Adequacy of Singapore's laws against unethical practices and profiteering among healthcare providers and pharmaceutical and medical equipment firms

13 August 2012

Question No. 614

Name of person: Mr Zaqy Mohamad

Question

             To ask the Minister for Health (a) whether our laws and regulations on ethical practices and profiteering among healthcare service providers, pharmaceutical companies and medical equipment suppliers are sufficient; (b) how does the Ministry monitor practices where serivce providers may include additional assessment procedures or over-prescribed medication in which ordinary Singaporeans may not be aware of or are not in a position to question as they are treated by professionals and specialists in the field; (c) whether the Ministry will consider the setting up of a watchdog body to assist in ethical governance; and (d) how do our regulations fare in terms of such practices compared to other developed countries.

Answer

            Singapore has in place a sound regulatory and professional standards framework for ethical and fair practices in the healthcare sector.

            Various Acts – the Private Hospitals and Medical Clinics Act, the Medicines Act and the Health Products Act – ensure the high standards and quality of the services and goods provided in the area of healthcare.  For example, pharmaceutical products must meet the specified standards for safety, efficacy and quality, while healthcare institutions must comply with minimum standards to ensure that services provided to patients are safe.

            The Medical Registration Act, the Dental Registration Act, the Nurses and Midwives Act and the Pharmacists Registration Act regulate standards amongst healthcare professionals.  Healthcare professionals such as doctors and dentists are additionally bound by their professional code of ethics.  They are also expected to abide by clinical practice guidelines published by MOH, which set out the evidence-based treatment protocols for various diseases and conditions.  Practices such as prescribing unnecessary or excessive medication, or having a patient undergo unnecessary tests and procedures, are unethical and subject to disciplinary action by professional bodies, such as the Singapore Medical Council and the Singapore Dental Council.

            Beyond the law and professional standards, it is important to empower our consumers and users of healthcare products and services with relevant information and knowledge.  MOH has been publishing information on the range of fees charged and typical bill sizes for common medical and dental procedures in public hospitals (since 2003) as well as in private hospitals (since 2011).  Clinics are also required to display their list of standard charges.  Hospitals are required to provide financial counselling to patients and explain the potential charges relating to the treatment they will receive.  These measures allow members of the public to make informed choices, in selecting the provider which best meet their needs.

            The Competition Act in Singapore outlaws anti-competitive behaviour such as collusion and price-fixing by providers.  The Act also applies to the healthcare sector, and prevents providers from colluding to profiteer and set artificially high prices for healthcare goods and services.

            Taken in its entirety, our system of legislative and professional regulatory requirements, rules preventing anti-competitive behaviour and measures to empower consumers, is comparable to that of other developed jurisdictions.

            While we do not see an immediate need to set up a watchdog body on ethical governance, we will continue to monitor best practices in other jurisdictions and adopt or adapt relevant ones here.  Patients or members of the public who have concerns relating to ethical practices may approach MOH, and the Ministry will look into them.