SINGAPORE - A new law to better regulate healthcare services in an evolving landscape was approved by Parliament on Monday (Jan 6).

The Healthcare Services Bill will give the authorities powers to license new models of care, such as telemedicine and private ambulance services, in order to safeguard the welfare and safety of patients.

It will replace the Private Hospitals and Medical Clinics Act, first enacted four decades ago, which licensed healthcare providers based on their physical premises.

Senior Minister of State for Health and Law Edwin Tong told the House the need for change is long due, given the rapidly evolving healthcare landscape and the increase in age-related illnesses and chronic diseases in Singapore's ageing population.

As care moves beyond the hospital to the community, the change will also allow for traditional healthcare settings to integrate other services, he added.

For instance, nursing homes will now be able to provide dementia care and geriatric clinical services at one location. Hospitals or medical clinics can provide telemedicine beyond services at their premises, offering more convenience and cost savings to patients, especially the aged sick with minor ailments or who are following up on chronic conditions.

Allied health services, which refer to services provided by a diverse group including dietitians, physiotherapists and speech therapists, will be covered under the new law. So will traditional medicine practitioners as well as complementary and alternative medicine providers.

However, the Ministry of Health (MOH) is taking a calibrated approach to progressively license healthcare services and has no plans to license these services as yet. "If significant patient safety risks emerge, we can then decide to license these services," said Mr Tong.

Beauty and wellness service providers, who do not diagnose, assess or treat diseases and are of minimal patient safety risk, fall outside the scope of the Bill, said Mr Tong.

To prevent public misperception that such unlicensed services are endorsed and licensed due to their close proximity and association with licensed services, they will not be allowed to co-locate with or within a licensed service, unless approval is given.

For instance, a spa cannot be co-located with a medical clinic.

Exceptions are made for allied health services and other services that complement licensed medical services.

For instance, a physiotherapist can be co-located with an orthopaedic clinic.

Other new provisions aimed at safeguarding patient safety and welfare include "step-in" powers that will allow MOH to temporarily take over the operations of residential healthcare service providers like nursing homes, should they be in serious financial trouble.

The new law will be implemented in three phases from early 2021 to the end of 2022 to give service providers time to prepare for the regulatory requirements. New provisions will first apply to current clinic laboratory licensees, followed by current clinic licensees and private ambulance operators, which are new licensees, in the second phase.

In the third phase will be current hospital licensees and other newly regulated services like telemedicine as well as new, innovative and potentially costly treatments like proton beam therapy, a new form of radiation therapy that uses protons to treat cancer.

Meanwhile, MOH said there are several initiatives in place to ensure new licensees are ready, such as the voluntary accreditation scheme (VAS) for private ambulance operators. More than 50 per cent have come on board the VAS, and MOH will be working with the VAS ambulance operators to develop and publish the range of fees charged, so that consumers are able to make better informed choices of the providers to use.

Twelve MPs spoke during the debate, and raised various concerns such as whether the law will help patients make better informed choices. Some members also asked whether it will place an unnecessary burden on licensees and drive up healthcare costs.

The law has been two years in the making. A draft version was put up online in January 2018 and public feedback was sought.

It was expected that it would be mandatory for all healthcare institutes, including laboratories, to input patient data in the National Electronic Health Record. However, this "elephant in the room" has been deferred until the enhancements that are being made are complete, and MOH will make further announcements on this at the appropriate juncture, Mr Tong said.