Monday, 13 January 2014

Hospitals Facing Severe Bed Crunch

Update 22 Aug 2014: Patient discharge lounges in some hospitals help ease bed crunch problem
A patient discharge lounge facility at the National University Hospital

Some acute care hospitals in Singapore have patient discharge lounges, which free up hospital beds by moving patients for discharge to a separate location. The Health Ministry said on Wednesday (Aug 20) that this will ensure hospitals have enough beds to meet the needs of the ageing population in Singapore.

Patients preparing to be discharged can use the lounge to wait for their medication, documents and family members. The National University Hospital (NUH), Changi General Hospital, Singapore General Hospital, and Khoo Teck Puat Hospital already have such facilities in place.

NUH sees about 150 admission and discharge cases each day. On average, its patients wait for about 1.5 hours to be discharged. "Under some circumstances when the family members are unable to pick up the patient on time, the waiting time will be even longer - maybe up to two to three hours," said Ms Karen Wong, a nurse clinician at NUH. "We will bring the patients to the discharge lounge and at the same time, we can clean up the beds to receive another new admission or patient."


A 78 years old grandma sleeping at TTSH Ward Corridor for 2 night straight
My 78 years old Grandma (mother's mother) was just admitted to Tan Tock Seng Hospital on 2 August 2014 (Saturday) around 11 am to A&E due to having fallen down and unable to walk

She was given X-ray and found out that she got a crack at her hip plate. However she will need to undergo treatment and she will need to stay at the hospital.

Initially we were told there was not enough patients wards when we ask for a ward B2 type and later on we received a SMS from the hospital on her bed and ward number.

Here is where the problem start; when my uncle went down at night 9pm to visit and pass her some of her stuffs like jackets and her favor mug, he was not happy that she was placed at the corridor in front of the nurse counter, instead of a ward.


Transformation of Singapore's healthcare model needed

Resolving the hospital bed crunch is not just a matter of expanding capacity, but is also about changing Singapore's care model, said Health Minister Gan Kim Yong at the topping-up ceremony of the new Ng Teng Fong General Hospital on Monday morning

This would mean changing the focus to be "less reliant on actual hospital beds, more reliant on community care, as well as home care," Mr Gan said.

One of the ways to do this is to strengthen the primary and long-term care sector, providing patients with alternatives to hospitals when they need medical attention.

"The bed situation will remain tight because given our ageing population, the demand for hospital beds will always be there," said Mr Gan.


Back to Third World from First in health care? Hardly

The Workers' Party secretary-general and Aljunied GRC MP, a veteran of Budget debates since 1992, aimed straight for the weak spot in the Ministry of Health: the shortage of public hospital beds and long waiting times at emergency wards.

He referred to a front-page report in this newspaper in January which recounted how one hospital put up an air-conditioned tent for patients waiting for a hospital bed, and said: "The hospital bed crunch, together with the public transport crunch and the riot in Little India is a star example of Third World problems in First World Singapore."

He could not resist another dig: "One certainly hopes that Singapore does not make history by going from Third World to First, and back to Third within one generation."

related:

Patients housed in 2 tents at CGH

Two large tents sit at the back of Changi General Hospital's Emergency Department, where patients wait eagerly for a hospital bed to be freed up. The tents were set up to help deal with the severe bed crunch at the hospital. These temporary quarters house up to a hundred patients.

RazorTV reported that some of the patients have to wait up to two days to move to the wards. But CGH is not the only public hospital struggling with bed shortage. Others like Khoo Teck Huat Hospital and Tan Tock Seng Hospital are sending some of their more stable patients by ambulance to Alexandra Hopistal - which still has available beds.

But it seems that the bed shortage will only be eased towards the end of the year, when the new Ng Teng Fong Hospital in Jurong and the 280 bed building - shared by CGH and St Andrew's Community Hospital - opens.


Are S'pore public hospitals on track to meet future healthcare needs?


By 2020, there will be six new public hospitals, which are part of the Health Ministry's plan to boost infrastructure to deal with the rise in demand for healthcare services.

But with Singapore currently experiencing a bed crunch at hospitals, are the ministry's plans on track to meet future healthcare needs?

Construction of the new Ng Teng Fong General Hospital and the adjacent community hospital has been ongoing since 2009.

related: Queue system at upcoming Ng Teng Fong General Hospital to cut patient waiting time

read more

10,000 beds by 2020: Gan’s magic wand?

Within a week, the minister has added 6,300 more beds to his Heathcare 2020 Masterplan. Is this for real or a mere knee-jerk reaction to placate public opinion? It is a substantial deviation from the Masterplan, yet no details have been disclosed so far. I hope that it is real; it is in line with what I advocated in my $60 billion economic rejuvenation plan for Singapore published in 2011………. This would enable Singapore to reach First World norms of about 58 beds per 10,000 population within 5 years, that is, by 2016.

Gan’s plan is 4 years behind, but at least he is doing something …….unlike his predecessor… During Khaw’s tenure as health minister for 7 years (2004-2011), the total number of beds ….. actually fell from 11,840 to 11,394 despite a population increase of 1 million…. So the number of beds per 10,000 population dropped from 28 to 22 . Which responsible health minister will allow such a substantial fall to happen, let alone the supposedly “best health minister Singapore has ever had” (in the famous words of ex-PM Goh Chok Tong)? Is it any wonder that there is such a severe bed crunch in public hospitals today?

Minister Gan must tell us what is the population size that he has used for the year 2020 when deciding to build 10,000 more beds by 2020. Is this population figure in line with the Population White Paper approved by Parliament in early 2013? What would be the expected number of beds per 10,000 population when the additional 10,000 beds are put in place by end 2020?



HEALTH MINISTER GAN KIM YONG: IT TAKES TIME TO BUILD NEW HOSPITALS

With the bed shortage at several public hospitals around Singapore, Gan Kim Yong, the health minister has urged all hospitals to make patients feel as comfortable as possible.

He said that they are already working to build new hospitals and nursing homes but they take time to build. In the meantime, they are working to find suitable solutions for patients such as moving patients to other hospitals that aren't full.

The Ministry of Health also explained that part of the reason for the bed crunch is the aging population putting more demand on health services.


Hospital Shame

The Independent Singapore did an interview with Dr Tan Lip Hong on the bed crunch at some of our hospitals, with the Changi General Hospital setting up an air-conditioned tent to accommodate patients. Dr Tan has worked as a GP in the heartlands for the past 19 years. He is also one of the authors of the Singapore Democratic Party’s healthcare plan.

What was your first reaction when you read this? - I am not surprised by this report. Why? The Singapore government has been under-investing in healthcare infrastructure for decades. Our hospital bed to population ratio is way below that of developed country standards. And these standards are calculated based on resident population. Given that our non-resident population is 30% of our total population, this would mean that the our problem is even more dismal.

The total population of Singapore has increased by at least 35 per cent in the last decade, yet the total number of hospital beds has remained more or less constant. The Health Minister has said that the ministry is aware of the situation, but said the extra beds will only come on-line in 2020 – in seven years’ time!

read more

Health Ministry working to tackle hospital bed crunch

In light of the bed crunch situation at hospitals, the Ministry of Health (MOH) is working to ensure that patients in public hospitals are cared for safely and comfortably.

The ministry says an ageing population and a smaller family unit have led to increased demand for health care services.

Senior Minister of State for Health Dr Amy Khor said this on the sidelines of a community event on Thursday.

related: HEALTH MINISTER GAN KIM YONG: IT TAKES TIME TO BUILD NEW HOSPITALS

read more

New hospital to be built in the north

Residents in the northern part of Singapore can look forward to a new hospital, possibly located in Woodlands, with construction set to begin after 2020.

The Health Ministry is looking at several sites for the new hospital and studying demographic needs and land use plans.

This was announced by Health Minister Gan Kim Yong on the sidelines of the ground-breaking ceremony for the Sengkang general and community hospitals, which will be ready by 2018.

related:
New Sengkang hospitals will boast 1,400 beds
New facilities developed to meet healthcare needs
More hospitals and polyclinics by 2030

Tackle bed crunch now
There is a Chinese saying that distant water cannot put out a nearby fire

SINGAPORE is experiencing its worst bed crunch ever.

Asked what the Ministry of Health (MOH) is doing about it, Health Minister Gan Kim Yong told The Straits Times that he is "cognisant" of the problem, and the Government will add 3,700 beds by 2020.

He added: "In the short term, Ng Teng Fong General Hospital is scheduled to open in 2014, and community hospitals in Yishun and Jurong will be ready by 2015."


Transformation of Singapore's healthcare model needed

Resolving the hospital bed crunch is not just a matter of expanding capacity, but is also about changing Singapore's care model, said Health Minister Gan Kim Yong at the topping-up ceremony of the new Ng Teng Fong General Hospital on Monday morning

This would mean changing the focus to be "less reliant on actual hospital beds, more reliant on community care, as well as home care," Mr Gan said.

One of the ways to do this is to strengthen the primary and long-term care sector, providing patients with alternatives to hospitals when they need medical attention.

"The bed situation will remain tight because given our ageing population, the demand for hospital beds will always be there," said Mr Gan.


Timely discharge, more beds added to deal with hospital bed crunch: Health Minister
Health Minister Gan Kim Yong on Monday set out the measures being taken to address the hospital bed crunch in the short and medium term

They include ensuring timely discharge of patients, adding more than 300 beds over the past six months and working with private hospitals to supply another 50.

Over the medium term, 1,200 beds, including in community hospitals and nursing homes, will be added by this year, and another 10,000 by 2020, as at least six new hospitals are scheduled to open by then.

Mr Gan was responding to Dr Lam Pin Min (Sengkang West), who had asked for an update on the bed crunch situation that made the headlines earlier this month, as public hospitals took extraordinary measures such as housing patients in a large air-conditioned tent and setting up beds along ward corridors.


Managing the bed crunch in hospitals

BED shortages at public hospitals are not new, though rarely have they been this bad - with some patients waiting more than two days to get one.

Each time they occur, new procedures, facilities or stop-gap measures are introduced to meet the growing demand.

Some of the more extreme measures taken in the past decade have seen rooftop gardens converted into wards and beds placed in corridors.



Hospital bed crunch: Better care network outside of hospitals needed

The solution to the ongoing hospital bed crunch cannot just lie in adding new beds.

Instead, a network of patient care outside of a hospital is necessary, said the head of the upcoming Ng Teng Fong General Hospital on Saturday.

"The centre of gravity (in patient care) cannot be in an acute hospital setting," said Mr Foo Hee Jug, who is now chief executive at Jurong Health Services. "We must do and plan activities right now to get patients comfortable with community care."



2014 BEGINS WITH STARK REMINDER OF PAP’S GROSS INCOMPETENCE

Patient beds in corridors and make-shift tents, a phenomenon normally associated with poor developing countries, are now a common sight in at least one of our world class hospitals (see attached report in today’s ST). How far down will Singapore descend into the Third World?

If Mr Lee Kuan Yew had brought Singapore from Third World to First in one generation, then his PM son has outdone him by bringing us back to Third World in less than half a generation!

Severe bed crunch in Singapore’s hospitals is not a new sight. There were reports of it some years back. I had also pointed this out in my essay on the Singapore economy that was released in February 2011, nearly 3 years ago. The relevant extract is as follows:

read more

Hospitals facing severe bed crunch take unusual steps
Changi General Hospital started housing patients waiting for beds in this large air-conditioned tent this week. The 800-bed CGH, along with Tan Tock Seng and Khoo Teck Puat hospitals, has resorted to sending patients to  Alexandra, one of the few public hospitals here with spare beds. Health Minister Gan Kim Yong said last night  that he was aware of the problem - hence, the push to add 1,900 more acute hospital beds and 2,600 community hospital beds by 2020. -- ST PHOTO: DESMOND FOO

A severe bed crunch at Singapore's public hospitals has forced several of them into taking some extraordinary measures.

Changi General Hospital (CGH), which has 800 beds, started housing patients waiting for beds in a large air-conditioned tent this week.

The 1,200-bed Tan Tock Seng Hospital (TTSH), meanwhile, has been forced to set up 49 beds along the corridors of its wards to cope with the demand

related:


Health Ministry working to tackle hospital bed crunch

In light of the bed crunch situation at hospitals, the Ministry of Health (MOH) is working to ensure that patients in public hospitals are cared for safely and comfortably.

The ministry says an ageing population and a smaller family unit have led to increased demand for health care services.

Senior Minister of State for Health Dr Amy Khor said this on the sidelines of a community event on Thursday.

related: Healthcare sector takes steps to tackle bed crunch


Do all to make patients comfortable: Minister Gan to hospitals

Amid an on-going bed crunch, Health Minister Gan Kim Yong has instructed all public hospitals to make patients feel comfortable and ensure their safety while they are being treated.

The Straits Times had reported today (Jan 8) that hospitals here are facing a severe crunch, with some resorting to using tents and renting space from the private sector.

Mr Gan responded in a statement today, saying that new hospitals, community hospitals and nursing homes which are already planned for would take time to build.“Right now, we are actively working to tackle the current crunch in a few public hospitals, such as tapping on available bed capacity in other public hospitals, as well as facilitating the timely discharge of patients to available beds in the community hospitals, or with the help of homecare providers,” he said.

related: Make patients comfortable: Health Minister


CHANGI GENERAL HOSPITAL RESORTS TO KEEPING PATIENTS IN TENTS DUE TO BED SHORTAGE

Singapore public hospitals are experiencing a severe shortage of beds. There are not enough beds to cope with demand and the various hospitals are taking unusual steps to house the patients.

Changi General Hospital set up a large air-conditioned tent outside this week for patients to stay in while waiting for beds in the hospital.

At Tan Tock Seng Hospital, dozens of beds were set up n corridors to meet demand


Public hospitals facing severe bed crunch?
20140110-114146.jpg

The latest serious hot topic in cyberspace now – other than the multi-million kidnapping case or some unhappy cinema patrons at Rex Cinema, is the dearth of beds in government run public hospitals. Many citizens have expressed outrage on this latest worrisome situation. We are talking about NOT one but all the government run public hospitals in our Singapore. How could it be? What happened to our legion of planners and scholars taking huge salary and yet fail to deliver this basic service to our citizens which we have always taken for granted until recently? It seems that this is one of the latest trends happening in Singapore where “Things Are Falling Apart!” Realy langgar!

I do not agree with Uncle Leong’s statement. I only subscribe partially to the second statement. Let me substantiate what I say here.

Back then in 1990 when I was an investigation officer (IO) on duty, I had to visit and interview patients in all the public hospitals across the island. We rotated between IO(R) – Routine or IO(C) – Crime every 4 or 5 days. All routine cases reported to the police between 6am to 6am the next day would come under my preview if happened in my divisional boundary.


SG hospitals house patients in corridors & tents
CGH began housing patients waiting for beds in this large air-conditioned tent this week. (Photo: ST)

The media reported yesterday (8 Jan) that a severe bed crunch at Singapore’s public hospitals has forced several of them into taking some extraordinary measures.

Changi General Hospital (CGH), which has 800 beds, began housing patients waiting for beds in a large air-conditioned tent this week while the 1,200-bed Tan Tock Seng Hospital (TTSH) was forced to set up beds along the corridors to cope with the demand. The 570-bed Khoo Teck Puat Hospital (KTPH) resorted to sending patients to Alexandra Hospital which still has spare beds at the moment.

Dr Lee Chien Earn, CGH’s chief executive officer, said, “Our bed occupancy rate has crossed 100% for certain periods over the past month and some patients have waited more than 24 hours for an inpatient bed.” This is despite CGH already renting a ward each from Parkway East Hospital and St Andrew’s Community Hospital.


Looking Like A War Zone

Speaking at the Singapore Anglican Community Services 100th Anniversary Charity Gala Dinner in Dec 2013, Lee Hsien Loong made the dubious claim that more social spending does not mean better results. As an example, he pointed out that the Americans spend more on healthcare than anybody else in the world, 18% of GDP. Singapore budgets only a minuscule 4% of our GDP for healthcare, and our life expectancy is longer and infant mortality rates are lower. The difference is that the cost of staying alive here is depleting our own savings intended for retirement needs. Unlike in America, there's no social security here.

"It is the results which count, not how much you spend, not how much the government takes onto itself," he boasted. One result of that parsimonious attitude towards healthcare spending is that we now have a shortage of hospital beds, with patients ending up in corridors or tented facilities associated with disaster relief zones.

Changi General Hospital (CGH) started housing patients waiting for beds in a large make shift air-conditioned tent this week. Tan Tock Seng Hospital (TTSH) has been forced to set up 49 beds along the corridors of its wards to cope with the shortage. Khoo Teck Puat Hospital (KTPH) resorted to sending patients to Alexandra Hospital, one of the few public hospitals with spare beds.


MORE ARMY BASES THAN HOSPITALS IN S’PORE

My sister has been a nurse for 20 years. The shortage of hospitals has been around for 10 years but yet, the PAP did not solve the problem.

Are army bases more important than citizens’ health? Face the fact, Internet is defeating Singapore Propaganda House. They have been in power because of their grip on the media. What problems? All the problems and the evil side of PAP are being brushed aside by the devilishly clever Singapore Propaganda House.

Reading the Singapore Propaganda House’s depiction of the 50 years of PAP rule is like watching an Indian movie, where the heroes are always right and they always win. The result? Singapore is now becoming a third world country. The worst part is their inept performances are being rewarded with monstrously huge salaries beyond our imagination. What kind of leaders are we having in Singapore?

read more

WE CAN COPE WITH 6.9M?

'Singapore public hospitals are experiencing a severe shortage of beds….Changi General Hospital set up a large air-conditioned tent outside this week for patients to stay in while waiting for beds in the hospital. At Tan Tock Seng Hospital, dozens of beds were set up n corridors to meet demand.

Meanwhile, Khoo Teck Puat hospital has resorted to sending patients on to Alexandra Hospital.’

Khoo Teck Puat is a new hospital and there is another one in Jurong East. And the strain on the system is there for everyone to see. Not forgetting that getting an appointment can mean more than a year in waiting.


Hospital bed crunch issue: MP Chia Shi-Lu elaborates on position

A Member of Parliament at the centre of an online furore due to his comments on the hospital bed crunch has elaborated on his position, and said the issue is due to several reasons.

On Wednesday, in a report on hospitals' unusual measures to tackle a bed shortage, The Straits Times had reported Tanjong Pagar GRC MP Chia Shi-Lu as saying that the crunch might be due to the holiday season rather than a spike in illnesses. But some netizens disagreed. They argued that the reasons went beyond this, as such shortages crop up at different times over the course of a year, and have been a problem for several years now.

The holiday season "exacerbated" bed shortages in public hospitals, Dr Chia, a consultant orthopaedic surgeon, said on Thursday.

related: PAP MP clarifies remarks on bed crunch

In several reports published yesterday, the problem of hospital bed shortages was highlighted and some of the unusual measures that hospitals were taking to deal with the bed crunch were made public.

At Changi General Hospital, a large tent was set up to house some patients while Tan Tock Seng Hospital put patients in corridors. (Full story see: Changi General Hospital resorts to keeping patients in tents due to bed shortage)

Following the spread of the news online, MP for Tanjong Pagar GRC, Dr Chia Shi-Lu had remarked that the bed shortage at the moment could be due to the holiday period instead of a spike in illness. He was then quoted by netizens and many poked fun at his remarks as they did not seem logical.


PAP MP clarifies remarks on bed crunch

People’s Action Party (PAP) Member of Parliament, Dr Chia Shi Lu, elaborated on Thursday his position on the hospital bed shortage problem.

On Wednesday, the Straits Times reported Dr Chia, who is a consultant orthopaedic surgeon and a member of the Government Parliamentary Committee on Health, as saying that the problem “might be due to the holiday season rather than a spike in illnesses.” [See here: “Hospital bed crunch due to “holiday season”, says PAP MP”]

His remarks sparked off criticisms from members of the public, some of whom related their own personal experiences online to rebut Dr Chia. On Thursday, according to the Straits Times, Dr Chia clarified his remarks and said that the bed crunch is “due to several reasons.”

related:
Interview with Dr Paul on the bed crunch issue in public hospitals
Make patients comfortable: Health Minister

Singapore’s Inadequate and Inefficient Healthcare Spending

When the news about public hospitals in Singapore faced serious bed crunch in the last week of 2013, which patients have to be left sleeping on corridors or even “air-conditioned tents”, a debate erupted on my Facebook on the comparison of Hong Kong’s healthcare spending vs Singapore.

The bed crunch in Singapore public hospitals is definitely NOT a new problem at all. There has always been bed crunch every now and then, especially during the seasonal peak of dengue epidemic every year. Way back in 2010, I have written on the very fundamental reason why we have to face severe shortages of hospital beds: the incompetency of PAP government of pure neglect in infrastructure building when they planned for a rapid increase in population. (http://singaporealternatives.blogspot.sg/2010/03/sorry-no-enough-minister-khaw.html)

The irony is that some years ago, Mr. Lee Kuan Yew has once criticized London’s healthcare system after his wife was deprived of VIP treatment that they used to enjoy in Singapore. He complained that they need to wait a long time for a bed, then for a CT scan on her brain. He claimed that he could get a bed very fast in Singapore, CT scan anytime etc. He then of course, self praise the healthcare system he has created.


Cartoon Press: Hospital Bed Crunch

The ST report, titled “Hospitals facing severe bed crunch take unusual steps”,  said the hospitals were housing patients in “tents and corridors” or were sending them to other hospitals.

It said Changi General Hospital (CGH), for example, is “housing patients waiting for beds in a large air-conditioned tent”.

Tan Tock Seng hospital, on the other hand, “has been forced to set up 49 beds along the corridors of its wards to cope with the demand” for beds.
This is not new for TTSH.


In 2010: Khaw Boon Wan vows PAP government will never be caught out by shortage of hospital beds again
Yawningbread.wordpress.com, 28 Jul 2010
Mr Khaw said that Singapore will not be caught out by a shortage of hospital beds again.

The building of Jurong General Hospital will start this year. The hospital, slated to have about 700 beds, should open before 2015.

Although Alexandra Hospital will then be closed and its 300 beds taken out of the system, there will still be a net increase of about 400 beds. A site in the Sengkang-Punggol area, which has a growing population, has been reserved for yet another new hospital. – Straits Times, 25 July 2010Full story
related:


Hospital Bed Crunch

– The Independent, SG: Hospital Shame