WE REFER to the letters 'Are subsidised patients treated by specialists?' by Mr Henry Lim (ST, Feb 11) and 'Doctor-patient link key to good health care' by Dr T. Thirumoorthy (ST, Feb 14).

We assure the writers that our priority is to provide appropriate and quality healthcare for all Singaporeans regardless of financial status. In fact, subsidised patients form the majority of our patients.

When a patient visits the polyclinics, the doctor will decide on the most effective course of treatment. When necessary, the patient will also be referred to a specialist in a hospital or national specialty centre.

Patients who are referred from polyclinics receive treatment at subsidised rates at specialist outpatient clinics regardless of which doctor they see.

Each patient at the specialist clinic comes under the care of a team of doctors led by a specialist. The attending doctor, whether a medical officer, registrar or consultant, would be an integral part of this team.

When a medical officer attends to a case, he does so under the specialist's supervision. As public healthcare institutions, we are a vital training ground for young doctors, who provide care to patients as part of a team of doctors.

Non-subsidised patients see the doctor of their choice and may be attended to in a different area, like the class of wards for inpatients. This arrangement has no bearing on the level of clinical care provided and all patients are assured optimal and appropriate care.

We have spoken to Mr Lim and have clarified that he has been receiving treatment at subsidised rates, regardless of which doctor he sees.

He raised the issue of access to specialists care at hospital specialist clinics for patients with chronic medical conditions. It is more important and effective that such patients get appropriate care in the appropriate setting.

Such patients are best treated and monitored at the primary care setting where possible, as this saves them time and the cost of specialist care that may not be required.

We have implemented various programmes where our specialists work closely with general practitioners and family doctors at polyclinics and in private practice. Together, they manage patients with chronic medical conditions such as asthma, diabetes and high blood pressure.

Some of these programmes are already showing results with patients reporting improvements in their conditions.

We thank both writers for their feedback and the opportunity to clarify these matters.