Delay in Opening of Ng Teng Fong Hospital

Madam, first, let me assure Members that besides Ng Teng Fong General Hospital, the other hospital projects under construction are currently on track.

The key reason for the delay of the Ng Teng Fong General Hospital was due to a delay in the building's exterior works. Let me explain. The building's exterior works, or referred to as the façade, comprise the functional elements such as windows, glass panels, air vents and cladding. These functional elements need to be installed so that the building is protected from the wind and the rain to allow internal building works and installation of critical equipment to proceed without the risk of damage by weather.

The Ministry of Health (MOH) and Jurong Health Services, which are overseeing the project, have been monitoring its progress since construction of the hospital started in 2012. Earlier this year, they detected that the progress of the exterior works had fallen behind schedule. The façade subcontractor had experienced problems with the production of façade components in its factory in Thailand. Jurong Health Services initiated discussions with the subcontractor to address these problems. Unfortunately, the curfews imposed in Thailand in June this year, did not help. This has created further disruption to the production and installation of the facade.

To put the construction back on track, Jurong Health Services had worked with the main contractor and façade subcontractor to assess the production status, and made plans for the contractors to re-schedule their production to meet the project timeline. Unfortunately, despite the additional measures taken, the overall construction programme has been delayed and this has affected the progress and delivery of the project.

Since the start of the year, a task force led by Assoc Prof Benjamin Ong, our Director of Medical Services (DMS), has been working with public health clusters to actively manage the demand and supply of hospital beds nation-wide. To mitigate the impact of the delay, I have asked DMS and his task force to ensure that our bed capacity is sufficient to meet our needs, especially during this period of delay.

Several measures have been implemented. Firstly, Jurong Health Services will continue to operate the 330-bed Alexandra Hospital until the new hospital is ready. In addition, another 150 beds from National University Hospital and Singapore General Hospital will be added to cope with any surge in acute care demand. The new Changi General Hospital-St Andrew's Community Hospital Integrated Building will also progressively open from December this year, as scheduled. These measures, along with other ongoing capacity-related initiatives, will add about 400 acute and community hospital beds to the system this

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year.

Separately, MOH continues to work with the hospitals to improve the processes of care delivery to facilitate timely discharge of patients to return home or to other appropriate care settings, including community hospitals or nursing homes. For example, the short-stay observation wards at Emergency Departments allow suitable patients to be managed and safely discharged once their condition stabilises, without the need for admission.

We have also put in place programmes to provide support for patients post discharge, such as the Interim Caregiver Service (ICS), which provides temporary help for patients who are fit to go home but whose discharge may be delayed because their families need time to work out their long-term caregiving arrangements. Over 400 patients have benefited from this service since January this year. In addition, some 800 homecare places have been added since the beginning of this year and we will also be adding new nursing home capacity in the next few years.

We have also stepped up efforts to encourage patients to visit general practitioners (GPs) for non-emergency conditions, so that Emergency Departments can focus on those who really need emergency care. For example, the Eastern Health Alliance (EHA) launched the GPFirst initiative in January this year, where EHA works with GPs in the east to encourage the public to tap on GPs to manage non-emergency cases. Almost 160 GP clinics are now participating in the scheme.

The MOH will actively work to ensure that the overall capacity in the national system is adequate to meet our needs.

I thank the Minister for the reassurance. I have three supplementary questions, Madam. Can the Minister share more on the progress and outcome of the collaboration with the private sector to increase bed capacity? Will this be a long-term solution? Will there be enough resources – doctors, nurses, therapists – to cope with this increase in bed capacity, as well as the provision of home-based medical services?

Madam, during my speech in the Committee of Supply (COS) debate, I had mentioned that we are in the process of developing a collaborative framework with the private sector. This takes several forms. With regard to the GPs, we have enhanced Community Health Assist Schemes (CHAS) over a period of time progressively and now, the GPs are participating very actively in our CHAS programme.

On the hospital side, we are also collaborating with several private hospitals. We are still in discussion with some private hospitals. Therefore, because we are still in discussion, I

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will not be able to share some of the details of the discussions. But I can share with Members some of the collaborations that are already ongoing.

For example, the National University Hospital has a collaboration with the West Point Hospital to provide additional beds for patients who are stable and are recovering from their illnesses and may require rehabilitation. So, they are now located in the West Point Hospital. Tan Tock Seng Hospital has also been working with a private hospital to explore the possibility of managing some of the patients. Changi General Hospital has a collaboration with Parkway East Hospital to look after some of its patients to provide additional bed capacity to Changi General Hospital. We are, as I have said, continuing our discussion with various private-sector operators on additional collaboration.

These are pilot in nature for the time being because we are venturing into a new collaboration. Once the details are worked out, once they are able to be sustainable, we do intend to see how we can work out a longer term relationship. This is to ensure that the private sector service providers will continue to play an important role in delivering healthcare as part of a national system. Although we have a public healthcare system and a private sector system, at the end of the day, it is one integrated system. We do intend to continue to find ways to tap on the capacity that is available in the private sector.

With regard to the Member's question about availability of manpower resources, this is a factor that we will take into consideration as well when we develop collaborations with the private sector to see where there is available capacity in the private sector, and we will tap on them. In some collaborative framework, we tap primarily on their bed capacity and the public hospitals provide the manpower. In other collaborations, we also tap on the manpower resources of the private hospitals. So, these models are quite flexible and adaptable, and we will look at the resources available to optimise the balance.

Mdm Speaker, in the Minister's reply just now, he did not mention anything about Khoo Teck Puat General Hospital. I would like to ask whether there is anything that can be done to reduce the waiting time for those patients waiting for a bed. According to my residents' feedback, some of them have to wait for more than 24 hours and some waited for more than 48 hours to have a bed. So, is there anything that can be done in a shorter time while waiting for the building of new hospitals?

I thank the Member. It is an important question. For the hospitals, whether it is Khoo Teck Puat Hospital or other public hospitals, they work very actively in the Emergency Department to manage the patients proactively. So, even while they are waiting for the allocation of beds, care is not compromised. The doctors work in teams to manage

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their condition and to deliver timely care and treatment.

At the same time, many hospitals, including Khoo Teck Puat General Hospital, have also been working proactively with the community, with patients, especially those who are known to have frequent admissions, to manage them in the community so as to reduce the need for attendance at the Emergency Department as well as to reduce the need for admission.

We need to work at this issue with a multi-prong approach, not just creating more beds, but also to improve the process and minimise the need for admission and for hospital beds. If we are able to keep our patients healthy, for a start, if not, even with conditions, we try to minimise the progression of their conditions so that their conditions are better managed to reduce the need for admission.

For some patients who have fall risks, we will also work with the community and the therapists to make sure that these patients are trained to be able to manage themselves to minimise the fall risks. And with the Enhancement for Active Seniors (EASE) programme introduced by HDB, we are able to modify the homes to render the home safer for some of these patients who are recovering from illnesses to minimise the need for admission.

I just want to ask the Minister to answer the last part of my Parliamentary Question on whether the other hospital projects are on course – the Yishun, as well as Jurong Community Hospitals. Are they on track for 2015?

Madam, as I said at the beginning of my reply, other than the Ng Teng Fong General Hospital, the other hospital projects under construction are currently on track.