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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“The movement partners professional chefs to deliver initiatives, such as AIC's Culinary Training and Chef Partnership Programme. To date, more than 200 cooks from over 70 Community Care organisations have taken part in the Culinary Training initiative to improve their culinary capabilities and cooking standards. Activities include practical training on preparing normal and soft-textured meals, and demonstrations by professional chefs on nutritious meal preparation based on the recommendations by dietitians. In the community, AIC's Meals-On-Wheels programme, which delivers meals to homebound clients who may be unable to prepare their own meals, has also adopted HPB's Healthier Catering guidelines. We will continue to look at ways to support better nutrition for all Singaporeans.”
“For families unable to afford basic living expenses, the Ministry of Social and Family Development's social service offices provide them with ComCare financial assistance, which cover their food expenses and other expenses. As part of the initiatives announced by the HealthySG taskforce, HPB will also be piloting a targeted programme with activities and incentives that are customised to the needs and circumstances of lower-income families. For a start, HPB will focus on improving nutrition for these families. Examples of activities would include guided healthier eating trails, supermarket tours, cooking classes and nutrition workshops. For children from lower-income families, the Early Childhood Development Agency (ECDA) has partnered KK Women's and Children's Hospital to deliver the KidSTART Home Visitation Programme. ECDA will also be working with the National University Hospital to extend the Programme to more children and their families. Through regular visits by ECDA and hospital home visitors, parents will receive support in acquiring skills and practical knowledge across areas of child development, health and nutrition. Under the National Seniors Health Programme, MOH and HPB also support seniors through community-based education efforts, such as regular health talks and cooking demonstrations. These help our seniors learn about the importance of a healthy balanced diet, as well as practical ways to incorporate key nutrients, such as protein and calcium, into their daily diet. In 2012, the Agency for Integrated Care (AIC) introduced the Nutrition Movement to support our Community Care service providers in preparing and providing nutritious and tasty meals for seniors.”
“According to the 2017 Global Burden of Disease study, nutritional deficiencies, such as protein-energy malnutrition, iodine, vitamin A and dietary iron deficiencies, accounted for less than 1% of the total disease burden in Singapore. Among Singaporeans less than 20 years of age, malnutrition accounted for about 4.5% of the disease burden in this age group. Based on data from the Health Promotion Board's (HPB's) School Health Services in 2017, the prevalence of children in Kindergarten 1 (K1) and K2 who were underweight and severely underweight was 7.6%. As for older Singaporeans, a National University of Singapore (NUS) study published in 2017 estimated the prevalence of under-nutrition among Singaporeans aged 55 and older at 2.8%. A study published in 2018 by the Centre for Ageing Research and Education, Duke-NUS Medical School, found that the prevalence of underweight in a nationally representative cohort of over 4,500 Singaporean residents aged 60 and above was 6.6%. The Ministry of Health (MOH) and HPB undertake efforts to encourage Singaporeans to eat healthily, such as raising the consumption of whole grains, fruits and vegetables, while reducing the intake of trans fat, sugar and salt. There are also specific efforts to address under-nutrition in children and seniors. For example, we have engaged maternity hospitals to implement the World Health Organization's Baby Friendly Hospital Initiative, which supports mothers in breastfeeding their infants as breast milk provides infants with all the essential nutrients for optimal growth and health. HPB has also introduced Healthy Meals programmes in preschools and mainstream schools. The programme enables children to have well-balanced meals and cultivate in them healthy eating habits.”
“The Chiropractic Association (Singapore) estimates that there are about 150 chiropractors in Singapore. Based on the number of business entities1 registered with the Accounting and Corporate Regulatory Authority, the number of chiropractic establishments is estimated to be about 90. Over the past five years, the Ministry of Health received an average of four chiropractic-related feedback per year, usually related to the misleading use of titles, advertising or claims, and sales and refunds on treatment packages. Chiropractic services are considered as complementary and alternative treatments and are not licensed under the Private Hospital and Medical Clinic Act. Chiropractors are encouraged to practise self-regulation through their professional associations. Most chiropractors in Singapore have four or more years of overseas university or postgraduate studies. For traditional Chinese medicine practitioners (TCMPs), applicants with a five-year local Advanced Diploma in TCM or an overseas TCM Bachelor's degree recognised by the TCMP Board can qualify for the Singapore TCMP Registration Examination. For physiotherapists, the Singapore Institute of Technology offers a four-year Physiotherapy Bachelor's degree programme, jointly developed with Trinity College Dublin. The Allied Health Professions Council also maintains a list of recognised overseas qualifications for physiotherapists to practise locally.”
“Early detection of breast cancer through screening is important because the outcomes of treatment for early-stage cancers are better, compared with late-stage breast cancer. Based on findings from focus group discussions conducted by the Health Promotion Board (HPB), women have several misconceptions surrounding breast cancer screening. Some examples include screening not being necessary when one feels healthy, "it is better not to know", and that mammograms are painful. HPB partners organisations, including Singapore Cancer Society, Breast Cancer Foundation, National Cancer Centre Singapore and National University Cancer Institute, to address these misconceptions and to make screening and the follow-up process easier to understand. HPB and its partners also actively dispel misconceptions associated with breast cancer screening and encourage regular screening through the annual Breast Cancer Awareness campaign, forums, media messages and in talks delivered by community leaders and breast cancer survivors. However, changing entrenched misconceptions is not an easy task. The Ministry of Health and HPB will continue our efforts on public education on breast cancer and we welcome suggestions to improve our early detection efforts and save lives.”
“The Eldercarer Foreign Domestic Worker (FDW) Scheme was started in November 2016 to provide eldercare training to FDWs prior to their placements with households. The FDWs undergo a Basic Eldercare Course, comprising two days of classroom training and half a day of on-the-job training on managing the day-to-day care of an elderly person. Households can apply for the Caregivers Training Grant (CTG), which is an annual $200 subsidy, per care recipient, that can be used to offset the Eldercarer FDW Scheme training cost. As of 30 September 2019, 413 FDWs have been trained under the scheme. Similarly, households which wish to equip their FDWs to care for persons with special needs can apply for the CTG as well. In addition to eldercare courses, the CTG also covers courses that specifically train caregivers to care for persons with special needs, such as autism and intellectual disabilities.”
“To keep basic dental treatment costs affordable for Singaporeans, subsidised dental care services are available at 10 polyclinics and about 700 dental clinics on the Community Health Assist Scheme (CHAS). Polyclinic patients, as well as CHAS Blue and Orange, Pioneer Generation, and soon Merdeka Generation cardholders, may also be referred for subsidised dental treatments at the National Dental Centre Singapore and National University Centre for Oral Health Singapore. Patients can also tap on their MediSave savings for more complex dental procedures, such as dental implants and wisdom tooth surgeries. Based on the Consumer Price Index compiled by the Singapore Department of Statistics, the inflation rate for dental services, after Government subsidies, was 2.1% per annum between 2009 and 2018. The average bill size for polyclinics and average charges for CHAS dental clinics for subsidised dental treatments grew by about 1% per annum from 2012 to 2018.”
“Singapore's overall healthcare workforce grew significantly by about 18,000 staff over the last four years. For nurses, there were about 42,000 nurses registered with the Singapore Nursing Board (SNB) at the end of 2018, up from about 38,000 as at end 2014. To optimise the use of manpower resources, we have embarked on efforts to raise productivity. These include initiatives on automation, streamlining of work processes, and shifting of care from hospitals into the community where appropriate. On average, between 2015 and 2018, around 3% of our practising nurses across the entire healthcare sector work on a part-time basis1.”
“Nurses who left the public healthcare sector in the past five years spent an average of seven years in service. This includes nurses who left to join the private healthcare and community care sectors as well as those who left nursing practice. The Ministry of Health welcomes all local non-practising nurses to return to the healthcare workforce. To facilitate their return, we have in place a Return to Nursing (RTN) scheme, which includes a refresher course. Over the years, we have enhanced the scheme. For instance, we have adopted a Place-and-Train format for the scheme where returning nurses first secure employment with their employers before commencing the refresher course. As a result, nurses are paid a salary while attending the course and the cost of the course is jointly borne by employers and the Government, and not the nurses. In the last 10 years, about 120 nurses have benefited from the RTN scheme. Overall, about 400 local nurses have returned to practice annually1.”
“To meet the needs of our ageing population, we need more healthcare professionals who are trained to serve older patients in general. We also need more specialists in geriatric medicine and related fields, such as rehabilitation care and palliative care. Today, all medical students are exposed to geriatric medicine and related disciplines early in their training. In addition, the Ministry of Health has increased the number of training positions for specialists in these disciplines. From 2013 to 2019, the specialist training intake for geriatric medicine, rehabilitation medicine and palliative medicine more than doubled from 11 to 23 positions. Specialists trained in Geriatric Medicine receive an additional allowance. To raise the ability of our pharmacists to care for the elderly, a local training programme in Geriatric Pharmacy was started in 2016. The programme has trained three pharmacists to date and aims to train another nine pharmacists in the next three years. For nursing, hospitals are conducting inhouse structured courses on Gerontology Nursing to equip nurses with the skills and knowledge in caring for older adults. Specialty training, such as the Advanced Diploma in Nursing (Gerontology), is also available for nurses who are interested in this field. In the last seven years, 497 nurses have undergone this diploma.”
“Our public healthcare institutions have in place infection prevention and control (IPC) programmes in accordance with the Ministry of Health (MOH) Guidelines. The programmes are aligned with international best practices to minimise the transmission of bacteria and reduce healthcare-associated infections. In patient care areas, such as inpatient wards and outpatient consultation rooms, paper hand towels are provided for the drying of hands after handwashing. In some public areas, jet-air hand dryers may be available. Routine cleaning is undertaken using hospital-grade cleaning agents and disinfectants to minimise the transmission of bacteria. All healthcare institutions also adopt hand hygiene practices, which include staff using alcohol-based hand rub before contact with patients. Visitors are also encouraged to observe hand hygiene when they are in patient care areas. All of us can also play our part by washing our hands before and after visiting our friends and relatives in hospitals.”
“Under the Pharmaceutical Care Excellence initiative, pharmacists who are trained can perform health screening, such as taking blood pressure readings or blood glucose checks, onsite at pharmacies or at community health events. Pharmacists perform these evaluations in partnership and under the oversight of licensed healthcare providers. This is important as the licensed providers are accountable for the conduct of the health screening, including the proper selection of participants for the health screening and appropriate follow up for those with abnormal results.”
“The Health Sciences Authority (HSA) evaluates medicines, including generics, for safety, quality and efficacy before as well as after they are registered and allowed for supply in our local market. Before giving approval for registration, HSA inspects local medicines manufacturers to ensure that they comply with international Good Manufacturing Practice (GMP) standards. As for assessing manufacturers based overseas, HSA taps on its membership in the Pharmaceutical Inspection Co-operation Scheme. Membership to the scheme is granted only if a regulator has a strict inspection regime comparable with the high standards and quality of the other members. Some members in the scheme include regulators from Australia, Canada, Germany, Japan, Switzerland and the United States. If a member regulatory authority has inspected the overseas medicines manufacturers, HSA would leverage their findings on the GMP assessment. Otherwise, HSA will conduct an overseas onsite inspection. After a medicine is registered and sold in the Singapore market, inspections of manufacturers continue to be conducted on a regular basis. HSA also carries out post-market product quality sampling to test and ensure that the medicines comply with quality requirements and are safe for use by patients. In addition, HSA exchanges information and intelligence with other leading international regulatory authorities on the quality of the medicines, including generics.”
“These courses range from eldercare, caring for persons with disability, including autism and intellectual disabilities, to psychosocial support. Since 2013, over 40,000 caregivers have utilised CTG. We will continue to review the range and support for these training programmes that support community care staff and caregivers to care for the elderly and persons with special needs better.”
“The Government or Government-appointed entities manage a wide range of training courses to equip both community care staff and informal caregivers with the necessary skills to care for the elderly and persons with special needs. To ensure relevance and quality, such courses are selected or developed to meet caregivers' specific training needs and are conducted by qualified training personnel who have relevant experience. There is a range of subsidised training programmes that caters to healthcare professionals like nurses, allied health professionals and healthcare assistants. For example, community care staff can attend short courses under the Agency for Integrated Care (AIC)-appointed Learning Institutes or skills training courses under the Singapore Workforce Skills Qualifications for Healthcare Support. For formal qualifications leading to an advanced or specialised diploma, for example, in gerontology, they can apply for the Community Care Manpower Development Award administered by AIC, which covers up to 90% of the programme fees. Social service professionals in the disability sector can also enrol in a range of disability-related training programmes offered by the Social Service Institute. These programmes are generally short courses that help individuals develop specific competencies in supporting persons with special needs. Eligible employees working in National Council of Social Service member agencies can apply for the Voluntary Welfare Organisation-Charities Capability Fund to subsidise the training fees. Family caregivers and foreign domestic workers can apply for the Caregivers Training Grant (CTG), which is a $200 annual subsidy for caregivers to attend training courses reviewed by AIC.”
“Telemedicine can potentially make access to healthcare services more convenient for Singaporeans. It is an evolving field. In 2015, the Ministry of Health's (MOH's) National Telemedicine Advisory Committee developed a set of telemedicine guidelines. These guidelines serve to guide healthcare providers in Singapore on the provision of safe and appropriate delivery of care via telemedicine. Overall, doctors providing telemedicine are expected to maintain the same standards of care as with in-person clinical consults. They should see their patients in-person when a physical assessment is warranted or refer them appropriately. Last year, MOH also set up a regulatory sandbox framework to facilitate the development of new and innovative telemedicine care models while ensuring patient safety and welfare. This arrangement enables telemedicine providers to work with the Ministry to better understand the challenges associated with the delivery of telemedicine. With the experience garnered through the sandbox, the telemedicine guidelines are being refreshed. MOH, in consultation with various professional bodies, has appointed a review committee comprising experienced family physicians and medical specialists from both public and private healthcare sectors, experts in medical informatics and medical ethics, as well as representatives from various Government organisations. The revised guidelines will be released in 2020. Together, the refreshed guidelines and regulatory sandbox will help inform MOH on how best to regulate telemedicine.”
“To ensure the quality of our medicines, companies that import new batches of ranitidine are required to test their products to ensure that they do not contain nitrosamine impurities above the internationally acceptable level before supplying them in Singapore.”
“On 16 September 2019, the Health Sciences Authority (HSA) stopped the sale and supply of eight brands of ranitidine medicines at clinics, hospitals and pharmacies. HSA tested all rantidine medicines supplied in Singapore when it was alerted that a nitrosamine impurity, N-nitrosodimethylamine (NDMA), might be present in these products. The recall was initiated as a precautionary measure following the detection of trace amounts of NDMA above 96 nanograms per day. This is the internationally acceptable level of what was reasonably safe if a patient takes the affected medicine every day continuously for a lifetime of 70 years. Ranitidine is used to reduce the production of acid in the stomach in conditions, such as heartburn and gastric ulcers. As it is generally prescribed for short-term use of a few days to a few weeks, the potential additional cancer risk of nitrosamines is assessed to be very low (0.00003%). Nonetheless, HSA instituted a recall of the affected products to limit patients' further exposure to these products. Patients who are concerned about the use of the affected ranitidine medicines should contact their doctor. Subsequently, Canada, Switzerland and the United States undertook recalls between 17 and 24 September. All the recalls were also at the retail level. So, too, was the global recall by Sandoz on 17 September. The root cause of nitrosamines in ranitidine medicines has yet to be established. HSA and international regulatory agencies are working with the companies supplying ranitidine medicines to identify the root causes of the contamination and to formulate the necessary measures to address the issue.”
“Singaporeans receiving treatments and follow-ups for cancer can tap on MediShield Life and MediSave to defray their costs for chemotherapy and radiotherapy. In addition, MediSave can also be used to pay for outpatient Magnetic Resonance Imaging (MRI), Computed Tomography (CT) scans and diagnostics for tumours, up to a limit of $600 per patient per year. Based on latest available data in 2017, the MediShield Life and MediSave limits of $3,000 and $1,200 per month respectively are sufficient to fully cover the costs for nine in 10 subsidised patients on chemotherapy. The Ministry of Health will continue to regularly review our healthcare financing schemes to ensure that they continue to be relevant and adequate. Singaporeans who face difficulties with their medical bills 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.”
“Typically, a blood test is used to determine whether a patient is infected with dengue fever. Before Government subsidy, a dengue blood test could cost about $70 to $80 at a General Practitioner clinic, and about $50 to $60 at a polyclinic. The cost may vary for a range of reasons, including the type of test used, operating costs of the clinic and the fees of the laboratory used.”
“The Health Sciences Authority (HSA) sets stringent standards on the quality of medicines sold in Singapore. Manufacturers are required to conduct tests to demonstrate to the Health Sciences Authority (HSA) that the medicines remain of good quality throughout their shelf life. These include conducting long-term stability studies under the condition of 30°C to establish the shelf life of the medicines, and at 40°C for a minimum period of six months to evaluate the impact of excursions to harsher conditions. The requirement adopted by HSA is in line with the most stringent international guidelines. These test conditions are sufficiently robust to ensure the continued quality of our medicines, even with current temperature elevations. All our medicines are stored in HSA-licensed premises where the temperatures are appropriately controlled to ensure that quality is maintained. Patients are also advised to keep their medications away from direct sunlight when storing them at home. HSA recognises the potential impact of climate change on the quality of medicines. We have assessed that the current testing requirements are sufficiently robust, considering the average annual temperature in Singapore have remained fairly consistent in the range of 27.5°C to 28.5°C since 2005 when the testing requirements were established. Nonetheless, we will continue to monitor local environmental changes and review the testing requirements where necessary. We will do this in collaboration with international regulators and our relevant stakeholders.”
“To cope with any surge in demand, the public hospitals have plans to ensure adequate staffing for critical services, such as Emergency Departments, and ramp up bed capacity as needed. At the polyclinics, fast track consultation and home medication delivery services are some of the measures deployed for vulnerable patients, including those who need support at home.”
“The Ministry of Health (MOH) has issued guidelines to public healthcare institutions to protect the welfare of its patients and staff during periods of haze. These guidelines apply to all public hospitals, polyclinics and nursing homes. In addition, MOH had provided funding to public hospitals, polyclinics and non-private nursing homes to purchase air purifiers and portable air coolers for use in naturally ventilated wards during haze situations. While MOH's current policy is for subsidised wards in public hospitals and for Government-built nursing homes to be naturally ventilated, these institutions can close the windows during sustained severe haze and deploy fans, portable air coolers and air purifiers to mitigate the effects of haze. Some of the newer hospitals, such as Ng Teng Fong General Hospital, Jurong Community Hospital and Sengkang General and Community Hospitals, are fitted with air filtration systems to supply filtered air to naturally ventilated wards during haze. MOH has also reminded residential and centre-based community care providers to replace outdoor activities with indoor ones when the haze situation worsens. Healthcare institutions will monitor patients closely for possible health effects from the haze, especially patients with higher care needs, including the elderly, pregnant women, children and those with existing chronic respiratory and heart disease. These patients will be given appropriate medical care when needed. To prepare for severe haze situations, MOH has also worked with the public hospitals and polyclinics to ensure adequate supply of masks and other medical supplies, including medications.”
“To ensure affordability of intermediate and long-term care (ILTC) services, the Government provides multiple layers of support to help Singaporeans. The Government provides means-tested subsidies of up to 80% for ILTC services. More subsidies are directed towards the lower-income, where needs are greater. We will be introducing several new schemes to further support Singaporeans' long-term care needs. By end 2019, the Home Caregiving Grant will be implemented to help with costs of long-term caregiving in the community. In 2020, we will introduce CareShield Life, a new long-term care insurance scheme that provides monthly cash payouts for those who are severely disabled. We will also implement ElderFund, a discretionary financial assistance scheme for low-income, severely disabled Singaporeans. To complement these, we will allow MediSave cash withdrawals for Singaporeans' long-term care needs. Finally, Singaporeans who have care needs but are unable to afford it despite all other available support measures, can apply for MediFund assistance at subsidised long-term care providers.”
“Home visits are primarily carried out by around 3,000 Silver Generation Ambassadors (SGAs), who are volunteers. On average, each SGA conducts 85 engagements per year. SGAs typically engage seniors at least once every 18 months. For seniors with more complex needs, the visits would usually be more frequent and some of these visits would be made by SGO staff rather than SGAs. SGO staff would work with community providers to develop an integrated and holistic package of support for the seniors. SGAs are given an allowance of $10 per senior engaged.”
“Hospital visitation by relatives and friends are allowed, subject to considerations, such as the patient's medical condition, visiting hours and restrictions on number of visitors at bedside to minimise disruptions. Where the patient has mental capacity, decisions on his healthcare and treatment plans rest with the patient himself. Under the Mental Capacity Act (MCA), individuals can make a Lasting Power of Attorney (LPA) to appoint anyone they trust as their donees, to make decisions relating to their personal welfare, in the event that they lose mental capacity. Such donees can make decisions relating to the individuals' healthcare and treatment, such as hospital visitation, but excludes certain key medical decisions, such as sterilisation and continuation or cessation of life-sustaining treatments. A deputy may also be appointed by the Court under MCA to make certain decisions on behalf of an individual who lacks mental capacity, when the individual has not made an LPA, and has no donee to make decisions on his behalf. In the absence of a donee or deputy, the doctor-in-charge would usually make decisions based on the best interests of patients under their care, but the Court may have to make these decisions, if there is an unresolved conflict over what the best interests of the patients are.”
“Following home visits, Silver Generation Ambassadors (SGAs) or officers may make recommendations to seniors to apply for healthcare and social support schemes or referrals to providers of other healthcare or social services that meet the seniors' needs. For engagements by SGAs between 1 March 2019 and 31 July 2019, the number of applications for different support schemes and referrals to other service providers subsequently are as shown in Table 1 below.1”
“From 2013 to 2018, the number of unique caregivers1 who utilised the Caregivers' Training Grant (CTG), and their profile are as shown in the table below. The caregiving courses that are most frequently taken up under the CTG are eldercare courses, such as those equipping caregivers to assist those who need help with Activities of Daily Living, and to care for seniors with dementia.”
“Over the past five years, about 6% of all MediSave withdrawals were for the MediSave account holder's parents' healthcare expenses, which include inpatient, day surgery and outpatient expenses. The details are in Table 1 below.”
“Based on available data from 2013 to 20181, an average of about 850 local nurses resigned from the public healthcare sector each year. The average resignation rate for this period was 6%. Over the same period, around 0.1% or 20 local nurses retired each year. The most common reasons cited by local nurses when they left the public healthcare sector include family commitment, further studies on their own accord and desire for a change in work environment.”
“Patients are hospitalised at the public hospitals only when they have a clear clinical need for admission. There have been a very small number of admissions due to non-medical circumstances. Examples include new-born babies who are well but are admitted as their mothers remained unfit for discharge after delivery, or patients who are well but unable to be discharged as they lack a caregiving arrangement. The number of these non-medical admissions have remained low at between 0.01% and 0.03% of all admissions in the past five years. With advances in medical science and changes in care models, some medical treatments that previously required patients to be admitted can be delivered effectively in an ambulatory or outpatient setting. As some of these treatments may remain costly, the Ministry of Health will review and consider them for MediShield Life and MediSave coverage, as appropriate. As an example, MediShield Life and MediSave can now be claimed by multiple myeloma patients who continue their autologous bone marrow transplants in the outpatient setting, potentially allowing these patients to shorten their hospitalisation stays by up to three weeks.”
“Between 26 July and 29 August 2019, the Ministry of Health (MOH) was notified of 26 typhoid fever cases, comprising 21 local and five imported cases. The local cases did not have recent travel history. Preliminary genetic analysis conducted on available typhoid bacteria samples from 18 of the local cases showed that they were similar, which suggest that the cases could be linked to a common source. MOH and the Singapore Food Agency (SFA) have been working together to investigate the cases. We have conducted checks at food establishments and caterers where the cases had consumed food from, traced food sources, collected food and water samples for testing, and screened food handlers to try to identify the source of infection. Thus far, none of the food and water samples tested or food handlers screened, tested positive for Salmonella Typhi. No common food establishment or upstream source has been identified to date. Investigations by MOH and SFA are ongoing. MOH has alerted the medical community to remain vigilant and report typhoid fever cases. We have also screened household members of the affected cases and advised them to seek treatment if they develop symptoms. Typhoid fever, like other food-borne diseases, can be prevented through general hygiene measures, including proper hand hygiene, and safe handling, cooking and consumption of food. MOH and SFA will continue with investigations and are closely monitoring the situation. Should the source of the outbreak be identified, MOH and SFA will provide an update and issue a public advisory on any additional precautions that members of the public should take.”
“This way, Singaporeans can live long and with greater peace of mind. Mr Speaker, I beg to move. [(proc text) Question proposed. (proc text)]”
“The Long-Term Care Support Fund is in addition to existing Government subsidies for long-term care services, such as nursing homes, home care and centre-based care services, existing Government assistance schemes, as well as the new Home Caregiving Grant. I would like to emphasise that the Long-Term Care Support Fund is a completely separate fund from the CareShield Life and ElderShield Insurance Fund. The Long-Term Care Support Fund, or the support fund, holds the $5.1 billion of Government monies and is used to provide Government support, while the CareShield Life and ElderShield Insurance Fund – we call the insurance fund – holds the premium monies collected and are used for CareShield Life and ElderShield payouts and expenses. So, just to repeat, the support fund holds the Government funding to help the Scheme through premium subsidies and so on, whereas the insurance fund holds the monies from premium payments which is used to fund payouts from the schemes. So, the two Funds are separate. Both Funds will be accounted for and managed separately and the accounts of each Fund will be made public. Mr Speaker, let me conclude. Our society is ageing and we need to prepare for this ahead of time. CareShield Life is a major step in expanding the role of insurance in the long-term care financing landscape. But the CareShield Life and Long-Term Care Bill goes beyond long-term care insurance. The Bill also enables enhancements to be made to the other two pillars of our long-term care financing system through the withdrawal of MediSave for long-term care and ElderFund. With the strengthening of the roles of insurance, savings and Government assistance, Singaporeans can have better protection and greater assurance for their long-term care needs.”
“These measures will help older Singaporeans who are not covered under ElderShield or CareShield Life. Severely disabled Singapore Citizens and PRs who are at least 30 years old will be able to make cash withdrawals from their own and their spouses’ MediSave Accounts to support their long-term care needs. Clause 66 of the Bill will amend the CPF Act to allow for this. To ensure that members have sufficient MediSave balances for other medical treatments, the amount that can be withdrawn for long-term care will be based on their prevailing MediSave balance, and up to $200 a month for each severely disabled individual. These cash withdrawals will supplement the CareShield Life or ElderShield payouts that they may be receiving. This will enhance the role of personal and family savings in supporting long-term care needs. Like CareShield Life and ElderShield, similar safeguards will be in place for those who lack mental capacity. Apart from allowing withdrawals from MediSave for long-term care, the Government will also play a part in helping Singaporeans with their cost of long-term care. The Bill provides for the establishment of a Government fund called the Long-term Care Support Fund in clauses 38 and 39. This Fund will be administered by MOH and $5.1 billion will be set aside in this Fund, as announced by the Deputy Prime Minister during Budget 2019. Monies in the Fund will be used to fund premium subsidies and participation incentives for the CareShield Life Scheme and to provide financial support for severely disabled persons under prescribed public schemes, such as Elder Fund, which I mentioned earlier. ElderFund is a new discretionary Government assistance scheme that will be implemented in January 2020.”
“These include safeguards over the scheme parameters and administration, the collection of premiums and payment of claims, and management of information. Let me elaborate. First, the governance of scheme parameters and administration will be overseen by an independent CareShield Life Council, to be appointed by the Minister under clause 37 of the Bill. The Council will review and make recommendations on policy and scheme parameters, to ensure that the schemes provide protection for Singaporeans in an affordable and sustainable manner. This includes reviewing CareShield Life's premium and payout increases beyond 2025. For the first five years of CareShield Life's implementation, until 2025, both premiums and payouts will increase at 2% per year. Adjustments thereafter will be reviewed by the Council. In addition, the Council will review the administration of the schemes and advise on matters related to the investment of the CareShield Life and ElderShield Insurance Fund. The Council will be appointed by the time the CareShield Life Scheme takes effect. It will comprise members with various professional expertise and a wide range of experience to perform the key functions of the Council. We are in the midst of setting up the Council, and will share more information later. Second, the Bill aims to ensure proper collection of premiums and payment of claims to protect the interest of policyholders. Clauses 48 and 49 of the Bill make false declarations and fraudulent disability assessment offences, with penalties to deter such offences. As mentioned earlier, the Bill will also enhance the role of personal and family savings, and Government support in helping the severely disabled with their long-term care costs.”
“Any CareShield Life premiums defaulted that cannot be recovered is a burden that will be shouldered by other policyholders in the form of higher premiums eventually. To be fair to the other policyholders, we need to take a strict stance against these willful defaulters. Therefore, Part 7 of the Bill provides for a premium recovery framework that is similar to the approach for MediShield Life. Penalties and interest can be imposed on outstanding premiums, and we intend to similarly appoint the Inland Revenue Authority of Singapore as a recovery body to recover outstanding premiums. Let me reiterate that for those who genuinely need help, we will help them with the premium payments. For ElderShield policyholders who do not pay their premiums, their ElderShield cover will lapse after the grace period, similar to their current terms and conditions. Premiums collected under CareShield Life and ElderShield will flow into the CareShield Life and ElderShield Insurance Fund that will be established by clause 35 of the Bill. The insurance fund will be a self-sustaining fund, supported by the premiums collected under both schemes. The CareShield Life and ElderShield Insurance Fund will be managed by CPF Board in a not-for-profit manner, for the benefit of policyholders. The Fund moneys can only be used for policyholders’ benefit and scheme administration. The Government or CPF Board, as the Fund administrator, cannot remove any Fund moneys for its own use, except for the cost of operating the schemes. Let me now touch on the issue of governance. I want to assure Singaporeans that there are safeguards in place to ensure proper scheme governance for both CareShield Life and ElderShield.”
“This is so that the schemes will remain solvent and sustainable, and to be fair to other policyholders who have dutifully paid their premiums. For those who need help with their CareShield Life premium payments, we will put in place measures to ensure premiums remain affordable. There will be means-tested premium subsidies of up to 30% to help lower- to middle-income Singaporeans with their premiums. Transitional subsidies will be given to Singapore Citizens born in 1980 or later for the first five years from CareShield Life’s commencement to ease their transition into the Scheme. For Singapore Citizens born in 1979 or earlier, they will be given participation incentives of up to $2,500, if they join CareShield Life in the first two years after the Scheme is available for sign-ups from mid-2021. This is to encourage early participation in the Scheme. In addition, seniors from the Pioneer Generation and Merdeka Generation will receive additional participation incentives of $1,500, so that they receive a total of $4,000 in participation incentives. The participation incentives will be netted off their premiums payable over a period of 10 years, thereby reducing the amount of premiums that the policyholders will need to pay. Policyholders who need further help with their CareShield Life premiums even after premium subsidies and support measures can receive Additional Premium Support. This is similar to MediShield Life and is the Government’s commitment to ensure that premiums remain affordable and that no one loses CareShield Life coverage due to his or her inability to pay. However, there may be a small group of willful defaulters who refuse to pay their CareShield Life premiums despite having the means to do so, even after reminders have been sent to them.”
“This will ensure the continuity of their care. Third, we will require third-party payees to first apply for the payouts for the policyholder’s care, as provided in clause 50 of the Bill. Not doing so without reasonable excuse is an offence. If convicted, the penalty is double that for the offence of false declarations or wrongful access of information under clause 48 of the Bill, given that these are offences against vulnerable persons. This ensures that payouts are prioritised for the care of the policyholder. Further, we will protect the payouts from creditors. Clause 20 of the Bill protects CareShield Life and ElderShield payouts from creditors, with two tight exceptions. First, the Bill allows premium debt to be netted off from the payouts, and we will use this only in the case of willful defaulters who do not pay CareShield Life premiums but have made claims to benefit from the Scheme. We will do so in a calibrated manner and will cap the amount of debt netted off from the payouts each month to ensure that policyholders will continue to receive the bulk of the payouts to meet their long-term care needs. The second case is where there are monies owed by the policyholder to a healthcare institution, for instance, a nursing home, arising from the care provided to the policyholder, if the policyholder or authorised applicant has already directed the payouts to this institution. This ensures that healthcare institutions providing care to the policyholder can continue to be adequately resourced to do so. Sir, I will now move on to premiums. Clause 14 requires that CareShield Life and ElderShield policyholders pay their premiums in a timely manner.”
“Overall, we want to strike a careful balance between facilitating access and convenience for Singaporeans with the safeguarding of health and confidential information. Mr Speaker, another key feature of CareShield Life and ElderShield is that payouts will be in cash. This gives claimants the flexibility to decide on their preferred care arrangement, so that they can remain at home or in the community if they wish and still receive the cash payouts. However, it is important that these cash payouts are safeguarded. We will balance between such flexibility and the need for safeguards in several ways. First, some severely disabled policyholders may lack mental capacity and are unable to manage their cash payouts or even apply for claims in the first place. In this case, a donee or a deputy can act on their behalf to apply for claims and receive and manage the payouts. In the absence of a donee or deputy, clause 16 of the Bill allows certain family members or caregivers to be authorised applicants to make claims on behalf of such policyholders and receive payouts as approved payees so as to support the care of the policyholders. However, to safeguard against the risk of misuse or fraud, the classes of persons who can make or receive claims will be a tight list approved by the Minister and generally limited to those who are caregivers for the policyholder. They can only receive the payouts for a limited period of one year, subject to appeals for an extension, if necessary, to give them time to apply to be appointed as a deputy for the policyholder. Second, we will allow policyholders or their authorised applicants to nominate healthcare institutions caring for the policyholders, such as nursing homes, as approved payees under the Bill.”
“These provisions also allow us to access and use disability assessments already done at healthcare institutions to assess the eligibility of those born between 1970 and 1979 for the auto-enrolment exercise into CareShield Life without having to get them to be assessed again. Nonetheless, individuals can opt out from the access and disclosure of such disability-related health information, and we will release more details on how individuals can do so nearer the launch date. But I should point out that if they do so, if they do opt out of the access and disclosure, they will lose some convenience. For example, severely disabled individuals will not receive any proactive outreach to apply for claims because we do not know their disability status, and they may need to go for a separate disability assessment even if they had been assessed for disability recently at a healthcare institution. In addition, individuals born between 1970 and 1979 will not be auto-enrolled and may need to go for a disability assessment in order to join CareShield Life. Part 8 of the Bill also enables CPF Board and AIC to access, subject to certain safeguards, an individual’s confidential information in the possession of another Government department or public authority for the administration of CareShield Life, ElderShield and prescribed social or healthcare-related public schemes. Again, this is meant to increase convenience for policyholders. The Bill makes the wrongful access, use or disclosure of any information collected an offence. If convicted, a person may be liable for a fine of up to $5,000, or imprisonment of up to 12 months, or both.”
“Policyholders who prefer higher coverage or better benefits can buy Supplements from private insurers. Existing Supplements administered by the private insurers will not be transferred to the Government. Clause 16 of the Bill provides for claims to be made for CareShield Life or ElderShield payouts. We recognise that being severely disabled can be a stressful situation for policyholders and their caregivers. Hence, we want to make the claim process more convenient. To this end, we plan to double the number of disability assessors to about 300 by the launch of CareShield Life, and we are working with healthcare institutions to progressively expand the types of disability assessments that can be accepted for claims, so that policyholders need not undergo another disability assessment if we already have similar data on their disability status. To further provide convenience to policyholders, Part 8 of the Bill will enable CPF Board and AIC to access an individual’s disability-related health information and allow the information to be disclosed to authorised persons approved by the Minister, for the administration of prescribed public schemes, or provision of support to disabled persons for prescribed purposes. These provisions allow us to proactively reach out to disabled individuals to inform them of their eligibility for claims, not just for CareShield Life and ElderShield, but also for other Government disability schemes, using disability assessments already performed at our healthcare institutions.”
“As announced earlier this year, we are transferring the ElderShield scheme, which is currently administered by private insurers, to the Government. This will be done in mid-2021, together with the launch of CareShield Life for older Singaporeans born in 1979 or earlier. The transfer allows ElderShield to be administered on a not-for-profit basis, with CPF Board and AIC as the Government's key administrators. This will facilitate a smooth upgrading from ElderShield to CareShield Life for those who choose to do so. This Bill will dis-apply the Insurance Act to the transfer, as otherwise the ElderShield portfolios cannot be transferred to the Government because the Government is not included in the definition of "transferee" in the Insurance Act. However, in practice, we will take reference from the requirements the Monetary Authority of Singapore (MAS) has put in place in governing the transfer to protect policyholders. This includes appointing an independent external auditor to audit the transfer and providing MAS with the full audit reports. Those who choose not to upgrade to CareShield Life will remain covered by their existing ElderShield policy. I would like to assure ElderShield policyholders that the terms and conditions of their ElderShield policy will remain. In addition, they will also benefit from the improvements to the claim process that will be implemented for CareShield Life. Now, let me move on to the benefits and payouts of the schemes. CareShield Life and ElderShield will remain as basic schemes to benefit severely disabled policyholders, as provided in clause 12 of the Bill. This keeps premiums affordable, which is crucial for a national scheme like CareShield Life that caters to a broad segment of Singaporeans.”
“However, the Scheme will be optional for older cohorts of Singapore Citizens and PRs born in 1979 or earlier, and they can join the scheme if they do not have pre-existing severe disability. The ElderShield Review Committee had recommended to keep the scheme optional for them because their circumstances and their needs could vary widely. To encourage participation of younger cohorts of this group, we will auto-enrol those born between 1970 and 1979, who are ElderShield policyholders and are not severely disabled. This makes it more convenient for them to join and they can still choose to opt out before 31 December 2023, if they wish to do so. So, they will be auto-enrolled, but they have the option to opt out of the Scheme and they can do so up to 31 December 2023. The new CareShield Life Scheme will be launched around mid-2020 for Singaporeans born in 1980 or later, and we aim to progressively launch the Scheme for Singaporeans born in 1979 or earlier, from mid-2021, about a year later. The Bill also provides for CareShield Life to cover all individuals who become Singapore Citizens or PRs after the Scheme commences. These are the new Singapore Citizens and PRs. This way, all new Singapore Citizens and PRs will participate in this national scheme and benefit from better support for their future long-term care needs, just like all Singapore Citizens and PRs today. The only exception is if they are born in 1979 or earlier, the older Singapore Citizens and PR, and are severely disabled. Like Singapore Citizens and PRs in those cohorts who are already severely disabled at the launch of CareShield Life, they will also not be able to join the scheme. Next, let me touch on ElderShield. Part 3 of the Bill provides for Government administration of the ElderShield Scheme.”
“First, clause 5 of the Bill provides for the establishment of the CareShield Life Scheme. It provides for the Central Provident Fund (CPF) Board to administer CareShield Life and be responsible for the issuance and servicing of the insurance policies, premium collection, payment of benefits and management of the CareShield Life and ElderShield Insurance Fund. I will talk about the Fund in a short while. We will also be appointing the Agency for Integrated Care (AIC) as the Administrator. AIC will be responsible for the assessment of an individual’s eligibility for the claim by ascertaining his or her disability status. This division in administrative roles between CPF Board and AIC allows us to tap on the expertise of the respective agencies. In particular, as AIC administers all of the Ministry of Health's (MOH's) disability schemes, AIC will be the natural touchpoint for seniors. They are best placed to advise disabled seniors and their caregivers on the various forms of long-term care services and financing schemes they can tap on. Clause 6 of the Bill defines the groups of individuals that will be covered under the CareShield Life Scheme. In line with our vision for inclusivity, the Scheme will apply to all Singapore Citizens and Permanent Residents (PRs) born on 1 January 1980 or later. Those who are at least 30 years old will be covered when the Scheme is launched. Subsequent cohorts would be covered on their birthday when they turn 30 years old. This provides universal coverage for future generations of Singaporeans, ensuring CareShield Life coverage for them, regardless of their health, pre-existing disability or financial status.”
“All these three pillars are essential – insurance, savings and Government support – and achieving the right balance among them is crucial in keeping our system inclusive, affordable and sustainable. Therefore, in addition to strengthening insurance, we have concurrently reviewed how other financing sources of long-term care can complement CareShield Life and ElderShield to better support Singaporeans with disability. We will enhance Government support for long-term care through the establishment of ElderFund in January 2020. ElderFund will be a discretionary Government assistance scheme for low-income, severely disabled Singapore Citizens who are aged 30 and above. It will provide up to $250 per month, especially to those who are unable to join CareShield Life, have low MediSave balances and face financial difficulties in meeting their long-term care needs. This is in addition to existing subsidies of up to 80% for long-term care services, such as nursing homes, and various other Government disability assistance schemes. Around mid-2020, we will also be extending the use of MediSave by allowing Singaporeans to withdraw cash from their own and spouses' MediSave for their long-term care needs. Severely disabled Singaporeans who are at least 30 years old will be able to make cash withdrawals of up to $200 a month from their own and their spouses' MediSave Accounts to support their long-term care needs. This CareShield Life and Long-Term Care Bill provides the legislative framework for the establishment, governance and administration of the CareShield Life Scheme, and also facilitates the implementation of other long-term care financing measures for the severely disabled I mentioned earlier. Mr Speaker, I shall now highlight the key provisions of the Bill.”
“One important area we need to address is long-term care financing. In 2016, the ElderShield Review Committee was set up to look into how we can provide greater financial support for Singaporeans who become severely disabled during old age. After rigorous deliberation and extensive public consultation, the Committee submitted its report to the Government last year with the following key recommendations. First, universal insurance coverage for Singaporeans born in 1980 or later, regardless of their health, disability and financial status, so that our future generations will have basic protection against the costs of long-term care. Second, higher payouts that increase over time and are for life, so that Singaporeans are better supported for as long as they remain severely disabled; and simpler claim processes, so that severely disabled Singaporeans and their caregivers can apply for claims more conveniently. The Government accepted the recommendations made by the Committee and the report was debated in Parliament in July last year. We announced our plan to introduce CareShield Life. The risk-pooling approach through the universal insurance coverage for CareShield Life reflects our desire to nurture an inclusive and caring society. I am glad that it had received support from Members of this House. Once again, I would like to thank the Committee for their work. Financing our long-term care is a shared responsibility. We come together as a society to pool our risks through insurance, CareShield Life and ElderShield, to address the variability of long-term care costs. Individuals and their families also play a part through their own savings, and the Government provides significant support through subsidies and assistance schemes, particularly toward the lower income.”
“Mr Speaker, I beg to move, "That the Bill be now read a Second time." Population ageing is a global phenomenon. For Singapore, the good news is that we are living longer, and many of our seniors live fulfilling and active lives, well into their silver years. However, ageing also comes with related illnesses and disability. To enable more of our seniors to age well with dignity and purpose, we need to prepare ahead of time. We need to look at how we can better organise social and health care, how we can enable our seniors to stay healthy, age-in-place and continue to contribute to the community, and how we can support them in their medical and long-term care needs. We have made significant progress in these areas over the past few years. In 2015, we implemented MediShield Life to provide universal health coverage, with better protection for all, so that all Singaporeans have peace of mind for their hospitalisation bills, and for life, so that older Singaporeans are covered, too, regardless of their age. That year, we also developed the Action Plan for Successful Ageing with various stakeholders, which now has over 70 initiatives underway to empower our seniors to live well, even as we live longer. Earlier this year, we announced the Caregiver Support Action Plan to strengthen the support for caregiving for our seniors. These include the Home Caregiving Grant, respite care services, and caregiver empowerment and training. More recently, we introduced the Merdeka Generation Package, to thank the Merdeka Generation for their contributions to Singapore and provide more support for their healthcare and long-term care needs in their silver years. This follows the Pioneer Generation Package that was introduced in 2014.”
“From 2015 to 2017, Singaporean Citizens and Permanent Residents (PRs) at the 10th to 40th percentile of subsidised hospitalisation bills paid $0 in cash, after taking into account subsidies, MediShield Life and MediSave deductions. Over the same period, the median amount of cash paid by Singaporean Citizens in the 10th to 40th per capita household income percentiles for subsidised hospitalisations was also $0, after taking into account subsidies, MediShield Life and MediSave deductions. The corresponding figures for Permanent Residents ranged from $38 to $47 over the same period.”
“Hand, Foot and Mouth Disease (HFMD) is a common childhood illness. Most children recover from HFMD on their own without treatment. As HFMD infections are not reportable and the majority are mild, the Ministry of Health (MOH) does not track the number or percentage of children who have contracted HFMD and the number of times they have contracted the disease during their life. As HFMD can be caused by different viruses, infection by one virus does not confer immunity to other viruses. As such, a person who has recovered from HFMD may be infected again. The key to controlling the spread of HFMD is to maintain high standards of personal and environmental hygiene, and to seek medical treatment early when the child is unwell. MOH works closely with the Ministry of Education, Early Childhood Development Agency and the People's Association to ensure that educational institutions, including childcare centres, remain vigilant and take measures to minimise the spread of infectious diseases. Parents should also ensure that their children with HFMD remain at home for the duration of the illness as advised by the doctors, to prevent spread to others.”