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.”
The complete record
Every one of 3,841 lines we hold for Gan Kim Yong, in date order, each linked to its source. Free to read, in full, without an account. Page 47 of 77.
“Mdm Chairman, I would like to thank Members for their comments and suggestions. With your permission, may I display a few slides to facilitate the discussion?”
“Mr Deputy Speaker, Sir, I beg to report that the Committee of Supply has made further progress on the Estimates of Expenditure for the financial year 2016/2017 and ask leave to sit again tomorrow.”
“Mr Chairman, may I seek your consent that progress be reported now and leave be asked to sit again tomorrow?”
“The Caregivers' Training Grant was introduced in 2007 to support caregivers of seniors who are 65 years or older and persons with disabilities with up to $200 each year to attend caregiver training courses. To date, more than 32,000 caregivers have benefited from this grant. In financial year (FY) 2015, caregivers who used the grant to attend courses pertaining to conditions, such as dementia, autism, dyslexia or intellectual disabilities, made up about 40% of the 6,000 caregivers who have used the grant to date. The average annual utilisation by these caregivers was $116 per grant recipient in FY2015. We do not have plans to increase the grant quantum at the moment, as the current grant of $200 per annum is generally adequate. Today, about 80% of all approved caregiver training courses cost $200 or less. The average annual utilisation per grant recipient has remained at about $160 for the past five years. We will continue to monitor the adequacy of the grant.”
“The insurers are also responsible for responding to queries on premiums and supporting the policyholder through the claims process. Page: 109 MOH will continue to review the processes for ElderShield sign-up, premium payment and claims, including working with other organisations, such as the Pioneer Generation Office, to help Singaporeans with ElderShield processes and their long-term care needs.”
“ElderShield is an insurance scheme that provides basic protection against the costs of long-term care arising from severe old-age disability. Depending on the policyholder's plan, the scheme provides cash payouts of either $300 a month for up to five years, or $400 a month for up to six years. As at end 2015, there were 1.2 million ElderShield policyholders, or about 65% of the resident population aged 40 to 83. Those aged 84 and above would not have qualified for ElderShield as they had exceeded the maximum entry age when ElderShield was introduced in 2002. Instead, they can apply for financial assistance under the Government-funded Interim Disability Assistance Programme for the Elderly if they meet the income and disability criteria. Since ElderShield was launched in 2002 till end-2015, there have been about 12,500 successful claims, with around $90 million paid out. Today, to ensure participation in the scheme, it is made as easy as possible, and all Singapore Citizens and Permanent Residents with MediSave accounts are automatically covered under ElderShield at the age of 40, unless they choose to opt out. As the scheme is operated by three Ministry of Health (MOH)-appointed insurers, that is Aviva, Great Eastern and NTUC Income, the insurers will send out premium notice letters once a year, before policy renewal. Premiums are usually paid via direct deduction from the policyholder or their family member's MediSave account. For those without a MediSave account when they reach 40 years old, the Central Provident Fund (CPF) Board will send an invitation letter to them to invite them to open a CPF account, so that they could be automatically covered under ElderShield.”
“Health screening plays an important role in helping individuals detect diseases early and seek treatment to manage these diseases promptly. Screening tests for diabetes and cervical cancer are available at affordable rates through the Health Promotion Board's Screen for Life programme. Singaporeans can visit general practitioner (GP) clinics participating in Screen for Life to enjoy a package rate of $10 for chronic disease screening which includes diabetes screening, and $10.25 for cervical cancer screening. Since 2014, individuals who hold the Community Health Assist Scheme (CHAS) or Pioneer Generation (PG) card can receive these tests for free at Screen for Life GPs, and receive subsidies for their doctor’s consultation fee, if they are due for screening. With these subsidies, CHAS and PG patients paid an average of only $2 per visit last year. In addition, eligible Singaporeans can receive subsidised cervical cancer and chronic disease screening at the polyclinics. The Ministry will continue to review these subsidies from time to time to ensure that screenings and follow-up consultations remain affordable for Singaporeans.”
“For Pioneer Generation (PG) patients with mobility restrictions, their caregivers can collect the prescribed medications and supplies on their behalf. The same subsidies will apply whether the PG patient collects the medications and supplies in person or through a caregiver. This includes PG subsidies as well as the Medication Assistance Fund. We will remind our healthcare institutions and staff of this arrangement, so that it is implemented effectively on the ground to benefit our PG patients. Page: 107”
“To verify that its systems are robust, SGH has engaged consultants from the Joint Commission International, a reputable accreditation and consultancy organisation, to conduct a thorough review Page: 14 and assessment of its clinical processes. We are also sharing the lessons learnt from this outbreak with all hospitals and working with them to ensure that their infection control, risk management and escalation protocols are in place. In December 2015, MOH set up a taskforce headed by Minister of State for Health, Mr Chee Hong Tat, to enhance the national healthcare system's ability to detect and respond to infectious disease outbreaks in hospitals and in the community. The taskforce is scheduled to complete its review by the middle of this year. MOH has decided to implement a number of the taskforce's interim recommendations earlier. This includes setting up a National Outbreak Response Team comprising experts from across the healthcare fraternity. This team will augment the efforts of healthcare institutions to deal with disease outbreaks. Other measures include simplifying processes for notification and reporting of infectious diseases by doctors and laboratories. MOH has also designated the Communicable Diseases Division to assume overall responsibility for overseeing surveillance of all infectious diseases. Madam, the Hepatitis C incident reminds us of the need to remain vigilant at all times. While it is not possible to completely prevent outbreaks in hospitals, MOH and our healthcare institutions are determined to learn from the mistakes made so that we continue to improve our systems and processes to provide better and safer care to our patients.”
“Not only is it entered into the staff's service record, it has a negative bearing on his career, including future promotion and awards. A warning or stern warning may be given together with a financial fine. But, Madam, the greatest penalty is not these disciplinary measures. For everyone involved, including those who had provided direct care to the affected patients, we will carry with us the pain and regret of this incident for a long time to come. It is, therefore, important for MOH, our healthcare institutions and healthcare workers to learn from what went wrong and make sure the mistake is not repeated. Instead of naming individuals and developing a blame culture in our healthcare institutions, we need to encourage a learning culture to make our hospitals as safe as possible for the patients. This culture of continual learning and improvement is important for enhancing patient safety and the quality of care. Looking ahead, our focus is to improve our systems and processes to enhance infection control and strengthen detection and response to infectious diseases. Revealing the names of the officers and specific sanctions each individual received does not contribute to better care of our patients. In deciding what to disclose, we have to bear in mind the longer-term impact on our healthcare system and healthcare workers and strike a careful balance. Let me now turn to the measures that we are putting in place to improve patient safety. Following the IRC's review, SGH has taken steps to improve infection control by enhancing its processes and strengthening cleaning and decontamination. SGH also enhanced its education and retraining programmes for staff and implemented stricter monitoring of infection control practices.”
“After a thorough investigation, the IRC concluded that the outbreak was caused by gaps in infection prevention and control practices at SGH, together with other overlapping factors, such as a change in the wards and greater susceptibility and exposure of the renal patients to intravenous Page: 13 procedures. As a follow-up to the IRC report, both SGH and my Ministry have taken steps to address the gaps. I will articulate this further later. MOH and SingHealth also instituted disciplinary procedures to hold our staff to account. We set up independent human resource (HR) panels to examine the roles, responsibilities and actions of key MOH and SGH staff in relation to the incident and to recommend appropriate disciplinary actions. The SingHealth HR panel submitted its recommendations to the SingHealth Board. The Board decided that the junior and frontline healthcare staff would be required to undergo retraining and competency assessment to improve their infection prevention and control practices. The Board also decided to hold 12 SGH leaders, including senior management, responsible for their failure to enforce a strong infection control regime and incident escalation protocols within the hospital. The MOH HR panel submitted its recommendations to the Public Service Commission (PSC). The PSC decided to take disciplinary action against four MOH officers holding Director-level or equivalent roles for their failure to intervene early and to ensure that the infectious disease notification and reporting system was effective and rigorous. The disciplinary sanctions imposed on MOH and SGH staff included warnings, stern warnings and financial penalties. Let me explain. When a warning is issued, it is lodged in the staff's service record. A stern warning is a more serious penalty.”
“Madam, our healthcare professionals are committed to doing their best to cure and care for their patients. They have played a critical role in providing good quality healthcare for Singaporeans. Unfortunately, gaps and lapses do happen. When an outbreak occurs, hospitals must do two things. First is to take steps to stop further transmission and care for the affected patients as best as they can. The second is to review the processes at the individual and system levels and make improvements to reduce the risk of any recurrence. The Hepatitis C outbreak in the Singapore General Hospital (SGH) is a painful incident – painful to the patients, their families and our healthcare professionals. The chief executive officer of SGH has apologised for the outbreak. The Ministry of Health (MOH) and SGH are committed to caring for all affected patients by providing them with counselling, support and appropriate Hepatitis C treatment. The well-being of the affected patients and their family members remain our top priority. My Ministry will continue to work with SGH to ensure that they receive the necessary support and care. Once again, let me apologise to the affected patients and their family members for this incident, and especially to those who have lost their loved ones. To identify the cause of the outbreak and address the gaps, my Ministry has set up the Independent Review Committee (IRC) comprising experienced clinicians from different disciplines, with support from local resource persons and international experts, to determine the cause of the Hepatitis C outbreak and provide an objective and critical review of the response.”
“Madam, may I take both Question Nos 6 and 7 together?”
“However, for patients whose bills exceed the $400 cap, they can use the Medisave of their family members to pay, or apply for Medifund at the polyclinics or subsidised specialist outpatient clinics in public hospitals if they face financial difficulties. We will continue to monitor the affordability of subsidised care, especially for chronic diseases, and ensure that the Medisave withdrawal limits continue to be sufficient.”
“Medisave withdrawal limits are set such that basic, subsidised healthcare expenses are affordable for all Singaporeans, after taking into account Government subsidies and MediShield Life payouts where applicable. These withdrawal limits are reviewed regularly. 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. In 2014, the $400 CDMP limit was sufficient for about eight in 10 subsidised patients with common chronic conditions. In addition, affordability will improve further with the introduction of Flexi-Medisave in 2015, where elderly Singaporeans can use an additional $200 per patient per year to pay for their outpatient treatments, including for chronic conditions, at public healthcare institutions and participating CHAS GP clinics. Medisave withdrawal limits are necessary to avoid premature depletion of limited Medisave savings, which were mostly sized for inpatient treatment. Nonetheless, we understand the needs of patients with chronic illnesses. Hence, we carefully set the Medisave limits, to strike a balance between their ongoing chronic treatment needs and their future needs, such as hospitalisation and insurance premiums. Therefore, it would not be prudent to allow patients to use Medisave to fully pay for all their medical bills for chronic illnesses, regardless of amount.”
“We have expanded the number of home and community care options to help support the care and social needs of their elderly loved ones during the week when they have to go to work. We have also made respite services more accessible. We have introduced weekend respite services at several eldercare centres across Singapore to support caregivers who may need a few hours off during the weekend. Some nursing homes also offer a respite care programme which provides overnight stay for seniors for a short period. For those looking after a family member with dementia, the Eldersit programme provides an eldersitter to look after the seniors at home and engage them in activities for a few hours when caregiving arrangements are not available. We will continue to work with other Ministries and the unions to encourage employers to adopt family-friendly practices and to strengthen support for working caregivers.”
“I would like to thank Miss Cheng Li Hui for her suggestion. We recognise that caregiving is no easy feat and care-giving responsibility will become heavier with Singapore's ageing population. We will certainly study this suggestion, taking into consideration the overall leave provision already put in place by employers and the caregiving needs of workers. Some employers offer a range of family-related leave benefits which can be tapped on to care for family members if necessary. For example, Infineon Technologies Asia Pacific Pte Ltd, a semiconductor company, offers two days of family-care leave as well as two days of eldercare leave. The DSO National Laboratories offers two days of family-care leave, on top of statutory leave and other schemes, such as compassionate leave. Public Service agencies also provide parent-care, paternity and maternity leave, separate from vacation leave. The Tripartite Committee on Work-Life Strategy launched the Tripartite Advisory on Flexible Work Arrangements to help guide employers and employees in implementing flexible work arrangements. The proportion of employers providing at least one form of flexible work arrangement has also gone up from 28% in 2008 to 47% in 2014. About seven in 10 employers also provide unplanned time-off for their employees to attend to personal matters. We encourage more companies to support their employees' caregiving responsibilities by providing flexible work arrangements or time-off to look after their elderly parents. In addition, the MOH has been strengthening caregiver support for Singaporeans, particularly those who have to juggle between work and caregiving roles.”
“The funding provided is determined with reference to how MOH will fund our BOL nursing homes. Third, the Government releases suitable land sites and state properties for interested providers to bid, in order to design and develop their nursing homes. As land is scarce and there is still a growing demand for nursing home services, MOH does state a minimum capacity that each site is expected to achieve, with reference to the size of the site and allowable intensity. Within this broad parameter, service providers are free to adopt their own designs for the nursing home facilities as they fund the development costs on their own. MOH does not specify the specific bed configurations or mix in these tenders. Such nursing home operators who develop their own nursing homes can offer to serve subsidised patients under the Nursing Home Portable Subsidy Scheme (PSS) through the Government's Requests for Proposals (RFPs). The PSS provides additional capacity to supplement subsidised nursing home capacity provided by VWOs and our own BOL facilities. In considering bids from such operators, MOH will consider both quality and the capacity to be offered. Bed configuration is not a factor for consideration.”
“The intermediate and long-term care landscape in Singapore has to evolve to meet the needs of an ageing population. MOH is expanding the capacity of nursing home services and, as land is scarce in Singapore, we must ensure efficient use of space so that we have sufficient capacity to meet the increase in needs. The design and layout of nursing homes also have to take into consideration the different care needs of the residents, the required manpower to provide adequate monitoring of the residents and that residents in nursing homes can live in a safe environment. There are currently three main modalities in developing new nursing home capacity. First, MOH develops purpose-built nursing homes and appoints operators through competitive tenders to operate these nursing homes under the Build-Own-Lease (BOL) scheme. Under this approach, MOH fully funds the development cost based on the scope of work and service provisions determined by the Ministry. MOH also directly determines the design of the facility, taking into consideration space norms and site characteristics. Most BOL nursing homes have some four to eight beds per cubicle, but we provide for some single-bedded rooms to cater to instances where patients require clinical isolation. Appointed BOL nursing home operators, whether private or VWOs, receive operating subventions to serve subsidised patients, as long as they meet the service requirements under the tender, which include setting aside the bulk of their licensed bed capacity for subsidised residents. Second, MOH also provides co-funding, both capital funding and operating subvention, to VWO operators who want to redevelop or expand their existing nursing home facilities to care for more patients.”
“Madam, I would like to clarify that our patients' circumstances vary and, therefore, it is difficult for a universal scheme like MediShield Life to cater to each and everyone's unique circumstances at the transition point. I can understand the angst of the patient that Mr Lim referred to. I will encourage the patient or Mr Lim to refer the case to us and we will take a look at the specifics of the case and see how we can help the patient, including providing financial assistance, or looking at other ways to help. The best way is to let us know the specific cases and we will see how we can tailor our assistance scheme to support them.”
“Madam, MediShield Life coverage is applicable for patients who were admitted on or after 1 November 2015. Individuals with existing MediShield coverage who were admitted before 1 November 2015 will continue to receive benefits under the old MediShield. This approach is consistent with the approach taken in past MediShield enhancements and provides a clear transition at the start of MediShield Life. This was communicated in MOH's various publicity materials, including booklets on MediShield Life, sent to each household. Significant Government subsidies of up to 80% are also available for those who use subsidised treatment in our public hospitals. Patients can also tap on Medisave for their share of the healthcare bills. Again, patients who face financial difficulties can approach the Medical Social Workers at the public hospitals for assistance, such as tapping on Medifund.”
“Madam, we are in constant dialogue with the insurance industry. In fact, I just had a session with them last week talking about MediShield Life as well as the private products, Integrated Plans, which ride on MediShield Life. Insurance companies also have other products that are independent of MediShield Life. They are also exploring collaboration with the hospitals, so that they are better able to match in terms of the services provided and the needs of their policyholders. We do have this constant dialogue and discussion with the industries, on the one hand, to better understand how the industry operates because we do have a very large universal scheme of MediShield; on the other hand, to also understand the difficulties and challenges they face in implementing MediShield Life as well as the Integrated Plan and also to get their input on how we can improve the product offering in terms of the healthcare insurance sector.”
“Madam, we will always try our best to streamline our processes. I must also stress that, again, as I have said in my reply, at every admission into the hospital, the patient is given a choice, whether he would like to be admitted as a private patient or he would like to be admitted as a subsidised patient. Every admission would be treated fresh. For those who want to switch to subsidised care from non-subsidised care, they will have to work with a medical social worker (MSW) to better understand their needs and tailor our solutions and our assistance, to meet the needs of the patients. I must stress that our MSWs actually go out of their way to help the patients. I have regular dialogues and engagements with the various healthcare professionals and one of the most enjoyable sessions is the session with MSWs, because whenever I meet them, they do not talk about anything else except the well-being of their patients. They always talk about how we can improve the processes, simplify the processes, so that the patients will get the assistance they need as soon as possible. So, rest assured that our MSWs are working very hard to help the patients to meet their needs and MOH will work with them to see how we can continue to streamline and improve our processes.”
“Madam, I thank Mr Cedric Foo for raising the question. It is a very important question. In fact, we have been working very hard over the last few years to encourage our employers to move towards portable medical benefits for their employees so that their employees would be able to continue to enjoy these benefits beyond their employment with a specific employer and beyond retirement. We have made some progress and we intend to continue to push in this direction. The real portable medical benefit is MediShield Life which we have introduced, because MediShield Life is universal and is independent of employers. We encourage the employers to provide additional contribution to Medisave to help their employees to pay for MediShield Life premiums or to purchase Integrated Plans which are portable. These are the ways that we hope would be able to help our employees to enjoy portable medical benefits. Assoc Prof Fatimah Lateef (Marine Parade): I support means-testing, but, essentially, when someone asks for a downgrading process to be started at the hospital, they need to see a social worker and there is a latent phase and a period where they have to wait. Sometimes, the waiting period is such that they may have already had another admission where they have to still pay the paying class rate or they may have had another one or two Specialist Outpatient Clinic appointments with a paying class clinic. So, therefore, I was wondering whether we can expedite and streamline the process of a downgrading.”
“Madam, I am sure Dr Tan is quite aware that our resources are always limited and, therefore, we have to try our best to target our subsidies and financial assistance to those who genuinely need them. For patients who are genuinely in financial difficulties, the hospitals and MOH will certainly extend our assistance to them, regardless of whether they have been using their employer insurance before they retire. I would be reluctant to grant special consideration for patients who, just because they have made use of employer's benefits or insurance, to waive means-testing or to make it easier for them. We treat all patients alike. Those who have needs for financial support, we will do so and we will continue to improve our processes to make sure that those who need financial assistance will get them in a timely manner and as much as they need to. But we have to bear in mind that the resources are always limited and we need to make sure that our assistance is targeted and reaches out to those who really need them.”
“Madam, all Singaporeans who are admitted to public hospitals can choose to be admitted into subsidised ward classes, regardless of whether they had been receiving unsubsidised or subsidised care previously. Hospitals provide financial counselling to patients prior to or upon admission, to help them select a ward class appropriate to their needs. Patients at the public hospitals who face difficulties with their medical expenses and wish to switch from non-subsidised care to subsidised care, can approach the staff at public hospitals for assistance. Each request is assessed on a case-by-case basis, taking into consideration various factors, such as his bill size, medical condition and any changes in financial means and his ability to pay, including employment status. Patients who request to switch to subsidised Specialist Outpatient Clinic services will also be similarly assessed. I would encourage patients who are facing financial difficulties to approach the medical social workers in the hospitals to discuss the various options.”
“Government pensioners, like all Singapore Citizens and Permanent Residents, have been covered under MediShield Life from 1 November 2015. Government pensioners will continue to enjoy all their existing medical benefits and will not pay higher out-of-pocket for their medical expenses than if MediShield Life had not been introduced. In addition, Government pensioners can use MediShield Life to help pay for the co-payment portion of their bills, if any. Some pensioners with larger bills may pay even lower out-of-pocket expenses with MediShield Life. The Government is paying the MediShield Life premiums in full for pensioners and their dependants on the Fixed Amount on Ward (FAW) and Co-payment on Ward (CPW) schemes. Pensioners on the Comprehensive Co-payment Scheme (CCS) and Medisave-cum-Subsidised Outpatient (MSO) scheme receive higher Medisave contributions from the Government. They can use this to help pay for their own and their dependants' premiums. The Public Service Division has written to all eligible Government pensioners in 2015 to inform them of this arrangement, conducted various engagement sessions with pensioners and is maintaining a hotline to clarify any queries.”
“We are nurturing more Advanced Practice Nurses through greater support for their training. We are also increasing funding support to the public healthcare sector to provide more opportunities for nurses to undergo skills upgrading for their professional development. Beyond salaries, working hours and career opportunities, another important area is for all of us, as a society, to continue to show appreciation, recognition and support for our nurses, not only on Nurses’ Day but every day.”
“Among nursing graduates from the 2008, 2009 and 2010 cohorts who joined the public sector, 76% remained in the public sector after five years. Since 2014, we have been progressively implementing the "Care" package recommended by the National Nursing Taskforce (NNT) to strengthen the development of the nursing profession in the areas of Career, Autonomy, Recognition and Education. As part of the package, nurses in public healthcare institutions and Ministry of Health (MOH)-subvented intermediate and long-term care sectors have received base salary increases of between 3% and 10% each year in 2014 and 2015, as well as a Nurse Special Payment of 0.5 month of their monthly base salary in December 2014 and 2015. To better enable nurses to balance their work with other family commitments, the public healthcare institutions are striving to make flexible and part-time work arrangements more accessible. After successful pilots of more flexible shift start times at Changi General Hospital, KK Women’s and Children’s Hospital, Singapore General Hospital and Tan Tock Seng Hospital, we are working to scale up the innovations across all public hospitals. To enhance the career progression of nurses in the public sector, the eligibility criteria for Enrolled Nurses (ENs) to undergo bridging studies have been revised. This has provided ENs with more opportunities to upgrade to become Registered Nurses, in line with the SkillsFuture initiative. In 2015, close to 180 ENs have enrolled in the bridging courses at Nanyang Polytechnic and Ngee Ann Polytechnic as compared to 45 in 2014. In addition, we have introduced the Assistant Nurse Clinician role in 2015 to enable experienced Senior Staff Nurses to take on a clinical leadership role.”
“Paediatric services are provided at various levels ranging from primary to tertiary care. At the primary healthcare level, general practitioners (GPs) and polyclinics manage common paediatric and neonatal conditions as well as provide well child services, such as developmental assessment and childhood vaccinations. There are already existing healthcare facilities in the north providing care for women and children at the primary care level, including the two polyclinics at Yishun and Woodlands and some general practitioner (GP) clinics, out of around 130 GP clinics in the north. In addition, there are nine specialised clinics that provide obstetrics and gynaecology and paediatric services in the community in the north. Over the next few years, residents in the north can look forward to new service developments and healthcare facilities. We will be opening Woodlands Integrated Healthcare Campus (WIHC), which includes a new acute hospital, in phases from 2022 to complement the existing Khoo Teck Puat Hospital in Yishun. The Ministry of Health is currently in the process of planning the clinical services for WIHC. Page: 142 Services planning for this new campus will be based on both regional healthcare needs and the optimisation of clinical expertise and manpower resources across the national healthcare system. We will ensure that good quality healthcare services are accessible to patients.”
“We will continue to work with HPB to monitor the take-up rate of vaccines under NCIS and, at the same time, enhance educational efforts to ensure that high vaccination coverage is maintained to protect our population.”
“Vaccinations under the National Childhood Immunisation Schedule (NCIS) are recommended as the standard of care to protect children against certain infectious diseases. Vaccinations against measles and diphtheria are compulsory in Singapore. The take-up rates for measles and diphtheria vaccinations are high among Singaporeans and Permanent Residents, with coverage in children aged two years maintained at around 95% or higher in the last five years. The high vaccination coverage confers herd immunity and reduces the risk of disease outbreaks. As measles and diphtheria vaccinations are bundled together in the form of combination vaccines with vaccinations on NCIS for other diseases, such as mumps, rubella, whooping cough, polio and tetanus, herd immunity is achieved for these diseases as well. The Ministry of Health (MOH) has taken an educational approach to encourage parents to comply with vaccinating their children. The National Immunisation Registry under the Health Promotion Board (HPB) tracks preschool children and sends letters to remind parents to bring their children for vaccination if they have not done so. HPB’s School Health Service actively follows up on unvaccinated children in primary schools. This has worked well and resulted in high levels of vaccination coverage among our children. The Health Sciences Authority has in place a robust surveillance system to closely monitor the safety of vaccines used here. In the last three years, while there were reports of adverse reactions suspected to be associated with vaccines, the majority of the reports relate to known adverse reactions, such as injection-site swelling or pain, fever and febrile fits.”
“Through these efforts, we aim to bring together the collective efforts of all stakeholders, so that we can work together to protect Singapore from existing and emerging threats of infectious diseases.”
“The Ministry of Health (MOH) has a robust surveillance system to monitor communicable diseases and protect public health. Aside from notifications of infectious disease cases by clinicians and laboratories, MOH also works with hospitals, polyclinics and other Government agencies to analyse disease syndromes and trending of different strains of infectious agents. With globalisation, there is an increased risk of infectious diseases spreading across borders. We have seen this with Ebola and, more recently, with Zika. In addition, infectious diseases can spread from animals to humans, as shown by diseases, such as Avian Flu and the Middle East Respiratory Syndrome. We need to remain vigilant and regularly review our systems and processes to keep an eye on these threats. One important aspect of an effective surveillance system is for our healthcare workers to look out for suspicious cases and report them promptly. In doing so, we should be careful not to increase the administrative burden on our healthcare workers, so that they can continue to focus on their core work and patient care. We need to make good use of information technology and data analytics to streamline our reporting processes and continually improve the national surveillance and response system. MOH is also enhancing our national capacity and capabilities in infectious diseases. We will work closely with the Institute of Infectious Diseases and Epidemiology on prevention, surveillance and response. Building on this collaboration, we will set up the National Centre for Infectious Diseases by 2018 to serve as the national facility for outbreak prevention and containment.”
“Drinking water is strongly encouraged through extensive presence of water coolers while all beverages sold in schools have to have reduced sugar levels. Through the increase in Physical Education (PE) periods, students’ base participation in sports and physical activities has also increased to at least two hours per week. Other opportunities for physical activity participation include Physical Sports Co-curricular Activities and sports enrichments, such as Sports Education Page: 128 Programme, inter-class games and sports carnivals. In addition, parents play a very important role in role-modelling active living and healthy eating for their children. Children develop these habits more effectively when these are done as a family, including the involvement of other care-givers. We will continue to work with the other agencies to monitor the trends of overweight and obesity, levels of physical activity and other risk factors in the children, youth and adult populations. Achieving a healthy lifestyle that includes active living and healthy eating needs to start from young. In this regard, we are working with partners on a holistic approach to address the health challenges faced by our children and youths, including overweight. We will develop more programmes and initiatives to help them cultivate healthy habits. We will make the necessary announcements in due course.”
“The Health Promotion Board conducts a triennial survey of lifestyle risk factors, including dietary habits and physical activity of students in secondary schools, Institutes of Technical Education (ITE), polytechnics, junior colleges/centralised institute (JCs/CI). The Ministry of Education (MOE) also monitors students’ weight status, measured as BMI-for-age, at the primary, secondary and JC/CI levels. During the survey period 2012-2014, the median duration spent on physical activity, which includes leisure, school-related physical activities and walking or cycling while commuting between places was reported at 250 minutes per week for polytechnic students, 339 minutes per week for secondary and JC/CI students, and 360 minutes per week for ITE students. In another survey conducted by the Ministry of Health in 2013, the median duration spent on physical activity, including leisure, work-related and commuting, was reported to be 450 minutes per week among adults aged 18 to 69 years. It was the highest among the young adults aged 18 to 29 years at 510 minutes per week but at its lowest among adults aged between 30 to 49 years at 420 minutes per week, before rising again in the 50 to 59 age group. The proportion of overweight and severely overweight children in our mainstream schools has increased from 11% in 2011 to 12% in 2015. Various initiatives have been introduced in schools to encourage good dietary habits and regular physical activity to promote health and help in weight management. For example, there are now more healthier options in school canteens. School tuckshop operators are encouraged to use healthier ingredients and healthier food preparation methods.”
“The mild, non-specific nature of the symptoms in the majority of infected patients will also make surveillance difficult. We urge the public to do its part by remaining vigilant and taking appropriate precautions to prevent mosquito breeding.”
“Due to concerns about the risk to the foetus during pregnancy, pregnant women are advised to reconsider travel plans to affected countries. To facilitate early detection, returning travellers who had travelled to countries with local transmission of Zika virus infection are advised to seek medical attention if they develop symptoms. Posters will be placed at airports for inbound travellers to serve as reminders. MOH has issued a medical circular to increase the awareness of Zika virus infection among the medical community. Zika virus infection has been included in the list of legally notifiable diseases. All medical practitioners and diagnostic laboratories are required to notify MOH of suspect and confirmed cases of Zika virus infection within 24 hours. Suspect cases of Zika virus infection will be tested by the National Public Health Laboratory (NPHL). MOH is also working with NEA to enhance their on-going laboratory surveillance for Zika virus. If a case of Zika virus infection is detected in Singapore, vector control operations will be stepped up to prevent further transmission of Zika virus infection. MOH will also actively look for Page: 94 additional cases in high-risk areas in relation to the case. Confirmed cases will be admitted to a public hospital for further management and public health precautions will be taken to ensure that they are not bitten by mosquitoes. This is to minimise the risk of Zika spreading and becoming endemic in Singapore. While MOH and NEA will take necessary steps to contain its spread, it may be challenging to prevent the disease from spreading and eventually becoming entrenched in Singapore, given the presence of the Aedes mosquito vector here.”
“MOH has been monitoring the Zika virus situation closely. Zika virus infection is transmitted by the Aedes mosquito, identical to dengue. It is generally a mild and self-limiting illness, though recent reports from Brazil of an association with brain malformation in babies of mothers infected during pregnancy is cause for concern. There is currently an outbreak of Zika virus infection occurring in the Latin America and Caribbean region since early 2015. Sporadic cases of Zika virus infection have also been detected from several countries in Southeast Asia, including Cambodia, Indonesia, Philippines, East Malaysia and Thailand, in recent years but there have been no reports of outbreaks. On 19 January, Taiwan reported an imported case of Zika virus infection from Thailand. There is an on-going surveillance programme for Zika virus infection in Singapore. While no cases have been detected so far, given that only one in five people infected with Zika virus displays symptoms and that the symptoms are generally mild, we cannot completely rule out the possibility that there are undetected cases in Singapore. Given the presence of the Zika virus infection in our region and the volume of travel by Singaporeans as well as tourists, it is inevitable that there will be imported cases of Zika virus infection into Singapore in time to come. Local transmission of the disease is also likely, as the Aedes mosquito vector is present. To reduce the risk of importation, MOH and NEA have advised travellers to countries with local transmission of Zika virus infection to protect themselves from mosquito bites. Posters will be placed in airports for outbound travellers to serve as reminders.”
“Hospital bills of foreigners are not subsidised. The median bill size for foreign workers increased by about 7% a year from 2011 to 2014 and was about $2,000 in 2014. Employers are required to purchase healthcare insurance coverage of at least $15,000 for their employees on Work Permits and S passes. This is sufficient to fully pay for 96% of day surgery and inpatient bills incurred by foreign workers at the public hospitals in 2014. Page: 93 All foreigners, including foreign workers, account for about 14% of the arrears cases that are outstanding for more than two months at the public hospitals, in all settings.”
“The cost of medicines differs across countries due to factors, such as operating costs as well as pharmaceutical firms’ pricing strategy for the various markets, which takes into account the size and purchasing power of the respective markets. To reduce the cost of medicines, our public healthcare institutions undertake joint group procurement for about 90% of our drugs to enjoy economies of scale. The savings are reflected in the prices of medicines sold to patients. To keep drugs affordable for subsidised patients, the Ministry of Health regularly reviews the subsidies of medications which were recently enhanced to improve their affordability. Since 1 January 2015, lower- to middle-income patients at the Specialist Outpatient Clinics (SOCs) and polyclinics can receive 75% subsidy for drugs listed on the Standard Drug List (SDL), up from 50% previously. This effectively halves the patients’ share of the cost of their medications. Pioneers enjoy a further 50% off their subsidised outpatient drugs. Besides helping patients pay for their drugs, the Ministry also regularly reviews the coverage of subsidised drugs. In 2015, 12 new drugs were added into the SDL and Medication Assistance Fund, including drugs used to treat colorectal cancer and Alzheimer’s disease. We will continue to review our policies to keep healthcare affordable.”
“Together, Singaporeans will age with confidence and live more fulfilling lives as members of a cohesive and caring Nation for All Ages. Page: 38”
“We will also continue to recruit and retain healthcare workers and enhance efforts to raise productivity and become leaner in terms of manpower. In parallel, we will invest in the development of telehealth and robotics to enable us to achieve higher productivity in healthcare and bring better care closer to Singaporeans, while being manpower-efficient. We will continue to invest in healthcare research to improve care delivery and outcomes. As our population ages, we will also need to develop innovative methods to help Singaporeans remain healthy and dynamic even as the average lifespan increases. From 2015 to 2020, MOH will continue to add more healthcare facilities to cater to the needs of our ageing population. Within this period, we will add more than 10,000 beds in acute hospitals, community hospitals and nursing homes, as well as more than 7,000 places to community care, home care and palliative home care. We will also increase primary care capacity through partnerships with GPs and the development of primary care facilities. Following the introduction of MediShield Life, MOH will work on developing a standardised private Integrated Shield Plan. We will also continue to review our financing policies to keep health and aged care affordable for Singaporeans. To ensure long-term affordability and sustainability for patients and society, we will also need to focus attention on providing appropriate and cost-effective care, to ensure that new treatments, drugs, devices/implants and medical technology are effective in improving health outcomes. Our plans will enable Singaporeans stay healthy and active throughout their lives. We will have access to high quality care and those of us who need support and assistance will receive them.”
“Page: 37 We will collaborate with various Government agencies, the people and private sectors, to jointly implement the Action Plan for Successful Ageing. The Action Plan aims to promote active ageing, build a cohesive community with inter-generational harmony and improve our city infrastructure to enable seniors to age confidently in place. Our vision is to achieve "One Singaporean, One Family Doctor", where more Singaporeans will establish a long-term partnership with a regular family doctor. Over time, the family doctor, being the first stop of care, will develop a more holistic understanding of each family member's health needs. This will enable them to provide care that is most appropriate for the patient. We will continue to engage and work closely with the primary care community to strengthen the sector and provide convenient, affordable and good quality care to Singaporeans. We will build on our six Regional Health Systems (RHSes) to reshape healthcare delivery by bringing care beyond hospital walls and integrating preventive, primary, hospital, long-term and home care services. This is so that patients can receive seamless care that is convenient, appropriate and cost-effective. The RHSes will strengthen partnerships among public sector, private sector and VWO healthcare providers and also leverage on technology, to provide care that is organised around patients' needs. We will redouble efforts to enhance patient safety and the quality of care in our healthcare system. The quality of our healthcare system relies on the knowledge and skills of our healthcare professionals. We will embark on efforts to develop a future-ready healthcare workforce by leveraging on SkillsFuture initiatives to strengthen healthcare career pathways.”
“We made healthcare more affordable for lower- to middle-income patients through significant subsidy enhancements for outpatient drugs, subsidised specialist outpatient care, community hospitals and long-term care. We also allowed more flexibility in the use of Medisave. The Pioneer Generation Package has significantly helped our Pioneers with their medical expenses and given them greater peace of mind with respect to healthcare costs. MediShield Life was rolled out on 1 November 2015, providing better coverage and higher payouts so that patients pay less for large hospital bills. MediShield Life will cover all Singaporeans and PRs, including the very old and those who have pre-existing conditions. To support successful ageing, we worked with the community to develop holistic health and social programmes and invested in infrastructure to create senior-friendly communities and make ageing a fulfilling journey. In addition, under the Health Promotion Board (HPB)'s Healthy Living Master Plan, we launched new initiatives, both within the community and at workplaces, to enable Singaporeans to stay fit and healthy. We faced renewed public health threats from emerging infectious diseases, such as Ebola and MERS, as well as haze, and continued to strengthen our emergency preparedness against these. MOH's foremost mission is to help Singaporeans stay healthy. We will continue to invest in Singaporeans' health by enabling citizens to adopt healthy lifestyles in workplaces, schools and the community. In partnership with other Government agencies, we will step up efforts to reduce obesity and smoking and also work in tandem with Singaporeans to overcome barriers to leading a healthy lifestyle.”
“MOH's vision is for all Singaporeans to live well, live long and with peace of mind. We will continue to invest in improving the health of Singaporeans and enhancing accessibility, affordability, quality and sustainability of healthcare for Singaporeans, as outlined in our Healthcare 2020 Master Plan introduced in 2012. In the past few years, MOH has increased the capacity of our healthcare system, in line with our Healthcare 2020 Master Plan. We expanded the Community Health Assist Scheme (CHAS) to allow about 1.4 million Singaporeans, including our Pioneers, to benefit from subsidised care at private general practitioners (GPs) and dental clinics. In partnership with the private sector, we established Family Medicine Clinics to care for the increasing number of Singaporeans with chronic diseases. We opened the Changi General Hospital-St Andrew's Community Hospital Integrated Building, Ng Teng Fong General Hospital, Jurong Community Hospital and Yishun Community Hospital, adding a total of 1,800 beds when fully opened. We increased the capacity of nursing homes, senior care centres and home care services. We also introduced new care standards for nursing homes, as well as guidelines for centre-based and home care, to improve the quality of care for our seniors. We invested in expanding, upgrading and recognising our healthcare workforce to raise the quality of healthcare. In particular, we worked with the Singapore Institute of Technology to launch new local allied health degree training programmes in Academic Year 2016. A CARE (Career, Autonomy, Recognition, Education) package was introduced to boost the nursing profession.”
“Currently, subsidised patients in our Public Healthcare Institutions (PHIs) receive care from a team of doctors, led by a senior doctor. This is to ensure that the Page: 140 patients will receive appropriate team-based care and, where necessary, the senior doctors in the team will attend to the patients. Patients who wish to choose a specific doctor will have to pay private rates. The same principle applies to Pioneers. Pioneers who are receiving treatment at the subsidised Specialist Outpatient Clinics (SOC) in PHIs receive an additional 50% subsidy on the net bill for subsidised services and medications. Pioneers who are currently private patients and wish to enjoy the Pioneer Generation subsidies at SOCs can apply to switch to the subsidised SOC. As subsidised patients, they may not continue to see their current doctor, but they will receive appropriate care from a team of doctors.”
“The public healthcare institutions review their fees, like hospital ward charges, consultation fees and emergency department charges, from time to time. Where necessary, fees are adjusted and the adjustments may be implemented at different times for different institutions. Such fee revisions take into account changes in operating costs and enable the institutions to maintain and enhance their quality of care and service to patients. The public healthcare institutions revise their fees only after careful consideration, and the Ministry of Health (MOH) works with the public healthcare institutions to minimise the impact on patients. The public healthcare institutions also adopt several measures to ensure that patients are adequately informed of the fee revisions. For example, the public healthcare institutions generally display their revised fees on their websites and also at the clinics and registration counters. They also highlight the fees during the financial counselling process where relevant. They advise patients of the fee revisions, whenever patients visit or are admitted soon after the fee revision. MOH recently enhanced subsidies at the specialist outpatient clinics and the polyclinics for the low- to middle-income families and Pioneers, to reduce the cost of subsidised treatment for them. Subsidised patients with financial difficulties can also approach the medical social workers to apply for assistance, such as MediFund.”
“In addition, since April 2015, the elderly have been able to use an additional $200 of MediSave a year to pay for various outpatient treatment, under the Flexi-Medisave scheme. These measures will help to reduce the number of patients, especially the elderly patients, who will exhaust their limits. My Ministry will continue to review the MediSave and CHAS limits regularly to ensure that outpatient care remains affordable. Page: 132”
“Subsidies at the specialist outpatient clinics, polyclinics and participating general practitioner (GP) clinics under the Community Health Assistance Scheme (CHAS) help to ensure that outpatient care is affordable. MediSave use is sized primarily to help Singaporeans pay for subsidised hospitalisation costs. Its use has been extended to outpatient treatment of chronic diseases under the Chronic Disease Management Programme (CDMP) to help patients to defray their cash payment for such treatments. Under CDMP, up to $400 per year per MediSave account can be used for the treatment of 19 chronic conditions. The annual MediSave limit is reviewed regularly and was last increased in January 2012 from $300 to $400 per year. In 2014, about 5% of the 200,000 subsidised patients, or about 10,000 patients, fully utilised the annual $400 limit from their own MediSave accounts, up from 3% in 2012. This includes patients seeking care at the specialist outpatient clinics, polyclinics and CHAS GP clinics. At CHAS GP clinics, patients can receive subsidies for the 19 CDMP chronic conditions under CHAS and Pioneer Generation (PG) packages. Generally, patients can be expected to co-pay for part of their treatment, with the lower-income and Pioneers paying less. In 2014, less than 2% of the 1.2 million CHAS members used up to their annual cap of chronic subsidy, similar to that in 2012 and 2013. Outpatient subsidies were enhanced recently, together with additional subsidies for Pioneers, to help reduce the amount that patients need to pay using their own MediSave or cash. Pioneers also have a higher CHAS subsidy limit than other CHAS beneficiaries.”