We refer to Ms Salma Khalik's commentary (Are MediShield Life payouts lower than subsidised fees?; Jan 4).

The Singapore National Eye Centre (SNEC) reviews and makes adjustments to its charges periodically to strike a balance between cost recovery and patient affordability. The cost for the most common procedures, such as cataract and glaucoma surgery, are closely monitored to ensure patients can pay with Medisave and make minimal cash outlay.

As a tertiary referral centre, less common but complex cases, with high risk of complications, would require the expertise of senior and experienced surgeons.

Such surgery requires longer operating time. For Mr Seow Ban Yam's case, a duct drainage operation was required for both eyes. The surgery took three hours.

Duct drainage surgery is not common. Of the 42,000 procedures SNEC performed in 2017, there were only seven such cases.

Research and training are important pillars of SNEC's mission.

Its budget for research and education are funded separately by government grants, philanthropy and other income totally unrelated to clinical revenue from subsidised patients.

SNEC recognises that it could do more frequent cost reviews to close prevailing gaps between current cost burden of patients and what it charges for financial sustainability.

With the latest review of SNEC's charges to better align a wider range of procedures with Medisave and MediShield claim limits, patients requiring complex operations of higher surgical table codes will see reduced charges, including that which Mr Seow underwent.

SNEC will introduce the fee revisions from March 1.

No patient requiring care, whether for simple or complex conditions, will be denied treatment due to an inability to pay.

Our staff are able to advise on the various government financial assistance schemes for patients who need them and these are further supplemented by philanthropic funds raised by SNEC for needy patients.

Charity Wai (Ms)

Chief Operating Officer

Singapore National Eye Centre