Nursing homes and community hospitals

22 Oct 2007

Question No:  395  

Question

Name of the Person: Dr Fatimah Lateef, MP for Marine Parade GRC

To ask the Minister for Health (a) if his Ministry will consider allowing a portion of the Medisave account to be used for the payment of the “caring fee” for chronically sick elderly residents in nursing homes; and (b) what is the average waiting time for placement in Government nursing homes and community hospitals.

Reply

Reply From MOH

Dr Fatimah Lateef asked about nursing homes and community hospitals.  Together with the other entities in the step-down care sector, such as chronic sick hospitals, hospices and day rehabilitation centres, they cater to the diverse needs of Singaporeans who cannot be adequately looked after at home, but require some sort of medical, nursing or other professional services.  The degree of professional intervention depends on the state of a patient which in turn determines the cost of providing the service.  Typically, a nursing home or day centre cost much less to run than say a community hospital.

The cost of running the step-down care sector has been largely borne by the Government, through direct operating subsidy to the entities and initial capital development grants.  Last year, my Ministry provided more than $100 million in direct subsidies.  With ageing of the population, we can expect this to grow.  But patients also co-pay and are means-tested to determine the level of subsidy that they receive.  In addition, various charities chip in to help lower-income patients pay their bills.

Medisave was designed to help pay acute hospitalization.  However, over the years, we have gradually extended its use to cover other medical services, provided such extension does not undermine the primary objective of Medisave.

For the step-down care sector, Medisave can now be used to help pay for services in community hospitals, chronic sick hospitals and hospices.  

For nursing home care, Medisave can be used, but in an indirect manner via ElderShield, as many patients in nursing homes are the target beneficiaries of ElderShield.  With the recent ElderShield reform, the role of Medisave to help fund care in nursing homes has been expanded.  Medisave can now be used to help pay the premiums for ElderShield Supplements, on top of basic ElderShield.

Dr Fatimah also asked about waiting time for placement in these step-down care institutions.  For community hospitals, there is hardly any waiting time.  For nursing homes, the waiting time now is about 1 to 2 weeks.   This is a considerable improvement from the past, but I will see how we can shorten this further as any delay means the patients are unnecessarily occupying costly acute hospital beds.  But we will need the co-operation and understanding of the patients and their families, to agree to speedy transfer from acute hospitals to nursing homes.