Streamlining MediFund Process

NOTICE PAPER NO. 2316
NOTICE OF QUESTION FOR ORAL ANSWER
FOR THE SITTING OF PARLIAMENT ON 7 NOVEMBER 2023 

Name and Constituency of Member of Parliament
Dr Tan Wu Meng
MP for Jurong GRC

Question No. 5291

To ask the Minister for Health (a) since 2021, how many Singaporeans have successfully applied for MediFund at one healthcare institution and have at least an annual appointment at another healthcare institution (i) within the same cluster and (ii) in a different cluster respectively; (b) how many of such patients have successfully applied for MediFund across all healthcare clusters they have been to; and (c) whether the MediFund application process can be streamlined to support needy Singaporeans who cannot afford their healthcare bills across different healthcare institutions.

Answer

1      Around 30% of the MediFund beneficiaries received MediFund assistance from more than one institution within the same public healthcare cluster and around 40% received MediFund assistance from more than one institution across public healthcare clusters. The Ministry of Health has devolved MediFund approvals to the MediFund Committees of individual healthcare institutions.  This is to enable the Committees to exercise greater discretion in assessing MediFund applications, thereby improving the accessibility to these funds. However, this also inevitably leads to multiple assessments for the same patients across institutions, when transferring from acute hospital to community hospital, you go through one more round of assessment and that adds to their inconvenience. 

2      We need to strike a balance between these two objectives of flexibility and convenience.  In line with that, MOH has reviewed the MediFund application process, to make it more seamless with limited impact on the flexibility and discretion of the MediFund committees and we will be implementing the following changes by March 2024. 

3      First, a mutual recognition arrangement between acute hospital and step-down care.  This means that when a patient benefitting from MediFund is transferred from an acute hospital to step-down care, he or she will continue to benefit from MediFund, without having to re-apply again. As the medical bills, social and financial circumstances of patients may vary over time or as they transfer from one institution to another, this automatic extension of MediFund will be for three months, or until the receiving institution re-assess the patient’s eligibility for continued MediFund assistance. 

4      Second change is a mutual recognition arrangement within the same healthcare cluster for outpatient treatment.  For example, if a patient is receiving MediFund at an outpatient institution, say a Polyclinic, and he goes to another MediFund institution within the same healthcare cluster, say a specialist at a Specialised Outpatient Clinic, he will automatically receive support from MediFund and does not need to re-apply for his outpatient bills another time.  This automatic support will be valid for a year, from the time MediFund is first extended to him at the outpatient setting. 

5      Lastly, more support for ComCare graduates.  Today, MediFund assistance is automatically extended to needy patients who are under ComCare assistance.  MediFund assistance is withdrawn when the patients graduate from the ComCare scheme.  There is a bit of a cliff effect. To strengthen support for these ComCare graduates on their journey to self-reliance, MediFund support will continue for three months after graduation from ComCare. 

6      I should clarify that under the law, MediFund Committees of each healthcare institutions continue to have full discretion over the application outcome and extent of support, to prioritise support towards those who need it the most.  Notwithstanding, MOH has been engaging them to agree to support the changes that I just mentioned.  MOH will be issuing these guidelines to the MediFund Committees. These enhancements should help smoothen the experience for MediFund beneficiaries as they transfer or seek care in different healthcare settings.  We expect them to come into force by March 2024.