Speeches
SPEECH BY MR ONG YE KUNG, MINISTER FOR HEALTH AND COORDINATING MINISTER FOR SOCIAL POLICIES, AT MOUNT ALVERNIA HOSPITAL’S 65TH ANNIVERSARY CELEBRATION AND OFFICIAL OPENING OF UPGRADED FACILITIES
9 April 2026
Ms Chan Chia Lin, Chairman, Mount Alvernia Hospital
Franciscan Missionaries of the Divine Motherhood Sisters
Dr James Lam, CEO, Mount Alvernia Hospital
Distinguished guests, ladies and gentlemen
1. The last official event that I attended here was in October 2023 – we were out there in the open – that was when I opened the St Anne Mother and Child Centre. It has since welcomed more than 12,000 babies and continues to serve many mummies and their babies. Unfortunately, I was told the number of babies is coming down. Not because of Mount Alvernia – [people are] just having fewer babies. Today, it is with great pleasure that I join you again, for the official opening of the new day surgery centre, as well as the upgraded intensive care unit and high dependency unit.
2. These upgraded facilities reflect the demographic reality we face. Singapore has become a super-aged society this year, where 21% or more of our population is aged 65 and above. I do not know why the magic number is 65. Somehow once you reach your 65th birthday, you are a senior and you are part of the calculation of a super-aged society. Today, Mount Alvernia turns 65 so you are contributing to your super-aged society.
3. The convergence of milestones – of us becoming super-aged and Mount Alvernia celebrating your 65th anniversary – reflects how Mount Alvernia Hospital has served the Singapore population as our nation has grown. The hospital has had a long and eventful life journey. Dr James Lam has gone through many of these, but let me just go through them briefly.
4. Founded in 1961 by the Sisters of the Franciscan Missionaries of the Divine Motherhood, [Mount Alvernia Hospital] started with just 60 beds. For 65 years, the hospital has attended to numerous patients, supported countless families, while remaining rooted to its motto “Serve all with Love”. And today, Mount Alvernia Hospital has over 350 beds, and has extended into multidisciplinary practice.
5. Mount Alvernia Hospital is also an important part of private healthcare in Singapore. It is also Singapore’s only private not-for-profit acute hospital.
The Role of Private Healthcare
6. Our healthcare ecosystem is diverse with services that span a continuum from prevention to rehabilitation. Across these care settings, healthcare professionals work tirelessly to restore health, prevent diseases and alleviate discomfort and pain. They are our family physicians, hospital clinicians, specialists, allied health professionals, pharmacists and nurses.
7. There are also Western Medicine and Traditional Chinese Medicine practitioners. They are founded on different principles and philosophies, and we continue to find ways to synergise them and their strengths.
8. And there is public and private healthcare too. And from time to time, I get asked the question: with Government healthcare expenditure rising, more public hospitals built, is there still a role for private healthcare?
9. The answer is clearly yes. There was a very nice quote just now – “between efficiency and sympathy”. So likewise, I think the spirit of healthcare is about being universal and egalitarian. And public healthcare delivers that. But we cannot be so egalitarian that we deprive the public of choice, of private healthcare. But we cannot have so much choice with different service standards that we lose the spirit of being universal and egalitarian. We have to strike a balance. Private healthcare has always played an important role in the care for the Singapore population. It is an integral part of the healthcare ecosystem and will remain so.
10. For example, in primary care, about half of accredited family physicians are in private practice. But most have joined national schemes such as the Community Health Assist Scheme (CHAS) and Healthier SG. They play key roles in chronic disease management and strengthening population health. Many GP clinics have also formed Primary Care Networks (PCNs), which collaborate with public healthcare clusters. These private GP clinics attend to roughly 80% of primary care patients.
11. Another area is long-term care, which is fast-expanding in the healthcare sector. Private providers, alongside social services agencies, community care organisations and other charitable organisations, play significant roles in operating nursing homes, Senior Care Centres, Active Ageing Centres, and delivering home and palliative care services.
12. And finally, in acute inpatient care, we have several private hospitals. Having private hospitals operating alongside public hospitals has been a longstanding government position.
Patient Share Between Public and Private Hospitals
13. It is neither desirable nor possible for public hospitals to be a monopoly. Even in the UK, where they declare care is mostly public, you have the National Health Service (NHS) which is so dominant – it does not have a monopoly. Because healthcare is free at the point of care at NHS, patient queues are long, and many UK citizens purchase private healthcare insurance and opt for private healthcare to skip the queues.
14. In Singapore, there is a White Paper written in 1993. I must confess that I only read it recently. It is titled “White Paper on Affordable Healthcare”. In the paper, it envisaged a greater role for private hospitals. It set out a long-term plan to raise the private share of acute hospital beds from 20% then, to 30% by 2010, which has already passed, with the public sector correspondingly reducing its share from 80% to 70%. And this was so that public hospitals could focus on their core public mission to provide care for the middle- and lower-income groups.
15. 2010 came and went. Sixteen years ago. The public sector is still operating about 80% of the hospital beds today. What has changed is that the public sector now takes in an even larger share of patients, accommodating about 90% of Singapore’s patients. So, 80% of beds accommodating 90% of inpatients. Bed occupancy rates at public hospitals are typically quite high, over 90%, while private hospitals are barely half occupied.
16. This is an unusual situation, given that almost 40% of Singapore residents have actually purchased healthcare insurance for private hospital care. Yet when they require hospitalisation, around half of them still choose to seek care in public hospitals.
17. So the role of private hospitals is diminishing not due to, but despite our policy intent. What is causing this unintended shift towards public hospitals?
18. I think [there are] a couple of reasons. One, as people get older, they tend to have multiple conditions and complications, and therefore they may prefer public hospitals where they can be cared for by a wider range of specialist disciplines. And today, we have a much higher proportion of elderly than in the 1990s.
19. There is also a cost consideration. I believe with private hospital charges getting more expensive, and private healthcare insurance premiums escalating, it is deterring some patients. Patients are worried about the size of the bill that they have to pay and whether they will be successful in making insurance claims. And so they opt for public hospitals, enjoy subsidies and use MediShield Life, which is rarely turned down.
20. Hence today, the healthcare cost gradient is distorted. We have the most affordable charges at public hospital Class B2 and C wards where subsidies are greatest, then Class B1 and A, followed by private hospitals. But private hospital bill sizes have become significantly higher than the Class A wards even for the same procedures, and even though both are not subsidised. Therefore, the cost curve of options is not a smooth slope. There is a steep climb from unsubsidised public to private hospital care.
21. The next question is: what led to higher costs in private hospitals?
22. One major driver is insurance. Insurance riders have become too generous over the years. They offer ‘total peace of mind’, and became the plan of choice for the large majority of our population. But this triggered off the tendency for people to ‘use more than necessary’, and providers to ‘serve more than necessary’. It is just human nature when someone else is paying the bill. And this has fuelled further rises in private hospital costs.
23. The strong coverage offered by private health insurance also supported a private hospital operating model geared towards high-end care. The last time Government tendered out land for private hospitals was some 20 years ago. I think we all remember which one. The land was won with a high bid price and today we have a high-end private hospital occupying the land. In the process, public healthcare also lost many good healthcare professionals to the private hospital, which was very painful for us. That experience has made the Ministry of Health (MOH) very cautious about having more private hospitals. And for that matter, very cautious about private hospitals expanding, which you have experienced.
24. We now realise that ‘total peace of mind’ is very expensive, in more ways than one, and has resulted in an unsustainable situation.
Smoothening the Cost Curve
25. We are therefore taking steps to narrow or fill the cost gap between public and private hospitals.
26. We are tightening the design of private healthcare insurance riders to refocus them on providing assurance against very large hospital bills, rather than small bills that are covered by deductibles and MediSave. This means moving insurance riders away from the ‘total peace of mind’ proposition, because it leads to escalating premiums, which over time will actually cost patients even more.
27. These new requirements came into effect earlier this month and I hope policyholders, in consultation with your financial advisors, will consider if the new policy riders meet their needs better and help them save costs.
28. Next, we encourage the establishment of lower-cost private hospitals. Not all private hospitals are high-cost or need to be high-cost. Mount Alvernia Hospital is a very good example. From time to time, I actually get members of the public writing to me, asking me why do certain unsubsidised treatments or diagnostic scans in a public hospital cost more than those in Mount Alvernia? You are therefore exerting competitive pressures on public hospitals and keeping us on the ball, which is good.
29. But we only have one Mount Alvernia, and we wish for more private hospitals like you. That is why I had earlier announced MOH’s plans to establish a new not-for-profit private acute hospital to provide another lower-cost private healthcare option.
30. To this end, the Government intends to release a plot of land for this new private hospital, in the Eastern region of Singapore. If we do proceed with this, it will be the first land release for private hospitals in almost two decades. It should be adequate for 300 to 400 hospital beds.
31. And to provide for a lower-cost option, we intend to stipulate certain requirements in the tender documents.
32. The first is bill size restrictions, so that the hospital bills are a certain percentile of the market. They cannot lead the market.
33. The second is to adopt a fixed-price land tender approach. Under such a model, bidders would then compete not based on how much they are prepared to pay for the land, but other qualitative factors, such as their care model, cost efficiency, approach to recruiting and developing manpower, and their commitment and policies towards affordable healthcare.
34. MOH has been consulting many stakeholders on this not-for-profit private hospital. We have encouraging responses from potential operators and also enthusiastic donors and philanthropists. I believe we can make this a good project that will strengthen the healthcare ecosystem, and involve many stakeholders outside of public healthcare.
35. There are still a few important issues we have to address, and I hope we will be able to address them and arrive at a decision in the second half of this year, to launch the tender.
Conclusion
36. And on this hopeful note, let me conclude by thanking Mount Alvernia Hospital again, for demonstrating that social mission is a key driving force behind good quality and affordable healthcare. I thank Mount Alvernia Hospital’s leadership, staff, and partners for more than six decades of service. May you have many more years of serving people and alleviating pain and discomfort. Congratulations on your 65th anniversary. Thank you.