Health — Topics | PAPERCUTS

13 Sep 2016

Recognition of Medical Certificates Issued by Traditional Chinese Medicine Practitioners

Patrick Tay asked whether the Ministry for Manpower can consider guidelines or legislation to formally recognize medical certificates from registered TCM practitioners for ailments like sprains, back pain, and torn muscles.
Lim Swee Say explained that under the Employment Act, employers must grant paid sick leave for MCs from government medical officers and private practitioners registered under the Medical Registration Act (MRA) who are appointed by the company.
Some employers, including the Public Service, extend paid sick leave to MCs from other private medical practitioners beyond the Act's requirements.
There were nearly 4,000 private medical practitioners registered under the MRA in 2015, and TCM practitioners can also be registered subject to Singapore Medical Council approval.
The debate highlights the current framework for MC recognition and raises the question of extending it to TCM practitioners for specific conditions.

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13 Sep 2016

Unjust Termination of Employment for Employees Diagnosed with Tuberculosis

The Ministry of Manpower states that employees can appeal for reinstatement under the Employment Act and Industrial Relations Act if unfairly dismissed, including cases involving tuberculosis.
Employers are encouraged to treat employees diagnosed with tuberculosis fairly and compassionately, while employees should declare their condition and adhere to treatment to minimise workplace transmission risks.
With treatment, employees with tuberculosis can become medically fit for work within two weeks and are unlikely to spread infection, and affected employees may seek MOM’s assistance if dismissed unfairly.

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13 Sep 2016

Freezing of Eggs of Healthy Women for Future Use

Miss Cheng Li Hui asked the Ministry of Health whether it would consider allowing all healthy women to freeze their eggs to preserve fertility due to later marriages and delayed parenthood.
Minister Gan Kim Yong explained that egg freezing is currently permitted only for medical reasons, such as before cancer treatment, and highlighted risks like ovarian complications, age-related pregnancy health issues, and limited long-term data on children born from frozen eggs.
The Minister noted that social egg freezing is not allowed due to medical, social, and ethical concerns, including the false expectation of guaranteed fertility and unanswered questions about unused eggs.
The government will continue monitoring international developments and review its position, considering medical, social, and societal values, while emphasizing that delaying parenthood still carries risks and alternatives are limited.

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13 Sep 2016

Pre-employment Tuberculosis Screening for Pre-school Staff

Dennis Tan Lip Fong asked about the actions when pre-employment TB screening is positive, precautionary measures for schools and childcare centres, and the potential for TB spread.
Pre-employment regulations require a chest X-ray and medical certification free from active TB for new staff, with centres advised to monitor for persistent cough and report suspected cases to parents, health officers, and ECDA.
Schools also pre-screen staff and report TB cases to MOE, while the TB Control Unit conducts free contact tracing and screening for exposed individuals, and infected staff are barred until medically cleared.
Centres and schools can operate by excluding symptomatic individuals, as transmission requires close prolonged contact, most latent TB cases remain non-infectious, and active cases quickly become non-infectious after treatment.
Childcare centres and schools follow safeguards and collaborate with the TB Control Unit, ECDA, and MOE to ensure children’s safety.

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13 Sep 2016

Subsidised or Free Health Screening Packages under MediShield Life

Joan Pereira asked whether the Ministry of Health would provide subsidised or free health screening packages under MediShield Life.
Gan Kim Yong explained that evidence-based health screenings are already available through programmes like Screen for Life and community health initiatives, targeting specific groups such as Pioneers and Community Health Assist Scheme cardholders.
He stated that MediShield Life is designed to cover large hospital bills and selected outpatient treatments, and including routine health screenings could affect premium affordability.
The Ministry is reviewing the Screen for Life programme to encourage more Singaporeans to undergo screenings and follow up with doctors for abnormal results.
No plans are in place to extend MediShield Life coverage to include subsidised health screening packages.

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13 Sep 2016

Practice by Managed Care Companies for Doctors to Pay Administrative Fees for Referral of Patients

The Ministry of Health and Singapore Medical Council have received feedback about managed care companies requiring doctors to pay administrative fees for patient referrals, raising concerns about potential conflicts of interest and higher patient costs.
The Singapore Medical Council is revising its Ethical Code and Ethical Guidelines to explicitly prohibit financial arrangements that compromise patient care, including fee-sharing with third-party administrators.
The Ministry of Health is working with medical bodies to raise doctors' awareness of appropriate managed care arrangements and will collaborate with insurers to ensure transparency and avoid conflicts of interest.

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13 Sep 2016

Accreditation and Licensing of Psychologists and Psychotherapists

The Minister for Health explained that clinical psychologists and other allied health professionals are registered under the Allied Health Professions Act, with several professions already registered since 2013, and that the Ministry is studying the accreditation of clinical psychologists in detail while engaging stakeholders.
The Minister stated that psychotherapy is less well-defined as it is used by various healthcare and non-healthcare professionals across different settings, making its regulation impractical at this time.
Voluntary membership bodies like the Singapore Psychological Society and the Association of Psychotherapists and Counsellors set their own standards and codes of ethics to guide their members.

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13 Sep 2016

Working Together to Address the Zika Outbreak in Singapore

The Minister for Health detailed Singapore's response to the first locally transmitted Zika cases, emphasizing a three-pronged approach of preparation, response, and long-term management, with a focus on vector control, public education, and special support for pregnant women.
The Minister for the Environment and Water Resources highlighted that mosquito control is the key strategy, involving source reduction and targeted fogging in clusters, and noted that public cooperation is essential as fogging alone is ineffective and construction sites and homes are major breeding grounds.
Ministers clarified that while the Zika strain in Singapore is from Southeast Asia and not the same as Brazil's, the priority remains community-wide efforts to eliminate mosquito breeding sites, with ongoing research and trials for new control methods like the Wolbachia mosquito project.

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13 Sep 2016

Creating Awareness among Students of Counselling Support

Schools teach social-emotional skills, provide resilience-building activities, and train teachers to identify and refer students in distress for counselling support.
Awareness is promoted through posters, helplines, and student handbooks, with schools also referring students and families to community resources or mental health professionals.
Outside school hours, 24-hour helplines are available, and parents can seek medical help from family doctors or hospitals.
The Ministry of Education reviews every student suicide case to identify any missed warning signs and is conducting a further review of strategies to prevent such incidents.

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13 Sep 2016

Prevention of Teen Suicides

The Minister outlined a multi-agency approach to address teen suicides, involving programs in schools for psychological resilience, community partnerships, and a 24-hour crisis hotline run by trained adults, while noting that teenagers are not suited to man such hotlines.
International best practices, like Britain's teen suicide prevention strategy, are being reviewed, and Singapore's suicide rates are relatively stable and low, though further studies are underway to understand new developments.
Concerns were raised about teachers' training in handling mental health issues, with the Minister defending the current system but acknowledging the need for continuous improvement and a follow-up from the Ministry of Education.
The Minister emphasized that every suicide is tragic and called for a collective effort from parents, families, and the community to support vulnerable youths and report warning signs.

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13 Sep 2016

Impact of Zika Outbreak on Singapore Economy

Assoc Prof Randolph Tan asked about strategies to limit the Zika outbreak's impact on tourism and the economy, and Thomas Chua Kee Seng inquired about government measures for affected businesses, similar to support during SARS.
The Senior Minister of State responded that it is premature to determine the outbreak's economic impact, Singapore remains a safe travel destination with no WHO travel restrictions, and the Singapore Tourism Board is addressing visitor concerns while monitoring feedback.
Government agencies are providing existing support schemes like working capital loans and business continuity grants, and are prepared to activate further measures if needed, while closely monitoring developments with health and environment authorities.

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13 Sep 2016

Measures to Prevent Mosquito Breeding

Multiple MPs raised concerns about the effectiveness and scope of mosquito breeding checks, particularly at construction sites and workers' dormitories, and asked for updates on past inspections and enforcement actions.
Suggestions were made for more stringent regulatory measures, including harsher penalties for repeat offenders, expanded inspection regimes, and mandatory use of insect repellent and mosquito nets.
The Minister requested to address the questions in a joint ministerial statement with the Minister for Health, indicating a coordinated government response to Zika virus containment and vector control.

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13 Sep 2016

Public Education and National Registry for Zika

Multiple MPs raised concerns about tracking Zika’s impact, including calls for a National Zika Registry, screening for pregnant women, and support for families with infants affected by microcephaly.
Questions were posed on offering free Zika screening to affected areas, providing support to suspected pregnant cases, and sharing lessons from managing recent Zika incidents.
Suggestions included raising public awareness about Zika’s effects on pregnant women, implementing temperature-taking in high-risk worker dormitories, and using traditional media to separate myths from facts.

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16 Aug 2016

Review of Yearly Cap on Use of Medisave

Foo Mee Har urged the Ministry of Health to review the yearly MediSave cap to better cover rising medication and treatment costs for chronic diseases, aiming for 90% of costs to be met by MediSave.
Gan Kim Yong stated that the Chronic Disease Management Programme allows up to $400 per MediSave account annually for chronic disease treatment, covering 19 conditions and more than 90% of chronic attendances at polyclinics.
In 2015, the $400 limit was sufficient for nine in 10 subsidised patients with common chronic conditions, an improvement from 2014, due to subsidy enhancements and the Pioneer Generation Package.
Patients exceeding the $400 cap can use family members' MediSave or apply for MediFund if they face financial difficulties.
The Ministry of Health will continue to monitor affordability and review MediSave withdrawal limits regularly, ensuring balances are not depleted prematurely.

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16 Aug 2016

Impact of Healthcare Infrastructure Expansion Plans on Staff's Remuneration

K Thanaletchimi questioned how healthcare infrastructure expansion would be funded without affecting staff remuneration, given the risk of healthcare clusters using reserves to cover excess capacity costs.
Gan Kim Yong stated that the Ministry of Health fully funds development costs for healthcare infrastructure, including spare capacity for future expansion, to prevent impact on staff pay.
He added that spaces for future use are designed for interim productivity to minimize holding costs, and MOH will assist with separate funding if institutions face difficulties.

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16 Aug 2016

Impact of Extending Equal Medical Benefits to Female Pensioners who Retired before 2005 and Their Dependants

Mr. Leon Perera asked about the number of female pensioners who retired before 2005, whether their dependants could receive equal medical benefits, and the cost of extending such benefits.
There are 8,400 female pensioners who retired before 2005, and pensioners on older medical schemes can switch to the more modern MSO scheme, which allows claims for spouses and children, but few have done so due to the older schemes' generosity.
Extending medical coverage to all dependants of female pensioners on older schemes would cost over $30 million annually.
All dependants, including spouses of these pensioners, already have lifelong protection through MediShield Life, and Pioneer Generation members receive additional healthcare subsidies and MediSave top-ups.

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16 Aug 2016

Career Progression of Dental Surgery Assistants

The Minister stated that the National Dental Centre and Singapore Dental Association jointly run a NITEC in Dental Assisting Programme that trains 25–30 Dental Surgery Assistants (DSAs) annually, with further upskilling opportunities in infection control, patient management, and emergency care.
DSAs can progress to Senior DSAs who take on larger responsibilities such as clinic coordination and training new staff, but the government assessed that registration or licensing is not necessary as dental surgeons remain responsible for patient safety and care standards.
The Ministry of Health is open to considering further enhancements to career progression and deep skilling for DSAs as part of strategic manpower planning, while maintaining that direct patient treatment and management are not part of their role.

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16 Aug 2016

Enhancing Care-giving Options for Dementia Patients

The Ministry of Health is working to make professional caregiving for dementia patients more attractive through structured training, better pay, and awareness campaigns to grow the local workforce.
The government provides subsidies for training foreign domestic workers in dementia care, with thousands having attended relevant courses to better prepare them for caregiving roles.
A comprehensive competency framework for dementia care is being developed to define required skills and guide career development for care staff.

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16 Aug 2016

Encouraging More Adults and Elderly to Go for Vaccinations

Melvin Yong questioned the low adult and elderly vaccination rates and proposed allowing MediSave to be used for all vaccinations, not just the current limited types.
Gan Kim Yong explained that an Expert Committee advises MOH on immunisation, recommending targeted vaccinations like influenza and pneumococcal for high-risk groups such as seniors and those with chronic conditions.
He noted that MediSave can currently be used for these specific vaccinations, but there is room to improve uptake through awareness and collaboration with healthcare professionals and the public.

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15 Aug 2016

Applications for MediFund and Grants Disbursed

About 670,000 MediFund applications were made annually over the past five years, with less than 0.15% not approved by MediFund committees.
Over 92% of applications in the past five years were granted full assistance, with average grants ranging from $100 for outpatient treatment to $1,800 for hospitalisations.
The Minister did not provide the specific breakdown of rejection reasons or the median, 20th percentile, and 90th percentile grant quantiles requested by the Member.

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