Gan Kim Yong
Singapore
“Consumer complaints relating to the secondary resale market for tickets to major events and concerts have generally remained low. Nonetheless, to protect the public from scams on secondary ticket resale platforms, the Police have imposed Code of Practice requirements under the Online Criminal Harms Act to require designated online service…”
“Singapore does not condone the use of forced labour. We criminalise forced labour in Singapore under various laws. Relevant Government Ministries and agencies, such as the Ministry of Manpower, Ministry of Home Affairs and Singapore Police Force, play their part in investigating complaints of suspected breaches in domestic laws that relat…”
“The Association of Banks in Singapore (ABS) discontinued the PayNow nickname feature as scammers had been exploiting the use of nicknames to impersonate legitimate entities and trusted individuals.”
“As of end-2025, around 6,900 private residential buildings have registered their solar installations with SP Group for the export of excess solar-generated electricity to the grid. The installed solar capacity of these residential buildings is 115.3 megawatt-peak (MWp), or around 5.5% of all current installed solar capacity in Singapore.”
“The one-year pilot extension of liquor trading hours has seen strong interest from businesses. As of 31 May 2026, the Police have approved 88 applications for the extension of liquor trading hours from public entertainment outlets in these areas.”
“The Government does not make projections of domestic or regional demand for renewable diesel or sustainable aviation fuel. Demand depends on commercial considerations, evolving market conditions and regulatory developments across different jurisdictions.”
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“I agree with the Members that providers play a critical role in managing costs. In the public sector, we will continue to develop and enforce strong clinical protocols, to guide doctors on what is clinically appropriate and cost-effective. Drugs are a good example. We have developed a Standard Drugs List (SDL) based on clinical appropriateness and cost-effectiveness. SDL drugs are subsidised and the list is regularly reviewed to ensure access and affordability of treatments for a wide range of illnesses. The SDL is a good guide for doctors on which are the effective drugs, based on sound clinical evidence. SDL drugs should be used as a first choice, unless there are medical indications otherwise. As Dr Chia has suggested, we will expand the use of Health Technology Assessment. We will apply it for medical devices and implants used in our public hospitals and the purchase of new costly technologies. This involves a rigorous review of patient outcomes and cost-effectiveness. We will do so in an efficient and targeted manner, to avoid increasing administrative costs. Assoc Prof Fatimah Lateef and Mr Yee Jenn Jong suggested close monitoring of insurance claims and healthcare consumption patterns. We will do so. However, we will need the support of our healthcare professionals, providers, patients and families to do this effectively. To better manage healthcare inflation, we will need to curtail unfettered choice, which does not translate into outcomes. We must work together to keep a lid on healthcare inflation. I am encouraged by Mr Faisal Manap's compliments for the Health Promotion Board's programmes. We will continue to strengthen our efforts in this area, guided by the Healthy Living Master Plan.”
“To meet these challenges, we need to foster greater collective support for healthcare costs. As Mr Sitoh Yih Pin has noted, the Government will raise its share of healthcare spending, from one-third in FY 2012 to 40% or more, going forward. We are strengthening risk-pooling through MediShield Life, in addition to enhancing subsidies, allowing more flexible use of Medisave, and having expanded coverage of Medifund. I thank Members, such as Mr Christopher de Souza, Mr Zainal Sapari and Ms Denise Phua, for raising valid concerns about the long-term sustainability of our system. This is a very important issue and I am glad that many Members recognise the need to manage overall healthcare costs. Patients' co-payments are an important safeguard. In setting co-payments, we need to balance between affordability and the need to focus providers and patients on cost-effective treatments and minimise over-consumption. In many countries, minimal co-payments have distorted the incentives for patients and doctors. As it is a third party – the Government or the insurer – footing the bill, they are less likely to consider the cost of treatment carefully, and may opt for more expensive treatments or drugs which do not lead to significantly better outcomes for patients. The costs are borne by the rest of society, in the form of higher premiums or taxes. Dr Chia has warned us against Page: 82 the pitfalls of such systems. Beyond co-payments, we will also need to work with providers and insurers to better manage healthcare inflation, as several Members have highlighted. Mr Yeo Guat Kwang called on providers to be prudent in offering healthcare services, while Mr Sitoh Yih Pin emphasised the need to tightly control the scope and delivery of services in subsidised wards.”
“Mdm Speaker, over these past two days, 24 Members have spoken about MediShield Life. I am heartened by Members' unanimous support for MediShield Life and what it means – Better Protection, For All, For Life. Many Members spoke passionately of how MediShield Life would help ordinary Singaporeans with large unexpected hospital bills, giving them better peace of mind. A number shared stories of their constituents who were unfortunately struck by serious illnesses and were concerned with how to pay their bills as they had no insurance coverage before MediShield Life. Members also spoke on related issues, such as the Integrated Shield Plans and Employer Medical Benefits. More importantly, Members also raised fundamental Page: 81 issues in healthcare financing, like how we can continue paying for our healthcare now and into the future. Let me start by addressing comments and questions on the larger healthcare system and financing framework in Singapore. I agree with Dr Chia Shi-Lu and Dr Lam Pin Min's observations about the quality and effectiveness of Singapore's healthcare system. We have achieved good outcomes, and at lower cost than most other countries. I earlier highlighted the key principles that have guided us through the years and which will remain important. First, emphasising cost effectiveness, with co-payments to guard against over-provision and over-consumption. Second, ensuring that healthcare is accessible for all Singaporeans, through targeted subsidies. And, third, maintaining sustainability for current and future generations. These principles continue to serve as the foundation for our healthcare financing system, even as we adapt our system to meet Singaporeans' changing needs.”
“Mr Deputy Speaker, I beg to move that the debate be now adjourned.”
“Whether one should buy an IP is very much a personal decision, and may change depending on the stage of life each of us is in, our desired level of health services, and our individual financial situation. Madam, let me conclude. Since the Committee announced their recommendations on MediShield Life almost two weeks ago, I am heartened that Singaporeans from all walks of life, young and old, have welcomed MediShield Life, as have employers and unions alike. 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 sick among us – and a more caring and progressive society, where those who are needy receive more help. Indeed, MediShield Life is a bold move to strengthen collective responsibility, where everyone is chipping in to cover those with pre-existing conditions, helping the less well-off through premium subsidies and financial assistance, and risk-pooling through insurance and family support. This shift is a major and timely undertaking for Singapore. MediShield Life is one major plank of our strategy to improve the social safety net for Singaporeans and build a more caring and inclusive society. At the same time, we will strengthen our efforts to manage healthcare costs, so as to ensure healthcare remains affordable and sustainable in the long term. Every citizen plays an important role in this, by leading a healthy lifestyle and making healthcare decisions wisely. I urge the House to support the Motion. Together, we can then fulfil our desire to live long and live well, and with peace of mind. Madam, I beg to move. [Applause] [(proc text) Question proposed. (proc text)]”
“This will provide peace of mind to all Singaporeans that they will continue to be covered at the basic level, even if they have exclusions on their IPs or drop out from their IP plans. To help provide an accessible and easily understood upgrade option for all Singaporeans, the Government agrees with the MediShield Life Review Committee to work with insurers to develop key features of a standard Integrated Shield Plan that provides coverage based on Class B1 charges. This will provide a good option for those who may want enhanced coverage beyond MediShield Life and we will provide more details after studying this carefully. Some Singaporeans have asked if they should consider giving up their IPs altogether and just rely on MediShield Life. I am not an insurance agent, so it is difficult for me to give specific advice, but I can share my views. I would suggest that they should consider their preferences very carefully and structure their insurance coverage according to their needs and ability to pay over the long term. Many Singaporeans may buy IPs during their younger working years, when they can comfortably afford the IP premiums which are lower, given Page: 61 their younger age. As premiums increase sharply in old age, especially after retirement, some start to find IP premiums unaffordable. While downgrading is an option, it is not an easy decision to make. Many feel unsure about how to do it, or whether to do it. Having a good understanding of IPs and MediShield will enable us to decide on the appropriate insurance coverage for ourselves, so we can make informed choices and spend our healthcare dollars wisely.”
“First, let me explain how IPs work together with MediShield. IPs are in fact made up of two components. First, a MediShield tier which Page: 60 provides coverage sized based on charges for Class B2 and C Wards. Second, a top-up component offered by the private insurer, which provides enhanced coverage for stays in higher ward classes or private hospitals. IP premiums collected by insurance companies are similarly divided into two components: first, the MediShield component, which is the same as what is paid by those who only have MediShield, and that goes to CPF for the MediShield pool; and the second component, which is the remainder, is kept by the insurance provider as premium for the top-up component. IP premiums are much higher than MediShield premiums because they are based on charges for higher ward classes. When implemented, MediShield Life will simply replace the current MediShield component within the IPs. Singaporeans who are currently on IPs will not be disadvantaged with the introduction of MediShield Life. Given that MediShield Life will take on a larger share of IP payouts, MOH will work with IP providers to take this into account when they set IP premiums. The overall increase for IP premiums resulting from the introduction of MediShield Life is expected to be the same, if not lower than the increase in MediShield Life premiums. IP policyholders will also receive the same premium subsidies on the MediShield Life portion of their IPs. In fact, all IP policyholders will benefit significantly from MediShield Life. They will enjoy MediShield Life coverage for life, including pre-existing conditions, even if these have been excluded from coverage by their IPs.”
“But more can be done to encourage both employers and employees to shift to portable medical benefits built on MediShield Life. The NTUC has made this suggestion in its submission to the Committee. I am encouraged that the public service has taken the lead to increase its employer Medisave contribution to public officers, to help them pay for MediShield Life or Integrated Shield Plans that are built upon MediShield Life. I hope more employers and unions will work together to do this for their workers. SNEF, NTUC and the Government have formed a tripartite working group to look into this issue and the Government will also consider strengthening incentives to companies who are willing to provide portable medical benefits that ride on MediShield Life for their employees, as recommended by the Review Committee. As a national health insurance scheme, it is essential that MediShield Life remains sustainable in the long run. The Committee has therefore stressed that we must set aside sufficient reserves and other provisions in the MediShield Life Fund to prepare for future liabilities, including long-term recurring claims and future premium rebates that arise from distributing premiums over our lifetime. I should stress that MediShield Life is a not-for-profit scheme. The reserves remain in the pool, for the protection and benefit of the policyholders. The Government will continue working with the actuaries and CPF Board to ensure adequate provisions are made for expected future payout commitments as well as unforeseen circumstances. Let me now move on to another topic that the Committee had studied, on the Integrated Shield Plans (IPs). Many Singaporeans want to know how their IPs will be affected with the implementation of the MediShield Life.”
“Universal lifelong coverage under MediShield Life ensures that all Singaporeans will always have assurance against large healthcare bills. It is in line with our move to a more inclusive society with stronger collective responsibility. To achieve this, the MediShield Life Review Committee has recommended that MediShield Life coverage be mandatory for all Singaporean Citizens and Permanent Residents, without exceptions. The Government fully agrees with this. As a national scheme, MediShield Life must cover all Singaporeans. We are providing very significant help to all, through Premium Subsidies and additional support, to ensure that everyone is covered by MediShield Life and that no Singaporeans will be denied coverage due to financial need. This will enable all Singaporeans to play our part in contributing to our national risk pool and benefit from the lifelong coverage. Page: 59 Some have expressed concerns about duplication in coverage for those with private insurance plans or employer medical benefits. Unlike MediShield Life, other healthcare coverage may not be guaranteed for life. Employees with healthcare coverage from their employers will lose such coverage when they leave employment or retire. For those with other private insurance, they may lose this coverage if they are unable to pay for the premiums when they grow old and may not be able to re-apply for coverage later if they have already developed some health conditions. MediShield Life provides an opportunity for stakeholders – employers and unions – to work together to better assure our workers of lifetime medical coverage and not just for the duration of their employment. The 1%-point increase in the employer Medisave contribution rate from 2015 will help.”
“In order to ease the shift from MediShield to MediShield Life, we will also provide transitional subsidies, over and above Permanent Subsidies and assistance, to all Singapore Page: 58 Citizens who face premium increases, for four years regardless of income. For most households, the additional 1%-point employer's Medisave contribution from next year will be sufficient to cover the increase in their MediShield Life premiums. In fact, after Government subsidies, total MediShield Life premiums for most households will remain within annual Medisave inflows, with no additional cash outlay needed. With substantial Government subsidies and support, premiums will be more affordable for most Singaporean households. Let me illustrate. In the first year of MediShield Life, with Premium Subsidies and first year transitional subsidies, the maximum premium increase will be less than $3 per month for the lower income, and no more than $6 per month for the higher income. Even after transitional subsidies have been phased out from the fifth year onwards, Singaporeans from lower income households will continue to benefit from permanent Premium Subsidies. Their premium increases compared to MediShield today will be no more than $11 per month. Those from high income households will see a maximum premium increase of $30 per month. All Pioneers will pay less for MediShield Life premiums than today, as I explained. For Pioneers aged 80 and above in 2014, they will have their premiums fully covered for life, after Premium Subsidies and Medisave top-ups. Madam, we are able to afford the hefty $4 billion package of Government help for MediShield Life because of our good governance, strong economy and sound public finances.”
“The Government will bear the bulk of the cost of including all Singaporeans, including those with pre-existing conditions. With the Government covering much of the cost, Singaporeans will need to pay only a small increase from their current premiums due to universal coverage to include everyone. This strikes a good balance between demonstrating shared responsibility and inclusivity while keeping premiums manageable. Overall, MediShield Life premiums will need to increase due to the enhanced benefits for the scheme, better spread of premium payments over a lifetime for those of working age, as well as a small component due to the collective effort for those with pre-existing conditions. The premiums can be fully paid for with Medisave. We will revise the Medisave withdrawal limits from time to time, to ensure that they always fully cover the MediShield Life premiums. I want to assure Members that those who need help with premiums will always receive support. For the Pioneer Generation, there will be significant Premium Subsidies of up to 60% as well as Medisave top-ups of up to $800 for them, for life. They will pay less for MediShield Life compared to MediShield today, but with better benefits. The Government will provide support also, for the lower to middle income households through Premium Subsidies, which will be a permanent feature in MediShield Life. Up to two-thirds of the population will be eligible for Premium Subsidies. For those who need more help to pay their premiums even after these subsidies, Additional Premium Support will be available, similar to Medifund. No Singaporean will lose MediShield Life coverage due to financial needs.”
“Under the current MediShield, this bill will exceed the claim limits, and after adding the deductible and co-insurance, Mr Tan would have to pay close to $4,700. MediShield Life's higher claim limits will fully cover the bill amount. Together with the lower co-insurance rate, Mr Tan's out-of-pocket payment will be nearly halved – he now only has to pay $2,400 of the $8,000 bill, which can be covered by Medisave. The Committee's recommendation for the lifetime claim limit to be completely lifted is also in line with MediShield Life's intent to provide lifelong coverage and will ensure that those who accumulate large bills over time, such as dialysis patients, will continue to be covered for life. While the Committee recommended significant increases in the claim limits, it felt that deductibles ought to be maintained at the current levels, despite calls to remove or lower them. Deductibles help to keep premiums affordable, by sieving out smaller bills. It ensures Page: 57 that MediShield Life remains focused on providing assurance against the fear of large bills, instead of paying for smaller amounts that can be covered by Medisave. The Committee also highlighted that premium affordability after retirement needs to be addressed. Many Singaporeans had suggested spreading out premium payments while they were working so as to better afford premiums during retirement. We agree with the Committee's recommendation that premiums should be more evenly distributed throughout one's lifetime. By paying premiums ahead during our working years, we build up a pool of rebates to cushion future premium increases during retirement. We recognise that the shift to universal coverage to bring those with pre-existing conditions into MediShield Life will need significant support.”
“Page: 56 The key principles of cost-effectiveness, accessibility and sustainability are sound and have served us well. However, we can do more to give Singaporeans greater assurance and peace of mind about healthcare costs, especially large and unexpected bills that may cause financial hardship to patients and their families. During Our Singapore Conversation, Singaporeans expressed support for greater collective responsibility, to come together as a community and as a nation, to provide help to those who meet with unexpected shocks. It is for these reasons that we decided to embark on MediShield Life – a national insurance scheme – as a decisive step towards this objective. The MediShield Life Review Committee took on the mammoth task of formulating recommendations on MediShield Life. They worked hard to listen to Singaporeans and weighed the pros and cons of the many ideas and suggestions received to come up with a comprehensive package of well thought-through recommendations. In doing so, they had to strike a balance between keeping premiums affordable for all Singaporeans while focusing on the most valued and impactful benefits. The benefit enhancements suggested by the Committee are significant and focused on large bills, which Singaporeans have expressed the most concerns with. Raising the claim limits will allow MediShield Life to cover more of such large bills, while lowering the co-insurance, which is the portion paid by patients, will reduce the out-of-pocket burden of our patients. Take, for example, Mr Tan, who was warded for a heart attack in Class B2 Ward. He incurred a bill of $8,000 after Government subsidy. By the way, this is a fairly large bill, as only an estimated four in 100 subsidised Class B2 and C bills are of this amount or higher.”
“The second hallmark of a good system is one that ensures that healthcare is accessible to all. To achieve this, we must calibrate what the patient needs to pay carefully. The very sick and the needy naturally need more help. This is why we vary subsidies depending on income, as well as the Annual Value of one's residence, as a proxy for one's means and wealth. This enables us to target subsidies at those who really need it. For those who still cannot afford their share of their bills, including those living in properties with higher Annual Value but are facing genuine financial difficulties for valid reasons, there will be additional help, such as from Medifund. Finally, our healthcare system must be sustainable. Otherwise, our children's generation will be paying for the bulk of our healthcare costs when we are old. With a growing number of elderly, our children will face an immense burden if we do not manage overall costs. We must learn from the experience of other countries. Many are coming under increasing strain as their shrinking workforce struggles to pay for the healthcare costs of an ageing population. An example is Hong Kong, where healthcare is made affordable through subsidies financed by taxes. The constant challenge is how to balance the finite government budget among the competing needs of healthcare, social services, education and so on. Insurance systems may find that premiums collected are increasingly unable to support the coverage. Some have opted to cut back on the scope of coverage and benefits. This is why we need to ensure that the Government, providers and patients, all have a responsibility in paying for and managing healthcare costs, so that their interests are aligned. This helps to keep healthcare not only affordable but sustainable, too.”
“In Germany, for example, co-payments are low but premiums are high, and employers and employees contribute up to 15.5% of their income towards the insurance fund. As Germany's population ages, not unlike Singapore today, their financing model is coming under increasing pressure. This is why co-payments remain a cornerstone of our healthcare financing framework to guard against over-consumption and over-provision. To build a cost-effective system and manage healthcare costs, we need to work further with the community, healthcare providers and insurers to do three things. The first thrust is to continue efforts we announced earlier during the Committee of Supply, to help every Singaporean live a healthy lifestyle. We will work with the community partners to make Page: 55 healthy living as effortless as possible. The second thrust is to ensure that healthcare dollars are spent wisely. The Government will continue to support healthcare providers to improve productivity and encourage cost-effective treatments. Providers should not prescribe more costly tests and treatments simply because patients are covered by insurance, if these provide limited value. Finally, the third thrust is to work with insurers and coordinate with the CPF Board, as the MediShield Life operator, to take a closer and harder look at charging practices, as the MediShield Life Review Committee has suggested. Today, hospital bill sizes are published on MOH's website to encourage awareness and allow for comparisons. The Government will do more and work with insurers to develop a framework for sharing of information on unusually large bill sizes and study the reasons for exceptionally high claims if they observe a certain pattern of claims or behaviours by healthcare providers.”
“I will elaborate more on MediShield Life later. Together, enhanced subsidies, greater use of Medisave and the shift to MediShield Life will provide greater support for Singaporeans to keep healthcare affordable. Our national healthcare spending has risen and Government spending on healthcare has risen even faster. What matters, however, is not how much we spend, but how we spend it, and the outcomes we get. The key is getting the best outcome at the lowest cost possible. At 4% of GDP, we currently spend less than most other developed countries, but with good outcomes. Life expectancies are high and rising, and our infant mortality rates are among the lowest in the world. However, we are still young compared with many developed countries and we will spend more as our population ages. Medical and technological advancements coupled with expectations for the latest treatment will also increase costs. We must continue to manage overall healthcare costs to ensure that they do not translate to sharp increases in insurance premiums. So, what are the hallmarks of a good system? One that achieves high quality outcomes, while being cost-effective, accessible to all, and sustainable for current and future generations. First, on cost-effectiveness. Co-payment imposes discipline on both providers and patients to focus on the most clinically-appropriate and cost-effective option. National insurance schemes with minimal co-payment at the point of treatment may sound alluring, but may not give the best outcomes. With minimal or no co-payment, patients are likely to consume more, or providers supply more – and more does not mean better. The costs are ultimately borne by the rest of us, in the form of higher premiums or taxes.”
“Over the last 10 years, we have increased the amount of Medifund assistance three-fold – from $34 million in 2003 to $102 million in 2012. These changes have made financial assistance more readily available for Singaporeans and also strengthened the assurance that all Singaporeans, regardless of income, would receive the care that they need. The Government's spending on healthcare will double to about $8 billion this year from just three years ago. The Government has also committed another $8 billion for the Pioneer Generation Package, to provide enhanced support for their healthcare needs, for life. Second, we are allowing more flexible Medisave use to further reduce Singaporeans' cash outlay for healthcare expenses. We have expanded Medisave use to more types of chronic diseases, and recommended screenings and vaccinations. By next year, we will be extending Medisave use to scans needed for treatment and diagnosis, and allowing the elderly more flexible use of their Medisave for outpatient medical treatment. With more uses for Medisave and longer life expectancies, we must also ensure that Singaporeans have enough Medisave for their old age needs. Therefore, for the elderly and lower income, the Government regularly tops up their Medisave balances through GST Vouchers and Workfare. Employers too, play their part, and will contribute an additional 1%-point to their employees' Medisave accounts starting from next year. Page: 54 Finally, MediShield will be enhanced and renamed as MediShield Life, to provide better, lifelong healthcare insurance protection for all Singaporeans. MediShield Life complements the other policy shifts by targeting larger bills. By sharing the risk among everyone, individual patients pay less of their bills.”
“Before going through the details of the Committee's recommendations, it is important to put in context the shift to MediShield Life as part of the broader changes in how we help Singaporeans pay for our healthcare. Many Singaporeans enjoy good health, but we worry about healthcare costs, for ourselves and for our parents. Spending on health and aged care will continue to grow with our rapidly ageing population. Families are also getting smaller. What used to be shared Page: 53 among several siblings is now shared among few and sometimes none. Our healthcare financing framework, consisting of heavy Government subsidies together with the 3Ms – Medisave, MediShield and Medifund – has served us well so far. However, it is not perfect and will need to constantly evolve to meet future needs arising from changing demographics. Social safety nets will also need to be strengthened, to give greater peace of mind. We announced three significant shifts in healthcare financing last year – increasing Government's share in healthcare spending, enhancing flexibility in Medisave and strengthening collective responsibility through MediShield Life. In doing so, we remain mindful to reinforce the ethos of individual effort and responsibility for the family – values that keep our society together and our economy strong. First, Government will do more. The Government has already increased healthcare spending significantly and will continue to do so. We have enhanced subsidies for outpatient and long-term care, and expanded coverage of the Community Health Assist Scheme (CHAS) for primary care. We have expanded Medifund assistance for more long-term care services, and for primary care.”
“Mdm Speaker, I beg to move, "That this House endorses Paper Cmd 4 of 2014 on 'MediShield Life Review Committee Report' as the basis for designing MediShield Life, to provide every Singaporean with better lifelong protection against large medical bills through better collective support, in a scheme that is financially sustainable, affordable to all, and strengthens our social safety net." At last year's National Day Rally, the Prime Minister announced the shift from MediShield to MediShield Life – to provide Better Protection. For All. For Life. As MediShield Life is a significant move, we wanted to seek as many Singaporeans' views as possible on this new scheme. We appointed the MediShield Life Review Committee in November 2013 to review and study the proposed parameters, and consult widely with the public and key stakeholders. Over the last eight months, the Committee has worked very hard to engage Singaporeans, and made significant and valuable recommendations for the new MediShield Life scheme. Last month, the Committee submitted its report to MOH. We have accepted all its recommendations on the design of MediShield Life. The Committee has also made many good recommendations and useful proposals in related areas. We will study these in greater detail. Committee Chairman Mr Bobby Chin and some of his committee members are with us today in the Chamber. I would like to place on record my deep appreciation for their contributions [Applause]. I would also like to thank the many Singaporeans who gave their views and suggestions. Madam, the introduction of MediShield Life is a major shift in our healthcare financing framework.”
“The PEG was introduced in July 2010 as an additional talent recruitment measure of the public healthcare clusters to attract more Singaporeans from overseas to supplement the local pipeline of doctors. The PEG was extended to dental students in February 2012. As at end FY2013, 438 medical students have been offered the PEG. Four hundred and sixteen of them have accepted the offer, three decided not to take up the offer, while 19 are still considering. Eleven dental students have been offered the PEG, of which, nine have accepted and two did not take up the offer. In total, $18 million has been reimbursed to PEG awardees.”
“From March 2010, MOH allowed the use of Medisave for elective hospitalisations and day surgeries overseas to give Singaporeans additional choices of Page: 150 hospitals when considering elective treatments. From 2010 to 2013, there were about 580 Medisave claims for overseas electives amounting to $1.5 million. The majority of the claims were for deliveries. On average, patients stayed about two days for the overseas hospitalisations.”
“The Interim Caregiver Service (ICS) aims to support patients and their caregivers in the transition from hospital back home. Under this service, we provide patients who require help with personal care, a caregiver who can support them in their activities of daily living when they return home, for a period of about two weeks. This service helps families work out the long-term caregiving arrangements for the patients, such as waiting for new foreign domestic workers to arrive. MOH started the interim caregiver service as a pilot at Changi General Hospital with NTUC Eldercare, a social enterprise, and Thye Hua Kwan Moral Society, a voluntary welfare organisation, in March 2013. This pilot has since been extended to include six acute hospitals and four community hospitals. The ICS has benefited close to 700 patients thus far. Over 60% of the patients are able to receive the service on the actual day of discharge or the very next day while over 80% do so within three days. Nevertheless, some 60 patients considered the service but had turned down the service due to a number of reasons, such as families deciding to take care of the patients themselves and the families' ability to put in place care arrangements earlier than expected. The number of interim caregivers is expected to grow to close to 100 by July 2014, which can potentially serve up to 130 patients a month. With the success of the pilot, MOH will encourage more providers to start the service over the next few months.”
“From 2004 to 2013, there were 9,174 and 18,289 persons above 50 years of age who underwent hip and knee replacement surgeries respectively at public hospitals. Over the same period, 526 and 426 persons aged 30 to 49 years underwent hip and knee replacement surgeries respectively at public hospitals. Common bone and cartilage conditions requiring joint replacement surgeries are hip fractures and osteoarthritis of the hip and knee joints. Fractures of hip joints are more common in the elderly and post-menopausal women due to thinning of bone structures (osteoporosis). Elderly patients are also at a higher risk of suffering fractures from falls. Osteoarthritis is more commonly observed in persons who are of advanced age, are overweight and/or have had previous joint injuries. MOH and HPB have several programmes to promote healthy living in the community and minimise the risk of developing bone and cartilage conditions. For example, "Lose to Win" is a structured programme to lose weight and to prevent obesity; STEP (Strength Training Exercise Programme), aims to prevent falls by improving the physical function of older adults; and OPTIMAL (Osteoporosis Patient Targeted and Integrated Management for Active Living Programme) to encourage our elderly to lead an active lifestyle. MOH and HPB will continue to partner various communities to educate our population on fall prevention and encourage healthy living.”
“Community Hospitals (CHs) play an important role in providing sub-acute and rehabilitation care for patients who have been stabilised from an acute hospital episode but still require continuing care during their recovery phase. MOH is building more CHs, with Jurong Community Hospital and Yishun Community Hospital expected to be completed in 2015. We are also working with CHs to enhance their capabilities, in particular, through manpower training and development, in order to better serve the needs of an ageing population. With the expansion of the CH sector, MOH is, indeed, open to working with new players to help run and add value to these services. Potential CH operators must have the capability to provide clinical services and attend to the continuing care needs of patients. They must also be able to work closely with other health and eldercare providers within the Regional Health System to provide integrated care to patients. They will need to have clinical, resourcing and administrative capabilities to run the hospital in a safe and sustainable manner. Co-operatives, social enterprises, public healthcare clusters, VWOs or private operators which are able to meet the criteria will be Page: 148 eligible to operate CHs.”
“Mdm Speaker, may I seek your consent to move, "That the debate be now adjourned."”
“Mr Deputy Speaker, may I seek your consent to move, "That the debate be now adjourned."”
“Professionals like architects, IT experts and urban and transport planners can also share their ideas on how we can build an intelligent city for all ages, leveraging on technology to make living easier for seniors, allowing them to participate as an active member of our society. The formulation of the action plan will involve various Government agencies and Ministries, private and the people sectors. We will consult widely and we hope that the plan will be ready by next year. The ideas and suggestions we gather will then be incorporated into our national action plan for successful ageing. We hope that, through the collective efforts of Singaporeans – of all ages and from all walks of life – we can build a Nation for All Ages. Singapore celebrates 50 years as a nation next year. The last 50 years of the Singapore Story is an amazing one of rapid development and growth, fuelled by youthful idealism and the strife for success. For the next 50 years and beyond, the Singapore Story will surely continue. But it will not be identical to the last 50 years because we are now more mature and also wiser, economically stronger and more confident about our future. But we are still young as a nation. We must remain youthful in our ideals and aspirations, even as each of us grow older. We will turn longevity into our advantage. We will work together to forge an action plan to make Singapore a Nation for All Ages. This will be the best tribute to our pioneers and the best gift to our next generation. 4.19 pm Page: 59”
“Through this programme, the more reserved seniors have become more active and participated in activities which they had not done before, such as ukulele classes and even signing up as a volunteer for the 2015 SEA Games. The pilot run, which was conducted in 2013 with 68 seniors, received very good feedback through various success stories shared by participants. We also want to hear suggestions from unions, employers and HR practitioners on how we can tap the talents and growth opportunities from a workforce that will enjoy longer years of productive lives and how the workplace can be made more welcoming and empowering for our seniors to put their experience and talents to good use. St Luke's ElderCare is a good example. Its comprehensive age-friendly HR strategy has empowered seniors and developed a culture of lifelong learning and this allows seniors to be more competent, confident and appreciative of their work while at the same time keeping Page: 58 them engaged. St Luke's has shown that, given opportunities, seniors can continue to contribute meaningfully. We also welcome ideas from community leaders, healthcare professionals and active agers on what we can do collectively to encourage and support our seniors to age actively and preserve good health for as long as possible. It is also important to explore how we can encourage and provide better support for multi-generation families, in terms of housing and amenities in the estates, how we can support them in strengthening family values and intergenerational bonds. For example, we are rolling out larger 3Gen flats for multigenerational families to stay together and injecting aged care services in our estates so that seniors can age at home close to their loved ones.”
“Page: 57 Moving beyond developing aged care services, the Committee will coordinate a whole-of-nation effort to put together a coherent national agenda to prepare our population for successful ageing. This is an action plan that will holistically chart strategies and initiatives to support and enable Singaporeans to achieve meaningful and successful ageing. It will cover seven diverse areas – lifelong learning for seniors, employment, volunteerism, urban infrastructure, healthcare, retirement adequacy and research into ageing. Ageing is a conversation that involves all of us – our aspirations for our silver years, how we hope to live our lives to the fullest, how we wish to relate to our peers and the younger generation, and the kind of society we wish to live in when we grow old. It is a conversation not just among the old, but also with the young. From the middle of this year, the MCA will hold a series of public consultations to hear the aspirations and suggestions from Singaporeans on what we should do to collectively plan for successful ageing for our seniors and ourselves in time to come. We will also engage voluntary welfare organisations, businesses, unions and academia in this whole-of-nation conversation on ageing. Let us now change the conversation about ageing – from worrying about the challenges that come from ageing to celebrating longevity. We want to hear ideas from educational institutions, voluntary welfare organisations and senior learners themselves on what can be done to help seniors continue to learn new things so that they can remain active and their days filled with excitement. For example, the Council for Third Age (C3A) has initiated Kopi and Toast, where active seniors mentor and encourage less active seniors to adopt an active lifestyle.”
“The Committee is currently finalising its proposed recommendations to MediShield Life and I understand that they will be ready to share some of these details next month. My Ministry will review and finalise the design of MediShield Life after the Committee has submitted its final report and aim to implement it by the end of 2015. Madam, we have announced the Pioneer Generation Package to recognise and honour our pioneers and address their concerns on healthcare. Together with MediShield Life and enhancements to subsidies for outpatient care, we reassure our seniors that we will take care of their healthcare needs. We will do more for them. Beyond lessening their worries, we want our seniors to live life to the fullest, to always have something to look forward to and continue to achieve their aspirations in their silver years. While we speak of the challenges of an ageing population, we should not forget that ageing and longevity are a blessing after all. We are all living longer and that is a good thing. But we must plan ahead to help Singaporeans age successfully and meaningfully. The Ministerial Committee on Ageing has spent the last few years building up aged care services to support an ageing population. By 2020, we will add about 5,000 nursing home beds as well as expand the capacity of our centre-based services. We will also give home care a big push to support seniors to age in place. We have rolled out a set of quality standards on nursing homes and we are in the midst of developing guidelines for home care. Aged care services are made more affordable with higher and more targeted Government subsidies for the middle- and lower-income families.”
“She has been undergoing dialysis for about a year and suffers from high blood pressure, heart conditions and cataract. In the past year, the total subsidised bill for her hospital stays came close to $8,000. MediShield Life will protect Singaporeans like Mr Hashim and Mdm Wong in the future, reducing the amount they have to pay for their healthcare bills and relieving them of a heavy burden. The Committee has shared with me that most Singaporeans hope that the MediShield Life premiums will remain affordable and can be fully paid for with Medisave so that they do not have to fork out cash for their premiums. Some shared that they are providing for a large Page: 56 family, for their children as well as their elderly parents, and are worried about whether they can continue to pay for their premiums in the future. They hope that the Government will provide those in financial need with more support to pay for their premiums. The Government understands their concerns and we would provide direct help to Singaporeans in three ways. First, we will provide permanent premium subsidies for the less well-off and our pioneers. These are permanent subsidies and not one-off help. To help everyone transit from MediShield to MediShield Life, the Government will also be providing transitional support for the first few years for all Singaporeans, so that the premium increases will be phased in. Secondly, we will provide Medisave top-ups for the elderly and the low-income to help them pay for the premiums. Thirdly, for those who still cannot afford the premiums, we will provide direct financial assistance, such as through Medifund, over and above the premium subsidies.”
“The Committee has to calibrate carefully and strike a balance between providing better protection for Singaporeans and keeping premiums affordable. The Committee shared in March this year its preliminary findings and thinking on MediShield Life. They suggested three key shifts: removing the lifetime claim limit of $300,000; increasing claim limits significantly for hospital stays and outpatient cancer treatments; and cutting patients' co-insurance rates by half. The Government is supportive of these recommendations. If implemented, MediShield Life will pay out more and cover a larger portion of the bills, reducing significantly what patients have to pay. Let me give you some examples of how these will work out. Forty-eight-year-old Mr Yee Kwek Chin was hospitalised for 14 days for stroke. His MediShield currently covered about $5,000 of his subsidised bill and he paid the remaining $4,800 using his Medisave. With the higher daily ward limits and lower co-insurance rates, the Committee has recommended for MediShield Life, patients like Mr Yee would need to pay only $2,500 of his bill, or half of what he has to pay today. Currently, MediShield coverage stops when one reaches 91 years old. For those Singaporeans who are older, like Mr Yasmuddin Rasul, who is 92 years old, they will not be covered under MediShield today. With MediShield Life, there will be no age limit. Older Singaporeans will be brought into the scheme and be covered for life. The removal of the lifetime claims limit will benefit long-term dialysis patients like Mr Hashim Abdul Rahim whom I met last week at the NKF Dialysis Centre. MediShield Life will also benefit patients like Mdm Wong Kui Lan, who is 65 years old and has no insurance coverage.”
“This is a long-term commitment, so that everyone will always be protected and have peace of mind. The MediShield Life Review Committee has been working since last November to review and recommend the key benefits and parameters for MediShield Life. Led by Mr Bobby Chin, the Committee has intensively engaged people of all ages and backgrounds. They have also spoken to key stakeholders and experts, such as the unions, grassroots, employers, academics, insurers, actuaries and healthcare professionals. I would like to express my sincere appreciation for the Committee's hard work and for those who have contributed their views, including the Government Parliamentary Committee on Health, which has put up a comprehensive list of proposals. It is, indeed, encouraging to hear that MediShield Life has received broad-based support from Singaporeans. Those with friends or family members who could not be covered by insurance due to their pre-existing conditions, such as those with cancer, stroke or heart conditions, were especially appreciative that MediShield Life would cover them and give them peace of mind about healthcare costs. I visited a National Kidney Foundation (NKF) Dialysis Centre last week in Ang Mo Kio and some of the patients there could not get insurance protection because of their kidney conditions. But with MediShield Life, they will be able to get the protection and peace of mind they have longed for, not just for dialysis treatments but also for hospital bills that they may face from time to time. Many Singaporeans understand that premiums will have to go up when benefits are improved. Some are concerned that improvements to benefits would lead to over- Page: 55 consumption of healthcare services, resulting in higher costs and higher premiums in the long run.”
“It is very difficult to estimate what kind of healthcare costs we will be facing because there are many, many drivers for healthcare costs. Ageing is one aspect; development of new technology is another aspect; easier access will also drive up demand and demand will drive up costs. Last year, we expanded MediShield to also cover congenital and neonatal conditions. With each improvement, Singaporeans are better protected. Moving from MediShield to MediShield Life next year is a much more significant shift. It will provide stronger and lifetime protection for all of us today and our children in future. It will also reflect a stronger sense of community, because it will involve Singaporeans coming together collectively to look after one another. This is what an inclusive and caring society is about. Page: 54 MediShield Life works on the concept of risk-pooling. All of us will each contribute our share into the pool and the few among us who face large hospital bills can then draw on the pool to help pay for their bills. This way, all of us can be protected and assured. However, for MediShield Life to work to protect all Singaporeans, all of us need to do our part. We must contribute our share of the premiums and we must do all we can to keep healthy. And I would encourage you to adopt the eight steps promulgated by Dr Janil Puthucheary. That would help us keep healthy longer. Healthcare providers need to deliver cost-effective services and avoid driving up demand or pushing up claims which will eventually result in higher premiums in future years. The Government has committed to ensuring that premiums for MediShield Life are affordable for everyone, not just the high income, but also for the middle and lower income.”
“Mdm Speaker, I rise in support of the Motion. Madam, the President's Address outlined several programmes to strengthen our social safety net. One of the key areas is keeping healthcare affordable for Singaporeans. Page: 53 In the last few years, we have reshaped our health and aged care services – adding capacity, bringing services closer to citizens and we have taken steps to make healthcare services more affordable for Singaporeans. We have increased subsidies in our hospitals and intermediate and long-term care facilities. We have expanded Medisave uses in the outpatient setting for chronic disease treatment, selected vaccinations and screenings. To make primary care at GP clinics more affordable, we introduced the Primary Care Partnership Scheme which later became the Community Health Assist Scheme (CHAS). CHAS was last enhanced this year with the removal of the age criterion and the inclusion of additional chronic diseases. We are going one step further to enhance CHAS by extending it to all pioneers regardless of their income and assets, and with even better benefits. In the next few years, we will put in place a new social compact so that all Singaporeans know that they are looked after, in good times and bad. One major initiative in this direction is the proposed MediShield Life. MediShield has played an important role in helping Singaporeans with large medical bills. Over the years, we have improved MediShield to keep up with the changing needs of Singaporeans. We extended the maximum age of coverage because Singaporeans are now living longer. We increased the claim limits to keep pace with medical inflation and improvements in healthcare technology. Here, I must disagree with Mr Giam that healthcare inflation is easy to estimate.”
“Madam, in view of the interesting speech that Dr Puthucheary has been delivering, may I seek the consent of the House to extend the speaking time for Dr Puthucheary?”
“The Global Page: 37 Burden of Disease Study 2010 ranked Singaporean men as having the world's second highest healthy life expectancy (HALE) at 68.1 years, and our women with the fourth highest HALE at 70 years, compared to 11th and 14th 20 years ago. We will help keep seniors healthy, active and safe in the community and provide good quality aged-care services when our seniors require them. We will create an environment that sees ageing as an opportunity and encourages our seniors to remain physically, economically and socially active and continue contributing to nation-building. We look forward to a Singapore where our seniors feel empowered and have a good quality of life as they age. Singapore will be a nation for all ages. Page: 38”
“The implementation of MediShield Life in end-2015 will provide lifelong universal coverage for all Singaporeans. We will increase direct patient subsidies in specialist outpatient clinics and enhance drug subsidies to lower-income patients' out-of-pocket expenses. The Pioneer Generation Package, to be rolled out over the next two years, will provide additional healthcare subsidies for our pioneers. We will also review financing for long-term care to better address citizens' concerns on the cost of severe old-age disability and long-term care. Finally, we will introduce more flexibility of Medisave use to cover more outpatient treatments. Additional subsidies to increase affordability must be complemented by efforts to manage overall healthcare costs to ensure the financial sustainability of these reforms. MOH will continue efforts to address the drivers of healthcare costs, including the use of new drugs and technologies, and to ensure appropriate use of healthcare services. Central to our mission as MOH is to help Singaporeans stay healthy. We will continue to work on the planning and delivery of preventive health services, including health promotion and education. We are implementing the Healthy Living Master Plan to ensure that Singaporeans have access to a healthy lifestyle that is affordable in the workplaces, schools and in the community. Going forward, MOH and the Health Promotion Board (HPB) will work with stakeholders to target the avoidable risk factors, such as obesity and tobacco use. We will continue to work on the Ministerial Committee of Ageing's vision of enabling our seniors to age-in-place gracefully. Our seniors are healthier than before.”
“We will step up efforts to recruit and retain healthcare workers, and create more opportunities for their professional development and career progression. We will also continue to innovate to raise productivity. MOH's focus is to create an integrated and patient-centric healthcare system that delivers better patient care. Through the development of Regional Health Systems, public, private and voluntary welfare organisation (VWO) healthcare providers across different care sectors work in partnership to keep our population healthy and deliver integrated care to patients. We will enhance primary care, strengthen partnership with GPs and develop the new Family Medicine Clinics (FMCs) so that patients, especially those with chronic conditions, Page: 36 will be better cared for by their regular family physician with support from the Regional Health Systems. As we increase intermediate and long term care capacity, we will also raise quality of care and strengthen capabilities of our service providers. In particular, we will expand the community-based services, such as the network of Senior Care Centres, and introduce measures to raise standards and quality of care. We will also develop and implement a new framework for home care services which comprehensively covers both home social and home health services, and provide more training and support to caregivers in taking care of their family members. We are also integrating our processes and IT systems across healthcare sectors, leveraging on the National Electronic Health Record System, which has been rolled out progressively and will be further enhanced over the next two years. MOH will continue to reform the financing framework to keep healthcare affordable for all Singaporeans.”
“MOH's vision is to enable all Singaporeans to live well, live long and enjoy peace of mind. To achieve this vision, we will improve the accessibility, affordability and quality of healthcare for Singaporeans as outlined in the Healthcare 2020 Master Plan. We will continue to develop new strategies and programmes to ensure that our health and aged care system meets our future needs. Over the past five years, we have expanded the capacity of our healthcare system by more than 2,000 acute, community and nursing home beds. In addition, we have opened several new facilities, including the NUH Medical Centre and the new National Heart Centre. We have also expanded and renovated six polyclinics, and opened six new Family Medicine Clinics. We have also expanded our healthcare professional workforce by almost 50% between 2008 and 2013. Our third medical school, the Lee Kong Chian School of Medicine, admitted its inaugural student intake in 2013. We have improved affordability through a series of health financing reforms to keep healthcare cost affordable for patients. These include top-ups to Medisave, enhancements to MediShield, higher subsidies, including expansion of subsidies for long-term care, screening and chronic diseases. We learned valuable lessons in responding to dengue, haze and emerging infectious diseases like H7N9 and MERS-CoV in 2013, and strengthened our emergency preparedness capabilities. MOH will continue to add more healthcare facilities. Altogether, from 2014 to 2020, we will add over 11,000 more acute hospital, community hospital and nursing home beds. In addition, we plan to build up to six new polyclinics by end-2020.”
“Under the ISP, we will continue to encourage eligible Singaporeans to undergo screening, not just for colorectal cancer, but also other cancers, as well as for chronic diseases. We recognise that "prevention is better than cure". Hence, MOH and HPB have been stepping up our efforts on encouraging healthy living in the population over the past years, including having a balanced diet, doing regular physical activity, leading a smoke-free lifestyle and going for regular health screening. To further consolidate these efforts and to make healthy living accessible, natural and effortless for all Singaporeans, MOH has developed a Healthy Living Master Plan which aims to keep Singaporeans healthy and free of illness for as long as possible through the adoption and maintenance of a healthy lifestyle.”
“Colorectal cancer is the most common cancer in Singapore. Screening for colorectal cancer in the recommended age-groups can detect cancers early, and has been shown to reduce mortality and improve health outcomes. Hence, the National Colorectal Cancer Screening Programme was established in 2011. Outreach for the programme was enhanced when colorectal cancer screening was incorporated into the Integrated Screening Programme (ISP). Under the ISP, Singaporeans and Permanent Residents aged 50 years and above are invited to screen for colorectal cancer annually using the Faecal Immunochemical Test (FIT) kits at the Community Health Assist Scheme (CHAS) GP clinics. The FIT test is available free of charge and CHAS patients enjoy a subsidy of $18.50 for each related GP consultations up to two visits a year. Under the CHAS scheme, GPs can also make subsidised referrals for those with abnormal results to have further tests done at the public hospitals, such as colonoscopy. Those who do not wish to go for FIT may opt for colonoscopy once every 10 years to screen for colorectal cancer. Medisave can be used to pay for colonoscopy. However, the procedure is not without risks as one in 10,000 may have perforation of the colon or other complications. Based on data from the Health Behavioural Surveillance Survey in 2013, 33.8% of Singaporeans aged 50-69 years old were screened for colorectal cancer with either FIT or colonoscopy within the recommended period. While this is an improvement from screening coverage of 26.8% in 2011, we will continue to step up our efforts to raise screening coverage with either FIT or colonoscopy. We will ensure that there are sufficient specialists and facilities Page: 124 available to perform colonoscopy for those with abnormal FIT results.”
“Patients who arrive at the Emergency Departments (EDs) are prioritised and attended to based on the severity of their conditions. All life-threatening (P1) cases are attended to immediately. For emergency but less life-threatening cases (P2), the median waiting times and 95th percentile waiting times for consultation are tracked on a monthly basis and they averaged about 24 minutes and 80 minutes respectively. Time taken for admission ranged from 2.6 hours at the median and 9.6 hours at the 95th percentile. Even before admission, medical teams will monitor the patients and institute appropriate investigations and treatments for them. As ED admissions can vary significantly from week to week, due to seasonal and other factors, such as multiple casualties in a traffic accident, it is more meaningful to study monthly trends. Our hospitals have put in place protocols to ensure care is not compromised despite high demand for ED services. At all shifts, the EDs are staffed by at least one senior doctor, working alongside a team of other doctors and ED-trained nurses. Our hospitals also deploy inpatient medical teams to initiate prompt medical assessment and definitive care at the ED, for patients who are awaiting admission. We have also stepped up efforts to encourage patients to visit general practitioners (GPs) for non-emergency conditions, so that our EDs can focus their resources on those who really need emergency services. One example is the GPFirst initiative launched in January this year, where the Eastern Health Alliance works with GPs in the east to educate and encourage the public to tap on GPs to manage non-emergency cases. Page: 123”
“MOH regularly reviews Singapore's healthcare manpower needs taking into account changes in population demographics and disease trends. The Ministry then works with MOE to make the appropriate adjustments to our local healthcare training pipelines. We have increased medical intakes by 80% over the past 10 years, from 230 in 2003 to 413 in 2013, through the expansion of the NUS Yong Loo Lin School of Medicine's medical intake, the establishment of the Duke-NUS Graduate Medical School in 2007 and the NTU Lee Kong Chian School of Medicine in 2013. The local medical intake is projected to grow to 500 doctors annually. Likewise, we have increased the nursing intake by 40% from 1,202 in 2003 to 1,682 students in 2013, through expanding intakes at the Institute of Technical Education and the Polytechnics as well as the Bachelor of Science (Nursing) course at NUS from 2006. We will further increase the nursing intake to 2,750. We will continue to monitor and take into account demographic trends and changes in our healthcare needs in our manpower projection. In parallel, we are working to enhance the attractiveness of healthcare careers by enhancing professional development, career advancement, remuneration, recognition and staff well-being. This is further supported by increased branding and outreach efforts to attract more young Singaporeans to join this meaningful and rewarding sector. Page: 122”
“Our public healthcare institutions will continue to encourage foreign healthcare staff to attend such programmes and to explore more ways to help them adapt to their working environment, so that they can better contribute towards the delivery of public healthcare in Singapore.”
“Public healthcare institutions have put in place programmes to familiarise foreign healthcare staff with the local clinical practice, language and cultural contexts, so as to help them adapt to the local working environment. These programmes cover a broad spectrum of topics, including Singapore's history, culture, policies and regulations, overview of healthcare in Singapore, workplace safety as well as practical resource information and general advice for living and working in Singapore. The programmes typically range from half a day to one day and all newly recruited foreign staff without prior working experience in Singapore are strongly encouraged to attend them. Language courses are also provided where necessary to enable better patient-staff communications. These include training in basic conversational Mandarin, Malay and Chinese dialects and the training duration per course is about 30 hours or more over several weeks. In addition, institutions also run orientation programmes for all new employees. The participation rate in such programmes in each institution varied depending on the profile and roles of foreign staff in each institution. Almost all staff participated in the orientation programmes. For language programmes, about 35% of foreign staff recruited in the last five years had participated in at least one language programme. Some of the foreign staff have been in Singapore for some time and are already familiar with our language and culture Page: 121 and, therefore, do not need to attend such programmes.”
“MOH does not routinely collect data on the situation of non-collection of medicines. However, feedback from the public hospitals indicates that most patients do collect their medicines as prescribed by their doctors. For the few patients who do not, the most common reason cited is that they already have sufficient medicines. Other reasons cited include patients wanting to collect medicines from other sources or at other times, patients not aware that there were medicines to collect or forgetting to collect them. Patients who have financial difficulties will be referred to medical social workers for assessment and provided with financial assistance where necessary. Page: 120 Our public hospitals will continue to improve in communicating and reminding patients to collect their medicines.”
“FSCs will also help to pull together community resources and services to help these families and individuals where necessary. For elderly persons who live alone, there are also befriending programmes and Senior Activity Centres that offer support through centre-based activities and home visits. To increase public awareness of mental health issues, the Health Promotion Board (HPB) conducts public education programmes regularly to promote mental well-being among children, adults and seniors. These programmes Page: 104 include workshops at the workplace where young employees pick up skills to manage stress and build their resilience. A workplace mental health promotion grant was put in place from 2011 to support employers in carrying out mental health promotion activities.”
“Suicidal behaviour has a large number of complex underlying factors, including family, social, economic and mental health issues. A local study based on Singapore's suicide statistics from 2000-2004 had reported that relationship problems were associated with one-third of all suicides and financial or employment issues were associated with a further one third. For suicides amongst elderly, gradual physical disability and suffering were important risk factors especially if coupled with the lack of adequate community and family support. However, it is important to note that it is often not just one factor but a combination of several factors interacting with each other which may trigger suicidal behaviour. In view of the complexities and multi-factorial triggers, multi-pronged strategies are required to help address suicide behaviours. These include collaborative efforts among different Ministries such as MSF, MOE, MHA, MOH and stakeholders in the social sectors. The broad approaches involve: (a) building greater resilience in the population; (b) developing targeted interventions for high-risk individuals, and; (c) increasing public awareness of mental health issues. Building resilience takes place at many levels. In schools, students are taught to set realistic and achievable goals for themselves, build positive and healthy relationships with others and seek help when necessary. There are a variety of professional services to support persons who are at risk. Family Service Centres (FSCs) provide professional intervention and support to help families and individuals resolve their social and emotional difficulties and build resilience, stability and independence.”
“Madam, I thank the Member for the supplementary questions. We have been tracking the outcome of our public education programmes. We have done surveys from time to time to better understand the awareness of HOTA and what are the implications. I do not have the exact numbers with me but from our studies and our surveys, we find that the majority of Singaporeans know about HOTA. They may not know all the implications of HOTA but we do know that a significant proportion of Singaporeans do understand the implications of organ donation under HOTA, and the possibility of opting out. To start with, we are sending letters to all Singaporeans and PRs reaching 21 years of age, to inform them of the option to opt out if they wish to. From time to time, when family members come into contact with the incident of a loved one passing away and they are confronted with the decision about organ donation, they may find it surprising and shocking at the point when they have just lost their loved ones. That is an encounter that we face from time to time at the hospital. When a person passes away, the family members are grieving. At the same time, the doctors and clinicians have to race against time to ensure the viability of the transplant. Therefore, they have to discuss with the family members on this issue that is sometimes very sensitive and very emotive. Therefore, we conduct training programmes for hospital staff so that they are better equipped in dealing with such issues to be able to understand the families' concerns and to manage the process in a more sensitive way. I hope that by doing so, we would be able to improve the success of organ donation.”