10,000 more beds by 2020 : Gan’s magic wand?

When news of Singapore’s worst hospital bed crunch broke early this month, Health Minister Gan said he was “cognisant” of the problem and that the Government would add 3,700 beds by 2020 (attached report 14 January 2014). He said nothing new. It is an oft-quoted figure taken out of the Healthcare 2020 Masterplan that was released in early 2012. It comprises 1,900 acute hospital beds and 1,800 community hospital beds. But on Monday 20 January 2014, Minister Gan disclosed a much higher figure to Parliament when he said “10,000 more beds will be added by the end of 2020” (http://www.moh.gov.sg/content/moh_web/home/pressRoom/Parliamentary_QA/2014/bed crunch.html).

Within a week, the minister has added 6,300 more beds to his Heathcare 2020 Masterplan. Is this for real or a mere knee-jerk reaction to placate public opinion? It is a substantial deviation from the Masterplan, yet no details have been disclosed so far. I hope that it is real; it is in line with what I advocated in my $60 billion economic rejuvenation plan for Singapore published in 2011. I proposed an additional 8,500 beds which represented a doubling of beds then existing in public hospitals around 2009 which was the latest year with published statistics available at the time. This would enable Singapore to reach First World norms of about 58 beds per 10,000 population within 5 years, that is, by 2016.

Better late than never

Gan’s plan is 4 years behind, but at least he is doing something about the problem unlike his predecessor Khaw Boon Wan. During Khaw’s tenure as health minister for 7 years (2004-2011), the total number of beds (in both public and private hospitals) actually fell from 11,840 to 11,394 despite a population increase of 1 million in the same period (source : Yearbook of Statistics). So the number of beds per 10,000 population dropped from 28 to 22 (population 4,166,700 in 2004 to 5,183,700 in 2011). Which responsible health minister will allow such a substantial fall to happen, let alone the supposedly “best health minister Singapore has ever had” (in the famous words of ex-PM Goh Chok Tong)? Is it any wonder that there is such a severe bed crunch in public hospitals today?

Ghost of the White Paper?

Minister Gan must tell us what is the population size that he has used for the year 2020 when deciding to build 10,000 more beds by 2020. Is this population figure in line with the Population White Paper approved by Parliament in early 2013? What would be the expected number of beds per 10,000 population when the additional 10,000 beds are put in place by end 2020?

Let us work out the numbers in case the minister is not promptly forthcoming. With 10,000 more beds adding to the stock of 11,853 beds in 2012 (latest year for available statistics), there will be a total of 21,853 beds in 2020. What will be the population then? The White Paper targets a population of 6.9 million by 2030, an increase of 1.5 million over 17 years (2013-30) or an average annual growth of 88,235 persons. Using this annual rate, the population will increase from 5.4 million in 2013 to 6.02 million in 2020. The number of beds per 10,000 population will then be 36 which is not even two thirds of First World norm.

Press for full disclosure of facts in the White Paper

Does this mean that Singaporeans will continue to see their loved ones lying on beds in hospital corridors and make-shift tents in the years ahead? We can avoid this Third World situation either by increasing the number of beds sharply to around 35,000 beds by 2020 or reducing the total population appropriately, or doing both at a slower pace or in ways that do not degrade the quality of public service. That is why it is vitally important for Singaporeans to oppose the Population White Paper unless adequate public facilities in essential services are put in place. And all the working numbers to achieve these facilities must clearly be shown to the people. That’s what we expect of a responsible and transparent government.

Tan Jee Say

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