Sun, 13 Apr 2003

Do S'pore hospitals really give better health care?

Hera Diani, The Jakarta Post, Singapore

We have heard all the talk about wealthy Indonesians getting medical treatment at Singapore's Mount Elizabeth Hospital, as they prefer the better service and technology compared what local hospitals can offer.

Managed by the Parkway Healthcare Group, the facade of the hospital is actually not that impressive, just like any other regular building. Inside, it is even a bit hectic with dozens of busy people moving about the halls.

Yet, thousands of Indonesian people come to the hospital every year, making them the highest percentage of foreign patients treated annually.

For those who have had to have medical care in Indonesia, which can be very slow, careless and overpriced, the organized, accurate and attentive service in hospitals here can be quite a welcome relief.

"The cost is indeed expensive, but the efficiency and professionalism make it worth the price," said Indonesian Jimmy Djimantoro, whose 71 year-old mother has just undergone heart surgery at the National University Hospital (NUH).

"Here the equipment is better and the doctors are more attentive than those in my hometown Surabaya. I've been told that my mother will be allowed to go home after eight days in the hospital, he added.

Due to the proximity, Mount Elizabeth, and other hospitals in the city-state have long been the destination for people in this country to receive medical services.

Data shows that among foreigners seeking medical treatment in Singapore, Indonesian people have the highest numbers from year to year.

Indonesian patients can even outnumber local patients, as happened at the NUH a year ago. Out of the total of 30,000 patients admitted to NUH last year, 65 percent were Indonesian.

A visit to six hospitals in Singapore, did not actually reveal anything so extraordinary, actually, with regard to the look of the hospitals, except for the new hospitals like Raffles Hospital with great architecture and interior design. Some private hospitals in Jakarta look even better.

Could it just be prestige that draw Indonesians to pursue the medical service here?

"Here in Singapore, the equipment is more complete. Maybe some of it is similar to equipment at home, but what makes the difference is the people who operate it. They're just better here," Jimmy said.

According to cardiologist Budi B. Dharmadji from Dr. Sutomo hospital in Surabaya, East Java, Indonesian hospitals are actually not lagging behind in technology.

"With heart surgery, for instance, it's not that different except for the price, of course. In Jakarta's Harapan Kita Heart Hospital, heart surgery costs around Rp 80 million (US$8,888), while here it can cost between Rp 200 million to Rp 250 million," said Budi, who is currently on a fellowship program at the Singapore General Hospital.

There are, indeed, some technologies that Indonesia has yet to provide, such as brachytherapy (radiation through veins to avoid blood clotting) and intravascular sound.

"Perhaps it is the image that draws Indonesians here," Budi said, adding that he did not see many Indonesian patients with heart problems coming to the hospital.

Djoni, meanwhile, transferred his two year-old daughter with a brain tumor to NUH as advised by neurologists in Cipto Mangunkusumo General Hospital in Jakarta.

"According to the doctors, there hadn't been any successful treatment of such cases in Indonesia," he said.

The technology in Singapore hospitals is more sophisticated. Doctors and experts are also more adept, as the country sets very high standards for its medical professionals.

A specialist, for example, can only practice after 15 years of successful tertiary education.

Nevertheless, it seems that the good service is what makes people keep coming back.

"For the same price, we could get afford a luxury suite and a better package in Jakarta's private hospital," said Jasmine, 33, who had just given birth at Singapore's Thomson Medical Center maternity hospital.

Jasmine has been living in Singapore for the past year, following her husband's transfer to a multinational company here. It cost her around S$3,000 to deliver her baby normally here.

"But the hospital staff are very attentive and caring. Ever since I came back home from the hospital, a nurse regularly calls me to check whether I have any problem with the baby or not."

Djoni agreed with Jasmine, saying that back home, it was often difficult to meet or consult with doctors.

"While here, as soon as we arrived, a team of doctors and specialists quickly came to meet us and discuss the ailment," he said.

The good service is perhaps also a marketing attempt as the competition for local market is tight. There are a total of 28 hospitals, with the an equal number of private and public hospitals, serving a population of 3.3 million.

Despite the number of Indonesians or other foreigners who seek medical treatment here, there has been a decrease in those numbers in the past year.

Data shows that from 8,463 patients went Singapore in 2001, and that figure went down to 7,275 in 2002.

Neurologist Keith Goh, who is famous for successfully separating Siamese twins in 2001, said that the number of Indonesian patients had been decreasing since the economic crisis began in 1997.

"More people are going to Malaysia and Thailand since the costs are cheaper," he said.

The cost of living in Thailand and Malaysia are roughly half of that in Singapore, yet the hospitals are nearly as good.

In an attempt to get more foreign patients, earlier this year, Singapore's government established a new department under the Singapore Tourism Board (STB) called the Healthcare Services department.

Program director of the department Chan Tat Hon said that the STB had done a good job in reaching customers, and disseminating information about the healthcare service in Singapore.

Chan denied, however, that the establishment of the new department was merely aimed at business.

"We're not thinking just of the economy of it. Medical treatment is something that you only want to do one time. Health is about your body, not just a product. We take this seriously, it is not just marketing. If in doing so it helps hospitals, good. But that's not our main focus," he said.

However, the country does not only invite more foreigners to seek medical treatment here, but also medical staff to work in the city-state.

"Many hospitals are still short of staff, like radiologists, neurologists and general physicians. We need a lot of resources from Indonesia, and other neighboring countries," said Goh.