预算辩论 · 2026-03-04 · 第 15 届国会
2026卫生部供给委员会辩论：AI作为国家医疗使命
MOH Committee of Supply 2026 — AI as National Healthcare Mission
MOH供给委员会辩论中，议员Mariam Jaafar发表重要AI医疗政策演说。她质问部长一个更大的问题：如果医疗真的是国家AI使命，目标就不能只是渐进式采用，必须建设一个完整的系统——基础设施、治理、人才、底层管道——让AI安全、有效、大规模地改善每一位患者的治疗效果。她指出新加坡需要培养同时精通临床实践和机器学习的"翻译型"人才。一旦证明AI能在大规模上安全可靠地改善患者结果，新加坡将获得全球竞争优势。
关键要点
- • 医疗AI目标不能只是渐进式采用
- • 需要建设完整的AI医疗生态系统
- • 培养临床+机器学习复合型人才
- • 大规模AI医疗效果证明将成为国家竞争优势
Pritam Singh和Sylvia Lim参与辩论
医疗AI从渐进采用走向系统性转型
参与人员（7）
完整译文（中文）
Hansard 英文原文译文 · 翻译日期：2026-05-02
主席：卫生部（MOH）O项负责人。Mariam Jaafar女士。
下午6时59分
从护理融资到健康融资
Mariam Jaafar女士（实巴旺）：主席，我提议，“将预算中O项的总拨款减少100元。”
S+3M，即补贴医疗储蓄（Medisave）、医疗保险（MediShield）和医疗基金（MediFund），是我国一项默默的成功。它保护了几代新加坡人免受灾难性账单的影响，维护了系统的可持续性，植入了共同责任、个人拥有权和公平性。
但它是为过去的风险设计的。S+3M最初是为急性医院事件设计的，比如手术、中风、突发住院。
如今，我们面临的主要风险是慢性、渐进、社区基础的疾病：糖尿病、痴呆、虚弱、心理健康状况。它们不会让家庭一夜破产，但会慢慢耗尽家庭资源。
痴呆日间护理每次约63元。即使有最新的补贴，中产家庭每年仍需支付超过12,000元，且不包括交通、居家护理、药物和照顾者收入损失。在我于兀兰的市民见面会中，我经常听到两个问题：一是“为什么我不能用我的医疗储蓄？那是我的钱”；二是“我已经用完了所有医疗储蓄用于慢性护理”。
下午7时
L女士，一位退休人员，照顾患有早期痴呆的丈夫，同时管理自己的糖尿病。她告诉我，“我一生都在储蓄，为什么感觉我的钱仍不足以保持独立？”或者24岁的K女士因其心理健康状况未被正式认定为慢性病而自费治疗。“我可能需要终身治疗，这怎么不是慢性病？”这些都是我们新加坡同胞的真实生活写照。
渐进的限额调整和覆盖范围扩展有所帮助，但并未从根本上改变激励机制。我们的系统仍然传递出一个信号：当你已经非常病重时，我们才更关注你。这必须改变。我们的生活方式风险上升速度超过人口老龄化。更多久坐工作，更多屏幕时间，更丰富的饮食，慢性病更早出现。
新加坡正在投资于人口层面的预防——占医疗预算的6%，计划翻倍。健康新加坡（Healthier SG）全额补贴常规筛查和免疫计划。公园、健身角、自行车道、活跃老龄中心和社区健康项目等活跃生活基础设施鼓励功能性健康。这些由中央资金支持。
但预防不仅仅是筛查。一些老年人需要物理治疗以防止跌倒。一些需要居家康复以防止再入院。一些需要认知刺激以防止痴呆发作。一些成年人需要体重管理计划以防止糖尿病恶化。一些青少年需要早期心理健康干预以防止恶化。这些是对独立性的投资，而非可有可无的生活方式福利。S+3M必须进化，不仅仅是支付账单，更要塑造行为，支持预防，维持独立。
补贴。我提出三项上游转变。
一、早期残疾支持。许多计划要求三项日常生活活动（ADLs）受限。引入“预虚弱”老年人的早期干预层级——资助物理治疗、平衡训练和力量锻炼。今天一个月的康复可以预防未来十年的护理院照护。
二、补贴诊断路径。由健康新加坡全科医生转介时，首次专家咨询和初步诊断扫描（CT或MRI），无论公私立，均应补贴。可治疗的疾病不应因有人因费用犹豫而变成绝症。
三、对夹心家庭实行更公平的经济状况评估。两个家庭可能人均收入相同，但支持年迈父母和幼儿的家庭负担更重。调整多被扶养家庭的补贴等级。
补贴必须易用、透明，并设计成鼓励早期预防行动。自动登记、共付额减少、整合医疗储蓄奖励和无缝数字理赔是推动行为的方式。
医疗储蓄。即使有补贴，新加坡人长期仍面临费用。医疗储蓄必须进化。我建议医疗储蓄灵活使用，年度提款限额与余额挂钩，设上限以维持可持续性。允许其资助慢性病管理、更广泛的预防筛查、基于证据的医生推荐功能健康或营养项目、轻微伤害或住院后的早期康复、痴呆或虚弱的早期干预、扩展心理健康支持。保留核心医疗储蓄用于重大事件。未用的灵活余额可结转，奖励负责任的早期行动。可根据慢性病管理和功能评估的改善发放奖励。
补贴和医疗储蓄灵活使用共同推动新加坡人早行动、遵守慢性护理并参与预防项目。新加坡人获得更多灵活性，同时系统保持灾难性保障。医疗保险生命计划（MediShield Life）仍用于罕见高额住院，保持保费可负担。若预防处方被证明节省成本，可探索保费抵扣。医疗基金仍是真正需要者的最后安全网。
S+3M实际上是我们跌倒时的安全网。但在老龄化社会，我们需要一个弹跳板，让我们保持站立、强壮、独立和健康。我们必须调整S+3M：不仅融资医疗，更融资健康本身，不是放弃原则，而是充分实现原则。
共同责任必须包括共同预防。个人拥有权必须赋能早期行动。公平必须承认累积负担。这不是多花钱，而是更早花钱，从而后续花更少——无论是财务、社会还是情感上。
先生，这些改变不影响一件事。政府必须竭尽全力保持医疗可负担，遏制医疗通胀。如果我们做对了，不仅治疗疾病，还能维护独立和尊严。不仅支付账单，还能投资健康。
卫生部是否承诺研究并报告，最好在下一个预算前，如何重新校准S+3M以更好支持慢性和预防护理？
（程序文本）提案问题。（程序文本）
主席：Mariam Jaafar女士。
个人责任与集体责任
Mariam Jaafar女士：医疗保健常被视为个人责任。个人确实重要，但在新加坡，医疗风险是共享的。保费集中，补贴集中，照顾负担共享。不存在纯私人医疗费用。
当可预防疾病上升时，保费上涨，税收上涨，家庭感受压力，照顾者离开劳动力市场。然而，今天只有约六成符合条件的居民定期参与推荐的慢性病筛查，四成仍未受保护。
预防护理能救命并降低成本，但前提是人们参与。如果预防至关重要，就不应依赖谁记得点击链接。选择加入需要时间、意识和信心——这些并非人人具备。预防必须是默认选项。我建议：转为选择退出筛查，主动、个性化健康辅导，辅以数字推动。
集体责任不是责备，而是设计。设计不只属于卫生部。它关乎孩子们在学校吃什么，熟食中心什么负担得起，工作场所如何安排时间和压力，社区是否鼓励或阻碍运动。健康选择必须是简单选择。
如果我们从上游设计，就能节省下游成本。卫生部是否考虑将关键预防项目设为选择退出，并说明如何跨政府部门合作，将预防默认嵌入日常生活？
改善北部健康
健康社区不是偶然形成，而是设计的。卫生部已启动改善北部健康的计划，我的选区兀兰正在试点综合预防健康模式。
北部条件优越。我们有多样的老年人和家庭，涵盖各种住房类型，强大的社区机构，以及加强慢性护理的机会。两家医院、数个综合诊所和活跃老龄中心近在咫尺，我们可测试如何将护理更贴近家园，完善综合护理团队模式。
试点基于四大支柱：一是强化转诊路径和慢性病支持；二是将护理更贴近家园，确保顺畅过渡；三是重新设计社区，使健康选择更简单；四是激活社区成为健康倡导者。
我支持此举，但不能停留在纸面政策，必须关乎真实人群，每天过更健康生活。因此，我有两个问题和三项请求给部长。
问题：一，如何衡量成功？二，基层动员将有哪些资源？
请求：确保镇级护理中心全面整合、人员配备稳定，居民可无延迟获得服务；扩大社区护理和照顾者支持范围，涵盖更多病症和家庭；直接让我的居民参与共设计干预措施，使方案反映真实需求，避免污名化任何社区。
健康结果由系统塑造——交通、饮食、工作模式及社会经济因素，而非道德缺陷。
想象一下。54岁的S女士每周三次在活跃老龄兀兰健身房进行力量训练，有志愿者伙伴监督。她不想做饭时，坎邦阿德米拉熟食中心有丰富健康且负担得起的清真食品。护理和支持更贴近家园，她的糖尿病得到控制，保持独立。
如果我们能为健康重新设计一个镇，我们就能重新设计一个国家。
医疗人工智能
首先，我声明本人为一家管理咨询公司的董事总经理，该公司涉足人工智能和医疗保健领域。
医疗人工智能常以应用案例讨论——早期疾病检测、自动化文书、风险预测、个性化医疗。这些令人印象深刻。但今天，我想问部长一个更大的问题：我们的雄心是什么？如果医疗是国家人工智能使命，我们的目标不能是渐进式采用。我们必须构建一个系统——基础设施、治理、人才、管道，使人工智能能安全、有效、大规模地转变护理，为新加坡每位患者带来更好结果。
一旦证明人工智能能安全可靠地大规模带来真实患者利益，新加坡自然将从采用者转为全球可信医疗人工智能领导者。新加坡已奠定坚实基础：HEALIX支持跨集群分析；国家电子健康记录（NEHR）汇聚患者记录；健康信息法案明确权利、责任和保障；早期人工智能试点已减轻临床工作负担，改善患者结果。
但仅有基础设施不足以使我们成为领导者。我们的数据仍然分散。互操作性支持护理交付，但创新和人工智能开发（包括第三方）安全访问仍有限。
要全球领先，三点关键。
一、更强的数据框架——国家数据架构、安全沙箱、合成数据集和联邦学习，支持人工智能创新同时保护患者隐私。
二、互操作系统，允许人工智能模型跨机构学习，同时让临床医生保持控制权。
三、治理规则：每个人工智能建议必须可解释、可审计、可问责。明确创新治理；自上而下或自下而上。
关于全球合作，我们立场明确：欢迎专业知识，但仅在保护数据、维护主权、建设本地能力和惠及患者的框架下。
法规也必须跟上。人工智能发展迅速。我们需要国家验证、认证和部署后监控——偏见、可解释性和实际表现标准，让患者和临床医生信任每个人工智能决策。
最后，人才。医疗人工智能是翻译问题。我们需要既懂临床现实又懂机器学习的专业人才。
先生，我们正走在用人工智能提升效率的轨道上。但新加坡必须成为人工智能解决方案安全构建、测试、认证和规模化的地方，患者结果在每一步都得到改善。医疗不应仅仅采用人工智能，新加坡必须制定可信、安全、有效人工智能的标准。
卫生部是否能概述一条明确路线图和时间表，加强数据访问框架、验证标准和人才培养，使新加坡成为可信医疗人工智能的领导者？
综合保障计划——额外提款限额
Pritam Singh先生（亚逸－宏茂桥）：2015年医疗储蓄缴款上限为48,500元。如今，医疗储蓄账户最高金额的基本医疗储蓄额为79,000元，约十年间增加了3万元。近70%的本地居民持有综合保障计划（IP），自医疗保险生命计划推出以来，允许使用医疗储蓄支付IP保费的最高额度（即年度提款限额）近十年未曾调整。
近年来，许多新加坡人持续抱怨自付费用，加之基本医疗储蓄额逐年大幅上涨，公众期望允许公积金成员使用更多医疗储蓄支付IP保费的额外提款限额应予以修订。多年后仍保持不变是不合理的。
卫生部是否计划近期审查此事？如果不，原因何在？
医疗人力
《海峡时报》上月一篇评论文章标题简洁表达了医疗系统的主要焦虑：“新加坡成为超级老龄社会：其医疗系统能否应对？”作者是一位公共卫生学者，观察到许多新加坡人在访问公立医院和医疗机构时的常见情景——大量坐轮椅、明显虚弱或行动困难的老年人。
卫生部表示，医疗人力预计将从2024年的129,000人增长20%，至2030年约156,000人。评估认为，这一人数大致能满足未来几年的人口医疗需求。
人口快速老龄化与医疗服务需求增加的交汇，将使医疗人力的充足性成为焦点，任何短缺或感知短缺将最直接反映在服务质量、专科护理等待时间和看诊等待时间等方面。
同时，鉴于预期患者负担加重，医疗工作者——包括辅助医疗专业人员、护士和医生——的福利令人担忧。另一个问题是，预计每年有10万名保单持有人将其保险覆盖从私营转向公立医疗部门，这可能严重加剧公立医疗系统压力。部长曾表示这一数字预计将增加。
第一，当医疗系统达到156,000人上限时，突发容量范围如何？是否包含额外医生、护士和辅助医疗人员的缓冲？如果有，具体多少？如果没有，是通过流程重组以少做多应对突发需求？若是后者，系统能维持最佳性能多久？
第二，卫生部是否计划扩大公开报告的统计数据范围，除现有的医院急诊、综合诊所和专科门诊等待时间外？
我们应仔细追踪系统应对人口结构变化带来的重大需求的能力。值得记住，医疗是非常独特的公共服务。总理将医疗确定为四大国家人工智能使命之一。人工智能确实能在生态系统层面注入新的生产力可能。
然而，对于需要医疗的普通新加坡人来说，医疗之所以是医疗，是因为那些在我们最脆弱时照顾我们的医生、护士和辅助医疗人员。在这方面，人文关怀和个人联系永远无法被人工智能完全取代。
因此，如果未来医疗人力需要额外缓冲，我们应相应投入更多财政资源。
主席：Hamid Razak医生，你可以一起发言。
遗传性癌症的成本复杂性
Hamid Razak医生（西海岸-裕廊西）：主席先生，对于一些新加坡人来说，医疗不仅仅是账单，而是一生的风险。
今天，在本院，我想分享我遇到的一位年轻新加坡人的故事——关达琳。她二十出头时被诊断出患有遗传性乳腺癌。她的生活一夜之间发生了改变。她经历了手术、手术并发症以及持续的化疗。她接受了重建手术，但部分重建费用未被覆盖，因为被认为是美容性质的。
对于一位年轻的癌症幸存者来说，重建并非美容手术。这关乎尊严，关乎心理康复。
如今社会上有许多像关达琳这样的人。我所说的是那些具有遗传性癌症风险的人。她的故事反映了更广泛的差距。
如今的癌症护理不仅临床复杂，而且在财务和心理层面也很复杂，尤其是遗传性疾病。因此，政策问题是：我们如何支持那些今天可能尚未生病，但明显处于高风险的人？为此，我想向部长提出三个广泛的问题。
首先，我们如何将遗传风险评估和基因咨询整合进初级保健，并将其连接到“更健康的新加坡”计划，使预防成为上游措施？
第二，卫生部是否会审查我们如何为医学指示的预防性手术和重建手术提供资金支持，包括涉及当前健康器官的高风险情况，以确保支持一致且易于理解？例如，在关达琳的案例中，如果在一侧乳房发现肿块且确诊为病变，她接受乳房切除术，那么另一侧目前健康但携带乳腺癌基因的乳房该如何处理？在照顾此类个体时，系统如何做到无缝衔接？
第三，我们如何加强年轻癌症患者的生存路径，包括心理和社会支持，而不仅仅是医疗随访？
主席先生，考验不仅是生存，更是幸存者如何重返生活。
精准医学与功能健康
主席先生，如果遗传性癌症说明了医疗护理的复杂性，那么精准医学则告诉我们如何智能地应对这一挑战。
我们已经看到方向。在国大医健系统（NUHS），健康长寿中心正在构建强化健康寿命的项目，不仅治疗疾病，还帮助新加坡人在衰老过程中保持身体强健、认知敏锐和代谢良好。
这很重要，因为公众需求已经存在。人们在主流体系之外寻求检测和优化。如果我们的公共路径不能跟上可信证据的步伐，我们面临两大风险——护理碎片化且质量不均，导致不平等加剧，以及错失新加坡作为可信赖区域中心负责任领导的机会。
虽然我们专注于照顾老年人和长者，这很重要，但随着社会发展，关键问题是如何优化每位新加坡人，无论年龄大小，达到其年龄段的最高健康潜力？因此，主席先生，我想问部长三个问题。
第一，卫生部评估和采纳精准医学及长寿相关新兴证据的路径是什么？如何确保安全和价值的明确保障？第二，“更健康的新加坡”计划如何逐步增加功能健康指标，包括代谢、认知和虚弱指标，使预防个性化而非泛泛而谈？第三，我们如何推动负责任的创新，确保基于证据、面向未来且值得信赖，使政策能随着证据出现及时调整，而不是在证据成为主流后等待两三年？
因为目标显然不仅是延长寿命，而是延缓衰退、保持独立和有尊严的老龄化。
癌症治疗费用与保障
林瑞莲女士（阿裕尼） ：主席先生，新加坡医疗费用通胀预计今年将达到近17%，远高于低于2%的整体通胀率。
我认可并同意需要控制成本和管理保险保费。针对癌症，卫生部已采取重大举措。例如，癌症药物清单现有约394种药物，符合MediShield Life和综合计划的补贴及理赔资格。
三个月前，卫生部宣布住院保险关键政策变更。今年4月起，综合计划的新附加险将不再覆盖卫生部设定的最低免赔额，且账单5%的共付额上限由每年3,000元提高至6,000元。新附加险的保费预计比现有附加险低约30%。
部长在TikTok发布了多段视频解释变更。在其中一段视频中，他似乎暗示现有附加险的唯一用途是降低免赔额和共保额，公众应考虑是否需要附加险。
然而，我了解到附加险可能对癌症患者尤为重要，原因有二。
首先，附加险帮助支付癌症药物清单外的昂贵药物，这对患者治疗至关重要。其次，存在损失限额问题。没有附加险，患者需支付住院账单的10%，且无上限。
第二个更普遍的问题涉及预防性医疗干预，可能不被保险覆盖。
一位年轻乳腺癌患者于1月28日在《海峡时报》论坛页面讲述了她的困境。她遵医嘱切除双侧乳房，尽管只有一侧患癌。她的住院保险覆盖了癌变乳房的手术，但对非癌变乳房的手术仅部分覆盖。
去年4月，卫生部承认预防与诊断护理的界限日益模糊，尤其涉及遗传性严重疾病如乳腺癌的情况。卫生部表示将于当年晚些时候发布乳房相关手术理赔规则指导执业者。
请问该审查的现状如何？
收入审查与孝道悖论
赖伟德先生（宏茂桥） ：主席先生，成年子女往往是年迈父母的默认照顾者。子女希望父母与他们同住是好事，父母健康活跃更佳。然而，一些新加坡人觉得为做正确的事而受到惩罚。这就是我所说的孝道照护悖论。
当子女将年迈父母接入家中，父母往往失去诸如社区健康援助计划（CHAS）、银发援助或其他补贴等福利。父母被视为高收入家庭成员或居住在高年租值的房屋类型中。
主席先生，为支持照护并鼓励孝道，我们需认识到照护责任的负担可能相较于住房收入或类型更为重大。我并非建议放弃医疗和社会援助中的收入审查，但我们可以更明确地识别照护家庭。我有三点建议。
第一，考虑设立照护者住房豁免。年长者搬入成年子女家中照护时，应独立评估，而非与整个家庭合并。第二，考虑设立过渡期。这是一个宽限期，使年长者的福利在照护安排变更时不会立即消失。第三，探索功能需求评估，根据实际需求而非仅看家庭收入或住房类型来评估社会援助。
主席先生，当成年子女将年迈父母接入家中照护时，我们应给予更多支持，而非更少。
医疗支出波动与MediSave限额
林志明副教授（盛港） ：我们中曾严重生病的人都深知医疗支出的波动性。即某一年可能无医疗支出，但另一年可能花费远超预期。
即使是慢性病患者也常如此，因为新诊断或治疗程序可能偶尔才需。健康经济学的系统研究证实了支出峰值的现实。此外，临终支出往往较高，也是波动性的另一表现。患者通常在生命最后几年花费最多。
MediSave目前对多种护理设有年度提款限额。此政策初衷良好，避免患者耗尽MediSave资金，尤其考虑到大部分护理费用确实发生在生命末期。
但此政策与医疗支出的波动性不符，也忽视了保险（包括公共保险如MediShield Life）在此类情况下的作用，因为这些保险更可能支付重大疾病费用，否则患者将耗尽MediSave。
中央公积金的实际数据支持MediSave账户可能存在过剩储蓄的观点。2022年，陈诗龙部长在答复国会质询时报告，85岁及以上会员的MediSave账户余额远超退休账户，比例接近五倍。
有两种方式可更好调整MediSave限额。
第一，允许未用额度最多结转三年。这样，发生超预期账单者无需依赖自付资金，尤其退休者的自付常由工作年龄家庭成员支付以补充医疗费用。
第二，设立分级理赔限额，随年龄增长逐步提高理赔额度。虽无法准确预测个体寿命，但可依据性别的总体死亡率统计调整限额。直觉上，晚年健康状况恶化，应允许更多支出。
主席先生，这些简单措施将更好地使MediSave使用与确保医疗需求时资金充足的良好初衷相匹配，无论需求是今天还是未来。
门诊MediSave使用
严彦松先生（阿裕尼） ：主席先生，我再次呼吁卫生部将所有慢性病纳入慢性病管理计划覆盖范围，而非仅限23种批准病症。这样任何需长期管理的病症都能通过CHAS获得补贴，并可用MediSave支付。
晚上7点30分
即使是慢性病管理计划内的病症，MediSave 500/700元提款限额也可能限制治疗。我在2021年曾提出此问题，高级国务部长认为限额是防止过度消费的必要措施。但这如何适用于公立医疗机构？那里的医生受薪且遵循严格协议。真正风险不是过度消费，而是治疗不足。患者在现金与治疗间被迫选择，有些可能为省钱而跳过用药或预约。
今天的自我节制可能导致明天巨额账单和紧急住院。这对患者和医疗系统都是巨大负担。卫生部是否评估过因MediSave提款限额严格导致的医疗不遵从的临床成本？新加坡人希望自力更生，不必申请补贴或医疗援助。卫生部应允许60岁以上患者在公立医疗机构更灵活使用MediSave，尤其是那些MediSave余额充足者。
心理健康资金与支持
郑德源先生（先锋） ：主席先生，我声明本人为国大医院集团心理健康委员会主席。我提出新加坡应将精神病院（IMH）定位为精神治疗与护理的真正卓越中心，并向部长提出三问以达成此目标。
IMH是我们唯一专门的精神病医院，拥有最资深的精神科医生和专业团队。但其资源被分散于各种病情严重程度。如果我们真心打造卓越中心，必须让IMH专注于其最擅长的领域——领导研究、培训下一代心理健康专业人员及管理最复杂病例。
第一个问题是人力资源。IMH是否比急症医院拥有更充足资源处理复杂精神病患者？卓越中心不仅要治疗，还应制定全系统及三大公立医疗集团的临床标准。IMH的专业知识如何被三大集团利用，以提升所有急症医院及社区的精神治疗与护理，避免IMH因过多转诊而效率低下？
第二个问题是护理路径。部长能否分享IMH及急症医院出院精神病患者被多诊所接纳的比例？卓越中心无法正常运作，如果其床位被准备转入下一级护理的患者占用。是否有计划扩充多诊所精神病容量，使IMH能专注真正需要专科护理的患者？稳定患者常因社区设施不足而滞留IMH。
第三个问题是是否有计划发展更多托管及下转设施——如庇护所、支持性居住——以便IMH床位留给需要其全面临床专长的患者？
心理健康
温立生医生（惹兰勿刹） ：主席先生，心理健康是国家优先事项。近年来，我们在认识到心理健康是社会和经济韧性的基础方面取得显著进展。年轻人、职场人士和长者的需求不断增长。越来越多人主动寻求帮助，这是好迹象。
但压力真实存在。心理健康问题每年给新加坡带来约160亿新元损失，主要因缺勤和带病工作导致生产力下降。此数字提醒我们，心理健康不仅是医疗问题，还影响工人、家庭和国家韧性。
问题不在于心理健康是否重要，而在于我们的体系是否能持续满足未来需求。
我们启动了国家心理健康与福祉战略，扩展社区服务，加强初级保健。进入下一阶段，部长能否更新进展？早期干预是否有可量化改善？等待时间是否稳定，尤其是中高风险病例？社区服务提供者是否得到充分支持以应对持续增长的需求？
每项战略最终都会达到仅靠扩展不足以应对的阶段，需要结构性强化。心理健康跨越医疗、教育、职场和社会部门。部长能否阐述心理健康办公室的角色和职责？它如何跨机构协调、追踪系统层面成果并确保问责？若真是全社会努力，治理必须明确且有意图。
主席先生，服务最终依赖于人。临床心理学家及其他高风险心理学专业需多年严格研究生培训和监督实践。标准必须保持高水平，患者安全依赖于此。
同时，需求增长。卫生部如何预测未来五至十年临床心理学家及相关心理健康专业人员的人力需求？是否有计划加强本地培训和监督能力，建立强大本地核心，同时保持专业标准？卫生部是否考虑加强高风险心理实践的专业监管，以保障患者并增强公众信心？
心理健康护理必须作为一体化系统运作。心理学家、辅导员、社工、职业治疗师和同伴支持专家各司其职，互为补充。人力规划和培训改革如何确保这些职业间更强整合，以及初级保健、医院和社区服务提供者间更好协调？患者不应经历碎片化，应体验连续性。
展望未来，我们也应关注人工智能在心理健康支持中的日益应用。AI工具或可用于自助心理教育和早期筛查，但应谨慎。如果技术开始替代专业护理，心理健康治疗往往涉及复杂临床判断和危机应对能力。部长能否分享卫生部如何看待AI在心理健康中的角色，以及为确保技术辅助而非替代专业人员所需的保障措施？
主席先生，若心理健康是国家基础设施，我们必须以坚实基础、明确标准和长期可持续性来建设。我期待部长的回应。
主席 ：何亭如女士，请一并发表您的三段发言。
心理健康专业人员监管
何庭如女士（盛港选区）：主席先生，我声明本人在福祉领域的从业者身份。鉴于心理健康危机没有缓解迹象，卫生部是否能提供最新情况，并承诺设定明确的时间表来规范心理健康专业人员？
我想重申呼吁规范治疗师和辅导员等专业人员，他们在支持心理健康状况个体方面发挥关键作用。规范很重要，因为客户可能不知道如果对专业标准或伦理有疑虑，应向何处寻求帮助。
同时，我们也必须确保专业人员的入门门槛不过高。大多数治疗和辅导资格要求最低监督小时数和实习，费用高达每小时200新元以上，这对应届毕业生和中途转行者来说可能很困难。我希望我们能探索更多降低这些门槛的方法。除了补贴外，卫生部是否也考虑使用技能未来（SkillsFuture）学分？
心理健康与福祉战略
设立国家心理健康办公室（NMHO）是迈向心理健康与社会经济决定因素连续体愿景的第一步，心理健康不仅仅是疾病的缺失。
话虽如此，我们仍需努力实现一个明确的愿景，以改善新加坡人的心理健康。例如，苏格兰2017年心理健康战略侧重于通过生命周期模型减少心理健康不平等及治疗和获取不平等；马来西亚国家心理健康战略计划旨在将青少年抑郁率从18%降至10%。这些战略清晰地描绘了改善心理健康与福祉的成功愿景，描述了心理健康人口的样貌，并包含了时间限定的目标和超越广泛关注领域的成果。
这与世界卫生组织近期关于促进和保护政府部门心理健康与福祉的政策和战略行动指导一致。该指导呼吁：一、积极与所有利益相关者接触，确保有实际经历者的有意义参与；二、定期报告和明确承诺；三、分配充分预算和专门资金支持政策指令和战略行动，防止实施延误。
我想提出四个澄清问题。第一，国家心理健康与福祉战略的成功图景是什么？为协调跨政策领域和部门的努力，战略应概述几个关键成果并设定明确目标。
第二，NMHO计划如何与各部委和机构合作，向新加坡人介绍当前举措和未来计划？纳入有实际经历者、社区和民间社会的持续反馈，将确保战略保持相关性并扎根于真实需求。
第三，NMHO将如何通过定期更新协调报告、监测和评估？例如，苏格兰2026年1月的监测报告追踪九个战略成果的关键绩效指标，以增强机构问责、响应性和效能。
第四，是否有专门资金支持心理健康与福祉举措以支撑战略？如果有，金额是多少？2020年至2022年，卫生部将约3%的医疗支出用于心理健康治疗、推广和预防。此金额是否增加，未来预计金额如何？
无烟一代
多年来，政府一直在研究可能推行无烟一代政策。今年早些时候，卫生国务部长在与我交流时表示，实施此类政策的效果并非简单明了，且我们现有措施已使吸烟率降至8.4%的历史最低水平。
主席先生，我同意实施无烟一代政策并非易事。黑市已使新加坡无法完全无毒品和无电子烟。同样，尽管执法人员努力，禁烟场所也未能完全无烟。
然而，尽管新西兰部分基于政治理念废除了相关法律，我们应继续研究如何在有实际证据证明其有效性和可实施性的情况下推行无烟一代政策。马尔代夫的政策已生效，英国法案也有望于2027年初实施。
像英国一样，我们有条件推出类似政策，正因为我们的吸烟率已很低。最新研究，包括诺丁汉大学今年1月发布的研究，表明世代禁烟将使吸烟率低于5%的水平提前数十年实现，这被定义为烟草的有效终结。
我强调终结目标，因为它设定了我希望我们尽快实现的目标。虽然与无烟一代政策相关，但我们应将终结目标作为总体政策目标。通过定期提高烟草税等决策，我希望我们追求的是最大化罪恶税的影响，而非考虑其财政收入影响。
同样，我们应加大力度遏制公共场所吸烟的健康影响，例如解决边走边吸烟的问题。新加坡对毒品和电子烟采取零容忍态度，我们必须对烟草采取同样态度。谢谢。
主席：蔡银洲先生，您可以将两段发言合并。
隐形医疗状况
蔡银洲先生（碧山-大巴窑选区）：谢谢主席。继我在预算演讲中提及隐形成本后，我想谈谈患有隐形疾病者的困境。
公共交通上的援助计划虽已支持部分人士，但许多患有隐形医疗、自身免疫或慢性疾病的人在日常生活中仍面临评判。卫生部是否考虑将这些举措扩展至小贩中心、图书馆等更多场所，营造一个以耐心而非怀疑为先的社会？
在新加坡，每五个儿童中就有一人，每十个成年人中就有一人忍受特应性湿疹的持续且令人难受的瘙痒。虽然可控，但持续治疗的费用，包括湿敷和光疗，是一笔重大经济和情感负担。卫生部是否考虑将特应性湿疹纳入慢性病管理计划，该计划已涵盖类似的银屑病等疾病？
最后，一些青少年因担心学校辅导员会自动且强制向家长报告自杀念头，尤其当这些念头源于家庭情况时，而不愿分享。为鼓励更多求助同时确保安全，卫生部是否会实施分级报告框架，允许根据风险程度更大程度保密？
主席，我们必须确保我们的护理基础设施足够强大，支持那些我们看不见的挣扎。我期待卫生部对更包容、更有同理心的医疗环境的愿景。
老年人一站式服务
我的第二段发言回应一个古老问题：什么是美好生活？我在碧山-大巴窑与许多长者交谈，他们的答案不仅仅是更多的援助，而是尊严、选择权和自主权，让他们能按自己的意愿度过晚年。
晚上7点45分
为此，我提出四项建议。
第一，将综合社区护理提供者扩展为“长者礼宾服务”。翁部长曾谈及单一协调点和85个子区域，这些将很快协调区域医疗系统、居家个人护理Plus、新加坡辅导中心、戒毒中心和积极老龄中心，形成“一环统筹……抱歉，是一份护理计划统筹一切”。
我建议除了临床成果外，进一步集中参与就业与就业能力学院的求职、人民协会的社区活动和社会服务办公室的经济援助申请的接触点。一个联系人，一个协调员，全面照顾长者作为一个整体的人。
第二，衡量真正重要的指标。在我们10月会议中，卫生部关于追踪社会孤立的回复侧重于出席率和外展人数。孤独感更深，这些数字只是表面。我请求卫生部与教育机构合作，定期开展广泛调查社会健康决定因素。我们需要本地化的“生活质量”指标，以了解我们的努力如何真正减少孤立。
第三，将专科医疗带入社区。无法进食、听力或行走直接关联认知衰退和死亡率上升。然而，获得专科帮助仍是障碍。我请求卫生部加强牙科、听力学和足病学设施，特别是在长者集中居住的地区。我们必须在生活质量迅速下降前发现这些障碍。
第四，我请求卫生部考虑在高等院校开设听力学和足病学的学位或文凭课程，以增加新加坡专业人才数量，从而更好地服务需要此类专科护理的长者。
通过简化访问、衡量重要指标、扩展专科护理和培养本地专业人才，我们确保长者不仅仅是“变老”，而是拥有自主权地生活。
提升长者护理与支持
叶汉荣先生（耀祖康选区）：主席先生，新加坡人享有较长寿命。但我们是在为生命增添年华，还是仅仅为年华增添生命？随着医疗从医院转向家庭，真正的考验不仅在于基础设施，更在于我们培养的关系、组织的支持和维护的尊严。
首先，社会孤立。在我们密集的社区，许多长者孤独生活，邻里环绕，却被沉默隔开。荷兰和丹麦等国将社会处方纳入初级护理，认识到处方可以是一个人、一个目标和归属感。
抑郁、焦虑和悲伤的心理健康支持仍然资源不足。老年痛苦常常隐形，却深刻感受。卫生部能否更新我们关于在健康新加坡计划下正式推行初级护理社会处方及其成果？我们如何将常规心理健康筛查纳入社区长者护理，以便早期发现痛苦？
在健康新加坡计划下，积极老龄中心正在扩展，作为长者社区的锚点。卫生部能否分享是否观察到社会孤立减少和福祉改善？
第二，痴呆症。家庭仍难以获得痴呆症专门的日间护理和临时照护服务。痴呆友好社区，即以同情而非污名对待认知混乱的社区，仍不均衡。卫生部将如何加快痴呆日间护理和临时照护能力建设？我们如何加强公众教育，使污名减少，包容增加？若要健康老龄，我们必须善待那些无法自我记忆的人。
第三，照顾者。尽管有补贴，许多照顾者仍面临经济压力和倦怠。照顾不应意味着健康下降、储蓄耗尽或孤立。卫生部是否会审视临时照护，使其成为标准且易于申请的权益？随着健康新加坡计划推出综合社区模式，如何衡量照顾者负担和协调成果，确保家庭获得缓解？
第四，姑息治疗。善终也是生活的一部分。尽管许多人希望在家中离世，但因家庭缺乏支持，许多人仍在医院去世。卫生部采取了哪些措施扩大居家姑息能力，并装备全科医生提供持续的医疗和心理社会支持？
最后，随着扩展的EASE计划允许私宅长者申请适老化补贴，这如何与健康新加坡计划的居家养老策略相辅相成？如何追踪使用率和影响？
主席先生，我们现在必须建立一个关怀社区，确保每位长者不仅活得更久，更活得有尊严。
支持与认可照顾者
法兹里·法兹维先生（亚逸拉惹选区）：主席先生，新加坡正成为一个照顾者的国家。随着社会老龄化，越来越多新加坡人将在生命中很大一部分时间照顾变得虚弱、残疾或慢性病的配偶、兄弟姐妹、父母或祖父母。支持存在，但照顾者仍感到支离破碎。许多人在医院和机构间反复讲述自己的故事，没有统一的照顾者身份认证，也没有贯穿各场景的简单入口。
无偿照顾不是小事。杜克-新加坡国立大学研究估算，75岁及以上需要人类协助的长者非正式照顾时间的货币价值约为每年12.8亿新元。
由于聚焦75岁以上需要协助的长者，这可能低估了更广泛的负担。这就是为何早期识别重要。当地综合护理研究发现，基线时感到压力的照顾者有约四分之一的概率在12个月后仍感压力，强调了早期评估和支持照顾者的重要性，包括出院规划时。
2026年预算加强长期护理融资，包括向长期护理支持基金追加4亿新元，用于CareShield Life增强的额外补贴。但仅靠融资无法解决认可和导航问题，因此我建议部长研究并试点英国部分地区使用的简单工具——照顾者护照。一旦确认为照顾者，便获得实体和数字凭证，实现跨接触点的认可并触发实际支持。
我设想的是新加坡版照顾者护照，允许在超市、药房及其他照顾相关场所享受折扣。更重要的是，护照应允许照顾者参与出院和护理规划，加快临时照护和培训的链接，促进结构化的工作场所灵活性对话，并通过社区伙伴支持日常生活参与。
我建议从两个至三个区域试点，持续六至九个月，每个试点招募约100名照顾者，随后评估采纳率、导航成果及照顾者压力变化。
我有三个问题请教部长。第一，卫生部是否会设立照顾者认可试点基金，支持这些试点及评估，以便推广？
第二，卫生部是否支持试点期间采用低负担验证模式，如自我声明并通过医疗或社会服务接触点验证？
第三，卫生部是否会资助最低运营部分：协调、简单二维码基础设施、合作伙伴接入及适度激活支持，以确保试点产生全国推广的证据？
议长先生，认可照顾者是加强我们社会基础设施的关键，以减轻照顾者负担，使支持一致且易于获取。
主席：资深议会秘书蔡恩泽先生，您可以将两段发言合并。
释放我们的银发红利
蔡恩泽先生（女皇镇选区）：先生，到2030年，每四个新加坡人中就有一人年满65岁或以上。这既是挑战，也是巨大机遇。我们常常关注长者的不足，是时候转变观念。长者不是负担，许多人渴望且能够为社会做出有意义的贡献。我们必须超越赤字思维，拥抱他们的全部潜力。
我最近会见了林达·弗里德教授，她是著名老年病学家、流行病学家，也是哥伦比亚大学梅尔曼公共卫生学院首位女性院长。她还是Experience Corps的开创者之一，这是一个跨代志愿者项目，吸引五十多岁的长者作为公立小学儿童的导师和辅导员，同时促进志愿者自身的健康与福祉。
该项目旨在实现“三重赢”：一，帮助儿童学业成功，特别是早期识字；二，提升老年人的身体、心理和社会福祉；三，通过连接不同代际，强化社区。
结果显著。学生识字能力提升，参与度更高，行为问题减少。志愿者抑郁减少，认知功能增强，社交联系更紧密。学校报告学习环境丰富，社区联系加深。
看似简单：积极参与的长者是健康的长者。然而，尽管我们理解社会健康决定因素的科学，激活它却是另一挑战。卫生部的银发守护者计划鼓励长者在积极老龄中心做志愿者。这是良好开端，但我们可以做得更多。赋权长者不仅丰富自身生活，还强化家庭、学校和社区，塑造一个每代人都能繁荣的新加坡。我建议长者贡献的三种方式。
第一，促进社会流动性。长者可以帮助面临经济、社会和情感压力的ComLink+家庭。许多家长因工作和照顾责任而压力重重，孩子在识字和算术方面可能落后。受Experience Corps启发，拥有教学或专业经验的长者可以辅导孩子，提供知识、耐心和鼓励。除了学业，长者还可以指导家长，分享观点和人生智慧。这样，他们不仅提供帮助，还带来稳定和希望。
第二，心理健康。一项针对21至89岁成年人的新加坡同行评审研究发现，2020年疫情封锁期间，老年人报告的抑郁、焦虑和压力水平显著低于年轻成年人。相比之下，大约三分之一的青少年报告有内化症状，如焦虑、孤独或抑郁。许多年轻人不愿意让父母或家人参与他们的挣扎。老年人凭借其稳定、不带评判的陪伴和生活经验，能够提供指导、安慰和希望；帮助年轻人减少孤立感，增强韧性。
最后，我们的遗产。历史通过亲身经历讲述时最具力量。像“纽约人类”这样的项目之所以引起共鸣，是因为它们真实、未经滤镜、充满人性。我们的老年人往往掌握着社区中最有意义的故事。作为社区导览员，他们成为通往那些可能永远不会出现在教科书中但却是我们共同记忆关键部分的活桥。通过他们的故事，我们不仅保存事件，还保存塑造我们遗产和集体人性的奋斗、价值观和默默的胜利。
先生，我们的老年人建设了我们今天所知的新加坡。他们的牺牲奠定了基础，他们的韧性推动我们前进，他们的智慧继续指引我们。让我们不要从限制的角度看待老年人，而是从可能性的角度看待。作为导师、辅导员、照顾者和导览员，他们可以塑造生命，强化社区。
让我们建设一个不惧怕衰老而是庆祝衰老的新加坡；让每位老年人都感到被重视、被赋权并且彼此相连。因为当我们提升老年人时，我们是在尊重过去，并确保未来不仅以成功定义，更以尊严、同情和共享的人性定义。
我们与多巴胺的危险调情
让我这次发言不从统计数据或政策开始，而是从三个简单的自我介绍开始。
“你好，我是Benny。我戒毒五年了。”我们大多数人会以钦佩回应。我们理解克服化学依赖所需的自律。
“你好，我是Benny。我戒酒五年了。”我们再次默默点头。我们知道成瘾对健康、家庭和生计的影响。
但如果我说：“你好，我是Benny。我戒除色情五年了。”我们内心会发生什么？我们会不自在地移开视线吗？抑制一丝嘲笑？还是质疑这是否算戒除？
晚上8点
这种反应告诉我们一个重要信息。虽然我们准备公开讨论物质成瘾，但当成瘾表现为行为、私密且性相关时，我们仍感不安。色情成瘾常被视为放纵或数字时代成长的一部分。然而对某些人来说，消费变得强迫、痛苦且干扰日常生活。
今天，我不是来道德说教或谴责欲望的。我是来询问我们是否足够关注一种可能正在悄然出现的行为成瘾，尤其是在年轻人中，并思考公共卫生能且应发挥什么作用。
当然，多巴胺不是敌人。它是神经递质，对大脑功能至关重要。它激励我们，强化学习，并在努力和成就后带来满足感。但多巴胺也在成瘾中扮演核心角色。
当某些物质或行为反复触发强烈的奖励信号时，大脑会适应。神经通路加强。随着时间推移，大脑开始优先考虑与该奖励相关的行为。起初是自愿的，但对某些人来说，可能变得难以控制。药物和酒精等成瘾物质对此效应广为人知。越来越多研究关注行为成瘾，包括赌博障碍、游戏障碍和强迫性性行为，这些都涉及类似的奖励通路。
如今，色情内容即时、匿名、廉价，且通过智能手机随时可得。没有物理障碍，几乎没有自然的停止点。对一部分人来说，反复接触和不断升级的消费可能固化难以逆转的模式。
一些国际研究表明，问题性色情使用可能影响低两位数比例的人群，具体取决于定义。方法学不同，但新兴文献表明这不是孤立现象。
即使新加坡的患病率较低，受影响的绝对人数仍可能相当可观。
我们还必须将此问题置于更广泛的数字生态系统中。现代生活围绕奖励循环构建。社交媒体通知、网络游戏成就、赌博胜利、自动播放流媒体。我们的注意力经济被设计成让我们持续参与。
色情存在于这一更大环境中。它是众多数字刺激之一，争夺我们的注意力。但它有一个重要不同点：它能塑造对亲密、同意和关系的期望。当接触开始得早，往往在情感成熟尚未形成时，所吸收的教训可能不反映相互尊重或健康沟通。
在新加坡，关于性的话题往往谨慎。家庭可能难以开启相关对话。学校对此话题持谨慎态度。公共话语仍然克制。但沉默不等于保护。当缺乏指导时，年轻人可能转向互联网作为主要教育者，而我们都知道互联网并非设计来传授价值观。
技术使诱惑工业化。曾经需要努力、耐心和真实人际互动的事物，现在瞬间呈现在设计来吸引注意力的屏幕上。如果我们的公共卫生响应仅聚焦于伤害后的治疗，我们将永远在应对损害，而非构建韧性。
先生，有人可能会问，为什么这是一个医疗健康问题？
因为行为成瘾重塑神经通路。它与焦虑和抑郁共存。它推动咨询、精神科护理和家庭治疗的需求。如果我们忽视它，它不会消失。它会在我们的诊所、心理健康医院病房和社会服务机构中出现。
这是一个健康问题，因为它影响大脑功能、心理健康、关系稳定，并推动咨询和精神科服务的需求。挣扎于强迫性色情使用的个体常报告在学校或工作中难以集中注意力，尽管尝试停止但消费不断升级，秘密行为和情感退缩，关系紧张，持续的羞耻感和低自我价值感。
这种行为可能起初是缓解压力，但随着时间推移会加剧痛苦。当关系恶化和情绪健康下降时，影响不局限于私人领域。它影响家庭、工作场所和社区。
因此，作为关注心理健康的政策制定者，我们不能仅因讨论不适而忽视新兴的行为成瘾。
在本地，社区组织如We Care社区服务观察到寻求强迫性性行为帮助的个体数量增加，包括问题性色情使用。涉及性、色情和爱情成瘾的报告案件近年来显著上升。疫情后，寻求在线色情行为帮助的人数较疫情前翻倍以上。
大多数客户年龄在20多岁。一些案例也出现在青少年中，甚至有些只有12岁；12岁，先生！这仅是那些主动求助的个体。更多人可能因污名或不确定向谁或哪里寻求帮助而保持沉默。
今天的青少年更早接触到露骨内容，往往是无意中通过同伴分享或算法推送。
2024年，超过460名19岁及以下青少年因性犯罪被逮捕。有关部门注意到，早期且反复接触色情材料可能是影响年轻人理解同意和健康关系的多个因素之一。
辅导员也指出，缺乏关于界限和尊重的有意义指导，年轻人可能误解网络上看到的内容为正常和可接受的行为。
当然，我们必须避免简单结论。家庭动态、同伴影响、创伤和更广泛的文化因素都起作用。但我们不应忽视形成期反复接触的潜在影响。
这些不仅是道德问题。这是我们需要解决的公共卫生和社会稳定问题。
让我花些时间分享一位新加坡人的故事。我们称他为Dale。
一切开始得很无辜；同学间分享杂志。然后是互联网，然后是一张盗版DVD。Dale看到的画面让他不安，但他年轻的心灵发生了变化。好奇变成习惯，习惯变成强迫。表面上，Dale正常生活：学习、工作、服兵役。内心却陷入循环。压力、拒绝、庆祝都成为诱因。行为后是崩溃：羞耻、厌恶、承诺停止。
他描述自己过着双重生活。周日去教堂，夜晚独自面对成瘾。罪恶感压得他喘不过气。曾有一刻他说：“我觉得我天生没有爱的能力。”
色情将亲密塑造成幻想和控制。
转折点是Dale走进了匿名性瘾者会议。普通男人——父亲、专业人士——分享他们的故事。Dale意识到自己不是唯一挣扎的人。孤立开始破裂。
在We Care的支持下，Dale学会追踪诱因，面对不适，命名情绪而非麻木。康复缓慢且不完美，但极具人性。
先生，当然，这不是道德失败的故事。这是早期接触、无声条件反射、秘密、羞耻和勇气的故事。在“成瘾者”的标签背后，是一个曾经好奇、被沉默困住、需要理解、社区和支持的人。
如果我们认真对待这个问题，必须从不适走向基于证据的策略。
目前，我们拥有的国家数据有限。我们的大部分理解来自国际研究和社区案例报告。我提出三步建议。
第一，委托一项严谨的跨学科国家研究，调查新加坡问题性色情使用。我们需要了解患病率、心理健康关联、关系影响和风险因素。有了证据，我们可以合理且负责任地调整应对措施。
第二，审视我们的数字和性教育框架。年轻人需要情绪素养、数字韧性以及关于同意和健康亲密的扎实理解。家长也可能需要支持，以应对快速变化的数字环境中的对话。如果接触日益普遍，那么为青少年及其家庭提供解读所遇内容的工具就变得至关重要。
第三，扩大社区成瘾服务的资金和能力。如果行为成瘾相关咨询需求上升，我们的支持体系必须跟上。寻求帮助的人应能获得便捷及时的支持。
早期干预是人道的、预防性的且具成本效益。
先生，这不是关于数字内容的问题。这是关于心理健康。这是关于年轻人如何形成对关系的期望。这是关于伴侣如何随着时间建立信任。如果我们想要强健的家庭和有韧性的青年，就不能将此问题视为禁忌。我们必须将其视为可解决的问题。
我们无法消除诱惑，但不应将伤害常态化。如果技术工业化了诱惑，那么我们的回应必须工业化韧性：深思熟虑、适度且关怀。
让我们不要因为话题不适而犹豫。让我们选择证据而非否认，勇气而非回避，支持而非污名。因为摆在我们面前的问题不是这个问题是否存在，而是我们是否能共同正面应对。
英文原文
SPRS Hansard 原始记录 · 抓取日期：2026-05-02
The Chairman : Head O, Ministry of Health (MOH). Ms Mariam Jaafar.
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From Financing Care to Financing Health
Ms Mariam Jaafar (Sembawang) : Chairman, I move, "That the total sum allocated to Head O of the Estimates be reduced by $100."
S+3M, subsidies Medisave, MediShield and MediFund, is one of our nation's quiet triumphs. It has protected generations of Singaporeans from catastrophic bills. It has preserved system sustainability. It has embedded shared responsibility, personal ownership and equity.
But it was built for yesterday's risks. S+3M was designed for acute hospital episodes. A surgery, a stroke, a sudden hospitalisation.
Today, our dominant risks are chronic, progressive, community-based: diabetes, dementia, frailty, mental health conditions. They do not bankrupt a family overnight, but they exhaust a family slowly.
Dementia day care costs about $63 per session. Even with the latest subsidies, a middle-income family still pays over $12,000 per year, before transport, home care, medications, and lost caregiver income. At my Woodlands Meet-the-People Sessions, I often hear two concerns: one, "why can't I use my Medisave? It's my money"; and two, "I already used up all my MediSave for chronic care".
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Mrs L, a retiree, cares for her husband with early dementia, while managing her own diabetes. She told me, "I saved all my life. Why does it still feel like my money isn't enough to stay independent?" Or K, 24, pays out of pocket for mental health care because her condition is not officially chronic. "I'm probably going to need this for the rest of my life. How is that not chronic?" These are the lived realities faced by our fellow Singaporeans.
Incremental cap adjustments and coverage expansions help, but they do not fundamentally reshape incentives. Our system still signals we pay more attention when you are already very sick. That must change. Our lifestyle risks are rising faster than our population ages. More sedentary work. More screen time. Richer diets. Chronic conditions appearing earlier.
Singapore is investing in population-level prevention – 6 % of our healthcare Budget, with plans to double. Healthier SG fully subsidises routine screenings and immunisation programmes. Active-living infrastructure like parks, fitness corners, cycling paths, Active Ageing Centres and community health programmes encourage functional health. These are centrally funded.
But prevention is more than screening. Some seniors need physiotherapy to prevent a fall. Some need home rehabilitation to prevent a re-admission. Some need cognitive stimulation to prevent the onset of dementia. Some adults need weight management programme to prevent diabetes progression. Some youths need early mental health interventions to prevent a spiral. These are investments in independence, not discretionary lifestyle perks. S+3M must evolve, not just to pay bills, but to shape behaviour, support prevention and sustain independence.
Subsidies. I propose three upstream shifts.
One, early disability support. Many schemes require three Activities of Daily Living (ADLs). Introduce an early intervention tier for "pre-frail" seniors – funding physiotherapy, balance training, and strength exercises. One month of rehab today can prevent a decade of nursing home care tomorrow.
Two, subsidised diagnostic pathway. When referred by a Healthier SG general practitioner (GP), the first specialist consultation and primary diagnostic scan, CT or MRI, public or private, should be subsidised. A treatable condition should never become a terminal one because someone hesitated over the cost.
Three, fairer means testing for sandwiched families. Two households may have the same per capita household income (PCHI), but the one supporting elderly parents and young children carries a heavier burden. Adjust subsidy tiers for households with multiple dependents.
Subsidies must be easy to use, visible and structured to encourage early preventive action. Automatic enrolment, co-payment reductions, integrated Medisave bonuses and seamless digital claims are ways to nudge behaviour.
MediSave. Even with subsidies, Singaporeans face costs over the long term. MediSave must evolve. I propose MediSave flex where the annual withdrawal limit is linked to balances, with an upper cap to maintain sustainability. Let it fund chronic disease management, broader preventive screenings, evidence-based doctor-referred functional health or nutrition programmes, early rehabilitation after minor injuries or hospital stays, early interventions for dementia or frailty, expanded mental health support. Keep the remainder MediSave core for major episodes. Unused flex balances roll over, rewarding responsible early actions. Bonuses can be awarded, tied to improvements in chronic disease management and functional assessments.
Together subsidies and MediSave flex nudge Singaporeans to act early, adhere to chronic care, and engage in preventive programmes. Singaporeans get more flexibility while the systems preserve catastrophic coverage. MediShield Life remains for rare, high-cost hospitalisation, keeping premiums affordable. Explore premium credits for preventive prescriptions if they are shown to save costs. MediFund remains the final safety net for those genuinely in need.
S+3M actually has been a safety net catching us when we fall. But in an ageing society, we need a springboard that keeps us standing, strong, independent and healthy. We must adapt S+3M: financing not only healthcare, but health itself, not by abandoning the principles, but by fulfilling them fully.
Shared responsibility must include shared prevention. Personal ownership must empower early action. Equity must recognise cumulative burden. This is not about spending more. It is about spending earlier, so that we spend less later – financially, socially, emotionally.
And, Sir, none of these changes one thing. The Government must do everything in its power to keep healthcare affordable and rein in healthcare inflation. If we get this right, we will not only treat illness. We will preserve independence and dignity. We will not only pay bills. We will invest in health.
Will the Ministry commit to studying and reporting, ideally before the next Budget, how S+3M can be recalibrated to better support chronic and preventive care?
[(proc text) Question proposed. (proc text)]
The Chairman : Ms Mariam Jaafar.
Personal versus Collective Responsibility
Ms Mariam Jaafar : Healthcare is often framed as personal responsibility. Individuals matter, yes, but in Singapore, healthcare risk is shared. Premiums are pooled. Subsidies are pooled. Caregiving burdens are shared. There is no such thing as a purely private health cost.
When preventable illnesses rise, premiums rise, taxes rise. Families feel the strain. Caregivers leave the workforce. Yet today, only about six in 10 eligible residents participate regularly in recommended chronic disease screenings. Four in 10 remain unprotected.
Preventive care saves lives and reduces costs, but only if people participate. If prevention is essential, it should not depend on who remembers to click a link. Opt-in assumes time, awareness and confidence – luxuries not everyone has. Prevention must be the default. I propose: move to opt-out screenings, proactive, personalised health coaching supported by digital nudges.
Collective responsibility is not about blame. It is about design. And design does not sit with MOH alone. It is about what our children eat in school. What is affordable at the hawker centre? How workplaces structure time and stress? Whether our neighbourhoods invite movement or discourage it? The healthy choice must be the easy choice.
If we design upstream, we save downstream. Will the Ministry consider making key preventive programmes opt-out and outline how the Ministry will work across Government to embed preventive defaults in daily life?
Improving Health in the North
Healthier communities do not just happen by chance – they are designed. MOH has launched a programme to improve health in the North, and Woodlands, my Constituency, is piloting an integrated preventive health model.
The North is well placed for this. We have a diverse mix of seniors and families, the full range of housing types, strong community institutions, and opportunities to strengthen chronic care. With two hospitals, several polyclinics and Active Ageing Centres within easy reach, we can test how to bring care closer to home and refine integrated care team models.
The pilot rests on four pillars: first, stronger referral pathways and chronic disease support. Second, moving care closer to home, with smoother transitions; third, redesigning neighbourhoods so that the healthy choice is the easy choice; and fourth, activating communities as health advocates.
I support this initiative. But it cannot be policy on paper – it must be about real people, living healthier lives, every day. I therefore have two questions and three requests for the Minister.
The questions: one, how will success be measured? Two, what resources will be available for grassroots activation?
The requests: ensure town-level care hubs are fully integrated and consistently staffed so residents can access services without delay; expand the scope of community-based care and caregiver support, to cover more conditions and families; and involve my residents directly in co-designing interventions so solutions reflect their real needs and let us avoid stigmatising any community.
Health outcomes are shaped by the systems – transport, food, work patterns as well as socio-economic factors, not moral failings.
Imagine this. Mdm S, 54, does strength training three days a week at the Active Ageing Woodlands Gym under the watchful eyes of a volunteer buddy. When she does not feel like cooking, there are plentiful healthy and affordable Halal options at Kampung Admiralty Hawker Centre. With care and support closer to home, her diabetes is under control and she stays independent.
If we can redesign a town for health, we can redesign a nation.
AI in Healthcare
First, I declare my interest as managing director of a management consulting firm that works in AI and healthcare.
AI in healthcare is often discussed in terms of use cases – detecting disease earlier, automating paperwork, predicting risk, personalised medicine. These are impressive. But today, I want to ask the Minister a bigger question: what is our ambition? If healthcare is truly a national AI mission, our goal cannot be incremental adoption. We must build a system – the infrastructure, the governance, the talent, the plumbing that lets AI transform care safely, effectively and at scale, with better outcomes for every patient in Singapore.
Once we show that AI delivers real patient benefit safely and reliably at scale, Singapore will naturally move from adopter to a global leader in trusted healthcare AI. Singapore has laid strong foundations: HEALIX enables analytics across clusters; the National Electronic Health Record (NEHR) aggregates patient records; the Health Information Bill clarifies rights, responsibilities and safeguards; and early AI pilots are already easing clinician workload and improving patient outcomes.
But infrastructure alone does not make us a leader. Much of our data is still fragmented. Interoperability supports care delivery, but safe access for innovation and AI development, including with third parties, remains rather limited.
To lead globally, three things matter.
One, stronger data frameworks – national data architecture, secure sandboxes, synthetic datasets, and federated learning that enable AI innovation without compromising patient privacy.
Two, interoperable systems that allow AI models to learn across institutions while keeping clinicians in control.
Three, governance rules: every AI recommendation must be explainable, auditable, accountable. Clear innovation governance; top down or bottom up.
On global collaboration, our stance must be clear: we welcome expertise, but only under frameworks that protect our data, preserve sovereignty, build local capability and benefit patients.
Regulations must also keep pace. AI evolves quickly. We need national validation, certification and post-deployment monitoring – standards for bias, explainability and real-world performance, so patients and clinicians can trust every AI decision.
Finally, talent. AI in healthcare is a translation problem. We need professionals fluent in both clinical realities and machine learning.
Sir, we are on track to drive efficiency with AI. But Singapore must be a place where AI solutions are built, tested, certified and scaled safely, and where patient outcomes improve at every step. Healthcare should not merely adopt AI. Singapore must set the standards for trusted, safe and effective AI.
Will the Ministry outline a clear roadmap, with timelines, for strengthening data access frameworks, validation standards and talent development, so Singapore leads in trusted healthcare AI?
Integrated Shield Plans - Additional Withdrawal Limits
Mr Pritam Singh (Aljunied) : The MediSave contribution ceiling in 2015 was $48,500. Today, its equivalent – the Basic Healthcare Sum of the maximum amount in the MediSave account – is $79,000, an increase of about $30,000 in a period of about 10 years. With close to 70% of locals holding an Integrated Shield Plan (IP), there has been no increase for close to 10 years since the introduction of MediShield Life with respect to the maximum amount one could use from MediSave to service IP premiums, or what is referred to as annual withdrawal limits.
With out-of-pocket expenses a consistent bugbear for many Singaporeans over the last few years, and the basic healthcare sum rising exponentially year-on-year, there is an expectation that the additional withdrawal limits that allow Central Provident Fund (CPF) members to use more of their MediSave money to service their IP premiums, are in need of a revision. It cannot be reasonably expected that this number or the amount of money that can be used should remain the same after so many years.
Does the Ministry plan to review this in the immediate term? And if not, why not?
Healthcare Manpower
The headline of an opinion piece last month in The Straits Times expressed a major anxiety of the health system succinctly: "Singapore as a super-aged society: can its health system cope?" The author, an academic with a specialty in public health, observed what is commonplace for many Singaporeans when they visit our public hospitals and healthcare institutions – a large number of seniors in wheelchairs, visibly frail, or struggling with mobility.
The Ministry has shared that the healthcare workforce is projected to grow by 20% from 129,000 in 2024 to about 156,000 in 2030. The assessment is that this number would be broadly adequate for the population's healthcare demands for the years to come.
The intersection of a rapidly ageing population and higher demand for healthcare services will bring the adequacy of the healthcare workforce into distinct focus and any shortages or perceived shortages will be reflected most acutely in service quality, waiting times for specialist care and waiting times to see a healthcare professional, amongst others.
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In parallel, there are real concerns and worries about the welfare of our healthcare workers, from allied health professionals to nurses and doctors, in view of heavier patient loads that are anticipated. Separately, the projected increase in healthcare manpower begs the question of how much allowance or buffer is being factored into the healthcare system, including in the event of Disease X type scenarios – a key lesson learned from the COVID-19 experience.
Second, there are deep concerns that the addition of 100,000 policyholders converting their insurance coverage from the private to public healthcare sector each year may significantly strain the public healthcare system. This is a number which the Minister has said he expects to increase.
First, what is the scope of the surge capacity when our healthcare system reaches the upper end of 156,000 healthcare workers? Does the surge capacity account for an additional buffer of doctors, nurses and allied health workers? If so, how much? Or is the surge capacity a case of restructuring processes to do more with less in times of surge demands? If it is the latter, for how long can the healthcare system operate at an optimum level of performance?
Second, does the Ministry plan to increase the range of publicly reportable statistics from what is currently available to waiting times at hospital emergency departments, polyclinics and specialist outpatient clinics, amongst others?
We should carefully track the capacity of the system to cope with the significant demands our demographic shift imposes on it. It is useful to remember that healthcare is a very unique public service. The Prime Minister identified healthcare as one of four national AI Missions. AI indeed stands to inject new productivity possibilities into healthcare at the ecosystem level.
However, at the level of a Singaporean who needs healthcare, what makes healthcare, healthcare, are the people – the doctors, the nurses, the allied health workers – who look after us when we are at our lowest. In that context, the human touch and the personal connection will never be fully replaced by AI.
So, if it means that our healthcare manpower in the years to come would require additional buffers, we should devote more fiscal resources towards it accordingly.
The Chairman : Dr Hamid Razak, you can take your two cuts together.
Cost Complexity in Hereditary Cancers
Dr Hamid Razak (West Coast-Jurong West) : Mr Chairman, Sir, for some Singaporeans, healthcare is not just confined to a bill. It is a lifetime of risk.
Today, in this House, I want to share the story of a young Singaporean I met – Gwendalyn. In her early 20s, she was diagnosed with hereditary breast cancer. Overnight, her life changed. She faced surgery, complications of surgery and continued chemotherapy for her condition. She underwent reconstruction, but parts of her reconstruction were not covered because it was deemed to be cosmetic.
For a young cancer survivor, reconstruction is not cosmetic. It is about dignity. It is about mental healing.
There are many such Gwendalyns in our society today. People I speak about are those with hereditary risk of cancer. Her story points to a wider gap.
Cancer care today is not only clinically complex, it is also financially and psychologically complex, especially for hereditary disease. So, the policy question is this: how do we support people who may not be sick today, but are clearly at elevated risk? To that end, I would like to ask the Minister three broad questions.
First, how can we integrate hereditary risk assessment and genetic counselling into primary care and connect it to Healthier SG so that prevention becomes upstream?
Second, will the Ministry review how we finance medically indicated preventive procedures and the reconstruction, including high-risk situations involving a currently healthy organ, so that support is consistent and understandable? For example, in the case of Gwendalyn, if a mass was found on one breast and was found to be diseased, she undergoes mastectomy, what about the contralateral breast, which at current state is healthy but we know she carries the gene for breast cancer? How can the system be seamless when caring for such individuals?
Third, how do we strengthen survivorship pathways for young cancer patients, including psychological and social support, not just medical follow-up?
Mr Chairman, Sir, the test is not just about survival, but about how survivors can return to life.
Precision Medicine and Functional Health
Mr Chairman, Sir, if hereditary cancers speak about how complex medical care is, then precision medicine tells us how intelligently we can respond to the challenge.
We already see the direction. At National University Health System (NUHS), the Centre for Healthy Longevity is building programmes that strengthen healthspan, not just treat illness, helping Singaporeans stay physically strong, cognitively sharp and metabolically well as we age.
This matters because the public demand is already there. People are seeking tests and optimisation outside the mainstream system. If our public pathways do not keep pace with the credible evidence, we risk two things – fragmented care with uneven quality, with widening inequality and a missed opportunity for Singapore to lead responsibly as a trusted regional centre.
While we focus on taking care of our seniors and our elderly, which is important, the key question as we go about with our society is how do we optimise every Singaporean, regardless of age, to reach the highest potential health for their age? So, Mr Chairman, Sir, may I ask the Minister three questions.
First, what is the Ministry's pathway to evaluate and adopt emerging evidence in precision and longevity-related medicine with clear safeguards for safety and value? Second, how can Healthier SG progressively add functional health markers, including metabolic, cognitive and frailty indicators, so that prevention becomes personalised and not just generic? Third, how will we enable responsible innovation so that we remain evidence-based, future-ready and trusted, so that our policies can keep pace as the evidence emerge, and we do not wait for two to three years after the evidence has already become mainstream?
Because the goal obviously is not just longer life. The goal is delayed decline, preserved independence and dignified ageing.
Cancer Treatment Costs and Coverage
Ms Sylvia Lim (Aljunied) : Sir, Singapore's medical cost inflation is projected to reach nearly 17% this year, significantly higher than general inflation, which is under 2%.
I recognise and agree that there is a need for cost containment and management of insurance premiums. On cancer specifically, MOH has made significant moves. For instance, the Cancer Drug List now has about 394 drugs listed that are eligible for subsidies and claims under MediShield Life and integrated plans.
Three months ago, MOH announced a key policy change in hospitalisation insurance. With effect from April this year, new riders on integrated plans can no longer cover the minimum deductible set by MOH while the co-payment of bills at 5% of the total bill will be capped at $6,000 per year instead of $3,000. With these changes, the premiums for the new riders are expected to be about 30% lower than for the existing riders.
Sir, the Minister for Health has put up various videos on TikTok to explain the change. In one of them, he appeared to suggest that the only use of the existing rider was to reduce the deductible and co-insurance, and the public should consider whether they need a rider at all.
However, my understanding is that riders may be essential, especially to cancer patients for other reasons.
First, riders help to pay for costly cancer drugs that are not on the Cancer Drug List, which could be critical for the patient's treatment. Second, there is the issue of loss limits. Without a rider, the patient would need to pay 10% of a hospitalisation bill without any cap.
The second more general issue relates to preventive medical interventions which may not be covered by insurance.
A young breast cancer patient wrote about her plight to The Straits Times' forum page on 28 January. She followed the doctor's advice to remove both breasts even though only one was cancerous. Her hospitalisation insurance covered surgery for the cancerous breast, but only partially for the non-cancerous one.
In April last year, MOH recognised that the line between preventive and diagnostic care was increasingly nuanced, particularly in cases involving genetic predisposition to serious conditions, like breast cancer. MOH mentioned that it would issue claim rules to guide practitioners on breast-related surgical claims later that year.
What is the present status of this review?
Means Testing and Filial Paradox
Mr Victor Lye (Ang Mo Kio) : Mr Chairman, adult children are often the default caregivers for ageing parents. It is a good thing when adult children want their parents to stay with them, even better when the parents are active and in pink of health. Nonetheless, some Singaporeans feel penalised for doing the right thing. This is what I call the filial care paradox.
When children bring ageing parents into their homes, the parents often lose their benefits, such as the Community Health Assist Scheme (CHAS), Silver Support or other subsidies. The parents are now seen as part of a higher-income household or living in a housing type with a higher annual value.
Sir, to support caregiving and encourage filial piety, we need to recognise that the caregiving responsibilities can weigh more proportionately than housing income or housing type. I am not suggesting that we abandon means testing in our healthcare and social assistance architecture. But we can recognise caregiving households more explicitly. I have three suggestions.
First, consider a caregiver housing carve-out. Seniors moving into an adult child's home for caregiving should be assessed independently instead of being lumped into the entire household. Second, consider a transitional period. This is a grace period so that the seniors' benefits do not immediately disappear when caregiving arrangements change. Third, explore functional needs assessment, where we assess the social assistance based on actual needs rather than looking solely at household income or housing type.
Mr Chairman, when adult children bring their ageing parents into their home and care for them, we should give them more support, not less.
Lumpy Medical Spending and MediSave Limits
Assoc Prof Jamus Jerome Lim (Sengkang) : Those of us who have fallen seriously ill at one point or another will be keenly aware of how our healthcare expenditures are lumpy. That is, we may go one year without any medical expenses, but in another year, we may end up spending far more than we would have anticipated.
This is often the case even for chronic conditions since new diagnostic or treatment procedures may only be required on occasion. The reality of spending spikes is corroborated by more systematic research in health economics. Moreover, it is also well-known that end-of-life spending tends to be elevated. This is another manifestation of lumpiness. Patients tend to spend most in the final years of their life.
MediSave currently faces annual withdrawal limits of several types of care. The policy is well-meaning. One does not wish for patient to exhaust their MediSave funds, especially knowing that most of their care costs will indeed be incurred at the tail end.
But this is problematic because the policy is not aligned with the lumpy nature of medical expenses. It also glosses over the role that insurance, including public ones, such as MediShield Life, plays in such instances, since these are more likely to pay out for major illnesses that will otherwise exhaust their MediSave.
Actual data from the CPF supports this notion that there may be excess for saving in our MediSave accounts. In response to a Parliamentary Question posed in 2022, Minister Tan See Leng reported that MediSave account balances for members significantly exceed their Retirement Accounts, with the ratio for those aged 85 and above close to five times larger.
There are two ways to better calibrate MediSave limits.
First, we can permit carrying over of unspent limits for up to three years. This will allow those who incur larger than expected bills to not have to rely on out-of-pocket funds, which, especially for retirees, are frequently paid for by working-age family members so as to be able to top up their medical expenses.
Second, we can have a tiered system of claim limits, with the amounts allowed for claims gradually raised according to age. While nobody can accurately predict when an individual's demise might be, we can rely on aggregate statistics on mortality by gender to adjust claim limits accordingly. It is intuitive to allow more spending at later ages where individuals' health will have deteriorated more.
Sir, these simple steps will help better align the actual usage of MediSave, with the well-meaning constraints imposed to ensure sufficiency in time of medical need, whether they may be today or tomorrow.
Outpatient MediSave Use
Mr Gerald Giam Yean Song (Aljunied) : Sir, I repeat my call for MOH to extend coverage for all chronic diseases under the Chronic Disease Management Programme and not just the 23 approved conditions. This would ensure any condition requiring long-term management can be subsidised under CHAS and paid for via MediSave.
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Even for conditions on the Chronic Disease Management Programme list, the MediSave 500/700 withdrawal limits can be restrictive. I last raised this issue in 2021 and the Senior Minister of State argued that the risk of overconsumption necessitates these caps. However, how does this apply to public healthcare institutions, where salaried doctors follow strict protocols? The real risk is not overconsumption but undertreatment. When patients are forced to choose between their cash and their care, some may choose to skip medications or appointments to save money.
Self-rationing today can lead to a massive bill tomorrow and emergency hospitalisation. This is a tremendous cost to both the individual patients and the healthcare system. Has the Ministry assessed the clinical cost of medical non-compliance caused by rigid MediSave withdrawal limits? Singaporeans want to be self-reliant and not have to appeal for subsidies or medical assistance. The Ministry should allow for more flexible MediSave withdrawals at public healthcare institutions for patients over 60, especially for those with significant MediSave balances.
Funding and Supporting Mental Health
Mr Patrick Tay Teck Guan (Pioneer) : Chairman, I declare my interest as Chairman of the Mental Health Board at the NHG Health. I rise to make the case that Singapore should position the Institute of Mental Health (IMH) as the true Centre of Excellence in psychiatric treatment and care, and to ask the Minister three questions towards that goal.
IMH is our only dedicated psychiatric hospital, housing our most experienced psychiatrists and specialised teams. Yet it remains stretched across the full spectrum of acuity. If we are serious about building a Centre of Excellence, we must free IMH to focus on what it does best – leading research, training the next generation of mental health professionals and managing our most complex cases.
My first question concerns manpower. Is IMH better resourced than our acute hospitals to handle complex psychiatric patients? And a Centre of Excellence should not merely treat; it should set clinical standards across our entire healthcare system and across all three public healthcare clusters. How is IMH’s specialist expertise being leveraged across the three clusters to uplift psychiatric treatment and care in all our acute hospitals and in the community, so that IMH is not bogged down by excessive referrals beyond what they can handle effectively and efficiently.
My second question concerns care pathways. Will the Minister share data on polyclinic acceptance rates for patients discharged from IMH and acute hospitals with psychiatric diagnoses? A Centre of Excellence cannot function if its beds are occupied by patients ready for step-down care. Are there plans to expand polyclinic capacity for psychiatric cases, so that IMH can focus its resources on those who truly need specialist care? Stable psychiatric patients often remain at IMH simply because there are no community facilities to receive them.
My third question is whether there are plans to develop more custodial care and step-down facilities – sheltered homes, supported living – so that IMH’s beds are reserved for those who need its full clinical expertise?
Mental Health
Dr Wan Rizal (Jalan Besar) : Chairman, mental health is a national priority. Over the past few years, we have made significant progress in recognising that mental well-being is foundational to our social and economic resilience. We see growing demands across young people, working adults and seniors. More people are coming forward to seek help and that is a good sign.
But the pressures are real. Mental health conditions cost Singapore around $16 billion annually, largely from lost productivity due to absenteeism and presenteeism. That figure reminds us that mental health is not just a healthcare issue. It affects our workers, families and national resilience.
So, the question is not whether mental health matters. The question is whether our system is built to sustain the demand ahead.
We launched the National Mental Health and Well-being Strategy. We expanded community services and strengthened primary care. As we move into the next phase, could the Minister update us on its progress? Are we seeing measurable improvements in early intervention? Are the wait times stabilising, particularly for moderate and higher-risk cases? Are community providers adequately supported as the demand continually grows?
Every strategy eventually reaches a point where expansion alone is not enough. It requires structural strengthening. Mental health also cuts across healthcare, education, workplaces and the social sector. Could the Minister elaborate on the role and mandate of the Mental Health Office? How does it coordinate across agencies, track system-level outcomes and ensure accountability? If this is truly a whole-of-society effort, then governance must be deliberate and clear.
Sir, access ultimately depends on people. Clinical psychologists and other higher-risk psychology disciplines undergo years of rigorous postgraduate training and supervised practice. Standards must remain high. Patient safety depends on it.
At the same time, demand is growing. How is MOH projecting manpower needs for clinical psychologists and allied mental health professionals over the next five to 10 years? Are there plans to strengthen the local training pipeline and supervision capacity to build a strong local core while maintaining professional standards? And does the Ministry see scope to strengthen professional regulation at higher-risk psychological practice to safeguard patients and reinforce public confidence?
Sir, mental health care must operate as one integrated system. Psychologists, counsellors, social workers, occupational therapists and peer support specialists each play important and complementary roles. How will workforce planning and training reforms ensure stronger integration across these professions and better coordination between primary care, hospitals and community providers? Patients should not experience fragmentation. They should experience continuity.
Sir, as we look ahead, we should also be mindful of the growing use of AI in mental health support. AI tools may be useful for self-help psychoeducational early screening, but we should be cautious. If such technologies begin to substitute professional care, mental health treatment often involves complex clinical judgement and ability to respond appropriately in crisis situations. Could the Minister share how MOH is thinking about the role of AI in mental healthcare and what safeguards may be needed to ensure that technology compliments, rather than replaces, trained professionals?
Sir, if mental health is a national infrastructure, then we must build it with strong foundations, clear standards and long-term sustainability. I look forward to the Minister’s response.
The Chairman : Ms He Ting Ru. Please take your three cuts together.
Mental Health Professionals Regulation
Ms He Ting Ru (Sengkang) : Mr Chairman, I declare my interest as a practitioner in the well-being space. With the mental health crisis showing no signs of abating, would the Ministry provide an update along with a firm commitment to fixed timelines to regulate mental health professionals?
I would like to repeat my call to regulate professionals, such as therapists and counsellors, who play key roles in supporting individuals with mental health conditions. Regulation is important as clients may not know where to go for help if they have concerns about professional standards or ethics.
At the same time, we must also ensure entry barriers are not prohibitive for professionals. Most therapy and counselling qualifications require minimum supervision hours and practicums costing upwards of $200 an hour, which can be difficult for fresh graduates and mid-career entrants. I hope we can explore more ways to reduce such barriers. Beyond subsidies, could the Ministry also consider the use of SkillsFuture credits?
Mental Health and Well-being Strategy
The set-up of the National Mental Health Office (NMHO) is a first step to a vision where mental health sits on a continuum with socio-economic determinants and is not merely the absence of illness.
That said, we still have to work towards a clear vision to improve Singaporeans' mental health. For example, Scotland's Mental Health Strategy 2017 focuses on reducing inequalities for mental health and treatment and access using a life stage model and Malaysia's National Strategic Plan for Mental Health aim to reduce adolescent depression rates from 18% to 10%. These strategies clearly outline a vision of success for improving mental health and well-being, describing what a mentally healthy population looks like. They also include time-bound targets and outcomes beyond broad focus areas.
This aligns with recent World Health Organization guidance on policy and strategic actions to promote and protect mental health and well-being across Government sectors. The guidance calls for: one, active engagement with all stakeholders and ensure meaningful participation of those with lived experiences; two, regular reporting and clear commitments; three, allocating fully costed and dedicated funding to support policy directives and strategic actions to prevent implementation delays.
I would like to seek four clarifications. First, what is the picture of success of the National Mental Health and Well-being strategy? To coordinate efforts across policy areas and sectors, the strategy should outline a few key outcomes and have clear targets.
Second, how does the NMHO plan to work with Ministries and agencies to engage Singaporeans on current initiatives and future plans? Incorporating ongoing feedback from those with lived experience, communities and civil society will ensure the strategy remains relevant and grounded in real needs.
Third, how will the NMHO coordinate reporting, monitoring and evaluation through regular updates? For instance, Scotland's January 2026 monitoring report track key performance indicators across nine strategic outcomes to enhance agency accountability, responsiveness and effectiveness.
Fourth, is there dedicated funding for mental health and well-being initiatives to support the strategy? If so, what is it? Between 2020 and 2022, MOH dedicated around 3% of its healthcare expenditure towards mental health treatment, promotion and prevention. Has this amount increased, and what are the projected amounts going forward?
Smoke-free Generation
For years now, the Government has been studying the possible roll-out of a tobacco-free generation policy. Earlier this year, the Minister of State for Health said in an exchange with me that the effectiveness of implementing such a policy is not straightforward and that we are already at an all-time low smoking rate of 8.4% with the existing suite of measures.
Mr Chairman, I agree that implementation of a tobacco-free generation policy is not straightforward. Black markets already stop Singapore from being completely drug-free and vape-free. Similarly, places where smoking is banned are not completely smoke-free despite the efforts of our enforcement officers.
Nevertheless, while New Zealand repeals its laws partly on grounds of political ideology, we should continue to study how to roll out a tobacco-free generation policy once there is real-world evidence on its efficacy and implementability. Maldives' policy has already come into effect, while the United Kingdom (UK) Bill is on track to becoming law, is set to be implemented at the start of 2027.
Like the UK, we are well-placed to introduce a similar policy precisely because our smoking rate is already low. The latest studies, including a Nottingham University study published in January, suggest that a cohort ban will bring forward by decades a smoking prevalence of under 5%, which is defined as an effective endgame for tobacco.
I highlight the end-game because it sets out a target I hope we can work as fast as possible to achieve. Although associated with the smoke-free generation policy, we should state the endgame as an overarching policy objective. With decisions like periodic increases to tobacco duties, I hope we are seeking to maximise the sin tax impact instead of considering its revenue impact.
Similarly, we should be doing more to curb the health impacts of public smoking, for instance, by tackling smoking while walking. Singapore takes a zero-tolerance approach to drugs and vaping. We must do the same with tobacco. Thank you.
The Chairman : Mr Cai Yinzhou, you may take your two cuts together.
Invisible Medical Conditions
Mr Cai Yinzhou (Bishan-Toa Payoh) : Thank you, Chairman. Following the invisible costs highlighted in my Budget speech, I want to address the struggles of those with invisible conditions.
With the helping hands scheme supporting those on public transport, many with hidden medical, autoimmune or chronic diseases still face judgment in daily life. Will the Ministry consider expanding these initiatives outside of public transport to more settings like hawker centres and libraries to fostering a society that leads with patience rather than suspicion?
In Singapore, one in five children and one in 10 adults endure the constant, debilitating itch of this atopic eczema. While manageable, the cost of continuous treatment, including wet wraps and phototherapy, is a significant financial and emotional burden. Will the Ministry consider adding atopic eczema to the Chronic Disease Management Programme, which already covers similar conditions like psoriasis?
Lastly, some youths are deterred from sharing suicidal thoughts with school counselors because they fear an automatic, mandatory reporting to their parents, especially when those thoughts might stem from family circumstances. To encourage greater help-seeking while ensuring safety, will the Ministry implement a tiered reporting framework that allows for greater confidentiality in a risk-proportionate manner?
Chairman, we must ensure our infrastructure of care is robust enough to support the struggles we cannot see. I look forward to the Ministry’s vision for a more inclusive and empathetic healthcare landscape.
One Touchpoint for Seniors
My second cut addresses the age-old question: what is a life well lived? For many seniors I have spoke with in Bishan-Toa Payoh, the answer is not just more handouts, but dignity, choice and the agency to live their golden years on their own terms.
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To this end, I have four proposals.
First, expanding the Integrated Community Care Providers into a "Senior Concierge". Minister Ong has spoken about a single coordination point for care and 85 sub-regions, which will soon provide coordination across Regional Health System, Home Personal Care Plus, Singapore Counselling Centre, Drug Rehabilitation Centre and Active Ageing Centres with One Ring to Rule… excuse me, One Care Plan to coordinate them all.
I propose beyond clinical outcomes, to further centralise touchpoints for participating in Employment and Employability Institute for job search, People's Association for community events and Social Service Offices for financial aid applications. One contact, one coordinator, for the whole senior as a person and being.
Second, to measure what truly matters. In our October Sitting, the Ministry's reply on tracking social isolation focused on attendance and outreach numbers. Loneliness cuts deeper and these numbers only scratch the surface. I ask the Ministry to partner with our educational institutes to conduct regular, widespread surveys on the social determinants of health. We need a localised version of "Quality of Life" indicators to understand how our efforts are truly reducing isolation.
Third, bringing specialist healthcare to the heartlands. Not being able to eat, hear or walk, is directly linked to cognitive decline and increased mortality. Yet, access to specialised help remains a hurdle. I ask the Ministry to ramp up dental, audiology and podiatry facilities, specifically to estates with high concentrations of seniors. We must catch these impairments before the rapid decline in quality of life.
Fourth, I ask the Ministry to consider introducing degree or diploma courses for audiology and podiatry in tertiary institutions, to increase the number of Singaporeans specialising in these areas and in turn, be better able to serve our seniors who require such specialised care.
By streamlining access, measuring what matters, expanding specialist care and building local expertise, we ensure our seniors are not just "ageing", but are living with agency.
Enhancing Elderly Care and Support
Mr Yip Hon Weng (Yio Chu Kang) : Mr Chairman, Singaporeans enjoy a long-life expectancy. But are we adding life to years or merely years to life? As healthcare shifts from hospital to home, the real test lies not only in infrastructure, but in the relationships we nurture, the support we organise and the dignity we uphold.
First, social isolation. In our dense estates, many seniors live in loneliness, surrounded by neighbours, yet separated by silence. Countries, like the Netherlands and Denmark, embed social prescribing into primary care, recognising that a prescription can be a person, a purpose and a place to belong.
Mental health support for depression, anxiety and grief remains under-resourced. Suffering in old age is often invisible, yet deeply felt. Can MOH update us on formalising social prescribing in primary care and outcomes under Healthier SG? How are we integrating routine mental health screening into community eldercare, so distress is detected early?
Under Age Well SG, Active Ageing Centres are expanding to anchor seniors in their communities. Can the Ministry share whether reductions in social isolation and improvements in well-being are being observed?
Second, dementia. Families still struggle to access dementia-specific day care and respite services. Dementia-friendly communities, where confusion is met with compassion rather than stigma, remains uneven. How will MOH accelerate dementia day care and respite capacity? How are we strengthening public education, so stigma recedes and inclusion grows? If we are to age well, we must care well for those who can no longer remember for themselves.
Third, caregivers. Many caregivers face financial strain and burnout despite subsidies. Caregiving should not mean declining health, depleted savings or isolation. Will MOH review respite care so it becomes a standard, easily claimable entitlement? As Age Well SG rolls out integrated community models, how will caregiver burden and coordination outcomes be measured to ensure families experience relief?
Fourth, palliative care. Living well includes dying well. Though many prefer to pass on at home, many still die in hospitals because families lack support. What steps are being taken to expand home-based palliative capacity and equip GPs to provide sustained medical and psychosocial support?
Finally, with the expanded EASE scheme allowing seniors in private homes to tap subsidies for age-friendly fittings, how does this complement Age Well SG's ageing-in-place strategy, and how uptake and impact be tracked?
Mr Chairman, we must now build a community of care that ensures every senior lives not only longer, but with dignity at the end.
Supporting and Recognising Caregivers
Mr Fadli Fawzi (Aljunied) : Mr Chairman, Singapore is becoming a nation of caregivers. Our ageing society means more Singaporeans will spend a significant part of our lives caring for a spouse, sibling, parent or grandparent who becomes frail, disabled or chronically ill. Support exists, but caregivers still experience it as fragmented. Many repeat their story across hospitals and agencies, with no common way to be recognised as a caregiver and no simple front door that follows them across settings.
Unpaid caregiving is not a small matter. A Duke-National University of Singapore study estimated the monetary value of informal caregiving time for seniors, aged 75 and above, who require human assistance, at about $1.28 billion a year.
As it focuses on 75-year-old-plus seniors needing assistance, it likely understates the wider burden. This is why early identification matters. Local integrated care research found that distressed caregivers at baseline had about a one in four chance of remaining distressed 12 months later, and highlighted the importance of assessing and supporting caregivers early, including during hospital discharge planning.
Budget 2026 strengthens long-term care financing, including a $400 million top-up to the Long-term Care Support Fund to fund additional subsidies from CareShield Life enhancements. But financing alone will not solve the recognition and navigation problem, so I asked the Minister to study and pilot a simple tool used in parts of the United Kingdom (UK) – a carer passport. Once a person is verified as a caregiver, they receive a physical and digital credential that enables recognition across touch points and triggers practical support.
What I have in mind is a Singapore-adapted caregiver passport that would allow some discounts at supermarkets, pharmacies and other caregiving-related outlets. More importantly, the caregiver passport should also allow caregivers to be involved in discharge and care planning, speed up linkage to respite and training, enable structured workplace flexibility conversations and support daily life participation through community partners.
I propose starting with two to three precinct pilots, for six to nine months, enrolling about 100 caregivers per pilot, followed by an evaluation to measure take up, navigation outcomes and changes to caregiver strain.
I have three questions for the Minister. First, will MOH seed a caregiver recognition pilot fund to support these pilots, including evaluation, so we can scale up works?
Second, will MOH support a low burden verification model during pilots, such as self-declaration with validation through healthcare or social service touchpoints?
Third, will MOH fund the minimum operating pieces: coordination, simple QR infrastructure, partner onboarding and modest activation support, so that pilots produce evidence for national adoption?
Mr Speaker, recognising caregivers is about strengthening our social infrastructure, so that we can relieve the burden on our caregivers and make support consistent and easy to access for all.
The Chairman : Senior Parliamentary Secretary Eric Chua, you may take your two cuts together.
Unlocking Our Silver Dividend
Mr Eric Chua (Queenstown) : Sir, by 2030, one in four Singaporeans will be 65 or older. This presents both a challenge as well as a tremendous opportunity. Too often, we focus on what seniors lack. It is time to shift that view. Seniors are not liabilities: many are eager and able to contribute meaningfully to society. We must move beyond a deficit mindset and embrace their full potential.
I recently met Prof Linda Fried, distinguished geriatrician, epidemiologist and the first female Dean at Columbia University's Mailman School of Public Health. She is also a trailblazer for co-designing Experience Corps, an inter-generational volunteer programme that engages seniors in their fifties as tutors and mentors for children in public elementary schools, while promoting the health and well-being of the volunteers themselves.
The programme aims for "triple wins": first, to help children succeed academically, especially in early literacy; two, boost the physical, mental and social well-being of older adults; and three, strengthen communities by connecting generations.
The results are striking. Students show improved literacy, better engagement and fewer behavioural issues. Volunteers experience reduced depression, enhanced cognitive function and stronger social connections. Schools report enriched learning environments and deeper community ties.
It seems simple: an engaged senior is a healthy senior. Yet, while we understand the science of social determinants of health, activating it is quite another challenge. MOH's Silver Guardian programme encourages seniors to volunteer at Active Ageing Centres. It is a great start, but we can do more. Empowered seniors do not just enrich their own lives; they strengthen families, schools and communities, shaping a Singapore where every generation thrives. I suggest three ways seniors can contribute.
First, on social mobility. Seniors can help ComLink+ families facing financial, social and emotional strain. Many parents are stretched by work and caregiving, while children may lag behind in literacy and numeracy. Inspired by the Experience Corps, seniors with teaching or professional experience can tutor children, offer knowledge, patience and encouragement. Beyond academics, seniors can also mentor parents, share perspective and life wisdom. In so doing, they provide not just help, but lend stability and hope.
Second, mental health. A peer-reviewed Singapore study of adults aged 21 to 89 found that seniors reported significantly lower levels of depression, anxiety and stress than younger adults during the 2020 pandemic lockdown. By contrast, about one in three youths reports internalising symptoms, such as anxiety, loneliness or depression. Many young people hesitate to involve parents or families in their struggles. Seniors, with their steady, non-judgemental presence and life experience, can offer guidance, comfort and hope; helping young people feel less isolated and more resilient.
Lastly, our heritage. History is most powerful when told through lived experiences. Projects, like Humans of New York, resonate because they are real, unfiltered, human. Our seniors often hold the most meaningful stories of our communities. As community docents, they become living bridges to moments that may never appear in textbooks, but remain a crucial part of our shared memory. Through their stories, we preserve not just events, but the struggles, values and quiet triumphs that shape our heritage and collective humanity.
Sir, our seniors built the Singapore we know today. Their sacrifices laid our foundations, their resilience carried us forward and their wisdom continues to guide us. Let us see seniors not through the lens of limitation, but of possibility. As mentors, tutors, caregivers and docents, they can shape lives and strengthen communities.
Let us build a Singapore where ageing is not feared but celebrated; where every senior feels valued, empowered and connected. For when we uplift our seniors, we honour our past and secure a future defined not only by success, but by dignity, compassion and shared humanity.
Our Dangerous Dalliance with Dopamine
Let me begin this speech not with statistics or policy, but with three simple introductions.
"Hi, I'm Benny. I'm sober and I have stayed away from drugs for the past five years." Most of us would respond with admiration. We understand the discipline required to overcome chemical dependency.
"Hi, I'm Benny. I'm sober and I have stayed away from alcohol for the past five years." Again, we nod silently. We know the toll addiction can take on health, on families, on livelihoods.
But what if I said: "Hi, I'm Benny. I'm sober and I have stayed away from pornography for the past five years." What happens inside us? Do we shift uncomfortably? Suppress a smirk? Or question whether that even counts as sobriety?
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This reaction tells us something important. While we are prepared to discuss substance addictions openly, we remain uneasy when the addiction is behavioural, private and sexual in nature. Pornography addiction is often dismissed as indulgence or simply part of growing up in a digital age. Yet for some individuals, consumption becomes compulsive, distressing and disruptive to daily life.
Today, I rise not to moralise or to condemn desire. I rise to ask whether we are paying sufficient attention to a behavioural addiction that may be quietly emerging, particularly amongst our young people, and to consider what role public health can and should play.
To be sure, dopamine is not the enemy. It is a neurotransmitter essential to how our brains function. It motivates us, reinforces learning and gives us satisfaction after effort and achievement. But dopamine also plays a central role in addiction.
When certain substances or behaviours repeatedly trigger intense reward signals, the brain adapts. Neural pathways strengthen. Over time, the brain begins to prioritise the behaviour associated with that reward. What begins as voluntary can, for some, become difficult to control. Addictive substances, such as drugs and alcohol, are well recognised for this effect. Increasingly, research has examined behavioural addictions, including gambling disorder, gaming disorder and compulsive sexual behaviours, which engage similar reward pathways.
Pornography today is instant, anonymous, inexpensive and available through smartphones at any hour. There are no physical barriers and few natural stopping points. For a subset of individuals, repeated exposure and escalating consumption can entrench patterns that are hard to reverse.
Some international studies suggest that problematic pornography use may affect figures in the low double digits, depending on definitions used. Methodologies differ, but the emerging literature suggests this is not an isolated phenomenon.
Even if prevalence in Singapore is lower, the absolute number affected could still be significant.
We must also situate this issue within the broader digital ecosystem. Modern life is structured around reward cycles. Social media notifications, online gaming achievements, gambling wins, auto-play streaming. Our attention economy is engineered to keep us engaged.
Pornography exists within this larger environment. It is one of many digital stimuli competing for our attention. But it differs in one important aspect: it can shape expectations about intimacy, about consent and about relationships. When exposure begins early, often before emotional maturity has developed, the lessons absorbed may not reflect mutual respect or healthy communication.
In Singapore, conversations about sexuality are often cautious. Families may find them difficult to initiate. Schools approach the topic carefully. Public discourse remains restrained. But silence does not mean protection. When guidance is absent, young people may turn to the Internet as their primary educator, and we all know that the Internet is not designed to teach values.
Technology has industrialised temptation. What once required effort, patience and real human interaction now arrives instantly on screens engineered to capture attention. If our public health response focuses only on treatment after harm, we will always be reacting to damage, rather than building resilience.
Sir, some may ask, why is this a healthcare issue?
Because behavioural addiction reshapes neural pathways. It co-occurs with anxiety and depression. It drives demand for counselling, psychiatric care and family therapy. If we ignore it, it does not disappear. It presents later in our clinics, our IMH wards and our social service agencies.
This is a health issue because it affects brain function, mental health, relational stability and drives demand for counselling and psychiatric services. Individuals struggling with compulsive pornography use often report difficulty concentrating at school or work, escalating consumption despite attempts to stop, secrecy and emotional withdrawal, strained relationships, persistent shame and low self-worth.
This behaviour may begin as stress relief, but over time it can worsen distress. When relationships deteriorate and emotional health declines, the impact is not confined to the private sphere. It affects families, workplaces and communities.
So, as policy-makers concerned with mental health, we cannot ignore emerging behavioural addictions simply because they are uncomfortable to discuss.
Locally, community organisations, such as We Care Community Services, have observed an increase in the number of individuals seeking help for compulsive sexual behaviours, including problematic pornography use. Reporting cases relating to sex, porn and love addiction have risen significantly in recent years. Post-pandemic, those seeking help for online pornography behaviours more than doubled compared with pre-COVID levels.
Most clients are in their 20s. Some cases have also appeared among teenagers, with some of them as young as 12; 12, Sir! These are only the individuals who have come forward. Many more may remain silent due to stigma or uncertainty about who or where to seek help.
Youths today are exposed to explicit content at younger ages, often unintentionally through peer sharing or algorithmic feeds.
In 2024, more than 460 youths aged 19 and below were arrested for sexual crimes. Authorities have noted that early and repeated exposure to sexually explicit materials can be one of several contributing influences shaping young people's understanding of consent and healthy relationships.
Counsellors have also pointed out that without meaningful guidance on boundaries and respect, young people may misinterpret what they see online as normal and acceptable behaviour.
To be sure, we must avoid simplistic conclusions. Family dynamics, peer influence, trauma and broader cultural factors all play roles. But we should not dismiss the potential impact of repeated exposure during formative years.
These are not purely moral questions. These are public health and social stability questions we need to address.
Let me take some time to share one Singaporean's story. Let us call him Dale.
It all began innocently; magazines shared among schoolmates. Then came the Internet, and then a pirated DVD. The images Dale saw disturbed him, yet something in his young mind shifted. Curiosity became habit. Habit became compulsion. Outwardly, Dale functioned: studied, worked, served National Service. Inwardly, he was trapped in a cycle. Stress, rejection, celebration all became triggers. After acting out came the crash: shame, disgust, promises to stop.
He described living a double life. Church on Sundays, alone with his addiction at night. And guilt was crushing. At one point he said, "I think I am born without the capacity to love."
Pornography had shaped intimacy into fantasy and control.
The turning point came when Dale walked into a Sexaholics Anonymous meeting. Ordinary men – fathers, professionals – shared their stories. Dale then realised he was not the only one struggling. Isolation began to break.
With support from We Care, Dale learned to trace his triggers, sit with discomfort and name his emotions instead of numbing them. Recovery was slow and imperfect but deeply human.
Sir, to be sure, this is not a story of moral failure. It is a story of early exposure, silent conditioning, secrecy, shame and courage. Behind the label of "addict" is a human being, once a curious boy, trapped in silence, who needed understanding, community and support.
If we are serious about addressing this issue, we must move from discomfort to evidence-based strategy.
Today, we operate with limited national data. Much of our understanding is extrapolated from international research and community case reports. I propose three steps.
First, commission a rigorous, interdisciplinary national study on problematic pornography use in Singapore. We need to understand prevalence, mental health associations, relational impacts and risk factors. With evidence, we can calibrate responses proportionately and responsibly.
Second, review our digital and sexuality education frameworks. Young people need emotional literacy, digital resilience and grounded understanding of consent and healthy intimacy. Parents too may need support navigating conversations in a rapidly evolving digital landscape. If exposure is increasingly common, then equipping youths and their families with tools to interpret what they encounter responsibly becomes essential.
Third, expanding funding and capacity for community addiction services. If demand for counselling related to behavioural addictions is rising, our support ecosystem must keep pace. Those who seek help should encounter accessible and timely support.
Early intervention is humane, preventive and cost-effective.
Sir, this is not about digital content. It is about mental health. It is about how young people form expectations about relationships. It is about how couples build trust over time. If we want strong families and resilient youths, then we cannot treat this problem as unspeakable. We must treat it as solvable.
We cannot eliminate temptation, but we should not normalise harm. If technology has industrialised temptation, then our response must be to industrialise resilience: thoughtfully, proportionately, with care.
Let us not hesitate simply because the subject is uncomfortable. Let us choose evidence over denial, courage over avoidance and support over stigma. Because the question before us is not whether this issue exists, but whether we can address it together head on.