Public Consultation on New Healthcare Services Bill

PUBLIC CONSULTATION ON NEW HEALTHCARE SERVICES BILL

The Ministry of Health (MOH) is inviting feedback on the draft Healthcare Services (HCS) Bill from 5 January 2018 to 15 February 2018. The purpose of the draft Bill is to better safeguard the safety and well-being of patients, while enabling new and innovative services that benefit patients to be developed, in the changing healthcare environment.

Need for New Healthcare Legislation

2.    Today, healthcare providers are licensed and regulated under the Private Hospitals and Medical Clinics Act (PHMCA), which was enacted in 1980 and last amended in 1999. The PHMCA was designed to protect patient safety through the licensing of physical premises delivering healthcare, namely, hospitals, medical clinics, clinical laboratories and healthcare establishments.

3.    Significant changes are taking place in the healthcare landscape in Singapore. Our ageing population and increased chronic disease prevalence have led to a growing need for new care models and coordinated team-based care across healthcare settings and providers. Advancements in medicine and health technologies are giving rise to new and fast changing healthcare services. Where most healthcare services were provided from physical “brick-and-mortar” locations in the past, there are now new services delivered wholly or partially through mobile and online channels.

4.    In response to the new and changing environment, MOH intends to repeal the PHMCA and replace it with the new HCS Act. In addition to better safeguarding the safety and well-being of patients in the changing healthcare environment while enabling the development of new and innovative services that benefit patients, it also strengthens governance and provides regulatory clarity for better continuity of care to patients, and addresses wider issues of patient welfare.

Key Features of Draft Bill

5.    The key features of the draft Bill are as follows:

(i) The regulatory scope will be broadened to include healthcare services, nursing and allied health services, traditional medicine, and complementary and alternative medicine. MOH has taken a risk-based regulatory approach, and standalone allied health and nursing services, traditional medicine, and complementary and alternative medicine will not be licensed at the moment even though they are within the scope of the Bill. Professionals such as physiotherapists and traditional Chinese medicine practitioners will be regulated through existing Professional Acts .

(ii) The regulatory basis will be shifted from ‘premises-based’ licensing to ‘services-based’ licensing. This is in recognition of new and emerging healthcare service models and businesses that are not based out of physical locations, such as telemedicine and mobile medical services.

(iii) Governance and oversight of licensed healthcare services will be strengthened. The roles, responsibilities and requirements of the key personnel involved in the licensed healthcare service and its governing bodies will be enhanced.

(iv) Provisions will be made to bring about safer and better continuity of care. “Step-in” safeguards have been added to minimise abrupt discontinuations in residential care services . Licensees will be required to contribute to the National Electronic Health Record to enable better care coordination and continuity of care for patients across licensed healthcare settings and providers. There will be an opt-out provision for patients.

(v) Safeguards will be put in place to ensure that patients’ NEHR records are kept confidential. The NEHR can be accessed only for purposes of patient care, and not for other purposes, including assessment for employment and insurance. Measures, including the provision of access logs to patients and regular audits on NEHR access, will be instituted to protect against illegitimate access. Penalties will be imposed for unauthorised access.

(vi) To protect patient safety and welfare, the HCS Bill prohibits unsafe practices, and authorises MOH to obtain and publish information on non-compliant licensees and unlicensed providers. There will also be provisions to impose restrictions on licensees employing personnel to work in healthcare services that cater to the frail or vulnerable .

(vii) Revisions will be made to restrictions on naming, publicity and advertisement, and provision of licensable healthcare services together with other unrelated or unlicensed services. This is to avoid public misperception and to safeguard patient interest.

PUBLIC CONSULTATION EXERCISE

6.    From 5 January to 15 February 2018, MOH will be holding a series of consultation sessions with stakeholders and members of the public. Members of the public can sign up for the sessions through www.HCSA.SG. Feedback and comments on the consultation paper and draft Bill can also be made on the REACH platform at www.reach.gov.sg.

7.    The feedback collected will complement the inputs which MOH had gathered from earlier stakeholder discussions. MOH will consolidate and publish a summary of the feedback provided as well as our responses, after the close of the consultation exercise.

----------------
MINSTRY OF HEALTH
5 JANUARY 2018