MOH: one error a week in Singapore’s hospitals
December 2nd, 2009 | 
Author: Written by Our Correspondent
According to the Ministry of Health, there were 4o1 hospital errors reported over the past seven years, or about one every week. Public hospitals, with heavier caseloads and more complicated cases, made 339 reports and private hospitals 62.
Among the errors: a patient had the wrong knee replaced while five others had swabs left in them after surgery.
These errors are usually kept private within the hospital though it is compulsory for hospitals and doctors to own up to their mistakes.
No one is identified when a mistake is reported. Nor does the ministry pursue those at fault. That is left to the hospital or patients to deal with.
The recent KKH chemotherapy blunder would not be reported in the media if not for the personal connections of one of the victim, Mrs Ng, whose relative contacted a Straits Times journalist who subsequently approached KKH for permission to interview the patients and doctors.
In the case, two patients were given an overdose of toxic chemotherapy drugs over a few hours instead of days. Their present condition is unknown as there appears to be a media blackout imposed on the matter.
Though a senior KKH doctor had apologized to the victims in person, there was no official statement of apology from KKH or its CEO Prof Ivy Ng, who is incidentally the wife of Education Minister Dr Ng Eng Hen. Health Minister Khaw Boon Wan apologized a few days later on his blog.
Such errors are not uncommon in Singapore’s public healthcare system where doctors and nurses are often overworked without adequate rest.
All doctors who graduated from Singapore’s NUS have to serve a mandatory 5-year bond in the public sector. Due to the huge disparity in pay between the public and private sectors, many left for private practice after the completion of their bonds.
Singapore nurses are also paid well below the market rate. The starting pay of a fresh nursing diploma holder is only about $1,500 a month. As a result, the turnover rate for nurses in public hospitals is astonishingly high with many leaving for private practice or changing jobs altogether.
Singapore’s healthcare system is constantly rated as one of the best in the world by World Health Organization (WHO). Senior Minister Goh Chok Tong once praised Mr Khaw as the “best” healthcare minister in Singapore.
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11 Responses to “MOH: one error a week in Singapore’s hospitals”
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Those poor junior docs in the public sector work up to 36 hours 4-6 times a month and it’s a 12 hour slog on regular days, or more in busier departments. No wonder MOH is having trouble recruiting Singaporeans back from overseas, so much so it is having to resort to FTs from China and India.
to err is human,we all make mistakes not only in the hospitals.
but i do wonder also why mistakes in the hosptials seldom
or almost never occur to some classes of patients?
pardon me for saying,have a fatal mistake occur to a patient
like a minister?
pay is not the only reason doctors leave for private practice. long working hours, wanting to start a family, bureaucratic red tape, and of course better remuneration – the same reasons anyone would choose a perceivably more manageable and rewarding job over a more demanding one.
on another note, this article references heavily what was just reported in ST today. why is that not mentioned when its contents are something that TR agrees with? in contrast, when TR disagrees with what ST reports, ST’s version is lambasted as sycophantic pandering of the “state media” to the “ruling party”, often in a quick response such as this. such responses are of course informative and definitely encouraged, but credit should be given where it is due. just a thought.
hey anonymous: you’re spot on!
let me tell you this. amongst those drs i know who left the public sector, its not the pay. i asked my friends—the greatest reason why they leave(junior AND senior drs included), is due to administrative bureaucracy.
the amount of paperwork(online and offline) needed just to admit and discharge one person for a 1 day stay is mind boggling. can i say…20 pages of notes/info/orders in A4 format!? or is it more.
but the nurses apparently have it worse. just go to any restructured hospital and ask the staff nurse in the ward, almost all are bonded. and most leave once they can. the attrition rate is possibly the highest amongst most professions!
my friend who is now happily working in the private sector tells me this(cut n paste): i left because of the junk. now i get better recognition, i’m paid 3 times more, my working hours are better. there is only so much a person can do within their work hours, even after adding 3-4 hrs of unpaid overtime. and the administrators adding more protocols and paperwork and tests to cut down mistakes is not going to help—it would if everyone had time. it makes things worse when you come up with a ton of checklists which people just mindlessly tick because they simply have no time to check.eg there is actually a checklist for every single time a ward patient goes for a simple chest x-ray! and when the administrators finally decided to get the hospital certified for JCI(for those not in the know, it is something like an ISO standard), i decided i had enough! its silly. how the heck do you fulfil a standard when someone hasn’t slept for 36 hours? so i quit. i can’t change what the administrators think. they come at 9 and go home at 5. one day the system will collapse—i’m happy i won’t be around then.
reminds me much of the SAF. when i was serving NS, it wasn’t easy adjusting from civilian life—i have it good. chauffeur driven, GCB home, maid, almost everything i wanted i got—to spartan bunks, communal living, jungles, mosquitoes, mud(i will never forget the swamps of lim chu kang where i was in muddy number 4 up to neck level for 4 days and skin rash for 2 weeks after, i even stepped on a snake before and killed 1 too) and washing my own clothes. i got my ippt gold. i never failed a single SOC(despite being barely over 1.6m tall). i never malingered for MCs. i took the punishment just like everyone else. but years after, i remember seeing some of those chiefs of something with stars on their shoulders—life is good, very good. and talk about warfare in aircon comfort. and we know the majority of them are there because they have got this scholarship called SAFOS(just cos they did well in the A levels, and some did even worse than myself..). these days i still pass my ippt yearly, but my regard for the SAF has gone way down. the people at the top don’t know, or they don’t care. and i guess, its the same for hospital administrators. what to do? you can’t change them.
Same at MOE. Haiz.
@Protoss
maybe your doctor-friends are the few good medical professionals left?
i find it hard to believe that doctors do not go into private prsctice for the money…i can assure you from my experiences that these private practitioners are very adapt at constantly
upping their fees…maybe you gotta recommned some fo these good doctors to us so that we can save some money?
Well, this is the Singapore system for the uninitiated. It’s polished on the outside but rotten inside.
The rate of 1 error per week for the past 7 years is clearly unacceptable. There are definitely systemic problems at our hospitals. The differences between public and private are also very telling. What is the remedy? Why has it gone on for so long? Where is the world-class leadership?
The PAP government claims to have committed heavy subsidy to public healthcare. In fact, most patients pay market rates (complemented by insurance policies previously paid for by the patients) while a small minority receive more substantial subsidies. Remember Medisave is your own money.
Any other form of government “subsidy” is really an illusion because it is a trade-off with a drop in service level. Who has heard of a public healthcare system where the patient has to wait for 3 hours to see the doctor for a scheduled appointment?
Sometimes the same doctor has to be away on short notice (to attend to other business) and the appointment is re-scheduled weeks/months later. Little thought is given to whether the medical issue can wait that long or to the possible impact. There just aren’t enough doctors (and other personnel) to run a decent public healthcare system. But that’s ok; the patients can wait since they are “subsidized”. It is even more infuriating when the medical staff are overworked and underpaid.
So where did the money go? There is a magical source of “subsidy” and a bloody sinkhole of “money” all at once called the “land cost”!
Not surprisingly, the Health Minister Mr. Khaw needs to work long hours attending long meetings and discussions.
Most meetings would involve how to raise hospital charges, bed and ward charges, outpatient fees and making profit for his ministry.
We paid Mr. Khaw to do it.
//Bird Talk
Other ministers also having long meetings. All talking about how to raise charges and fee:
ERP gantries.
ERP increase charges
Car Parking fine
Car Parking charges
Littering fine
Jay walking fine
cigarette tax
alcohol tax
levis charges
late charges
All out to make profit out of you.
Nearly one in 10 hospital prescriptions contain a mistake, ranging from the minor to the potentially lethal, research has found.
But the study, commissioned by the General Medical Council, found very few errors would have caused serious harm.
http://news.bbc.co.uk/2/hi/health/8391667.stm
Overwork or not. Too many regulations or not. In the healthcare line, it is one’s responsibility to be alert.
If you are one that cannot be careful with another’s human life, please consider a job change.
A mistake a week might mean each year 52 human beings have to go thru things that should not happen in the first place.