Health — Topics | PAPERCUTS

8 May 2019

Review of Drug Testing Standards in Singapore

The Health Sciences Authority tests all medicines sold in Singapore against stringent international standards, including pre-approval assessments and post-market surveillance, with generic medicines subject to the same controls.
HSA’s standards and processes are aligned with those of other major jurisdictions like Australia, Canada, the EU, Japan, and the US, and its laboratory is accredited to international testing standards.
Following the Losartan recall due to nitrosamine impurities, HSA took proactive measures such as testing alternatives, recalling affected products, and facilitating patient switches, which went beyond actions in many other countries.
Public healthcare institutions worked together to reach patients, provide early appointments for switching medications, and avoid panic, with stock restrictions expected to ease and return to normal from July.
HSA continues to collaborate with suppliers and international agencies to address the root cause of contamination and ensure long-term medicine safety.

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7 May 2019

Update on Deployment of Smart Gravitraps

Miss Cheng Li Hui inquired about the number and locations of Smart Gravitraps deployed in a trial since late 2018, their data usefulness for dengue control, and potential nationwide introduction.
The NEA, with a local start-up, developed a Smart Gravitrap prototype that identifies mosquito species and gender remotely, reducing manual data collection efforts.
A six-month pilot trial of the prototypes is planned for the second half of 2019 at two construction sites to guide product development, with decisions on nationwide rollout pending trial results.

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7 May 2019

Proportion of Ministry of Health’s Budget Allocated for Public Acute Hospitals

Assoc Prof Walter Theseira questioned the Minister for Health on the proportion of the Ministry's budget allocated to public acute hospitals, the breakdown between capital and operating costs, and trends over the past five years.
Over the last five years, MOH's total expenditure rose from $4.7 billion in FY12 to $10.2 billion in FY17, with funding to public acute hospitals decreasing from 77% to 66% of the budget.
The decrease in proportion for public acute hospitals is due to increased spending on preventive health, primary care, and intermediate and long-term care.
The allocation for public acute hospitals is about 15% for capital spending and 85% for recurrent operating costs.
The debate highlights shifts in MOH's budget priorities towards broader healthcare needs beyond acute hospital care.

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7 May 2019

Ageing in Place

A study by Duke-NUS found that 97.9% of seniors over 65 prefer to age in place at home with family, foreign domestic workers, or home care services, while only 2.1% prefer a nursing home.
The Ministry of Health does not have corresponding data on the percentage of caregivers who want their care recipients to age in place.
Seniors generally wish to age within familiar communities and be supported by loved ones for as long as possible.

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7 May 2019

Inclusion of Persons with Mental Health Conditions in Special Employment Credit and Open Door Programmes

Member of Parliament Anthea Ong questioned the Ministry of Manpower about extending the Special Employment Credit and Open Door Programme to persons with mental health conditions and considering legislative interventions for workplace mental health risks.
The Ministry responded that these programmes currently cover individuals with permanent disabilities under the Enabling Masterplan, distinguishing them from mental health conditions which may be manageable, and highlighted existing support like the Job Club at IMH and stress management initiatives.
Follow-up exchanges clarified that while employer support for hiring persons with mental health conditions is limited under current schemes, alternative assistance is available through the Adapt and Grow Initiative and partnerships with mental health institutions.

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7 May 2019

Mental Well-being of Youths

Anthea Ong asked about the number and percentage of youths who flagged mental wellbeing as a top concern, the Ministry’s plans to address youth mental health, and how these align with the Community Mental Health Masterplan and other agencies.
The Minister responded that 2,100 of 3,600 youths in Youth Conversations voted for mental health as a top interest, and highlighted various initiatives including youth-led projects, funding grants, and peer support programmes in schools that complement the Masterplan.
Ong further asked about support for young working adults and metrics for measuring impact, and the Minister clarified that youth programmes extend to working adults and that project-specific KPIs will be used to assess impact.

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7 May 2019

Misinformation Regarding Medical and Social Effects of HPV Vaccination

Mr Alex Yam raised questions about the opt-in HPV vaccination programme, seeking feedback on its implementation, ways to address misinformation, and concerns over mistrust from the anti-vaccination movement.
Dr Amy Khor stated that 93% of Secondary 1 female students in 25 schools opted for the vaccine, highlighted its safety and WHO endorsement, and outlined ongoing education efforts including information packages for parents.
The Ministry contacts parents who decline vaccination to provide information, with reasons for refusal including prior vaccination or preference for private clinics, and less than 1% citing safety concerns.
Misinformation about HPV vaccination is acknowledged as common online, with parents directed to reliable sources like HealthHub and healthcare professionals for accurate information.
Evidence shows no link between HPV vaccination and increased promiscuity, as studies indicate vaccinated females do not have sex earlier or more partners than unvaccinated ones.

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7 May 2019

Measures to Prevent Measles Outbreak in Singapore

The Minister for Health highlighted that high vaccination coverage is the key measure to prevent measles outbreaks, with Singapore maintaining a 95% and 93% vaccination rate for children, and noted that the 43 cases in early 2019 were all sporadic with no community outbreak.
Measures include mandatory vaccination for local and long-term foreign children, free vaccination at polyclinics, reminders from the Health Promotion Board, and catch-up programmes in schools, with plans to further raise coverage and protect vulnerable populations like infants and the immuno-compromised.
The Minister revealed that among the 43 measles cases, 33 were unvaccinated and the rest were vaccinated but likely due to vaccine ineffectiveness, while adults have high immunity from past natural infection, and reasons for low vaccination include passive parental behaviour and inconvenience.
In response to supplementary questions, the Minister discussed potential actions like pre-school vaccination requirements and ensuring worker coverage, while noting that factors like online misinformation may contribute to vaccine hesitancy but the main issue is often passive delay by parents.

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7 May 2019

Update on Project Wolbachia and Reason for Spike of Dengue Cases in First Quarter 2019

The Senior Minister of State reported a spike in dengue cases in early 2019 due to high Aedes aegypti mosquito populations, with robust surveillance and control measures in place, including the expansion of Gravitrap monitoring and the early launch of the National Dengue Prevention Campaign.
Project Wolbachia has progressed through Phases 1 and 2, achieving 50% and 70-80% mosquito population suppression respectively, with Phase 3 underway to test sustainability in larger areas and develop automation for scalability, though the Minister emphasized the need for careful evaluation before large-scale deployment.
MPs raised concerns about the pace of Wolbachia trials, public education, fogging effectiveness, and potential expansion to other areas like Jurong, with the Minister defending the systematic approach and noting that fogging is secondary to source reduction, while public outreach and production facility improvements are ongoing.

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7 May 2019

Dealing with Increased Incidence of Tuberculosis Cases

The Ministry of Health reported that tuberculosis incidence rates have remained stable over the past five years, with nearly half of new cases in 2018 among those aged 60 and older, linked to past exposure and latent infection.
Measures include contact investigations by the Tuberculosis Control Unit, adherence to 2016 clinical guidelines, and use of rapid DNA tests for multi-drug resistant TB to enable faster isolation and treatment.
The government is pursuing a three-pronged strategy to reduce TB incidence: public education campaigns, healthcare practitioner training, and policy reviews to enhance early detection, with a long-term goal to match low TB rates of high-income countries.

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6 May 2019

Medical Insurance Coverage for Foreign Domestic Workers

The Minister stated that the government does not track how many employers purchase medical insurance beyond the compulsory $15,000 coverage for inpatient care for foreign domestic workers, noting that 96% of medical bills over the past three years were below this amount.
Employers facing difficulties paying medical bills for their workers without additional insurance can seek assistance from hospitals, and outpatient care bills are typically lower and managed directly by employers.
The Ministry is not requiring compulsory medical insurance to cover outpatient care, as this would raise premiums for all employers and may not be widely supported.

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6 May 2019

Public Education Programmes on Vaccines

Joan Pereira asked whether the Ministry of Education will implement public education programmes to inform parents and students about vaccine facts to support informed choices on voluntary vaccinations.
Ong Ye Kung highlighted high vaccination take-up rates in schools, such as over 90% for diphtheria, polio, and HPV vaccines, and emphasized the goal of achieving herd immunity to protect against serious diseases.
The Ministry of Health and Health Promotion Board conduct public education programmes and provide resources like HealthHub to ensure continued support for vaccination programmes.
MOE supports HPV vaccination efforts by distributing information packages to parents and students to enable informed choices, and will continue collaborating with MOH to sustain vaccination support.

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6 May 2019

Increase in Mass Food Poisoning Cases

The Singapore Food Agency (SFA) has conducted over 95,000 inspections from January 2018 to March 2019, with a focus on high-risk caterers, and has taken enforcement actions against food hygiene lapses.
Investigations found that poor food handling, lack of cleanliness, and inadequate personal hygiene were main causes of recent mass gastroenteritis cases, prompting SFA to increase surveillance and issue advisories to food operators.
SFA is strengthening regulations by increasing penalties, prosecuting serious offenders, and requiring re-training for suspended food handlers and hygiene officers to build a stronger food safety culture.
A multi-pronged approach emphasizes joint responsibility among industry, consumers, and the government, including measures like disinfection protocols and infection control in pre-schools to prevent disease spread.

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6 May 2019

Government Support for Diagnosis, Treatment and Subsidy for Persons with Rare Diseases in Singapore

Christopher de Souza queried the government's support for diagnosing, treating, and subsidising persons with rare diseases in Singapore.
Health Minister Gan Kim Yong explained that most rare diseases are childhood-diagnosed, with early diagnosis and treatment improving lifespan and quality of life, supported by the National Expanded Newborn Screening Programme covering over 30 rare diseases.
Patients can access subsidised inpatient and outpatient services at public healthcare institutions, use MediShield Life and MediSave for bills, and apply for financial assistance like MediFund and Medication Assistance Fund.
For costly medications for rare conditions, hospitals negotiate discounts, waive fees, or use charity funds, and MOH is exploring enhanced support to be detailed later this year.

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6 May 2019

Remedial Actions Following High Blood Pressure Drug Recall

Joan Pereira asked what is being done to ensure all blood pressure medication is tested and cleared before reaching the market following a recall of three brands.
Gan Kim Yong explained that the Health Sciences Authority recalled losartan-based medicines containing an impurity above the acceptable limit and outlined the existing regulatory process for drug approval and post-market surveillance.
The HSA noted that testing for nitrosamine impurities like NMBA was not previously required but has now been mandated for future batches of ARB medicines, with ongoing collaboration to address contamination.

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6 May 2019

Percentage of Spending on Mental Health, Diabetes and Ageing versus Total Healthcare Spending in 2018 against Amount Budgeted for 2019

Anthea Ong requested the percentage of Singapore’s 2018 actual and 2019 budgeted healthcare spending allocated to mental health, diabetes, and ageing.
For the 2017 financial year, MOH reported that mental health received about 3%, diabetes about 11%, and ageing about 6% of the $8.7 billion operating healthcare expenditure.
The figures reflect subvention to public healthcare institutions and specific programmes but exclude broader initiatives like school counselling, Pioneer/Merdeka Generation funds, and other non-MOH funded ageing programmes.

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6 May 2019

Profile of Healthcare Workers Providing Long-term Care Services and Their Skill and Manpower Gaps

Assoc Prof Walter Theseira asked for a breakdown of long-term care workers by nationality, education, skill level, rank, and service type, as well as current manpower and skill gaps and plans to address them.
Minister Gan Kim Yong reported that in 2018 there were 12,020 workers in MOH-subvented long-term care providers, with about 40% being locals, but detailed data on education and skill levels is unavailable.
To meet rising demand, training places for nursing have increased by 30% since 2013, recruitment events have brought over 1,000 locals into community care, and efforts are underway to improve productivity through technology and streamlined processes.
Plans to upskill the workforce include subsidised training through AIC-appointed institutes, scholarships via the Community Care Manpower Development Award, and a new Skills Framework to map job roles and competencies for targeted training.

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6 May 2019

Breakdown of Singaporeans Utilising Nursing Homes, Home Care, Day Care and Respite Care Services

Assoc Prof Walter Theseira asked the Minister for Health for a breakdown of Singaporeans using nursing homes, home care, day care, and respite care services by household income, housing type, and age group.
In Q4 2018, around 16,000 unique residents used subsidised home and community care services, while about 12,000 used subsidised nursing home services, including respite care in both settings.
Among subsidised home and community care users, half were aged 80 and above, three in 10 were 70 to 79, and the rest were 69 or younger, with about three-fifths receiving the maximum subsidy.
Among subsidised nursing home residents, four in 10 were aged 80 and above, three in 10 were 70 to 79, and the remainder were 69 or younger, with over four-fifths receiving the maximum subsidy.

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6 May 2019

Number of Seniors Benefiting from Home-based Care Services from 2016 to 2018

Assoc Prof Walter Theseira asked for annual figures from 2016 to 2018 on seniors benefiting from home-based care, referrals received by the Agency for Integrated Care, number of home-based care providers, and employees excluding foreign domestic workers.
Minister Gan Kim Yong reported that over 70 home-based care providers exist, with worker numbers rising from 890 in 2016 to 1,120 in 2018 based on government-funded providers.
Subsidised home care services benefited 5,200 seniors in 2016, 6,000 in 2017, and 6,700 in 2018, while referrals to the Agency for Integrated Care were 15,800 in 2016, 16,300 in 2017, and 14,400 in 2018, noting that referrals are non-unique and not all lead to service uptake.

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6 May 2019

Average Waiting Time for Seniors to Access Care Services

Assoc Prof Walter Theseira asked for the average waiting times for seniors to access home-based, daycare, and respite care services from 2016 to 2018.
MOH reported that median waiting times were around 7 days for home care and 20 days for daycare services during this period, with no detailed data provided for respite care.
The ministry noted that capacity for home and daycare services had increased, with vacancies exceeding waitlists nationally, and waiting times vary by factors like provider capacity and care needs.
For planned respite care, access is typically within two weeks, while emergency situations can be addressed via the Singapore Silver Line or AICare Links, and interim caregiver support is available for post-discharge patients.
Overall, the response emphasized ongoing efforts to expand care services and support seniors through various initiatives, but specific annual averages for 2016–2018 were not provided beyond the median figures.

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