Ong Ye Kung
Singapore
“The Ministry of Health (MOH) recently enhanced the Community Health Assist Scheme (CHAS) dental subsidies, which are tiered by income, for common preventive and restorative procedures.”
“Healthier SG GP clinics may also refer their enrolled patients to Active Ageing Centres and Community Health Posts to fulfill their social prescriptions and for subsidised services, such as medication management.”
“Public hospitals, such as the National University Hospital, the Singapore General Hospital and Tan Tock Seng Hospital, have deployed robotic-assisted surgical (RAS) systems for minimally invasive soft-tissue surgeries.”
“The Health Sciences Authority (HSA) welcomes drug producers to choose Singapore as part of their first-wave filings. As long as a pharmaceutical product is approved by at least one regulatory agency, such as China's National Medical Products Administration (NMPA), it would also qualify for the abridged route.”
“A decrease in estimated glomerular filtration rate in patients with diabetes can be due to multiple reasons. Doctors will first investigate the underlying cause before determining whether the patient should be referred to a specialist. Some causes are reversible and cause transient reduction in renal function.”
“Information on the Lasting Power of Attorney (LPA) cannot be made visible on the National Electronic Health Record system as it is protected under the Mental Capacity Act. Such information may only be disclosed by the Public Guardian to specified persons upon satisfactory submission of evidence(s) required under the law.”
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“The question has been addressed in the answer to Question No 31 in the Circular for Written Answers To Questions For Oral Answer Not Answered by End of Question Time on 9 January 2024. [Please refer to "Appeals for Individuals who Missed Out on COVID-19 Resilience Medal", Official Report, 9 January 2024, Vol 95, Issue 118, Written Answers to Questions for Oral Answer not Answered by End of Question Time section.]”
“The average waiting time for patients seeking subsidised endodontic treatment, including root canal treatment, at public healthcare institutions is about 30 days. Regardless, emergency dental cases will be seen and stabilised on the same day before being referred for further management. In addition to public healthcare institutions that offer dental services, eligible Singaporeans can also benefit from subsidised root canal treatment at private dental clinics which are part of the Community Health Assist Scheme. There are many requests for treatments to be eligible for MediSave deduction. They need to be carefully considered, to strike a balance between improving healthcare affordability, ensuring MediSave adequacy and keeping Central Provident Fund contribution rates reasonable for all. MediSave can currently be used to pay for dental day surgical treatments, which generally incur higher out-of-pocket costs. Nevertheless, patients who cannot afford their dental treatment after subsidies and/or MediSave use can approach medical social workers for MediFund and other financial assistance. The Ministry of Health will continue to review our financing schemes to ensure dental services remain affordable.”
“Private cord blood banking is an elective, for-profit service, where parents pay to store their child’s cord blood for potential future use. There have been 14 withdrawals for transplants since the establishment of cord blood banking services in 2001. The Healthcare Services (Cord Blood Banking Service) Regulations 2021 set licensing requirements for cord blood banks in the collection, handling, processing, storage and distribution of cord blood. The requirements are aimed at assuring the viability of the cord blood units released for transplant purposes. The Ministry of Health will review areas to strengthen these regulations, where appropriate, arising from the Cordlife incident.”
“Processed foods, and especially ultra-processed foods (UPFs), are associated with poor nutritional characteristics, higher energy density; higher sugar, salt and saturated fat content; lower fibre and vitamin content and, hence, adverse health impact. Currently, there are no international medical or dietary recommendations on the intake of UPFs. Singapore has also not introduced legislation targeting UPFs. Nevertheless, the Health Promotion Board has implemented measures to encourage healthier eating and to consume less saturated fats, sugar and salt. The measures include the Healthier Choice Symbol, Nutri-Grade marks for pre-packaged and freshly prepared beverages, promotion of low sodium salt and prohibition of partially hydrogenated oils. If effective, it will cut down the consumption of UPFs.”
“The Institute of Mental Health does not discharge patients who fail to attend appointments. Patients who default on follow-up appointments will be called by a case manager and encouraged to return for follow-up. Should the patient decline, a home visit may be conducted based on a risk assessment of the patient’s condition.”
“The average Assisted Reproductive Technology success rates by age groups, from 2017 to 2021, are as follows. The success rates between public and private centres are comparable. Data for 2022 is not available due to lag in data availability and the nine-month gestational delay.”
“The Government provides a range of financial support schemes to defray the cost of assistive devices for seniors: (a) the Seniors’ Mobility and Enabling Fund provides subsidies for assistive devices that support seniors to age-in-place; (b) vouchers of up to $200 per set of assistive devices, such as spectacles, hearing aids and dentures, are available for seniors who participate in functional screening through Project Silver Screen; and (c) for assistive devices that are also medical implants listed on the Implant Subsidy List, subsidised patients in public healthcare institutions will be eligible for subsidies. Patients may also tap on MediShield Life and MediSave to pay for implant costs, subject to prevailing criteria and limits. Applicants who require further financial assistance may approach their healthcare providers or visit any Agency for Integrated Care Link.”
“Obesity is not considered internationally or locally as a chronic disease. However, obesity is associated with several chronic diseases, including diabetes, hypertension, lipid disorders, chronic kidney disease, which are under the Chronic Disease Management Programme. Patients requiring weight management can access relevant programmes and should speak to their doctor for advice. Under Healthier SG, doctors will develop care plans and refer patients to the relevant weight management programmes according to each patient’s condition and care goals.”
“The portability issue typically arises when employees change employers and lose corporate health coverage. This is an issue that the National Trades Union Congress (NTUC) has regularly raised over the years. It has been substantively addressed with MediShield Life, which is an enhanced national insurance plan. There have been calls for another type of portability in the individual health insurance market, to allow policyholders to switch insurers without undergoing underwriting again. As these are commercial products, it is unlikely that insurers will do so as there is a strong likelihood that dissatisfied policyholders with pre-existing conditions will seek to change insurers, making the receiving insurer worse off. Therefore, the only way to do this is via Government regulation. However, this will have other implications. Not all insurance policies are compatible to facilitate portability between insurance companies. While portability may trigger more intense price competition among insurers, there may also be pressures to cut benefits or raise premiums in order to remain sustainable. The feasibility study on Integrated Shield Plan portability is ongoing and we will consider the experiences of other countries who have attempted this.”
“The amount of healthcare subsidies provided to Singaporeans has increased significantly over years. Performing means-testing based on Per Capita Household Income or Annual value of residential property is to ensure that even as the amount of subsidies increase, more subsidies continue to be channelled to Singaporeans who need them the most. It is not a means to save healthcare subsidies. Patients who face difficulties in paying their medical bills after subsidies, insurance and MediSave can apply for financial assistance schemes such as MediFund, where their circumstances will be holistically assessed.”
“The current co-funding limit of three fresh and three frozen cycles is based on clinical evidence which shows that the success rate of assisted reproductive technology decreases for successive cycles and as a woman progresses in age. It therefore strikes a balance between providing public-funded financial support to couples aspiring to be parents and ensuring the prudent use of public funds by taking into account clinical efficacy. We will continue to monitor emergence of new data that show improved outcomes with further cycles. By setting a total funding limit based on six cycles, we also ensure parity and equitable treatment across all couples, regardless of their family size.”
“The median waiting time for beds increased by 2.4 hours from November 2023 to December 2023. This is due to the increased number of patients requiring hospitalisations during the recent COVID-19 wave. Nevertheless, hospitals will activate inpatient teams to start investigations for all patients in the Emergency Departments and prioritise treatments for the urgent cases. Day and home care services are available during festive periods. The capacity, however, is dependent on the number of centres we have established and are in operation. The Ministry of Health has expanded centre capacity by more than four-fold from 2,100 day places in 2011 to 9,200 day places in 2023. Loved ones of individuals with care needs may approach any Agency for Integrated Care Link for assistance.”
“My response today will also address the written question filed by Mr Yip Hon Weng, on the recognition of healthcare workers for the COVID-19 Resilience Medal (CRM) and the appeal channel. About 91% of 68,6001 healthcare workers in our public healthcare institutions are recipients of the CRM. The remaining did not receive the CRM mainly because they were not assessed as having contributed substantially or on a sustained basis toward the COVID-19 Pandemic within the specified period of contribution. A very small number were disqualified due to their disciplinary records. Outsourced workers such as cleaners, porters and patient care assistants are also included in the nomination process. About 2,000 of them in our public healthcare institutions are CRM recipients. The list of CRM awardees was published in the Government Gazette on the Prime Minister’s Office website on 31 May 2023. From 31 May 2023 to end August 2023, the Ministry of Health (MOH) had received and reviewed numerous appeals for the COVID-19 Resilience Medal from the healthcare sector, and added more awardees to the list. Despite the rigorous nomination process and inclusive approach, it is possible that some employers may have missed out nominating their staff. Individuals who feel they are deserving but have been missed out for the CRM can write to MOH, and we will review their appeals with their employers accordingly.”
“The key factors that the Agency for Care Effectiveness considers are that treatments should be both clinically-effective and cost-effective, in order to be included in the Cancer Drug List (CDL). For treatments that are already assessed and on CDL, they will remain on the list unless there are specific reasons to remove them, such as if the company defaults on contractual agreements with the Ministry of Health or upon company request or safety recalls.”
“The question has been addressed in the oral reply to Question No 31 on the Order Paper for 9 January 2024. [Please refer to "Appeals for Individuals who Missed Out on COVID-19 Resilience Medal", Official Report, 9 January 2024, Vol 95, Issue 118, Written Answers to Questions for Oral Answer not Answered by End of Question Time section.]”
“The Ministry of Health does not track the numbers that the Member asked for. There will always be a time lag between the revision of annual values of residential properties for taxation purposes and the revision of annual value thresholds to determine subsidy levels. The Government has increased the annual value thresholds used for healthcare subsidy schemes with effect from 1 January 2024 to ensure that Singaporeans with greater needs continue to receive support. Patients who face difficulties in paying their medical bills after subsidies, insurance and MediSave can apply for financial assistance schemes, such as MediFund, where their circumstances will be holistically assessed.”
“The Ministry of Health does not track the number of women and men who have undergone fertility screening at public and private hospitals.”
“Some parents elect to store their children's cord blood during delivery. Cord blood banking service is a licensable healthcare service regulated under the Healthcare Services Act, which covers the activities on the handling, processing and storage of cord blood obtained from an individual and intended for clinical use. All cord blood banks in Singapore are subject to inspections once every two years to assess their compliance with regulatory requirements. Targeted audits may also be conducted to review any specific areas of concerns. If a cord blood bank is found to be non-compliant, the Ministry of Health can take regulatory action. This includes modifying any licence condition, shortening the licensing term, or enforcement actions, such as imposing financial penalties or prosecution. The penalties include fines of up to $20,000 or imprisonment for a term not exceeding 12 months, or both. Consumers can seek recourse from their cord blood banking provider in the event of service lapses, depending on the service contracts that they have entered into.”
“Over the past three years, 10 safety incidents involving medical escort and transport of seniors by service providers and transport vendors appointed by the Ministry of Health (MOH) and the Agency for Integrated Care (AIC) have been reported. Service providers appointed by MOH are required to adhere to service standards and requirements. These service providers are also required to conduct training to ensure that staff and volunteers are able to carry out their roles safely. MOH and AIC did not receive reports on similar incidents involving gig-platforms services during the same period. MOH will continue to review our policies and regulations to ensure the safety and well-being of clients of our eldercare services.”
“Internationally, there is currently no recognised health-based guidance value, such as an acceptable daily intake, for caffeine. There are also no international standards, either by the United Nations or World Health Organization, on the amount of caffeine allowed to be added to food. This likely reflects the inconclusive evidence for a common maximum threshold based on the negative effects of caffeine. The effects, both good and bad, differs across individuals, depending on one's sex, age, weight and differences in susceptibility. As a result, the Food Regulations in Singapore do not impose maximum limits on caffeine that are added to beverages. Caffeine should be consumed in moderation and individuals are advised to moderate their intake if they experience side effects. The Health Promotion Board has published information on caffeine effects on Health Hub and the Ministry of Health will continue to monitor the developments internationally on this front.”
“Aesthetic procedures by licensed healthcare providers are medical procedures, regulated under the Healthcare Services Act 2020 (HCSA). Likewise, advertising of aesthetic procedures is also regulated under the Healthcare Services (Advertisement) Regulations 2021 (HCSAR), where there are various safeguards to ensure that the advertised contents are accurate, truthful and do not induce unnecessary consumption of the healthcare services. To illustrate, under HCSAR, non-medical professionals, including social media influencers, are not allowed to advertise any licensable healthcare services, unless they possess an HCSA licence. Anyone who advertises healthcare services without a valid licence may be liable, on conviction under HCSA, to a maximum fine of $20,000 and/or a jail term of 12 months. Patients who have any concerns with regard to the illegal advertisements on medical aesthetic procedures can lodge a complaint with the Ministry of Health for investigations.”
“The Ministry adopts a multi-pronged approach to attract Singaporeans to join the healthcare industry, which includes engaging students early to pursue healthcare careers, offering Career Conversion Programmes to attract mid-careerists, redesigning jobs in healthcare and keeping remuneration competitive. We complement this local core with foreign healthcare workers, including nurses and support care staff. In the last five years, we have grown our national healthcare workforce from about 100,000, to over 120,000. Clinical and patient-facing manpower grew from 85,000 to 98,000. Non-clinical manpower grew from 19,000 to 22,000. Amongst them, about 80% are Singapore residents. Today, one in 20 students choose to enrol in a healthcare course and hence, we are getting our fair share of the local talent pool that will help maintain a majority of Singaporeans amongst our healthcare workforce. That said, we will have to continue to build up both the local and foreign manpower pipelines, in order to meet the growing demand for healthcare services in Singapore.”
“The Tripartite Framework for Prevention of Abuse and Harassment in Healthcare recommends that healthcare institutions provide both formal and informal training for healthcare workers, to manage difficult situations and potential conflicts. Some public healthcare institutions already equip their staff with such training, for example, effective communication skills and techniques to de-escalate tense situations, or self-defence techniques to protect themselves against physical abuse. Healthcare institutions should also provide mental health support training for supervisors to better support staff who have been abused or harassed, for example, how to recognise signs of mental trauma so that affected staff can be referred for counselling or further support. The Ministry of Health will work with healthcare institutions to make more of such training available to healthcare workers as they implement the framework.”
“The Tripartite Framework for the Prevention of Abuse and Harassment in Healthcare covers all staff who are working within the healthcare institutions' premises. It will therefore include security professionals and other contract staff and employees of contractors providing services in a healthcare setting. The public healthcare clusters have committed to adopting the Framework. The Tripartite partners strongly encourage other healthcare institutions, such as community care organisations, private hospitals and clinics, to adopt the zero-tolerance policy and adapt the guidelines for their operating environment as soon as they can.”
“Family cord blood banking services of the Singapore Cord Blood Bank (SCBB) have always been available to parents who choose to deliver their babies in the private hospitals. Should the parents subsequently choose to discontinue SCBB's family cord blood banking services, the Ministry of Health encourages them to donate the cord blood units to the public inventory if the units meet the public donation criteria.”
“The Tripartite Framework for the Prevention of Abuse and Harassment in Healthcare recommends that every public healthcare institution set up a staff protection function to review reported abuse and harassment incidents and help ensure the well-being of the staff involved, such as the provision of mental health support. To protect the healthcare worker, additional measures may be taken to discontinue exposure to the abuser and possible reprisals in the course of their work. Staff may be provided time-off and re-assigned to other duties temporarily. Public healthcare institutions may also take action against those who continue to display abusive behaviour toward healthcare workers. These include warnings, discharging abusive patients who do not require urgent care and temporarily barring abusive next-of-kin and visitors from the premises of the healthcare institution. Public healthcare institutions will also assist healthcare workers in making a Police report, if necessary.”
“Screening tests are recommended based on scientific evidence of their effectiveness and the potential benefits and harms. Lung cancer screening is conducted through Low-dose Computerised Tomography (LDCT). Use of this test has to be balanced against unnecessary exposure to radiation and the financial cost of screening. As such, LDCT screening is only recommended for very heavy smokers or ex-smokers, who are at high-risk of lung cancer. LDCT screening for lung cancer is not recommended for the general population, nor for non-smokers and those with a family history of lung cancer. Today, LDCT scans are ordered if needed, during Specialist Outpatient Clinic (SOC) consultations. Patients who are referred to SOCs and are assessed to require LDCT scans are eligible for means-tested subsidies.”
“Currently, the Allied Health Professions Act provides for the registration of five allied health professions: Diagnostic Radiographers, Occupational Therapists, Physiotherapists, Radiation Therapists and Speech Therapists. Other professions who work in healthcare institutions, such as psychologists, including those who provide behavioural therapy services, have existing safeguards in place as they are subject to the clinical governance framework of the healthcare institutions and existing healthcare legislations, such as the Healthcare Services Act in healthcare settings. In non-healthcare settings, such as the early intervention programmes funded by the Ministry of Social and Family Development, operators may employ therapists, psychologists and other professionals to provide therapy services. Where necessary, the funding agreements specify the minimum qualifications and training required, before staff can be deployed to provide such services. We will continue to perform risk assessments of various allied health professions to consider if these professions will need to be registered.”
“Implants are unlisted if they have not been registered with Health Sciences Authority (HSA); or have not yet been assessed for listing by the Agency for Care Effectiveness; or they have been assessed, but are found to be non-clinical or not cost-effective. If they have not been assessed, they will continue to be subsidised at up to 50%, capped at $1,000. Implants that have already been assessed to be non-clinically- or cost-effective, or that are not registered with HSA, will not be eligible for subsidies. However, patients may continue to claim for these implants from MediShield Life, Integrated Shield Plans and MediSave. Subsidised patients who face financial difficulties can approach the institution's Medical Social Workers to apply for financial assistance, such as MediFund.”
“The Institute of Mental Health is currently conducting two research studies to understand the risk factors for suicide and self-harm, as well as the mitigating factors for prevention and/or reduction of self-harm. The studies consider demographic factors, such as age, ethnicity, gender and socio-economic status, of suicide attempters and completers, among other risk factors measured. Both studies are ongoing and results are projected to be ready by 2025.”
“In the last five years, the average age of pregnant teenagers, defined as those aged 13 to 19, is 18 years old. Our hospitals, particularly the KK Women's and Children's Hospital and National University Hospital, offer comprehensive support for pregnant teenagers, including antenatal care, screening for sexually transmitted infections and depressive symptoms, counselling services and educational resources. They will be cared for by a multi-disciplinary team involving doctors and nurses from the Obstetrics and Gynaecology team, as well as medical social workers. Apart from hospitals, support is also available by social service organisations in the community. Pregnant teenagers who proceed with childbirth will be provided with emotional and practical support by the multi-disciplinary team. This includes information and resources regarding pregnancy, advice on financial assistance and following up with patients and the family to ensure compliance to antenatal and post-natal visits. Following childbirth, the teenage mother will follow-up with the multi-disciplinary team for review and counselling on contraceptive options. Pregnant teenagers seeking an abortion in Singapore will undergo mandatory pre-abortion counselling with a trained counsellor. Unmarried teenagers below 16 years of age are required to undergo mandatory pre-abortion counselling at the Health Promotion Board Counselling Centre. The session will provide information on the abortion procedure, educate them on issues, such as responsible love, sexual behaviour and contraceptive methods, and provide advice on social support to prevent repeated unplanned pregnancies. Those who require further support and follow-up are also directed to the Family Service Centres or helplines.”
“Like most developed countries, Singapore continues to experience a capacity crunch post-COVID-19. This is aggravated by an ageing population. Hospitals are seeing more elderly patients with more complex conditions, who require much longer length of stays. We will need to continue increasing our hospital capacity. We have also been building up our nursing workforce and the staffing situation in our public hospitals has improved relative to a year ago. While hospital infrastructure projects were delayed due to the pandemic, we are progressively catching up. Tan Tock Seng-Integrated Care Hub has opened 300 beds since October 2023 while Woodlands Health Campus is expected to be in operation by middle of this year, with 360 beds in operation and almost 600 by end of the year. Plans for Eastern Integrated Health Campus and redevelopment of Alexandra Hospital remain on track to be completed by the end of the decade. In addition, hospitals are tapping on facilities like Transitional Care Facilities and alternative care models like Mobile Inpatient Care@Home to expand overall capacity.”
“The list of CRM awardees was published in the Government Gazette on the Prime Minister's Office website on 31 May 2023. From 31 May 2023 to end August 2023, the Ministry of Health (MOH) had received and reviewed numerous appeals for the COVID-19 Resilience Medal from the healthcare sector and added more awardees to the list. Despite the rigorous process and inclusive approach, it is possible that some employers may have missed out nominating their staff. Individuals who feel they are deserving but have been missed out for the CRM can write to MOH and we will review their appeals with their employers accordingly.”
“My response today will also address written questions filed by Mr Leong Mun Wai and Mr Yip Hon Weng, and oral Parliamentary Question filed by Dr Tan Wu Meng for a subsequent Sitting, on the recognition of healthcare workers for the COVID-19 Resilience Medal (CRM) and the appeal channel. Overcoming the COVID-19 pandemic crisis was a national concerted effort, hence our approach in conferring the CRM was to be as inclusive as possible, with no quotas set. To ensure that standards are met and the process is rigorous, the eligibility criteria is that the individual must have made substantial contributions on a sustained basis during the pandemic1 in: (a) managing the public health crisis at the frontlines; (b) supporting frontline operations, such as vaccination, testing, managing dorms or recovery facilities, and so on; or (c) managing the consequences of COVID-19 on Singapore's economy, supply chains or social cohesion. The individuals are nominated by their employing organisations based on these criteria. As the CRM is a national-level award, individuals with criminal records and Public Service officers with disciplinary records and within the debarment periods are also disqualified. About 91% of 68,6002 healthcare workers in our public healthcare institutions are recipients of the CRM. The remaining did not receive the CRM mainly because they were not assessed as having contributed substantially or on a sustained basis toward the COVID-19 pandemic within the specified period of contribution. A very small number were disqualified due to their disciplinary records. Outsourced workers, such as cleaners, porters and patient care assistants are also included in the nomination process. About 2,000 of them in our public healthcare institutions are CRM recipients.”
“China underwent a surge in respiratory illnesses towards the end of 2023. This was to be expected after post-pandemic opening up, which was the experience of many countries, including Singapore. These illnesses are typically caused by common respiratory pathogens, such as influenza, COVID-19, respiratory syncytial virus and Mycoplasma pneumoniae, which are also circulating in Singapore. What we need to watch out for are new pathogens and new variants of COVID-19, which the Ministry of Health (MOH) is actively monitoring with our international partners. MOH issued public advisories on 2, 8 and 15 December 2023 to encourage the public to remain vigilant and to adopt necessary precautions during this period, including when travelling. This includes keeping up-to-date with vaccinations, practicing good personal hygiene, wearing a mask in crowded places and minimising social interactions if unwell.”
“All cord blood banks in Singapore are currently subject to scheduled inspections every two years to assess their compliance with regulatory requirements under the Healthcare Services Act. In addition, the Ministry of Health may conduct additional visits, including unannounced visits, if there are any specific areas of concerns and suspected lapses. Consumers can seek recourse from their cord blood banking provider in the event of service lapses, depending on the service contracts that they have entered into.”
“My response will also cover the matter raised in the question by Ms See Jinli Jean1 who filed a Parliamentary Question, which is scheduled for a subsequent Sitting. The Seniors' Mobility and Enabling Fund (SMF) supports seniors to age-in-place by providing eligible Singaporeans aged 60 years and above with means-tested subsidies to offset the cost of home healthcare items and assistive devices. On average, of the 16,400 unique seniors who applied for SMF device subsidies annually since 2019, more than 99% were successful. This is because applicants are usually advised on their eligibility before they make an application. Applicants who do not meet the eligibility criteria or whose applications were rejected may approach their healthcare providers or visit any Agency for Integrated Care Link should they require further assistance. Project Silver Screen (PSS) is a community functional screening programme that assesses seniors' needs and provides prescription for spectacles and hearing aids. And 99% and 7% of SMF beneficiaries who received spectacles and hearing aids respectively participated in PSS. The remaining beneficiaries directly obtained their subsidised devices from our healthcare institutions. We do not currently track SMF applicants by economic activity.”
“The Ministry of Health does not track the number of times patients from specialist outpatient clinics at public hospitals and polyclinics declined to collect their prescribed medication. We also do not monitor the average price of such medication. A research study published in March 2023 concluded that a wide range of non-cost-related factors influenced medication adherence. This includes concern about side effects, lack of knowledge of the medication and the disease.”
“The Ministry of Health is currently evaluating the shingles vaccine's clinical and cost-effectiveness, with a view to decide if it should be included in the National Adult Immunisation Schedule (NAIS). If yes, it will be eligible for subsidies and MediSave usage.”
“Synapxe receives and blocks an average of 3,000 malicious emails per day and 1.7 million attempts to bypass Internet-facing firewalls per month. Critical Information Infrastructure in the healthcare sector are regulated under the Cybersecurity Act. We adopt a layered Defence-In-Depth approach to safeguard our systems. In addition, we have an Advanced Security Operations Centre with detection and response capabilities; incident response processes calibrated against actual security incidents; and aligned to the National Cybersecurity Incident Response Framework. More than 10 cybersecurity table-top exercises have also been conducted in the last five years. The Internet connectivity disruption for public healthcare institutions on 1 November 2023 was triggered by abnormal spikes in Internet traffic, also known as a Distributed Denial-of-Service (DDoS) attack. The abnormal traffic circumvented the anti-DDoS blocking services and overwhelmed the firewall. This caused the firewall to filter out the traffic, as well as other services requiring Internet connectivity, including websites and Internet-reliant services, which became inaccessible. Since the disruption, Synapxe has enhanced its anti-DDoS measures. The public healthcare sector will take this opportunity to learn from the episode, review its defences against DDoS attacks and improve its incident response and recovery time.”
“Data related to alcohol consumption can be found in the Ministry of Health (MOH)'s National Population Health Survey report and the Global Burden of Disease 2019 study. Details of both studies are publicly available. There is extensive, well-documented evidence in international studies showing that regardless of age, excessive alcohol consumption may result in alcohol dependence and increase the risk of alcohol-related harm, such as the development of chronic disease, violence and high-risk behaviours. Alcohol consumption from a young age can affect brain development in adolescence and have long-term adverse effects on cognitive functions.”
“These questions have been addressed in my oral reply to Question No 10 on the Order Paper for 22 November 2023. [Please refer to "Inclusion of Risdiplam in Rare Diseases Fund to Treat Spinal Muscular Atrophy", Official Report, 22 November 2023, Vol 95, Issue 117, Oral Answers to Questions section.]”
“The Ministry of Health will be prepared to resource the Health Sciences Authority to step up enforcement against vaping, including detection and removal of online advertisements and sales of e-vaporisers. However, this will not be enough. We need to also work with partner agencies, such as the Immigration and Checkpoints Authority, National Environment Agency and Ministry of Education, to strengthen enforcement against possession and use of e-vaporisers and intensify education and awareness initiatives.”
“The Internet connectivity disruption for public healthcare institutions on 1 November 2023 was triggered by abnormal spikes in Internet traffic, also known as a Distributed Denial-of-Service (DDoS) attack. The abnormal traffic circumvented the anti-DDoS blocking services and overwhelmed the firewall. This caused the firewall to filter out the traffic, as well as other services requiring Internet connectivity, including websites and Internet-reliant services, which became inaccessible. Throughout the incident, patient care was not compromised. Mission critical systems needed for clinical services and operations at the public healthcare institutions, including access to patient records, continued uninterrupted. There has been no evidence to indicate that public healthcare data and internal networks have been compromised. DDoS attacks are on the rise, with changing attack methods. Those who deploy them have a variety of motives, from hacktivism to petty misdemeanor. The defences against DDoS attacks will have to constantly evolve to keep up with developing threats. The public healthcare sector will take this opportunity to learn from the episode, review its defences against DDoS attacks and improve its incident response and recovery time.”
“The National Mental Health Office will comprise officers from, the Ministry of Health (MOH), Ministry of Social and Family Development and Ministry of Education. It will function as one integrated office within MOH and adopt a citizen-centric approach to the implementation of the Strategy and the development of future mental health and well-being initiatives.”
“The human papillomavirus (HPV) vaccination is nationally recommended for females aged nine to 26 years for prevention of cervical cancer in females. No HPV vaccine has been approved by the Health Sciences Authority for use in persons older than 45 years. The Ministry of Health does not have data on HPV vaccination by vaccine type across all ages. However, as HPV vaccination is offered to all Secondary 1 female students, our records show that in 2022, more than 90% of Secondary 1 female students have received the vaccine. The HPV 9-valent vaccine is currently not cost-effective when compared to the bivalent HPV vaccine, based on the pricing of the manufacturer. Hence, it is not included under the national immunisation schedules and is not eligible for subsidy or MediSave claims.”
“Dermal fillers and botulinum toxin injections are health products which must be registered by Health Sciences Authority (HSA) before they can be supplied in Singapore. They should only be administered by qualified medical practitioners for patient safety and consumers are strongly advised against using do-it-yourself injectable kits which are marketed for aesthetic purposes. HSA conducts regular surveillance of local websites and e-commerce platforms to promptly take down product listings of such do-it-yourself injectable kits. Anyone caught selling these products without an appropriate licence can be fined up to $50,000 and/or jailed for up to two years under the Health Products Act.”
“The human papillomavirus (HPV) vaccination is nationally recommended for females aged nine to 26 years, as the Ministry of Health (MOH) has assessed that this is a clinically effective and cost-effective strategy for preventing cervical cancer. On the other hand, males do not get cervical cancer. While HPV vaccination also confers protection against HPV-related anal cancer, the incidence amongst males is about ten times lower than cervical cancer amongst females. As such, HPV vaccination of males does not provide the same level of benefit as for females, nor is it likely to be cost-effective at the population level. Nevertheless, males who feel that they are at high risk of getting HPV may choose to go for HPV vaccination at a general practitioner clinic. MOH will continue to monitor for new developments and review our policy on HPV vaccination where necessary.”
“Singapore has implemented all of the recommended MPOWER measures. We have attained the highest level of achievement in the following areas: monitor tobacco use and prevention policies, offer help to quit tobacco use and warn about the dangers of tobacco (health warnings). Areas in which Singapore has yet to attain the highest level of achievement are: protect people from tobacco smoke, warn about the dangers of tobacco (mass media), enforce bans on tobacco advertising, promotion and sponsorship and raise taxes on tobacco. The Ministry of Health will continue to review and enhance our tobacco control measures and work with the relevant agencies to reduce the prevalence of smoking in Singapore.”
“For insurance plans to remain sustainable without rejecting individuals with pre-existing conditions, a large risk pool comprising both healthy and unhealthy individuals is necessary. This is why MediShield Life (MSHL), our national health insurance scheme, was designed to cover all Singapore Residents from birth, regardless of pre-existing conditions. Integrated Shield Plans (IPs) and other private health insurance plans offer optional coverage on top of MSHL. As these are private products, underwriting decisions are subject to insurers' commercial and actuarial considerations. If insurers cannot reject applicants with pre-existing conditions, they may have to increase premiums for all policyholders to ensure that their insurance risk pool remains sustainable. Depending on their underwriting practices, insurers may still offer coverage to applicants with pre-existing conditions, but with exclusions or risk loading, that is, higher premiums. This allows such applicants to benefit from some coverage without adversely affecting other policyholders.”