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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“There are ongoing studies conducted by the Institute of Mental Health, with funding support from the Ministry of Health, to understand the risk factors for suicide and self-harm, as well as the mitigating factors for prevention and/or reduction of self-harm. These studies will inform future measures to provide outreach and holistic support for persons in crisis.”
“The Ministry of Health (MOH) and the Agency for Integrated Care (AIC) support nursing homes (NHs) in the adoption of technology and digital solutions through schemes, such as the Productivity and Digitalisation Uplift Grant (PDU). Thus far, the PDU has supported 16 NHs in the implementation of Autonomous Mobile Robots (AMRs) for delivery of items, such as food, linen and other consumables. The use of AMRs has led to at least 10% savings in staff time, allowing them to dedicate more time to direct care provision. AIC has also developed implementation guidelines and streamlined application processes to support more NHs to adopt AMRs. NHs that would like to use other technologies, such as hands-free smart glasses to enhance productivity and service delivery can apply for funding support under PDU. Thus far, AIC has not received any requests from NHs to support the use of this technology.”
“The response will also cover the matters raised in the oral question by Mr Sharael Taha1 scheduled for a subsequent Sitting. Under the MediSave500/700 scheme, Singaporeans can withdraw up to $500 or $700 annually, depending on the complexity of their conditions, from their own or family members' MediSave. The scheme covers the treatment of 23 approved conditions under the Chronic Disease Management Programme (CDMP). In addition, patients who are 60 and above can withdraw a further $300 from their own or spouse's Flexi-MediSave every year. The current limits are adequate to meet the needs of nine in 10 patients. From early 2024, Singaporeans who enroll in Healthier SG no longer need to co-pay 15% of their bill in cash. They can use their MediSave to fully pay for the treatment of their CDMP conditions at their Healthier SG clinics up to the prevailing MediSave limit. Patients who face difficulties with their medical bills may apply for financial assistance at public healthcare institutions. MOH regularly reviews the list of CDMP conditions and the MediSave500/700 limits to ensure these strike a balance between keeping immediate treatments affordable for Singaporeans and preserving MediSave for their future healthcare needs. Should the member come across cases that need additional assistance, do let us know and we will see how best to help.”
“The Ministry of Health (MOH) works with the Agency for Integrated Care (AIC) to provide training programmes and training subsidies for the community care sector, including nursing homes. This includes the Community Care Traineeship Programme provided by the AIC Learning Network. There are also training subsidies for in-service staff and fresh entrants to pursue a range of clinical and non-clinical skills training through the Community Care Manpower Development Awards. Since 2020, MOH and AIC have embarked on efforts to redesign support care job functions within the community care sector. This aims to equip our support care workforce, being the majority of the workforce in nursing homes, with a broad range of skills to enable them to deliver better and more holistic care, as well as provide opportunities for good performers to progress to managerial roles. Additionally, AIC regularly partners the sector on job fairs and has rolled out various initiatives to enhance sector recruitment, such as publicity campaigns to elevate the sector, an online careers portal, as well as scholarships for students and mid-career jobseekers. It also conducts overseas recruitment of foreign nurses and support care staff to supplement the local core in the community care sector. Through the ongoing community care salary enhancement exercise, we have also boosted salaries for the sector in the last three years, including those of local and foreign nurses and support care staff. Most recently, we introduced a sign-on bonus for eligible fresh nursing graduates who join publicly-funded residential community care organisations within this year.”
“The response will also cover the matters raised in the oral question by Mr Yip Hon Weng1 scheduled for a subsequent sitting. The Ministry of Health (MOH) partners the Silver Generation Office to do extensive outreach to eligible seniors to apply for severe disability claims under CareShield Life and ElderShield. Our outreach also includes working with nursing homes, public healthcare institutions, home care providers and disability-focused social service agencies, which may more regularly interact with persons with disabilities and their caregivers. MOH also reaches out to eligible claimants under other severe disability schemes, such as MediSave Care. On the suggestion of making automatic payout disbursements to individuals based on their health conditions, this may result in payouts going to some who do not satisfy the severe disability criterion for CareShield Life and ElderShield claims. Over time, it will cause premiums to rise for all and, hence, will be a matter to be considered carefully. Another reason for individuals to fall through the cracks is that we have made joining CareShield Life optional for individuals born before 1980. This is unlike those born from 1980 who are universally included. Nevertheless, these individuals can still join CareShield Life as long as they do not have severe disability and there are participation incentives of up to $4,000 available if they join by 31 December 2023. MOH is also reaching out to them to explain the benefits of CareShield Life and encourage them to enrol onto CareShield Life. We hope community organisations will also support us in this effort.”
“According to the Ministry of Health’s community surveillance data, the number of influenza cases in January to July 2023 had increased compared to the same period in 2022. This was likely due to COVID-19’s dominance and the effective Safe Management Measures that were in place in 2022. Individuals at a higher risk of developing severe influenza infection are recommended to get vaccinated against influenza annually. These include young children aged between six months and below five years old, all persons aged 65 and above, and other vulnerable persons with underlying medical conditions that predispose them to severe influenza. Persons experiencing respiratory symptoms should limit social interactions, see a doctor if symptoms persist or worsen, and wear a mask if leaving home.”
“The Health Promotion Board (HPB) focuses on preventive health and upstream efforts to promote mental health and well-being among Singaporeans. HPB incorporates art-related activities, for example, mindful colouring, in mental well-being workshops, which have been shown in research to bring benefits, such as reducing stress levels. Individuals may include art-related activities in their daily lives to better cope with stress. For art therapy which incorporates elements, such as painting, drawing and craft, evidence on effectiveness is still evolving. The appropriate inclusion of art, music, exercise and social interactions into our daily routine will be good for all of us. The use of these techniques as interventions for health and mental health should be guided by professional recommendations and family doctors.”
“To support at-risk individuals in the community, the Agency for Integrated Care has collaborated with social service agencies to set up and expand the network of community mental health teams that offer mental health assessments and psychosocial interventions, with linkages to other ancillary support services. The Interagency Taskforce on Mental Health and Well-being, comprising representatives from over 30 Government agencies, public and private sectors, has put together a comprehensive strategy to strengthen the mental resilience and well-being of the population, including suicide prevention. The strategy is targeted to be released by the end of this year.”
“Suicide prevention requires coordinated whole-of-Government and whole-of-society efforts targeted at multiple sectors and involves a full spectrum of measures from upstream prevention, such as building mental resilience, early risk detection and addressing suicide triggers to downstream interventions, such as crisis support and treatment of associated mental health conditions. Current preventive efforts include the Health Promotion Board’s public education and campaigns to raise mental health awareness, build mental resilience and reduce stigma. These aim to normalise help-seeking by mentally distressed individuals and equip the community with effective skills to support one another. These efforts are sustained through on-ground programmes, social media outreach and the online portal MindSG, which offers mental health resources curated by professionals. In addition, the SG Mental Well-Being Network was launched in 2022 to bring together partners and citizens to strengthen mental health and well-being outcomes for our society. Well-Being Circles have been set up under this initiative in different neighbourhoods to strengthen community and peer support by equipping citizens with the skills to care for their own mental well-being and that of others around them. Today, there are six Well-Being Circles in different neighbourhoods and over 500 citizens have been trained as peer supporters. We will continue to support community stakeholders to initiate more of such Well-Being Circles.”
“To ensure supply chain resiliency, healthcare institutions, drug and medical supplies companies, local distributors and retailers keep close track of their supplies and will bring in more stock or alternative brands when the situation requires. The Ministry of Health (MOH) also maintains stockpiles of key medicines and medical supplies and has diversified its procurement sources. In extreme situations, MOH will impose sales limits to prevent hoarding and to ensure that the medicines and medical supplies are fairly distributed.”
“The public healthcare clusters provide a housing allowance for foreign healthcare staff to help defray their accommodation expenses. Private healthcare employers also do something similar. The Ministry of Health (MOH) and MOH Holdings are setting-up hostel-like accommodation to provide greater certainty and ease the transition and onboarding of new foreign healthcare staff employed by the public healthcare clusters into Singapore. We will continue to monitor the needs of our healthcare workers, including whether long-term accommodation is needed.”
“The Response, Early Intervention and Assessment in Community Mental Health (REACH) teams collaborate closely with schools, including madrasahs, to provide interventions for students with mental health needs. Waiting times for referrals to REACH vary depending on the severity of the mental health need. In 2022, the median wait time for a student to be referred to REACH for a mental health assessment was within 24 hours for urgent cases, and between 17 and 31 days for less severe cases. The REACH teams received an average of about 10 referrals from madrasahs per year over the last three years. The Ministry of Health works closely with the public healthcare clusters to review manpower needs and ensure adequate resourcing for REACH teams to support students’ mental health needs.”
“Whether the renewal of existing certification starts from the expiry of the existing certification or from point of training completion depends on the training provider, as different providers have differing administrative and IT systems. The Singapore Resuscitation and First Aid Council (SRFAC) will work with providers to see if they can standardise the practice. SRFAC has set a two-year certification validity for its accredited courses, including the Standard First Aid. Their assessment is that two years will better ensure currency of skills and the practical challenges of requiring more frequent refresher retraining.”
“We agree with the need to increase participation rates of male seniors. Elderly men are generally more driven by specific interests when deciding whether to take part in activities and we also observed that they prefer activities that give them agency. Thus, some AAC providers have organised programmes, such as pool table games, guitar playing, and having dedicated timeslots for "Uncles’ Time" or "Men’s Club" where they can participate in activities like breakfast and walks as a group. While there are no plans to build dedicated Active Ageing Centres (AACs) for men, AAC providers are encouraged to conduct a range of activities that meet the interests of both elderly men and women, to ensure that AACs can remain as inclusive spaces for all seniors.”
“We understand that the Member has encountered a case where an elderly resident sounded the alarm at night, but the response from the neighbours only came an hour later. We are reviewing the response mechanism. Proper maintenance of hardware and prompt response will likely require various parties, such as the Housing and Development Board, Town Councils, Agency for Integrated Care, Active Ageing Centres and responders, such as the Police, Singapore Civil Defence Force, CISCO and neighbours, to come together.”
“The case of delayed urgent treatment by a doctor who paid two ambulance services a commission for taking patients to his clinic is already under investigation for professional misconduct by the Singapore Medical Council (SMC) since August 2021, after complaints against the doctor were filed. There are currently no other cases involving the making of gratuitous payments to private ambulance operators that have been reported to the Ministry of Health or the SMC. SMC’s Ethical Code and Ethical Guidelines disallow such practices, and also doctors participating in fee splitting or sharing by offering gratuitous payments, gifts or other rewards in exchange for patient referrals. Doctors must always act in the best interests of patients. Failure to do so constitutes a breach of the Ethical Code and Ethical Guidelines and will be subjected to the SMC disciplinary process, including being removed from the professional register.”
“Since July 2023, more than 954,000 SMS invitations have been sent and more than 310,000 residents have enrolled on to Healthier SG. About 75% of about 1,300 CHAS general practitioner (GP) clinics have signed up and they would have the capacity to manage the enrolled residents, over and above their daily workload. Under Healthier SG, GPs will receive IT grants and annual service fees which are tiered based on the level of care and effort required to look after their enrolled patients. These incentives have been useful in incentivising GPs to join the programme. We will, nevertheless, continue to encourage more GPs to sign up through our outreach efforts.”
“Public hospitals employ a triage system to ascertain the urgency of the conditions of patients and then attend to them in a timely manner depending on the circumstances. That is the nature of hospital operations. Hence, it is not practical to set concrete targets on waiting times, because waiting times depend on conditions and circumstances. Notwithstanding the above, based on 2022 figures, 95% of subsidised patients were given an initial psychiatrist appointment within three months.”
“These questions have been addressed in my reply to Question No 15 for oral answer at the 3 August 2023 Parliament Sitting.”
“Based on the 2021 National Population Health Survey, 1% of young adults aged 18 to 35 had one or more of the following chronic diseases – diabetes, hypertension and hyperlipidaemia. At the primary care setting, all Singaporeans with chronic diseases under the Chronic Disease Management Programme (CDMP) are eligible for Community Health Assist Scheme (CHAS) subsidies at CHAS clinics, regardless of income and age. They can also opt to seek care at polyclinics, which provide subsidies of up to 75% for chronic services and treatment. If assessed by general practitioners or polyclinics to need specialised care, they may also be referred to public specialist outpatient clinics, where they will be able to receive means-tested subsidies of up to 70%. Patients will also be able to tap on their own and family members’ MediSave for all CDMP episodes, up to the prevailing withdrawal limits. Needy patients who still cannot afford their bills at public healthcare institutions can tap on MediFund. No one will lose access to appropriate care due to an inability to pay.”
“Together with the Agency for Integrated Care and Social Service Agencies, the Ministry has set up Community Outreach Teams and Community Intervention Teams (COMIT) to provide care to persons with mental health needs. Based on data reported to the Ministry of Health, in the last three years, COMIT, polyclinics and general practitioners under the Mental Health General Practitioner Partnership Programme had supported around 47,000 clients with mental health needs. Approximately 15% of the clients managed by COMIT and polyclinics were men aged 55 and above. Our COMIT service providers and polyclinics monitor the progress of their clients through pre- and post-intervention assessment.”
“Employees working in administrative and support roles form an essential part of our healthcare workforce. As shared during the debate on the Healthier SG White Paper in Parliament in October last year, we will need to grow the number of nurses, allied health professionals and support care staff to 82,000 by 2030 to meet Singapore’s growing healthcare needs. Alongside the increase in nurses, there has also been a corresponding increase in the hiring of administrative and support staff by our public healthcare clusters, with over 3,000 such hires in the first half of this year. The Ministry of Health will continue to work with the public healthcare clusters to build the capacity and capabilities of administrative and support staff, to better attract and retain them.”
“As explained earlier, as our society ages, we need three healthcare subsystems – acute care, preventive care and aged care – to work in concert. In developing the aged care system, the Ministry of Health is stepping up efforts to combat social isolation and draw seniors out of their homes to keep them socially connected. Social connectedness is a major social determinant of health. We will leverage on the Silver Generation Office to conduct outreach to such seniors, and Active Ageing Centres (AACs) to be staging points for seniors to participate in community activities and be part of a social support network. Battling social isolation will need to be a multi-stakeholder community effort, involving the People’s Association and grassroots organisations, SG Cares Volunteer Centres, healthcare clusters, AACs and other community partners.”
“Suicide is tragic, personal, complex and multi-faceted. The best interventions include building mental resilience, encouraging help-seeking, spotting early indicators for crisis intervention and supporting individuals in crisis, with support from multiple stakeholders. This will be addressed in the next Sitting together with similar Parliamentary Questions for a more holistic reply. [Please refer to "Addressing Rise in Suicide Cases and Making Mental Healthcare Assistance Readily Accessible", Official Report, 03 August 2023, Vol 95, Issue 110, Oral Answers to Questions section.]”
“Indeed, elderly men are generally more driven by specific interests when deciding whether to take part in activities, unlike women who may choose to participate for social reasons. We also observed that they also prefer activities that give them a sense of agency. To cater to this, some Active Ageing Centres (AACs) empower elderly men to initiate and take the lead to organise programmes that they are interested in, such as guitar playing or playing pool. AACs also encourage their male seniors to take up volunteering opportunities, such as delivering meals or checking in and befriending other seniors, to give them a useful role in the community. More AACs have also started offering communal dining which draws a good mix of male and female participants, enabling them to form social connections with the larger community. The Ministry of Health will continue to support and expand these activities to encourage active ageing in the community.”
“The short answer is yes, the Ministry of Health (MOH), the Ministry of Education (MOE) and the Ministry of Social and Family Development (MSF) will work together to roll out preventive care strategies upstream in preschools and schools, to help our young pick up lifelong good health habits. There is a growing body of literature, including our local research findings, which showed that how our young eat, sleep and use devices can have a profound impact on the health and development of our children later on in life. MOH, MOE and MSF will share more details on the programme when ready.”
“In 2022, the Ministry of Health did an extensive survey with 3,000 healthcare workers participating. The survey showed that 24% of healthcare workers reported incidents of abuse. As the member is aware, we are implementing a zero-tolerance policy towards abuse of healthcare workers.”
“Since 2015, the Ministry of Health (MOH) has injected around 5,200 more day care places and 5,400 more home care places. As at end 2022, there are 8,700 day care places and 12,300 home care places. MOH and the Housing and Development Board have also launched over 400 units of Community Care Apartments at Bukit Batok and Queenstown in 2021 and 2022, providing another option for ageing in the community. We will continue to develop this sector. MOH will expand aged care capacity and enhance home-based care to enable seniors to stay at home for as long as possible. MOH also plans to collaborate with stakeholders, such as Agency for Integrated Care and community care providers, to provide social and community support, to enable seniors to age in communities. This is part of MOH’s effort to develop three healthcare sub systems – acute care, preventive care and aged care – to support residents as our society ages.”
“Devices for continuous glucose monitoring have been around for a while, but they are not cheap and the health outcomes not straightforward. The Ministry of Health (MOH) has, therefore, been gathering more evidence, reviewing the clinical and cost-effectiveness of these devices and speaking to suppliers on pricing. Based on the results, we will consider whether they can be included under the Chronic Disease Management Programme.”
“The median waiting time for a new subsidised appointment was 45 days to see a psychiatrist and 42 days to see a psychologist. The interval for follow-up appointments varies from patient to patient and is based on the healthcare professional’s assessment of the patient’s needs. Public hospitals employ a triage system to ensure that patients are seen in a timely manner based on the urgency of their condition. Patients whose conditions are more severe or who require more urgent assistance are given earlier appointments. Persons in need of urgent mental healthcare can also access various mental health counselling helplines operated by social service agencies, support groups and hospitals, or seek medical help at the 24-hour Emergency Services located at the Institute of Mental Health (IMH). In addition, IMH has crisis teams that provide on-site crisis interventions to persons with a known or suspected mental health condition who are at risk of harm to self or others. Patients with mental health conditions can also receive care from primary care doctors in the community. As at end-2022, there were over 410 trained general practitioners (GPs) who provide mental health services. Community Health Assist Scheme (CHAS), Pioneer Generation and Merdeka Generation cardholders are eligible for additional subsidies of up to $540 annually for the management of mental illnesses under the Chronic Disease Management Programme (CDMP), which include major depression, anxiety disorders, including obsessive compulsive disorder, bipolar disorder and schizophrenia, at CHAS GP clinics which provide mental health services.”
“Healthcare workers in the public healthcare clusters have the flexibility to source for their preferred accommodation and live within the community. The public healthcare clusters provide their foreign healthcare workers with a housing allowance to help defray their accommodation expenses. MOH Holdings has been studying the feasibility of facilitating hostel-type accommodation to support new foreign healthcare workers when they first arrive in Singapore, before transiting to housing options available in the market after they have had some time to settle in.”
“According to the Global Burden of Disease 2019 study, the estimated number of annual deaths attributable to second-hand smoke for Singapore has increased from 245 in 2010 to 296 in 2019. After adjusting for the effect of population ageing, the age-standardised death rate has declined from 5.2 per 100,000 population to 4.0 per 100,000 population over the same period.”
“The World Health Organization (WHO) suggests that non-sugar sweeteners should not be used as a means of achieving weight control or reducing the risk of non-communicable disease over the long term. WHO indicates that this recommendation is “conditional”, given low certainty of evidence. The statement is also not related to the safety of consuming sweeteners within recommended use levels. It is important that we have a balanced and nutritious diet, which means consuming a wide variety of foods in moderation for overall health and well-being. We recognise that non-sugar sweeteners could condition our palates to demand sweet food and drinks. Hence, the Health Promotion Board’s Healthy Meals in Schools and Preschools Programmes disallow the sale of beverages containing sugar substitutes in preschools and mainstream schools. Further, under the Nutri-Grade grading system, drinks that contain sweeteners cannot obtain Grade “A”. Existing materials about non-sugar sweeteners on HealthHub are still relevant. We will continue to monitor developments closely and review these materials as needed.”
“Unlike medicines, health supplements are not meant to prevent or treat ailments and, hence, not allowed to make claims related to the relief or prevention of hangover. If we come across such claims, we will ask companies to remove them. Health supplements are not regulated to the same stringent degree as medicines and do not require Health Sciences Authority (HSA)’s approval prior to supply. Nevertheless, HSA conducts post-market surveillance to monitor the safety of health supplements through sampling of these products and will issue consumer advisories to stop purchasing or taking these supplements if there are any prohibited substances detected. So far, no advisories have been issued for "hangover" supplements. General consumer guides and advisories on health supplements are also available on the HSA and HealthHub websites to enable consumers to make better decisions, should they choose to purchase or consume them.”
“To promote blood donation, the Health Sciences Authority (HSA) and Singapore Red Cross work together to partner entities, such as the People's Association, companies and religious and social organisations, to conduct regular marketing campaigns and leverage digital platforms. As announced recently, after reviewing international evidence, HSA will remove later this year, the deferral for apheresis donors with geographical risk of variant Creutzfeldt-Jakob disease.”
“Public healthcare clusters and community care organisations provide their foreign healthcare workers with a housing allowance to help defray their accommodation expenses. The Ministry of Health (MOH) does not mandate the amount of housing allowance paid by public healthcare clusters and community care organisations. However, we continue to monitor this as part of the salary package for foreign healthcare workers. In the meantime, MOH Holdings has been studying the feasibility of facilitating hostel-type accommodation to support new foreign healthcare workers when they first arrive in Singapore, before transiting to housing options available in the market after they have had some time to settle in.”
“Singapore Citizens and Permanent Residents can already use their MediSave to pay for medical expenses of immediate family members on Long-Term Visit Pass (LTVP), such as their parents, spouses and children. However, to prevent premature depletion of Singaporeans' MediSave, MediSave cannot be used for other LTVP family members, such as siblings and grandparents. LTVP patients who face financial difficulties with their healthcare bills may also approach medical social workers for assistance. The Ministry of Health will also assess appeals on a case-by-case basis.”
“We value the contribution of senior healthcare workers and want them to contribute as long as possible. Many of our senior healthcare workers may also be seasoned healthcare professionals who continue to contribute meaningfully by grooming the next generation through mentorship and education. We do this by working with our public healthcare clusters to support upskilling and reskilling efforts; redesigning jobs to make them less physically demanding; deploying assistive technology; and reassigning the senior workers to new roles where possible and accepted. As a standard practice, clusters will re-employ healthcare workers beyond the statutory retirement age of 63 and extend beyond if the healthcare workers are willing. For those who have retired, we also hope that they consider volunteering in healthcare roles. The healthcare clusters have extensive volunteer programmes ranging from care-related duties in the wards to community engagement roles that are not physically demanding. They may also take up volunteer roles in the community care sector, such as at nursing homes, Active Ageing Centres (AACs) or with home care services, where they can support other seniors.”
“Between 2020 and 2022, around 180,000 to 220,000 Singapore Citizens used their MediSave to pay for their family members' healthcare expenses per year. These make up about 16% of Singapore Citizens who used MediSave for healthcare expenses. To encourage mutual support within the family, there are no specific MediSave withdrawal limits for one's family members. However, such withdrawals are still subject to the treatment-specific MediSave withdrawal limits that are sized to be sufficient for subsidised patients.”
“The Ministry of Health is aware that some polyclinics are facing tight capacity and are putting in place measures to address this. The two Parliamentary Questions will be addressed in the next Sitting on 4 July together with similar Parliamentary Questions related to polyclinic appointment bookings for a more holistic reply. [Please refer to "Ensuring Seniors' Access to Polyclinic Care", Official Report, 4 July 2023, Vol 95, Issue 106, Oral Answers to Questions section.]”
“The bivalent messenger ribonucleic acid vaccines against the Omicron strain currently offered under the National Vaccination Programme are the most updated formulations for now. The Ministry of Health will assess new vaccines when they become available. More details will be provided in the next Sitting together with a similar Parliamentary Question for a more holistic reply. [Please refer to "Recent Decision not to Recommend Those Aged 60 to 75 to Take Second COVID-19 Booster Shot", Official Report, 4 July 2023, Vol 95, Issue 106, Oral Answers to Questions section.]”
“Today, Community Health Assist Scheme (CHAS) subsidies cover a range of dental procedures that are appropriate for the primary care setting at private dental clinics and are not meant to cover complex dental procedures. Patients referred for more complex procedures, such as non-aesthetic orthodontic treatment for medical reasons, from polyclinics and CHAS dental clinics to the national specialty dental centres, namely, the National Dental Centre and the National University Centre for Oral Health, will receive subsidised care where appropriate. We will continue to review our subsidy framework regularly, including the coverage of dental services for CHAS cardholders, to ensure the continued affordability and accessibility of dental care at the appropriate settings.”
“Making healthcare subsidy and financing portable is a multi-step process, because many services and private providers are involved. We have already taken a few important steps. First, to support anchoring of chronic care with the general practitioners (GPs) in the community, we announced at this year's Committee of Supply that eligible Healthier SG chronic enrollees would be able to opt for the Healthier SG Chronic Tier at their enrolled Healthier SG GPs from early 2024 onwards, to access means-tested subsidies of up to 75% for selected chronic medications and at comparable prices to the polyclinics. Second, to support care at home, MediSave will be extended to Ministry of Health (MOH)-funded home medical and home nursing providers from 1 October 2023. All providers who have made the necessary systems upgrade can start claiming MediSave for their patients from that date. We will also extend drug subsidies of at least 50% to all Singaporeans receiving long-term medical care services by MOH-funded providers from the fourth quarter of 2024. This will improve access to subsidised drugs, especially for those who are homebound. Third, mainstream financing schemes are also being extended to more telehealth services. We have extended subsidies and MediSave for video consultations for home palliative care services since 1 July 2023 and will make permanent the extension of Community Health Assist Scheme subsidies and MediSave to video consultations for chronic disease management later this year. Further steps will be taken in the coming months.”
“The Interagency Taskforce for Mental Health and Well-being has made recommendations to improve the accessibility, coordination and quality of mental health services. These include establishing a tiered care structure and harmonising referral workflows and assessment tools, to enable community mental health teams to collaborate seamlessly with social care services. A common Information Technology platform would also be a key enabler to enhance information sharing and care coordination. The implementation plans for the recommendation are in progress. More details will be provided when ready. Concurrently, there are ongoing efforts to improve training and support for healthcare workers in the mental health sector. The National Mental Health Competency Training Workgroup is developing a competency training framework that will enable mental health workers to acquire the requisite knowledge and competencies for delivering high quality and effective care. Mental health workers from the community mental health teams, such as Community Resource Engagement Support Team (CREST) and Community Intervention Team (COMIT), also attend regular mental health training programmes. Besides mental health capability-building, CREST and COMIT have enhanced workplace support for their staff through more emphasis on self-care, including helpful ways to prevent and cope with burnout, and strengthened supervisory arrangements to support staff. The Taskforce recommendations, including indicators to be developed to monitor the progress of the recommendations, will be included in the development of a national strategy for mental health and well-being by the end of the year.”
“The Ministry of Health's (MOH's) fee benchmarks serve as a reference for doctors, hospitals, patients and insurers on what is considered a reasonable fee for routine and typical cases. While not mandatory, the fee benchmarks have fostered price transparency, instilled discipline in charging and helped moderate increases in fees since 2018. Integrated Shield Plan (IP) insurers take reference from the fee benchmarks in setting their panel fees, which they have adjusted to at least the lower bound of the fee benchmarks. While MOH has encouraged them to consider the full range of the fee benchmarks, the decision on panel fees would need to be balanced against the insurer's own commercial considerations and the needs of the policyholders. Panel fees aside, insurers may differ in the number of doctors they choose to empanel as it could depend on other panel selection criteria. Doctors may also choose not to be empaneled if they have a sufficiently large patient base. Nevertheless, IP panels have grown considerably since August 2021, with most having at least 500 private specialists. Under the Extended Panel initiative, policyholders may also access key panel benefits, such as co-payment cap, if their specialists are on other insurers' panels and agree to the insurers' terms. Apart from the fee benchmarks, MOH has introduced other cost-management measures, such as minimum 5% co-payment for IP riders, the introduction of the Cancer Drug List and the removal of as-charged coverage for cancer drug treatments. We will continue to monitor the situation and take further steps if necessary. We encourage all parties to play their part in keeping costs sustainable.”
“Our healthcare workforce comprises a sizeable majority of Singaporeans, and foreign manpower from many countries. They serve patients alongside one another and go through crises together. Foreign healthcare workers are an integral part of our healthcare system and, for those who become valued members of our healthcare community and demonstrate commitment to Singapore, we have been and are prepared to grant them Permanent Resident (PR) status. Over the past five years, around 1,200 foreign healthcare workers were granted PR status on average each year. More than six in 10 are nurses, and the remainder include doctors, allied health professionals and other healthcare workers. In the past year, more nurses were granted PR status, in recognition of the essential role they played in fighting the COVID-19 pandemic and in preparation to support Singapore's growing healthcare needs.”
“The Ministry of Health (MOH) considers both the current and projected number of seniors, as well as other factors, such as local service needs and the accessibility and service boundaries of Active Ageing Centres (AACs), when planning for new AACs. Before finalising the site, MOH will seek the views and support of key community stakeholders. Sites for AACs can be identified in advance for planning purposes and the tender process to select a provider triggered later. The average time taken from launch of tender to operationalisation of an AAC is about two years.”
“The Ministry of Health (MOH) does not specifically audit admissions at the emergency departments (EDs). However, patients at EDs are reviewed by senior doctors to assess if they are suitable for admission to hospital or the Extended Diagnosis and Treatment Units (EDTUs) for observation. MOH also monitors the profile of patients admitted at EDs. From January to May 2023, about 20% of adult patients admitted at EDs are discharged within two or fewer days and this figure has been decreasing over the years.”
“Elective egg-freezing (EEF) will be implemented by July 2023, alongside the Assisted Reproduction (AR) regulations under the Healthcare Services Act. The procedures for EEF, as well as the estimated costs for egg retrieval, are identical to those for in-vitro fertilisation. As EEF is not a medically indicated procedure, subsidies, co-funding or MediSave for egg retrieval and/or storage for EEF will not be available. All licensed AR service providers will be allowed to provide EEF. This includes the AR centres at Singapore General Hospital, KK Women's and Children's Hospital and National University Hospital.”
“The majority of public healthcare institutions utilise third party bill collection services to follow up on outstanding bills. If a patient expresses difficulty in repayment, the collectors will provide the contact details of a medical social worker who can help to assess the patient's eligibility for financial assistance.”