Sweeping healthcare regulations that include banning the hire of specified people to prevent abuse of the elderly are in the pipeline as the Health Ministry undertakes a major update of the law for the first time in 18 years.
With the increasing use of virtual care such as telemedicine and with a rapidly ageing population, the move is a much needed update, said Dr Tan Tze Lee, president of the College of Family Physicians.
Beside covering a wide range of medical treatments and services, the Healthcare Services Bill will also give the authorities more powers, such as higher penalties for infringements.
The draft Bill, which is seeking feedback and is expected to come before Parliament this year, will replace the Private Hospitals and Medical Clinic Act. Passed in 1980, the Act deals only with physical entities. Implementation of the new rules is expected to occur over a one-year period from end-2019 until December 2020.
The proposed legislation will include allied healthcare like physiotherapy, plus complementary and alternative medicine such as chiropractic.
But there are no plans currently to license these various services and treatments not covered in the existing Act, Dr Raymond Chua, director of the Health Regulation Group in the Health Ministry (MOH), said of the proposed legislation.
The Bill also updates penalties to reflect Singapore's current economic status.
For instance, the current fine for offering a healthcare service without a licence is up to $20,000 and a maximum jail term of two years.
In the draft Bill, the maximum fine is $100,000, while the jail term remains unchanged.
There is also a slew of new offences. One example is furnishing false or misleading statements to the MOH, such as when applying for a clinic licence. The maximum fine for the offence is $20,000 and a jail term of up to one year.
The broadened scope of the proposed Act is essentially to safeguard patient safety and welfare, strengthen regulatory clarity, improve governance of healthcare providers and ensure continuity of care and accountability.
The last refers to a new "step-in" measure for residential care services such as nursing homes, should they be unable to continue owing to factors like bankruptcy.
A temporary operator will be appointed to ensure all patients continue to be cared for until they can be transferred to another place.
There will also be restrictions on employment of staff to take care of the frail elderly in such places as a hospice or nursing home. For instance, a person caught abusing an elderly person will be prohibited from working in such a setting.
The Bill also lists specific practices and services that are considered unsafe and banned in Singapore. These include mesotherapy, in which injections of a cocktail of vitamins, enzymes, hormones and plant extracts are given in aesthetic treatments. Often, the exact formula of the cocktail is not stated.
Further, licensed premises, like a general practice clinic, cannot also house unlicensed services, like a beauty salon. If shop space is shared, a wall must separate them, each with its own entrance.
Another change is that new companies cannot use the words "national" or "Singapore" without permission. But those already so named do not have to change their names.
MP Joan Pereira, a member of the Government Parliamentary Committee for Health, said the Bill is "a very timely and necessary step as the healthcare services landscape in Singapore is maturing".
The MOH is seeking feedback on the draft Bill in the next six weeks, ending Feb 15. The Bill can be found at www.HCSA.sg.There are also two public consultations: on Jan 24, from 6pm to 9pm; and Feb 10, from 2pm to 5pm. Those who want to attend can sign up at www.HCSA.sg