Patient workload in public hospitals

21 November 2011
Question No. 27

Name of person: Mr Seah Kian Peng

Question

To ask the Minister for Health (a) what is the amount of profit that the restructured hospitals made last year from private patients; (b) whether there is excess capacity in these hospitals and, if so, how much; and (c) how many subsidised patients does a senior consultant see in a month and what proportion is this out of his total patient load.

Answer

1    In 2010, there were 4 million outpatient attendances at our public hospitals, of which 2.7 million (or 67%) were subsidised. During the same period, there were 345,000 inpatient discharges, of which 250,000 were from subsidised Class B2/C wards; and if we included B1 wards, which also received some subsidy, this accounted for close to 85% of the total inpatient workload. Government subvention to the public hospitals for their subsidised patient services alone amounted to $2.2 billion. Generally, services that are not subsidised, such as Class A ward admissions or private day surgery, are charged on a cost-recovery basis. The public hospitals generated an aggregated surplus of $11 million, or around 1% of revenue, from such services in 2010.

2    At our public hospitals, every admitted patient is assigned a specialist who will lead the delivery of care, usually through a team-based system comprising other doctors, nurses and allied healthcare professionals where appropriate. We do not monitor the workload of individual senior consultants by their subsidised and total work load.

3    Mr Seah also asked about the capacity in the public hospitals. Most of our public hospitals are running at about 85% capacity on average. The capacity is tight. And we are taking steps to address this. For example, in terms of manpower, we increased the number of specialists last year by about 8%, from 1,850 to 2,000. We are also expanding our healthcare infrastructure.

4    But bed numbers are just one measure of health care capacity. As our hospitals develop evidence-based care pathways to better manage patients, they are also able to reduce the average length of stay whilst at the same time improving the quality of care. These measures effectively expand the capacity of hospital beds, allowing us to admit more patients with the same bed numbers.

5    Our public hospitals also streamlined their processes. They were able to maintain the median waiting time for admission from the Emergency Department (ED) of about 1.4 hours in 2009 and 2010, despite a 4.5% increase in admissions. They have also maintained the median waiting time for new Specialist Outpatient Clinic (SOC) appointments for subsidised patients at around 28 days in 2009 and 2010, even though attendances rose by 3.5% from 2009 to 2010 – this is comparable to Hong Kong, where the median waiting time was around 5 weeks. For subsidised patients requiring urgent appointments, such as for suspected cancer, the current median waiting time is within 2 weeks.

6    We will continue to expand our infrastructure and manpower to meet healthcare needs. The Ng Teng Fong General Hospital will add 700 beds in 2014. Planning for the Sengkang General Hospital has begun. Other than acute hospitals, we will also ramp up developments such as community hospitals and nursing homes; and we will strengthen our primary care capabilities – this is an area that Mr Seah raised in a separate question [1]; I will be speaking on this in greater detail then.

7    I would like to reassure Mr Seah that even as we seek to expand both infrastructure and manpower capacity in our public hospitals, the clinical care of patients, whether subsidised or not, remains our top priority.

[1]       Notice Paper No 71 of 2011; *28: To ask the Minister for Health whether the Ministry has plans to expand the network of polyclinics so as to provide greater accessibility and to keep medical costs affordable for residents.