Health — Topics | PAPERCUTS

7 Nov 2016

Mandatory Insurance Coverage for Contract Workers

Ms Chia Yong Yong asked if there are plans to mandate insurance coverage for contract workers, including health, personal accident, and life insurance, to be purchased by companies hiring them.
Lim Swee Say explained that contract workers are classified under contracts of service (employees) or contracts for service (self-employed), with different statutory benefits applying to each.
Employees under contracts of service are entitled to medical benefits via MediSave contributions and work injury compensation, but there is no mandatory insurance requirement for self-employed individuals under contracts for service.
Self-employed persons are required to contribute to their CPF MediSave accounts if their annual net trade income exceeds $6,000, which can be used for health insurance premiums.
Contract workers under contracts of service can contact the Ministry of Manpower if they are not receiving statutory benefits they are entitled to.

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7 Nov 2016

Adoption of WHO Suicide Prevention Strategy

Singapore’s approach aligns with the WHO suicide prevention framework, involving inter-agency collaboration to promote resilience, reduce stigma, support at-risk groups, and provide crisis intervention, with ongoing efforts to adapt measures to local needs.
Stigma reduction is addressed through public education by organizations like the Samaritans of Singapore, Silver Ribbon, and the Institute of Mental Health, which conduct outreach and workshops to encourage help-seeking behavior.
Police refer individuals who attempt suicide to support services; those showing mental instability are assessed by the Institute of Mental Health, and multi-agency teams provide counselling, care, and follow-up support.

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7 Nov 2016

The Kwong-Wai-Shiu Free Hospital (Transfer of Undertaking and Dissolution) Bill

The bill provides for the transfer of assets, rights, and liabilities of The Kwong-Wai-Shiu Free Hospital to a successor company and the consequent dissolution of the hospital.
It includes a consequential amendment to the Income Tax Act and was presented by Minister for Health Gan Kim Yong for a second reading at the next sitting.
The parliamentary sitting was suspended briefly and resumed at 4:20 pm, with Mdm Speaker presiding.

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7 Nov 2016

Criminalisation of Suicides

The Senior Minister of State explained that suicide remains a criminal offence in Singapore to signal societal opposition, though prosecutions are rare and police respond with sensitivity, prioritising safety, using handcuffs only when necessary, and providing referrals to support services.
The government is open to reviewing the policy but must consider not inadvertently sending a signal that suicide is acceptable while ensuring emergency services retain the power to intervene and provide support.
Police officers receive basic training to handle suicide attempts sensitively, and a multi-pronged, whole-of-government approach involving various ministries and community partners focuses on prevention, mental health education, and early intervention.

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7 Nov 2016

Reducing Misuse of MediShield Claims by Allowing Claims for Some Outpatient Treatment

Mr Ong Teng Koon raised concerns about families unable to afford outpatient fees even after government subsidies and questioned if some might be forced to seek unnecessary hospital admissions to use inpatient insurance, leading to bed misallocation.
The Minister of State for Health outlined existing support mechanisms, including enhanced outpatient subsidies, expanded MediSave use, and MediShield Life coverage for specific treatments, while cautioning that broadening MediShield Life coverage could increase premiums and affect sustainability.
The Minister emphasized that MediFund serves as a safety net for low-income families after other subsidies and savings are applied, and stressed the importance of right-siting patients to appropriate care settings to ensure system sustainability.

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7 Nov 2016

Additional Help for Costly Medical Tests

Ong Teng Koon inquired about assistance for families who cannot qualify for extra government subsidies to cover high outpatient medical fees for tests like MRIs, CT scans, and blood tests, which can cost thousands.
The Minister of State for Health explained that Singaporeans receive substantial subsidies of up to 70–75% for such diagnostics, with post-subsidy costs typically far below a thousand dollars, citing median MRI and CT scan costs of $260 and $140 respectively.
Additional financial support includes using MediSave for outpatient scans (up to $300 or $600 annually based on condition), extra MediSave for the elderly, and MediShield Life coverage for costlier treatments like chemotherapy, with further help from MediFund for low-income patients.

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7 Nov 2016

Regulation of Managed Care and Third Party Administrator Companies

MOH is considering regulating managed care and Third Party Administrator (TPA) companies to prevent them from compromising patient safety or escalating healthcare costs, with ongoing stakeholder consultations.
The Singapore Medical Council has revised its Ethical Code and Ethical Guidelines to require doctors to disclose financial arrangements with TPAs and ensure fees are commensurate with administrative work, effective from 1 January 2017.
MOH is assessing whether to reinforce disclosure requirements through regulations and is working with insurers to ensure TPAs avoid conflicts of interest and disclose financial arrangements to policyholders.

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10 Oct 2016

Support in Schools for Students Struggling with Suicide and other Mental Health Issues

Schools have trained counsellors to refer students showing distress and, for high-risk cases, connect them to REACH teams and social service agencies; after a suicide, MOE activates CARE teams to support staff and students and provide resources to parents.
MOE teaches social and emotional skills like time management and coping strategies from primary to secondary levels, with teachers trained to offer initial support and helplines printed in student handbooks.
The Minister did not directly address whether every school has access to mental health professionals or the proposal to prototype a mindfulness programme for peer reflection.
The debate highlights a structured response to mental health crises but leaves questions on universal professional access and specific programme innovation open.

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10 Oct 2016

Prevalence of Diabetes among Household Types

Ms Kuik Shiao-Yin asked about diabetes prevalence by household income and housing type, strategies to help lower-income families manage diabetes, and collaboration to ensure access to affordable nutritious food.
Minister Gan Kim Yong noted that lower-income households in smaller housing types have higher diabetes prevalence but good access to care, with MOH emphasizing healthy eating, physical activity, screening, and affordable management.
HPB promotes healthier eating through the Healthier Choice Symbol Programme, low-cost recipes, partnerships with foodcourts and school canteens, and proactive screening outreach to lower-income groups.
Subsidies for diabetes screening and treatment are available via CHAS GPs, polyclinics, and public hospitals, with higher subsidies for lower-income and pioneer generations.
The national Diabetes Prevention and Care Taskforce will enhance public education to promote healthy lifestyles and effective diabetes care across all socio-economic backgrounds.

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10 Oct 2016

Measures to Detect and Reduce Incidence of Tuberculosis

The Ministry of Health advises individuals with prolonged cough symptoms to seek early medical assessment and emphasizes treatment adherence to prevent TB recurrence and drug resistance.
Entry requirements include medical examinations and chest X-rays for work permit applicants to screen for active TB, while doctors are reminded to report cases to the ministry for contact tracing.
The Tuberculosis Control Unit screens high-risk contacts of TB patients and uses DNA fingerprinting to monitor disease spread, aligning with global health guidelines.
TB rates in Singapore have declined over time, with new cases among citizens and permanent residents dropping from 52 per 100,000 in 1995 to 38 per 100,000 last year.
Singapore continues its efforts to reduce TB as a public health threat through detection, treatment, and prevention measures.

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10 Oct 2016

Arrests Made for Attempted Suicides

Louis Ng Kok Kwang questioned the number of arrests for attempted suicides last year, whether police follow a specific protocol for such cases, and if arrest-free suicide prevention practices could be considered.
K Shanmugam explained that attempting suicide is a criminal offence but prosecutions are rare, and police respond with sensitivity, prioritizing safety and assessing risks of harm.
In 2015, 837 out of 1,096 attempted suicide cases led to custody, but only two were prosecuted, with arrests primarily to prevent self or others' harm.
Police recommend follow-up actions like counseling with Samaritans of Singapore, engaging family support, or referring to IMH for mental health assessments and treatment.
The government emphasizes compassionate response and support over punitive measures, though arrests remain a legal tool for safety in high-risk situations.

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10 Oct 2016

Subsidy for Maternity and Delivery Services at Restructured Hospitals for non-Singaporean Women

Assoc Prof Daniel Goh asked whether non-Singaporean women whose child will be a Singapore Citizen at birth should receive subsidies for maternity and delivery at public hospitals.
Health Minister Gan Kim Yong stated that subsidies are differentiated by citizenship, with citizens receiving higher benefits, and this principle applies to all healthcare services including maternity.
The minister noted that newborns who are Singaporeans are eligible for subsidies and other benefits, and that MOH has extended inpatient subsidies to non-citizen spouses on Long-Term Visit Pass-Plus since 2012.
Gan Kim Yong emphasized that extending further subsidies to foreigners who are not Permanent Residents or Long-Term Visit Pass-Plus holders would require careful consideration due to policy objectives and costs borne by Singaporeans.

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10 Oct 2016

Employers' Obligations to Offer Insurance and Medical Coverage for Female Employees in Response to Zika Virus Threat

Ms K Thanaletchimi questioned whether the Government would raise awareness of employers' obligations to provide medical coverage, paid leave, and insurance for female employees amid the Zika virus threat.
Minister Lim Swee Say confirmed that advisories have been issued for past health crises like H1N1 and MERS-CoV, outlining employer obligations in pre-travel checks, precautions during travel, and paid sick leave and medical coverage for infected employees.
The Minister noted that these obligations also apply to local Zika transmission, with MOM recently issuing advisories to employers and dormitory operators on measures to limit spread and manage pregnant or suspected infected employees.
MOM is collaborating with relevant agencies to enhance checks at worksites and dormitories, emphasizing that workers, employers, and dormitory operators must all contribute to minimizing local Zika transmission.

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10 Oct 2016

Cost Increase to Employers for Mandatory Corporate Medical Insurance

Leon Perera asked the Minister for Health about the estimated cost increase to employers and the impact on the Budget from making portable corporate medical insurance mandatory.
The Minister replied that MediShield Life already provides portable basic health insurance for all Singaporeans, covering pre-existing conditions and employment changes.
Employers can voluntarily offer portable medical benefits, with tax incentives such as higher deductions for medical expenses up to 2% of employees' remuneration.
Portable benefits can include contributions to Medisave or direct payment of insurance premiums, and employers are already required to contribute to Medisave for MediShield Life premiums.
The government’s focus is on ensuring MediShield Life meets Singaporeans' needs, rather than mandating additional corporate insurance.

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10 Oct 2016

Improving Diagnosis and Treatment of Dementia

MOH is expanding memory clinic capacity and training hospital staff to improve early diagnosis and management of dementia, with attendances rising from 7,500 to over 13,000 between 2011 and 2016.
Community support is being enhanced through public education, resource toolkits, CREST teams, caregiver training grants, and a three-fold increase in dementia day care places to 3,000 by 2020.
Palliative care for advanced dementia is being expanded, including dedicated hospice wards and home-based services like the "Programme Dignity" pilot.
Families receive support via training grants for caregivers, including foreign domestic workers, and collaboration between hospitals and primary care providers.
Public hospitals are reconfiguring wards and collaborating with primary care to better care for dementia patients.

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10 Oct 2016

CPR Training for All National Servicemen

Miss Cheng Li Hui asked whether the SAF would train all national servicemen in CPR and AED techniques, highlighting their importance for first-aid in terror attacks.
The Minister for Defence confirmed that all recruits are trained in basic first aid, including CPR and AED, during Basic Military Training since September 2010.
SAF instructors, medical vocations, and operationally-ready NSmen in medical roles undergo regular CPR and AED training, which is accredited by the National Resuscitation Council.

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10 Oct 2016

Enhancing Home-based Care Options for Young Children, Elderly and Disabled

The government has expanded home-based care services for seniors and introduced the Home and Community Care Masterplan to improve home-based care quality and flexibility, including training eldercarers and piloting new care models.
Parents receive enhanced parental leave provisions and financial support, such as the Baby Bonus Cash Gift with Baby Bonus Plus, to help with caregiving costs and bonding with newborns.
Caregivers of persons with disabilities can access training grants, support centres, and a pilot home-based care services program providing therapy and daily living assistance.
Families hiring foreign domestic workers for caregiving receive a concessionary levy and monthly grants to offset costs, especially for low-income households caring for seniors or persons with disabilities.

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10 Oct 2016

Subsidies for Immunisations for Children and Elderly

Miss Cheng Li Hui raised questions about extending full subsidies for compulsory childhood immunisations at private GP clinics and providing free immunisations for elderly Singaporeans against influenza, T-dap, pneumococcal pneumonia, and herpes zoster.
The Ministry of Health (MOH) follows the Expert Committee on Immunisation (ECI) recommendations, allowing Medisave use for all recommended vaccinations and providing full subsidies at polyclinics for Singaporean children for certain vaccines.
Medisave can be used for influenza and Pneumo23 vaccines for high-risk groups like the elderly, but the ECI does not recommend diphtheria, pertussis, tetanus, and herpes zoster vaccinations for the elderly.
Singaporean babies receive a $4,000 Government grant in their Medisave accounts, which can be used for all vaccinations under the National Childhood Immunisation Schedule (NCIS), including at private clinics, ensuring full government support for these costs.
MOH will continue to review vaccination policies based on ECI inputs to maintain accessibility and affordability for Singaporeans.

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13 Sep 2016

Installation of Subsidised Mosquito Screens for Lower-income Households

Joan Pereira asked the Minister for National Development whether the Ministry would consider subsidizing mosquito screens for lower-income households to protect against dengue and Zika.
The Housing and Development Board currently has no plans to subsidize mosquito screen installation, focusing instead on vector control strategies.
The National Environment Agency and People's Association conduct outreach in dengue and Zika clusters to advise residents on precautions like using insect repellent and wearing long-sleeved clothing.
Residents are encouraged to stay vigilant and prevent mosquito breeding at home by following the five-step Mozzie Wipeout.

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13 Sep 2016

Statistics on Patients Defaulting on Medical Bills

From 2010 to 2015, 95% of patients in public hospitals settled their bills within two months of discharge, a figure that has remained stable.
Of the remaining 5% with arrears over two months, Singapore Citizens and Permanent Residents account for about 86% and typically owe around $350, while foreign patients owe about $1,400 on average due to the lack of government subsidies.
Some arrears are being paid in installments or are under assessment for financial assistance, and the total debt owed by each category is not specified.

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