Hansard, 1993-03-17

ORAL ANSWERS TO QUESTIONS - RESTRUCTURED HOSPITALS - (Operational cost) asked the Minister for Health (a) what is the operational cost of running restructured hospitals, giving a breakdown of the profit/loss of these hospitals from 1990 to 1992 and (b) whether there will be an increase in the charges of these hospitals and, if so, what measures his Ministry is taking to curb the rising charges.

ORAL ANSWERS TO QUESTIONS - RESTRUCTURED HOSPITALS - (Operational cost) Mr Speaker, Sir, the total operational cost of running the Singapore General Hospital, Kandang Kerbau Hospital, Toa Payoh Hospital and the National University Hospital for 1990, 1991 and 1992 are as follows: Operating Operating Government Net Year Cost Surplus/(Deficit) Subsidy Surplus/(Deficit) 1990 $486m ($201m) $181m ($20m) 1991 $534m ($195m) $187m ($8m) 1992 $547m ($182m) $208m $26m $1567m ($578m) $576m ($2m) ------ ------- ----- ------ The net surplus of $26 million in 1992 was mainly due to an increase in the subsidy received by NUH. This was because NUH's subsidy in earlier years was under-computed by about $10 million and this shortfall was paid to the hospital in 1992. Sir, manpower costs account for 65% of the operating costs of hospitals. As long as Singaporeans enjoy good pay increases, medical cost must rise accordingly. This is because hospitals also have to pay competitive wage increases in order to be able to recruit and retain their staff. It is therefore better that hospitals increase their fees by small amounts every year to cover their cost increases, rather than to defer such revisions and have large increases every few years. The hospitals will, however, continue to improve and streamline their operating systems and procedures, and optimise on the use of manpower. Other measures which the hospitals are taking to control costs include: a) Restricting the purchase and regulating the use of expensive medical equipment; b) Controlling the use of expensive drugs; c) Automating labour intensive procedures; and d) Avoid duplication of services amongst hospitals. Since hospital operating costs will continue to increase, it is inevitable that part of the cost increases be absorbed by the patients. However, for subsidised patients, because of Government subsidies, much of these cost increases will be borne by the Government. The Government will pay for as much as 80% of the cost increases for Class C patients and 65% of the cost increases for B2 patients.

ORAL ANSWERS TO QUESTIONS - RESTRUCTURED HOSPITALS - (Operational cost) Sir, could the Minister ask the restructured hospitals to present statements of accounts to Parliament?

ORAL ANSWERS TO QUESTIONS - RESTRUCTURED HOSPITALS - (Operational cost) Sir, the hospitals are private companies owned by the Government and their accounts are published every year. If Members of Parliament wish to have them, I can arrange for Members to receive their annual reports.

ORAL ANSWERS TO QUESTIONS - RESTRUCTURED HOSPITALS - (Operational cost) Sir, may I ask the Minister what was the percentage of manpower cost of these restructured hospitals before they were restructured?

ORAL ANSWERS TO QUESTIONS - RESTRUCTURED HOSPITALS - (Operational cost) Sir, the manpower cost of the hospitals appeared to be higher before they were restructured. In fact, the manpower cost amounted to slightly over 70%. This is because a fair bit of the operating cost was actually hidden subsidies provided by the Government. By restructuring, we were able to recognise these hidden subsidies and therefore the manpower cost, as a percentage of the total operating cost, went down to 65%.

ORAL ANSWERS TO QUESTIONS - RESTRUCTURED HOSPITALS - (Operational cost) Sir, does the Minister envisage an improvement of the deficit situation now that there will be a revision of the Consultation Fee Scheme?

ORAL ANSWERS TO QUESTIONS - RESTRUCTURED HOSPITALS - (Operational cost) Sir, the revision in the Consultation Fee Scheme will in no way affect the operating cost. This is because the Consultancy Fee Scheme comes out from more or less a fixed pool of money. The revision only affects how that sum of money is to be distributed amongst the doctors.

MEDICAL AND HOSPITAL CHARGES - (Conditions for waiver) asked the Minister for Health if he will state (i) the conditions under which a patient can apply for a waiver of medical and hospital charges and (ii) the number of such applications in each restructured hospital and the number of successful applicants for the years 1990 to 1992.

MEDICAL AND HOSPITAL CHARGES - (Conditions for waiver) Sir, any Class B2 or C inpatient or subsidised outpatient who is unable to pay his hospital charges can apply for full or partial remission of the charges. In evaluating an application, the medical social workers take into consideration the choice of ward class, the size of the hospital bill and the home and financial background of the patient and his family. Details of the applications for waiver received by the hospitals from 1990 to 1992 are as follows: 1990 1991 1992 No of No of No of Hospital Applns No Approved Applns No Approved Applns No Approved Kandang 39 38 36 34 52 51 Kerbau (97%) (94%) (98%) Hospital National 428 428 371 371 603 603 University (100%) (100%) (100%) Hospital Singapore 2545 2401 1347 1346 1983 1974 General (94%) (99%) (99%) Hospital Toa Payoh 50 50 62 60 132 132 Hospital (100%) (97%) (100%) Total 3062 2917 1816 1811 2770 2760 (Rate of (95%) (99%) (99%) Approval)

ESTIMATES OF EXPENDITURE FOR THE FINANCIAL YEAR - 1ST APRIL, 1993 TO 31ST MARCH, 1994 Order read for consideration in Committee of Supply [6th Allotted Day].

ESTIMATES OF EXPENDITURE FOR THE FINANCIAL YEAR - 1ST APRIL, 1993 TO 31ST MARCH, 1994 Head R (cont.) - Resumption of Debate on Question [16th March, 1993], "That the total sum to be allocated for Head R of the Main Estimates be reduced by $100." - [Mr Peter Sung]. Question again proposed.