A Paradigm Shift – From Premises to Services: the New Healthcare Services Act January 17, 2020 The Healthcare Services Act 2020 (HCSA), when it comes into force in phases in 2021 and 2022, will repeal the existing Private Hospitals and Medical Clinics Act (Chapter 248 of Singapore Statues) (PHMCA), and make certain consequential and related amendments to a number of other Acts.