The Straits Times says

Keep patients posted on fee increases

While saving taxpayers' money is part of the general remit of civil servants, it would be unrealistic to expect them to contain all costs unremittingly. And while they are "supposed to be able to communicate with the public and communicate well", to quote the Civil Service College, one would forgive them if particular efforts fall short now and then. But that leniency would be tested when fees are ratcheted up and no effort is made to explain or justify the increases.

The issue arose recently when no announcements were made about the raising of the consultation fees charged at polyclinics. One group, the National Healthcare Group, raised its fees in April, while the other, SingHealth, did so earlier this month. The two healthcare groups run the 18 polyclinics here, which cater to the primary healthcare of about 20 per cent of the population, mainly lower-income groups.

Generally, it behoves public sector bodies to explain to the public what is driving costs up, and not wait to be asked. When this newspaper inquired about the polyclinic fee hike, it was attributed to "rising operating costs such as utilities, infrastructure, equipment upgrades and inflation". The healthcare groups also added that "the total bill continues to be affordable" to patients and no one would be turned away if he or she lacked the means to pay.

To be sure, the increases are relatively small in this instance - about 60 cents to 90 cents more per consultation for an adult. But the principle of due notice ought to apply whether fee revisions are small or big. This would serve the purpose of preparing users to meet a new fee schedule. Indirectly, it can also help to reinforce an organisational discipline of doing the utmost to hold fees at a level that people have already adjusted to. Without a restraining hand, fee hikes across disparate agencies could add up to a significant sum and bite into the budgets of those who have to watch their recurrent spending closely, including sandwiched householders and retirees.

Increases affecting public transport fares, taxi tariffs, university fees, utility charges and tax rates are usually accompanied with explanations and might even be debated publicly. Private sector tactics to dodge such attention include product down-sizing, dynamic pricing (for example, to exploit demand peaks), complex tariffs, a system of veiled surcharges and a gradualist approach to higher prices. Some might offer a short price freeze as a precursor to future increases without supplying any data to justify their moves.

Public services, however, need to be costed and priced far more transparently, of course - where possible, with estimated changes over time to facilitate the budget projections of end-users. Healthcare costs, in particular, ought to be managed openly to eliminate the guesswork.

A version of this article appeared in the print edition of The Straits Times on July 16, 2015, with the headline 'Keep patients posted on fee increases'. Print Edition | Subscribe