Health — Topics | PAPERCUTS

8 Jan 2018

Cybersecurity Measures for National Electronic Health Record System

Joan Pereira inquired whether there are standardized nationwide cybersecurity measures for healthcare providers to protect the National Electronic Health Record (NEHR) from hacking.
Gan Kim Yong confirmed that healthcare providers must comply with nationwide cybersecurity standards, including secure IT systems, two-factor authentication, and regular anti-virus updates to safeguard NEHR data.
The Ministry of Health will collaborate with the Cyber Security Agency and healthcare providers to monitor threats, implement additional safeguards, and conduct resilience exercises to maintain cyber-readiness.

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8 Jan 2018

Helping Children with Rare Diseases

Dr. Tan Wu Meng highlighted the devastating impact of rare genetic diseases like Pompe disease and Gaucher disease on children, emphasizing their rarity, catastrophic effects, and the high cost of treatment, urging the government to extend support as part of a fair and inclusive society.
The Senior Minister of State for Health, Chee Hong Tat, acknowledged the challenges and shared examples of collaborative efforts (e.g., MediShield Life, MediFund, and private partnerships) that have reduced costs for patients like Emily and Chloe, committing to a review of options to better support children with rare diseases.
The debate concluded with Parliament agreeing to adjourn, while the Ministry of Health plans to propose solutions later in the year, possibly including a new fund, to address the financial burdens on affected families.

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8 Jan 2018

Fee Benchmarks for Medical Procedures

The Ministry of Health introduced fee benchmarks as part of a broader strategy to manage healthcare costs for an ageing population, with an independent committee advising on their setting using historical data and stakeholder input.
The benchmarks aim to enhance transparency and guide reasonable charging without restricting competition, as doctors can still charge above or below the reference fees, and will be regularly reviewed.
Concerns were raised that benchmarks might cause lower-charging doctors to raise fees, but the Ministry expects most doctors to prioritize patient welfare and hopes the benchmarks will help identify and address overcharging.
The benchmarks will initially cover doctors' fees but may expand to include facility fees and other cost components, with ongoing efforts to improve data presentation and cost-effectiveness in healthcare.
Stakeholder representation, including patient groups through organizations like the Consumers' Association of Singapore, is intended to ensure diverse perspectives, though individual patient representation is not feasible.

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7 Nov 2017

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

The bill raises the minimum legal age for tobacco purchase and use from 18 to 21, implemented gradually over three years, to reduce youth smoking initiation and addiction.
It imposes a comprehensive ban on the purchase, use, possession, sale, and distribution of emerging tobacco products like e-cigarettes and heat-not-burn devices, citing health risks and gateway effects.
The government defends the phased age increase as balancing public health goals with consideration for current young smokers, while rejecting arguments for allowing e-cigarettes as cessation aids due to insufficient evidence of safety and efficacy.

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7 Nov 2017

Importance of Generalist Doctors' Roles

The Ministry of Health recognizes generalist doctors as central to providing holistic care for an ageing population and is elevating their status through initiatives such as the Chapter of Family Medicine Physicians and increased training positions.
To support generalist doctors, MOH is funding postgraduate Family Medicine training, enhancing practice environments through private GP clinics and Community Health Centres, and resourcing Primary Care Networks for chronic disease management.
A Generalist Competencies Standing Committee has been appointed to review and define the core competencies for resident doctors, ensuring the healthcare system meets future needs.

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6 Nov 2017

State of Mental Health in Singapore

The Minister for Health, Gan Kim Yong, shared that the 2010 Singapore Mental Health Study found 9.3% of residents experienced at least one mood or anxiety disorder in their lifetime, with Major Depressive Disorder and Obsessive Compulsive Disorder being the most common.
A second Singapore Mental Health Study is underway to update this data and include conditions like schizophrenia and sleep disorders, while a 2016 study highlighted significant stigma that can hinder people from seeking treatment.
Government agencies, healthcare providers, and community partners are collaborating on initiatives such as a public education campaign by the National Council of Social Services and the enhanced Community Mental Health Masterplan to reduce stigma and strengthen community-based care.

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6 Nov 2017

Participating Companies and Employees in National Steps Challenge

Miss Cheng Li Hui asked the Minister for Health for statistics on past participation, targets for the upcoming Corporate Challenge, promotion measures, and how their effectiveness is evaluated.
The Health Promotion Board reported that over 65,000 employees from 260 organizations participated in the Season 2 Corporate Challenge, with participants walking an additional 1,500 steps daily on average due to peer influence, organizational support, and a competitive team element.
For the next season, the HPB aims to attract 90,000 employees and is engaging trade associations, chambers, and unions to promote participation among Singapore-based companies.

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6 Nov 2017

Statistics of Persons Sued by Public Hospitals for Arrears of Hospital Bills

In the last two years, 26 individuals were sued by public hospitals for arrears of hospital bills, with 15 settled out of court, one resolved via default judgment and payment, and 10 still ongoing.
The figures exclude cases where employers fail to pay for their employees’ medical bills.
The Minister emphasized that timely bill payment is crucial for public healthcare institutions to maintain resources and that Singaporeans can use subsidies, MediShield LIFE, and MediSave, or seek assistance from medical social workers if facing difficulties.

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6 Nov 2017

Generalists to Help meet Singapore's Future Healthcare Needs

The Ministry of Health is investing in broad-based training for all doctors by incorporating generalist skillsets into medical school curricula and defining these competencies for postgraduate specialist training, including a mandatory Geriatric Medicine programme for non-Internal Medicine residents.
Current training pathways already provide flexibility, allowing doctors to gain generalist experience (such as three years in Internal Medicine) before choosing a specialty, and the Ministry will assess if similar flexibility is needed for surgical specialties.
Generalist doctors are emphasized as central to providing patient-centric, holistic care for Singapore’s ageing population, guiding the focus on strengthening their role in the healthcare system.

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6 Nov 2017

Anti-smoking Messages in Schools and Reducing Accessibility of Cigarettes to Minors

Miss Cheryl Chan inquired about barriers to quitting smoking beyond treatment costs, school anti-smoking programs, and inter-agency efforts to limit cigarette access for minors.
Health Minister Gan Kim Yong highlighted that quitting requires personal determination, with support from HPB’s “I Quit” campaign and multi-agency public education to prevent smoking initiation.
Schools and tertiary institutions integrate anti-tobacco messages and provide cessation counseling, while laws impose fines and license suspensions for selling tobacco to minors, with plans to raise the minimum legal age to 21.

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6 Nov 2017

Cold Chain Integrity of Drugs

K Thanaletchimi asked whether the Health Sciences Authority will mandate temperature monitoring of drugs from source to patient and if the Ministry provides strict guidelines including temperature loggers as evidence of compliance.
The Ministry of Health stated that the Health Sciences Authority already requires drug manufacturers, importers, wholesalers, and retail pharmacies to store drugs under proper conditions, including validated cold chain processes.
Companies may use various temperature monitoring methods, such as loggers or electronic systems, and HSA conducts regular inspections to verify compliance by checking raw data from these devices.

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6 Nov 2017

Support for Children with Attention Deficit Hyperactivity

The Ministry of Health collaborates with the Ministry of Education and other agencies to identify and support children with ADHD through programs like REACH, which involves multidisciplinary teams working with schools.
For children below seven, suspected developmental conditions including ADHD are flagged by doctors and preschool teachers, with screening and referrals managed through Case Filter Meetings and early intervention programs.
Subsidies are available for services like REACH and early intervention, with additional financial assistance for parents who need it, though diagnostic methods for younger children are approached cautiously.

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6 Nov 2017

Automatically Permitting Usage of MediSave Savings of Persons without Mental Capacity

Ms Sylvia Lim asked if the Government could automatically permit the use of MediSave savings for medical expenses when a person lacks mental capacity and cannot consent.
Health Minister Gan Kim Yong explained that authorisation is generally required to protect patients, but there are existing measures like lifetime authorisation while mentally well, and authorisation via a donee, deputy, or family members for incapacitated patients.
The Government will study the suggestion along with stakeholder feedback to balance assistance for incapacitated patients with safeguards for their interests.

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6 Nov 2017

Exceeding MediSave Claimable Limit under MediSave Maternity Package

Zainal Sapari inquired about the number and percentage of women exceeding the MediSave Maternity Package limit, reasons for cost overruns, and whether greater flexibility can be given for using MediSave beyond the limit for complications during delivery.
Gan Kim Yong stated the package covers subsidised care with specific claim limits and noted that over two years, three-quarters of subsidised deliveries had no out-of-pocket costs, while eight in ten had payments of $500 or less.
He added that patients facing financial difficulties can seek assistance from medical social workers, with appeals considered case-by-case.

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6 Nov 2017

Development of Type 2 Diabetes

Ms Kuik Shiao-Yin questioned how social factors influence Type 2 diabetes in Singapore, how the Ministry of Health collaborates with other agencies to address these determinants, and how clinicians tailor self-management advice to individual patient needs.
The Senior Minister of State for Health explained that social determinants like income and education affect diabetes risk and that the Ministry works with social ministries, community groups, and volunteers to promote healthy living and ensure healthcare accessibility.
Initiatives such as the NurtureSG Taskforce, healthier school meals, and subsidized health check-ups aim to foster healthy habits from a young age, especially for vulnerable children and youth.
Targeted programs, including partnerships with welfare organizations and subsidized screenings for lower-income groups, are designed to improve early detection and support lifestyle changes.
Healthcare providers engage patients, caregivers, and community partners to address challenges like social isolation and low health literacy, enhancing self-care and treatment adherence.

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6 Nov 2017

Importance of Nutrition in Managing Diabetes and Pre-diabetes

The Senior Minister of State for Health emphasized that nutrition is a key component in the fight against diabetes, involving healthy, balanced diets and lifestyle changes, with initiatives like the Healthier Choice Symbol programme to increase healthier food options.
He highlighted efforts to expand low glycemic index claims to more food categories and industry collaboration to develop healthier staple foods, alongside promoting physical activity and the national Screen For Life screening programme.
The Diabetes Risk Assessment (DRA) tool was launched to raise awareness and encourage younger adults to assess their risk, with about 44,000 users aged 18–39 since its inception and around 8,500 found to be at higher risk.

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6 Nov 2017

Incidence of Diabetes by Income Group

The Minister stated that data on diabetes incidence by income group is unavailable, but studies abroad suggest higher prevalence in lower-income groups, a trend likely mirrored in Singapore.
The Health Promotion Board (HPB) promotes affordable healthier food through public education, the Healthier Choice Symbol, and collaborations with supermarkets and community partners.
Initiatives include the Healthier Corporate Food Bundle for lower-income households, cooking demonstrations, and enhanced subsidies for health screenings under Screen For Life.
Efforts also focus on encouraging an active lifestyle, such as through the National Steps Challenge, and improving menus for food aid programs to include healthier options.

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3 Oct 2017

Measures to Optimise Outpatient Appointments and Unified Appointment Tracking System for Polyclinics and Restructured Hospitals

Dr Tan Wu Meng asked the Ministry of Health to study a unified appointment tracking system for polyclinics and restructured hospitals and to examine outpatient appointment patterns by age, measures to optimise appointments, and the possibility of converging appointments for elderly patients.
The Senior Minister of State for Health responded that the Ministry lacks specific data on outpatient appointments by age but acknowledged the need for better appointment coordination and highlighted existing efforts to consolidate appointments within hospitals for patient convenience.
He announced plans to pilot more unified systems within healthcare clusters and study harmonising appointments across the three clusters, agreeing that more unified systems would benefit patients.
Dr Tan Wu Meng further suggested involving primary care practitioners, Family Medicine physicians, GPs, intermediate and long-term care sectors, and nursing homes in data sharing for a seamless patient journey.
The Senior Minister of State affirmed that Regional Health Systems coordinate the entire care spectrum, from health promotion to long-term care, and that clusters will engage both public and private partners to improve coordination.

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3 Oct 2017

Requirement for Third Party Administrators to Adhere to Singapore Medical Council Ethical Guidelines

Dennis Tan Lip Fong raised concerns about third-party administrators (TPAs) potentially driving up healthcare costs and questioned whether the Ministry tracks the number of medical professionals working with TPAs.
The Senior Minister of State for Health clarified that the Ministry does not regulate TPAs or track their arrangements with doctors, but the Singapore Medical Council's ethical guidelines bind medical professionals and protect patient interests.
Dennis Tan suggested regulatory control over TPAs to align their practices with medical ethics and reduce conflicts between business and professional concerns.
The Senior Minister of State acknowledged TPAs' influence on healthcare costs and doctor behavior, noting that the Ministry engages TPAs to encourage compliance with ethical guidelines but currently does not plan to regulate them directly.

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3 Oct 2017

Healthier Food without Higher Food Bills

The Minister explained that the Healthier Choice Symbol (HCS) helps consumers identify healthier foods, with over 3,500 products currently available, and that healthier eating does not always require expensive purchases, as demonstrated by NTUC Foodfare’s cheaper HCS-tagged drinks and HPB’s lower-cost recipes.
An MP questioned why healthier versions of the same product, like low-sugar kaya, are significantly more expensive than regular versions, seeking public education on the price difference.
The Minister acknowledged that lack of economies of scale often makes initial production of healthier items more expensive but noted that prices may become competitive as demand grows, and he emphasized that healthier eating can also involve moderation, cooking methods, and food preparation techniques that do not increase costs.

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