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If the PAP government don't kill you, the hospitals will


Alfrescian (Inf)

Doctor suspended 3 years, fined $25,000 for overprescribing cough mixtures containing codeine​


Dr Andrew Tang Yen Ho had prescribed 270ml of cough mixture to each of the 10 patients. PHOTO: ST FILE

Salma Khalik
Senior Health Correspondent

MAY 4, 2020

SINGAPORE - A doctor has been suspended for three years and fined $25,000 for overprescribing cough mixtures containing codeine to 10 patients.
This is the second such infringement for Dr Andrew Tang Yen Ho of Tang Medical & Surgery at Block 8 Jalan Batu.
In May 2013, the Singapore Medical Council (SMC) suspended him for six months over a similar offence.
Dr Tang, who was also fined $10,000, gave an undertaking then that he would not re-offend.
But in 2015, the Ministry of Health (MOH) audited the medical records at his clinic and was concerned about his prescription of cough mixtures containing codeine.
Codeine is an opiate, and excessive use could lead to addiction and abuse.
The ministry then sent a letter to the SMC to investigate the matter.

But the doctor did not respond to any of SMC's queries, which forced the professional watchdog to serve him a notice of inquiry in February last year.
In spite of multiple attempts by the SMC to contact him, which included a hand-delivered letter that was accepted by a woman claiming to be his mother, Dr Tang did not attend the hearing and subsequent judgment and sentencing.
He also did not appoint anyone to represent him.

The SMC had checked with the Immigration and Checkpoints Authority to ascertain that he was in Singapore on the relevant dates.
Dr Tang faced 30 charges in all.
They involved three offences against each of the 10 patients: inappropriate prescription of the cough mixture, failure to exercise competent and due care of his patients, and failure to keep proper medical records.
The disciplinary tribunal (DT) found him guilty of inappropriate prescription, but acquitted him of the other charges.

The tribunal found that Dr Tang had prescribed 270ml of cough mixture containing codeine to each of the 10 patients on multiple occasions.
This was more than the 240 ml limit per patient per visit, as advised by the MOH.
In its written judgment published on Monday (May 4), the tribunal said: "The number of times the respondent 'overprescribed' the quantity of cough mixture containing codeine for each patient ranged from four to 21 times."
It added that he had also prescribed the cough mixture within four days of the previous visit on four occasions, involving four of the patients.
The SMC's lawyer had asked for a 36-month suspension for each of the three most serious charges, to run consecutively.
In other words, a total suspension of nine years.
As the tribunal is only empowered to impose a maximum suspension of three years, the counsel then asked for the doctor to be struck off the register to reflect the severity of the offence.
However, the tribunal did not agree that "just because the DT cannot impose any heavier suspension sanction than three years, a striking off is the only other option".
This, it said, would violate the principle as "a striking off would be a crushing sentence on the respondent in relation to the level of misconduct".
This was partly because, while there was potential harm, there had been no real harm done to any of the 10 patients.
It decided that the just penalty is the maximum suspension of three years, and a fine of $25,000.
The doctor also has to pay the cost of the proceeding, including SMC's legal costs.
The tribunal dismissed the other 20 charges.
It said that none of the 10 patients were given solely cough mixture containing codeine.
They were also given other medication to treat their various problems, and hence Dr Tang's treatment "was not unacceptable".
It added that his medical record-keeping, though "not up to standard", was "not inadequate".


Alfrescian (Inf)
Lanjiao lah. MOH you take simi serious view? If you have taken any serious view, why force people to take so many jabs and causing unnecessary deaths?


Alfrescian (Inf)
If body is already cremated liao, investigate simi lanjiao ?
Find some cheap scapegoat and close case?


Alfrescian (Inf)

Parents seeking $3.3m from psychiatrist, IMH in medical negligence suit over son’s suicide​


IMH said there were no red flags of imminent risk of suicide on Sept 6, 2017, the day before the man took his own life. PHOTO: LIANHE ZAOBAO FILE

Selina Lum
Senior Law Correspondent

Jan 12, 2023

SINGAPORE - In a lawsuit seeking an estimated $3.3 million in damages, the parents of a 31-year-old man who took his own life have accused two psychiatrists of being negligent in treating their son, which they say led to his suicide.
Mr Steven Joseph Arokiasamy, 67, and Madam Tan Kin Tee, 66, are suing Dr Nelson Lee, a psychiatrist in private practice, as well as the Institute of Mental Health (IMH) for the actions of its senior consultant, Dr Gomathinayagam Kandasami.
Their older son, Mr Salvin Foster Steven, who had a long and complex psychiatric history, fell to his death from his bedroom window on Sept 7, 2017.
They alleged that Dr Lee failed to diagnose their son with schizophrenia, and that both doctors wrongfully prescribed Concerta, a drug used to treat attention deficit hyperactivity disorder (ADHD), to him at inappropriate doses.
They accused the two doctors of failing to prescribe adequate doses of anti-psychotic medication to Mr Salvin.
They also blamed Dr Kandasmi for failing to admit Mr Salvin for observation on Sept 6, 2017 – a day before his suicide – after they took their son, who had been acting erratically in recent weeks, to see the psychiatrist.
Mr Steven and Madam Tan, who are separately represented by Mr V. K. Rai and Mr Anil Balchandani, contended that as a result of Mr Salvin’s death, they both suffered from persistent complex bereavement disorder and could no longer work.

Thus, Madam Tan, who left her job as a school counsellor in 2019, and Mr Steven, who left his job in the civil service in 2020, suffered a reduction in income.
The suit was heard in the High Court on Thursday. The trial has been adjourned to September.
Dr Lee, who practises at The Psychological Wellness Centre, treated Mr Salvin between November 2011 and July 2016. He diagnosed Mr Salvin with bipolar disorder and ADHD, and prescribed Concerta from April 2012.

Mr Steven and Madam Tan said their son developed a dependence on the drug, but Dr Lee continued to prescribe Concerta and did not advise Mr Salvin against taking more than the prescribed dose.
They said Mr Salvin began showing symptoms of psychosis, such as hearing voices or believing that people were plotting against him.
In May 2015, after being charged with the assault of two police officers, Mr Salvin was remanded at IMH and was diagnosed with paranoid schizophrenia.
He was returned to Dr Lee’s care in June 2015. Mr Steven and Madam Tan alleged that, in spite of being provided with the diagnosis, Dr Lee continued to prescribe Concerta to Mr Salvin and did nothing to prevent him from overdosing.
Dr Kandasami took over Mr Salvin’s care in August 2016, after he was sentenced to a one-year mandatory treatment order for the assault.
The couple alleged that Dr Kandasami did nothing to prevent Mr Salvin from overdosing on Concerta and ignored his psychotic symptoms.

Dr Lee, who is represented by Mr Jansen Aw, said his diagnosis of ADHD and bipolar disorder was reasonable in light of the symptoms and medical history.
There was a lack of overt and persistent psychotic symptoms supporting a diagnosis of schizophrenia, he said.
Dr Lee said Mr Salvin showed improvements when he was on Concerta and, for the first time in many years, managed to get a job in a warehouse in July 2015.
IMH, which is represented by Senior Counsel Kuah Boon Theng, said Dr Kandasami’s care and treatment of Mr Salvin was appropriate.
Mr Salvin’s response to medication was closely monitored during his mandatory treatment, and he did not show signs of psychosis, it said.
IMH said there were no red flags of imminent risk of suicide on Sept 6, 2017.
It disagreed with the couple’s assertion that Mr Salvin’s death was caused by psychosis, noting that the coroner had found his fall to be a “deliberate act of suicide”.
“The plaintiffs are understandably devastated, and IMH empathises with them for their loss. However, the deceased’s unfortunate demise was not the result of any negligence on the part of IMH and its doctors or staff,” said Ms Kuah in her opening statement.


Alfrescian (Inf)

KKH looking into monitoring newborns’ vital signs until handover, following death of 11-day-old​


The baby died from a brain injury in April 2021. PHOTO: ST FILE

Samuel Devaraj

Jan 25, 2023

SINGAPORE - KK Women’s and Children’s Hospital (KKH) is looking into monitoring a newborn’s vital signs until it is handed over to other teams in the hospital, after an 11-day-old baby died of a brain injury in April 2021.
State Coroner Adam Nakhoda noted in a report released recently that for a period of time after the baby’s birth, his vital signs were not recorded. The coroner described this lack of continuous documentation as not ideal.
He said in the report that the baby’s mother, who was delivering her first child, underwent an emergency caesarean section.
After the baby was born at about 4.30am, he was found to have three tight loops of the umbilical cord around his neck. The cord was removed immediately and he was placed on a resuscitator.
As his vital signs were noted to be less than optimal, he was given assisted ventilation for two minutes, which helped his heart rate and oxygen level in the blood improve.
However, at three minutes after birth, his blood oxygen level was noted to be borderline, and he was given medical help till his vital signs improved.
The baby was observed to be vigorously moving and had a good cry, and State Coroner Nakhoda noted that nothing amiss was observed.

However, when the baby was taken to the viewing room so that his father could see him, the coroner said, it was apparent that his condition had begun to deteriorate.
The father and a nurse noticed that he was giving weak cries and appeared limp.
When this became more pronounced and the baby did not show spontaneous limb movements and was not breathing spontaneously, the nurse took him back into the operating theatre.

His vital signs were not recorded from the seventh minute after birth until he was taken back into the operating theatre at about 5.20am.
The nurse put him back on the resuscitator, reattached a probe that allowed for measurement of his blood oxygen level and heart rate, resumed the assisted ventilation and then activated a Code Blue emergency alert, which is used when a patient is in cardiac or respiratory arrest.
The baby was transferred to the neonatal intensive care unit and connected to a ventilator.
But his condition continued to deteriorate. An ultrasound found indications of swelling of the brain, and there was suggestion of severe brain disease.
By the fifth day after the baby was born, his condition had worsened further, and his parents agreed to withdraw care after discussion with the medical staff and careful consideration.
The baby was pronounced dead on April 12, 2021, at about 12.30pm.

State Coroner Nakhoda ruled out foul play and said the baby had died of natural causes.
He also noted that the cause of death was certified to be a brain injury that occurs when the organ experiences a decrease in oxygen or blood flow.
He added that it was unlikely that the wrapped umbilical cord had played a part, as there was a period where the baby was well and breathing independently.
A senior consultant at KKH’s department of neonatology stated in a medical report that there was no documentation of continuous monitoring of the baby’s vital signs, considering his initial stable status.
The consultant added that on review of this, the hospital is working to ensure that documentation of a newborn’s vital signs is maintained until the newborn is handed over to other teams in the hospital.
State Coroner Nakhoda said he was heartened by this.
“Losing a child is always a devastating event, perhaps more so when the child is a newborn,” he added.


Alfrescian (Inf)

IMH doctor not required to tell family she was giving drug that likely led to patient’s death: Coroner​


The patient's death was ruled as a medical misadventure. PHOTO: LIANHE ZAOBAO

Samuel Devaraj

Jan 26, 2023

SINGAPORE - After he was administered a mood stabiliser while in the Institute of Mental Health (IMH), Mr Shawn Ho Chet Hsiong, who has intellectual disability and autism spectrum disorder, died from multiple organ failure.
After his death on June 23, 2020, Mr Ho’s brother asked why his family was not notified before the drug - carbamazepine - was given.
But in a report dated Jan 11, 2023, State Coroner Adam Nakhoda said there was no legal requirement for this.
The coroner, who ruled the death as a medical misadventure, said that as Mr Ho, 27, did not have the mental capacity to consent to receiving carbamazepine, it was for the treating clinician to decide on the appropriate treatment.
The coroner determined that starting him on the drug was appropriate.
While it is good clinical practice for the attending doctor to update a patient’s family on the prescription of a new medication where feasible, the coroner found that it was reasonable that the associate consultant psychiatrist managing Mr Ho had not done so.
Apart from it not being a legal mandate, State Coroner Nakhoda accepted that there were insufficient resources available to keep the family updated, especially with the reduced manpower as a result of Covid-19 restrictions.

Mr Ho, who had limited verbal communication skills, needed help with daily living activities and was prone to self-injurious and aggressive behaviour, was admitted to IMH on April 20, 2020.
This was after his aggression behaviour - particularly towards his mother - worsened when activities at his day activity centre stopped during the Covid-19 circuit breaker.
Mr Ho was placed in a ward which, according his psychiatrist, was one of IMH’s busiest, with most of its patients having aggression or suicidal issues.

The psychiatrist said that even in normal times, there were simply insufficient resources to inform every family about changes in a patient’s medication, let alone during the Covid-19 pandemic, which had halved the ward’s manpower.
Mr Ho’s aggressive behaviour did not improve after he was admitted, and on one occasion, he hit another patient.
Noting that Mr Ho had previously responded well to mood stabilisers, the psychiatrist started him on carbamazepine, which State Coroner Nakhoda said was “appropriate and necessary as it was the therapy of last resort”.
Among the alternatives considered, lithium was deemed unsuitable because preventing the level of lithium from becoming toxic required Mr Ho to closely monitor his water and salt intake.
The doctor not confident that Mr Ho would do so sufficiently after he was discharged.

Said the coroner: “In view of the treatment goals, which were to address and reduce Shawn’s aggression and self-injurious behaviour, allow him to be discharged back to his family and re-enrolled at the day activity centre, I accepted that initiating carbamazepine was the only viable option for him.”
He added that failing to address the aggression and behaviour meant Mr Ho would have to remain in IMH and be placed in restraints for a long time, which would have led to other serious issues like pneumonia and urinary tract infection.
Mr Ho’s psychiatrist said she would have told the family if IMH was proceeding with a high-risk intervention or if they had made it clear that they wanted to be updated before any new medications were started.
Otherwise, she would normally provide a summary to the family near the discharge time.
Before carbamazepine was used, reasonable and necessary precautions were taken including, a test for HLA-B allele, a gene variant, said State Coroner Nakhoda.
As Mr Ho was negative for the allele, his risk of developing a rare skin disorder or toxic epidermal necrosis - severe skin reactions most often triggered by particular medications - was 0.007 per cent.
“This was a very low risk. Unfortunately, a very low risk does not mean that there was no risk.” said the coroner.
After developing a fever on June 5, 2020, Mr Ho was transferred to Changi General Hospital and he was found to have redness on his spinal area the next day.
He developed a rash that spread rapidly and was transferred to Singapore General Hopsital, where he eventually died.
Ruling out foul play, State Coroner Nakhoda said the cause of death was certified as multiple organ failure due to toxic epidermal necrolysis and that the most likely culprit was the carbamazepine.
“Having stated my findings, I wish to extend my sincere condolences to Shawn’s family on their loss,” he added.


Alfrescian (Inf)

Anaesthetist who left patient during operation to take phone calls suspended 2½ years​


According to CCTV footage, the anaesthetist left the operating theatre “multiple times”, with the longest period being nine minutes. PHOTO ILLUSTRATION: UNSPLASH

Salma Khalik
Senior Health Correspondent

JAN 11, 2023

SINGAPORE – An anaesthetist who walked out of the operating theatre several times to take calls from other patients while another in his care was undergoing surgery has been suspended for 2½ years, the Singapore Medical Council said on Tuesday.
During the operation in 2016, the patient suffered a complication when a blood clot blocked oxygen from his lungs, an event known as a pulmonary embolism. He was successfully resuscitated by a team of doctors, but died the following day.
The Singapore Medical Council’s disciplinary tribunal said the patient’s chances of surviving the embolism was very low. But that chance may have been further lowered by Dr Islam Md Towfique’s delay in recognising the changes in the patient’s vital signs and consequent delay in taking action.
Dr Islam told the tribunal it was common practice for anaesthetists to leave the operating theatre for short periods of time.
The patient, 64, had surgery performed at Gleneagles Hospital on a fracture caused by his bone marrow cancer on Sept 1, 2016. Given his age, obesity, prior heart problems and cancer, he was “considered a high anaesthetic risk patient”, said the tribunal.
During the operation, his oxygen reading fell below 90 per cent, “into the 80s and 70s”. Normal range for blood oxygen level is between 96 per cent and 99 per cent. Despite that, the oxygen given to the patient was not increased.
Hospital parent firm Parkway Pantai Ltd said in a letter to Dr Islam that “increasing the oxygen delivery is one of the first few actions that an anaesthetist should initiate when a patient’s SpO2 falls, and yet for almost 50 minutes, with the SpO2 either un-recordable or in an unacceptable range, this remedial action was not taken”.

In his defence, Dr Islam, a veteran doctor, said: “I was with the patient and did apply my expertise to keep the Haemodynamics but I forgot to increase the oxygen to 100 per cent.”
Parkway suspended him for six months in 2017, and reported the incident to the SMC.
The expert for the SMC, which was the prosecuting body, said things can go wrong very quickly, “so we need to be there... there is not at any point... that it’s safe for an anaesthetist to leave the patient”.

He added that “all you need is less than a minute for things to go wrong”.
The tribunal agreed with the prosecution that the potential harm to the patient from Dr Islam’s multiple departures from the operating theatre “would be serious injury or even death”.
The hospital CCTV in the corridor outside the operating theatre showed Dr Islam left the operating theatre “multiple times”. The longest period he was gone was nine minutes.
Aside from those times, Dr Islam also went several times to the adjoining induction room, but these were not recorded by the CCTV.
Dr Islam had argued that there was nothing wrong with his leaving the operating theatre for short periods as this “behaviour would not be that different from that of his other anaesthetic colleagues”.
The surgeon who had carried out the operation and who gave evidence on behalf of Dr Islam at the hearing said the anaesthetist has continued to leave the operating theatre to take phone calls.

The tribunal rejected Dr Islam’s contention that the harm caused by his behaviour was minimal, as the prospect of surviving the blockage to the lung was minimal.
It said such a defence “would lead to an illogical outcome where a doctor treating a patient whose condition makes the prospects of survival low is able to take less care because the chances of survival were small in any event”.
The tribunal also agreed with the SMC that such misconduct “causes significant harm to public confidence in the medical profession and the healthcare system”.
“The respondent’s conduct in repeatedly leaving the operating theatre to attend to phone calls which he acknowledged were not urgent would shock the public and harm public confidence in the medical profession.” It also disagreed with Dr Islam’s claim that his conduct was not motivated by financial gain.
Most of the calls were from patients, both overseas and local, wanting to know when they could come for treatment, so he “was simply servicing other patients who would be paying his fees after coming to Singapore for treatment”.
Dr Islam also asked for a one-third reduction of his sentence, given the long time it has taken for the case to be heard.
But given that he has continued the practice of accepting calls in the midst of surgery, the tribunal said a one-sixth reduction was more appropriate.
It reduced his 36-month suspension to 30 months. He also has to pay the costs and expenses of the proceedings, including the cost of SMC’s lawyers, and undertake to refrain from such future conduct.


Alfrescian (Inf)

Forum: Address factors that make doctors lose the human touch​

Apr 5, 2023

I refer to Dr Quah Thuan Chong’s letter, “Medical care and what love’s got to do with it” (April 3).
While I appreciate his sentiments, it is unfair to generalise that junior doctors are lacking in what he characterises as the “human touch”. There are many factors which may have contributed to his perceptions, and these warrant addressing.
First, the current workflow which requires junior doctors to spend most of their time typing into electronic medical records limits the opportunity to interact with patients. Rather than acquiring the skills of doctoring during their nascent years of training, they have been relegated to becoming glorified typists.
A former CEO at a healthcare facility used to say that his mantra was to make the facility more efficient by doing everything “cheaper, faster and better”. With due respect, I think such a philosophy contributes to the dehumanisation of the medical profession.
Second, despite the recent attention paid to improving the welfare of junior doctors, many senior doctors still insist on junior staff turning up at 6am and finishing work later than 7pm, all in the name of “training”.
In addition, senior clinicians have been observed bullying and humiliating junior doctors, to the point that some junior doctors have been driven to depression. Junior doctors tend to emulate the behaviour of their seniors, who should be setting better examples.
Third, the expectations of patients have changed over the years. While patients were generally respectful of healthcare workers previously, we now face patients who come with a sense of entitlement and general disrespect for professionals.

In addition, the relative ease with which complaints and legal action can be taken against doctors does not help the stressful environment within which they work. This requires a reset of public expectations which, while not impossible, requires herculean political will to step in from the authorities.
If office-holders and hospital administrators seem unwilling to take care of junior doctors and treat them with respect, how can we expect them to take care of patients? We can do better.

Sitoh Yih Yiow (Dr)


SG has been done a disservice by Salma Khalik who reports on health issues as can be seen by increased costs and lower atandards


Alfrescian (Inf)

Forum: Time to look at restraint-free care of elderly patients​

Apr 8, 2023

My 84-year-old mother suffers from various chronic diseases and has been hospitalised due to a recurring heart condition. I visit her at Tan Tock Seng Hospital frequently and each time, I notice that nurses restrain the movements of some elderly patients by tying their hands to both sides of the bed rails.
It is an unpleasant and disturbing sight to see some of these patients looking agitated and despondent, and trying to free themselves.
I understand the need to restrain elderly patients in situations where they pose a risk to themselves and others, but I worry about the detrimental effects, such as muscle atrophy and other injuries. I also wonder how this affects the patient’s recovery.
The psychological impact on them is another concern. Being restrained could lead to anxiety, depression, feelings of helplessness and humiliation. My mother tells me that is how she feels. She is tied down every night after the family leaves to prevent her from scratching herself.
I am told that restraining patients, especially at night, helps them to rest better, but I fear my mother may not be able to reach the emergency call button should she have a heart attack in the middle of the night. Restraining her may be doing her more harm than good.
Are there better solutions for elderly patients other than the use of physical restraints? With Singapore’s ageing population, there is an urgent need to look at how to take better care of elderly patients.

Zoelyn Lim


Alfrescian (Inf)

SKH patient buys Panadol via foodpanda after long wait; hospital says it prioritises emergency cases​


TikTok user Jombadok, in a video posted last week, claims that he waited for his painkillers for almost two hours before he decided to order them via foodpanda. PHOTOS: SCREENGRAB FROM TIKTOK

Elaine Lee

Sep 19, 2023

SINGAPORE – Sengkang General Hospital (SKH) says it prioritises patients in emergency cases over the less serious ones, after an inpatient complained on TikTok that he had to buy painkillers via foodpanda after waiting for almost two hours at the hospital for the medicine.
In a Facebook post on Monday, SKH said it was aware of a TikTok video circulating online of a patient ordering Panadol via the food delivery app as a result “of an alleged lack of promptness by the hospital in addressing his needs”.
Addressing the allegation, SKH said it would like to assure the public that the patient’s care team had “rendered the appropriate care” based on his condition.
“SKH is committed to attending to every patient in a timely manner,” it added. “Patients with less acute conditions may sometimes experience longer waiting times compared with those who are being treated for serious urgent and life-threatening emergencies.”
TikTok user Jombadok, in a video posted last week, claims that he waited for his painkillers for almost two hours before he decided to order them via foodpanda. The reason for his hospitalisation is not explained.
“Can you imagine... (I’m) asking for Panadol and I cannot get the medicine from a first-world hospital... it is really ridiculous,” he says in the video.
Filming himself collecting his painkillers from a foodpanda delivery rider at the hospital lobby, he tells the rider, who appears surprised, about his situation. Jombadok does not say how long it took for his delivery to arrive.

He adds that it is his first time warded at SKH and he will be discharging himself from the hospital against medical advice the next day because he is unable to get medication from the hospital.
“No point. I might as well (stay) at home. I have my painkillers at home... (the hospital) is a let-down,” he says in the video.
The Straits Times has reached out to Jombadok and SKH for more information.



Alfrescian (Inf)

Forum: Why ask the elderly to do Zoom call when simple call will do?​

OCT 3, 2023

My mother is 81, and recently had to undergo an operation at KK Women’s and Children’s Hospital (KKH).
The hospital set the pre-admission financial counselling as a Zoom call, despite my mother telling the staff that she did not know what Zoom was or how to use it.
A few days before the scheduled Zoom call, she received two SMSes reminding her to join the call at the appointed time, and that a link would be sent to her in a separate SMS.
On the scheduled date, my mother had yet to receive an SMS containing the link, so I called KKH’s hotline to inform the hospital that we did not have access to the call. The hotline agent assured us that she would inform the clinic, which would assist us.
No calls came, and I had to make several calls again through the hospital’s hotline. After more than two hours of calling and waiting, I finally received a call, and the financial counselling was successfully completed over my mobile phone in five minutes.
I understand that Zoom calls can be productive for the young, but there are many seniors who are not tech-savvy, and will need their children or caregivers to take time off and be present to join and help with the Zoom call.
I asked the hospital why it needed to schedule a Zoom call if the counselling could have been done so easily with a phone call. The answer was that the Zoom call was necessary for signatures to be taken. I am not aware of how signatures can be collected via Zoom.

Better judgment should be exercised in the use of technology, and seniors should be offered other options that better meet their ability and needs. Technology should serve the elderly, not inconvenience them.

Ho Cheong Tong


Alfrescian (Inf)

Elderly penalised for late settlement of medical bills​

Dec 14, 2023

Every three months, I visit Ang Mo Kio Polyclinic to treat my diabetes, high cholesterol and high blood pressure.

Unless full payment of outstanding medical bills is made at the polyclinic, patients will not get to see the doctor.

There are many seniors struggling to cope with the high cost of living. On previous occasions, I was denied medical care until I paid the outstanding amount in full. It is not right to deny medical care to seniors just because they are late with payments.

Raymond Anthony Fernando


Alfrescian (Inf)

Forum: Unfair to charge retroactive payments for patients who transfer to higher class wards​

APR 18, 2024, 05:00 AM

Last week, my mother, who is 98 years old and frail, was admitted to the high-dependency ward in Singapore General Hospital (SGH) as a Class C patient. Unfortunately, her experience there was far from conducive to her recovery. The ward, accommodating five patients, was consistently noisy, with frequent disturbances from phone usage, visitor traffic, and monitor alarms. As a result, my mother found it difficult to rest and became increasingly stressed.
One week later, SGH transferred her to a general ward. In a general ward, there are A1 (one patient to a room), B1 (six to a room) and C (eight to a room) classes available. My family believed that a quieter environment would greatly benefit her well-being and recovery, and so opted for A1.
But we were told that if she were to be moved to a single-occupancy room, the bill for her earlier stay as a Class C patient would be retroactively changed to reflect her new Class A1 status, effectively doubling the amount payable. While we understand the need for different charges for different classes of patients, based on amenities and services provided, we find retroactive charging illogical and unfair.
A patient should be charged Class C rates for the period she stayed in a Class C ward, not Class A1 rates for services and amenities she did not consume. All the more so for patients who had no choice but to opt for a quieter ward to rest and recover faster.
Retro-charging places an unnecessary financial burden on families already grappling with the emotional and physical challenges of caring for their loved ones. I hope that SGH or the Ministry of Health will review its policy regarding retroactive payment for ward transfers and consider removing this anomaly.
That would alleviate financial strain on families and ensure that patients can access the appropriate level of care without undue financial penalty.

David Kong