Every year, three public hospitals see more than 15 cases of foreign workers whose hand injuries have not been treated properly, reported the Sunday Times, January 1, 2012, in a full-page spread. The hospitals were Singapore General Hospital, National University Hospital and Tan Tock Seng Hospital — these are the three with dedicated hand surgery units.

. . . it appears that some workers were not getting treated by doctors were were skilled enough to tackle their injuries,  or prescribe the right kind of therapy.

SGH hand surgeon Andrew Yam told the Sunday Times that some foreign workers turned to public hospitals as they were not given medical leave from the doctors who initially treated them, despite having stiff and painful fingers.

“Some of them come because they realise that something is not quite right,” he said.

They usually have few or no medical records to show because such documents are retained by their employers or the doctors who initially treated them.

The head of NUH’s department of hand and reconstructive microsurgery, Dr Peng Yeong Pin, told The Sunday Times, “A lot of times, the workers who come feel they have been abandoned, that no one is looking after their interests.”

— Sunday Times, January 1, 2012: When that hand injury just won’t heal, by Tan Hui Yee

The feature mentioned several specific cases, including a “disturbing” one in which a private surgeon overlooked the fact that part of a nerve in a patient’s hand had been severed. It was left unattended.

A graphic showing two other badly treated cases:

The newspaper also noted that,

Typically, these workers have no independent means to pay for their medical treatment and are sent by their companies to private hospitals after getting injured. But they surface at public hospitals alone a few weeks later, desperate for help.

— ibid.

The feature did not go into depth as to why companies seemed to prefer private hospitals.

It discussed briefly the controversy over what “light duties” mean when prescribed by doctors, instead of medical leave.

Home’s executive director Jolovan Wham asked if the private doctors were giving these workers fewer days of medical leave than appropriate so that employers need not report the accidents to MOM, thus keeping their safety records clean.

Meanwhile, some workers have been known to be assigned to routine manual work while being on light duty.

— ibid.

NUH was one hospital that took a stand on this. It would not certify a worker for light duties unless it was confident that that the company would assign him to sedentary duties.

Keppel Offshore and Marine was lauded in an accompanying article for its injury management system. It has its own medical centre for its 30,000 workers staffed with a doctor and 12 nurses. The medical centre keeps in close contact with NUH over its cases. The company’s light duties programme was also described.

For the feature, the Ministry of Manpower (MOM) told the newspaper that it would “take stern action against employers who are found to be colluding with any institution or medical professional to short-change a worker with work injuries of his medical care and rest.”

The newspaper was quick to note in the following paragraph:

In the past two years, the ministry received an average of 30 cases a month involving foreign workers seeking help over employers who did not give them medical treatment. But MOM has not penalised any employer so far.

All employers, its spokesmen said, met their work injury compensation and medical treatment obligations after intervention by the ministry.

— ibid.

Not addressed was whether the 30 cases a month of delayed response, causing much pain and distress, might have been reduced if MOM had been sterner, or even whether the 30 cases were just the tip of an iceberg.