Health-care schemes reviewed regularly to stay relevant

14 Sep 2011, The Straits Times

Be open, not defensive, in tackling health-care issues

I REFER to the study by researchers Jacinta Tan and Jacqueline Chin, whose findings indicated that the current health-care system makes it hard for those without financial means to spend their last days at home ('Subsidy dearth for end-of-life home care'; Tuesday).

The research highlighted many gaps and pertinent issues in the current health-care system.

I personally experienced how hard and financially tough it was to care for my father, who was diagnosed with cancer and who has since passed on.

He was treated in Singapore General Hospital, and needed prolonged care at home during his last days. The bill added up to a six-digit figure. He had limited Medisave savings and inadequate health insurance, so it was left to our family to foot the entire medical bill.

So I was disappointed to read the Ministry of Health's reply to a query in the article. Instead of acknowledging the serious gap in the health-care funding or promising to address the problem, the ministry spokesman offered a standard response that means-tested subsidies for hospice home medical and nursing services are available to patients who require financial assistance.

The reply gave me the impression that the ministry is a faceless organisation without a heart. Many patients, like my late father, cannot obtain access to subsidised medical care in restructured hospitals because the system is rigid.

Consequently, such patients cannot spend their last days at home and in peace.

I am not advocating that we turn Singapore into a welfare state, but with a fast-ageing population, issues identified by the researchers will become more acute unless measures are undertaken to address them now.

Addressing such issues starts with the ministry's acknowledgement that there is a problem and not by being defensive about it.
Explaining the cold hard facts of its policies does not solve the problem. We know what the policies are.

Patrick Tan

Reply From MOH

In “Be open, not defensive, in tackling health-care issues” (ST, 8 Sept), Mr Patrick Tan was concerned about possible gaps in our current healthcare system, particularly in the care of the terminally-ill.

We are sorry to hear of the passing of Mr Tan’s father. It is never easy having to deal with the impending and eventual loss of a loved one. Our thoughts are with Mr Tan and his family.

We agree with Mr Tan that most patients would like to spend their last days at home and with peace of mind.  Mr Tan is also correct that our current healthcare financing system is not perfect and remains a work in progress. As society evolves and our healthcare needs change over time, we will need to review our schemes to stay relevant. Given finite resources, one principle that we try and uphold is that of ensuring that assistance is targeted and given to those with the greatest need. As Mr Tan noted, we will need to regularly review the adequacy of our financing system in helping those who require assistance.

Caring for patients with terminal illness goes beyond funding issues. It is also important to raise the quality of care and support, both within our healthcare institutions and within the community. The Ministry of Health is currently undertaking a holistic review of end-of-life (EOL) care. This involves many aspects such as increasing the number of palliative care specialists and nurses, training health care professionals on Advance Care Planning, and subsidising inpatient, home hospice and home palliative care.

To equip and support the family and caregivers in caring for the terminally ill, we have initiated government-funded programmes such as the Advanced Care Planning Programme which aims to facilitate healthcare professionals, patients and family members in making on health care issues and choices towards the end of life. We have also initiated programmes to care for patients with advanced non-cancer conditions such as end stage heart or lung failure who require palliative care outside hospitals. 

We thank Mr Tan for taking the time to provide his feedback on a difficult and personal matter.

Bey Mui Leng, Ms
Director, Corporate Communications
Ministry of Health