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 48 of 77.
“Patients can tap on MediSave to pay for their share of the hospital bill, after subsidies and insurance payouts. For those with financial difficulties, they can approach the medical social workers to apply for assistance, such as MediFund. This will ensure that health care will remain affordable.”
“Hospital bill sizes vary depending on the severity and complexity of the patients’ conditions and type of treatment received. To help patients with their hospital bills, the Ministry has put in place a range of measures. These include significant Government subsidies of up to 80% for those who choose subsidised C Class wards; MediShield coverage for large hospital bills; MediSave to help with patients’ share of the bill; and MediFund for the needy. Today, the majority of hospital bills in B2 and C Class wards are almost fully covered by subsidies, MediShield and MediSave, with three quarters paying $100 or less in cash. To better help Singaporeans with large subsidised hospital bills, MediShield Life will be introduced from 1 November 2015. We have raised the claim limits under MediShield Life Page: 130 and removed the lifetime limit. This means that MediShield Life will cover more and will be adequate for most B2 and C Class bills. Co-payment under MediShield Life will also be lowered, ranging from 10% for the smaller bills to 3% for the larger bills above $10,000. This means that patients will pay a significantly lower share of the larger bills. While we ensure affordability, we also need to be mindful of the need to manage healthcare costs. Setting caps on hospital bills may inadvertently encourage wasteful consumption, like ordering more tests than necessary, because any expenses above the cap will be "free" to the patients. However, they have to be paid for ultimately by all of us, through higher taxes or premiums. Hence, it is better to have claim limits to help manage the cost of treatment, and instead, provide help to ensure that patients are able to pay for their bills.”
“Research is an important enabler that creates medical discoveries and innovations which can improve the health and well-being of Singaporeans. Over the years, MOH has set up multiple initiatives to build up our translational and clinical research capabilities, develop research talent and fund research programmes and projects that improve medical care and human health in Singapore. From 2006 to 2012, MOH spent approximately $210 million on cancer research in general. Specifically, $1.1 million went towards brain tumour research. In the same period, there was also funding of more than $50 million for non-site specific cancer research, which included research on tumours that had spread to different parts of the body and did not have a defined primary site. Other public sector agencies also provide a significant amount of funding to research in scientific areas that contribute to cancer research, such as cell and molecular biology, genomics, proteomics and bioinformatics. These agencies include the National Research Foundation (NRF), the Ministry of Education (MOE) and the Agency for Science, Technology and Research (A*STAR). In the last five years (2010 to 2014), based on data from the National Registry of Diseases Office (NRDO), the average number of new brain tumour cases reported per year was approximately 400, or 3.3% of the 12,300 new cancer cases. Most of these cases were reported in public healthcare institutions.”
“In very hot weather, some people may be at risk of heat-induced illnesses which include heat rashes, heat cramps, heat exhaustion and the more severe heat stroke. Some precautions that can be taken to prevent heat-induced illnesses include wearing loose-fitting, heat permeable and light coloured clothing, drinking fluids to stay hydrated, taking more breaks between activities, reducing outdoor activities during the hottest time of the day or staying in the shade, and watching for early signs of heat injury and seeking medical attention if the condition persists or worsens. So far, heat-induced illnesses do not seem to be a major problem in Singapore. The number of hospital admissions for heat-induced illness has decreased over the years. This could be due to the preventive measures taken by the population against heat exposure. Currently, the risk of heat-induced illnesses is highest among those who are physically active outdoors. Few elderly are hospitalised for heat-induced illnesses. Nevertheless, we will work with the National Environment Agency (NEA) to provide relevant information to the public to prepare them for hot weather. Page: 175”
“From May 2014, all house officers came under a national framework for training and assessment renamed the Postgraduate Year 1 (PGY1) training. For the PGY1 year, the Singapore Medical Council (SMC) stipulates that work should not exceed 80 hours per week, including night call hours. However, the SMC also stipulates at least four night calls per month for PGY1 doctors to learn how to manage acute conditions, under supervision, with the medical team at night. In addition, there should be at least 10 hours of rest between duty periods and an off day each week. PGY1 doctors cannot be scheduled for more than 24 hours of continuous active duty managing patients. For those who have completed a 24-hour duty period duty period, their hand-overs to colleagues or other activities, for example, educational activities, should not take more than an additional six hours. Hospitals, generally, comply with these guidelines. With regard to the frequency and duration of night calls, some hospitals have started to implement a shift system thereby reducing long working hours in clinical departments where such work patterns are suitable. For example the half call is an extension of another five to six hours to the 8-hour day and the night float is a 10-hour overlapping night shift together with this. This avoids the more tiring 24-hour continuous duty type call. These overlapping shifts, together with the steady increase in the number of house officers over the years, have lessened the work hours and frequency of night calls. Page: 135”
“The Caregivers Training Grant was introduced in 2007 to support caregivers of seniors and those with disability with up to $200 each year to attend caregiver training courses. We do not have plans to increase the annual cap for the grant at the moment, as the current grant quantum is generally adequate. Today, about 80% of all approved caregiver Page: 134 training courses cost $200 or less. Over the last four years, the average annual utilisation of the grant was about $160 per caregiver. In the last two years, we have further refined the training framework and worked with training providers to raise the quality of the courses offered. The grant now benefits more than 6,000 caregivers annually. More than 26,000 caregivers have benefited from this grant to date. We will, however, continue to monitor the utilisation and adequacy of the Caregivers Training Grant.”
“Mr Deputy Speaker, I beg to move, "That the debate be now adjourned." Resolved, "That the debate be now adjourned." – [Mr Gan Kim Yong.]”
“I have just explained that we do have temperature screening for direct flights from Korea as well as from Middle East, the affected areas. But it is also important to point out, as I had mentioned in my reply, that there is an incubation period. During the incubation period, the passenger or the visitor may not display any symptoms, but he may already be carrying the virus, so symptoms will develop over the period of up to the next 14 days. Therefore, it is important for us, in addition to border monitoring and screening measures, that our healthcare institutions remain alert to this threat, so that they can identify passengers or patients who have travelled overseas. It is a matter of practice that all our doctors, when they see respiratory symptoms displayed among their patients, will ask about their travel history. It is something that we have always been reminding our doctors. We have also sent circulars to our doctors regularly to inform them of the latest development in the region as well as in the Middle East, so they are kept up-to-date of the development. We do have border screening processes but it is not a 100% fool-proof system because of the incubation period. And some of them may have travelled through other countries as well, so they may not be directly travelling from the affected countries. They might have stayed a few days in other countries and, therefore, while it is important to have border screening, it is not the only measure that we should rely on. What is more important is to ensure that our healthcare facilities are on high alert, they are vigilant, they are aware of this threat, and they are looking out for these symptoms and the travel history of their patients.”
“I take Prof Tan's point and we will look at how we can extend our public education, exercises and information, to as wide an audience as possible, including school children. We have been working very closely with MOE. MOE is one of the members of the Inter-Ministerial Committee I mentioned earlier, so they are very closely linked to what we are doing, and they themselves have also developed contingency plans and are carrying out education with their children.”
“Thank you, Madam. Indeed, this is a very serious matter and MOH takes this very seriously. Therefore, we regularly remind members of the public and Singaporeans that MERS-CoV and Ebola, are real threats and we must take these threats seriously. We have also been sharing information as much as we possibly could with our Singaporeans as well as visitors who are coming to Singapore. That is why at the Airport, you would also see posters that are put up, for passengers who do not come from affected areas. We also want to remind them that should they have any difficulties, do consult our medical professionals. It is an area that we will continue to look at and we will consider various forms of exercises. I think going beyond exercises, infectious diseases are something we will need to learn to live with. In the past, if you look back at maybe a decade or so ago, infectious diseases may not be so common. SARS was a major impact to Singaporeans. Before that, you may find that the threat of infectious diseases may come and go, and it happens from time to time. Going forward, I am afraid that it is going to be quite a constant feature because of the increased international connectivity. We are going to see that different forms of infectious diseases will threaten Singapore from time to time. An example is that MERS-CoV emerged in 2012. Before MERS was over, Ebola emerged. And now both Ebola and MERS are threats to Singapore. Bird flu, on the other hand, is also not totally eliminated either. So, I am afraid that going forward, we have to be constantly vigilant, so that we will be able to protect ourselves against the importation of these cases.”
“There was some initial confusion. That is what appeared to have led to an explosion of cases, which has led to a significant number of fatalities. Subsequently, as we see now, it appears to have imposed quite good control over the situation and the spread is now constrained. Page: 34 The reason why I ask about an emergency preparedness exercise is because the danger is that, regardless of how many systems we have, the population may not recall how difficult it is and how confusing it may be, when the initial signs first appear. So, I would like to press the Minister on this point whether it is necessary to have a wider preparedness exercise, maybe even involving the schools.”
“Confirmed cases will be treated in isolation rooms and our healthcare workers taking care of them will wear the appropriate personal protective equipment (PPE), and they have been trained to minimise the risk of contagion. In parallel, MOH will conduct contact tracing and quarantine all close contacts, to prevent further spread. We will update and exercise our response plans regularly. Recently, we conducted such an exercise at the Changi Airport and the simulated patient was conveyed in a portable medical isolation unit (PMIU) to Tan Tock Seng Hospital. We will continue to carry out similar exercises from time to time involving not only MOH but also other agencies as well. The public, too, plays an important role in national preparedness by keeping up-to-date with the Government's advisories and exercising personal responsibility and good hygiene practices. The People's Association recently launched a nation-wide programme to train grassroots leaders on preventive measures to handle MERS-CoV so that they in turn can share the information and knowledge with residents at the constituency level. MOH and the Inter-Ministerial Committee will continue to monitor and assess the MERS-CoV situation. Our priority remains to prevent, detect and contain any imported case into Singapore so that its impact on the community would be minimised. Assoc Prof Randolph Tan (Nominated Member): I would like to thank the Minister for his comprehensive response. What has happened to South Korea has been very difficult and very tragic. It is not possible to ignore the fact that South Korea, together with Singapore, is affected by SARS about a decade ago, so you cannot ignore the concerns. Just looking at South Korea's experience, it appeared to have been too laggard in its response.”
“In addition, travellers arriving from MERS-affected countries are given individual health advisories on the symptoms of the illness they should look out for and they are advised to seek immediate medical treatment if they have such symptoms. They are also reminded to inform the healthcare professionals of their travel history, so that proper infection control measures can be taken while they are being tested for MERS-CoV. Temperature screening at the air checkpoints has been implemented to screen direct flights from the Middle East and South Korea. However, as MERS-CoV has an incubation period of up to 14 days, infected travellers may not have any fever when they pass through Page: 33 temperature screening and, therefore, they may not be picked up or detected at entry. Hence, our doctors and hospitals have been reminded to remain vigilant to the threat of MERS-CoV among travellers from the affected areas. Persons with symptoms of severe respiratory illness upon return from the Middle East or South Korea, and those with any respiratory symptoms and had visited a healthcare facility in South Korea or the Middle East, will be subjected to further investigations to rule out the possibility of MERS-CoV infection. They will be isolated until this investigation is completed. This year, up to 10 July 2015, a total of 62 such suspected cases have been investigated locally and all have tested negative for MERS-CoV. However, it is a matter of time that the contagion will reach our shores. Therefore, beyond the preventive measures that I mentioned, Government agencies have contingency response plans in place should there be an imported case.”
“Madam, the Ministry of Health (MOH) has been closely monitoring the global situation of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) since the disease emerged in 2012. WHO's current assessment is that the transmission of the disease is mainly among households and hospital contacts, and there is no evidence of sustained community transmission. Nevertheless, we must remain vigilant to the possibility and the impact of an imported case from the Middle East, South Korea or elsewhere. There has been very close inter-Ministry coordination and planning to prepare for such an incident. An Inter-Ministerial Committee (IMC), co-chaired by Minister Chan Chun Sing and myself, has been formed since late last year to oversee whole-of-Government preparedness against dangerous infectious diseases, including MERS and Ebola. We have taken a multi-pronged approach and have put in place various measures to detect imported MERS-CoV cases and contain any further transmission in Singapore. Our first line of defence is on prevention and detection, through public education, border screening and vigilance among the medical community. Let me elaborate on some of the measures. As part of public education efforts, MOH has a dedicated webpage on MERS-CoV and has published a set of FAQs to help Singaporeans understand the disease and advise them on the precautionary measures they can take to protect themselves. At our borders, MOH has been issuing health advisories to travellers going to countries with active transmission of MERS-CoV including the Middle East and South Korea.”
“Mdm Speaker, can I take both questions together?”
“To help keep medicines affordable for patients, the Government has adopted a multi-pronged approach. First, our public hospitals procure the majority of their drugs in bulk to enjoy economies of scale. The savings are reflected in the pricing of the medicines in the public hospital pharmacies and passed on to patients. Second, subsidised patients enjoy heavy Government subsidies off the prices of drugs listed under the Standard Drug List (SDL) and the Medication Assistance Fund (MAF). These are drugs that have been assessed to be clinically- and cost-effective. Since 1 January 2015, subsidies for SDL drugs at the Specialist Outpatient Clinics and Polyclinics have been enhanced to 75% for lower- to middle-income patients. On top of the enhanced subsidies, Pioneers can enjoy an additional 50%-off for their subsidised drugs. This move has significantly lowered the cost of subsidised drugs in the public healthcare institutions and widened the gap with prices in private retail pharmacies. The Ministry of Health will continue to review our policies to ensure that healthcare remains affordable for Singaporeans. For needy patients, they can also apply to MediFund for financial assistance.”
“The human papilloma virus (HPV) vaccination was added to the National Childhood Immunisation Schedule (NCIS) in November 2010. The vaccine is recommended by the Expert Committee for Immunisation (ECI) for girls aged nine to 26. As notification is voluntary, our data on the take-up rate for HPV is based on the numbers who have made claims from MediSave. Based on this, over the past three years, from 2012 to 2014, 34,209 persons have taken up HPV vaccinations. To raise the awareness of HPV vaccination among girls aged nine to 26, information on HPV infection and the vaccination is included in print media, such as parents and women's magazines, and disseminated through professional healthcare societies, such as the Obstetrics and Gynaecological Society of Singapore and the College of Family Physicians. HPV-related information will also be made available to the public on digital media in May 2015 on Health Promotion Board's Screen for Life website. We will continue to monitor the uptake of HPV vaccination and work to increase awareness of the benefits of vaccination.”
“Over the five-year period from 2009 to 2013, the average success rate of IVF treatment, calculated in terms of the percentage of fresh cycles performed which Page: 117 resulted in a live birth, was 22% in public hospitals and 20% in private healthcare institutions. A total of 11,979 fresh cycles were performed for Singaporean couples, that is, where at least one spouse is a Singapore Citizen, during that period and the success rate was 22%. The co-funding policy for assisted rreproduction technology (ART) treatment, which applies to ART centres in public hospitals only, was enhanced in January 2013 and also extended to cover frozen cycles. In that year, more than 80% of IVF treatment cycles for Singaporean couples in the public hospital ART centres benefited from the co-funding. Couples can also make use of their MediSave to pay for IVF treatment in both the public and private centres.”
“As part of MOH’s efforts to improve affordability of long-term care, we will also be reviewing ElderShield and other long-term care financing schemes. Page: 101”
“ElderShield is an insurance scheme which provides basic protection against the costs of long-term care arising from severe old-age disability. It helps patients who are unable to perform at least three out of six Activities of Daily Living2 cope with the co-payment for the cost of long-term care, after Government subsidy. The current scheme, ElderShield400, pays out $400 per month for a maximum of six years, while those who were enrolled in ElderShield before September 2007 and had not opted to upgrade would be on the older ElderShield300, with a $300 monthly payout for a maximum of five years. For those who were unable to join ElderShield when it was launched in 20023, they would be covered under a Government assistance scheme, IDAPE, if they meet the income criteria. Since 2002, 9,200 claimants have received payouts under ElderShield300, 1,700 claimants have received payouts under ElderShield400 and 14,400 have received IDAPE payouts. Claims are expected to grow significantly in the future, as the population ages. The payout period is sufficient to cover most ElderShield and IDAPE claims, with about 70% of all claimants fully covered until they pass away. Those who live beyond their ElderShield and IDAPE payout periods may continue to receive Government subsidies for long-term care, if they are eligible. Subsidies for nursing home care, home care and community care services were enhanced in 2012 and the qualifying income raised to benefit middle-income households. In 2014, the Pioneer Generation Disability Assistance Scheme was introduced to provide an additional help of $1,200 per year to Pioneers who are moderately or severely disabled.”
“MOH conducted a briefing for the abortion institutions on the various enhancements on 7 April 2015. In addition, a summary of the feedback received from the public consultation and the enhancements to be implemented have been put up on the MOH website. Page: 100”
“The Ministry of Health (MOH) carried out a month-long public consultation exercise in November 2014 on the criteria for pre-abortion counselling. We sought feedback from the public on whether we should extend pre-abortion counselling to all pregnant women seeking termination of pregnancy (TOP) in Singapore. Currently, mandatory pre-abortion counselling only applies to women who satisfy the criteria as set out in the Guidelines on TOP. Feedback was received through online channels and through focus group discussions with various stakeholders, including healthcare professionals, social workers and non-governmental organisations. There was overall support for pre-abortion counselling to be extended to all pregnant women seeking TOP in Singapore so that these women can make an informed decision on whether to undergo an abortion. MOH will thus be extending pre-abortion counselling to all pregnant women seeking TOP in Singapore, regardless of their nationality, educational status and number of children, with effect from 17 April 2015. There will be other enhancements made to the pre-abortion counselling programme. First, existing abortion counsellors will be required to attend a refresher course once every two years to update their counselling skills and techniques. The refresher course will also cater to former abortion counsellors who have not been actively providing counselling for the past two years and are keen to resume their services. Second, MOH will lay out the recommended components of pre-abortion and post-abortion counselling in the updated Guidelines on Termination of Pregnancy. These components include medical, psychosocial and emotional aspects. Third, we will update the abortion counselling materials to be used during pre-abortion counselling.”
“The Basic Healthcare Sum (BHS) is the estimated savings that we need for our basic subsidised healthcare needs in old age. The BHS will need to be adjusted yearly, to keep pace with growth in Medisave, due to inflation and expanding uses of Medisave. This is to ensure that we will have enough savings for our healthcare needs after retirement. Once a person reaches age 65, his BHS will be fixed for the rest of his life. As there will no longer be a Medisave Minimum Sum with effect from 1 January 2016, a CPF member will no longer need to transfer any monies from his other CPF accounts into the Medisave Account before he can withdraw his CPF monies from the Ordinary and Special Page: 99 Accounts. Therefore, the quantum of CPF monies he can withdraw from his Ordinary and Special Accounts will not be affected by his Medisave balance.”
“First, I will address the issue on the Medisave Withdrawal Limit, what we call the Additional Withdrawal Limit, designed to apply to the private insurance coverage component of the Integrated Plan. We will have to review this and discuss with the industry as well as with the various stakeholders to determine the amount. We want to make sure that, as the hon Member said, it is sufficient but we also want to make sure that it does not inadvertently drive up the premiums. Because as you enhance affordability, there is a risk that the premiums will also be driven up. At the same time, we need to calibrate it very carefully to balance the desire to help individuals purchase private insurance plans but also ensure sufficient balance in their Medisave account to be able to cater to the basic premium to be paid for the MediShield Life. So, it is a matter of balancing. But I hear your request. We will bear the request in mind when determining the level of the Additional Withdrawal Limit. We will need to take into account all these various factors in arriving at the appropriate limit. Assoc Prof Dr Muhammad Faishal Ibrahim: I thank Mr Gerald Giam for his question. As I mentioned earlier, the issue of pneumococcal disease, the potential for public health outbreak or epidemic is not as high as the others. Nevertheless, what our nurses have been doing is that they have been talking to the parents and also encouraging them to have this vaccination for their children. We will continue to do this. I want to also share that it is the responsibility of the parents to think about how this can facilitate good health for their kids. Page: 145”
“I will take the third question of Flexi-Medisave. After we announced it some time ago, we went to get feedback, consulted and engaged the GPs on how to roll this out, especially CHAS GPs. We have also got feedback from polyclinics and SOCs as well, who will be involved. The feedback generally is very positive. Patients like it because it gives them more flexibility. But, of course, they hope not just $200 but more. That is to be expected. We need to tread very carefully. On the one hand, we want to give flexibility to our patients but on the other hand, we have to make sure that they have sufficient savings and that they preserve their savings for the longer term retirement needs. From hospitals and the GPs, there was some feedback. Because some of these claims may be very small in nature, so some of the GPs may feel that they are not equipped to handle individual cases of claims for small amounts. Therefore, some of the GPs said that they would need more time. As we roll it out, they will come on board the programme later on. As we first roll it out, the polyclinics and the SOCs will be involved, Government, public healthcare institutions will be involved and some CHAS GPs will be participating, but not all of them. We will roll this out in phases and we will learn from experience in rolling this out and see how we can continue to refine it.”
“We will press on with our plans, but we must also look ahead into the future. We have started our planning processes to prepare for the future. We must continue on this journey to innovate and transform our healthcare system to ensure that it is a quality, affordable and sustainable one to keep Singaporeans healthy beyond 2020. Home-, Centre- and Community-based Care”
“Patients rely on healthcare providers to advise and act in their best interests, and provide treatments that are appropriate and necessary. My Ministry will be placing more emphasis on developing capabilities in assessing new health technologies, including devices and drugs, to ensure that they are both clinically-effective and cost-effective. This will ensure that patients get the most bang for their buck for the treatment and medications that they receive. 4.30 pm Our long-term healthcare strategy will involve further and deeper transformative changes to both the way care is organised, as well as the way it is delivered. We have been taking steps towards this by developing community care and setting up Regional Health Systems. We will go further in the next phase to integrate our healthcare system. In particular, we will also study how to bring together the public, people and private sectors, and explore more ways to strengthen partnerships among various stakeholders to optimise the use of scarce healthcare manpower and infrastructure. Over time, the aim is for one integrated national healthcare system where everyone works together as a team to serve the needs of all Singaporeans. Mr Alex Yam and Dr Chia asked about our efforts in IT productivity. IT plays an important role in healthcare delivery and we will be launching a new Community Hospital Common System (CHCS) to all community hospitals by end of this year to link up their IT systems with partnering public healthcare institutions. This will help healthcare professionals across acute and community hospitals share information on their patients and improve the patient's care experience. Mdm Chair, under Healthcare 2020, we have made progress towards making our healthcare system a better one.”
“These benefits will be available to seniors for a time-limited period in 2015, to recognise their contribution to Singapore and to celebrate SG50 with them. Some of the benefits in the SG50 Seniors' package include: (a) dining discounts at more than 50 F&B establishments island-wide; (b) discounted or free entry to places of attraction as well as discounts off hotels and travel packages; and (c) complimentary courses offered by Council for Third Age's senior learning providers. This is one way of bringing the whole society together to celebrate SG50 with our seniors and to honour them with special privileges and benefits. Dr Chia asked about the progress on our plans to meet the long-term needs for healthcare services. What is next after Healthcare 2020? Even as we continue to work hard on implementing Healthcare 2020, the journey to transform our healthcare system is a continuous one. We have started work to look beyond 2020, to prepare for Singapore's long-term healthcare needs. As Assoc Prof Fatimah has pointed out, the Government and all stakeholders have important parts to play in ensuring the long-term sustainability of our healthcare system. At an individual level, enhancing Government subsidies, MediShield Life, Medisave and Medifund will help to ensure healthcare remains affordable to individual patients. But such measures are insufficient on their own, we must also ensure that overall healthcare bill grows at an affordable pace, so that we – as individual patients and as a society – can continue to afford it. We need to ensure that we make the best use of all our available healthcare resources. Page: 109 Longer-term sustainability also requires that our healthcare providers play their part in delivering cost-effective services.”
“At the city level, seniors also provided useful feedback on how our built environment can be enhanced to make it easier and safer for seniors to move around and stay active, creating a city for all ages. Respective Ministries will study these ideas and develop specific programmes under the Action Plan. For instance, we are working with MOE to study how to further expand the scope and scale of learning opportunities for seniors to enrich and empower them. We are also working with MCCY to make volunteering more accessible, attractive and meaningful for our seniors. MOM and MOT have also taken into account the feedback from Page: 108 focus groups and are exploring ways to enhance the employability of older workers, and make our public transportation network more senior-friendly. Over the next few months, we will be studying and seeking inputs, such as how to promote senior learning and volunteerism, how to support seniors living in our heartlands with assisted living services, and how to promote research and innovation to transform the lives of seniors in the future. These initiatives will help equip our current seniors as well as prepare our future generations of seniors for meaningful ageing. More details will be announced when the Action Plan is ready later this year. Madam, we are celebrating SG50 this year. Singapore has made good progress over the last 50 years as a young nation. To recognise the contributions of our seniors and to celebrate SG50 with them, we will be introducing the SG50 Seniors' package. Over the past year, MOH and the Singapore Business Federation have partnered more than 100 organisations to develop special benefits for our seniors.”
“Since 1 September last year, we have expanded our regular hospital bill publications to include "Total Operation Fees" for the public sector. Mr Pritam Singh asked if MOH can look into publishing drug prices. In the public hospitals, charges and subsidies that patients receive for their drugs are reflected in the patient's pharmacy bills in an itemised manner. Treatment and drugs used for different patients will vary, even for the same condition, and drugs constitute only one aspect of the overall treatment. This is further complicated by the subsidies for different groups. Private GPs also adopt different pricing structures for drugs and consultation. Hence, it is more useful to reflect the total bill, as a comparison to help patients make decisions. Let me now come to the issue of ageing as raised by Dr Chia and Ms Ellen Lee. As noted by Ms Lee, our future seniors will have different aspirations from the current generation. Last year, the Ministerial Committee on Ageing (MCA) announced plans to develop an Action Plan for Successful Ageing. Since then, we have gone on to engage more than 1,300 Singaporeans through many focus group discussions. Many participants shared with us what successful ageing meant to them, at the individual, community and the city level. At the individual level, many seniors told us that they aspire to have opportunities for learning and employment so as to remain active. Seniors are also keen to volunteer their time and expertise and in doing so, find new meaning and fulfilment in their lives. At the community level, seniors also enjoy social activities with their families and friends and suggested having more spaces and programmes in the community to support these interactions.”
“There is therefore really no need to set a withdrawal limit for this component that applies to the MediShield Life premium. But beyond this, there will be an Additional Withdrawal Limit, or AWL, that will apply to the premium for additional private insurance coverage only. Today, the withdrawal limit applies to the entire premium of the IP, which comprises two components – the MediShield and the additional private insurance coverage. Going forward, we will restructure this withdrawal limit. Medisave will cover the entire premium that is applicable for MediShield Life for everyone. Therefore, there is no need to set a limit for the withdrawal to pay for MediShield Life premiums. But we do need to set a limit for the private insurance coverage component, and that limit will be called the Additional Withdrawal Limit. The details of that limit will be shared with Singaporeans later. In setting the new Additional Withdrawal Limits, we will have to balance between helping Singaporeans pay for their IP premiums using Medisave and ensuring that they have enough Medisave for their other healthcare needs. Mr Heng Chee How suggested that the introduction of MediShield Life might offer a fresh chance to revisit the concept of portable medical benefits to better protect our workers. I shared last year that a tripartite work group has been formed to look into this. Tripartite Page: 107 partners will be engaging employers to discuss how adoption of portable medical benefits can be further encouraged and I will be very happy to support the work group, if necessary, to ensure that we make progress on this portable medical benefit front. We also need to help patients navigate their healthcare journey and make more informed decisions.”
“MOH has been working with the Integrated Plan insurers to develop a Standard IP, based on coverage at Class B1 wards. Benefits will be aligned across all insurers, so that the plan can be easily understood. Page: 106 Those looking for enhanced coverage that is more affordable than Class A or private hospital plans can consider this plan, Standard IP. We aim to introduce the new Standard IP in the first half of 2016, soon after the roll-out of the MediShield Life this year. This will give time for Singaporeans to focus on MediShield Life, and better understand and adjust to the changes resulting from MediShield Life before the changes to the IPs are made. To help policyholders to make informed decisions about buying IPs, MOH is working with Monetary Authority of Singapore (MAS) to ensure that insurers present their products more transparently and more accurately. This will also address Dr Chia's concern on IPs. Most Singaporeans use Medisave to pay for MediShield and IPs. Since every IP policy comprises two parts, it is also timely to consider restructuring the Medisave Withdrawal Limits, or MWLs, for health insurance premiums also into two components. Today, the Medisave Withdrawal Limits, or MWLs, apply to the total IP premium, combining premiums for MediShield and the additional private insurance coverage. Singaporeans are not aware of how much Medisave is being used for MediShield and how much is directed towards the additional private insurance component. With MediShield Life, we will give Singaporeans more certainty, by ensuring that Medisave will always be allowed to cover the net MediShield Life premiums including additional premiums, if any, and after subsidies.”
“The Government will also help through various forms of subsidies. The Pioneer Package and the Transitional Subsidies will be given independent of income and wealth. For Premium Subsidies targeted at the lower- and middle-income, there is also no need for individuals to apply. Government will use information available in our records to identify those who are eligible and the amount that you are eligible for. But you can help by doing a simple check to ensure that your household information is up-to-date and accurate. In a few months' time, MOH will be sending out a letter with more details on what Singaporeans need to do. We will guide you along step-by-step so there is no need to worry. Mr Ang and Dr Chia also asked about the progress of the development of the Standard Integrated Shield Plan or Standard IP. Let me first talk about Integrated Shield Plans or IPs. IPs comprise two parts. The first part is a basic MediShield portion run by the CPF Board. This portion is the same for those without IPs and for those with IPs. They are the same. When MediShield Life is implemented at the end of this year, it will automatically replace the MediShield component. The second portion is the additional private insurance coverage run by private insurers, typically to cover Classes A and B1 in public hospitals, or private hospitals. In other words, all IP policyholders are already covered by MediShield today and they will be covered by MediShield Life in time to come. Similarly, IP premiums also include MediShield premiums. There is, therefore, no double coverage and no double premium. Many Singaporeans also shared that it was difficult to compare IPs and wanted a standardised option with enhanced coverage beyond Class B2 and C.”
“This is necessary given rising life expectancy and healthcare expenditure, and given the expanding use of Medisave. Currently, the annual MMS adjustments are applied to all cohorts, including older Singaporeans who are well into retirement. From 2016, we will fix the Basic Healthcare Sum for each cohort when they turn 65 years, with no subsequent changes in their lifetime, so that members can have more certainty on the amount of Medisave that they should keep for their retirement healthcare needs. This cohort-based approach for the Basic Healthcare Sum is also similar to the approach that has been taken for the Retirement Sum. We hope that this will make it easier for members to understand and to plan their retirement. Mr Ang Wei Neng asked for an update on the implementation details of MediShield Life. I thank Members for their unanimous support of the MediShield Life Scheme Bill which was Page: 105 passed in Parliament in January. There is much for MOH and CPF Board to do before MediShield Life coverage kicks in at the end of 2015. Singaporeans need not apply to join MediShield Life. You will automatically be included. You will be notified of the new premiums and the subsidies you will receive as and when your existing MediShield policy is due for renewal during the one-year period starting end of 2015, when MediShield Life coverage starts. Let me just clarify: the coverage for MediShield Life will start by the end of this year for all Singaporeans, but premium payments will only be due when your existing policy is due over the course of next year. I want to assure Singaporeans once again that MediShield Life premiums will be affordable. Singaporeans will be able to pay for the premiums using their Medisave.”
“There are two limits on the Medisave account. One is the Medisave Minimum Sum (MMS). This is the minimum amount you need to have in your Medisave before you can withdraw your other CPF monies from age 55. The other is the Medisave Contribution Ceiling (MCC). This is the upper limit on your Medisave savings. Any Page: 104 additional Medisave contributions beyond this amount will flow to your Retirement or Special Accounts. Dr Chia has asked if we can consider adjustment to these limits and we will do so. To simplify the rules, we will remove the Medisave Minimum Sum (MMS). This means that you will no longer be required to use your CPF monies to first top up your Medisave account to the MMS when you apply to withdraw your CPF monies from the other accounts at the age of 55. You only need to follow the withdrawal rules as explained by the Minister for Manpower earlier. Second, from January 2016, the Medisave Contribution Ceiling (MCC) will be renamed as the Basic Healthcare Sum. This is in line with CPF terminology and reflects more accurately that the sum is estimated based on what is needed for basic subsidised healthcare needs in our old age. So, MMS will be removed; MCC will be renamed Basic Healthcare Sum. Any additional Medisave contributions beyond the Basic Healthcare Sum will continue to be channelled to your Retirement and Special Accounts, and, eventually, will help to increase your CPF LIFE payouts. 4.15 pm The new Basic Healthcare Sum will be set at $49,800 on 1 January 2016. This is a 2.7% increase over the current MCC of $48,500 set last year. Beyond 2016, we will need to adjust the Basic Healthcare Sum annually to keep pace with the growth in Medisave use by the elderly.”
“From 1 April this year, under the new outpatient Flexi-Medisave scheme, the elderly aged 65 and above can use another $200 per year from Medisave to pay for outpatient medical treatment at SOCs, polyclinics and participating Community Health Assist Scheme (CHAS) clinics. We just expanded the list of chronic diseases covered under Medisave and CHAS last year. I am glad to announce that four more chronic conditions – epilepsy, osteoporosis, psoriasis and rheumatoid arthritis – will be covered under CHAS and Medisave use from 1 June this year. This brings the total number of chronic conditions covered to 19, which covers the most common chronic conditions. Mrs Chiam has proposed for the Chronic Disease Management Programme (CDMP) to cover eczema. CDMP conditions are selected based on professional inputs, taking into consideration various factors, such as disease prevalence and the effectiveness of early intervention to reduce complications. There is currently no plan to include eczema in the CDMP but we will take note of Mrs Chiam's request. We regularly review this programme from time to time. But, meanwhile, Singaporeans can enjoy subsidised treatment for eczema at the polyclinics, SOCs and CHAS GP clinics, a point that Mrs Chiam asked. Those with difficulties can also approach the Medical Social Workers at our public healthcare institutions for assistance. We will continue to review Medisave use, but this has to be balanced against the need to ensure that our Medisave savings are adequate for our retirement healthcare expenses. In January this year, we increased the Medisave contribution rate from employers to help Singaporeans save more. I hear Dr Chia's call to fine-tune and simplify our Medisave rules, and so we will do that. Today, let me just explain.”
“She visits the National Neuroscience Institute four times a year. She used to pay a subsidised rate of $50 for tests and consultation a visit. In September last year, her bill was reduced to $30 due to the enhanced subsidy, then further halved to $15 as she is a Pioneer. For medication, she can expect to pay only $20 a visit this year instead of the usual $80, after taking into account both the enhanced subsidies and her Pioneer benefits. For those requiring longer term care, we have progressively extended subsidies to drugs prescribed by Intermediate and Long Term Care (ILTC) providers since 1 January this year. Mrs Lina Chiam asked about pensioners' eligibility for pensions coverage in approved Page: 103 community hospitals. Pensioners are eligible to claim for their stay if they stay in Ang Mo Kio-Thye Hua Kuan Community Hospital. Mrs Chiam also suggested that we extend Medisave limits for pensioners in community hospitals. The current withdrawal limit is generally sufficient as it covers eight out of 10 bills. With MediShield Life which covers community hospital stays, almost all patients would see their community hospital bills fully covered by MediShield Life and Medisave. Those who still need help can appeal and we will exercise some flexibility on a case-by-case basis. Assoc Prof Fatimah Lateef and Dr Chia Shi-Lu have asked about further flexibility for outpatient Medisave usage. We have made steady progress on this second front. Recent Medisave changes include extending Medisave use to outpatient scans.”
“Our healthcare Clusters have been working with community partners to provide more holistic care for our patients in the community setting. For example, the Eastern Health Alliance (EHA) and its community partners have been deploying professionals together with neighbourhood volunteers to reach out to at-risk residents, through their Neighbours for Active Living programme. Take Mr Sim, for instance. He is an 82-year-old resident living in Tampines, suffering from multiple chronic conditions. He has difficulties walking after a fall and is currently being cared for by his 75-year-old wife, Mdm Liew. The EHA team checks on Mr Sim to make sure he takes his medication, and applies for the various medical and transport subsidies for the couple. They also bought a walking frame and guided Mr Sim on how to use it. Today, the team regularly calls and visits the elderly couple to make sure that they are well. Let me now move on to healthcare financing. MOH has made three major policy shifts to give patients and their families greater peace of mind about healthcare costs. First, the Government would shoulder a higher share of national healthcare spending. Second, we expanded the use of Medisave and helped Singaporeans to save more in their Medisave accounts. Third, we will increase the role of risk-pooling through MediShield Life. We have significantly enhanced subsidies, especially for the lower- and middle-income families in the subsidised SOCs and for outpatient drugs. To date, about 360,000 patients have benefited from the higher subsidies. Pioneers also receive additional subsidies. Since September last year, about 340,000 or about three-quarters of all Pioneers have enjoyed the benefits. One such patient is 70-year-old Mdm Lee Soon Meng.”
“I am pleased to let Members know that we have achieved Temporary Occupancy Permits (TOP) for both the Specialist Outpatient Clinics (SOC) tower and the ward tower of the hospital. Our care model will evolve as our population ages. Mr Low Thia Khiang asked about rehabilitative care. Rehabilitation plays a pivotal role in our care of an ageing population. We are strengthening rehabilitative care by more than doubling our capacity for community hospitals. Minister of State Dr Lam Pin Min will talk more about plans in this area and my Senior Minister of State Dr Amy Khor will share how the Ministry is developing manpower to support rehabilitation, as well as strengthening home and community care. Our specialist centres are also being expanded and upgraded to better serve Singaporeans. Last year, we opened the new National Heart Centre (NHC) building. By 2019, we will open a new Centre for Oral Health (COH) at the NUH. This will allow us to expand dental services for Singaporeans and provide more training capacity for dentists and dental therapists. We are also improving Singaporeans' access to quality primary care within their communities. Last year, I announced that we would be building two new polyclinics in Jurong West and Punggol. This year, I am pleased to announce that we will build a new polyclinic and, in answer to Mr Liang Eng Hwa, this new polyclinic will be in Bukit Panjang. This will serve residents staying in the region. This will also relieve pressure on nearby polyclinics, such as Choa Chu Kang Polyclinic. We will also be redeveloping Yishun and Marine Parade polyclinics to better Page: 102 serve residents there. Mdm Chair, even as we build more facilities, we also need to continue to find new ways to give better care to our patients.”
“Using education as an indicator and taking obesity as an example, the 2010 National Health Survey showed that women with PSLE education and below were 1.4 times more likely to be obese compared to those with GCE "A" level education and above. However, men with lower educational qualifications were less likely to be obese. This compares favourably with a study of 22 European countries, in which less educated women and men were 2.8 and 1.9 times more likely to be obese on average. Our survey shows that the lower educated have good access to healthcare services and reasonably good outcomes for key chronic conditions, such as diabetes. Healthcare 2020 focuses on further improving access and affordability of healthcare to achieve better Page: 101 outcome for all Singaporeans and especially the more vulnerable. At the same time, we will also help them to have stronger awareness and better understanding of health issues so that they can take personal responsibility of their health outcomes. This is why the Health Promotion Board (HPB) has targeted its health promotion outreach and messages to ensure that these messages and outreach will reach all socio-economic groups. Parliamentary Secretary Assoc Prof Faishal will elaborate on our health promotion efforts later. Let me update the House on the progress of Healthcare 2020, as requested by Dr Chia Shi-Lu. First, on infrastructure developments. Over the last decade, we have added more than 1,200 acute beds and 500 community hospital beds. From now till 2020, we target to add at least 1,700 acute beds, from our two new general hospitals. This rate of expansion of development is more than double that in the last decade. The Ng Teng Fong General Hospital is scheduled to open by July 2015.”
“Madam, as we celebrate our 50th year of nation-building, let me also take this opportunity to thank our pioneering healthcare professionals, who have overcome a host of public health challenges arising from the lack of proper sanitation and poor food hygiene practices in the early years. As a result of their efforts, the average life expectancy now stands at 83 years, well above most countries, compared to just 65 years then. Infant mortality rates also improved from 26 per 1,000 live births to two per 1,000 live births. Our pioneers also worked tirelessly to train up the next generation of healthcare professionals and nurtured in them the spirit of service and excellence. Mr Harbhajan Singh is one such pioneer. After reaching the retirement age in 2002, he stayed on and to date has chalked up a total of 55 years of service in Tan Tock Seng Hospital (TTSH). Mr Singh was also part of the team of frontline healthcare workers involved in battling the Severe Acute Respiratory Syndrome (SARS) outbreak in 2003, and he stands ready to battle again new emerging infectious diseases such as Ebola. Because of the commitment and devotion of pioneers like Mr Singh, we all can enjoy a modern and robust healthcare system today. Let us say a big "Thank You" to all of them. Mr Gerald Giam asked about how socio-economic factors affect health outcomes in Singapore. Health outcomes have improved for all Singaporeans, as seen through the overall improvements in life expectancy and reductions in infant mortality. However, as with other countries, there are differences in health outcomes and risk factors across different socio-economic groups.”
“Mdm Chair, I would like to thank Members for their comments and questions. If I may have your permission, I would like to show some slides, please.”
“The Medical Protection Society announced its intention to change the medical indemnity cover for obstetricians and gynaecologists from occurrence-based to claims-based cover. Occurrence-based cover would cover the practitioner for incidents that occurred during the period that they paid membership or premiums, regardless of when the claim for the incident is made. In claims-based cover, a practitioner is only covered for claims made during the period of cover paid for. Compared to occurrence-based cover, the membership fees for obstetricians are expected to be lower under claims-based coverage. A practitioner will need to purchase tail cover if he wishes to remain protected for any claims made after the period of cover has ended. MPS has indicated that tail cover (run-off cover), which is available in five-year blocks, enables it to price coverage more accurately. MOH is looking into this matter and is in discussion with the stakeholders representing the obstetricians and gynaecologists to address their concerns. Page: 168”
“However, introducing a direct caregiver allowance may inadvertently monetise family support and filial piety, which are priceless. We will nevertheless continue to study new ways to beef up support for caregivers.”
“Caregivers play an important role and we should indeed support them in their caregiving roles. We have sought to do so in a number of ways. Families with children below 12, or family members above 65 or with disabilities currently benefit from a lower Foreign Domestic Worker (FDW) Levy. In his Budget 2015 announcement, Deputy Prime Minister Tharman announced a further reduction of the concessionary levy to $60 and extension of the lower levy to families with children aged between 12 and 16. This is on top of the enhancement of existing tax reliefs, such as parent and handicapped relief for parent, spouse, sibling and child, announced last year, to provide greater support for working caregivers. We also have in place other financial schemes to help defray the cost of caring for our loved ones. Examples are the Foreign Domestic Worker (FDW) Grant, ElderShield, IDAPE and the recent Pioneer Generation – Disability Assistance Scheme which was introduced in September 2014. Other than financial support, caregivers may also tap on the current range of eldercare and disability services such as home and community care options and respite care to help them with their caregiving responsibilities. For instance, they can receive an annual Caregiver Training Grant to equip themselves with the necessary skills in caring for the physical and emotional needs of their care recipients. MOH has also made respite services more accessible. Besides offering subsidised nursing home care for eligible seniors, we have also introduced weekend respite services at nine centres across Singapore. For persons with disabilities, MSF is expanding the Day Activity Centres and piloting home-based care services for those who do not require or are not suitable for centre-based services.”
“Patients served by the public sector healthcare institutions already have a single health record shared among our institutions, such as hospitals, SOCs and polyclinics. All community hospitals, 56 community healthcare providers and close to 40% of GP clinics have access to NEHR. MOH is actively working with the remaining private healthcare providers not yet on board to encourage their participation. We urge all our healthcare providers across care settings and especially those in the private and people sectors to support and participate in the NEHR so that we can achieve our vision of "One Patient, One Health Record" as soon as possible.”
“Since the NEHR was first rolled out in 2012, we have been progressively enhancing the system and reaching out to user groups. Some of these enhancements include a re-designed user interface and customised care setting views to better support clinical workflows; clinical communications and medication reconciliation pilots to better support care provisioning to patients; data augmentation to expand the breadth of patient-centric information to support decision making and a case management system to better support chronically-ill patients with complex care needs. Going forward, NEHR will continue to develop new IT functions and provide information to support the integration of care services for the patient across the healthcare sector. This includes the development of the Continuity of Care Record (CCR) functionality which would provide a mechanism for institutions to share patient's active problem list and care plan, with the end state being a seamless integration with hospital EMR systems. Future developments will also include the use of data analytics to support both decision making at the point of care and national planning for MOH. NEHR will be staged across many years. In the meantime, as our care model continues to evolve to meet emerging challenges and growing healthcare needs, we will need to constantly review our IT system. For this reason, we have developed a Health IT Master Plan, or HITMAP in short, jointly with our public and private sector stakeholders to guide our path forward, including NEHR. As our IT solutions, including NEHR, will involve procurement exercises, it will not be in our interest at this stage to reveal the overall budget set aside for NEHR.”
“In practice, a treating clinician would always verify with the patient and take the relevant history where necessary to ensure appropriate care is provided.”
“As of February 2015, about 550 (or 37% of 1,500) private GP clinics have access to the NEHR, up from about 190 in March last year. In general, GPs find that access to the NEHR enables them to provide better care to their patients. Some GPs have not participated in NEHR due to a variety of reasons, including concerns over the necessary changes in day-to-day work processes, the impact on operational cost and unfamiliarity with IT. We will continue to engage with all user groups to address their concerns and make enhancements to NEHR to support the changing ways in which we deliver care. The Member also asked about EMRs, which are detailed transactional records of a patient within a hospital. They allow the healthcare worker to enter clinical observations or assessments, order medication, make electronic orders for tests and review results and radiological images. For example, medication given to the patient during a stay in hospital would be contained within their EMRs but not within NEHR. In comparison, NEHR is a non-transactional record of the patients' health journey that contains the summary record of each healthcare encounter. For example, when a patient is discharged from hospital, the medications prescribed to them as part of their ongoing care will be sent to the NEHR. The discharge summary is also sent to the NEHR to ensure that any other clinician is able to understand critical and relevant information in order to facilitate better ongoing care for the patient. Clinicians enter information once into their local EMR system and the relevant information is automatically extracted and sent to NEHR. As we roll out NEHR progressively, data will be collected progressively.”
“Non-Singaporean foreign-trained medical specialists must first be accredited by the Specialists Accreditation Board before they are conditionally registered by the Singapore Medical Council to practise. Under conditional registration, they are required to practise under supervision for a period of two years in an SMC-approved institution before they can apply for full registration. The Singapore Medical Council granted conditional registration to 375 non-Singaporean foreign-trained specialists to practise in the public sector Restructured Hospitals for the five years since 2010. One hundred and twenty-one specialists in this group have successfully completed their supervised practice under conditional registration and were granted full registration. Of this group who achieved full registration, all were still practising in the Restructured Hospitals as at end December 2014.”