MOH to review healthcare regulations amid changing landscape

SINGAPORE: The Ministry of Health (MOH) will review the regulations on healthcare services in Singapore to keep pace with advances in medicine and technology, Minister of State for Health Lam Pin Min on Tuesday (Oct 25).

Speaking at a scientific conference organised by Duke-NUS Medical School, Dr Lam said the ministry will hold focus group sessions with healthcare industry players on how the Private Hospitals and Medical Clinics Act (PHMCA) should be revised starting next month.

Under the PHMCA, the Health Ministry oversees the licensing and quality of hospital services and other medical establishments. The legislation, enacted in 1980, was last amended in 1999.

Since then, Dr Lam said, much has changed in Singapore’s healthcare landscape and there are many areas to be reviewed.

For example, he noted that the current licensing framework under the PHMCA is premise-based: "It works on the assumption that all healthcare services are provided from a physical, bricks-and-mortar location."

This needs to change given the increasing prevalence of mobile, online and co-located services, he said.

Dr Lam added that the current regulations do not differentiate appropriately between certain types of healthcare institutions, resulting in some institutions "force-fitting" into the Ministry's regulations. For instance, community hospitals have, historically, been subject to the same requirements as acute hospitals, he said.

Ren Ci Community Hospital, for example, offers rehabilitative care to patients, but does not provide services such as surgery or radiology. As such services are required under the current Private Hospitals and Medical Clinics Act, adjustments had to be made to keep the community hospital running.

"MOH has been pretty flexible in accommodating the community hospitals," said Ren Ci Community Hospital CEO Loh Shu Ching. "So they have waived certain requirements with regards to PHMC Act for us. The Act does require hospitals to have a proper A&E. It talks about hospitals having dietetic services, lab services and radiology services."

With a review of the Act underway, Ms Loh said she hopes changes to the legislation will take into account the changing healthcare environment - an area the Health Ministry is looking into.

"What would be more appropriate is to tier the PHMCA’s regulatory requirements according to the type and nature of service," said Dr Lam, adding that MOH will also take the opportunity to strengthen governance systems and improve regulatory clarity.

One healthcare player said regulators need to play catch-up. 

"Today, patients have so many choices," said Mr Jean-Luc Butel, President of K8 Global and a global healthcare advisor. "They can choose private sector, community hospitals, large university hospitals; they can go on the Internet. They can buy so many products over the counter, diagnostic kits. So the decision-making process has become very complex and therefore the regulators need to look at that."

In the coming months, the Minister of State said the Health Ministry will consult widely with healthcare representatives such as clinics, hospitals, clinical labs and nursing homes. It will also reach out to patient groups and members of the public on how its regulatory framework for healthcare services can be improved.

However, Dr Lam stated that a balance will have to be struck in some areas as the views of stakeholders may differ.

- CNA/mz