Auditing Medical Examinations for Foreign Workers

Madam, employers are required to send their foreign workers for a medical examination by a Singapore-registered doctor within 14 days of arriving in Singapore. MOM reviews the medical examination reports of all foreign workers as part of the work pass application process. Foreign workers who are found to have specific infectious diseases or to be unfit for work will not be issued with work passes, and must leave Singapore.

We work with our public health professionals in MOH to identify the infectious diseases that are of public health concern. The medical examination screens for these infectious diseases and also helps to give an indication of the foreign worker's general fitness for work at the point of examination, based on the professional judgement of the doctor.

MOM continually works with MOH to ensure the medical examination framework remains relevant to the public health threats facing Singapore and to strengthen the process of medical screening for foreign workers.

I thank the Senior Parliamentary Secretary for his answer. This question was posed in relation to a similar question that was posed during this sitting by the hon Member, Dr Lam Pin Min, to MOH. This was in relation to a recent complaint against two clinics who were conducting these medical screenings and there were some questions raised about the adequacy of the screenings. As I understand from the answer, it is still under investigation.

My first question relates to a concern that has been raised previously, which is that there have been some concerns about how robust the manner in which these medical examinations are being carried out. My first question to the Senior Parliamentary Secretary is: what is the procedure by which the criteria are formulated and reviewed? I understand this would be done by MOH but perhaps I could just get some understanding about how this process is carried

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out.

The second question relates to another observation. Because the definition for passing a particular medical examination is perhaps not entirely definite, that is to say that when the worker sees one medical practitioner, and he sees another one, there may be a difference in the opinion about his fitness to work. This is not due to any wrongdoing but, certainly, depending on the criteria and the way it is set out, there could be some difference in opinion. So, there have been cases where a worker is seen by one practitioner —

Yes, Madam, I will come to that. The worker is seen by one practitioner and he fails the examination and he is seen by another one, and he passes. I would like to ask whether the Ministry is going to look at any way of preventing this, for example, perhaps by setting up a central database where every single examination is recorded, so that if this worker goes to another practitioner, then there is a record that can be verified.

I thank the Member for his suggestion. I think we can consider the last part of his suggestion, that is, transferability of information from one medical practitioner to another. But on the process of review, we generally have an open communication with MOH to review healthcare threats posed by foreign workers working in Singapore. There is no specific timeframe. There is no specific best time. As and when it is necessary to review, we will consider.

The results of the tests on four infectious diseases have shown that the incidences of failure are very small and there is no reason for us to have an aggressive review of the process of enlarging the number of infectious diseases that we want to consider screening.

Sir, the purpose of the medical examinations – both at the outset when the worker comes and applies to work in Singapore, as well as the six-monthly medical examination – are to ensure that the workers are healthy and at the same time are fit for work. The opinion of the medical professional will be sought on whether the person is fit for work. The tests of the four infectious diseases are very objective and that includes HIV. Information will be passed to MOM which will review every application to work in Singapore, application for work permit as well as application for renewal. Essentially, HIV is one of the diseases that we screen and information is available and known to MOM.

Mdm Speaker, I thank the Senior Parliamentary Secretary for the reply. My issue here is not so much the medical examination when the work permit is given out but when the work permit is renewed after two years. Right now, from the regulations, as I understand them, only HIV is the infectious disease that the doctor has to ensure that the worker whose work permit is being renewed has to be free of.

I do not believe there is something specific in the current regulations when a work permit is renewed which states that the doctor has to physically certify or sign off that this worker is fit for work. All that has to be done is just to ensure that the worker is not HIV-positive. I think it is important that when the work permit is renewed that at least there has to be some note that the doctor puts in there that this worker is actually fit to work. I do not believe that is the case right now.

Madam, the workers are tested on at least four infectious diseases at the outset and every six months thereafter. At the point of renewal of their permits, they are also tested for the said infectious diseases. As long as it is in the cycle of six months, they are tested. The results of the tests will determine whether they can be allowed to work in Singapore and be issued work passes. As to whether the doctor has to certify that the worker is fit for work is usually immaterial because the test results, which are objective, will determine whether the worker should be allowed to work in Singapore.

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