SINGAPORE - Mount Elizabeth Hospital has a 24-hour walk-in Emergency department, but it is "not equipped or staffed to manage all forms of emergency cases", said the Ministry of Health (MOH).
This was why the six Filipino victims of Sunday's (Dec 29) Lucky Plaza accident were not taken to Mount Elizabeth, although it was near the accident site.
MOH added that most private hospitals "are not able to provide proper resuscitation and emergency treatment for severe and multiple trauma patients".
The ministry and the Singapore Civil Defence Force (SCDF) said in a joint statement on Tuesday that Tan Tock Seng Hospital (TTSH) was the nearest hospital that is equipped to handle such an emergency.
They were replying to queries from The Straits Times on why the SCDF had taken the six Filipino domestic helpers, who were hit by a car behind Lucky Plaza on Sunday afternoon, to TTSH instead of Mount Elizabeth Hospital, which was about 200m away.
Two of the women died later from their injuries in hospital, two are warded and the other two have been discharged.
The MOH spokesman told The Straits Times on Tuesday that all public hospitals - except for Alexandra Hospital - have emergency departments that "can resuscitate and provide initial treatment of acute emergencies in both adults and children".
She added: "The hospitals maintain strict clinical standards in their provision of emergency care, including the presence of emergency medicine specialists and surgeons on a continuous 24/7 basis."
Raffles Hospital is the only private hospital that meets the ministry's "minimum standards for trauma care".
But even this hospital does not have the capacity to manage "mass casualty incidents". So while ambulances have been taking patients who are not facing life-threatening conditions there since 2015, it is not a designated hospital for serious trauma cases.
Patients taken there by SCDF ambulances may receive subsidised emergency care, as well as follow-up treatment at Raffles Hospital.
However, while most public hospitals can treat all trauma cases, only two are fully equipped for children.
So should children require more care "beyond the initial resuscitation and stabilisation treatment", they will be stabilised and sent on to either KK Women's and Children's Hospital or the National University Hospital.
MOH and SCDF explained on Tuesday that SCDF emergency ambulances take patients with severe trauma to the nearest accident and emergency department that is equipped with the necessary resources, equipment and specialist medical support to deal with such complexities of care.
In this case, TTSH was the nearest such hospital, not Mount Elizabeth Hospital.
"In addition, as part of pre-hospital medical care management, all SCDF emergency ambulances are equipped with the necessary medical equipment and manned by well-trained paramedics and crew that are capable of performing resuscitation on patients," the authorities said.
SCDF conveyed the six victims to TTSH in five ambulances.
TTSH was alerted by the first SCDF ambulance to be on standby to receive the patients.
Mount Elizabeth's chief executive Noel Yeo said in a Facebook post on Monday that the hospital's 24-hour emergency department is open to all patients, regardless of who they are, and the hospital will dispatch staff to attend to emergencies via its ambulance service.
Dr Yeo said the hospital's A&E team would have responded immediately had it been activated or informed of the incident on Sunday.
He said it learnt later from news reports that SCDF was activated and had arrived to attend to the casualties.
Netizens had asked why the accident victims were taken to TTSH in Novena and not Mount Elizabeth Hospital, which is located near the accident scene.
Dr Yeo said: "While the hospital is capable of treating emergencies, it is not set up like the restructured hospitals for severe traumatic conditions, which include multiple trauma and extensive burns."
The MOH spokesman said on Tuesday: "MOH is happy to work with the private hospitals to establish the minimum standards that they should meet, should they wish to upgrade their suite of clinical services to provide emergency care services in the future."