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Singapore Budget 2014: Hospital bed crunch comes under fire

Patients waiting for a bed on Jan 10, 2014, at Khoo Teck Puat Hospital’s emergency department, which has 18 cubicles. The recent hospital bed crunch raises serious questions about patient safety and the adequacy of health-care infrastructure, said
Patients waiting for a bed on Jan 10, 2014, at Khoo Teck Puat Hospital’s emergency department, which has 18 cubicles. The recent hospital bed crunch raises serious questions about patient safety and the adequacy of health-care infrastructure, said Workers' Party chief Low Thia Khiang in a hard-hitting speech during the debate on the Health Ministry's budget on Wednesday, March 12, 2014. -- ST PHOTO: KUA CHEE SIONG

The recent hospital bed crunch raises serious questions about patient safety and the adequacy of health-care infrastructure, said Workers' Party chief Low Thia Khiang in a hard-hitting speech during the debate on the Health Ministry's budget on Wednesday.

Mr Low (Aljunied GRC) said the bed crunch was an example of Third World problems in First World Singapore and added: "One certainly hopes that Singapore does not make history by going from Third World to First, and back to Third within one generation."

While acknowledging the bed crunch problem is not new and tends to wax and wane, he said the problem has become severe enough to "warrant MOH to take a hard look".

The bed crunch was also criticised by the chairman of the Government Parliamentary Committee for health, Dr Lam Pin Min (Sengkang West), even as he noted the many accolades that Singapore's health-care system has won for its quality and efficiency.

Dr Lam said: "While we seek to add more beds to the system in the form of acute and community hospitals, let us not lose sight of the bigger picture.

"To me, the bed crunch also points to the fact that we have not effectively deployed our resources and ensured right siting of care."

Responding, Health Minister Gan Kim Yong stressed that building capacity has been a key focus of Singapore's health-care policy. From 2003 to 2013, beds in public acute and community hospitals as well as in nursing homes increased by over 30 per cent, he said.

The Healthcare 2020 master plan also lays out moves to add more capacity to meet long-term demand, said Mr Gan. For instance, the new Ng Teng Fong General Hospital and new integrated building at Changi General Hospital will open at the end of this year. Sengkang General Hospital will also be ready in 2018.

Hospitals are also taking steps to manage rising demand in the short-term. Last year, more than 300 beds were added to existing facilities, while restructured hospitals have leased some 50 beds from the private Parkway East Hospital and Westpoint Hospital. Further collaborations with other private hospitals are also being explored.

On the bed crunch, Mr Low noted that many of the restructured hospitals are accredited by America's Joint Commission International, which recognises that they have met certain standards of patient safety which include having minimum distances between patient beds and adequate facilities to reduce hospital-acquired infections.

With news of hospitals housing patients along corridors or in tents making headlines recently, he asked if these moves were acceptable to the JCI committee.

And with the crunch more prevalent in subsidised beds, Mr Low asked if non-subsidised beds could be converted to subsidised beds as this would take less time than building new hospitals. Mr Gan replied that converting private beds to subsidised beds has its contraints.

The National University Hospital converted some private beds to subsidised ones last year and lost the use of the wards for more than three months as a result, he said. The process involved reconfiguring the space and carrying out renovations like re-wiring and piping to add medical gas points, nurse substations and other infrastructure.

"As a government, we must also ensure that our hospitals can meet the needs of all Singaporeans, both private and subsidised patients and we need to strike a fine balance," said Mr Gan. When subsidised beds are filled up, hospitals will allow patients to use higher bed classes if necessary, he said.

"Hence, these private beds are already acting as potential capacity for patients when bed demand is high."

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