Health — Topics | PAPERCUTS

14 Jan 2019

Infectious Diseases (Amendment) Bill

The Infectious Diseases (Amendment) Bill proposes to enhance surveillance by allowing remote medical examinations, streamlining disease reporting, and enabling one-time orders for sample collection to improve efficiency and reduce duplication.
The Bill introduces stricter border controls, allowing refusal of entry to unvaccinated non-citizen travellers without prior isolation or vaccination, and transfers existing measures for screening travellers entering or leaving Singapore into the Act to prevent disease importation and spread.
Amendments expand the scope for disease control within Singapore, including requiring surveillance or contact tracing in more premises beyond workplaces and dormitories, and allowing calibrated restrictions for lower-risk individuals to balance public health and personal liberties.
The Bill facilitates information sharing for public health purposes, granting immunity to operators who disclose data in good faith and enabling the Director of Medical Services to share information without ministerial approval to prevent outbreaks.
The amendments also clarify provisions for national public health research during non-crisis times and the use of identifiable data, while ensuring data protection and confidentiality are maintained.

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14 Jan 2019

Tobacco (Control of Advertisements and Sale) (Amendment) Bill

The Minister for Health introduced the Bill to amend the Tobacco (Control of Advertisements and Sale) Act, marking its first reading and setting the stage for a second reading in a future sitting.
The amendment aims to tighten regulations on tobacco advertisements and sales, aligning with broader public health objectives to reduce smoking prevalence.
The debate underscores the government's commitment to enhancing existing tobacco control measures through legislative updates.
The Bill was formally presented and scheduled for further parliamentary scrutiny, reflecting the standard legislative process.

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14 Jan 2019

Traditional Chinese Medicine Practitioners (Amendment) Bill

The Minister for Health introduced a bill to amend the Traditional Chinese Medicine Practitioners Act, aiming to update existing regulations for the profession.
The bill was presented for its first reading in Parliament and scheduled for a second reading at the next available sitting.
The amendment seeks to refine the legal framework governing traditional Chinese medicine practitioners in Singapore.
The legislative process was formally initiated with the bill's introduction and referral for further parliamentary scrutiny.

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14 Jan 2019

Reason Behind Improperly Sterilised Equipment at Tan Tock Seng's Dental Clinic and Preventive Measures Put in Place

The improper sterilisation at Tan Tock Seng Hospital’s dental clinic was due to human error, where staff failed to start the sterilisation cycle and did not verify the instruments before use, leading to eight packs being used without proper sterilisation.
Public healthcare institutions have multiple sterilisation checks, including mechanical parameter monitoring, chemical indicator verification, and end-user checks, along with mandatory staff training and competency assessments.
Internal audits on sterilisation processes are conducted routinely, ranging from as often as every six months, with findings shared to improve system-wide practices.
Following the incident, TTSH implemented stronger safety controls, such as linking loading and cycle initiation, enhancing pre-procedure checks, improving workflows, and refining training and audits.
The Ministry has instructed all healthcare institutions to heighten vigilance, step up training, and conduct immediate safety reviews, while also performing random audits and reviewing practices across the sector to prevent recurrence.

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20 Nov 2018

Effectiveness of Efforts to Attract and Retain Singaporean Medical Students Studying Abroad to Work in Singapore

MOH has increased local medical school intakes by 40% since 2012, making them the primary source of doctors, which is expected to reduce reliance on overseas-trained Singaporeans.
Over 200 overseas-trained Singaporean doctors return annually, a doubling since 2010, with over 90% remaining in practice and 80% staying in the public sector for five years or more.
The government is enhancing retention through improved work environments, technology to streamline workloads, and more career development and training opportunities for doctors.
Retention efforts also extend to other healthcare professionals like nurses, with increased salaries, autonomy, and training opportunities, alongside higher intakes in local nursing courses.
MOH will continue to review manpower strategies based on future healthcare needs to ensure adequate supplies of medical staff.

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20 Nov 2018

Air Filters Effective in Filtering Out Harmful Effects of Second-hand Smoke

Louis Ng asked the Ministry of Health if any air filters are proven to effectively remove the harmful effects of second-hand smoke in private homes.
The Minister for Health, Gan Kim Yong, stated that no air filtration technology is known to be effective at removing the harmful effects of cigarette smoke.
He explained that cigarette smoke contains both particulate and gaseous toxic components, and residential air cleaners cannot adequately remove gases like formaldehyde, benzene, and carbon monoxide.
The Ministry's response highlights the limitations of current home air filtration systems in fully addressing second-hand smoke hazards.
The exchange underscores the need for other measures beyond air filters to protect private residences from second-hand smoke.

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20 Nov 2018

Key Performance Indicators for Scheme to Help Hospitals Scale Up Adoption of Smart Technologies

The $62.5 million Smart Nursing Ward programme was launched in 2018 to reduce nurses' administrative workload by adopting smart technologies like robots and RFID.
Key performance indicators include achieving at least 10% nursing time-savings, but it is too early to assess progress as many projects are just starting.
Examples of technologies being explored include Autonomous Mobile Robots for deliveries and monitoring, which have shown potential time savings in pilots.

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20 Nov 2018

Appeals by Singaporeans Aged 62 and Above to Use MediSave Beyond Withdrawal Limit

Over the past two years, about 200 appeals were made by Singaporeans aged 62 and above to use MediSave beyond withdrawal limits, with approximately half approved on a case-by-case basis considering treatment complexity, complications, and financial hardship.
The Ministry of Health stated that MediSave withdrawal limits are generally sufficient, with 92% of post-subsidy hospitalisation and day surgery bills covered by MediShield Life and MediSave in 2017, and most elderly patients in subsidised wards paying little to no cash.
There are no plans to lift the withdrawal limit, but the government has enhanced outpatient subsidies, introduced MediShield Life, and raised MediSave limits for chronic care and flexi-use to support the elderly.
The ministry will continue monitoring affordability and consider appeals for excess usage, while balancing any future limit increases against the long-term sustainability of MediSave accounts.

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20 Nov 2018

Recourse for Children with Chronic Conditions Who Are Refused Health Insurance and Not Eligible for MediFund

The Minister outlined that all Singaporean children can access government subsidies, MediSave, and MediShield Life regardless of private insurance status, with additional support available via MediFund for those needing further financial help.
Subsidies of up to 75% for outpatient care and 80% for inpatient hospital care are available, along with CHAS subsidies for chronic conditions, which will soon extend to all Singaporeans.
MediSave can be used for chronic disease management under the Chronic Disease Management Programme, and newborns receive a $4,000 MediSave Grant, with parental MediSave also available for children’s medical bills.
MediShield Life covers all Singaporean children from birth for conditions like cancer and congenital issues, while MediFund committees have flexibility to assist middle-income patients facing special circumstances.
The government’s existing framework provides multiple layers of support, ensuring children with chronic conditions are not left without recourse for medical needs.

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20 Nov 2018

Social Safety Net for Disabled who Need Institutional Long-term Care Beyond ElderShield

The government provides multiple supports for severe disability, including ElderShield, CareShield Life, government subsidies up to 75% for nursing homes, MediFund, and new schemes like ElderFund and MediSave withdrawals.
CareShield Life covers those born in 1980 or later, and ElderFund offers monthly assistance for low-income severely disabled citizens who cannot join CareShield or have low MediSave.
Additional programs like the Interim Disability Assistance Programme for the Elderly and Pioneer Generation Disability Assistance Scheme provide further cash payouts for eligible groups.
The Ministry is open to considering special support for severely disabled individuals who have exhausted ElderShield and face financial difficulties.
Overall, the social safety net combines insurance, subsidies, savings, and discretionary aid to address long-term care needs.

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20 Nov 2018

Practice of Engaging Foreign Agents to Bring Overseas Patients to Singapore Public Hospitals

Miss Cheng Li Hui questioned the duration, awareness, and impact of public hospitals engaging foreign agents to bring overseas patients, suggesting they might crowd out Singaporeans.
The Ministry of Health stated that public hospitals no longer have contracts with foreign agents, foreign patients make up only 1.5% of attendances, and Singaporean wait times for specialist appointments have improved.
Pritam Singh raised concerns about potential scheduling disparities for subsidised patients and requested absolute numbers of foreign patients, to which MOH responded that prioritisation is based on medical urgency and provided the 2017 figure of 10,900 foreign attendances.

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19 Nov 2018

Sign-ups as Dementia Friends through Dementia Friends Mobile App

Assoc Prof Daniel Goh asked about the number of sign-ups through the Dementia Friends mobile app and whether the app is suitable for use by the wider public without specific training.
As of end-October 2018, over 2,000 people have signed up as Dementia Friends through the app, which was launched in October 2018 under the Dementia-Friendly Singapore initiative.
The app is designed for both caregivers and the general public to access information on dementia, support services, and events, and to help locate lost persons with dementia through community alerts.
Caregivers can activate a network of Dementia Friends via the app when a person with dementia is lost, and nearby users can assist in bringing them to designated Go-to Points for reunification.
The government encourages all members of the public to download the app, sign up as Dementia Friends, and share it with others, regardless of specific training.

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19 Nov 2018

Update on Hand, Foot and Mouth Disease Infections

Assoc Prof Daniel Goh asked whether HFMD infections are increasing and if current transmission control efforts need improvement.
Minister Gan Kim Yong stated that HFMD cases fluctuate yearly and detailed collaborative efforts with MOE, ECDA, and PA to educate preschools on hygiene and infection control.
During peak months, MOH reminded preschools to screen children more vigilantly and ECDA increased health visits to preschools with ongoing transmission.
MOH will continue to regularly review and update its policies and response measures for HFMD control.

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19 Nov 2018

Revocation by SAF’s In-camp Medical Officers of Medical Leave Issued by Private GPs to Full-Time National Servicemen

Member of Parliament Muhamad Faisal Bin Abdul Manap inquired about the number of cases in the last three years where SAF’s in-camp medical officers revoked medical leave issued by private GPs to full-time national servicemen, the reasons for such revocations, and the processes involved prior to revocation.
Minister for Defence Ng Eng Hen clarified that SAF medical officers do not revoke medical certificates from external practitioners; instead, they may conduct a clinical review and propose amendments to the MC, such as adjusting its duration or exempting the serviceman from certain activities.
The amendment process involves the unit medical officer discussing the case with the issuing practitioner or referring the serviceman to a specialist for advice, and servicemen may seek further clinical review at any time, though such amendments are infrequent in the SAF.

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19 Nov 2018

Revenue Generated by Contracts that Referred Foreign Patients to Public Hospitals

Assoc Prof Daniel Goh Pei Siong asked about the revenue and patient numbers from foreign patient referral contracts, and whether these compromised Singaporeans' access to public healthcare.
Minister Gan Kim Yong stated that MOH and public healthcare institutions prioritize Singaporeans, do not actively market to foreigners, and have ceased all contracts with service providers for foreign patient referrals.
Between 2013 and 2017, foreign patients accounted for about 1.5% of inpatient and day surgery attendances, with those referred via contracts making up 0.4% and contributing 0.8% of revenue in relevant institutions.
Singaporeans remain the majority of patients, and foreign patients have not impacted services or subsidized appointment slots for locals, with waiting times for specialist appointments improving.
MOH will continue ensuring that meeting Singaporeans' healthcare needs remains the priority.

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19 Nov 2018

Children below Age 18 who Are Diagnosed with Obesity-related Illnesses

Dr Lim Wee Kiak asked the Minister for Health about the number of children below 18 diagnosed with obesity-related illnesses, the adequacy of medical resources, and prevention efforts.
About 13% of children aged 6–18 in Singapore are overweight, with a small fraction showing impaired fasting glucose and about one in three having elevated blood pressure or lipids.
Higher-risk overweight children are referred to the Health Promotion Board’s Student Health Centre for assessment and lifestyle coaching, with those diagnosed referred to specialist care.
The Health Promotion Board collaborates with schools to promote physical activity and healthier meals, while Student Health Advisors provide counselling in secondary schools.
The Ministry of Health and Health Promotion Board continue efforts to foster healthy behaviors through initiatives like NurtureSG’s booklet for parents.

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19 Nov 2018

Causes of Double-digit Growth in Healthcare Inflation over Last Decade

Seah Kian Peng asked the Minister for Health about the causes of double-digit healthcare inflation over the past decade, which has far exceeded normal inflation rates.
Minister Gan Kim Yong explained that National Health Expenditure grew at an average of 11% per year from 2006 to 2016, driven by an ageing population, higher healthcare service utilization, and capital investments in new public healthcare facilities.
Government support for healthcare expanded significantly, with spending increasing by 17% annually, raising the government's share of total health expenditure from 30% to over 40%, which helped lower the actual inflation borne by Singaporeans to an average of 2.6% per year from 2007 to 2017.
The minister emphasized that despite high overall expenditure growth, healthcare inflation remained close to general inflation due to increased subsidies like the Pioneer Generation Package, MediShield Life, and CHAS.
The government will continue to monitor healthcare inflation and work to keep healthcare affordable for all Singaporeans.

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19 Nov 2018

Extent of Doctors Over-servicing Patients

The Minister for Health, Gan Kim Yong, acknowledged that precise data on over-servicing is hard to obtain, citing an average of 19 annual complaints to the Singapore Medical Council about unnecessary treatment between 2013 and 2017.
The Agency for Care Effectiveness has issued 39 clinical guidances to define appropriate care, such as for the use of PET-CT scans in cancer management, to discourage unnecessary services.
Insurance industry measures include pre-authorization frameworks for Integrated Shield Plans and mandatory co-payment requirements to promote medically necessary treatments.
The Singapore Medical Council’s 2016 Ethical Code explicitly requires doctors to prioritize patients’ interests over financial considerations, with a circular reminder sent in March to reinforce this.
The minister emphasized that all stakeholders must collaborate to curb over-servicing and ensure healthcare remains affordable and sustainable.

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19 Nov 2018

Update on Community Mental Health Master Plan

The Community Mental Health Master Plan launched in 2017 has expanded services to 10 polyclinics (targeting 12 by 2021), trained 155 GPs and 19 community intervention teams, and established 34 outreach teams and six Dementia Friendly Communities.
Mental health education is promoted in Singapore through school programmes like those from the Health Promotion Board, with the ministry noting that mandatory mental health literacy programmes internationally are still nascent.
Studies by the National Council of Social Service (NCSS) have examined the impact of mental health conditions on employment, workplace attitudes, and quality of life, with findings guiding recommendations for workplace adjustments and fair employment practices.

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19 Nov 2018

Amount Spent and Subsidy Given for Supplements Dispensed to Pregnant Patients at Public Hospitals and Polyclinics

Dr Chia Shi-Lu asked the Ministry of Health about patient spending and government subsidies for supplements like folic acid and iron for pregnant patients over the last three years, and how institutions ensure the supplements meet required levels.
The Minister for Health, Gan Kim Yong, stated that folic acid and iron supplements are subsidised up to 75% under the Standard Drug List, with average patient costs of $3 for folic acid and $30 for iron over pregnancy, and government subsidies of $11,300, $15,400, and $17,300 in 2015, 2016, and 2017 respectively.
Folic acid dosages are typically 5 mg per day from preconception to 12 weeks to prevent neural tube defects, while iron supplements are routinely given from 20 weeks, with doctors assessing anaemia to adjust doses as needed.

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