The Singapore Medical Council is absolutely correct in saying that whatever fee the patient pays "must reflect the fair work done by third parties in handling and processing the patients" and "must also be transparent to the patient" ("Doctors barred from paying agents percentage of fees"; Dec 14).

Indeed, patients should not be asked to pay more, as fees are already high today.

I relate this issue to seeing a doctor at a polyclinic.

There are times when we are told by the doctor to go to a specialist at a hospital because the polyclinic does not have the expertise or instruments to do what is needed.

A referral letter is written and a "consultation fee" is charged by the polyclinic.

Notably, the fee charged by the hospital specialist would be considerably higher if one were to walk in without a referral letter, hence making visiting the polyclinic first a necessity for many patients.

The polyclinic consultation fee or referral fee should be deducted from the final bill when the patient receives actual treatment at the hospital.

This is one way to reduce, albeit a little, the escalating outpatient cost we have to bear.

Daniel Chan Wai Piew