Following the implementation of the Healthcare Services Act in phases since January 2020, the Ministry of Health (MOH) announced the first and second reading of the Healthcare Services (Amendment) Bill (Bill) on 6 February 2023 and 6 March 2023 respectively. If passed, most of the amendments as set out in the Bill will be implemented together with the second phase of implementation of the Healthcare Services Act (HCSA) in mid-2023.
In more detail
The first phase of the HCSA came into effect in January 2022, with the second and third phases slated to come into effect in June 2023 and the end of 2023 respectively.
The MOH has continued to refine the HCSA, proposing amendments to the HCSA in October 2022. Our previous alert discussing these proposed amendments may be found here.
After taking into consideration feedback from stakeholders, the MOH has released further details on the proposed amendments. The main objectives of these amendments are to enable the MOH to be nimbler in responding to the evolving healthcare landscape, to enable premises-neutral care to be delivered across its healthcare settings and to strengthen governance to safeguard patient safety and welfare.
The MOH’s proposed changes to the HCSA can be categorized into two main themes: (i) future-proofing HCSA for regulatory agility; and (ii) stronger governance to protect patient safety and welfare. Some key proposed changes are set out below.
Future-proofing HCSA for regulatory agility
First, the amendments will introduce regulation of four primary modes of service delivery: (i) permanent premises; (ii) temporary premises; (iii) conveyances; and (iv) remote provision, where licensees must obtain approval to provide licensable healthcare services by any of these four modes.
The clearer regulatory framework seeks to give service providers confidence to continue to provide and expand home care services. Bringing medical services closer to the community and into homes will enhance convenience for both patients and their caregivers, reducing caregiver burden.
Second, the MOH will also remove the 14-day notice period for any modification of license conditions where there is immediate or imminent harm to patient safety or public health. This would allow the MOH to swiftly implement new healthcare protocols to protect public health under exceptional circumstances.
Stronger governance to protect patient safety and welfare
There have also been several amendments geared at protecting patient safety and welfare.
First, licensees will be required to obtain approval before providing a specified service, which would generally apply to services that involve more complex or higher risk procedures, such as liposuction, endoscopy, radiation oncology services, etc. Second, licensees will be required to seek approval from the MOH before appointing a clinical governance officer (CGO). This replaces the existing obligation for licensees to merely notify the MOH when it appoints a CGO. This would allow the MOH to ensure upfront that a competent individual is appointed to better safeguard patient safety.
Third, the robustness of employee background screening has also been enhanced by the MOH, where the MOH will have flexibility to vary the scope of restrictions of employees/engaged individuals in different healthcare settings based on the anticipated risk of patient harm. For example, certain licensees may be prohibited from employing any individual who has committed egregious crimes without approval from the MOH.
Fourth, advertising restrictions will be implemented to ensure that consumers are not misinformed of a healthcare provider’s services. In particular, licensees will be prohibited from using a specialty name in their business names or logos if there is no practitioner practising in such specialty. For example, a clinic may not be called “The Brain Clinic” if there is no neurologist practising in that clinic. Additionally, to avoid public misperception, licensees may not use the terms “Singapore” or “National” in English or other languages (unless such terms are used in existing business names, in which case the existing business names may be retained).
Finally, the regulatory framework for healthcare service advertising will be streamlined. Some advertising requirements for non-licensable healthcare services will be regulated under the HCSA. For example, non-HCSA licensees will be prohibited from claiming to treat medical conditions or diseases.