Tuesday, 27 October 2015

Call for a COI on Hepatitis C cluster @ SGH

Update 8 Dec 2015: WP calls for Committee of Inquiry on Hep C outbreak
Committee deliberations should be made public; detailed explanation on delay in public notification needed

The Workers’ Party (WP) has called for the committee reviewing the Hepatitis C outbreak at the Singapore General Hospital to be reconstituted as a Committee Of Inquiry (COI) under the Inquiries Act, citing a need for the committee’s deliberations to be made public.

The party suggested the appointments of retired health-care professionals and clinicians, as well as a person qualified to be a High Court judge, to be part of the COI to “conduct a truly rigorous and, where necessary, critical review”.

In the statement from Non-Constituency Member of Parliament-elect Leon Perera, the WP referenced past COIs convened for the 2011 MRT breakdowns and 2013 Little India riot to strengthen public confidence in the public transport and security systems respectively.

related: Hepatitis C outbreak: Govt will form COI if WP gives evidence in inquiry hearing

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Review Committee finds fault with SGH’s practices on Hepatitis C outbreak
Photo – The Straits Times, Tan Weizhen

The report by the Independent Review Committee (IRC) has found that sloppy practices, including poor infection control, led to the Hepatitis C outbreak in Singapore General Hospital’s (SGH) renal wards 64A and 67 where 25 patients were infected between the period of April and June 2015.


The report by the review committee was submitted to the Ministry of Health (MOH) on 5 December and has been accepted by the ministry.


The independent review committee headed by Professor Leo Yee Sin, the director of the Institute of Infectious Diseases and Epidemiology, was announced by MOH on 6 October to review the report by SGH submitted to the ministry on 24 September. The review committee was convened on 28 September by the Minister of Health, Gan Kim Yong.


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What is missing in SGH report
Associated Press/Joseph Nair - The windows of wards are seen with the sign of Singapore General Hospital on Tuesday, Oct. 6, 2015 in Singapore. The top public hospital in Singapore said Tuesday that four of its patients died after a new renal ward was hit by an outbreak of hepatitis C, likely from intravenous treatment. (AP Photo/Joseph Nair)

It must be the briefest statement to end a brewing crisis. And it was said with a firm air of finality.

“There is no evidence to suggest that the escalation from the director of medical services to the minister was deliberately delayed,” Leo Yee Sin, chairman of the committee that investigated the Hepatitis C scare at SGH, said last week.


Their report was damning, exposing lapses in protocols at Singapore’s oldest hospital. This pride of Singapore’s health care industry was tardy in recognising the outbreak, its own investigations were messy and there were delays in reporting the matter to the Ministry of Health.


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Review committee places fault of Hep C outbreak on poor practices at SGH


It also found no evidence of deliberate delays by SGH or MOH staff in escalating the outbreak or in informing the Minister for Health.


It’s in — the independent review committee that looked into the Hepatitis C virus (HCV) outbreak at Singapore General Hospital (SGH) has released its report on its findings today (December 8).


Three days prior, their report was submitted — and later accepted, by the Ministry of Health (MOH), and if you’d like to read the entire thing, it’s available here. It’s 80 pages long, though, so we thought we’d take you through some key points from a shorter version of it:


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Ministry of Health’s Review Committee on virus outbreak: SGH staffs at fault


The Independent Review Committee set up by the Ministry of Health (MOH) blamed staffs at the Singapore General Hospital (SGH) for the Hepatitis C virus outbreak occurred between April and June.


According to the 79-page report, SGH staffs committed multiple breaches of infection control:

  • Not following standard procedures in administering blood-taking and giving medication
  • Inefficient workflow designs
  • Contaminated medical equipment and environment due to inadequate cleaning and disinfection practices
7 patients living in affected wards died due to the infection. Police investigations have also revealed no foul play. However it is not mentioned if the SGH staffs guilty of the infection control breaches will be taken to task for criminal negligence leading to deaths.

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Hepatitis C Outbreak: SGH’s Sloppiness Killed Patients, Says Independent Committee

25 people were infected with Hepatitis C and 8 of those in the affected ward died – with 7 deaths linked to the infection. All this, due to sloppy handling of equipment by staff at Singapore General Hospital

That was the finding of the Independent Review Committee, tasked with investigating the outbreak which was covered up for months before word spread to the Ministry of Health, and Singapore’s Health Minister.


18 spot checks found that staff were lax with the hygiene, and the handling of contaminated equipment.


The committee also found that there were gaps in infection prevention and control practices, failure by SGH to recognise the outbreak, and delays in notifying the higher-ups in the hospital as well as the MOH.


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SDP calls for Minister of Health to take responsibility for Hep C incident

Singapore Democratic Party (SDP) calls for Minister for Health Mr Gan Kim Yong to take responsibility for the Hepatitis C episode which took place during April to June this year that had 25 patients infected and claimed seven lives.

The press release which was signed off by Dr Chee Soon Juan, SDP’s Secretary-General, pointed out that the incident is the largest recorded hospital outbreak of hepatitis C in Asia and one of the largest in the world with tragic consequences for many families, yet the outbreak was allowed to “smoulder for months before the public and, in particular, those at risk were alerted”.

SDP goes on to state that the report released by the Internal Review Committee (IRC) appointed by the Ministry of Health (MOH) over the Hepatitis C infections saga “puts the blame squarely on the Singapore General Hospital (SGH) staff and seemed eager to absolve the MOH of its responsibilities over the matter”.

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WP calls for stronger response and escalation framework after Hep C outbreak

A stronger response and escalation framework for Healthcare-Associated Infections (HAIs) is required after the outbreak of Hepatitis C at the Singapore General Hospital (SGH), said the Workers’ Party in a press release on Wednesday.

The Independent Review Committee convened to look into the outbreak – which contributed to the deaths of seven patients – released its report yesterday, citing a combination of overlapping factors, such as poor infection control and sloppy practices at SGH, as leading to the incident. The Ministry of Health (MOH) has announced that it will put together a taskforce to look at the recommendations of the committee and determine an action plan.

“We urge this taskforce to solicit feedback widely from the medical profession and the broader public,” read the WP’s statement, which was signed off by Non-Constituency Member of Parliament Leon Perera, who is part of the WP Executive Council’s media team. “We also recommend that this taskforce be co-led by a respected, retired healthcare professional to ensure that recommendations are formed from a perspective of sufficient independence from the existing organization structure. This taskforce bears a heavy responsibility as MOH is the last line of defence against failures in any healthcare institution.”

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What Singapore’s lead opposition parties said in response to the Hep C review report
WP decided to call off its crusade for a COI, while SDP somehow managed to link it to ministerial salaries

On Tuesday, we saw the independent review committee tasked with investigating the closely-watched Hepatitis C outbreak at the Singapore General Hospital’s renal unit release their report for public scrutiny (and in case you missed it, you can read our summary of it here).

The Workers’ Party:
  • Decided to abandon its pursuit of launching a Committee of Inquiry into the matter (whew).
  • Suggested things it hopes the newly-formed taskforce (to be headed by this MP-elect, by the way:) will look into
Singapore Democratic Party:
  • Noted that the report seemed to absolve the Ministry of Health of blame over what had happened.
  • Asked when the serious information circulating various divisions was communicated to the highest levels of authority in the ministry, calling for the release of emails and communication among those involved.
  • Declared that the Health Minister should take responsibility for the communication taking place within his ministry, and also should take responsibility for the seven Hep C-linked deaths that occurred as a result of the outbreak.
  • Said that if exceptionalism is a justification for high salaries, ministers should not be excused for lapses like this.
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IRC report shows escalation and notification process was flawed and needs overhaul

The report identifies gaps in the infection control procedures for Healthcare-Associated Infections (HAIs) at SGH, as well as in the national system for notification, escalation and response. For example:
  • blood specks infected with Hepatitis C Virus (HCV) found on the wall of Ward 67
  • the delays in the SGH renal unit notifying SGH infection control
  • the MOH-CDD’s failure to classify the initial notifications as acute HCV
  • the failure to perform certain elements of investigation before 3 September, which were only undertaken at the request of the Director of Medical Services (DMS) on 3-17 September
  • SGH senior management and some clinicians assuming that SGH was liaising with MOH-CQPT (Clinical Quality, Performance & Technology Division) and that MOH-CQPT would inform the DMS if necessary
This incident contributed to the loss of seven lives. We should take an extremely serious view of such failings and gaps. We welcome the Minister’s assurance that changes will be made to reduce the risk of this incident recurring, and that the issue of accountability of personnel will be addressed by Human Resource (HR) panels at SGH, SingHealth and MOH. We look forward to reviewing the decisions from these panels when these are made public.

The Independent Review Committee (IRC) has made several recommendations for addressing the gaps it identified, such as creating a team within MOH to deal with outbreaks, improving the national notification and surveillance system for acute HCV and strengthening the escalation process for unusual HAIs. MOH has also announced the formation of a Taskforce to review these recommendations and determine an action plan.

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MINISTER MUST TAKE RESPONSIBILITY FOR COMMUNICATIONS BREAKDOWN IN MOH

The report released today by the Review Committee appointed by the Ministry of Health (MOH) over the Hepatitis C infections saga puts the blame squarely on the Singapore General Hospital (SGH) staff and seemed eager to absolve the MOH of its responsibilities over the matter.

For example, it says that while “within SGH, communication with senior management took place early...there was a delay in escalation from...SGH to MOH”.

But this is contradicted by the report itself as the Committee also states that “from late April onwards” – which was when the infections were first discovered – the MOH was informed through three of its divisions serially: beginning with the Hospital Services Division (HSD)'s National Organ Transplant Unit (NOTU), and also the Communicable Diseases Division (CDD) and the Clinical Quality, Performance and Technology Division (CQPT).

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Off with (whose) head?
Just whose head should roll? It’s not a surprise that an opposition party would ask for a governing member to fall on his sword – or demand that he be guillotined. It also will be no surprise if the G ignored it

SGH’s parent company, SingHealth, is convening a disciplinary panel and the Health ministry is doing the same. These are normal HR practices and likely to be guarded as internal affairs not meant for public consumption. So a range of penalties will probably kick in if staff members are found wanting during the Hepatitis C outbreak. Warning letter? Suspension? Demotion? Sacking?

The IRC report named no names beyond the people with big titles who had to face the media with public pronouncements. It blamed things that went wrong, rather than the people who allowed things to go wrong or the people who did things wrong. It blamed the unwieldy system of reporting outbreaks, the lack of structures and clear responsibilities with the hospital and the ministry and even the lay-out of the affected ward. But it also said that the outbreak was “unusual” because Hep C patients don’t show symptoms and can only come about when someone takes a good look at lab reports on their blood.

Now, if the sword fell on the medical staff in the ward, you can expect the usual complaint that it is always the “little people’’ who get the chop for not sticking to standard operating procedures when ministering to patients. Maybe some of them deserve this, say, a particularly sloppy medical staff member who doesn’t deserve his or her position as a healthcare professional. Who wants to stay in a dirty hospital ward?

related: WP wants an explicit timeline…and here’s the outbreak timeline

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Unhygienic Practices in SGH Persisted Despite Lapses that Caused Hepatitis C Infections

Singapore General Hospital has said it will learn from incident whereby 25 patients were infected with Hepatitis C after staying at one of the hospital’s wards.

But in the wake of the infections, and even as investigators were trying to find the cause of the infections, unhygienic practices continued.

The independent review committee tasked with investigating the outbreak of infections conducted 18 spot checks and found that staff failed to observe appropriate hygiene in handling medical equipment.

Related Posts:
4 Dead After Hepatitis C Outbreak at SGH, Drug Injections Blamed for Infections
SGH Accused of Hiding the Truth about Hepatitis C Infection Cases Last Year
“They Never Told Me I was Staying in the “Infected” Ward Until 2 Days Ago”
MOH: Delay in Disclosing Hepatitis C Outbreak Was Not Politically-Driven
Review Committee Finds One More SGH Patient Died due to Hepatitis C Infection
One More SGH Patient Found to Have Contracted Hepatitis C
SGH Finds Two More Hepatitis C Infections in Latest Screenings
Hepatitis C Timeline Reveals SGH’s Shocking Lack of Regard for Patients Lives


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Hepatitis C deaths/infection – innocent taxpayers pay the price but SGH, MOH not accountable for screw up?

Singaporeans should not expect any accountability from a own self hold own self accountable PAP government. If PAP had wanted to hold any PAP-appointed CEO/senior civil servants accountable, a COI would have been convened, not another PAP ‘independent’ review committee.

The current situation is similar to another ‘independent’ committee set up to review AIM by MND: it found no misuse of funds by town councils which sold public property at a steep discount to AIM, a PAP-owned company. The outcome of every wayang committee is a foregone conclusion – wait long long for accountability to be addressed.

MOH said that “within MOH, there was no single division with clear responsibility and capability to deal with the issue, resulting in a gap in ownership”. Will even an idiot believe this?

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Govt will convene Committee of Inquiry if Workers' Party can present evidence for allegations over hep C infections: MOH
The Workers' Party has called for the Hepatitis C independent review committee to be reconstituted as a Committee of Inquiry.ST PHOTO: ALICIA CHAN

In response to the Workers' Party (WP) call for a Committee of Inquiry (COI) to probe the cluster of hepatitis C infections at the Singapore General Hospital, the Government said yesterday that it would convene one only if the WP could "lead evidence" to substantiate any allegations of impropriety.

The WP had called for the independent review committee looking into the hepatitis C infections to be reconstituted as a Committee of Inquiry (COI) under the Inquiries Act, arguing that the situation is "at least as grave" as the 2011 MRT breakdowns or the 2013 Little India riot, both of which were probed by COIs.

In response, the press secretary to the Minister of Health released a statement on Sunday evening that said:
"The WP statement is careful not to make any suggestion that SGH or MOH officers acted with improper motives. Yet it has asked for a COI ahead of the Committee's report and the conclusion of Police investigations."
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Govt will convene COI on Hep C cluster if WP is prepared to present evidence for allegations: MOH

The Ministry of Health (MOH) said in a statement on Sunday (Oct 25) that the Government will convene a Committee of Inquiry (COI) to investigate the cluster of Hepatitis C cases at the Singapore General Hospital (SGH), "provided the WP (Workers' Party) is prepared to lead evidence before the COI, to substantiate whatever allegations it might have".

Earlier in the day, WP's Central Executive Council member Leon Perera had said in a statement on the opposition party's website that the "outbreak and the Government’s response to it have exposed potential gaps in our public health protection protocols".

On Oct 6, SGH announced that 22 patients in its renal ward had contracted Hepatitis C. It also said the infection could have been a contributing factor in up to five deaths. Last week, the hospital said three more patients warded at its renal ward between January and June had tested positive for Hepatitis C. As of now, only one of the three is confirmed to be linked to the cluster as further tests are being conducted on the other two.

related: SGH Hepatitis C cluster: Workers' Party calls for COI to be formed

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Further Response to Ministry of Health’s (MOH) Press Secretary

We thank the MOH for its latest reply on this issue. All Singaporeans have a stake in an effective healthcare system. Everyone should feel confident that the risk of serious infection in our public healthcare facilities is at an absolute minimum. We note that both MOH statements on Sunday 25 October did not engage with our reasons for reconstituting the current review committee as a COI.

Being tasked to review the workflow of senior civil servants who regulate medical practice in Singapore may place the members of the review committee (who are currently serving in public healthcare institutions and the MOH itself) in an awkward position. For example, one of the questions the committee should address is the extended time lapse between the notification of MOH and the public announcement and initiation of containment measures.

It is in this context that we suggest augmenting the committee with retired clinicians and a current or former High Court Judge as well as appointing a retired healthcare administrator or clinician as co-chair.

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Hepatitis C outbreak: Inappropriate for WP to provide evidence should COI be convened, says Perera

Non-Constituency Member of Parliament Leon Perera said today (Oct 26) that it was “inappropriate” for the Workers’ Party to provide evidence should a Committee of Inquiry (COI) be convened as it “does not have inquisitorial or investigative powers to marshal evidence through subpoenas of records and witnesses”.

Yesterday, the WP had called for a COI into the Hepatitis C outbreak at Singapore General Hospital, saying that the current review committee — consisting of seven medical professionals from the ministry and public hospitals — may be in an “awkward position” because they will have to “critique the actions of senior civil servants”.

The Ministry of Health (MOH) responded on the same day, saying it will convene one if the WP is willing to provide evidence.

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Response to Ministry of Health’s (MOH) Press Secretary

We thank the MOH for their reply to our statement calling for a COI on the Hep C infection cluster at SGH.

The last sentence of the MOH statement refers to “whatever allegations it (the Workers’ Party) might have.” However the MOH statement itself observes that our statement did not impute any improper motives to SGH or MOH officers. Hence we find the reference to “allegations” that we may or may not have to be confusing, distracting and unhelpful. We have been consistently clear that we are not making allegations in this regard.

We are calling for strengthening of the review process by reconstituting the current review committee as a COI. The MOH statement does not address the points we made about the relative merits of a COI for investigating this matter in respect of:
  • the composition of the committee, which we have suggested should include more retired healthcare professionals and a person qualified to be a Judge, given that the committee’s remit has been broadened to include assessing MOH’s workflow
  • the value of the committee’s deliberations being made public, in terms of strengthening public confidence in our system
  • the necessity of tasking the committee to explicitly address the issue of the timeline in public notification and containment measures.
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WP calls for COI into hep C outbreak but MOH demands evidence first

The Workers’ Party (WP) said that it welcomes “the broadening of the remit of the independent review committee to include review of MOH’s procedures and actions” with regard to the hepatis C outbreak at the Singapore General Hospital (SGH).

However, the WP said that “the outbreak and the government’s response to it have exposed potential gaps in our public health protection protocols.”

“Aside from the risk to human life, the matter has considerable implications for Singapore’s status as an international business and tourism hub,” the WP said in a statement on Sunday.

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Is the WP Barking Up the Wrong Tree by Badgering Health Authorities on the Hepatitis C Outbreak?

Reading the letters have flitted back and forth rapidly, it seems you’d need more than kid’s glove to handle the Ministry of Health and Singapore General Hospital.

Both entities have been defensive and evasive all at once, to the point that asking questions has almost become a disease.

The Workers’ Party has thrown its hat into the fray, and has now been portrayed as “the opposition that’s turning this into a political issue again”.

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5 things we learnt from the exchanges between the government and Workers’ Party on the Hep C outbreak

There were several questions asked about MOH and SGH’s handling of the incident. As Singapore’s main opposition party, the Workers’ Party (WP) decided to ask more questions, specifically on the Hep C independent review committee.


Here are five things we have learnt from the exchanges between the Government and WP on the Hep C review:
  1. Leon Perera has a head start among the new MPs in terms of prominence
  2. WP’s persistence and political influence paid off
  3. The politics of impatience
  4. The defensive tone in the responses offered by the government
  5. On scoring political points
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WP calls for a COI on Hepatitis C cluster at SGH
Yahoo Newsroom - AFP News/Roslan Rahman - Singapore General Hospital

The Workers’ Party (WP) has called for the independent review committee looking into the outbreak of Hepatitis C virus infections at the Singapore General Hospital to be reconstituted as a Committee of Inquiry (COI) under the Inquiries Act.

Making this proposal in a media release on Sunday (25 Oct), Leon Perera, WP’s Non-Constituency Member of Parliament-elect, said the deliberations of the separate COI to investigate the December 2011 MRT breakdowns and the 2013 Little India Riots were made public, strengthening public confidence in the public transport and security systems, respectively.

“The Hepatitis C outbreak is at least as grave an incident as the MRT breakdowns and Little India riot, with serious implications for the public confidence of Singaporeans and foreign stake-holders in our vital national institutions,” Perera said.

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MOH DEMANDS WP PROVE ALLEGATIONS OF WRONGDOING BEFORE ASKING FOR INQUIRY

The Workers' Party (WP) has called for a Committee of Inquiry (COI) into the cluster of Hepatitis C cases at the Singapore General Hospital (SGH)

An Independent Review Committee has been appointed to review the cause of the incident and surrounding circumstances. To facilitate its work, the Review Committee has engaged additional resource persons, including international advisers, to ensure that it has access to all the necessary expertise to do its review thoroughly.

The Committee’s findings and recommendations will be made public. A Police report has also been filed and the Police are conducting investigations.

The WP statement is careful not to make any suggestion that SGH or MOH officers acted with improper motives. Yet it has asked for a COI ahead of the Committee’s report and the conclusion of Police investigations. If the WP believes that there are questions that the Committee cannot answer, or that any officer acted with improper motives, it should state so directly. The Government will convene a COI provided the WP is prepared to lead evidence before the COI, to substantiate whatever allegations it might have.


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Hep C Saga: Difference between review committee and committee of inquiry

The WP seemed to have pre-empt what MOH would say and had earlier declared in its statement, “Calls on the government to explain the delays in detail should not be met by calls to provide evidence of any inappropriate motivation.”

Did the WP overreact by calling for a COI to look into the matter?

To allow us to determine this, let us first take a look at what are the Terms of Reference (ToR) of the review committee set out by the MOH and how this compares to a COI under the Inquiries Act.

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International experts for Independent Review Committee

On the side-lines of a community event on Saturday (Oct 17), Health Minister Gan Kim Yong said that international experts will be invited to help and advise the Independent Review Committee (IRC) looking into the cause of the cases of Hepatitis C infections at the Singapore General Hospital (SGH) and to prevent future such incidences.

The committee was formed after the outbreak was made public, and is made up of seven medical professionals from the Health Ministry, Tan Tock Seng Hospital (TTSH), the National University Hospital, and Changi General Hospital.

According to Mr Gan, the committee will also look at the processes in both SGH and the Ministry of Health to identify whether there are any gaps and areas that need to be strengthened.

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That letter from the MOH to the Straits Times

Those with long memories of the Singapore government’s celebrated fights with journalists will tell you that the combative letter from the Ministry of Health to The Straits Times a week ago shows that its media policy is still stuck in the quagmire of the Lee Kuan Yew era.

And all this talk of a light-touch media policy is just that: Talk.

The government could have said in its response to ST assistant political editor Rachel Chang that it was premature to hint of a cover-up because an inquiry into the Hepatitis C scandal was on-going.

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THE WORKERS’ PARTY CALLS FOR A COMMITTEE OF INQUIRY ON THE HEPATITIS C CLUSTER AT SGH

The Workers’ Party welcomes the broadening of the remit of the independent review committee to include review of MOH’s procedures and actions.

Drawing the right lessons from the outbreak of the Hepatitis C virus infections at the renal ward of the Singapore General Hospital (SGH) is critical for Singapore. It is tragic that four individuals may have lost their lives as a result of these infections in one of our leading healthcare institutions, and one more person may have died for reasons possibly related to the infections.

The outbreak and the government’s response to it have exposed potential gaps in our public health protection protocols. Aside from the risk to human life, the matter has considerable implications for Singapore’s status as an international business and tourism hub.

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WP Queries Delay In Hep C Outbreak Announcement

The Workers’ Party extends its deepest condolences to the affected families and friends of the four patients who passed away since the outbreak of the Hepatitis C virus infections at the renal ward of the Singapore General Hospital (SGH) that affected 22 patients.

It was reported SGH had been aware of the infection cluster since early June 2015, but information surrounding the outbreak was only made public four months later, in October 2015. An outbreak of Hepatitis C is a potential public health risk. The knowledge of such an outbreak is relevant to all citizens as they weigh their treatment options.

The Workers’ Party would therefore like to seek clarifications from the Minister with regard to the standard protocol in releasing information on such outbreaks, whether or not they occur within a treatment facility. These questions are posed with a view to strengthen Singapore’s infection control protocols in the future.
  • Is there a timeframe within which healthcare institutions must report such incidents to the Ministry?
  • What does the Ministry believe is a permissible interval of time before the public is made aware of such incidents?
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Hep C-related communication must be made public: Chee Soon Juan
AFP News/Roslan Rahman - Chee Soon Juan, Secretary-General of the opposition Singapore Democratic Party, speaks to his supporters at Chua Chu Kang stadium during a rally ahead of Singapore's September 11 election, on September 3, 2015

Singapore Democratic Party (SDP) chief Chee Soon Juan has called for a "full and complete release" of all information relating to the Hepatitis C outbreak, including official correspondence such as emails and memos to address unanswered questions about the timeline of events.

This follows a letter to The Straits Forum by Health Minister Gan Kim Yong's press secretary Lim Bee Khim, which stated that Gan was only informed of the outbreak on 18 September. The letter was a response to a Sunday Times commentary which questioned if there were political motivations behind the timing of the release of the information.

Twenty-two kidney patients who were hospitalised from April to June were infected with Hep C during their stay. Eight patients died, with five deaths possibly linked to the virus. Almost 1,000 patients have also been screened for the disease. The Health Ministry has since reported the matter to the police, in order to ascertain if there was any foul play.

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Hepatitis C outbreak – why is the government afraid of convening a COI?

Minister Gan seems confused/doesn’t know his job or perhaps he is just trying to confuse the public with an outrageous substantiate-your-allegation smokescreen. Gan owes it to the family members of the deceased to convene a COI because procedural lapses by public officers have probably resulted in 8 deaths.

Gan should bear in mind that when the government convened the Little India riot COI, there wasn’t a single deaths resulting from police action and no allegation of improper police conduct. As regard the SMRT major disruptions COI there was no loss of life and no allegation of wrongdoing by SMRT’s Ferrari-driving CEO.

The first question on Gan’s mind should have been why was he informed only 6 months after the first incident in April. Members of the review committee are also perceived by Singaporeans as not independent and this will lead to more erosion of public trust of the government. This is similar to the review of AIM by MND which was another case of “own self check own self”.

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Can we have the truth?

The Hepatitis C virus infections at the renal ward of the Singapore General Hospital saga has shown the glaring ineptitude of the PAP Government in a cover-up of the medical mishap of such magnitude from the public until October  when the discovery was made in April/May. What really dismayed the public was the wide gap of misadministration when the MOH's Director of Medical Service knew of the existence of the cluster of 22 infections on 3 September and 18 September when the Minister for Health was informed of the cluster. And the public was only informed in October. It just is not the kind of confidence to be given to the public of the ineptitude of the Healthcare system when six inexplicable deaths were involved and the public only came to know about them so long after.

The attitude of the Minister for Health in all these ill-boded events seems so remotely in evidence. He seemed to accept the late reporting of the cluster to him as something normal and quite contented to allow his officials to handle the incident apparently without oversight. This seems to be supported by the letter of his Press Secretary to the Straits Times Forum on 20 October. There could be no question that the formation of the independent review committee could not have been done without his knowledge or imprimatur.

But is the independent review committee really the answer to the task of thoroughly investigating the unfortunate outbreak of Hepatitis C virus infections at the renal ward and the inexplicable inordinate delay in announcing it to the public? The composition of the committee is such that it may not be able to act freely and independently without awkward constraints. It is hardly in the public interest if its report is not independent in the strictest sense.

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SGH hep C outbreak: 2 infected patients part of affected cluster
This brings total to 25 patients infected

The two Singapore General Hospital (SGH) patients who had earlier tested positive for hepatitis C have been found to be part of the affected cluster, bringing the total number of patients infected in the hospital’s hepatitis C outbreak earlier this year to 25.

“Phylogenetic studies done for the two patients who were tested positive as announced on 23 October showed that they are part of the affected cluster,” said SGH’s Chairman of the Medical Board Fong Kok Yong in a statement issued by the hospital today (Oct 26).

The patients were admitted to Wards 64A and 67 from April to June 2015.  “We will provide the patients and their family with our full support and ensure that the patients receive timely and appropriate care,” said Prof Fong.

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related:
6 drug resistant TB cases in AMK
Hepatitis C: Chronic & Acute infections
Hepatitis C cluster @SGH: 22 infected, 4 have died
Three recent healthcare outbreaks in Singapore
Staff Disciplined after Hepatitis C Outbreak