Health — Topics | PAPERCUTS

8 Sep 2014

Public Hospitals Undergoing Construction or Renovations

Sylvia Lim questioned what mechanisms ensure prudent spending in public hospital construction, renovations, and refurbishments, highlighting concerns over financial discipline.
Gan Kim Yong explained that MOH enforces rigorous reviews of planning parameters, cost benchmarks, and space allocation, with large projects over $500 million subject to further scrutiny by the Ministry of Finance's Gateway Process to optimize cost-effectiveness.
Public procurement for healthcare infrastructure is conducted via competitive tendering based on price and quality, ensuring the most competitive bids are selected.
To instill financial discipline, public hospitals must self-fund general renovations, refurbishments, and equipment replacements, promoting responsible management of infrastructure.
The overarching objective is to ensure healthcare facilities are functional, patient-friendly, and cost-effective while making optimal use of space and resources.

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8 Sep 2014

Amount of Annual Medisave Top-ups under the Pioneer Generation Package

The Pioneer Generation Package provides lifelong annual Medisave top-ups ranging from $200 to $800, with the amount determined by year of birth rather than current age to give extra support to earlier cohorts who missed newer CPF and healthcare enhancements.
The rationale for using year of birth is that older pioneers typically have lower Medisave savings and receive top-ups for a shorter duration, while younger pioneers get lower amounts but over a longer period.
Other elements of the package, such as MediShield Life premium subsidies, increase with age to maintain affordability, while outpatient subsidies remain the same for all pioneers regardless of age.
The Pioneer Generation Package supplements broader government support for the elderly, including GST Vouchers, higher Medisave top-ups for older seniors, and subsidies for long-term care services.
Additional assistance for healthcare needs is available through schemes like MediFund Silver for those unable to afford medical costs.

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8 Sep 2014

Extension of Opening Hours for Polyclinics and Private Clinics on Community Health Assist Scheme

Foo Mee Har asked how the government can encourage polyclinics and private clinics under the Community Health Assist Scheme (CHAS) to extend their opening hours to divert non-emergency cases from hospital Accident and Emergency (A&E) departments.
Gan Kim Yong outlined existing measures such as Health Promotion Board campaigns to help the public distinguish between emergencies and non-emergencies and to promote regular family doctors.
He highlighted initiatives like GPFirst, where general practitioner clinics partner with hospitals to manage mild to moderate conditions, reducing unnecessary A&E visits.
Polyclinics and Family Medicine Clinics (FMCs) are collaborating with CHAS clinics to extend operating hours and share information about after-hours care, with some FMCs already operating until 9 pm daily.
The Ministry of Health will continue public education efforts to encourage appropriate use of primary care services and reduce pressure on A&E departments.

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8 Sep 2014

Impact of Removal of Medical Fee Guidelines on Healthcare Costs

Gerald Giam asked whether the removal of the SMA Guidelines on Fees in 2007 led to more competitive fees in primary and specialist care, and if not, whether it contributed to healthcare inflation, and if the Ministry would re-introduce the guidelines.
Minister Gan Kim Yong stated that MOH has monitored private sector charges, showing median surgeon fees for 10 common procedures rose 3.2–9.7% annually from 2007 to 2013, with overall healthcare inflation at 3.4% per annum, but variation above the 75th percentile makes it hard to attribute direct impact to the fee guidelines.
MOH is focusing on enhancing price transparency by publishing total hospital bills and operation fees, and is addressing cost drivers like an ageing population and new medical technologies through health technology assessments and medical device committees.

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8 Sep 2014

Insufficient Monies in Medisave Accounts for MediShield Life Premiums

The Minister outlined four ways the government provides substantial help to keep MediShield Life premiums affordable, including permanent subsidies for lower- and middle-income families, the Pioneer Generation, and transitional support for all citizens.
It was noted that about nine in ten inactive CPF members have sufficient Medisave balances or family support to cover at least three years of MediShield Life premiums, with additional top-ups available through schemes like the GST-Voucher.
The government emphasized that with permanent subsidies, additional premium support for the needy, and other measures, no Singaporean will be unable to afford MediShield Life premiums or fall out of the scheme.

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8 Sep 2014

MediShield Life Premiums for those who Undergo Regular Health Screening

Chen Show Mao asked if MediShield Life premiums could be reduced for those who undergo regular health screenings like the Integrated Screening Programme.
Gan Kim Yong explained that MediShield Life premiums are set based on expected claims, and discounts for screeners would require higher premiums for others, so alternative incentives are preferred.
The Ministry of Health is enhancing health promotion through initiatives like community screenings, healthier food options, and increased subsidies under CHAS and for Pioneers.

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8 Sep 2014

Delay in Opening of Ng Teng Fong Hospital

The six-month delay in opening Ng Teng Fong General Hospital is due to setbacks in exterior façade work, caused by production issues at a subcontractor's factory in Thailand and curfews there, though other hospital projects remain on schedule.
The Ministry of Health is mitigating the delay's impact by keeping Alexandra Hospital operational longer, adding beds from other hospitals, and implementing initiatives like GPFirst and post-discharge support to manage bed demand.
Collaborations with private hospitals are being explored as a long-term solution to increase capacity, with flexible models that use either public or private manpower, while efforts focus on improving care processes to reduce unnecessary admissions.
The Health Minister reassured that hospitals are managing patient wait times through proactive emergency department care and community programs, even as new facilities like Changi General Hospital’s integrated building open as planned.

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8 Sep 2014

Singaporeans in Ebola-hit Countries

Dr Janil Puthucheary inquired about the number of Singaporeans in Ebola-affected countries and the support for their potential evacuation.
The Senior Minister of State for Foreign Affairs confirmed there are 12 Singaporeans in Nigeria and one in Liberia, all registered with MFA, which is in regular contact and advising them to consider returning.
The Ministry of Foreign Affairs issued a travel notice advising against non-essential travel to affected areas, while the Ministry of Health issued a health advisory following WHO's declaration of a Public Health Emergency of International Concern.
In case of an Ebola symptom or confirmed case, MFA will work with local authorities, employers, and MOH to facilitate medical evacuation, provided the individual is certified fit for travel.
Singapore's overseas missions remain in close contact with local authorities and are ready to provide consular assistance to Singaporeans if needed.

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8 Sep 2014

Impact of Ebola Outbreak on Singapore

The Ministry of Health has implemented low-risk assessment, travel advisories, and screening at checkpoints for passengers from Ebola-affected countries to detect and manage potential cases early.
Healthcare facilities are prepared with centralized isolation protocols, infection control measures, and support plans to handle suspected or confirmed Ebola cases, though intensive supportive treatment remains the primary approach.
The government coordinates with media to reduce public alarm during health scares and monitors experimental treatments like ZMapp while emphasizing their limited availability and role.
Singaporeans traveling to or returning from affected regions, including volunteers, are advised on precautions and monitored for symptoms to prevent local transmission.

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5 Aug 2014

Community Health Assist Scheme (CHAS)

Mary Liew asked the Ministry of Health to engage employers to promote CHAS sign-ups and to extend acceptable medical certificates to all CHAS-registered clinics.
MOH, through the Agency for Integrated Care, is working with unions and public/private employers via talks, roadshows, mailers, newsletters, and posters to increase CHAS awareness.
MOH encourages employers to spread CHAS awareness internally and to accept medical certificates from any registered doctor for sick leave purposes.

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5 Aug 2014

Government Subsidy for Healthier Essential Foods

Dr Chia Shi-Lu asked whether subsidies for healthier cooking oil could be extended to other essential foods like brown rice, which is more expensive than white rice.
Health Minister Gan Kim Yong stated that the Healthier Ingredients Subsidy Scheme already covers brown rice and whole-grain noodles, not just cooking oil, and has been expanded to wholesalers and central kitchens this year to improve reach.
The scheme aims to reduce price differentials between regular and healthier food ingredients, with positive feedback received so far and regular reviews planned to benefit more Singaporeans.
HPB is also running public education campaigns to encourage healthier eating, with examples like a major restaurant chain making brown rice the default option for a signature dish.
The Ministry welcomes and will continue exploring innovative ideas to promote healthier eating habits.

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5 Aug 2014

Preparations for Singapore to Respond to Provisions in Trans-Pacific Partnership Agreement Related to Public Health and Environment

Gerald Giam questioned how Singapore can legislate on public health and environment under the TPP's Investor-State Dispute Settlement (ISDS) provisions, and asked about past ISDS cases against Singapore.
Lim Hng Kiang explained that the TPP ensures a stable investment regime for both foreign and Singaporean investors, with safeguards against frivolous ISDS suits.
He stated that the TPP does not restrict Singapore from adopting measures for legitimate public policy reasons, including protecting public health and the environment.
He confirmed that no multinational company has challenged or threatened to challenge Singapore through ISDS to date.
The response emphasized that Singapore can implement public interest legislation while maintaining commitments under the TPP.

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5 Aug 2014

Medisave for Home-based Healthcare

David Ong proposed allowing Medisave to be used for home-based healthcare for the elderly to reduce hospital congestion and ease caregivers' burdens, prompting the Ministry of Health to outline existing subsidies and cautious plans for gradual Medisave expansion while ensuring adequacy for future hospitalization needs.
The Ministry highlighted current support, including up to 80% subsidies for eligible home care, increased Medisave limits for home palliative care, and upcoming Flexi-Medisave for outpatient treatments, while emphasizing careful consideration to prevent premature depletion of Medisave savings.
David Ong raised concerns about quality and cost of private home care providers, suggesting extensions of CHAS and Medisave for hospice care, with the Ministry responding by detailing existing subsidy frameworks, quality guidelines in development, and clarifying that home palliative and hospice care are already eligible for Medisave.
Chia Shi-Lu asked about expanding Medifund criteria for those in financial need, and the Ministry affirmed that no one will be deprived of care, with providers using charity funds or alternative assistance for those unable to afford services after subsidies.

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4 Aug 2014

Size of MediShield Fund's Reserves and Percentage Needed to Meet Claims and Premium Rebates

As of 31 December 2013, the MediShield Fund’s reserves stood at $1.7 billion, which are used to cover scheme liabilities such as policyholders’ claims and premium rebates.
About two-thirds of the reserves support ongoing and future claims, including incurred but not yet submitted claims, expected future claims, and long-tail continuing claims, while the remainder is set aside for future premium rebates.
The portion of reserves allocated to premium rebates is expected to increase under MediShield Life to smooth premium increases in old age, with the fund’s liabilities and reserves reviewed annually using actuarial principles and audited independently.

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4 Aug 2014

Lack of Bed Space in Government Community Hospitals for Patients from Acute Hospitals

Assoc Prof Fatimah Lateef raised concerns about patients unable to transfer from acute to community hospitals due to bed shortages or affordability issues with private options.
Minister Gan Kim Yong outlined plans to expand community hospital capacity with new facilities and additional beds from current hospitals, aiming to add over 1,600 beds by 2020.
The Ministry of Health has implemented transitional care programs, home-based support, and interim caregiver services to facilitate patient discharge and recovery without relying solely on community hospital beds.
Subsidies for home-based rehabilitation and services at Senior Care Centres are provided to make community care more affordable and accessible.

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4 Aug 2014

Ascertaining Mosquito-breeding Sites in Covered Drains

Sylvia Lim queried how agencies detect mosquito-breeding sites in covered drains.
Covered drains have access points for weekly cleaning by PUB, with twice-weekly cleaning in dengue cluster areas.
Town Councils must maintain similar inspection and cleaning regimes for drains under their responsibility.

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4 Aug 2014

Dealing with Recent Spike in Dengue Cases

The surge in dengue cases is driven by a dominant serotype (Type 1), low population immunity, and persistent Aedes mosquito populations, with NEA intensifying inspections, enforcement, and exploring new measures like the Wolbachia technique.
Ministers discussed potential adjustments to penalties, including tiered fines based on breeding ground scale and greater transparency on errant contractors, while emphasizing the challenge of proving direct liability for medical claims.
The Sanofi vaccine shows limited efficacy, especially against the prevalent Type 1, and is not yet approved; alternative approaches like Celgosivir are in early trials, with focus remaining on source eradication and public cooperation.

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9 Jul 2014

MediShield Life

Members unanimously supported MediShield Life for providing lifelong, universal coverage against large medical bills, emphasizing its role in strengthening Singapore's social safety net and offering peace of mind, especially for the elderly and those with pre-existing conditions.
Key concerns raised included premium affordability for lower-income groups, pensioners, and young families, with calls for sustained subsidies and support beyond the transitional period to prevent anyone from dropping out due to financial hardship.
The debate highlighted the need for better public communication and education on the scheme's details, particularly for seniors, to ensure understanding and address misconceptions about coverage and premiums.
Several MPs stressed the importance of cost control and sustainability, urging prudent healthcare spending, regulated premium increases for Integrated Shield Plans, and incentives for employers to adopt portable medical benefits.
The government reaffirmed its commitment to funding MediShield Life with $4 billion in subsidies over five years, ensuring no one is left behind, and outlined ongoing outreach efforts to explain the scheme to all Singaporeans.

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9 Jul 2014

Better Efforts to Communicate Government Schemes to Target Groups

The Government has adopted a multi-channel approach, including dialect videos on YouTube, radio, and TV, as well as content in official languages, to ensure Pioneer Generation Package and MediShield Life information reaches diverse audiences, with plans to expand to Malay and Tamil formats.
The Minister of State emphasized that while policies can be complex, communications aim for simplicity and accuracy, using engaging formats like comedy skits and leveraging both traditional and digital platforms, including community outreach and helplines.
Feedback from MPs highlighted the effectiveness of innovative methods like World Cup-themed videos, but also called for slower-paced explanations, broader use of paid media like transit ads, and analysis of which channels are most effective for future outreach.

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8 Jul 2014

Impact of MediShield Life on Pensioners

As of June 2014, approximately 32,000 pensioners were distributed across older medical schemes, with 60% on the Fixed Amount on Ward (3%) and Co-Payment on Ward Scheme (57%), and 40% on the Comprehensive Co-Payment Scheme.
The Government announced on 4 July 2014 that measures would be taken to ensure pensioners would benefit from MediShield Life coverage and be no worse off compared to their existing medical benefits.
These measures were specifically designed to help pensioners under the various legacy medical schemes transition to MediShield Life without losing existing coverage or facing increased financial burden.

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