In a Facebook post on Sunday (30 Sep), Mr Inderjit Singh wrote to say that he was glad Ministry of Health (MOH) has finally decided to restrict medical tourism in public hospitals.
Just last week, MOH told public hospitals to terminate all contracts with foreign agents who refer patients from overseas. As TOC understands, the practice of paid referral for foreign patients to be warded in local hospitals, has been going on for decades. "I was glad to read today's ST headlines that reported that MOH has decided to now restrict medical tourism in government restructured hospitals," said the former Member of Parliament from People's Action Party. Mr Singh who served as a MP for 18 years, is of the view that public hospitals should serve the interests of Singapore residents first and leave medical tourism to private hospitals.
"I highlighted this in my FB post in 2014 which I have extracted here. Medical Tourism should be left to private hospitals only and government hospitals should serve only our resident population," he added.
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MOH took four years to accept ex-MP Inderjit Singh’s call that Govt hospitals should only serve Singapore residents
The Ministry of Health reported late last week that it has instructed all Government hospitals to terminate their contracts with foreign agencies that refer patients from abroad to local hospitals. According to news reports, foreign agents work with local hospitals to refer foreigners to seek treatment in Singapore. These agents, who assist potential patients to find a local hospital and help to make specialist appointments, earn a hefty cut of up to 8 per cent of a foreign patient’s hospital bill as a commission fee for their services. Some of the Government hospitals here that have used such foreign agencies include the Changi General Hospital, Singapore General Hospital and the National University Hospital.
One of the largest such foreign agencies is based in Jakarta, Indonesia and has been referring thousands of foreign patients to Singapore public hospitals for over a decade, boasting that it is an “official partner” of several government hospitals here. While thousands of foreigners came to Singapore as part of this “medical tourism,” some Singaporeans were left without a bed or even a washroom during the public hospital bed crunch across Singapore, in recent years.
In one notable case in 2014, CGH pitched tents on its hospital grounds to accommodate patients after reaching 100 per cent bed occupancy and despite renting wards from private hospitals to hold patients.
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Inderjit Singh 29 September at 21:57
I was glad to read today's ST headlines that reported that MOH has decided to now restrict medical tourism in government restructured hospitals. I highlighted this in my FB post in 2014 which I have extracted here. Medical Tourism should be left to private hospitals only and government hospitals should serve only our resident population.
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Inderjit Singh 26 May 2014
Response to the President Address
At the Re-Opening of 2nd Session of Parliament May 2014
19. Take the case of the bed crunch at hospitals earlier this year. With such disequilibrium, why then promote medical tourism for government restructured hospitals? I was shocked to discover last year that all our government restructured hospitals are involved in promoting medical tourism around the region. Shouldn't the services in our government restructured be for Singaporeans and residents first? That is one example of poor planning and complacency that bed demand will never exceed supply.
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MOH puts a stop to foreign patient referral contracts
The Health Ministry (MOH) has told public hospitals to terminate all contracts with foreign agents who refer patients from overseas, after The Sunday Times highlighted the existence of such a practice. The Sunday Times learnt that the National University Hospital (NUH), Singapore General Hospital (SGH) and Changi General Hospital (CGH) have such contracts with third-party agents.
In one case, an Indonesian agent was contracted to provide NUH "administrative services". For every foreign patient accepted by NUH, the agent is paid 8% of the patient's hospital bill, excluding doctors' fees.
If patients brought in by the agent spend more than $500,000, the agent gets an additional 2% cut for every dollar above the cap. If the fees go past $1 million, the agent gets an additional 4% for every dollar above that.
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MOH didn’t know about medical referral fees until now?
MOH didn’t know about referral fees that has been going on for years?
This has been going on for decades. So, arguably, aren’t you surprised by “(MOH) has told public hospitals to terminate all contracts with foreign agents who refer patients from overseas, after The Sunday Times highlighted the existence of such a practice”?
This is arguably even more ludicrous, given that the payment of referral fees to third parties has been barred since December 2016 (“Doctors barred from paying percentage of fees to 3rd-party agents”, Today, Dec 14, 2016).
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The flaw in privatising public services
I am sure many Singaporeans are as flabbergasted I was upon learning that public hospitals were paying agents to solicit foreign patients (The Straits Times, 30 Sep 2018, “MOH puts a stop to foreign agent referral contracts”). Hospitals that are set up with public funds, ostensibly to provide healthcare to Singaporeans, are instead trying to make profits by soliciting foreign patients. This raises a whole host of anxious questions: Do I, as a subsidised Singaporean patient, get the same quality of service? Are there technologies available to foreign patients that are not available to me because I am not rich? In the cases of conflicting demands for the same resources – doctors, operating theatres, diagnostic equipment, am I queued behind wealthy full-paying foreigners?
The fact that the Ministry of Health has put a stop to this practice may perhaps make these questions moot. However, reacting to this one instance misses the underlying problem behind many of negative outcomes for Singaporeans.
Our government’s approach of privatisation and assigning a profit motive to providers of public services creates the wrong incentives for the leaders. In order to meet the Key Performance Indicator (KPI) of making money and being profitable, they lose the sense of mission behind serving the public, and making Singapore a better place for Singaporeans.
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Citizens' healthcare takes priority over medical tourism
Dr Jeremy Lim's appeal to revive medical tourism should not be considered in government hospitals, as the present healthcare infrastructure already has trouble meeting demand ("Why we must have foreign patients"; last Wednesday).
As it stands, our government hospitals, community hospitals & national specialist centres are struggling to cope with increasing demand for specialist care and in-patient care, with occupancy rates almost at full capacity.
Given the persistent bed crunch in hospitals, how could government hospitals accept more foreign patients? With the impending commencement of MediShield Life, we would likely see a rise in citizens switching from private hospitals to government hospitals, and increased demand for Class B1 & Class A beds in government hospitals.
related: SingHealth, NUH to stop using agents by end of Oct
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$4.3b revenue likely for Singapore from medical tourism this year
Singapore is expected to see some 850,000 foreign patients bringing in US$3.5 billion (S$4.31 billion) worth of revenue from medical tourism this year, after foreign patient numbers grew at a compound annual growth rate of 15% over the last 3 years, according to a report.
Across the Asia-Pacific, the number of medical tourists visiting the region is expected to grow by 15-20 per cent annually until 2015.
"Cost-effective treatment is a significant driver for medical tourists to seek healthcare treatment," said the Frost & Sullivan (India) report, commissioned by Religare Health Trust (RHT) which is seeking a listing on the Singapore Exchange (SGX). Frost & Sullivan also highlighted that the waiting time in Western countries for elective surgery can span two to three months whereas in South Asian countries, it is limited to two to three weeks.
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Asia's leading destination for advanced medical care
International patients come to Singapore each year for a whole range of medical care from health screenings to high-end surgical procedures in specialties such as cardiology, neurology, oncology, ophthalmology, organ transplants, orthopaedics, and paediatrics. In 2013, medical expenditure generated from travellers was S$832 million.
With well-respected doctors trained in the best centres around the world, internationally-accredited hospitals and speciality centres, medical travellers to Singapore can be assured of quality treatment.
As a multi-faceted medical hub, Singapore attracts a growing number of medical professionals and multi-national healthcare-related companies from various parts of the world to share and exchange their expertise, conduct healthcare-related research and training as well as host international conferences and events.
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Top 10 Medical Tourism Destinations in the World
Singapore is one of the most developed countries in the world, maintaining the top spot in the World Health Organization’s ranking of healthcare in Asian countries. According to Bloomberg, Singapore ranked at the top of countries with the most efficient healthcare systems in 2014, above 50 other countries. Gleneagles Hospital is one of the best hospitals in Singapore, offering excellent medical services state-of-the-art facilities and well-trained specialists.
Seeking health care in Singapore saves a patient 25% to 40% of what they would have spent on the same services in the United States. As the medical tourism market becomes more competitive and countries invest more in it, these countries are likely to remain at the top while more countries spring up in the race to being key players in the industry of medical travel.
Patients seeking medical treatment abroad should not look far away from these countries, as each promises quality care and a relaxing ambiance at an affordable cost. However, patients are advised to make adequate research on the countries and hospitals they seek to visit for treatment checking for international accreditation of the hospitals, quality and standard of care provided, and the skills of the needed medical professionals.
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Hospitals facing severe bed crunch take unusual steps
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:
related:
Ex-MP Inderjit Singh was against medical tourism in public hospitals
Hospitals Facing Severe Bed Crunch
"Buffet Syndrome” leading to rising healthcare costs
Is the Rise of Healthcare Cost Unsustainable?
Tweaks in Our SG Healthcare
Health Cost
