Futile attempts to buy medicine despite prescription

I read Dr Hajime Ichiseki's letter with interest ("Better outcomes with patient-centred eldercare"; Sept 3), particularly on how Japan allows its citizens to see any healthcare provider at any time, without proof of medical necessity.

In Singapore, I have experienced a closed system, where each hospital sets firm boundaries.

My aged mother has had dementia for more than 15 years, and we have been caring for her at home.

She has been under the care of a geriatrician at Tan Tock Seng Hospital (TTSH), and has had homecare support from the Care For The Elderly Foundation.

On Aug 4, she was diagnosed with urinary tract infection and was prescribed an antibiotic by a doctor from the Care For The Elderly Foundation.

I went to the TTSH pharmacy to purchase the medicine but was told that as it was a restricted drug, I needed to get a doctor from TTSH to prescribe it.

I sought the TTSH geriatrician's help. His assistant told me to buy the medicine from Guardian, Watsons or Unity. But these pharmacies did not carry the amount of the antibiotic that my mother needed.

So, I went back to TTSH and explained the situation to the pharmacist. She kindly offered to contact the Care For The Elderly Foundation to get the doctor who had prescribed the medicine to sign an indemnity form so that TTSH could release the medicine.

Unfortunately, when she contacted the Care For The Elderly Foundation on Aug 26, the doctor who had prescribed the medicine had emigrated, and no other doctor was willing to sign the form.

The Care For The Elderly Foundation was recommended to us by TTSH. Why, then, does it not support prescriptions given under the scheme?

I tried all the major hospitals and polyclinics, but none would sell the medicine to me, as all required a prescription by their in-house doctor.

How can a hospital refuse to sell to a patient medication prescribed by a certified medical practitioner?

Until today, I have still not managed to purchase the medicine for my mother. Her infection has worsened and we have to submit a new urine sample to the lab to determine another course of treatment. My fear is that this whole process may start again.

Our medical system should be more integrated and better coordinated. This is the only way to ensure our aged parents are well taken care of.

Kaw Jik Hoon