Health — Topics | PAPERCUTS

9 Jan 2017

Tracking of Zika Cases and After-effects

Ang Wei Neng asked for an update on Zika spread, recent case numbers, infections in pregnant women, and birth outcomes, with Gan Kim Yong reporting 458 total cases as of 31 December 2016, 12 in November and four in December, and 17 pregnant women infected.
Of the 17 pregnant women, four gave birth with no abnormalities, one had a miscarriage unrelated to Zika, two terminated pregnancies early with Zika-related abnormalities undeterminable, and 10 remain in monitoring with no obvious evidence of Zika-related issues so far.
MOH is tracking infants exposed to Zika during pregnancy until age three, and given the presence of Aedes mosquitoes, Zika cases may continue, urging vigilance and mosquito breeding prevention.

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9 Jan 2017

Minimise Sale of Beverages with High Sugar and Caffeine Content in School Canteens

The Ministry of Education requires school canteens to follow Health Promotion Board guidelines limiting beverage sugar content to six grams per 100 millilitres, with a focus on encouraging water consumption.
Institutes of Higher Learning collaborate with health authorities to promote healthier food and beverage options, with about 30% of campus outlets currently participating in the Healthier Dining Programme.
While sugar limits are enforced in schools, there are no specific national guidelines on caffeine content in beverages sold in educational institutions.

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9 Jan 2017

Evidence that Section 309 of Penal Code Deters Attempted Suicides

Leon Perera questioned the evidence that Section 309 of the Penal Code deters attempted suicides and asked what efforts the Government will make to ensure the law does not deter those with suicidal thoughts from seeking help.
Minister K Shanmugam stated that the law was enacted to make it clear society disapproves of suicide, noting Singapore’s suicide rate is lower than many developed countries based on WHO statistics.
He explained that prosecutions under the law are rare and police are trained to respond with sensitivity and compassion, prioritizing the safety of the individual.
The Government adopts a multi-pronged approach involving agencies and social organizations to prevent suicide through upstream prevention, reducing stigma, and providing crisis support.
Initiatives include programmes by VWOs like Samaritans of Singapore and Silver Ribbon, as well as public education by the Institute of Mental Health to encourage help-seeking and early treatment.

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9 Jan 2017

Pilot Public-Private Partnership to Send Emergency Cases Transported by SCDF Ambulances to Raffles Hospital

Assoc Prof Fatimah Lateef asked about the outcomes of the pilot partnership between SCDF and Raffles Hospital, which sends non-life-threatening emergency cases to Raffles Hospital during weekday daytime hours.
Health Minister Gan Kim Yong explained the collaboration started in June 2015 to improve emergency care access by using private sector capacity, with SCDF ambulances transporting suitable patients to Raffles Hospital.
The partnership has served over 3,500 patients with health outcomes comparable to public hospitals, and over 90% of surveyed patients were satisfied with the service.
The initiative has reduced SCDF ambulance travel and turnaround times, increased overall emergency care capacity, and provided patients with government subsidies similar to public hospitals.
MOH remains open to future private sector collaborations, focusing on patient care quality and affordability in any expansion decisions.

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10 Nov 2016

Policy on Students Getting Hurt on School Premises

The Ministry prioritizes student safety through proactive measures like regular infrastructure checks and teaching safety skills, with a tiered response for injuries ranging from first aid for minor cases to ambulance and hospital transport for serious ones, all covered by school-purchased accident insurance.
The insurance covers medical expenses for injuries during school activities and CCAs, but coverage duration and portability post-graduation are case-specific; the Ministry urges flagging unique cases for individual assistance.
Coverage extends to incidents during school-related interactions, even if not formal CCAs, with the Ministry assessing each incident's nature to determine insurance applicability and emphasizing protection for students.
The Ministry assures ongoing support for students’ recovery and claims processes, working with insurance companies while cautioning that blanket coverage statements are avoided in favor of incident-specific evaluations.
The debate underscores a commitment to student welfare, with policies designed to address injuries comprehensively while maintaining flexibility for diverse scenarios on school premises.

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10 Nov 2016

Genetic Screening for Women Seeking Fertility Treatment

The Ministry of Health (MOH) is reviewing the use of Pre-implantation Genetic Screening (PGS) in Singapore, following earlier requests to permit it for women with recurrent miscarriages or infertility to improve chances of healthy live births.
A three-year pilot PGS programme will be conducted by the National University Hospital (NUH) starting early next year to assess the clinical effectiveness of newer PGS technologies.
MOH will also examine ethical implications and regulations to prevent misuse, such as banning sex selection, and plans to consult stakeholders and the public for their views.
Details on eligibility criteria, funding, and other trial specifics are currently being worked out and will be announced closer to the programme's commencement date.

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9 Nov 2016

Police Post at Institute of Mental Health to Protect Staff

K Thanaletchimi requested a police post at the Institute of Mental Health (IMH) to protect staff from threats and abuse by patients, citing the inconvenience of reporting incidents at distant police stations.
The Senior Minister of State for Home Affairs, Mr Desmond Lee, responded that IMH already has 24/7 Auxiliary Police Officers, panic alarms, and protocols for handling incidents, with police taking action against abusive individuals based on past cases.
Ms Thanaletchimi clarified that staff face difficulties reporting due to the far police post and reiterated the need for an on-site post to safeguard healthcare workers, as advocated by union members.
Mr Lee explained that past hospital police posts were phased out in 2011 for resource rationalization and that reports can now be made at Neighbourhood Police Posts or Centres, while noting efforts to improve efficiency.
The exchange concluded with Ms Thanaletchimi urging serious consideration of her request for a police post specifically at IMH due to high abuse incidences.

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8 Nov 2016

Cyclists of Electric/Motorised Bicycles or Vehicles' Liability for Victim's Medical Fees

Er Dr Lee Bee Wah proposed amending the law to require cyclists of electric or motorised bicycles or vehicles found guilty in accidents with pedestrians to pay compensation for medical fees.
Khaw Boon Wan stated that current law already allows injured persons to seek compensation via private settlement or civil court action.
He added that in criminal cases, courts can consider ordering compensation based on the circumstances of each case.
The response indicates existing mechanisms address compensation without the need for new legislation.

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8 Nov 2016

Number of Smokers and Patients with Smoking-related Diseases

The number of patients with smoking-related diseases has fallen slightly, with age-standardised hospitalisation rates decreasing from 15.8 to 15.0 per 1,000 residents over the last three years.
The prevalence of smoking has declined, particularly among those aged 30 and below, falling from 16.8% to 13.4% based on national health surveys.
The Ministry of Health does not plan to reduce hospital subsidies for smokers, as it could discourage them from seeking treatment and lead to worse health outcomes.
The focus is on helping smokers quit through a comprehensive tobacco control plan and over 200 smoking cessation touchpoints, including a toll-free QuitLine and online resources.
Non-legislative and legislative measures are in place to encourage smokers to quit and prevent youths from starting smoking.

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8 Nov 2016

Training and Help for Teachers to Cope with Stress

The Ministry provides schools with resources like a Parent Engagement Guide and training for teachers on parent engagement, with school leaders offering guidance or direct intervention in parent-teacher disputes.
Measures such as work allocation support, regular resource reviews, and protected vacation time are in place to manage teachers' work-related stress, and teachers are encouraged to discuss workload concerns with supervisors.
Dedicated MOH professional counsellors offer individual counselling and conduct workshops for teachers on stress management and difficult conversations to support their psychological well-being.

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8 Nov 2016

Number of Citizens and Permanent Residents Unable to Pay MediShield Life Premiums

As of September 2016, about 51,000 residents, or 1% of MediShield Life members, had outstanding premiums totaling $12.8 million, with reasons including living overseas and being uncontactable.
The government provides subsidies and Additional Premium Support to help lower- and middle-income households, including Pioneer Generation members, pay their premiums.
The Minister noted that the non-payment trend's direction is unclear as it is the first year of MediShield Life, but efforts to reach out and assist payers will continue.

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8 Nov 2016

Measuring Quality of Healthcare Delivery and Adequacy of Healthcare Resources

The Minister outlined that Singapore’s healthcare system uses benchmarks such as life expectancy and Healthy Life Expectancy rankings, alongside infrastructure and manpower expansion plans under the Healthcare 2020 Masterplan to measure quality and resource adequacy.
The Pioneer Generation Package and MediShield Life have provided substantial financial support to the elderly, with over 400,000 pioneers benefiting and significantly higher payouts for older Singaporeans under MediShield Life.
The Ministry is expanding the healthcare workforce by 30,000 by 2020 and investing in care redesign and technology to improve service delivery and address ageing population demands.
The Minister acknowledged the physical and mental demands on healthcare workers and highlighted efforts to improve their career prospects, recognition, and well-being through initiatives like the Care Package and “Care To Go Beyond” campaign.
The Minister emphasised the importance of collective societal support for healthcare workers, encouraging recognition and appreciation from patients, families, and the public to help sustain their morale and effectiveness.

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8 Nov 2016

Defined Route for Foreign Medical Graduates who Take Singapore's Qualifying Examinations

The Ministry of Health stated that Singaporeans who are foreign medical graduates from unlisted overseas schools must apply to the Singapore Medical Council to sit for the Qualifying Examination, with no preparatory programmes offered by NUS or hospitals, though an information package is provided.
Candidates who pass the examination can practise under provisional qualification and are encouraged to apply directly to healthcare clusters for clinical attachments to familiarise themselves with the local system.
The Ministry noted that preparatory requirements vary by individual and therefore does not offer structured programmes, while NUS’s examination package includes curriculum extracts and past papers for preparation.

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8 Nov 2016

Encouraging Employers and Employees to Shift to Portable Medical Benefits

The Minister highlighted that while 90% of employers offer medical benefits, only 4% provide portable benefits, with the government promoting MediShield Life as a universal, portable platform for all Singaporeans.
Discussions revealed employers prefer non-portable schemes for cost-effectiveness and employee retention, while employees may lack awareness or prefer schemes with no co-payment, prompting tripartite efforts to encourage a longer-term perspective.
Members of Parliament called for increased incentives, better education, and possibly legislation to mandate portability, especially for outpatient coverage and to protect those with pre-existing conditions, while the Minister emphasized leveraging MediShield Life as the primary solution.

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7 Nov 2016

Psychological or Psychiatric Issues Related to Problem Gambling

Chen Show Mao inquired about the number of people with psychological or psychiatric issues related to problem gambling from 2006 to 2015 and the most common conditions identified.
Gan Kim Yong reported that from FY2008 to FY2015, the National Addictions Management Service saw between 168 and 526 patients annually for suspected gambling disorder, averaging 407 in the last five years.
Among patients treated for pathological gambling, the most common associated psychiatric conditions were adjustment disorders, depression, and substance abuse.

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7 Nov 2016

Actions against Persons for Attempted Suicides in 2015

Police officers respond to attempted suicide cases with sensitivity and compassion, prioritizing the individual's safety and using handcuffs only when necessary to prevent harm or escape.
Individuals taken into custody may be sent to police stations, hospitals, IMH, or referred to SOS, but the police do not maintain data on specific referral numbers to IMH or SOS.
In 2015, only two out of 1,096 attempted suicide cases were prosecuted, highlighting that arrests aim to provide help rather than pursue charges, and detention duration varies based on case circumstances.

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7 Nov 2016

Mental Health Declaration for Job Applications

The debate centered on whether employers, particularly the Public Service, should require job applicants to declare any history of mental illness.
Assoc Prof Daniel Goh asked if the Government should lead by example by removing such declarations for non-sensitive Public Service positions.
The Government's position, as stated by Lim Swee Say, is that job applications should only ask for information relevant to assessing suitability, and Public Service declarations do not disqualify candidates.
The Tripartite Guidelines on Fair Employment Practices emphasize merit-based recruitment, considering skills, qualifications, experience, and personal attributes over medical history.

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7 Nov 2016

Verification of Foreign Nurses' Qualifications

The Singapore Nursing Board verifies foreign nurses' qualifications by directly obtaining educational transcripts from their institutions and requires them to pass English-based licensure exams and secure employment with local healthcare institutions before registration.
Foreign nurses undergo job-based competency assessments during a six- to twelve-month probation period; those who fail to meet standards as Registered Nurses may be considered as Enrolled Nurses under supervision or placed in support care roles, with healthcare institutions making final employment decisions.
All nurses, regardless of their registration status, can work in settings like step-down care or nursing homes, provided they meet the specific job requirements for patient safety, with institutions responsible for transfers and retention efforts if standards are not met.

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7 Nov 2016

Singaporean Co-workers Acting as Guarantors for Foreign Nurses

Singaporean colleagues are allowed to be guarantors for foreign nurses under public healthcare sponsorships, alongside family members, with over 3,600 nursing sponsorships awarded in the past five years, including 448 to non-Singaporeans.
Four foreign-sponsored nurses were unable to complete studies, with two paying damages and one serving a bond, while no guarantors have paid liquidated damages, and the remaining case is being followed up.
Public healthcare institutions monitor and support recipients academically and non-academically to prevent defaults, and the government continues to sponsor foreign nurses to meet national healthcare needs while prioritizing local nurse growth.

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7 Nov 2016

Reasons for Higher Bills for Patients with Integrated Shield Plan Riders

Assoc Prof Daniel Goh asked the Ministry to study the causes behind higher bills for Integrated Shield Plan riders—such as patient overconsumption, provider over-servicing or overcharging, or insurer oversight—and to determine these causes before making co-payments compulsory.
Minister Gan Kim Yong explained that the Health Insurance Task Force (HITF) is studying recommendations to achieve more efficient and sustainable healthcare outcomes, noting multiple factors contribute to rising claims costs, including ageing population, better access, technology, and insurance product design.
All stakeholders—healthcare providers, patients, and insurers—share responsibility in managing costs, with providers ensuring appropriate treatments, patients making informed choices, and insurers designing products to encourage appropriate care.
The government has enhanced fee transparency and designed co-payments in the healthcare financing system to encourage prudence and appropriate care, aiming for a more sustainable and affordable healthcare system.

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