Committee of Supply 2024 debate, Day 6: Ong Ye Kung on managing hospital capacity crunch and rising healthcare costs

The Government will expand hospital capacity and catch up for the time lost due to the COVID-19 pandemic, said Health Minister Ong Ye Kung. Outlining the strategies in Parliament on Wednesday (Mar 6), he said the Government intends to add another 4,000 beds by 2030 and should see new capacity coming on stream every year from now to 2030. It opened about 640 new acute and community hospital beds since June last year. They make up over 11,000 public hospital beds. In 2024 and 2025, Woodlands Health will commission up to 700 beds. In 2026, Sengkang General Hospital and Outram Community Hospital are expected to expand by about 350 beds by converting non-clinical spaces into hospital wards. In 2027, the Elective Care Centre at Singapore General Hospital (SGH) is expected to open with 300 beds. In 2028 and 2029, the redeveloped Alexandra Hospital is expected to open progressively. In 2029 and 2030, the new Eastern General Hospital Campus is expected to open progressively. In the early 2030s, the Government hopes to see the completion of a new regional public hospital. It has just completed one in the North - Woodlands Health - and is building another in the East, as well as expanding SGH in the central region. The next new public hospital will be in the West in Tengah Town, to be run by the National University Health System cluster. Mr Ong warned against being trapped in the mindset of “building hospitals” when thinking about capacity. There is potential to better anchor care outside of hospitals and in the community, he said. To facilitate appropriate transfers from acute hospitals to community settings, the Government will provide more funding to community hospitals. From the fourth quarter of this year, more diagnostic services like CT and MRI scans and relevant drugs will be subsidised at community hospitals. It will also align the community hospital subsidy framework to the acute hospital subsidy framework so that patients receive the same subsidy rate of 50 per cent to 80 per cent throughout their inpatient stay. Secondly, the Government will make Mobile Inpatient Care at Home (MIC@Home) a mainstream service in public healthcare institutions from April. The hospitals intend to price MIC@Home similar to or lower than a normal ward. Patients will be supported by subsidies, MediShield Life and MediSave - no different from a physical inpatient stay. The Government will further expand the capacity of MIC@Home from 100 in 2023 to 300 in 2024, with the potential to scale up further later. Thirdly, the Government will encourage telehealth. By the second half of this year, it will expand MediSave coverage to telehealth consults for preventive care services. Turning to concerns over rising healthcare costs, Mr Ong said Singapore has weaved together a more robust way of paying for healthcare, comprising subsidies, MediSave, MediShield Life and MediFund. The Government will be conducting a comprehensive review of MediShield Life, which aims to cover nine out of 10 subsidised bills. However, this nine in 10 benchmark is being eroded because the size of hospital bills is getting even bigger, said Mr Ong. As a result, the proportion of subsidised bills adequately covered by MediShield Life has come down to around eight out of 10 and is expected to continue to slip. The Ministry of Health has tasked the MediShield Life Council to look at ways to give Singaporeans greater assurance against large bills by increasing how much a patient can claim for surgeries and hospital stays. Mr Ong said it envisages a “fairly significant” increase in the claim limits. Secondly, it should explore enhancing outpatient coverage by raising the claim limits for treatments such as kidney dialysis to reduce out-of-pocket expenses for patients. The Council will also explore extending coverage to more types of outpatient care. Thirdly, the Council has to consider expanding MediShield Life coverage to new groundbreaking treatments, specifically Cell, Tissue and Gene Therapy Products. The Council will complete its review in the second half of this year. Mr Ong said while the Government addresses these immediate concerns, it should not lose sight of the long-term and strategic direction of healthcare - to continue to “build health and not just treat illnesses”. This strategy is crystalised around Healthier SG. Since it was launched in July last year, 2.4 million Singapore residents aged 40 have been invited to participate in the initiative. As of last month, 765,000 have enrolled with a family doctor of their choice. Of these, 60 per cent are enrolled with GPs and the remaining with polyclinics. To enhance Healthier SG, the Government will expand the range of health protocols to cover more conditions. It will also improve the health plans to start giving more specific advice, such as recommending aerobic exercise three times a week instead of “exercise more”.