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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“In 2020, there were 63,800 seniors aged 65 and above living alone. Not all of them require support. Befriending services provide psycho-social support to vulnerable individuals who have limited family or social support and are at risk of social isolation. Currently, there are over 10,500 befriendees supported by the various befriending programmes funded by MOH. Under the new Eldercare Centre service model that was rolled out in May 2021, Active Ageing Centres (AACs) and Active Ageing Care Hubs (AACHs) work with the Silver Generation Office (SGO) to proactively reach out to seniors in the community through outreach activities, such as home visits. Collectively, they match seniors at risk of social isolation with befriending services, and regularly update their databases of engaged seniors. MOH has onboarded 60 AACs and AACHs onto the new service model in FY2021. These, currently, oversee around 145,900 seniors, including about 3,500 befriendees. We are on track to onboard at least 200 centres by FY2024.”
“All persons are medically assessed at vaccination centres, polyclinics or participating Public Health Preparedness Clinics before being vaccinated. The Expert Committee on COVID-19 Vaccination has advised that only those with previous vaccine allergies are medically ineligible; the vast majority of individuals are suitable for mRNA vaccines.”
“Nurses in the ILTC sector, also known as the community care sector, have different job requirements including working hours, compared to public healthcare sector nurses. MOH works closely with the Agency for Integrated Care and Community Care Organisations (CCOs) to ensure that salaries of staff in the sector remain competitive. In 2020, we provided funding to CCOs to raise the salaries of local nurses and support care staff. Earlier this year, we announced further funding support for salaries and expanded the support to more job groups, such as allied health professionals, pharmacists, administrative and ancillary staff. Over the years, we have also strengthened various recruitment and workforce development support for the community care sector. We embarked on a pilot to redesign support care jobs within the sector to enhance career progression for these staff. The CCOs can also tap on funding support from the Ministry to hire and train new staff. We have also introduced scholarships, traineeship programmes and training subsidies for the sector to attract talent and develop the workforce. We are embarking on a Care to Go Beyond public communications campaign to raise awareness of the job opportunities in the sector.”
“All of our existing and upcoming new polyclinics provide sheltered vehicular drop-off points and barrier-free access for the patients and visitors. Due to the pandemic, the polyclinics have put in place pre-entry screening and segregation measures to ensure the safety of their patients, visitors and staff. Some polyclinics are using their drop-off areas and/or car parks temporarily to conduct these services. Alternative barrier-free and sheltered access are available. For Woodlands Polyclinic, alternative barrier-free and sheltered access are available in the vicinity of the polyclinic. While they may not be as convenient as the original access points, we seek everyone’s patience and understanding as we work to improve the situation.”
“Fully vaccinated patients recover faster and are infectious for a shorter period. Based on a recent study of local cases by the National Centre for Infectious Diseases (NCID), viral levels in vaccinated patients can decline to undetectable or non-infectious levels within 10 days after illness onset. This takes around 15 days, on average, for unvaccinated patients. However, during the infectious period, vaccinated and non-vaccinated patients are equally likely to transmit to others.”
“Based on our national public health records, there were 4,535 patients in 2019 compared with 4,763 patients in 2020. Patients under 21 years old and/or their caregivers are counselled prior to the start of treatment. This is conducted by healthcare professionals, such as doctors and pharmacists, and the counselling may include the purpose, the common side effects, the monitoring and safe use of the anti-depressants being dispensed. Information leaflets may also be used. Recommendations would also include how and when to seek further medical help.”
“About 1,000 individuals had previous allergic reactions to other vaccines. These persons have been referred to allergists to assess their suitability for mRNA vaccines. The assessment is fully subsidised for Singaporeans, Permanent Residents and long-term pass holders. A separate group of about 7,100 individuals had allergic reactions after taking the first dose of a COVID-19 mRNA vaccine. They have been invited to complete their vaccination with two doses of Sinovac-CoronaVac under a dedicated public health programme. Of these persons, 3,900 have indicated their interest to do so.”
“Vaccination protects seniors from a higher risk of severe symptoms if infected with COVID-19. MOH has, therefore, pursued several initiatives to support seniors in getting vaccinated. For example, we have deployed mobile and home vaccination teams, many manned by volunteers. During the initial stages of our vaccination programme, many seniors came forward to get vaccinated. However, as we attained higher vaccination rates, seniors who remain unvaccinated would require further persuasion and assurance. The Health Promotion Board (HPB)’s "Let’s Get Our Seniors Vaccinated" programme was launched to further support our national vaccination efforts. Under the programme, a $30 voucher is given to each referrer to cover the costs involved in supporting seniors throughout the vaccination process, such as accompanying seniors to the vaccination centre. This is a token amount that acknowledges the additional effort needed to encourage seniors who may be vaccine-hesitant and require deeper engagement to address their concerns. In the first two weeks of launching the programme on 13 August 2021, about 550 seniors were successfully referred for their first dose of vaccination. This is an encouraging outcome and we hope that more seniors will come forward for their vaccination with the support from referrers. We thank the many people who have stepped forward to help in our national vaccination programme in many different ways. With every extra person vaccinated, all of us are better protected.”
“Our assessment is that COVID-19 has brought Singaporeans together to fight the pandemic. The great majority of Singaporeans have observed safe management measures, donned masks, maintained higher standards of personal hygiene and took their vaccinations. We are now one of the most highly-vaccinated countries in the world, partly due to the various measures we have taken, including setting up mobile vaccination teams, home vaccination teams and enabling walk-in vaccinations. However, for various reasons, there remains a minority of individuals who are unvaccinated. As we transit into a COVID-19-resilient nation, more economic and social activities will resume, which means these individuals are at higher risk of being exposed to the virus and falling severely ill. Hence, it will be more prudent for them not to take part in higher risk activities, such as big events and dining in restaurants in the company of other persons. However, if they really wish to, they can take a pre-event test before participating in these higher-risk activities. For now, the differentiated measures are necessary to keep unvaccinated individuals and vulnerable people in our community safe. As we achieve a very high level of vaccination, reaching or approximating herd immunity, it is possible to remove the differentiated measures. In the meantime, it is important to continue to explain that these are public health measures to protect unvaccinated individuals and not let the policy be mistaken or misrepresented as discriminatory.”
“Health supplements are products which are marketed as enhancing a person’s well-being, for example, by making claims, such as "for vitality", "supports joint function". As these products are not meant to prevent, treat or cure diseases, the supplements can be imported or placed on the market for sale to consumers, without HSA’s approval. To protect public safety, HSA prohibits the addition of potent medicinal ingredients in health supplements. Any claims that these products can prevent, treat or cure any medical conditions, such as diabetes, hypertension and cancer, are also prohibited. HSA administers a post-market surveillance programme to monitor the safety of health supplements and to initiate product recalls when necessary. HSA publishes guidelines on the safety and quality standards to facilitate industry’s introduction of safe and quality products in the market. These include information, such as disallowed ingredients and claims, toxic heavy metal and microbial limits. To inform the public, HSA issues press releases on unsafe health supplements and false or exaggerated claims. Consumer guides and advisories on the HSA and HealthHub websites enable consumers to make better decisions, should they choose to purchase or consume health supplements.”
“The Medicine (Advertisement and Sale) Act (MASA) prohibits any persons who are not licensees under the Private Hospitals and Medical Clinics Act (PHMCA) from advertising claims to treat any medical condition, so as to prevent any unnecessary inducement to members of the public to seek any unlicensed services. This prohibition applies across all forms of advertisements, including those on digital media platforms. MOH will investigate any contravening advertisements and take the appropriate enforcement actions against offenders under MASA.”
“The Health Sciences Authority has approved six Antigen Rapid Test (ART) self-test kits for sale at major retailers and e-commerce platforms and are actively reviewing new kits for public sale. From 1 October onwards, the public can also make an appointment for an ART test at the 20 Quick Test Centres (QTCs), which can be used to fulfill pre-event test (PET) requirements. This is in addition to the network of around 1,000 private clinics that are offering ART tests for PETs. Together, the increased access to tests could make the tests more competitively priced.”
“Patients on the Home Recovery Programme will be provided with a Care Pack that includes a thermometer, pulse oximeter and information on how to conduct daily self-monitoring of their own temperature, blood oxygen level and pulse rate. The patients are also informed on how to detect symptoms and warning signs, such as low blood oxygen level and the appropriate escalation protocol, including contacting the 24/7 telemedicine provider for medical assistance or call 995 in the event of medical emergencies.”
“Home Recovery is commonly practised and in fact the default mode of recovery in many countries, from US, UK, Germany, France, Japan and so on. We have been more cautious, admitting infected patients to hospital, or to Community Care Facilities. However, given that over 98% of individuals infected with COVID-19 has mild or no symptoms, we should right-site their recovery to be at home, so that hospital beds can be freed up for those who truly require the medical care. Hence, we implemented the Home Recovery pilot scheme from 30 August 2021. Forty individuals have been allowed to recover at home and 15 have been discharged as at 12 September 2021. Given the positive pilot results, we will expand home recovery as the default care management protocol for fully vaccinated, younger individuals under 50, from 15 September 2021. They should not have significant co-morbidities or underlying illnesses and must be able to self-isolate in a room at home with an en suite bathroom. Their household members should not be above 80 years old, regardless of vaccination status and not belonging to any vulnerable groups, that is, individuals who are pregnant or with weakened immune response. Parents have also been requesting for their children who are infected with COVID-19 to recover at home. Hence, we will also roll out home recovery for infected children between five and 11 years old who do not have co-morbidities or underlying illnesses. These children are generally well with no or minimal symptoms. They will first be assessed by the hospital to be clinical fit for home recovery, before sending them back home for their recovery journey.”
“The Institute of Mental Health (IMH) campus renovation work is still ongoing and is slated for completion in end 2023. The refurbishment works do not affect the clinic operations and waiting times for appointments have not been affected by the refurbishment works. For 2020, the median waiting time for new subsidised patients was 29 days to see a psychiatrist and 18 days to see a clinical psychologist. The corresponding waiting times in 2019 was 22 days and 14 days for psychiatrist and clinical psychologist appointments. IMH does not track waiting times specifically for appointments to see counsellors, as many healthcare professionals and social workers provide counselling as part of their work. IMH monitors appointment waiting times closely and implements measures to optimise appointment slots. For example, IMH will review staffing schedules and clinical operations including calling of patients prior to their appointment to check for any last-minute cancellations so that other patients’ appointments could be brought forward. IMH also conducts triaging of the conditions of referred patients via phone calls and suitable patients are offered therapy with psychologists over teleconference platforms. Non-urgent cases are referred to primary and community-based care to enable specialist services to focus on more urgent and complex cases. MOH will continue to work with IMH and service providers in the community to ensure that we provide holistic and timely support for persons with mental healthcare needs.”
“We currently have about 6,000 patient-days of medical oxygen supplies. This supply could be replenished in a day, if required.”
“The current MediShield Life chemotherapy claim limits will continue until the changes take effect in September 2022. The MediShield Life changes will help to slow down the increase in cost of cancer drugs, as it supports more effective negotiations with drug suppliers for better drug prices and encourages the use of clinically proven and cost-effective treatments. Hence, it is not meaningful to estimate savings assuming drug prices remain constant. Over the past few months, we have achieved an average price reduction of 30% and over 60% for some drugs. The exact impact of the changes will depend on various factors, including the changes in utilisation patterns and whether the drug suppliers are willing to reduce their prices further.”
“Singapore’s approach is to secure a diverse portfolio of vaccines to cater to the clinical needs of different segments of the population. This includes non-mRNA vaccines such as the inactivated vaccine by Sinovac and the protein-based vaccine by Novavax. The timeline for approval is dependent on the companies’ applications to HSA and the availability of data. MOH and HSA are working with the manufacturers to facilitate their regulatory submissions. In the meantime, vaccines in the WHO Emergency Use Listing can be made available by private providers through the Special Access Route (SAR). Two non-MRNA vaccines have been made available under SAR.”
“The Health Sciences Authority (HSA) has received a small number of non-serious adverse event (AE) reports with the Pfizer-BioNTech/Comirnaty vaccine in pregnant women. These include rash, syncope (fainting), dizziness and one report of Bell’s Palsy (temporary weakness of the facial muscles). These AEs are similar to those reported in the general population. There is currently no evidence of safety concerns when mRNA vaccines are used in pregnant women, based on real-world clinical data. MOH and HSA will continue to monitor both the local and international safety data.”
“The COVID-19 Mental Wellness Taskforce (CoMWT) was formed to address the psychosocial impact of COVID-19 pandemic on the population. One of the recommendations of the CoMWT is to develop a National Mental Health Competency Training Framework, which will align existing mental health trainings towards a common set of training standards and competencies expected of professionals and para-professionals who support persons with mental health conditions. This recommendation has been accepted by the new Interagency Taskforce on Mental Health and Well-being, and will be further worked on under the auspices of the new taskforce. More details will be provided when ready.”
“MOH will closely monitor the implementation of these measures and work with HPB to determine accountability and the prudent use of resources as we continue with our efforts to encourage Singaporeans to adopt healthier lifestyles.”
“In planning for the various seasons of the National Steps Challenge, HPB would estimate demand based on past seasons’ trend and projected increases in demand due to the new season’s eligibility criteria. However, this resulted in an over-estimation of the demand, and surplus of 341,000 fitness trackers. Of the excess fitness trackers, 120,000 remain functional. Forty-eight thousand have been used to replace faulty trackers and those with expired warranties. About 3,000 trackers have also been used to support community partners, companies and other Government agencies in their health and wellness initiatives. The remaining 69,000 functional trackers will continue to be used for similar purposes. Unfortunately, the rest of the excess fitness trackers have been disposed of, as they have exceeded the average useful life or were no longer functional. HPB has conducted a full review of the matter. It has enhanced the processes for central monitoring of the movement and stocks of fitness trackers. HPB now tracks movement across and at all distribution channels closely on a daily basis to detect signs of excesses building up. Audits and physical stock checks will also be done twice a year instead of annually. Excess inventory from previous years will be counted towards providing trackers for the following year’s activity. Moving forward, HPB will be more conservative in its projections of the number of fitness trackers to be procured. Any additional purchase of trackers will be done only when excess bookings are received from participants. HPB has also broadened the criteria of replacement for the one-to-one exchange and will proactively inform our participants so that they will come forward to exchange the trackers if their trackers are defective.”
“As the Member is aware, MOH has agreed with the EC19V’s recommendation to administer a third dose of COVID-19 vaccines to individuals who are immunocompromised. This will start after 14 September in Vaccination Centres, as well as hospitals and Specialist Outpatient Clinics which provide COVID-19 vaccination under the national vaccination programme.”
“We have a responsibility to protect patients and staff in our hospitals from COVID-19 infections. We have had several clusters in the hospitals, have had to close wards, and subject patients and healthcare workers to testing and quarantine. Given the risk of infections brought in by visitors, from 19 August 2021 onwards, unvaccinated visitors to hospital wards will need to have a valid negative antigen rapid test (ART) or polymerase chain reaction (PCR) test result obtained within the 24 hours prior to their visit. Fully vaccinated persons can also get infected and can shed the virus, but because they have a lower risk of spreading the infection, we will allow these vaccinated visitors to enter hospital wards without the need for a pre-visit COVID-19 test. All visits will be limited to 30 minutes. Each patient can register up to two visitors for each admission, with only one visitor at the patient’s bedside at any time. Patients who are very ill can register up to five visitors, with two visitors allowed at the patient’s bedside at any time. All visitors to the hospital must wear a high filtration efficiency face mask at all times. They must not eat or drink in the hospital wards. They must not use the patients’ toilets in the wards and they must avoid sitting on patients’ beds. As we transit into the endemic stages of COVID-19, MOH will monitor the exposure risks in our hospitals and adjust the hospital visitation policy accordingly.”
“To date, no private medical service providers have applied for importation of COVID-19 vaccines other than the inactivated virus vaccines approved by the World Health Organization (WHO).”
“There were over 30,000 short-term visitor arrivals (excluding lorry or van drivers) from 1 April 2021 to 30 June 2021. Out of these arrivals, almost 17,000 individuals were still in Singapore as of 30 August 2021. The breakdown of the vaccination status of these individuals is not available. Since 18 August, the MOH has extended the COVID-19 National Vaccination Programme to short-term pass holders who have been in Singapore for at least 60 days continuously.”
“From 2018 to 2020, based on the data available, an average of about 290 women per year sought care for post-natal depression at the public hospitals. About one out of three of these women were first-time mothers.”
“As of 5 September 2021, 17% or about 930,000 of our population are yet to be vaccinated with any dose of the COVID-19 vaccine. Of the unvaccinated, more than half are children below the age of 12 and are not yet eligible. The remaining 400,000 unvaccinated comprise about 100,000 seniors aged 60 and above, and an estimated 300,000 individuals aged 12 to 59 years. A small group of about 1,000 individuals have a previous allergic reaction to other vaccines and may potentially not be able to receive COVID-19 vaccines. They are being referred to specialists for further assessment.”
“KK Women’s and Children’s Hospital (KKH) and National University Hospital (NUH) are the two public healthcare institutions with paediatric ICU capacity and capability. For 2021, the paediatric ICU beds capacity in both hospitals was 32 beds. Since the start of the COVID-19 pandemic in 2020, none of our local paediatric COVID-19 (C+) cases have required supplementary oxygen or ICU care. However, should the need arise, we are able to stand up an additional 20 paediatric ICU beds within a week. Both hospitals currently have a total of 16 accredited paediatric intensivists, five Paediatric ICU Associate Consultants (PICU), and 163 PICU trained or experienced nurses.”
“MediShield Life does not deny claims due to non-disclosure of health conditions. All Singapore Residents receive universal and lifelong protection under MediShield Life, including for pre-existing conditions. The Member may be referring to Integrated Shield Plans (IPs), which are private and optional plans that provide additional coverage on top of MediShield Life. IP claims are assessed by the private insurers based on the contractual terms agreed between the insurer and policyholder. We do not track the number of IP claims denied due to non-disclosure of minor unrelated health conditions. Nevertheless, we expect private insurers to be fair and reasonable to policyholders. Insurers should not reject major illness claims on the basis of undeclared conditions that are minor and unrelated. Policyholders who feel that their claims have been unfairly rejected and are unable to reach a satisfactory resolution with the insurer may file a claim for mediation or adjudication at the Financial Industry Disputes Resolution Centre (FIDReC). MOH is also establishing a Clinical Claims Resolution Process (CCRP) for IP claim disputes of clinical nature. More details will be released later this year.”
“Agencies’ enforcement teams will monitor whether establishments are indeed making appropriate checks on their patrons’ vaccination, or test, status. Individuals who are found to have deliberately misrepresented themselves and/or others, for example through the provision of false or misleading verification documents and/or information, could be subject to criminal enforcement and prosecution.”
“MOH and the Smart Nation and Digital Government Office (SNDGO) have developed various digital solutions to assist businesses to check for valid vaccination certificates and detect fake displays. Businesses are strongly encouraged to use the SafeEntry (Business) App to check an individual’s vaccination status by requesting the individual to tap his or her TraceTogether (TT) App or Token against the businesses’ SafeEntry (Business) App. This would confirm the status of the individual’s vaccination status directly with MOH’s databases. It also allows individuals to concurrently and conveniently perform SafeEntry check-in. Businesses may also ask to see individuals’ TT App or HealthHub App for their vaccination, or test, status. There are a number of ways to verify the certificates as genuine and to ensure that what is displayed is not just a screen shot of somebody else’s TT App or HealthHub display. For example, businesses can look out for the “signal” animation on the TT App. One can also tap through icons in the App or click on the “refresh” button next to the “COVID Health Status”. Lastly the business can check the particulars on the HealthHub App against the individual’s Government-issued identification card. As for Singaporeans, Permanent Residents and Long-Term Pass Holders who received vaccination overseas, they would need to present proof of their overseas vaccination and submit themselves to a serology test at participating healthcare providers. After confirmation of a positive result for their serology test, their vaccination status would then be updated in MOH’s databases by their healthcare provider. Their vaccination status would thereafter be displayed in the TT App or the HealthHub App.”
“The supplies are expected to arrive around 20 September, barring unforeseen circumstances, and should be available for sale in the private healthcare institutions a few days after. We have started our booster programme for seniors and individuals who are immunocompromised, using the mRNA vaccines. The EC19V is reviewing international data to consider a booster programme for younger age groups. It is also studying a heterologous strategy, that is, administering a non-mRNA booster shot that is different from the first two primary mRNA doses. If indeed we decide to proceed on such a booster strategy, the shots will also be administered free of charge to residents of Singapore.”
“I will address Questions Nos 103 and 104 from the Order Paper and also address Mr Dennis Tan1’s question scheduled for tomorrow’s Sitting on a similar topic. Let me start with some background. Early last year, at the initial stage of the COVID-19 pandemic last year, the Government negotiated with various pharmaceutical companies to secure supply of vaccines which were still under clinical trials development. At that time, there were no ready vaccines for us to choose from. Subsequently, Pfizer-BioNTech and Moderna submitted the required data to the Health Services Authority and was approved for use under our national vaccination programme. Because of advance planning and some fortune, we were able to benefit from these two vaccines that turned out to be highly effective against the COVID-19 virus. Separately, the Government brought in 200,000 doses of the Sinovac vaccine and allocated 170,000 of it, also for free, to 31 approved private healthcare institutions to administer under the Special Access Route to individuals who wish to take them. MOH kept a portion of the Sinovac stock to cater to individuals who found out they were allergic to the mRNA vaccines after taking the first dose and indicated interest to receive the Sinovac vaccine to complete their vaccinations. There are 3,900 of these individuals to date. The various Sinovac vaccinations at public and private healthcare institutions have led to about 1.5% of our population to be vaccinated with Sinovac. Over time, as the stock depleted, MOH facilitated private healthcare institutions to bring in new supplies of the Sinovac vaccine. The process took a while, which was why the clinics suspended the booking of new appointments.”
“From a public health point of view, persons who have received two doses of an mRNA COVID-19 vaccine authorised under the Pandemic Special Access Route (PSAR) are considered fully vaccinated, and do not require any further vaccine doses at this time. The safety of receiving two complete regimens of two different vaccines is not established. If an individual wishes to take additional vaccines in order to travel to certain countries, then the consideration at this point is one of allocation and fairness. There are individuals who are unvaccinated for various reasons and are waiting for additional stocks of the vaccines from Sinovac to arrive, so that they can get vaccinated. MOH’s view is that this group should be prioritised above those who want additional vaccinations in order to travel.”
“Under the Medicines Act, anyone who publishes false and misleading advertisements relating to medicinal products or prohibited claims that the product will prevent, alleviate or cure specified diseases, can be fined up to $5,000 and/or jailed up to two years. The Health Sciences Authority (HSA) therefore monitors the advertisements of health supplements, directs companies to comply with the Act and holds them responsible for their advertising and marketing activities. Generally, a light-touch approach is adopted for first-time offenders, while stricter enforcement actions are taken for recalcitrant cases. In deciding whether prosecution is warranted, HSA also considers whether there is evidence that consumers had been harmed or that the supplements marketed were harmful. Over the last five years, HSA has reviewed 243 advertisements relating to claims made for health supplements. One hundred and eighty-two advisories and warnings have been issued and advertisers have been directed to take corrective actions such as ceasing and rectifying the offending advertisements. Prosecution action was taken against one recalcitrant advertiser which had made prohibited claims. For recalcitrant cases, apart from the penalties imposed by the court, HSA will actively publicise these cases and also engage key media outlets to publicise the prosecution outcome to educate and warn consumers against falling prey to these companies’ misleading claims.”
“Rostered Routine Testing (RRT) has been mandated for groups who work with vulnerable populations, have a higher risk of exposure to COVID-19, or are living or working in settings where an outbreak would be difficult to control. This includes our frontline workers at our borders and care facilities, as well as workers living in dorms. Nevertheless, we have encouraged all Singaporeans to voluntarily undergo regular self-testing as a matter of social responsibility to keep Singapore safe and to protect themselves and their loved ones. MOH has discussed the matter with the Speaker of Parliament and recognising that MPs tend to meet many of their residents, Members of this House will set a good example to undergo supervised self-tests with Fast and Easy Testing modes ahead of each Parliamentary Sitting.”
“I thank the Member for his question. I will address it in a combined reply on 14 September 2021.”
“While an important concern is to safeguard the safety and welfare of patients, SMC will also consider whether there is a need for a doctor to take time off clinical practice in order to obtain proper care for a mental health condition. Doctors who have had mental health conditions and have fully recovered can continue to practise independently. For doctors who are still receiving psychiatric care, SMC considers whether he can continue to practise safely, either independently or under supervision by another senior doctor. Professional support for the doctor is made possible through these processes by the treatment, counselling and therapy provided by psychiatrists, psychologists and medical colleagues who supervise the doctor’s work. Doctors who are mentally incapacitated by their conditions and, therefore, pose a danger to their patients if they continue to engage in clinical practice will be referred to a Voluntary Insight Committee, Health Committee or an Interim Orders Committee appointed by SMC. These are for serious or severe conditions which require close supervision or the cessation of practice.”
“Each institution also has specific measures, platforms and dedicated emotional support programmes, for example, feedback sessions with senior management, helplines, anonymous counselling services, resilience workshops and mindfulness training sessions to help address these concerns. There are also confidential communication channels for staff to provide feedback on disruptive workplace behaviour so that timely interventions can be made, in order to bring about a more conducive work environment that promotes mutual respect amongst healthcare workers and their peers. These measures are communicated to the junior doctors through various means including email, orientation programmes, the institution’s intranet, posters within the institution and regular engagement sessions. To monitor the effectiveness of the measures, MOH works with the public healthcare institutions to conduct regular focus group discussions (FGDs). In the recent FGD involving PGY1s in late 2020, the reported burnout rate has decreased overall from 50% in 2019 to 39 % in 2020. There were less adverse feedback from PGY1s about working hours. Nonetheless, there are still some areas of concerns which MOH is working with the hospitals and specific departments to address. SMC is committed to protecting the health and safety of the public by ensuring that registered medical practitioners are fit to practise. If a doctor’s mental health condition is declared or reported to SMC, a medical report from his psychiatrist will be required to allow SMC to better assess the impact of the mental health condition on the doctor’s ability to provide safe and appropriate care for patients.”
“MOH works with the healthcare clusters on various initiatives at the national and cluster levels to improve the well-being of healthcare professionals, including junior doctors. At the national level, MOH has been working with the Singapore Medical Council ("SMC") to monitor the situation in our public healthcare institutions and to ensure that their guidelines on the total allowable work hours per week are complied with and sufficient rest periods are provided in the work schedules of post-graduate year 1 doctors (PGY1s) to ensure that they have adequate rest. There are similar guidelines in place for all junior doctors. MOH has been working with key stakeholders to review the night call system and to ensure that junior doctors are distributed across the various departments based on their training needs and the clinical service demands. In addition, MOH has started reviewing the job scope and roles of doctors and optimising the system in which they are working in. This includes changes to the team structure and the implementation of alternative manpower coverage systems, both of which aim to balance the work hours and further improve the well-being of junior doctors. We will progressively engage the hospital clusters when implementation details are ready. At the cluster and institutional level, junior doctors’ wellness workgroups have been formed, to address specific issues related to junior doctors’ wellness. In addition, there are structures and facilities in place in the public healthcare institutions for the welfare of healthcare staff, which include call rooms, rest areas and staff lounges.”
“The Caregivers Training Grant (CTG) provides subsidies for caregivers to attend approved courses to better care for their loved ones. To strengthen take-up, we have enhanced the courses so that caregiver training remains relevant and accessible. For example, there are more online training programmes during this COVID-19 period. We have also raised awareness through AIC Links, AIC’s website and social media platforms. Hospitals, community care organisations and employment agencies for foreign domestic workers also share about the CTG to their clients and caregivers. MOH will continually review our support for caregivers of seniors, including frail senior or those with dementia. For example, MOH launched the Caregiver Support Action Plan in 2019. Key initiatives include the launch of four community outreach teams and seven support networks to support caregivers’ socio-emotional well-being, enhanced respite care options and the introduction of the Home Caregiving Grant, which provides a monthly cash pay-out of $200 to eligible care recipients to help defray the costs of community caregiving. Earlier this year, we launched a new pilot to provide caregivers with a structured support system when their loved ones are first diagnosed with dementia.”
“MOH will closely monitor the implementation of these measures and work with HPB to determine accountability and the prudent use of resources, as we continue with our efforts to encourage Singaporeans to adopt healthier lifestyles.”
“In planning for the various seasons of the National Steps Challenge, the Health Promotion Board (HPB) would estimate demand based on past seasons’ trend and projected increases in demand due to the new season’s eligibility criteria. However, this resulted in an over-estimation of the demand, and surplus of 341,000 fitness trackers. Of the excess fitness trackers, 120,000 remain functional. Forty-eight thousand have been used to replace faulty trackers and those with expired warranties. About 3,000 trackers have also been used to support community partners, companies and other Government agencies in their health and wellness initiatives. The remaining 69,000 functional trackers will continue to be used for similar purposes. Unfortunately, the rest of the excess fitness trackers have been disposed of, as they have exceeded the average useful life or were no longer functional. HPB has conducted a full review of the matter. It has enhanced the processes for central monitoring of the movement and stocks of fitness trackers. HPB now tracks movement across and at all distribution channels closely on a daily basis to detect signs of excesses building up. Audits and physical stock checks will also be done twice a year instead of annually. Excess inventory from previous years will be counted towards providing trackers for the following year’s activity. Moving forward, HPB will be more conservative in its projections of the number of fitness trackers to be procured. Any additional purchase of trackers will be done only when excess bookings are received from participants. HPB has also broadened the criteria of replacement for the one-to-one exchange and will proactively inform our participants so that they will come forward to exchange the trackers if their trackers are defective.”
“This question for written answer has been addressed by oral reply to Question Nos 4 and 5 standing on the Order Paper for 2 August 2021. [Please refer to "Regulatory Approval for Novavax Vaccine and Vaccination for Short-term Visit Pass Holders Staying with Long-term Residents to be Offered Vaccination in Singapore", Official Report, 02 August 2021, Vol 95, Issue 35, Oral Answers to Questions section.]”
“Testing is a key enabler in our efforts to contain COVID-19. As of 30 June 2021, 1,176 of close to 127,000 Polymerase Chain Reaction (PCR) swab tests conducted on close contacts of COVID-19 infected individuals were found to be COVID-19 positive. Additionally, about 959,000 PCR swab tests were conducted on individuals who had respiratory symptoms and presented themselves at our Public Health Preparedness Clinics and Polyclinics. Of these, about 255 tested COVID-19 positive. Workers in higher risk settings such as our borders, the Construction, Marine and Process (CMP) sectors, inpatient healthcare, as well those living in high density environments, such as dorms, undergo rostered routine testing (RRT). As of 30 June 2021, there are about 550,000 workers who are undergoing PCR RRT, of which, 536 of them had tested COVID-19 positive. RRT allows us to detect and ringfence cases early. It protects workers and limits the spread of COVID-19 by allowing us to detect spread early and to intervene. RRT also helps us focus public health resources where it is needed. Positive test results allow rapid intervention to protect workplaces and the community. Negative test results are also useful as it provides reassurance to the workers and their clients, and allow these groups of employees in critical roles, to avoid facing further restrictions on social activities.”
“HSA has published a guideline titled "What you need to know about masks" which provides information on the specifications of good quality medical and surgical masks. HSA also licenses manufacturers of medical and surgical masks, which requires them to meet standards, such as the EN 14683 or ASTM F2100, which are adopted by the European Union and USA respectively. A list of locally-manufactured medical and surgical masks that have been tested and verified to meet these standards has also been published by HSA on their website. Importers of medical and surgical masks are required to notify HSA and submit test reports to show that their products meet a minimum bacterial filtration efficiency based on the EN 14683 or ASTM F2100. HSA also engages the various e-commerce platform administrators on an ongoing basis, to check on the vendors selling medical and surgical masks on their platforms and ensure that the masks on sale are from HSA-licensed local manufacturers or importers with evidence of import notification to HSA.”
“"Long COVID" is not a distinct medical condition or a formal diagnosis and refers to persons who have continued symptoms of COVID-19 infection. The underlying reasons for continued symptoms vary, as do the symptoms themselves. We continue to offer care to all these patients, who require support from different clinical teams, depending on their condition. A multi-centre study led by the National Centre for Infectious Diseases (NCID) showed that one in 10 COVID-19 patients who recovered after the initial infection continued to display symptoms, such as cough or breathlessness, six months after resolution of the acute illness. Those aged above 65 years and who had severe infection were associated with an increased likelihood of these persistent symptoms.”
“As of July 2021, the mean time to issue the QO from notification of case was two days. The longest time interval was 14 days. This happened for a small number of individuals, where it was particularly difficult to trace the contacts of the infected. The mean time in January 2021 was shorter – 1.5 days, as we had fewer daily cases then. While on the subject, we would like to record our appreciation for the men and women who work 24/7 on the contact tracing and quarantine ops, as they are a vital enabler for our COVID-19 strategy and we urge members of the public to cooperate with their requests for information, so that we can all be better protected.”
“This question for oral reply has been addressed by written answer to Oral Questions 49 and 50, taken on 26 July 2021. [Please refer to "Encourage Utilisation and Expansion of Elderly Befriender Services to Reduce Elderly Suicide Rates", Official Report, 26 July 2021, Vol 95, Issue 33, Written Answers to Questions for Oral Answer Not Answered by End of Question Time section.]”