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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“Eric is 78 years old and has been volunteering actively at Siglap for the past five years. In particular, he helps out with the Health Peers Programme run by CGH and the South East Community Development Council (SECDC). Eric keeps himself busy by encouraging fellow seniors in Siglap to go for health screenings and he visits the residents to raise awareness of diabetes prevention and management. In the process, his volunteer work helps keep him fit! Mr Eric Teo exemplifies the spirit of SG Cares and shows us how seniors, too, can care for fellow seniors. I hope his experience inspires more Singaporeans, regardless of age, to come forward to volunteer in the community, so that we make SG Cares an enduring movement. Minister Grace Fu will speak more on volunteerism in her speech. Last but not least, several Members touched on the role of caregivers in the Budget Debate. We recognise the dedication of caregivers and the important role they play in caring for our seniors. My Ministry will provide greater support for caregivers. Providing respite options will give relief to caregivers who need help for a few hours over the weekend. They can leave their loved ones at one of the 10 senior care centres across Singapore, where they will be looked after. For those who need a longer respite, they can have their elderly cared for at one of the over 40 nursing homes for several days, up to a month. In addition, our Eldersit programme provides an eldersitter, just like babysitter, to look after seniors with dementia at their homes. We have also rolled out financial schemes to help defray the costs of care and caregiver training. Going forward, there is room to do more. Emotional and timely support is important for caregivers.”
“This move also allows us to plan ahead for eldercare services at the national level and in a more integrated manner. As Dr Lily Neo suggested, the transfer of services under the Senior Cluster Network (SCN) from MSF will enable MOH to better integrate SCN services into the wider CNS. For example, MOH can now engage service providers to discuss new opportunities for SACs to help seniors age in place, such as through active ageing programmes. Sir, ultimately, however, what defines us as a nation is how well we, as a society, collectively show respect, care and concern for our seniors. The progress we make in strengthening intergenerational bonds will shape our social fabric in the future. We see this happening in many purposeful ways. For example, St Joseph’s Home, which Mr Kok Heng Leun mentioned earlier, has a childcare centre and intergenerational playground co-located with the nursing home, creating many opportunities for shared experiences like meals and activities. At Bedok Orchid RC, students from Temasek Junior College read newspapers and share current affairs with seniors every week, including the Budget. Not only do both parties gain new insights, they also form new friendships. Volunteerism is another way through which we unlock our community resources. The 15,000 volunteer Health Ambassadors and Health Advocates from our Health Promotion Board (HPB) come from all walks of life and play an important role in health promotion and raising public awareness. We can also harness the immense wealth of knowledge and experience of older volunteers who continue to contribute to the society, as Dr Tan Wu Meng and Dr Lily Neo suggested. A good example is Mr Eric Teo, whom I met last month.”
“I agree with Dr Lily Neo, who suggested that the new SGO act as a liaison agency for seniors to proactively connect them to services in the community. As mentioned earlier by Minister Desmond Lee, my Ministry will also be working with the SSO to do this. Moving forward, SGO will do more targeted outreach to bring preventive health and wellness programmes to seniors. For those with multiple needs, they can be quickly connected with relevant health and social support services under AIC. 1.00 pm One example of a senior who has benefited from CNS is Mdm Lim. She is now in her 70s and used to be a lively Chinese opera singer but spent more time alone at home after retirement. Thanks to a PG Ambassador, Madam Lim is connected to TOUCH Community Services, which subsequently helped her install grab bars in her home, arranged for medical escort and transport services for her medical appointments and also linked her up with Meals on Wheels so that she gets proper meals. Today, she attends the National Trades Union Congress' (NTUC’s) SilverACE Senior Activity Centre at Taman Jurong regularly and even takes up taichi at the nearby Community Centre (CC). Madam Lim also spends time with a befriender every week. I am cheered to know many helping hands are working together to care for her through CNS. Sir, our second shift is to consolidate all health and social aged services under MOH to better support seniors to age well within the community. The transfer of MSF’s social care functions to MOH allows us to deliver support to seniors more seamlessly, with AIC as our central implementation agency to coordinate all social and health-related services for seniors and their caregivers.”
“This is why we piloted the Community Networks for Seniors (CNS) in 2016 to mobilise and coordinate efforts of community volunteers, service providers and other stakeholders in each community to care for seniors. In Tampines, for example, the Evergreen SAC and the Residents' Committees (RCs) work together to organise regular active ageing activities to keep seniors well and active. We recently started a Community Nurse Post at Evergreen SAC, where a nurse from Changi General Hospital (CGH) is available once a week to help conduct health checks and follow-ups for residents. For lonely seniors, volunteers and block representatives visit and befriend them. Care Line, a 24/7 telecare and befriending service, is also available. Should seniors require a home visit to check in on them, the Singapore Red Cross volunteers can be activated. Sir, our vision is to build more of such "communities of care” throughout Singapore. We are making two structural moves to achieve this. First, the repositioning of PGO as SGO, housed within the AIC, will help extend our outreach efforts to seniors beyond the Pioneers and tap on the capabilities and services of AIC. Some 3,000 volunteers have been trained as Pioneer Generation (PG) Ambassadors since 2014. They have done good work and many of them have established personal relationships with the seniors they care for. In fact, one in four PG Ambassadors are themselves seniors aged 60 and above. Our PG Ambassadors remain the cornerstone of our efforts to create local communities of care. They have connected with more than 400,000 seniors in almost 800,000 engagements since 2014. The conversion of PGO to SGO reflects the Government’s commitment to proactively reach out to our seniors, to engage them, understand their needs and care for them.”
“Sir, Minister Desmond Lee has mentioned the SG Cares movement and how it will galvanise the whole nation to care for fellow Singaporeans, especially the more vulnerable, including the seniors. Let me elaborate on our efforts in supporting seniors, our initiatives to build "communities of care", and how we can each play our part in nurturing a caring society. We will continue to plan ahead for our seniors. Since 2011, we have expanded our healthcare capacity to help seniors age in place. We are continuing to develop new models of care and improve the affordability of eldercare services. In 2012, intermediate and long-term care (ILTC) subsidies were enhanced to cover up to two-thirds of Singaporean households. As many Members know, we are reviewing ElderShield to provide stronger support for disability in old age, and recommendations of the review committee will be released by mid-year. This year’s Budget has put aside $2 billion for ElderShield subsidies to ensure premiums will be affordable. We are also enhancing our Seniors’ Mobility and Enabling Fund (SMF) and expanding the Community Silver Trust (CST) fund to cover active ageing initiatives. Preparing for our ageing population is a whole-of-nation, whole-of-Government endeavour, which is why we launched the Action Plan for Successful Ageing in 2015 to drive collective action in areas, such as employability, senior volunteerism, health and wellness, housing and transport. Dr Amy Khor gave an update of the action plan in Parliament last month. I agree with Dr Tan Wu Meng that we must address the needs of seniors holistically. Seniors often have multiple needs, and we can better coordinate services among partners and stakeholders.”
“Mr Chairman, may I also have your permission to display some slides?”
“All our polyclinics and specialist outpatient clinics have implemented appointment booking to minimise waiting time for patients. As many of our patients are elderly, appointments are given based on clinical need. This ensures that patients who are more ill or require urgent medical attention are seen earlier regardless of age. Nevertheless, clinic staff are trained to identify patients with potential fall risks, mobility issues or who appear unwell and assistance will be provided when necessary. Wheelchairs are available and service points are also installed with mobility aids, such as grab bars, ramps and lifts. Priority seats are available for those who need to sit while waiting for their turn. Polyclinics also have self-help kiosks, online or mobile platforms for payment and booking of next appointments for the convenience of the patients and caregivers. Medications can also be home-delivered or collected at selected retail outlets and Pillbox lockers. These initiatives minimise the need to queue at payment or pharmacy counters.”
“Fixed Amount on Ward (FAW) pensioners are entitled to comprehensive medical benefits at Government healthcare institutions and are hence not required to set aside any MediSave. However, they may opt to set aside MediSave. One thousand two hundred and thirty-six, or 99.6% of FAW pensioners, have zero MediSave balances. Co-payment on Ward (CPW) pensioners need to set aside 30% of their cohort's applicable Basic Healthcare Sum (BHS). In 2016, 8,200, or 50% of CPW pensioners, have MediSave balances below 30% of their cohort’s applicable BHS. For all Central Provident Fund (CPF) members, any MediSave monies above their respective BHS is automatically transferred to their other CPF accounts. FAW and CPW pensioners will be able to withdraw these monies if they had met their applicable Retirement Sum.”
“The ElderShield Review Committee (ESRC) is in the process of reviewing the ElderShield scheme, including the payout quantum and duration. It has consulted widely and obtained valuable inputs from stakeholders. The Government Parliamentary Committee for Health has also submitted a report to the Committee. ESRC will be making its recommendations to the Government by the middle of the year. ElderShield is an insurance scheme that provides basic protection against the costs of long-term care arising from severe disability, especially in old age when such risks are higher. Enrolment to the current ElderShield scheme begins at age 40 to allow policyholders to pay their premiums during their working years from age 40 to 65. Coverage will start from age 40, with lifetime protection for the policyholders as they age and become elderly over time. The opt-out rate for ElderShield was 11% in 2007 and this has decreased to 5% in 2016.”
“The proportion of births registered at public hospitals was 41.7%, 43.3% and 44.7% in 2014, 2015 and 2016 respectively. For private hospitals, the figures were 58%, 56.4% and 54.9% respectively. A small proportion of births occurred at other locations, such as personal residences. For elderly decedents aged 65 and older, 57.7%, 59% and 59.1% of deaths were registered at public hospitals in 2014, 2015 and 2016 respectively. Less than 2% of elderly deaths were registered in private hospitals from 2014 to 2016. Other places of death, which include nursing homes, charitable institutions and personal residences, comprised approximately 40% of elderly deaths in the period 2014-2016.”
“The number of Singapore residents aged 65 and above who lived alone in the past five years is shown in Table 1 below. We do not track the number of elderly found dead in their homes while living on their own. Given the growing number of seniors living alone, the Ministry of Health (MOH) has been making additional efforts, together with our community partners, to engage and care for our seniors. We launched the Community Network for Seniors (CNS) in 2016, which aims to develop a strong system of community-based support to complement family support, so as to keep seniors healthy and socially engaged and help them age well in place. A key focus area is befriending. We work with our network of Pioneer Generation Ambassadors, grassroots leaders and community voluntary welfare organisations (VWOs) to connect seniors who are lonely or at risk of social isolation with befrienders or neighbour volunteers in their neighbourhood. To date, we have over 850 volunteers serving 2,500 vulnerable seniors in 47 constituencies. We are also leveraging technology to better support our seniors. For example, Changi General Hospital is piloting Care Line, a 24/7 tele-befriending and telecare service. This programme supports seniors living in the community through alerts on active ageing activities in their area, information about programmes and urgent assistance if seniors are unwell. Building communities of care requires all of us to play our part. MOH will continue to work with our community partners, other agencies and our fellow Singaporeans to support our seniors.”
“Common outpatient non-chronic illnesses seen at the primary care setting include the common cold, diarrhea, vomiting, sprains and strains. Between 2015 and 2016, the average total bill size of a non-chronic attendance at polyclinics was about $16 for Singapore Citizens, after Government subsidies. This includes an average cost of medications of $4. Over the same period, Community Health Assist Scheme (CHAS) Blue and Pioneer Generation cardholders at general practitioner clinics participating in CHAS paid slightly more than $20 per visit on average for non-chronic attendances, including medications. Before CHAS subsidies were applied, their average bill was $45 per visit, about half of which was medication costs. At our public healthcare institutions, including polyclinics, patients who have concerns about their medical bills, may apply for financial assistance, such as MediFund.”
“Prescription-only medicines can only be dispensed from a licensed healthcare institution or retail pharmacy with a valid prescription. Anyone who contravenes this law can be fined up to $50,000 and/or jailed for up to two years under the Health Products Act. The Health Sciences Authority (HSA) works with local web administrators to educate online sellers on the laws regulating prescription drugs and the consequences of illegally selling prescription drugs online. It also works with the web administrators to remove inappropriate online content advertising such sales. In the area of enforcement, HSA monitors online sites to detect illegal sales of medicines and takes actions against those who engage in such sales. As the issue extends beyond local sites, HSA also works with the International Criminal Police Organization (INTERPOL) and its overseas counterparts to tackle the illegal sale of medicines. Finally, HSA has embarked on public education efforts to complement its preventive and enforcement activities. It has issued consumer advisories and press releases to raise public awareness on the dangers of purchasing medicines online. In January 2018, for example, HSA launched an online campaign which included an educational video to highlight the risks of buying from dubious online sources. This video is also being shown by our three public healthcare clusters and three major retail pharmacy chains.”
“There is no mandatory reporting to the Government on the take-up rate of parent care leave across the private sector. According to the Ministry of Manpower's (MOM's) Conditions of Employment Survey 2016, 19% of employers1 provided paid parental care leave for employees to take care of their parents when sick in 2016, up from 6% in 2008. The Government encourages employers to provide more family-friendly practices, including family-related leave benefits, via a few ways. First, the Civil Service has introduced two days of parent care leave per year. Around four in 10 civil servants utilised the parent care leave in 2016. Second, MOM's Work-Life Grant funds each company up to $160,000 over four years to implement Flexible Work Arrangements (FWAs)2 to help employees better manage work and family responsibilities, which may include caregiving for aged parents. Third, MOM also launched the Tripartite Standard on FWAs in October 2017 to encourage more employers to publicly commit to offering FWAs in their companies. As of 2016, 67% of employees work in companies that offer at least one formal FWA, up from 56% in 2011. Close to eight in 10 employers also provide unplanned time-off or ad hoc teleworking for their employees to attend to personal matters. The Ministry of Health will continue to work with other Ministries and tripartite partners to encourage employers to adopt family-friendly practices, and to strengthen support for working caregivers.”
“Seniors requiring wheelchair transport assistance can apply for funding under the Seniors' Mobility and Enabling Fund (SMF) to offset the cost of wheelchairs and other assistive devices, as well as transport services to the Ministry of Health (MOH)-funded eldercare and dialysis services. Based on our estimates, over the last five years, 23,000 seniors received subsidies for wheelchairs under the SMF, and 6,000 seniors who are wheelchair users benefited from our transport subsidies. We do not have other data that provide comprehensive information on the total number of residents who require wheelchairs. We have also been working with transport providers to support seniors who are frail or require wheelchairs. For example, the MOH-funded Medical Escort and Transport (MET) services provide transport and accompaniment services for such seniors who need to attend medical appointments at hospitals, specialist outpatient clinics and polyclinics. Seniors from lower-income families receive higher levels of funding under both the SMF and MET. To increase transport options for frail and wheelchair-bound seniors, the Agency for Integrated Care (AIC) is appointing centralised providers to operate transport services to eldercare centres. AIC has also trained drivers from our taxi companies and, more recently, drivers from Uber, to better cater to passengers who are in wheelchairs.”
“The Human Papillomavirus (HPV) is a cause of cervical cancer. Infection from HPV serotypes 16 and 18, which account for 70% of cervical cancer cases, can be prevented through vaccination. HPV vaccination for females aged nine to 26 years has been recommended under the National Childhood Immunisation Schedule since November 2010. Singaporeans can use their MediSave for HPV vaccination. Based on information from MediSave claims, about one in four Singapore female residents aged 26 years in 2016 have been vaccinated. The Ministry of Health and the Health Promotion Board have been stepping up on public education efforts, such as making HPV-related information more readily available to the public through the HealthHub website and social media platforms. This has to be done sensitively as HPV is a sexually-transmitted infection. Parents are also encouraged to discuss HPV vaccination with their family doctors, so that they can make an informed decision to vaccinate their daughters.”
“Government pensioners receive one of the four Post-Retirement Medical Benefits: Fixed Amount on Ward (FAW), Co-payment on Ward (CPW), Comprehensive Co-payment Scheme (CCS) and MediSave-cum-Subsidised Outpatient (MSO) scheme. FAW pensioners are entitled to comprehensive medical benefits at Government healthcare institutions, and hence not required to set aside any MediSave. CPW pensioners only need to set aside 30% of their cohort’s applicable Basic Healthcare Sum (BHS). The average MediSave balance of CPW pensioners is $15,700. CCS and MSO pensioners are subject to their cohort's applicable BHS. The average MediSave balances are $47,400 and $43,300 for each pensioner under the CCS and MSO schemes respectively. On average, CPW, CCS and MSO pensioners made one, two and three transactions per person respectively in 2016.”
“The Institute of Mental Health (IMH) does not maintain data on the number of cases suspected of mental health conditions who were referred by the Police or other agencies arising from neighbourly disputes. However, the Agency for Integrated Care (AIC) has been receiving referrals for mental health assessments arising from neighbourly disputes. Between 2015 and 2017, 31 referrals were received by AIC, of whom eight had active mental health symptoms and were referred to IMH for treatment. In the community, residents who observe persons who display disturbing behaviours can contact AIC at careinmind@aic.sg for assistance and referral. If they encounter persons in crisis, residents can contact the IMH Mental Health 24-hour Helpline at 6389 2222, which is manned by counsellors who are trained to assess and triage cases, and activate home visit teams quickly if necessary. In cases where a person is behaving in a manner that is dangerous to self or others, members of the public should call 999 for urgent Police assistance.”
“The GPFirst programme is a pilot scheme first introduced at Changi General Hospital (CGH) in January 2014. GPFirst aims to encourage patients with non-emergency conditions to seek treatment at General Practitioners (GPs) rather than at the Emergency Department (ED). Patients assessed by the participating GPs as requiring ED care are referred to the ED with minimal delay. In recognition that the patient has incurred initial charges at the GP, a $50 subsidy is provided to offset the patient’s ED bill. In 2016, about $1 million was invested in the GPFirst programme at CGH which would include the ED subsidy, expenses on GP engagement initiatives and publicity to raise the awareness of the programme. The programme not only helps to reduce non-emergency cases seen in CGH’s ED, thereby saving unnecessary ED expenses by the hospital and the patients. More importantly, it also enables the ED to focus on attending to patients with critical conditions in a timelier manner. Patients with non-emergency conditions will also benefit from more timely access to care at the GPs and cost savings as the GP charge would typically be less than $50, as compared to $120 if he visits the CGH ED. From CGH's pilot, the Ministry of Health has concluded that the benefits justify the cost of running the GPFirst scheme. The scheme will be extended to more public hospitals in 2018. This will entail establishing close partnerships with GPs, promoting awareness among residents and learning from CGH's pilot.”
“MediShield Life was introduced in November 2015 as a universal healthcare insurance scheme that provides all Singapore Citizens (SCs) and Permanent Residents (PRs) with lifelong coverage against large healthcare bills. MediShield Life has been successfully implemented. Since its launch, around 300,000 SCs and PRs have made successful claims, including around 40,000 who were previously uninsured. Overall claims increased from $758 million in 2016 to $845 million in 2017. To promote better understanding of MediShield Life and its features, roadshows were conducted in partnership with the media and community organisations. These include media advertisements and targeted outreach to seniors through the Pioneer Generation Office and Grassroots Organisations. These efforts have helped to raise public awareness and appreciation for MediShield Life. With Government subsidies and financial assistance from Additional Premium Support, we have achieved a very high compliance rate for payment of MediShield Life premiums. As at end October 2017, about 1% of Singapore Residents have not fully paid their premiums. The Ministry of Health will continue to work with the Ministry of Social and Family Development (MSF) and Central Provident Fund Board to follow up with these individuals and provide assistance to low-income Singaporeans. No one will lose their MediShield Life coverage due to genuine financial difficulties in paying for the premiums.”
“Under the Medical (Therapy, Education and Research) Act, anyone from 18 years of age and who is not mentally disordered can pledge to donate their whole body upon death to be used for research, transplant or education purposes. In the last three years, the numbers of new pledges for whole body donation after death to be used for medical research are as shown in the table below.”
“Over 4,200 residents are currently receiving Government subsidies for home-based nursing care provided by the Ministry of Health (MOH)-subvented providers. This is an increase of 15% from a year ago. Up to two-thirds of Singaporean households can meet the income criteria for receiving these subsidies. Lower-income households will receive higher levels of subsidies, which can be up to 80%. In addition, the Government also supports caregivers of seniors in other ways. For example, the Seniors' Mobility and Enabling Fund (SMF) provides funding to offset the cost of assistive devices and home healthcare items. Families which need to hire a foreign domestic worker (FDW) to care for frail seniors may be eligible for a concessionary levy, as well as the FDW Grant, to help offset the cost of hiring an FDW. We aim to expand home-based care service capacity to 10,000 places by 2020. We will also continue to work on the quality and affordability of home and community-based care services. For example, we recently introduced Integrated Home and Day Care services where home-based care is paired with care at day care centres. This flexible model enables seniors to interact with others on days when they are well, and cared for at home on other days. We are currently reviewing the ElderShield scheme to help Singaporeans better prepare for the costs of long-term care.”
“The Health Promotion Board (HPB) has introduced many initiatives to encourage individuals to live healthily, as well as go for regular health screening under Screen For Life (SFL). The screening subsidies under HPB's SFL were recently enhanced.”
“The 2017 American Heart Association (AHA) and American College of Cardiology (ACC) guidelines have defined high blood pressure as 130/80 millimeters of mercury (mmHg) or higher. However, the Ministry of Health (MOH) has decided to maintain its definition of hypertension as blood pressure 140/90 mmHg or higher in its Clinical Guidelines for Hypertension, after consulting local experts. This value remains the general consensus globally, supported by guidelines from societies, such as the International Society of Hypertension, the European Society of Cardiology and the National Heart Foundation of Australia. If Singapore adopted the new AHA guidelines, our hypertension prevalence would double from 21.5% to 43.2%4. Despite the differences in definition, the management approach under the MOH's current and US' newly introduced definition is broadly similar. Under both sets of guidelines, all individuals with hypertension should change their lifestyles, whereas medication is recommended for hypertensive individuals with blood pressure higher than 140/90 mmHg. However, specifically for those with cardiovascular risk factors, the US guideline differs from the current general global consensus in recommending initiation of medication at a lower target of 130/80 mmHg, after an individual risk assessment. We will continue to monitor developments in this aspect and finetune our guidelines where necessary. Hypertension can be effectively prevented through healthy lifestyle habits, such as maintaining a balanced diet and avoiding excess salt intake, regular physical activity and not smoking. For those with hypertension, screening and early detection will facilitate prompt treatment to achieve good health outcomes.”
“There are benefits and cost savings from the economies of scale achieved through central procurement of common essentials across public healthcare institutions. Since 2001, the public healthcare clusters have been supported by a centralised Group Procurement Office (GPO). Today, GPO procures about 90% of standard drugs and 60% of non-standard drugs across our public healthcare clusters. It also covers certain common items, such as surgical supplies and contract services. More recently, GPO procurement services have been extended to community hospitals and nursing homes. On information technology (IT) procurement, the Integrated Health Information Systems (IHiS) has centrally coordinated IT system purchases to allow public healthcare institutions to benefit from volume discounts. It has also consolidated the data centres of individual institutions for better efficiencies. These have brought about cost savings for our public healthcare system. We will continue to look for ways to bring about greater efficiencies and cost reductions in the healthcare system through bulk purchase and central procurement, and to pass on the savings to our patients.”
“Healthcare providers are required to protect their patient records, including electronic records, and to comply with nationwide cybersecurity standards for the purpose of contributing to and accessing the National Electronic Health Record (NEHR). These include installing a secure information technology (IT) system, using two-factor authentication and regularly updating the anti-virus security software to enhance the protection against cyberattacks. The Ministry of Health will continue to work closely with the Cyber Security Agency and healthcare providers to monitor the cybersecurity threat landscape and put in place additional safeguards when new risks emerge. We will also conduct regular exercises to test the resilience of our systems and maintain a high level of cyber-readiness.”
“These included initiatives to better outreach to individuals suffering from mental health conditions for early treatment, and enhancement of mental health services in the primary care sector.”
“In 2010, the Institute of Mental Health (IMH) conducted the first Singapore Mental Health Study which concluded that 9.3% of Singapore Residents would have at least one mood5 or anxiety disorder at some point of their adult lifetime. Among the illnesses assessed, Major Depressive Disorder (MDD) and Obsessive Compulsive Disorder (OCD) were the most common mental health conditions in Singapore. MDD affected one in 17 Singapore Residents and OCD affected one in 33 Singapore Residents at some point in their lifetimes. The second Singapore Mental Health Study is currently underway. It will inform us how the mental health landscape has changed in the years since the first study and provide insights into other conditions, such as schizophrenia and sleep disorders. In addition, IMH has also conducted the Mental Health Literacy Study, which was completed in 2016. The study focused on social perceptions and stigmatisation of mental illness. The study suggested considerable stigma towards individuals with mental health conditions, which could hinder such individuals from seeking treatment. Government agencies, healthcare providers and community partners have been working together on efforts to reduce the stigma of mental health conditions and encourage help-seeking. For example, the National Council of Social Services is embarking on a multi-year public education campaign to promote a more inclusive society for persons with mental health conditions. The enhanced Community Mental Health Masterplan announced in 2017 is being implemented to strengthen community-based care for persons with mental health conditions.”
“To encourage working adults to participate in the National Steps ChallengeTM, the Health Promotion Board (HPB) introduced a Corporate Challenge in Season 2 which lasted from 14 November 2016 to 28 February 2017. Over 65,000 employees from 260 organisations participated in the Corporate Challenge. The National Steps ChallengeTM has successfully motivated more Singaporeans to become more active. When individuals took part in the Corporate Challenge, we found that participants walked an additional 1,500 steps per day on average. Interviews with participants indicated that peer influence and organisational support were instrumental in motivating them to walk more. A competitive team element also spurred participants to improve and sustain their efforts. The upcoming season of the Corporate Challenge will take place from 1 December 2017 to 31 March 2018. HPB aims to attract 90,000 employees to participate. HPB has been actively engaging trade associations, chambers and unions, such as the Singapore Manufacturing Federation, Food Industry Asia, Singapore National Employers Federation, National Trades Union Congress U Live and Singapore International Chamber of Commerce to reach out to their member companies. We will continue to reach out to more corporations and individuals to participate in the National Steps ChallengeTM and adopt a healthy lifestyle.”
“In the last two years, 26 individuals were issued writs of summons for the arrears of bills by our public healthcare institutions, of which 15 cases were settled out-of-Court, one case resulted in default judgment and was resolved with the individual making payment, and the remaining 10 cases are still in progress. These figures exclude employers who are required to pay for their employees' medical bills but have not done so. It is important for patient bills to be paid promptly so as not to deprive public healthcare institutions of the resources they need to deliver healthcare services to patients. For Singaporeans, Government subsidies and MediShield LIFE cover a significant proportion of public hospital bills. MediSave can be used to help defray the costs of the remainder of the bill. Singaporeans who face difficulties with their healthcare bills can approach our medical social workers for assistance.”
“Generalist doctors play a central role in providing patient-centric and holistic care for an ageing population. To strengthen and empower generalist doctors, the Ministry of Health is investing in training and development of broad-based professional competencies for all doctors. We plan to incorporate a set of core clinical curriculum of generalist skillsets in our medical schools’ undergraduate curriculum. For postgraduate training, efforts are underway to define the generalist competencies that should be integrated into the training programmes for specialists. For example, a mandatory Geriatric Medicine Modular Training Programme for non-Internal Medicine residents2 has been instituted as part of Residency training to equip residents with the necessary skills of managing elderly patients within their respective specialties. We noted Dr Tan's comments on allowing flexibility in recognising generalist experience of doctors so that they are not disadvantaged when selecting their training path later. This is already the case for specialties with an Internal Medicine background where doctors spend three years in generalist Internal Medicine training before selecting one of the 15 different specialties for further training. The Ministry will study further if there is similar need for surgical specialties.”
“In addition, the tobacco retail licence will also be suspended or revoked. Persons who give or buy tobacco for underaged persons are also liable to a fine upon conviction. The Ministry of Health will continue its efforts to prevent people from starting to smoke, and to help those who are already smoking to quit.”
“The Health Promotion Board (HPB) offers a range of smoking cessation programmes under the "I Quit" campaign to support smokers to quit smoking. However, because smoking is addictive, smokers have to be disciplined and determined and many may need to try a few times before succeeding, particularly those who have been smoking for a long period of time. We discourage people, especially the young, from even starting to smoke through a multi-agency, multi-prong approach, including through tobacco control legislation and public education. For example, HPB works closely with the Ministry of Education to incorporate anti-tobacco messages in schools and institutes of higher learning. The aim is to raise awareness about the benefits of leading a tobacco-free lifestyle, highlight the adverse effects of smoking, and equip youths with life skills to refuse cigarette offers. To help youths who are already smoking, smoking cessation support is provided through counselling by Student Health Advisors based in 50 schools, school-based smoking cessation programme as well as telephone counselling by Quitline. Those who need help can call 1800 438 2000. It is illegal to sell tobacco to underaged persons and we are planning to raise the minimum legal age from 18 to 21 as outlined in the Tobacco (Control of Advertisements and Sale) (Amendment) Bill which will be tabled for Second Reading shortly. To curb supplies of tobacco to underaged persons, the Health Sciences Authority conducts surveillance on tobacco retailers for tobacco sales to underaged persons and investigates feedback from the public and leads from partner agencies. The penalty for selling tobacco products to underaged persons is a maximum fine upon conviction of $5,000, and $10,000 for subsequent offences.”
“The Health Sciences Authority (HSA) requires all drug manufacturers, importers, wholesalers and retail pharmacies to keep their drugs in proper storage conditions, including cold chain storage, under appropriate temperature where necessary. The drugs are also required to be distributed using validated processes to ensure cold chain storage is maintained. The companies can use different ways to measure and monitor the temperature, such as temperature loggers, or more sophisticated electronic facility management systems. HSA conducts regular onsite inspections of the premises of the drug manufacturers, importers, wholesalers and retail pharmacies to assure that the regulatory requirements are complied with. During the inspections, HSA checks the raw data captured by the temperature monitoring devices or facility management systems to verify good temperature controls.”
“These sessions are chaired by KKH and NUH paediatricians to determine the needs of the child and whether they need to be referred to KKH and NUH's Child Development Programme for further assessments and early intervention through therapies and medical follow-up. There are also other support programmes outside of our hospitals. Those with milder needs may be supported under the Development Support programme offered in some 350 participating preschools, where services are provided by specially trained early childhood professionals or therapists. Those with moderate to severe developmental needs can be referred to 21 Early Intervention Programme for Infants and Children centres run by voluntary welfare organisations. The REACH service and other services which I have mentioned receive heavy Government subsidies to keep the services affordable. Parents who have financial difficulties can approach the relevant agencies for additional assistance.”
“The Ministry of Health has worked with the Ministry of Education and other agencies to better identify and support children with Attention Deficit Hyperactivity Disorder (ADHD). For school-going children at or above the age of seven, we have established multidisciplinary teams under the Institute of Mental Health (IMH) Child Guidance Clinic, KK Women’s and Children’s Hospital (KKH) and National University Hospital (NUH) comprising psychiatrists and mental health professionals who work with school counsellors and allied educators to assist students with ADHD and other emotional or behavioural difficulties. This programme is called REACH, which stands for Response, Early Intervention and Assessment in Community Mental Health. There are currently four REACH teams serving schools in the North, South, East and West zones. The children may be referred to IMH’s Child Guidance Clinic, NUH’s Department of Psychological Medicine or KKH’s Child and Adolescent Mental Wellness Service for assessment and interventions. As a child's development and function may change with age, healthcare professionals generally avoid making a definitive diagnosis of ADHD at younger ages. Nevertheless, children below the age of seven with suspected developmental conditions, including ADHD, can be identified through touchpoints, such as doctors and preschool teachers. Preschool teachers who identify children with suspected developmental delays may flag them to specially trained Learning Support Educators who will, in turn, screen the children for referral to assessment and review Termed the Case Filter Meeting.”
“I thank Ms Sylvia Lim for her suggestion. As a general principle, a patient's authorisation is required for the use of his MediSave. This is a safeguard to protect the patient. However, the Government understands that patients who have lost their mental capacity face many difficult challenges, and we have implemented measures over the years to help these patients and their families, including simplifying the process for authorising MediSave withdrawals. One initiative is to allow a patient to give lifetime authorisation for MediSave withdrawals while he is still mentally well. This arrangement will remain valid even if the patient were to subsequently lose his mental capacity. For a patient who is already mentally incapacitated, a donee acting under a Lasting Power of Attorney or a deputy appointed by the Court under the Mental Capacity Act may authorise the use of the patient's MediSave. If there is no donee or deputy appointed, individuals related to the patient, such as the patient’s family members, can apply to authorise the withdrawal on the patient's behalf. We will study Ms Lim's suggestion, together with feedback from other stakeholders, as part of our continuous review on ways to assist patients who have lost their mental capacity, while providing the necessary safeguards to protect patients' interests and well-being.”
“The MediSave Maternity Package is sized to be adequate for subsidised care. Patients can claim up to $900 for pre-delivery bills, and up to $450 per day for hospitalisation, while claim limits for delivery procedure ranges from $750 for a normal vaginal delivery to $2,150 for a more complicated delivery, such as caesarian birth. Over the last two years, the package fully covered three in four subsidised deliveries, resulting in zero out-of-pocket payment by the patients. Eight in 10 subsidised deliveries had an out-of-pocket payment of $500 or less. Patients who face financial difficulties may approach medical social workers at our public healthcare institutions for assistance and we will consider each appeal on a case-by-case basis.”
“Under the Seniors' Mobility and Enabling Fund (SMF), Singaporeans aged 60 and above can apply for means-tested subsidies to offset the cost of assistive devices, home healthcare items and transport services to Ministry of Health (MOH)-funded eldercare and dialysis centres. They would need to meet the scheme’s household monthly income criteria and assessed by qualified healthcare staff to require the equipment or services to live independently in the community. As long as they continue to receive care services and the eligibility conditions continue to be met, the SMF subsidies will not be withdrawn. Seniors with queries or appeals on SMF can contact the Agency for Integrated Care.”
“Based on a recent survey by the Health Promotion Board (HPB), none of the infant formula milk for children from 0 to 12 months contained any added sugar. As for formula milk for children one year and above, two products contained added sugar of around two grammes per 100 millilitre (ml) of milk. Another product, a high-calorie formula for supplemental nutrition, contained seven grammes of added sugar per 100 ml of milk. HPB recommends that children aged one year and above can take full cream milk, if they are eating and growing well. HPB further recommends that parents planning to give their children high-calorie formula milk as a nutritional supplement should consult their child’s paediatrician or nutritionist.”
“As telemedicine services continue to evolve, MOH will monitor the developments and review our policies and regulations so as to enable new care models that are beneficial for patients, while ensuring their safety and welfare at all times.”
“Telehealth platforms enable patients to receive care in convenient locations of their choice. Patients can receive more timely advice and intervention to manage their conditions without having to schedule an appointment to visit a healthcare institution. This reduces the caregiver burden and empowers individuals to take an active role in their health. In 2015, the Ministry of Health (MOH) issued a set of National Telemedicine Guidelines to guide healthcare providers in the safe and appropriate delivery of healthcare services through telemedicine. This is complemented by the Singapore Medical Council's Ethical Code and Ethical Guidelines and accompanying Handbook on Medical Ethics issued in 2016 that set out the standards of care required of doctors practising telemedicine. Based on the guidelines, the standard of care expected of doctors providing telemedicine should be comparable to what patients would receive in a face-to-face consultation. Doctors providing care via virtual platforms have a responsibility to ensure that the remote diagnosis made is accurate and that patients receive appropriate medical advice and management for their conditions. If in doubt, doctors should offer to see the patients face-to-face to conduct a physical assessment or refer the patient to the nearest clinic or healthcare institution. Today, telemedicine is typically offered as an extension of care for stable patients, taking place after a doctor has had an initial face-to-face consultation with the patient and is satisfied that the patient is suitable to be followed up via telemedicine.”
“We have been collaborating with community partners, employers and healthcare institutions to encourage Singaporeans to go for health screening. Our healthcare clusters also conduct community health screening programmes and encourage patients to go for screening when they visit polyclinics and general practitioners. These efforts have benefited more than 40,000 residents in 2016. The Health Promotion Board works with businesses and unions to conduct onsite screening for employees. One example is the "Check Car, Check Body" programme which offers health screening to taxi drivers while they wait for their taxis to be serviced at the service centres. To date, we have reached out to over 200,000 workers, including taxi drivers and bus captains. We welcome the participation of other corporations in these programmes to benefit even more workers. Besides workplaces, we also tap on networks of the People's Association and grassroots organisations to educate Singaporeans about the importance of going for regular health screenings. The Ministry of Health will continue our partnerships with these organisations to enhance the coverage of diabetes screening. This is a key component of the War on Diabetes.”
“Our target is to increase this to 40% of stalls across all hawker centres and coffee shops by mid-2019. These are part of HPB's efforts to help Singaporeans choose healthier food options and lead healthier lives.”
“Consuming large amounts of high glycemic index (GI) food is one of the risk factors for diabetes. Common high GI foods consumed in Singapore include refined staple grain products, such as white rice and white bread, and sugar-sweetened beverages like soda. From 2007 to 2016, the Health Promotion Board's (HPB's) efforts to work with beverage manufacturers have resulted in a 30% reduction in the median sugar level of sugar-sweetened beverages sold in Singapore. More recently, seven leading beverage manufacturers whose products comprise 70% of Singapore's beverage market, have committed to limit the sugar content of their beverages sold in Singapore to 12% or less. This is the first time major beverage companies have made such a public commitment, as part of their move towards healthier offerings for consumers. These efforts are a good start, but we are not stopping here. The Ministry of Health (MOH) is studying additional measures to further reduce sugar consumption in Singapore, taking reference from experiences in other countries. These include the use of warning labels and advertising restrictions on prepackaged beverages with high sugar content. For refined staple grain products, MOH will invest $20 million over the next three years under the Healthier Ingredient Development Scheme to support food manufacturers to innovate and produce healthier ingredients, such as wholegrain noodles and brown rice bee hoon, which have lower GI but taste just as nice as the original versions. In addition, HPB's Healthier Dining Programme encourages consumers to choose wholegrain, low GI and lower-calorie meal options. As of August 2017, there are over 3,100 food and beverage stalls across 67 hawker centres and 450 coffee shops offering at least one healthier option in their menus.”
“We have been strengthening our community mental health services to better support persons with mental health conditions in the community and enhance their access to care services. For persons who display disturbing behaviours in the community, the Agency for Integrated Care (AIC) will serve as a first touchpoint to coordinate care and a link to healthcare and social service agencies. AIC can be contacted at careinmind@aic.sg for assistance and referral. In cases where a person is behaving in a manner that is dangerous to self or others, members of the public can call 999 for urgent Police assistance. Under section 7 of the Mental Health (Care and Treatment) Act (MHCTA), persons who are at risk of harm to self and/or others and are reported to be mentally disordered, can be brought by a Police Officer to the Institute of Mental Health (IMH) for mental health treatment. The person will be warded, if assessed to require management in an inpatient setting. Patients will be discharged from the IMH inpatient ward when the doctors assess that their acute psychiatric condition have stabilised and improved. Longer-term recuperation at home amongst supportive family will be better for the patients’ full recovery and reintegration with society. IMH monitors the patients discharged to ensure that they remain compliant with their follow-up appointments and medication. IMH also works with families and community-based organisations on care coordination, case management, caregiver support and education, and other forms of social support, for the discharged patients. Overall, in supporting the patients’ recovery and reintegration, families, community and social and healthcare organisations all have a part to play.”
“The safety of milk products and supplements is regulated by the Agri-Food and Veterinary Authority (AVA) under the Singapore Food Regulations. Food manufacturers and importers must ensure that they are safe and suitable for consumption. There is a variety of adult milk products and supplements for different needs and at different price ranges available in the market today. There are no plans to regulate the sales and prices of adult milk products and supplements for now. Seniors who require such products and are in need of financial assistance can apply to the Seniors' Mobility and Enabling Fund (SMF) for means-tested subsidies to defray the costs of such products. More than 4,000 beneficiaries have received subsidies for milk products and supplements from SMF to date. We will continue to monitor the situation to support seniors who are in need.”
“The World Health Organisation's (WHO's) recommendation is for adults and children to reduce daily intake of free sugars to less than 10% of their total energy intake. This is consistent with the policy position adopted by the Health Promotion Board. The 5% level is what WHO refers to as a "conditional recommendation". WHO has explained that a conditional recommendation is one "where the desirable effects of adhering to the recommendation probably outweigh the undesirable effects but these trade-offs need to be clarified; therefore, stakeholder dialogue and consultations are needed before the recommendation is implemented as policy."”
“Based on audits conducted by the Ministry of Health, physical restraints are not widely used in aged care facilities and generally only used as a last resort under specific circumstances, when other methods have been unsuccessful. These include situations where the senior poses an immediate risk to themselves or others, particularly those with high fall risk or those who have a tendency to pull out their life-supporting tubes. This is a professional matter which is reviewed on a regular basis by doctors and nurses in the aged care facilities. The use of restraints to ensure patient safety is also documented and discussed with caregivers. The Ministry will continue to partner the providers to strengthen care processes to bring about safer and better care for seniors. To this end, the Agency for Integrated Care facilitates regular training programmes for aged care providers as part of ongoing quality improvement efforts, including alternatives to using restraints.”
“Research is important to help us better understand the distribution, causes and effects of diseases so as to strengthen the detection, prevention, control and management of these diseases. Approaching residents at their homes to seek consent for participation in such research is one way of reaching out to participants. It provides greater convenience for the research participants. Prior to embarking on any research involving human subjects, the research proposal would have to be approved by an Institutional Review Board (IRB). IRBs play an important role in carrying out an independent ethical review of the need for research and ensuring that there are adequate safety measures to protect research volunteers, including obtaining their informed consent. Informed consent should be sought from participants in an appropriate and voluntary manner, prior to commencement of the research. The benefits and risks of the research should be clearly explained, and measures put in place to protect the confidentiality of research participants against accidental loss, disclosure or unauthorised access of confidential health information. Under the Human Biomedical Research Framework of the Human Biomedical Research Act (HBRA), the role of researchers and IRBs will be formalised, and they will come under the supervision and control of a Research Institution. The Ministry of Health will conduct regular audits of the Research Institutions to ensure that its systems and governance are in compliance with HBRA. This will further strengthen the measures to protect the welfare of participants in research studies.”