Health — Topics | PAPERCUTS

15 Aug 2016

Review of Standard Drug List to Include Medication for Common Age-related Illnesses

Foo Mee Har asked the Ministry of Health to review the Standard Drug List to include medications frequently prescribed for common age-related illnesses.
The Ministry of Health regularly reviews the Standard Drug List, considering feedback from doctors on commonly used drugs, including those for age-related conditions.
Over the last three years, 44 drugs were added to the list, with 34 (77%) used for common age-related illnesses such as diabetes and high blood pressure.
The Ministry will continue its practice of conducting regular reviews of the Standard Drug List.

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15 Aug 2016

Referral by Private General Practitioners of Non-emergency Cases to Government Accident and Emergency Departments

The Minister reported that in 2015, approximately 39,000 patients were referred by private GPs to public hospital A&E departments, with about 70% not being warded after assessment.
It was clarified that non-warded patients are not necessarily inappropriately referred, as they may require specialized tests, monitoring, or further review that are not available in GP clinics.
The Ministry affirmed that most GP referrals to A&E are appropriate for patients’ medical conditions, and Regional Health Systems will continue collaborating with GPs to enhance primary care and reduce acute hospital visits.

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15 Aug 2016

Tender Evaluation Method in Procurement of Manpower Services at Restructured Hospitals and Institutions

The Ministry of Health does not centrally mandate a specific tender evaluation method, allowing public healthcare institutions flexibility to design their procurement processes while adhering to national principles of transparency, fair competition, and value for money.
Institutions predominantly use the Price-Quality Method (PQM) for manpower and outsourced service tenders, but the weightage for quality versus price is adjusted based on service complexity, typically ranging from 60% to 80% for quality, rather than a fixed 70/30 split.
Contract durations and the proportion of tenders awarded under PQM vary by institution and service type; the Ministry did not provide specific data on the minimum duration or percentage of PQM-compliant contracts over the last three years.

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15 Aug 2016

Means Testing for Medifund across Restructured Hospitals and Specialist Centres

Dr Tan Wu Meng asked about the proportion of MediFund recipients visiting multiple public institutions, those needing repeated means tests, and the portability of medical social worker records across facilities.
Over the past three years, about one in five MediFund recipients visited more than one public hospital or specialist centre in a year.
MediFund eligibility is assessed by each institution’s committee based on medical social workers’ evaluations, with information shared among institutions for patients needing cross-facility financial assistance.
MOH and public healthcare institutions are enhancing case record sharing and streamlining assessments, such as SingHealth’s One MediFund Assessment initiative, to reduce repeated means-testing for patients using multiple facilities.
The goal is to make MediFund access more convenient for patients while allowing each institution’s committee to retain flexibility in individual case decisions.

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15 Aug 2016

Mandatory Autism Testing for Babies

Kwek Hian Chuan Henry asked if the government plans mandatory autism testing for babies aged 18 to 24 months to enable early intervention, while Tan Chuan-Jin stated that developmental paediatricians recommend diagnosis at two to three years old, as symptoms may not be evident earlier and milder cases may be diagnosed later.
The Ministry of Health provides every child with a Health Booklet that includes developmental screening checklists at various ages, incorporating red flags for conditions like autism, and parents are encouraged to use these milestones to monitor their child's development.
Healthcare professionals can refer children with detected developmental delays to the Child Development Programme at KKH or NUH for assessment, and parents can also seek assessment directly at polyclinics or these departments.
Children diagnosed with moderate to severe autism are referred to the Early Intervention Programme for Infants and Children for early intervention services.

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15 Aug 2016

Reasons for Recent Occurrence of a Cluster of Tuberculosis Cases

Dr Lily Neo asked the Minister for Health whether the recent tuberculosis cluster is alarming and to explain the reason for its occurrence.
The Minister explained that tuberculosis spreads through prolonged close contact and the cluster among residents of a single housing block was unusual because no clear close interactions have been identified.
As a precaution, the Ministry of Health screened past and current residents of the block, finding two with active TB who are now receiving treatment and are no longer infectious.
Residents with latent TB are not infectious, and most will not develop active TB; they have been advised to monitor symptoms and seek medical review if needed.
The Ministry emphasized that early detection and prompt treatment are essential to control tuberculosis infections.

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15 Aug 2016

Increasing Singapore's Organ Transplant Rate

The "Live On" campaign launched in 2008 has contributed to a rise in organ transplants, increasing from an average of 174 cases per year (2004-2007) to 220 cases per year (2008-2015), with nearly 2,000 deceased donor transplants recorded between 2004 and 2015.
Singapore's combined kidney transplant rate in 2015 was 20 per million population, higher than Japan (13 pmp) and Hong Kong (11 pmp) but lower than Australia (40 pmp) and the United Kingdom (49 pmp).
The Ministry of Health provides training for healthcare staff on sensitive communication with families and has protocols to facilitate dignified organ donation, while also planning a new outreach campaign to further improve public attitudes and awareness.
The existing opt-out system under HOTA is under review, with the ministry noting that other countries' experiences with mandated choice policies have shown mixed results and more study is needed before any changes are considered.

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15 Aug 2016

Recourse for Employers of Foreign Domestic Workers with Mental or Critical Illnesses

Patrick Tay Teck Guan asked about recourse for employers whose foreign domestic workers (FDWs) have pre-existing mental or critical illnesses not covered by compulsory insurance and whether such illnesses should be mandated for coverage.
Lim Swee Say explained that FDWs must be certified fit by a Singapore-registered doctor and declare their medical history, with false declarations leading to work pass revocation, court charges, and permanent bans from working in Singapore.
Employers bear the cost of medical treatment for FDWs, including undiscovered illnesses, but current compulsory insurance covers 97% of inpatient and day surgery bills at public hospitals, with assistance available for those facing genuine difficulties.
Mandating coverage for pre-existing illnesses would raise insurance costs for all employers, so it is carefully considered, though employers can voluntarily purchase additional insurance or conduct more medical checks before hiring.

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15 Aug 2016

Government Oversight of Contracts for Healthcare Workers Recruited for Public Healthcare Institutions through Private Agencies

Ms K Thanaletchimi raised concerns about the lack of oversight by the Ministry of Health on public healthcare institutions using private recruitment agencies, where workers face perpetual contract renewals without permanent tenure.
Health Minister Gan Kim Yong explained that public healthcare institutions use these agencies mainly for short-term manpower needs and ensure mandatory statutory contributions are made.
He clarified that contract terms, including tenure and renewals, are negotiated between agencies and workers, falling outside the purview of healthcare institutions and the Ministry.
The debate highlights the tension between meeting temporary staffing needs and protecting workers from indefinite contract renewals without permanent employment status.
This situation underscores the limited regulatory control the Ministry has over private agency employment terms in the public healthcare sector.

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11 Jul 2016

Reviews of Standard List of Drugs and Medications of Restructured Hospitals

Assoc Prof Fatimah Lateef asked how often the standard list of drugs in restructured hospitals is reviewed, focusing on costs and generic drug prices.
Health Minister Gan Kim Yong stated the Standard Drug List is reviewed annually by the Drug Advisory Committee, which assesses drug applications based on clinical essentiality, therapeutic improvement, and safety and cost-effectiveness.
The minister confirmed that public healthcare institutions procure generic versions of drugs where available to lower costs for patients.

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11 Jul 2016

Senior Citizens Diagnosed and Treated for Hearing Impairment

Between 2013 and 2015, public hospitals diagnosed 16,300 Singaporean seniors with hearing loss requiring hearing aids, with about 5,500 eventually using them.
Under the Seniors’ Mobility and Enabling Fund (SMF), 3,954 seniors applied for hearing aid subsidies, 9,934 received them, and about 640 needy seniors got 100% subsidy.
On average, seniors paid around $300 co-payment after receiving about $2,700 in SMF subsidies, and those unable to pay could seek further financial aid from medical social workers.
Including the Assistive Technology Fund and the former Special Assistance Fund, a total of $10.4 million was disbursed for hearing aid subsidies between 2013 and 2015.

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11 Jul 2016

Number of Singaporeans Who Have Signed Advanced Medical Directives

From 2010 to 2015, the number of Singaporeans who signed an Advanced Medical Directive each year ranged from about 2,500 to 4,000, with a cumulative total of 24,682 signatories since the AMD was introduced in 1997.
Between 1997 and 2015, 10 Advanced Medical Directives were actually acted upon by healthcare institutions.
Advance Care Planning, introduced in 2011, saw about 5,100 plans completed by 2015 to guide end-of-life care decisions, though these are not legally binding like AMDs.

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11 Jul 2016

Compliance with National Standards of Care in Nursing Homes

Leon Perera asked whether Singapore has national standards for nursing homes covering facilities, staff, hygiene, and supervision, and whether a third-party accreditation body assesses compliance.
Minister Gan Kim Yong stated that nursing homes are licensed under the PHMC Act, with MOH conducting regular checks and engaging independent auditors to assess care standards, while a volunteers' programme gathers feedback from residents and families.
MOH regularly reviews and enhances nursing home standards, with enhanced standards developed by an industry workgroup in 2014 and incorporated into licensing requirements in April 2015, enforced from April 2016.

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11 Jul 2016

Need for Upfront Settlement of Bills by Patients Fully Covered by Insurance Policies upon Discharge from Hospital

Dr Lim Wee Kiak asked why fully insured patients must pay hospital bills upfront and be reimbursed later, and whether the process can be streamlined.
Minister Gan Kim Yong explained that MediShield Life covers subsidies for Class B2/C wards, but patients in higher classes or private hospitals face higher bills and may need to pay deposits.
Hospitals require upfront payments due to uncertainty about private insurance payouts, but may reduce deposits if insurers provide Letters of Guarantee.
Integrated Shield Plan insurers offer Letters of Guarantee up to $10,000 for eligible patients, helping to ease upfront payment burdens.
The Ministry encourages public hospitals to discuss financial assistance options with patients who need help with bills.

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11 Jul 2016

Regulars, NSmen and NSFs Diagnosed with Mental Health Problems

Mr Dennis Tan asked for annual data since 2011 on regulars, NSmen, and NSFs diagnosed with mental health problems linked to service, how commanders are trained to identify and support affected personnel, and whether the SAF provides treatment and compensation including for those who have left service.
Minister Ng Eng Hen stated that the incidence of mental health conditions among NSFs is about 4% and lower than the national rate, with a multi-pronged approach including training for commanders, monitoring and counselling for servicemen with pre-existing conditions, dedicated psychologists, and a 24-hour hotline.
The SAF follows the Work Injury Compensation Act but generally provides more generous compensation, and medical expenses for treatment at government or restructured hospitals are paid even after servicemen leave service.

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11 Jul 2016

Regulations for F&B Outlets to Display Calorie and Nutrition Information on Menus

Mr Zaqy Mohamad asked the Ministry of Health to consider regulations requiring F&B outlets to display calorie and nutrition information on menus to support the national war on diabetes and counter rising obesity.
Minister Gan Kim Yong noted that evidence from other countries shows calorie labeling can reduce calorie consumption and incentivize businesses to offer healthier options, citing examples like Dian Xiao Er, The Soup Spoon, and McDonald's.
The Ministry will study the proposal through the Diabetes Prevention and Care Taskforce, consulting stakeholders including hawkers and small businesses to balance benefits and implementation costs.

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11 Jul 2016

Local Employees Covered under Portable Medical Benefits Options Eligible for Higher Tax Deductions

The Minister noted that only about 4% of companies, covering roughly 20% of local workers, currently provide voluntary portable medical benefits, despite existing tax incentives.
The Government is shifting focus toward encouraging employer contributions to employees' Medisave accounts and leveraging MediShield Life as the primary platform for portable medical benefits.
The Minister indicated that the Tripartite Guidelines on Re-employment of Older Employees already encourage employer Medisave contributions, and partners will continue efforts to promote broader adoption.

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11 Jul 2016

No Claim Discount on MediShield Life for Elderly without Claims in Three Years

Melvin Yong proposed a "No Claim Discount" on MediShield Life premiums for seniors who go three years without making a claim.
The Ministry of Health rejected the idea, citing concerns that it could discourage people from seeking essential medical care, leading to worse health outcomes and higher costs later.
The Ministry also noted that some individuals may need hospitalization due to accidents despite taking good care of their health, making a no-claim discount unfair in such cases.

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11 Jul 2016

Travel Alerts for Countries with Zika Virus Infections

Dr Lim Wee Kiak asked whether the Ministry of Health will issue travel alerts for high-risk Zika-affected countries and if there will be a multi-Ministry effort to manage infectious disease outbreaks given Singapore's high tourism traffic.
The Minister of State for Health responded that advisories are already issued to travelers to Zika-affected countries, with special guidance for pregnant women, and highlighted inter-agency coordination through the Homefront Crisis Management System used during past outbreaks like Ebola and MERS.
Dr Lim expressed concern about Zika being brought back from the Rio Olympics and asked about controls for athletes and regional cooperation with Malaysia and Indonesia.
The Minister confirmed advisories are provided to athletes and all travelers to Brazil, emphasizing mosquito bite prevention and symptom monitoring, and affirmed the need for regional and WHO collaboration to monitor and respond to Zika and other outbreaks.

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11 Jul 2016

Main Complaints from Cardholders in Community Health Assist Scheme

Er Dr Lee Bee Wah raised concerns about complaints from CHAS cardholders against clinics, particularly regarding medical fees and requested data on complaints and actions taken over the past three years.
The Minister of State for Health reported about 300 complaints from 2013 to 2015, half related to charges like incorrect billing or high fees, with the Agency for Integrated Care engaging clinics to address issues and advise on clearer communication and itemized billing.
Er Dr Lee Bee Wah suggested making itemized billing compulsory and displaying the CHAS hotline more prominently in clinics, to which the Minister responded that itemized billing is currently encouraged but not mandatory, with plans to consider making it compulsory and improving signage.

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