Patients Accessing Subsidised Care at Public Hospitals and Specialist Centres

Dr Tan Wu Meng asked the Minister for Health (a) over the past three years, how many Singaporeans at public hospitals and specialist centres have requested to change from a paying class to subsidised care; (b) how many of such patients have accessed paying class care through (i) employment-linked insurance or (ii) personal integrated shield plans; and (c) of these, what proportion subsequently received subsidised care at the same rates as de novo subsidised patients.

Upon admission, Singaporeans can choose to be admitted into private or subsidised ward classes regardless of their means and hospitals provide financial counselling to patients to help them select a ward class appropriate to their needs.

To receive subsidised specialist outpatient (SOC) treatment, a patient needs a referral from a subsidised inpatient ward class, emergency department or a polyclinic. Hence, patients who opt for private ward will be considered as private patients and charged unsubsidised rates should they require follow-ups at the SOCs after discharge.

Nonetheless, should they need to switch to subsidised care due to financial concerns, for both the inpatient and SOC settings, they can approach the staff at our public healthcare providers for assistance. The providers assess such requests on a case-by-case basis, taking into consideration patient’s financial circumstances and ability to continue to pay unsubsidised rates. For patients facing genuine financial difficulties, the providers will exercise some flexibility and allow them to switch to subsidised service and pay subsidised rates.

In the past three years, on average, we have received about 2,400 requests a year to switch from private to subsidised inpatient or SOC care, out of a total of 80,000 admissions from private wards and 1,000,000 private SOC attendances a year. About 70% of these requests are approved.

Patients with Integrated Shield Plans make up about 35% of all requests in the inpatient setting. Our public healthcare providers’ administrative records do not capture whether a patient’s insurance scheme is employment-linked.

I would like to assure the Member that our public healthcare providers will consider, among other things, changes to a patient’s circumstances, such as loss of income or private insurance coverage, in assessing whether to accede to requests to switch to subsidised care. Patients facing financial difficulties should approach the medical social workers to discuss their options.