I asked a doctor friend on Sunday. Here's his reply:
"this involves catchment areas that have been set in stone. this is one of the major problems faced by patients and ambulance ppl.. for example, if the patient has been followed up in SGH his whole life, seen doctors there, had operations there.. say he suffered an accident or heart attack within the TTSH catchment area, even if the patient gave explicit instructions to be sent to SGH (primary care giver) for continuity of care, the ambulance ppl are obligated (and have no choice but) to send him to TTSH.
similarly, if you take the example of the old Alexandra hospital. one of its catchment area boundaries is the road between the hospital and alexandra village (beyond that is SGH catchment). I would suggest to anyone that has an accident in that vicinity, please crawl across the road to alexandra village area so you will be brought to SGH instead of Alexandra.. (which is now known as Jurong General Hospital, and run by locum doctors).
raffles hospital at night is run by skeleton staff. mostly locum doctors and non-specialists. i assume they have one a&e consultant on duty. other than that, i dont think they would be able to handle an emergency of this scale."
"an issue that arises with the first scenario i gave was that doctors in TTSH will be blindsided initially because they have incomplete and sparse medical records about that patient on the online records system. detailed info and visits to SGH will be on hardcopy / servers in SGH.
two options - a) ask for medical records to be copied and sent to TTSH, b) stabilize patient and send back to SGH after discussing with the doctors there
problem with both is - extremely time consuming. it will take at least 1-2 days before medical records arrive. and valuable time lost because the best ppl to take care of the patient are in the other hospital."
"if i'm not wrong, non-private ambulance staff are not allowed to send patients to private hospitals.
there is a lack of the concept of altruism and beneficence in this sense. who put these guidelines in place, or what agreements have been made between private and non-private organizations puzzles me."