Health — Topics | PAPERCUTS

20 Oct 2022

Data on Registered Local and Foreign Doctors

Leong Mun Wai asked the Minister for Health for the total number of registered foreign doctors, their average annual increase since 2000, and a breakdown by nationality.
He also requested data on how many Singaporean and non-Singaporean doctors, graduated from local or foreign universities, were granted registration to practice in Singapore since 2000.
Ong Ye Kung responded that as of 31 December 2021, 15,423 doctors held active practising certificates, with 93.2% being Singapore Citizens or Permanent Residents and 63.4% locally trained.
Of the non-resident doctors, 6.9% were locally trained and 93.1% were foreign trained, with the majority coming from India, Malaysia, Myanmar, the Philippines, and the United Kingdom.

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20 Oct 2022

Prevalence of Self-harm amongst Elderly

MOH does not track the overall prevalence of elderly self-harm in Singapore, but cases seen at public acute hospitals have remained stable at around 10 annually over the last five years.
The government uses a multi-pronged approach that includes upstream prevention, proactive outreach, and crisis intervention, with initiatives like the Live Well, Age Well programme, Active Ageing Centres, and Community Outreach Teams.
Seniors can access support through various community services, including befrienders, mental health helplines, and referrals to intervention teams and family service centres, with efforts also made to make resources available both online and in person.

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20 Oct 2022

Preparing Singapore for Dementia

The debate highlighted Singapore's urgent need to prepare for a projected 65% increase in dementia cases by 2030, stressing the economic and caregiving burdens on families and society.
A government minister outlined a three-pronged strategy focusing on prevention, capacity-building for care services, and enhanced caregiver support, including community initiatives and dementia-friendly infrastructure.
The speaker proposed strengthening medical and community capacity, such as more memory clinics, trained specialists, and assisted living models, while urging faster dementia-friendly designs in public estates.
The government response confirmed measures like expanding dementia day care places, financial subsidies for caregiving, and collaboration with businesses to make Singapore more dementia-inclusive.
Both sides emphasized the importance of early detection, healthy lifestyles to reduce risk, and societal compassion to support persons with dementia and their caregivers.

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20 Oct 2022

Efficacy of Bivalent COVID-19 Vaccines Compared with Original Boosters

The Minister for Health confirmed that the bivalent Moderna/Spikevax vaccine has been available since 14 October 2022, with a Pfizer-BioNTech version expected by year-end, offering better protection against newer variants and prioritizing individuals aged 50 and above, with plans to extend to those aged 18-49 as supplies secure.
Residents who have recovered from COVID-19 are recommended to take the bivalent vaccine three months after infection, and those who have already received a second booster are advised to get the bivalent shot five months after their last dose, within a 5 to 12-month window, with simplified public communication planned to address confusion.
Individuals with multiple COVID-19 infections are still encouraged to take boosters, as hybrid immunity from vaccination and infection is beneficial, and the focus is on maintaining regular booster shots rather than counting past infections.

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5 Oct 2022

Targeted versus Medium-term Outcome Indicators of Healthier SG Programme

The debate focused on comparing current baseline data and future 10-year targets for key health indicators under the Healthier SG programme, with questions raised on metrics like obesity, diabetes control, and hospital admission rates.
Minister Ong Ye Kung provided 2019/20 data showing 10.5% obesity, 38% diabetes control, and 35.7% hypertension control, plus pre-COVID rates for avoidable emergency attendance (44.8%) and elderly fall-related admissions (44.6%), noting some indicators are under review.
MOH emphasized it is prioritising scheme design and rollout before setting definitive 10-year targets, which will be based on current baselines and disclosed publicly once established.

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5 Oct 2022

Targets for Resident and GP Enrollments and Health Screenings for Healthier SG Programme

Gerald Giam asked the Minister for Health for specific three-year targets on resident enrolment rates, GP clinic participation, chronic disease and cancer screening rates, diabetes screening compliance, and Health 365 app usage under the Healthier SG programme.
Ong Ye Kung responded that targets are being set to achieve short-, medium-, and long-term outcomes but emphasized the focus is on designing, rolling out, and stabilizing the programme first before disclosing performance indicators.
The Minister highlighted that Healthier SG is a dynamic, multi-year transformation effort requiring careful execution and monitoring before public KPI disclosure.
No specific numerical targets were provided in the response, as the current priority is on programme implementation rather than releasing fixed metrics.

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5 Oct 2022

Increasing Claim Limit of MediShield Life for Couples Experiencing Serious Pregnancy Complications

Leon Perera proposed increasing MediShield Life claim limits for couples facing serious pregnancy complications, noting the last review was in 2019.
Ong Ye Kung explained that current limits are tied to ICU and general ward daily rates, which were updated as of March 2021.
The Ministry of Health committed to regular reviews to ensure coverage remains adequate.

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5 Oct 2022

Streamlining and Enhancing Palliative Care Process across Healthcare Continuum

The Ministry of Health is working with providers to identify patients with palliative care needs early and enable care across home, hospice, and nursing home settings, while building capacity and capabilities in all these settings.
The Ministry collaborates with the Agency for Integrated Care, Singapore Hospice Council, and Health Promotion Board to raise awareness through the Advance Care Planning programme, caregiving resources, and public outreach.
MOH is reviewing hospital discharge processes to increase support and respite services for caregivers, making it easier for patients to be in their preferred environment.

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5 Oct 2022

Annual Leave Taken by Nurses in Restructured Hospitals in Past Five Years

Louis Ng Kok Kwang asked the Minister for Health for the mean and median annual leave days taken by nurses in restructured hospitals over the past five years, and if the data is unavailable, whether the Ministry would start collecting it.
Ong Ye Kung responded by providing a table showing the mean and median annual leave days taken by nurses from 2018 to 2021.
The debate focused on the need for data transparency regarding nurses' leave usage in restructured hospitals.

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5 Oct 2022

Assessing Sufficiency of Financial Support for Those Deemed Medically Unfit for Employment

Minister Masagos Zulkifli stated that MSF regularly reviews ComCare assistance schemes to ensure support adequacy, citing recent increases in ComCare Long-Term and Short-to-Medium-Term Assistance from August 2022.
He questioned why households with medically unfit individuals would have different expenditure needs compared to unemployed but medically fit households, noting that specific medical expenses are considered during SSO assessments.

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5 Oct 2022

Difference between Polyclinics and Private Family Doctors' Charges for Outpatient Consultations and Medications

Gerald Giam asked if patient costs at Healthier SG family doctors would match polyclinics without raising polyclinic fees to match them.
Ong Ye Kung clarified that drug prices for common chronic medications will be made more comparable through subsidies and price limits at participating GP clinics.
Full cost equality for all care components, like consultations and investigations, is not possible due to differing operating costs between polyclinics and GPs.
Polyclinic fee adjustments are based on actual cost changes, such as healthcare worker salaries, and not to artificially equalize charges.
The government aims to reduce cost differences through targeted subsidies rather than forcing identical pricing across settings.

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5 Oct 2022

Switching Outpatient Treatment from Polyclinics to Enrolled Private Family Doctors Given Healthier SG

Gerald Giam asked whether residents currently using polyclinics will be required to switch to private family doctors under Healthier SG.
Ong Ye Kung responded that Singaporeans can continue choosing where to seek care, including polyclinics or private GPs, after enrolling under Healthier SG.
The minister encouraged residents to return to their enrolled clinic for continuity of care but emphasized that the choice of care location remains flexible.

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5 Oct 2022

Impact of Healthier SG on MediSave Withdrawal Limits for Chronic Disease Management

Gerald Giam Yean Song asked if the annual MediSave withdrawal limits for chronic disease management would be completely lifted under Healthier SG.
Ong Ye Kung stated that the withdrawal limit remains relevant to ensure adequate healthcare savings through life.
He noted that in 2021, about nine in ten patients using MediSave for chronic disease management did not hit their annual limits.
The Ministry of Health will continue monitoring MediSave use and regularly review withdrawal limits.

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5 Oct 2022

Codes of Practice for Healthcare Institutions Offering Novel Therapies

The Ministry of Health and public healthcare institutions operate under regulatory frameworks and ethical guidelines that require novel therapies to be assessed for safety, efficacy, and ethics, with professional consensus and expert consultation sought when appropriate.
Unproven treatments not accepted as standard care must only be offered in strict research or trial contexts, following regulatory approvals, ethics committee reviews, and informed patient consent.
Patients in remission or with no evidence of disease after cancer treatment, including novel therapies, must undergo regular follow-up based on clinical guidelines to monitor for potential relapse.

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5 Oct 2022

Registered and Enrolled Nurses for Nurse-to-patient Ratios in General Wards and in Intensive Care Units

Louis Ng Kok Kwang asked for the current breakdown of registered and enrolled nurses in nurse-to-patient ratios for general wards and intensive care units.
Ong Ye Kung stated that general wards in public acute hospitals typically have one nurse for every four or five beds.
In intensive care units, the ratio is usually one nurse per patient, increasing to two nurses for more complex cases.
The average skills mix is about 80% registered nurses and 20% enrolled nurses, varying by hospital needs and patient acuity.

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5 Oct 2022

Building a Healthier SG

The Minister emphasized the need for an integrated healthcare system focusing on preventive care, with traditional Chinese medicine (TCM) playing a supportive role in lifestyle and preventive practices, while maintaining distinct regulatory frameworks from Western medicine.
Concerns about GP clinic crowding and drug price disparities were addressed, with plans to manage enrolment in phases and achieve drug price parity, especially for lower-income residents, through phased implementation and incentives.
The debate highlighted the importance of balancing key performance indicators (KPIs) with collaboration among healthcare stakeholders, avoiding punitive measures like clawbacks, and shifting towards value-based and capitation funding models.
Manpower challenges were acknowledged, with plans to expand local training and retain foreign healthcare workers through residency pathways, while also addressing workforce attrition and improving conditions for healthcare professionals.
The Minister outlined a three-system approach—acute care, public health, and aged care—to support ageing in communities, leveraging existing community assets and expanding eldercare centres to promote social connections and delay frailty.

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5 Oct 2022

Building a Healthier SG

The debate endorsed the Healthier SG White Paper, emphasizing preventive care, long-term patient-doctor relationships, and community partnerships to improve Singapore's health outcomes, with many MPs supporting the shift from treatment to prevention despite concerns about implementation.
Key discussions focused on funding models, particularly the move to capitation funding, with MPs urging safeguards to ensure quality and access, while the Ministry clarified that GPs would receive a base fee plus performance-based incentives to encourage preventive care.
MPs raised practical challenges such as GP capacity, IT systems for health records, inclusion of alternative medicine like TCM, mental health integration, and support for seniors and caregivers, with the Ministry outlining plans for phased rollout, IT grants, and community partnerships to address these issues.

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5 Oct 2022

Sharing of Counselling Information when Primary School Students Transition to Secondary School and Beyond

Mr Darryl David asked about the trend in mental health counselling referrals for Primary school students and how their support is managed during the transition to Secondary school and beyond.
The Minister of State for Education confirmed that the number of Primary school students referred for mental health issues has been stable over the past five years, with about 16 per 1,000 students requiring support in the last year.
Counselling support is extended to Secondary schools through coordination with parents, and with consent, sensitive information is shared on a need-to-know basis to ensure continuity of care.
Mr David further inquired about the sharing of such information beyond MOE, such as with MINDEF for National Service, and the Minister of State responded that inter-agency discussions are ongoing to ensure continuous care while respecting confidentiality and individual wishes.
The Ministry is engaged with the inter-agency task force on mental health to address the continuity of support across different stages of a student’s life.

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5 Oct 2022

High Incidence of Anxiety, Depression and Other Mental Disorders Among People Exposed to Second-hand Smoke

Louis Ng asked if the Ministry is aware of studies linking second-hand smoke to mental health disorders and whether it will review home policy, to which Dr Amy Khor responded that MOH and NEA continually enhance tobacco control efforts, including extending smoking bans in public areas.
Dr Khor noted that while evidence suggests an association between second-hand smoke and mental health conditions, it is inconclusive about direct causation, but she assured that the government remains concerned and is actively looking for practical solutions.
Louis Ng pressed for a threshold for policy change and asked if protecting people at home could be prioritized like in public areas, to which Dr Khor reiterated ongoing efforts and declined to commit to specific amendments based on future evidence.

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4 Oct 2022

Breakdown of Invoices Issued to Patients at Public Healthcare Institutions Since 2021

Dr Tan Wu Meng asked the Minister for Health for billing invoice data from public healthcare institutions since 2021, broken down for inpatients and outpatients and by time intervals from care episode to invoice issuance.
Ong Ye Kung responded that about seven million invoices were issued to public hospital patients in 2021, with 96% issued within 30 days and 98% within 90 days of care.
The response did not provide the specific breakdowns by inpatient/outpatient status or the full range of time intervals requested.

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