On the other hand, the 12 private hospitals tend to be smaller, providing 25 to 500 beds each. Government's role as the dominant health care provider allows the Government to control the supply on number of hospital beds, the introduction of high-tech/high-cost medicine, and the rate of cost increases in the public sector, which sets the benchmark in terms of pricing for the private sector.

The 8 public hospitals comprise 5 acute general hospitals, 2 hospitals specializing in obstetrics & gynecology and psychiatry, and 1 community hospital. The general hospitals provide multi-disciplinary acute inpatient and specialist outpatient services and a 24-hour accident & emergency service. In addition, there are 6 specialty institutes for ophthalmology, dermatology, oncology, cardiology, neuroscience and dentistry. The tertiary specialist care on cardiology, renal medicine, hematology, neurology, oncology, radiotherapy, plastic and reconstructive surgery, pediatric surgery, neurosurgery, cardio thoracic surgery and transplant surgery are centralized in two of the larger general hospitals, the Singapore General Hospital and the National University Hospital. The private hospitals have similar specialist disciplines and comparable facilities.

Within the public hospitals, patients have a choice of the different types of ward accommodation on their admission. 79% of the public hospitals' beds are heavily subsidized with the remaining 21% being either private (1-2 bedded) or semi-private (4-bedded) beds. Patients pay more when they request for higher level of physical amenities while the standard of medical care is the same for all types of accommodation. Generally, the more serious medical conditions are attended to in the public hospitals, by the senior consultants or specialists regardless of the type of ward accommodation chosen by the patients. The average length of stay in the general hospitals is about 5.6 days. The hospital beds are well utilized, with an average occupancy rate of about 81%.

Since 1985, the Government has restructured 5 of its acute hospitals and 6 specialty institutes to be run as private companies wholly owned by the government. This is to enable the restructured hospitals to have the management autonomy and flexibility to respond more promptly to the needs of the patients. In the process, commercial accounting systems have been introduced, providing a more accurate picture of the operating costs and instilling greater financial discipline and accountability. The restructured hospitals are different from the other private hospitals in that they receive an annual government subvention or subsidy for the provision of subsidized medical services to the patients. They are expected to be managed like a not-for-profit organization. The restructured hospitals are subject to broad policy guidance by the Government through the Ministry of Health.

The Government has also introduced low cost community hospitals for intermediate health care for the convalescent sick and aged who do not require the more expensive care of the acute general hospitals.

Dental Services

The emphasis of the public service is in preventive dentistry targeted at pupils in schools. A network of 184 clinics, within the schools, provide a range of dental services such as basic dental care, oral hygiene care, oral health screening, dental health education and dental counseling.

The school dental program, fluoridation of potable water (since 1958) and the widespread availability of fluoridated toothpaste have brought dental decay and tooth loss to a very low level. A survey in 1994 showed that a child at age 12 has only one decayed, missing or filled tooth; and that 97% of our population at age 18 did not lose any permanent tooth because of dental decay.

Outside of the school clinics, dental care is primarily delivered by private practitioners. To a smaller extent, the Government provides dental care at military camps, polyclinics and public hospitals. Specialty services and training of postgraduates are undertaken at the National Dental Center and the National University Hospital.