Health

• Dr Lim Wee Kiak raised concerns about barriers to early diagnosis of young-onset dementia, including fears about insurance coverage and job prospects, and asked how these can be addressed and public awareness enhanced.
• Minister Ong Ye Kung clarified that under Tripartite Guidelines, employers cannot ask about medical conditions unless job-related, and a dementia diagnosis does not affect MediShield Life but may impact new commercial insurance applications.
• The Minister suggested purchasing commercial insurance early before screening and highlighted efforts by the Agency for Integrated Care to raise awareness through media, events, and community support.

• The number of children aged six and below with developmental needs has risen from 5,300 in 2019 to 7,000 in 2023 due to better early screening.
• Annual enrolment in early intervention programmes like EIPIC increased from 3,600 in 2021 to 5,700 in 2023, a 58% rise over three years.
• In 2023, the average waiting time for EIPIC or EIPIC-P was 7.5 months, influenced by referral volume and sector capacity.
• To reduce waiting times, the Early Childhood Development Agency plans to add 1,500 new places in 2024, a 26% increase from 2023.
• Children are assessed by paediatricians and referred to suitable intervention programmes based on their level of support needs.

• He Ting Ru asked if the government has conducted studies on the quantifiable effects of dense urban living on physiological stress responses and to share findings.
• Desmond Lee confirmed a three-year study by URA, HDB, and A*STAR on the urban environment's impact on mental well-being.
• The study aims to inform future planning for a healthy living environment in Singapore.
• It builds on existing research, such as the benefits of greenery on mental well-being.
• Findings will be shared when the study is complete.

• Dr Wan Rizal asked about preventive strategies for youth mental health issues like social media use and body image concerns, and how schools are supported to implement them, as well as targeted measures for rising severe symptoms and equitable access for disadvantaged youths.
• Minister Ong Ye Kung outlined upstream efforts, including mental health education in school curricula, student development experiences, and peer support structures, aligned with the study's protective factors like resilience and social support.
• To ensure accessibility, Youth Community Outreach Teams and Youth Integrated Teams provide free mental health services to youths aged 12-25, with plans to expand to 15 teams by 2030 and extend services to all polyclinics and Healthier SG clinics.
• Future measures include a National Mental Health Helpline and Textline service in mid-2025 for psychological first aid, a Positive Use Guide on Technology and Social Media in early 2025, and studies on age assurance to protect youths from inappropriate online content.

• The Ministry of State for Health introduced the MediShield Life Scheme (Amendment) Bill to update the existing 2015 Act.
• The Bill was presented by Ms Rahayu Mahzam on behalf of the Minister for Health and received its First Reading in Parliament.
• It was scheduled for a Second Reading at the next available parliamentary sitting and ordered to be printed.

• Assoc Prof Razwana Begum Abdul Rahim asked about programmes and resources to identify and support children affected by adverse childhood experiences (ACEs), with the Minister of State outlining existing initiatives like IMH's FRIENDS and Resilience Programmes, KKH's Anchor Start and Project RESTORE, and community mental health services such as CREST-Youth and YITs.
• The Minister emphasized that healthcare professionals are trained to recognise signs of ACEs and make referrals, and highlighted the need for a whole-of-Government and whole-of-society approach to collaborate across ministries and touchpoints for early identification and support.
• Assoc Prof Razwana supplemented by inquiring about screening for ACEs in clinics and partnerships between schools and social services, with the Minister responding that upstream efforts involve training professionals and proliferating early identification across multiple sectors to build stronger families and support children.

Melvin Yong Yik Chye asked about the number of annual cases of health products with banned substances detected by the Health Sciences Authority (HSA) in the past three years. Ong Ye Kung responded that HSA has detected an average of 10 cases per year during this period. HSA regularly issues consumer advisories and press releases regarding adverse reactions from illegal health products and provides guidance on purchasing from reputable sources.

Jean See Jinli raised questions about the trend of hearing loss among different age groups over the past decade and measures to prevent avoidable hearing loss in Singaporean youth. Ong Ye Kung reported that self-reported hearing loss in adults aged 18-74 has risen from 1.3% in 2013 to 9.2% in 2023, especially among those aged 60 and above, likely due to increased awareness. Hearing screenings are conducted for Primary 1 and Secondary 2 students, with stable prevalence rates of 0.4% and 0.2% for hearing impairment, respectively. The government implements measures like newborn hearing screenings and protective equipment in noisy school settings while promoting awareness about noise exposure from lifestyle choices among youths.

Hany Soh queried the Minister for Health regarding the number of appeals made by patients to access their MediSave accounts beyond the annual limit over the past three years, along with the success rates of these appeals. Ong Ye Kung indicated that this question has already been addressed in a previous response provided on September 9, 2024, referencing the review of MediSave withdrawal limits due to rising healthcare costs.

Assoc Prof Jamus Jerome Lim inquired about the potential expansion of the Flexi-MediSave scheme for outpatient medical treatment for the elderly. Ong Ye Kung explained that Singaporeans aged 60 and above can currently use Flexi-MediSave for outpatient consultations and medications, covering both acute and chronic conditions. The scheme was expanded in 2023 to include home medical and nursing services, although fewer than three in 10 eligible users reached the annual limit of $300. The Ministry will continue to review the Flexi-MediSave scheme to ensure it meets the needs of Singaporeans.

Carrie Tan inquired about psychological safety training for senior management in social service agencies and support for mental well-being of social workers. Masagos Zulkifli B M M responded that the National Council of Social Service (NCSS) offers leadership training that includes staff motivation and creating supportive environments. He encouraged social service agencies to adopt good practices for psychological safety as recommended by the Tripartite Advisory on Mental Health and Well-being. Funding is available for agencies to enhance their people practices, and resources for managing mental well-being are accessible through NCSS's online Wellness Resource Hub and the Caring for Social Service Professionals Scheme, which subsidizes counseling services.

Ong Hua Han asked about the factors behind the decrease in suicide rates from 476 in 2022 to 322 in 2023 and the Ministry's measures to continue this trend. Ong Ye Kung referenced provisional data from the Report on Registration of Births and Deaths 2023, emphasizing a whole-of-society approach to tackle suicide. The Ministry has implemented public education campaigns, trained support personnel, built resilience among youth, and expanded community mental health services. A key focus is changing societal attitudes to normalize mental health conversations and reduce stigma in seeking help.

Neil Parekh Nimil Rajnikant asked the Minister for Health about efforts to reduce the gap between health-span and lifespan for Singaporeans, and the role of employers in improving health-span. Ong Ye Kung emphasized that reducing the current 10-year gap is a key healthcare objective, involving expanding healthcare capacity, leveraging technology, and promoting preventive care strategies. Employers are encouraged to retain older workers beyond retirement age, adopt healthy workplace practices, and support health initiatives, as highlighted in the Tripartite Statement released to enhance employee health and well-being.

He Ting Ru asked the Minister for Health about the enforcement actions related to unauthorized sales of GLP-1 agonist drugs over the past two years. Ong Ye Kung confirmed that 16 cases of unauthorized sales or illegal advertisements have been investigated since 2022, with ongoing investigations and no prosecutions yet. Additionally, 82 non-compliant listings of these drugs have been removed from e-commerce platforms. He emphasized the challenges of enforcing regulations on the Internet and advised consumers to avoid purchasing medicines from unverified online sources due to health risks.

Louis Ng Kok Kwang asked for an update on the potential extension of the ANGEL scheme, aimed at retaining nurses, to include administrative and support healthcare workers. Ong Ye Kung responded that there are currently no plans to extend the scheme beyond nurses, as it specifically targets their retention in the public healthcare sector. He explained that the needs and circumstances of different healthcare professions vary significantly, and the ANGEL scheme is essential for retaining nurses due to their large representation in the workforce. The Ministry of Health regularly reviews salaries for all public healthcare workers and continues to explore other measures to attract and retain talent.

Ong Hua Han questioned the Minister for Health about the rates of healthcare-associated infections (HAIs) over the past five years, the Ministry's actions to reduce them, targets for management, and the potential for periodic data reporting on HAIs. Ong Ye Kung provided specific statistics on HAI rates in acute public healthcare institutions for device-associated infections and multi-drug resistant organisms, noting varying rates from 2019 to 2023. The Ministry aims to minimize HAIs and has established a Technical Advisory Group to develop targeted actions for reducing Carbapenemase-producing Enterobacteriaceae infections over the next three years. The rise in certain infection rates is linked to global patterns and antibiotic usage in hospitals.

Tan Wu Meng questioned the need for trainees in certain medical specialties to pay an additional monthly training fee and whether this affects applications from less well-off junior doctors. Ong Ye Kung explained that postgraduate medical training is heavily subsidized by the Government, with a $450 monthly co-pay for residents in popular specialties to balance training costs and encourage diversification into less sought-after areas of specialization to meet healthcare needs.

Yip Hon Weng asked about the follow-up actions by the Ministry of Health concerning inappropriate practices by MaNaDr Clinic regarding teleconsultation services and medical certificates. Ong Ye Kung confirmed that investigations are ongoing against MaNaDr Clinic and its doctors. Enforcement actions will be taken if there are breaches of the Healthcare Services Act 2020, and any medical practitioners found in violation of the Singapore Medical Council's Ethical Code will face disciplinary actions. The Ministry will share further details once the investigations are completed.

• Mr Liang Eng Hwa questioned whether the Ministry of Manpower would review the age limit for foreign domestic workers (FDWs) to work in Singapore, currently set at 60 years old, and whether it would consider employer appeals for yearly extensions beyond this limit.
• The Ministry of Manpower explained that the age limit helps mitigate rising medical costs for employers, as these costs generally increase with age, which is a burden on households.
• The Ministry noted that on appeal, it may approve work permit renewals beyond the age limit, taking into account the MDW’s health, experience, and the employer’s household needs.

• Mr Melvin Yong Yik Chye asked about safeguards for workers dealing with birds to protect them from H5N1 avian flu.
• NParks contractors must wear protective equipment like gloves and masks, double-bag carcasses in biohazard bags, and practice hand hygiene and equipment disinfection.
• Animal rescue services have implemented vaccination policies for workers as an additional measure.
• There are currently no confirmed human or animal cases of avian influenza, including H5N1, in Singapore.