Title: The Future of Healthcare Infrastructure: Merging B2 and C Wards Under Singapore’s Healthcare Facility Design Standards (HFDS)
Abstract
This paper examines the implications of Singapore’s newly introduced Healthcare Facility Design Standards (HFDS), which standardize public hospital layouts to merge B2 and C subsidised wards under the 2025 framework. By reducing maximum beds per subsidised ward to six, the policy aims to enhance patient care, streamline construction processes, and enable future adaptability. The paper explores the rationale for the merger, the benefits of standardized design, and the role of HFDS in shaping the next generation of public hospitals in Singapore, using early adopter projects as case studies.
- Introduction
Public healthcare systems globally are under pressure to optimize resources while improving patient outcomes. In Singapore, the Ministry of Health (MOH) has introduced the Healthcare Facility Design Standards (HFDS) to standardize hospital infrastructure, including ward layouts, plumbing systems, and lifts. A key feature of this framework is the phasing out of subsidised wards with eight or more beds and the proposed merger of B2 (five–six beds) and C-class (five–twelve beds) wards into a unified six-bed model. This paper analyses the structural and operational shifts under HFDS, its potential impact on patient care, and the broader implications for healthcare infrastructure in Singapore. - Background: Current Hospital Ward Designs in Singapore
Singapore’s public hospitals have traditionally offered subsidised wards (B2 and C classes) to provide affordable care for low-income patients. B2 wards typically have five or six beds, while C wards range from five to twelve beds. These layouts reflect historical compromises between cost efficiency and resource allocation. However, disparities in bed numbers and ward amenities have raised questions about equity in care delivery. The 2021 MOH report highlighted that “the physical differences between B2 and C class wards are no longer so obvious,” signaling a shift toward standardization. - The Healthcare Facility Design Standards (HFDS)
3.1 Overview of HFDS
Launched on December 9, 2025, HFDS is a national framework developed by MOH Holdings and the three public healthcare clusters (Singapore General Hospital, Tan Tock Seng Hospital, and National University Hospital). It establishes uniform specifications for new and redeveloped hospitals to enhance efficiency, reduce costs, and future-proof infrastructure. The framework addresses not only ward layouts but also plumbing, lifts, and spatial configurations.
3.2 Standardized Ward Layouts
Under HFDS, general wards are classified into three categories:
A class: Single-room, private wards.
B1 class: Four-bed wards.
B2/C class: Six-bed wards, merging the former B2 and C classes.
The design employs a modular 8.4m x 8.4m grid system, allowing flexibility in internal configurations. This modular approach facilitates swift reconfiguration for expansions, technology upgrades, or adjustments to pandemic preparedness.
3.3 Other Standardized Features
Standardization extends to plumbing systems, lift capacities, and emergency infrastructure. For instance, lifts are sized to accommodate medical equipment, and plumbing designs prioritize hygiene and rapid maintenance. These features reduce customization costs and accelerate construction timelines.
- Merger of B2 and C Wards: Rationale and Implications
4.1 Historical Distinctions and Reasons for Merger
Historically, C-class wards were cheaper and more crowded, often perceived as less desirable for patient privacy and comfort. The merger with B2 wards eliminates superfluous class distinctions, aligning with a broader goal of equitable care delivery. MOH’s 2021 review emphasized that technological and infrastructural advancements have eroded the practical differences between these ward types.
4.2 New Ward Classification Under HFDS
By capping subsidies wards at six beds, HFDS ensures a balance between affordability and patient comfort. The 8.4m x 8.4m grid allows consistent room sizes and infection control measures, critical for reducing hospital-acquired infections. Additionally, standardized layouts enable staff to optimize workflows, improving operational efficiency.
4.3 Implications for Patient Care and Subsidized Services
The reduction in bed density may enhance patient privacy and satisfaction, particularly among subsidised wards’ lower-income users. However, challenges remain in ensuring that demand for fewer beds does not strain capacity. MOH’s phased implementation—targeting new hospitals first—allows existing facilities to adopt the framework during refurbishments, minimizing disruption.
- Benefits and Challenges of HFDS Implementation
5.1 Cost and Construction Efficiency
Standardization reduces design complexity, streamlining procurement and construction. Early adopters like Tengah General Hospital (TGCH) and the Tan Tock Seng Medical Tower are projected to achieve 15–20% cost savings through modular components and bulk purchasing. The uniformity also enables faster approvals and shorter build times, addressing Singapore’s aging healthcare infrastructure.
5.2 Flexibility and Future Adaptability
The modular grid system supports scalable upgrades. For example, a six-bed ward can be reconfigured into four single rooms if demand for private wards grows. This adaptability is crucial for integrating emerging technologies, such as smart healthcare systems or AI-driven diagnostics.
5.3 Potential Challenges
Challenges include the upfront costs of redeveloping existing hospitals and potential resistance from stakeholders accustomed to older systems. Additionally, the cultural shift from class-based ward distinctions may require public education to align expectations.
- Case Studies: Early Adopters of HFDS
6.1 Tengah General and Community Hospital (TGCH)
TGCH, located along Tengah Garden Avenue, is the first hospital to fully adopt HFDS. Its 8.4m x 8.4m grid-based wards and standardized plumbing systems are expected to shorten construction timelines by 30%. The hospital will prioritize community care, blending subsidised services with preventive medicine.
6.2 Tan Tock Seng Hospital Medical Tower
The redevelopment of TTS’s medical tower includes integrated modular spaces for infectious disease management, reflecting HFDS’s emphasis on future-proofing. Standardized lifts and emergency systems enhance rapid response capabilities.
6.3 National University Hospital (NUH) Redevelopment
NUH’s phased refurbishment under HFDS will replace C-class wards with six-bed layouts. The project underscores MOH’s commitment to retrofitting existing hospitals without major structural alterations.
- Conclusion and Future Directions
The merger of B2 and C wards under HFDS marks a transformative step in Singapore’s healthcare infrastructure. By prioritizing standardization, the framework reduces costs, enhances flexibility, and promotes equitable care. Early adopters like TGCH demonstrate the feasibility of this model, offering a blueprint for other nations grappling with resource allocation in public healthcare. Future research could explore the long-term impact of HFDS on patient outcomes and compare its efficacy with international standards, such as the U.S. Department of Veteran Affairs’ modular hospital designs. Ultimately, HFDS exemplifies how strategic design can align with public health objectives in an era of rapid technological and demographic change.
References
Ministry of Health, Singapore. (2025). Healthcare Facility Design Standards (HFDS) Launch Announcement.
Straits Times (2025). New Framework to Standardise Public Hospital Buildings in Singapore.
Healthcare Design Magazine. (2022). Modular Design in Modern Hospitals: Global Trends and Case Studies.
World Health Organization. (2021). Health Facility Design Guidelines for Low-Resource Settings.
This paper synthesizes policy analysis, design principles, and case study insights to provide a comprehensive overview of Singapore’s shift toward standardized healthcare infrastructure. It underscores the critical role of design in addressing both immediate and long-term challenges in public healthcare delivery.