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 49 of 77.
“Mdm Speaker, I beg to move, "That the debate be now adjourned." [(proc text) Resolved, "That the debate be now adjourned." − [Mr Gan Kim Yong]. (proc text)]”
“Mdm Speaker, may I seek your consent and the general assent of the Members present to move that the proceedings on the item under discussion be exempted from provisions of Standing Order 48(8) to remove the time limit in respect of Minister Shanmugam's speech?”
“Sir, I believe there are already existing incentives for tax benefits for CPF top-ups and some of the top-ups will go into Medisave. We will explore whether we have other incentives to encourage people to top up purely for Medisave. This is probably something we can look at going forward. [(proc text) Question put, and agreed to. (proc text)] [(proc text) Bill accordingly read a Second time and committed to a Committee of the whole House. (proc text)] [(proc text) The House immediately resolved itself into a Committee on the Bill. – [Mr Gan Kim Yong]. (proc text)] [(proc text) Bill considered in Committee; reported without amendment; read a Third time and passed. (proc text)] Page: 138”
“These are very exceptional circumstances because we also want to make sure that even as you tap on other members' accounts, you do not deplete the Medisave balance of the other members. So, we will encourage members who have difficulties to appeal to CPF and we will consider, on a case-by-case basis, to allow them to do so.”
“I beg your pardon. So, if they are legalised, then they are legalised and they ought to operate properly. But primarily, we intend to appoint the CPF Board as well as the Inland Revenue Authority of Singapore (IRAS) to be our agents.”
“We have provided certain budgets based on our estimates but, again, this is a new Scheme, and we will allow the Scheme to roll out. And I am sure the Minister for Finance is very supportive and, if need be, I will have to go to the Minister for Finance to beg for more money to help us ensure that all Singaporeans, whether they are from low income or middle income, will all be able to afford the premiums under MediShield Life.”
“Sir, our common aspiration is clear, and the journey towards it has begun. I would like to urge the Members of the House to give your support to the MediShield Life Scheme Bill and join us in this journey towards a more inclusive, caring and progressive society. Sir, I beg to move.”
“MediShield Life Scheme is the embodiment of Singaporeans' aspiration for a more inclusive, caring and progressive society. It is this aspiration that guided the development of this Scheme, how we make it easier to extend help to the vulnerable and the needy, why we include those with pre-existing conditions, how we ensure those who are able will pay their premiums and the reason for wrapping up the debate in these themes. Page: 136 The Government will do our best to support all Singaporeans in this significant shift to MediShield Life and the Bill is designed with this in mind. We are facilitating premium payments and eligibility checks for subsidies so that the vulnerable groups among us will receive timely help with minimal hassle. We seek Singaporeans' understanding and help to work with us in extending the support for those who are less well-off amongst us. Individuals should continue to play their part to uphold this collective responsibility that many have pledged their support for, which include leading healthy lifestyles and making wise healthcare decisions. This will go a long way in ensuring that premiums will remain affordable for everyone. I would like to reiterate that this Bill goes beyond providing the legislative framework for the operation of a national Scheme. It is a Bill that provides many firsts in the Government's efforts to help Singaporeans fulfil their aspiration. Like many first steps, there will be lessons to learn from and things to improve on. We will work with Singaporeans to bring the Scheme closer to our vision as we move forward. If there are hiccups along the way, I am sure there will be, please bear with us and we will do our best to fix them as quickly as we can.”
“With the substantial enhancements, MediShield Life will be adequate for the vast majority of Singaporeans. Therefore, consider very carefully when you think about IPs. Dr Lim Wee Kiak suggested that the MediShield Life Scheme also covers palliative care, medication, outpatient mental treatment and preventive dental and eye screenings. The Member is among many who hope for MediShield Life to include additional benefits. We have already taken a significant step from MediShield with the benefits proposed by the MediShield Life Review Committee last year. We will continue to review how we can improve MediShield Life in the future but there is a need to balance premium affordability and benefit coverage. In the meantime, there are also other forms of subsidies, such as those under the Community Health Assist Scheme (CHAS), which can help Singaporeans with other healthcare expenses. Sir, let me conclude. Many Singaporeans who took part in Our Singapore Conversation and the focus group discussions hosted by the MediShield Life Review Committee supported having a universal national healthcare insurance scheme, not just for the benefits and assurance that it brings to those who are covered but also for the ideal behind such a national Scheme – that all Singaporeans will come together as a nation to build this healthcare safety net so that no one is left behind. The debate on this Bill has largely focused on the how and the what of the MediShield Life Scheme – how do we carry through the recommendations of the MediShield Life Review Committee and what each of us have to do for the Scheme to work well. It is also important for us to revisit the why – why did we embark on this national health insurance Scheme in the first place.”
“The Ministry will also play its part. We encourage patients and doctors to bear in mind cost-effectiveness even as they seek out newer treatments. We work with clinicians to develop clinical protocols and guidelines. This is to encourage cost-effective treatment of patients and choice of drugs. Hospitals are required by law to provide financial counselling at the point of admission to help patients make informed decisions. Many have also spoken about the sustainability of the Scheme and of the subsidies. It is important that the MediShield Life Fund is sustainable and therefore it must strike a careful balance between benefits and premium affordability. The Government has, in fact, committed to support the Premium Subsidies for the lower- and middle-income. We will continue to be prudent in managing our resources to ensure that the Government is able to sustain these subsidies. Members have also asked about the benefits of the Scheme, such as whether claims can be paid for self-inflicted injuries or whether benefits can be extended to new areas. MediShield Life does not cover self-inflicted injuries so as not to encourage such behaviour. Page: 135 But if the injuries arose from mental illness, as mentioned by Ms Chia, we will review their coverage on a case-by-case basis. Some asked about the need for Integrated Shield Plans (IPs). The Minister of State has suggested three key factors to consider. I would encourage Singaporeans to consider carefully whether you really need the IP and whether you are prepared to pay the higher premiums, not just when you are young but also when you are old. Miss Penny Low has also cautioned against overspending on IPs, and as a result, depleting Medisave.”
“To manage overconsumption and over-provision of treatment, MediShield Life retains deductible and co-payment components to safeguard against the "buffet syndrome". We Page: 134 will continue to carefully monitor claims. Ensuring the provision of cost-effective and sustainable care is a larger journey that involves more than MediShield Life. We can do more with everyone's help. All of us – patients, healthcare providers, insurers, family members – need to do our part. For example, healthcare providers should provide care that is appropriate and not over-prescribe tests or medication and help to guide patients in making wise and cost-effective treatment choices. More expensive does not mean better, as highlighted by Dr Lim Wee Kiak. The CPF Board and private insurers need to continue to carefully monitor claims for inappropriate or excessive treatment. Most importantly, all of us can encourage each other to make healthy choices, such as eating healthily, wisely and exercising regularly. Dr Lily Neo has suggested building some incentives akin to the No-Claim Bonus into MediShield Life Scheme to encourage Singaporeans to stay healthy. This was also raised by those who participated in the MediShield Life review. The MediShield Life Review Committee weighed the pros and cons and decided that there are better ways to promote healthy lifestyles. They were concerned that with incentives like the No-Claim Bonus, patients might delay treatment to maintain their No-Claim Bonus, which could result in serious consequences. Moreover, the need for medical treatment may not always be avoided even when good care is taken, such as when accidents occur or for congenital conditions. Introducing incentives in the Scheme may unduly penalise these patients even when it is no fault of theirs.”
“In response to Mrs Lina Chiam's concerns about the recovery bodies that would be engaged to collect outstanding premiums, I would like to clarify that we will be appointing the IRAS and the CPF Board as recovery bodies, as I mentioned earlier. There will be no involvement of "loan sharks". Assoc Prof Fatimah Lateef and Mr Hri Kumar reminded us about the need to be mindful of the cost and effectiveness of various recovery measures when recovering premiums from wilful defaulters. We would like to assure Members that the various premiums recovery measures will not be imposed mechanically but will be done with discretion and flexibility. We will seek direction on this from the MediShield Life Council when it is formed. Er Dr Lee Bee Wah was concerned that recovering outstanding premiums from joint monies might not be fair to the other party who jointly owns the monies. Clauses 13(4) and 13(7) allow an owner of the joint monies to surface their objections regarding the amount to be deducted from the joint monies. Mr Ang Wei Neng suggested recovering premiums not just from Medisave Account, but also from the Ordinary and Special Accounts. Monies in the CPF Ordinary and Special Accounts are set aside to help with other daily living needs in retirement and we will not tap the protected monies in these accounts. I am sure the Minister for Manpower will also not agree. However, we wish to clarify that the premiums can be deducted from any CPF monies that are withdrawn as cash. Several Members have shared their concern on the potential for the overconsumption of medical treatment under MediShield Life and the sustainability of MediShield Life and Government subsidies. These are important concerns and I thank the Members for raising them.”
“Third, for those who need further help with their premiums even after Premium Subsidies and Transitional Subsidies, the Additional Premium Support is available to help them. Assoc Prof Fatimah Lateef and Ms Chia Yong Yong were concerned that adults who are mentally incapacitated may face difficulty paying premiums and even more so if they come from low-income families. Sir, while adults are liable for their premiums, for those who are unable to pay, we will encourage and facilitate family support and for their immediate family members to pay for their premiums. For low-income needy families who are unable to afford premiums even after all the Premium Subsidies, we will make Additional Premium Support available to them. Page: 133 While the Government will do our best to help the needy, including the elderly referred to by Er Dr Lee Bee Wah, afford their premiums, all Singaporeans should play their part to ensure that their Medisave accounts have sufficient balances for premiums payment and respond to notices for alternative payment arrangements and Additional Premium Support. If an individual repeatedly fails to pay premiums or respond despite multiple notices and reminders, we would have to impose penalty for late payment to be fair to the rest of the Singaporeans who pay their premiums on time. Let me emphasise that the premiums recovery framework and penalty are directed at a small group of freeloaders who are wilful defaulters and do not contribute their share, even though they can afford to. They will continue to be covered under MediShield Life and their debts will be unfairly shouldered by those who have paid their share responsibly. Appropriate premium recovery measures and penalty will have to be in place to deter freeloaders.”
“When we facilitate the payment of premiums by any of these family members through Medisave, the family member will be notified before his Medisave monies are deducted, and he may elect to cancel this arrangement if he wishes to do so. In the case of children below age 21, parents are liable for the premiums of their children. They will be required to pay for their children's outstanding premiums, through deductions from their Medisave accounts, or other means. Assoc Prof Fatimah Lateef asked about the definition of "parent" in clauses 4(3) and 5(5) of the Bill in the context of a single lady who is not legally married but has decided to have a child of her own. I wish to clarify that in the situation described by Assoc Prof Fatimah Lateef, the single lady will be responsible for the child's premiums as the parent of the child. I would like to add that citizen babies born on or after 26 Aug 2012 will receive a $3,000 Medisave grant under the Marriage and Parenthood Package, which can be used to help pay for their premiums. Mr Baey Yam Keng was concerned that this Medisave grant would not be sufficient to cover the premiums incurred by a young adult in his initial years when he may not yet have the financial means to pay. I would like to assure the Member that immediate family members, including parents of the young adult, are allowed to help pay for his premiums if he runs out of Medisave balances. If the family is in trouble facing financial difficulties, Additional Premium Support will apply. Second, for those who have missed premiums payments due to insufficient Medisave balances or family support, notices and reminders will be sent to give them sufficient time to respond or make arrangements to pay.”
“Section 56A needs to be retained to support this transfer, as well as to preserve continuing obligations on NTUC Income with regard to the transfer and certain subsections under section 56A that have continuing application. While Members generally support having appropriate penalty and premiums recovery measures in place to ensure social responsibility in premiums payment, several have voiced their concerns on whether sufficient efforts will be done to help Singaporeans pay premiums, so that the measures will not be unfairly imposed on those who intend to pay but either cannot afford to or simply forget to do so. I would like to assure Members that we will make premiums payment as convenient for all Singaporeans as possible by putting in place a comprehensive framework of measures. This is also to ensure that penalty and premiums recovery measures are only targeted at those who have the means but wilfully refuse to respond to payments for extended periods of time. The premiums payment framework will involve the following measures. First, we will facilitate payment of premiums by other immediate family members, such as parents and spouses, so that they can use their Medisave to pay for their loved one's premiums. Mr Hri Kumar has asked about the reference to premiums payable by "other persons" in clause 4(2)(b) of the Bill, and if an individual can object to the deduction of another person's premiums from his Medisave account. We would like to clarify that, today, Medisave may be used to pay for health insurance premiums for yourself and your Page: 132 immediate family members such as your spouse, children and parents. Clause 4(2)(b) supports this process.”
“Offenders may be punished with a fine of up to $5,000 or imprisonment of up to 12 months, or both. In response to Mr Alex Yam's query on the sufficiency of this punishment, this is in line with similar offences under the Pioneer Generation Fund Act. Page: 131 In response to Mr Gan Thiam Poh's query on whether authorised persons will be allowed to check individual's credit records with banks, we would like to assure the Member that the eligibility checks for MediShield Life Premium Subsidies will only extend to existing income records within the Government databases. These will not be extended to private or commercial records, including any bank or credit card records. Ms Chia Yong Yong asked about the handling of information by appointed insurers and the differences between section 59 of the CPF Act and clause 37(8) of the Bill. Under section 59 of the CPF Act, information is shared with insurers today to enable them to administer Integrated Shield Plans (IPs) for their policyholders and enable the use of Medisave for these plans. Clause 37(8) enables this sharing of information to continue. In addition, clause 37(8) tightens the scope of disclosure compared to section 59 of the CPF Act, where the Minister's approval is needed before information can be passed to insurers. All insurers remain bound to handle information securely on behalf of their policyholders under the Personal Data Protection Act, as should be the case for all information that they handle for all policyholders. The Member also asked about the retention of section 56A in the CPF Act. The CPF Board previously administered plans that provided higher coverage than the basic MediShield. These plans were transferred to NTUC Income after a competitive tender in 2005.”
“As shared earlier, stringent safeguards are in place to protect the information from unintended or inappropriate use. First, only authorised persons will be allowed to access, use or disclose medical and financial information for the specified purposes. These purposes are set out clearly in clauses 26 to 28. They will be required to sign appropriate undertakings. Second, the Minister in charge of the agency that controls the information requested will have to approve the disclosure of that information and can impose appropriate terms and conditions. Here, I wish to clarify with Mr Gerald Giam on his query on clause 30. Clause 30, in fact, relates to the power of the Minister concerned to impose appropriate terms and conditions in order to safeguard the information, such as stipulating access controls. It is not, as Mr Gerald Giam supposed, to give the Minister broad powers to approve access and disclosure of information. This is for the Minister who is in charge of the information, in addition to the Minister for Health who is in charge of MediShield Life. So, for example, if MOH requires the information from another Ministry, the Minister in charge of that Ministry has to approve before I can have access to the information. Sir, in response to Mr Giam's query on cybersecurity standards, MOH and the CPF Board will continue to adhere to the Government's cyber security standards, and these standards include a range of internal processes and technical safeguards. Third, clause 29 of the Bill makes it an offence for any person to access, use or disclose information about an individual obtained under Part 5 of the Bill without authorisation or the written consent of the individual concerned.”
“This shift to MediShield Life is an important step and I am pleased to announce that, to further ease the transition, the Government will increase the Transitional Subsidies it will provide to Singapore Citizens for the first two years of the Scheme. In the first year, all citizens who face an increase in their net premiums will be subsidised 90% of the net increase in premiums, followed by 70% in the second year. This is higher than the earlier announced rate of 80% and 60% for the first and second year respectively. The Transitional Subsidy rate for the third and fourth years of the Scheme will remain at 40% and 20% respectively. What this means is that Singapore Citizens moving from MediShield to MediShield Life will pay only 10% of the net premium increase in the first year, or less than $3 per month, while enjoying significantly enhanced benefits under MediShield Life. Many Members have asked questions about the facilitated eligibility checks and the safeguards in place to protect individuals' information. Page: 130 Sir, allow me to briefly reiterate that MOH intends to extend MediShield Life subsidies to all eligible Singaporeans as conveniently as possible, especially subsidies for lower- to middle-income Singaporeans. The MediShield Life Scheme Bill provides the framework for this approach and enables us to provide subsidies to those who are vulnerable and may find it difficult to apply for subsidies themselves. Dr Janil asked when individuals can opt in for the facilitated eligibility checks. They can apply any time and will take effect from the next policy renewal date. Assoc Prof Fatimah Lateef, Mr Gerald Giam and Ms Jessica Tan voiced their concerns about safeguards in place to protect individuals' information.”
“In line with the principles of family support, eligibility criteria for Additional Premium Support will take reference from the principles of MediFund, to assist the needy with limited self and family support. Mr Karthikeyan expressed concerns about individuals who are temporarily facing financial distress. I would like to assure Members that flexibility will be exercised for individuals who need help because of their unique or sudden unfortunate circumstances. Dr Amy Khor mentioned in her speech how we will work with relevant agencies and organisations to reach out to the genuinely needy to provide them with timely help. We will do what we can to ensure that those who need the help will get it. In response to Ms Jessica Tan's query on what measures will be in place to help PRs who are facing financial difficulties and are unable to afford premiums, I would like to clarify that eligible PRs can also receive Premium Subsidies at half the subsidy rates for citizens. Fourth, there will be Transitional Subsidies to help Singapore Citizens ease the transition from MediShield to MediShield Life in the initial four years. We announced last year that the Transitional Subsidies will offset the increase in payable premiums in the first four years of the Scheme, that is, after taking into account Premium Subsidies with subsidy rates of 80% in the first year, 60% in the second year, 40% in the third year and 20% in the fourth year. In the fifth year of MediShield Life, after Transitional Subsidies have been phased out, lower- to middle-income households will still continue to benefit from Premium Subsidies. Dr Chia Shi-Lu has expressed concerns about transition and asked if we can provide greater help.”
“Ms Tin Pei Ling and Mr Baey Yam Keng expressed their concerns about Pioneers who may face difficulties with higher premiums over time. Sir, allow me to recap the rationale and assurance of the Pioneer Generation (PG) Package. The intention of the PG Package is to provide Pioneers with greater assurance so that they do not have to worry about their healthcare costs, including MediShield Life premiums, in their old age. The PG Subsidies for MediShield Life premiums are not based on means and apply equally to all Pioneers. To help with premium affordability, the subsidies increase with age, rising from 40% at age 65 to 60% at age 90. Together with the annual Medisave top-ups for Pioneers, premiums are highly affordable. To Mrs Lina Chiam's suggestion, I would like to highlight that with the PG Subsidies and Medisave top-ups, Pioneers aged 80 and above will have their premiums fully covered. The Government also provides annual Medisave top-up to all eligible elderly Singapore Citizens aged 65 and above under the GST Voucher to support their medical needs. Younger Pioneers can tap on this to further offset MediShield Life premiums if needed. No one, especially our Pioneers, will lose their MediShield Life coverage due to the inability to pay for their premiums. Third, there will be Additional Premium Support for Singaporeans, including Pioneers, who need further help with their premiums even after Premium Subsidies. We would like to assure Members like Ms Tin Pei Ling and Assoc Prof Fatimah Lateef that the Government will proactively reach out to Singaporeans, including Pioneers, who have insufficient Medisave Page: 129 balances and insufficient family support and assess if they need Additional Premium Support.”
“Employers who do not offer portable medical benefits can review the coverage and structure of their employer medical benefits to tap on and even build on top of MediShield Life or IPs. MediShield Life will continue to cover them for life even when they leave the employment or retire. They need not worry about developing medical conditions that cannot be covered even if they are no longer employed. Page: 128 In response to Mr Png Eng Huat's query on how pensioners can benefit from this Scheme, MediShield Life will provide additional benefits above and beyond that provided for under the pensioners' existing medical benefits. It will, however, not take away anything that they are already enjoying today. Therefore, I hope Mr Png is now clear about the benefits that the MediShield Life will provide. The provisions of this Bill also reflect the overall philosophy of the MediShield Life Scheme in moving towards a more caring and inclusive society. Members in the House have shared concerns about the premium affordability, which were also brought up during the MediShield Life review. As I outlined in my Second Reading speech earlier, the Government has committed a large slate of measures and subsidies to help Singaporeans afford their premiums. Let me briefly recap these subsidies and address queries that the Members have raised. First, there will be Premium Subsidies for the lower- to middle-income Singaporeans of up to $2,600 household monthly income per person. Premium Subsidies are a permanent feature of the Scheme, which means that Singaporeans will receive them for as long as they meet the criteria. Second, there will be Pioneer Generation (PG) subsidies for all Pioneers.”
“I thank the Members' support for the Bill, and the support for universal coverage to ensure that no Singaporean is left behind to shoulder any unexpectedly high medical bills on his own. There are pockets of Singaporeans who may not fully appreciate the benefits of a universal scheme. Therefore, Ms Ellen Lee is right that there is a need to help Singaporeans understand what it means to have a universal Scheme and the spirit behind it and I seek Members' help to continue our outreach efforts and share about MediShield Life with grassroots leaders, community leaders and Singaporeans. Ms Jessica Tan, Dr Lily Neo and Mr Alex Yam asked about whether some Singaporeans can be excluded from the MediShield Life Scheme, such as those who are residing overseas. Sir, all Singapore Citizens and permanent residents (PRs) are required to participate in the national risk pool even if they are overseas. They can also benefit from MediShield Life coverage any time they return to Singapore and seek medical treatment here, regardless of any changes in their health or life circumstances. Companies offering portable medical benefits generally build on top of the MediShield Life layer and there is minimal duplication. For example, some may make additional contributions to employees' Medisave while some may purchase Integrated Shield Plans (IPs) for them. Assoc Prof Fatimah Lateef asked about how Singaporeans with portable medical benefits from their companies can also benefit from MediShield Life Scheme. It is for this reason that the Government encourages companies to move towards portable medical benefits and they are supported by incentives to do so.”
“Mr Deputy Speaker, I thank the Members for their support for the MediShield Life Scheme and the Bill, and for their comments. I have also learnt something new at this Sitting – it is very dangerous to nod your head in the Parliament. I am, indeed, heartened by the strong interest in the Scheme as this is a very important universal mandatory Scheme that applies to all Singaporeans. For this reason, my round-up speech is likely to be longer than my Second Reading speech. Members have reflected their concerns and sought clarifications on how this will affect various groups of Singaporeans, especially those who are more vulnerable. Their concerns have echoed the feedback we received from the members of the public over the past months and I thank Singaporeans for their contributions. The MediShield Life Review Committee worked hard and listened hard to Singaporeans and came up with a comprehensive package of well thought-through recommendations, which garnered unanimous support from the Members last year. This MediShield Life Page: 127 Scheme Bill will allow us to carry through the Committee's recommendations. I will address the Members' questions and requests as well as explain the thinking behind some of the provisions of the Bill and provide a better understanding of the Scheme. Sir, I will address the issues that have been raised in the following three broad themes: (a) Towards a more inclusive society through MediShield Life; (b) Towards a More Caring and Progressive Society, meaning those who are needy will receive help and those who are able should do their part; and (c) Ensuring sustainability in our healthcare system. First, on the inclusiveness of MediShield Life.”
“This enables the Scheme to tap on their expertise and resources in administering these measures in an effective and sensitive manner. Madam, let me conclude. MediShield Life is a major step to strengthen collective responsibility and give Singaporeans peace of mind. We discussed at length during the Parliamentary debate last year on issues ranging from the benefit features and premium affordability to Fund sustainability. The debate concluded with unanimous support for this significant shift in healthcare financing. We are taking another step now to make this a reality. The MediShield Life Scheme Bill will provide the legislative framework for this shift to take place and for the implementation and administration of the Scheme. MediShield Life is a complex Scheme. We will step up our outreach efforts to explain the benefits of MediShield Life, how Singaporeans can receive subsidies and support for Page: 49 premium payments and to explain the effects of the Act. Madam, the idea of MediShield Life goes beyond healthcare and insurance. It is in fact a reflection of the kind of society we want to build; a more inclusive society where we pool our resources together to help the vulnerable and the sick among us. And a more caring and progressive society, where those who are able play their part while those who are needy will receive more help. This MediShield Life Scheme Bill sets the framework not only for the introduction of universal coverage for all, but also for every Singaporean to play a part in nurturing an inclusive, caring and progressive society. Mdm Speaker, I beg to move. [(proc text) Question proposed. (proc text)] 1.55 pm”
“If necessary, the recovery body may prevent those with outstanding premiums from leaving the country without paying them, as provided for in clause 16 of the Bill. Those who are notified about such a direction from the recovery body and yet choose to violate the direction will be committing an offence punishable with fine or imprisonment or both. Clause 17 allows the recovery body to impose a penalty, not exceeding 17%, on outstanding premiums and any interest imposed on the outstanding premiums. This is aligned with the maximum penalty of 17% for income tax arrears. Let me clarify that the 17% is not a recurrent penalty. It is the total maximum penalty that can be imposed on a year's outstanding premiums. It acts as a deterrent for delaying payment and will go towards covering the enforcement costs of recovering premiums. Clause 11 allows interest to be imposed on outstanding premiums. This interest is not a penalty but to fairly reflect the opportunity cost to the MediShield Life Fund, which could have earned a return from investing the premiums to support payments from the Fund. I assure Members that we will exercise discretion and impose interest and take the various recovery measures only in appropriate circumstances, when the defaulters wilfully refuse to pay their premiums despite multiple reminders and attempts to contact them and to help them over an extended period of time. The MediShield Life Council will provide direction on the broad approach towards premium recovery. I would also like to clarify that late payment of premiums will not be a criminal offence. IRAS and the CPF Board will be appointed as recovery bodies to help ensure that premium payment is made in a timely manner.”
“Their premium defaults will translate to bad debts to the MediShield Life Fund and lead to higher premiums for all Singaporeans. The MediShield Life Review Committee had noted this and recommended that the Government adopt appropriate premium recovery measures and penalty to ensure social responsibility in the payment of premiums. Let me emphasise that the premium recovery framework and penalty are directed at this small group of freeloaders who are wilful defaulters and do not contribute their share, even though they can afford to. It is necessary to have a set of firm measures in place to deter defaults and uphold the spirit of collective responsibility behind MediShield Life. This will ensure that the MediShield Life Fund remains sustainable and can meet its commitments to all Singaporeans. It also ensures that the debts of these freeloaders will not be unfairly shouldered by those who have paid their share responsibly. This is similar to other countries with mandatory national insurance schemes which have also adopted strict enforcement measures, to ensure compliance and recover outstanding premiums. Part 3 of the Bill provides for a robust premium recovery framework, with powers adapted from the existing income tax legislation. Whether it is MediShield Life premiums or taxes, they rely on the same principle of collective responsibility and there is a need to take a firm stance against those who are able to but refuse to play their part. Clause 12 empowers a recovery body to appoint defaulters' agents such as banks and employers who can be required to pay defaulters' outstanding premiums from the Page: 48 defaulters' savings and salaries respectively.”
“Third, clause 29 of the Bill makes it an offence for any person to access, use or disclose information about an individual obtained under Part 5 of the Bill without authorisation or the written consent of the individual concerned. Offenders may be punished with a fine of up to $5,000 or imprisonment of up to 12 months, or both. Mdm Speaker, let me now address the issue of premium payments and recovery measures for the MediShield Life Scheme. As MediShield Life is a universal and self-sustaining scheme, all citizens and PRs must play their part in paying their premiums on time, to ensure that the Scheme can continue to pay out the benefits and meet its commitments. To facilitate and assist Singaporeans in paying their premiums, a comprehensive framework of measures will be put in place, in addition to the subsidies and support I mentioned earlier. Page: 47 First, we will facilitate the process for other immediate family members to pay for your MediShield Life premiums if you do not have sufficient Medisave balance. Second, for those who have missed premium payments due to insufficient Medisave balances, we will send regular reminder letters to alert them to top up their Medisave and to make use of alternative payment modes available. Third, we recognise that there may be some who need further help with their premiums even after Premium and Transitional Subsidies. Some may not be aware of the help available or how to access it. We will put in place measures to help the vulnerable to ensure that those who are needy will receive help. However, there may be a small group who refuse to pay their premiums, despite multiple notices and reminders, even though they have the means to do so.”
“These facilitated eligibility checks will ensure that eligible Singaporeans are able to access MediShield Life Premium Subsidies as conveniently as possible, without having to apply individually and submit supporting documents. While MOH will do our best to use the latest information, the outcome of the facilitated eligibility checks depends on information in the Government databases being up to date. We all know in our interactions with other Singaporeans that some Singaporeans may not have updated their NRIC addresses after moving to a new address. Some who have rented out their flats may not have updated their tenants' particulars as well. So, to help us compute your subsidy eligibility, we urge individuals to do their part by checking and updating their records. Similar to the access to medical information, Singaporeans may choose not to participate in the facilitated eligibility checks so that the Ministry of Health and CPF Board will not access their information, but this means that they will not receive any Premium Subsidies as we will not be able to assess their eligibility. However, if you do change your mind subsequently, you can still apply later to be assessed. I would like to assure Members that stringent safeguards are in place to protect the information from unintended or inappropriate use. First, only authorised persons will be allowed to access, use or disclose medical and financial information for specified purposes. They will be required to sign appropriate undertakings. Second, the Minister in charge of the agency that controls the information requested will have to approve the disclosure of that information and can impose appropriate terms and conditions.”
“For the 94% of Singaporeans who are already covered under MediShield today, including those who bought Integrated Shield Plans, their existing Medisave payment arrangements will be retained. For those who wish to have another immediate family member to help with premium payments, they can request the Board to do so. These Medisave payment arrangements will be provided for under clause 4 of the Bill. For children below the age of 21, clause 4 further provides for their premiums to be borne by their parents. Citizen babies born after 2012 can tap on the $3,000 Medisave grant under the Marriage and Parenthood Package to help pay for their premiums. The one percentage point increase in employers' CPF contribution to Medisave accounts this year will also help to cover the increase in MediShield Life premiums for most Singaporean households. For needy Singaporeans who need further help with their premiums even after these subsidies and support measures, the Government will provide Additional Premium Support on a case-by-case basis for their premiums. Mdm Speaker, Premium Subsidies and support are a key feature of the MediShield Life Scheme. The MediShield Life Review Committee recommended that the process of applying for subsidies should be as simple and convenient as possible so that those who need them will receive them. Many Singaporeans have also suggested that we simplify the application process to reduce the need to provide similar information to different agencies repeatedly. Page: 46 Therefore, Part 5 of the Bill allows MOH to do so by using individuals' information in Government databases, to check and compute Premium Subsidies for each individual.”
“Notwithstanding, they can submit the necessary medical reports and documentary evidence to certify that they do not have any pre-existing medical conditions or if they change their minds later, they can consent to the access of their medical information. Mdm Speaker, let me now move on to MediShield Life premiums and payments. With the significant benefit enhancements and provision of universal coverage under MediShield Life, premiums will have to increase to support the higher payouts. However, premiums will remain affordable for all Singaporeans through a variety of measures. First, the Government will provide strong support in the form of various subsidies and support measures, to help Singaporeans with MediShield Life premiums. For lower- to middle-income households, they will be able to benefit from MediShield Life Premium Subsidies. The eligibility criteria for the Premium Subsidies will be based on household monthly income per person and the Annual Value of one's residence. MOH will also take into account multiple property ownership, to better reflect the individual's financial circumstances, similar to the approach for other Government schemes such as the GST- Page: 45 Voucher (U-Save) Scheme. Besides Premium Subsidies, the Government has also announced special subsidies and Medisave top-ups for all Pioneers. With these subsidies and top-ups, all Pioneers will pay less for their MediShield Life premiums than they would otherwise have to. The Government will also provide Transitional Subsidies for all Singapore Citizens over four years, to help ease the shift from MediShield to MediShield Life. Second, Medisave may be used to pay the full MediShield Life premiums.”
“MOH is currently reviewing the list of serious pre-existing medical conditions, with specialist advice from clinicians, and will share more on the broad categories of such conditions later. Individuals who have to pay the Additional Premiums will be informed Page: 44 before the start of the Scheme. I wish to assure Members and the public that we will adopt a fair and compassionate approach in the assessment for Additional Premiums. The key focus would be on serious pre-existing medical conditions that are likely to be life threatening or have high risk of future complications or recurrence, and therefore may require prolonged treatment. Singaporeans with these conditions will benefit significantly from the enhanced protection when they are covered under MediShield Life, as many of them would not have been able to get insurance coverage for their pre-existing medical conditions in the past. Madam, having a serious medical condition is worry enough. Therefore, we want to make the process of identifying such individuals a more convenient one. Part 5 of the Bill allows MOH and CPF Board to do so by accessing individuals' information already existing in Government administrative databases and medical institutions. We hope that, through this, the majority will avoid having to undergo medical assessments or provide medical reports. We understand that some Singaporeans may not be comfortable with us accessing their medical information. They may choose to decline MOH and CPF Board access to their medical information. However, if they do so, we will not be able to ascertain that they do not have pre-existing medical conditions and, therefore, they will have to pay the Additional Premiums under MediShield Life.”
“This will reduce the financial burden on these individuals by spreading the costs more evenly across the population. This is also aligned with views gathered from Our Singapore Conversation where Singaporeans expressed support for greater collective responsibility to help one another with unexpectedly large hospital bills. Clause 3 of the Bill provides for the MediShield Life Scheme to apply to all Singapore Citizens and Permanent Residents (PRs). This enables those who are currently uninsured and those with pre-existing medical conditions to benefit from MediShield Life coverage. However, this also means that the Scheme will face higher costs, given the higher risks of these groups. As noted by the Review Committee, while it would be fair that those with pre-existing medical conditions pay higher premiums to reflect the higher risks, we also need to ensure that the Additional Premiums would not be too onerous. On balance, the Review Committee recommended that: the Government bears the bulk of the costs of bringing in individuals with pre-existing medical conditions; these individuals with pre-existing medical conditions shoulder part of the costs by paying Additional Premiums of 30% for the first 10 years; and the rest of Singaporeans co-share a modest part in the spirit of collective responsibility. Under the Scheme, a pre-existing medical condition is one that has already developed before an individual's insurance coverage begins. Those who fall ill only after their insurance coverage begins will not be considered to have pre-existing medical conditions and will therefore not need to pay Additional Premiums.”
“This is the spirit of collective responsibility, but with strong support from the Government. Up to two-thirds of the population are eligible for Premium Subsidies of up to 50%. Premium Subsidies are a permanent feature of the Scheme – which means that these subsidies will continue to be extended to Singaporeans who meet the criteria and will not be phased out over time. Clause 8 of the Bill provides for the establishment of a MediShield Life Council, comprising up to 17 members. We have benefited much from the wide-ranging experience and professional expertise of the members of the MediShield Life Review Committee. I am confident that we will also benefit from the advice and guidance of the MediShield Life Council in the implementation and administration of the Scheme. The key roles of the Council are outlined in clause 8 of the Bill. The Council will review the design of MediShield Life Scheme benefits and parameters regularly, consider appeals for Additional Premium Support, and decide on the approach and Page: 43 guidelines for the recovery of outstanding premiums. The Council will be established by the time the Scheme takes effect. We are working through the details of setting up the Council and will release more information later. Let me now turn to the issue of universal coverage under MediShield Life and the approach for bringing in those with pre-existing medical conditions. The MediShield Life Review Committee consulted extensively on the issue of universal coverage. The vast majority of Singaporeans strongly supported bringing the uninsured, including those with pre-existing medical conditions, under MediShield Life. Many saw this as part of the move towards a more inclusive society.”
“The key recommended enhancements include: (a) removal of the lifetime claim limit so that it will provide life-long protection; (b) increase the policy year and daily claim limits so that it will cover more; and (c) reduce co-insurance rate so that patients pay less especially for larger bills. The Committee also recommended that MediShield Life should be universal for all Singaporeans with no exemption but appealed for the Government to bear the bulk of the Page: 42 cost of bringing those with pre-existing conditions under MediShield Life, and to provide the support needed to keep premiums affordable, especially for the vulnerable groups. The Ministry of Health (MOH) has been preparing for the introduction of the MediShield Life Scheme and this Bill will provide the legislative framework for the establishment, governance and administration of the Scheme. Mdm Speaker, I shall now highlight the main features of the MediShield Life Scheme Bill. First, clause 3 of the Bill provides for the establishment of the MediShield Life Scheme and for the transition from MediShield to MediShield Life. It also provides for the Scheme to be administered by the CPF Board. Clause 7 of the Bill provides for the current MediShield Fund to be renamed the MediShield Life Fund, and that all payments under the Scheme are to be met from the Fund. CPF Board, as the administrator for MediShield Life, is not liable for payments under the Scheme, and therefore cannot use other monies that it holds to meet the obligations under the Scheme. In short, the MediShield Life Fund is to be a self-sustaining insurance fund supported by premiums it collects. All of us contribute to the Fund. Those who fall seriously ill get payouts from the Fund.”
“Mdm Speaker, I beg to move, "That the Bill be now read a Second time." Madam, Prime Minister Lee announced in August 2013 during the National Day Rally that MediShield would be enhanced and renamed MediShield Life. This marks a significant shift in healthcare financing towards greater collective responsibility to give Singaporeans better peace of mind so that they need not face life's uncertainties alone. This strategic shift is in line with the Healthcare 2020 Master Plan to keep healthcare accessible, affordable and sustainable over the long term. It is also a response to the feedback received during Our Singapore Conversation that Singaporeans want to come together as a community and nation, to better support the more vulnerable and needy, especially those who meet with unexpected shocks in their life journeys. The MediShield Life Review Committee headed by Mr Bobby Chin was set up in November 2013 to review and make recommendations on the MediShield Life Scheme design and parameters, taking into account feedback from the public and key stakeholders. After eight months of extensive public consultation and intensive study, the Committee submitted its report to the Government and the White Paper on the "MediShield Life Review Committee Report" was debated in Parliament in July last year. I am pleased that it received unanimous support from Members of this House. As recommended by the Committee, MediShield Life will provide every Singaporean with better and lifelong protection against unexpectedly high medical bills, regardless of changes in their life or health circumstances.”
“Today, we have Professional Conversion Programmes (PCPs) for mid-career professionals who are keen to join healthcare as nurses, physiotherapists, occupational therapists or diagnostic radiographers. Under the Healthcare PCPs, trainees receive funding that covers the full fees of a local training programme, a monthly training allowance and a Career Transition Bonus upon graduation. Our Healthcare PCPs focus on disciplines where we have the most significant manpower needs and where there is adequate faculty to support a local training programme. There are currently no plans to extend the PCPs to podiatrists, respiratory therapists, perfusionists or physician assistants. Instead, the Ministry of Health offers scholarships for Singaporeans to be trained as podiatrists and respirational therapists overseas. Over the past five years, we have awarded 20 scholarships for podiatry and 12 scholarships for respiratory therapy. Our public healthcare institutions also provide in-house training for biological sciences graduates to become perfusionists. We presently do not have physician assistants in the healthcare sector Page: 108 but are reviewing the various healthcare provider roles as we plan for the future. We will continue to review our Healthcare PCPs as part of our strategy to grow and develop healthcare manpower.”
“Secondly, we are also supporting efforts to enhance the training of our family physicians in palliative care. The Division of Graduate Medical Studies at the Yong Loo Lin School of Medicine launched a Graduate Diploma in Palliative Medicine for doctors last year. The Page: 149 course trains doctors, especially family physicians, to better deliver palliative care to patients both in the clinic and home settings. Lastly, to help with the retention of staff, MOH has also rolled out several initiatives across the Intermediate and Long-Term Care (ILTC) sector, such as funding MOH-subvented providers, to raise staff salaries and enhancing subsidies to support the training and development of staff. With these initiatives, we have seen the number of doctors, nurses and medical social workers in the sector increased by a third between 2012 and 2014, from 150 to 205. We will continue to monitor the growth of manpower in the palliative care sector to ensure that palliative care services are able to grow as planned to serve our ageing population.”
“MOH recognises the importance of end-of-life issues, such as Advance Care Planning (ACP) and palliative care services, in supporting the needs of our ageing population. We are working comprehensively to raise awareness of these issues. We partner community organisations to reach out to the general public on end-of-life issues in the heartlands. For instance, MOH recently supported the Both Sides Now campaign organised by Lien Foundation and Ang Chin Moh Foundation. The mobile art exhibitions and performances gave visitors an opportunity to reflect and share about the topics of living and dying. We also supported the Singapore Hospice Council’s three-year Community Outreach Programme, which aims to share with the general public about palliative care services through grassroots events and outreach activities. The Agency for Integrated Care is working with Voluntary Welfare Organisation (VWO) providers in the community care and social care sectors to train their staff and volunteers to be advocates of ACP. These advocates will introduce the idea of ACP to clients and their families in the community to raise awareness of ACP. We have also trained more than 1,000 healthcare professionals as ACP facilitators to guide patients and their families in discussions on end-of-life and ACP issues. To support the increase in demand for inpatient and home palliative care services, we aim to double the number of doctors, nurses and medical social workers in the palliative care sector from around 150 in 2012 to 300 by 2020. We plan to do so through three main areas. Firstly, we have enhanced the funding model for home palliative care from 1 July 2014 to give providers greater certainty in planning ahead, including recruiting additional manpower to expand their services.”
“HPB also provides a workplace health promotion grant for employers to implement mental health and well-being related initiatives for their employees. In FY2014, 718 workplaces have taken up this grant benefiting an estimated 150,000 employees. More than 80% of these workplaces have invested at least 30% of their grant on providing services, such Page: 148 as phone or face-to-face counselling, psychological assessment and interventions.”
“To encourage synergy between mental health professionals, both our public hospitals and mental health teams in the community adopt a multidisciplinary approach. For example, each patient admitted is assigned a lead clinician who will lead the delivery of care, supported by a team-based system comprising other doctors, nurses and allied healthcare professionals where appropriate. The multidisciplinary approach has enabled specialists and allied health professionals to work closely together. For patients who have higher needs and require closer follow-up, IMH has put in place a post-discharge programme to ensure that these patients comply with follow-up treatment through telephonic case management and home visits when necessary. To ensure that patients are supported in the community, AIC has worked with VWOs, social agencies and grassroots organisations to manage and care for people with mental health issues. These community programmes provide clinical care, psychotherapy, education and support for both the patients and caregivers. They complement the hospital teams in outreach to them within the community setting and conduct home visits for these patients where necessary. Over the last two years, these programmes have benefited over 18,000 clients, caregivers and community partners. In terms of affordability, MOH had enhanced MediShield coverage from 1 March 2013 to cover inpatient treatment of psychiatric conditions. Most Integrated Shield Plans also provide enhanced coverage for such treatment, on top of MediShield. In addition, Medisave can be used for the outpatient treatment of bipolar disorders, schizophrenia, depression and anxiety.”
“The Ministry of Health (MOH) provides funding for a range of healthcare scholarships and educational sponsorships to develop healthcare professionals and leaders. These scholarships and sponsorships include formal training programmes leading to diplomas, degrees, masters and doctorates as well as skills attachment programmes in renowned overseas centres. The scholarships and sponsorships cover tuition fees, maintenance expenses, miscellaneous training-related costs and salaries. Over the past five years, MOH and the public healthcare sector awarded more than 1,000 healthcare sponsorships to nurses, medical social workers and occupational therapists. In FY2014 alone, there were about 200 such awards. MOH regularly reviews the scholarships and programmes to ensure that the terms and benefits remain adequate and the areas of training are aligned with our healthcare needs. Page: 147”
“The Ministry of Health (MOH) does not routinely track the total number of children with eczema in Singapore. Between 2010 and 2013, about 1% of children below 16 years of age attended our polyclinics and public sector specialist clinics for eczema each year, but others may have been treated by GPs or specialists in the private sector. The Medisave for Chronic Disease Management Programme (CDMP) was introduced in 2006 to improve outpatient chronic disease management through evidence-based structured Disease Management Programmes. Medisave may be used to pay for outpatient treatment of conditions covered under the CDMP which helps patients to reduce their out- Page: 146 of-pocket payments. The coverage of CDMP has been expanded over the years and now covers 15 common chronic conditions. These conditions were selected based on various considerations, such as disease prevalence and effectiveness of early intervention to reduce complications. The selection criteria continue to be refined to better meet the healthcare needs of patients, while bearing in mind the need to ensure sufficient Medisave balances to meet our lifetime healthcare needs. There is currently no plan to include eczema in the CDMP. Subsidies for eczema treatment are widely available for all Singaporeans at the polyclinics and subsidised specialist outpatient clinics (SOCs), and for lower- to middle-income Singaporeans at GP clinics under the Community Health Assist Scheme (CHAS). Singaporeans with difficulties managing their medical bills despite Government subsidies can also approach the Medical Social Workers (MSWs) at the public institutions for assistance.”
“RHS is also paying more attention to frail patients by helping them manage and monitor their chronic or complex conditions and to improve their health awareness and capability to take care of themselves. Under Khoo Teck Puat Hospital’s Ageing-In-Place (AIP) programme, community nurses are deployed to the patients’ homes to manage and monitor their conditions. These nurses also serve as the single point of contact to patients by coordinating healthcare services, such as home and medical care and specialists appointments, as well as non-medical services, such as befriending, wellness and home help. Over 3,000 patients have benefitted from AIP and similar programmes island-wide. We will continue to work closely with partners in healthcare and social care in the community and monitor the results of the various initiatives. We will learn from these initiatives and refine our healthcare service delivery models to better address patients’ needs in a cost-effective manner.”
“Regional Health Systems (RHS) has been established with the aim of developing and strengthening partnerships across care providers in the region, both private and public, and across care settings – tertiary, primary and community care, to deliver integrated care to our population. RHS has embarked on several programmes, ranging from preventive health to management of chronic diseases to caring for frail patients. For preventive health, RHS has actively moved into the community in partnership with community organisations to conduct health screenings as well as programmes to help residents embark on a healthier lifestyle. In Taman Jurong for example, Juronghealth System has partnered the grassroots to reach out to and recruit residents for health screening and linked up with Lakeside Family Medicine Clinic to provide subsequent patient follow-up services. Over 12,000 residents have benefited from this and other similar programmes. Page: 145 In terms of chronic disease management, RHS has made efforts to integrate care between specialist outpatient clinics and primary care providers to better care for patients in the community. A good example is the partnership between Frontier Family Medicine Clinic (FMC) and the National University Hospital (NUH). Supported by data linkages, Frontier FMC’s primary care physicians can access appropriate patient information from NUH to facilitate shared care to patients. Overall, this results in fewer appointments, more integrated care for the patient and savings for the system as a whole. Over 2,000 patients have benefited under this and similar arrangements thus far.”
“The Government introduced the Pioneer Generation Package in recognition of our Pioneers’ contributions to nation-building. From 1 September 2014, Pioneer patients receive an additional 50% off subsidised services at polyclinics and subsidised Specialist Outpatient Clinics (SOCs). All Pioneers can benefit from special Community Health Assist Scheme (CHAS) subsidies when they visit private medical and dental clinics under the scheme. More recently, since 1 January 2015, Pioneers also receive an additional 50% off subsidised medications at polyclinics and subsidised SOCs. Over a three-month period from September to November 2014, about 300,000 Pioneers have made a visit to the subsidised SOCs, polyclinics or CHAS clinics. There were about 250,000 visits by Pioneers to the subsidised SOCs, 330,000 visits by Pioneers to the polyclinics and 340,000 visits by Pioneers to CHAS clinics. A total of $27 million in additional special subsidies were received by the Pioneers for these visits.”
“MOH has been publishing clinical practice guidelines (CPGs) since 1998. Many of these CPGs have been focused on ensuring primary care providers are updated on the current best practice in common conditions that they encounter, an example being the "MOH CPG on Diabetes Mellitus" published in March 2014. There have also been CPGs to guide providers in hospital care, an example being the "MOH CPG on the use of intravenous recombinant Tissue Plasminogen Activator (rTPA) in Ischaemic Stroke Patients", aimed at providing guidance on timely initiation of this therapy in centres with appropriate facilities and expertise. While the main aim of MOH’s CPG programme has been to provide guidance to both public and private sector doctors on appropriate management of disease conditions, CPGs can also be used to guide the development of clinical programmes and audits. Examples of Page: 123 these were the CPGs related to the management of chronic diseases. Recommended clinical care components for the Medisave for Chronic Disease Management Programme were extracted from the relevant chronic disease CPGs and formed the basis for evaluation of appropriate practice thereafter. Going forward, MOH will continue to strengthen its CPG framework and other measures to ensure that patients receive appropriate care and avoid over-consumption.”
“For example, over 40% of nursing homes (or 24 homes) have already completed care planning training with AIC in 2014 and additional runs will be held in 2015 to cater to homes’ needs. In addition, we will place emphasis on areas with new requirements. As these domains have been articulated in the ENHS and are new standards, nursing homes may need more help to develop enhanced systems and processes. To support our nursing homes, AIC is developing additional training programmes with feedback from the sector for these areas. AIC has also started regular learning platforms for homes to share best practices with each other for improvement since February 2014 and about half of all nursing homes are regularly represented at these sessions. MOH plans to introduce the standards in April 2015, but only enforce this in April 2016 after a one-year grace period. We will continue to work closely with the sector to support nursing homes in meeting the enhanced standards so that our seniors can enjoy better quality care.”
“The new set of nursing home standards was developed by an industry-led workgroup to ensure that our seniors receive consistent quality care. It was finalised in January 2014 after consultations with the wider industry and members of the public. MOH and the Agency for Integrated Care (AIC) have launched several efforts to help nursing homes achieve these standards. Last April, we launched a Guide to ENHS for nursing homes. The Guide explains how the nursing homes could meet these standards and provides examples of processes, tools and templates that nursing homes can adopt. The Guide has been well received. Over 90% of nursing homes have also participated in AIC’s voluntary baseline assessments to help each nursing home identify particular needs and potential areas for improvements to meet the standards. From the baseline assessments, some of the areas that need enhancement include existing requirements, such as care planning and emergency preparedness, and new requirements, such as advanced care planning, dignity of care, psychosocial and mental health and organisational excellence. AIC has designed training to help nursing homes enhance their capabilities in these areas. Funding support is available for nursing homes to send their staff for these training courses and participants can receive up to 90% subsidy on their course fees. In 2014, AIC conducted more than 200 runs of training courses, providing over 4,000 training places in Page: 122 support of ENHS. Regional Health Systems (RHS) has also offered training in clinical areas to the nursing homes to help improve their care standards. The training courses cover the existing requirements that need enhancements.”
“For the 44 SMC disciplinary proceedings that concluded between 2011 and 2013, taxation has been completed for seven cases, of which six had a proportion of the bill reduced after taxation. In these cases, between 37% and 78% of the costs were recovered after taxation and the cumulative amount that was taxed down amounted to about $926,000. The remaining bill was eventually undisputed. These taxation cases do not include cases which are pending cost negotiations and outcomes of appeals. In each of the cases taxed, SMC paid the legal fees that were incurred. Page: 137 Taxation is a procedure that determines the proportion of the costs of the winning party that the losing party is made to bear when the costs are disputed. It must not be confused with whether the legal fees incurred were reasonable, and as the Law Society explained, the taxation framework is such that there is usually a considerable difference between what a losing party eventually pays and the costs incurred by the winning party in the disciplinary proceedings. For that reason, most cases that undergo taxation would result in the winning party not being able to recover a proportion of the costs incurred. Invariably, the legal expertise required and the costs of the disciplinary process increase with the complexity of the cases. SMC must carry out its public duty to ensure that patients' interests are protected. If it fails to pursue such cases due to financial considerations, there will be a loss of confidence in its ability to safeguard the interests of patients and in the integrity of the medical profession. SMC will continue to ensure that the legal fees of the law firms engaged are reasonable and commensurate with the work done.”
“Mr Deputy Speaker, I beg to move, "That the debate be now adjourned." [(proc text) Resolved, "That the debate be now adjourned." – [Mr Gan Kim Yong]. (proc text)]”