Koh Poh Koon
Singapore
“In 2025, for walk-in patients, the median and 95th percentile doctor consultation waiting times were eight minutes and 72 minutes respectively. However, the Ministry of Health (MOH) does not track waiting times by peak versus off-peak hours, but it is likely that 95th percentile waiting times happened during peak hours.”
“The offences and penalties for importing, supplying or abusing SPS products are similar to those in the MDA, to ensure similar level of deterrence. Mr Speaker, with your permission, may I ask the Clerks to distribute a handout that summarises the changes in legislative penalties for key offences.”
“So, if you are a Singaporean student, you will expect that there will be some subsidies to the fees. The third question on how can the public, who may want to seek psychological care, know who is legitimate.”
“Sir, I thank the Member for his question on audiologists. In general, a qualified audiologist in Singapore needs a higher level of certification because a diploma level may not be quite enough to perform the task. So, we will look and see whether there is a way to actually find an in-between.”
“We are starting with registration to give formal recognition to those who are practising in higher risk sub-sectors in psychology and making sure that the quality, the standards and the support is given to them to deliver the care that the clients and the patients need.”
“It takes a bit of, not just system change in the providers, in the doctors and the care teams, but also, a gradual shift in the mindset of our population as well. So, it is something that we have to continue to do. There is no magic bullet to this and it is not something we can achieve overnight. 12.15 pm”
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“Sir, I thank the Member for his question. I do not have the numbers for the percentage of walk-in versus scheduled appointments. But I think, in general, most patients who do not have pressing issues will try to fix an appointment because they want certainty of time and to also reduce their waiting time. But healthcare being the way it is, there will always be a sudden onset of discomfort and unwellness that will prompt a walk-in appointment. That is why we do not work just based on polyclinic resources alone and we have resourced many of our general practitioner (GP) clinics with Community Health Assist Scheme (CHAS), so that patients have an additional option to go to a nearby GP clinic and get subsidised treatment at the GP clinics as well, even if it is a walk-in situation. It is about actually working with the entire resources of what we have in the entire healthcare ecosystem and not just focusing on polyclinics per se. And I think, over time, as we improve on our Healthier SG enrolment, there will be better relationships between the patient and their enrolled GP so that that stronger nexus and better understanding between the patient and the GP will hopefully also spread the load out for each individual patient to the GP clinics where they also have easier access to care and nearer their homes as well. 12.30 pm”
“So, there are quite a lot of complicated dynamics happening in a clinic on a day-to-day basis and it is very hard to predict ahead of time how each day will pan out. What we are trying to do is to stick as much as possible to more scheduled appointments, so, we minimise that variance as far as we can. We see that for scheduled appointments, the median waiting time in 2025 for a scheduled appointment is about 10 minutes. So, you can see that the medical staff tries as far as they can to complete a consultation and conversation within an allocated timeframe so that they minimise the snowballing effect. But the 95th percentile waiting time in 2025 for a scheduled appointment can go as high as 52 minutes. Again, like I said, if you are towards the end of that morning session where the prior patients before you had longer conversations, that snowballs into a much longer waiting time for those at the end of that session. This is what a healthcare clinic usually goes through and we will try our very best to resource with more consultation slots to actually meet all those demands. What the clinic tries to do is that, for those who turn up in a walk-in manner and for which the staff triage that this is actually not something that is an emergency or extremely urgent, they will try to schedule the next day's appointment for this resident, so that he or she can come back the following day without having to be subjected to a long waiting time as a sudden walk-in patient. I hope that kind of gives the Member a sense of how complicated it is, but how the efforts are still being made to try and reduce waiting time.”
“Sir, I thank the Member for his question. I think that is a question that many patients also ask. Let me explain what exactly happens in a clinic because it is not such a straightforward issue as trying to stick to increased capacity. Because in the midst of increasing capacity, we also want to optimise the use of that capacity. We could actually leave a lot of empty slots just in case there are walk-in patients, but that means there will be a lot of time wasted that will not be used if there are no walk-in patients. In the sense, there will always be a trade-off there. When we do schedule appointments, we hope that we can stick to the time. When the patient arrives, we then serve the patient within that allocated time. But as you can imagine, it is often not so straightforward to determine ahead of time how that conversation and the consultation with each particular patient will go. Even if we allocate, say, 15 minutes for what we think is a reasonable consultation time, sometimes the patient that comes in that time slot may have a very complex issue or multiple medical problems that takes a far longer conversation and examination to complete. In which case, it may take half an hour and, therefore, it eats into the next patient's consultation time. In a busy clinic, sometimes, such long conversations, on a particular day, you may have quite a few complicated patients that come in sequentially. That means that there will, therefore, be a snowball effect and patients who are seen at the later part of the session, of the morning session or afternoon session, will therefore end up experiencing a longer waiting time, even though they have been given a scheduled appointment.”
“In 2025, for walk-in patients, the median and 95th percentile doctor consultation waiting times were eight minutes and 72 minutes respectively. However, the Ministry of Health (MOH) does not track waiting times by peak versus off-peak hours, but it is likely that 95th percentile waiting times happened during peak hours. That is why it is important for us to operate on an appointment basis as much as possible, to optimise capacity and patient waiting times and to spread out patient arrivals across the day. That said, we always schedule fewer appointments than full capacity to accommodate walk-in patients with acute medical needs.”
“We will work with NEA and MSE on the Member of Parliament's suggestion to see how we can continue to help manage the issue of second-hand smoke and smoking within our heartlands. On setting standards for emission of tobacco products, this is already in current section 15 and the new section 14. We have existing limits on the content emission of nicotine and tar of cigarettes that will continue under the TVCA. On the suggestion to reduce addictiveness or tobacco and nicotine products, the Member of Parliament was likely referring to the nicotine cap policy I had mentioned earlier. We have considered this before and will continue to study it. It is possible to do so under the new section 14. But I do hear the Member's suggesting that the UK has a cap of 1.0 milligram and actually in Singapore, our nicotine emission yield is also capped at 1.0 milligrams since 2013. So, if the Member were to look this up, it is actually under the Tobacco (Control of Advertisements and Sale) (Limits on Certain Substances) Regulations 2010. So, our limits are no different from what the Member has cited from the UK. Mr Speaker, I believe I have addressed the clarifications raised by Members. I thank Members for their suggestions and support of this Bill. Mr Speaker, Sir, I seek to move. 2.52 pm”
“Finally, Members have asked about monitoring the effectiveness of the current enforcement approach, as well as monitoring trends in emerging substances of abuse. Beyond the number of offenders, we also monitor recidivism rates and other key indicators. MHA already works with international and regional partners, such as the Commission on Narcotic Drugs, the United Nations Office on Drugs and Crime and the Association of Southeast Asia Nations (ASEAN) counterparts, to monitor the emergence of new psychoactive substances. MOH and MHA also review various sources of data to identify and be alert to emerging substances of abuse. Specific to vaporisers, HSA also collects and exchanges intelligence with the World Health Organization and international regulatory counterparts and, on our own, we conduct random testing of vaporisers that we have seized to detect any new substances that is emerging in our market. If another psychoactive substance or product emerges in tobacco products, vaporisers or imitation tobacco products, it can be listed in the Schedule of TVCA fairly quickly, by amending the Schedule via an order in the Gazette made by the Minister for Health. So, there will be less scrambling and a lot more responsiveness to any emerging threats. Mr Gerald Giam cited clause 37 on the definition of smoking. Let me clarify that this is actually an amendment to the Ministry of Sustainability and the Environment (MSE)/NEA's smoking prohibition on certain places. It is not for the Tobacco Control Act, but it is actually an amendment to NEA's Smoking (Prohibition in Certain Places) Act. Smoking Area Ban policy is also under MSE and NEA's purview, but I understand where the Member is coming from.”
“Mr Yip asked about the safeguards that ensure the accuracy of our laboratory tests, given that a positive urine test can be presumed to mean that the individual has consumed SPS and committed an offence. HSA has extensive experience supporting CNB in conducting laboratory tests for enforcement under the MDA. So, these powers and capabilities are not new to HSA. Expanded powers require adequate resources to support implementation – this was also a point emphasised by a few Members. We adopted a whole-of-Government enforcement approach, where relevant agencies, such as the Police, CNB, NEA and National Parks Board (NParks) assist in the detection and referral of suspected cases to HSA. So, the enforcement is not done just by HSA alone. This has multiplied our effective enforcement capacity, with more than 13,000 officers authorised to-date. These agencies will continue to be authorised under the TVCA. To Mr Yip's question, HSA carefully assesses the suitability of these officers before empowering them with enforcement powers. This applies to officers from HSA and across other agencies. Officers are only authorised for specific powers that match their roles and experience and must also undergo prescribed training and competency assessments before being deployed. After deployment, they continue to be overseen and reviewed by their supervisors. On rehabilitation capacity, having operated these programmes for the past six months, we have provided for sufficient capacity, including in the DRC. We will regularly review capacity utilisation and projections, based on the latest offender numbers and trends and make the necessary adjustments.”
“Support will be provided to owners and occupiers of specified premises so they will understand how to fulfil their new obligations. As I have mentioned, this is not entirely new, it is similar to the obligations under the Smoking (Prohibition in Certain Places) Act that public entertainment premises are already subject to and it is not meant to be onerous or impose a disproportionate amount of legal liability on premise operators. HSA will support them in complying with these obligations. Practical guidance on the identification of prohibited products, how to engage and handle individuals possessing or using these prohibited products and when to engage HSA for further assistance, will be provided. To protect these owners and occupiers, it will be an offence for individuals to hinder, obstruct, threaten, abuse or assault owners and occupiers in the course of performing their duties. HSA will publish a handbook of best practices today on their website to illustrate what constitutes "due care" by owners and occupiers of land, buildings and places under the new offence of allowing other individuals to store prohibited products or their components in these spaces. I thank Dr Wan Rizal for his suggestions on this and, understandably, owners and occupiers may worry that the storage of prohibited products could happen, even if they have done their best to prevent it. Let me assure you that each case will be assessed based on the particular facts of each situation, and owners and occupiers who have exercised due care do not need to worry. We intend for the Bill to commence on 1 May and will provide support to responsible persons and owners and occupiers before then.”
“We will work closely to make sure that we have intelligence to deal with this. On vaporisers specifically, with the help of intelligence sharing, joint operations by HSA and ICA detected 59 large-scale smuggling cases in 2025, seizing around 230,000 vaporisers and related products. Thirteen of these cases have been charged. Dr Hamid, Mr Yip, Dr Wan Rizal, Dr Choo and Mr Vikram Nair have raised a few operational issues. Members asked how enforcement actions will be differentiated for SPS under the TVCA, and controlled drugs and psychoactive substances under the MDA. A SPS, once scheduled under the TVCA, will be automatically excluded from the framework of psychoactive substances under the MDA because this framework in MDA works on a negative list approach and SPS has been excluded. To Dr Hamid and Mr Yip's question on frontline enforcement, officers will assess the situation to route the case to the appropriate agency. Laboratory testing of the substance may be conducted to ascertain the identity of the substances involved and subsequently refer to the appropriate authorities. To Mr Vikram Nair's questions, when it comes to rehabilitation, those who are suspected or are found to have consumed only SPS will be handled by HSA. If both SPS and controlled drugs or psychoactive substances under the MDA are consumed, the MDA rehabilitation framework will take precedence, given the seriousness of those drugs and offences. Similar principles apply to prosecution. HSA and CNB will investigate the cases jointly if necessary. The ultimate decision on prosecution will be made by the Attorney-General's Chambers. For cases to be charged under the TVCA, we will take guidance from the existing body of law, including precedent cases charged under the MDA.”
“We have to go really upstream and stop the flow of these items into Singapore. If the products contain SPS, the penalties will be as severe and aligned to those for Class C controlled drugs under the MDA. During the investigations of suspected import and supply offences, HSA takes into account several factors, including the quantity and types of prohibited products involved as well as evidence of intent to sell or supply to others, to determine the nature of the offence and how an individual is involved. Factors such as age and number of past offences will be taken into consideration by the Courts when determining the appropriate sentences. Specifically for youth offenders, the Courts will also consider youth-specific sentencing options such as probation or reformative training. As Mr Yip and Dr Wan Rizal mentioned, supply channels are becoming more complex and decentralised, especially through the use of social media and messaging platforms. On the ground, we have also adapted our enforcement approach to better detect import and supply offences. Let me share two examples. First, HSA actively monitors sales and advertisements of vaporisers on such platforms and works with platform owners to remove these listings. HSA also collaborates with the Infocomm Media Development Authority and the Online Criminal Harms Act (OCHA) Office to block vaporiser websites targeting locals. Over 10,000 online advertisements were removed since 2024 and 27 websites blocked under the OCHA since September last year. Second, vaporiser supply chains predominantly operate overseas. The Immigration and Checkpoints Authority (ICA), CNB and Singapore Police Force already engage in information sharing with their foreign counterparts.”
“The providers of rehabilitation programmes will explore the underlying causes for the use of vaporisers and etomidate, and offenders will learn healthy coping habits and how to withstand peer pressure. These are tips that will help them to sustain a vaporiser-free lifestyle, post rehabilitation. For youths under 21 years old, the Youth Enhanced Supervision Scheme under the Ministry of Social and Family Development has an added element of family involvement, with some sessions conducted together with their parents or guardians. Parents can also refer to the Parent's Guide on Vaping on the Families for Life website for tips on having conversations with their children on vaping. To Dr Wan Rizal's question, HSA will closely engage parents and guardians and use the powers of section 19S judiciously. Parental and family support, I am sure we all agree, are crucial to helping young offenders quit. Parents who refuse to be involved in their children's counselling without reasonable justifications will potentially face criminal charges. However, despite our best efforts, if individuals decide to re-offend repeatedly, penalties will escalate rapidly. For vaping, they will be prosecuted and subject to the increased fine, up to $10,000. For etomidate vaping, they will be detained in the DRC for institutional treatment and rehabilitation. In answer to Mr Vikram Nair's question, this will be separate from other drug offenders. By the time they are sent to the DRC, these reoffenders would have been caught at least three times and given multiple chances to quit. To Mr Yip's question, mandatory imprisonment is imposed for importers and suppliers of section 15 tobacco products and vaporisers because they drive the continued availability of these harmful products.”
“Schools and IHLs have also played a big part to educate the young on the harm and consequences of vaping. The messages are also integrated into the school curriculum. Dr Neo Kok Beng asked about this earlier. For those who have already started vaping, we adopted a calibrated multi-layered approach. This approach provides multiple chances to quit before the more serious penalties apply. First, the avenue to seek help to quit remains open under the QuitVape Programme. Those who come forward voluntarily will not be penalised for doing so. In the past six months, more than 110 persons came forward to quit etomidate vaping. We hope more will do so. Next, for individuals who have been caught vaping, penalties will kick in, along with a requirement to attend rehabilitation for repeat offenders. For those consuming etomidate, testing of their urine or hair samples may be required on top of rehabilitation. To Ms Kuah Boon Theng's question, students caught for the first time will be guided by school counsellors and referred to the Health Promotion Board's (HPB's) QuitLine when needed. Her suggestion of working in a more coordinated manner across different Ministries, resourcing the counsellors, is something that we will take back and look at how to do so, although today, we do have close collaboration between HSA and the Ministry of Education. To Dr Choo Pei Ling's question, suspected offenders may have to undergo interviews, investigations and testing prior to being sent for rehabilitation. This explains the turnaround time between detection and start of the rehabilitation programme. We are working to minimise this turnaround time.”
“Mr Deputy Speaker, I thank the Members who have spoken and for their unanimous support for the amendments proposed in the Bill. Members have raised a number of thoughtful views and constructive comments. I have touched on some of these in my opening speech, so I will now elaborate more on other areas that were raised by Members. First, beyond increasing penalties to enhance deterrence, Mr Yip Hon Weng asked whether our enforcement approach would truly reduce youth exposure and initiation. Well, the fact is that firm enforcement alone will never eliminate vaping. However, a strong deterrence posture remains essential if we are serious about reducing the harm it can cause to our people. Vaping has not yet become deeply entrenched in Singapore. This gives us a critical window to act decisively. That is why we are targeting the entire supply ecosystem, the entire supply chain, through robust enforcement while at the same time supporting users through rehabilitation to prevent vaping from taking root in our society. Dr Hamid Razak and Mr Vikram Nair rightly pointed out the importance of preventive education. Many people, especially the young, picked up vaping out of curiosity or peer pressure. Therefore, we have also stepped up preventive education efforts in tandem. The national campaign across multiple platforms includes digital display panels cross the island, in our heartlands, especially, mainstream media and social media to inform the public about the dangers of vaping and etomidate vaporisers. We also collaborated with many online content partners to reach out to young people because this is where young people are consuming information, so this is a good way to reach out to them.”
“The Smoking (Prohibition in Certain Places) Act imposes similar obligations. The TVCA will spell out the steps which owners and occupiers of specified premises will be required to carry out, such as telling the offending individual to stop or leave the premises and seeking HSA's assistance if necessary. As a start, specified premises will include discotheques, pubs, bars, lounges and night clubs. These are entertainment venues where people often gather and where we have seen vaping incidents occur. HSA has already been working with some of these operators on anti-vaping measures in their premises, like putting up anti-vaping signages, and we are thankful for their cooperation. HSA will continue to work closely with the operators to comply with this new requirement, creating a safer environment for patrons. There are several related and consequential amendments to several other pieces of legislation, such as the Poisons Act, MDA, Civil Defence Act, Merchant Shipping Act, and Road Traffic Act, to align to the TVCA. I will not elaborate here. Sir, this Bill represents our commitment to protect public health, particularly against vaporisers, and to deter those who would undermine it. It consolidates the lessons we have learned over the last six months. With this Bill, we will move from temporary measures into a more structured approach, embedded in our legal framework, that can address current challenges and provides flexibility to respond to future trends. I urge Members of the House to support the Bill. Mr Speaker, I beg to move. [(proc text) Question proposed. (proc text)] 1.11 pm”
“The largest warehouse seizure exceeded 400,000 vaporisers and components, worth more than $5 million in street value. These are often cases where offenders rented storage units to run their illegal operations. Under the new section 18A, introduced by clause 10, it is an offence for owners and occupiers of land, buildings and places to allow other individuals to store prohibited products in these spaces. To avoid liability, the owner or occupier must have exercised due care to prevent such storage from happening. This may involve: conducting proper background checks on tenants, including asking them for uses of their storage spaces; explicit clauses in tenancy agreements on prohibited activities; conducting ad hoc inspections and so on. HSA will publish a handbook of best practices that owners and occupiers can refer to. The intent is to allow us to take action against owners or occupiers who allow or turn a blind eye towards storage of such illegal products in their premises for supply and distribution purposes. To facilitate enforcement, particularly against importers and suppliers of prohibited products, we are also introducing new powers to seize vehicles and trailers reasonably suspected of being used, or is intended to be used in connection with committing an offence under the TVCA, and to seize cash that is reasonably suspected to be evidence that a TVCA offence has been committed. While vaping is prohibited, some continue to do so in public settings, for example in night clubs, bars and pubs. Under clause 12, we are imposing obligations on owners and occupiers of specified premises to take certain actions when they find someone in possession of or using any section 15 tobacco product, vaporiser or imitation tobacco product.”
“For offences involving the sale or supply, including possession for the purpose of sale or supply, of these products, offenders will face mandatory imprisonment for up to six years, and additionally, may face a fine of up to $200,000. For offences involving the sale, supply or import of imitation tobacco products, the penalties will be increased to a fine of up to $100,000, or imprisonment of up to three years, or both for first-time offences; and a fine of up to $200,000, or imprisonment for up to six years, or both for repeat offences. We will also be introducing new statutory presumptions and offences to further strengthen our controls and enforcement on the supply chain. Rebuttable presumptions relating to possession and knowledge of the nature of prohibited products under the new sections 14 to 16A and SPS products will be introduced, along with similar presumptions in relation to vehicles and trailers in which such products are found. For example, with the new presumption under section 16C, if vaporisers are found in a vehicle entering Singapore, the driver of that vehicle will be presumed to be in possession of the vaporisers, and cannot avoid legal liability by simply claiming ignorance that the vaporisers are present in the vehicle. This will address the current challenge where most of the illegal operations bringing vaporisers and other prohibited products into Singapore are run from overseas, and it is extremely difficult for our enforcement authorities to obtain the evidence needed to prove that the suspect knew about the presence of the products found in their vehicles. Similar presumption clauses are also found in the MDA. HSA has uncovered several cases of illegal vaporiser operations in warehouses and storage units.”
“The Chief Executive can also require individuals subject to community-based rehabilitation orders to comply with other requirements, like undergoing urine or hair tests. Non-compliance can result in prosecution. Besides community-based rehabilitation at the Institute of Mental Health and social service agencies, the Chief Executive can also, under section 19U, order institutional treatment and rehabilitation in the DRC, for re-offending cases of SPS consumption. The Chief Executive can also require certain persons, such as those discharged from DRC after treatment and rehabilitation for SPS consumption, to provide urine or hair samples to check if they are still consuming SPS. Those who do not comply can be prosecuted. Finally, we will enhance penalties for offences involving section 15 tobacco products, vaporisers and imitation tobacco products. Mr Speaker, while etomidate vaporisers triggered the recent escalation in enforcement efforts, the majority of offenders we have caught are actually users of vaporisers that do not contain etomidate. We are therefore significantly increasing the penalties for offences involving these products to strengthen deterrence. For purchase, use and possession, the maximum fine will be increased from $2,000 to $10,000. The enhanced penalties are coupled with the new powers to order rehabilitation, so that those who need help to quit can receive support. For offences involving the import of vaporisers or section 15 tobacco products, we are introducing mandatory imprisonment for up to nine years, and additionally, offenders may face a fine of up to $300,000.”
“These adults are liable to imprisonment for up to 10 years for the first offence and imprisonment for two to 10 years for repeat offences. Section 19H addresses adults who involve young or vulnerable persons in importing or supplying SPS products. These adults are liable to imprisonment for four to 20 years and four to 15 strokes of the cane. Section 19I makes it an offence to arrange or plan gatherings where SPS products are used or supplied. Those found guilty are liable to imprisonment for two to 10 years and up to five strokes of the cane. Sir, rehabilitation is the main intervention implemented by MOH for etomidate vaporiser offenders. Today, this is effected in lieu of prosecution under Poisons Act. We will now provide for specific powers for the Chief Executive of the Health Sciences Authority (HSA) to order community-based rehabilitation and institutional treatment and rehabilitation under the TVCA. A community-based rehabilitation order can be made as long as the Chief Executive has grounds to believe that an individual has consumed an SPS. Such grounds of belief could arise from, for example, observation of an individual behaving erratically or appearing disoriented who is also found in possession of an SPS product; or an individual testing positive for SPS in their urine or hair; or admission by an individual that they have consumed SPS. Aside from SPS consumption, community-based rehabilitation can also be ordered for individuals who use vaporisers or section 15 tobacco products, based on observation of use, say, by an enforcement officer, or an admission of use. As per our current practice, rehabilitation will only be ordered for repeat offenders, to support them to quit vaping.”
“Members may also access these materials through the MP@SGPARL App. As Members can see on the handouts, individuals who supply SPS products will face two to 10 years imprisonment term and two to five strokes of the cane. Those who import these products will face stiffer penalties – three to 20 years imprisonment term and five to 15 strokes of the cane. And those caught possessing or purchasing such products, or consuming SPS, if prosecuted, can be liable to a fine of up to $20,000, or imprisonment for up to 10 years, or both. On the offence of consuming SPS, I would also like to highlight that although one of the Ministry of Health’s (MOH’s) criteria for listing a substance or product as an SPS is that it is abused or is likely to be abused by using a tobacco product, vaporiser or imitation tobacco product, the consumption offence is not confined to a specific mode. This means that once a substance or product is listed as an SPS, even if an individual abuses the SPS through means other than a vaporiser, tobacco product or imitation tobacco product, for example, in its liquid form or through a patch, they can still be dealt with under the TVCA. Like the MDA, it will be an offence for Singapore Citizens and Permanent Residents to consume SPS overseas. This deters locals from going abroad to feed their addiction to evade enforcement in Singapore. We have also introduced new offences to better protect our young people and children, again drawing from the MDA. Section 19G targets adults who, being in possession of SPS products, first, knowingly or recklessly leave them where children can access them, or second, do not take reasonable steps to prevent the use of SPS products by young persons.”
“The offences and penalties for importing, supplying or abusing SPS products are similar to those in the MDA, to ensure similar level of deterrence. Mr Speaker, with your permission, may I ask the Clerks to distribute a handout that summarises the changes in legislative penalties for key offences.”
“Third, in addition to the four categories, “Specified Psychoactive Substances” (SPS) will also come under the scope of the TVCA. These are substances or products that will be specified in a new Schedule, provided for in clause 23, being substances and products that can cause a psychoactive effect when consumed, and are also abused or likely to be abused by using a tobacco product, vaporiser or imitation tobacco product. Etomidate, currently under the MDA, will be listed in this new Schedule. Concurrently, etomidate will be removed from the MDA. The Minister for Health can amend this Schedule by order in the Gazette. The TVCA will focus on SPS, while the MDA will continue to govern the abuse of controlled drugs, including those abused through vaporisers or tobacco products. Hence, controlled drugs will not be included in this Schedule under the TVCA. The TVCA introduces two presumptions to do with the nature of SPS. One, a rebuttable presumption that such substances have a psychoactive effect when consumed. Two, for prosecution purposes, a person is deemed to have the knowledge that a product or substance is an SPS as long as the person knows that the SPS has a psychoactive effect when consumed. The person does not need to know the name or chemical composition of the SPS. These provisions mirror sections 22A and 22B of the MDA. Fourth, we are consolidating the enforcement levers under various pieces of legislation today, under the TVCA. Stiffer penalties will be applied to offences related to the products I just described – prohibited products, as well as tobacco products, vaporisers and imitation tobacco products containing SPS, that is, SPS products.”
“This reflects the broader mandate and coverage of the new law. Second, we have updated the categories of prohibited products under the TVCA. One, tobacco products, such as cigarettes, that contain any prescribed substances, or contain or emit substances exceeding prescribed limits. For example, this includes cigarettes whose emissions contain nicotine or tar in excess of the prescribed limits. The TVCA calls these "section 14 tobacco products". Two, various types of prohibited tobacco products such as smokeless tobacco and heated tobacco products, and their components too. The TVCA calls these "section 15 tobacco products". Three, vaporisers and their components. And four, other imitation tobacco products that are not already covered by the other sections I mentioned above, and their components. This allows us to future-proof our legislation, ensuring that new products that resemble any existing tobacco product or may be used to mimic the act of smoking, will be prohibited. Future-proofing is important, especially given that the tobacco industry has been introducing new products to circumvent tobacco control regulations. One example is products containing nicotine analogues, which will be considered a tobacco product moving forward, and can be prohibited under the TVCA. To be clear, products in all four categories are already prohibited currently under the Tobacco (Control of Advertisements and Sale) Act. When I say “prohibited”, I am referring to the entire supply ecosystem. Hence, under the Bill, we are making it clear that giving, transporting, sending or delivering these prohibited products within Singapore, offering to do any of these acts and possessing such products for the purpose of doing any of these acts, are prohibited.”
“First-time offenders are required to attend rehabilitation, in lieu of prosecution for illegal possession of etomidate under the Poisons Act. Those who default on the rehabilitation are prosecuted under the Poisons Act and may be subject to a custodial sentence. Third, repeat etomidate vaporiser offenders are placed under mandatory urine-test supervision, or detained in the Drug Rehabilitation Centre (DRC), under the MDA. Finally, we also introduced a new rehabilitation requirement for repeat vaporiser users, bearing in mind that vaping is harmful, even if does not contain psychoactive substances like etomidate. Over the past six months, we have caught more than 5,100 persons for vaporiser-related offences. Of these, more than one in 10, or 593, are etomidate vaporiser users. Among the offenders placed on rehabilitation, 42 defaulted their rehabilitation – of which one has been convicted and imprisoned and the rest will be charged. Seventy offenders have completed their rehabilitation programmes, with four youth offenders re-offending after their completion. These past six months have been critical, not just for enforcement, but also to consolidate lessons from our enforcement experience and review our laws. We are now ready to put in place a new law, which will not only prohibit vaporisers, but will also allow for enforcement against the abuse of etomidate and potentially other psychoactive substances through such delivery devices in the future. The new law is built upon the existing Tobacco (Control of Advertisements and Sale) Act, which will be broadened and strengthened. Let me walk Members through the key changes. First, we are renaming the Tobacco (Control of Advertisements and Sale) Act to the Tobacco and Vaporisers Control Act (TVCA).”
“Mr Speaker, on behalf of the Minister for Health and Coordinating Minister for Social Policies, I move, "That the Bill be now read a Second Time". On 1 September 2025, the Government launched a coordinated response to enhance the enforcement approach towards vaping, due to the emergence of etomidate-laced vaporisers or "Kpods". In the past, cigarette smoking and drug abuse were two separate issues. But vaporisers have changed that. It is no longer just about nicotine. People are using vaporisers to abuse etomidate or even other more serious controlled drugs. This makes vaporisers a bridge between these two worlds, creating new challenges in vaping enforcement and health protection. Hence, the Ministry of Health (MOH) worked closely with the Ministry of Home Affairs (MHA) and other agencies to leverage existing legislation to develop a new regime for enforcement, rehabilitation and education. Specifically, as our existing laws, particularly the Tobacco (Control of Advertisements and Sale) Act and Poisons Act, are not designed for such enforcement actions, we temporarily listed etomidate and its analogues as Class C controlled drugs in the Misuse of Drugs Act (MDA). I will refer to these substances collectively as “etomidate”. We then used legislative levers in the Poisons Act to take action against first-time etomidate vaporiser offenders as well as repeat offenders under the MDA. It was not ideal, but we made it work. In gist, this is how the enforcement system works today, since September 2025. First, we imposed much tougher penalties for those who illegally import, sell, supply or traffic etomidate – enabled by listing etomidate as a controlled drug under the MDA. Second, we created a rapid escalation of actions against etomidate vaporiser users.”
“We are starting with registration to give formal recognition to those who are practising in higher risk sub-sectors in psychology and making sure that the quality, the standards and the support is given to them to deliver the care that the clients and the patients need. At the moment, we are not looking at anything more than that for now. But let us take it one step at a time. Certainly, in the healthcare sector, we also have given out retention and measures to AHPs, I think it was in just about 2025, if I am not wrong. So, we will look at it holistically as part of supporting our AHPs.”
“And we hope that some of the First Stop resources we put forth will be a way in which our counsellors can convince the individual through a phone call to be prepared to step forward and receive care. Having said that, that will flow into the second question on the Tiered Care Model, on whether there are ways to monitor those who are at high risk and whether they receive care. Again and following from the train of thought, I would want to assure the Member that those who are deemed to be high risk will always be prioritised. So, for example, if they receive counselling online or through a phone call and the counsellor assesses that this individual is at risk of suicide ideation, they will try their very best to convince the individual to step forward and receive care. And if the person is prepared to come forth, there will be a protocol to fast track them to make sure that they receive immediate attention from a qualified psychiatrist or even present at the A&E in IMH, where care can be immediately rendered. Like I said, the biggest hurdle is whether they are prepared to step forward and not really the care capacity per se. So, I hope this is something that the Member can understand, why it is not meaningful for us to track some of these timelines, because the counterfactual is unmeasurable. There is no way to measure who are at risk and whether they turn up or eventually they become a suicide case. The counterfactual is unable to be validated. So, we will therefore, focus on putting forth resources, to make sure that if they are prepared to step forward, the resources will be available. On the third question on retention for psychologists. I think let us take one step at a time.”
“Sir, on the first question regarding KPIs for the NMHO, I did mention in my earlier Parliamentary Question replies a few days ago that our key focus now is on building capacity, because in ensuring enough capacity to meet the needs of those who may need to seek help, naturally, it will reduce many of these waiting times. But what is important is that putting forth the First Stops for Mental Health, which is accessible – for example, mindline.sg is 24 hours and is accessible and it is anonymous – would really remove the key barriers that are holding everyone back from seeking at least the first contact point to get some advice and seek further help. And in terms of KPIs, therefore, the First Stops would not have waiting time. There is a 24/7 available chatbot. There are counsellors who are manning the phone lines that you can actually call anytime to speak to them or to text them on WhatsApp. So, I think from that first touchpoint, there is really no waiting time. But what is important is to make sure that the individual who gets into the first touchpoint, is prepared to also receive help from higher tiers of care if they need to. Often time, this is where the challenge is. Many of them will be reluctant to move on to the next tier of care, because as all of us have dealt with in a community on challenging individuals with mental health issues, sometimes getting them to even come forward to seek help is the problem. It is not that the resources are not there, but they are not willing to come forward. And it is multi-factorial. It is difficult, so it is really about convincing them, working with them, earning their trust.”
“Sir, I thank the Member for his question on audiologists. In general, a qualified audiologist in Singapore needs a higher level of certification because a diploma level may not be quite enough to perform the task. So, we will look and see whether there is a way to actually find an in-between. But ultimately, we cannot sacrifice standards just to meet the needs of people who want to take a shorter course to get there. The first thing is to maintain standards. But there are actually some of these audiology programmes that are done at a lower level. For example, I do believe that there are some basic industrial audiometry course at Temasek Polytechnic, but that is really more for industrial application of technicians who are actually screening at the industry level, not so much as a clinical setting where you actually provide services at the hospital. 12.30 pm”
“So, if you are a Singaporean student, you will expect that there will be some subsidies to the fees. The third question on how can the public, who may want to seek psychological care, know who is legitimate. In the meantime, before registration, it will be very hard for us to provide a detailed list of the individual specialists or psychologists. But perhaps, what they can do is to check whether this individual is registered, at least for the moment, with the Singapore Psychological Society. Because at least, that is the community of practice that is recognised as peers. So, that will be a place to start for now. But certainly, for those psychologists who are practising in our public healthcare institutions, there is already a governance framework in place and the public should at least be comforted that these are the ones that have already been under supervision and recognised by our public healthcare institutions.”
“Sir, I thank the Member for her three clarification questions. On the first question about how many psychologists will end up eventually in the system and what does the new pathway mean in terms of increasing the headcounts, I would say it is probably very hard to tell at the moment. The course, I think the initial phase of intake will only be about for 10. So, we will also see what the uptake is from the first intake of the course. But bear in mind that there is also a pathway for existing psychologists to upgrade. So, that is an existing pathway. We need to actually just sense out what is the demand overall from the undergraduates as well as the in-service psychologists over time. The challenge also is because we have not done registration of psychologists before this. So, we do not really have an accurate number how many psychologists there are out there. But offhand, the Singapore Psychological Society has about 1,700 members. Most of them are also practising in the clinical space. So, if we take that as a ballpark, that is roughly probably the numbers that we are going to start with when we formally do the registration. But in time to come, once the registration is done, we will have a better grasp of the situation. On the second question of what support will be given to the aspiring students who may want to enter the course, we are still in the midst of discussing with the institutions. But I would say, minimally, they will have to meet entry criteria, because that standard is not something we can lower. But beyond that, other support measures, like whether there will be subsidies for the course fees, it will largely, my understanding is, it will be in line with what the IHLs have today.”
“It takes a bit of, not just system change in the providers, in the doctors and the care teams, but also, a gradual shift in the mindset of our population as well. So, it is something that we have to continue to do. There is no magic bullet to this and it is not something we can achieve overnight. 12.15 pm”
“Sir, I thank the Member for his two questions. On the first question of team-based care and whether certain AHP-led services are underutilised. We acknowledge that this is one of the challenges we have to continue to deal with, because patients do have autonomy on who they eventually want the care to be given. So, it is not something that we can do to force person to see a particular professional. And that is why, building rapport is important. At the same time, we are also signalling that these are professionals that have been trained, given accredited certification to perform at a higher level. And over time, we hope that the lived experience of patients who have seen these professionals will validate some of the outcomes that patients are looking for, so that over time we build confidence, build rapport in the community, and patients will gradually accept the kind of referral pathways that we are channelling to. One of the things that we are doing in the CHP is to have more nurses actually now fronting many of the conversations for our seniors. It is a good way to socialise to our seniors and our patients that the nurse can deliver many of the care that they already need. So, it will take multiple approach to do this and it will take some time as well. But increasingly, we are also seeing that this capacity will be better utilised by the population. The second question on enrolment across the different providers, especially in Healthier SG, that indeed is something that we have to continue to work on. Because beyond enrolment is also how well the clients or the patients follow-up with what is needed in the implementation of the care plan. So, we are under no illusion that just because we roll out Healthier SG, everything will be very smooth right at the beginning.”
“Adopting a "no wrong door" approach to facilitate access to services and right-siting care in primary and community settings encourage individuals to seek help early in non-stigmatising environments while avoiding over-medicalising mental health needs. We also hear Mr Eric Chua's concerns about our people paying for the silent addiction to explicit materials. On this, we recognise that addiction extends beyond individual health to affect families and the broader society. Individuals may also face underlying difficulties such as financial hardship and lack of social support. The National Addiction Management Service, situated within the IMH, was established to provide treatment and assistance for individuals seeking help for addictions. The National Addiction Management Service specialises in addiction medicine research, which includes intoxicating substance use and emerging areas of concern such as Internet and gaming. MOH, together with the Ministry of Social and Family Development, and National Council of Social Service, and other stakeholders across sectors, will continue to develop and enhance access to addictions services in the community. Sir, healthcare is highly dynamic and fluid, compounded by shifting patient demographics and needs. As we navigate the road ahead and future challenges together, these three pillars will work in tandem to strengthen the core foundation of our healthcare system. We are not just filling positions – we are building a sustainable workforce and system that can adapt, collaborate and deliver good quality care to all Singaporeans.”
“Youth-oriented self-help services, such as Let's Talk and Ask-a-Therapist, can also be accessed on mindline.sg. 11.45 am In addition to these services, an ecosystem of support is available within the education system. Educators and staff are trained to look out for signs of distress in students, and refer those who require further support to counsellors in schools or IHLs as well as community mental health professionals. Peer support structures are in place for students to look out for one another and encourage distressed peers to seek help from trusted adults. Youths are also taught ways to build mental wellness and resilience through the Character and Citizenship Education curriculum in schools and mental well-being programmes in the IHLs. Fourth, we are enhancing capabilities of community service providers through the National Mental Health Competency Training Framework and have trained over 160,000 frontline personnel and volunteers to identify and guide individuals in mental distress to support avenues. Fifth, we have promoted mental health and wellbeing through educational efforts for the general public, parents and youths through campaigns such as Beyond the Label and resources like Parenting for Wellness and the Positive Use Guide. Lastly, we have strengthened workplace mental health support in collaboration with the Ministry of Manpower and Workplace Safety and Health Council. The Well-Being Champions Network has grown from 54 founding member organisations to 800 over the last two years. As mental health is a complex and multi-faceted issue, we continue to work with various agencies to track and monitor medium- to long-term trends, including overall state of mental health and well-being of our population, for evidence of improvements from the baseline.”
“Since the launch of the National Mental Health and Well-being Strategy in 2023, we have established the National Mental Health Office in 2024 to coordinate and oversee multi-agency mental health initiatives. First, we have guided mental health service providers to adopt the Tiered Care Model and improve care coordination across different providers, enabling clients to receive seamless care at the most appropriate care setting. Second, we have expanded the capacity of mental health services across the primary, community, acute and long-term care sectors. Polyclinics and GPs are equipped to provide care to individuals with mild to moderate mental health conditions, such as anxiety and depression. Community mental health teams provide a range of mental health support to individuals with mental health needs. Today, we have 71 Community Outreach Teams (CREST) and 26 Community Intervention Teams (COMIT) to conduct outreach, screening and assessment, psychological intervention and service linkages for seniors with mental health needs or dementia and their caregivers. By 2030, we will expand the number of CREST and COMIT to 75 and 35 respectively. We have also established the First Stop for Mental Health services to facilitate easy access and navigation of mental health services. Third, we expanded support in encouraging help-seeking amongst youths. Youths can access CREST-Youth and CHAT, which are sited in the community. Those who need psychosocial interventions may then be referred to the Youth Integrated Teams. The recently launched Grovve – spelled g-r-o-v-v-e – at *Scape also provides mental health services to youths where they gather, to improve access and reduce barriers and stigma.”
“With this, our AHPs will be more versatile and able to work more collaboratively to deliver care holistically. For nursing, we are working with the polytechnics to redesign existing nursing post-diploma specialty programmes into a work-study format. This allows the nurses to learn and practise in real-world settings as training is based directly on job activities, enabling nurses to become competent and productive more quickly. Two Advanced Diploma in Nursing programmes – Palliative Care and Community Health – will be prioritised for initial launch in a work-study format. With enhanced capabilities, our healthcare workforce is better positioned to deliver comprehensive care. Ms He Ting Ru has asked for an update on the regulation of mental health professionals. We will be registering five higher risk sub-disciplines of psychologists to ensure high standards of practice, ethics and professional conduct so that our people receive safer and higher quality psychological services. These are clinical, clinical neuropsychology, counselling, educational and forensic psychologists. MOH and partner Ministries will work with Singapore Psychological Society to raise public awareness of the psychologist professions and support our professionals and stakeholders in navigating the registration process. The detailed registration schedule, requirements and roadmaps will be announced by early 2027. The third and last pillar is to develop a flexible and agile healthcare system that can respond to fast-evolving healthcare needs. One example is in mental health. Mental health concerns came to the fore during the COVID-19 pandemic and remains a key national agenda in MOH. Ms He Ting Ru and Mr Alex Yeo asked about this.”
“We have spoken in this House before about the challenges in attracting and recruiting nurses, especially during the COVID-19 pandemic. While the attrition of nurses has since fallen back to pre-COVID-19 levels of around 7%, we will continue our efforts to encourage more nurses to stay and contribute to the public healthcare system, as well as attract aspiring individuals to build a career in this sector. In 2024, we rolled out the Award for Nurses' Grace, Excellence and Loyalty scheme, and reviewed and adjusted nursing salaries in 2025. In 2025, we have also increased the salaries of allied health professionals (AHPs), pharmacists and administrative, ancillary and support staff in public healthcare institutions by up to 7%. But retention of healthcare workers is not enough to build a robust healthcare system. We need to continuously upskill our healthcare workforce to take on new and expanded roles. Healthcare today does not fit neatly into traditional silos. A patient with multiple conditions needs professionals who can work seamlessly together. That is why we are moving from rigid, specialty-focused training to flexible, competency-based learning delivered via stackable modules in a work-study format where possible. This reduces time away from work and the impact on patient care. For AHPs, we are working with IHLs to build up shared competencies across relevant allied health training programmes to better support a team-based shared-care model. These will be rolled out progressively, starting with students who begin their studies from Academic Year 2027 onwards. Separately for mental health, the shared competencies are outlined under the National Mental Health Competency Training Framework to create a "common language" among our AHPs.”
“To Dr Wan Rizal's query on strengthening the local pipeline of clinical psychologists while maintaining professional standards, we have worked with the Ministry of Education and NUS to offer eligible undergraduate students an accelerated pathway to specialise in Clinical Psychology at Master's level, with the first intake in 2026. Unlike the current training model, where an undergraduate needs at least seven years to be qualified as a clinical psychologist, this includes four years for their Bachelor's degree in Psychology, followed by one or two years of work experience before enrolling in the two-year Master of Psychology (Clinical) programme, this new accelerated pathway for undergraduate-to-Masters pathway can be completed in five years. It would enable aspiring undergraduates, who set their minds fairly early, to be trained as clinical psychologists through a carefully curated curriculum. This curriculum comprises didactic learning and clinical training during the undergraduate years, developing practitioners with knowledge and skills to care for their patients. Graduates of this five-year programme will receive both a Bachelor's degree with Honours and a Master's degree. NUS' new accelerated undergraduate-to-Masters pathway will complement existing postgraduate training pipelines, including its existing standalone two-year Master of Psychology (Clinical) programme for those with relevant clinical work experience. Together, these programmes expand our clinical psychologist manpower pipeline to meet increasing mental health needs. Healthcare workers remain the bedrock of our healthcare system. Even as we create new training pathways, we have implemented strategies to improve retention of our healthcare workers.”
“Mr Patrick Tay will be pleased to know that MOH has been giving IMH additional funding to enhance the psychiatric services and upgrade its infrastructure for better patient care, to be a leading hub for mental health training and education, and establish its position in tertiary and quaternary mental health research. There are also ongoing efforts to enhance psychiatric in-patient, outpatient and crisis care capabilities across our public healthcare institutions to support individuals with both physical and mental health services in the same hospital. In each of these, care team transformation provides integrated care for patients – promoting team-based care, right-siting of care to the community so that it is more accessible and affordable for our people, and redesigning roles so that professionals are allowed to advance and perform at the apex roles in a safe manner. The second pillar is to build a sustainable manpower pipeline. Our current healthcare workforce is broadly adequate for the population's healthcare demand. We will need to grow our healthcare workforce by 20% by 2030 to meet the projected manpower demand. We are working closely with institutes of higher learning (IHLs) to introduce more training pathways to build up a strong local pipeline through Pre-Employment Training. Mr Cai Yinzhou would be pleased to know that the graduate-entry Master of Science (Audiology) programme at NUS runs biennially and has an average of 13 graduates per cohort. For podiatrists, demand is being met through scholarships for local talents to pursue podiatry studies overseas and recruitment of overseas-trained podiatrists.”
“Singapore's healthcare system has delivered good health outcomes at an affordable level. Our life expectancy is about 86 years, as reported by the Institute for Health Metrics and Evaluation, ahead of many other countries, such as Japan, Switzerland, Australia, South Korea, the United Kingdom (UK) and the US. On the other hand, our national healthcare expenditure is at 4.4% of our GDP, which is less than half of what other countries spent. This was reported by the World Bank in 2019, and you saw earlier from the charts that Minister has shown that indeed we were able to achieve good health outcomes at a fraction of the cost relative to other countries. In addition, our hospitals have contingency measures to respond to surge in bed demand. These include adding beds, expediting clinically appropriate discharges and deferring non-urgent electives to free up acute capacity for incoming patients. If required, hospitals can also tap on facilities, like the Transitional Care Facilities and the Mobile Inpatient Care @ Home, to augment overall capacity. Even as we augment capacity, our people are at the heart of the healthcare system. Public healthcare institutions roster staff to ensure adequate rest in between shifts and also monitor the well-being of our staff as they care for our people. These are experiences we learnt also from the recent COVID-19 pandemic. With the increased demand in mental health services, the Institute of Mental Health (IMH) will continue to serve as national centre for psychiatric services and focus on providing quaternary care to patients with more complex mental health needs.”
“We agree with the vision shared by Dr Haresh Singaraju on how social prescription is integral to preventive care and Healthier SG. That is why the Health Plan in Healthier SG includes encouraging patients to adopt lifestyle changes, more exercise and less unhealthy food. However, we acknowledge that social prescription is still not commonly adopted, and there are more that we can do together to encourage that. We will work with community partners to make these interventions available to residents. In particular for seniors, the network of AACs will support them in this. Minister of State Rahayu has elaborated earlier in her speech. In addition, the hospitals also have their respective initiatives in social prescriptions. I also want to assure Mr Pritam Singh that our public hospitals have in place protocols to expedite urgent cases in the Emergency Department, and urgent referrals from primary care to Specialist Outpatient Clinics. Waiting time alone is not indicative of the quality of medical services. Patients present with varying degrees of severity. And in all the top hospitals of the world, patients with more urgent and severe conditions are up-triaged and seen earlier and given necessary resuscitation. That is how healthcare systems function. Based on several sources, which the Members can also Google, Singapore's healthcare system is consistently ranked within the top 20. In 2000, the World Health Organization ranked Singapore's sixth best in the world. Our public health institutions have also consistently been recognised as being one of the best in the world. In 2026, Newsweek and Statista, a global data platform, ranked the Singapore General Hospital 10th, while the National University of Singapore (NUS) and Tan Tock Seng Hospital are also in the top 100.”
“30 am And upon discharge, the care of such a patient could then be handed over to their family physician, some of whom are now trained as family medicine specialists, to manage patients with more complex medical conditions. Likewise, team-based care has been introduced in the polyclinics and Primary Care Networks since 2015 and 2018 respectively. Under such a model, patients with chronic diseases are managed by multi-disciplinary care teams comprising doctors, nurses and care coordinators. This ensures care continuity and builds the trust between patients and their care team. In response to Mr Cai Yinzhou's query on the provision of specialist dental, audiology and podiatry services in the heartlands, we recently enhanced Community Health Assist Scheme (CHAS) subsidies for dental care and are expanding dental services at polyclinics and strengthening partnerships with community dental providers – moves that will bring affordable dental care closer to where our seniors live. Most geriatric dental needs can be managed by polyclinics and CHAS dental clinics. Specialist care is available for more complex conditions at our hospital dental clinics as well as two national specialty dental centres – the National Dental Centre Singapore and the National University Centre for Oral Health. Additionally, while podiatry services are available at selected polyclinics, foot screening services for patients with diabetes are available at all polyclinics as well as Healthier SG GPs through their respective Primary Care Networks. Besides transforming our care team in the hospitals and right-siting care to the community, we also want to empower our people to take ownership of their health.”
“Mr Chairman, when Minister spoke about our journey towards becoming a super-aged nation, he highlighted something fundamental, that our people are at the heart of healthcare transformation. I will speak on our approach to workforce and care transformation in healthcare, which is carried out via three pillars. First, we redesign roles and right-site care. Second, we build pipeline to ensure manpower sustainability. And third, we develop a flexible and agile healthcare system. Picture this: a patient with diabetes, heart conditions and mobility challenges, juggling multiple appointments across different clinics, each visit requiring time off work, not just for the patient but for the caregiver sometimes, special transport arrangements and often, a caregiver's support to accompany them for these visits. This fragmented experience is not just inconvenient. It is unsustainable as our population ages and our healthcare needs become more complex. How can we meet the rising healthcare needs of an ageing population, improve the care experience while maintaining the quality and standards of care? First, we redesign roles and right-site care. Today in a hospital ward, a patient receives coordinated care through a team led by a principal doctor (PD) who is accountable for the patient's overall care plan. Under the new care team model, a PD need not be a specialist. Once they are trained and assessed to be competent, a Hospital Clinician may take on the role of a PD to supervise, oversee and coordinate care, incorporating the inputs of various healthcare professionals. Patients need not be seen by different doctors for each condition, thus reducing the number of referrals to other specialists during their stay. 11.”
“The third is the post-incidence management and this is where the zero-tolerance stance by the institution is something that we emphasise to management within the hospitals. So, I want to assure the Member, as well as all our healthcare workers, that incidents like these will be taken seriously. If there is a concern that the hospital has not been fair to the staff, they can escalate it to MOH, where we will take a separate independent review on this as well. 10.32 am”
“Thank you, Sir. I want to thank the Member for expressing some of the potential concerns and indeed, as he has a resident who has spoken to him on this. I should take this chance to also reiterate that MOH and the Government takes a zero-tolerance stance against abuse of any healthcare workers. I am aware that hospitals do even report perpetrators to the Police for further investigation and take actions against them. The reason why it is important for the hospital to have an internal process is because the incident management itself does involve making an assessment on the perpetrator – sometimes, the perpetrator himself is the patient. And therefore, there are medical confidentiality issues to allow appropriate judgement on whether that action was something that ought to be taken to task for or if the patient is not compos mentis and he is actually not in the right frame of mind. And so, the action was committed because he has no self-control, because he could have mental illness, for example. So, there are real reasons why we keep this process internal to the hospital, because they are in the best position to make a judgement. If I can just illustrate this, there are three parts to incidence management. First, is the immediate response and that involves actually dealing with, sometimes, the patient who is the one causing the harassment or the patient's next of kin. That has to be something that is dealt with onsite, not by an external third-party. Secondly, is the reporting and review of the incidence. That is where I made the point earlier about reviewing the medical information behind this. The circumstances that led to the incident would involve some confidential information about the patient, for example.”
“Sir, the National Mental Health Office works closely with various agencies, including the Agency for Integrated Care, as well as touchpoints with our community partners that are delivering some of these care in the community. Through the regular interactions and structured meetings, we do get a sense of what the resourcing gaps might be. And right now, one of our measures is to push forth training resources and having some pocket guides to help the care providers right-site the clients to the right level of care so that they are not overburdened by those who need more care than they can provide. In these interactions and formalised meeting sessions, we will be able to get a sense of where the gaps might be and if need be, provide them with extra resources. It could be funding, could be training support to be able to deliver the services that they need to do in the community.”
“Sir, the Member's first question would be more appropriately directed to the Ministry of Digital Development and Information (MDDI), which is the agency and the Ministry responsible for working with the app developers on app design and how they put forth products onto the market. So, I urge the Member to perhaps raise the questions with MDDI in a subsequent Parliamentary Question. But on his question of whether we will do more to educate and protect users from some of the harmful things that might be available on apps, the answer is yes. But we will need to look at how we can balance between increased protection for users versus personal autonomy, and the practicality of enforcement. Because at the end of the day when we – I am not sure whether the Member was referring to young adults as in adults or if he was referring to teens – because if we are talking about a young adult, he is still an adult and he does have personal autonomy. So, our approach has been to go more upstream to educate, to raise awareness, but also to work upstream with developers and app stores to make sure that there are some age appropriate safeguards, so that for those who are below a certain age threshold for which they are not deemed as adults, put some barriers in place so that they are not actually exposed to it when they are still teens or young people. So, I think that that is something that we will continue to do in a evidence-driven way – looking at the proportionality of the measures that we are going to do, but also make sure that it is feasible and ensure that there are no unintended consequences of any measures we put forth.”
“" Maybe a case management approach to check in on the person, to just find out how you are doing after the first few months, to just make sure you handhold not just the individual, but maybe work with the HR in the company to understand how the HR for the company can better support this person who may need a lot more guidance, being away from the workforce for some time. So, these are ideas we are all exploring right now.”
“How we can actually then enlarge this could be through the various trade associations and chambers or even through the Career Longevity Centre, where employers themselves can conduct conversations and workshops, share their own experience, so that SMEs and companies of different sizes can learn together, have a community of practice and that then takes away some of the fears of even embarking on this transformation of the workplace, by the companies. So, that concept is exactly what we are thinking of. How we operationalise it, is something that is still in discussion and we are open to ideas. The third one on how we can help caregivers. If we can get our career and employment support ecosystem, as Minister and myself had articulated, up to speed, crowding in a lot more of the private sector players in this space as well, some of the resources that we put forth, not just for the senior workers, can also be useful to those caregivers who have left the workforce for some time, who needed maybe a bit more of a skills uplift. So, the concept of the Career Longevity Centre or the combination of WSG and SSG coming together can do, is indeed in that direction, to put a one-stop kind of service for those who may need not just upskilling, but also have a bit more planning on how they can re-enter the workforce, and eventually find a better way to manage their entry into the workforce, perhaps even consider a case management-type of approach. In other words, the caregiver who may have been out of the workforce for some time, you cannot just leave the person alone to just, "Oh, here is a job, and good luck to you. It is between you and your employer.”
“Sir, on the Member's first question about whether we will consider a Company Training Committee-style support. The answer is yes, because the Company Training Committee structure and the format is really a means to an end. So, if there are companies today, even before we start with the Career Longevity Centre, for example – even today, any company that is keen to do a more systematic transformation of their workplace in the business model, together with bringing workers along, can already approach NTUC, where there is a team of dedicated industry training officers that can guide a company through a Ops-Tech road mapping process and then chart out the road map for them to do a Company Training Committee-style transformation. That can affect the whole entire company's workforce, not just for the mid-careerists. The second question on whether there will be sector-specific multi-stage pathways. That is one area of thinking we are looking at as well, because as I said in my speech, there is no one-size-fits-all model that will work for all companies or for all sectors. So, in order to have a little bit more of a targeted, tailored-made kind of a pathway for companies, we think that the AfA concept of what we are doing by having companies from different sectors piloting some of the ways in which they help to transform into a multi-generational workplace. They could then start to share their learnings with fellow companies in the same sector. So, that is one approach that we can take.”