By Andrew Loh
People’s Action Party (PAP) Member of Parliament, Dr Chia Shi Lu, elaborated on Thursday his position on the hospital bed shortage problem.
On Wednesday, the Straits Times reported Dr Chia, who is a consultant orthopaedic surgeon and a member of the Government Parliamentary Committee on Health, as saying that the problem “might be due to the holiday season rather than a spike in illnesses.” [See here: “Hospital bed crunch due to “holiday season”, says PAP MP”] His remarks sparked off criticisms from members of the public, some of whom related their own personal experiences online to rebut Dr Chia.
On Thursday, according to the Straits Times, Dr Chia clarified his remarks and said that the bed crunch is “due to several reasons.”
Dr Chia said the “holiday season ‘exacerbated’ bed shortages in public hospital”, the Straits Times reported.
Dr Chia said told the newspaper:

“When you have a double holiday like this, Christmas and the New Year around the same time with school holidays as well, you get problems on the demand side.
“During these holidays, some polyclinics and specialist clinics are closed, so you may have a few more people going into the emergency departments instead. Among these people, you may find a higher chance of someone needing to be admitted.”

He also said “a variety of other reasons lay behind the bed crunch issue.”
According to the Straits Times;

Some of these were administrative and social in nature, including more patients scheduling minor surgeries during the holiday period when work is slower.
There are also some families who are not ready to take their loved ones home from the hospital and want them to stay for one or two more days, he pointed out. This gives caregivers a short respite from looking after them.
Dr Chia added that hospitals try to prevent situations like these by encouraging patients to be discharged when possible.
“Most doctors find it very difficult to force patients to leave. Telling them, look, you should go home, because people are waiting for your beds…it’s easier said than done,” he added.

However, Dr Chia’s latest explanation has again attracted criticism.
Posting on the Straits Times Facebook page, Peter Tan said:

What I do agree is that some patients with non-critical surgery during these period. BUT, I thought there are proper hospital scheduling software? Can’t be all the patients come at same time to do operations, as well as hospital will allow them to come all at same time too. Unless there is an epidemic where demands outstrip supplies, seasonal changes should be predictable using MOH data + 6.9m estimates.
Never plan properly just admit lor. What’s the big deal?

Guo Xiongwei said:

Something that is out of the norm.
Did ST report annually for the past 10 years that hospitals run out of beds during the holiday season? I don’t recall reading such.
If there’s such a bed crunch this year, is it possibly due to the current 5.4m population than the 4m at year 2000? More population, obviously more demand.

And Peter Tan echoed what some felt:

Think. For scheduled appointment for surgery, there are allotments. Where got suka suka go do surgery whenever you feel like it. Unless there is an epidemic or major industrial accident, all seasonal spike should already be contained.

On Wednesday, the Health Ministry explained how it is tackling the bed crunch problem. This include building more hospitals, with  the new 700-bed Ng Teng Fong Hospital opening this year, and two community hospitals next year. A new hospital in Sengkang will also be operational in 2018.
In the meantime, hospitals are also renting beds from private ones, and discharging patients to community hospitals.
In his Committee of Supply speech in Parliament in 2012, Health Minister Gan Kim Yong laid out the government’s long-term vision for the healthcare sector in 2020.
Specifically, Mr Gan elaborated on the plans to expand the number of hospitals and beds.
“By 2020, we will increase the number of acute hospital beds by more than 30%, or 1,900 beds, and Community Hospital beds by around 1,800, which is a tripling of the 800 Community Hospital beds we have today,” he said. “Altogether, we will provide 3,700 more hospital beds over the next 8 years.”
He said that the new Ng Teng Fong General Hospital in Jurong and the Jurong Community Hospital, to be opened in 2015, will together add more than 1,000 beds in total in the west.
In the northeast, the government will advance the opening of the new Sengkang General Hospital from 2020 to 2018. The hospital will have “a higher than usual capacity” and together with its sister community hospital, will provide 1,400 beds in total.
“We intend to integrate acute and community hospital beds to provide greater flexibility and to better cater to the needs of patients.”
In the east, there will be increased capacity of both Changi General Hospital and St Andrew’s Community Hospital through the construction of a new Integrated Building, which will yield around 250 acute and community hospital beds. This will be ready by 2014 and increase the combined bed capacity of Changi General and St Andrew’s by more than 25%.
In the north, the new Yishun Community Hospital next to Khoo Teck Puat Hospital will be ready by 2015.
“In the central region,” Mr Gan said, “we will build a new community hospital in the Outram campus, where Singapore General Hospital is. Together, Yishun and Outram will add another 800 CH beds.”
While all these will be welcome by the public, the current shortage can also be nerve-wrecking for those who need the medical attention.
Former Nominated Member of Parliament (NMP), Associate Professor Paulin Tay Straughan, recently had had to admit her husband at the National University Hospital (NUH).
On Tuesday morning, she had dropped him off at the Emergency Department of NUH to be treated for a chronic ailment. Her husband was bleeding internally.
Ms Straughan said he had to wait 12 hours to get a bed.
She said she was “stunned and shocked” with the situation.

“I knew that we had a bed crunch, because this was already highlighted by news reports several years ago, but I didn’t realise that this was a sustained phenomenon and it had gotten so serious.”

She added, “We certainly don’t hope that tents become a permanent feature, containers become a permanent feature in a hospital establishment.”
She was apparently referring to the tents which the Changi General Hospital had put up in the past week to cater to patients who could not get a regular bed in the hospital.
“How did we allow ourselves to come to this state? A glitch is when it happens once in a blue moon. But when it happens so frequently then it’s no longer a glitch, it’s the new norm,” she said.
“So the question is what happened in the planning, the masterplan for hospital beds 5 to 10 years ago?”
Clearly, the cause of the crunch should not simply be laid on the “holiday season”, even if it does contribute to the problem. The MOH, in its statement on Wednesday, did not finger the holiday season as the cause or even a cause of the crunch.
What is needed is more information from the authorities.
Speaking to The Online Citizen about the matter, Dr Paul Tambyah, an infectious diseases expert, said:

“There are many other factors which may have contributed to this surge including the ongoing dengue epidemic (although a lot more of these patients are being treated as outpatients). We need more data to understand the specific reasons for the increase at this time if indeed it is an unusual surge.”