The Public Accounts Committee (PAC) reported to Parliament that some of the Intermediate and Long-Term Care (ILTC) institutions had used the payouts belonging to the patients without their authorisation, including one institution which treated the money as its own revenue.

The Ministry of Finance (MOF) made arrangements with the Ministry of Health (MOH) and the Central Provident Fund Board for ILTC institutions to help patients apply for various Government payouts such as GST credits.

The ILTC institutions also act as proxies, under MOF’s Guidelines for Encashment by Third Party, to encash the cheques of patients who are unable to do so themselves.

The committee asked MOF whether it requires the institutions to maintain separate records for each patient and whether documentary proof of authorisation by a patient or next-of-kin to use monies held in trust by the institutions is required.

The Permanent Secretary of MOF informed the committee that MOF’s third party encashment guidelines require the institutions to maintain a record of the encashment made on behalf of each patient.

MOF added that it would only release monies after a letter of undertaking is provided by the ILTC institutions.

The committee noted that this addresses safeguards in relation to encashment of monies but not the subsequent use of monies held in trust by the institutions for its patients.

MOF also informed the committee that there are existing rules under prevailing law (e.g. Mental Capacity Act) governing what the institutions can do with the monies entrusted to them and who can authorise the use of such monies when a patient lacks capacity.

The committee noted that in the light of the lapses reported by Auditor-General's Office (AGO), these rules alone are not adequate.

MOF, together with other relevant agencies, should require the institutions to set up operational procedures to comply with the rules.

Going forward, MOF is working with MOH to clarify to ILTC institutions their obligations with respect to their handling of patients’ monies.

MOF will also work through MOH and other relevant agencies to better disseminate the information to all institutions and remind them of their responsibilities.

To help prevent unauthorised use of patients’ monies, the committee recommends that MOF, together with other relevant agencies, require a letter of undertaking that monies encashed on behalf of the patients be used only with explicit approval by patients or their legal representatives.