In a move to ensure that Singapore’s regulatory system for healthcare services are kept up-to-date, the Ministry of Health (MOH) will be reviewing the Private Hospitals and Medical Clinics Act.

Speaking at a scientific conference organised by Duke-NUS Medical School, Minister of State for Health Lam Pin Min said that the review was a way to “keep pace” with the rapid advances in medicine and health technology, as well as “new and changing modalities of services, and the profile and needs” of the population.

The Act — which stands as the key piece of legislation for all healthcare services in Singapore used by public and private patients — was enacted in 1980 and last amended in 1999. Since then, much had changed in Singapore, Dr Lam said.

For instance, the licensing framework now under the Act is “premise-based”, working on the assumption that all healthcare services are provided from a physical, brick-and-mortar location, but given the growing prevalence of mobile, online and co-located services, this would need to change.

The authorities may also look at tiering the Act’s regulatory requirements based on the nature and type of service because, right now, it does not “differentiate appropriately” one type of healthcare institution from another, and this may result in the “force-fitting” of some institutions to fit the regulations, Dr Lam said.

As an example, community hospitals have historically been subjected to the same requirements as acute hospitals.

The review would aim to strengthen governance systems and improve regulatory clarity, he added, so that service providers would be more aware of their responsibilities and become more “accountable” to patients.

From November, the ministry will be holding focus-group discussions with representatives from large and small healthcare players, including nursing homes. It will also reach out to groups of patients and the public.

Ms Lai Foong Lian, director of nursing and head of Jamiyah Nursing Home, said that an urgent need would be to review the entire eldercare system.

“As long as nursing homes are under the purview of the MOH’s licensing, it tends to be more medicalised,” she said, pointing to how there are documentation protocols in giving out medication, for example.

Dr Belinda Wee, co-founder of private nursing home Good Shepherd Loft — which has just about 30 beds — is hoping that the authorities will look into differentiating the regulations for institutions of various sizes, especially for small players like the home.

She would also like the review to look into a more standardised auditing process for inspectors because the existing process is still quite “subjective” and “ad hoc”.

Other observers agreed that the impact of digital technology must be considered in updating the Act.

Ms Loh Shu Ching, chief executive officer of Ren Ci Hospital, is concerned about service standards and patient safety with the proliferation of online services.

“To some extent, the laws are always playing catch-up, especially when the spectrum of service has grown over the years, along with the use of new technologies,” she said.

Dr Jeremy Lim, who leads management consultancy Oliver Wyman’s health and life sciences practices across the Asia-Pacific region, said that technology would enable nurses and other professionals to provide advice remotely, not just from hospitals and clinics. And a single setting might provide various healthcare services and so “merit different levels” of regulatory oversight.

Given the evolving needs, the Act should see an automatic review every five years, he added. Toh Ee

Source:
courtesy of TODAY

by TOH EE MING

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