Health — Topics | PAPERCUTS

27 Feb 2023

Inclusion of Generic Emtricitabine and Tenofovir Disoproxil Fumarate in Standard Drugs List

Leong Mun Wai asked if a study has been conducted on including generic emtricitabine and tenofovir disoproxil fumarate in the Standard Drugs List for HIV pre- and post-exposure prophylaxis.
Ong Ye Kung noted that the Ministry of Health regularly reviews subsidy lists to ensure drug affordability, and 17 anti-retroviral drugs are currently subsidized for HIV treatment.
The government stated that emtricitabine and tenofovir disoproxil fumarate are available for treatment but not for pre-exposure prophylaxis in adults under current subsidy schemes.
Ong Ye Kung emphasized that pre- and post-exposure prophylaxis are supplementary HIV prevention methods that are not fully effective and do not protect against other STIs.
He warned that promoting these drugs might send the wrong signal, undermining recommended prevention methods like avoiding casual sex and using condoms correctly.

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27 Feb 2023

Cost Savings from Removing Reward Milestones in National Steps Challenge for Clocking Daily Cumulative Steps

Leong Mun Wai queried the estimated cost savings from removing reward milestones for 7,500 and 10,000 daily steps in the National Steps Challenge and how these savings compare to potential health costs from a more sedentary lifestyle.
Ong Ye Kung explained that the Health Promotion Board is expanding community physical activities, increasing weekly outreach from 31,000 to 47,000 participants.
Due to resource limits, HPB must lower maximum Healthpoints individuals can earn in the challenge, as participants at various step levels already develop active habits with minimal Healthpoint influence.

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27 Feb 2023

Dentists Specialising in Geriatric Dental Services in Public Healthcare System

Leong Mun Wai asked about the current number of dentists specializing in geriatric dental services in the public healthcare system and plans to improve accessibility and availability by 2030 due to Singapore's ageing population.
Ong Ye Kung stated that most geriatric dental needs are handled by general dentists at polyclinics, Community Health Assist Scheme clinics, and private dental clinics, with complex cases referred to specialists at national dental centres and hospital clinics.
There are currently 12 dentists with specialized training in geriatric dentistry and another five in training, with the dental school providing geriatric dentistry teaching in the undergraduate curriculum and a postgraduate training program.

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27 Feb 2023

Balance in MediSave Amounts Following Death of CPF Account Holders

Patrick Tay asked for statistics on the number of CPF account holders who died with different ranges of MediSave balances, but the Ministry only provided data for those aged 85 or older.
The Ministry highlighted that for those who die at an advanced age, most have relatively low MediSave balances, with only a small proportion having more than $10,000.
Tay suggested allowing greater MediSave use for chronic illnesses, rare diseases, and life-prolonging treatments, while the Ministry noted existing Flexi-MediSave enhancements and schemes for terminal illness.
The Ministry emphasized ongoing reviews to balance affordability and savings for future healthcare needs.

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24 Feb 2023

Data on Subsidised and Unsubsidised In-vitro Fertilisation Treatments

Louis Ng Kok Kwang asked the Ministry of Health for data on the number and percentage of women who used all co-funded IVF cycles without success and those who continued unsubsidised treatments over the last five years.
From 2017 to 2021, about 1% (200 out of 19,000) of women who attempted assisted reproduction treatment fully used all six co-funded cycles without a live birth.
Approximately 50% of those who used all co-funded cycles without success (about 100 women) continued with unsubsidised seventh cycles in public or private centres.
The Ministry tracks the number and percentage of individuals continuing IVF treatments unsubsidised, as evidenced by the provided figures.
The data highlights that the majority of women who used all co-funded cycles did achieve a successful live birth, with a small fraction proceeding to unsubsidised treatments.

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24 Feb 2023

Tracking of Children Contracting Hand, Foot and Mouth Disease

Louis Ng Kok Kwang questioned the Ministry of Health's policy of not tracking the number or frequency of Hand, Foot and Mouth Disease cases among children.
Ong Ye Kung explained that HFMD is not notifiable because it is a common, mild, and self-limiting childhood illness, so the Ministry does not track specific numbers.
The Ministry maintains a sentinel surveillance program using selected hospitals, polyclinics, and GP clinics to monitor trends in HFMD attendance, severe cases, and circulating pathogens.

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24 Feb 2023

Uploading of TraceTogether Device Data onto Ministry's Server

Leong Mun Wai questioned the Ministry of Health about the most recent upload of TraceTogether Bluetooth data from devices to the Ministry's server.
Ong Ye Kung responded that the Ministry stopped all such uploads on 26 April 2022.
The exchange highlights the timeline for when TraceTogether device data was no longer being actively transferred to the Ministry's servers.

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24 Feb 2023

Protocols and Fee Levels for COVID-19 Treatment Administered by Private Practitioners

The Ministry of Health explained that COVID-19 treatment is now managed under the standard healthcare framework, with fees for mild cases at polyclinics similar to other respiratory diseases (around $20-$35 for subsidised patients) and severe cases covered by the S+3M support scheme (subsidies, MediShield Life, MediSave, MediFund).
General practitioners can set their own fees for mild COVID-19 symptoms, but the government encourages public communication of costs and ensures financial assistance is available for those unable to pay, including for long COVID or ICU treatment.
To encourage timely medical attention, especially for the elderly, the government emphasises that the S+3M framework fully covers bills for financially needy patients, and no special COVID-19 protocols or subsidies are maintained as the disease is treated like other endemic illnesses.

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23 Feb 2023

Discontinuation of "It's OKAY to Reach Out" Campaign for Mental Health

Leon Perera questioned why the "It's OKAY to Reach Out" mental health campaign was discontinued in March 2022 and asked if the Health Ministry plans similar future initiatives.
Minister Ong Ye Kung clarified the campaign was not discontinued in March 2022 but continues with outreach via social media, online, and on-ground programs.
The Health Promotion Board also runs other mental health programs, including one for parents and the MindSG portal for mental health resources.

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23 Feb 2023

Revision to Cancer Drug List and Impact on Integrated Shield Plans' Coverage of Cancer Treatments

The Cancer Drug List (CDL) has expanded from 270 to 340 treatments, covering about 90% of HSA-approved drugs and 90-95% of patients in private and public institutions, with average drug price reductions of 30% since 2021.
Integrated Shield Plans will preserve coverage for non-CDL cancer treatments until 30 September 2023, after which most patients are expected to have completed such treatments, with others potentially shifting to CDL options or seeking alternative insurance or subsidised care.
The government continues to negotiate with drug suppliers to lower prices and expand the CDL, aiming to improve cost-effectiveness and reduce financial burdens on patients while ensuring ongoing support for those with extended treatment needs.

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23 Feb 2023

Increases in Starting Salaries for House Officers, Medical Officers and Junior Residents in Public Healthcare System

House Officers and first-year Medical Officers received 7% and 13% increases in starting salaries respectively from 1 January 2023.
The salary adjustments for eligible in-service Medical Officers, Residents, and Dental Officers depend on their years of service and bond period.
The different increments across junior doctor levels reflect market movement of salaries by seniority.
The Ministry of Health will continue reviewing salaries to keep them competitive in the public healthcare system.

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22 Feb 2023

Factors beyond Annual Value of Home in Assessing Medical Subsidies for Retirees

Christopher de Souza proposed that medical subsidies for retirees should consider more than just the annual value of their home, especially for those with landed property but little savings.
Ong Ye Kung explained that subsidies are means-tested using per capita household income and annual value, which together are the best available proxies for financial need, despite not being perfect.
He noted that disregarding annual value could lead to inequitable outcomes, such as wealthy retirees in high-value homes receiving higher subsidies than low-income families.
The government already provides additional non-means-tested support for seniors, such as higher subsidies at polyclinics and benefits for Pioneer and Merdeka Generation seniors.
Retirees who still struggle after subsidies can apply for discretionary assistance like MediFund, which considers a broader range of factors.

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22 Feb 2023

Emergency Response Cases Reported or Attended through myResponder App and Plans to Increase App Subscription

Between 2018 and 2022, Community First Responders attended 7,670 emergency cases via the myResponder app, with 4,525 being cardiac arrest cases and 3,145 minor fire incidents.
To increase app subscriptions and grow the pool of Community First Responders, SCDF is leveraging community events, resilience programmes, and training sessions to promote the app and emergency preparedness.
SCDF is expanding the availability of AEDs and fire extinguishers in the community, with targets to place AEDs within 250 metres in urban areas by end 2025 and install fire extinguishers at HDB lift lobbies.
The AED-on-Wheels Programme is being expanded, with new partners like SingPost joining to add more vehicles equipped with AEDs to the roving response network.
Calls made through the app’s 995 widget are received as standard emergency calls, with no distinction from the regular 995 hotline.

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22 Feb 2023

Debate on Annual Budget Statement

Nadia Ahmad Samdin supported the Budget while highlighting concerns about middle-class squeeze, social mobility, and mental health, proposing initiatives like a mental well-being credit scheme and better support for seniors, families, and youths.
Wan Rizal endorsed the Budget and suggested improvements for workers' well-being, including work-life balance for healthcare and education staff, expanding preschool education, and enhancing support for families with special needs.
Louis Ng focused on the challenges faced by nurses, recommending protected rest time between and during shifts, and increased ancillary support to reduce burnout and improve patient care.
Darryl David supported the Budget but raised concerns about wealth inequality, suggesting enhanced housing support for families and better encouragement for fathers' roles in parenting.
Joan Pereira emphasized community unity and crisis preparedness, advocating for more training in life-saving skills and stronger local networks to respond to future emergencies.

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14 Feb 2023

Raising Public Awareness on Nutri-Grade Labelling and Key-performance Indicators for its Success

The Ministry of Health is using the Nutri-Grade labelling system, launched in December 2022, to help consumers make informed beverage choices, with expectations that public familiarity and healthier decisions will increase over time.
Success is measured by tracking reductions in median sugar levels in beverages, increased consumer preference for lower-sugar and lower-saturated-fat drinks, and decreased overall sugar consumption from beverages, using data from market supplies, demand, and the National Nutrition Survey.
Implementation for freshly-prepared drinks, including industry guidance and onboarding, is scheduled to take effect by the end of 2023.

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14 Feb 2023

Development and Launch of mRNA-based Vaccines for Cancer in Singapore

The Singapore government is actively supporting the development of mRNA-based cancer vaccines through funding, research collaborations, and focus on diseases affecting local ethnic populations, with projects like EBV vaccines and personalized RNA treatments underway.
No mRNA-based cancer vaccines are yet approved globally, but Singapore is building capacity through the Singapore Translational Cancer Consortium to coordinate and integrate local cancer research efforts.
Singapore is positioning itself as a hub for clinical trials, including for mRNA cancer treatments, leveraging existing platforms to attract global biopharmaceutical partnerships and benefit local patients.

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14 Feb 2023

Empowering Community Disputes Resolution Tribunals to Require Medical Assessments of Claimants and Respondents

Dr. Tan Wu Meng asked whether Community Disputes Resolution Tribunals (CDRTs) can be empowered to require medical assessments for parties involved in disputes where a significant medical condition may cause harm.
The Senior Parliamentary Secretary explained that CDRTs currently use a multifaceted approach, including preliminary mental health assessments by court psychologists, referrals to specialists, and possible compliance bonds to ensure medical treatment.
An inter-agency committee is reviewing the dispute management framework to address neighbour disputes linked to mental health and to consider empowering CDRTs to issue Mandatory Treatment Orders.

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14 Feb 2023

Expected Cost Savings for Government from Pursuit of Healthier SG Initiative

Mr Yip Hon Weng asked the Minister for Health about expected healthcare budget savings from the Healthier SG initiative over the next five years.
The Senior Parliamentary Secretary replied that it is too early to provide a robust budgetary estimate as the initiative has just begun and the focus is on getting everyone on board.
Mr Yip then asked when the Ministry plans to move to the new healthcare financing model under Healthier SG, given its mid-year launch.
The Senior Parliamentary Secretary stated that the Ministry will address these issues as they arise and make appropriate announcements when ready.
The debate highlighted the government's cautious approach to budgeting for Healthier SG, emphasizing current focus on implementation and future announcements on financing changes.

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14 Feb 2023

Continuous Monitoring of Vital Signs of Babies Admitted to Neonatal Intensive Care Units at Hospitals

Ms Hany Soh asked about the number of hospitals in Singapore practicing continuous monitoring of vital signs for babies in neonatal intensive care units and whether others plan to review their monitoring procedures.
The Senior Minister of State for Health confirmed that all acute hospitals with neonatal services routinely perform continuous monitoring in NICUs and noted that several hospitals are enhancing monitoring for higher-risk infants not in NICUs.
Ms Hany Soh suggested that the Ministry of Health consider implementing a standard operating procedure for automatic parental support in neonatal care.
The Senior Minister of State acknowledged the suggestion and stated it would be considered.

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7 Feb 2023

Update on Improving Living Conditions in Migrant Worker Dormitories

The Ministry of Manpower has implemented new standards for dormitories approved from September 2021, including larger living spaces, in-room Wi-Fi, en-suite toilets, and enhanced public health features, with six Quick Build Dormitories currently meeting these requirements.
MOM is developing a transition plan to upgrade existing dormitories while considering infrastructure constraints and potential bed supply disruptions, and plans to build and own two new Purpose-Built Dormitories with enhanced standards and public health innovations.
MOM proactively monitors and supports dormitories through regular inspections by Forward Assurance and Support Teams and has introduced the Primary Care Plan to provide migrant workers with accessible and affordable primary healthcare services.

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