5D4N at the Royal Victoria Hospital – thoughts on healthcare provision

So it seems like July has been a bit of an non-month blogging-wise. July started off busy with a full 5 days of ballet intensive classes straight after work (some notes from that coming up), then a week of rest, followed by a week of being terribly ill, and another week of recovering from it – which pretty much brings us to the present.

Being ill even included a 5 day 4 night stay at the Royal Victoria Hospital. Singaporeans have been calling for more affordable healthcare, pointing to the universal healthcare provision in countries like the UK. However, having been through the hospital system here, I can safely say that universal healthcare funded by the government and taxes isn’t as fantastic as people might make it out to be.

A case in point is the recent article in the BBC that hospitals in Northern Ireland failed to meet the 12hr waiting time target for A&E more than 700 times between April and June – and 12hrs shouldn’t even be a target !

DISCLAIMER NO1: In no way do I mean to suggest that the NHS system is bad. I like the fact that universal healthcare provision means that the poor do not need deny themselves treatment from fear that they might not be able to afford the bills. However, given that the NHS ranks top among 11 other wealthy countries worldwide means that Singaporeans need to consider what universal healthcare provision can entail, even as we should  definitely do more in terms of healthcare provision for the needy in Singapore.

DISCLAIMER NO2: While I will go on to express dissatisfaction with certain aspects of my treatment, the hospital is understaffed and the healthcare workers are overworked and probably underpaid. I know they have been doing their best to care for all the patients in their charge and I thank them for that.

So, what did I think could have been improved on, in my time in A&E and in the wards?

  • I had to tell at least 10 different people what was wrong with me. Perhaps it’s part of hospital protocol, but did they not read my file, or the GP’s note? It was a lengthy recounting of the last 5 days, the symptoms, the vomiting, which part of my tummy was sore, etc. All while dehydrated with a very low blood pressure. Yet they wondered why my blood pressure stayed so low.
  • Despite telling so many people what was wrong, I was the one giving diagnoses, not the medical staff. The staff were wondering why my blood pressure didn’t go up even after having lots of saline pumped into me. While I’d told them that I’d eaten about 1 meal’s worth in the last 3 days, no one thought to put two and two together until I suggested I needed some insulin. The doctor actually commended my “good point”.
  • No one seemed to be concerned that I hadn’t eaten much. As mentioned above, I had only about a meal’s worth in the last 3 days and nothing at all that day. Yet, it was only till about 6pm that I managed to get some tea and biscuits – the nurse who brought me food was surprised that no one had offered me dinner, and the nurses I’d spoken to earlier didn’t seem to think that my stomach acid working on my stomach lining was a matter of concern.
  • I was the only one who successfully diagnosed some of my stomach pains. It was me – not any of the medical staff – who eventually figured out that the pain at the top of my stomach was actually gastric pains. And whoever who brushed aside my concerns about stomach acid was WRONG.
  • Pursuing lost causes to the detriment of the patient. Ok, perhaps this isn’t a fair comment, but the doctors were adamant that giving me even more saline would increase my blood pressure – even though the previous 4.5 litres did little to my condition. It just seemed strange that it didn’t occur to them that a patient who hadn’t had a good night’s sleep in 4 days, hadn’t eaten much in 3 days, is slightly anemic, of a small built and generally good physical health would naturally have low blood pressure. At 1am I was convinced that all I needed to increase my blood pressure was some sleep – and damned if I wasn’t right again, as things picked up the next day.
  • There are fewer staff on Saturdays, and even fewer on Sundays. I simply do not understand the rationale behind this, since it’s not as if there are fewer patients on weekends.
  • If I weren’t alert and conscious, I would have missed out on medicines, injections and tests. The staff are so busy that I needed to remind them that I hadn’t received my pills or the daily dose of anti-clotting injection. Even medicines weren’t dispensed at regular intervals as the staff are just so busy. To take the cake, whoever who was in charge hadn’t even written me down to have my bloods drawn, even though keeping track of certain counters in my blood was a key step in ascertaining my progress towards recovery. If I hadn’t requested for my blood to be drawn I probably would have been there for 6 days and 5 nights instead.
  • Hygiene isn’t a key concern. Only one staff I saw sanitised his hands before touching patients – the rest didn’t seem to use much soap or hand sanitisers at all. The patients aren’t brought to shower either – it kinda seemed like if you’re able to wash yourself then feel free to work away on your own, but if you’re not then washing is only available upon request. It’s quite a contrast from hospitals back home where I noticed staff washing their hands whenever they go in and out of wards and before they come into contact with patients. Patients in the public hospitals in Singapore get a shower daily too.
  • It took more than 4 hours for the pharmacy to dispense 54 pills. This is no exaggeration. At 4pm I was told that I could be discharged in an hour when my pills arrived, but I was still there past 8pm, tired and desperate to go home.
  • Different people tell me different things. I needed proof that I had been in hospital, and 3 staff I spoke to assured me that I’ll get a card indicating the dates I was warded for upon discharge. The doctor I spoke to also said that he’ll write me that certificate, and a staff said it was already sitting in my file for me when I’m discharged. No prizes for guessing that after the long wait for the pills was over, I had to wait further as no one had sorted that card out for me, and one of the nurses had to do it there and then.

Further to my interesting experience at the hospital, I’d also like to highlight that if I were to fall ill today, I usually won’t be able get an appointment to see the GP till the day after. If I’m ill on weekends or bank holidays, there are no GPs open at all – you just have to deal with it on your own until a weekday comes round again. If you really, really need medical attention, you then haul yourself to the out of hours department at the nearest hospital and wait at least a few hours on a “not busy” day.

This is an example of what universal healthcare provision is like.


3 thoughts on “5D4N at the Royal Victoria Hospital – thoughts on healthcare provision

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