SPS Mahzam dismisses WP Jamus Lim’s incentive proposal to curb excess hospitalization

SINGAPORE: Senior Parliamentary Secretary (SPS) for Health Rahayu Mahzam revealed that non-emergency admissions to public hospitals have consistently constituted about 20% of total admissions over the last decade.

During the Parliamentary sitting on Friday (16 February), SPS Mahzam emphasized that hospital admissions are based on clinical necessity.

“Some patients have medical conditions that are non-urgent and yet in patient care is medically necessary.”

She further explained that these admissions, being medically necessary, allow patients to utilize their MediSave or MediShield Life.

SPS Mahzam noted that some patients stay longer in hospitals due to homes not being ready to receive them, and concerted efforts are undertaken to minimize such overstays through appropriate pricing and placement of patients in suitable care settings.

SPS Mahzam was responding to a Parliamentary question (PQ) filed by Associate Professor Jamus Lim, Workers’ Party Member of Parliament for Sengkang GRC.

Assoc Prof Lim asked the Health Minister for each year over the past 10 years, how many cases of non-emergency and non-critical admissions to public hospitals took place; how many of such cases claimed hospital stays from their MediSave or MediShield Life insurance policies; and how many of such patients are deemed to have “overstayed”.

He also inquired about whether the Ministry of Health (MOH) has plans to discourage unnecessary hospitalisations by offering cash incentives for those who do not make hospitalisation insurance claims for the entire year.

Regarding Assoc Prof Lim’s suggestion of offering cash incentives to discourage excess hospitalization, SPS Mahzam expressed caution, stating that such incentives might discourage necessary care, especially among lower-income individuals.

During his supplementary question, Assoc Prof Lim clarified that his inquiry was an extension of the earlier discussion in Parliament by Dr Janil Puthucheary, Senior Minister of State for Health, regarding transitional care.

Assoc Prof Lim sought clarification of MOH’s intent to ramp up transitional care, which aims to reduce excess hospitalization by redirecting individuals who might otherwise remain in hospitals due to insufficient transitional care facilities.

In response, SPS Mahzam thanked Assoc Prof Lim for recognizing the need to prioritize hospital beds for those in genuine need.

She reiterated concern about putting incentives in place that could lead to unintended consequences, such as people avoiding necessary treatment to receive rewards for not making claims.

“We’re really concerned if we put the wrong incentives then there may be a perverse reaction of people not getting the treatment they need if they are actually being rewarded for not making a claim.”

However, she acknowledged the importance of transitional care and mentioned that the MOH is already ramping up and expanding transitional care facilities, along with providing a suite of home care services to address post-discharge needs.

“As you can see, there is a larger shift towards preventive care, towards healthy SG, and this is something we want to encourage more residents to look at a larger picture.”

“We want to shift care within the community and get people to stay healthy within the community so that we can shift a lot more of these concerns away from the hospital, ” SPS Mahzam added.

Public concerns over lengthy waiting times at Singapore hospital despite Minsiter’s assurance of a ‘10,000-Bed-Strong System’

Assoc Prof Lim had earlier raised concern about hospital capacity crunch in the parliament.

On 10 January, he asked the Minister whether there remains shortages of hospital beds and available nursing staff in public hospitals, relative to a year ago.

He also asked what the progress of ongoing plans to increase hospital capacity; and whether public hospitals are currently facing capacity constraints, even in non-crisis environments, and, if so, why.

In response, Health Minister Ong Ye Kung said Singapore is “progressively catching up” with the post-COVID hospital capacity strain.

He highlighted that the Tan Tock Seng-Integrated Care Hub (TTSH-ICH) has successfully added 300 beds since October 2023, while the upcoming Woodlands Health Campus (WHC) is slated to commence operations by mid-year, initially offering 360 beds.

Minister Ong projected WHC’s bed capacity to nearly reach 600 by year-end.

Mr Ong acknowledged that like most developed countries, Singapore continues to experience a capacity crunch post COVID-19.

He highlighted that this challenge is further compounded by an ageing population, resulting in an increased influx of elderly patients with complex health conditions necessitating extended hospital stays.

Addressing the media on 22 December last year, Minister Ong acknowledged the strain caused by the year-end surge in COVID-19 cases, which resulted in approximately 600 to 700 hospital beds being occupied by COVID-19 patients.

“We are a 10,000-bed-strong system. To take up 600 or 700 beds, it’s 6 or 7 per cent, which is not small. It’s a significant workload on our healthcare workers and our system.”

Despite the Minister boasting the resilience of Singapore’s “10,000-bed-strong system”, a recent revelation by a reader highlighted issues at Ng Teng Fong Hospital’s A&E department on 2 January, indicating a consultation wait exceeding 6 hours and a bed wait of up to 25 hours.

Expressing dismay, the reader remarked, “I always thought we are a first world country. How is it that our planning so screw up? Didn’t MOH plan for this population explosion as well as aging population?”

When queried by Channel News Asia last November, MOH said the waiting time for beds is dependent on several factors, such as the patient’s condition and the existing patient load in A&E departments.