Haresh Singaraju
Singapore
“Chair, I have two questions. This surrounds clinical capacity. One is on team-based care, as the Senior Minister of State has mentioned, that it has been around since 2015, and that is something which the clusters have done great works and set up frameworks for.”
“The nurse flags it. Something else is going on. She comes in this time. She tells the doctor that her husband died last year. She has not left the flat since. He refers her through the social prescribing pathway and a link worker to a gardening group three blocks away. She liked gardening. She goes and she goes again.”
“But if this well-being framework exists a year from now, Mdm Tan walks into that clinic and an important arm of a complex chronic care is addressed by the nurse who already knows her by name and social background.”
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“I thank the Senior Minister of State for the reply. I have two supplementary questions. One, from the perspective of a public healthcare doctor, and another from an SAF medical officer and commander. At this juncture, many NSFs who do see us in public healthcare do raise concerns in terms of the social strains they face during these times, and we are aware of social partners that can offer such help. I wonder if we can strengthen the communication between public healthcare and that of the SAF during their NS time, such that we can inform the commanders that these are gaps that the NSFs are facing, and therefore the kind of avenues that we can refer these NSFs to. And on the other front, as an SAF medical officer and commander, I recognise that there are avenues to support these NSFs, in terms of the various social issues they present with. But is such education provided during the commander training, or even during the medical officer courses, such that once we recognise these psychosocial stressors, in terms of who we can refer to within the SAF, as well as externally? Because from my understanding currently, it is not in the curriculum.”
“Chair, I have two questions. This surrounds clinical capacity. One is on team-based care, as the Senior Minister of State has mentioned, that it has been around since 2015, and that is something which the clusters have done great works and set up frameworks for. Yet many of the services, nurse-led, pharmacist-led, allied health-led services are underutilised. How exactly will the Ministry help in terms of the national effort to get patients and citizens to understand and trust the care that these providers provide? And second, is on the aspect of Healthier SG enrolment, where we have had residents who have enrolled across public and private. Have we studied the factors to strengthen that relationship such that patients do not drift across?”
“The nurse flags it. Something else is going on. She comes in this time. She tells the doctor that her husband died last year. She has not left the flat since. He refers her through the social prescribing pathway and a link worker to a gardening group three blocks away. She liked gardening. She goes and she goes again. Her blood pressure finally holds. She did not need a new programme. She needed a care team alongside her and a community partner that mattered to her. Let us build that environment. 8.30 pm Technology and AI in Healthcare”
“As we prepare to inject more professionals into the system, getting this right is not optional. It is the condition for that investment to pay off. Some will say patient preference for doctors is too strong, but care is growing more complex and no single pair of hands can manage it alone. That is why we have trained these professionals in the first place, not to replace the doctor, but to surround the patient. Preference follows familiarity, but familiarity requires introductions and reminders. That is the national effort I asked for. Think of aviation. Co-pilots were trained, but deferential. The captain made every call. The industry changed the default to structured team functioning. Every professional's input carried weight. Accident rates fell. The same principle applies. The clusters can build the frameworks, but shifting public expectation requires more than any single cluster can do alone. My third ask: lead that national effort to help Singaporeans understand and trust the care that nurses, pharmacists and allied health professionals provide. Support the clusters in ensuring investment in training translates into care. Three asks each with a metric, each building on what already exists. Mr Chairman, let me show you what this looks like when all three asks work. A senior enrols at her neighbourhood clinic. Because she stays, her doctor learns her story. Over months, he stabilises her chronic conditions. Once stable, her nurse takes over, adjusting medications, coaching on lifestyle and function preservation. Her care coordinator tightens preventive care. She remains well for a year, then two, then her blood pressure climbs. The nurse titrates. It climbs again. She misses an appointment. The care coordinator calls and brings her back. She misses another.”
“That is precisely why the ask is not an open floodgate, but a mapped, maintained and matched pathway resourced to sustain. But a pathway only works if patients stay long enough to use it. Healthier SG has enrolled over 1.3 million Singaporeans as of August 2025, but enrolment is not yet activation. From what I see in practice, not all enrolled patients have completed even a first health plan. They have signed up, but never sat down. Enrolled patients can still seek care elsewhere. Some will ask, is this not about patient choice? It is. But continuity is not exclusivity. No one loses the right to see another doctor. What changes is the default that one doctor, one team knows you. Subsidies encouraged the first step, but a subsidy is not a relationship. Without activation, patients drift and the social needs that only surface over time never do. My second ask activate what enrolment promises. Publish how many enrolled patients stay and how many actively engaged through follow-ups, screenings and care team visits? We must continuously learn what make patients stay. The Ministry consulted widely before Healthier SG launched; continue that rigour. And resource are providers GPs and polyclinics alike to keep them. Keeping them takes a team. Team-based care is the direction our system has committed to, our clusters have built the frameworks. We have trained nurses, pharmacists and allied health professionals to practise at the top of licence. But without familiarity, many patients choose otherwise and never benefit. What we hear on the ground suggests utilisation is not where it should be. If we build capacity and fail to activate it, the system pays twice: once to train; once when the doctor does the same work.”
“Mr Chairman, I address the Minister on two fronts: strengthening social prescribing and optimising clinical capacity. Beneath both lies one observation. We have built the parts of a better healthcare system, including social programmes, trained professionals and enrolment infrastructure. My three asks are about making them work together. I welcome that social prescribing is already part of our system under Healthier SG, but the referral options remain narrow, largely involving Active Ageing Centres and Sports SG, while the ecosystem around is wide. This limits the match to what matters to the patient and when we match well, they go. To match well, our care teams need a maintained real time directory of what exists in each neighbourhood. We are not starting from scratch. SingHealth Community Hospitals are the world's first World Health Organization Collaborating Centre for Social Prescribing with trained well being coordinators and proven outcomes. The Living Asset Map developed by SingHealth Community Hospitals with the Ministry of Culture, Community and Youth and Singapore Land Authority already captures community assets in real time, updated by practitioners on the ground. The evidence is there. The Minister himself said in Geneva in May 2023, that 60% of health is socially determined, not in hospitals, but in homes and in communities. My first ask follows from his words: scale the Living Asset Map across all three clusters. Map the full ecosystem: arts, culture, heritage, nature, sports, informal community partners and interest groups and resource link workers to close the last mile. Some may worry that widening referrals could overwhelm social partners.”
“Today, over half of our building stock carries the mark. Making the invisible visible changed how an entire industry competed. Workplace culture is no less invisible and its consequences for families are no less real. Australia's Family Friendly Workplaces programme, developed with the United Nations Children's Fund (UNICEF), has certified employers covering over a million employees in under five years and has since expanded to the UK. The model works. Start with the public sector. The Made For Families brand mark already sits in the Strategy Group in the PMO. The architecture is there. The Government has committed approximately $400 million annually for Shared Parental Leave at steady state. Build on that by rewarding certified employees with prominent job listings, enhanced tax deductions and prioritised Government procurement. Make the mark worth carrying. Mr Chairman, in my Budget speech, I proposed a cross-domain well-being framework to tell us whether people's lives are truly improving. This certification is one practical application measuring the domain where aspiration most often meets its quiet barrier. My generation of parents is not asking the Government to raise our children. We are asking our workplaces to not make us choose between raising them and building a career. I ask for a tiered certification that tells family something no fund transfer can – you can still be you and your employer will make room. Progressive Workplaces and Families”
“Young couples today already know what a family-friendly workplace looks like – flexible hours without eyebrows raised, nursing rooms, supervisors who check in not just on output but on how you are coping. The Government itself has described this in detail across five areas under its Made For Families initiative. But no young couple choosing between two job offers can tell which company actually delivers and which just says it does. The Government already has the Made For Families brand mark, two tripartite standards, the Work-Life Ambassador Scheme, the Flexible Work Arrangement guidelines and the new Shared Parental Leave scheme. At least six instruments, and I have not listed them all. Good intentions, every one of them, but no single standard that tells an employer or a jobseeker what a family-friendly workplace actually looks like. I have one ask – pilot a Made For Families workplace certification, a tiered national standard that measures where the workplace truly supports family life. Companies that achieve higher tiers receive funding support and visible recognition, a mark that they carry into recruitment so that young Singaporeans know, "This is a place where I can build a career and a family". This goes beyond young couples. When a workplace gets it right for families, that same culture reaches the parent whose child has a disability, the worker juggling a parent's medical appointment and a child's school schedule, and the senior worker navigating health concerns. A certified workplace supports all of them. We have done this before. The Building and Construction Authority's Green Mark launched in 2005 as a voluntary standard. The Government required public sector buildings to certify first. By 2008, it was statutory for the private sector.”
“Mr Chairman, in my Budget speech, I asked this House, across domains, is this person's life improving? I now turn to the domain where aspiration most often meets its quiet barrier – the workplace. This Government has built strong foundations. Thirty weeks of parental leave takes full effect this April. LifeSG credits, the Large Families Scheme – the financial architecture is sound. Yet our TFR remains at 0.97. The United Nations Population Fund's (UNFPA) 2025 report warned that financial incentives alone are largely ineffective when structural barriers remain. It is not always about money. It is about structure. We certify our food. We certify our childcare centres. Our estates are built for play and communal living. Housing, education, healthcare costs, each being addressed, each with metrics, each with accountability. We have not certified whether a workplace lets a parent be a parent. The workplace may be the last significant barrier within our direct reach and it has no metrics. In the Government's 2021 Marriage and Parenthood survey, 92% of married Singaporeans said they wanted two or more children. The Ministry of Social and Family Development's (MSF's) own Family Trends Report published last July found that among women whose families are largely complete, four in 10 ended up with fewer than two. That is a gap between what people want and what the system delivers. In 2020, Minister Josephine Teo told this House that paternity leave take-up in the public sector was 84% against the national rate of 53%. In MSF's latest Family Trends Report, the national figure is 56%. It barely shifted. The legislation changed. The culture has not. The public sector understood that. The rest of the market has not caught up. Same law, different culture, different result.”
“But if this well-being framework exists a year from now, Mdm Tan walks into that clinic and an important arm of a complex chronic care is addressed by the nurse who already knows her by name and social background. The couple reopens the laptop and this time, the data tells us what their silence never could – not just whether the money was enough, but whether the workplace made room. This is what it means to see people clearly. The question is whether a year from now we will know if anything changed for them.”
“Not a new dashboard, not another satisfaction survey. A single report that tells us whether our elderly are living better and whether our young families are getting the support they need. One cohort at each end of the life course, one proof of concept. If the linked analysis through the well-being framework works for these two, there is no reason it cannot extend to the sandwiched generation caught between them and, in time, across life's course. If the infrastructure to do this already exists and I believe it does, then what remains is a decision on timeline. I would welcome the Minister's indication on when this might begin. The timeline itself signals how seriously we take the integration this Budget promises. If there are barriers I have not accounted for, I would welcome that candour too, because understanding what stands in the way is in itself progress. I am aware that what I am proposing is not as modest as it may sound. Cross-domain measurement means the Ministry's outcomes become partly shaped by another Ministry's performance. That is a significant shift in how we govern. I am not asking it for it to be easy. I am asking for it to begin. Mr Speaker, this is not a call to spend more. It is not a call to change direction. It is a call to see clearly whether our economic progress is reaching our people. The Prime Minister asked us to strengthen our social bonds and build a Singapore that belongs to all of us. I am asking how we will know if we have. Mdm Tan is still in the queue. The nurse still has an empty slot. The couple is still pondering at the dining table.”
“It now pairs lower-income families with dedicated family coaches, tracks progress across preschool, employment, debt clearance and housing, and has begun integrating health action plans in partnerships with our healthcare clusters. That is real progress and it is the closest model we have to what I am describing. But ComLink+ is programme-specific and population limited – lower-income families with children living primarily in public rental housing. It currently serves over 10,000 families. The elderly enrolled in Healthier SG with complex chronic care demands is not covered. The middle-income couple weighing a second child is not covered. The question is not whether we can do this for some families in need. We can and we are. The question is whether we are ready to build this as routine Government infrastructure across populations, across the life course. Cross-domain measurement cannot live within a single Ministry, not because any Ministry has fallen short, but because the architecture was never designed for it. That is precisely why this must sit in the Prime Minister's Office, in the Strategy Group, the only body with convening authority across domains. I ask the Government: direct the Strategy Group in the Prime Minister's Office in coordination with MOH, MOM and MSF to publish, within 18 months, a single integrated well-being report for two defined cohorts as a start. First, Healthier SG enrollees aged 65 and above; second, middle-income families with children under six. Begin with the baseline – who these people are – across every domain that touches their lives as of this Budget, organise that through a well-being framework. Then 18 months from now, measure again and tell this House whether anything changed.”
“We have the data infrastructure, the governance density and, with the Public Sector Governance Act strengthened last month, the legal authority for cross agency data sharing with appropriate safeguards. To be clear, I am not proposing open access to individual records. I am proposing linked analysis governed by the same rigour of the Public Sector Governance Act and the protections of the Personal Data Protection Act, so that outcomes across domains can be assessed without compromising the privacy this House rightly guards. Build this framework and everything else follows. Social prescribing gets data to prove what works. Team-based care gets validated by outcomes, not throughput, whether the workplaces truly support the families they depend on becomes a question we can finally answer. Let me put this in Budget terms, because this is a fiscal argument as much as a social one. If linked data show that a housing intervention reduced downstream healthcare costs for the same cohort, that is not a well-being insight. That is a budget insight. It is the difference between allocating by tradition and allocating by proof. This House asks every Ministry to justify its spending. The question is whether we have yet given them the tools to do so across the domains, and that tool must carry weight. If the data show that a cohort's well-being is declining across domains, this House should expect that finding to inform the next budget cycle, not the next study. Measurement earns its place only when it is tied to decisions. Genuine cross-domain work is already underway. ComLink+ mentioned in this Budget, too, deserves particular recognition.”
“The gap between a parental leave policy that looks generous on paper and a workplace culture that quietly penalises those who use it. This is not a gap any single policy can close. No single Ministry sees both sides of that equation, which is precisely why no single Ministry has closed it. Each of them – Mdm Tan, the nurse, the couple – was counted. None was heard. A well-being framework would have seen Mdm Tan not as six diagnoses, but as a person whose trust the system had not yet earned. It would have given the nurse something the current system does not, proof that her care made a difference. And it would have seen the couple not as two incomes, but as a family doing calculations on hope. Not because it adds new programmes, because it asks a question the current architecture does not: across domains, is this person's life improving? The Prime Minister puts it well. What matters is not just the policies we announce, but the outcomes they deliver in people's lives. That standard is the right one and I am asking this House how we intend to measure ourselves against it. I believe we can, because no country has yet done what Singapore is positioned to do – link individual level administrative data across domains, organise it through a well-being framework and run it as routine Government infrastructure. The Nordics built rich individual level datasets but channelled them primarily through academic research. The OECD adopted well-being frameworks at the supra-national level but could not bridge sovereign data silos. Wales passed the Well-being of Future Generations Act but lacked the digital infrastructure to wire it to individual lives. Each solved the piece. None solved the system. Singapore can.”
“The gap between what we measure and what matters does not stop at the clinic door. It follows families home. A couple sits at their dining table after their toddler has gone to bed. The laptop is open, the childcare fees, mortgage, career plans, caregiving help. They are doing the sums on a second child. I have met such couples a few times along their healthcare journey at their six weeks postnatal checks through their children's milestones and their own health reasons and concerns. The mothers tell me they are coping. Their affect says otherwise. On separate occasions, the fathers come in for something routine and ask, almost as an afterthought, whether it is normal to feel this overwhelmed. I empathise. These are the conversations that never reach a policy paper, and they are the conversations that shape whether a family grows. Thirty weeks of parental leave, once fully in effect this April, is among the most generous in the region. LifeSG credits, Large Families Scheme – the financial incentives are healthy, but the United Nations Population Fund's 2025 report spanning 14 countries and over a third of the global population found that financial incentives alone are largely ineffective when structural barriers remain. This couple's question is not just about money. It is whether their workplaces will make room for the life they want to build, whether a supervisor will raise an eyebrow, whether a promotion will be quietly deferred, whether flexibility is a policy on paper or a practice in the room. They close the laptop. They do not decide against the second child. They decide not yet. And that decision acquired, private and unmeasured one, is exactly what across domain well-being framework would catch.”
“We measure what the system produces – wait times, enrolment rates, disbursements with extraordinary precision – but we do not yet assess whether the system changed the outcome for the person it was built to serve. The Singapore Public Sector Outcomes Review spans four themes and dozens of indicators across domains, across every domain of national life. It tracks outputs and throughput. It does not capture whether a person's health, housing, employment and social connection are collectively improving. That is the gap, not an effort in integration. Each Ministry sees its slice. No one sees the whole person, the very thing a family physician is trained to do. Every week, I see it. If there is a place where the whole person view should begin, it is Healthier SG. As of August 2025, it enrolled over 1.3 million residents into a care relationship. The most significant shift from episodic treatment to sustained health management in primary care this country has undertaken. That relationship is the foundation. My question is, what else it can carry? Beyond Active Ageing Centres and sports programmes, social prescribing pathways remain narrow. The culinary class at my community club, five minutes from my clinic, is not linked; neither is the e-sports interest group for seniors near my home. Not because it does not work. Because no one has built the bridge and that bridge is key for heartfelt social connection. In May 2025, the World Health Assembly adopted its first resolution recognising social connection as a public health priority. Singapore is a member. If we already have the infrastructure and we do, the question is not whether social prescribing works, is why the connections remain incomplete.”
“Mr Speaker, Mdm Tan is 78. She has six chronic conditions, the kind of complexity that team-based care was built for. Every quarter, despite a worsening gait, she makes her way to my polyclinic with a plastic bag of medications. Down the corridor, a nurse with years of clinical experience and an advanced practice qualification waits for Mdm Tan as scheduled. The clinic briefed her on what this nurse could do, but a couple of conversations in one clinic cannot undo a lifetime of expectation. Mdm Tan has seen a doctor every quarter for years. That is not a habit. It is a relationship. We do not yet have a national framework that helps patients understand what team-based care looks like and their benefits, especially for complex chronic care. So, Mdm Tan expresses politely that she would like to only see the doctor instead. The doctor's queue grows and the nurse waits for her next patient. I am not questioning patient choice. I am questioning whether the system gave patients enough reason to choose differently. And no key performance indicator captured it. Across our public healthcare, we do not yet systematically track utilisation of advanced practice nurses or care managers and even pharmacist-led clinics. The result is predictable. Trained professionals underutilised while doctors run behind, and patients like Mdm Tan wait longer as their healthcare and social needs compound. What I saw in that corridor is not a clinical gap. It is a measurement gap. And it is not unique to healthcare. It runs quietly through the domains this Budget touches. Mr Speaker, this is a substantial Budget, substantial enough to change that. This Budget rightly bets on AI as an engine of growth. But the longer serving engine is our people. The test is whether they are better off.”
“This is not the first time across-Ministry policy has landed at healthcare door. It will not be the last. So, I say this: continue to consult healthcare at design. We know what good design looks like, driving licensed medical assessments where verification is needed before you drive, work permit medical examinations where clearance is needed before the permit, disabled parking labels, where need is verified upfront. These systems work because they are tied upstream with verification built in from the start. For mobility scooters, the gap was the commercial market. When devices became available commercially, there was no equivalent gate. I am glad to note that mobility vehicles will now need to be registered with LTA. Pegged with healthcare certificate or medical need, this creates a system that is tight at entry. This is good design and I welcome it. Prevention is better than cure. This is true in medicine. It is true in policy too. Mr Deputy Speaker, I return to where I started – the ah ma, the uncle, the pakcik. Let us set up this policy well for them. The assessors, let us continue refining our guidelines and supporting our clinicians and occupational therapists to do their work with confidence and let us learn from this for what may come next.”
“The Singapore Medical Association's guidelines on medical assessment of fitness to drive is a good model. It matured over years, it is now a trusted reference. I note that the "Frequently Asked Questions" (FAQ) clarifies that assessors acting in good faith will not be second guessed. We welcome that assurance. These consultations may be difficult, especially when a resident wants a scooter but does not qualify. But this is not new to us, we navigate these conversations every day. I encourage my fellow clinicians to approach these assessments with confidence. These are opportunities for meaningful conversation to understand our residents' needs, review their conditions and help them move forward safely. Third, a reflection on the system. Mobility scooters have been around for years. They serve those who needed them, often under funding safeguards that ensured appropriate use. But as these devices became commercially available, usage grew far beyond the intended population. And now, we respond with certification, with healthcare as gatekeepers. I understand why this response is necessary and I credit the Ministry for consulting the professional bodies and developing guidelines before roll-out. But I ask the Government: how did we get here, reacting downstream instead of having built in safeguards upstream from the start? Healthcare will do her part for public safety and the public good. We always have. But let me name what such a reactive policy costs. Ideal implementation in healthcare takes time. In the meantime, there will be workarounds, goodwill, clinicians doing what needs to be done. This is added to existing responsibilities. Workarounds in our systems, goodwill is not infrastructure. The question now is: how do we avoid being here again?”
“It will serve them well, not just for this, but for their health over the long term. Right doctor, right records, right outcome. For those already using scooters and unsure if they qualify, we should encourage them to have an honest conversation with their doctor. For some, this may be the first medical review in years. Conditions change, some may have improved, some may benefit from intervention. This is not just certification, it is an opportunity for care. And for those who may not qualify, our role is to help them understand their options, including alternatives that may serve them better. Second, the guidelines are sound, but refinement will be needed. Mr Speaker, I have read the guidelines. These were developed after consulting 11 professional bodies. The guidelines give us a foundation. We are not starting from zero, but clinical practice will surface grey zones conditions that do not fit neatly. Residents whose function fluctuates, residents whose needs are hard to access in a clinic room. Consider the resident in her 60s who can walk but has fallen three times this year. She is not immobile, but is she safe? These are the cases that do not fit neatly into "yes" or "no". Without clear guidance, different doctors may reach different conclusions and residents may learn to shop around. Consistency protects both the resident and the system. For some of these cases, we welcome the option to tap on our occupational therapists. They assess function where it matters: in the home, on the path, in real life. That said, we will need supplementary guidance over time, learning from real cases, refining our approach. I ask that the Ministry gathers feedback after roll-out and convenes sessions where practitioners can learn from case studies.”
“Mr Deputy Speaker, this is an omnibus Bill that amends six Acts. I rise to speak on the Certificate of Medical Need for driving or riding mobility vehicles. I am a family physician. I run a polyclinic. Some of our residents need mobility scooters. My team and I know who they are. The ah ma with severe arthritis. Her knees have given way, but her spirit has not. She still wants to go to the market, she still wants to choose her vegetables. The uncle who has lost his leg to diabetes. He is not asking for pity, he is asking to get around. The pakcik recovering from stroke. Six months ago he was walking, now he is learning to live differently. These are the people this provision is meant to protect. I support this Bill. I have three points. The first two are practical, the third is a reflection. First, guide residents to their primary provider. The Bill requires a Certificate of Medical Need, but it does not specify which doctor should assess. This matters. A certificate is only as good as the assessment behind it and an assessment is only as good as the information available to the assessor. When a resident needs a Certificate of Medical Need, my advice is simple: see their regular doctor, their family physician, their enrolled Healthier SG clinic. Why? Because they know the resident. They have the medical history. They have watched the residents' mobility change over time. They understand the home environment, the daily routine, their goals, their values. That is the doctor best place to certify need. I therefore ask that public messaging reinforces this clearly, not just see a doctor, but see your doctor. And for those who do not yet have a regular doctor to enrol into Healthier SG, start building their relationship.”
“While I support this Bill, I urge the Minister to address these concerns, please.”
“These need not be free, but they must be accessible and sustained; not tapering off after implementation, but continuing for as long as the obligations continue. Third, portability must align with continuity. Part 7 provides for portability of health information. Patients can request their records be transferred. This is right. Patients should control their own information. But there is a tension. Healthier SG encourages patients to build long-term relationships with one family doctor. Continuity improves outcomes. Trust takes time and NEHR supports this, giving access to specialist and hospital records, enabling coordinated care. Yet, seamless portability makes it easier to move between private providers. If records follow effortlessly, why stay with one doctor? I am not suggesting we restrict portability. There are valid reasons to change primary providers: relocation, a breakdown in relationship perhaps. But if portability inadvertently undermines continuity, NEHR risks enabling fragmentation. Episodic care from whichever provider is nearest, cheapest or most convenient, leading to wasted resources. The technology is neutral. The outcomes depend on policy coherence. I ask the Minister: what measures will ensure that portability reinforces, rather than weakens, the care relationships Healthier SG seeks to build? In closing, Mr Speaker, this Bill matters. It matters to the patient hoping the next doctor knows what the last one did. It matters to the clinician wanting to do the right thing but uncertain of the rules. It matters to the small practice owner worried about compliance. Legislation alone does not build trust. Trust is built through clarity, through support, through coherence between policies meant to work together.”
“I ask the Minister: will the Ministry commit to facilitating and supporting the development of clear, practical guidance, in consultation with the profession, on what constitutes reasonable access and review? Next, governance is central, enablement must be central too. NEHR is centrally governed. Standards are set by the Ministry, but implementation is local and the burden falls unevenly. Public institutions have the resources to maintain systems, keep them updated and respond when things go wrong. We cannot say the same for private practice. I still speak to friends from medical school, former colleagues now in private practice. The solo GP in Bedok, the small group practice in Jurong: they face the same data security and breach reporting standards under Parts 4 and 5, with far fewer resources. I know senior doctors, still sharp, still caring, who are thinking of hanging up their white coats early. Not because they cannot practise medicine, but because they cannot keep up with the infrastructural demands. Clinicians should be caring for patients, not managing systems. I do not argue for lower standards. Patient data must be protected, but enablement must match governance. Central standards require central support and this support must be sustained, not just during roll-out. If we expect doctor-patient relationships to last decades, the support must last too. I ask the Minister: will there be dedicated, sustained support for smaller practices? This could take many forms: shared IT services, pooled cybersecurity monitoring, simplified compliance pathways. Existing structures like Primary Care Networks could be leveraged.”
“The Bill tells us what we must not do, but not what we must do, or how much is enough. A patient comes to see me. Cough for two weeks. No clinical red flag features. I take a history, examine her and I am satisfied. Likely a viral or post-viral cough. I treat her symptomatically. I do not access the NEHR. Three months later, it turns out she had early lung cancer. A CT scan done elsewhere six months ago showed a lung nodule. It was in NEHR. I did not see it. Was I wrong? I had no reason to suspect cancer. My clinical assessment was adequate. But the information was there. Consider the reverse. I access NEHR. Years of records. Hundreds of entries. How deep must I go? How wide? If I click "Result A" but not the adjacent "Result B" because it seems unrelated to the current consult, is that reasonable? Or will I be asked, later, why I did not check? Clause 99 protects those who act in good faith and with reasonable care, but it does not define what reasonable care looks like. In practice, clinicians exercise professional judgement every day. But what does reasonable care and professional judgement look like with 10 minutes of consultation time and 10 years of records? I am not asking for immunity from accountability. I am asking for clarity. Clarity on what reasonable access looks like. What constitutes adequate review. How we should document the choices we make, against the ever-increasing complexity and demands of clinical care. And this guidance must be sustained. Not a one-time circular, but updated as systems and practice evolve. Without this, clinicians will practise hesitantly. Some will over-access, lost in screens. Others will under-access, afraid of what they might find. Neither serves patients.”
“Mr Speaker, I wish to declare that I am a family physician with the National University Polyclinics. I am a father of young children. Growing up in the heartland and now serving in public healthcare, I have lived and worked among Singaporeans across generations, across every walk of life. Every day, I sit across the table from patients: the uncle in his 60s managing six chronic conditions; the young mother bringing her newborn for a jaundice review, hoping the hospital's records have already reached me; the elderly auntie who cannot remember which medicines to take; and the caregivers, trying to make sense of it all for loved ones who cannot. They come because they trust we will help them make sense of a system that can feel overwhelming. And I work alongside nurses, care coordinators, allied health staff, administrators and fellow doctors. People who entered healthcare to help, doing their best under difficult conditions. I speak today for both: for patients and families who depend on the system and for healthcare workers who make it work. Mr Speaker, the vision behind this Bill is right. One patient, one health summary, one care journey. Information that follows the patient. Fewer duplicated tests. Fewer medication errors. Better patient safety. Better clinical decisions. The Bill sets clear boundaries. Clause 6 – excluded purposes: employment and insurance related matters. Clause 38 makes it an offence to access the NEHR, for these purposes. Penalties are serious. Patients must trust that their health information will not be used against them. These protections matter. But the Bill is only as good as the trust it builds, from patients and from providers. I have three observations. First, the boundaries are clear, the grey zone is not.”