Gan Kim Yong
Singapore
“Consumer complaints relating to the secondary resale market for tickets to major events and concerts have generally remained low. Nonetheless, to protect the public from scams on secondary ticket resale platforms, the Police have imposed Code of Practice requirements under the Online Criminal Harms Act to require designated online service…”
“Singapore does not condone the use of forced labour. We criminalise forced labour in Singapore under various laws. Relevant Government Ministries and agencies, such as the Ministry of Manpower, Ministry of Home Affairs and Singapore Police Force, play their part in investigating complaints of suspected breaches in domestic laws that relat…”
“The Association of Banks in Singapore (ABS) discontinued the PayNow nickname feature as scammers had been exploiting the use of nicknames to impersonate legitimate entities and trusted individuals.”
“As of end-2025, around 6,900 private residential buildings have registered their solar installations with SP Group for the export of excess solar-generated electricity to the grid. The installed solar capacity of these residential buildings is 115.3 megawatt-peak (MWp), or around 5.5% of all current installed solar capacity in Singapore.”
“The one-year pilot extension of liquor trading hours has seen strong interest from businesses. As of 31 May 2026, the Police have approved 88 applications for the extension of liquor trading hours from public entertainment outlets in these areas.”
“The Government does not make projections of domestic or regional demand for renewable diesel or sustainable aviation fuel. Demand depends on commercial considerations, evolving market conditions and regulatory developments across different jurisdictions.”
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“Available evidence suggests that the rate of human-to-human transmission of this virus appears to be higher than that of SARS. For now, the evidence also suggests that transmission is mostly via droplets. What this means is that the virus is carried within droplets emitted from an infected person over a short distance, such as when the person coughs or sneezes. If these droplets come into contact with the eyes, nose or mouth of an individual, directly or indirectly through hands that have come into contact with these droplets, the individual may become infected. To clarify, there is no evidence currently to suggest that the virus is airborne. There are other viruses, such as chickenpox, which can easily be transported via air currents and do not require droplets to contact the eyes, nose or mouth. The novel coronavirus is not in this category of viruses. The novel coronavirus could also transmit through surface contact. Let me explain. When a person sneezes or coughs, the droplets fall onto the surfaces of tables and chairs, for example, and the virus may remain alive for up to a few days. When someone else touches the surfaces of these tables and chairs, the virus can be transferred to his hand and if he then rubs his eyes or nose without washing his hands, he may become infected. So, we should wash our hands. This is also why we only quarantine the close contacts of confirmed cases. For more transient contacts, such as individuals that the confirmed cases may have walked past in malls or hotels, the risk of transmission is low. For coronaviruses generally, the person is most infectious when he is displaying symptoms or what you call symptomatic, and this is likely to be the case for the novel coronavirus as well.”
“We anticipated that we would need a whole-of-Government effort to respond swiftly to this threat when it arrives in Singapore. We had to take precautions and coordinate plans across Government agencies to fight this. In fact, the following day, after we had set up the Taskforce, we saw the first local imported case. Wuhan and additional cities in Hubei were then locked down by the Chinese government. By this time, we had already issued travel advisories for Wuhan and extended our temperature screening at the airport to all incoming flights from China. The infection continued to spread at a rapid pace, reaching several foreign countries and all provinces of China by 29 January 2020. The latest WHO report showed that there were more than 14,000 reported cases in China and 304 deaths. Twenty-three countries have also reported a total of 146 confirmed cases and one death. The number is changing every day. Locally, we have 18 confirmed cases. Forty-three recently admitted suspect cases are pending test results while 240 suspect cases were tested and cleared. All of the confirmed cases are being treated in isolation rooms. Overall, the conditions of most of our confirmed cases are improving. To date, there is no evidence of local community transmission. However, we should not be complacent and we must be prepared for this scenario. Let me now share about what we know about this novel coronavirus. This virus comes from the family of coronavirus, which includes other viruses, such as the Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS), as well as the milder variants causing the common cold. The medical consensus at this moment is that the novel coronavirus is more transmissible but appears less deadly than SARS.”
“Beyond health, businesses would also have concerns as many have been affected by our prevention and containment measures. Let me take this opportunity to provide some background on the virus, give an update on the current situation and touch on the healthcare-related measures that we have put in place. Minister Lawrence Wong, my co-chair of the Taskforce, will provide more details on the efforts of the various Government agencies and how we are working together with all the stakeholders. As the situation unfolds, we will share as much information as possible and as soon as possible. While we cannot be complacent, I am confident we will overcome this challenge as we have in the past if we work together. We have been preparing for this, we are anticipating scenarios ahead, taking decisive actions as the situation evolves and we will do our best to keep Singapore and Singaporeans safe. First, let me start with an update. The situation in China and globally is still developing rapidly even as we speak and we still have very limited knowledge of the virus as scientists all over the world are racing against time to understand this virus better. The virus was first detected in Wuhan in December 2019, although it may well have existed earlier while remaining undetected. On 31 December, the WHO was first informed of a cluster of pneumonia cases of unknown cause detected in Wuhan. Soon after, on 2 January, the Ministry of Health (MOH) alerted our medical professionals and effected temperature screening for all flights arriving from Wuhan at our airport. The infection continued to spread in China. By 22 January 2020, over 500 confirmed cases were reported in China with a death toll of 17, when we decided to set up the Multi-Ministry Taskforce.”
“Mr Speaker and Members, many Members of this House and our fellow Singaporeans are concerned about the 2019 novel coronavirus. This virus has affected not only China but many countries worldwide and cases are still growing daily with no signs of abating yet. The Singapore Government has set up a Multi-Ministry Taskforce to coordinate the whole-of-Government efforts to combat this outbreak even before the first confirmed imported case occurred here. On 30 January, the World Health Organization (WHO) declared that the outbreak constituted a Public Health Emergency of International Concern, raising the global alert levels. We have, therefore, put in place pre-emptive measures to protect the public health. Some other countries have also done so. It is heartening to know that China is doing all they can to contain the spread of the virus, and we have witnessed their decisive actions to put in place strong measures, such as travel restrictions for their own residents, cancellation of outbound tour groups, and bringing back residents from overseas. We wish China well in their efforts to combat this virus and we have every confidence that China and other countries, including us here in Singapore, will work together and complement one another to win this battle internationally. It is not just a problem for China but for the world. We have to work together and collaborate with one another. For this reason, Singapore will be putting together an assistance package to help the communities in China severely affected by the novel coronavirus. More details about the package will be provided later. I can understand why Singaporeans are concerned as there are many unknowns about the virus: how it will develop and how long this will last.”
“Local training programmes are available for psychiatrists, psychologists and counsellors. Under the Ministry of Health's (MOH's) Health Manpower Development Plan (HMDP), over the past three years, an average of three overseas experts from a variety of professions visited local healthcare institutions to advise and teach aspects of mental healthcare each year. In addition, under HMDP, an average of 13 local mental health professionals were sent to overseas centres to study and learn different models of care delivery each year. A Skills Framework was established in January 2019 to guide the developmental pathways of psychologists, including clinical psychologists. This framework for psychologists is administered by the Ministry of Social and Family Development (MSF). MSF had also set up a Social Service SkillsFuture Tripartite Taskforce to drive, coordinate and implement tripartite collaborations for manpower development initiatives, including that for psychologists. Currently, there are about 2481 psychiatrists and 4732 psychologists in Singapore. This translates to 4.4 psychiatrists and 8.33 psychologists per 100,000 population. Within the public health sector, the number of psychiatrists and psychologist increased by 8% to 1824 and 7% to 171 respectively in the last three years. MOH does not have specific numbers of counsellors practising in Singapore as many healthcare professionals and social workers provide counselling as part of their work. Whilst there is no international consensus on the number or ratio of mental health professionals to population, the MOH will continue to monitor the numbers to ensure appropriate access and quality.”
“Over the last three years from 2016 to 2018, the average number of subsidised patients who received inpatient treatment for mental health conditions was about 6,900 per year, with an average length of stay of 21 days per admission. The average number of subsidised patients seen as outpatients for mental disorders was about 60,000 per year. MOH will continue to work with public hospitals and service providers in the community, including schools, social service agencies and family service centres, to provide holistic support for all persons with mental healthcare needs and to ensure timely access to quality care and support.”
“The five most common mental health conditions that were seen at public hospitals were schizophrenia, depression, anxiety, bipolar disorder and substance abuse. At the polyclinics, depression, anxiety and insomnia were the three most common mental health conditions. Schizophrenia and depression were also common mental health conditions receiving service from the community intervention teams funded under the Ministry of Health (MOH). For the whole public healthcare system, the average age of subsidised patients for the different mental health conditions seen was between 40 to 501. MOH does not track data on income nor time taken between onset of symptoms and treatment as the patient might have seen providers outside the public healthcare system. However, based on the Singapore Mental Health Study (2016)2, a self-reported survey, the median time taken between the onset of symptoms and seeking help is 11 years for Obsessive Compulsive Disorder, four years for bipolar disorder and alcohol abuse, two years for Generalised Anxiety Disorder and one year for Major Depressive Disorder. Stigma and lack of mental health literacy may be contributory factors to the delay. There are various initiatives by the Government, as well as healthcare and community providers to proactively reach out to raise awareness of mental conditions and provide information on avenues to seek help, facilitate early identification and access to interventions. We have community outreach teams to educate the public on mental health conditions and dementia and refer those with such conditions to the appropriate health and/or social services. We have also increased access to mental health and or dementia services in 12 polyclinics.”
“MOH will continue to work with public hospitals and service providers in the community, including schools, social service agencies and family service centres to ensure that we provide holistic and timely support for persons with mental healthcare needs.”
“In 2018, the average overall median waiting time for new subsidised appointments across the public hospitals was 27 days1 to see a psychiatrist, and 28 days2 to see a psychologist. However, anyone requiring urgent mental health assistance or who wishes to see a psychiatrist, may contact the Institute of Mental Health's (IMH's) 24-hour Mental Health Helpline3 or seek medical help at the 24-hour Emergency Services located at IMH. The Ministry of Health (MOH) does not have specific numbers of counsellors practising in Singapore as many healthcare professionals and social workers provide counselling as part of their work. For cases requiring community support, patients can be referred to Community Outreach Teams and Community Intervention Teams, and these cases are usually contacted within two weeks. There are around 2484 psychiatrists and 4735 psychologists practising in Singapore, which translates to 4.4 psychiatrists and 8.36 psychologists per 100,000 population. To reduce waiting time, the hospitals have implemented measures, such as reviewing work processes to optimise appointment slots and efficiency of clinical operations, for example, calling patients prior to their appointment, tightening the triaging of urgency of cases, tiering services to the appropriate level of care, and right-siting of non-emergency or more stable cases to primary and community-based care to enable specialist services to focus on more complex cases. As of March 2019, we have set up 41 community outreach teams and 21 allied health-led community intervention teams to provide mental health support in the community.”
“The "Community Blueprint to End HIV transmission in Singapore" has provided the community's perspective on the impact that the human immunodeficiency virus (HIV) has on patients and their families, and recommendations to ending HIV in Singapore. The Ministry of Health (MOH) shares the community's aim in supporting people living with HIV and ending HIV transmission in Singapore. Various initiatives are currently in place to support HIV prevention and control efforts. These include programmes to increase awareness of HIV and lower barriers to testing, improve linkages to care for persons who test positive, and increase the affordability of HIV treatment. MOH has been working with Action for AIDs to engage with the community stakeholders on the Blueprint and will continue to work with the community to strengthen the strategies to reduce HIV transmission, including measures to increase access to HIV testing and medication.”
“Appeals for additional MediSave withdrawal beyond these limits are assessed on a case-by-case basis, taking into consideration circumstances of the patient and his family, such as whether more complex treatment was required, as well as the family's social and financial situation. In some appeal cases, the patient may already have low MediSave balances, or expect recurrent treatment in future years, and additional MediSave withdrawals may not be the only or the best solution. To ensure that these patients have enough MediSave for their future needs, we may instead refer such cases to Medical Social Workers for other forms of support, such as MediFund. For cases that are likely to face more complicated and challenging social and financial issues, the Ministry of Health may work with other agencies, such as the Ministry of Social and Family Development and the Housing and Development Board, to coordinate support for these patients. In other cases, the patient may have sought unsubsidised care resulting in unexpectedly large bills. In such cases, we would encourage the patient to also work out alternative payment arrangements, such as payment through an instalment plan, instead of prematurely depleting their MediSave balances which would be needed in future. As it takes time to obtain information and assess a patient's financial and clinical circumstances, it generally takes around one month to process an appeal after we have received it. We will continue to review MediSave withdrawal limits and our healthcare financing schemes to ensure that they remain adequate and relevant. No Singaporean will be denied access to necessary and appropriate healthcare because of an inability to pay.”
“Based on data1 from the National Trauma Registry, between 2012 and 2018, the number of children aged nine years and below2 who were treated in public hospitals for traumatic injury due to a motor vehicular accident ranged between 106 and 225 cases per year as shown in Tables 1 and 2 below. We are not able to ascertain from the Registry's data whether children injured in motor vehicular accidents were a direct result of them not being secured in child car seats and/or seatbelts. Among those treated in public hospitals, more than half were known to have used car seats and/or restraints, while the status of the remainder is unknown. Motorists and their passengers should use appropriate restraints at all times while riding in motor vehicles.”
“Third, on accessibility, we have set up clinical eye care services in the community, particularly for seniors who may be less mobile. For example, MOH has worked with the public healthcare institutions (PHIs) to establish mobile eye services in the community, which provide in-depth visual testing to detect a wide range of eye conditions, including cataract. The PHIs have also established six Community Eye Clinics (CECs) island-wide since June 2018, to provide prompt eye assessment and treatment for persons with stable eye conditions that do not require complex care by specialists. Specific to cataract management, optometrists and doctors at the CECs would also provide advice on monitoring symptoms, good eye health habits and appropriate follow-ups. The above measures enable earlier detection and appropriate management of cataract and other vision disorders, so that our seniors can maintain their quality of life as far as possible.”
“Cataract is one of the leading causes of blindness commonly associated with ageing. The risk of developing cataracts is higher if one regularly smokes or drinks alcohol or has chronic diseases, such as diabetes. The Ministry of Health (MOH) has efforts in place to promote general eye care amongst seniors. First, in prevention, the Health Promotion Board conducts regular health talks in the community to equip seniors with bite-sized information to improve their physical, mental and functional health. Maintaining good eye health is one of the key topics, and seniors are taught the importance of good vision, early detection and management of common eye conditions, such as cataract and glaucoma, as well as simple eye care tips. Seniors can also obtain information on eye care and nutrition via the HealthHub website or app. Second, on early detection, we encourage our seniors to attend regular health screenings. In 2018, MOH partnered Temasek Foundation to roll out Project Silver Screen (PSS), a nationwide functional screening programme for seniors to check their vision, hearing and oral health. As part of the screening, seniors are advised on good eye care practices, and those with abnormal vision screening results are referred to an optometrist or eye specialist for further assessment. Since January 2018, more than 61,000 seniors have benefited from PSS, with about 20% referred for follow-up eye care services. In addition, patients with diabetes, who are at higher risk of developing eye disorders, including cataract, are recommended to undergo regular eye screening as part of their routine care in polyclinics and Primary Care Network general practitioner clinics.”
“Community case management services coordinate services required by seniors who have weak social support or complex social-health needs. The Social Service Offices work closely with community partners to provide financial support to needy seniors. Community outreach teams provide seniors at risk of dementia or depression with basic emotional support and coping strategies, including where to seek help if needed. Family Service Centres also provide counselling and support services to families with seniors to help them with relationship problems, as well as financial and emotional difficulties. Seniors with care needs, and who have no or little family support, are also supported by Senior Group Homes, Sheltered Homes and Nursing Homes, which provide residential and socio-emotional support. We do not track the number of lonely elderly deaths where bodies are undetected for extended periods of time. Building communities of care is a whole-of-society effort. The efforts outlined above aim to enable our elderly to live well and leave well in the community. The Ministry of Health will continue to work with our community partners, Government agencies and fellow Singaporeans to support our seniors.”
“The Government works with community partners on multi-pronged interventions to support our seniors, especially those living alone and with low income, to age well in the community. First, we reach out to seniors proactively to check on their well-being. As part of regular home visits, Silver Generation Ambassadors (SG Ambassadors) assess seniors' health and social needs and inform them of the various Government policies and schemes to support them. The SG Ambassadors also encourage well seniors to take part in active ageing programmes, and refer frail seniors to relevant agencies for their care needs. The Silver Generation Office's engagements complement the efforts of Senior Activity Centres that reach out to seniors in the community, particularly those in the lower-income group. Second, programmes are in place to support seniors' needs, especially for seniors who live alone or are low-income. A key focus area is befriending. The network of SG Ambassadors, grassroots leaders and social service agencies connects seniors at risk of social isolation to community befrienders. The befrienders visit seniors at least twice a month, supplemented with phone calls. Seniors may also be referred to CareLine, a 24/7 hotline that provides tele-befriending services as well as emergency response to seniors in distress, which is especially helpful for those living alone. There are also various community-led initiatives which complement formal befriending services, such as the Neighbour Cares programme in Jurong East. Under this pilot, resident volunteers keep a lookout for any visible signs of distress from vulnerable seniors in neighbouring units. Third, seniors with complex needs will receive more intensive follow-up.”
“Since the introduction of the Community Health Assist Scheme (CHAS) in 2012, the number of clinics participating in CHAS has more than doubled. In 2018, there were over 1,000 CHAS general practitioner (GP) clinics and 700 CHAS dental clinics island-wide. About 90% of cardholders would also have access to at least one CHAS GP clinic within 400 metres of their homes. To participate in CHAS, clinics must complete an e-learning module to familiarise themselves with the scheme. GP clinics must also be accredited for MediSave so that they can make MediSave claims for patients. We have streamlined the processes involved in enrolling in CHAS as well as allowed clinics to register for and complete their e-learning modules while their application for accreditation is being processed. CHAS is a voluntary scheme, and clinics may choose not to participate in CHAS for a variety of reasons. Nevertheless, we will continue to encourage GP clinics to participate in CHAS and help play a bigger role in providing affordable primary care to Singaporeans. We will also continually review how our processes can be streamlined, so that it is easy for them to do so. Clinics with specific suggestions may write in or call the Agency for Integrated Care to provide their feedback.”
“Each year, about 1.2 million Singaporeans make withdrawals from MediSave for various medical expenses. The Central Provident Fund (CPF) Board receives between 500 to 600 appeals from Singaporeans each year to use their MediSave beyond withdrawal limits for inpatient and outpatient treatments. The quantum of withdrawal appealed for varies, depending on various factors, such as whether there are complications in treatment, or whether non-standard drugs and treatments are needed. There were about four to five MediSave appeals over the last three years for rare diseases, which affect fewer than one in 2,000 patients.”
“AIC has supported and referred over 2,900 persons for health and/or social services as of March 2019, of which some were involved in neighbour disputes. Such cases are generally challenging to address as the causes are usually multifaceted and complex and require multi-stakeholder support and involvement. Nonetheless, there have been cases where persons involved in disputes and suspected to have mental health conditions were successfully supported through multi-agency efforts among AIC, community mental health partners and healthcare institutions and other agencies, such as the Singapore Police Force, Housing and Development Board and grassroots organisations. The Government cannot address such issues, which are usually not just medical in nature but may also involve social issues, alone. Time and a whole of community effort is often required to address such issues for a more caring and inclusive society.”
“The Ministry of Health has worked with the Agency for Integrated Care (AIC) to develop services to support persons with mental health conditions under the Community Mental Health Masterplan. For example, AIC acts as a "first touchpoint" for agencies, service providers and members of the public to refer persons suspected to have mental health condition(s) for further support. AIC, with the support of relevant stakeholders, could refer such persons to the appropriate medical and social services. In addition, AIC works with community service providers to set up community outreach teams and community intervention teams. The community outreach teams educate residents on mental health conditions and support persons with mental health conditions by providing basic emotional support, follow-up and service linkage to health and social services. As of March 2019, we have 41 community outreach teams which have reached out to over 234,000 people. The community intervention teams provide allied-health services, such as performing mental health needs assessment and psychosocial therapeutic intervention, for persons with mental health conditions. Twenty-one community intervention teams have been developed and deployed as of March 2019. Persons with mental health conditions will benefit from having strong family and social support from an inclusive community, besides receiving mental health treatments. For neighbour disputes, the Community Mediation Centre and Community Disputes Resolution Tribunals are platforms where various stakeholders can be engaged to find a resolution. If suspected mental health conditions are highlighted at these platforms, the persons could be referred to AIC for further support.”
“Adults with intellectual disability and/or ASD can also be referred to the Adult Neurodevelopmental Service at IMH, which carries out assessment and treatment of behavioural issues or co-existing mental health conditions in these individuals. The Ministry of Health will continue to work with our healthcare providers and partners to ensure that every individual has access to quality mental health care, including for those who are differently-abled, and to ensure that care and support are tailored to the unique needs of this group.”
“Persons with different abilities are handled by various groups of healthcare professionals in the public healthcare system. Efforts have been made to facilitate early detection and referral for management of mental health conditions for all individuals in Singapore, including for persons with special needs, who may have higher rates of co-occurring mental health conditions than the general population. For example, general practitioners are trained to diagnose and manage stable mental health conditions while psychiatrists and psychologists manage conditions that require more specialised management. Community outreach teams also reach out to individuals who are at risk of, and diagnosed with, mental health conditions, to provide support for these individuals in the community. More specific help is available to individuals with different sensory needs. For example, students with hearing impairments are assisted by school psychologists in their respective special schools to support their mental health needs. Children with developmental and intellectual disabilities, including those with Autism Spectrum Disorder (ASD), can access services by the Child Development Programme, where a multidisciplinary team of healthcare professionals provide a holistic approach of assessment, diagnosis and interim therapy, including attending to behavioural and mental health needs. The Institute of Mental Health (IMH) has also set up a Child Guidance Clinic to provide professional services for children aged six to 18 with developmental delay and/or intellectual disability with co-morbid mental health conditions.”
“Recognising how our living environment can influence behaviours, our infrastructure agencies, such as the Ministry of National Development, the Ministry of Transport and others, have strived to build a city that encourages active lifestyles and mobility. This includes more than 350 parks and gardens, 200 kilometres (km) of covered linkways, and 440 km of cycling paths and park connectors. And there are plans to further enhance the living environment to support a more physically active citizenry. All these efforts have led to encouraging results as 80.9% of Singaporeans had sufficient total physical activity in 2017, up from 73.1% in 2013. Reducing obesity in our population requires coordinated and continuous efforts from all relevant stakeholders. In the long term, such efforts may also lead to a reduction in the prevalence of chronic diseases like diabetes and hypertension and their accompanying complications. MOH will continue to monitor the trends in obesity, physical activity and nutritional habits of Singaporeans, and work with the other Government agencies and the wider society to tackle this issue.”
“These efforts are complemented by health education outreach in schools in partnership with stakeholders, such as South-West Community Development Council, Sengkang General Hospital and the National Youth Achievement Award Council, and at workplaces where HPB works with industry partners to roll out relevant workplace health promotion programmes, such as workshops and health coaching. These programmes have contributed to better diets. From the National Nutrition Survey 2018, Singaporeans are consuming fewer calories, better-quality carbohydrates consisting more wholegrain, fruits and vegetables, as well as substituting saturated fat with unsaturated fat. However, our sugar intake remains high at 60 grammes per person per day. As such, we will be introducing new regulatory measures for pre-packaged sugar-sweetened beverages (SSBs), namely, nutrition labelling and advertising prohibitions for less healthy SSBs. To encourage exercise, HPB, SportSG, and People's Association offer a wide range of physical activity programmes and sport facilities island-wide. MOE also makes facilities and sports equipment available beyond the formal curriculum time to encourage better utilisation. There are targeted programmes, such as those that cater to at-risk professionals, managers, executives and technicians at the workplace to increase the adoption of a more active lifestyle. For seniors, Active Ageing Programmes are also made available at over 600 locations island-wide where the elderly can participate in group exercises and health workshops.”
“Based on the 2017 National Population Health Survey, the prevalence of obesity1 among adult Singaporeans aged 18 to 59 was 8.9%, and that among seniors aged 60 to 74 was 6.9%. This has remained stable since 2013. The proportion of overweight2 children in our mainstream schools, aged six to 18, has increased from 11% in 2013 to 13% in 20173. The Ministry of Health (MOH) and the Health Promotion Board (HPB) work with other Government agencies to combat obesity through the promotion of physical activity and better diets, such as eating more healthily and reducing daily sugar consumption. This is also in line with our overall strategy in Singapore's War on Diabetes. To promote healthier diets, HPB has introduced programmes, such as the Healthier Choice Symbol and the Healthier Dining Programme, to increase the availability of healthier options, as well as campaigns, such as the Eat, Drink, Shop Healthy Challenge, to incentivise healthier purchases. To further create a healthy food environment, the Housing and Development Board and HPB collaborated to include the provision of healthy meals as a consideration in Price-Quality tenders for new eating houses, awarding more points for tenderers that offer healthy meal options. In partnership with the Ministry of Education (MOE) and the Early Childhood Development Agency, HPB has also implemented healthy meals programmes4 in all mainstream schools and eight in 10 preschools, to inculcate healthy eating habits from young.”
“Regulations on the marketing of unhealthy products apply to both digital and non-digital media domains. For example, advertising and promotion of tobacco products, such as e-cigarettes, are prohibited, including through online platforms. On unhealthy food, marketing to children has been regulated via the Singapore Code of Advertising Practice, with additional Guidelines for Food Advertising to Children. In addition, the Ministry of Health announced in October 2019 that we will be introducing a product grading system for pre-packaged sugar-sweetened beverages and will prohibit product advertisements for the least healthy ones on all local mass media platforms, including online channels. We will look into how we can monitor digital marketing more closely. We also agree with Prof Lim Sun Sun's suggestion to educate young consumers about marketing of unhealthy products, together with like-minded partners.”
“The review will take into account learnings from the implementation of our existing mental health plans, such as recruiting more mental health service providers and addressing mental health stigma to improve awareness of mental well-being and strengthen access to mental health support.”
“These are neighbourhoods which are equipped to better support persons with dementia and their caregivers to continue living well at home, where residents, grassroots leaders, businesses and the community are trained to recognise dementia signs and symptoms. We are on track to expand the number of DFCs to 15 by 2021. In addition, MOH has more than tripled the number of Dementia Day Care places since 2015. These Day Care Centres can serve up to 3,400 persons with dementia each day. Working caregivers, in particular, can have peace of mind, knowing that their loved ones are well-cared for in the day. MOH has also increased dementia capability and capacity in the acute hospitals. We have piloted new specific inpatient dementia services in three acute hospitals, namely, Khoo Teck Puat Hospital, Changi General Hospital and the Institute of Mental Health; and two community hospitals, namely, St Luke's Hospital and Saint Andrew's Community Hospital; to cater to patients of varying severity. We are now working to expand such inpatient dementia services to more hospitals to strengthen hospitals' capabilities in inpatient dementia care. Since 2012, we have also grown outpatient Memory Clinic capacity in our acute hospitals to ensure that persons with dementia have access to early outpatient assessment, detection, multidisciplinary intervention and caregiver support. For long-term care, new nursing homes developed by MOH are designed with dementia-friendly features to cater to the needs of persons with dementia. We are currently adopting a whole-of-Government approach to review the overall strategy on mental health together with other Ministries and stakeholders, and will also consider consultation with relevant stakeholders.”
“In 2007, the Ministry of Health (MOH) implemented the National Mental Health Blueprint to improve early detection and treatment for persons with mental health conditions. Subsequently, the Community Mental Health (CMH) Masterplan was launched in 2012 to place more focus on mental health care in the community for persons to receive care closer to home. Through these plans, MOH has increased accessibility and capacity of mental health services in the healthcare institutions and community, facilitated early identification and access to interventions. For example, the Agency for Integrated Care has worked with community service providers to set up 41 community outreach teams to educate the public on mental health conditions and dementia and refer those with such conditions to the appropriate health and/or social services. We have also increased access to mental health and/or dementia services in 12 polyclinics. According to the Well-being of the Singapore Elderly study 2013, one in 10 seniors aged 60 and above is estimated to have dementia. We recognise that there are differences in the needs of persons with mental health conditions, such as depression and anxiety, and those with dementia. However, the broad approach is similar, that is, to increase access to appropriate care, through early identification, build capabilities and capacity in the community to identify and treat such conditions. With this approach, we have strengthened dementia services in the community. For example, we have established eight Dementia-Friendly Communities (DFCs) to create an inclusive society for persons with dementia and their caregivers.”
“The capacity of long-term care services as at June 2019 was approximately 15,800 nursing home beds, 7,100 day care places, 9,500 home care places, and 6,100 home palliative care places. The utilisation rates were about 85%, 52%, 54% and 45% respectively. These included all subsidised clients and private clients who were reported by providers. The utilisation rates across the services show that there is sufficient long-term care capacity nationally. We have expanded capacity over the years to ensure that the care needs of an ageing population across different settings are met. We monitor capacity and take-up rate regularly and adjust our development plan accordingly to respond to changing care needs.”
“The Ministry of Health (MOH) works with public hospitals to ensure the welfare of patients and staff during periods of haze or heat. They may deploy portable air purifiers and coolers in wards where needed. Newer hospitals, such as Ng Teng Fong General Hospital, Jurong Community Hospital and Sengkang General and Community Hospitals, also have built in air filtration systems to supply filtered air to naturally ventilated wards. While MOH does not stipulate temperature and humidity thresholds at public hospitals or eldercare facilities, newer institutions are designed to ensure adequate air flow through the naturally ventilated areas. Older hospitals have progressively implemented mitigating measures, such as spot-cooling, to lower the ambient temperatures when they are remodelled or renovated. Drinking water is readily available within the institutions for staff and patients or clients, including the elderly, to stay hydrated. On heat stroke and heat exhaustion, there are approximately 100 hospital admissions annually over the past five years.”
“The dementia care village at the Gibraltar Crescent site is intended to be a pilot to experiment with new community and housing models for seniors with dementia to age in place, supported by a model of care that is less medicalised and promotes independence and autonomy. In land scarce Singapore, suitable sites to test such pilots are not always readily available. The Gibraltar site was shortlisted by agencies as a suitable site as it allows a home-like environment that offers opportunities to innovate care for seniors with dementia. The learnings from the pilot could then be applied to existing as well as future facilities to improve dementia care for our seniors. State-owned bungalows have been retained to preserve the heritage of the area and are leased for a variety of uses, including social use. The use of bungalows at the Gibraltar site for dementia care is in line with this approach. Retrofitting is allowed based on guidelines of Additions and Alterations, and prospective tenderers will bear the cost of retrofits and take that into account in bidding for the site.”
“MOH started a three-year pilot on Pre-Implantation Genetic Screening (PGS) in 2017, to test for chromosomal abnormalities in pre-implanted embryos created through in vitro fertilisation (IVF). Under this pilot, women who are 35 years and above, or any woman with two or more recurrent implantation failures, or two or more pregnancy losses were recruited. Thus far, 298 patients have been enrolled under the pilot study. The pilot is scheduled to end in December 2019. MOH will evaluate the clinical outcomes from the pilot in consultation with experts before deciding if PGS should be a routine clinical service. The pilot study outcomes include comparing the embryo implantation success rates, pregnancy rates and live birth rates between women on IVF programmes who had received PGS with those who had not received any PGS. The review will take into consideration the available international evidence concerning PGS testing, the ethical challenges associated with PGS and the regulatory framework that needs to be established for governing PGS.”
“The Ministry of Health (MOH) also tracks generic versus branded drug utilisation patterns in our public healthcare institutions to encourage the use of generics where appropriate. In addition, MOH regularly reviews the drugs we subsidise in the public healthcare sector to add those assessed to be clinically effective and cost-effective. Over the last three years, about 40 additional drugs were listed for subsidy. Where they apply, MediSave and MediShield Life also help patients pay for their drug bill. For those who are unable to afford, there is MediFund and the Medication Assistance Fund that can be tapped on to help the patient pay for their drugs.”
“Changes in the pricing of medications depend on several factors, such as whether they are patent protected, whether there are comparable alternatives, as well as the cost of development, production and distribution. Between countries, the prices of drugs may also differ significantly as suppliers take into account differences in market size, ability to pay, supply chain structure, competition and currency differences. We are taking various steps to manage drug costs. First, we are aggregating drug demand and integrating supply chain management across the public healthcare sector through the Agency for Logistics Procurement and Supply (ALPS) to achieve better economies of scale and create greater negotiating leverage. ALPS is consolidating functions, such as purchasing, storage, packaging and dispensing, so as to lower the cost of managing our drug supply chain. ALPS will also progressively streamline their system and deploy technology to improve supply chain efficiencies. Second, we are adopting value-based pricing approaches for drug purchases, especially for patented drugs. The Agency for Care Effectiveness (ACE) performs health technology assessment to evaluate the benefits of a drug. It then negotiates drug prices to levels commensurate with the benefits. Third, we are making efforts to ensure the appropriate use of drugs. We encourage doctors to recommend or prescribe drugs where there is evidence that it is effective for the patients’ specific conditions, and to avoid prescribing drugs where benefits are unproven or unclear. Where a less costly generic alternative is just as effective, we encourage the use of the generic version. ACE publishes guidances to help doctors keep abreast of the latest clinical evidence.”
“While the Ministry does not specifically track over-prescription of medication, there are measures in place to minimise excessive provision of medication. Depending on a patient's condition, doctors generally prescribe a supply of medication till the patient’s next appointment date. The supply of medication is normally set at no more than three months for normal medication and no more than six months for more stable chronic illnesses. For newly prescribed medications, public healthcare institutions encourage patients to collect a shorter duration of medication to prevent wastage, as the medication may be unsuitable. Public healthcare hospitals also carry out medication reconciliation prior to a patient's discharge. This is a process of creating a consolidated list of all medications a patient is taking and reconciling them where appropriate. It helps to reduce potential adverse effects arising from medication interactions and reduce unnecessary drugs. Dispensing pharmacists also review the patient's medication to eliminate unnecessary or excessive supply of medication. Beyond the public healthcare institutions, the Pharmaceutical Society of Singapore also holds regular public education events to encourage patients not to over collect medications.”
“Mental health therapy and counselling treatment are typically provided in the outpatient setting. Subsidies are available for patients receiving these treatments in public healthcare institutions. Under the Chronic Disease Management Programme, patients with mental health conditions, such as schizophrenia, major depression, bipolar disorder and anxiety, can also withdraw up to $500 from MediSave per year to defray the cost of these outpatient treatments. In addition, patients aged 60 and above may withdraw another $200 per year under the Flexi-MediSave scheme. Where a patient's mental health condition leads to an inpatient stay in a public hospital, he or she can receive subsidies and MediShield Life coverage for his or her hospitalisation bill. MediSave can also be used to cover the inpatient stay. Singaporeans who face difficulties with their medical bills at public hospitals after Government subsidies, MediShield Life and MediSave may approach medical social workers at public healthcare institutions for additional financial assistance. No Singaporean will be denied access to necessary and appropriate healthcare because of an inability to pay.”
“Professional Conversion Programmes (PCPs) in nursing support mid-career Singaporeans who wish to enter the nursing profession. In the last three years, close to 300 locals underwent such programmes. About 40% of them were from non-nursing professions in the health and social services sectors. The other 60% come from a wide range of industries, such as manufacturing, finance and public administration. The PCPs for Registered Nurses at the Diploma and Degree level are accelerated programmes that allow mid-career individuals to complete their training in two years, compared to fresh school leavers who would take three years to do so.”
“Healthcare inflation measures the growth in actual prices of healthcare-related goods and services, inclusive of taxes and after Government subsidies. It is calculated based on the Healthcare Consumer Price Index (CPI) compiled by the Singapore Department of Statistics. We currently do not have specific data on inflation for dental services without Government subsidies. Between 2009 and 2018, the inflation rate for dental services provided by the private sector was 2.3% per annum. These inflation figures reflect the price changes for dental procedures commonly used by Singaporeans, such as scaling and polishing, filling, dental prosthetics (dentures) fitting, root canal treatment and so on. Dental implants are currently not included in the CPI basket as they are less frequently used.”
“MediSave is primarily designed to help Singaporeans put aside sufficient savings for their hospitalisation expenses, particularly in old age. In considering any further expansion, it is important to ensure that Singaporeans have enough MediSave for such purposes. Today, MediSave is allowed for active rehabilitation, which helps patients recover their functional status, including those who are recovering from stroke. From mid-2020, severely disabled patients aged 30 and above can withdraw up to $200 per month in cash from their own and/or their spouse's MediSave accounts to support their care needs, which can be used for maintenance exercise. There are also other forms of support available to patients. Patients receive subsidies of up to 80% for non-residential long-term care services, including maintenance exercise. Those who require further financial assistance can approach medical social workers for assistance.”
“In our public hospitals, mental health therapy and counselling are provided at Specialist Outpatient Clinics. Between 2017 and 2018, the overall median waiting time for new subsidised psychiatrist appointments across the public hospitals ranged from 24 days to 27 days. Patients whose conditions are more severe or who require more urgent attention are given earlier appointments. Other than referrals to Specialist Outpatient Clinics, under the Community Mental Health Masterplan, we are strengthening primary and community-based care and support for those with stable mental health conditions. The Ministry of Health will continue to work with public hospitals and service providers in the community, including schools, social service agencies and family service centres to ensure that we provide holistic and timely support for persons with mental healthcare needs.”
“The Health Promotion Board's (HPB's) Workplace Mental Health Solution initiative supports mental well-being programmes and resources at workplaces. For example, a one-day onsite management training workshop helps equip managers and human resource (HR) personnel with knowledge to be supportive leaders at their workplaces. Two half-day workshops are also available to provide skills to those supporting others at work and developing and implementing workplace mental health programmes. Close to 1,400 managers and HR personnel have benefited from these programmes since 2017. HPB also partners landlords and developers to bring mental well-being talks and workshops onsite. Small and medium enterprises can choose from a list of co-funded mental well-being activities for implementation. There are also health coaching programmes which incorporate mental health tips for shift workers in sectors, such as retail, food and beverage and cleaning. In 2018, 9,500 workers benefited from these mental well-being activities. In addition, HPB runs Talk2US. This is a free and confidential helpline to support working adults with workplace-related stress. Talk2US has helped over 460 employees in 2018.”
“In recent years, the Government has introduced a range of initiatives to help Singaporeans save for their healthcare needs. For example, we provide Goods and Services Tax Voucher (GSTV) MediSave top-ups of up to $450 each year to Singapore Citizens aged 65 and above. Eligible seniors also receive annual MediSave top-ups of between $200 and $800 under the Pioneer Generation Package, and MediSave top-ups of $200 for five years between 2019 and 2023 under the Merdeka Generation Package. Singaporeans can tap on their family members' MediSave to pay for their healthcare expenses, and do not need to exhaust their own MediSave accounts before doing so. The number of Central Provident Fund (CPF) members with MediSave balances of less than $100 and tapped on their family members' MediSave for their medical treatment is about 2% of all CPF members who utilised MediSave each year between 2016 and 2018. MediFund is a safety net for patients who face financial difficulties with their medical bills after Government subsidies, MediShield Life and MediSave. Independent MediFund Committees consider each case holistically taking into consideration patients' circumstances, and patients are not required to fully exhaust their own or their family members' MediSave. As such, we do not track the number of Singaporeans who have received MediFund assistance because they have exhausted family members' MediSave or who have no family members.”
“About three quarters of these patients had used antibiotics in the preceding 30 days. Antibiotics should only be prescribed when necessary. Antimicrobial Stewardship Programmes have been implemented in all public hospitals since 2011 to guide doctors on appropriate antibiotic use, so as to slow down the emergence of AMR. Recognising that a long-term multi-prong approach is necessary to address AMR, the National Strategic Action Plan was launched in 2017 to reduce and prevent the spread of AMR through the five key pillars of (a) Education; (b) Surveillance; (c) Infection Prevention and Control; (d) Optimisation of Antimicrobial Use; and (e) Research. Under the pillars of Education and Optimisation of Antimicrobial Use, the National Centre for Infectious Diseases is working on professional education efforts, such as training programmes and guidelines on the management of infections and antimicrobial use. Patients, too, have an important role to play in the appropriate use of antibiotics. In 2018, the Health Promotion Board launched the annual "Use Antibiotics Right" public education campaign to address the general public's misperception that antibiotics are needed for minor ailments, such as the common cold or flu, and to encourage patients to discuss with their doctors the necessity for antibiotic use. Patients are also reminded to follow the instructions given by their doctors on their prescribed antibiotics. We will continue to work with all stakeholders to tackle AMR as everyone has a part to play.”
“Antimicrobial resistance (AMR) is a commonly occurring phenomenon, where microorganisms change and develop resistance after being exposed to antimicrobial drugs. However, the excessive and inappropriate use of antimicrobials has exacerbated its development. Today, AMR has been observed across a range of diseases, from common respiratory and urinary tract infections to more serious diseases, such as tuberculosis, malaria and sexually transmitted diseases like syphilis. Treatment for resistant infections often involves newer generation drugs that are usually more expensive, require longer duration of treatment or lengthier stay in hospitals, and sometimes with potentially more side effects. AMR in the community, such as those treated in the general practitioner setting, is not centrally tracked. In our public hospitals, AMR is monitored through indicators on infection by the bacteria methicillin-resistant Staphylococcus aureus (MRSA), a resistant infection common in the hospital setting, and carbapenemase-producing Enterobacteriaceae (CPE), a more recent form of antimicrobial resistance of emerging concern globally. The infection rate of MRSA has dropped from 17.6 per 10,000 inpatient days in 2011, to 10.6 per 10,000 inpatient days in 2018. Between 2015 and 2018, CPE infection rates here have hovered around 0.9 per 10,000 patient days per year. Individuals with weakened immune systems and those who require invasive procedures or medical devices are more vulnerable to AMR infections. A study of patients in public hospitals infected with CPE found that the median age was 66 and many had chronic diseases, such as diabetes or heart disease. AMR is often exacerbated by the inappropriate and overuse of antibiotics.”
“CNS then works with various healthcare and community partners to coordinate care services for the seniors, including ensuring seniors receive medical follow-up in a timely manner. MOH will continue to expand care options in the community and work with the public hospitals, polyclinics and community providers to assist frail patients to access medical care.”
“About 12% to 20% of patients aged 65 and older do not show up for their Specialist Outpatient Clinic (SOC) appointments despite alerts and reminders by the hospital or polyclinics. Based on surveys conducted by public hospitals, the main reasons for not attending SOC appointments include improvement in the patient’s medical condition, the patient having sought other treatments or treatments at other healthcare providers, the patient or caregiver not being well enough to attend, the patient had forgotten about or decided not to proceed with their appointments. Other than alerts and reminders to the patients or their nominated caregivers, the Ministry of Health (MOH) has put in place the Medical Escort and Transport scheme to accompany and assist frail patients from their homes for their medical appointments at SOC or polyclinic and back. At hospitals and polyclinics, staff are trained to identify and assist frail patients when they arrive for appointments, for example, providing wheelchairs and wheelchair assistance if needed. In cases where a patient has multiple SOC appointments, hospitals may help consolidate his or her appointments to reduce the number of visits needed. As our goal is to enable seniors to age-in-place, we have also put in place measures to support frail seniors and their caregivers by enhancing the accessibility, quality and affordability of care options in the community. For example, the Silver Generation Office reaches out to seniors through its volunteers, the Silver Generation Ambassadors (SGAs). When needed, SGAs connect seniors to health and social care services through the Community Network for Seniors (CNS).”
“As at end June 2019, dementia day care centres across the island had capacity to serve up to 3,400 clients each day. At the same time, there were about 3,100 Singaporeans utilising dementia day care1. Some may not attend day care every day, depending on their individual care arrangements. The Ministry of Health (MOH) provides means-tested subsidies for transport to and from dementia day care centres for eligible clients. This includes subsidies for centre-owned transport services, taxi services or private hire car services where appropriate. MOH will continue to monitor the demand for dementia day care services and support seniors and caregivers to receive the care they require.”
“We will continue to look into new and enhanced approaches and initiatives to encourage early and regular HIV testing among at-risk groups.”
“Singapore's approach towards the prevention and control of human immunodeficiency virus (HIV) is based on the four key principles of "ABCD". That is: "A", abstinence from casual sex; "B", being faithful; "C" correct and consistent use of condoms; and "D", early detection and treatment. The benefits of "D" or early detection and treatment of HIV infection are clear. It can suppress the HIV viral load and prevent the onset of Acquired Immune Deficiency Syndrome (AIDS), thus enabling HIV-infected persons an improved quality and length of life that is relatively symptom-free. Based on our estimates, 77% of HIV-positive persons in Singapore know their status. Among those who know their status, 86% are on treatment. And 98% of those on treatment are virally suppressed. We have been working on efforts to encourage more at-risk persons to test for HIV regularly. Testing has been made widely accessible in primary care and hospital clinics. For persons who prefer anonymity, there are designated anonymous test sites at general practitioner clinics as well as an Action for Aids mobile testing van operating at different sites. The Health Promotion Board (HPB) also works with partner agencies on outreach programmes to encourage at-risk individuals to take preventive measures on HIV and to go for early and regular HIV testing. These include tapping on platforms, such as World AIDS Day activities. We have made some progress through these efforts. The proportion of persons diagnosed with late-stage HIV infection decreased from 51% in the five-year period between 2009 to 2013 to 44% between 2014 and 2018. The proportion of new HIV-positive cases detected through voluntary testing increased from 14% from 2009 to 2013 to 19% between 2014 and 2018.”