Why was daughter referred to hospital with no children's A&E?

On Jan 15, my 12-year-old daughter, accompanied by her grandmother, visited the Choa Chu Kang Polyclinic as she had a fever and felt like there was "something" in her throat.

She was worried, as she had swallowed a fish bone during recess at school the day before.

She saw a doctor and was referred to the accident and emergency (A&E) department of Ng Teng Fong General Hospital (NTFGH).

My wife rushed back from work to take her to the hospital.

When they reached the hospital at around 3pm, a nurse told them that NTFGH did not have a children's A&E department.

Since they were already there and had a referral letter for that hospital, my wife decided to take a gamble and wait for the doctor's diagnosis.

When they saw the first doctor, my wife specifically mentioned that my daughter was 12.

The doctor did not mention anything about not treating children.

They later saw a second doctor, who said that an X-ray would be done but, as the thickness of the scope that goes down a child's throat differs from that for an adult's throat, she had to contact another doctor.

They then got a letter of referral from NTFGH to the National University Hospital (NUH).

I took them to the NUH children's A&E department.

We arrived at 7pm. My daughter underwent a scope diagnosis on her throat and was discharged with the appropriate medication at around 11.30pm.

The polyclinic should have known that NTFGH does not have a children's A&E department and cannot treat children.

But it seemed that no one at the polyclinic realised the mistake.

We were told that NTFGH has already sent a circular to all public hospitals to say that it does not have a children's A&E department.

The counter staff my wife spoke to said that there have been many incidents of children being referred to the hospital.

Why does this happen so often?

Had the patient been in a life-threatening situation, she could have died while going from one hospital to another.

Andrew Yap Jong Teng

Hospital, polyclinic reply:

We thank Mr Andrew Yap Jong Teng for his feedback.

Choa Chu Kang (CCK) Polyclinic has since contacted Mr Yap to explain the referrals.

All patients seeking emergency care at public hospitals' emergency departments will be attended to in a timely and appropriate way.

Given Mr Yap's daughter's condition, CCK Polyclinic sent her to the nearest hospital, Ng Teng Fong General Hospital (NTFGH), and she was attended to by doctors from the emergency and ear, nose and throat departments.

The doctors assessed that a further examination of her nose and throat would be needful to determine the cause of the discomfort.

To do so safely, a paediatric-sized scope would be required.

Hence, NTFGH arranged with the National University Hospital (NUH) to transfer the patient safely for further care.

This is part of the collaborative arrangement that NTFGH has with NUH to transfer paediatric patients who require specialised care or inpatient services to NUH.

NTFGH had informed the mother of the possibility of a transfer to NUH for further care or admission at the point of registration and triage.

We apologise for the inconvenience placed on Mr Yap's family over the transfer.

We assure Mr Yap that CCK Polyclinic and NTFGH take emergency cases seriously, ensuring that these patients are attended to in a safe and appropriate way.

Quek Lit Sin (Dr)
Head, Emergency Department
Ng Teng Fong General Hospital

Richard Hui (Dr)
Head, Choa Chu Kang Polyclinic
National Healthcare Group Polyclinics

A version of this article appeared in the print edition of The Straits Times on February 15, 2016, with the headline 'Why was daughter referred to hospital with no children's A&E?'. Print Edition | Subscribe