SINGAPORE – A cardiologist in private practice admitted that he used to pay two ambulance services a commission for taking patients to him.

This was stated in the “Decision of an Interim Orders Committee” released by the Singapore Medical Council (SMC) on July 28, based on information provided to it by the Ministry of Health (MOH).

The IOC was set up by the SMC to decide if any action against Dr Wong Siong Sung needed to be taken before the disciplinary hearing against him is concluded.

One allegation is that Dr Wong would run some patients through a battery of scans, many of which were not necessary, in order to inflate their bills, the report said.

As a result of these tests, three patients were allegedly delayed from receiving the urgent treatments they needed.

SMC’s disciplinary inquiries usually take years to complete.

The MOH complaint said that Dr Wong used to pay between 10 per cent and 20 per cent of what he billed patients to the Singapore Ambulance Association (SAA) and the Singapore Emergency Ambulance Services (SEAS) for taking the patients to him.

Having received a complaint, MOH carried out an audit on Aug 6, 2020, and said that Dr Wong had done unnecessary tests and scans on five patients taken by the ambulance services to his facilities.

According to the “Agreed Statement of Facts” (ASOF), three patients were delayed from getting the urgent treatments they needed. One of the patients died.

Dr Wong is the medical director of Healthy Heart Specialist Centre (HHSC) and Somerset Imaging Centre (SIC).

According to the ASOF one patient had fallen at home and hurt his head. An SAA ambulance took him to HHSC and SIC at around 10.40am, where he had computed tomography (CT) scans of his brain, cervical spine, thorax and pelvis. He was also given an electrocardiogram test.

During the CT scans, the patient’s condition deteriorated. He vomited and had difficulty breathing. He was taken to a hospital at around 1.50pm, where he died three days later. His death was caused by a stroke.

Two MOH experts in emergency care said that the patient was “a priority one case” who needed urgent medical attention. He should have been taken straight to a hospital emergency department. Instead, “140 minutes elapsed from the time that P1 (the patient) was conveyed from his home to HHSC and SIC, to the time that he was conveyed to hospital”.

One of the experts said the delay of more than two hours had a negative impact, but it would require a neurosurgeon’s expert opinion on whether the outcome might have been different.

The second patient also fell and had a fracture at the top of her left leg. Following an X-ray that showed the fracture, Dr Wong wanted to do a CT scan and a magnetic resonance imaging (MRI) scan despite the woman being disoriented, restless and confused upon arrival.

Her family objected and called 995 to have her moved to a hospital. On arrival at the hospital, she was assessed to be suffering from hyponatremia, or low blood sodium.

The experts said she needed immediate medical attention and should have been directly transferred to an acute hospital. The trip to SIC was unnecessary, and the multiple transfers added to her pain and suffering.

Dr Wong was called to the home of the third patient, who had abdominal pain and low oxygen saturation. The patient was taken by SEAS to HHSC and SIC, where he remained from 1.15pm to 5.45pm.  

The ASOF said Dr Wong ordered CT scans of his thorax, brain, abdomen and pelvis, and MRI scans of his heart and prostate “instead of prioritising immediate resuscitation or stabilisation”.

In August 2021, MOH filed a complaint with the SMC against Dr Wong. Among other things, MOH had obtained a police report made by a radiographer formerly employed by HHSC/SIC, and tip-offs and complaints made by a former marketing staff member of the companies, a patient and the Corrupt Practices Investigation Bureau (CPIB).

An earlier statement by the SMC listed the six conditions imposed by the IOC under which Dr Wong is allowed to continue practising for 18 months or till the disciplinary inquiry is completed. They include not paying ambulance services for referring patients to his place of work or making house calls.

Timeline of events

Aug 6, 2020: The Ministry of Health (MOH) carries out an audit of Healthy Heart Specialist Centre (HHSC) and Somerset Imaging Centre (SIC) after receiving a complaint.

Oct 13, 2020: The Corrupt Practices Investigation Bureau (CPIB) does not take further action against Dr Wong, HHSC and SIC as it agreed with MOH that the matter falls under the purview of the Singapore Medical Council (SMC).

Aug 3, 2021: MOH files a complaint against Dr Wong with the SMC.

Oct 25, 2022: SMC’s Complaints Committee requests an Interim Orders Committee (IOC) be convened.

Jan 20, 2023: IOC sends a notice of inquiry to Dr Wong. At the time, the case had yet to be referred to a Disciplinary Tribunal.

May 23, 2023: Interim orders take effect for 18 months or till disciplinary hearing is completed.

Editor’s Note: The article has been edited for clarity. The decision on the merits of the matter will be made by the Disciplinary Tribunal convened by the Singapore Medical Council.