Health — Topics | PAPERCUTS

6 Aug 2018

Statistics on Awareness and Practice of Breast Self-Examination among Females in Singapore

Joan Pereira asked the Ministry for Health for statistics on female awareness and practice of breast self-examination in Singapore and whether it will collaborate with schools to educate students and provide necessary follow-up.
Health Minister Gan Kim Yong highlighted that breast cancer is the most common cancer among females in Singapore, with the Health Promotion Board (HPB) partnering healthcare providers and community organizations like the Breast Cancer Foundation for annual awareness efforts and distributing information booklets at polyclinics.
Surveys indicate that about 45% of women in Singapore perform regular breast self-examinations, and HPB emphasizes education for females aged 30 and above, recommending regular self-exams and mammogram screenings for those 50 years and older.
While HPB's outreach benefits all ages, including students, the Ministry focuses on older females due to the age-related increase in breast cancer risk, rather than prioritizing school-based education for students.

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6 Aug 2018

Hospital Admissions and Deaths from Alcohol Overdose in Last 10 Years

Mr Kok Heng Leun asked the Minister for Health for the number of hospital admissions and deaths from alcohol overdose over the past 10 years.
Minister Gan Kim Yong reported an average of about 550 hospital admissions per year for alcohol-related conditions between 2008 and 2017.
The Minister stated that no deaths were reported with alcohol intoxication as the primary cause during this period, but noted an average of 14 deaths per year from long-term effects of alcohol.

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6 Aug 2018

Proportion of Full-time National Servicemen Downgraded for Mental Issues

Sylvia Lim inquired about whether the proportion of Full-Time National Servicemen downgraded for mental issues has increased in recent cohorts compared to earlier decades.
Minister Ng Eng Hen stated that approximately 4% of each National Service cohort over the past five years was downgraded for mental health issues, primarily after pre-enlistment check-ups.
The Minister noted that the prevalence of mental disorders among NSFs reflects that of the general male population in Singapore.
He emphasized that the Singapore Armed Forces provides comprehensive support, including medical treatment, counselling, and a 24-hour hotline for NSFs.
Unit commanders receive training to understand mental health conditions and regularly interview NSFs to identify and address any psychological stresses.

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6 Aug 2018

Elderly Patients Readmitted within 30 Days after Discharge From Hospital

Assoc Prof Daniel Goh Pei Siong questioned whether readmission rates for elderly patients within 30 days of discharge from public hospitals have declined in the past five years and what measures are in place to reduce them.
Health Minister Gan Kim Yong stated that readmission rates for patients aged 65 and above have slightly increased from 18.9% in 2013 to 19.5% in 2017, but when adjusted for age and condition severity, they range between 11.6% and 11.8%.
The Ministry of Health and public hospitals have implemented programmes like Hospital-to-Home, which provides integrated care support, and expanded community hospitals to offer sub-acute and rehabilitation care, aiming to reduce readmissions.
Ongoing efforts include collaboration with community and primary care providers to improve continuity of care after hospital discharge.

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6 Aug 2018

Treatments that Blend Western and Traditional Chinese Medicine

Joan Pereira asked about the number of ongoing clinical trials for integrative Western and TCM treatments and how the landscape and costs will evolve.
The Ministry of Health has funded eight million dollars through the TCM Research Grant since 2013, supporting ten projects in various stages, including trials on acupuncture for dry eyes and TCM for childhood asthma.
TCM currently plays a complementary role in Singapore’s healthcare system, with some treatments like acupuncture incorporated where evidence supports efficacy and safety.
The Ministry is in early research stages and cannot yet estimate future costs of integrated treatments but will continue monitoring progress and evaluating evidence.
A third grant call closed in June 2018 with proposals under review, indicating ongoing support for collaborative research between TCM practitioners and healthcare institutions.

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6 Aug 2018

Advance Medical Directive as Opt-out Scheme for Older and Terminally Ill Persons

Dr Chia Shi-Lu proposed making the Advance Medical Directive an opt-out scheme for individuals aged 85 and above, and those over 80 who are terminally ill and have been unconscious for over a year.
Minister Gan Kim Yong affirmed that the Advance Medical Directive is a voluntary, personal document representing a considered decision, and the Ministry does not support an opt-out scheme to preserve the principle of personal choice in medical decisions.
In the absence of an Advance Medical Directive, decisions on treatment should be made by the attending doctor in consultation with family and caregivers, focusing on the patient's best interests and any documented preferences.

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6 Aug 2018

Smartphone Addiction among Young Children and Teenagers

Murali Pillai inquired about the Ministry of Health’s concerns and planned actions regarding rising smartphone addiction among young children and teenagers.
Health Minister Gan Kim Yong noted that smartphone addiction is not a recognized medical diagnosis, though some youth seek help for impulse disorders linked to device use, with no upward trend in such cases reported from 2013 to 2017.
The Ministry outlined existing measures, including public education, media campaigns, and intervention services through NAMS, REACH, CHAT, and TOUCH Community Services to address behavioral addictions like gaming and smartphone overuse.

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6 Aug 2018

Drug Rehabilitation Centre’s Assistance for Inmates to Stop Addiction and Cultivate Healthy Pursuits

The Enhanced Drug Rehabilitation Regime (EDRR) introduced in 2014 assesses inmates' risk levels and provides tailored psychology-based programmes to address underlying attitudes and beliefs behind drug abuse, with lower-risk inmates learning relapse prevention skills and high-risk inmates undergoing intensive counselling for issues like criminal thinking.
The Singapore Prison Service offers meaningful activities such as basketball clinics, urban farming, family programmes, skills training, and religious counselling to engage inmates and promote healthy alternatives to drug use.
Community-based programmes complement in-centre rehabilitation by allowing inmates to serve the tail-end of their detention under structured supervision, supporting reintegration into society and working with community partners to strengthen support.
The enhanced regime has led to encouraging results, with the two-year recidivism rate for DRC inmates dropping from 60%-70% in the 1990s to around 30% for the 2015 release cohort, and further enhancements are planned for better outcomes.

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6 Aug 2018

Locations of SingHealth Dental Clinics

Zainal Sapari asked about the considerations for SingHealth dental clinic locations, average waiting times, plans to expand clinics in large estates, and potential availability in every polyclinic.
Gan Kim Yong stated that subsidised dental care is available through 700+ CHAS clinics and 10 polyclinics, with median waiting times dropping from 5.8 months in 2013 to 4.5 months in 2017.
Three SingHealth polyclinics in the eastern region served about 31,000 patient attendances in 2017, and the Ministry of Health considers overall capacity when planning dental services, so not every polyclinic needs a dental clinic if there is adequate subsidised access.

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6 Aug 2018

Smoking (Prohibition in Certain Places) (Amendment) Bill

The Smoking (Prohibition in Certain Places) (Amendment) Bill was introduced to amend the existing Act, presented by Dr Amy Khor on behalf of the Minister, and read for the first time in Parliament.
The bill aims to strengthen regulations on smoking prohibitions in specified areas, with its second reading scheduled for the next parliamentary sitting.
The amendment reflects the government's ongoing efforts to expand smoke-free zones and protect public health in Singapore.

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6 Aug 2018

Findings and Follow-up Actions on National Service Training Death

The COI found that CFC Lee’s death resulted from heat stroke, with contributing factors including breaches of safety regulations—such as unauthorized intense training the day before and insufficient rest—and inadequate on-site casualty management and delayed evacuation.
The SAF has implemented immediate measures, including a simplified evacuation protocol for disoriented personnel, enhanced cooling methods, and stricter enforcement of safety rules, to prevent future heat injuries and achieve zero training fatalities.
The Minister emphasized collective responsibility for safety, urging soldiers to speak out about health concerns and commanders to proactively remove at-risk individuals, while awaiting outcomes from police and coroner inquiries before any disciplinary actions.

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6 Aug 2018

Cyberattack on SingHealth's IT System

The Singapore government confirmed a sophisticated cyberattack on SingHealth's IT system, resulting in the theft of personal and medication data for 1.5 million patients, including targeted records of the Prime Minister, with a Committee of Inquiry convened to investigate.
In response, authorities implemented measures like internet surfing separation for public healthcare systems, though this caused operational disruptions, while emphasizing that no financial data was accessed and safeguards like two-factor authentication remain in place.
The government affirmed its commitment to advancing Smart Nation initiatives despite the attack, highlighting ongoing investments in cybersecurity expertise and the need for a balance between digital efficiency and security resilience.

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6 Aug 2018

Safeguarding Health Data from Cyberattacks

Multiple MPs raised concerns about the SingHealth cyberattack, questioning the integrity of health data, potential infiltration of subversive programs, and whether the breach compromised other government networks.
The debate highlighted demands for immediate rectification measures, improved security protocols, and clarity on how to detect data tampering or alterations in medical records.
MPs also pressed for explanations on the delay in public disclosure of the breach and questioned whether new security measures were affecting public hospital and polyclinic operations.

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11 Jul 2018

Primary Sources of Infection for Tuberculosis in Singapore

The primary source of tuberculosis infection in Singapore is close and prolonged exposure to individuals with active TB, particularly in households, workplaces, and schools, with the elderly and immunocompromised being more at risk of developing active disease.
The Ministry of Health implements strategies like early detection, directly observed treatment, contact tracing, and screening of foreign work permit applicants to control TB spread, alongside guidelines and genome sequencing to improve management.
To address multi-drug resistant TB, rapid DNA testing and directly observed therapy are used to reduce treatment failures and drug resistance.
Public education and targeted awareness for older Singaporeans are being enhanced, and preschool staff undergo mandatory medical checks for active TB, with daily health monitoring to protect children.
While latent TB prevalence is high among the elderly, universal screening is not deemed cost-effective, but efforts to educate and encourage symptom awareness are being intensified.

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11 Jul 2018

Specialised Transportation of Seniors to Care Centres

Assoc Prof Daniel Goh asked the Minister for Health about a potential crunch in specialised transportation for seniors to care centres and its impact on placements.
The Senior Minister of State confirmed that funded eldercare centres must provide transport, with subsidies for mobility assistance and multiple transport options like vans and centralised services.
The Ministry stated that while occasional short-term challenges may arise, AIC works with centres to find alternatives, ensuring minimal impact on client placement.
Assoc Prof Goh further inquired about future supply capacity and deeper collaboration with taxi operators, to which the Ministry replied that current options are adequate with spare capacity.
The Ministry noted collaborations with taxi and private hire operators may expand beyond driver training to include specialised vans if needed.

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10 Jul 2018

Research on Awareness Level of Smoking-related Health Risks among Singaporeans

A 2016 study found high awareness among Singaporeans of smoking's link to health risks, with 82% knowing about lung cancer and 74% aware of heart disease.
The Health Promotion Board runs educational programs in schools, social media campaigns, workplace talks, and online resources like HealthHub.sg to raise awareness.
Mandatory graphic health warnings on tobacco products have been in place since 2003 and are regularly updated, with a new public education campaign planned for this year.
The government is also considering standardized tobacco packaging with enhanced warnings and uses a multi-pronged approach including legislation and cessation support.

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10 Jul 2018

Standardisation of Starting Salary for MOH Scholars Across All Its Healthcare Clusters

Er Dr Lee Bee Wah questioned if starting salaries for MOH scholars are standardised across healthcare clusters, and if not, why discrepancies exist.
Minister Gan Kim Yong confirmed that salaries are standardised within a range across public healthcare institutions.
He explained that institutions determine exact salaries based on factors like qualification level and relevant working experience.
The minister’s response did not specify the salary range or list actual discrepancies between clusters.

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10 Jul 2018

After-arrest Mental Healthcare Provided for Mental Illness Cases

Assoc Prof Daniel Goh Pei Siong inquired about the after-arrest mental health care provided to individuals with mental illnesses involved in incidents leading to their arrest.
K Shanmugam responded that the Police arrange for a trained volunteer to accompany mentally ill persons during interviews with investigation officers.
By the end of 2018, the Police will pilot the Home Team Community Assistance and Referral Scheme (HT CARES) at a Land Division to assist arrested persons needing mental illness treatment.
Under HT CARES, social workers contracted by the Police will work with offenders to identify underlying issues that may have led to the offence.
The effectiveness of the pilot will be studied before deciding on further steps, with more details to be released later.

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10 Jul 2018

Accuracy of National Service’s Physical Employment Standards System

Christopher de Souza asked about ensuring accuracy in the PES system when private medical practitioners recommend a downgrade.
Ng Eng Hen explained that PES grades are assigned at pre-enlistment screening based on medical history and examinations, with further specialist assessments if needed.
The SAF Medical Board, chaired by a senior officer, reviews and updates PES grades objectively, considering both private and public sector medical assessments.
For complex cases, a Specialist Medical Board with a civilian senior medical specialist provides additional objective advice.
Final PES grades incorporate operational context and requirements of the SAF to ensure optimal contribution from each serviceman.

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10 Jul 2018

Proposal to Review Specialist Training under Accreditation Council for Graduate Medical Education

Assoc Prof Fatimah Lateef asked if the ACGME-based specialist training will be reviewed, customised for local needs, and aligned with producing more generic specialists for the population.
Health Minister Gan Kim Yong stated that the ACGME-I system was introduced in 2010 to provide structured training and was reviewed in 2014, concluding it met objectives but requiring contextualisation.
The Ministry has made improvements, such as broader competencies for holistic care, starting specialist training after PGY1, and mandatory geriatric training for non-Internal Medicine residents.
MOH will continue engaging stakeholders, including healthcare institutions and ACGME-I, to refine the training framework for local needs.

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