Health — Topics | PAPERCUTS

11 Jul 2016

Measures to Prevent Medical and Dental Clinics from Over-provision of Services under Community Health Assist Scheme

The Minister of State for Health outlined that MOH provides guidelines, conducts regular audits, and investigates complaints to prevent over-servicing under CHAS, having recently suspended two clinics for errant practices.
Seah Kian Peng expressed concerns from residents about rising prices and questioned the effectiveness of controls, suggesting a more proactive approach given the use of public funds.
The Minister responded that while complaints exist, no clear evidence of over-charging has been found due to variations in GP practices, and only a small number of clinics are under investigation relative to the total.
Leon Perera raised a specific concern about GPs charging consultation fees for follow-up visits when claiming CHAS subsidies, and the Minister advised submitting details for investigation if such practices occur.
The Minister emphasized that MOH will take action against misconduct if found through audits, but also encouraged patient-clinic engagement and transparency in charges to address misunderstandings.

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11 Jul 2016

Plans for Improving and Streamlining Community Health Assist Scheme

The Ministry reported 1.4 million CHAS cardholders, including 600,000 Blue and 400,000 Orange cardholders, with ongoing reviews to address feedback on eligibility, subsidies, and application processes.
A member raised concerns that the $1,100 monthly household income per person criterion for Blue cards is too low, suggesting a review of thresholds and a possible merger of Blue and Orange cards to ease polyclinic workload.
The Ministry acknowledged the feedback and committed to regular reviews of subsidy levels, coverage, and eligibility criteria to ensure affordable primary care access for Singaporeans.
The Blue CHAS covers the 30th percentile of income, while Orange covers the 31st to 50th percentile, with the Ministry noting the scheme’s coverage percentage relative to the population.

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9 May 2016

Update on Community Health Assist Scheme's Inclusion of GP clinics and Dental Clinics

Assoc Prof Fatimah Lateef requested an update on the review to include all GP and dental clinics in the Community Health Assist Scheme (CHAS).
Minister Gan Kim Yong noted that 900 GP and 650 dental clinics participate in CHAS, with over 96% of cardholders having a clinic within 15 minutes by public transport.
The government will continue engaging more clinics to join CHAS, aiming to expand coverage and affordable primary care access for residents.

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9 May 2016

Progress of Public-Private Partnership Projects

Assoc Prof Fatimah Lateef inquired about the Ministry of Health's progress on public-private partnerships and plans for wider rollout.
The Minister of State for Health outlined several collaborations, including the Community Health Assist Scheme, emergency care with Raffles Hospital, and partnerships in long-term care like portable subsidies for nursing homes.
Assoc Prof Fatimah Lateef asked for patient feedback on the Raffles Hospital collaboration and whether it could be extended beyond office hours and to other emergency departments.
The Minister responded that initial teething issues were resolved, patient feedback has been positive, and the collaboration could inform future partnerships to enhance subsidized care.

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9 May 2016

Integrated Shield Plan Coverage for Inpatient Hospice Services

Dr Tan Wu Meng asked whether all private insurers cover inpatient hospice services under Integrated Shield Plans and if the Ministry would mandate such coverage, similar to restructured hospital admissions.
The Ministry of State for Health noted that some riders already cover hospice care but mandating coverage would raise premiums, while current affordability is supported by subsidies, charity, and MediSave, with most patients not needing out-of-pocket payments.
The Minister emphasized ongoing reviews of subsidies and MediSave usage to ensure affordability and sustainability, and efforts to expand palliative care capacity across settings.
Dr Tan highlighted concerns for the "sandwich class" who may not qualify for full subsidies but rely on their IP benefits, pointing out a gap between coverage in restructured hospitals versus inpatient hospices.
The Minister reiterated that hospice care support includes subsidies and charity, and while some riders cover hospice care, the focus remains on MediShield Life’s core purpose of covering large hospital bills, with ongoing reviews to address needs.

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9 May 2016

Private Insurers Offering Riders for Basic Standard B1 Integrated Shield Plans

Dr Tan Wu Meng proposed incentivising private insurers to offer riders for basic standard B1 Integrated Shield Plans to cover pre-existing conditions and exploring a reinsurance risk pool to lower premiums.
The Ministry of Health stated that while MediShield Life provides lifelong coverage for pre-existing conditions, it has no plans to incentivise private insurers for such riders, as the focus is on affordable basic insurance and avoiding taxpayer costs.
The Ministry noted that insurers can already offer risk-loaded policies for pre-existing conditions and will explore the reinsurance pool idea with industry players.

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13 Apr 2016

Committee of Supply – Head O (Ministry of Health)

Members raised concerns about women's health, particularly diabetes prevention and gestational diabetes, and the need for integrated health screening, education, and monitoring for women.
The debate highlighted the importance of strengthening primary care, including supporting family doctors, expanding polyclinics and Family Medicine Clinics, and enhancing subsidies through the CHAS scheme.
The Ministry outlined initiatives for an ageing population, such as community networks for seniors, home and community care services, and the National Silver Academy, while also addressing the need to grow the healthcare workforce and improve mental health support.
Members discussed challenges in eldercare, including calls to review ElderShield for better long-term care coverage, and proposed measures like a sugar tax or food labelling to combat obesity and diabetes.
The Ministry emphasized preventive health, healthy living initiatives, and transparency in healthcare costs, while committed to managing infectious diseases like Zika and dengue through vaccination, surveillance, and public education.

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13 Apr 2016

Committee of Supply – Head O (Ministry of Health)

Members raised concerns about the affordability and accessibility of healthcare, specifically questioning the fairness of compulsory MediShield Life coverage for overseas Singaporeans and the rising premiums for Integrated Shield Plans, urging the Ministry to review opt-out options and ensure premium increases are justified and transparent.
There was a strong emphasis on preventive and community-based care, with calls to enhance support for seniors, including health promotion, disease screening, and integrated eldercare services, as well as to improve home-based and palliative care to reduce hospital reliance and support caregivers.
The Minister outlined a three-part strategy to transform healthcare: shifting from hospital-centric to community-based care, focusing on value over quality, and moving from healthcare to health, including declaring a "War on Diabetes" and establishing a task force to address chronic diseases.

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12 Apr 2016

Committee of Supply – Head O (Ministry of Health)

Chia Shi-Lu advocates shifting healthcare focus from treatment to prevention, urging stronger anti-tobacco measures, incentives for healthy lifestyles, and better support for seniors to age in place, while cautioning about fiscal sustainability.
Leon Perera criticizes the current 100-minute polyclinic waiting time KPI as unacceptably high, suggesting it be reduced to 45 minutes and that waiting times be published separately for appointments versus walk-ins, with real-time updates and multilingual support.
Low Thia Khiang highlights persistent long waiting times at Specialist Outpatient Clinics for subsidized patients, urging MOH to publish detailed waiting time data and address whether resource constraints are disproportionately affecting these patients.
Dennis Tan Lip Fong points out bureaucratic inefficiencies in the process for patients to downgrade from private to public tertiary care, proposing streamlined administrative procedures to reduce unnecessary waiting and consultations.

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5 Apr 2016

Adequacy of Places for Home Care and Centre-based Care Services for Elderly

The Ministry of Health reported 6,900 home care and 3,500 centre-based day care places, an increase from 2011, and is on track to meet 2018 targets of 10,000 home care and 6,200 daycare places.
In 2015, the Agency for Integrated Care received 8,500 home care and 7,800 daycare referrals, but not all led to service take-up due to alternative arrangements, hospital readmissions, or multiple concurrent referrals.
There is no waiting list for home care due to sufficient capacity, but there is a median 20-day wait for daycare due to geographical imbalances and patient preferences, with interim services offered while waiting.

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4 Apr 2016

Statistics on ElderShield Premium Payers and Payouts

As of end-2015, there were 1.2 million ElderShield policyholders, representing about 65% of residents aged 40 to 83.
Since ElderShield's launch in 2002 until end-2015, approximately 12,500 successful claims have been processed, with around $90 million paid out.
ElderShield is automatically provided to eligible individuals at age 40 unless they opt out, with premiums typically paid via MediSave, and MOH is reviewing ways to improve processes, including collaborating with other organizations.

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4 Apr 2016

Subsidies for Diabetes and Cervical Cancer Tests at Polyclinics and GP Clinics

Louis Ng asked the Ministry of Health to consider higher subsidies for diabetes and cervical cancer tests at polyclinics and GP clinics to boost early detection.
Health Minister Gan Kim Yong highlighted existing low-cost screenings under the Screen for Life programme, with diabetes screening at $10 and cervical cancer screening at $10.25, and free tests for CHAS and Pioneer Generation cardholders since 2014.
The Ministry stated it will continue reviewing subsidies to ensure screenings and follow-up consultations remain affordable for Singaporeans.

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4 Apr 2016

Pioneer Generation and Other Subsidies for Elderly Patients not Physically Present to Collect Medications

Assoc Prof Fatimah Lateef asked the Minister for Health about exceptions for Pioneer Generation patients unable to physically collect medications due to mobility issues, so they can still use PG subsidies and the Medication Assistance Fund.
Minister Gan Kim Yong confirmed that caregivers can collect medications and supplies on behalf of PG patients with mobility restrictions, with the same subsidies applying whether collected in person or via a caregiver.
The Ministry will remind healthcare institutions and staff to implement this arrangement effectively to benefit PG patients.

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4 Apr 2016

Disciplinary Actions and Preventive Measures Related to Hepatitis C Outbreak at SGH

The Minister for Health stated that disciplinary actions were taken against 12 SGH leaders and four MOH directors, resulting in warnings, stern warnings, and financial penalties for failures in infection control and reporting, but declined to disclose individual names or specific reasons to foster a learning culture over blame.
In response to the Hepatitis C outbreak, SGH and MOH implemented corrective measures including retraining staff, enhancing infection control processes, and engaging external consultants to review clinical procedures.
MOH established a National Outbreak Response Team and simplified disease notification processes to strengthen the healthcare system's ability to detect and respond to future infectious disease outbreaks.

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4 Apr 2016

Use of Medisave for Terminal Illnesses and End-stage Diseases

Assoc Prof Fatimah Lateef asked if MediSave usage for terminal and end-stage patients could be liberalised further.
The Ministry of Health highlighted existing subsidies and recent increases in MediSave withdrawal limits for hospice and home palliative care, noting that most patients face minimal out-of-pocket costs.
The Ministry assured that cases exceeding limits can seek help through MediFund or the Medication Assistance Fund, with appeals considered case-by-case to ensure affordability.

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4 Apr 2016

Framework for Healthcare Institutions in line with Counter-terrorism Plans

Assoc Prof Fatimah Lateef inquired if the Ministry of Health would create a framework for healthcare institutions to align with national counter-terrorism plans, following recent security initiatives.
The Minister of State for Health outlined that public healthcare institutions already maintain baseline security measures and are reviewing plans with the Ministry of Home Affairs to address heightened threats, with the review expected to be completed in a few months.
In response to follow-up questions, the Minister confirmed that security awareness programs would be extended to all staff levels, including non-medical personnel, and that private healthcare institutions follow guidelines and participate in Police-led workgroups to ensure alignment with national security efforts.

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24 Mar 2016

Compensation for National Servicemen Injured During Service Period

The Ministry of Defence provides comprehensive support for National Servicemen injured during service, including covering all medical expenses for treatment at government or restructured hospitals, even after service or if injuries recur.
Compensation for permanent disabilities from service-related injuries is provided, equivalent to the Work Injury Compensation Act but doubled for military training or operations, with additional amounts for total permanent disability.
Welfare support is available through the SAF Benevolent Fund, which offers a $12,000 one-off grant for immediate needs and up to $42,000 annually for mid-to-long-term assistance, with eligibility re-assessed every two years and no renewal limit.
The SAF Care Fund provides a one-off Helping Hand Grant of up to $5,000 and a monthly $300 Care Support Grant, with eligibility re-assessed every three years and no renewal limit.
These assistance schemes aim to ensure the well-being of injured National Servicemen and their families, with no specified caps on the amounts or tenures for most grants, subject to periodic re-assessment.

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14 Mar 2016

Basis of Yearly Medisave Claim Limits

The Ministry sets Medisave claim limits to ensure basic subsidised healthcare expenses remain affordable, considering government subsidies and MediShield Life, with regular reviews of these limits.
Under the Chronic Disease Management Programme, Singaporeans can use up to $400 per Medisave account annually for chronic disease treatment, with Flexi-Medisave providing an additional $200 for elderly patients at public institutions and participating GP clinics.
The Ministry balances ongoing chronic treatment needs with future healthcare savings, hence does not support fully funding all chronic illness bills with Medisave to prevent premature depletion, but offers alternatives like family member Medisave or Medifund for those facing difficulties.

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14 Mar 2016

Bed Capacity Requirement for Tender of Sites for Nursing, Step-down and Long-term Care Facilities

Leon Perera inquired whether there is a minimum bed capacity requirement for land sites released for nursing, step-down, and long-term care facilities, and if a minimum proportion of four-bed or more rooms is required for government subsidies.
Health Minister Gan Kim Yong explained that due to land scarcity, MOH sets a minimum expected capacity for released sites based on size and allowable intensity, but does not specify bed configurations or mixes in tenders.
Nursing home operators can bid for land sites and self-fund development, while MOH uses other methods like purpose-built homes and co-funding for VWOs to expand capacity for an ageing population.
For government subsidies via the Portable Subsidy Scheme, MOH considers quality and capacity offered by bidders but not bed configurations, and most purpose-built homes have multi-bed cubicles with some single rooms for isolation needs.

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14 Mar 2016

Helping Pioneers Sign Up for Pioneer Generation Package and Understand MediShield Life

Miss Cheng Li Hui asked about the progress of Pioneer Generation Ambassadors (PGAs) in contacting the 450,000 Pioneers, the number of seniors not covered by the Pioneer Generation Package, and whether PGAs could also help non-Pioneers understand MediShield Life.
As of February 2016, 3,000 PGAs had visited 240,000 Pioneers (about 60%), and the program will continue reaching the remaining Pioneers with details on the Package and MediShield Life.
Mass communication efforts and community outreach have raised awareness, with 96% of Pioneers aware of the Package and 87% feeling assured about affordable healthcare costs.
MediShield Life outreach extends beyond Pioneers to all Singaporeans through dialogues, roadshows, and financial counselling, with over 32,000 reached via more than 100 events.

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