Forum: Have 24-hour clinics beside hospitals to reduce A&E waiting time
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Nearly 40 per cent of attendances at public hospital emergency departments (EDs) are for non-urgent, non-life-threatening conditions, according to the Ministry of Health (MOH). Despite years of public education and initiatives such as GPFirst and NurseFirst, EDs remain persistently overcrowded.
This suggests the issue is not public awareness, but access.
People often turn to EDs because they are open 24 hours, well-equipped and conveniently located. Rather than trying to divert patients away from hospitals entirely, MOH should meet this demand more strategically by having 24-hour family medicine clinics beside public hospital EDs.
Under this model, patients with non-urgent conditions can be directed to the adjacent clinic, while true emergencies proceed to the ED. This would shorten ED waiting times, allow emergency physicians to focus on critical cases, and ensure non-urgent patients still receive timely care.
MOH already has a useful policy lever. Since May 2025, the Price-Quality Method, introduced with HDB, allocates clinic space based on quality rather than the highest bid. For clinics located next to EDs, MOH can add two requirements: the ability to provide comprehensive care across all age groups, and 24-hour operations.
Operating round-the-clock clinics is costly, particularly due to after-hours staffing. Instead of direct subsidies, the authorities can support these clinics through lower rental rates, making the model financially viable while maintaining care standards.
This is a pragmatic, patient-centred solution. It aligns care with urgency, improves ED efficiency, and acknowledges how patients actually use the healthcare system, especially after hours.
Desmond Wai Chun Tao (Dr)
