Health — Topics | PAPERCUTS

9 Mar 2017

Guidelines for Pre- and Post-precision Medicine Counselling Confidentiality

Assoc Prof Fatimah Lateef inquired about the Ministry of Health's plans to issue guidelines on confidentiality and counselling for personalised (precision) medicine.
The Minister of State confirmed that existing laws (PHMCA and HBRA) already protect medical record confidentiality and informed consent, but MOH is drafting new standards for genetic testing services to address counselling, personnel competency, and data security.
MOH plans to release these standards as a code of practice in the second half of 2017, enforce them by the end of 2018, and monitor compliance through audits, including oversight of testing costs and practitioner qualifications.

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3 Mar 2017

Abandonment of Nursing Home Residents

Mr Leon Perera asked about the number of nursing home residents abandoned or unable to pay bills from 2011 to 2016, the procedures nursing homes follow in such cases, and government support for operators.
The Minister of State for Health responded that the government does not specifically track abandonment cases, nursing homes attempt to contact families, and financial assistance is provided through subsidies, MediFund, and charitable support.
The Minister added that nursing homes may help residents seek legal recourse under the Maintenance of Parents Act, but the government cannot replace family warmth despite providing financial aid.
Mr Perera asked follow-up questions about cases where residents could not continue due to non-payment and the procedures for unpaid bills, which the Minister addressed by explaining contact efforts and available financial support.

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2 Mar 2017

Link between Heat-not-burn Tobacco Products and Risk to Health

The Ministry of Health and Health Sciences Authority state that heat-not-burn tobacco products pose similar health risks to traditional cigarettes, with comparable nicotine levels and limited independent evidence supporting claims of reduced harm.
Concerns are raised that these products could attract youth, act as a gateway to nicotine addiction, and undermine public health protections, with the US experience cited as a cautionary example.
The Ministry is prioritizing a precautionary approach, emphasizing that no safe level of tobacco use exists and that any product claiming to aid smoking cessation would require rigorous scientific validation and regulatory approval.

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1 Mar 2017

Debate on Annual Budget Statement

The debate focused on long-term economic transformation, urging support for industry shifts and workforce upskilling to adapt to global disruptions, while calling for proactive assistance to vulnerable groups like retrenched workers and low-income families.
Speakers highlighted challenges in eldercare, advocating for technology-driven solutions, community volunteering, and policy changes to help seniors age independently and reduce future healthcare costs.
Concerns were raised about healthcare affordability and potential overconsumption due to insurance coverage, suggesting better cost control, patient education, and systemic reforms to ensure sustainability.
The importance of public trust and empathetic communication was emphasized, with calls for more inclusive policies and community engagement to support the working poor and prevent social inequality.
Fiscal prudence was discussed, including suggestions for progressive revenue measures like property tax adjustments, to address aging population costs without overburdening lower-income households.

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1 Mar 2017

Link between Better Air Quality and Reduction in Healthcare Costs

Mr Leon Perera asked if the Ministry would consider conducting a study to quantify healthcare cost savings from incremental improvements in air quality over different timeframes.
The Senior Minister of State responded that studies exist on the economic costs of air pollution, both globally and locally, and that Singapore has set air quality targets based on WHO guidelines while implementing measures to reduce emissions.
Mr Perera followed up, suggesting the government include estimates of positive impacts on healthcare costs in future budget or policy presentations to better assess investments in air quality.
The Senior Minister of State noted that various studies with differing methodologies inform policy reviews, and that air quality targets and policies are set considering both health benefits and local constraints.

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28 Feb 2017

Medical Chits from Doctors not in Company-assigned Panel

Ms K Thanaletchimi asked whether all companies recognize medical chits from Singapore-registered doctors outside their approved panel, the number of salary deduction cases reported in the last three years, and how the Ministry of Manpower handles such cases.
Under the law, employers must provide paid sick leave and cover medical costs for MCs issued by Government or company-approved doctors, but many employers extend this to any registered doctor.
No cases of salary deductions due to unrecognised MCs have been filed in the Labour Court in the last three years, though MOM receives about 15 queries annually on this issue.
MOM urges employers to ensure accessible approved doctors and exercise flexibility in emergencies; employees can seek help from MOM or the Tripartite Alliance for Dispute Management.

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28 Feb 2017

Advice on Lasting Power of Attorney at Nursing Homes and Step-down Care Institutions

K Thanaletchimi asked whether the Ministry of Health could provide awareness, education, and counselling on Lasting Power of Attorney (LPA) for the elderly in nursing homes and step-down care institutions, and improve access to pro-bono legal services.
The Minister of State for Health responded that the Ministry and the Agency for Integrated Care (AIC) are working with the Office of Public Guardian to raise LPA awareness among aged care providers and the public, including through Advance Care Planning outreach to nursing homes.
AIC conducts talks and case discussions with aged care providers and, in collaboration with the Law Society’s Pro Bono Services Office, has organised seminars and legal clinics to offer pro-bono consultations on LPA and related legal issues for staff, residents, and families.
The Ministry commits to continuing efforts to increase LPA awareness and accessibility for the elderly.

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28 Feb 2017

Complaints of Excessive Charging by Doctors in Private Practice

Health Ministry officials reported receiving an average of 160 bill-related feedback cases annually over the past two years, with 23 specific overcharging complaints in 2016, 90% of which involved private institutions.
Existing measures include ethical guidelines requiring doctors to charge reasonably, published data on hospital and surgical fees, mandatory financial counselling, and itemised bills for certain patients to improve transparency.
Proposals discussed involve expanding pharmacists' prescribing rights for common ailments and publishing GP fee surveys, with the Ministry currently studying these ideas while noting practical considerations like patient convenience.
For patients facing high drug costs, especially Pioneer Generation members, the Medication Assistance Fund and the Agency for Care Effectiveness are available to help with non-standard or expensive medications.
The debate also highlighted the potential to enhance nurse practitioners' roles to handle common ailments, which could reduce costs and ease the burden on general practitioners.

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20 Feb 2017

Forensic Medical Examination for Victims of Sex Crimes

Chen Show Mao asked whether victims of sex crimes must file a police report before receiving a forensic medical examination and why the examination is only available at three hospitals.
K Shanmugam explained that police reports are required to initiate investigations, and the three hospitals were chosen for their 24/7 obstetrics and gynaecology specialist clinics to facilitate forensic evidence collection.
He noted that forensic examinations focus on evidence gathering for criminal investigations, not medical treatment, and victims can seek immediate medical care without a police report.
A new OneSAFE Centre at Police Cantonment Complex was launched to make examinations more convenient for adult rape victims reported within 72 hours, reducing the need to travel to the three hospitals.

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20 Feb 2017

Impact of Government's Anti-smoking Campaign on Youth Smoking

The Minister reported that overall smoking rates in Singapore have declined from 18.3% in 1992 to 13.3% in 2013 but have remained stable at about 13% over the past three years, with a persistently high rate among men at 23.1%.
The government employs a multi-pronged approach, including expanded outreach by the Health Promotion Board (HPB) which saw participation in smoking cessation programs more than double from about 6,000 in 2013 to 15,000 in 2016.
For youths, efforts focus on prevention and cessation through educator workshops, integration of anti-tobacco messages in school curricula, and counselling by Student Health Advisors in some schools.
The Ministry is considering various tobacco control measures, including the possibility of increasing the minimum age for buying cigarettes, while learning from other countries' experiences.

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20 Feb 2017

Automation and Robotics in Hospitals

Miss Cheng Li Hui inquired about the progress, prevalence, and productivity gains of automation and robotics in Singapore’s hospitals over the last three years.
Minister Gan Kim Yong highlighted that automation and robotics serve as a workforce multiplier to address labour constraints and rising healthcare demand, with over 200 projects funded since 2012, including pneumatic tube systems, automated guided vehicles, and pharmacy automation that has reduced waiting times by up to 50% and increased capacity by nearly 30% in some hospitals.
The government is expanding tele-health platforms and remote monitoring tools to deliver care beyond hospitals, while also focusing on workflow redesign, job role adjustments, and staff upskilling to sustain productivity improvements.

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20 Feb 2017

Mandatory Reporting of Workers' Injuries by Doctors

Louis Ng Kok Kwang asked if the Ministry of Manpower would mandate doctors to report work injuries requiring 24+ hours of hospitalisation or 3+ days of medical leave, citing potential under-reporting by employers.
The Minister of State clarified that employers are already legally required to report such injuries under existing laws, with enforcement actions taken against non-compliant employers, and that doctors, employees, and dependents can also submit reports directly to MOM.
Louis Ng raised concerns about under-reporting of work injuries similar to past under-reporting of occupational diseases, and asked if doctors could use the existing "iReport" system for work injuries.
The Minister of State explained that while doctors are mandated to report occupational diseases due to their often gradual onset, employer reporting for injuries is high (over 95%), and doctors can use "iReport" for work injuries while monitoring continues before imposing further requirements.

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20 Feb 2017

Health Screening for Persons with Disabilities and Special Needs

Dennis Tan asked what efforts have been made to include persons with disabilities and special needs in health screening campaigns, and the Ministry of Health replied that inclusive programmes are provided through HPB's school health services, REACH teams, and the Screen for Life programme, which is open to all Singaporeans, including those with disabilities, at accessible locations.
The Ministry emphasized that health promotion and education target all Singaporeans, but some individuals with disabilities may require customized advice from family physicians, and the Ministry continues to review initiatives to meet diverse needs.
Dennis Tan raised supplementary questions about specific campaigns targeting common illnesses and higher risk groups, and collaboration with VWOs, and the Ministry responded that person-centric screening letters are sent to all eligible individuals, including those with disabilities, and inclusive campaigns like "War on Diabetes" apply to everyone, with special programmes offered through Senior Care Centres and VWOs.

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20 Feb 2017

Trends Involving Singaporeans Seeking Primary Healthcare Services at Polyclinics and Family Clinics

In 2015, 82% of primary care visits were to polyclinics and 36% to CHAS GP clinics, with some patients visiting both, while referrals from polyclinics and GPs accounted for 32% and 7% of new specialist outpatient clinic attendances, respectively.
The Ministry of Health is enhancing affordability and access through schemes like CHAS and the Chronic Disease Management Programme, introducing standardized referral protocols, and piloting initiatives like Family Medicine Clinics and primary care networks to strengthen primary care.
To address waiting times and encourage elderly patients to use GPs, MOH plans to build more polyclinics, promote CHAS GP services, and explore community volunteer support, while recognizing scalability challenges for Family Medicine Clinics.

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20 Feb 2017

Culling of Free-roaming Chickens at Sin Ming

Residents in the Sin Ming area lodged over 20 complaints about free-roaming chickens between 2015 and 2016, prompting AVA to cull more than 20 chickens due to public health risks, primarily from bird flu.
The Minister of State emphasized that culling was a last resort after scientific assessment, noting chickens are more susceptible to bird flu than wild birds and releasing them could harm native species, while alternative methods like vaccination or rehoming were deemed unsuitable.
Members of Parliament raised concerns about consultation with residents, the effectiveness of culling versus FAO recommendations, and whether a threshold for future actions would be established, with AVA committing to ongoing research and stakeholder engagement for humane management.

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7 Feb 2017

Healthcare Subsidies for Long-Term Visit Pass Holders Married to Singapore Citizens

Kok Heng Leun asked if Long-Term Visit Pass (LTVP) holders married to Singapore Citizens could receive healthcare subsidies similar to those for LTVP-Plus holders.
The Minister of State for Health stated that subsidies are based on the individual's citizenship status, not their spouse's, and only LTVP-Plus holders receive subsidies for inpatient services at the same level as Permanent Residents.
The Minister explained that extending subsidies to more LTVP holders would be funded by Singaporeans and requires careful consideration, as the LTVP and LTVP-Plus categories are intentionally differentiated by the government.
Members of Parliament sought clarification on the criteria for the differentiation and the potential cost impact, but the Minister noted that detailed cost studies would require separate parliamentary questions.
The debate highlighted the government's policy of differentiating benefits by citizenship and resident status, with limited subsidies extended to certain foreign spouses to support Singaporeans.

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6 Feb 2017

Specialist Team for Attempted Suicide Cases

The government adopts a multi-agency approach focusing on prevention, crisis intervention, and support for at-risk groups, prioritizing immediate safety in attempted suicide cases.
Police serve as first responders to ensure rapid intervention, with protocols to refer individuals to organizations like the Samaritans of Singapore or the Institute of Mental Health for counseling and assessment.
A specialist team with psychological expertise is not currently deemed necessary, as the existing staged approach works effectively and mobilizing additional experts could delay critical response times.

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6 Feb 2017

Blue and Orange CHAS Cards Issued in 2015 and 2016

Pritam Singh asked the Minister for Health for the number of Blue and Orange CHAS cards issued in 2015 and 2016.
The Minister for Health, Gan Kim Yong, reported 290,000 Blue and 170,000 Orange CHAS cards issued in 2015.
In 2016, 400,000 Blue and 240,000 Orange CHAS cards were issued.
The figures show an increase in both Blue and Orange CHAS card issuances from 2015 to 2016.
The response provided specific numbers to address the query about CHAS card issuance in those years.

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6 Feb 2017

Criteria for Auto-renewal of Community Health Assist Scheme (CHAS) Card

Assoc Prof Daniel Goh Pei Siong questioned if CHAS cards are auto-renewed for non-responding households, if they retain the same subsidy tier, and if auto-renewal applies to retired seniors with unchanged household situations.
Gan Kim Yong explained that CHAS eligibility and subsidy tiers are based on updated household income, property value, and composition, requiring renewal every two years to verify current circumstances.
MOH sends reminder letters and pre-filled forms to facilitate renewal, partners with agencies for outreach, and makes forms accessible online and at community locations to ensure convenience.
The ministry reviews the renewal process periodically to maintain public convenience and ensure households receive appropriate subsidies based on their latest circumstances.

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6 Feb 2017

Benefits of Integrated Healthcare Clustering

Each integrated healthcare cluster will serve a population of 1 to 1.5 million Singapore residents, comparable to Hong Kong’s clusters serving 0.5 to 1.8 million people.
The clustering aims to deliver more comprehensive, person-centered care closer to patients, reducing the need for specialist visits and accident and emergency department use.
The reorganization will facilitate scaling up services to benefit more Singaporeans and offer staff broader professional development opportunities.
The transformation supports Healthcare 2020 goals by addressing growing healthcare needs from an ageing population and increased chronic diseases.

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