Two public hospitals have raised emergency department fees in the past four months, with a third set to do the same if the Ministry of Health (MOH) gives the green light.
Singapore General Hospital (SGH) increased its fees by 9 per cent in December from $99 to $108, while charges at Khoo Teck Puat Hospital (KTPH) went from $98 to $103 in February.
While both say this was done to cope with rising costs, the new fees make their emergency departments the costliest in the public sector. Alexandra Hospital is the cheapest at $88 among Singapore's six public general hospitals. MOH declined to reveal which other hospital is looking to charge more.
The fee typically covers basic investigations and procedures, drugs and X-ray services. Patients are charged extra if they need specialised emergency tests or scans.
KTPH and SGH also started charging more for certain classes of beds and consultations.
In February, KTPH raised the cost of its B2 beds from $65 to $70. The hospital has over 90 per cent occupancy rates, which means patients needing a bed often face a long wait.
Consultation fees for subsidised patients at its specialist outpatient clinics went up from $32 to $35 for the first visit, and $30 to $32 for follow-ups. Fees for private patients were not raised.
A spokesman said the increases were "to recover rising operating costs of running the hospital".
SGH, which treats more than one million patients a year, raised both inpatient and outpatient fees in December. Its chief executive officer Ang Chong Lye said SGH is over 30 years old, and needs to expand facilities "to improve patient outcomes and safety".
He added: "Any under-collection of revenue would mean fewer resources available to meet this need. The adjustment to fees can help to recover only a small fraction of rising costs".
SGH and KTPH see more than 300 patients at their emergency departments every day. This can exceed 400 on especially busy days. More than 2,000 people seek emergency treatment at public hospitals daily.
Hospital emergency departments have been struggling to cope with the rise in patient numbers and a shortage of beds.
This has forced hospitals into unique steps, including squeezing three patients into a cubicle for one, setting up an air-conditioned tent outside, or putting patients in beds lined along corridors or in the decontamination area.
While a lack of infrastructure is one problem, it becomes worse when patients who do not really need emergency treatment turn up. This often happens at night when most clinics are closed.
A spokesman for MOH, which has to approve all fee changes, urged people with non-emergency conditions to see a private GP instead - "so that a hospital's emergency department can be focused on those who really need emergency services".
"Public hospitals adjust their charges from time to time to keep pace with rising costs. This is done while bearing in mind the impact on patient affordability."