Health

He Ting Ru asked the Minister for Health about barriers to signing advance medical directives (AMD), strategies to boost participation beyond current public education efforts, and the potential for simplifying the certification process. Ong Ye Kung responded that the complexity of the AMD process, which requires legal documentation and two witnesses (including a doctor), is a barrier but serves to protect individuals' interests. He mentioned that without an AMD, doctors can recommend withdrawal of life-sustaining treatment based on the patient's case, and having an Advance Care Plan (ACP) or a Lasting Power of Attorney (LPA) is easier to establish. Awareness of end-of-life planning has led to an increase in AMD uptake, from 3,000 in 2015 to over 8,000 in 2024.

Kwek Hian Chuan Henry proposed the establishment of medical panels at healthcare groups, staffed with senior doctors, to provide a holistic view on treatment plans and financial support for patients, particularly those with chronic conditions. Ong Ye Kung responded that centralizing decision-making for treatment and financial support is not optimal, as doctors often have differing opinions and decisions should be made close to the bedside. Financial support policies are set by the Ministry of Health, but individual patient assessments for MediFund are handled case-by-case at the healthcare institution level. This decentralization allows for flexibility and responsiveness to patient needs.

Dr. Wan Rizal asked about the regulations and safety measures for using ketamine as a treatment for severe depression in Singapore. The Senior Minister of State for Health, Dr. Janil Puthucheary, confirmed that ketamine nasal spray was approved in October 2020 and is administered under strict supervisory conditions in clinical settings. He outlined safeguards, including its classification as a controlled drug to prevent misuse, and the ongoing monitoring of treatment effectiveness. Yip Hon Weng raised concerns about public perceptions of ketamine due to its recreational use history and sought information on educational initiatives for both the public and healthcare professionals regarding its therapeutic applications.

Ng Ling Ling raised concerns about the rising cases of human metapneumovirus (HMPV) in China and its implications for Singapore, asking how the government would mitigate cross-border transmission, the sufficiency of the subsidized flu vaccination for seniors, and protection measures for children. Joan Pereira inquired about the number of HMPV cases detected, the most affected age groups, fatalities, and infection reduction measures in Singapore. Dr. Janil Puthucheary responded that HMPV symptoms resemble common colds, with current preventive advice focusing on hygiene and medical consultation for vulnerable groups, stating there are no vaccines for HMPV. Ng Ling Ling requested that the Ministry of Health send alerts about flu variants and review vaccination criteria under Healthier SG in light of recent flu-related fatalities. The Minister indicated that vaccination criteria are regularly reviewed, emphasizing the importance of focusing interventions on evidence-based outcomes.

He Ting Ru raised questions about the Grow Well SG initiative regarding personalized health plans for children, seeking details on contact time, personnel involvement, and additional manpower needs for implementation. Yip Hon Weng inquired about effective information dissemination, support for parents, and monitoring of screen usage guidelines for children. The Minister for Health, Ong Ye Kung, responded that information will be shared through annual school health screenings with trained personnel, with the expected engagement time for children being about 30 minutes. He emphasized that while no additional manpower will be recruited, existing staff are motivated to adapt to new responsibilities associated with the initiative. Ong acknowledged the need for tailored support for diverse parental challenges and the commitment to continually update guidelines based on new evidence from ongoing studies.

• Mr. Patrick Tay Teck Guan inquired about the annual number of psychological or mental health injury claims under the Work Injury Compensation Act 2019 and their success rates.
• The Minister for Manpower, Tan See Leng, reported that from 2020 to 2024, there were 23 claims for mental disorders, averaging 4.6 claims per year.
• Out of the 23 claims, 12 were successful, six were rejected or withdrawn, and the remaining claims are still being processed.

• Mr. Chua Kheng Wee Louis inquired about the government's plans to review MediShield Life and Integrated Shield Plans for overseas medical treatment.
• Minister Ong Ye Kung explained that MediShield Life is intended as a basic health insurance plan covering subsidized care in Singapore, and expanding it to include overseas treatments could increase premiums and compromise its purpose.
• Ong noted that Integrated Shield Plans typically offer coverage for emergency medical treatments abroad, but this is determined by individual insurers' commercial policies.

• The debate focused on the need to promote awareness of sarcopenia and its impact on older adults, as well as the importance of preventive measures like resistance training.
• Minister Ong Ye Kung highlighted that seniors with a balanced diet and active lifestyle are at lower risk for sarcopenia and outlined initiatives to support active aging.
• The government has allocated $3.5 billion for Age Well SG initiatives, which include expanding Active Ageing Centres (AACs) and offering programs like the Health Promotion Board's Steady Lah for muscle strengthening.
• Community activities for those aged 50 and above include group exercises and workshops on healthy eating, aimed at enhancing physical health and awareness.
• Public awareness campaigns by the Ministry of Health focus on promoting healthy eating and physical activity among seniors, emphasizing the importance of protein intake.

• There is a growing trend of Singaporeans seeking medical treatment in Malaysia due to factors like affordability and accessibility.
• The Ministry of Health (MOH) does not track the number of Singaporeans traveling to Malaysia for medical care or their reasons.
• MOH is focused on ensuring healthcare in Singapore remains affordable, accessible, and of high quality, with recent expansions in hospital capacity and new care models.
• Upcoming increases in MediShield Life and MediSave limits are intended to cover a significant portion of subsidized medical bills.
• Singapore aims to maintain its reputation for quality healthcare but does not seek to actively promote medical tourism.

• Ms. Hazel Poa inquired about the Ministry of Education's monitoring of bullying, depression, and suicide rates among students as indicators of well-being.
• The Ministry of Education acknowledges monitoring mental health and discipline cases but notes that not all incidents are reported, as some families seek private help.
• The Ministry collaborates with schools to enhance student well-being, providing support networks and community resources for mental health.
• Schools with higher needs receive targeted support and resources from the Ministry to address well-being issues effectively.
• Parental involvement is emphasized as crucial in supporting students' mental health and well-being at home.

• Concerns were raised about the potential increase in food poisoning incidents among students as schools transition to food catering due to a decline in canteen operators.
• Foodborne gastroenteritis cases in schools have been linked to both caterers and canteen stall holders, with caterers posing a higher risk due to larger food distribution volumes.
• The Singapore Food Agency (SFA) enforces strict food safety measures for licensed caterers, including training for food handlers, cleanliness standards, and mandatory food timestamps.
• Caterers are subject to inspections and can face penalties for food safety violations, with a system in place for increased surveillance of those with past infringements.
• The Ministry of Education collaborates with school canteen operators to ensure compliance with food safety standards and educates students on personal hygiene and food safety practices.

• Mr. Liang Eng Hwa proposed that the Ministry of Health consider allowing the use of MediSave for shingles vaccination.
• Minister Ong Ye Kung indicated that vaccines deemed cost-effective are eligible for MediSave and subsidies.
• The current pricing of the shingles vaccine does not align with its benefits, and the Ministry will continue discussions with the manufacturer.

• Clinical trial approvals in Singapore have declined from 178 in 2008 to 127 in 2023, despite increased biomedical investments.
• The decline is attributed to Singapore's smaller demographic base, which limits the number of participants in trials, and increased competition from regional players with larger populations and lower trial costs.
• Singapore remains competitive by focusing on its strengths, such as strong healthcare infrastructure and research capabilities, and is actively participating in multinational clinical trials.
• The Health Sciences Authority (HSA) is streamlining processes to enhance trial efficiency and transparency, particularly in high-impact areas like oncology.
• Singapore continues to be a significant production base for the industry, with the HSA recognized as a reputable agency for health product registration.

• Dr. Lim Wee Kiak inquired about the timeline and factors influencing the Ministry of Health's evaluation of stem cell therapy for cartilage repair as a mainstream treatment.
• Minister Ong Ye Kung stated that the adoption of stem cell therapies depends on the emergence of clinical evidence, as they are currently considered investigational due to insufficient consistent evidence of effectiveness.
• The Ministry of Health is monitoring both local and international studies to assess the clinical and cost-effectiveness of these therapies.
• Singaporeans are advised to exercise caution when seeking stem cell treatments abroad, given the current regulatory status.

• Louis Ng Kok Kwang raised concerns about the current nursing support staff to nurse ratio of 1:11 in public healthcare institutions and inquired if the Ministry of Health has considered increasing this ratio.
• Minister Ong Ye Kung responded that the ratio has remained stable at 1:11 for the past decade and that efforts have been made to strengthen the healthcare workforce, including nurses and support staff.
• Ong emphasized that the focus is on spreading administrative duties to allow healthcare professionals to work more effectively within their roles.

• Ms. Joan Pereira and Mr. Yip Hon Weng raised concerns about the adequacy of communication from insurers regarding changes in hospitalisation insurance coverage and the need for timely notifications to policyholders.
• They questioned the measures in place to ensure that policyholders receive clear explanations of changes and how the Ministry of Health holds insurers accountable for any lapses in communication.
• Minister Ong Ye Kung stated that Integrated Shield Plans are subject to Ministry of Health requirements and that insurers must provide timely and clear information about changes, with a minimum notification period of 30 days before any changes take effect.

• Louis Ng Kok Kwang proposed that the Ministry of Health consider providing subsidies, co-funding, or MediSave for egg freezing.
• Ong Ye Kung responded that current financing policies allow MediSave usage for medically necessary egg freezing and provide co-funding for future assisted reproduction treatments.
• The government aims to encourage young couples to marry and start families sooner, rather than delaying their plans through financial support for egg freezing.

He Ting Ru asked the Minister for Health about the average length of stay for patients in transitional care facilities from 2022 to 2024, the expansion of the Mobile Inpatient Care @ Home (MIC@Home) programme to 300 beds by 2024, and the current average length of stay under MIC@Home. Ong Ye Kung responded that the average length of stay in Transitional Care Facilities was 32 days in 2023 and expected to be 37 days in 2024. He also indicated that MIC@Home currently has about 185 beds and that the average length of stay for patients under this program is six days.

Hany Soh asked the Minister for Health about the detection of "Kpods" or vape juice mixed with etomidate cases in 2024, enforcement efforts by the Health Sciences Authority (HSA), and support for consumers looking to quit. Ong Ye Kung referenced a previous oral reply given on January 8, 2025, which addressed these questions in detail. Further information can be found in the official parliamentary report from that date.

Yip Hon Weng asked about waiting times for subsidized dental services, plans for more polyclinics offering dental services, promotion of dental health, and potential inclusion of dental care in the Primary Care Providers scheme and Healthier SG programme. Ong Ye Kung responded that median waiting times for non-emergency basic dental services at polyclinics are approximately three months, while specialist services have a one-month wait, with emergency cases addressed immediately. Subsidized dental services are offered at 14 polyclinics and over 900 private clinics under the Community Health Assist Scheme, with the Ministry of Health monitoring demand for potential expansion. Oral health promotion initiatives are already in place in schools and through public-private partnerships.