Health

• The Ministry of Health (MOH) is investigating eight telemedicine providers for non-compliance with guidelines, primarily related to lapses in clinical care and inappropriate advertising.
• One provider, MaNaDr Clinic, has had its license revoked due to serious breaches, while others have received warnings or suspensions.
• In the past year, 59 complaints regarding telemedicine services were received, involving over 20 licensees, indicating a significant concern about the quality of care.
• The investigations include assessing the appropriateness of short consultations and ensuring that proper clinical assessments are conducted.
• The MOH encourages public feedback on telemedicine services to help monitor and address potential abuses in the system.

He Ting Ru asked the Minister for Health about research plans regarding informal care time and costs for caregivers of seniors aged 75 and above, as well as time-use studies for these informal carers. Ong Ye Kung responded that various Ministry-funded research has already been conducted on aging and caregiving, including studies by DUKE-NUS CARE and the Central Provident Fund Board. He acknowledged the sacrifices involved in caregiving and highlighted ongoing initiatives to support caregivers.

Assoc Prof Jamus Jerome Lim asked about the average response time for private ambulances, their training standards compared to SCDF personnel, and circumstances when they advise calling SCDF. Ong Ye Kung clarified that SCDF ambulances are for life-threatening emergencies, while private ambulances handle less urgent cases, and response times for private services are not tracked. Private ambulance services are regulated and must maintain certification, ensure staff qualifications, and conduct regular training, with protocols in place for triaging patients and referring emergencies to SCDF. In a life-threatening situation, the public is advised to call SCDF first.

Wan Rizal raised concerns about the rise in vaping among youths, asking the Minister for Health about measures to prevent and educate against vaping in schools, as well as enforcement effectiveness and recidivism statistics. Ong Ye Kung responded that multiple agencies are collaborating to enhance enforcement against vaping, including increased operations at various locations and streamlined processes for issuing penalties. The Health Sciences Authority has removed approximately 6,000 online listings of e-vaporisers in 2024, with 15% of offenders being repeat violators. The government acknowledges that combating vaping requires ongoing public education efforts, especially targeting the youth.

Louis Ng Kok Kwang questioned the Minister for Health about the cost changes for in-vitro fertilisation (IVF) treatments at public hospitals and private clinics over the past decade. Ong Ye Kung responded that the cost of IVF cycles at public Assisted Reproduction centres has risen by approximately 2% annually. The Ministry does not have data on IVF costs at private Assisted Reproduction centres.

Tan Wu Meng urged the Minister for Health to enhance support for fertility preservation for young cancer patients, particularly those from low-income families, as they may have limited MediSave resources. The Minister of State for Health, Rahayu Mahzam, acknowledged the use of MediSave for egg freezing and assisted reproduction treatments, and expressed the ministry's commitment to reviewing and possibly extending support separate from the MediShield Life 2024 review. Tan highlighted the emotional challenges these patients face and emphasized the need for equitable access to fertility preservation options for all young cancer patients. The Minister indicated awareness of these concerns and acknowledged previous suggestions made by Tan regarding support for cancer patients' fertility treatments.

Gerald Giam Yean Song asked the Minister for Manpower about the health risks of prolonged standing in the retail sector and the possibility of introducing voluntary guidelines for seating breaks. Tan See Leng confirmed that the Ministry regularly reviews studies on health risks from prolonged standing, noting potential issues like swollen feet and weakened muscles. The Ministry, alongside the Workplace Safety and Health Council, has issued guidelines encouraging retailers to provide rest for staff, implement ergonomic practices, and support older workers in maintaining health and productivity.

Jean See inquired about the impact of increasing MediShield Life premiums on self-employed persons (SEPs), asking for statistics on those unable to meet MediSave contributions. Minister Tan See Leng reported that 1.4% of active SEPs had insufficient MediSave balances for the upcoming premiums, with half of that group unable to fulfill their contributions. The government provides support through a $4.1 billion package, including enhanced subsidies and MediSave bonuses to assist older SEPs. Assurance was given that no individual would lose MediShield coverage due to financial hardship, with support available for those unable to pay premiums.

Melvin Yong Yik Chye raised questions about a trial allowing pharmacists to administer influenza vaccinations, specifically regarding additional training for pharmacists and safety protocols for allergic reactions. Ong Ye Kung confirmed that pharmacists must complete required training and competency assessments to participate. He explained that the safety protocols for allergic reactions involve post-vaccination monitoring, administering adrenaline autoinjectors, and referral to medical help if needed.

Zhulkarnain Abdul Rahim questioned the Minister for Health about measures to regulate online sales of medications, raise awareness of associated risks, prevent abuse and misdiagnosis, and verify medication content. Ong Ye Kung responded that only licensed healthcare institutions and pharmacies can sell prescription medicines online, ensuring they are registered with the Health Sciences Authority (HSA). The HSA provides advisories to discourage purchasing from unverified sources and monitors online platforms to prevent illegal sales, with penalties for offenders including fines up to $50,000 and/or imprisonment for up to two years.

Hazel Poa questioned the Minister for Health about the effects of proposed increases in MediShield Life deductibles on inpatient and outpatient bills, including estimated percentages of bills impacted and the number of Singaporeans affected. Ong Ye Kung explained that deductibles serve to filter out smaller bills, maintaining efficiency in the healthcare system while minimizing individual financial burdens. He noted that the inpatient deductible adjustment, the first since 2015, helps prevent significant premium increases and that most affected bills would still be manageable through MediSave. The introduction of a new outpatient deductible is intended to correspond with an expansion of coverage and increased claim limits, which are expected to mitigate financial impact for most patients. The government will allocate substantial resources to offset costs, with additional support measures, including MediSave top-ups to help citizens cope with rising healthcare expenses.

Louis Ng Kok Kwang asked if there are plans to mandate support from healthcare facilities for single unwed mothers regarding prenatal and delivery health issues. Ong Ye Kung acknowledged the difficulties faced by single unwed mothers, highlighting that public hospitals offer comprehensive support through multidisciplinary teams, including medical assessments and counseling. He noted the proactive approach of hospitals in identifying at-risk mothers and connecting them with community support agencies. Both public and private healthcare systems provide equitable antenatal and postnatal care tailored to individual needs.

He Ting Ru asked the Minister for Sustainability and the Environment about the number of instances in the last three years when dengue inspection officers couldn't enter homes due to residents being unavailable or properties being vacant. Grace Fu Hai Yien reported that NEA inspected an average of 600,000 homes each year, with a 40% average accessibility rate. In dengue cluster areas, the accessibility rate exceeded 90%. When initial inspections fail, NEA officers return for further attempts and may issue notices under the Control of Vectors and Pesticides Act if access remains denied. From 2021 to 2023, NEA conducted 129 inspections under this act when homes were persistently inaccessible.

Cheryl Chan Wei Ling asked about training plans for caregivers of single seniors and individuals with special needs in mental well-being management. Ong Ye Kung responded that under the National Mental Health and Well-being Strategy, the goal is to train over 130,000 frontline personnel and volunteers by 2030 to provide basic mental health support. This training will include caregivers who work with seniors and special needs individuals. Eligible households can access the Caregivers Training Grant of up to $400 annually for approved courses.

Hazel Poa asked if MediSave withdrawal limits could be adjusted annually to align with inflation in healthcare costs, similar to adjustments for CPF sums. Ong Ye Kung responded that MediSave withdrawal limits are reviewed every three years as part of a holistic review of the MediShield Life scheme. He noted that this approach allows for more comprehensive consideration of healthcare financing adjustments rather than automatic annual changes. Other features of MediSave are also reviewed periodically.

Tan Wu Meng asked about the diagnosis rate, morbidity, and subsidy eligibility for patients with craniopharyngioma in Singapore. Ong Ye Kung reported that approximately 40 patients were diagnosed with this rare brain tumor from 2014 to 2023, but specific morbidity data is not collected. Patients with craniopharyngioma qualify for the same subsidies and MediSave/MediShield Life coverage as cancer patients, including significant financial assistance for treatments. Those struggling with healthcare costs can seek additional support from medical social workers in public healthcare institutions.

Louis Ng Kok Kwang asked about the target ratio of nurses to administrative and support healthcare workers under the Ministry of Health's 2030 recruitment plans for the public healthcare system. Ong Ye Kung stated that the current ratio of nursing support staff to nurses is approximately 1:11, which has been stable for the past decade. He noted that comparing nurses to administrative staff is not meaningful due to their different functions. The Ministry will work on attracting and retaining healthcare workers to address service demands.

Gan Thiam Poh questioned the Prime Minister about targets for maintaining a sufficient working-age population to support the ageing demographic and the government's policy measures to balance the needs of seniors without financially burdening future generations. Indranee Rajah responded that the government does not set specific targets for the working-age population but focuses on keeping seniors healthy and productive. Strategies include investing in skills for older workers, promoting age-friendly workplaces, and gradually raising retirement ages. The government is also managing healthcare expenditures and promoting programs like Age Well SG to support seniors living at home. These efforts aim to help seniors age well while minimizing the burden on younger generations.

Christopher de Souza asked about the completion of the review regarding the cost effectiveness of the shingles vaccine and the potential addition of the vaccine to the National Adult Immunisation Schedule for subsidies, especially for vulnerable seniors. Ong Ye Kung confirmed that the review of the shingles vaccine, Shingrix, has been completed, revealing that at the proposed price, the vaccine is not considered cost-effective for population-level prevention. The Ministry will continue discussions with the manufacturer and monitor pricing for potential future consideration.

Tan Wu Meng questioned the Minister for Health about whether the assessment of cancer therapies for the Cancer Drug List considers treatment outcomes related to quality of life and the impact on caregivers' roles and employment. Ong Ye Kung explained that the Agency for Care Effectiveness uses established Health Technology Assessment (HTA) methods to evaluate the clinical and cost effectiveness of therapies, which includes health-related costs and quality of life outcomes. Non-health related costs and benefits are generally excluded from HTA due to their subjective nature, but thresholds can be adjusted to account for these factors.