Polyclinics to set aside slots for walk-in patients with urgent medical needs, elderly patients with mobility issues

[The_King]

SINGAPORE: Polyclinics will set aside slots for walk-in patients with urgent medical needs and elderly patients who are frail and have mobility issues, Senior Minister of State for Health Janil Puthucheary said in response to questions about polyclinic appointments on Tuesday (Jul 4).

Members of Parliament (MPs) had filed questions on how the Ministry of Health (MOH) would ensure access to polyclinic care for the elderly who cannot book appointments online, and others asked if it was possible to release appointment slots in a few fixed tranches each day rather than a single release at 10pm. 

The issue of patients being unable to secure online appointments is not a new one, with MPs raising such concerns in earlier sittings. 

On Tuesday, Dr Janil noted that the healthcare system was facing increasing demand due to an ageing population, and that new polyclinics had been delayed due to the COVID-19 pandemic. 

"As a result, some polyclinics have greater demand and less easy availability of appointments," said Dr Janil.

Polyclinics will put in place short-term measures to address these issues. 

It will set aside slots for walk-in patients with urgent medical needs and elderly patients, particularly those who are frail and who have mobility issues. 

"To do so, non-urgent cases may be given an appointment for another day or advised to seek treatment at a nearby Community Health Assist Scheme (CHAS) GP (general practitioner) clinic. Polyclinics will also try to leverage telemedicine as much as possible, and contract private GPs to help deliver the service," said Dr Janil. 

Responding to MP He Ting Ru's (WP-Sengkang) question on releasing appointment slots in tranches, Dr Janil said some polyclinics already did so. 

"However, this does not solve the issue of capacity constraint and in fact may frustrate patients more if they are repeatedly unable to book appointments," he added. 

MP Tan Wu Meng (PAP-Jurong) asked for monthly data showing how fast online booking slots are fully reserved, and how many patients logged into the polyclinic online appointment booking system the night before a consultation date but did not proceed to book one. 

Dr Janil said MOH did not have the data requested by Dr Tan.

 

Several MPs then raised problems their residents faced in getting polyclinic appointments and suggested ways to improve the process. 

Dr Tan, Mr Liang Eng Hwa (PAP-Bukit Panjang), Assoc Prof Jamus Lim (WP-Sengkang) were among MPs who said residents faced significant difficulties trying to book polyclinic slots. 

Leader of the Opposition Pritam Singh (WP-Aljunied) asked if it was possible to increase the number of walk-in slots at polyclinics and asked for the percentage of walk-in slots set aside. He also asked for the number of complaints from those unable to book appointments online.

In reply, Dr Janil said that he did not have the data sought by Mr Singh. 

Dr Janil added that it was possible to increase the proportion of walk-in slots but that it would not improve overall capacity, which was at the "heart of the issue". 

"I understand there is frustration with the online system for seniors. But there are also people who are able to use the online system and as a result the availability of the resources and the capacity for the services at the polyclinic are better matched to those patients," said the Senior Minister of State for Health. 

He reiterated the need for balance between online bookings and walk-in slots. 

"If we went to a fully walk-in system, that would have an implication on the ability for the care teams to deliver the service that they are used to delivering. If we went to a fully online system, indeed, the frustrations that members in this house have highlighted will become worse, so we need a balance.

"The question then is, what is the best way of determining that balance and this is left to the operational teams running the polyclinic to take into account their capacity, the services that they deliver, the demographics of their population, and it can vary over time," Dr Janil said. 

Assoc Prof Lim asked if online bookings could be channelled towards telemedicine. 

Dr Janil replied that the authorities were exploring the option, but that professional teams would assess whether patients required in-person appointments or online consultations. 

"I think that's something for a clinical judgement rather than a policy position, but we would support the teams so that we can optimise the use of telemedicine and make sure that we improve the capacity available at the polyclinics," added Dr Janil. 

Raising the example of a resident who failed to secure an online booking for her elderly mother four days in a row, and another who was not IT savvy, Dr Tan suggested the use of a hotline residents could call in for bookings instead. He also suggested improving subsidies at CHAS GP clinics to be comparable to polyclinics. 

Dr Janil responded that the ministry would continue to explore "the role of things like hotlines and other ways to improve our processes so that the appointments and the services available at the polyclinics are indeed more accessible and user friendly". 

He added that the question of subsidies at CHAS GP clinics was constantly being reviewed. 

"We will have to constantly review the conditions as well as the level of subsidy that we provide for the CHAS GP clinics and indeed take into account the relationship with what happens in the polyclinic," Dr Janil said. 

Source: CNA/wt(zl)

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