Worker can’t get surgery; everything’s a bureaucratic mess

Posted by on April 20, 2017 in Articles, Stories

By Namgay Choden

Hasan Mohammad Suman’s left thumb was injured December 2016 when it was jammed between steel bars at his worksite. It is late February now as I speak with him. He is scheduled to have surgery tomorrow at Ng Teng Fong Hospital in Jurong East.

However, for the surgery to go ahead, he has to present a Letter of Guarantee from his employer — an assurance that the employer will cover the cost of the operation. Hasan hasn’t been able to get one so far.

Hasan has tried hard to get the letter. He even mentioned it to a well-meaning case officer at MOM, he says, showing me a note written on a piece of stickypad paper. On it is scribbled a request to the doctor to provide an official recommendation on the urgency of Hasan’s surgery. If the doctor produces such a recommendation, it will empower MOM to compel the employer to issue a Letter of Guarantee.

“I go tomorrow hospital at 8.30 am,” says Hasan. But his surgery is scheduled only at 11am the next day, I point out. He says he has a plan. He says he will go to the hospital first, very early in the morning to try to get the note from the doctor, then go to the ministry and see what can be done.

But something else is also on his mind, and he soon turns to it. He asks me, “Please tell me what to do. Please tell me, how to get my MC payment [medical leave wages] and also my salary.” I suggest that he should talk to his lawyer further. Hasan admits that his lawyer has not been of much help to him. In fact, he does not even know how much the lawyer will charge him for his case.

Hasan agrees to meet me the day after for a follow up on his story. However, he doesn’t show up and I have to call him. Picking up the call, he tells me in in a forlorn voice that he has been unable to obtain such a letter from the doctor. There will be no operation to save his thumb.

Meanwhile, he has also to scrounge for money. Hasan has not received  his medical leave wages (“MC pay”) nor reimbursement for his hospital expenses.

He reveals too that along with his co-workers, he was not paid punctually by the employer even before the accident. But what can be done about that now? He has no clue.

Hasan is navigating, often in circles, a complex bureaucracy that he cannot make sense of. While Hasan’s biggest plight is not receiving the necessary treatment on time, the lack of counsel from Hasan’s lawyer is at the same time perplexing.

Most workers find themselves at a complete loss after they’ve suffered an accident. Perhaps due to aggressive promotion by small law firms and their Tamil- or Bengali-speaking legal assistants  — these are not your normal law firms, but law firms that almost exclusively live (and grow fat) on work injury compensation cases — many workers like Hasan turn immediately to them for help.

The problem, which these workers don’t realise, is that while the worker expects a comprehensive suite of help, these law firms are only interested in taking a cut of the compensation payout, while doing as little work as possible. They are certainly not set up to do social work, e.g. helping the client get medical treatment, or getting him his medical leave wages on time. They are surely not interested in salary issues, and as the story above reveals, Hasan has a salary problem from before the accident.

As a result, the vast majority of their clients are in similar predicaments as Hasan, left without help or support even though he has hired a lawyer  –and will be billed by the lawyer eventually.

The “Letter of Guarantee” problem also needs explaining. The law says that employers are responsible for all essential medical care. To effect this, MOM requires doctors to certify that a treatment procedure is “immediately and medically necessary”. The problem is, MOM has still not realised that this benchmark is ambiguous. “Necessary” for what? Necessary for saving a life? Necessary for restoring the thumb to viable functionality?

If the benchmark is “necessary for saving a life”, then no doctor will ever certify that Hasan’s operation is “immediately and medically necessary”. If the benchmark is for restoring the thumb to viable functionality, then perhaps there’s a good case for such a certification. However, Singapore is a society where nearly everybody tries to play safe. Until MOM clarifies what its benchmark is, doctors tend to be unwilling to stick their necks out and certify that an operation is “immediately and medically necessary”.

As the above writer says, that only leaves Hasan “navigating, often in circles, a complex bureaucracy that he cannot make sense of.”

 

TWC2 is an organization that is dedicated to assisting low-wage migrant workers when they are in difficulty. We are motivated by a sense of fairness and humanity, though our caseload often exceeds our
means.

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