Singapore Healthcare- Collective response from some Gleneagles specialists

Hi Friends,

The letter below was written after a group of Gleneagles specialist doctors felt that what Dr Lee Wei Ling ( yes she is MM's daughter but she usually still has a mind of her own) wrote  in the previous week's column made a lot of sense (Training GP's to be family physicians) . And as usual, they turned to me and said, " SC, can you write to the papers and say that we support her on this" and like they say- the rest was history.

It was almost like drafting a UN resolution- some contentious items were left out and the final  result was agreeable to most ( but some had cold feet- but that's another story).

I did not expect anyone to read the letter as it was only on the online edition. But the miracle of the internet meant that obscure stuff does get picked but by some and  apparently, angrydoc did just that but  unfortunately he ( or she) is negative and cynical about any government intervention ( he calls it subsidy).  Read his blog post here : Subsidy and other pre-occupations

From the tone of angrydoc- I guess the 27 ( and some others who did not get to sign it as I was rushing it to the editor) will be considered "Old School" ( or even anachronistic) doctors who believe that Medicine is about healing the sick ( and not just pandering to some who wish to look younger or cannot accept what Nature has provided). 

Of even more concern to us is the crass commercialization that has seeped into most aspects of Medicine in Singapore.

I guess if this bit of activism does not achieve anything- we can console ourselves that we did not just stand idly by and behaved like so many sad accounts of how Singaporeans just sat immobile whilst some poor girl was being assaulted on a crowded bus or how some flat dwellers said that , yes, they heard violent noises of someone being killed but they wanted to just mind their own business. 

My 27 Gleneagles friends are not like that- we feel things can be better and that our opinions do  matter.

Cheers

Dr Huang Shoou Chyuan

The letter that was published in the online forum page (12 May 2010)

Get GPs back on track



WE ARE doctors specialising in various fields at Gleneagles Medical Centre and we support Dr Lee Wei Ling's gallant attempts to bring medicine in Singapore back to its noble roots ('Train GPs to be family physicians'; April 21).



We suggest the following:


• 
Invasive aesthetic procedures should be carried out only by doctors who have had adequate surgical training. Only then will the practitioner be able to recognise the early signs of complications. Complications happen even in the best surgeon's hands, but it is often how soon these are detected and the course of action taken that determine the fate of the patient. Aesthetic medicine is here to stay and the Ministry of Health (MOH) should organise properly sanctioned courses for all doctors who are keen to carry out invasive aesthetic procedures. The bar must not be set too low, and being allowed to carry out such dangerous procedures after attending dubious one- to two-day courses should be a thing of the past.


• 
General practitioners (GPs) are the vanguards of our health-care system. We want each GP to take his proper place as a 'specialist in taking care of the entire patient'. All of them have undergone training at great expense to the state or their families. MOH should make available rotation positions at various hospital departments for all GPs before they start work and at regular intervals after that, to provide opportunities for 'refreshers' to those who feel they need updates or have gaps in their knowledge of certain specialities. National service 'reservist-style' make-up pay is innovative and workable for this.



• Government subventions for GPs to treat subsidised cases is a win-win for all. GPs get more income and hence will be less likely to go for the more lucrative 'aesthetic medicine' route, and the already overcrowded polyclinics will be able to perform even better. In the same vein, many private specialists are also keen to help by treating subsidised patients who are presently referred to overcrowded specialist clinics at public hospitals.



The medical profession should do regular soul-searching, and if we find that we have deviated from our intended paths, we should have the courage to take remedial actions to rectify this.



Dr Huang Shoou Chyuan 



NB: The Straits Times Editor chose to ignore the fact that the letter above was signed by 27 specialists of Gleneagles Medical Centre

Singaporeans' Medisave Money for Malaysian hospitals

Hi Friends,

Gong Xi Fa Cai!

May we not just have material blessings but also good health so that we can live meaningful lives amongst our kinfolks, friends and community.

My largely unedited letter has been published in the Straits Times Forum today.

I am disturbed that MOH –which had backed down earlier about setting up Old Folks’ Homes in Malaysia after an uproar, has now introduced it again, albeit in a different skin.

Healthcare initiatives- Old Folks’ Homes and now this
The Old Folks’ Home initiative and now the Medisave for Malaysia move is an admission that certain Singaporeans have been priced out of their own homeland.

To some,it seems a logical solution,” If Singaporeans cannot afford to live their remaining days in Singapore- why not just let them do it in Malaysia”. Now it is –“ If Singaporeans cannot afford to have quality healthcare on our own shores- maybe Malaysia boleh (can) ( with a little help from Medisave)”

But others will ask questions like "Why is it that the MOH feels that in our multi-strata healthcare system, which range from C class beds in public hospitals to the super-duper suites in our private hospitals (that even regional royalties feel comfortable in), cannot meet the needs of Singaporeans? Shouldn’t we try to meet the demands and aspirations of Singaporeans within our system instead of sending them up north? Did we not pay tax so that our system can help us when we are sick and old?

MOH should try harder to improve the system so that Singaporeans feel they get more “bang for their dollars" . I do not recall all major stakeholders being consulted about this.

Impact for tourism industry

What about our national plan to make Singapore a regional centre of excellence for Medical Tourism? Each medical tourist comes typically with at least 2-3 family members. This is a huge spin-off with a multiplying effect for hotels, F&B and shopping centres. In one stroke, the MOH has just leaked out a family secret ( and I am not agreeing to this) that Malaysian hospitals are cheap and just as good!

Malaysia has just got a very un-expected Lunar Near Year Hong Bao from MOH! No amount of publicity nor advertisements by Malaysia’s tourism board can compare with such an ringing endorsement from none other than Malaysia’s erstwhile competitor.

Read this space- there will soon be insurance policies which are priced below our present premiums, but with a catch- “Co-payment if treated in Singapore hospitals, but, full reimbursements if treated in Malaysia”

I guess this populist move will win the minister many votes for the coming elections. Why worry about our healthcare system?

Cheers

Dr Huang Shoou Chyuan

Will it come back to haunt us later? (16 Feb 2010 ST Forum)

I REFER to last Thursday's report, 'Medisave can be used in 12 Malaysian hospitals'. The move by the Ministry of Health (MOH) to allow Medisave deduction for hospitalisation in Malaysian hospitals is, in my view, like scoring an own goal in a soccer match.

To say the least, it sends a confusing signal. It is as though MOH is admitting that it has failed in its mission to cater to all Singaporeans in our own often-lauded health-care system.

Is the claim that even the poorest Singaporean will be looked after in our health-care facilities - with its subsidies and special funding such as Medifund - just an empty boast now?

MOH is in fact using national resources - Medisave infrastructure - to build up a competitor's capabilities. Is MOH still serious about helping Singapore become a medical tourism centre of excellence?

This populist measure may seem to placate short-term demands - only to come back to haunt us later when our own health-care and tourism industries are hollowed out in the medium to long term.

By then, any new measure will be futile and like shutting the stable door after the horse has bolted.

Dr Huang Shoou Chyuan

World Cup 2010: Singapore's MDA has duty to fulfil responsibility to Singapore's public

Hi Friends,

The letter below was published in the Straits Times Forum page (22.1.10) ( albeit in a truncated version).

The letter:

Dear Editor,

The Media Development Authority (MDA) should take decisive action now to ensure that key World Cup 2010 matches, including Opening match, semi-finals and final matches are telecast over the free-to-air channels, regardless of what cable content providers do for the following reasons:

1. MDA collects license fee of $110 per year from each household with a television set and the paying public expects MDA to telecast content which the public deems as basic infotainment. With increased affluence, these key World Cup matches would easily qualify as a must-have item in any given menu just as key events in the recent Olympic games were.

2. There are still many households in Singapore who cannot afford cable subscriptions. Hence MDA should never abrogate its basic responsibilities to cable content providers such as Starhub or Singtel. Of course, if these cable providers had bought the rights (which they had not) and wanted to telecast all the matches to cater to die-hard football fans, they are just meeting their commercial obligations.

It is time MDA or other relevant government bodies step in to do the right thing.

The public expects no less!

Dr Huang Shoou Chyuan