Health

Tin Pei Ling addressed the need for more attention on atopic dermatitis (eczema), highlighting its high prevalence in Singapore and the significant burden it places on patients' physical and mental well-being. She called for the inclusion of moderate-to-severe eczema in the Chronic Disease Management Programme (CDMP) and urged the Ministry of Health to consider adding effective treatments like Dupilumab to the list of subsidized medications. Senior Minister of State Janil Puthucheary acknowledged these concerns, explaining the current treatment options and subsidies available, while emphasizing a commitment to regularly review the adequacy of support for patients with eczema. Discussions revealed challenges regarding the cost-effectiveness of newer treatments and the need for standardized treatment guidelines for eczema.

Christopher de Souza raised concerns about the booking difficulties senior citizens face for polyclinic appointments and any additional measures taken since July 2023 to assist those who are not technologically savvy. Dr. Janil Puthucheary reported an increase in seniors visiting polyclinics, from over 260,000 in July 2023 to over 300,000 in July 2024. Seniors can receive assistance for appointment bookings at polyclinics, Active Ageing Centres, and Community Health Posts, as well as through call centres or in-person visits. Polyclinics will also triage walk-in patients with urgent needs, including frail seniors, if appointment slots are full.

Dr. Tan Wu Meng raised issues regarding the portability of Integrated Shield Plan (IP) insurance and the challenges faced by policyholders when switching providers after changes in coverage terms. The Minister of State for Health, Rahayu Mahzam, acknowledged that the need for portability is driven by policyholders unhappy with coverage changes, difficult claim processes, and rising premiums as they age. She explained that while IP portability could enhance competition, it is uncommon internationally, and implementing it would require significant structural changes, such as a risk equalization fund. Rahayu confirmed that IP insurers should also have social responsibility towards policyholders, especially as many current products face sustainability challenges, necessitating a reassessment of their design to avoid future issues.

Yeo Wan Ling and Melvin Yong Yik Chye raised concerns about health issues faced by migrant workers in Singapore and access to medical treatment. Dr. Koh Poh Koon, the Senior Minister of State for Manpower, outlined measures taken by the Ministry of Manpower to improve healthcare access for migrant workers, including mandatory employer coverage of medical fees and the introduction of the Primary Care Plan for affordable outpatient care. A study indicated that 96% of migrant workers can access primary health services, with common health issues being acute respiratory infections and musculoskeletal conditions. The Ministry emphasized the importance of balancing privacy and chronic condition management for workers while ensuring they are informed about healthcare options.

• He Ting Ru questioned the Ministry of Health about Singaporeans seeking dental treatment in Johor Bahru, cost differences, clinic closures, and measures to boost the dental industry's competitiveness.
• The Ministry does not track data on Singaporeans seeking dental care in Johor Bahru or procedure costs there.
• Dental clinics in Singapore increased by over 10% from 2019 to 2023, contrary to closures.
• The Ministry emphasized higher business costs in Singapore but committed to ensuring dentists are well-trained, services are safe and high-quality, and affordability through support schemes.
• No specific new measures were announced to directly counter regional competitors, focusing instead on existing quality and affordability frameworks.

• Ong Hua Han inquired about any ongoing or planned studies in Singapore to explore the usefulness of the body roundness index as a predictor of obesity and related health risks.
• Ong Ye Kung stated there is currently insufficient evidence on the index's usefulness for Asian populations and that the Ministry of Health will monitor research while using waist circumference and body mass index for national screening.

• Joan Pereira raised concerns about decision-making authority and accountability when patients undergo a combined course of TCM and mainstream healthcare treatments if their condition worsens.
• Ong Ye Kung emphasized that TCM integration must be evidence-based and cautious, citing the existing model for acupuncture in lower back and neck pain management.
• The current approach requires medical specialists to assess and refer patients for TCM treatment, with specialists responsible for reassessing and deciding on continuing or discontinuing TCM.
• Future TCM incorporations into public health institutions will follow a similar rigorous process with defined roles for mainstream and TCM providers.
• The Minister did not directly address who bears ultimate responsibility for patient outcomes but implied shared accountability through structured protocols.

• Leong Mun Wai proposed extending MediShield Life coverage to include maternity charges to reduce financial burdens on expecting parents.
• Ong Ye Kung stated that MediShield Life is designed for large subsidised medical bills from accidents or illnesses, and general maternity expenses are not covered, though subsidies and MediSave support are available.
• The government provides up to 80% subsidies for maternity expenses, uses MediSave through the MediSave Maternity Package, and covers serious pregnancy complications under MediShield Life.
• Additional parental support includes the Baby Bonus Cash Gift and an increased MediSave Grant for Newborns from $4,000 to $5,000 starting April 2025.

• The Ministry of Health explained that Emergency Department physicians follow established treatment protocols, guidelines, and clinical judgement to triage patients and decide on diagnostic tests.
• Not all tests need to be performed in the Emergency Department; some can be conducted later during inpatient stays based on clinical assessment by the care team.
• Treatment protocols are regularly reviewed using clinical evidence and best practices, with process and outcome indicators monitored to ensure patient safety and clinical quality.

• Dennis Tan Lip Fong inquired about the number and success rate of applications by Singaporean seniors to the Agency for Integrated Care for hearing aid funding outside the Seniors Mobility and Enabling Fund or Assistive Technology Fund over the past three years, and the funding range for successful cases.
• Ong Ye Kung responded that the Seniors’ Mobility and Enabling Fund and Assistive Technology Fund provide up to 90% means-tested subsidies for hearing aids, with over 99% success among about 4,000 annual applicants since 2019, and criteria were revised in 2024 to target greater needs.
• Seniors who do not qualify for these funds can seek alternative financial support from the Agency for Integrated Care, SG Enable, or hospital social workers, but the Government does not track applications for such alternative funding.
• The Government will continue to regularly review the Seniors’ Mobility and Enabling Fund and Assistive Technology Fund to ensure adequate support for those in need.

• Joan Pereira asked the Minister for Health if policyholders above 55 could opt out of the enhanced MediShield Life scheme to retain existing premiums and coverage, citing concerns over premium increases.
• Ong Ye Kung emphasized that MediShield Life is a national scheme requiring universal participation for collective risk-sharing, with no opt-out allowed.
• The government announced $4.1 billion in support measures to offset $1.8 billion in premium increases over three years, ensuring most Singaporeans face no net premium rise.
• Support includes enhanced subsidies and MediSave top-ups, with specific protections for Pioneer and Merdeka Generation seniors.
• Additional Premium Support will assist those still struggling to pay premiums despite the overall cushioning measures.

• Dr Wan Rizal asked the Minister for Digital Development and Information about support mechanisms for young users and their families to mitigate mental health impacts from interacting with AI platforms that simulate human interactions.
• Mrs Josephine Teo stated that research on AI's mental health impact is still nascent, and the government equips Singaporeans to use technology safely and healthily through school curricula, digital literacy education, and parental resources via the Digital for Life portal.
• Additional support includes initiatives like the National Library Board’s S.U.R.E. program and community services such as TOUCH Community Services and Youth Integrated Teams, which provide counselling and mental health support for youths affected by digital and AI interactions.

• The Singtel landline outage lasted about three hours and did not disrupt direct patient care services in public healthcare institutions.
• Approximately 2,300 calls to public healthcare contact centres were unable to be completed during the outage, affecting appointment-related requests.
• Patients were able to use alternate digital channels such as HealthHub, cluster apps, live chats, and online contact centres to access services during the disruption.

• Joan Pereira asked if holistic measures—psychological, financial, and social support—are provided to families and friends of self-radicalised youths even after the youths’ release from detention.
• The Minister stated that an Internal Security Department aftercare officer is assigned to families to provide social support and work with community partners for financial aid when needed.
• Families also receive religious counselling, psychological support, and rehabilitation initiatives, with examples including cyber-wellness programmes for youths and their parents.
• Friends of such youths can seek psychological or social support through their schools.
• The measures extend beyond detention, aiming to support both families and friends of self-radicalised youths.

• Leong Mun Wai questioned why policyholders under 40 are excluded from redeeming MediShield Life premium discounts earned through the Healthy 365 app.
• Ong Ye Kung explained that the pilot project aims to encourage healthier lifestyles and is targeted at those aged 40 and above.
• The age restriction aligns with the Healthier SG initiative, which also focuses on the same age group.
• Targeting this group is intended to better demonstrate the link between healthy habits and health outcomes for potential permanent adoption.

• The Bill amends the MediShield Life Act to expand coverage for new outpatient and home-based care models, enabling the scheme to keep pace with evolving healthcare delivery beyond traditional hospital settings.
• It introduces a clearer framework for approving, suspending, or revoking medical institutions' eligibility for MediShield Life claims, targeting specific treatments or services to ensure accountability and appropriate use of funds.
• The amendments strengthen premium recovery efforts by allowing digital service of demand notes and using means information to calibrate enforcement, while maintaining support measures to ensure affordability and prevent coverage loss for those unable to pay.

• The Communicable Diseases Agency Bill was introduced to establish a new agency and make related amendments to other Acts, presented by the Minister of State for Health on behalf of the Minister for Health.
• The bill was read for the first time and scheduled for a second reading in the next parliamentary sitting, with the proceedings to be printed.
• The debate focused on the formal legislative process to set up the agency, without detailed policy discussions in the initial presentation.

• MOH plans to integrate TCM into preventive care under Healthier SG, focusing on lifestyle changes and collaboration with Western doctors, with a voluntary accreditation system for TCM service providers to ensure quality and safety.
• Medical certificates from TCM practitioners are not automatically recognised under the Employment Act, but employers may use discretion to accept them, especially if practitioners are accredited.
• TCM interventions may be integrated into acute hospital settings if proven safe, efficacious, and cost-effective, with established referral protocols, similar to the current integration of acupuncture for specific conditions.
• Subsidies and MediSave use for TCM treatments are currently limited, but future integration could allow for subsidies if treatments meet regulatory standards and are combined with Western care for chronic conditions.
• MOH will consult TCM practitioners and Western doctors to foster cross-disciplinary training and collaboration, enhancing mutual respect and confidence in standards, though specific timelines for accreditation are still being developed.

• The Ministry of Health requires telemedicine providers to be licensed under the Healthcare Services Act and adhere to professional standards set by the Singapore Medical Council, with periodic audits and investigation of complaints to ensure quality.
• Following a case where a clinic was found to be issuing unjustified medical certificates, the Ministry took prompt enforcement action, revoking the clinic's licence and referring doctors for disciplinary action, demonstrating that existing regulatory frameworks are effective.
• The Ministry affirmed that standards and audits are in place, patient feedback channels exist, and it will consider measures like mystery shopping if needed, but sees no need to revise current guidelines specifically for telemedicine as existing rules already cover such services.
• While the Ministry continues to promote telehealth services, especially for seniors and those with mobility issues, it balances innovation with vigilance, enforcing standards to prevent abuse and maintain public trust.

Rahayu Mahzam, Minister of State for Health, addressed concerns about the Senior Mobility Fund (SMF) and noted that over 16,000 seniors have applied for assistance since 2019, with 99% eligible for subsidies. A correction clarified that this number refers to annual applications rather than cumulative. Seniors who do not meet eligibility requirements can seek additional support from the Agency for Integrated Care (AIC).