Preventing hospital overcrowding

SINGAPORE - The image of Changi General Hospital housing patients waiting for beds in an air-conditioned tent, published in this newspaper, might have jolted Singaporeans in two ways.

It projected the noteworthy enterprise of a public hospital faced with a severe bed crunch trying to make the best of a difficult situation, and it also brought home the scale of the growing demand for hospital care here.

While high standards and careful planning characterise public health care here, it is challenged from time to time by seasonal peaks in demand, sudden outbreaks of contagious illnesses and other exigencies.

Typically, public hospitals bear the brunt of such challenges.

Although 80 per cent of primary health-care services are provided by private practitioners, and government polyclinics provide the remaining 20 per cent, the opposite is true for hospitalisation care, which is more costly.

There, 80 per cent is provided by the public sector and 20 per cent by the private sector. Given the role played by public hospitals, large fluctuations in demand will occasionally cause overcrowding.

When these fluctuations are seasonal, public hospitals must be commended for coming up with creative solutions - such as a short-stay unit - that do not compromise the professional and safety standards that Singaporeans rightly take for granted in their hospitals.

However, these measures remain ad hoc. A wider concern is whether steps are being taken to meet the rising needs for hospitalisation over the longer term.

The Health Ministry has assured that with planned expansion in hospital facilities coming on stream, there will be 1,900 more acute hospital beds and 2,600 community hospital beds by 2020.

Ng Teng Fong General Hospital will be completed this year, followed next year by two new community hospitals in Jurong and Yishun. Sengkang General Hospital is scheduled for completion by 2018.

The urgency is in order given the needs of an ageing population.

Meanwhile, though, some difficult questions have to be asked. If it is true that the crunch was partly caused by the holiday season rather than by a spike in illness, it is a sad commentary on the attitudes of some Singaporeans.

Choosing to go on holiday, while a relative lies sick in hospital, is a filially impious act. Knowing that this will delay his or her discharge from hospital - at the expense of those who need the beds more - is no less than an anti-social act.

The fact that the hospital stay is paid for does not mitigate the social irresponsibility displayed.

Hospitals are not hotels. Public hospitals, which are heavily subsidised with the taxpayers' dollars, certainly are not intended to cater to the holiday plans of people. Tackling the bed crunch will call for both steps to ramp up supply and moderate demand.


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