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 Health Promotion Board (HPB) conducts vision screening in preschools and schools. Over the last five years, the proportion of students with vision problems, including myopia and astigmatism, has been stable at about 28% among Primary 1 students, 65% among Primary 6 students, and 70% in Secondary 4 students. Since 2001, HPB and the Ministry of Education (MOE) have put in place the National Myopia Prevention Programme. NMPP aims to delay the onset of myopia and reduce its progression in children, through public education targeting young children, their parents and teachers to inculcate good eye care habits, and vision screening to detect and correct poor vision early. Spending more time outdoors can prevent or delay the onset of myopia. Under a NurtureSG initiative, the Early Childhood Development Agency requires that children in a full day preschool programme spend at least half an hour outdoors daily. HPB has also been advocating for children to take part in outdoor activities after school and on weekends. To make spectacles affordable and accessible to students from lower-income families, HPB partnered ophthalmic optics company Essilor to establish the Spectacles Voucher Fund in 2006. This provides students on MOE's financial assistance schemes who require spectacles with a $50 voucher for a spectacle frame and a voucher for free lenses.”
“All Singaporeans and Permanent Residents can make voluntary cash contributions to the MediSave accounts of their loved ones, including siblings. This can be used to pay for MediShield Life and ElderShield premiums, as well as other healthcare expenses. MediSave accounts can be topped up to the applicable Basic Healthcare Sum of the recipient, subject to the annual cap on total contributions (mandatory and voluntary) of $37,740 across all the recipient's Central Provident Fund (CPF) accounts. CPF Board also allows MediShield Life and ElderShield premiums to be paid directly from the MediSave account of the insured's siblings on a case-by-case basis, if the insured and immediate family members do not have sufficient MediSave, and the insured is financially dependent on their siblings. This is to help preserve the siblings' MediSave for themselves and their own immediate family members. No one will lose their MediShield Life coverage because they cannot afford the premiums. Singaporeans who require additional support after receiving means-tested subsidies and help from their families can apply for Additional Premium Support.”
“There are currently no plans to introduce a discount on annual MediShield Life premiums for those who do not file any claims. This idea was considered by the MediShield Life Review Committee when they conducted their review in 2014. After careful deliberation, the Committee decided against the idea. The Committee was concerned that, with such premium discounts, Singaporeans might delay necessary medical treatment even though they are ill, which could result in worse outcomes, such as medical complications, prolonged illness and poorer health outcomes. Health conditions that are not well managed could result in higher healthcare costs to the individual in the long run. Such features may, therefore, not be suited for MediShield Life as a national and basic health insurance scheme. Nevertheless, we understand the desire to recognise those who make an effort to stay healthy. The Ministry encourages healthy living through separate initiatives under the Health Promotion Board. For example, under the current Eat, Drink, Shop Healthy Challenge, Singaporeans who purchase healthier food options at participating outlets can earn Healthpoints, redeem them for supermarket and food and beverage vouchers, and stand a chance to win a staycation. Similarly, the National Steps Challenge also encourages participants to take more steps through vouchers and prizes.”
“Peer support is also encouraged and students are taught to look out for their peers and seek help from trusted adults around them, such as their school counsellors. The Ministry of Health regularly reviews the screening tests and preventive health programmes, taking into consideration the local context and scientific developments. HPB's screening programmes are reviewed every three to five years, and the last review was done in 2015.”
“Singapore operates a comprehensive screening system for children, starting from when they are very young. New-born babies are screened for congenital conditions, including Glucose-6 Phosphate Dehydrogenase (G6PD) deficiency, hearing impairment, hypothyroidism and metabolic disorders in which the body cannot properly turn food into energy. In addition, developmental screening is also carried out from birth, to detect any disability even amongst apparently healthy children. Such screening is conducted at hospitals, polyclinics, by family doctors as well as private paediatric specialists. Children suspected to have developmental disabilities, such as autism spectrum disorder, are referred to the Child Development Units for further assessment and intervention, if necessary. In the schools, the Health Promotion Board's (HPB's) School Health Service conducts oral and physical health screening, including vision screening, screening for hearing impairment, growth and developmental assessment. The most common medical conditions picked up from health screening in the schools are myopia, obesity and scoliosis. Students who need specialist care or further assessment are referred to the Specialist Clinics at the Student Health Centre or to restructured hospitals. School teachers are trained to identify students who show signs of emotional distress and provide them with the needed support or refer them to school counsellors for help. In addition, the Response, Early Intervention and Assessment in Community Mental Health (REACH) teams work closely with schools and train the school counsellors to identify students with mental health needs.”
“HSA will also provide them with advice on the regulatory requirements and work with them to rectify non-compliant advertisements. HPA also empowers HSA to direct the offending party to take such corrective measures as issuing a clarification advertisement to clear up any misleading or false claims in the earlier contravening advertisement. Under HPA, the maximum penalty for advertising a non-health product as a health product or advertising a health product in a false or misleading way, is a fine of $20,000, or imprisonment up to 12 months, or both.”
“Currently, western pharmaceutical drugs and medical devices are regulated under the Health Products Act (HPA). These products are used for the specific purpose of prevention, diagnosis, monitoring, treatment or alleviation of medical conditions and symptoms. Products meant to promote a person’s general well-being are not regarded as health products under HPA, and companies are not allowed to make any claims that these products can prevent, diagnose or treat any medical conditions. Examples include massage equipment and similar devices using electromagnetic waves and electrotherapy to relax muscles and improve blood circulation, as well as devices meant for fitness tracking. Complementary health products, such as traditional medicines and health supplements, which claim to alleviate certain symptoms of disease conditions or enhancing a specific function of the body are regulated under the Medicines Act (MA). Examples include medicated oil and balms for pain relief and glucosamine supplements for joint health. Under HPA and MA, false and misleading claims are prohibited. Additionally, there is a list of serious diseases such as diabetes, hypertension and cancer for which advertisements are prohibited. This is to prevent consumers from being misled that a product can treat such diseases which may lead to inappropriate self-medication and delay in seeking necessary medical treatments. Direct advertising to the public of prescription only medicines or medical devices for professional use only is also prohibited. The Health Sciences Authority (HSA) conducts surveillance on published advertisements. When non-compliant advertisements are detected, the advertisers will be ordered to stop and remove the publication of these advertisements.”
“Data contribution to the National Electronic Health Record (NEHR) is currently voluntary for all private healthcare licensees and the Ministry of Health (MOH) has been reaching out to healthcare providers to encourage participation. To enhance patient safety and continuity of care, MOH is looking to mandate under the new Healthcare Services Bill that all licensed healthcare providers, including clinical laboratories, contribute data to NEHR. In the meantime, public consultations are ongoing. Dedicated teams have been set up and trained to engage various groups of licensees, including laboratories, hospitals and general practitioners (GPs), to better understand their concerns and needs, and provide relevant support and assistance. We are also working with information technology providers supporting clinical laboratories, hospitals and GPs to enable connections with NEHR.”
“There are currently no plans to extend Pioneer Generation (PG) subsidies to Traditional Chinese Medicine (TCM), which plays a complementary role in our healthcare system. PG subsidies are meant to help Pioneers with part of their healthcare costs in hospitals, polyclinics and general practitioner clinics. The Ministry of Health provides support for TCM development in various ways, including funding and support for TCM capability development, continuing education and research. Charitable TCM establishments with Institution of Public Character status also benefit from tax exemption and are eligible to receive tax deductible donations, which enable them to provide affordable TCM services in the community. Under the PG package, all Pioneers receive life-long annual MediSave top-ups of up to $800, depending on the year they were born. Pioneers who stay healthy will be able to save more of these MediSave top-ups for their future needs. More importantly, staying healthy will enable them to age well and lead an active life. To help them do so, we have several measures to encourage our Pioneers to stay healthy. For example, the Health Promotion Board encourages Pioneers to do regular physical activity through the "You Can Get Moving" campaign. Another measure is the enhanced Screen for Life programme. From 1 September 2017, Pioneers can receive free health screening and the first follow-up consult when they go for recommended screenings.”
“There is consensus amongst international health authorities and medical professionals that artificial sweeteners can be used as part of a balanced diet to help a gradual shift away from high sugar food and beverages. Currently, no jurisdiction has banned artificial sweeteners. The US Food and Drug Administration and the European Food Safety Authority have allowed the use of artificial sweeteners for human consumption. However, the sale of artificially sweetened food and beverages is not allowed in schools in Singapore as we want to prevent children from developing a habit of consuming sweet-tasting food and drinks. This complements our healthy meals programme in schools which promotes the drinking of plain water. We will continue our efforts to raise public awareness and foster a supportive environment for consumers to make healthier food and beverage choices and to keep Singaporeans healthy and active.”
“As at 31 December 2016, there were about 13,000 registered doctors in Singapore, with a strong local core of 84% local doctors. As our ageing population will continue to drive demand for medical manpower, the Ministry of Health (MOH) has been working with the Ministry of Education to review and plan our local medical training pipelines to meet Singapore's future healthcare needs. The local medical intakes have increased from 354 in 2012 to 471 in 2016 and is projected to grow to 500 in 2018. Besides growing local intakes, we are also attracting more Singaporean doctors trained overseas to return and practise in Singapore through the Pre-Employment Grant (PEG) and Relocation Incentive (RI) introduced in 2010. Since inception, about 900 PEGs and 300 RIs have been awarded. The number of newly registered overseas-trained Singaporean doctors returning annually has doubled from 92 in 2012 to 182 in 2016. While we have increased the pipelines of local doctors, foreign doctors are needed to supplement the local pool. With more Singaporeans joining the medical workforce, we expect the recruitment of foreign doctors to moderate going forward. With an ageing population, the type of disciplines in demand will shift towards the more generalist disciplines, such as Family Medicine, Internal Medicine and Geriatric Medicine. MOH has shared with medical students and junior doctors through dialogue sessions and medical residency briefing sessions on this shift. We will continue to raise awareness of the changing postgraduate training needs amongst junior doctors and medical students.”
“Under the ART co-funding scheme, eligible couples can receive up to 75% in co-funding from the Government for ART treatment cycles, for a maximum of three fresh and three frozen ART cycles, until the patient reaches 40 years of age. MOH's AR database captures information on the number of live-births by individual ART cycles, and thus the success and failure rates at each cycle. Of Government-funded cycles of ART between 2013 and 2015, 75.3% were unsuccessful after the first cycle. This figure increased to 79.3% and 81.9% after the second and third cycles respectively. The likelihood of a successful cycle of ART is higher for those who are younger. Please refer to tables below for the breakdown by year.”
“Today, the Health Sciences Authority (HSA) requires all manufacturers, importers and wholesalers of drugs to be licensed. To ensure traceability and supply chain integrity, they will need to keep records for every receipt and supply of drugs and comply with standards in distribution. A drug's product name, batch number, expiry date and registration number will have to be indicated on each unit pack. In addition, HSA carries out post-market surveillance on quality or safety concerns arising from drugs. HSA agrees that a standardised bar-coding system can further improve drug traceability. Unfortunately, there is yet to be an internationally harmonised bar-coding standard for drug manufacturers and suppliers. Given our small market size, imposing our own requirement for all drug manufacturers and suppliers to adopt a standard bar-code could lead to companies being deterred from bringing their drugs into Singapore or passing on the additional cost to patients. This would not be beneficial to Singaporeans. HSA will continue to monitor international developments in this area. At the same time, it will continue to improve on its current system on drug safety and traceability.”
“We will continue to work closely with MHA and the Home Team on security preparedness and response at our public hospitals.”
“MOH has been working with MHA on the security protection of our public hospitals. Each hospital has put in place preventive security measures, physical security operations, contingency plans covering incident response and consequence management to deal with different scenarios and threat levels, including terrorist incidents. Assessments are carried out regularly on the competencies of the security personnel. In addition, there are programmes to raise security awareness among staff, patients and visitors. Hospitals also conduct regular training and exercises, including with the Home Team forces. In the event of a security incident, our public hospitals are resourced with their own security personnel onsite who can provide immediate response to "deny, delay and contain", while waiting for the arrival of Home Team quick response forces where necessary. The plan also covers appropriate actions by staff, patients and visitors, including evacuation. Our public hospitals are receiving ongoing support from Home Team agencies. They have participated in the Safety and Security Watch Group scheme with the Police and SCDF to strengthen the safety and security of their patients and staff on their premises and learn from good practices. The majority of public hospitals have also signed up as Project Guardian members and their security personnel are trained to react and complement Police response to an incident. The Police conduct regular patrols at public hospitals and their vicinity. These include patrols by the Emergency Response Teams, who are trained and equipped to respond to a terrorist incident. During periods of heightened alert, the Home Team may deploy additional forces to beef up the security of the hospitals.”
“The Pioneer Generation Disability Assistance Scheme (PioneerDAS) was introduced in September 2014 as part of the Pioneer Generation (PG) Package for a special generation of Singaporeans. PioneerDAS is one of the measures amongst broader Government support for long-term care, which includes means-tested subsidies at senior care centres and nursing homes, the Seniors' Mobility and Enabling Fund and the Foreign Domestic Worker Grant. The Government also provides public assistance, Comcare and MediFund for those who face financial difficulties and need more help. From its launch in September 2014 to end 2014, the Agency for Integrated Care (AIC) received around 6,700 applications. The application numbers in 2015 and 2016 were about 9,000 and 8,600 respectively. About 95% of applications have been approved. To help more Pioneers, AIC has extended automatic PioneerDAS inclusion to Pioneers receiving payouts under ElderShield or the Interim Disability Assistance Programme for the Elderly, or those who qualify for the Foreign Domestic Worker Grant. This auto-inclusion has benefited an additional 15,000 Pioneers.”
“Any person who sells tobacco to an underaged person is liable, upon conviction, to a maximum fine of $5,000 for the first offence and $10,000 for subsequent offences. Retailers caught selling tobacco to underaged persons are also liable to have their tobacco retail licence suspended or revoked. Among non-cigarette tobacco products, Ang Hoon, a kind of unfiltered tobacco product, is the most common. Ang Hoon and other loose tobacco leaf products made up 1.7% of all tobacco products imported for local consumption in 2016. Although the import of Ang Hoon has been declining in Singapore over the years, there are concerns overseas that the use of roll-your-own tobacco products may be on the rise among youths due to their lower prices and the misperception that they are less harmful than manufactured cigarettes. In fact, unfiltered tobacco products like Ang Hoon are just as harmful to health as cigarettes. To prevent an increase in smoking of Ang Hoon among youths here due to a misperception that it is less harmful, we will include relevant messages in our education campaigns to dispel such misconceptions. We will also continue to ensure that the law against tobacco sales to minors is enforced across all categories of tobacco products.”
“We have adopted a multi-pronged approach to reduce the consumption of tobacco. To ensure that the public is aware of the harms of smoking, graphic health warnings have been mandated on all tobacco products. With effect from 1 August 2017, the point-of-sale display ban will also come into force for all tobacco products. The Health Promotion Board (HPB)'s "I Quit" campaign supports smokers to quit by working with community partners and employers to organise roadshows encouraging smokers to sign-up for the "I Quit 28-Day Countdown" smoking cessation programme. Smokers can also call the HPB’s Quitline or access online resources for help to quit. In 2016, these programmes reached more than 16,000 smokers, including those who use loose tobacco leaves. For the youths, HPB works with MOE and Institutes of Higher Learning to incorporate anti-tobacco messages into the curriculum and co-curricular activities, thereby raise awareness about the benefits of a tobacco-free lifestyle, informing youths on the harms of smoking and teaching how to refuse offers to smoke. In addition, Student Health Advisors are deployed to some schools to address health, issues including supporting youths to quit tobacco use. Our outreach efforts have reached out to about 50,000 students in 2016. Laws governing tobacco sales to underaged persons are consistently enforced, regardless of tobacco product type. The Health Sciences Authority (HSA) conducts educational initiatives and regular enforcement to help retailers comply with the law and takes stern action on errant retailers who do not. In 2016, a total of 30 retailers were caught selling tobacco to underaged youths.”
“NDCS will strengthen the following: (a) standard operating procedures for sterilisation, handover and use of dental instruments; (b) documentation and inventory accounting process for sterilisation and movement of dental instruments from CSSD to the clinics, and (c) incident escalation and reporting, recall and risk management frameworks. In addition, NDCS will institute regular training and competency assessments for all staff involved in the sterilisation and handling of instruments to ensure familiarity with the processes. While the risk of infection to affected patients is extremely low in this incident, it is a serious breach of the institution's infection control system nonetheless. Our healthcare institutions need to be more vigilant and have a stronger reporting and incident escalation culture. These will enable us to detect and mitigate any incidents expeditiously. The learning points from this incident will be shared across the healthcare clusters, so that we can collectively improve our standard of patient safety and care.”
“Patient safety is of utmost importance to our public healthcare institutions. We apologise for the lapse at the National Dental Centre Singapore (NDCS) on 5 June and 6 June, which had led to the use of partially sterilised dental instruments. SingHealth has conducted an investigation and the Ministry of Health has received its report on 30 June 2017. The Ministry is reviewing the report and is also conducting its own investigation. The SingHealth investigation showed that the incident originated from human error by a staff, who failed to complete all the steps in the sterilisation process for one batch of dental instruments. In addition, her supervisor and department manager did not fully recognise the potential impact of the error. As a result, there was a delay in escalating the incident to senior management, and up to 72 packs of affected instruments might have been used on patients, before all affected instruments were successfully recalled. The findings also revealed procedural weaknesses and a lack of vigilance amongst some staff. At various points of the process – from the issuance of the instruments from the Central Sterile Supplies Department (CSSD), through the receipt of the instruments at the clinics, to the unpacking of the instruments before use on patients, the error could have been detected and an alert raised. Following the incident, NDCS has instituted immediate corrective measures. Additional independent verifications have been put in place to ensure completeness of the sterilisation process. Clearer work instructions have been disseminated to all staff to ensure that the sterility of the dental instruments is checked prior to use.”
“Specialist Outpatient Clinic (SOC) waiting times for new appointments vary across hospitals and across specialties within each hospital. The median waiting time for new, non-urgent subsidised appointments at Specialist Outpatient Clinics (SOCs) has fallen slightly from 29 days in 2013 to 27 days in the first quarter of 2017, despite an increasing patient load across all hospitals (see Table 1 below). Patients with more urgent conditions, such as suspected cancers and cardiac conditions, are fast-tracked for their appointments.”
“Patients at the emergency departments (EDs) are prioritised and attended to based on the severity of their conditions. All life-threatening (P1) cases are attended to immediately. For emergency but non-life-threatening (P2) cases, the median waiting times across the EDs averaged about 23 minutes, 22 minutes, 18 minutes and 17 minutes in 2013, 2014, 2015 and 2016 respectively. For patients who required admissions, the median waiting time for admission averaged about two hours, 2.3 hours, two hours and 1.6 hours in 2013, 2014, 2015 and 2016 respectively. Our hospitals have protocols to ensure care is not compromised despite high demand for ED services. Even while patients wait at the EDs for admission, medical teams continue to monitor them and institute appropriate investigations and treatments.”
“The oral health of our 12-year-old children is ranked amongst the best in the world. However, the proportion of Primary 1 children with dental caries had increased slightly from 50.9% in 2007 to 53.1% in 2016, indicating that the dental health of pre-primary children has not improved in the last decade. Dental treatment for pre-primary children has been provided at nominal cost at Health Promotion Board's (HPB's) School Dental Centre since 1999, and HPB has been conducting oral health promotion in kindergartens and childcare centres since 2002. To address the rising trend of dental caries in Primary 1 children, HPB introduced the tooth-brushing programme with optimally fluoridated toothpaste in 2014, which has reached 1,026 childcare centres (out of 1,279 childcare centres in 2016). Through this programme, HPB aims to raise awareness of the importance of using optimally-fluoridated toothpaste among parents, teachers and children, and inculcate effective tooth-brushing habits in children from young. Going forward, as an initiative under the NurtureSG Plan, HPB will move upstream to offer free oral health screening for preschoolers aged three to four years, to at least 800 childcare centres by 2019, and 1,100 childcare centres by 2020.”
“HSA has in place a post-market surveillance system to monitor the safety of health products, including health supplements. Our healthcare professionals report adverse events to HSA. HSA also keeps a close watch on safety issues encountered in other countries. In addition, HSA routinely samples health supplements sold here and tests them. Should there be any quality or safety concerns detected, HSA will take the necessary actions, including working with the companies to remove the products from sale or informing the public to stop consuming these products.”
“The Health Sciences Authority (HSA) applies a risk-based approach in the regulation of different categories of health products. Western pharmaceutical drugs are used mainly by healthcare practitioners in the treatment and prevention of diseases. They are regulated stringently as they are inherently more potent. Health supplements, on the other hand, are intended for enhancing a person's health. They are not meant to prevent, treat or cure diseases, or alleviate the symptoms of diseases. They generally contain well-established ingredients, such as vitamins, minerals or substances derived from natural sources. As health supplements are generally of lower risk than western pharmaceutical drugs, they do not require approval by HSA before they can be sold locally. They can be purchased over the counter without medical supervision. Our regulatory approach for health supplements is similar to that adopted by the United States, the European Union countries and Japan. We are mindful that introducing pre-market regulation for health supplements could result in companies passing on the regulatory cost to consumers or forgo introducing products into Singapore which has a small market size, thereby reducing consumer choice. Nevertheless, importers, wholesale dealers, sellers and manufacturers of health supplements are responsible for ensuring the safety and quality of their products. They must ensure that their products do not contain harmful substances or potent active ingredients used in western pharmaceutical drugs. Dealers must also ensure that product claims are truthful and not misleading, and that product advertisements do not make claims for treatment or prevention of diseases.”
“The Ministry of Health regulates advertisements of health products and services to protect consumers from false and misleading claims that may put their health at risk. Under the Health Products Act (HPA), any false and misleading advertisements will be liable to a maximum penalty of $20,000, imprisonment of up to 12 months, or both. Some health products, including Chinese Proprietary Medicines and Traditional Medicines, are currently regulated under the Medicines Act (MA). The maximum penalty for any false and misleading advertisements under the MA is a $5,000 fine, imprisonment of up to two years, or both. We intend to amend the legislation to move the regulation of Chinese Proprietary Medicines and Traditional Medicines from MA to HPA. The higher penalties under HPA will apply once the move is completed. We are also reviewing the Private Hospitals and Medical Clinics Act to enhance the regulation of health services advertisements by healthcare institutions.”
“Under the Chronic Disease Management Programme (CDMP), Singaporeans can use up to $400 per MediSave account per year to pay for their chronic disease treatment. Nineteen chronic conditions are covered under CDMP, which accounts for more than 90% of chronic attendances seen at polyclinics today. The $400 CDMP limit was sufficient to fully cover the post-subsidy bill for nine in 10 subsidised patients with common chronic conditions at public healthcare institutions and participating Community Health Assist Scheme (CHAS) general practitioner (GP) clinics. At these institutions, elderly patients aged 65 and above may also tap on an additional $200 Flexi-MediSave each year to help pay for their outpatient treatments. Patients with higher medical bills for chronic conditions can tap on the MediSave accounts of their spouse, children and parents, up to $400 per family member per year. To illustrate, an elderly patient with a spouse and two children could use up to $1,800 of MediSave per year for his chronic conditions, $600 from his own MediSave account and $400 each from his wife and children. If they still face financial difficulties, they can apply for MediFund at the polyclinics or subsidised specialist outpatient clinics in public hospitals. The Medication Assistance Fund is also available for needy patients who require long-term medication that are not on the Standard Drug List. The Ministry of Health will continue to monitor the affordability of chronic disease care and regularly review the MediSave withdrawal limits.”
“Patients with normal health screening results may have their results mailed to them and there is no need for them to visit the polyclinics. If they prefer, they can also collect their results at the polyclinics. There is no additional fee charged by polyclinics for the original issuance of the screening results. For patients who require further evaluation, it is important that the doctor meets with the patient to review the results, address concerns and/or advise on management options. Medication and treatment may also be initiated if necessary. Patients with existing chronic conditions may review their results during their next scheduled appointment at no additional cost, or at a separate sitting, if necessary. A standard subsidised polyclinic consultation fee would apply for Singaporeans and Permanent Residents. General practitioner (GP) clinics offer different types of health screening and adopt different charging practices. Some package the health screening and post-screening consultation in a single charge, while others charge patients a separate fee for post-screening follow-ups. GPs may also decide that mailing of results would suffice when a face-to-face visit is not needed. As part of the enhanced Screen For Life (SFL) initiative which will take effect from 1 September 2017, we are extending subsidies to all eligible Singaporeans for recommended screenings at Community Health Assist Scheme (CHAS) GP clinics. This is part of our national strategy to encourage health screening and follow-ups, as well as to reinforce the role of GPs in preventive health and chronic disease management. Under the enhanced SFL initiative, eligible Singaporeans will pay a single nominal fee for the screening tests and post-screening consultation where required. Pioneers need not pay.”
“Patients who require outpatient treatment for major depression and anxiety can receive subsidies for their treatment at our public healthcare institutions. They can also tap on MediSave under the Chronic Disease Management Programme. Needy patients who cannot afford medical treatment can approach the medical social worker at the healthcare institutions for financial assistance.”
“A local study4 conducted by NUH found that the prevalence of maternal depression is about 12% antenatally, and 7% postnatally. Most pregnant women are managed by the obstetricians during their pregnancy, who play a major role in identifying antenatal and postnatal depression symptoms both in the private and public sectors. Since 2007, the KK Women's and Children's Hospital (KKH) and the National University Hospital (NUH) have been funded under the National Mental Health Blueprint to provide screening and early intervention for postnatal depression. The NUH Women's Emotional Health Service (WEHS) and KKH's Postnatal Depression Intervention Programme (PDIP) provide depression screening at two to eight weeks postpartum, at no charge, during outpatient postnatal review at the specialist clinics. Under the NUH WEHS, women are also screened antenatally at three time points – registration, trimester two, and trimester three. Both programmes accept patients referred from other hospitals, including private hospitals. Since 2007, both programmes have screened around 80,050 women, and 818 women were subsequently referred to and seen by psychiatrists for further follow up. Women who are screened positive for depression would be managed by a multidisciplinary team comprising a psychiatrist, case manager and psychologist. The women and their family members will also be given useful contacts and information on managing their emotional health. Both programmes also provide antenatal talks and classes open to women and their spouses, covering antenatal and postnatal depression, and on keeping emotionally well during and after pregnancy. Through various media platforms, KKH also raises public awareness on postnatal depression.”
“While the risk of infection to affected patients is extremely low in this incident, it is a serious breach of the institution’s infection control system nonetheless. Our healthcare institutions need to be more vigilant and have a stronger reporting and incident escalation culture. These will enable us to detect and mitigate any incidents expeditiously. The learning points from this incident will be shared across the healthcare clusters so that we can collectively improve our standard of patient safety and care.”
“Additional independent verifications have been put in place to ensure completeness of the sterilisation process. Clearer work instructions have been disseminated to all staff to ensure that the sterility of the dental instruments is checked prior to use. NDCS has also audited their sterilisation records in the six months prior to the incident. The records confirmed that sterilisation was completed in all other cases. A check on the sterilisation equipment also indicated that it was fully functioning. NDCS will strengthen the following: (a) standard operating procedures for sterilisation, handover and use of dental instruments; (b) documentation and inventory accounting process for sterilisation and movement of dental instruments from CSSD to the clinics, and (c) Incident escalation and reporting, recall and risk management frameworks. In addition, NDCS will institute regular training and competency assessments for all staff involved in the sterilisation and handling of instruments to ensure familiarity with the processes. Four NDCS staff directly involved in the incident, including supervisors and senior NDCS management, have been found to have fallen short in their level of vigilance and the speed in escalation of incident management. Disciplinary actions have been taken against them. These include warnings, as well as financial penalties. The Ministry will review the findings of the SingHealth report, as well as our own investigation findings. We will consider if further regulatory actions are necessary. We will also closely monitor the implementation of remedial actions and standards of care at NDCS through regular audits.”
“Prior to the start of clinic hours on 7 June, all dental instruments were thoroughly checked and confirmed to have undergone the complete sterilisation process. Additional controls, such as requiring a second person to check that the sterilisation process was completed, were also implemented. Among the 714 patients who had visited the outpatient clinics on levels 2, 4 and 6 from the late afternoon on 5 June to the end of clinic hours on 6 June, up to 72 could have come into contact with the affected instruments as there were up to 72 sets of the affected instruments that had been used. As the first two steps of the sterilisation process were completed, including thermal washer disinfection which would remove close to 100% of organisms of concern, the risk of infection to patients was assessed to be extremely low. NDCS dentists began contacting all of these patients on 10 June to inform them of the incident and reassure them on their low risk of infection. From the findings, the incident originated from human error by a staff. In addition, her supervisor and department manager did not fully recognise the potential impact of the error. As a result, there was a delay in escalating the incident to senior management and up to 72 packs of affected instruments might have been used on patients, before all affected instruments were successfully recalled. The findings also revealed procedural weaknesses and a lack of vigilance amongst some staff. At various points of the process, from the issuance of the instruments from CSSD, through the receipt of the instruments at the clinics, to the unpacking of the instruments before use on patients, the error could have been detected and an alert raised. Following the incident, NDCS has instituted immediate corrective measures.”
“Patient safety is of utmost importance to our public healthcare institutions. We apologise for the lapse at the National Dental Centre Singapore (NDCS) on 5 June and 6 June, which had led to the use of partially sterilised dental instruments. SingHealth has conducted an investigation and the Ministry of Health (MOH) has received its report on 30 June 2017. The Ministry is reviewing the report and is also conducting its own investigation. The SingHealth investigation showed that on the afternoon of 5 June, a staff of the Central Sterile Supplies Department (CSSD) of NDCS failed to complete all the steps in the sterilisation process for one batch of dental instruments. The batch of affected instruments were subsequently dispatched to the outpatient clinics at levels 2, 4 and 6 of NDCS. Around 4.00 pm, another NDCS staff noticed that the sterilisation indicator tapes on some instrument packs had not changed colour, indicating that the sterilisation process has not been completed. She alerted the first NDCS staff as well as her immediate supervisor. An immediate attempt was made to recall the affected instruments. However, not all the affected instruments were retrieved. On 6 June, before NDCS started operations at 8.00 am, the manager of CSSD checked the sterilisation records and detected the incomplete sterilisation of one batch of instruments on the previous day. She activated the department to retrieve all affected instruments from the clinics. At 4.00 pm on 6 June, the manager of CSSD reported the incident to the senior management of NDCS. The Director of NDCS immediately activated another round of recalls to ensure that all affected instruments were retrieved.”
“In addition, MOH has mandated graphic health warnings on the harms of smoking on tobacco product packaging since 2004. These are revised on a regular basis to ensure their relevance. We will continue to press on with anti-smoking public educational efforts and collaborate with the various agencies in this area where necessary.”
“While there is no formal inter-Ministerial committee to oversee the efforts to educate smokers on smoking hazards, the Ministry of Health (MOH) works closely with relevant Government agencies and educational institutions to educate Singaporeans on the health risks of tobacco use and to help smokers quit smoking. For example, the Health Promotion Board (HPB) works closely with the Ministry of Education and Institutes of Higher Learning to incorporate anti-tobacco messages into the schools' curriculum and co-curricular activities. This is to raise awareness about the benefits of leading a tobacco-free lifestyle and to inform youths on the harms of tobacco smoking. In addition, Student Health Advisors are deployed to some schools to provide support and counselling to students on health issues, including smoking cessation counselling. HPB also organises interactive programmes, such as skits and workshops, to discourage experimentation with tobacco products and teach students ways to refuse offers to smoke. Our outreach efforts have reached out to about 50,000 students in 2016. HPB launched the "I Quit" programme in 2011 and worked with the People's Association and employers to organise roadshows at community events and workplaces to encourage smokers to sign-up for the I Quit 28-Day Countdown smoking cessation programme. HPB also works closely with the Ministry of Defence on smoking cessation workshops to educate Singapore Armed Forces Servicemen on the harmful effects of smoking and encourage them to quit smoking. Smokers can call HPB's QuitLine or access online resources, such as the HPB HealthHub portal, for additional support to quit smoking. In 2016, these programmes reached out to more than 16,000 smokers.”
“Singaporeans with mental illnesses are receiving funding support for their treatments. In 2013, MediShield was enhanced to cover inpatient treatment of psychiatric conditions so as to support the timely and appropriate treatment of mental illnesses. This health insurance coverage remains under MediShield Life today. Government subsidies are also available to patients receiving inpatient and outpatient mental health treatments and consultations at public healthcare institutions. For Community Health Assist Scheme (CHAS) cardholders, subsidies are provided for outpatient consultations at CHAS general practitioner (GP) clinics. Patients who need to pay for the balance of their fees after Government subsidies and MediShield Life can use their MediSave. Under the Chronic Disease Management Programme (CDMP), MediSave may be used for the outpatient treatment of bipolar disorders, schizophrenia, depression and anxiety. Seniors can further tap on Flexi-MediSave for their outpatient treatment. Those who cannot afford their treatments even after subsidies, MediShield Life and MediSave can approach the medical social workers for MediFund assistance. Some Singaporeans with mental illnesses may require financial assistance that extend beyond their treatments. They can apply for such assistance under ComCare through the Social Service Offices. Depending on the needs and circumstances of the individuals, the ComCare package could include cash and other types of assistance, such as utilities charges and housing rental fees. Individuals who have permanent mental incapacity can also apply for early Central Provident Fund withdrawal under the Medical Grounds Scheme.”
“Our public healthcare clusters conduct surveys to gather feedback from their employees on workplace stress. Common sources of stress in the hospitals include the fast pace of work, unreasonable demands from patients and their caregivers, and personal issues, such as health or financial problems. Detailed findings cannot be shared because the scale and scope of surveys, as well as the profile of staff surveyed, differ across clusters. While the findings vary across clusters, the findings are shared with relevant staff and are used to develop programmes to support employees in managing workplace stress and maintaining mental well-being. Employee support programmes that have been implemented range from lunchtime talks and workshops on mental health and stress and emotional management, to staff counselling programmes to help them overcome work stress and personal problems. Some employers also have dedicated hotlines for their employees to seek professional help. The public healthcare clusters will continue to work closely with the Healthcare Services Employees' Union to improve employee health and well-being at the workplace.”
“Telepharmacy can improve productivity and convenience for customers. It is regulated by the Health Sciences Authority (HSA) to ensure that providers put in place the necessary controls and safeguards. Since the first pilot in 1997, the Ministry of Health (MOH) and HSA have expanded the scope of telepharmacy services. For example, pharmacies were allowed in 2009 to provide prescription-only medicines through telepharmacy. Previously, this was only allowed for non-prescription medicines. To date, 146 retail pharmacy outlets are offering telepharmacy services. These include outlets at the three largest retail pharmacy chains, namely, Guardian Pharmacy, Unity Pharmacy and Watsons. In April 2017, MOH launched a Smart Health Video Consultation platform to enable our public healthcare institutions to provide different services through video consultation. These include a new model of telepharmacy service at KK Women's and Children's Hospital and Tan Tock Seng Hospital. HSA will continue to review the regulations for telepharmacy services to keep up with technological changes and provide better service to patients. We also welcome opportunities to collaborate with care providers and retail pharmacies to co-create new solutions in this area.”
“The Health Insurance Task Force (HITF) report made several recommendations to manage escalation in healthcare costs and insurance premiums. We are reviewing the recommendations and discussing with relevant stakeholders. These require support from healthcare providers, insurers and patients. All stakeholders need to work together to achieve a sustainable healthcare system for Singapore.”
“There are many providers in our private primary care sector, comprising solo practitioners as well as medical practice groups of varying sizes. No single provider dominates the private primary care market. The Ministry of Health (MOH) encourages clinics to keep their patients informed of temporary closures. If the closure is for an extended period, the clinic should refer their patients to other clinics appropriately to ensure continuity of care. In the event when the clinic is unable to refer patients out, MOH will facilitate the referrals to other clinics and polyclinic(s) in the area, if necessary. Regardless of whether the closure is temporary or permanent, MOH will work with affected clinic(s) to ensure continuity of care for patients. Clinics are required to keep proper records of patient clinical information under the Private Hospitals and Medical Clinics Act. To facilitate better portability of such information, MOH is stepping up efforts to encourage more medical clinics to be linked to the National Electronic Health Records (NEHR) system, including through providing grants for general practitioner clinics to adopt GPConnect, an integrated information technology solution which provides seamless connection with NEHR. In the event of a clinic sale or transfer, an application for transfer of licensee will have to be made to MOH no less than 30 days before the planned day of the sale or transfer. MOH will conduct inspections and other checks to ensure that the safety and quality of clinical care to patients will not be affected.”
“The dental appointment waiting times for non-emergency treatment at our polyclinics have declined over the past few years, from 6.4 months in 2013 to 5 months in 2016. Middle- and lower-income patients who are eligible for the Community Health Assist Scheme (CHAS) have the additional option to seek dental treatment at any of the over 700 participating dental clinics.”
“At our public hospitals, over 95% of patients with suspected cancers would be given an appointment within three weeks. Depending on his condition, the patient may subsequently require various further investigations, including blood tests, biopsies or imaging investigations, such as X-rays, Magnetic Resonance Imaging (MRI), Computed Tomography (CT) or Positron Emission Tomography-Computed Tomography (PET-CT) scans. For patients with suspected cancer, the current waiting time for a CT or MRI scan for initial diagnosis at the National Cancer Centre on the Singapore General Hospital Campus, the National University Hospital and Tan Tock Seng Hospital is within two weeks. For cases deemed urgent by doctors, these scans can be arranged within two to three days. For PET-CT specifically, there is one machine each at the Singapore General Hospital and the National University Hospital. PET-CT scans are only recommended as first line investigations for certain types of lymphomas, lung, breast and skin cancers. The current waiting time for cancer patients requiring PET-CT scans is within one week. For most cancers, there is a very low risk of rapid metastases over a three-week time period.”
“The Ministry of Health (MOH) has been working with healthcare providers to encourage early diagnostics and reduce unnecessary hospital admissions. First, hospitals provide quick and effective treatment to patients at the Accident and Emergency Department, and enable patients with less serious conditions to return home safely without requiring admission. We have increased the number of procedures which can be done in the outpatient setting or as day surgeries. We are also equipping community care providers to monitor and manage discharged patients, so that they can be cared for in the community without returning to the hospital. Next, we are strengthening primary care to provide medical diagnosis and treatment to patients closer to home. Many non-emergency conditions can be appropriately managed at a primary care setting supported by early diagnostic testing and treatment. Primary care doctors are also able to treat patients requiring minor procedures. We have introduced common escalation and referral protocols where patients may be directly referred for hospital-based tests to help with diagnosis and management. Third, we are encouraging more healthy living and disease screening programmes in the community. This facilitates early detection and management of chronic diseases and selected cancers. Together, these efforts help to improve patient well-being and keep our healthcare system sustainable over the longer term.”
“With Singapore's ageing population, we need more nurses to meet our growing healthcare needs. Introduced in 1994, the Asian Nursing Scholarship sponsors good students from Asian countries to pursue nursing studies in our polytechnics and supplement our nursing workforce upon graduation. Between 1994 and 2016, an average of about 200 Asian Nursing Scholarships were awarded a year. Less than 1% of scholarship holders were unable to complete their studies or absconded before completing their studies. Less than 3% did not fully serve out their bond after completing their studies, including those who have absconded. We will continue to work with the relevant authorities to attempt to recover the liquidated damages. Information on the number of scholars who started work but failed their work probation are available from the 2013 intake cohort onwards. Thus far, none of the 301 scholarship holders from the cohort has failed work probation. It should be noted that some of them are still in their probation period. Subsequent cohorts have yet to start their work probation. Applicants for ANS need to meet the polytechnics' academic requirements, of which English is one of the required subjects. Some may be asked to undergo additional selection tests and interviews to assess their English proficiency. We monitor the performance of the scholars closely. Those who have difficulties coping will be counselled and given closer support. The ANS programme has helped develop a pool of locally-trained foreign nurses to supplement our local nursing manpower supply. We will continue to review the programme regularly to enhance its effectiveness.”
“The human milk bank is still in its planning stages. It is a partnership between Temasek Foundation Cares and KK Women’s and Children’s Hospital, and the bank is funded by Temasek Foundation Cares. My Ministry will share further details of the human milk bank when it is finalised later this year.”
“The Smart Health Video Consultation (VC) initiative was introduced in our public healthcare institutions last November. The practice is evolving. Our chief considerations are patient safety. Clinicians would assess individual patient’s suitability before offering the option. For a start, VC has been introduced in psychiatric counselling, paediatric eczema pharmacy follow-up consultation, paediatric home care service, lactation consultation, speech therapy, post-stroke, communicable disease, and cancer patient care. These are also areas where it has been found to work well overseas. Early indications show that it is bringing about greater productivity and convenience for patients. It is still too early to assess the likely extent of adoption and the impact on cost savings. We will continue to monitor its rollout and encourage greater adoption.”
“Prevention is a key strategy in our war on diabetes. Besides healthy eating and frequent exercise, it is also important for Singaporeans to go for regular health screening. Based on the 2016 Health Behaviour Surveillance of Singapore survey conducted by the Health Promotion Board, 78% of Singaporeans aged 40 to 69 had gone for basic health screening in the past three years for high blood pressure, high blood lipids and diabetes. This was an improvement from the 73% in 2010. There was no significant difference by gender. Older Singaporeans are more likely to go for chronic disease screening than their younger cohorts. Among those who have abnormal screening results, a significant proportion do not follow up to see a doctor. The need for post-screening consultation is assessed based on factors like the health screening results, as well as individual and family risk factors. The Ministry of Health is enhancing our health screening programmes to achieve two objectives. First, we want to encourage more Singaporeans who meet the age and risk criteria to go for screening. Next, we want to encourage those who receive abnormal screening results, for example, those who are tested positive for diabetes or who are pre-diabetic, to follow up to see a doctor. Ultimately, each person has to decide whether he or she wants to go for health screening and the follow-up consultation. While the Government will provide support and encouragement, individuals must also take responsibility for their own health.”
“Madam, certainly, MOH will be very keen to work with the unions and healthcare employers to see how we can expand this programme to reach out to more healthcare professionals to encourage them to upgrade themselves, as well as for those from outside the healthcare sector to enter the healthcare sector to serve our patients.”
“Madam, in 2016, MOM implemented the Adapt and Grow initiative to support workers, especially mid-career Professionals, Managers, Executives and Technicians (PMETs), in finding jobs. Some 300 jobseekers were placed into the healthcare sector through this initiative last year. Complementing this, the Agency for Integrated Care (AIC) has also been organising recruitment fairs, through which about 400 mid-career locals were hired in 2016. MOH will enhance the Professional Conversion Programme (PCP) to recruit more mid-career Singaporeans as nurses. We will increase funding support for employers of mid-career nurses for their professional conversion training and on-the-job training. In addition, we will offer overseas nursing Masters scholarships starting from 2017 for non-nursing degree graduates to pursue nursing studies. Healthcare employers can tap on Workforce Singapore (WSG)'s PCP for Professional Executives to recruit mid-career administrators. In addition, those with managerial experience and are planning to switch to the community care sector can be placed on the Senior Management Associate Scheme (SMAS) and undergo training provided by AIC and the employers. MOH will also enhance its place-and-train programmes to recruit mid-career individuals into support care staff positions. On-the-job training funding support will be provided to public healthcare and community care employers for every newly hired support care workers. We will continue to work closely with our partners, such as MOM, WSG, Employment and Employability Institute (e2i), healthcare employers and the unions, to reach out to mid-career job seekers and facilitate their shift to the healthcare sector?”