Health

• Foo Mee Har questioned the health risks of rising COVID-19 cases and whether new protocols or measures to protect vulnerable groups and healthcare capacity are needed.
• Ong Ye Kung reported that the recent COVID-19 wave peaked in early May 2024 and has been declining, with low hospital and ICU occupancy, allowing Singapore to manage without additional restrictions.
• MOH is focusing on endemic management like influenza, encouraging vaccinations especially for seniors, with 320 Healthier SG clinics and five vaccination centres available.
• Vaccination coverage is a concern, with about 60.5% of the population not receiving a COVID-19 vaccine in the last two years, potentially increasing severe infection risks.
• MOH plans to continue monitoring and protecting healthcare resilience through vaccination and existing measures rather than imposing new health controls.

• The Ministry states that Childhood Developmental Screening checks are voluntary but streamlined to coincide with vaccination appointments, and non-attendance does not automatically indicate neglect or abuse, as parents may have legitimate reasons like work commitments.
• ComLink+ family coaches and preschool outreach workers engage lower-income families to encourage attendance at both vaccinations and developmental screenings.
• Community partners, health institutions, and social service agencies are trained to watch for signs of neglect or abuse and refer cases to Child Protective Service if needed.
• Suspected cases can be reported by the public or partners via the National Anti-Violence and Sexual Harassment Helpline, with protocols in place for investigation when families cannot be contacted.

• For 2020-2022, over 70% of children aged two attended at least four of the five recommended Childhood Developmental Screening checks, while around 40-50% of children aged three attended at least five of the six recommended checks in subsidised primary care settings.
• Inclusion Coordinators and early childhood educators in preschools identify children with potential developmental needs for further assessment, and polyclinics opportunistically remind parents of CDS check importance.
• Parents are encouraged to use the child’s Health Booklet for developmental checklists and seek help if delays are noticed, with the system designed to ensure appropriate follow-up for children who may miss checks.

• Louis Ng asked whether the Ministry of Health will review the one-year ban on blood donations by ex-offenders after prison release.
• The Health Sciences Authority maintains the ban based on World Health Organisation guidelines to protect blood supply safety.
• The policy cites a higher prevalence of blood-borne infections among ex-offenders as justification for the deferral period.
• The current deferral period is aligned with practices in developed countries like Australia, Canada, and the United States.
• No immediate change to the policy was indicated, emphasizing the focus on blood safety standards.

• Ms Nadia Ahmad Samdin asked the Minister for Health how many people are expected to benefit from the Healthier SG Chronic Tier scheme and how many CHAS cardholders had yet to enrol in Healthier SG GP clinics as of February 2024.
• The Minister estimated that at steady state, about 300,000 residents—two-thirds of chronic enrollees from CHAS, Pioneer Generation, and Merdeka Generation—will benefit from the Chronic Tier scheme.
• As of end February 2024, 760,000 or 60% of CHAS cardholders aged 40 and above had not yet enrolled in Healthier SG.

• Dr Tan Wu Meng questioned whether insurers excluding pre-existing conditions when applying for new Integrated Shield Plans could lead to dominant market positions and whether panel doctor lists might be scrutinized under the Competition Act.
• The Ministry of Health, after consulting the Competition and Consumer Commission, found no evidence of collusion or abuse of dominance, as the market has seven insurers with no single player holding a dominant share.
• The real issue is that insurers avoid covering high-risk customers with pre-existing conditions due to higher claim probabilities, which is a social security concern rather than a competition problem.
• The government addresses this through subsidies, MediShield Life coverage for all regardless of pre-existing conditions, and MediFund as a safety net for those unable to afford care.
• Panel doctor arrangements are not anti-competitive, as they do not restrict price or product competition, and both doctors and patients retain choice in selecting providers.

• The Child and Maternal Health and Well-being Taskforce has rolled out 28 of 48 initiatives, with the remainder to be implemented over the next two years; evaluation of these initiatives will begin in 2025 based on effectiveness and participation rates.
• Family Nexus centres, which integrate health and social services for families, are being piloted in four locations with positive feedback; expansion to other regions will consider the density of young families and the outcomes of the pilots, with specific areas like Woodgrove division being considered for future rollout.
• Key initiatives address maternal mental health screening and support, childhood obesity, and balanced screen use, with evaluation methods including participant feedback and monitoring of health outcomes; guidelines for screen use are available and the government is considering more decisive measures.

Tan Wu Meng asked the Minister for Health about the evaluation of healthcare insurance policies regarding coverage for fertility preservation therapy for cancer patients. Ong Ye Kung responded that the Ministry does not assess private insurance coverage for such therapies, as they are optional and based on insurers' choices. MediShield Life does not cover fertility treatments, designed primarily for large hospital bills, but patients can use MediSave up to a limit of $15,000 for fertility treatments including egg freezing on medical grounds.

Tan Wu Meng asked the Minister for Health about the number of young cancer patients who received curative intent therapy affecting fertility and their fertility preservation choices over the past three years. Ong Ye Kung responded that the Ministry of Health does not have data on these young cancer patients or information regarding their fertility preservation therapy decisions and reasons for not undergoing it.

Louis Ng Kok Kwang questioned the Minister for Health about the number of mothers aged 19 and younger who had their pregnancies confirmed at polyclinics, public hospitals, and private hospitals over the last five years. Ong Ye Kung responded that the Ministry of Health does not track confirmed pregnancies but monitors teenagers seeking obstetric care, which decreased from about 600 in 2018 to 500 in 2022. He also noted a decline in the percentage of pregnancies managed at public health institutions, dropping from 71% to 62% during that period.

Melvin Yong Yik Chye asked about the measures in place to ensure optimal temperature storage for elective egg-freezing at medical institutions and the frequency of audits by the Ministry of Health. Ong Ye Kung responded that only licensed Assisted Reproduction Services providers offer elective egg-freezing and must adhere to regulatory requirements for egg storage. These providers implement a quality management system, ensure uninterrupted power supply, monitor temperature controls, and have protocols for addressing deviations. Inspections are conducted routinely every two years, along with additional targeted audits or unannounced inspections as necessary.

Leong Mun Wai raised questions about the proportion of full-time National Servicemen assigned to non-combat roles such as clerks and storemen since 2000, and whether these proportions have changed and are expected to change due to health issues in the population. Ng Eng Hen responded that since 2016, approximately 8% of National Servicemen have been deployed as clerks, 4% as storemen, and 3% in other non-combat roles, with these figures remaining stable over the past eight years. He noted an increase in the number of enlistees with mental or health issues, prompting the SAF to redesign its medical classification and vocational deployment systems to better accommodate servicemen with varying health conditions. The SAF aims to optimize contributions from all servicemen by leveraging technology and re-evaluating role requirements.

Leong Mun Wai questioned the rationale behind retroactive charging for upgrades to higher-class hospital wards when patients have not utilized the additional services prior to the upgrade. He also inquired whether such retroactive charges apply when patients downgrade to lower ward types. Ong Ye Kung stated that this issue was previously addressed in an oral response related to another question on the Order Paper for May 7, 2024, referencing the official report for more details.

Joan Pereira asked about the possibility of including kidney health tests in Project Silver Screen, the national screening programme for seniors. Ong Ye Kung responded that there is currently no cost-effective test for kidney disease suitable for population-level screening. He emphasized that existing medical evidence supports screening for kidney disease only among higher-risk patients, such as those with diabetes or hypertension, as part of the Healthier SG initiative.

Yip Hon Weng asked the Minister for Health about the possibility of mandating transparent fee schedules from health insurers to aid patients in making informed decisions for private healthcare. Ong Ye Kung explained that mandatory fee schedules are not applicable since fees depend on individual patient conditions and procedures, but noted that healthcare providers could publish agreed-upon fees with insurers. The Ministry of Health has created benchmarks for about 30 common conditions to guide reasonable fees and provides historical bill sizes on its website. Additionally, the Ministry monitors claims processing durations for private insurance and publishes this information online for public access.

He Ting Ru questioned the Minister for Home Affairs regarding the Attorney-General's position on the similarity between "apprehend" in the Mental Health (Care and Treatment) Act and "arrest" in other legal contexts, as well as the steps taken to protect the constitutional rights of those apprehended under the MHCTA. K Shanmugam explained that the High Court ruled that apprehensions under the MHCTA are distinct from arrests under the Criminal Procedure Code, impacting the Police's powers during such apprehensions. Amendments have been made to clarify that essential arrest powers, like search and seizure, apply during MHCTA apprehensions, while ensuring individuals are taken to medical practitioners rather than police lock-ups. The amendments aim to uphold constitutional rights for those apprehended under the MHCTA.

Yip Hon Weng raised concerns about strategies to retain locally trained doctors in the public healthcare system and ensure adequate staffing in essential medical specialties, while also addressing the need for more overseas specialists due to an ageing population. Ong Ye Kung responded that the public sector's mission and opportunities for learning have helped maintain a low attrition rate of 3% to 5%. The Ministry has a sufficient pipeline of specialists, but is increasing training for key specialties in response to the ageing population. Efforts are ongoing to expand local medical school intakes and attract Singaporeans trained abroad, alongside the appropriate integration of foreign doctors.

Zhulkarnain Abdul Rahim raised concerns about strategies to engage social media in combating vaping among youths in Singapore. Rahayu Mahzam noted that there is a global rise in youth vaping, which is often promoted through social media, but Singapore has banned e-vaporisers since the start to mitigate harm. The Ministry of Health is collaborating with social media platforms to enforce regulations, including the proactive removal of vaping-related content and engaging youth organizations to tailor anti-vaping campaigns. The Ministry also monitors illicit vaping sales online and is reviewing regulations to adapt to new digital marketing trends to enhance anti-vaping measures.

Nadia Ahmad Samdin raised concerns about ensuring clear communication from Cordlife to affected parents regarding potential ramifications of transferring cord blood units to other banks. Chua Kheng Wee Louis questioned the Ministry of Health's (MOH) plans for compensation for customers with damaged cord blood units and the criteria for such compensation. Saktiandi Supaat inquired about the MOH's regulatory actions regarding Cordlife and assistance for parents wanting to transfer their units. Dennis Tan Lip Fong asked about possible legislation to protect parents seeking refunds when services fail. Senior Minister of State Janil Puthucheary highlighted that the MOH's role is limited due to the contractual nature of services and outlined the ministry's regulatory actions and engagement with other cord blood banks regarding unit transfers.

• The prevalence of complete edentulism in Singapore is less than 3% overall and about 13% for those over 60, with rates remaining stable below 3% over the last two decades.
• Singapore's edentulism rate for those over 60 is significantly lower than the average of about 30% in many other countries, though specific comparisons to Asia and Western Europe were not detailed.
• The Ministry of Health monitors oral health trends and has implemented preventive measures, including Project Silver Screen since 2018, which provides functional oral health screening for residents aged 60 and above to facilitate timely intervention.