The following question stood in the name of Mr Gerald Giam Yean Song –
15 To ask the Minister for Health (a) what is the range of consequences that public healthcare institutions (PHIs) can impose on patients who abuse or harass healthcare workers; (b) how are these specific consequences made known to patients, apart from general notices that abuse of staff is not tolerated; (c) in each of the last three years, how many times have patients been prematurely discharged due to such behaviour; and (d) how do PHIs ensure the well-being of such patients.
Ms He Ting Ru (Sengkang): Question No 15, Sir.
The Senior Parliamentary Secretary to the Minister for Health (Ms Rahayu Mahzam) (for the Minister for Health): Mr Speaker, in accordance with the recommendations of the Tripartite Workgroup for the Prevention of Abuse and Harassment of Healthcare Workers, the Ministry of Health (MOH) will work with public healthcare clusters to develop the details of the standardised zero-tolerance policy. This will be completed in the second half of 2023 and will include guidelines to help institutions protect staff from abuse and harassment while fulfilling the duty of care for patients in need.
In particular, as explained during the announcement of the policy on 17 March this year, for patients who require urgent care, care will be delivered regardless. Likewise, patients will only be discharged when clinically assessed to be ready to do so.
The suggestion that hospitals may prematurely discharge patients due to the zero tolerance against abuse policy creates a false dilemma. The great majority of patients are respectful and appreciative to healthcare workers. As for the very small minority who are abusive, they typically do not require urgent care and may not even be patients. It is also not difficult to identify such behavior and actions, which the common man or woman will find unacceptable. As for the rare instances where a patient requiring urgent care is abusive, we will manage them sensitively and, as was also previously explained, care will be delivered as needed.
Ultimately, the zero-tolerance policy against abuse is about drawing a line between right and wrong and being fair to healthcare workers and the great majority of patients.
Mr Speaker: Ms He Ting Ru.
Ms He Ting Ru: Thank you, Mr Speaker. Just a quick supplementary question.
Are there a series of warnings or other types of escalating measures that healthcare institutions can take with patients and/or their family members for behaviour that constitutes abuse or harassment? For example, would there be any intervention from a social worker or someone with conflict resolution training to ensure that healthcare staff do not deal with the situation alone? And how many warnings are issued? What is the process before any punitive action is taken against these individuals?
Ms Rahayu Mahzam: At this juncture, our public healthcare clusters have policies in place to handle abuse cases. The staff are trained to assess and de-escalate potential conflicts and manage abusive situations and, in the event of an incident, they know how to activate protocols to escalate when patients or caregivers turn abusive. Signs are displayed at the premises to prominently remind visitors to treat healthcare staff with respect and, where necessary, security officers’ or Police intervention would be sought. So, at the moment, there are some measures that the hospitals have put in place, including issuing a warning, disengaging by refusing unreasonable requests or discharging abusive patients who are clinically assessed. These are all things that are available to them at this juncture.
But generally, the hospitals do not do this. They still treat the patients. Hence, there is a need to actually come up with this framework and this is the framework we are working on to provide something that is standardised for all the public healthcare institutions to apply, where there is a commonsensical approach to deal with such situations of extreme cases where there is a need to actually deny service to them.
But at this juncture, there are already efforts in place to de-escalate, to give warnings, to make sure that it does not come to that situation. We are working on this framework and, hopefully, when this comes out, it will be a better situation for all.
Mr Speaker: Ms He.
Ms He Ting Ru: Thank you, Mr Speaker. Just a quick follow-up. I am just wondering when this framework is going to be ready.
Ms Rahayu Mahzam: My apologies because I believe we had made some announcements and indication of the next phase of the efforts of the Work Group. We will inform the public and give updates on this in due course.
Ministry of Health
21 April 2023
https://sprs.parl.gov.sg/search/#/sprs3topic?reportid=oral-answer-3190
Office of the Leader of the Opposition 