The advancement of modern technology in healthcare services, increasing ageing population and chronic diseases prevalence, calls for a change in legislation, says the Ministry of Health (MOH) Singapore.

With that, the MOH announced on 5 January, the draft of a new bill known as the Healthcare Services Bill (HCS Bill) – that can be accessed online. This new bill will be used to replace the previous act – Private Hospitals and Medical Clinics Act (PHMCA) – that was last amended about 19 years ago. This consequently calls for “new care models and coordinated team-based care across healthcare settings and providers.”

The Bill, is expected to be enacted later this year and will determine the regulatory standards for a variety of services, including medical transport, radiation oncology and tissue banking. It will be implemented in three phases: starting with Phase 1 from December 2019, dealing with the existing PHMCA medical and dental clinics, as well as clinical laboratories.

HCS Bill to provide more safeguards for patients

The broader scope of the Bill is needed “to safeguard patient safety and well-being, strengthen regulatory clarity, enhance governance of healthcare providers and ensure continuity of care and accountability”.

Restrictions on engaging healthcare workers who cater to frail or vulnerable groups will be introduced. This intends to prevent the abuse of elderly in places such as nursing homes, hospices and chronic sick units, as well as ban the hire of such abusers.

“The Bill will facilitate the development and licensing of services such as tele-medicine, genetics screening and new cell tissue and genetic therapy services,” said Adjunct Associate Professor Raymond Chua, MOH’s director of health regulation group at a media briefing.

The HCS Bill broadens the scope of coverage in the healthcare services. Photo credit: MOH Singapore
The HCS Bill broadens the scope of coverage in the healthcare services. Photo credit: MOH Singapore

Traditional medicine and allied health and non-physician healthcare will also be administered by the Bill, even though those services currently do not need to be licensed.

A member of the Government Parliamentary Committee for Health, Ms Tin Pei Ling complimented on the broadening of regulations to include non-premises-based services. “With ageing, there is increasing need for mobile care services such as home nursing. Already, there are companies operating in this area of need where they match supply of professional freelance nurses to home- or bed-bound patients.”

Furthermore, specific practices and services listed in the Bill that are considered unsafe will be banned. Licensed premises such as a general practice clinic are forbidden to house unlicensed services, for example a beauty salon – unless a wall separates them and each consists of its own entrance.

Services-based licensing framework under the HCS Bill. Photo credit: MOH Singapore
Services-based licensing framework under the HCS Bill. Photo credit: MOH Singapore

Contribution to NEHR, now compulsory

The Bill also deems it compulsory for all healthcare providers or institutes, including laboratories, to input patient details into the central database – National Electronic Health Records (NEHR) – so that all doctors and other medical practitioners will be able to access them. However, employers and insurers will be prohibited from accessing system.

The NEHR will enable any doctor to access relevant medical information to help in treatment and diagnosis, and also prevents loss of data – should a doctor retire. This is particularly useful in emergencies as timely access to medical records will be able to save lives.

“I think it will help them to save time and cost because if they had a lab test or X-ray done in other settings, it can prevent them from having duplicate tests,” said Associate Professor Chua.

Doctors can only access basic information, like diagnosis, laboratory reports, medications, allergies and immunisations, and the discharge report. There is also an opt-out option for patients who are concerned about their privacy.

New and stricter penalties to govern the healthcare landscape

With the implementation of a new Bill, stricter penalties will be in force as well.

For example, the current legislation states that a person who does not have relevant licence and offers a healthcare service, can be fined up to SGD20,000 and jailed for not more than two years. However, for the new Bill, the maximum fine will be increased to SGD100,000 instead, with the jail term unchanged.

In addition, this Bill also has new punishable offences. For example, if false or misleading statements are provided to the MOH, when applying for a clinic licence, a maximum fine of SGD20,000 and a jail term of maximum one year will be implemented.

There may be further changes to the final Bill, as MOH is hoping to receive more feedback over the next six weeks. The public and relevant healthcare providers can also join the consultation session for better understanding.

A member of the Government Parliamentary Committee for Health, MP Joan Pereira commented, “the Bill is a very timely and necessary step as the healthcare services landscape in Singapore is maturing".

“The bill once enacted will be able to better safeguard the welfare and safety of the patients as well as see how we can facilitate better continuity of care for patients,” Associate Professor Chua said. MIMS

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