Health

Chua Kheng Wee Louis asked the Minister for Health about the prevalence of next generation sequencing (NGS) in Singapore and its effectiveness in cancer identification and treatment. He also inquired whether the government plans to issue guidelines on NGS usage. Ong Ye Kung informed that the question has been previously addressed in a written reply during a parliamentary sitting on January 7, 2025, and directed to check the official report for details.

Xie Yao Quan raised a question about the possibility of raising the maximum age for first-time blood donors from 60 to 65. Minister Ong Ye Kung explained that the current age limit is based on the higher cardiovascular risks among elderly individuals, which increases the likelihood of adverse reactions after donation. The Health Sciences Authority regularly reviews donor eligibility criteria and will consider the suggestion during their next assessment to potentially expand the donor pool while ensuring safety.

Melvin Yong Yik Chye asked about plans to detect the use of "Kpods," a vape juice mixed with etomidate, which online sellers claim are undetectable by urine tests. Ong Ye Kung reported that the Ministry of Health, in collaboration with the Health Sciences Authority and enforcement agencies, has intensified checks to uphold the ban on e-vaporisers. As of December 2024, over 14,000 fines were issued for possession and use of e-vaporisers, and 6,800 illegal listings were removed, indicating increased enforcement efforts. Testing revealed five e-vaporiser cases containing etomidate, and offenders face serious penalties under the Poisons Act. The presence of etomidate in vaping products emphasizes the harmful nature of vaping and the commitment to enforcing bans, with support programs like I Quit available for those wanting to stop vaping.

Christopher de Souza asked the Minister for Health about the possibility of bulk purchasing shingles vaccines to lower costs and improve their cost-effectiveness for the population. Ong Ye Kung responded that the Ministry of Health employs value-based pricing and bulk purchasing to secure cost-effective drug and vaccine pricing. He noted that the current price of the shingles vaccine does not reflect its benefits, but the Ministry remains committed to engaging with the supplier for better pricing.

Gerald Giam Yean Song asked for the total projected expenditure of the Next Generation Electronic Medical Record (NGEMR) system and its impact on public healthcare costs, along with measures to ensure it provides value for money without increasing costs for patients. Ong Ye Kung stated that the phased roll-out of NGEMR was completed at some institutions by July 2024, with full implementation costing the government $1.5 billion over 10 years. NGEMR will replace over 100 legacy IT systems, improving care coordination by allowing doctors access to comprehensive patient records across institutions. The system will also enhance operational efficiency and health outcomes through the use of analytical tools.

Melvin Yong Yik Chye raised concerns about the increasing prevalence of occupational diseases (ODs) in the workplace during his Adjournment Motion, highlighting their debilitating effects on workers' health and productivity. He emphasized the need for improved workplace health surveillance and mandatory health screenings to detect and address ODs early. Yong proposed amending regulations to expand surveillance beyond high-risk industries and called for a national Centre of Excellence for Occupational Diseases to consolidate research and enhance public education. Senior Minister of State Zaqy Mohamad acknowledged these concerns, outlining government initiatives to strengthen detection, awareness, and prevention of ODs in Singapore's workforce.

Christopher de Souza asked for an update on the review of MediSave usage for root canal treatment to help seniors afford dental care. The Minister of State for Health, Ms Rahayu Mahzam, confirmed that Singaporeans can currently receive subsidies for root canal treatment at public institutions and CHAS-participating clinics. There have been numerous requests to permit MediSave use for this treatment, given its increasing commonality among seniors. The Ministry of Health is still in the process of reviewing this matter.

Yip Hon Weng asked the Minister for Health about support for patients facing delayed billing invoices at public healthcare institutions, which complicates their insurance claims due to missing deadlines. The Minister of State for Health, Rahayu Mahzam, responded that insurers generally do not reject claims due to delays not caused by patients and that the National Cancer Centre Singapore (NCCS) is offering assistance to affected patients. Yip expressed concerns about patients feeling unfairly treated due to technicalities and suggested that institutions and the Ministry of Health should be more proactive in helping residents negotiate with insurers. Rahayu acknowledged the concern around billing delays and noted that public healthcare institutions provide interim support, while also mentioning the complexities surrounding insurance portability and potential premium increases.

• Mr. Yip Hon Weng inquired about the Ministry of Health's timeline for developing guidelines on Next Generation Sequencing (NGS) for cancer treatment and its potential as a screening tool.
• Minister Ong Ye Kung explained that NGS is used for genetic sequencing, with small panel NGS being routinely used for tumor profiling in some cancer cases, potentially covered by MediSave and MediShield Life.
• Large panel NGS is currently utilized in Singapore primarily for research purposes in clinical trials due to insufficient evidence for routine testing in certain cancers.
• The Ministry of Health is actively reviewing emerging evidence to establish guidelines for the appropriate and cost-effective use of NGS in clinical settings.

• Mr. Yip Hon Weng raised concerns about the ability of outpatient clinics in private hospitals and patients to opt out of sharing health records with the National Electronic Health Record (NEHR).
• Minister Ong Ye Kung clarified that NEHR information is strictly for clinical care and is only accessible by healthcare professionals involved in a patient's care, with no access for insurance companies or employers.
• The upcoming Health Information Bill will require all licensed healthcare providers, including private institutions, to contribute patient health records to the NEHR to ensure continuity of care and reduce unnecessary tests.
• Patients will not be able to opt out of contributing their records to the NEHR, but the Bill will include provisions for patients to have some control over how their medical information is shared with healthcare providers.

• Patrick Tay Teck Guan inquired about the review of MediSave limits for baby delivery expenses in the context of promoting parenthood.
• The Minister for Health, Ong Ye Kung, announced an increase in MediSave withdrawal limits for delivery expenses effective from April 1, 2025.
• The MediSave limit for a typical delivery will rise from $2,750 to $4,280, and the MediSave Grant for Newborns will increase from $4,000 to $5,000 for Singaporean citizens.

• Dr. Lim Wee Kiak raised concerns about the ethical considerations, medical risks, and safeguards related to prescribing puberty blockers to minors experiencing gender dysphoria.
• Minister Ong Ye Kung stated that there is insufficient evidence supporting the safety and clinical benefits of puberty blockers for children, noting that many do not continue to experience gender dysphoria into adulthood.
• The Ministry of Health does not recommend the use of puberty blockers for minors with gender dysphoria.

• Dr. Lim Wee Kiak inquired about the tracking of Singaporeans on long-term anti-depressant medication and the Ministry of Health's plans for public awareness regarding its use and potential risks.
• Minister Ong Ye Kung reported that approximately 85,000 Singaporeans were prescribed anti-depressants in 2023, but the duration of use is not tracked.
• The Ministry emphasizes that prescriptions are based on clinical assessments, and patients are informed about the risks and benefits of anti-depressants before treatment.
• Educational resources on safe usage and side effects of anti-depressants are available through various government agency websites.
• The Ministry is also addressing the root causes of young people's reliance on anti-depressants as a coping mechanism.

• Dr. Wan Rizal raised concerns about the stigma surrounding mental health conditions, particularly among older adults and those with lower education levels, and inquired about targeted interventions for these groups.
• He also questioned how the effectiveness of current initiatives to reduce stigma is being evaluated and what plans exist for sustaining these efforts over the next five years.
• Minister Ong Ye Kung referenced a previous parliamentary response that addressed these questions, indicating that the issues have been discussed in detail in an earlier session.

• Ms. Joan Pereira raised concerns about the food contamination incident involving 70 passengers and crew members who fell ill on the Coral Princess cruise that departed Singapore on 17 October 2024.
• She inquired whether the source of contamination was traced to supplies loaded in Singapore and what measures would be implemented to prevent future incidents.
• Minister Grace Fu Hai Yien responded that the investigation by the US Centers for Disease Control and Prevention found no link between the contamination and supplies loaded in Singapore.

• Ms. Ng Ling Ling inquired about the tracking of miscarriage rates from IVF pregnancies in public hospitals and whether these rates are higher than those of normal pregnancies over the past three years.
• The Minister for Health, Ong Ye Kung, stated that the Ministry does not track miscarriage rates for IVF or normal pregnancies, noting that pregnancy loss from IVF can be attributed to various factors.
• The Ministry is conducting a Pre-implantation Genetic Screening (PGS) study aimed at improving IVF success rates for women with recurrent pregnancy losses and is evaluating its clinical effectiveness.

• Dr. Wan Rizal inquired about measures to enhance public recognition of mental health conditions like OCD and schizophrenia, which remain under-recognized despite improvements in mental health literacy.
• Minister Ong Ye Kung highlighted the importance of mental health literacy in combating stigma and mentioned various initiatives, including campaigns by the Health Promotion Board and the National Council of Social Service, aimed at raising awareness.
• Community support programs, such as Well-being Circles and outreach teams, are in place to assist vulnerable groups, particularly seniors and those with lower education levels.
• Recent studies indicate that public awareness and attitudes towards mental health conditions have improved, with OCD becoming more recognizable.
• The government plans to continue strengthening efforts under the National Mental Health and Well-being Strategy and to develop targeted approaches to further reduce stigma.

• Over 490,000 migrant workers are currently enrolled in the Primary Care Plan (PCP), which aims to provide accessible and affordable healthcare services.
• The PCP requires medical service providers to meet specific licensing, regulatory, and quality standards, including language support for migrant workers.
• Migrant workers benefit from low co-payment fees for healthcare services, leading to high satisfaction rates and increased usage of medical facilities.
• Employers can save at least 20% on healthcare costs per worker with the PCP, which offers predictable expenses and protection against unexpected bills.
• The Ministry of Manpower will continue to gather feedback from employers to improve the PCP and promote preventive healthcare among migrant workers.

• Dr. Wan Rizal inquired about the measures for rapid deployment of public health interventions and support for healthcare workers in response to emerging diseases.
• Minister Ong Ye Kung emphasized that while complete preparedness for pandemics is impossible, Singapore has established a robust contingency plan based on COVID-19 experiences, including clinical protocols and stockpiles of antivirals.
• Recent amendments to the Infectious Diseases Act empower the Ministry of Health to implement necessary measures, such as lockdowns, to control disease spread and allow time for vaccine development.
• Singapore is actively involved in global vaccine development initiatives and has established local vaccine manufacturing capabilities to enhance its pandemic response.

• The Communicable Diseases Agency (CDA) is being established to consolidate Singapore's public health functions for better management of infectious diseases, as recommended in the COVID-19 White Paper.
• The CDA will focus on five key areas: prevention, preparation, detection, response, and enabling, aiming to enhance Singapore's capabilities against future pandemics and infectious disease threats.
• Concerns were raised regarding the transition of employees from existing health agencies to the CDA, emphasizing the need for continuity in public health services and the retention of institutional knowledge.
• The CDA will work collaboratively with other government agencies and international organizations to ensure a coordinated response to infectious diseases and to enhance global health initiatives.
• The Bill outlines the governance structure and operational framework for the CDA, which is expected to be fully operational by the first half of 2025.