One hundred years ago, in 1910, a group of Cantonese merchants founded the Kwong Wai Shiu Hospital (KWSH) to provide their Cantonese comrades with free medical care. Originally, the hospital only served Cantonese members. In 1974, however, its constitution was amended and it admitted anyone from any ethnic or racial group.
The hospital, located along Serangoon Road and which came about from an agreement between the British colonial authorities and the merchants, was built on a 6 hectare piece of land with a 99-year lease. The British government charged it a nominal annual rental of S$1.
Fast-forward to 2010.
Kwong Wai Shiu Hospital and Nursing Home has 14 buildings within its compound. Its facilities include an In-patient Department (IPD), an Out-patient Department (OPD), a Day Rehabilitation Centre (DRC) and a Traditional Chinese Medicine (TCM) Centre. It also operates a 350-bed nursing home facility which is dedicated to the care and treatment of senior citizens who need daily treatment on a long term basis.
When its 99-year lease expired in February this year, the land was returned to the Singapore government. After discussions with the Ministry of Health (MO) and the Singapore Land Authority (SLA), the hospital was granted a new 5-year lease – till 2015 – and had its rental increased from the nominal S$1 to S$1.4 million.
When The Online Citizen visited the hospital, we found out that the hospital’s licence to operate as a private hospital and clinic was only for a two-year period – from 01 January 2010 to 31 Dec 2011.
It has been reported by the media that the MOH, under the new agreement, “has agreed to substantial increase in subsidies” for the hospital. These subsidies could be up to S$1 million to pay its rental of S$1.4 million and a further S$4.8 million for its annual expenses. These figures are, however, just speculation as the government has not made any such agreement public. Even the hospital’s management doesn’t seem to know exactly how much the government will provide.
Inevitably, such non-disclosure by the government throws up many questions.
As a non-profit community hospital which has been running as a charity since 1910, and which depends on patient fees and donations, why is the hospital’s rent being raised 1.4 million times, from $1 to $1.4 million?
It is puzzling that the SLA would raise its rental to S$1.4million and then for MOH to say it will subsidise the rental by up to S$1 million. Even if that were so, its rental would still rise by $400,000 – in one fell swoop, without any explanation by the SLA or the MOH.
It is even more curious if you consider that last year, and according to the Straits Times, “four of the six community hospitals here raised their charges, some by as much as S$50 a day” and the MOH did nothing to help them with the costs of operating the hospitals.
Why the sudden ostentatious generosity towards KWSH now?
In conjuction with KWSH’s rental being increased, we now know that MOH only gave $170,000 last year to KWSH, which is only about 1.5 per cent of the hospital’s annual expenses.
I find it puzzling that KWSH was able to maintain prices for the last 16 years with just $170,000 from MOH. Now, however, under an agreement with MOH last September, the ministry said it would provide as much as 40 per cent of the hospital’s annual expenses – expected to be some $4.8 million. Even with this infusion from MOH, KWSH now says that it does not rule out the possibility of raising prices next year.
So, previously with just $170,000 (which is just 1.5 per cent of its annual expenses), from MOH, the hospital did not have to raise charges, for 16 years.
Now, even with $4.8 million (which is 40 per cent of its annual expenses) from MOH, the hospital may raise charges?
What gives?
We would like to suggest that the agreement be made public, so that we may try to understand why KWSH may have to increase prices, despite a 28-fold increase in MOH funding.
Will the other community hospitals receive similar substantial increase in funding too?
The MOH said, in response to a Straits Times query, that “funding to community hospitals was on a need basis”. What criteria exactly does the MOH use to determine the amount of funding?
Since the agreement was in September last year, why is it taking so long, as about six months have lapsed already, for KWSH to extract financial and patient records for MOH to determine the size of the subsidy funding, as reported by the Straits Times?
Also, as a result of the agreement, KWSH has begun means testing to decide the level of subsidy that each patient should get.
What this means is that a Singaporean patient whose family income is as little as $1,440 (based on a family of four) may have to pay 25 per cent of the cost, rising gradually to 100 per cent for higher income families up to $5,600, in accordance with MOH’s subsidy scale.
This is a departure from KWSH’s 100 year-old tradition of fulfilling its mission of giving free care to anyone, and serving patients without the stress of having to be means-tested under MOH procedures.
In this connection, at least one Voluntary Welfare Organisation (VWO) had opted out of means-testing in the past, to spare its beneficiaries the stress of the process for the critically ill.
Since KWSH had a operating surplus of $1.4 mllion (which coincidentally is what they have to pay for rental now) for the last financial year, perhaps maintaining the status quo without any increase in rent or funding may turn out to be better from the perspective of patients.
As a charity 50-bed community hospital, 350-bed nursing home, out-patient clinic, day rehabilitation centre and traditional Chinese medicine (TCM) centre, we understand that its charges are probably the lowest in Singapore, and most of its patients are the poor and lower-income.
For example, its TCM general consultation with 1-day prescription at $2 and out-patient doctor consultation (inclusive of standard medication) from $8 to $12, are even lower than what the polyclinics charge.
With a staff strength of more than 250 employees plus volunteers, its annual operating expenses of $11.5 million is arguably the most cost-efficient healthcare facility in Singapore.
To encourage more charity healthcare institutions like Kwong Wai Shiu Hospital, the Government should give it more financial assistance, instead of raising its rent.
After all, as we understand, Singapore’s healthcare spending at less than four per cent of GDP, and public healthcare spending at about two per cent of GDP, is already one of the lowest in the world.
Finally, the future of KWSH is uncertain. The hospital’s board members have expressed hope that it will remain as a hospital and nursing home when its current lease expires in 2015. However, a Singapore Land Authority (SLA) spokesman said that it would depend on the outcome of discussions and consultations with MOH and other government agencies.
How different will the KWSH of the future be, after its agreement with MOH for funding?
Perhaps we will only know when its lease ends in 2015.
“My heart was full of pain,” said Ms Ling Bee Sian, director of operations of KWSH, who signed over the hospital to SLA officials in February. “It’s hard to imagine that this land does not belong to us anymore.”
Will poor and lower-income Singaporeans still be able to have KWSH to go to in five years’ time?
Leong Sze Hian / Andrew Loh
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Headline picture from: http://www.panoramio.com/photo/11087819
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Another case of sucking ever ounce of life from the poor and sick
KWSH is sitting on a prime piece of land.
There should not be any speculation on the future of KWSH on the present site when the temporary lease expires in 2015. Just imagine how much a 6 hectare will fetch in open tender? You think the government will allow the poor to enjoy receiving treatment on such a prime site?
The British government has compassion to grant KWSH a 99 year lease at $1 norminal rental. If not for the 99 year lease granted by the British government, KWSH would have been kicked out of the present site long ago, just as Raffles Institution was torn down.
PAP has claimed that no one will be left behind but its policies is leaving the poor to fend for themselves and faciliating the rich to be richer.
So the British government had more heart and was not as money minded as the current one.
Also, it showed that the MOH’s model of healthcare is no good. The argument is that by providing too low a cost of health care to the people, people will misuse it and not taking good care of their own health. This is nonsense! Just look at the Taiwan model.
Our MOH failed miserably compared to their Taiwan counterparts, and to think our ministers are paid millions.
if only this writer dare to verbalise the undercurrent of this article:
the govt is set to control this hospital and use it to strengthen its controls on the prices that patients pay on medical expenses.
Make no mistakes, the govt make you save hard in medisave only to take it away from you like mad through the hospitals that it operates (through proxy).
It is not their intention to keep medical cost low for you.
They don’t want you to have excess medisave monies or to return it to your families when you pass away.
Take a guess why they need to do that.
If u observed carefully, the rental trick is a very common yet powerful employed by the current regime. Just think abt how the GST is implemented and get increased.
At casual thought, one would think that the rental is still cheap as MOH will be providing susidies of up to 1 million ( sweet to pacify and allow them to ammend the $1 rental agreement). Once everything is written on paper black and white, bingo, you are at their mercy.
Anytime, anyhow, they are in control and able to change or increase the rental. Next, they are going to increase the rent heavily, on the other hand, offered u another plot of land located elsewhere.
Got it??
Anything the PAP govt lands its greasy paws on will be corrupted or robbed/co-opted, and I’m sure that prime piece of land KWSH is sitting on is no exception.
SLA and some quasi-govt linked real estate developers are salivating and encircling their prey like hyenas or vultures as I’m typing this.
It’s all about the money. Always has been. Altruism, and heritage be damned, let’s see how much this darling can line our pockets and bump up the GDP.
If the PAP were personified as a son, he would not bat an eyelid selling his parents for some extra pocket money.
RIP KWSH. I hardly knew ye. The best we can hope for is that the URA does conservation and transforms you into some tourist magnet spot. But I’m not holding my breath for that to happen.
i think the govt’s land policy is one of the least understood policy. to many, it seems schizophrenic to raise rent and provide subsidy after that.
the main rationale behind this a internal govt management issue. Land is scarce in Singapore, hence they create a stat board specially to protect and ration out land- even to public bodies. after all, public bodies can be inefficient in land use and even then, they can sit on land that can be better use in other ways. hence, SLA is created to control and allocate land, balancing the different demands. Making the public bodies pay for land instills discipline in their use of land because they have to make room from their budget.
Why PAP? Why? As if the lower-income group isn’t finding it harder and harder to survive in this cut-throat Singapore. It’s all about profit isn’t it?
I also think that the GST is one policy that is highly misunderstood by many people.
The main rationale in the GST is that there are many poor and needy singaporean that need our help. Indeed, in fact our parliament itself got as many as 20-40 poor and needy mp. They required salary of million to support their luxury condo, presentable cars and Hi-So lifestyle.
I already said it before; we are run by Businessmen. So this is no surprise at all… everything they do now, will have repercussions – regardless of HOW MUCH they deny what they have done, and are STILL DOING…
Agreed. Singapore is being run like an enterprise and those at the top only care about how to maximize profit first. In other words, profit first, Singaporeans second.
If the @#%^%&PAP seats still remain intact after the next election, migrate if you can. Otherwise have to go corner ‘suck thumb’.
What it means is that the PAP govt wants abosulte control of everything….housing, health care, CPF etc.
Damn if this hospital is in Hong Kong, the people will fight for it to get the govt. to continue the $1 annual rental for another 99 years lease. Just imagine the whole network has been set up and the facilities have been built.
Another one lease is coming up is the Thai Temple with a huge sleeping Budda…it is hear to this hospital. I was told by the owner’s daughter, that the lease will be up this year or 2012. They don’t know where to move to?
What will happen? Let’s guess.
A ex-army general will be assigned to be in-charge of the hospital and another ex-PAP MP will be in-charge of the temple. what’s next…you continue to think.
Damn, this PAP govt. MUST be voted out.
“…and had its rental increased from the nominal S$1 to S$1.4 million.”
WTF there.
Goes to show that PAP no doubt, NO DOUBT, loves to suck money out of citizens, not even the poor and sick, which Kwong Wai Shiu looks after. Disgraceful.
“It is puzzling that the SLA would raise its rental to S$1.4million and then for MOH to say it will subsidise the rental by up to S$1 million. Even if that were so, its rental would still rise by $400,000 – in one fell swoop, without any explanation by the SLA or the MOH.”
You guys shld try to get Ngiam Tong Dow’s take on this Alice in Wonderland payment. He commented on this few yrs back. I’ll chk if I got article and forward it to TOC.
Better still get his views on this mickey mse gimmick.
things have gotten worse since MOH / SLA come into the picture, hasn’t it ?
Since it is a chairtable cause, why couldn’t SLA just extend the lease for another tenure on the same terms (i.e nominal rent). Is the government so desperately greedy to milk the $ from a organisation which is obviously doing some good to the society ?
It is so typical of gahment, isn’t it ?
People, PAP has to plug the hole in Temasek & GIC. Where got time to bother with the poor?
why do they have to increase the rental by the million and then give subsidy by the million again? The idiots up there ……..oops I mean the elite up there has a habit of making simple things complex or it is a case of them trying to convince the people that they are genuinely helping the poor by confusing the people. This trick always works when you can’t convince them you confuse them.
“Soldiers load your smoke grenade, Fire!”
“Soldiers reload and make ready!…..Fire!”
“Soldiers unload and report clear!”
Again, this may be the case of continually voting in a government that only measures itself based on GDP.
When will we wake up?
another election topic to raise.
When the pigs increase the rental to 1 million and then give 1 million subsidy, it looks good on the account because they can then claim that X amount was given per year in subsidy in Hellcare for Singaporeans. But the truth is that nothing was given in real term.
Just wonder how many such cases exist in the total amount of subsidy “given” annually in Hellcare and other type of subsidy?
Next GE – Bear in mind MOH Minister and Parl Sec
(Khaw Boon Wan and Hawazi Daipi) are both in Sembawang GRC.
One stone kill two birds!
The Pariah, http://www.singaporeenbloc.blogspot.com
Q: Ever wonder who are the pen-pushers behind all these clever public policies in SLA and MOH?
A: Likely all the Govt Scholars educated with citizens’ money.
As Public Servants – instead of SERVING THE PEOPLE after they graduate, they sell their souls to politicians to ensure maximum bonus and promotions.
Wish I could say I was disappointed, but this is exactly what I’ve come to expect from the PAP.
If the government is desperate to building another condo or shopping mall at this piece of prime land near boon keng MRT, they should the very least relocate KWSH to another location with minimum rental. Of course they will have to foot the bill of relocation.
Looks like we cannot deny that “ang moh better”.
Better in what way? In my opinion, in at least 2 ways:-
(1) the colonial masters exercised compassion in governance;
(2) the locals (who were governed) enjoyed the benefit of living in a more humane society.
We must look at things in a comprehensive manner, which includes its proper historical context.
I mean, the British did a good deed in 1910. Why did I emphasize the year 1910? Think about it. In 1910, Britain was at the height of its economic/political power. Britain was at that time a world power: its naval fleet the most powerful/advanced; they had the British Empire, governing vast colonies in Canada, India, Australia and also many mid-sized and smaller territories in Africa, Asia, the Caribbean, etc. It was also the world leader on the intellectual scene. Oxford and Cambridge dominated because USA’s Harvard/Yale/MIT have not yet come into prominence. Beyond Oxford and Cambridge, British authors, poets, musicians, composers, scientists, engineers, etc contributed to advances in their respective fields. This is the historical background.
Yet, the high-powered British rulers in 1910 had it in their hearts to deal compassionately with their local subjects (who were, generally, far less advanced in education and in economic/political power).
What a stark comparison:
(a) Rental of Land
British charged S$1/- only
PAP charging S$1,400,000/-
(b) Length of Lease
British offered 99 years
PAP offering 5 years
Is this why we struggled for Merdeka in the 1960s? What good has Merdeka brought us ordinary Singaporeans? I’m sure it was great for the PAP and the elite. But from this KWSH incident, I find the British to have done far more for the good of the ordinary people of Singapore.
I wonder what more the PAP has to do, before Singaporeans wake up to the fact that PAP governs for the benefit of PAP/elite and NOT for the benefit of ordinary Singaporeans.