If the patient is having convulsions, urgent treatment can be
given on a gurney while waiting for a bed. There is no compromise
of medical care. Drugs can be injected to control the seizures and
there is no difference to the patient whether he is in a bed or
lying on a gurney. If necessary, oxygen can also be given on a
gurney.
In the Emergency Room of top hospitals in the UK and US, I have
seen patients waiting for a bed for hours as well. The problem is
not unique, if there is a spike in demand for hospital beds for
whatever reasons, patients will have to wait for a bed.
In a national crisis, eg. avian flu epidemic, it is possible to
create more beds by postponing all surgical operations apart from
those that are needed for life-threatening conditions. Patients who
are stable can be transferred to convalescent homes to create bed
space in acute hospitals.
But apart from such national crisis, it is difficult for hospitals
to ask patients who are recovering to go home earlier because
others have a greater need for their beds.
Khaw Boon Wan made an interesting observation during the SARS
crisis. At that time, TTSH was the SARS hospital and no operations
were done. After the SARS crisis, he was expecting a sudden
increase in cases due to the backlog of operations. However, they
did not come. People were so afraid of SARS and going to TTSH that
they carefully considered if they really needed to see a doctor and
have that operation. Many decided against it. Khaw Boon Wan thinks
that we are over-servicing our patients ie. many operations done
were not really necessary and many patients could be treated
outside of the hospital.
Singaporeans must recognize that resouces are limited and doctors
have to do what they can given the resources. If we expect more, we
must be prepared to pay more, but Singaporeans have made it clear
they do not want to pay more for healthcare.
