking process. We are trying very hard to improve the service provision for primary care by both expanding our network of polyclinics, as well as leveraging on the experience and capability of the GP clinics and family physicians that are in the community and that can serve this resident population very well.

Mr Deputy Speaker: Mr Saktiandi Supaat.

Mr Saktiandi Supaat: Thank you, Mr Deputy Speaker. I am asking this supplementary question on behalf of Ms Joan Pereira who is on medical leave. She has a very strong conviction about asking this supplementary question, so I am conveying this question to the Senior Minister of State.

Can the Senior Minister of State consider asking polyclinics to consider prioritising walk-in patients who are seniors? Because Ms Joan Pereira is very particularly interested in making sure our seniors walking in, as well as those with mobility issues, are attended to, given that they may find it challenging to go to the GPs. I think the Senior Minister of State has highlighted it somewhere at the beginning, but I think it is very, very focused on seniors – whether there could be prioritising for them, especially those who are very aged and have mobility issues.

Dr Janil Puthucheary: Sir, I thank Ms Joan Pereira and Mr Saktiandi Supaat for asking that question. As I mentioned in my original answer, the walk-in residents, the walk-in patients are triaged and assessed, and part of that assessment will, indeed, be their state of frailty, and their age and their mobility are considered as part of that assessment.

I think the right thing to do is to allow the professional judgement of the clinical team at the site to make the assessment as to the urgency of their needs, rather than set a very arbitrary cut-off in terms of an age, for example, or other factors where actually the key thing is to assess the needs of that patient at that time. And that is, indeed, what the clinical services will do. I thank the Members for their question.

Mr Deputy Speaker: The final supplementary question. Dr Tan Wu Meng.

Dr Tan Wu Meng (Jurong): I thank the Senior Minister of State for his answers. A number of my Clementi residents are quite concerned about the implications of the online booking process for polyclinic appointments. Some may be quite elderly, less able to go online, less able to quickly click to secure the appointment when the bookings open. I have residents who tell me that, for some polyclinics, the online slots are used up within half an hour of the online booking starting on some days.

Can I ask the Senior Minister of State whether MOH is looking at the take-up of these online bookings, whether there is a trend towards fewer seniors being able to get these online bookings and whether the seniors are as able to attend the polyclinics as before?

Secondly, can I also ask the Senior Minister of State in the event there are CHAS GP clinics interested in participating in an online booking portal, whether there could be a future pilot project to integrate these GPs into the online booking process as well, if there is interest?

Dr Janil Puthucheary: I thank the Member for his questions. For his first supplementary question, I do not have the data with me about the proportions of seniors that are attending now as compared to historical data. I would be happy to provide it if he would like to file a separate Parliamentary Question. But, in general, as I engage with the polyclinic staff and the clinicians who provide these services, it is quite clear that a very high proportion of their workload is, indeed, the seniors. And so, the senior residents within the geographical area are, indeed, attending, are able to access the services and receive the care from the polyclinic care teams. But as I said, I would be happy to look at the data, specifically, if he would like to file a related question.

On his suggestion about integration of the CHAS GP clinics into an online booking system, it is a suggestion worth studying and we will, indeed, look to see how we can improve access to primary care services for residents.