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.”
The complete record
Every one of 2,932 lines we hold for Ong Ye Kung, in date order, each linked to its source. Free to read, in full, without an account. Page 29 of 59.
“MOH only has data on attrition of doctors by their age. Over the past five years: Among 29 year olds, attrition rate went up from 4% in 2018 to 6% in 2019, then dropped to 2% in 2020 and 2021; Among the 30 year olds, it was 8% in 2018 to 10% in 2019, then 5% to 6% in the last two years; and Among the 31 year olds, it was from 6% in 2017, 9% in 2018, then 3% to 4% in the last two years. There are many factors that affect attrition, including morale, job satisfaction, work conditions, and most importantly, a sense of mission. This explains why during the COVID-19 pandemic during the past two years, attrition rate generally dropped for doctors. We will continue to monitor these factors closely, and engage with staff to improve them, and address any issues.”
“This question will be addressed in my reply to Dr Lim Wee Kiak and Mr Yip Hon Weng on 5 July 2022.”
“For Parliamentary Question 61, Members should refer to the combined oral reply to Parliamentary Questions 46 to 49 taken on the 4th of April 2022. Dr Lim asked a second PQ on the evaluation, referral and management of patients after COVID. These patients’ issues have a wide variety of symptoms. The clinical follow-up and referral for further evaluation and treatment, are specific to their individual medical issues and risk factors. The clinicians involved will make these decisions taking into account relevant risk factors.”
“Exercising personal responsibility to avoid high risk activities, especially when symptomatic, and practicing good personal hygiene remain effective at reducing the risk of transmission in the general population. For certain healthcare and laboratory personnel who are at higher risk of occupational exposure, such as those who will directly and frequently work with infectious monkeypox cases or specimens, the proper use of personal protective equipment, and infection control practices, are effective at reducing risk of transmission. For this group, MOH is also evaluating vaccination for protection before potential exposures on a case by case basis. MOH will continue to monitor the monkeypox situation closely and calibrate our preparedness and response measures as needed. Members of the public are encouraged to keep up to date with the Government’s advisories. They should exercise personal responsibility to monitor their personal health and maintain good hygiene, especially during travel. They should also avoid close contact with other individuals known or suspected to be ill with monkeypox infection.”
“Similar to the management of other emerging infectious diseases, the key to controlling the spread of monkeypox is early diagnosis and isolation of the case, contact tracing and monitoring of close contacts, and if necessary placing them in quarantine. We require travellers to declare relevant symptoms using the electronic Health Declaration Card on arrival for early detection of cases. Individuals with symptoms will be referred for further assessment. We have also disseminated information on monkeypox, including symptoms and precautionary measures for the public to adopt. We urge individuals to see a doctor promptly when they develop symptoms, and to isolate themselves from others. To reduce spread, cases are isolated in hospital, and their close contacts quarantined for up to 21 days from the last date of exposure, for monitoring, and offered smallpox vaccines as post-exposure prophylaxis to reduce their risk of infection or severe symptoms. MOH has also provided regular updates to all medical practitioners and healthcare institutions on the monkeypox situation, including guidance and protocols on the criteria for identifying suspect cases as well as the subsequent management of confirmed cases. Unlike COVID-19 vaccination, mass population-wide vaccination with the smallpox vaccine is not recommended as a preventive strategy for monkeypox, in line with international recommendations and the global response thus far. Although the smallpox vaccine is up to 85% effective at preventing monkeypox, it has potentially severe side effects. For the general population, the risks of complications outweigh the benefits, because they are at low risk of being infected.”
“This will collectively address the PQs for oral answer No. 41 and 42 in the order paper, and also oral PQs filed by Dr Lim Wee Kiak, Ms Joan Pereira and Dr Wan Rizal for the sitting on and after 5 July. On 22 June 2022, the World Health Organization (WHO) reported that since 1 January 2022, over 3,400 laboratory confirmed cases of monkeypox had been detected from 49 countries globally, including one imported case in Singapore. This global spread of monkeypox is driven mainly by person to person transmission. However monkeypox is unlikely to become a global pandemic like COVID-19, as transmission requires close or prolonged physical contact with infectious persons or contaminated material. WHO had also determined that this outbreak does not constitute a Public Health Emergency of International Concern (PHEIC) as of 23 June 2022. Monkeypox is typically a self-limiting illness where patients recover within 2 to 4 weeks. A small percentage of those infected can fall seriously ill or even die. Those particularly vulnerable to complications are young children, pregnant women or immunocompromised individuals. Data from the current multi-country outbreak indicated that in Europe, where the majority of recent cases were reported, 99% of the cases were men, and many have self-identified as men who have sex with men. Given that sexual contact with infected individuals appeared to be the main driver of the current monkeypox outbreak, and that transmission requires close physical or prolonged contact, the risk to the general public remains low. The Ministry of Health (MOH) has developed protocols and processes to manage monkeypox. These have been applied to the recent imported case reported on 21 June.”
“The requested data is shown in the table below: Based on available data, the majority of the public hospitals and National Specialist Centres reported around 3% to 5% postponement of non-urgent procedures in 2021. The statistics of patients who have chosen to seek care at private healthcare institutions instead are not tracked by public hospitals and National Specialist Centres.”
“Between 2 November 2021 and 30 April 2022, $19.35 million had been distributed to eligible applicants under the Quarantine Order Allowance (QOA) Scheme.”
“MOH, MSF and HPB have just recently updated the contents of the pre-abortion counselling booklet which is made available as part of mandatory counselling. This booklet includes the alternatives to abortion, such as raising the child or putting the child up for adoption, as well as resources and social support available for each of these choices. The updated booklet has been circulated to all approved institutions under the Termination of Pregnancy Act as of 31 March 2022.”
“Individuals who are diagnosed with advanced illness and passed away at home are usually already under the care of their regular family doctor, home medical or home palliative services. The care providers would usually advise family members to contact them, including outside office hours, for assistance in the event of death. Individuals may also suddenly or unexpectedly pass away at home from natural causes. Some private general practitioners can conduct house calls for their regular patients to provide certification of their death. Families can also contact private medical providers who provide 24-hour house call services to certify death.”
“The current upper age limit for elective egg freezing (EEF) is determined based on international scientific evidence and professional consensus that egg quality declines significantly after 35 years of age and considering that egg freezing is an intrusive procedure that is not without downsides or risks to the women undergoing it. Hence, the age limit helps manage expectations, avoids giving false hope and safeguards women against Assisted Reproduction (AR) providers promoting the retrieval of frozen eggs beyond the age limit. MOH will continue to monitor medical advances and review the age limit from time to time. Nevertheless, we will consider appeals from women who miss the upper age limit slightly. Women may seek their AR practitioner's assistance to appeal on their behalf when EEF is implemented. More details will be provided to AR centres in due course.”
“These questions have been addressed by the reply to Question No 74 in the Written Answers to Questions for Oral Answer Not Answered by End of Question Time section for the Sitting on 9 May 2022.”
“The Serangoon Polyclinic project is on schedule with the demolition works completed and construction works expected to commence by end of this year. The polyclinic is on track to open by 2025, barring any unforeseen circumstances.”
“The onset of dementia can be prevented or delayed through the adoption of healthy lifestyle habits, including having regular physical activity, maintaining a balanced diet, not having excessive alcohol intake and not smoking. Screening for chronic conditions, such as diabetes, high blood pressure and high cholesterol, would enable early detection and timely intervention to reduce the associated risk of dementia. However, there is no clear evidence internationally that population-wide dementia screening in persons without recognised signs or symptoms of cognitive impairment is an effective public health intervention. Hence, our current efforts continue to be more targeted, focusing on increasing dementia literacy and awareness, early identification of persons at risk or suspected to have dementia in the community and referral for early interventions. Over the last year, our community outreach teams have reached out to 150,000 persons and provided assistance to 4,000 persons who were at risk of developing dementia and/or mental health conditions.”
“As of April 2022, all polyclinics and close to 60% of private medical clinics have access to the National Electronic Health Record (NEHR). All healthcare professionals who are involved in direct patient care can apply to access NEHR. To support the outcomes of the Healthier SG programme, care providers will be able to access patients' medical records, track their patients' conditions and progress over time, and share the records with other healthcare providers, using NEHR. To govern these processes and to ensure secure data sharing, we intend to table a Health Information Bill.”
“Lianhua Qingwen Jiaonang (LHQW) 莲花清瘟胶囊 capsules are classified as Chinese Proprietary Medicines (CPMs) in Singapore, approved for the relief of cold and flu symptoms. CPMs are not intended for the prevention, treatment or cure of specific diseases. We are aware of claims circulating on social media platforms that LHQW can be used to prevent or treat COVID-19. To date, there is no conclusive evidence from controlled clinical studies to substantiate those claims. Locally, there is an ongoing local study to investigate the effectiveness of LHQW in reducing COVID-19 symptoms.”
“Under the "I Quit" Programme run by HPB, participants are supported for up to six months to quit smoking. Participants may also join "I Quit" repeatedly as some require multiple attempts before quitting successfully, due to the addictive nature of nicotine. Individuals who wish to quit on their own can also tap on resources at HealthHub for tips on various coping methods, such as picking up new hobbies to relieve stress. Local success rates for unique participants of smoking cessation programmes range from 10% per year for telephone-based interventions, to 20% per year for programmes that combine intensive counselling and pharmacotherapy. This is comparable to international experience where reported rates of successful smoking cessation range from 7.5% to 20.1%. Persons who wish to quit vaping will not be penalised when they come forward to seek professional help or participate in cessation programmes.”
“This will also address Written Question Nos 29 and 30 asked by Mr Yip Hon Weng for the Sitting on 9 May 2022. MOH takes a multi-pronged approach to curb the use of tobacco products, including vaporisers, or e-cigarettes in various settings. At the checkpoints, ICA deploys a variety of technologies to detect contraband items, including radiographic scanners, X-ray machines and hand-held screening devices, to ensure that all goods that enter Singapore are lawful and legitimate. ICA also conducts pre-arrival risk assessments and profiling to aid the detection of contraband items. When suspicious items are detected, ICA ground officers will refer the passenger and/or vehicle for further checks. Any prohibited or controlled items detected will be referred to the appropriate regulatory authority, for example, HSA for e-cigarettes/vaporisers, for follow-up investigation. From 1 January 2022 to mid-April 2022, close to 300 persons were caught for importation of vaporisers and related components at the Causeway checkpoints. While the opening of borders does pose a risk of increased illicit smuggling of vaporisers, these products can also be sourced via e-commerce and enter Singapore via mail packages even when borders are closed. To address the use of vaporisers within Singapore, we work with various partners and stakeholders to strengthen enforcement measures and public education efforts. The Health Promotion Board (HPB) will roll out a vape-free campaign later in 2022 targeted at youths and younger adults through popular digital platforms, to communicate that vaping is harmful and illegal and penalties will apply for offences related to prohibited tobacco products, such as vaporisers. Smoking cessation efforts are also in place to support those who wish to quit.”
“The Ministry does not intend to impose any additional caps on the working hours for healthcare workers beyond what is already stipulated in the Employment Act or the public healthcare cluster's employment contracts. In addition, for junior doctors, there are existing hospital guidelines, such as total allowable work hours per week and the provision of sufficient rest periods. Public healthcare institutions should put in the necessary efforts to adhere to these guidelines. The experience with the pandemic has shown us that there will be times when healthcare workers will be subject to exigencies of service. Flexibility in deploying healthcare workers is important to ensure that our public healthcare clusters can manage the operational needs on the ground. The public healthcare clusters have established workgroups to look into enhancing the support for healthcare workers and care model transformation that will ensure a more sustainable work-life balance.”
“The pre-screening measures implemented by the Health Sciences Authority (HSA) are reviewed regularly to align with the latest safe management measures (SMMs). After the most recent review on 19 April 2022, the COVID-19 travel-related deferral was removed. For now, HSA will retain the pre-screening criteria to defer those with close contact with COVID-19 infected persons, and with respiratory symptoms, fever and COVID-19 infections. Mobile blood donation drives continued to be conducted regularly during the pandemic. The number and frequency were reduced, due to the inability of some companies to organise blood mobile drives at their premises. In such instances, arrangements were made for donors to donate blood at HSA's blood collection centres. As SMMs are relaxed and more staff return to the workplace, engagement of corporate companies to host mobile drives will be stepped up.”
“MediSave is not allowed for home care setting today. We have been cautious in extending its use, as home care is, generally, unregulated and there is a need for measures to ensure appropriate delivery of home care. The exception is home palliative care, where admissions are more tightly gatekept and eligibility criteria better defined. Hence, patients can use MediSave for chronic disease medications prescribed by Long-Term Care (LTC) providers under the home palliative care limit. Furthermore, LTC patients who are severely disabled can make cash withdrawals under MediSave Care to pay for their LTC expenses. Patients who face difficulties paying their subsidised LTC bills may also apply for financial assistance, such as MediFund. MOH will review the need to extend MediSave use to chronic medication for home medical care, as part of our effort to encourage right siting of care and fulfilling the wishes of patients to recover in the familiarity of their homes.”
“Additionally, to reduce the waiting time for patients requiring investigations, such as oesophagogastro-duodenoscopy (OGD) and selected cardiac tests, all polyclinics can refer eligible patients directly for such tests at the public hospitals without needing a first Specialist Outpatient Clinic (SOC) consultation.”
“For colonoscopy, the median time to the investigation was approximately 38 days in 2021, an increase from about 31 days in 2019. Based on available data from our hospitals, over the past three years, an average of six subsidised patients per hospital each year waited more than five months for a first appointment for colonoscopy. For transthoracic echocardiogram, an average of 130 patients per hospital, per year, waited more than five months for a first appointment for the scan. These patients constitute fewer than 3% of the total patients who had undergone the scan. In these cases, these patients were mostly already seen by the specialist, who then ordered these investigations based on their clinical indications. Patients assessed to have higher risks or significant symptoms are prioritised with fast-tracked appointments, as clinically indicated. Earlier alternative investigations are also offered, if clinically appropriate. Integrated Shield Plans (IP), generally do not cover cancer screening at both public and private hospitals, as no hospitalisation is required and these are neither a treatment nor an illness. There are other ways in which diagnostic tests are subsidised and made affordable. All polyclinics can refer patients to public hospitals and national specialist centres, including those not within their cluster, for subsidised care which includes subsidised tests, as prescribed by the specialist. Community Health Assist Scheme (CHAS) general practitioner clinics can also refer CHAS cardholders for subsidised care at public hospitals.”
“I thank the Member for the question, I intend to answer Question No 13. So, whether the Ministry will conduct a study on the impact of the COVID-19 pandemic on various aspects, as I mentioned, we have issued a Press Statement on 24 March, and said that we will collate all the data, and do a proper study. It is a special report on the impact of the entire pandemic and we will answer some of the questions, including the data required.”
“Indeed, we all take responsibility for our own health and make our own decisions regarding our own health status, including vaccinations. The issue that we do need to consider here is that, in a pandemic crisis, individual decisions also affect the society and the healthcare system. The Member would remember that 3.5% of our population is not fully vaccinated. They accounted for 20% of ICU cases and deaths and also add on a certain workload to our healthcare system, which, in extremis, when the numbers are huge or when we have a big wave, may mean adding a lot of pressure to our healthcare system. When that happens, it is not just the unvaccinated who will suffer, not those who are infected that will suffer, but everyone who requires hospital care, acute care and emergency services will suffer. So, it is because of that, that the decision not to vaccinate yourself is no longer just about yourself; it is also a role for us to protect the whole society. Having said that, the last time the Member asked me that question, since then to now, we have relaxed many of the VDS restrictions for this group, because, given the current situation, we do not think it is needed. But we do worry about the next variant of concern. Most likely, it will evolve and emerge in the months to come. So, given that posture, I think, just maintain these three most risky settings where VDS will still apply and we will continue to review the situation.”
“The answer to both questions is yes. So, if the temple dinner has more than 500 people, they ought to install a SafeEntry check-in counter; and then the auction and performance can proceed.”
“I thank the Member for her question. I read the article as well and I thought there might be a supplementary question on it. I will need to check with GovTech with regard to the status of all the equipment. As for those who have inadvertently disposed of them, do report them. I am sure the Government agencies will be as helpful as they can to try to replace them. I think our key consideration is not so much about protection of the equipment, but to make sure that should we have another variant of concern, businesses, individuals, we are ready to respond. Mr Speaker, Ms Nadia Ahmad Samdin also asked about the data. I mentioned this in an earlier reply, which is, that for events, for example, nightlife with dancing, where SafeEntry data is still collected, it will be purged very quickly.”
“As mentioned in the Ministry of Health (MOH) press release on 24 March 2022, MOH is continuing to collect and analyse the data, particularly the recent Omicron data, to find out more comprehensively the impact of this crisis on Singapore residents and we will release a special report soon to estimate the excess deaths over the past two and half years of the pandemic and the key factors causing the excess deaths. I should emphasise that whether it is official COVID-19 death toll or excess deaths, Singapore will have one of the lowest rates in the world, amongst countries that have chosen to live with COVID-19 and resumed normal lives, and that is because of the cooperation of everyone in Singapore and the effectiveness of protecting our healthcare system.”
“But, in Singapore, this is not an issue. Two, there are infected persons who died of other illnesses, where the COVID-19 infection might have been a contributory factor but not the main cause. Three, care-seeking behaviours changed. For example, individuals with chronic conditions may put off their check-ups, treatments and medications during the pandemic, to their own detriment. Four, there are many regions where their healthcare systems were overwhelmed. When that happens, proper care is denied and the people who suffer are not just the COVID-19-infected patients, but everyone who needs hospital care. Our excess deaths in 2021 among Singapore residents is about 1,535. That is for 2021, when we had a Delta wave, after accounting for ageing. COVID-19 deaths as at end 2021 among residents is 804, or about 52% of excess deaths. The remainder excess deaths could be due to some of the factors I explained earlier, except under-reporting, which is not an issue in an urban environment like Singapore; also, the last reason I mentioned, hospitals being overwhelmed. That is not a big factor here, because we prioritised the protection of our healthcare system, going into a circuit breaker when necessary. So, although our hospitals came under significant pressure at the height of the infection waves, they were not overwhelmed, and hospitals could continue to give priority to serious and urgent cases.”
“So, the DORSCON framework is most likely still relevant, but it needs to be part of a larger emergency preparation and public communications framework that we have already developed and people now understand. Members also asked about "excess deaths". Let me first explain what it is. It means comparing death rates across the years, taking into account the changing age profile of the population. If the death rate goes up in a pandemic, above that expected in the absence of a pandemic and over what is expected from population ageing, it means there are excess deaths. For Singapore, our age-standardised death rate has decreased from 2017 to 2020, from 563 per 100,000 residents to 519 per 100,000 residents. In 2021, the rate increased to 557 per 100,000 residents, almost back to 2017 levels. So, 2021 is about the same as 2017, just a notch lower. So, there are excess deaths in 2021, compared to 2020. Mr Leon Perera asked why that is so and how we calculate excess deaths. We used well-established, internationally-practised methods, including age adjustments. There are excess deaths in 2021 because there had been a global pandemic, causing millions of deaths around the world, and Singapore was not exempted. During a pandemic, excess deaths will be higher than officially reported deaths directly caused by the disease. To illustrate, a recent WHO analysis of excess deaths found that while the officially reported number of COVID-19-related deaths around the world is slightly over six million, "excess deaths" during this pandemic is 15 million – about 2.5 times more. There are a few reasons to explain the difference in the two numbers. One, in some parts of the world, there can be under-reporting in regions where testing is insufficient or where data is difficult to collate.”
“In the initial phase of the pandemic, MTF decided that, for transparency, we would announce the DORSCON level and colour code publicly, too. This would help alert the public to the need for personal vigilance and social responsibility. However, it had also led to certain public reactions, such as the rush to the supermarkets. This is one key issue for review as DORSCON is meant to bolster preparedness, not to induce public anxiety. A key factor to consider in our review of the DORSCON framework is that after more than two years of the pandemic, the Government and our society have learnt a lot about pandemic response. We have developed a comprehensive response system, covering health protocols, border controls and safe management of social and economic activities. It is also tiered and differentiated, catering to different activities and settings, such as schools, offices, public spaces, eating places, nightlife, events and so on, with various severity conditions. Therefore, from a public communications point of view, we believe that the public now pays much less attention to the DORSCON colour code and takes care to understand the various public health measures in detail, and then respond and do their part accordingly, be it taking vaccination, wearing masks or abiding by the safe management measures (SMMs). So, I am confident that today, we have a much more sophisticated public that understands what they need to do when a pandemic turns for the worse. The response of the public and the contribution of everyone in our society are, ultimately, what give us resilience during a pandemic outbreak.”
“We will have to take into account if there is a new variant of concern, whether it is more severe or more infectious than the Omicron variant, whether past infections and current vaccines continue to confer strong protection against the new variant and how all these affect our hospital capacity. I can understand that some members of the public and Members of the House want a system, with transparent and clear triggering points, but I am afraid this is not possible when we are in a pandemic crisis with fog of war. Through MTF's actions over the years, I hope the public would also appreciate where we are coming from. We do what is necessary to protect lives when danger is upon us and we will step down measures when they are no longer needed, no longer necessary, so that people can resume their normal lives. So, the best step for the public to take is not to delete your TraceTogether app and not to throw away your TraceTogether tokens. Please keep them. Members asked about the Disease Outbreak Response System Condition (DORSCON) framework. DORSCON was established after SARS in 2003, then reviewed and progressively improved upon from the experiences drawn from managing the H1N1 pandemic in 2009, and the coordination for the Middle Eastern Respiratory Syndrome Coronavirus and Ebola Virus Disease. Post-COVID-19, we will, certainly, review it further, along with our response measures, given all that we have learnt during this pandemic crisis. The DORSCON framework was developed as a tool for Ministries and agencies to coordinate and execute the Government's response to outbreaks of infectious diseases. By and large, it has served its purpose well in this pandemic.”
“With the pandemic situation stabilised, the Multi-Ministry Taskforce (MTF) took decisive steps to open up social and economic activities to almost pre-COVID-19 norms. So, to Ms Sylvia Lim's question, temples can start to organise dinners, barring any changes in rules later. Mr Lim Biow Chuan asked if individuals who are not fully vaccinated can be allowed to enter malls and dine in F&B outlets. I would like to clarify that they can enter malls as we have significantly removed vaccination-differentiated safe management measures (VDS) for non-fully vaccinated persons. However, we still need to remain cautious because the next infection wave is highly possible. We also need to watch out for new variants that may threaten us again. Hence, MTF decided to maintain VDS for the three most risky settings: nightlife outlets with dancing, events with more than 500 participants at any point in time and then, F&B outlets where there is a constant flow of diners who are mask-off and interacting. For F&B outlets, we will, however, not deploy TraceTogether and SafeEntry, but instead put the onus on customers to ensure that they are fully vaccinated before visiting an F&B outlet. We will continue to review our VDS measures as the pandemic situation evolves. We are taking a cautious "step down but not dismantle" posture for our public health measures. If the situation requires, we will have to step up VDS and reactivate TraceTogether and SafeEntry. Ms Nadia Ahmad Samdin asked what the criteria are to reactivate these measures. It is a matter of judgement, depending on the severity of the situation.”
“Mr Speaker, Sir, may I address Question Nos 9 to 13 and also the Question for Oral Answer filed by Mr Louis Chua1 for the Sitting on or after 10 May, please?”
“This question has been addressed by Question No. 34, as contained in the Circular for Written Answer on 4 April 2022. [Please refer to "Disability Assessments for ElderShield Payouts", Official Report, 4 April 2022, Vol 95, Issue 60, Written Answers to Questions section.]”
“In the last three months, Singapore went through a severe pandemic crisis. It is a global crisis that affects all countries and regions. Fortunately, our population is highly vaccinated. Hence, COVID-19 infections have not translated into many cases with severe illness and our ICU wards did not come under pressure. It has been the hospital Emergency Departments (ED) that are most busy. During that time, MOH had approved the diversion of SCDF ambulances on seven different occasions from three hospitals (CGH, KTPH and SKH). We are able to do so because the conditions of the patients were non-critical. This helped hospitals manage their capacity at the EDs, so that patients with critical conditions can be attended to quickly. The duration of diversions varied, ranging from two hours to six hours. All patients presenting at EDs are triaged at registration, usually within half an hour, to determine the level of priority for emergency treatment. Their waiting times for clinical consultation varies, depending on the clinical condition of the patient. Critically ill patients are seen almost immediately.”
“In normal, pre-COVID-19 times, we maintain about 460 isolation beds across our public hospitals. In the last three months, due to the COVID-19 pandemic, public hospitals operated between about 960 and 1,680 isolation beds to care for COVID-19 patients. Public hospitals also had to activate surge capacity beyond normal ward capacity. As the Member would appreciate, during a pandemic crisis where emergency responses are the order of the day, such plans have to be very regularly activated.”
“COVID-19 infected patients who are critically ill are allowed visits by family members, but with limits, to minimise the risk of infections spreading in hospitals. As the pandemic situation continues to improve, the visiting rules will be reviewed.”
“A study by the Institute of Mental Health (IMH) on Singapore population’s psychological responses and mental well-being found that about 13% of the respondents reported symptoms of depression or anxiety in the period from May 2020 to June 2021. Programmes were available to help provide Singaporeans with psychological support during this period and continue to be available. The National CARE Hotline (NCH) provides emotional and psychological first aid to those who are affected. HPB provides a national mental health resources portal on HealthHub to provide Singaporeans with credible, reliable and convenient access to mental health information. Specific programmes to help children and their families cope with the COVID-19 pandemic are also available. For example, MSF offers evidence-based parenting programmes, such as the Positive Parenting Programme (Triple P) and Signposts, to equip parents with skills and strategies to build strong, healthy relationships with their child (aged up to 16), and confidently manage their child’s behaviour. Measures to support students’ mental health are provided in the schools by MOE. These include Mental Health Education lessons taught within the refreshed Character and Citizenship Education curriculum. Teachers also conduct regular check-ins to closely monitor and support students’ mental well-being. The Agency for Integrated Care (AIC) has also been working with community partners to set up community mental health teams to reach out and offer a range of mental health support services for individuals, including youths, at risk of or suspected to have mental health conditions.”
“To manage the COVID-19 pandemic, we encourage all clinics to join the Public Health Preparedness Clinics (PHPC) scheme and the Swab-and-Send-Home (SASH) programme. The Agency for Integrated Care (AIC) also reaches out to support clinics with onboarding. However, there are some clinics that are not suitable to be on the SASH programme due to factors such as infrastructural and/or manpower constraints, for example, need for dedicated swabbing area. MOH and AIC have engaged and onboarded over 900 PHPCs that offer Polymerase Chain Reaction (PCR) swabs and/or Antigen Rapid Tests (ART). These PHPCs are located islandwide, with an average of around 20 such clinics within each town. To further enhance the accessibility of these tests in the community, MOH has also introduced COVID-19 testing facilities for various test purposes, including 224 Quick Test Centres (QTCs) providing ART and 11 Combined Test Centres (CTC) providing ART and PCR. In addition, all polyclinics provide COVID-19 PCR and ART swab tests for their patients. For home-bound clients, there are also more than 20 home care providers that can provide PCR tests if they require such tests. As the COVID-19 situation evolves, MOH will continue to work closely with the COVID-19 testing providers to ensure that the necessary testing resources are in place and accessible to all.”
“MOH does not track the data for overtime hours for doctors and nurses. These are operational arrangements by the healthcare clusters and involve exigencies of service. Nevertheless, we acknowledge the hard work and effort put in by all our healthcare workers. During the COVID-19 global pandemic crisis, the pressure on our healthcare workers has increased tremendously. This is especially so over the last few months, because, due to the Omicron variant, all healthcare workers have put in an exceptional amount of extra effort and hours to take care of patients and keep our healthcare system running. Even before the pandemic, our healthcare workers have been the backbone supporting our healthcare system and enabling us to strengthen and increase our healthcare capacity over the past decade. As we now, hopefully, turn the corner from the current wave of COVID-19, our public healthcare clusters will do our best to allow staff the opportunity to rest and recharge and take vacation days and annual leave whenever possible.”
“From 1 November 2021 to 25 March 2022, 8,845 cases of reinfection were detected in Singapore. The vast majority of reinfection cases are mild, with one case requiring ICU admission and two deaths reported. The majority of reinfection cases are below 60 years of age.”
“Based on current practice, when Nuvaxovid is made available in Singapore as a vaccine under the National COVID-19 Vaccination Programme, individuals can exercise choice of vaccine, so long as usage is in accordance with the recommendations of the Expert Committee on COVID-19 Vaccination. While Novavax had announced that the vaccine was found to be 80% effective against COVID-19 in a late-stage trial in adolescents aged 12 to 17 when the Delta variant was dominant, the company has not applied for the use of vaccine for persons under 18 years. The Health Sciences Authority and EC19V will evaluate the data from this study and will continue to monitor for more information on the efficacy and safety of Novavax’s Nuvaxovid COVID-19 vaccine before making the appropriate recommendations for this age group.”
“This was written in 400 AD, during the era of Northern Wei (北魏). Even in highly patriarchal ancient China, there was recognition that there are inherent differences between men and women. But there are many roles that can be equally performed by both women and men. As our daughters grow up and start their own families, they will likely face the same dilemma as many women today, juggling multiple responsibilities and feeling guilty if they fall short of being the "superwoman" who can handle it all. But if my daughters decide as a life priority to start a family and spend more time as mothers to bring up their children, even at the expense of their career progression, I will be immensely proud of them. And if they decide they prefer to be single and use their talents to contribute to community and society, I will also be immensely proud of them. But whichever priority they put greater weight on, whatever life course they choose, they should not be pressured to do so. This shall be their choice. As a son, father and husband, and a Member of this House, I see our collective duty to support women in whatever they set out to do and accelerate away from our antiquated past of women and men stereotypes, at home, at work, in society. The future that we envision must be a society that dispels unconscious bias, promotes the right value of mutual respect between all individuals, upholds meritocracy and provides as much support as we can to enable caregivers to find better balance in their roles. In my mind, this equality to freedom of choice is the heart of this White Paper and the reason why I strongly support it. [Applause.]”
“I want to make a special shout-out to our youths, having met many of them during my time as Minister for Education. I say to them: be kind to all your friends, accord respect and courtesy to one another, listen to the views of everyone, girls and boys, keep the games and the jokes appropriate and tasteful – not from your point of view, but from theirs. Sexual offences are a rising problem amongst your generation. The boys might be uncomfortable with hearing this, but I think it is important you hear this. Never be part of the problem, but be part of the solution. When in doubt, always do the right thing. Watch out for the girls and, if it is late at night, offer to walk them to the bus stop, to the MRT station or to their destinations. Most of you take wefies now. But on those rare occasions where you take a photo with your class, your CCA group or with the Minister, do not let the girls kneel in front and you stand at the back comfortably. So, boys, volunteer to squat in front. Or at least position yourselves freely as equals. Safe management measures (SMM) restrictions are now lifted, you can now take group photos again without one-metre spacing. So, make this the new post-COVID-19 norm! Mr Speaker, Sir, to end the speech, let me talk about a familiar character in Chinese history – which is 花木兰 (Hua Mulan). Members are familiar with the story. A poem was written about her called "The Ballad of Mulan" or 木兰辞. I thought the last few lines are particularly meaningful. In Chinese, it goes like this: 雄兔脚扑朔, 雌兔眼迷离； 双兔傍地走，安能辨我是雄雌! Roughly translated, it says: when you catch hold of a rabbit, the male will kick its legs; if you catch hold of a female rabbit, it will close its eyes. But when they run side by side, you cannot tell which is male and which is female.”
“Mr Speaker, Sir, I have been speaking as a son, father and husband. Now, let me speak as a man, to fellow men. I say let us all be stakeholders in a fair and equal society. At the most basic level, let us respect women through our words and actions. Offences against women are clearly wrong and the vast majority of us agree with that. Perhaps what is less obvious is the occasional insensitive remark that reflects an unconscious bias or stereotype. Understand and see things from a woman’s point of view. Stop mansplaining, using diminutives, or doing things in the presence of women that they feel embarrassed by. Let us be more proactive in supporting the women in our lives, just as they support us. This could mean undertaking the roles that society often expects women to do, like household chores, parenting, arranging for food during a gathering or conference or Parliament Sitting. Many men already do these things and we can, certainly, do more as equal partners in society, and in solidarity with women. Finally, while we accord women respect, let us take a step further to be chivalrous. I may be old-fashioned, but I personally think there is much virtue in men extending a special courtesy to women. To be honest, I often feel uneasy, just because I am a Minister, that people, including my female staff, will attempt to carry my bag or open the door for me. And I will always try to stop them and offer to open the door for them instead, often reminding them etiquette comes before protocol. Such courtesy is timeless. It does not lessen the person at the receiving end or imply that they cannot do it themselves! They are perfectly capable of doing it themselves. Instead, it adds a certain appreciation and complementarity to the relationship between women and men.”
“The recommendations in the White Paper are careful in recognising and striking this balance – championing equality, especially of opportunities and progression, but yet recognising the beautiful differences between women and men. It is a wiser approach. There are many practical initiatives – anti-discriminatory measures in the workplace, FWAs, stronger support for caregivers, allowing elective egg freezing, and upholding stiffer penalties for sexual offences. Of particular importance are the moves to strengthen the family support infrastructure, which are empowering for women at various stages of their lives. On this, let us also have some perspective. It is not difficult to ask for more subsidy. Taking the Home Care Grant (HCG), for example, $400 is not enough, increasing from $200 to $400 is not enough, so, let us increase some more, give to more people. From a technical perspective, the HCG is not universal but broad-based. No doubt, if you transfer someone from a nursing home to a homecare environment, the Government saves on subsidies and we can think about how to help such individuals and such families more. But when you implement HCG, it does not cater to just this group. It is, actually, quite broad-based – whoever meets the means-tested criteria is eligible. So, it is not cheap. It is quite a big scheme. And if you want to expand it, double it, expand the number of recipients, you are looking at more budget. So, where does the budget come from? It has to come from some taxes and if you cannot raise taxes, if you object to raising taxes, then where will the money come from? So, we will continue to find ways to support families: from housing to education to, generally, having a safe, peaceful environment to bring up children as well as for homecare.”
“This is by a Hollywood star, Denzel Washington. He was paying a tribute to his late mother in one of the talk shows, I think. And he said this, I quote, "A mother is a son's first true love" when he is born; "a son is a mother's last true love" when she dies. The last three words I added. Single or married, mothers or women without children – women have special roles to play in their families and society because of these differences between women and men. However, where does recognising inherent differences stop, and biasness and stereotypes begin? It is a very difficult and sensitive question, which I have no answer to. During this debate, we hear many examples, many suggestions: how about enhancing this scheme, that scheme? But let us have that broader philosophical question in mind. We want to get rid of biasness but there are also inherent differences between women and men, beautiful differences. Look at leave. We only catered for maternity leave in our Employment Act decades ago. And that was a world where women needed to recuperate after childbirth, and where child-minding and taking care of the infant were mostly performed by women. So, maternity leave went to the women. In 2004, we introduced childcare leave, and then, infant care leave in 2008 as we saw men performing more of such roles. Then, in 2013, I believe, we introduced one week of paternity leave. And as we saw more men participating, we introduced a second week in 2017. In 2022, should we, therefore, declare all these as family leave, to be equally shared between men and women? Is it equality or are we no longer recognising that there is still a difference between men and women? So, let us be wise when we make such suggestions and choices.”
“Some families even have a breadwinner mother and a stay-at-home father because this is the best play of the family's strength – unheard of in my growing up years. Employers can decide, without the compulsion of law, that it makes better business sense to get rid of gender bias in hiring, promotion, appointment to boards and succession planning. Having said that, the push for greater equality between men and women is a nuanced and long-term exercise. I have highlighted the existence of societal biasness that we need to correct. But at the other end of the spectrum, there are inherent differences between women and men that cannot be ignored and should, in fact, continue to exist. That is what I believe. Let me quote Mother Teresa in a message for the World Conference on Women in 1995: "I do not understand why some people are saying that women and men are exactly the same and are denying the beautiful differences between men and women... As I often say to people who tell me that they would like to serve the poor as I do," and Mother Teresa would tell them: "What I can do, you cannot. What you can do, I cannot. But together we can do something beautiful for God. And it is just the way the differences between women and men." Many women I know, including my wife, are against gender biasness in society, but they will also fiercely guard the difference between women and men. Because they know daughters have a special bond with their parents that is different from the relationship that sons have. A woman, in a room full of men, is often able to articulate a different perspective. And for mothers, maternal instincts are non-substitutable. It comes from carrying the child for nine months, manifested in a mother wanting to nurse the child after birth. Let me offer another quote.”
“And education, as a driving force, is now turbo-charged by the advancement of technology. What used to require physical strength can now be automated or done by machines. So, neither men nor women are better at numerical calculation, more empathetic or more meticulous. It is individuals that have varied strengths and weaknesses. I was Transport Minister before. During that time, I met many women engineers working in LTA, SMRT and SBST. When I was Education Minister, I met many male students training to be nurses. And, now, as Health Minister, I see many of them serving in hospitals. In my GRC, we have two successful women: one, Mariam Jaafar, who was trained as an engineer; two, Poh Li San, she was a Super Puma helicopter pilot. The lines that were once perceived between male and female-dominated occupations are blurring and, the overlap, I believe, will enlarge over time. Let me talk about the third driving force that is challenging the past and, that is, our own effort to change the status quo. The patriarchal structure will evolve faster if people now conclude that, as a society, if we treat men and women more equally, it is better for the welfare of our families and our loved ones. This will take time. The Government will have a key role. By enacting policies, such as universal access to education, the Women’s Charter and all the various recommendations in the White Paper before the House today, we can catalyse and help accelerate into that new future. Society must also play a part, that means, you and I – everybody, every family. I look after a constituency. There are many BTO units and many young couples have moved into them. And I can see many husbands are now significantly involved in household and child-minding responsibilities.”