Protection for Patients from Unnecessary Optional Medical Screenings

Mr Yip Hon Weng asked the Minister for Health (a) how does the Government protect patients from being subjected to unnecessary optional medical screenings; and (b) how many cases of abuse or fraudulent medical claims have been detected in the past five years.

Physicians are encouraged to take reference from the clinical guidelines on screening tests published by the Screening Test Review Committee (STRC). The STRC is made up of senior clinicians from across various disciplines. The STRC Guidelines recommend tests shown to be safe, cost-effective and appropriate for health screening, in the early detection of illnesses in asymptomatic patients. Such patients may be apparently healthy individuals, or patients that are seeking treatment for a particular disease but are offered further screening tests to detect diseases that have not yet manifested. The Guidelines also highlight tests which have insufficient clinical evidence to be effective for the screening of certain diseases and encourages patient to be educated on possible harm of screening using these tests.

The Singapore Medical Council's Ethical Code and Ethical Guidelines (ECEG) require that doctors offering screening tests ensure that these are validated and clinically appropriate. The ECEG also mandates that advertisements for health screening services must also be factual, verifiable and not be misleading, or induce the public to seek healthcare services which they may not need.

MOH supports appropriate health screenings through subsidies for the Screen for Life (SFL) programme. Under this program, Singapore residents are encouraged to go for regular, evidence-based, health screening at Community Health Assist Scheme (CHAS) General Practitioner clinics, polyclinics and participating community providers. Clinicians will assess patient factors such as age, gender and medical history before prescribing the appropriate health screening. MOH also allows MediSave to be used for specific screening tests such as mammograms in higher risk age groups.

Based on audits of claims for MediSave claimable health screening tests, there had been no evidence of fraud or abuse detected. Nevertheless, MOH takes a serious view of any attempts to defraud or abuse the healthcare system, public funds or Medisave, and will continue to work with the medical community to investigate any such reports. We encourage the public to provide feedback to MOH if they are aware of such cases of fraud or abuse. MOH will also continue to educate the population on the appropriate use of health screening tests.