Health

Yeo Wan Ling inquired about the reasons for rejection of Home Protection Scheme (HPS) Insurance applications and the existence of an exclusion list for pre-existing medical conditions. Tan See Leng explained that approximately 1.3% of HPS applications were rejected in the past three years primarily due to serious pre-existing conditions, such as multiple conditions or cancer, but there is no specific exclusion list. The Government is currently reviewing ways to expand HPS coverage, considering policyholder affordability and the scheme's financial viability, with further details to be announced after completion of the review.

He Ting Ru raised concerns about the qualifications of individuals advertising psychological services in Singapore, specifically asking if the government has data on those who meet or do not meet the Singapore Register of Psychologists' standards and the qualifications commonly claimed by those who fail to meet these standards. Ong Ye Kung stated that the Ministry of Health restricts advertising of healthcare services to protect consumers and does not collect data on such advertisers. The Ministry is collaborating with various stakeholders to assess the need for better regulation of psychologists to ensure safe psychological practices in Singapore.

Assoc Prof Razwana Begum Abdul Rahim asked the Ministry of Education about data on the links between academic stress and attempted suicides in primary, secondary, and university students. Chan Chun Sing responded that this topic was previously addressed in a written answer on 6 August 2024.

Ong Hua Han raised questions about the trends, barriers, and outreach plans for caregivers of persons with disabilities seeking mental well-being assistance. Masagos Zulkifli acknowledged the heightened stress levels faced by caregivers and highlighted feedback from engagements under the Enabling Masterplan 2030 on the need for better awareness and access to resources. Caregivers can access the Enabling Guide and utilize support services from SG Enable and mental health helplines. SG Enable has piloted respite programs and peer support initiatives like CaringSG to help caregivers. The Ministry will continue to assess and improve support for caregivers as part of the ongoing Enabling Masterplan 2030.

Tan Wu Meng asked the Minister for Health about the potential for portable subsidy vouchers to help elderly and less mobile patients bridge the cost difference between polyclinics and private GP clinics, as well as measures to improve access to polyclinic care for seniors facing challenges with digital booking systems. Ong Ye Kung responded that government subsidies already help reduce costs for eligible patients, including seniors with additional support through CHAS. Polyclinics primarily operate on an appointment basis but allow for phone bookings and walk-ins, reserving slots for urgent or frail patients. Non-urgent cases might be directed to nearby CHAS GP clinics for treatment.

Mohd Fahmi Aliman asked if the Ministry of Health has reviewed the pricing structure at hospital canteens, especially those run by third-party vendors, and requested data on price differences compared to local dining. Ong Ye Kung responded that public hospitals select vendors based on affordability, food variety, quality, and health options, comparing vendor prices to local establishments to ensure competitiveness. Hospitals require vendors to seek approval for price changes and welcome feedback on any high-pricing concerns in public hospital food establishments.

• Ong Hua Han raised three questions about CPF members with pre-existing health conditions under the Home Protection Scheme, including the percentage affected, how exclusions are determined, and whether lower premiums are possible.
• Tan See Leng stated that only about 1.8% of HPS applications in the last three years had exclusions due to pre-existing conditions, and most members with such conditions are covered without exclusions.
• Exclusions are assessed based on the severity, prognosis, control of the medical condition, and the individual's health risk profile, aligning with industry practice.
• Standard premiums are applied even when exclusions are imposed, as the goal is to align claim likelihood with that of healthy members.

• Dr Syed Harun Alhabsyi asked for data on five-year trends and current waiting times for nursing home admission, stratified by general care, psychiatric care, and intellectual disability needs.
• The Minister for Health stated that median wait times for general care nursing home beds have been stable at about one month over the past five years.
• The median wait time for psychiatric care nursing home beds has been around two to four months over the same period.
• Service providers have generally been able to place clients into nursing home respite and night respite services upon request, with wait times not considered meaningful due to varying lead times in requests.

• Yip Hon Weng asked the Ministry of Health to consider launching an education campaign to help the public understand their actual insurance needs, given that many Integrated Shield Plan (IP) and rider holders still opt for subsidised public healthcare despite paying for higher coverage.
• He also proposed exploring means-testing mechanisms to encourage IP holders to use private healthcare options, which could ease pressure on subsidised healthcare services.
• Ong Ye Kung responded that the issues raised had already been addressed in a previous oral reply to Parliamentary Questions on 6 August 2024, directing reference to the relevant official report.

• Since 2019, nearly 2,450 clinics have been audited for fraudulent claims under CHAS, MediSave, MediShield Life, and COVID-19 schemes.
• The Ministry of Health revoked or suspended the accreditation of 11 clinics and suspended or terminated the CHAS participation of three more for serious non-compliance.
• Enforcement actions range from engagement and training to suspension and revocation, with egregious cases referred to police and professional councils for further investigation.

• Ms Hany Soh asked the Ministry of Health about local reports of "flesh-eating bacteria" and measures to prevent a local outbreak.
• Minister Ong Ye Kung explained that necrotising fasciitis is a rare but serious infection caused by bacteria found on skin or in water, with about 80 cases reported annually in Singapore and no clusters.
• The Minister advised avoiding raw or undercooked seafood, keeping wounds clean and covered, and seeking prompt medical treatment to minimize infection risk.

• Louis Ng Kok Kwang asked whether the Ministry of Health is investigating if the transportation of injured workers in private vehicles complies with the Healthcare Services Act 2020, and what the findings or future plans are.
• Ong Ye Kung responded that the need for an ambulance depends on the circumstances, but serious work injuries most likely require emergency ambulance conveyance.
• Investigations into the two fatal incidents at the worksites are ongoing, and the Ministry of Health will provide further details when ready.

• The Ministry of Home Affairs has updated healthcare measures in prisons to tackle the transmission of HIV, Hepatitis B, and Hepatitis C, with no known instances of inmates contracting these diseases while incarcerated.
• While there is a higher prevalence of these diseases among inmates compared to the general population, this is attributed to pre-incarceration factors rather than transmission within prison.
• The Ministry ensures that healthcare measures align with Ministry of Health standards and has provided a vaccination response regarding Hepatitis B in reply to a question in April 2020.

• Hany Soh questioned the recent take-up rate for breast cancer screening and suggested expanding the Health Promotion Board’s Screen for Life programme by easing eligibility for free or subsidised screenings.
• Ong Ye Kung reported that close to 40% of women aged 50 to 69 underwent breast cancer screening in the past two years, citing the 2022 National Population Health Survey.
• He noted that breast cancer screenings under the national subsidised programme increased by almost 50% in the first half of 2024 compared to two years earlier, attributing the rise to Healthier SG, which allows eligible enrollees to access free screenings.

• Assoc Prof Razwana Begum Abdul Rahim asked the Ministry of Education whether it collects data on causal links between academic stress and mental health issues like anxiety and depression among primary and secondary school students.
• Minister Chan Chun Sing explained that academic stress can be both beneficial for resilience and harmful if excessive, but mental health issues are usually compounded by multiple factors such as self-esteem and relationships, not just academic stress alone.
• The Ministry of Education, schools, and Institutes of Higher Learning will continue to collaborate with parents to strengthen students’ mental well-being and resilience, focusing on holistic development and supportive environments.

• Assoc Prof Jamus Jerome Lim asked the Minister for Health about the average waiting time for patients referred by medical social workers to medical service providers and whether the process is triaged for urgent cases.
• Ong Ye Kung clarified that medical social workers in public healthcare do not directly refer patients to doctors in polyclinics or public hospitals.
• Patients typically make direct appointments with polyclinics or are referred by family physicians to see specialists.

• The Ministry of Health Holdings employs junior doctors who were rotated among public healthcare institutions during the pandemic, with many being awarded the COVID-19 Resilience Medal, though some were not nominated due to not being in a single place of practice.
• Health authorities have worked to nominate additional healthcare workers, including junior doctors on rotation and medical officers who re-enlisted for National Service, for the medal.
• An updated list of awardees will be published in the latter half of 2024 to recognize those who contributed but were previously excluded.

• The Ministry of Health does not track data on the number of patients diagnosed with suicide ideation year by year from 2019 to 2023.
• A 2016 Singapore Mental Health Study estimated that 7.8% of the population has lifetime suicidal ideation, with higher prevalence among young adults aged 18–34 compared to those 50 and above.
• The top three mental health conditions associated with suicidal ideation are Bipolar Disorder, Generalized Anxiety Disorder, and Obsessive Compulsive Disorder.
• Other factors linked to suicidal ideation include being divorced or separated and having a physical illness, but the Ministry notes it is often not possible to attribute suicidal ideation to any single circumstance or condition.
• No specific data or discernible trends for children, youth, or seniors from 2019 to 2023 are available, as the Ministry does not track this information.

• Member Joan Pereira inquired about the Ministry for Transport's efforts to collaborate with Singapore Airlines (SIA) to support the mental well-being of staff and passengers affected by the SQ321 turbulence incident.
• Minister Chee Hong Tat confirmed that SIA is already providing medical assistance and counselling to affected staff and passengers from the incident.
• The debate highlighted ongoing measures by SIA to address the mental health needs of those impacted by the mid-air turbulence event.

• Louis Ng Kok Kwang asked for an update on efforts to raise participation in the PGS pilot and suggested lowering the current age criteria of 35.
• Ong Ye Kung reported that 605 patients have enrolled and 199 tested since February 2024, with the pilot continuing to recruit consenting patients.
• The Ministry is reviewing clinical outcomes and safety before deciding on mainstreaming PGS, and maintains that the age limit of 35 is clinically appropriate based on aneuploidy risk.