Janil Puthucheary
Singapore
“Sir, I thank Ms Lee for her two supplementary questions, which address what are our targets and what is it that we measure. Indeed, the issue of how we should think about recycling and waste disposal will be at the heart of our review of our Zero Waste Masterplan.”
“Another strategy that we are embarking on is the strengthening of the reuse of waste residue and treated toxic industrial waste before and after they are landfilled.”
“Sir, about half of our recycling material is exported. It is processed overseas. There are business arrangements between businesses here in Singapore and businesses in the region or overseas, to be able to handle the recycling of waste and recycling of material, whether domestic or non-domestic, already today.”
“Sir, I thank Ms Poh for her questions. Indeed, we do have to shift behaviours. The incentives and disincentives around recycling and waste disposal are an important part of it. We will consider her suggestion on looking at the fees.”
“The heat advisory that goes out is clearly defined. In my original answer, I explained what a heat wave was. There are clear definitions that we have been using in Singapore since 2016, if I recall. It was then last revised in 2023.”
“Sir, in the planning of schools, the Ministry of Education ensures that our students can access a primary school near their homes. Except for a small number, 15 of Special Assistance Plan schools, all primary schools offer the three official mother tongue languages.”
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“So, MOH will continue to call out false news, disinformation, put out timely facts and clarifications through the media, as well as our various social media platforms. We try to maintain a sort of a central repository of this at the MOH website and at gov.sg/resources. Mr Gerald Giam then asked about the possibility of international students and other non-residents receiving the vaccination. As I have explained, we are studying how, when and the process through which people who are here for a shorter period of time can potentially get the vaccine and details will be announced later.”
“Mdm Deputy Speaker, I thank the Member for the questions. The first question was whether, if somebody had a first dose of mRNA COVID-19 vaccine and had an allergic reaction and completed the process through Novavax, would they be considered fully vaccinated? So, that is taking the analogy from what I have just described as a process where you take one dose of an mRNA vaccine and a second dose of the Sinovac or Coronavax vaccine. I think the first thing is that we should not try to second-guess or jump the gun on the professional process that needs to be undergone through our Expert Committee on COVID-19 Vaccination (EC-19 Committee). We need the data submitted by Novavax. We need to study it and make sure that it meets the standards of quality, safety and efficacy. And, in principle, if it does meet those same standards, I see no reason why it should not be considered in the same way as the other processes that I have just described. But I think it is premature at this point to guarantee that it will be. We will get the data, will put it through the process and then we will announce the details later on. Mr Gerald Giam brought up a very important point, which is that seniors can get concerned about private messages spreading vaccine misinformation or disinformation. Indeed, MOH continues to try to push back against this by putting out information and infographics. Everyone has a responsibility. It is not just MOH, but, as a society, we do need to make sure that we are providing everyone – our families, our friends, our workplace context – reliable information and not inadvertently spreading misinformation and disinformation. We need to give them access to where they can also educate themselves and seek more information.”
“Individuals who have received one dose of an mRNA COVID-19 vaccine but are unable to receive the second dose due to allergic reactions have been invited to take the Sinovac or Coronavac vaccine. The Ministry of Health (MOH) has established a dedicated public health programme for them to be vaccinated at a clinic in public hospitals for closer monitoring, considering their previous allergic reaction. These individuals, who receive one dose of the mRNA vaccine and then complete the vaccination process with Sinovac or Coronavac, will be considered as fully vaccinated. This group of individuals who are allergic to the mRNA vaccines may also choose to wait for the Novavax vaccine that MOH has procured and expects to be delivered by the end of the year. MOH and the Health Sciences Authority (HSA) are working closely with Novavax to facilitate the regulatory submission for their protein subunit vaccine. The review timeline will depend on the availability and the submission of data by the company to HSA. While we recognise the need to facilitate timely access to the vaccine, there should be no compromise on the scientific rigour of the assessment of their quality, safety and efficacy. As for the Sinovac vaccine, on 5 July 2021, the company submitted to HSA the critical data requested by the agency for PSAR approval. HSA is conducting a careful and thorough review of the data and aims to complete its evaluation before the end of August. The national vaccination programme will cover all who make Singapore their home or who are here for an extended period of time. We are reviewing how short-term pass holders, such as those who are more vulnerable and who have been in Singapore on an extended basis due to COVID-19 travel restrictions, may receive vaccinations.”
“My answer will also cover Written Question No 23 from today's Order Paper as well as the Oral questions filed by Mr Yip Hon Weng1 and Mr Gerald Giam2 for future Sittings. Mdm Deputy Speaker, the national vaccination programme has been progressing well. As of 31 July 2021, 61% of our population have completed the full vaccination regimen. We are also making steady progress with our seniors: 79% of those aged 70 and above have been vaccinated with at least one dose. More seniors are coming forward to be vaccinated; each day, about 1,000 seniors sign up for their first dose. We have to continue encouraging our seniors to get vaccinated because they are the most vulnerable to serious illnesses. More than 96,000 or 21% of seniors aged 70 and above have not booked a vaccination appointment. This is six percentage points higher than the general population. We will continue to reach out to as many seniors as possible and encourage them to get vaccinated. Staff and volunteers from the People's Association and the Silver Generation Office have intensified their outreach efforts through house visits and engagement dialogues. They are trained and equipped with an information kit to correct misinformation about mRNA vaccines and allay the fears of seniors. The Ministry of Health (MOH) has also called on all primary care providers to persuade seniors who are their regular patients to go for their COVID-19 vaccinations. Our mobile vaccination teams have started to provide bed-bound and less mobile seniors with vaccinations in their homes or in the heartlands. The service has started in a few towns with a higher proportion of seniors and complements the main vaccination efforts at the vaccination centres, all of which are wheelchair-accessible.”
“Mdm Deputy Speaker, may I please address Question Nos 4 and 5?”
“Mr Deputy Speaker, indeed, the Ministries and agencies involved will continue to monitor and are concerned about an increased trend in attempted scam calls and spoof calls using the +65 prefix. We will try to work upstream. There is unfortunately a problem in that there are also legitimate calls that will end up using the +65 prefix, for example, Singaporeans who are roaming overseas and calling back home. But we will continue our efforts and we are as concerned as the Member. As far as education, indeed, that is the key. The main prevention is going to be the vigilance of the public, the awareness of what a scam might look like, what they may be trying to get away with. In this, the education and outreach is not confined only to the specifics of a scam call or a spoof call, as our general efforts to education the public around using online technologies, digital technologies – which are often what the scam calls are trying to extract value from; as people have a comfort and understanding about those things; they will become more vigilant, more understanding about what is possible and what needs to be protected in this space. We thank all stakeholders in our community who have helped to spread the word on this.”
“Mr Speaker, I thank the Member for the questions. It would be premature to discuss the details of this at this point in time. As I have explained in my initial answer, the process is very early. Many countries have not really gotten significant proportion of their population vaccinated. And in truth, we are only getting going recently, and so, it is something that we will update as and when we have further information in the future.”
“Mr Speaker, I thank the Member for his question. The answer is no. The factors taken into account for approving the vaccine are the vaccine's quality, its safety and its efficacy.”
“Mr Speaker, I thank the Member for the question. Indeed, it is so and that is why, in the previous announcements, there were accommodations made for individuals who have completed the full vaccination regimen, such as from 24 April 2021, if you have had more than two weeks after your second dose, one can gain entry into events that require pre-event testing without the need to undergo pre-event testing. Similarly, the same set of information has allowed us to make changes to the rostered routine testing for some personnel. So, the short answer to the Member's question is yes.”
“Border measures will also take into account other factors, such as the number of COVID-19 cases and the infection control measures implemented in the source countries. Hence, progress on cross-border recognition of vaccine certification may take some time. We will provide further updates when there is significant progress. The COVID-19 vaccination programme remains voluntary. MOH encourages everyone who is medically eligible to get vaccinated.”
“Sir, the Health Sciences Authority (HSA) and the Expert Committee on COVID-19 Vaccination (EC19V) will only approve COVID-19 vaccines that have met our high safety, quality and efficacy standards for use here in Singapore. The effectiveness of the Pfizer-BioNTech and Moderna vaccines, which are currently the only COVID-19 vaccines allowed for use in Singapore, are widely recognised internationally. MOH will be releasing further information on how individuals can show their valid vaccination status when ready. We will make it easy and convenient to prove one’s vaccination status, including for persons without smart phones. The measures required for the unvaccinated are generally based on public health considerations to prevent infection and, so, would not distinguish between those who choose not to be vaccinated and those who were not medically eligible. Other vaccines may be available in the future for those who are not currently medically eligible. We will continue to evaluate scientific data and review the eligibility criteria accordingly. Data on the duration of the vaccine’s protection and its effectiveness in preventing transmission, has been encouraging thus far. More data is needed to assess if changes to border measures, such as testing and Stay-Home Notice (SHN) requirements, can be made for vaccinated individuals. More information is also needed to assess if such measures will be affected by the different types of vaccines. We are actively discussing with international counterparts on the possible mutual recognition of vaccination certificates. However, most countries have only just started vaccinations.”
“Mr Speaker, may I take Question Nos 10 to 13 together, please?”
“Mr Speaker, I thank the Member for her question. There are two points which are slightly separate. One is the importance of making sure that we make our materials, transactions and interactions available in multiple languages. Indeed, we will pay quite a lot of attention to this, especially on the ground at the service counters at the vaccination centres. The separate issue is residents who then experienced symptoms after having had a vaccination. What the Member is describing is a situation where one has clinical symptoms a day after vaccination and was worried about whether these are problems where you need medical help. I would suggest that perhaps a MOH hotline manned by our non-clinical staff may not be the best first port of call for residents in such a situation. If they have clinical symptoms, if they have persistent pain, persistent fever, rash and, especially things like difficulty breathing, what they need is to seek clinical help and they should do so from the relevant hospital, polyclinic and clinical care providers that are close to them.”
“Mr Speaker, I thank the Member for the question. The issue is the limit of our vaccine supplies. Even though there may be some people who are a little bit agnostic about exactly when they get it and are willing to defer, the reality is that we are vaccinating people as quickly as possible, given the supplies that come in. So, if we were to prioritise one group, it will be at the expense of another who currently wish to be vaccinated. The slots are booked and the capacity is being used up and the vaccines are being used up. So, we recognise that there are people who wish to be prioritised. We do have an appeals channel. We will try our best. There are criteria and it is very helpful that documentation is submitted to support those criteria and we will work our way through these appeals to try to help as many people to be vaccinated as soon as possible. But, ultimately, the limit is not our wish to force people who are perhaps a little bit hesitant at this point – we do encourage everybody to do it – the limit is actually the rate at which the supplies are coming in.”
“Mr Speaker, I thank the Member for his concern. We are, indeed, tracking the completion of vaccinations among the essential workers closely and we do so through the employers as well as some of the regulatory bodies for the relevant domain. We could not wait to complete every single essential worker before we then started with the elderly, the vulnerable or other at-risk groups. So, we have a parallel processing, if you like, that essential workers continue to be vaccinated although most of them have largely been done so, together with the roll-out to the elderly. And, just as now, not all the elderly are vaccinated, we have started with the next group and we will, in parallel, open up to more and more segments of our population as our vaccine supplies come in. But we will continue to pay close attention to make sure that those who are vulnerable or who are at high risk or who perform these essential functions will get priority.”
“Mr Speaker, I thank the Member for the questions. The take-up rate is healthy across the vaccines that have been licensed and are being used in our various centres. But Sinovac has not been licensed yet. So, it is a bit premature to talk about that at this point in time. The target is for as many of our eligible residents as possible to be vaccinated. Herd immunity, indeed, is useful. But you can also imagine that we would perhaps want to make sure that individuals who want to travel overseas would also continue to be protected and that requires them to be vaccinated because, once they are overseas, they will not benefit from herd immunity here in Singapore. So, let us get that number as high as possible and we hope to be able to offer the vaccinations to all eligible Singaporeans along with residents by the end of 2021. It is a little bit premature to be then talking about the relaxation measures for the next phase when we have not reached it.”
“Mr Speaker, I thank the Member for his questions. As I have mentioned, we are studying the matter of antibody levels. I think before we make a decision about how we would look at what is happening in the population, let us, first, do those studies. For most vaccinations previously, that has not been the approach to go with a population-wide antibody assay. It is also logistically very difficult and would place a burden on our population. So, we need to be sure that it is useful and necessary before we would do such a thing. However, with the issue of variants, assaying a set of antibodies to a prior vaccination is not going to be necessarily useful to inform the clinical risk for a new variant that perhaps was not there when the vaccination was delivered. So, I think there are two separate issues – the issue of virus variants is being closely studied by our experts as well as international experts; and the matter of if, when and whether we should be doing serology and antibody testing is also being studied. So, let us complete those studies before we make any decision on that basis.”
“Ms Lim is correct; indeed, the advice has shifted. It is severe anaphylactic reactions that we are most concerned about. And as an increasing number of people has been vaccinated, we have confidence over the situations in which someone previously thought to be ineligible might now go forward and have the vaccine. Indeed, the online systems and our various guidance to people manning counters and hotlines has changed. The way in which we are catching up is that the citizens involved remain as part of our patients, the patients of the healthcare providers, the vaccine system will continue to track this process. Most people are able to go forward and complete the vaccination. If there are individuals who have been deemed ineligible, I would reinforce that this is about deferring the appointment and the consultation to a time where they might subsequently become eligible. We will continue to pay close attention to this segment of the population.”
“Mr Speaker, I thank the Member for the suggestion for a standby system. We will continue to study how best to deal with the challenges of prioritising those most at risk, those who have some urgent need and having some equitable distribution across our population, even as we try to cover as many people as possible before the end of the year. But we will study her suggestion. The point she makes about the prioritisation for workers in certain religious settings highlights the need for continued safe management measures and vigilance from everybody involved. But if there are specific individuals who might have particularly high risks, we will look at their situation and try our best to accommodate.”
“These could be staff who are working at the vaccination sites or frontline volunteers who have an active role in engaging seniors on vaccinations. As with other established vaccines, people who receive the COVID-19 vaccine may experience common side effects, such as pain at the injection site and fatigue. Should the side effects persist or get worse after a few days, they should see a doctor and seek medical attention. In very rare cases, the COVID-19 vaccine can cause a severe allergic reaction, such as difficulty breathing, swelling of face, throat, eyes or lips, a fast heartbeat, dizziness and weakness or a bad rash all over the body. In the event of a severe allergic reaction, please call 995 or visit the nearest hospital immediately. Members of the public can also visit www.vaccine.gov.sg or the MOH website to further understand the post-vaccination symptoms. MOH will be conducting further studies to monitor and review the extent and duration of immunity provided by the COVID-19 vaccines. This includes collecting selected post-vaccination samples from groups such as healthcare workers, frontline staff and seniors, to monitor the persistence of antibodies up to 24 months. Currently, in line with international practices, there are no plans to test the serology of everyone who is vaccinated in Singapore. We will share more details about the studies once they are completed. Vaccination is a key enabler to reduce the risk of community transmission and allow more economic and community activities to resume. As more vaccine stocks arrive, we will continue to expand our vaccination programme to more segments of the population, so that all Singaporeans and long-term residents in Singapore will have the chance to be vaccinated by end-2021.”
“If all goes well, we will complete the vaccination programme as scheduled by the end of the year. Some members of the public may wish to receive their vaccination early for a variety of reasons. Since 16 March, we have opened up an appeals channel for Singapore Citizens and Permanent Residents who need to travel overseas on compassionate grounds, for employment or study purposes. Applicants will need to meet certain criteria. These are listed on www.vaccine.gov.sg/appeal. They will need to submit sufficient documentation to support their appeal. We will prioritise appeals with earlier travel dates if they are able to complete the two-dose regimen prior to departure. Close to 98% of those who booked appointments for COVID-19 vaccinations in the last 30 days have showed up for their appointments. We estimate that about 1% of those who turned up were rejected because of concerns about allergies and contra-indications. We encourage everyone to be vaccinated when your turn comes and to turn up at the vaccination appointments that you have made so that you do not deny another person the opportunity. However, such cases do not result in vaccine wastage. We closely monitor the appointment bookings and historical take-up rate, and deliver the appropriate number of vaccine doses to the vaccination sites. Unopened vials can be stored at the vaccination sites for at least three days. Vaccination site providers will start a new vial only when they have checked that there are individuals awaiting vaccination, to avoid vaccine wastage. At the end of the day, to utilise any balance remaining in a multi-dose vial and further minimise wastage, there are pre-planned lists of individuals who will be invited to be vaccinated.”
“Religious workers might also face potential risks as they may engage in regular and non-transient contact with worshipers and devotees, including the elderly and vulnerable. Older religious workers, aged 45 and above, are already eligible for vaccination. Religious workers are also required to comply with safe management measures in the conduct of religious services and in other engagements with worshippers or devotees. We continue to make steady progress with our vaccination programme. As of 3 April 2021, around 1.52 million COVID-19 vaccine doses have been administered. Around 1.05 million individuals have received at least one dose of the vaccine, of which more than 468,000 individuals have received their second dose and completed the full vaccination regimen. To date, about 60% of eligible seniors aged 70 and above, and close to 70% of eligible seniors aged 60 to 69 have received the COVID-19 vaccination or booked their vaccination appointments. We have recently invited citizens and residents aged 45 to 59 to begin to register for their vaccinations and close to 500,000, or about half, had done so. We are encouraged by the strong response. Those who have registered will progressively receive invitations through SMS to make appointments for their vaccination. This may take some time given the number of people who have registered. To date, about 17% of eligible individuals have received the vaccination or booked their appointments and we expect the rest should receive the SMS by the middle of May and they can expect a booking slot by early June. We thank everybody for their patience. People under the age of 45 have also been patiently waiting for their turn. Based on current schedule, we plan to begin inviting them in June to book their slots.”
“Sir, we would like to thank everyone for their support of our vaccination programme. We will continue our efforts to encourage the take-up of the vaccine. Vaccination is free for all Singaporeans and long-term residents. We have expanded the number of vaccination centres to 31 today and there will be a total of 40 vaccination centres islandwide by mid-April, so that individuals can be conveniently vaccinated near their home or place of work. Our supply of vaccines remains limited by the ability of vaccine manufacturers to deliver, given the high levels of global demand. This has resulted in limited booking slots in recent days. I apologise for the inconvenience caused to those who have not been able to book earlier. As more supplies arrive, we will progressively open more slots. We have had to prioritise our vaccinations, starting with our healthcare workers, vulnerable elderly and those involved in COVID-19 operations. The Expert Committee on COVID-19 Vaccination had also recommended that we prioritise those personnel whose job roles are of critical importance to the functioning of Singapore and are at higher risk of exposure to and onward transmission of COVID-19. This is critical to ensure that key sectors would be able to continue functioning effectively even during a local outbreak, and further reduce risks to our vulnerable populations and the community at large. Such personnel include those involved in safeguarding our borders and maintaining law and order, those involved in the provision of utilities such as water, energy and telecommunications services, workers who ensure the supply of essential food items, and land transport workers involved in ensuring that our transport services are kept running.”
“Mr Speaker, may I address Question Nos 1 through 9 on the Order Paper, please?”
“Mr Chairman, the answer is yes. It is not just MOH that is interested in this. This is an area where the academics and the professionals working with people with mental health issues are very interested in looking at. This is not going to be an area that we can have complete prevention. We also have to research into areas about how we can help people cope and mitigate the mental health issues that they come across. It is not going to be easy to pinpoint a single factor, just like diabetes. While we can concentrate our efforts on sugar or weight loss activity, we will have a variety of things to direct attention and the efforts of the individual in the family. But the reality is it is a wide space with many different causes and many different paths through it, and it will be something that requires effort from a multi-disciplinary team and, indeed, the whole of society. But the short answer is yes, we are very interested in this.”
“So, with the capability that we had in October 2019, would we have picked up COVID-19 outbreak in October 2019? The short answer is yes. We pick up outbreaks of disease on a regular basis. Our level of paranoia, anxiety, concern about this increased after SARS, as a result of which clinical teams across the healthcare network have to report any number of either confirmed or suspected infectious diseases. And we have surveillance systems. So, the real answer is not really whether we would have picked it up, but how quickly would we have picked it up and how quickly would we have responded and put in place many of these strategies that we now see as normal for containing disease outbreak. Whether it is the testing, the tracing, speed of that, the ability to quarantine individuals, the ability to do the sequencing and stand up therapeutics. So, certainly, our capabilities have improved and increased quite significantly since the first outbreak. So, the short answer to the Member's question is yes but we can do it much better today. One of the reasons why we can do it much better today is because this is not SARS. We have learned the lessons from SARS, we have learned the lessons from COVID-19, and we have to prepare that Disease X, the next pandemic and the next crisis, will be like neither. And we need that institutional agility and institutional capability to deal with the unknown, which is one of the more difficult things that we have to do. I hope that answers the Member's question.”
“Thank you, Mr Chairman. If I understand the Member's questions correctly, if an outbreak had occurred now? With the capability we had then or the capability we have now?”
“We must learn the lessons from this experience. The preparations for the next crisis, whatever it is, are underway and require that we keep ourselves and our healthcare system in good health. Prevention is best, preparation is also necessary.”
“To reach out to persons with or at-risk of mental health conditions or dementia, including seniors, community teams also reach out to residents and their caregivers to provide mental health or dementia information, basic emotional support and links to appropriate services, health or social, as necessary. For seniors at risk of social isolation, the AACs, Silver Generation Office and local grassroots organisations connect them to befrienders who will reach out to them on a regular basis, providing companionship and encourage them to participate in social activities, keeping active and keeping connected with the local community. Seniors can also sign up with CareLine, which is a 24/7 social support hotline that provides tele-befriending services as well as emergency response to seniors in distress. While we do all this to build up the capabilities in our community partners, we will make sure that our main psychiatric sector, IMH, is updated. Since 2018, IMH has been undergoing refurbishment and improvement works to facilitate the care and improve operational efficiency and safety for patients and staff. And these works are expected to be completed by the end of 2022. Mr Chairman, to fight COVID-19 we have had to rely on the skill, dedication and professionalism of our people. We have had to develop and deploy technology and we have had to scale up clinical services, all the while looking after the many healthcare issues that are unrelated to the pandemic, but essential to our health. We have had to be agile, steadfast and determined. We are all a bit tired and fatigued, but also hopeful and confident that we can find our way forward. Our ability to get this far was the result of many years of investing in our people, our facilities, systems, research and capabilities.”
“The three of us are working together, just as MOE, MSF and MSH are working together on this important area. To look into the psycho-social impact of the COVID-19 pandemic on the population, we set up the COVID-19 Mental Wellness Taskforce in October 2020. The Taskforce has reviewed and recommended three areas to work on, namely, to develop a national mental health and well-being strategy; secondly, a national mental health resources webpage; and a national mental health competency training framework. Beyond COVID-19, we will evolve the Taskforce into an inter-agency platform on mental health and well-being, by mid 2021. The platform will oversee mental health and well-being efforts, focusing on cross-cutting issues that require multi- and inter-agency collaborations. We are working out the details of the platform and will share more when ready. Dr Tan Yia Swam asked about the support for other vulnerable groups such as our seniors and building a more inclusive society. The Government recognises that those who suffer from mental health conditions may face discrimination. We have been working with partners to roll out initiatives to address this issue. It will take a whole-of-society approach to tackle this issue effectively. The National Council of Social Service launched the “Beyond the Label” movement in 2018 to fight the stigma of mental health conditions and encourage social inclusion, positive attitudes and support towards persons living with mental health conditions. The movement also provides a platform for more conversations about mental health and promotes greater awareness and the acceptance of mental health conditions among the public.”
“In addition, 21 community intervention teams were established to provide mental health interventions such as psycho-social therapeutic interventions and counselling. We have met our targets of 50 community outreach teams and 18 community intervention teams ahead of our end 2021 timeline. To Dr Wan Rizal’s question on support for youth and their families, we have piloted the Integrated Youth Service (IYS) within the Agency for Integrated Care (AIC), the Institute of Mental Health (IMH) and Care Corner, which is one of our community partners in the North. Since April 2020, Care Corner has begun community outreach using online platforms, and has reached out to over 2,600 users. In November 2020, the Care Corner team moved into the new Woods Square Community Space, to provide face-to-face mental health screening and basic emotional support sessions for persons with mental health challenges, and to conduct experiential resilience or mental well-being events. MOH and AIC have also worked with other community partners to set up youth community outreach teams to reach out to young people in mental distress to provide basic emotional support and resources. The team would also engage the family to understand the stressors and the home environment. Links to social and health services would also be provided. Through the Youth Mental Well-being Network, we have heard from the youth, mental health and social sector professionals, patients and caregivers, on how we could improve the mental well-being of our young people. Minister of State Sun Xueling earlier shared on how the Network has initiated ideas for over 30 potential ground-up projects. Parliamentary Secretary Eric Chua will also be sharing about an initiative to provide positive peer support during his MSF speech.”
“Residents can also look forward to a comprehensive range of primary care services, including medical treatment for acute conditions, chronic disease management, women’s and children’s health services, as well as radiological, laboratory and pharmacy services. Another example of the on-going work to improve routine clinical care services despite the pandemic is to ensure our population has timely access to the right level of rehabilitation care. We have developed the National One-Rehab framework. Under this framework, patients will have improved access to community-based rehabilitation and benefit from expanded capacity and capability in the care providers. Our hospitals, polyclinics and community care providers will embark on a multi-year pilot to validate this new care model. Our hope for patients with stable musculoskeletal conditions such as lower back pain who do not require surgery or complex interventions to receive this rehabilitation care in the community, instead of only at specialist clinics or hospitals. During last week’s Budget debate, we heard Dr Shahira Abdullah, Ms Carrie Tan, Dr Wan Rizal, Ms Mariam Jaafar and Mr Eric Chua speak about mental health. Since the launch of the Community Mental Health Masterplan in 2012, and its enhancement in 2017, we have increased the capacity of community mental health services. We are on track to meeting our targets by end 2021. In primary care, we have over 220 GP partners and 14 polyclinics providing mental health and/or dementia services. We have set up 50 community outreach teams and reached out to over 350,000 persons with mental health or dementia needs.”
“Finally, we will develop a national R&D Programme for Research in Epidemic Preparedness And Response – and the acronym is appropriately called PREPARE to strengthen our R&D capabilities to prevent, prepare for and respond to future public health crises. It will include (a) strengthening infectious disease collaboration networks locally and regionally; (b) strengthening capabilities for the accelerated development of diagnostics, therapeutics and vaccines; and (c) establishing a national infectious disease repository and database for research and data analysis. To further address Mr Ang’s question, MOH regularly reviews our national response and is conducting an interim review. It will include other Ministries and Agencies. We will share details when completed. 5.00 pm Beyond pandemics, we must ensure that the healthcare needs of our general population are met. The work continues. Our polyclinics are a vital element in our Public Health primary response. Built in 1980, Clementi Polyclinic is one of our oldest and smaller polyclinics. Its central location has served residents well, with about 850 patients seen per day. We will be redeveloping the polyclinic by 2027 to better serve residents in the region. Dr Tan Wu Meng asked whether we have considered patient’s comfort and staff’s performance in our design of healthcare facilities. The answer is yes. When designing new healthcare facilities, the design team will engage stakeholders including the care team, patients and carers, and the facilities management team. The redeveloped Clementi Polyclinic will undergo the same process. It will be more spacious with more elderly-friendly and accessibility features.”
“The NEHR has also been enhanced this year to meet the requirements for COVID-19 vaccinations, displaying alerts and reporting problems. As we do this, data security remains a key priority. We have been taking steps to improve the security of our NEHR through technical and process enhancements, in response to the security reviews that we conducted in 2018. We expect to complete most of this within the year and onboard more healthcare institutions to contribute to NEHR more securely. Beyond COVID-19, we must be ready to respond to future public health crises by having the right systems and capabilities. We will do so in four ways. First, we will enhance our surveillance and response capabilities through the use of new technologies to enable us to more effectively consolidate, analyse and generate insights from large amounts of data. Second, we will augment our human capabilities to prepare Singapore against future threats. Skilled clinical teams will always play an important role in detecting and managing new diseases and outbreaks, and we also need other experts such as epidemiologists, data scientists, statisticians and software engineers like Daniel. We need teams to investigate and perform advance analytics, for example, to determine the likelihood of spread and inform our response to an outbreak. Third, while we remain in DORSCON Orange for now – DORSCON stands for Disease Outbreak Response System Condition – we will look into strengthening our DORSCON framework, incorporating lessons learnt from the pandemic so that we can better communicate public health risk and to help us more effectively respond as a whole society when "Disease X" strikes, the next serious pandemic crisis.”
“He has contributed to two IT projects supporting the fight against COVID-19. Now, he is developing the user-facing components of the system supporting the One-Rehab framework, which I will speak a little bit more about later. We hope that more people will see opportunities in this HealthTech space and embrace the possibility that with some training, they can join the healthcare family, not necessarily as a clinician but contributing to the success of our public healthcare eco-system. As Mr Ang Wei Neng pointed out, we can and should learn many things from our fight against COVID-19. For example, our early, comprehensive and persistent contact tracing and quarantine efforts have played a key role in our COVID-19 response. Besides the vigilance and skill of our healthcare workforce, our digital tools such as SafeEntry and TraceTogether continue to be central to the speed and efficiency of our contact tracing. Coupled with our aggressive testing strategies, these measures have contributed to our success in keeping the number of our community cases under control, for now. To swiftly identify COVID-19 cases and contain the outbreak, we have built up our testing capacity and our community testing operations. Through targeted operations as well as routine surveillance testing, such as the testing of our hawker centre workers, we have so far been able to detect cases and quickly prevent spread. As a repository of patient records, the National Electronic Health Records (NEHR) has also been a key enabler in facilitating this provision of care during the pandemic. Healthcare professionals can access NEHR for their patients' COVID-19 test results and their existing medical conditions before the vaccination.”
“During the Budget debate, Mr Darryl David asked about staff benefits. Dr Wan Rizal also asked about this just recently. Our public healthcare institutions do pay close attention to staff leave and make time for sufficient rest. These are planned to ensure sufficient staffing for patient safety. There are also rostered breaks and staff rotations to ensure sufficient rest during and between shifts. To better support our healthcare staff, a cross-cluster Staff Wellbeing Committee, with representatives from our public healthcare institutions and MOH, has been set up. The committee will share best practices and provide feedback to MOH on possible enhancements to improve staff wellbeing. Besides healthcare workers, our HealthTech – health technology – engineers have also played an important role. They have rapidly developed systems to support new operational demands, including the on-going vaccination operations. These are also important capabilities that we need within our system. Thus, to grow our health technology workforce, we work closely with the Integrated Health Information Systems (IHiS) to redesign jobs and actively recruit people into new roles, including software engineers, systems analysts and cybersecurity professionals. To facilitate mid-career switches into HealthTech, IHiS, Infocomm Media Development Authority (IMDA) and SkillsFuture have curated specific training programmes. One such example of a mid-career switch is a gentleman by the name of Mr Daniel Ong, whom I spoke to recently. He was a copywriter and his formal education was in English Literature. He could not write code before joining IMDA's Tech Immersion and Placement Programme, which is part of our TechSkills Accelerator. In March last year, Daniel began work at IHiS as a front-end developer.”
“We have needed to deal with the pandemic and continue the usual clinical services and, now, stand up a massive national vaccination exercise. Many of these skills, tools, processes and systems we have developed are distributed across our healthcare network and the care providers. But centrally, at MOH, we have had to also develop and improve our organisational capability to manage the response to this crisis and, hopefully, be better prepared for the next. At MOH, we have set up a new Crisis Strategy and Operations Group. They have worked hard, in collaboration with other Ministries and other agencies, to coordinate COVID-19-related operations. This is a capability and a team that we will need in order to be better prepared for the next pandemic. We are heartened by the appreciation demonstrated by the public for our healthcare workers. However, today, there are still cases of harassment and abuse against staff. This has affected their well-being and their safety. To Dr Wan Rizal's question, we take abuse and harassment against our healthcare workers very seriously and will not hesitate to take appropriate action when necessary. The enhancements to the Protection from Harassment Act in November 2014 gave additional protection against harassment to Public sector healthcare professionals and support care staff. Public healthcare institutions also have policies in place to handle abuse cases. The institutions conduct training for healthcare staff, including on de-escalation measures during potential conflict and abuse. In addition, we will work with the clusters and the Healthcare Services Employees' Union (HSEU) on a tripartite effort to strengthen messages against abuse and harassment of public healthcare staff.”
“Mr Chairman, Singapore is fortunate to have a workforce in the healthcare family driven by professionalism and dedication. Our people answered the call of duty, they have carried us far in this fight against COVID-19 and have contributed to keeping Singapore safe during the pandemic. Our infectious diseases experts and staff at the National Centre for Infectious Diseases (NCID) and other public healthcare institutions have worked to provide clinical guidance to and support for public health operations. Laboratory specialists at the National Public Health Laboratory provided guidance for COVID-19 tests and conducted genomic analysis to support cluster investigations and surveillance for variants. The staff at the public and private healthcare institutions do their duty, putting themselves in harm's way. They undertake healthcare operations in high-risk locations like the foreign workers' dormitories, emergency departments, hospital wards and intensive care units across our healthcare system. I echo the sentiments of many in the House to express our deep appreciation for colleagues in many, many different roles. The work continues and Members will know that we started our national vaccination operations at NCID on 30 December 2020. NCID was one of several initiatives and projects that came out of the lessons we learned from SARS. In the test of that crisis, we identified vulnerabilities and in our response, developed capabilities and institutions that exist to this day, like NCID, helping us with COVID-19. In this crisis, we are learning new lessons and responding to different vulnerabilities. We need to institutionalise the capabilities that we are developing.”
“Regionally, Singapore led the development of ASEAN Model Contractual Clauses, terms and conditions that may be included in legally binding contracts for the transfer of personal data across borders. We also led the development of an ASEAN Data Management Framework – a guide for businesses to implement a data management system with appropriate data protection safeguards. With these ready-to-use and flexible templates to transfer personal data, businesses operating in ASEAN markets stand to benefit from shorter contract negotiations on data flows. In conclusion, Mr Chairman, our success in digitalisation has also exposed new vulnerabilities. These will only grow as technologies evolve and become more complex. Trust in our digital systems is key to the success of our digital economy efforts. And without the trust to transact, or to innovate, our best efforts to develop our digital ecosystem and reap the dividends, create opportunities, will fall short. Strong foundations such as I have described will fortify our defences against online threats, and support this trust that we need to grow. But they are not sufficient. We need our companies and people to be aware of the risks, vigilant of the manifestations of these risks, and make informed choices to protect our safety. We can and must make the online space more secure and more trusted and thus create more opportunities for all of us.”
“This effort contributes to a rules-based multilateral order in cyberspace, and gives all states, big or small, confidence, predictability and stability, essential for economic progress, job creation and technology adoption. In terms of AI governance, Singapore takes an open and collaborative approach to govern the use of AI, recognising that we need to safeguard consumers’ interest and facilitate innovation. We launched the second edition of the Model AI Governance Framework in 2020, which incorporates feedback and examples from international and local companies across a diverse set of sectors, in response to the first edition of the Framework. It translates key ethical AI principles such as human centricity into practical measures, in line with our National AI Strategy. Ultimately, we lay strong foundations so that our people can look ahead, and reap the full benefits of the digital economy. We will remain open and integrated with the global economy to enable our companies to maximise opportunities beyond our shores. While our existing trade agreements meet the needs of traditional trade in goods and services, we recognise the need for new norms and rules to support cross-border digital transactions like e-invoicing, data flows, digital identities. This is why Singapore pioneered Digital Economy Agreements, or DEAs, building on our existing networks and initiatives. These DEAs facilitate seamless end-to-end digital trade, enable trusted data flows and build trust in digital systems. Beyond these DEAs, businesses can look forward to further support for transferring data to and from overseas seamlessly and securely.”
“Our cybersecurity talent base is a key enabler of these efforts and we are working closely with industry partners and Government agencies to nurture and grow our cybersecurity workforce. First, to meet near-term demand, we facilitate the training and upskilling of cybersecurity professionals, as well as fresh and mid-career non-cybersecurity professionals for cybersecurity jobs, through programmes such as IMDA’s Tech Skills Accelerator. Second, to strengthen our talent pipeline for the longer term, we encourage youths to pursue a career in the field through cyber outreach initiatives like SG Cyber Talent. We have engaged over 7,000 participants to-date. And thirdly, to groom world-class cybersecurity leaders, we launched the SG Cyber Leaders programme to create a community for current and developing cyber leaders to exchange ideas, and learn about global best practices. All of us need to play our part to create a safer and more secure cyberspace. There are things that we can do as individuals. We should enable two-factor authentication, update our software in a timely manner, choose a passphrase rather than a password, and stay vigilant to spot the signs of phishing. But there are also things that we do as a country. Our effort extends globally. Singapore participates actively in international discussions to develop and implement norms in line with our interests. As cyber threats are global and transborder, we are working closely with international partners across the UN and ASEAN to develop and implement norms for responsible state behaviour. For instance, we are producing an implementation checklist with specific actions that countries can take to implement cyber norms.”
“In concrete terms, this means that CII owners should not trust digital activity in their networks without verification. They should also authenticate continuously, detect anomalies in a timely manner, and validate transactions across network segments. This work will continue and will become increasingly complex in the future. Cybersecurity therefore has to be a collective effort and a core part of our lives in this digital age – integrated into the products we use and the way we behave online. As more enterprises go digital, our exposure to cyber threats grows in parallel. Cyberattacks on companies have a far reaching impact on our wider economy. So, as part of the Safer Cyberspace Masterplan, CSA will launch the SG Cyber Safe Programme to support companies in strengthening their cybersecurity. It comprises two parts. First, we will provide informational resources and educational material for key roles including C-suite executives, cybersecurity teams and frontline employees, based on their specific roles and knowledge needs. We need to shift attitudes and raise cybersecurity awareness through in-house training. Secondly, we will roll out a voluntary SG Cyber Safe Trustmark to provide a mark of distinction for companies that have invested appropriately and significantly in cybersecurity. This means that if you are a consumer, a business looking for an HR processing service for example, and care about the cybersecurity level of the service provider, you may look for this Trustmark for added assurance that this service provider takes cybersecurity seriously. CSA will engage stakeholders regarding the specifics of this Trustmark from April this year.”
“The reality is that we will not be able to prevent every cyberattack – malicious actors only need to exploit one vulnerability to compromise our systems, while defenders must safeguard systems under their charge against all threats, all the time. Consistent and deliberate efforts to strengthen our cybersecurity are thus critical. 5.15 pm Many essential services like banking and healthcare are powered by information and communications technology. These systems are our Critical Information Infrastructure or CIIs. Today, all CII owners must maintain a mandatory level of cybersecurity as part of the Cybersecurity Act. However, we also recognise that most organisations, including CII owners, engage vendors to support their operations. Therefore, we also need to manage cybersecurity risks across the supply chain. Doing so requires CII owners to have a better understanding of their vendors to identify systemic risks and improve the level of cyber hygiene with the vendors. To this end, we are developing a CII Supply Chain Programme – a partnership involving all stakeholders – Cyber Security Agency of Singapore (CSA), CII owners, and their vendors. The programme will provide recommended processes and sound practices for all stakeholders to manage cybersecurity risks in the supply chain. The discussions that we will have with the stakeholders as a result of this programme will also help the Government improve our policies around supply chain security. In the longer term, our CII sectors and the companies there will also need to adopt a zero-trust cybersecurity posture. This shift in mindset is necessary to defend against supply chain attacks by highly sophisticated threat actors, such as those behind the SolarWinds breach.”
“As a result, 28 million suspected scam calls were blocked in the fourth quarter of last year. However, the space is dynamic, there is an evolving behaviour of scammers and people who try to do malice to us, so existing solutions to block scam calls from overseas will never be foolproof. Today, no telco can verify with absolute certainty that a given incoming call is fraudulent. So, IMDA is working with the telcos to build new analytic capabilities within their networks to better identify and block spoofed calls with numbers that appear local, without blocking legitimate calls. These measures fit in with what MHA is doing in terms of their broader approach to mitigate scams. We will continue to work closely with MHA through the Inter-Ministry Committee on Scams. Cybersecurity threats are also growing in both number and sophistication. Members have just heard about the recent SolarWinds breach. This cyberattack compromised a network management software used extensively by major companies and governments worldwide. Notably, the software that was compromised was trusted and had privileged access to internal networks. It was a very sophisticated attack that went undetected for months. Closer to home, Singtel reported that some files were taken as a result of a breach to FTA, a third-party file sharing system that Singtel uses. Singaporeans are concerned about whether our systems are safe; so are we. And sensitive information needs to be sufficiently protected. With more activities taking place online, it is important that people trust the digital systems we use to store, collect and transfer our information.”
“Under the amended PDPA, if there is a data breach which may cause significant harm to affected individuals, you are to be notified directly by the shop so you can take timely, proactive measures to protect your data, such as by changing your passwords. If you choose to opt out of the mailing list, the shop is required to remove your details from the list and stop sending you recommendations within a reasonable period. So, businesses, as a result of the amendment, are held to a higher standard with more transparent and accountable practices. Like data, electronic transactions are also central to the global economy. To support wider digitalisation, the Parliament passed the amendment to the Electronic Transactions Act this year to adopt the Model Law on Electronic Transferable Records from the United Nations Commission on International Trade Law (UNCITRAL). The shipping, logistics and finance sectors now stand to benefit from faster and more secure electronic transactions compared to paper-based transactions. We expect to see benefits in terms of efficiency, productivity and, hopefully, cost savings as well. One concern arising from our digital push is the rise in online scams. In Singapore the most common type of scams relates to e-commerce and these increased by almost 20% from 2019. Overall, victims to scams lost more than $200 million last year. We take this matter very seriously – it is something that people are anxious about, it erodes trust in their transactions and their activities online – and we are working across the Government to tackle these scams. For example, we require telcos to attach the "+" symbol for all incoming overseas calls. IMDA also requires telcos to enhance capabilities to block calls from commonly spoofed numbers.”
“5G standalone networks unlock the full suite of capabilities, including network slicing and ultra-reliable low latency communications, necessary for applications such as cloud gaming and smart factories. 5G deployment has started and by the end of next year, we will have at least 50% standalone outdoor coverage for 5G. Nationwide 5G standalone coverage will arrive by the end of 2025. However, robust digital infrastructure alone cannot guarantee safe and secure spaces. Other keys to a strong foundation are a robust regulatory regime and an approach to remain relevant and fit-for-purpose amidst the evolving technological landscape. Data is a critical resource used to inform business decisions and also power emerging technologies such as artificial intelligence. Personal data requires strong safeguards and accountability but there is a balance we need to strike. You overcorrect for business innovation and you undermine consumer protection, privacy and trust. On the other hand, pursuing consumer interests narrowly hampers, potentially, business development. The public may ultimately suffer from poorer and more costly services. Our strong foundations therefore also need us to be agile and calibrated. We recently amended the Personal Data Protection Act (PDPA). For example, you may subscribe, to the mailing list of an online shop and as a result, you can receive customised recommendations based on your browsing history or based on your prior transactions. This is a benefit to you as a customer, as the consumer, from having shared your data.”
“Mr Chairman, I thank the various Members for their cuts and questions and I hope to address several of them in my response, especially those from Ms Jessica Tan, Mr Alex Yam, Mr Seah Kian Peng, Mr Xie Yao Quan and Mr Christopher de Souza. The digital space has had a deep impact on our daily lives and this transformative effect will continue for some time. For many Singaporeans, digitalisation carries the promise of more convenience, more efficiency and more options. As we do more online, we face an increased risk of cyberattacks, online scams and data breaches. We need safe and secure digital spaces. We need the online environment to be an enabler so that our people can benefit from the opportunities of this digital age. Today, I will focus on how we develop online safety and security – the strong foundations of our plans for digitalisation. Our strategies have to cover a broad range from infrastructure development, regulations and partnerships. We need to address a wide variety of issues so that our companies and our people can trust the digital systems that are so central to our lives. Beyond assurance, we want people to step up, to be empowered, to take charge of their online safety and to embrace the digital age with confidence. Strong foundations depend on a robust digital infrastructure. Our past investments in this infrastructure have recently enabled workers to switch to telecommuting and students to attend online lessons with relative ease during the pandemic. Looking ahead, we will need world-class, secure and resilient 5G networks. It was thus a policy priority for our nationwide 5G networks to be standalone – new standalone networks, 5G all the way through, from end to end.”
“Mr Speaker, my apologies to the Member. I do not have the data in front of me. The Parliamentary Question (PQ) was very much about the considerations for Phase Three, Reopening. I would say that the turnaround time is affected by a number of processes. Some of them are logistic and administrative as well as the laboratory process itself. We can follow up with the Member and his constituent separately. I just want to make an additional point, Mr Speaker, about the question that was raised earlier. If we do have more vaccines, it is possible that we can accelerate our timeline, but ultimately, this will depend on Singaporeans being willing and coming forward to be vaccinated.”
“Mr Speaker, I thank the Member for his question. The fundamentals of how we managed COVID-19 – safe management, hand-washing, PPE, distancing, reducing the dwelling time of crowds in crowded areas – these are going to be necessary and important parts of our fight against COVID-19, for as long as the virus is with us, whatever the variant may be. How we apply a given set of safe management measures will very much depend on the burden of disease currently in Singapore and and the risk that our population is exposed to. This will be a dynamic process as we go forward. And then, separately, we have to have processes in place to deal with the outbreaks themselves. So, the first portion was about how we prevent outbreaks and transmission. The second is when outbreaks occur. Again, the fundamentals will be the same: that we need to test people, we need to contact trace people and then we need to quarantine. What we will need to calibrate is, for example, how many steps removed you might want to contact trace, how long one quarantines an individual for, and what are the tests before someone is released from a quarantine. So, these are the general processes, but I think when it comes to the specifics of a given viral variant – these are now in a hypothetical space – the key point would be that we take reference from technical and professional advice. And we are very grateful that we have a depth of technical and professional advice to advise us in fighting COVID-19.”
“Mr Speaker, the vaccination timeline is dependent on a number of factors; most importantly, our ability to ramp up the capacity and capability of the vaccination centres and also the willingness of Singaporeans to step forward to get vaccinated and, indeed, the supply of vaccines. The approval or licensure of one given vaccine is not a rate limiting step in that process. We will look at the vaccine licensure as an issue of safety and efficacy of a given vaccine. Assoc Prof Jamus Jerome Lim (Sengkang): I thank the Senior Minister of State for his elucidation. I am wondering if he would be willing to share the processes that the Ministry may have in place for if there are outbreaks of more virulent strains of COVID-19 which are not as amenable to the traditional safe management measures, which would render some of our existing procedures less efficacious.”