Health — Topics | PAPERCUTS

6 Mar 2019

Neighbours with Behavioural or Mental Health Problems Who Cause Nuisance, Inconvenience or Pose Hazards and Dangers

The Government prioritizes resident safety, with Police intervening in threats to life or property, and offers mediation through grassroots leaders, the Community Mediation Centre, and referrals for mental health support via the Agency for Integrated Care.
For severe cases, Police can apprehend individuals who are a risk to themselves or others and take them for psychiatric assessment, potentially leading to treatment in a psychiatric institution.
Intractable disputes can be addressed through the Community Disputes Resolution Tribunals, which can order mandatory mediation, counselling, or hearings, and issue Special Directions for compliance, including psychiatric assessment or treatment.
Agencies like HDB, PA, grassroots leaders, and voluntary welfare organisations collaborate with the AIC to find sustainable solutions, with the CDRT able to enforce orders through bonds and court-ordered psychiatric assessments.

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6 Mar 2019

Calculation of Norm Costs of Running Long-term Care Services

Louis Ng questioned how the Ministry of Health calculates norm costs for long-term care services, noting they are often lower than the real costs claimed by voluntary welfare organisations (VWOs) as reported by the Lien Foundation in 2018.
MOH explained that it collaborates with VWOs, private and public providers to conduct regular costing exercises, determining costs based on service requirements and averaging them to establish a norm cost used as a funding reference.
MOH acknowledged that costs can vary among providers due to differences in care models, cost structures, and productivity, with some having higher or lower costs than the norm.
The government provides means-tested subsidies of up to 80% for long-term care, with additional financial assistance options like MediFund and charity support from VWOs, while the Community Silver Trust offers dollar-for-dollar matching for donations.

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6 Mar 2019

Committee Of Supply – Head O (Ministry of Health)

Parliament debated the Ministry of Health's budget, focusing on preventive care, healthcare affordability, and support for an ageing population, with MPs raising concerns over rising chronic diseases, dementia, and caregiver support.
Minister Gan Kim Yong outlined initiatives to transform healthcare, including expanding the Community Health Assist Scheme (CHAS) to cover all Singaporeans for chronic conditions and enhancing primary care networks and community-based services.
Key updates were provided on the Merdeka Generation Package, the War on Diabetes, mental health services, and the regulation of private ambulances, with an emphasis on keeping healthcare sustainable and accessible for all citizens.

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6 Mar 2019

Government Assistance for CHAS-registered Clinics to Better Advise Patients

Joan Pereira asked the Ministry of Health (MOH) about assistance provided to Community Health Assist Scheme (CHAS)-registered clinics to better advise patients on their options.
MOH partners with CHAS clinics to provide subsidies, issues clinical and guidelines, and works with the Agency for Integrated Care (AIC) for training, outreach, and support to ensure clinics understand scheme details.
With increasing CHAS eligibility, MOH clarifies that CHAS clinics can refer patients to public hospital Specialist Outpatient Clinics under subsidised care, but CHAS subsidies do not apply on SOC visits, and this information is communicated via AIC platforms.

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5 Mar 2019

Recurrent Costs of Government's Healthcare and Long-term Care Expenditure

Louis Ng asked the Minister for Health to state the percentages of recurrent versus capital costs in the government's healthcare and long-term care expenditures.
The Minister replied that in 2016, the government's $9.3 billion healthcare expenditure comprised about 80% recurrent costs and 20% capital costs.
For long-term care, the $830 million government expenditure in 2016 consisted of approximately 70% recurrent costs and 30% capital costs.

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5 Mar 2019

Total Cost of Providing Long-term Care in Singapore in Latest Available Financial Year

Louis Ng Kok Kwang asked for the total cost of providing long-term care in Singapore in the latest financial year and the breakdown of how this cost is shared among individuals, the government, insurance, and charities.
The Minister for Health stated that full 2017/18 data would be available later in 2019 due to the extensive data compilation process.
Based on 2016 data, total national health expenditure on long-term care was about $1.3 billion, with two-thirds borne by the government and one-third by private financing sources.
The minister noted that further breakdown among individuals, insurance, and charities could not be provided due to data constraints.
The response focused on formal and informal care-giving, indicating that the data covers both types of long-term care services.

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4 Mar 2019

Incorporating Counselling of Victims and Witnesses of Traumatic Events in Psychological Preparedness and Training in Community Emergency Exercises

Joan Pereira asked whether psychological preparedness and training for counselling victims and witnesses of traumatic events could be incorporated into community emergency exercises.
The Ministry of Home Affairs (MHA) has been focusing on community psychological preparedness, especially after terror attacks, through initiatives like the HEART Team, which includes psychologists and mental health practitioners.
MHA and HEART Teams collaborate with the People’s Association to integrate psychological first aid into community emergency exercises, using skills-based role-playing to train grassroots leaders and Community Emergency Response Team members.
Over 1,100 community responders and 350 public service officers have been trained in psychological first aid, and several HEART Team exercises have been conducted as part of Community Crisis Response Exercises.

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4 Mar 2019

Risks Associated with Buying Health Products Sold Online

Ms Joan Pereira asked if the Ministry of Health will work with the Ministry of Education to inform students about the risks of buying health products online.
The Senior Parliamentary Secretary responded that the Health Sciences Authority already runs public education campaigns, including online videos and advisories, to highlight these dangers.
He added that efforts are specifically targeted at school students through collaborations with the Health Promotion Board and direct outreach to tertiary students.
The Health Sciences Authority will continue working with the Health Promotion Board and Ministry of Education to educate students on the risks and the need for discernment when purchasing health products online.

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1 Mar 2019

Checks and Audits on CHAS Subsidy Calculations

Members of Parliament raised concerns about the accuracy of CHAS subsidy calculations after a system error led to incorrect subsidies for 7,700 recipients, questioning audit frequency, on-site verification, in-house computation, vendor accountability, and the outsourcing of IT systems.
The Health Ministry explained the error stemmed from a wrong software file version during a server migration, resulting in an estimated $2 million in overpayments, with costs to be recovered from the vendor NCS, while underpaid recipients would be reimbursed.
The Ministry outlined existing audit processes, agreed to enhance beneficiary verification, and committed to reviewing testing and deployment procedures, including independent quality assurance, but defended outsourcing as efficient for mature systems.

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27 Feb 2019

Impact of Chronic Stress

Louis Ng Kok Kwang asked about the health research findings on how chronic stress affects brain development, cognitive ability, and life satisfaction.
Health Minister Gan Kim Yong explained that stress is a normal body response to challenges but chronic stress can be detrimental, with childhood stress linked to negative brain development and increased risk of mental disorders.
In adults, chronic stress is associated with impairment in cognitive functions like memory and attention, though the physiological mechanisms remain unclear.
Life satisfaction is influenced by factors such as optimism, relationships, and a supportive environment, which can help build resilience to cope with stress.
The Minister highlighted that while stress impacts physical and emotional well-being, more research is needed to fully understand the processes involved.

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26 Feb 2019

Debate on Annual Budget Statement

The Senior Minister of State emphasized that Singapore's healthcare system already provides structural subsidies, such as universal polyclinic subsidies, MediShield Life, CareShield Life, and CHAS enhancements, which are not cohort-based but designed to benefit all Singaporeans, with means-testing to support lower and middle-income groups.
He defended the Pioneer and Merdeka Generation Packages as additional tributes funded by budget surpluses to show appreciation for seniors' contributions, rejecting the Workers' Party's characterization of them as politically motivated and explaining that surpluses are accumulated during a government term before being set aside for such packages.
The Minister criticized the opposition for politicizing the packages while simultaneously calling for more government support, arguing that such criticism is contradictory and undermines the government's long-term financial planning for both current and future generations.

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26 Feb 2019

Guidelines on Disability Duration for Specific Injuries for Doctors

Louis Ng asked the Ministry of Health to consider issuing specific guidelines for doctors on determining the duration of medical leave and light duties for injured workers.
The Senior Minister of State replied that while broad ethical guidelines exist, specific prescriptive guidelines are difficult due to varying medical and work circumstances, and doctors must use professional judgment; MOH will study if specific guidance is needed.
MOH plans to consult professional bodies to assess the feasibility of creating more specific guidelines for certain injury types.
The issue of medical certificate duration for injured workers was previously raised with the Ministry of Manpower, which is reviewing the matter and will conduct public consultation.

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26 Feb 2019

Stricter Measures to Ensure Pre-employment Blood Tests Cannot be Forged

Dr Intan Azura Mokhtar questioned the Minister for Health about stricter measures to prevent forging pre-employment blood tests, prompting a response on existing verification processes and penalties for fraud.
The Ministry of Health explained multiple identity verification points for blood tests and that HIV tests require referrals from registered doctors, with fraud leading to prosecution and professional disciplinary action.
Further clarification sought on forgery of other work qualifications, with the Ministry noting cross-checking with issuing institutions to ensure authenticity, particularly for healthcare sector applicants.

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18 Feb 2019

Annual Budget Statement

The Minister for Finance outlined a strategic budget focused on safeguarding Singapore’s security and sovereignty amid global uncertainties, committing about 30% of expenditure to defence, diplomacy, and cyber security, while urging national unity and vigilance against evolving threats.
Economic transformation measures include support for enterprises and workers through industry transformation maps, enhanced financing schemes, and tighter foreign workforce policies in services to drive productivity, with $4.6 billion allocated over three years for capability-building and job initiatives.
Social policies emphasize caring for an ageing population, with a Merdeka Generation Package offering lifelong healthcare benefits and a $6.1 billion fund, alongside enhanced Workfare support and a new $5.1 billion Long-Term Care Support Fund for CareShield Life subsidies.
Climate change and infrastructure resilience are prioritized, with plans for long-term investments in sustainability, zero-waste initiatives, and coastal protection, alongside fiscal measures like diesel tax adjustments to promote greener practices.
The budget maintains fiscal discipline with a projected deficit, funded by past reserves, and sets out a fair, progressive tax system while preparing for a future GST increase, ensuring intergenerational equity and sustainable growth.

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13 Feb 2019

Ageing with Purpose; Support for Care-givers

The debate highlighted a whole-of-society approach to supporting Singapore’s ageing population and caregivers, emphasizing collaboration between the government, community, families, and individuals.
Several speakers called for financial support for caregivers, such as a Caregiver Allowance and extended MediSave use for siblings, which the government addressed with a Home Caregiving Grant and policy adjustments.
Workplace flexibility, re-entry support for caregivers, and enhanced respite care services were identified as key areas for improvement, with the government committing to focus on flexible work arrangements and expanding respite care options.
The need for better care navigation, caregiver training, and stronger community support networks was emphasized, with plans to leverage Silver Generation Offices and digital tools to improve accessibility.
Both motions were passed, affirming the House’s commitment to ensuring Singaporeans age with purpose and dignity while strengthening support for caregivers through a collective effort.

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12 Feb 2019

Success Rate of Appeals to use MediSave Beyond Annual Withdrawal Limits

In 2016 and 2017, about 17% of Singaporeans aged 65 and above with chronic conditions fully used their outpatient MediSave limits, 16% for diagnostic scans, and 16% for Flexi-MediSave.
Over the past two years, MOH received about 200 appeals annually from all age groups for outpatient MediSave use beyond limits, with about half approved based on case-by-case considerations of exceptional circumstances.
MOH has increased MediSave withdrawal limits and lowered the age for Flexi-MediSave to improve affordability, and will continue monitoring policies and reviewing appeals.

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12 Feb 2019

Progress on Project E-learning Mental Health First Aid Programme

As of November 2018, over 900 individuals from 26 organizations have attended the Project E-learning Mental Health First Aid (MHFA) programme, with more than 800 certified.
Participants were primarily from Government agencies, social organizations, educational institutions, grassroots groups, and faith-based groups.
Certified individuals are understood to have used their skills to support friends, co-workers, and family members with mental health conditions, though no formal tracking of mobilization exists.

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12 Feb 2019

Top Three Causes of Death among Elderly Persons Aged 65 and Above

Dr Intan Azura Mokhtar asked the Minister for Health for the past five years about the top three causes of death among elderly persons aged 65 and above and the number of elderly persons dying annually from pneumonia or pneumonia-related complications.
From 2013 to 2017, the top three causes of death among Singapore residents aged 65 and above were cardiovascular diseases, cancer, and pneumonia.
During this period, between 3,000 and 3,750 elderly persons died from pneumonia each year, accounting for about 25% of total elderly deaths.

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12 Feb 2019

Unauthorised Possession and Disclosure of Information from HIV Registry

The Minister for Health detailed the unauthorized disclosure of HIV Registry data by Mikhy Farrera Brochez and Dr. Ler Teck Siang, affecting over 16,000 individuals, and outlined MOH's decision-making process on public disclosure, emphasizing the balance between transparency and patient well-being.
MOH has implemented enhanced data security measures, including stricter access controls, a two-person approval process for data downloads, and expanded data governance, while also providing support services for affected individuals.
The government highlighted ongoing legal actions against Brochez and Ler, stressed the need for societal support to reduce HIV stigma, and affirmed that penalties for data misuse are under review.

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12 Feb 2019

Preventive Measures Implemented Following Data Leak Involving Persons with HIV

Members of Parliament raised concerns about how to protect the personal data of 14,200 people affected by the HIV registry leak, prevent stigmatisation and discrimination, and maintain public trust in HIV testing.
Questions focused on access controls and tracking of HIV registry data, the deportation and prior actions of the leaker, and the timing and adequacy of alerts to affected patients.
Further queries addressed the takedown of the online leak, protection from harassment, and steps to prevent the leaker from misusing the data internationally.
The Minister for Health was asked about additional security measures for confidential information and the review of public disclosure standards for data breaches.

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