预算辩论 · 2026-03-05 · 第 15 届国会
2026卫生部供给委员会辩论：预防医疗与AI
MOH Committee of Supply 2026 — Preventive Healthcare & AI
卫生部长王乙康在供给委员会辩论中宣布新加坡正式成为超老龄社会（65岁以上人口超21%），推出ACE-AI预测工具（由Synapxe开发）用于糖尿病及高脂血症风险筛查，强调"AI增强而非AI决定"原则，2027年初推广至所有Healthier SG诊所。同时宣布BRCA1/2基因检测补贴（2026年12月起，最高70%补贴），MediShield Life将覆盖预防性手术（乳房切除术Q3 2026、输卵管卵巢切除术Q4 2026），MediSave慢性病与预防护理限额提升（2027年1月起500/700提至700/1000），惠及91万+患者。
关键要点
- • 新加坡正式成为超老龄社会
- • ACE-AI预测糖尿病/高脂血症风险
- • AI增强而非AI决定原则
- • BRCA1/2基因检测补贴
- • MediSave限额提升惠及91万+患者
推动AI预防医疗，强调临床医生把关
医疗AI预防性应用与健保制度改革
"AI-enhanced, not AI-decided — clinicians remain in the loop."
参与人员（1）
完整译文（中文）
Hansard 英文原文译文 · 翻译日期：2026-05-02
[(程序文本) 预算总目O（续）‒ (程序文本)]
[(程序文本) 继续辩论问题 [2026年3月4日] (程序文本)]
[(程序文本) “将预算总目O的拨款总额减少100元。” ‒ [玛丽亚姆·贾法尔女士]。(程序文本)]
[(程序文本) 再次提出问题。(程序文本)]
主席：卫生国务部长拉哈尤·马哈赞。
上午10时33分
卫生国务部长（拉哈尤·马哈赞女士）：主席先生，我的发言涵盖了本部将护理服务更贴近社区的举措，我们如何加强健康生活的环境和生态系统，以及我们改善人口健康的努力。
随着社会老龄化，改善人口健康和预防保健对于实现更长寿、更健康的生活至关重要。我们通过“健康新加坡”和“乐龄新加坡”将预防医疗嵌入社区，支持居民在仍相对年轻健康时，以及随着年龄增长时的健康需求。
亚历克斯·杨先生和哈米德·拉扎克医生会高兴地知道，关于衰弱和功能健康（如骨质疏松和痴呆症）的“健康新加坡”护理协议正在顺利制定，预计于2028年推出。这些护理协议将确保通过“健康新加坡”的全科医生（GP）更一致地提供循证护理。
玛丽亚姆·贾法尔女士也谈到了改善社区健康，特别是北部地区。我们的数据显示，北部地区糖尿病和高血压的患病率高于全国平均水平，居民的体育活动较少。我们在持续审视这些趋势的原因的同时，也在加大该地区的预防保健力度。
我们将从兀兰镇开始。首先，我们将提升该镇的社区健康站（CHP）。其次，我们将改善社区内由专科医生支持的护理服务的可及性。第三，我们将通过开放社区空间开展锻炼项目、在“健康365”中引入数字导览功能以及赋能本地社区健康倡导者，支持居民参与健康生活活动。
随着老年人年龄增长，因行动不便，前往多科诊所和医院变得困难。许多人也忽视尚未严重或紧急的症状。及早咨询医疗专业人员可以更早发现问题，从而实现更早干预和更好的健康结果。我们赞同哈雷什·辛加拉朱医生的观点，即将患者与社区资源连接起来非常重要，我们正通过将护理直接带入社区来提升医疗服务的可及性。
我很高兴宣布，自今年初起，国大医院集团健康部门已逐步提升兀兰镇的11个社区健康站。这些位于活跃老龄中心（AAC）内的升级社区健康站将每周开放一次。所有居民，包括非老年人，都可以随时前往这些升级社区健康站，获得诸如一般健康咨询、基本健康评估和社会处方服务（包括将居民与社区项目和资源连接）、预防健康和疾病管理支持（包括健康指导、用药评估以及慢性病和衰弱管理项目）、照护者支持及出院后随访等服务。
这些服务由国大医院集团健康部门的社区健康团队提供，团队成员包括社区护士和健康指导员，并根据居民需求引入药剂师、营养师和治疗师。他们还与该地区的全科医生及医院的医疗专业人员密切合作，为患有慢性病和衰弱的居民提供协调护理。例如，糖尿病患者可在升级社区健康站获得持续支持，包括血糖监测和个性化健康咨询，社区健康团队会定期向患者的专科医生更新其进展和病情变化，确保必要时能及早采取干预措施。
对于已经在活跃老龄中心参加项目的老年人，他们也可以方便地咨询医疗人员，无需另行访问。我们还注意到，一些患者因工作安排或行动不便而错过专科预约。为此，兀兰医院将于本月底启动一项新举措，通过兀兰镇的升级社区健康站和与个人的远程会诊，为社区患者提供专科医生支持的护理。
从糖尿病和哮喘开始，选定患者可以选择通过远程会诊，在升级社区健康站接受专科医生支持的门诊护理。患者无需前往兀兰医院，而是在升级社区健康站见健康指导员或护士管理病情，并通过远程会诊获得专科医生的支持。通过定期监测健康状况，护士能够及早发现控制不佳的迹象，与专科医生合作进行早期治疗，帮助患者避免不必要的住院。
兀兰医院还开始为接受结肠镜筛查且筛查结果低风险的选定患者推广远程会诊。患者无需亲自前往兀兰医院，如需帮助，可选择在任何地点（包括社区健康站）远程会诊专科医生。此项服务将进一步扩展至兀兰医院的其他专科和程序。
通过这些服务，患者将在社区护理团队的支持下，在邻里中获得更好的照护，同时减少前往兀兰医院的次数。这将帮助患者以更灵活的方式获得所需护理，同时兼顾其他事务。国大医院集团健康部门估计，此举将节省约500次专科门诊的实体就诊，随着该举措的推广，节省次数预计将进一步增加。
即使我们将医疗服务更贴近社区以提升可及性，我们也认同玛丽亚姆·贾法尔女士的观点，即健康始于个人选择，我们可以设计更健康的生态系统，支持个人在不同环境中做出更好的健康选择。
一个关键环境是居民所居住的邻里。健康促进局（HPB）进行的一项研究发现，居民更愿意参与在日常环境中举办的健康活动，这些环境应当便捷、绿化良好且能无缝融入他们繁忙的生活。他们也重视有趣且由社区驱动的社交体验。
这些见解表明，需要与本地社区合作伙伴采取协作的自下而上的方法。他们既了解居民的需求和偏好，也熟悉邻里的社区空间。他们在促进邻里设施和空间的使用、鼓励参与活动以及建立社交联系方面发挥关键作用，使健康生活既吸引人又可持续。
因此，健康促进局将与本地社区合作伙伴合作，使居民更容易参与健康生活活动。从2026年4月起，更多居民将能在熟悉、便利且宽敞的地点参加锻炼和运动课程，这些地点包括社区大厅、广场和邻近住宅的商场，如888广场和富春社区中心。
在社区举办更多活动的同时，我们将帮助居民探索并更好地利用现有的邻里设施。健康促进局将增强“健康365”手机应用，加入导览和游戏化功能，连接居民与附近的健康和活跃机会。例如，居民可能会被提示完成邻里内公园连接道或步道的快走，并在指定点完成数字“签到”。该功能将于2026年6月起逐步推出。居民通过“健康365”应用追踪参与情况时，仍可获得奖励。
除了基础设施，关键还在于软件——社区的网络和纽带。我们希望居民彼此关心，鼓励亲友、邻居参与更健康的生活方式，建设更健康的人群和更健康的城镇。
健康促进局将支持深刻理解居民需求和社区资源的本地社区利益相关者，共同设计健康生活方式项目。这包括从2026年6月起开发以公民为中心的操作手册，帮助合作伙伴有效规划适合居民的相关活动。
通过集体所有权，居民将受益于为他们量身定制的健康生活方式计划和活动。我们还将共同监测进展，不断完善和改进这些举措。健康促进局（HPB）将探索如何将成功的元素推广到其他城镇。
除了自下而上、社区主导的倡议外，我们还在寻找减轻生活方式风险因素、改善人民健康的方法。一个例子是何亭如女士提到的世代禁烟或无烟世代政策。这意味着从特定出生世代开始限制所有烟草产品的获取。
通过我们目前多管齐下的政策措施、公众教育和戒烟支持，我们在降低吸烟率方面取得了良好进展。吸烟率多年来持续下降，2024年降至8.4%，18至29岁年轻成人的吸烟率更低，约为5%。
我们也在不断审视我们的烟草控制政策，包括一些其他国家正在探索的无烟世代政策。采用世代禁烟政策需要认真考虑。我们对该政策持开放态度，将研究其有效性、影响以及如何在新加坡的背景下实施。
卫生部（MOH）正集中精力打击电子烟的祸害。因此，目前我们将继续关注国际动态，借鉴其他国家实施世代禁烟政策的经验。主席先生，请允许我用马来语说几句话。
（马来语）：[请参阅本地语演讲。] 采用更健康的生活方式是我们社区需要共同努力的目标。2024年全国人口健康调查显示，我们的马来/穆斯林社区在某些方面还有提升空间。首先是健康筛查。马来族群的慢性病筛查率下降了近10个百分点，从2019年的64%降至2024年的55%。乳腺癌筛查率从2019年的29%降至2024年的仅18%。当慢性病和癌症未能早期发现时，可能会出现严重并发症，需要更密集且昂贵的治疗。
我理解健康话题，如筛查，可能让人感到畏惧。因此，能够在熟悉的环境中与值得信赖的医疗工作者交谈以获得指导非常有帮助。对我们社区的许多人来说，清真寺就是提供这种支持的场所。因此，我很高兴宣布，位于兀兰的两座清真寺——安努尔清真寺和尤索夫·伊沙克清真寺，将于2026年9月与国大医院集团（NHG Health）合作，提供社区健康计划（CHP）服务。将提供一系列服务，从一般健康咨询和基础健康评估，到预防健康、疾病管理和出院后跟进支持。
上午10点45分
我们将根据社区需求定制这些服务，例如，咨询可由流利马来语的社区护士和健康教练进行，以帮助减少沟通障碍，尤其是对老年人。NHG Health还将征求阿萨提扎（伊斯兰教教师）的反馈，将信仰指导纳入健康讲座。通过将医疗服务带到社区常去的熟悉场所，并与宗教及社区领袖合作，医疗服务将更易于社区获得。
为了进一步鼓励马来/穆斯林社区进行健康筛查，自2025年5月起，健康促进局试点了“Jom Check!”（让我们检查！）计划。该计划在小组环境中提供个别支持，帮助居民注册“更健康的新加坡”（Healthier SG）并预约健康筛查。这是与多家医疗合作伙伴共同开展的。截至目前，已在全岛组织了16场活动，覆盖超过300名居民，反馈积极。因此，健康促进局将扩大“Jom Check!”计划，惠及更多居民。
像现在定期进行健康筛查这样的小行动，可以预防未来更大的健康问题。通过“更健康的新加坡”，这更容易实现，符合条件的注册者可享受健康筛查的特别补贴。目前，约57%的符合条件居民已注册“更健康的新加坡”，60岁及以上人群的注册率更高，约为70%。我们的社区在过去一年中注册增长最高，这非常令人鼓舞。对于尚未注册的人，我强烈鼓励你们迈出关键一步，今天就注册。
第二个关键问题是肥胖。我们社区中有32%，约三分之一的人肥胖，较2020年的24%上升了近10个百分点。这是一个重大关切，因为肥胖增加了患多种慢性病的风险。全国营养调查显示，我们社区的热量摄入以及甜食和饮料的消费量最高。我们还摄入大量饱和脂肪，这可能与过量使用食用油有关。然而，我相信我们可以做出符合生活方式和文化的小而可持续的改变。事实上，在我们的文化和宗教中，平衡非常重要。照顾好我们的身体是一项神圣的责任。让我们减少糖、钠和饱和脂肪的摄入，吃健康均衡的饮食。
政府与伊斯兰宗教理事会（MUIS）、马来族群教育与发展理事会（MENDAKI）、人民协会亲善坊（PA MESRA）及“守护健康，守护社区”网络（JKJU）合作，将继续支持提升社区健康和福祉的努力。看到社区稳步进步，我感到欣慰。通过重点领域五（FA5）的努力，2025年已有超过9万人参与各类项目。
我们正值斋戒月，这是我们社区决心过更健康生活的理想时机。我们将继续与合作伙伴携手，走进社区。来吧，让我们今天就迈出第一步，报名参加健康计划。
（英文）：主席先生，我们的目标是确保通往更健康生活的道路足够宽广，让每个人都能行走。通过我们的举措，没有人需要独自面对健康之旅。通过与社区合作伙伴和居民携手合作，我们可以建设一个健康生活包容、可及且成为每个人现实的新加坡。
主席：王乙康部长。
社会政策协调部长兼卫生部长（王乙康先生）：主席先生，三年前，即2023年4月，我曾向议会通报，新加坡将在2026年——也就是今年——成为超级老龄社会。届时，65岁及以上人口将达到21%或以上。
如果你考虑到，2025年6月，也就是去年，65岁及以上人口已达20.7%。这一比例每年大约增长一个百分点。因此，我们现在应该已经超过21%。所以，当我发言时，新加坡已经是超级老龄社会。欢迎来到超级老龄的新加坡。
具体转变的时间点是什么时候？实际上，我认为没人知道。我们可以做个估算。那一刻发生了什么？没有什么戏剧性的事情。没有新加坡民防部队的警报声或其他。它悄然来临，也悄然过去。
老龄化不是轰然到来，也不是轻声细语。它悄然进展，带来真实而深远的影响。在卫生部，我们在医院、急诊科、护理院深切感受到这一点，我们正尽最大努力管理工作量，照顾所有病人。
更重要的是，我们多年前就预见了这一人口结构转变，并采取了尽可能多的早期行动。这包括提高商品及服务税以加强财政状况；提高退休和再就业年龄；建设更多适合老年人的街道和两房灵活式及长者公寓；通过银发支持计划、公积金终身计划（CPF LIFE）和医疗保险终身计划（MediShield Life）增强长者的财务保障。
这些政策酝酿已久，帮助缓冲了这一深刻人口转变的影响。
但可以说，准备应对老龄人口最复杂的任务是维持和转型医疗系统。这是我今天想谈的两个主题——维持和转型。让我先谈谈维持医疗系统。
护理需求的增加意味着医疗系统必须扩大容量。我们将变得更大，我们正在这样做。在本届议会开幕时，卫生部补充文件设定了2025年至2030年间新增2800张公立急症及社区医院床位的目标。我们正按计划推进。
然而，满足不断增长的需求并运营更大的系统将花费更多。如果不加以谨慎管理，医疗支出的增加可能会给公共财政和家庭预算带来压力。事实上，如果我们过于奢侈，不加节制，可能会使我们的系统陷入瘫痪。
我们如何确保医疗保健保持负担得起？我认为我们需要从最高层开始，确保国家医疗账单得到控制。否则，这就像泰坦尼克号沉没，而你却在甲板上舀水。它必须保持漂浮。
国家医疗支出——也就是国家的医院账单。记住，这笔账单最终总是由人民支付，无论是通过医疗费用、税收、保险费还是医疗保障缴款。归根结底，始终是人民在买单。
所以，政府可以声称“我们提供廉价甚至免费的医疗保健”。这其实并不完全正确。事实是，医疗保健从来不是真正免费的，即使患者在服务点不支付任何费用，他们也会以其他方式支付。一个无节制消耗医疗资源的病态国家将产生庞大且浪费的账单，这对人口、家庭、患者和人民来说代价非常高昂。
主席先生，征求您的许可，我可以在屏幕上展示几张幻灯片吗？
主席：请讲。[幻灯片已展示给尊敬的议员们。请参见附件1。]
王乙康先生：谢谢。这是一张不同国家的散点图，你们可以看到新加坡是一个异常值，位于右下角。让我来解读这张图。纵轴衡量的是人口在医疗保健上的支出。发达经济体，如屏幕上的不同点，通常在医疗保健上花费约占国内生产总值（GDP）的9%至12%，美国是另一个极端，支出达17%。新加坡的支出低于5%。
横轴是平均寿命。这是国际公认的健康结果的通用衡量标准。新加坡拥有世界上最高的寿命之一。当然，除了寿命之外，还有许多其他健康结果的衡量标准，在所有这些指标上，新加坡都与许多发达经济体相当甚至更好。
那么，我们是如何成为这样的异常值的？我认为这与议员们熟悉的S+3M医疗融资体系密切相关。MediSave是该体系的关键。
新加坡人和我们的雇主将每月收入的一部分存入MediSave。政府也会不时为不同群体提供补贴，我们在本次预算中再次这样做。然后我们用MediSave直接共同支付医疗费用的一小部分。因此，即使是适度的共同支付，也能极大地培养纪律性，减少供应和需求双方的不必要消费。
我们不必走得太远就能想象当这种纪律被削弱时会发生什么。看看新加坡的私人医疗。由于过于慷慨的保险，包括住院保险附加条款，共同支付的纪律被削弱。因此，私人医院账单迅速上升，私人保险费也迅速攀升。一旦魔鬼出瓶，就很难再放回去。但这不会阻止我们尝试，我们会努力。
在我们的S+3M体系中，多方支付者共同承担国家医疗账单。除了共同支付，我们还有像MediShield Life这样的保险计划，它发挥着重要作用。很大一部分费用也由慈善资金支付。我们感谢所有捐赠者和慈善组织。
但最大的比例，约占国家医疗账单的一半，是通过税收收入支付的，作为政府医疗补贴再分配。政府的医疗预算今年约占GDP的2.7%，预计到2030年将升至约3.5%。这0.8个百分点的增长实际上非常显著。这意味着政府的医疗预算将从今年约225亿新元增加到2030年的约300亿新元。
2030年以后，政府的医疗预算可能还会继续增长。我们必须确保这种增长能够由经济增长和税收收入的增加支持。同时，我们必须继续保持这种纪律，避免出现其他地方看到的不可持续的医疗支出水平。
我接下来想谈谈医疗系统的转型。为年轻人口设计的医疗系统与为老龄人口、超级老龄社会设计的系统截然不同。
对于年轻人来说，疾病往往是偶发性的。你住院治疗，接受治疗，出院，然后康复。良好的健康是默认状态。另一方面，老年人的护理过程复杂且持续。当健康时，他们需要预防性护理；生病时，他们需要协调护理，因为他们往往患有多种疾病；出院后，他们需要康复护理和社区随访护理。良好的健康不是默认的，而是老年人持续追求的目标。
因此，我们需要从偶发的医院护理转向跨场所的持续多学科护理。这一转变反映在我们随时间分配医疗资金的方式上。让我在屏幕上展示另一张图表。[请参见附件2。]
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左侧的图表显示的是我们2021年的政府医疗预算高度。右侧的柱状图是2024年。议员们可以看到，总体预算增加了1.5倍。但我想提醒大家注意组成部分。
在本十年初，即2021年，我们医疗部门约四分之三的运营资金用于急性医院护理——即柱状图中的白色部分。剩下的四分之一用于老年护理和人口健康，包括预防和初级护理。
今天，向右看，2024年。预算是2021年的1.5倍，但急性医院护理的比例从四分之三下降到近三分之二——剩余三分之一用于老年护理和人口健康。
具体来说，老年护理的资金比例从2021年的11%上升到2024年的13%——即绿色部分。在同一时期，人口健康的比例从14%增长到19%。这些变化主要由我们的国家项目“更健康的新加坡”和“安享新加坡”推动。
展望未来，这张图表会如何变化？我认为，老年护理的支出比例几乎肯定会进一步增长，因为我们需要更多的护理院、老年护理中心、康复服务和临终关怀。至于人口健康，我们尽力保持其比例在19%左右。随着总支出的增加，仅仅维持这一比例就需要强烈的承诺，继续投资于人口健康。
主席先生，今天，我和卫生部的同事们将谈论进一步转型医疗保健和为未来做好准备的措施。高级国务部长许文远将谈论人力资源。这是一个关键议题，包括我们如何大幅缩短临床心理学家的培训时间。目前需要七到八年，我们将缩短到约五年。高级国务部长陈杰厚将谈论通过技术将护理锚定在社区。
议员们听到拉哈尤国务部长谈论人口健康和预防护理，包括我们在北部地区的工作，那里的慢性病患病率较高。玛丽亚姆·贾法尔女士提出了问题，她错过了那部分发言。
我必须强调——以防她之后提出许多澄清问题——预防护理和人口健康仍然是我们工作的总体战略重点，由“更健康的新加坡”和“安享新加坡”支撑。我感谢玛丽亚姆·贾法尔女士和哈雷什·辛加拉朱博士对此的发言。这是医疗转型的核心，卫生部同意他们提出的许多观点。
我现在将谈论支持医疗转型的三项新举措。
本届供应委员会（COS）和预算辩论的第一个共同话题——人工智能，再次出现。玛丽亚姆·贾法尔女士和朱佩玲博士谈到了人工智能如何加强医疗服务，我们表示赞同。
谈到医疗中的人工智能，我们遵循两个原则。
第一，护理应是人工智能增强的，而非人工智能决定的。临床医生始终参与其中，医疗保健依然是深具人文关怀的事业。
第二，我们采取实用的、基于用例的方法。人工智能不应是寻找钉子的锤子，也不是寻找问题的解决方案。我们在知道它能改善患者结果或护理服务且成本效益合理的地方部署人工智能。
其中一个用例是健康筛查。全球许多人工智能模型已被训练用来预测健康人群在近期内是否可能发展成严重疾病。如果我们适当且负责任地使用，这类工具非常有用。它帮助临床医生更早介入，可以延缓甚至预防严重疾病的发生。
卫生部利用匿名患者数据为本地环境开发了这样一个模型。通过该模型，审查个人当前的健康状况，可以识别他/她在未来三年内患慢性疾病（如糖尿病或高胆固醇）的高风险——高风险定义为75%及以上。
我们选择糖尿病和高胆固醇是因为它们是中风和心脏病发作的主要驱动因素，每天有60名新加坡人受到影响——每天有60名新加坡人发生心脏病发作或中风。如果采取早期行动，如调整生活方式和服用药物，许多病例是可以预防的。
这款人工智能风险评估工具将于2027年初向所有“更健康新加坡”计划的注册医生推广。如果工具将患者标记为高风险，医生可能会建议更显著的生活方式调整，并将三年一次的检查改为每年检查。这些额外的筛查将继续在“更健康新加坡”计划下获得补贴。
第二项举措，我认为是令人兴奋且重要的突破，即利用基因组学加强预防护理。哈米德·拉扎克医生对此提出了问题。
我们生来就带有基因。它们塑造了我们的生物蓝图，确实，许多疾病与我们的遗传特征有关。但我们不必对此抱有宿命论态度。基因不是我们的命运。我们的生活方式和风险管理非常重要。
因此，我们不会盲目地翻查我们的基因蓝图，寻找我们知之甚少的瑕疵和可能的突变。这会给我们所有人带来很多焦虑，我们将成为一个疑病症泛滥的国家！
所以，我们不应盲目猜测，而应聚焦于科学所揭示的蓝图部分。
这意味着采取疾病特异性的方法，识别我们已知会导致某些疾病的遗传特征，并且对这些疾病已有成熟的预防干预和治疗路径。
这正是我们去年针对家族性高胆固醇血症（FH）所做的。FH是一种遗传性疾病，即使在年轻人中也会增加心脏病发作的风险。
FH基因检测项目为胆固醇异常升高的个人提供补贴基因检测。如果检测呈阳性，我们将为其直系亲属提供相同的检测。这就是所谓的级联检测。通过这样做，我们尽力识别新加坡尽可能多的携带FH基因突变的个体，然后采取措施降低他们未来心脏病发作和中风的风险。
接下来我们将介绍另一种遗传疾病，即遗传性乳腺癌和卵巢癌（HBOC）。
据估计，新加坡每150人中就有1人携带与HBOC相关的基因突变，如BRCA1或BRCA2。这些突变显著增加女性一生中患乳腺癌和卵巢癌的风险。
从今年12月起，我们将为有HBOC风险的个体（如有HBOC家族史者）提供补贴基因检测。他们将在检测前后接受遗传咨询。如果检测呈阳性，我们也将为其直系亲属提供检测——级联检测。
预计每年将有超过2000人符合检测资格。
我们将使检测费用负担得起。除了补贴外，检测费用还可使用医疗储蓄（MediSave）抵扣。
对于检测出携带突变者，将提供适当的预防干预。通常包括更频繁的乳腺MRI或乳房X光检查，或口服药物。
患者最终将在医生的咨询下决定适合的干预措施。少数患者可能选择手术干预。议员们可能还记得，著名女演员安吉丽娜·朱莉在发现自己携带BRCA1基因突变后，进行了双侧预防性乳房切除术。
我遇到过新加坡选择预防性乳房切除术以降低乳腺癌风险的女性，如Gwendalyn Too女士，这些女性表现出了极大的勇气。
遗憾的是，她们抱怨无法为此类手术申请保险理赔，因为医疗保险（MediShield Life）通常不覆盖预防性手术。设计如此是有充分理由的，目的是保持保障的重点和保费的可负担性。私人保险则在医疗保险基础上提供补充保障。
哈米德·拉扎克医生和林秀仪女士对此提出了问题。事实上，非营利组织“新加坡她赋权”（SG Her Empowerment，简称SHE）创始人施蒂芬妮·张女士多次向我反映此问题。
我理解这些关切。
随着医学科学的进步，预防护理与治疗护理的界限日益模糊。如果高风险个体无法接受预防性乳房切除术，她很可能最终需要癌症治疗，包括切除乳腺癌细胞或癌变组织的治疗性乳房切除术。
因此，有理由在医疗保险中谨慎扩展覆盖某些选定的预防性手术。我们准备在临床需求明确、滥用风险极低、适合通过保险进行风险分摊且不会给医疗保险计划带来财务负担的情况下实施。
降低乳腺癌风险的预防性乳房切除术，以及预防卵巢癌的双侧输卵管和卵巢切除术，符合这些标准。
因此，我们将于今年晚些时候将医疗保险和医疗储蓄扩展至覆盖HBOC的预防性手术。我还应补充，乳房重建手术也将继续覆盖，与现行政策无异。这将更好地支持女性利用基因组学更好地照顾自身健康。
我认为这是在3月8日国际妇女节前夕一项有意义的政策变革。[掌声]
第三项举措是增加医疗储蓄的使用灵活性，以鼓励早期干预，减少后续并发症。
林志明副教授正确地描述了医疗费用的“块状”特性。确实，有大量文献表明，临终前的医院费用几乎呈垂直上升趋势。因此，即使考虑通胀，平均新加坡人在生命最后10年内的医院费用几乎是前10年的四倍。
这也解释了医疗储蓄提款系统的现有设计及其原因。该系统对复杂治疗和长期住院设有更高的提款限额，且可根据需要提取。这符合医疗储蓄的初衷，即为重大住院事件共同支付费用，无论是突发还是老年时发生。
通过这种设计，扣除补贴、医疗保险和医疗储蓄后，九成新加坡人的补贴住院账单自付费用低于500新元。
然而，人们天性更担心当前的医疗费用，而非潜在的、意外的或未来的“块状”住院账单。
因此，作为缓冲措施，我们设有灵活医疗储蓄（Flexi-MediSave）和医疗储蓄500/700计划，为慢性病管理、扫描、牙科就诊等提供灵活性，同时不过度削弱医疗储蓄应对老年或紧急重大住院账单的初衷。
但自1984年医疗储蓄实施以来，情况已发生变化。那时，新加坡人平均寿命约为73岁。如今，我们活到85岁甚至更长。
一方面，保留医疗储蓄应对重大住院账单仍然重要；另一方面，随着寿命延长，预防护理和慢性病管理的支出需求也增加。
因此，我理解议员们多次提出的各种呼吁，即允许医疗储蓄更灵活使用，涵盖更多慢性病，或者如普里塔姆·辛格先生建议，用于支付更高的私人保险保费。
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但我也持现实观点，无论卫生部多频繁审查医疗储蓄计划，无论我们多大程度放宽和扩大其使用范围，公众和议员们每年在预算辩论期间，甚至预算辩论之外，仍会不断敦促我和卫生部进一步放宽该计划。
这是该计划的“业力”——因为它被设计为医疗融资体系的核心。它必须始终在当前与未来医疗需求之间、慢性病管理与重大住院事件之间权衡。
医疗储蓄计划本质上存在权衡，是零和游戏。更多余额用于反复医疗费用意味着未来住院时余额减少，反之亦然。当这种紧张关系过于严重时，我们将不得不考虑提高缴费率，以便拥有更大的资金池可用。
因此，这种紧张关系是刻意为之，是设计的一部分。我们必须不断且谨慎地管理这种平衡，以确保共付制度得以维系，同时确保负担得起，并保持公积金缴费率对所有人来说合理。
因此，我们持续进行定期审查，研究如何扩大医疗储蓄（MediSave）的使用范围，并提供更灵活的提取方式。例如，我们最近提高了老年人的灵活医疗储蓄限额，并将诊断扫描的年度限额翻倍。
这一次，我们将对MediSave500/700计划进行进一步调整。该计划帮助患者支付慢性病管理计划（CDMP）中疾病的经常性费用。蔡银洲先生和贾瑞德先生对此提出了问题。
目前，患有简单慢性病的个人每年可使用最多500新元，而患有复杂慢性病的个人每年可提取最多700新元。
为了在社区中为预防和慢性护理提供更多支持，我们将把医疗储蓄限额从500/700新元提高到700/1,000新元。这将惠及目前约有91万名使用该计划的患者，其中约20%的患者年度账单超过提取限额。
我们还将扩大CDMP涵盖的疾病清单，新增甲状腺功能亢进症和甲状腺功能减退症。此外，我们正在研究是否可以将其他慢性疾病，如湿疹，纳入CDMP。
随着上述改进，我们将重新命名“MediSave500/700”。这个名字实际上很笨重，每次调整限额都要改名。我们将其更名为“MediSave慢性及预防护理计划”，以反映其覆盖范围。该变更将于2027年1月生效。
在结束这一部分之前，请允许我回应林秀娟女士提出的问题。
感谢她观看我的抖音视频。她提到了附加保险（riders）在为癌症药物清单（CDL）之外的癌症治疗提供额外保障方面的作用。近期对住院附加保险（IP riders）的调整，目的是防止共付额过度减少，因为这会引发“自助餐综合症”，进而导致私立医院账单迅速攀升。涵盖非CDL门诊药物的住院附加保险不会导致这种共付额的侵蚀，因此该功能不会受到调整影响。我还要指出，住院附加保险的调整仅影响新投保人，现有投保人不受影响。我们在调整住院附加保险时，会始终关注癌症患者的利益。主席先生，请用中文发言。
（中文）：[请参阅方言发言。]2026年标志着新加坡进入超高龄社会阶段。我们应以冷静和理智的心态看待这一里程碑，就像庆祝生日一样。虽然作为社会我们集体年龄增长了一岁，但生活照常，没有突发或剧烈变化。
新加坡一向为雨天做准备，我们早已为老龄化社会做好准备。在过去十年中，政府在多个领域逐步调整政策，目标是确保每位新加坡人在老年时获得支持，生病时获得医疗照顾，并拥有住所。
最重要的是确保我们的人民即使身体变老，内心依然年轻。因此，预防医疗已成为卫生部的核心政策重点。
说到卫生部（MOH）或中文“卫生部”，我对这个中文名称有些想法。严格来说，“卫生”更常与卫生清洁相关，但卫生部并不管理卫生清洁事务。卫生清洁事务由可持续发展与环境部管理，该部由傅瑾萱部长领导。然而，从医学角度看，大家都理解“卫生”概念是关于预防、抗击和治疗各种传染病，这仍是我们的重要使命。
然而，现代社会的医疗挑战与过去不同。非传染性疾病，如癌症、心脏病和糖尿病，现在造成的危害远超过传染病。为了更好地反映卫生部的核心政策重点，我们将把卫生部的中文名称改为“保健卫生部”，在名称中加入“保健”二字。当我们的名称反映核心政策重点时，部门的言行自然会随之调整。
有人可能会问，改名是否会花费大量资金。请放心，不会，因为我们的标志、法律文件、文档、网站等大多只使用英文名称。这也凸显了另一个问题。名称变更主要影响未来的媒体报道，开支极少，但其传达的意义非常重要。
我还刚刚宣布了几项新政策。
第一，为了让慢性病医疗费用更负担得起，我们将从明年起把年度医疗储蓄提取限额从500新元提高到700新元，而复杂慢性病患者的年度限额将从700新元提高到1,000新元。
第二，我们将从今年年底开始，为高风险女性提供补贴的遗传检测，检测遗传性乳腺癌和卵巢癌。
第三，我们将利用人工智能（AI）辅助医生预测个人患慢性病的风险，如高胆固醇和糖尿病。对于高风险的新加坡人，我们将通过“更健康的新加坡”计划鼓励他们采取预防措施。
说到人工智能，过去一年，我与卫生部团队访问了美国和中国，学习他们在医疗技术应用方面的经验和做法。在美国，我们参观了几家知名医院。当我问他们哪种AI应用场景最有效时，他们一致认为，利用AI记录患者病史既节省时间又省力，是最佳应用场景。
我赞同这种做法。虽然用例看似简单，但它让每个人都能受益。它鼓励大家接受新技术，理解新技术是帮助我们的，而非威胁我们。
在我们的公立医院，我们已经开始使用AI记录病史。我们的AI能理解英语、普通话、马来语、泰米尔语和粤语。我不确定为什么只有粤语在方言中被支持，但它目前正努力学习其他方言。
有人曾开玩笑说，最有经验的医生会看人或患者；有经验的医生会看病症；经验较少的医生会看电脑。我相信在不久的将来，在AI的帮助下，大多数医生将能更多地关注患者本人，而不仅仅是电脑。
今年，我还访问了中国，参观了一些医院和科技公司。我发现中国医院也大胆尝试新技术，他们的创新勇气值得我们学习。
然而，我们也必须认识到中国和新加坡之间存在差异。例如，在我访问的中国医院，一些传统手术已被机器人手术取代。但机器人手术成本很高，这些费用通常由患者自负，导致医疗保险费上涨。
因此，在新加坡，我们在推广机器人手术或其他技术时非常谨慎。我们必须考虑成本效益和患者的负担能力。
从希波克拉底到华佗，再到人工智能和机器人手术，医疗领域发展迅速。我们将采取多管齐下的方法，制定长期政策，利用高质量医疗团队和具成本效益的技术，为人民带来更好的医疗服务。
（英文）：主席先生，三年前我向议会通报，今年我们将成为超高龄社会，这不是为了制造恐慌，而是为了做好准备。
我们向超高龄社会的过渡是稳步的，而非剧烈的。这反映了有计划的长期规划，包括医疗体系的转型。
事实上，医疗转型本质上是一个长期事业，而非一次性改革。它是无数小步骤的积累，每一步都经过判断和目的性规划，精心执行。今天，我们宣布了进一步的有计划步骤。
主席先生，我希望议会继续支持我们长期规划、长期治理的方法，提前预见未来挑战，并在挑战压倒我们之前采取行动。如果我们这样做，就无需害怕成为超高龄社会。我们可以拥抱它，并充分利用它。
归根结底，定义我们的不是65岁以上新加坡人的比例。我们可以运用更智慧的头脑，少为年龄带走的东西哀悼，多为它留下的东西庆幸。
重要的是，新加坡人不仅寿命更长，而且健康寿命也更长。我们不仅是一个超级老龄化社会，也在努力成为一个超级健康的社会。[掌声]
主席：高级国务部长许宝琨。
卫生部高级国务部长（许宝琨博士）：主席先生，当部长谈到我们迈向超级老龄化国家的旅程时，他强调了一个根本点，那就是我们的人民是医疗转型的核心。我将谈谈我们在医疗领域通过三大支柱推进的人力和护理转型方法。
首先，我们重新设计角色和合理配置护理场所。其次，我们建立人才培养渠道以确保人力资源的可持续性。第三，我们发展一个灵活且敏捷的医疗系统。
请想象这样一个场景：一位患有糖尿病、心脏病和行动不便的患者，需要在不同诊所之间安排多个预约，每次就诊都需要请假，不仅患者本人，有时照顾者也需请假，还需特殊交通安排，且通常需要照顾者陪同。这种支离破碎的体验不仅不便，而且随着人口老龄化和医疗需求日益复杂，这种模式是不可持续的。
我们如何满足老龄化人口日益增长的医疗需求，改善护理体验，同时保持护理质量和标准？
首先，我们重新设计角色和合理配置护理场所。如今，在医院病房中，患者通过由主治医生（PD）领导的团队接受协调护理，主治医生对患者的整体护理计划负责。在新的护理团队模式下，主治医生不必是专科医生。一旦经过培训并评估合格，医院临床医生可以担任主治医生角色，监督、管理和协调护理，整合各类医疗专业人员的意见。患者不必为每种病症见不同医生，从而减少住院期间转诊至其他专科医生的次数。
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出院后，此类患者的护理可以交由其家庭医生负责管理，其中一些家庭医生已接受家庭医学专科培训，能够管理更复杂的病情。
同样，自2015年和2018年起，团队护理模式已在多诊所和初级保健网络中引入。在这种模式下，慢性病患者由由医生、护士和护理协调员组成的多学科护理团队管理。这确保了护理的连续性，并建立了患者与护理团队之间的信任。
针对蔡银洲议员关于在社区提供专科牙科、听力学和足病学服务的询问，我们最近提升了社区健康援助计划（CHAS）牙科补贴，正在扩展多诊所的牙科服务，并加强与社区牙科服务提供者的合作——这些举措将使负担得起的牙科护理更接近我们的老年人居住地。
大多数老年牙科需求可由多诊所和CHAS牙科诊所管理。对于更复杂的病情，专科护理可在医院牙科诊所以及两个国家级专科牙科中心——新加坡国家牙科中心和国立大学口腔健康中心获得。
此外，虽然足病学服务仅在部分多诊所提供，但糖尿病患者的足部筛查服务在所有多诊所及通过各自初级保健网络的“更健康新加坡”全科医生处均可获得。
除了在医院转型护理团队并将护理合理配置到社区外，我们还希望赋能人民，让他们对自身健康负责。我们赞同Haresh Singaraju博士关于社会处方是预防护理和“更健康新加坡”不可或缺部分的愿景。因此，“更健康新加坡”中的健康计划鼓励患者采取生活方式改变，增加运动，减少不健康饮食。
然而，我们承认社会处方尚未普遍采用，我们还有更多工作可以共同推动。我们将与社区合作伙伴合作，使这些干预措施惠及居民。特别是对于老年人，辅助活动中心（AAC）网络将支持他们。国务部长拉哈尤在她的发言中已详细说明。
此外，医院也有各自的社会处方举措。我还想向Pritam Singh议员保证，我们的公立医院已制定加快急诊科紧急病例处理和初级保健向专科门诊紧急转诊的协议。仅凭等待时间不能反映医疗服务质量。患者病情严重程度不同。在世界顶级医院中，病情更紧急和严重的患者会被优先分诊，提前就诊并接受必要的抢救。这就是医疗系统的运作方式。
根据多个来源，议员们也可以自行搜索，新加坡的医疗系统始终排名全球前20。2000年，世界卫生组织将新加坡评为全球第六。我们的公立医疗机构也一直被公认为世界一流。2026年，Newsweek和全球数据平台Statista将新加坡中央医院排名第十，国立大学和陈笃生医院也进入前100。
新加坡医疗系统以可负担的成本实现了良好的健康成果。根据健康指标与评估研究所的数据，我们的预期寿命约为86岁，领先于许多国家，如日本、瑞士、澳大利亚、韩国、英国和美国。另一方面，我们的国家医疗支出占GDP的4.4%，不到其他国家的一半。世界银行2019年报告了这一数据，正如部长之前展示的图表所示，我们确实以远低于其他国家的成本实现了良好的健康成果。
此外，我们的医院有应对床位需求激增的应急措施，包括增加床位、加快临床适宜的出院流程以及推迟非紧急择期手术，以释放急性病床容量。如果需要，医院还可以利用过渡护理设施和移动住院护理@家等设施，增强整体容量。
即使在扩充容量的同时，我们的人民仍是医疗系统的核心。公立医疗机构安排员工轮班，确保员工有足够休息时间，并监测员工在照顾患者过程中的身心健康。这些经验也是我们从近期新冠疫情中学到的。
随着心理健康服务需求增加，心理健康研究所（IMH）将继续作为国家精神科服务中心，重点为复杂精神健康需求患者提供四级护理。Patrick Tay议员会高兴地知道，卫生部已向IMH提供额外资金，提升精神科服务和基础设施，以改善患者护理，打造领先的心理健康培训和教育中心，并确立其在三级和四级精神健康研究中的地位。
我们还在持续提升公立医疗机构的精神科住院、门诊和危机护理能力，以支持患者在同一医院同时获得身心健康服务。在这些方面，护理团队转型提供综合护理——推动团队护理，将护理合理配置到社区，使其更易获得且负担得起，并重新设计角色，使专业人员能够安全地晋升并在顶级岗位发挥作用。
第二大支柱是建立可持续的人力资源渠道。我们当前的医疗人力大致能满足人口的医疗需求。到2030年，我们需要将医疗人力增加20%，以满足预计的人力需求。我们正与高等院校密切合作，推出更多培训路径，通过就业前培训建立强大的本地人才储备。
蔡银洲议员会高兴地知道，国立大学的硕士（听力学）研究生入学课程每两年开设一次，每届平均有13名毕业生。对于足病学，需求通过为本地人才提供海外足病学奖学金和招聘海外培训的足病医生来满足。
针对温立扎尔医生关于在保持专业标准的同时加强本地临床心理学家人才培养管道的提问，我们已与教育部和国大合作，为符合条件的本科生提供加速路径，使其能够在硕士阶段专攻临床心理学，首批招生将于2026年开始。
与现行培训模式不同，现行模式下本科生至少需要七年时间才能成为合格的临床心理学家，其中包括四年心理学学士学位学习，随后一至两年工作经验，然后进入为期两年的心理学（临床）硕士课程。新的本科直升硕士加速路径可在五年内完成。
这将使那些较早确定志向的本科生通过精心设计的课程接受临床心理学培训。该课程包括本科阶段的理论学习和临床训练，培养具备照顾患者所需知识和技能的从业者。
完成该五年课程的毕业生将同时获得荣誉学士学位和硕士学位。
国大新的本科直升硕士加速路径将补充现有的研究生培训管道，包括为具备相关临床工作经验者开设的独立两年制心理学（临床）硕士课程。这些课程共同扩大了我们临床心理学家的人才储备，以满足日益增长的心理健康需求。
医疗工作者依然是我们医疗体系的基石。即使我们开辟了新的培训路径，也实施了多项策略以提升医疗工作者的留任率。
我们曾在本院讨论过吸引和招聘护士的挑战，尤其是在新冠疫情期间。虽然护士流失率已回落至疫情前约7%的水平，但我们将继续努力鼓励更多护士留任并为公共医疗系统贡献力量，同时吸引有志者投身该行业。
2024年，我们推出了“护士恩典、卓越与忠诚奖”计划，并于2025年审查并调整了护士薪酬。2025年，我们还将公共医疗机构的辅助医疗专业人员（AHPs）、药剂师及行政、辅助和支持人员的薪资提高了最多7%。
但仅靠留住医疗工作者不足以构建强健的医疗体系。我们需要不断提升医疗人员技能，以承担新的和扩展的职责。现代医疗不再局限于传统的专业分工。患有多种疾病的患者需要能够无缝协作的专业人员。因此，我们正从僵化的专业培训转向灵活的、基于能力的学习，通过可叠加模块以工学结合的形式进行，尽可能减少离岗时间和对患者护理的影响。
针对辅助医疗专业人员，我们正与高等院校合作，建立相关辅助医疗培训项目的共享能力，以更好支持团队协作的共享护理模式。这些将逐步推行，首先针对2027学年开始学习的学生。
针对心理健康领域，共享能力已在国家心理健康能力培训框架中明确，旨在为辅助医疗专业人员创造“共同语言”。借此，我们的辅助医疗专业人员将更具多功能性，能够更协作地提供整体护理。
针对护理，我们正与理工学院合作，将现有护理专科文凭后课程重新设计为工学结合模式。此举使护士能够在真实工作环境中学习和实践，培训内容直接基于工作活动，帮助护士更快达到胜任和高效水平。
两个高级护理文凭课程——姑息护理和社区健康——将优先以工学结合形式推出。通过提升能力，我们的医疗队伍将更好地提供全面护理。
何亭如女士询问了心理健康专业人员的监管情况。我们将对五个高风险心理学子领域进行注册，以确保高标准的执业、伦理和专业行为，保障公众获得更安全、更高质量的心理服务。这五个领域是临床心理学、临床神经心理学、咨询心理学、教育心理学和法医心理学。
卫生部及合作部委将与新加坡心理学会合作，提高公众对心理学专业的认知，并支持专业人员及相关利益方顺利完成注册流程。详细的注册时间表、要求和路线图将于2027年初公布。
第三个也是最后一个支柱是发展灵活且敏捷的医疗体系，以应对快速变化的医疗需求。心理健康是其中一个例子。
心理健康问题在新冠疫情期间凸显，且仍是卫生部的重要国家议题。何亭如女士和杨伟伦先生对此提出了问题。
自2023年启动国家心理健康与福祉战略以来，我们于2024年成立了国家心理健康办公室，负责协调和监督多机构的心理健康举措。
首先，我们指导心理健康服务提供者采用分层护理模式，改善不同服务提供者间的护理协调，使客户能在最合适的护理环境中获得无缝服务。
其次，我们扩大了初级、社区、急性及长期护理领域的心理健康服务能力。多科诊所和全科医生配备能力，为轻度至中度心理健康状况（如焦虑和抑郁）患者提供护理。社区心理健康团队为有心理健康需求的个人提供多样化支持。
目前，我们拥有71个社区外展团队（CREST）和26个社区干预团队（COMIT），负责为有心理健康需求或痴呆症的老年人及其照护者开展外展、筛查评估、心理干预及服务联结。到2030年，CREST和COMIT团队数量将分别扩大至75个和35个。我们还设立了心理健康一站式服务，方便公众轻松获取和导航心理健康服务。
第三，我们加强了鼓励青少年寻求帮助的支持。青少年可通过社区设点的CREST-Youth和CHAT获得服务。需要心理社会干预者可转介至青少年综合团队。
新近在*Scape推出的Grovve（拼写为g-r-o-v-v-e）也为青少年提供心理健康服务，方便他们在聚集地获得帮助，提升可及性，减少障碍和污名。青少年自助服务如“Let's Talk”和“Ask-a-Therapist”也可通过mindline.sg访问。
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除上述服务外，教育系统内也建立了支持生态。教育工作者和员工接受培训，关注学生的困扰迹象，并将需要进一步支持的学生转介至学校或高等院校的辅导员及社区心理健康专业人员。学生间设有同伴支持结构，互相关注并鼓励有困扰的同学向可信赖的成年人寻求帮助。
青少年还通过学校的品格与公民教育课程及高等院校的心理健康项目，学习建立心理健康和韧性的方法。
第四，我们通过国家心理健康能力培训框架提升社区服务提供者能力，已培训超过16万名前线人员和志愿者，帮助他们识别并引导心理困扰者寻求支持渠道。
第五，我们通过“超越标签”等宣传活动及“健康育儿”和“积极使用指南”等资源，促进公众、家长和青少年的心理健康与福祉教育。
最后，我们与人力部及职安局合作，加强职场心理健康支持。过去两年，心理健康冠军网络成员从54个创始组织增长至800个。
鉴于心理健康问题复杂多面，我们持续与各机构合作，追踪和监测中长期趋势，包括人口整体心理健康与福祉状况，以评估基线以来的改善情况。采用“无错门”策略，促进服务获取和在初级及社区环境中合理安置护理，鼓励个人在无污名的环境中及早寻求帮助，同时避免对心理健康需求的过度医疗化。
我们也听到了蔡艾立先生关于我们的人民为对露骨材料的无声成瘾买单的担忧。对此，我们认识到成瘾不仅影响个人健康，还会影响家庭和更广泛的社会。个人也可能面临潜在的困难，如经济困难和缺乏社会支持。
设在心理健康研究所（IMH）内的国家成瘾管理服务，旨在为寻求成瘾帮助的个人提供治疗和援助。国家成瘾管理服务专注于成瘾医学研究，包括使用致醉物质和互联网及游戏等新兴关注领域。
卫生部（MOH）与社会及家庭发展部、国家社会服务理事会及跨部门其他利益相关者，将继续发展和提升社区成瘾服务的可及性。
先生，医疗保健高度动态且流动性强，患者人口结构和需求不断变化。随着我们共同应对未来的道路和挑战，这三大支柱将协同工作，加强我们医疗体系的核心基础。
我们不仅是在填补职位空缺——我们是在建设一个可持续的劳动力和系统，能够适应、协作并为所有新加坡人提供优质护理。
主席：高级国务部长陈杰豪。
卫生部高级国务部长（陈杰豪先生）：先生，正如翁部长早前在议会所分享，欢迎来到超级老龄化的新加坡。
这一趋势将加速。到2030年，每四个新加坡人中就有一人年龄在65岁及以上，其中四分之一年龄在80岁及以上。在未来十年内，到2040年，每三个老年人中就有一人年龄在80岁及以上。
老年人可能需要更多支持。例如，老年人使用的医院护理量是年轻人的八倍。
因此，我同意许多议员关于其影响的看法。
首先，关于照顾者。如今，看到一位在职成年人支持60多岁的年迈父母，而这些父母又照顾80多岁的祖父母，这种情况并不罕见。我在我的选区确实看到许多这样的家庭。随着家庭规模持续缩小，照顾者的负担将加重。
其次，医疗系统将面临越来越大的压力。如果一半的老年人至少患有一种慢性疾病，到2030年我们将需要照顾近50万名老年人，而去年约为40万人。
这就是为什么我们希望老年人尽可能保持健康。正如部长所说，这不仅仅是活得更长，而是活得更健康更长久。
今天，我将概述我们如何做到这一点，以技术为助力。首先，让老年人在社区中健康老龄化。其次，为他们提供全方位照护。第三，支持医疗服务提供者实现更好成果。
正如多位议员指出，许多老年人面临社会孤立。一项研究估计，这种风险相当于每天吸15支香烟。
议员们应该熟悉银发一代办公室（SGO）。自2022年以来，SGO已开始预防性健康访问，接触了超过60万名老年人，并将有需要者连接到辅助活动中心（AACs）、老年护理中心（SCCs）和社区心理健康服务等。
鉴于较年轻的老年人更懂数字技术，SGO通过LifeSG应用程序接触这部分群体。自去年12月以来，已有超过3,000名老年人收到个性化的服务推荐。尚未使用该服务的老年人，请下载LifeSG应用程序了解详情。
过去两年，我们将辅助活动中心网络从154个扩大到230多个，目前服务约10万名老年人。超过150个老年护理中心提供日间护理服务，包括痴呆症患者和临时照护，90多个社区外展和干预团队提供心理社会支持。我们将继续扩大这些服务。
黄志明先生、叶汉荣先生和法兹里·法兹维先生为照顾者发声，并提及其他国家如何认可和支持照顾者。
与议员们一样，我们相信照顾者扮演着重要角色，我们正在加大支持力度。我们正在提升长期护理补贴和资助。今年，我们将人均家庭收入（PCHI）门槛从3,600新元提高到4,800新元，覆盖约七成家庭。我想向黄志明先生和玛丽亚姆·贾法尔女士保证，这些补贴不依赖于日常生活活动需求的数量。
去年，超过14,000名老年人的照顾者受益于补贴的居家和中心临时照护服务。我们将做得更多。
从4月1日起，超过5,600名符合条件的老年人及其照顾者可享受升级的居家个人护理服务，包括居家临时照护、用药提醒及24/7技术支持的跌倒检测和事件报告。
议员们还谈到了兼顾工作和照护的照顾者。我们理解他们的挑战。各部委提供支持，例如弹性工作安排和照顾者培训补助，帮助抵消家庭照顾者和外籍家庭佣工的培训费用。符合条件的照顾者还可享受增强的育婴假政策，如新的共享育婴假和无薪婴儿护理假。
我们将继续研究议员们的建议，探索更好支持照顾者的方法。
赖伟强先生谈到了依赖PCHI评估家庭照护情况可能带来的意外后果。我理解他的担忧。PCHI的收入测试方法已在上周预算辩论中讨论。卫生部将参考该框架。然而，处于困难境地且需要额外支持的个人可联系医疗社会工作者。
赖先生提出了几项改进现有框架的建议。卫生部将与财政部共同研究这些建议。
何德仁副教授和蔡艾立先生倡导老年人参与社区贡献，包括帮助其他老年人。我同意。这种参与赋予老年人目标感。老年人可参与志愿服务，一些组织提供培训和津贴。
例如，作为银发一代大使，他们帮助开展对其他老年人的外展活动。老年人还可加入新加坡医疗志愿军，协助基本患者护理。50岁及以上者占这些项目志愿者的20%至40%。我们欢迎更多合作伙伴加入此项工作。
让我转向生命终结的话题。
我同意叶汉荣先生的观点，我们希望老年人“善终”，或如中文所说，“安然离去”。自2023年以来，我们大幅扩展了社区姑息治疗服务，提升补贴并促进临终出院。我们希望更多新加坡人在家中度过最后时光，在舒适的环境中，身边有亲人陪伴。
反响积极。截至2025年6月，居家姑息治疗的使用率约为90%。随着需求增长，我们将扩大容量。我们希望继续支持希望在家陪伴亲人走完最后旅程的家庭。
接下来，我向蔡银洲先生和叶汉荣先生保证，我们确实跟踪项目成果，如虚弱患病率、社会参与和照顾者福祉。我们与包括研究机构在内的不同方合作进行跟踪。
现在让我谈谈护理服务转型。到2030年，约有10万名老年人需要至少一项日常活动帮助，如进食或洗澡。他们可能需要来自不同服务提供者的服务。我们希望他们的体验尽可能无缝，不必东奔西跑才能获得服务。技术将是实现更紧密护理协调的关键助力。
我同意蔡先生的观点，我们希望让老年人更容易获得社会和健康服务。
首先，我们在新加坡84个子区域引入了综合社区护理提供者。这意味着每个区域有单一方协调老年人的护理。目前，老年人接受多个服务提供者的多次护理评估。这不仅造成服务提供者的重复工作，也给老年人带来不便，且可能因不同护理计划导致护理不协调。
我们将简化整个流程。从下个月起，需要多项长期护理服务的老年人只需由综合社区护理提供者使用标准化、国际认可的工具进行一次全面评估。每位老年人将基于该评估制定单一社区护理计划。老年人所访问的每个服务提供者都将参考该护理计划。
这种方法将确保老年人享受到无缝的体验和更好协调的护理。我们将从今年十月开始逐步推行这一举措。我们通过为社区护理提供者建立一个通用的信息技术平台，来实现这种新的协调和服务交付方式。
阿扎尔·奥斯曼先生询问了远程会诊的问题。我请该议员参考高级国务部长许宝琨最近对国会提问的回应。基本上，卫生部同意议员的观点，利用科技改善患者的医疗体验。
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例如，2022年推出的生产力与数字化补助金已支持了240多个项目，如自动化淋浴和生命体征监测系统。我们打算加强该补助金，以更好地利用医疗保健领域的技术解决方案，包括利用机器人技术和人工智能。
先生，当我在一月份向本院介绍《健康信息法案》时，我曾表示卫生部将协助医疗服务提供者遵守相关条款。我很高兴提供最新进展。
首先，我们正在与医疗服务提供者使用的健康信息管理系统供应商合作，以确保符合必要的要求。其次，我们将提供资源指南和培训，帮助医疗服务提供者及其员工理解并实施这些要求。第三，我们将启动国家电子健康记录（NEHR）连接补助金，并于今年七月开放申请。
该补助金将抵消医疗服务提供者接入全国电子健康记录（NEHR）的费用。对于典型的医疗服务提供者，该补助金将覆盖健康信息管理系统最多两年的订阅费用。对于拥有内部系统的提供者，资金支持将覆盖最多40%的系统升级费用。卫生部将拨出最多4500万新元用于此项工作。
让我举例说明这项工作如何适用于一个拥有五名员工的典型诊所。他们中的大多数已经订阅了健康信息管理系统。他们可以申请并受益于国家电子健康记录连接补助金。除了国家电子健康记录连接补助金外，诊所还可以获得新加坡网络安全局高达70%的共同资助，以聘请网络安全顾问。他们还可以获得新加坡企业发展局高达50%的资金支持，用于采用网络安全解决方案，例如反恶意软件解决方案。总的来说，诊所可以获得大约20,000新元的补助金。先生，请用普通话讲。
（用普通话）：[请参阅方言发言。] 在农历新年期间，互致问候时，我注意到长辈们现在说“恭喜发财”的少了。取而代之的是，他们经常说“身体健康！”。他们明白保持健康的重要性，尤其是在疫情之后。
为了鼓励老年人保持身心健康，我们已经建立了230多个辅助活动中心。今年，我们还将指定综合社区护理服务提供者。
护理团队将根据老年人的需求协调和规划更全面的医疗保健。例如，如果老年人需要家庭个人护理服务以及访问老年护理中心，他们只需联系一个护理团队，减少了与不同社区护理提供者联络的麻烦。
我们也在积极利用科技，为新加坡人提供更精准、更便捷的护理体验。例如，面临跌倒风险的长者可以享受增强版居家个人护理服务下的24小时智能监测。如果不幸发生意外，系统能够及时通知相关人员提供帮助。这样，家属也能安心。
如今，越来越多的老年人变得精通科技。因此，我们推出了LifeSG应用程序。通过LifeSG，新加坡老年人理事会（SGO）可以与老年人互动，并为他们制定个性化的健康计划。
自去年十二月以来，已有超过3,000名老年人受益。从今年七月起，全科医生可以在其计算机系统中查看由专科医生、医院及其他医疗机构之前记录的患者健康档案。通过这种方式，医生能够更全面地了解患者的状况，为他们制定最合适的个性化健康计划，并免去患者重复叙述病史的麻烦。老年人无需担心记住医生所诊断的疾病或所开具的药物。
俗话说，“家有一老，如有一宝”。我们将利用科技提升护理质量，确保长者在熟悉的环境中接受治疗。我们也将继续扩大这些服务，让每位长者都能获得所需的关怀和支持。我们希望我们的宝贝——家中的长者——能够幸福地生活，在家中安享晚年。
（英文）：通过《健康信息法》和其他数字健康优先事项，我们正在建设一个更加互联、响应迅速且安全的医疗系统。这是为了支持我们更广泛的医疗转型，将护理扎根于社区，提供更多围绕老年人的协调服务。重要的是，一个以人为本的医疗系统。
主席：我们有时间进行澄清。玛丽亚姆·贾法尔女士。
玛丽亚姆·贾法尔女士（实龙岗）：谢谢您，先生。部长实际上并没有直接回应我在发言中提出的许多具体问题，但他确实承认有许多好点子。因此，我期待未来能看到其中一些想法的落实，但今天我想重点澄清三点。
第一个问题是关于拉哈尤国务部长在兀兰试点项目上的发言。感谢她的分享。我的澄清是，卫生部如何与其他机构合作，以最大限度地发挥该试点项目的效果？拥有健康促进局的数字导航系统来寻找健康食品选项是一回事，另一件事是增加健康食品选项的数量，特别是清真食品选项。这就需要与国家发展部等部门合作。因为当我们在一个咖啡店里只有一家清真店铺，且只供应印度煎饼和炒面时，依赖这些食品很难维持健康的生活方式。
我第二个澄清是关于人工智能话题，想请教部长。作为一名顾问，我完全支持实用案例的方法。重要的是这些用例必须能够规模化；他提到的一些内容确实做到了这一点。但规模化也需要在基础设施、治理和人才方面做大量工作，这些我在即席发言中也提到了。所以，我想知道他是否能就此发表一些看法。
我的第三个澄清问题也是给部长的，我很高兴听到关于MediSave500/700的变化，或者我们现在称之为MediSave慢性病和MediSave预防护理。这实际上完全是我关于MediSave灵活使用建议的核心。部长分享了关于预防护理医疗支出的数据，例如，但目前有多少MediSave被用于慢性病和预防护理？卫生部是否做过任何模型分析，如果我们基于余额设立MediSave慢性病和MediSave预防护理，这将如何影响可持续性？
王乙康先生：我先从第二个问题——人工智能规模化开始。她提出的观点，我们都同意。所以，我没有太多补充，但我想玛丽亚姆·贾法尔女士也知道我们采取的所有措施，她在发言中也提到了。就信息技术基础设施而言，国家电子健康记录（NEHR）、下一代电子病历、HEALIX、新加坡公共医疗的人工智能医学影像平台。我们在幕后默默搭建了这些系统，同时加强了网络安全。因此，已经完成了大量的基础工作。
因此，我们现在已经处于一个阶段，如果某个用例在特定沙盒中的医院被证明是有用的，我们可以将其规模扩大。这花费了多年的准备时间。我认为我们现在已经准备好以非常积极的方式去做这件事。
至于医疗储蓄账户（MediSave），进行建模是很困难的。我们可以做，但事实是，不同人群的需求差异非常大。
前段时间，我们在议会中回答了一个问题，即85岁及以上的人去世时，其医疗储蓄账户（MediSave）余额是多少。我们整理了2017年至2021年的数据。结果显示，20%的人余额少于1,000新元；50%的人余额在1,000至10,000新元之间；30%的人余额超过10,000新元。那么，这是否过多？这取决于我们谈论的是谁。那些拥有10,000至30,000新元的人，我认为这已经很多了。那些余额少于1,000新元的人，我认为几乎不够用。
我们确实需要为他们的老年储蓄医疗储蓄账户。因此，我认为有些议员提出了这个建议：我们是否可以根据余额给予更多的灵活性？我们能否放宽一些规则？从概念上讲这是正确的，但实际上并不容易。这不仅仅是建模的问题，而是能够满足个别情况的需求。
对于适用于全体人口的计划来说，制定精准的政策从来都不容易。但我们会尝试。我们会努力。我们会采纳建议，尽力而为。
既然我站在这里，我就代表拉哈尤国务部长回答。针对北部地区，我们可能会与社区内的其他机构合作，考虑不同的事项。关于更多的清真食品选择和健康选择，让我们坐下来看看是否能与包括国家环境局在内的其他机构合作。
但我们考虑的实际上是一个护理模式，而不仅仅是食物。我们会对此进行研究。这个护理模式鼓励居民进行早期检查，注册“更健康的新加坡”计划，并在社区医疗伙伴（CHP）的支持下，使流程非常简单，提供非常便捷的接触点。我们将与当地国会议员和顾问一起，确保更多人响应我们的预防护理推动。
主席：哈雷什·辛加拉朱博士。
哈雷什·辛加拉朱博士（提名议员）：主席，我有两个问题，围绕临床能力。首先是关于团队护理，正如高级国务部长所提，这一模式自2015年起已存在，集群医疗机构在这方面做了大量工作并建立了框架。
然而，许多由护士、药剂师和辅助医疗人员主导的服务利用率偏低。卫生部将如何在国家层面帮助患者和公民理解并信任这些服务提供者所提供的护理？第二个问题是关于“更健康的新加坡”计划的注册，我们有居民在公私部门均有注册。我们是否研究过如何加强这种关系，避免患者在不同提供者间漂移？
许宝琨博士：先生，感谢议员的两个问题。关于第一个问题，团队护理及某些辅助医疗人员主导服务利用率偏低，我们承认这是我们必须持续应对的挑战，因为患者有自主权选择最终接受护理的专业人员。因此，我们无法强制患者必须看特定专业人士，这就是为什么建立信任关系非常重要。
同时，我们也在传递这些专业人员经过培训并获得认证，能够提供更高水平的服务。随着时间推移，我们希望患者的实际体验能够验证他们所期望的护理效果，从而逐步在社区中建立信心和信任，患者也会逐渐接受我们所引导的转诊路径。
我们在社区医疗伙伴中采取的措施之一是让更多护士成为许多老年人对话的主导者。这是向老年人和患者普及护士能够提供许多所需护理的好方法。因此，这需要多管齐下的方式，也需要时间。但我们也越来越看到，这种能力将被更好地利用。
关于第二个问题，尤其是在“更健康的新加坡”计划中不同提供者的注册情况，这确实是我们需要持续努力的方向。因为除了注册之外，还涉及患者是否能很好地跟进护理计划的实施。我们并不幻想仅凭推出“更健康的新加坡”计划，初期一切就会非常顺利。
这不仅需要提供者、医生和护理团队的系统变革，也需要我们人口心态的逐步转变。因此，这是一个持续的过程，没有灵丹妙药，也不是一蹴而就的。
12点15分
主席：哈米德·拉扎克博士。
哈米德·拉扎克博士（西海岸-裕廊西）：主席，我想提出两个澄清问题。首先，针对拉哈尤国务部长。我非常欢迎2028年起针对骨质疏松症等虚弱症的护理协议。我想问，作为护理协议的一部分，是否会有有意的策略，将早期教育纳入30至40岁人群，正因为骨量峰值和肌肉峰值发生较早，通过生活方式干预如营养、抗阻训练和维生素D，是否会将其纳入策略，以便我们不仅将其视为老龄化问题，而是作为全生命周期的预防策略？
第二个澄清给部长。我认为许多医生会欢迎将遗传性癌症纳入保障范围。我想问，因为这是高风险群体，风险降低治疗成本肯定很高，而“医疗保险生命”（MediShield Life）是风险共担原则，这可能存在利益冲突。卫生部是否会考虑为“医疗保险生命”的设计及高风险个体的治疗费用采用单一概念，而非零散治疗？因为健康乳房的风险降低治疗与已检测出癌症的乳房治疗之间可能存在时间差，这将是个人一生的额外成本。
拉哈尤·马哈赞女士：感谢您的提问。护理协议仍在制定中。感谢议员的建议——这是我们可以考虑的内容。我们会参考筛查测试审查委员会和护理效果机构的临床指南，利用相关证据和数据来确定协议内容。议员提出的建议我们会带回去考虑纳入。
王乙康先生：关于遗传性乳腺卵巢癌（HBOC），希望我理解议员的问题正确。我们实际上做过模型分析，因为风险降低性乳房切除术能节省未来治疗费用，整体对“医疗保险生命”的影响非常小，这也是我们愿意推行的原因。
主席：朱佩玲博士。
朱佩玲博士（蔡厝港）：主席，感谢部长详尽的回应。在新加坡最新的城镇——中大镇，许多年轻家庭正在发生一件非常特别的事情。自去年以来，我在居民中遇到了19对双胞胎。这反映了许多中大镇夫妇正处于组建家庭的阶段。
正如部长所指出，年轻人口的医疗需求往往是偶发性的。但像中大镇这样的城镇也为我们提供了一个难得的机会，可以从早期开始预防。部长能否分享卫生部如何与其他机构合作，将预防健康纳入新城镇建设，从一开始就融入，而不是等人口老龄化后才引入？
王乙康先生：一些基本步骤——就像果树，我们先摘低垂的果实，然后逐渐摘更高的。有时我们会先考虑最高的。最低的就是哈雷什博士提到的，我们必须坚持一个医生，一个全科医生，他成为我们的家庭医生，为我们的家庭健康提供建议。因此，有了“更健康的新加坡”计划。
所以，对于像中大镇这样的新城镇，请尽可能多地让居民注册“更健康的新加坡”计划。之后，确保他们跟进体检、疫苗接种和健康筛查。如果议员能推广戒烟，打击电子烟，这些都是确保健康的基本步骤。把这些都落实好。
除此之外，我们非常乐意与朱博士及其他机构合作，看看还能在中大镇实施哪些健康项目。
主席：何亭如女士。
何亭如女士（盛港）：先生，我有三个澄清问题要问高级国务部长许宝琨。第一个是关于临床心理学家的新加速路径。我的澄清是，预计未来通过该路径进入该职业的人数会增加多少？
我的下一个澄清是关于心理学家注册的宣布。我感谢卫生部的宣布。我知道该职业中有很多人非常期待这个消息，他们听到后非常高兴。我有两个澄清问题，实际上这两个问题是我发言时被删减的部分。
第一个问题是，对于有志进入该行业的人士，有什么支持措施？因为正如我提到的，实习和监督费用可能相当高昂。我的澄清是，卫生部正在做什么，或者卫生部如何看待解决那些有志进入该行业的专业人士面临的入行障碍问题？第二点是，对于那些实际上寻求这些服务的客户来说，在这些注册要求生效之前，如果他们对专业伦理和标准有疑虑，他们有什么申诉途径和支持？
许宝琨医生：先生，感谢议员提出的三个澄清问题。关于第一个问题，即最终会有多少心理学家进入系统，以及新路径在增加人数方面意味着什么，我认为目前很难判断。该课程的初期招生人数大约只有10人。因此，我们也将观察首批招生的反应。但请注意，现有心理学家也有升级的途径，这是现有的路径。我们需要感知本科生以及在职心理学家整体的需求情况。
挑战还在于，因为我们之前没有对心理学家进行注册，所以我们没有准确的数据知道有多少心理学家。但据我所知，新加坡心理学会大约有1700名会员，其中大多数也在临床领域执业。如果以此作为大致估计，这大概就是我们正式进行注册时的起始人数。但随着注册的实施，我们将更好地掌握实际情况。
关于第二个问题，即对有志报读该课程的学生会提供什么支持，我们仍在与相关院校讨论中。但我认为，最低要求是他们必须符合入学标准，因为这是我们不能降低的标准。除此之外，其他支持措施，比如是否会对学费提供补贴，据我了解，大致会与现有高等院校的政策保持一致。因此，如果你是新加坡学生，预计会有一定的学费补贴。
第三个问题是，公众如果想寻求心理护理，如何辨别谁是合法的。在注册生效之前，我们很难提供详细的个别专家或心理学家的名单。但他们可以先查验该人士是否至少注册于新加坡心理学会。因为至少这是一个被认可的同行专业社区，所以这是目前的一个起点。当然，对于在我们公共医疗机构执业的心理学家，已经有治理框架，公众至少可以放心，这些心理学家已经接受监督并被公共医疗机构认可。
主席：普里塔姆·辛格先生。
普里塔姆·辛格先生（阿裕尼）：我有两个问题。第一个与我对医疗人力的关注有关。我也注意到多位官员提到我们已进入超级老龄社会。针对这一点，卫生部是否在考虑新的指标或数据点，以反映医疗系统在这一新环境下的运行情况？例如，卫生部现在发布的医疗机构统计数据，包括急诊科就诊人数、入院时间和床位占用率，我认为这些数据很有帮助。
但是否还有其他指标也对公众有帮助，比如诊所的等候时间？是否有其他指标能反映医疗系统的表现，尤其是在我们所处的新环境下？
我的第二个澄清问题涉及我之前提到的额外提款限额。我理解部长关于医疗储蓄账户（MediSave）及其“因果报应”的观点，即对医疗储蓄的需求总是很大，以应对开支。当然，随着基本医疗保障金额逐年增加，这在某种程度上是不可避免的。基于此，我想询问是否会考虑通过医疗储蓄账户提高额外提款限额？
王乙康先生：我会把普里塔姆·辛格先生的建议放入我们的愿望清单，这个清单已经相当长了。我们每年都会审查，下一次会全面审视愿望清单。但为了管理议员的期望，我想说医疗储蓄账户的重点，我完全理解大额一次性支出与经常性开支之间的矛盾。但所有这些都是在确保补贴医疗可负担且最大限度减少新加坡人自付费用的背景下进行的。额外提款限额是针对私人保险的，我们会记住这一点。
至于议员的第一个问题，卫生部有很多指标。如果议员提交国会质询，我可以提供很多指标，告诉他我们正在监控的内容，包括等候时间、急诊科、诊所、床位占用率、不同环境下的平均住院时间等，这些都是即时的运营指标。
中期来看，我们希望在“更健康的新加坡”计划的注册人数、随访检查、筛查率、疫苗接种率等方面取得成效。长期来看，则关注人口健康状况，比如慢性病患病率、癌症死亡率等。关键绩效指标（KPI）数量达到数百个，我们会持续监控所有这些指标。
主席：蔡银洲先生。
蔡银洲先生（碧山-大巴窑）：主席，我有四个补充问题。第一个是给许宝琨高级国务部长。提到有听力学硕士课程，但我想问是否有计划开设听力学文凭或本科课程，以及足病学课程，据我了解，国大医学院网站上显示我们没有本地相关课程。
第二个澄清问题是给陈振声高级国务部长，关于支持照顾者的灵活工作安排。我理解灵活工作安排因情境和工作场所不同而异。卫生部如何帮助正式确认照顾者身份，并合法化他们对灵活性的需求，使他们能更好地向雇主说明需要灵活工作的理由？
第三个问题是关于综合社区护理提供者安排。感谢陈振声高级国务部长分享“一次护理评估计划”和一次临床评估。未来是否会有改进，除了临床结果外，还能进行一次财务评估，以及为可能寻找兼职工作的长者提供一名就业协调员？
最后一个问题是关于社会处方。我们确实看到社会处方在对抗孤独感方面的需求，正如陈振声高级国务部长所强调，孤独感相当于每天吸15支烟。我的问题是，既然我们衡量医疗处方，那么社会处方如何被衡量，干预措施如何被追踪？
我的问题还源于我之前提交的国会质询中提到的辅助活动中心（AAC）参与度作为衡量标准。我们如何更好地考虑长者可能活跃的其他领域，比如信仰团体、社区俱乐部或中心活动，或他们可能参与的课程志愿服务？我们如何将这些纳入考量？陈振声高级国务部长也提到正在与学校进行研究，如果他能分享更多细节，将不胜感激。
许宝琨医生：先生，感谢议员关于听力学家的提问。一般来说，新加坡合格的听力学家需要较高的资格认证，因为文凭水平可能不足以胜任相关工作。我们会考虑是否有办法找到一个中间方案。但最终，我们不能为了满足想通过短期课程进入该领域的人的需求而牺牲标准。首要任务是保持标准。
但实际上，有些听力学课程是在较低层次进行的。例如，我确实相信淡马锡理工学院有一些基础的工业听力测量课程，但那更多是针对工业应用，供实际在工业层面进行筛查的技术人员使用，而不是临床环境中在医院提供服务的那种。
中午12点30分
王乙康先生：我来回答最后一个问题，前两个问题由高级国务部长陈杰豪回答。
社会处方，能被追踪吗？现实情况是，不能被追踪，因为那是你的生活。我们在这里提供支持和资金，让你尽可能轻松地来到辅助活动中心参与。但至于你如何生活，我恐怕无法追踪，也不认为我应该追踪。但请至少注册使用Healthy 365——这个应用程序会帮助你追踪。
陈杰豪先生：主席，我会尝试回答蔡先生的问题。蔡先生，如果我听错了你的问题，请纠正我，因为我试图理解你的四个问题。其中一个问题是，社会处方是否是“一站式关怀评估计划”的一部分。实际上，这是“更健康的新加坡”计划的一部分，关怀计划也包括社会处方。例如，饮食、生活方式、锻炼以及许多其他方面。所以，这当然应该是该关怀计划的一部分，但这超出了综合社区关怀服务提供者的职责范围，后者更关注老年人及其需求。
蔡先生还问综合社区关怀服务提供者和综合关怀机构是否能满足不同类型的活动需求，比如基于信仰的志愿服务，或者对园艺感兴趣的老年人作为社交活动。
我想说的是，我们今年开始推出综合社区关怀服务提供者框架，并将在未来几年持续推进。这是一个涵盖新加坡84个子区域的非凡工程——将不同的各方和合作伙伴聚集在一起。在每个区域、每个子区域，都有不同的服务提供者和各方提供不同的服务——从陪伴服务、康复服务到更多其他服务。
因此，将不同的合作伙伴聚集在一起，形成共同的语言来讨论、理解、接触并为老年人提供服务，这并非易事。基于此评估开发标准化工具，制定关怀计划，实施关怀计划，并让我们的老年人完整经历该关怀计划，也都不简单。所以，我想说，让我们一步步来，社区中已经有许多活动和其他合作伙伴提供不同的服务和志愿机会给老年人。我们欢迎这些，这确实是多元社区结构的一部分，也是“我们优先”社会的重要组成部分。
主席：法兹利·法兹维先生。
法兹利·法兹维先生（阿裕尼）：主席，我有一个问题想向陈杰豪高级国务部长澄清。我想请他确认卫生部是否会采纳我关于照顾者护照的建议，以及卫生部是否有任何考虑可能阻止该建议被采纳。
陈杰豪先生：主席，请允许我借此机会回答蔡先生之前我未及回答的关于灵活工作安排的问题，以及我们如何与不同合作伙伴合作。我在发言中提到各部委支持照顾者的努力，我们理解照顾者在工作与照顾之间的挑战。这是他们正在努力解决的，包括灵活工作安排和其他举措。我们将继续与同事及社区其他合作伙伴合作。
关于法兹利·法兹维先生提到的照顾者护照问题，如果我理解正确，他提到的是英国的做法。正如我之前发言所说（法兹维先生当时不在场），我们当然欢迎议员们的所有建议，包括其他议员在卫生部部长答问会及其他场合提出的建议。
针对他的建议，我在网上查阅过相关信息。我必须声明，我获得的信息仅来自网络资源。这是英国的一个自下而上的倡议，旨在让涉及的不同方——从医院到他之前提到的超市——表达对照顾者的关怀和支持。例如，一些医院可能提供更长的探视时间，医院餐厅可能给照顾者用餐折扣，一些超市也可能提供折扣。这是一个自发的倡议，由不同方参与。
由于是自下而上的倡议，我了解到实施情况可能不均衡。照顾者在英国不同地区可能有不同体验，去不同超市也会有不同体验。有些超市提供支持，有些则没有。这是自愿性质的努力。像许多自下而上的倡议一样，我们当然欢迎它们。政府也有许多资助计划支持自下而上的倡议。如果法兹利·法兹维先生知道有个人或团体愿意支持我们的照顾者并组织自下而上的努力，我们会考虑这些提案。
主席：万立骏医生。
万立骏医生（惹兰勿刹）：谢谢主席。我有三个问题想向高级国务部长许文远澄清。高级国务部长之前提到成立了国家心理健康办公室（NMHO）以协调多机构举措。请问高级国务部长能否分享他们的关键绩效指标（KPI），例如是否减少了平均等待时间、改善了护理连续性、减少了危机就诊？如果有，这些数据多久报告一次？
高级国务部长还提到“绑定护理”和“无错门”方法，我对此表示欢迎。卫生部是否会分享期望的服务标准，例如首次联系的最长时间、中高风险病例首次临床预约的最长时间，以及跨机构的升级协议？
第三个问题是，高级国务部长谈及护士和辅助医疗人员的留任措施。针对心理学家，是否有具体的留任水平？例如，专科路径、晋升以及公共部门薪酬竞争力等方面。
许文远博士：主席，关于第一个问题，即国家心理健康办公室的KPI，我在几天前的议会质询答复中提到，我们目前的重点是建设能力，因为确保有足够能力满足需要帮助者的需求，自然会减少许多等待时间。但重要的是推出“心理健康第一站”，它是可及的——例如，mindline.sg全天候开放，且匿名——这将真正消除阻碍大家至少寻求首次接触点以获得建议和进一步帮助的关键障碍。
因此，在KPI方面，第一站不会有等待时间。它有24/7的聊天机器人，还有值班的辅导员，你可以随时打电话或通过WhatsApp发信息与他们交流。所以，我认为从首次接触点来说，实际上没有等待时间。
但重要的是确保进入首次接触点的个人准备好接受更高级别的护理帮助（如果需要）。这往往是挑战所在。许多人不愿意进入下一层级的护理，因为我们在社区中处理有心理健康问题的挑战个体时都知道，有时让他们主动寻求帮助本身就是问题。不是资源不足，而是他们不愿意主动寻求。
这涉及多种因素，非常困难，因此关键是说服他们、与他们合作、赢得他们的信任。我们希望推出的一些第一站资源能成为辅导员通过电话说服个人准备迈出步伐接受护理的途径。
话虽如此，这也引出了第二个关于分层护理模式的问题，即是否有方法监测那些高风险人群及其是否获得护理。同样，沿着这个思路，我想向议员保证，那些被认为是高风险的人群将始终被优先考虑。例如，如果他们通过线上或电话咨询，咨询师评估该个人有自杀意念的风险，他们会尽最大努力说服该个人主动寻求护理。如果该人愿意主动求助，将有一套快速通道协议，确保他们能立即获得合资格精神科医生的关注，甚至直接到精神健康院急诊部接受即时治疗。
正如我所说，最大的障碍是他们是否愿意主动求助，而不是真正的护理能力本身。
所以，我希望议员能理解，为什么我们追踪某些时间线并没有太大意义，因为反事实是无法衡量的。没有办法测量谁处于风险中，谁会出现，或者最终成为自杀案例。反事实无法验证。因此，我们将重点投入资源，确保如果他们愿意主动求助，资源是可用的。
关于第三个问题，即心理学家的留任问题。我认为我们应该一步一步来。我们首先从注册开始，给予那些在心理学高风险子领域执业者正式认可，确保他们获得质量、标准和支持，以提供客户和患者所需的护理。
目前，我们暂时不会考虑更多其他措施，但让我们一步步来。
当然，在医疗保健领域，我们也为辅助医疗专业人员（AHPs）提供了留任措施，我记得大约是在2025年，如果我没记错的话。所以，我们会整体考虑，作为支持辅助医疗专业人员的一部分。
主席：副教授林占武。
副教授林占武（盛港）：我的问题是给王部长的。部长先生，我在发言中提到了医疗支出的不均匀性，不仅仅是在临终关怀的背景下，也是在持续的基础上。这是基于我从居民那里收到的反馈。
同时，我也非常清楚部长提到的当前使用与未来使用之间的内在矛盾，这也是为什么我建议允许未用完的年度限额最多结转三年，这样可能在谨慎提款限制和灵活使用以满足不均匀需求之间取得平衡。
所以，如果我可以换个方式提出我的问题：部长认为允许这种有限的年度医疗储蓄限额结转，可能会遇到哪些后勤或行为上的困难？
王乙康先生：我不会立即说“是，好主意”，或者“否，我们会拒绝”。我认为这是一个有趣的想法。正如我所说，我们每年都会审查该计划。我确实想看看如何创造更多灵活性，我们会考虑你的建议。
主席：叶汉荣先生。
叶汉荣先生（耀祖康）：谢谢主席。我想澄清关于老龄化和超级老龄社会的问题。在老年活动中心（AAC）附近居住的老年人中，有多少比例是积极参与的？这是第一个澄清。
其次，我了解到像银发世代办公室（SGO）这样的机构会主动在其场所与老年人互动，但我们还有什么不同的做法来接触那些社会孤立、可能不会主动参与AAC活动的老年人？
陈杰豪先生：部长先生，正如我之前演讲中提到的，我们已将老年活动中心的覆盖范围扩大到约230个中心。这是在过去两年内完成的。我们现在服务约10万名老年人，并希望在几个方面做得更多。
首先，不仅仅是老年活动中心的数量，这是一个方面。更多的老年活动中心使老年人更方便、更容易到家附近的老年活动中心，在他们熟悉的环境和社区中。这就是我们扩大覆盖范围的原因。
但除了老年活动中心的数量，老年活动中心开展的活动也很重要，使老年人觉得有意义，愿意来参与，不至于社会孤立。他们来参与，参与活动，建立新朋友。希望他们也能改变生活方式，变得更健康、更快乐。
未来几年，我们将扩大老年活动中心的活动种类，不仅仅是做健康伦巴等活动，还会提高健康意识，并在老年活动中心内设立社区健康伙伴（CHP），为老年人提供服务。我们将继续探索更多可能性，不仅仅是数量，更是活动的质量。
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第三，银发世代办公室有银发世代大使，他们主动接触老年人。正如我提到的，自2022年以来，他们已接触超过60万名老年人。他们不仅仅是走访和交谈，还进行友谊访问和预防性健康访问，了解老年人在家中的情况、需求以及家庭背景，识别适合他们的服务，尤其是靠近他们住所的服务，并将他们连接到这些服务——无论是老年活动中心、社区俱乐部还是心理健康服务。
银发世代大使不仅仅是走访者，他们也是社区的重要接触点和服务连接者。
我们希望为社会孤立的老年人做更多工作。我们一直与社区伙伴合作，不仅是老年活动中心和社区俱乐部，还有其他社区组织，包括信仰团体和志愿组织，主动接触这些老年人。我们与他们紧密合作。
这就是综合社区护理计划（ICCP）的作用。对于从公共医疗机构（即医院）出院的老年人，我们如何确保他们不被遗忘、不被孤立？这就是ICCP的转介流程。ICCP会为这些老年人制定评估和护理计划，并联合合作伙伴主动接触这些老年人，尤其是独居老人。
所以，针对议员的问题，我欢迎任何建议。这是卫生部未来几年的重要优先事项。
主席：林秀仪女士。
林秀仪女士（亚历山大）：谢谢主席。我想回到部长的抖音视频。我应该澄清，我平时不常看他的抖音视频，但那段视频是有人推荐给我的。
我听到保险业的一些反馈，说那段关于住院保险（IP）和附加险的视频给部分公众留下了附加险不太必要的印象。视频中，附加险被象征为一匹木马。我记得视频中部长有一幕把木马从桌上弹开。
我不知道部长是否知道这种反馈，即该视频可能给公众留下附加险不太有用的印象。部长能否借此机会再次重申，附加险确实是谨慎的选择，理由正如我在发言中提到的？
王乙康先生：当注意力持续时间如此短暂，而你又试图在短视频中传递大量信息时，这确实是个挑战。
我不惊讶保险业给出这样的反馈，但我认为视频和我们发布的信息是严肃的，即你必须审视自己是否真的需要附加险。
我们回顾一下，保险的目的是覆盖我们无法承担的费用。对大多数人来说，如果我们有一次住院，费用可能高达数万甚至数十万，保险加补贴可以覆盖这部分费用。
附加险不承担这部分费用。撇开癌症不谈，附加险覆盖的是共付额。附加险覆盖的是自付额和5%的共付部分。这是附加险的核心目的。
因此，请仔细考虑。与您的理财顾问沟通。随着年龄增长，附加险的保费涨幅最大，权衡成本和收益，看看附加险是否适合您。
我认为视频的核心信息依然准确，我们应该认真审视自己的财务需求，评估我们想要保护的风险，并检查——我是否需要附加险？如果需要，保险公司4月份推出的新附加险，虽然覆盖的共付额较少，但费用更低，是否更适合我？采取这些步骤。
需求各不相同。不同的人有不同的需求。有些人确实希望支付更高的保费，以便获得尽可能多的保障。那也无妨。但对于其他人，尤其是那些使用公共医疗机构、享受补贴医疗的人来说，要仔细考虑你是否真的需要附加险。
主席：林女士。请简短发言。
林秀玉女士：谢谢您，主席。跟进部长的问题，是否存在这样一种情况：如果没有附加险，患者需要自付10%的住院费用，且没有上限？这就是关于赔付限额的一个担忧。
王乙康先生：这说法不太准确。如果你说的是附加险，如果你根本没有附加险，是的，你需要支付10%的共付额。如果你考虑去私立医院，账单可能高达数十万新元，而你想防范这10%的共付额，那么附加险可能适合你。
但请记住，随着年龄增长，到了七八十岁，保费可能高达每年一万新元。没有附加险，你就节省了这笔保费。所以，请自行计算，咨询你的理财顾问。
但如果你总是在补贴的公共医疗环境中接受治疗，MediShield Life会介入，加上补贴，如果你生病，暴露于数万甚至数十万新元的风险非常不可能。然后，再考虑附加险是否适合你。记住，在公共医疗机构，如果你负担不起，还有MediFund可以申请。
主席：说到这里，我认为所有澄清问题都已提出并得到回应。请问玛丽亚姆·贾法尔女士，您是否愿意撤回您的修正案？
下午12时51分
玛丽亚姆·贾法尔女士：感谢各位议员的激烈讨论。我认为医疗保健可能是最复杂的部委之一。我代表卫生政府议会委员会，感谢医疗大家庭，从卫生部的每一位工作人员到医院和社区的前线人员。基于此，我请求撤回我的修正案。
[(程序文本) 经许可，修正案撤回。 (程序文本)]
[(程序文本) 头O项下的20,035,377,700新元被批准作为主要预算的一部分。 (程序文本)]
[(程序文本) 头O项下的2,467,566,400新元被批准作为发展预算的一部分。 (程序文本)]
英文原文
SPRS Hansard 原始记录 · 抓取日期：2026-05-02
[(proc text) Head O (Cont) ‒ (proc text)]
[(proc text) Resumption of Debate on Question [4 March 2026] (proc text)]
[(proc text) "That the total sum to be allocated for Head O of the Estimates be reduced by $100." ‒ [Ms Mariam Jaafar]. (proc text)]
[(proc text) Question again proposed.(proc text)]
The Chairman : Minister of State Rahayu Mahzam.
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The Minister of State for Health (Ms Rahayu Mahzam) : Mr Chairman, my speech covers the Ministry's initiatives to bring care closer to the community, how we are strengthening our environment and ecosystem for healthy living and our efforts to improve our population's health.
As our society ages, improving our population's health and preventive care is critical for longer, healthier lives. We have embedded preventive healthcare into the community through Healthier SG and AgeWell SG to support residents while they are still relatively young and healthy, and as they age.
Mr Alex Yeo and Dr Hamid Razak would be pleased to know that the development of Healthier SG Care Protocols related to frailty and functional health, such as for osteoporosis and dementia are progressing well and would be rolled out in 2028. These care protocols will ensure evidence-based care is provided more consistently through Healthier SG general practitioners (GPs).
Ms Mariam Jaafar also spoke about improving community health, in particular the north region. Our data shows that in the north, the prevalence of diabetes and hypertension is above the national average, and residents engage in less physical activity. While we continue to review reasons for these trends, we are simultaneously stepping up our preventive care efforts in the region.
We will start off with Woodlands Town. First, we will enhance the Community Health Posts (CHPs) in the town. Secondly, we will improve access to specialist-supported care in the community. Thirdly, we will support residents to engage in healthy living activities by opening up community spaces for exercise programmes, introducing digital wayfinding in Healthy 365 and empowering local community health advocates.
As seniors age, visiting polyclinics and hospitals can be difficult due to mobility issues. Many also ignore symptoms that are not yet serious or urgent. Consulting a healthcare professional early can lead to earlier identification of issues, which in turn leads to earlier intervention and better health outcomes. We agree with Dr Haresh Singaraju's view that it is important to connect patients to community resources, and we are enhancing accessibility of health services by bringing care directly into the community.
I am pleased to announce that NHG Health has been progressively enhancing 11 CHPs across Woodlands Town since the start of this year. These enhanced CHPs, which are located within Active Ageing Centres (AACs), will be opened once a week. All residents, including non-seniors, can walk-in to these enhanced CHPs to access services such as: general health advice, basic health assessments and social prescriptions which include linking up residents with community programmes and resources, support for preventive health and disease management; including health coaching, medication review and chronic disease and frailty management programmes, and support for caregivers and post-discharge follow-ups for patients returning home from hospitals.
These services are provided by NHG Health's community health teams comprising community nurses and health coaches, who will bring in pharmacists, dietitians and therapists based on residents' needs. They also work closely with GPs in the region and healthcare professionals in hospitals to provide coordinated care for residents with chronic diseases and frailty. For example, residents with diabetes receive ongoing support at enhanced CHPs through glucose monitoring and personalised health counselling, with the community health teams regularly updating the residents' specialist doctor on their progress and any changes in their condition. This ensures interventions can be made early if needed.
For seniors who are already at the AACs for programmes, they can also consult healthcare staff easily without needing to make a separate visit. We have also noticed that some patients miss specialist appointments due to work schedules or limited mobility. To address this, Woodlands Hospital will launch a new initiative starting end of this month to provide specialist-supported care for patients in the community through the enhanced CHPs in Woodlands and direct teleconsultation with individuals.
Starting with diabetes and asthma, selected patients can choose to receive specialist-supported outpatient care at an enhanced CHP through teleconsultation with the hospital care team. Instead of travelling to Woodlands Hospital for their appointment, they will be able to see a health coach or nurse at the enhanced CHP to manage their condition and will receive support from the specialist doctor through teleconsultation. With regular monitoring of health conditions, nurses are able to pick up early signs of poor control and work with specialist doctors for early treatment and help patients avoid unnecessary hospital admissions.
Woodlands Hospital has also started rolling out teleconsultation for selected patients who have undergone colonoscopy screening with low-risk screening results. Instead of making a trip to Woodlands Hospital, patients can choose to teleconsult their specialist doctor from anywhere, including at the CHP, if they need help. This option will be further expanded to other specialties and procedures in Woodlands Hospital.
With these services, patients will be better supported by the community care teams in their neighbourhood, while requiring fewer visits to Woodlands Hospital. This will help patients access required care in a more flexible way, while working around other commitments. NHG Health estimates this will save about 500 physical specialist outpatient clinic visits. This is expected to increase further as the initiative expands.
Even as we are bringing healthcare services closer to the community for greater accessibility, we agree with Ms Mariam Jaafar that health begins with individual choices and we can design a healthier ecosystem to support individuals to make better personal health choices in different settings.
One key setting is the immediate neighbourhood that residents live in. The Health Promotion Board (HPB) conducted a study and found that residents are more likely to participate in health activities held in everyday surroundings that are accessible, green and fit seamlessly into their busy lives. They also value social experiences that are fun and community driven.
These insights point to the need for a collaborative, ground-up approach with local community partners. They understand both residents' needs and preferences and the community spaces within the neighbourhood. They also play critical roles in facilitating access to neighbourhood facilities and spaces, encouraging participation in activities and building social connections that will make healthy living appealing and sustainable.
Thus, HPB will work with local community partners so that residents will find it easier to access and participate in healthy living activities. From April 2026 onwards, more residents will be able to join workout and exercise sessions in familiar, convenient and spacious locations including community halls, plazas and malls near their homes, such as 888 Plaza and Fu Chun Community Centre.
In tandem with holding more activities in the community, we will help residents explore and make greater use of existing neighbourhood amenities themselves. HPB will enhance the Healthy 365 mobile app with wayfinding and gamification features to connect residents to nearby opportunities to stay healthy and active in their everyday environment. For example, residents may be prompted to complete a brisk walk along park connectors or trails within their neighbourhood and complete digital "check-ins" at designated points. This feature will roll out progressively from June 2026. Residents can continue to receive rewards when they track their participation via the Healthy 365 app.
Beyond the infrastructure, what will be key is the software – the networks and bond of the community. We want residents to look out for one another and encourage relatives, neighbours and friends to participate in healthier lifestyles that will build healthier people and healthier towns.
HPB will support local community stakeholders, who have deep understanding of residents' needs and community resources, to co-design healthy lifestyle programmes. This includes developing a citizen-centric playbook from June 2026 to help partners effectively plan relevant activities for residents.
Through collective ownership, residents will benefit from healthy lifestyle programmes and activities that are tailored to them. We will also jointly monitor progress to continually refine and improve on the initiatives. HPB will explore how to expand successful elements to other towns.
Besides ground-up, community-led initiatives, we are looking at ways to mitigate lifestyle risk factors to improve the health of our people. One example is a cohort smoking ban or tobacco-free generation policy as mentioned by Ms He Ting Ru. This means to restrict the access to all tobacco products for a specific birth cohort onwards.
Through our current multi-pronged approach of policy measures, public education and cessation support, we are making good progress in reducing the prevalence of smoking. Prevalence has declined over the years, to 8.4% in 2024 and even lower in young adults aged 18 to 29 years at about 5%.
We are also continually reviewing our tobacco control policies, including the tobacco-free generation policy which some other countries are exploring. Adopting a cohort smoking ban requires serious consideration. We remain open to the policy and will study its effectiveness, impact and how it may be implemented in Singapore's context.
The Ministry of Health (MOH) is focusing our attention on combating the scourge of vaping. Hence, for now, we will continue to monitor international developments and learn from the experiences of other countries in how they implement a cohort smoking ban. Mr Chairman, allow me to say a few words in Malay.
( In Malay ) : [ Please refer to Vernacular Speech .] Adopting healthier lifestyles is something that we need to work towards collectively in our community. The National Population Health Survey 2024 showed that our Malay/Muslim community has some areas to improve on. First, health screening. Chronic disease screening among Malays fell nearly 10 percentage points, from 64% in 2019 to 55% in 2024. Breast cancer screening rates went down from 29% in 2019 to just 18% in 2024. When chronic conditions and cancer are not detected early, serious complications may arise, which will require more intensive and costly treatment.
I understand that topics on health, such as screening, can be daunting. Thus, it helps to be able to speak to trusted healthcare workers in a familiar setting to guide us along. For many in our community, the mosque is such a setting that provides this support. I am therefore pleased to announce that the two mosques in Woodlands, An Nur Mosque and Yusof Ishak Mosque, will be partnering with NHG Health to provide CHP services by September 2026. A range of services, from general health advice and basic health assessments, to support for preventive health, disease management and post-discharge follow up will be provided.
10.45 am
We will tailor these services to our community's needs, for example, consultations can be conducted by community nurses and health coaches who are fluent in Malay to help minimise communication barriers, especially for seniors. NHG Health will also seek feedback from asatizahs to include faith-based guidance into health workshops. By bringing healthcare services to familiar settings frequented by our community, and partnering with religious and community leaders, healthcare will become more accessible to our community
To further encourage health screening among our Malay/Muslim community, since May 2025, the HPB has trialed the Jom Check! (Let's Check!) programme. This programme provides individual support in small group settings to help residents enroll in Healthier SG and book health screening appointments. This is done in collaboration with many healthcare partners. So far, 16 sessions have been organised islandwide, reaching more than 300 residents. We have received positive feedback. Thus, HPB will scale up Jom Check! to reach out and benefit more residents.
Small actions, like going for regular health screenings now, can avert bigger problems in future. This is easier to do with Healthier SG, as eligible enrollees can enjoy special subsidies for Healthier SG screening tests. Today, about 57% of eligible residents have enrolled into Healthier SG. This percentage is higher for those aged 60 and above, at approximately 70%. Our community also registered the highest growth in enrolment over the past year. This is very encouraging. For those who have not yet enrolled, I highly encourage you to take that crucial step and enroll today.
A second key issue is obesity. Thirty-two percent, or about one in three people in our community, is obese, a rise of nearly 10 percentage points from 24% in 2020. This is a major concern, as obesity increases our risk for developing multiple chronic conditions. The National Nutrition Survey shows that calorie intake, as well as consumption of sweet foods and drinks, is highest among our community. We also consume a high amount of saturated fat. This could be due to the excessive use of cooking oil. However, I am confident that we can make small, sustainable changes that is in line with our lifestyle and culture. Indeed, in our culture and religion, balance is important. Taking care of our body is a sacred responsibility. Let us reduce our intake of sugar, sodium and saturated fat and eat a healthy, balanced meal.
The Government, together with MUIS, MENDAKI, PA MESRA under M 3 and partners from the Jaga Kesihatan, Jaga Ummah network (JKJU), will continue to support efforts to enhance our community's health and well-being. I am heartened when I see our community making steady progress. Through the efforts of Focus Area Five (FA5), more than 90,000 people have participated in various programmes in 2025.
We are now in the holy month of Ramadan which is an ideal time for our community to resolve to lead a healthier lifestyle. We will continue to work with our partners to reach out to the community. Come, let us all take the first step today and enrol in a health programme.
( In English ): Mr Chairman, our goal is to ensure that the path to a healthier life is wide enough for everyone to walk on. Through our initiatives, no one has to navigate their health journey alone. By working hand-in-hand with our community partners and residents, we can build a Singapore where healthy living is inclusive, accessible and a lived reality for every one of us.
The Chairman : Minister Ong Ye Kung.
The Coordinating Minister for Social Policies and Minister for Health (Mr Ong Ye Kung) : Mr Chairman, three years ago, in April 2023, I informed the House that Singapore would become a super-aged society in 2026 – this year. This is when 21% or more of our population will be 65 and above.
So, if you consider, in June 2025, last year, already 20.7% of our population was 65 and above. And that percentage has been going up by about one percentage point every year. So, we should have crossed 21% by now. So, as I speak, Singapore is a super-aged society. So, welcome to super-aged Singapore.
When was the exact point of transition? Actually, I do not think anybody knows. We can do an estimation. What happened at that exact moment? Nothing dramatic. There was not a Singapore Civil Defence Force siren or anything. It came and went.
Ageing does not arrive with a bang. Neither is it a whimper. It progresses quietly, with a real and profound impact. And at MOH, we feel it very strongly in the hospitals, in the emergency department, in nursing homes, and we are doing our best to manage the workload and care for all our patients.
More importantly, we foresaw this demographic transition years ago and took as many early actions as we can. This includes raising the Goods and Services Tax to strengthen our fiscal position; increasing the retirement and re-employment ages; building many more age-friendly streets and 2-room Flexi and senior apartments; and bolstering financial security for seniors through Silver Support, Central Provident Fund (CPF) LIFE and MediShield Life.
These policies are long in the making. They have helped cushion the impact of this very profound demographic transition.
But arguably, the most complex task to prepare for an older population is to sustain and to transform the healthcare system. These are the two topics I want to talk about today – sustain and transform. Let me first touch on sustaining the healthcare system.
Rising demand for care means the healthcare system must expand its capacity. We will become bigger, which we are doing. At the Opening of this term of Parliament, the MOH Addendum set out the target of adding 2,800 more public acute and community hospital beds between 2025 and 2030. We are on track.
However, meeting rising demand and running a larger system will cost more. And if we do not manage this carefully, rising healthcare spending can strain public finances and household budgets alike. In fact, if we are really extravagant, if we are not careful about it, it will cripple our system.
How do we ensure healthcare remains affordable? I think we need to start at the very top to ensure that the national healthcare bill is under control. Otherwise, it is like the Titanic sinking, and you are pouring water out of the deck. It must be floating.
National healthcare expenditure – that is the hospital bill of the nation. That bill, remember this, is always and ultimately paid by the people, whether through healthcare charges, through taxes, through insurance premiums, through medical security contributions. Ultimately, it is always paid by the people.
So, a government can claim that "we provide cheap or even free healthcare". It is actually not very true. The truth is healthcare is never really free, even if patients do not pay anything at the point of delivery. They will just pay in some other ways. A sick nation that consumes healthcare indiscriminately will incur a large and wasteful bill and it will be very costly to the population, to the households, to the patients, to the people.
With your permission, Mr Chairman, may I display a couple of slides on the screens, please?
The Chairman : Go ahead. [ Slides were displayed for hon Members. Please refer to Annex 1 . ]
Mr Ong Ye Kung : Thank you. This is a scatter chart of different countries and you can see Singapore is an outlier, in the bottom right corner. Let me interpret this chart. The vertical axis measures how much the population spends on healthcare. Developed economies, shown by the different dots on screen, typically spend around 9% to 12% of gross domestic product (GDP) on healthcare, with the United States (US) – outlier in the other direction – spending 17%. Singapore spends below 5%.
The horizontal axis is average lifespan. This is an internationally accepted and generic measure of health outcomes. And Singapore has one of the highest lifespans in the world. But of course, beyond lifespan, there are many other measures of health outcomes and across all these measures, Singapore is comparable to or even better than many developed economies.
So, how did we become an outlier like this? I think it has a lot to do with our S+3M healthcare financing system that Members are familiar with. And MediSave is the linchpin of that system.
Singaporeans and our employers set aside part of our monthly income into MediSave. The Government also provides top-ups from time to time for various segments of the population, and we did that again this Budget. And we then use MediSave to co-pay directly for a small part of the cost of healthcare. So, even for a modest co-payment, it goes a long way to instil discipline and reduce unnecessary consumption on both the supply as well as the demand sides.
We do not have to look very far to imagine what happens when that discipline is eroded. You just look at private healthcare in Singapore. The discipline of co-payment was weakened because of overly generous insurance, including the IP riders. As a result, private hospital bill sizes have been rising rapidly, and private insurance premiums have been escalating very quickly. Once that genie is out of the bottle, it is difficult to put it back. But it will not stop us from trying. We will try.
In our S+3M system, multiple payers pull their weight to pay for this national healthcare bill. Apart from co-payment, we have insurance schemes like MediShield Life. It plays a sizeable role. A big part of it is also paid by charity dollars. We thank all the donors and philanthropic organisations.
But the biggest proportion, about half. of the national healthcare bill is paid through tax revenues, redistributed as Government healthcare subsidies. The Government health budget today is about 2.7% of GDP this year, and it is expected to rise to about 3.5% of GDP by 2030. This 0.8 percentage point increase is actually very significant. It means increasing the Government's health budget from about $22.5 billion this year to about $30 billion in 2030.
And beyond 2030, the Government's health budget will likely continue to grow. We must ensure that the increase can be supported by economic growth and by rising tax revenues. And at the same time, we must continue to maintain that discipline and avoid unsustainable levels of healthcare spending that we see elsewhere.
The next topic I want to talk about is transforming the healthcare system. A healthcare system for a young population is very different from one for an older population, for a super-aged society.
For a young person, sickness tends to be episodic. You are admitted to hospital, you get treatment, you get discharged and then you recover. Good health is the default. On the other hand, an older person's care journey is complicated and continuous. When well, they need preventive care; when sick, they need coordinated care because they tend to have multiple conditions; post discharge, they need rehabilitative care and follow-up care in the community. Good health is not a default; it is a continuous quest for an old person.
So, from episodic hospital care, we now need continuous multi-disciplinary care across settings. This shift is reflected in how we have allocated healthcare funding over time. Let me show another chart on screen. [ Please refer to Annex 2 . ]
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The chart on the left, the height of the chart is our Government healthcare budget in 2021. The right bar is 2024. Members can see that, overall, budget has increased by 1.5 times. But I want to draw Members' attention to the composition.
At the start of this decade, 2021, around three-quarters of our operational funding for the healthcare sector went towards acute hospital care – that is the white portion of the bar. The remaining one-quarter was spent on aged care and population health, including preventive and primary care.
Today, we move to the right, 2024. The budget is 1.5 times that of 2021, but the share of acute hospital care has fallen, from three-quarters to almost two-thirds – the remaining one-third going to aged care and population health.
Specifically, the share of funding for aged care rose from 11% to 13% – that is the green portion – between 2021 and 2024. Over the same period, the share for population health grew from 14% to 19%. These shifts are driven largely by our national programmes, Healthier SG and Age Well SG.
Looking ahead, how would this chart go? I think, almost certainly, the share of spending on aged care will grow further, because we need more nursing homes, senior care centres, rehabilitation services and hospice care. As for population health, we do our best to maintain this share at around 19%. With total spending rising, maintaining the share alone requires a strong commitment to continue to invest in population health.
Mr Chairman, today, my MOH colleagues and I will be speaking on further steps to transform healthcare and get ready for the future. Senior Minister of State Koh will speak about manpower. It is a key agenda, including how we will significantly shorten the time to train clinical psychologists. We are taking seven to eight years currently; we will reduce it to about five years. Senior Minister of State Tan Kiat How will speak about anchoring care in the community through technology.
And Members heard Minister of State Rahayu speaking about population health and preventive care, including what we are doing in the north, where prevalence of chronic diseases is higher. There was a question by Ms Mariam Jaafar, she missed that part of the speech.
I should emphasise – this is in case she asks many clarifications later – preventive care and population health remain the overarching strategic thrust of what we are doing, anchored by Healthier SG and Age Well SG. I thank Ms Mariam Jaafar and Dr Haresh Singaraju for speaking about this. This is at the core of healthcare transformation and MOH agrees with many of the points they have raised.
I will now speak about three new initiatives to support healthcare transformation.
The first common topic this whole Committee of Supply (COS) and Budget debate – AI, once again. Ms Mariam Jaafar and Dr Choo Pei Ling spoke about how AI can strengthen healthcare delivery and we agree.
When it comes to AI in healthcare, we are guided by two principles.
One, care should be AI-enhanced, not AI-decided. Clinicians remain in the loop and healthcare remains a profoundly human endeavour.
Two, we take a practical, use case approach. AI should not be a hammer looking for a nail, a solution looking for a problem. We deploy AI where we know it will improve patient outcomes or the delivery of care, and where it can do so cost-effectively.
One such use case is in health screening. Around the world, many AI models have been trained to predict if a well person is likely to develop severe diseases in the near future. If we use it appropriately and responsibly, such tools are very useful. It helps the clinicians intervene earlier; it can delay or even prevent the onset of serious diseases.
MOH has developed such a model for our local context using anonymised patient data. With this model, by reviewing an individual's current health status, it can identify if he/she has a high risk – high risk defined by 75% or above – of developing chronic diseases, such as diabetes or high cholesterol, within the next three years.
We chose diabetes and high cholesterol because they are the key drivers of strokes and heart attacks, which affect 60 Singaporeans every day – every day, 60 Singaporeans either have a heart attack or a stroke. Many of these cases can be prevented if early actions were taken, such as through lifestyle adjustments and medication.
This AI risk assessment tool will be rolled out to doctors for all Healthier SG enrolees from early 2027. If the tool flags a patient as high risk, the doctor may recommend more significant lifestyle adjustments and instead of three-yearly check-ups, maybe annual check-ups. These additional screenings will continue to be subsidised under Healthier SG.
The second initiative, I think is an exciting and significant one, and a breakthrough, which is to use genomics to strengthen preventive care. Dr Hamid Razak asked about this.
We are born with our genes. They shape our biological blueprint and indeed, many diseases are linked to our genetic characteristics. But we need not be fatalistic about it. Genes are not our destiny. How we live, how we manage risk matters a lot.
So, we do not go fumbling through our genetic blueprint, hunting for blemishes and possible mutations that we know little about. It will create a lot of anxiety in all of us, and we will become a nation of hypochondriacs!
So, instead of shooting in the dark, we should focus on the parts of the blueprints that are illuminated by science.
This means taking a disease-specific approach, identifying genetic characteristics that we know drive certain diseases and for which we know there are established preventive interventions and treatment pathways.
This is what we did for familial hypercholesterolemia (FH). We did that last year. FH is a genetic condition that increases the risk of heart attacks even amongst young people.
The FH genetic testing programme offers subsidised genetic testing for individuals with abnormally high cholesterol levels. And if they are tested positive, we will offer the same test to their immediate family members. This is what we call cascade testing. By doing so, we try to identify as many individuals as we can in Singapore with the FH genetic mutation. And then, we take steps to reduce their risk of future heart attacks and strokes.
We will now move on to our next genetic condition, which is hereditary breast and ovarian cancer (HBOC).
In Singapore, it is estimated that one in 150 individuals carry a gene mutation, such as the BRCA1 or 2, that are associated with HBOC. Such mutations substantially increase a woman's lifetime risk of developing breast and ovarian cancer.
From December this year, we will offer subsidised genetic testing to at risk individuals for HBOC, such as individuals with a family history of HBOC. They will undergo genetic counselling before and after the test. And if they test positive, we will also offer the test to their immediate family members – cascade testing.
We expect over 2,000 individuals to be eligible for the test annually.
We will make the test affordable. In addition to subsidies, the cost of the test can also be offset using MediSave.
For those found to have the mutation, they will be offered suitable preventive interventions. Typically, this means more frequent breast MRIs or mammograms or oral medication.
Patients will ultimately decide, in consultation with their doctors, which intervention is appropriate. A minority may opt for surgical interventions. Members may recall celebrity actress, Angelina Jolie, after she discovered she had the BRCA1 gene mutation, she underwent a double preventive mastectomy.
I came across women in Singapore who chose to undergo preventive mastectomy to reduce their risk of breast cancer, such as Ms Gwendalyn Too, and these women have demonstrated great courage.
Unfortunately, they lament that they cannot claim insurance for such surgeries, because MediShield Life generally does not cover prevention. And it is designed to be so for a good reason. It is to keep coverage focused and premiums affordable. Then private insurance takes dressing from MediShield Life.
Dr Hamid Razak and Ms Sylvia Lim asked about this. In fact, Ms Stefanie Thio – she is the founder of the non-profit organisation SG Her Empowerment (SHE) – has raised this issue with me several times.
I share the concerns.
With advances in medical science, the boundary between preventive and curative care is increasingly blurred. If a high-risk individual is unable to undergo preventive mastectomy, she has a high chance of eventually needing cancer treatments, including a curative mastectomy to remove cancerous cells in her breast or cancerous tissue in her breast.
There is, hence, a case for MediShield Life to be judiciously extended to cover certain selected preventive surgeries. We are prepared to do so when there is a clear clinical need, minimal risk of abuse, the procedure is suitable for risk-pooling, through insurance, and it does not financially burden the MediShield Life scheme.
Risk-reducing mastectomies for breast cancer prevention, and the removal of both fallopian tubes and ovaries for ovarian cancer prevention, fall within these criteria.
We will therefore extend MediShield Life and MediSave to cover preventive surgeries for HBOC later this year. I should add that breast reconstruction is also covered, no different from today. This will better support women to harness genomics to better take care of their health.
I think this is a meaningful policy change ahead of International Women's Day on 8 March. [ Applause. ]
The third initiative is to inject more flexibility in the use of MediSave to encourage early intervention and reduce downstream complications.
Assoc Prof James Lim was right to describe medical expenses as lumpy. Indeed, it is very well documented that hospital expenses escalate almost like a vertical wall towards the end of life. And so, even after accounting for inflation, the average Singaporean living up to their mid-80s spends almost four times as much on hospital expenses in the last 10 years of their life compared to the previous 10 years.
But that explains the existing design of the MediSave withdrawal system, and why the system is designed like that, why the scheme is designed like that. It has higher limits for more complex treatments and longer hospital stays, and you can draw on it as and when you need it. This meets the original objective of MediSave, which is to co-pay for major in-patient episodes, whether they happen unexpectedly or in old age.
With this design, after subsidies, MediShield Life and MediSave, nine in 10 Singaporeans pay less than $500 out-of-pocket for their subsidised in-patient bills.
However, it is human nature to worry about present medical expenses rather than lumpy potential, unexpected or future hospital bills.
Hence, as a relief valve, we have schemes, like Flexi-MediSave and MediSave500/700, to provide flexibility for chronic disease management for scans, for dentist visits, and so forth, without overly diluting MediSave's original objective of catering for these big lumpy hospital bills in old age or during emergencies.
But the situation has changed since MediSave was implemented in 1984. At that time, people in Singapore lived to about 73 on average. Today, we live to 85 and beyond.
On one hand, it continues to be important to preserve MediSave for big hospital bills. On the other hand, as people live longer, the need to spend on preventive care and chronic disease management also go up.
Hence, I can appreciate the repeated and various calls by Members to allow MediSave to be used more flexibly, to cover more chronic diseases, or as Mr Pritam Singh suggested, to pay for higher private insurance premiums.
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But I also hold the realistic view that no matter how frequently MOH reviews the MediSave scheme, how much we liberalise and expand its usage, the public and Members of the House will continue to press me and MOH to liberalise the scheme every year during the COS and probably, outside of the COS.
It is the karma of the scheme – because it is designed to be the linchpin of the healthcare financing system. It must always navigate between present and future healthcare needs, between recurring disease management and the major hospitalisation episodes.
Trade-offs are inherent in the MediSave scheme. It is zero sum. Using more balances for recurrent medical expenses means having less in the future when we are hospitalised and vice versa. And when the tension becomes too severe, we will have to consider raising contribution rates so that you have a bigger pot to spend.
The tension is therefore deliberate and a design feature. It is a balance we must constantly and carefully manage, to ensure the system of co-payment is held together while ensuring affordability and keeping CPF contribution rates reasonable for everybody.
Hence, we continue to have ongoing, regular reviews to study where we can expand the use of MediSave and provide more flexible withdrawals. For example, we recently increased the Flexi-MediSave limit for seniors, and we doubled the annual limit for diagnostic scans.
This time, we will make further changes to the MediSave500/700 scheme. This scheme helps patients pay for their recurring costs of managing conditions on the Chronic Disease Management Programme (CDMP). Mr Cai Yinzhou and Mr Gerald Giam asked about this.
Today, individuals with a simple chronic condition can use up to $500 a year, while those with complex chronic conditions can withdraw up to $700 per year.
To provide more support for preventive and chronic care in the community, we will raise MediSave limits from $500/$700 to $700/$1,000. This will benefit over 910,000 patients who currently tap on the scheme, roughly 20% of whom have annual bills exceeding the withdrawal limits.
We will also expand the list of conditions covered under the CDMP to include hyperthyroidism and hypothyroidism. In addition, we are studying whether we can include other chronic conditions, such as eczema, in the CDMP.
With the above enhancements, we will rename "MediSave500/700". It is actually a cumbersome name. Every time you change the limit, you change the name. We will rename it to "MediSave Chronic and Preventive Care Scheme", to reflect its scope of coverage. The changes will be effective January 2027.
Before I end this section, let me address the question posed by Ms Sylvia Lim.
I thank her for watching my TikTok videos. She mentioned the role of riders in providing additional coverage for cancer treatments not on the Cancer Drug List (CDL). The objective of the recent changes to IP riders is to prevent over-erosion of co-payment because that sets off a "buffet syndrome" and then that leads to rapid escalation of private hospital bills. IP riders covering non-CDL drugs for outpatient treatment, do not contribute to this erosion and therefore, this feature will not be affected by the changes. I should also point out that the changes to IP riders affect only new policy holders, but not existing policyholders. We will always watch out for the cancer patients when we make changes to IP riders. Mr Chairman, in Mandarin, please.
( In Mandarin ) : [ Please refer to Vernacular Speech .] Two thousand twenty-six marks the year when Singapore enters the super-aged phase. We should view this milestone with level-headedness and a calm mind, much like celebrating a birthday. Whilst we are collectively a year older as a society, life continues as usual without sudden or dramatic changes.
Singapore has always prepared for rainy days and we have long been preparing for an ageing society. Over the past decade, the Government has progressively adjusted policies across various domains with the goal of ensuring every Singaporean has support in old age, medical care when ill and a home to live in.
The most important point is to ensure that our people remain young at heart despite growing old physically. Therefore, preventive healthcare has become the MOH's core policy focus.
Speaking of the MOH or "卫生部" in Chinese, I do have some thoughts on this Chinese name. Strictly speaking, "卫生" is more commonly associated with hygiene, yet MOH does not manage hygiene matters. Hygiene matters are managed by the Ministry of Sustainability and the Environment, which is helmed by Minister Grace Fu. However, from a medical perspective, everyone understands that the concept of "卫生" is about preventing, fighting and treating various infectious diseases, which remains an important mission of ours.
However, the medical challenges of modern society differ from those of the past. Non-infectious diseases, such as cancer, heart disease and diabetes now cause far more harm than infectious diseases. To better reflect MOH's core policy focus, we will change the Ministry's Chinese name to "保健卫生部", adding "healthcare" into the name. When our name reflects our core policy focus, the words and actions of the Ministry will naturally follow suit.
Some may ask whether changing MOH's Chinese name would cost a lot of money. Please be assured that it will not, as most of our logos, legislation, documents, websites and so forth use only our English name. This highlights a separate issue. The name change will mainly affect future media reports and the expenditure will be minimal, but the meaning it conveys is very important.
I have also just announced several new policies.
First, to make medical expenses for chronic diseases more affordable, we will raise the annual MediSave withdrawal limit from $500 to $700 starting next year, whilst the annual limit for chronic disease patients with more complex conditions will be raised from $700 to $1,000.
Second, we will begin providing subsidised genetic testing for hereditary breast and ovarian cancer for higher-risk women from the end of this year.
Third, we will use artificial intelligence (AI) to assist doctors in predicting individual's risk of developing chronic diseases, such as high cholesterol and diabetes. For high-risk Singaporeans, we will encourage them to take preventive measures through Healthier SG.
Speaking of AI, over the past year, I have visited the US and China with the MOH team to study their experiences and practices in applying technology in healthcare. In the US, we visited several renowned hospitals. When I asked them which AI application scenario was the most effective amongst all possibilities, they unanimously said that using AI to record patients' medical histories saves both time and effort and is the best application scenario.
I agree with this approach. Although the use case seems simple, it allows everyone to benefit from it. It encourages everyone to accept new technology and understand that new technologies can help us, rather than threaten us.
In our public hospitals, we have already started using AI to document medical histories. Our AI understands English, Mandarin, Malay, Tamil and Cantonese. I am not sure why only Cantonese among the dialects but it is currently working hard to learn other dialects.
Someone once joked with me that the most experienced doctors will look at the person or the patient; experienced doctors will look at the illness; and less experienced doctors will look at the computers. I believe that in the near future, with the help of AI, most doctors will be able to look at the person and not just at the computers.
This year, I also visited China and toured some hospitals and technology companies. I found that Chinese hospitals are also boldly trying out new technologies and their courage to innovate is something worth learning from.
However, we must also recognise that there are differences between China and Singapore. For example, in the Chinese hospitals I visited, some traditional surgeries have already been replaced by robotic surgery. However, robotic surgery is very costly, and these expenses are often borne by the patients themselves, causing medical insurance premiums to increase.
Therefore, in Singapore, we are very cautious when promoting robotic surgery or any other technology. We must consider both cost effectiveness and patient affordability.
From Hippocrates to Hua Tuo (華佗), to AI and robotic surgery, the medical field has been advancing rapidly. We will take a multi-pronged approach to adopt long-term policies and make use of high-quality medical teams and cost-effective technology to bring better medical services to our people.
( In English ): Mr Chairman, when I informed the House three years ago that we would be a super-aged society this year, it was not to instil fear, but to prepare ourselves.
Our transition to a super-aged society has been steady rather than dramatic. It reflects deliberate, long-term planning, including transforming the healthcare system.
Indeed, healthcare transformation is fundamentally a long-term endeavour, not one sweeping reform. It is the accumulation of numerous small steps, each taken with judgement and purpose, each carefully planned and executed. And today, we announced further deliberate steps.
Mr Chairman, it is my hope that this House continues to support our approach of long-term planning, long-term governance, to anticipate future challenges early and act before they overwhelm us. If we do so, we need not fear being a super-aged society. We can embrace it and we make the best of it.
Ultimately, it is not the percentage of Singaporeans above 65 that defines us. We can exercise our wiser minds, to mourn less for what age takes away from us than what it leaves behind.
What matters is that Singaporeans are not just living for longer; we are living healthier for longer. We are not just a super-aged society, but we are striving to be a super-healthy one as well. [ Applause. ]
The Chairman : Senior Minister of State Koh Poh Koon.
The Senior Minister of State for Health (Dr Koh Poh Koon) : Mr Chairman, when Minister spoke about our journey towards becoming a super-aged nation, he highlighted something fundamental, that our people are at the heart of healthcare transformation. I will speak on our approach to workforce and care transformation in healthcare, which is carried out via three pillars.
First, we redesign roles and right-site care. Second, we build pipeline to ensure manpower sustainability. And third, we develop a flexible and agile healthcare system.
Picture this: a patient with diabetes, heart conditions and mobility challenges, juggling multiple appointments across different clinics, each visit requiring time off work, not just for the patient but for the caregiver sometimes, special transport arrangements and often, a caregiver's support to accompany them for these visits. This fragmented experience is not just inconvenient. It is unsustainable as our population ages and our healthcare needs become more complex.
How can we meet the rising healthcare needs of an ageing population, improve the care experience while maintaining the quality and standards of care?
First, we redesign roles and right-site care. Today in a hospital ward, a patient receives coordinated care through a team led by a principal doctor (PD) who is accountable for the patient's overall care plan. Under the new care team model, a PD need not be a specialist. Once they are trained and assessed to be competent, a Hospital Clinician may take on the role of a PD to supervise, oversee and coordinate care, incorporating the inputs of various healthcare professionals. Patients need not be seen by different doctors for each condition, thus reducing the number of referrals to other specialists during their stay.
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And upon discharge, the care of such a patient could then be handed over to their family physician, some of whom are now trained as family medicine specialists, to manage patients with more complex medical conditions.
Likewise, team-based care has been introduced in the polyclinics and Primary Care Networks since 2015 and 2018 respectively. Under such a model, patients with chronic diseases are managed by multi-disciplinary care teams comprising doctors, nurses and care coordinators. This ensures care continuity and builds the trust between patients and their care team.
In response to Mr Cai Yinzhou's query on the provision of specialist dental, audiology and podiatry services in the heartlands, we recently enhanced Community Health Assist Scheme (CHAS) subsidies for dental care and are expanding dental services at polyclinics and strengthening partnerships with community dental providers – moves that will bring affordable dental care closer to where our seniors live.
Most geriatric dental needs can be managed by polyclinics and CHAS dental clinics. Specialist care is available for more complex conditions at our hospital dental clinics as well as two national specialty dental centres – the National Dental Centre Singapore and the National University Centre for Oral Health.
Additionally, while podiatry services are available at selected polyclinics, foot screening services for patients with diabetes are available at all polyclinics as well as Healthier SG GPs through their respective Primary Care Networks.
Besides transforming our care team in the hospitals and right-siting care to the community, we also want to empower our people to take ownership of their health. We agree with the vision shared by Dr Haresh Singaraju on how social prescription is integral to preventive care and Healthier SG. That is why the Health Plan in Healthier SG includes encouraging patients to adopt lifestyle changes, more exercise and less unhealthy food.
However, we acknowledge that social prescription is still not commonly adopted, and there are more that we can do together to encourage that. We will work with community partners to make these interventions available to residents. In particular for seniors, the network of AACs will support them in this. Minister of State Rahayu has elaborated earlier in her speech.
In addition, the hospitals also have their respective initiatives in social prescriptions. I also want to assure Mr Pritam Singh that our public hospitals have in place protocols to expedite urgent cases in the Emergency Department, and urgent referrals from primary care to Specialist Outpatient Clinics. Waiting time alone is not indicative of the quality of medical services. Patients present with varying degrees of severity. And in all the top hospitals of the world, patients with more urgent and severe conditions are up-triaged and seen earlier and given necessary resuscitation. That is how healthcare systems function.
Based on several sources, which the Members can also Google, Singapore's healthcare system is consistently ranked within the top 20. In 2000, the World Health Organization ranked Singapore's sixth best in the world. Our public health institutions have also consistently been recognised as being one of the best in the world. In 2026, Newsweek and Statista, a global data platform, ranked the Singapore General Hospital 10th, while the National University of Singapore (NUS) and Tan Tock Seng Hospital are also in the top 100.
Singapore's healthcare system has delivered good health outcomes at an affordable level. Our life expectancy is about 86 years, as reported by the Institute for Health Metrics and Evaluation, ahead of many other countries, such as Japan, Switzerland, Australia, South Korea, the United Kingdom (UK) and the US. On the other hand, our national healthcare expenditure is at 4.4% of our GDP, which is less than half of what other countries spent. This was reported by the World Bank in 2019, and you saw earlier from the charts that Minister has shown that indeed we were able to achieve good health outcomes at a fraction of the cost relative to other countries.
In addition, our hospitals have contingency measures to respond to surge in bed demand. These include adding beds, expediting clinically appropriate discharges and deferring non-urgent electives to free up acute capacity for incoming patients. If required, hospitals can also tap on facilities, like the Transitional Care Facilities and the Mobile Inpatient Care @ Home, to augment overall capacity.
Even as we augment capacity, our people are at the heart of the healthcare system. Public healthcare institutions roster staff to ensure adequate rest in between shifts and also monitor the well-being of our staff as they care for our people. These are experiences we learnt also from the recent COVID-19 pandemic.
With the increased demand in mental health services, the Institute of Mental Health (IMH) will continue to serve as national centre for psychiatric services and focus on providing quaternary care to patients with more complex mental health needs. Mr Patrick Tay will be pleased to know that MOH has been giving IMH additional funding to enhance the psychiatric services and upgrade its infrastructure for better patient care, to be a leading hub for mental health training and education, and establish its position in tertiary and quaternary mental health research.
There are also ongoing efforts to enhance psychiatric in-patient, outpatient and crisis care capabilities across our public healthcare institutions to support individuals with both physical and mental health services in the same hospital. In each of these, care team transformation provides integrated care for patients – promoting team-based care, right-siting of care to the community so that it is more accessible and affordable for our people, and redesigning roles so that professionals are allowed to advance and perform at the apex roles in a safe manner.
The second pillar is to build a sustainable manpower pipeline. Our current healthcare workforce is broadly adequate for the population's healthcare demand. We will need to grow our healthcare workforce by 20% by 2030 to meet the projected manpower demand. We are working closely with institutes of higher learning (IHLs) to introduce more training pathways to build up a strong local pipeline through Pre-Employment Training.
Mr Cai Yinzhou would be pleased to know that the graduate-entry Master of Science (Audiology) programme at NUS runs biennially and has an average of 13 graduates per cohort. For podiatrists, demand is being met through scholarships for local talents to pursue podiatry studies overseas and recruitment of overseas-trained podiatrists.
To Dr Wan Rizal's query on strengthening the local pipeline of clinical psychologists while maintaining professional standards, we have worked with the Ministry of Education and NUS to offer eligible undergraduate students an accelerated pathway to specialise in Clinical Psychology at Master's level, with the first intake in 2026.
Unlike the current training model, where an undergraduate needs at least seven years to be qualified as a clinical psychologist, this includes four years for their Bachelor's degree in Psychology, followed by one or two years of work experience before enrolling in the two-year Master of Psychology (Clinical) programme, this new accelerated pathway for undergraduate-to-Masters pathway can be completed in five years.
It would enable aspiring undergraduates, who set their minds fairly early, to be trained as clinical psychologists through a carefully curated curriculum. This curriculum comprises didactic learning and clinical training during the undergraduate years, developing practitioners with knowledge and skills to care for their patients.
Graduates of this five-year programme will receive both a Bachelor's degree with Honours and a Master's degree.
NUS' new accelerated undergraduate-to-Masters pathway will complement existing postgraduate training pipelines, including its existing standalone two-year Master of Psychology (Clinical) programme for those with relevant clinical work experience. Together, these programmes expand our clinical psychologist manpower pipeline to meet increasing mental health needs.
Healthcare workers remain the bedrock of our healthcare system. Even as we create new training pathways, we have implemented strategies to improve retention of our healthcare workers.
We have spoken in this House before about the challenges in attracting and recruiting nurses, especially during the COVID-19 pandemic. While the attrition of nurses has since fallen back to pre-COVID-19 levels of around 7%, we will continue our efforts to encourage more nurses to stay and contribute to the public healthcare system, as well as attract aspiring individuals to build a career in this sector.
In 2024, we rolled out the Award for Nurses' Grace, Excellence and Loyalty scheme, and reviewed and adjusted nursing salaries in 2025. In 2025, we have also increased the salaries of allied health professionals (AHPs), pharmacists and administrative, ancillary and support staff in public healthcare institutions by up to 7%.
But retention of healthcare workers is not enough to build a robust healthcare system. We need to continuously upskill our healthcare workforce to take on new and expanded roles. Healthcare today does not fit neatly into traditional silos. A patient with multiple conditions needs professionals who can work seamlessly together. That is why we are moving from rigid, specialty-focused training to flexible, competency-based learning delivered via stackable modules in a work-study format where possible. This reduces time away from work and the impact on patient care.
For AHPs, we are working with IHLs to build up shared competencies across relevant allied health training programmes to better support a team-based shared-care model. These will be rolled out progressively, starting with students who begin their studies from Academic Year 2027 onwards.
Separately for mental health, the shared competencies are outlined under the National Mental Health Competency Training Framework to create a "common language" among our AHPs. With this, our AHPs will be more versatile and able to work more collaboratively to deliver care holistically.
For nursing, we are working with the polytechnics to redesign existing nursing post-diploma specialty programmes into a work-study format. This allows the nurses to learn and practise in real-world settings as training is based directly on job activities, enabling nurses to become competent and productive more quickly.
Two Advanced Diploma in Nursing programmes – Palliative Care and Community Health – will be prioritised for initial launch in a work-study format. With enhanced capabilities, our healthcare workforce is better positioned to deliver comprehensive care.
Ms He Ting Ru has asked for an update on the regulation of mental health professionals. We will be registering five higher risk sub-disciplines of psychologists to ensure high standards of practice, ethics and professional conduct so that our people receive safer and higher quality psychological services. These are clinical, clinical neuropsychology, counselling, educational and forensic psychologists.
MOH and partner Ministries will work with Singapore Psychological Society to raise public awareness of the psychologist professions and support our professionals and stakeholders in navigating the registration process. The detailed registration schedule, requirements and roadmaps will be announced by early 2027.
The third and last pillar is to develop a flexible and agile healthcare system that can respond to fast-evolving healthcare needs. One example is in mental health.
Mental health concerns came to the fore during the COVID-19 pandemic and remains a key national agenda in MOH. Ms He Ting Ru and Mr Alex Yeo asked about this.
Since the launch of the National Mental Health and Well-being Strategy in 2023, we have established the National Mental Health Office in 2024 to coordinate and oversee multi-agency mental health initiatives.
First, we have guided mental health service providers to adopt the Tiered Care Model and improve care coordination across different providers, enabling clients to receive seamless care at the most appropriate care setting.
Second, we have expanded the capacity of mental health services across the primary, community, acute and long-term care sectors. Polyclinics and GPs are equipped to provide care to individuals with mild to moderate mental health conditions, such as anxiety and depression. Community mental health teams provide a range of mental health support to individuals with mental health needs.
Today, we have 71 Community Outreach Teams (CREST) and 26 Community Intervention Teams (COMIT) to conduct outreach, screening and assessment, psychological intervention and service linkages for seniors with mental health needs or dementia and their caregivers. By 2030, we will expand the number of CREST and COMIT to 75 and 35 respectively. We have also established the First Stop for Mental Health services to facilitate easy access and navigation of mental health services.
Third, we expanded support in encouraging help-seeking amongst youths. Youths can access CREST-Youth and CHAT, which are sited in the community. Those who need psychosocial interventions may then be referred to the Youth Integrated Teams.
The recently launched Grovve – spelled g-r-o-v-v-e – at *Scape also provides mental health services to youths where they gather, to improve access and reduce barriers and stigma. Youth-oriented self-help services, such as Let's Talk and Ask-a-Therapist, can also be accessed on mindline.sg.
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In addition to these services, an ecosystem of support is available within the education system. Educators and staff are trained to look out for signs of distress in students, and refer those who require further support to counsellors in schools or IHLs as well as community mental health professionals. Peer support structures are in place for students to look out for one another and encourage distressed peers to seek help from trusted adults.
Youths are also taught ways to build mental wellness and resilience through the Character and Citizenship Education curriculum in schools and mental well-being programmes in the IHLs.
Fourth, we are enhancing capabilities of community service providers through the National Mental Health Competency Training Framework and have trained over 160,000 frontline personnel and volunteers to identify and guide individuals in mental distress to support avenues.
Fifth, we have promoted mental health and wellbeing through educational efforts for the general public, parents and youths through campaigns such as Beyond the Label and resources like Parenting for Wellness and the Positive Use Guide.
Lastly, we have strengthened workplace mental health support in collaboration with the Ministry of Manpower and Workplace Safety and Health Council. The Well-Being Champions Network has grown from 54 founding member organisations to 800 over the last two years.
As mental health is a complex and multi-faceted issue, we continue to work with various agencies to track and monitor medium- to long-term trends, including overall state of mental health and well-being of our population, for evidence of improvements from the baseline. Adopting a "no wrong door" approach to facilitate access to services and right-siting care in primary and community settings encourage individuals to seek help early in non-stigmatising environments while avoiding over-medicalising mental health needs.
We also hear Mr Eric Chua's concerns about our people paying for the silent addiction to explicit materials. On this, we recognise that addiction extends beyond individual health to affect families and the broader society. Individuals may also face underlying difficulties such as financial hardship and lack of social support.
The National Addiction Management Service, situated within the IMH, was established to provide treatment and assistance for individuals seeking help for addictions. The National Addiction Management Service specialises in addiction medicine research, which includes intoxicating substance use and emerging areas of concern such as Internet and gaming.
MOH, together with the Ministry of Social and Family Development, and National Council of Social Service, and other stakeholders across sectors, will continue to develop and enhance access to addictions services in the community.
Sir, healthcare is highly dynamic and fluid, compounded by shifting patient demographics and needs. As we navigate the road ahead and future challenges together, these three pillars will work in tandem to strengthen the core foundation of our healthcare system.
We are not just filling positions – we are building a sustainable workforce and system that can adapt, collaborate and deliver good quality care to all Singaporeans.
The Chairman : Senior Minister of State Tan Kiat How.
The Senior Minister of State for Health (Mr Tan Kiat How) : Sir, as shared by Minister Ong with this House earlier, welcome to super-aged Singapore.
This trend will accelerate. By 2030, one in four Singaporeans will be 65 years and older, and one in four of them will be aged 80 and above. Within the next decade, by 2040, one in three seniors will be aged 80 and above.
Seniors will likely need more support. For example, seniors use eight times the amount of hospital care than those who are younger.
So, I agree with many Members who spoke on the implications.
First, to caregivers. Today, it is not uncommon to see a working adult supporting elderly parents in their late 60s, who are in turn taking care of their parents in their late 80s. I certainly see many of such families in my constituency. With family size continuing to shrink, the burden on caregivers will get heavier.
Secondly, there will be increasing pressure on the healthcare system. If half of our seniors have at least one chronic disease, we will have to care for close to half a million of them in 2030, up from about 400,000 of them last year.
That is why we want our seniors to remain healthy for as long as possible. As the Minister said, it is not just about living longer, but living healthier for longer.
Today, I will outline how we are doing so, with technology as an enabler. First, getting seniors to age well in the community. Second, wrapping care around them. Third, supporting healthcare providers to deliver better outcomes.
As pointed out by a number of Members, many seniors face social isolation. A study has estimated that this risk is equivalent to smoking 15 cigarettes a day.
Members would be familiar with the Silver Generation Office (SGO). Since 2022, SGO has started preventive health visits, engaged more than 600,000 seniors and connected those with needs to services like AACs, Senior Care Centres (SCCs) and community mental health services.
Recognising that younger seniors are more digitally savvy, SGO is reaching out this group through the LifeSG app. Since December last year, over 3,000 seniors have received personalised recommendations on services useful to them. For seniors who have not yet availed themselves to this service, please check out the LifeSG app.
We have also grown the AAC network from 154 centres to over 230 over the last two years, now serving around 100,000 seniors. More than 150 SCCs provide day care services, including for those with dementia and respite care, and over 90 community outreach and intervention teams offer psychosocial support. We will continue to expand these services.
Mr Ng Chee Meng, Mr Yip Hon Weng and Mr Fadli Fawzi spoke up for caregivers and referenced what other countries are doing to recognise and support caregivers.
Like Members, we believe that caregivers play a vital role and we are doing more to support them. We are enhancing long-term care subsidies and grants. This year, we will raise the per capita household income (PCHI) threshold from $3,600 to $4,800. This will cover about seven in 10 households. I would like to assure Mr Ng Chee Meng and Ms Mariam Jaafar that these subsidies are not dependent on the number of Activities of Daily Living needs.
Last year, caregivers of over 14,000 seniors benefitted from subsidised home and centre-based respite services. We will do more.
From 1 April, more than 5,600 eligible seniors and their caregivers can benefit from the enhanced Home Personal Care service, featuring home-based respite care, medication reminders and 24/7 technology-enabled monitoring for fall detection and incident reporting.
Members also spoke about caregivers who are juggling work and care. We empathise with their challenges. Support is available through various Ministries' effort, for example, Flexible Work Arrangements and the Caregivers Training Grant, which helps to offset costs for training family caregivers and migrant domestic workers. Eligible caregivers can also tap on enhanced parental leave provisions such as the new Shared Parental Leave and Unpaid Infant Care Leave.
We will continue to study Members' suggestions as we explore ways to better support our caregivers.
Mr Victor Lye spoke about the unintended consequences of relying on PCHI to assess the caregiving circumstances of families. I appreciate his concerns. The PCHI means testing approach was discussed at the Budget debate last week. MOH takes dressing from this framework. However, individuals in difficult circumstances who require additional support can approach our medical social workers.
Mr Lye gave a few suggestions on how we can improve the current framework. MOH will study his suggestions with the Ministry of Finance.
Assoc Prof Terence Ho and Mr Eric Chua advocated for seniors to contribute to the community, including helping fellow seniors. I agree. Such involvement gives our seniors a sense of purpose. Seniors can tap on volunteering opportunities, with some organisations providing training and allowances.
For example, as Silver Generation Ambassadors, they help conduct outreach to other seniors. Seniors can also join the SG Healthcare Corps to assist with basic patient care. Those aged 50 and above comprise 20% to 40% of volunteers across these programmes. We welcome more partners to join this effort.
Let me turn to the topic of end of life.
I agree with Mr Yip Hong Weng's point that we want our seniors to "leave well", or as the Chinese say, "安然离去". Since 2023, we have significantly expanded community palliative care services, enhanced subsidies and facilitated hospital discharges at the end of life. We want more Singaporeans to spend their final days at home, in an environment where they feel comfortable, surrounded by loved ones.
The response has been positive. As of June 2025, the utilisation rate for home palliative care was around 90%. We will expand capacity as demand grows. We want to continue supporting families who wish to be with their loved ones at home during their final journey.
Next, I assure Mr Cai Yinzhou and Mr Yip Hong Weng that we do track outcomes of our programmes, such as frailty prevalence, social participation and caregiver well-being. We do so with different parties, including research institutions.
Let me now turn to care delivery transformation. By 2030, around 100,000 seniors will need help with at least one daily activity like eating or showering. They will likely need services from different service providers. We want their experience to be as seamless as possible and not have to run from pillar to post to receive these services. Technology will be a key enabler for tighter care coordination.
I agree with Mr Cai's point that we want to make it easier for seniors to access social and health services.
First, we have introduced Integrated Community Care Providers in 84 sub-regions around Singapore. This means a single party to coordinate care for seniors within each area. Currently, seniors undergo multiple care assessments done by different service providers they go to. Not only does this duplicate effort for providers and create greater inconvenience for our seniors, our seniors may also end up with uncoordinated care due to different care plans.
We will streamline this entire process. From next month, seniors requiring multiple long-term care services will need only one comprehensive assessment done by the Integrated Community Care Providers using a standardised, internationally-recognised tool. Each senior will have a single community care plan developed based on this assessment. Every provider that the senior goes to will take reference from this care plan.
Such an approach will ensure seniors benefit from a seamless experience and better coordinated care. We will progressively roll this out from October this year. We are enabling this new way of coordinating and delivering services through a common IT platform for community care providers.
Mr Azhar Othman asked about teleconsultations. I refer the Member to Senior Minister of State Koh Poh Koon's recent response to a Parliamentary Question on this matter. Fundamentally, MOH agrees with the Member to make good use of technology to improve the healthcare experiences for our patients.
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For example, the Productivity and Digitalisation Grant launched in 2022 has supported more than 240 projects, such as systems to automate showering and vital signs monitoring. We intend to enhance the grant to make better use of technology solutions in the healthcare sector, including harnessing robotics and AI.
Sir, when I brought this House through the Health Information Bill in January, I said that MOH will help healthcare providers meet the provisions. I am pleased to provide an update.
First, we are working with the vendors for health information management systems used by healthcare providers to comply with the necessary requirements. Second, we will provide resource guides and training to help healthcare providers and their staff understand and implement these requirements. Third, we will launch the National Electronic Health Record (NEHR) Connect Grant and open it for application in July this year.
The Grant will offset the cost for providers to onboard the NEHR. For typical healthcare providers, this grant will cover up to two years of subscription costs for the health information management systems. For providers with in-house systems, the funding support covers up to 40% of enhancement cost. MOH will set aside up to $45 million for this.
Let me illustrate how this work for a typical clinic with five staff. Most of them already subscribe to a health information management system. They can apply and benefit from the NEHR Connect Grant. On top of the NEHR Connect Grant, the clinic can receive up to 70% co-funding support from the Cyber Security Agency of Singapore to engage cybersecurity consultants. They also benefit from up to 50% funding support from Enterprise Singapore to adopt cybersecurity solutions, such as those for anti-malware. In total, the clinic can receive about $20,000 in grants. Sir, in Mandarin, please.
( In Mandarin ) : [ Please refer to Vernacular Speech .] During the Chinese New Year period, when exchanging greetings, I noticed that seniors would say "Gong Xi Fa Cai" less now. Instead, they often say "Good Health!". They understand the importance of maintaining good health, especially after the pandemic.
To encourage seniors to maintain their physical and mental health, we have established over 230 AACs. This year we will also designate integrated community care service providers.
Care teams will coordinate and plan more comprehensive healthcare according to seniors' needs. For example, if seniors need home personal care services as well as visits to senior care centres, they only need to contact one care team, reducing the hassle of liaising with different community care providers.
We are also actively using technology to provide more precise and convenient care experiences for Singaporeans. For instance, seniors at risk of falling can enjoy 24-hour smart monitoring under the enhanced home personal care services. If an accident unfortunately occurs, the system can promptly notify relevant personnel to provide help. This way, family members can also have peace of mind.
Nowadays, more seniors are becoming tech savvy. Therefore, we launched the LifeSG application. Through LifeSG, the SGO can interact with seniors and set personalised health plans for them.
Since December last year, over 3,000 seniors have benefited. From July this year, GPs can view patients' health records previously documented by specialists, hospitals and other medical institutions in their computer systems. This way, doctors can have a more comprehensive understanding of patients' conditions, formulate the most suitable personalised health plans for them and eliminate the need for the patients to repeat their medical histories. Seniors do not need to worry about remembering the diagnoses or medications that have been prescribed by the doctors.
As the saying goes, "having a senior at home is like having a treasure". We will leverage technology to enhance care quality and ensure that seniors receive treatment in a familiar environment. We will also continue to expand these services, so that every senior can receive the care and support they need. We want our treasures – our seniors at home – to live happily and age well at home.
( In English ): Through the Health Information Act and other digital health priorities, we are building a more connected, responsive and secure health system. This is in support of our broader healthcare transformation to anchor care in the community with more coordinated services that wrap around our seniors. Importantly, a healthcare system that puts people first.
The Chairman : We have some time for clarifications. Ms Mariam Jaafar.
Ms Mariam Jaafar (Sembawang) : Thank you, Sir. The Minister did not actually address many of the direct questions I had in my speeches, but he did acknowledge that there were many good ideas. So, I look forward to seeing some of those perhaps come in future, but I wanted to focus on three clarifications today.
One is to Minister of State Rahayu on the Woodlands pilot. I thank her for her sharing. My clarification is how is MOH also working with other agencies to get the most out of this pilot? It is one thing to have the HPB's digital wayfinding to find healthy food options. There is another to increase the number of healthy food options, especially halal food options. And that would require working with, say, the Ministry of National Development. Because when we have a coffee shop where there is only one halal store and it serves roti prata and mee goreng, and when you depend on those, it is kind of hard to maintain a healthy lifestyle.
My second clarification is for the Minister on the AI topic. The consultant in me says, absolutely, yes, fully support the practical use case approach. The important thing is that these use cases must scale; and some of the things he outlined does that. But scaling also requires a lot of work on infrastructure, governance and talent that I brought up in my cut speech. So, I wonder if he could say something about that.
My third clarification is also for the Minister, and I am happy to hear about the changes to MediSave500/700, or now we call it MediSave chronic and MediSave preventive care. It was actually entirely the crux of my suggestion on MediSave flex for that purpose. The Minister shared data on the healthcare expenditure on preventive care, for example, but how much of MediSave is used today for chronic and preventive care? And has the Ministry done any modelling on if we made MediSave chronic, MediSave preventive care, based on balances, how would that actually impact the sustainability?
Mr Ong Ye Kung : I will start with the second question, AI scaling. The points she made, we agree. So, I do not have much to add, but I think Ms Mariam Jaafar is also aware of all the steps we have taken, and she mentioned that in her cut. In terms of IT infrastructure, NEHR, Next Generation Electronic Medical Records, HEALIX, AI Medical Imaging Platform for Singapore public healthcare. We set up all this quietly in the background, and then at the same time, strengthened cybersecurity. So, a lot of background work has been done.
We are now, therefore, in a position where we are ready to say if a use case proves to be useful in a hospital in a particular sandbox, we can scale it up. That took many years of preparation. And I think we are ready to do that now in a very proactive way.
As for MediSave, it is difficult to do modelling. We can. But the fact is, the needs across the population are so different.
Sometime back, we gave an answer in Parliament how much MediSave is left at the point of demise for someone aged 85 and above, when they die. And so, we collated the data from 2017 to 2021. Two in 10 have less than $1,000; five in 10 have $1,000 to $10,000; three in 10 have more than $10,000. So, is it excessive? It depends on who we are talking about. Those with $10,000, $30,000. I think that is a lot. Those with less than $1,000, I think is barely enough.
We really need to save their MediSave towards their old age. So, I think some Members have raised this suggestion: can we have a bit more flexibility based on balances? Can we free up the rules a bit? It is conceptually correct, but it is not so easy. It is not a matter of modelling, but being able to cater to individual circumstances.
For a scheme that applies to the whole population, it is never easy to do precise policy. But we will have a go. We will try. We will take in the suggestion. We will try our best.
Since I am standing here, I will answer on behalf of Minister of State Rahayu. Working with other agencies in the community for the north, we might be thinking of different things. On more halal food choices, healthy choices, let us sit together and see whether we can work together with other agencies, including the National Environment Agency.
But what we are thinking about is actually a care model, not so much just food. We will look into that. But a care model where we encourage residents to do early check-ups, enrol for Healthier SG, with the support of a CHP that makes things very easy, a very convenient touchpoint that, together, with local Members of Parliament and advisors, we can make sure that more people respond to our preventive care push.
The Chairman : Dr Haresh Singaraju.
Dr Haresh Singaraju (Nominated Member) : Chair, I have two questions. This surrounds clinical capacity. One is on team-based care, as the Senior Minister of State has mentioned, that it has been around since 2015, and that is something which the clusters have done great works and set up frameworks for.
Yet many of the services, nurse-led, pharmacist-led, allied health-led services are underutilised. How exactly will the Ministry help in terms of the national effort to get patients and citizens to understand and trust the care that these providers provide? And second, is on the aspect of Healthier SG enrolment, where we have had residents who have enrolled across public and private. Have we studied the factors to strengthen that relationship such that patients do not drift across?
Dr Koh Poh Koon : Sir, I thank the Member for his two questions. On the first question of team-based care and whether certain AHP-led services are underutilised. We acknowledge that this is one of the challenges we have to continue to deal with, because patients do have autonomy on who they eventually want the care to be given. So, it is not something that we can do to force person to see a particular professional. And that is why, building rapport is important.
At the same time, we are also signalling that these are professionals that have been trained, given accredited certification to perform at a higher level. And over time, we hope that the lived experience of patients who have seen these professionals will validate some of the outcomes that patients are looking for, so that over time we build confidence, build rapport in the community, and patients will gradually accept the kind of referral pathways that we are channelling to.
One of the things that we are doing in the CHP is to have more nurses actually now fronting many of the conversations for our seniors. It is a good way to socialise to our seniors and our patients that the nurse can deliver many of the care that they already need. So, it will take multiple approach to do this and it will take some time as well. But increasingly, we are also seeing that this capacity will be better utilised by the population.
The second question on enrolment across the different providers, especially in Healthier SG, that indeed is something that we have to continue to work on. Because beyond enrolment is also how well the clients or the patients follow-up with what is needed in the implementation of the care plan. So, we are under no illusion that just because we roll out Healthier SG, everything will be very smooth right at the beginning.
It takes a bit of, not just system change in the providers, in the doctors and the care teams, but also, a gradual shift in the mindset of our population as well. So, it is something that we have to continue to do. There is no magic bullet to this and it is not something we can achieve overnight.
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The Chairman : Dr Hamid Razak.
Dr Hamid Razak (West Coast-Jurong West) : Chairman, I would like to ask two clarifications. One, for Minister of State Rahayu. I really welcome the care protocols for osteoporosis, such as frailty, from 2028. I would like to ask, if, as part of this care protocol, whether there will be intentional strategy to include early education for those in their 30s and 40s, precisely because peak bone mass and peak muscle mass happens much earlier through lifestyle interventions, such as nutrition, resistance exercises and vitamin D, whether that is going to be part of the strategy, so that we can frame this, not just as an ageing issue, but a life course preventive strategy?
Next clarification to the Minister. Really, I think a lot of the physicians will welcome that hereditary cancers will now be included as part of the coverage. I would like to ask because this is a high-risk group and risk reduction treatment in this group will definitely entail high costs, whereas MediShield Life is a principle of risk-pooling and this may be actually competing interests, whether the Ministry will look at design implications for MediShield Life as well as treating the treatment costs for these high-risk individuals in a single concept rather than as an episodic treatment? Because there may be a time lapse risk-reduction treatment for a healthy breast versus a breast that has already cancer detected and this will be supplemental cost throughout the life course of an individual.
Ms Rahayu Mahzam : Thank you for that question. The care protocols are still being developed. I thank the Member for this suggestion – something that we can look into. What we do is that we take guidance and recommendations from the Screening Test Review Committee as well as the Agency for Care Effectiveness Clinical Guidelines. So, there are some evidence and data that we will use in determining these protocols. But what the Member has raised will be something we will take back and will consider to be included.
Mr Ong Ye Kung : On HBOC, I hope I get the Member's question right. We actually did the modelling because risk-reducing mastectomy saves future treatment costs and overall, actually, the impact on MediShield Life is quite negligible, which is why we are prepared to do this.
The Chairman : Dr Choo Pei Ling.
Dr Choo Pei Ling (Chua Chu Kang) : Mr Chairman, I thank the Minister for his comprehensive response. In Tengah, Singapore's newest town with many young families, something quite remarkable is happening. Since last year, I have met 19 sets of twins among residents there. It reflects the stage of life many couples in Tengah are in as they begin building their families.
As the Minister noted, healthcare needs for younger population are often episodic. But towns, like Tengah, also gives us a rare opportunity to start prevention early. Could the Minister share how MOH is working with other agencies so that preventive health can be built into new towns, like Tengah, right from the start, rather than introduce only when populations have already aged?
Mr Ong Ye Kung : Some of the basic steps — It is like a fruit tree. We go for the lowest hanging. Then, we go higher and higher. Sometimes, we think of the highest first. The lowest is what Dr Haresh mentioned. We got to stick to one doctor, one GP, where he becomes our family doctor, advises us on the health of our family. Hence, Healthier SG.
So, a new town, like Tengah, please go for it and get as many people as we can, enrol for Healthier SG. After that, ensure that they follow up with their check-ups, with their vaccinations, with their health screening. It will help if the Member promotes anti-smoking, enforce against vapes. All these are very basic steps to ensure good health. Put all these in place.
Beyond that, we will be more than happy to work with Dr Choo, with other agencies, to see what other health programmes we can implement in the Tengah town.
The Chairman : Ms He Ting Ru.
Ms He Ting Ru (Sengkang) : Sir, I have three clarifications for Senior Minister of State Koh. The first relates to the new accelerated pathway for clinical psychologists. So, my clarification is, what is the projected increase in the number of entrants to the profession as a result of this, in the future?
My next clarification relates to the announcement of the registration of psychologists. I want to thank MOH for announcing this. I know there are a lot of people in the profession who actually really anticipate this, and they are very happy to hear this. I have two clarifications relating to this, and they were actually part of my cut.
The first is, what is the support for people who are aspiring to enter the profession? Because as I mentioned, the practicums and the supervision costs can be quite prohibitive. My clarification relates to what is the Ministry doing, or how is the Ministry looking to address some of the concerns about barriers to entry for professionals who are interested in entering the professions? And then, the second point is, for people who are actually seeking these services, for clients, what support is available if they have, in the meantime before these registration requirements come in, what recourse do they have and what support do they have if they have concerns about professional ethics and standards?
Dr Koh Poh Koon : Sir, I thank the Member for her three clarification questions. On the first question about how many psychologists will end up eventually in the system and what does the new pathway mean in terms of increasing the headcounts, I would say it is probably very hard to tell at the moment. The course, I think the initial phase of intake will only be about for 10. So, we will also see what the uptake is from the first intake of the course. But bear in mind that there is also a pathway for existing psychologists to upgrade. So, that is an existing pathway. We need to actually just sense out what is the demand overall from the undergraduates as well as the in-service psychologists over time.
The challenge also is because we have not done registration of psychologists before this. So, we do not really have an accurate number how many psychologists there are out there. But offhand, the Singapore Psychological Society has about 1,700 members. Most of them are also practising in the clinical space. So, if we take that as a ballpark, that is roughly probably the numbers that we are going to start with when we formally do the registration. But in time to come, once the registration is done, we will have a better grasp of the situation.
On the second question of what support will be given to the aspiring students who may want to enter the course, we are still in the midst of discussing with the institutions. But I would say, minimally, they will have to meet entry criteria, because that standard is not something we can lower. But beyond that, other support measures, like whether there will be subsidies for the course fees, it will largely, my understanding is, it will be in line with what the IHLs have today. So, if you are a Singaporean student, you will expect that there will be some subsidies to the fees.
The third question on how can the public, who may want to seek psychological care, know who is legitimate. In the meantime, before registration, it will be very hard for us to provide a detailed list of the individual specialists or psychologists. But perhaps, what they can do is to check whether this individual is registered, at least for the moment, with the Singapore Psychological Society. Because at least, that is the community of practice that is recognised as peers. So, that will be a place to start for now. But certainly, for those psychologists who are practising in our public healthcare institutions, there is already a governance framework in place and the public should at least be comforted that these are the ones that have already been under supervision and recognised by our public healthcare institutions.
The Chairman : Mr Pritam Singh.
Mr Pritam Singh (Aljunied) : Just two questions from me. One pertains to my cut on healthcare manpower. I also note the comments made by various officeholders about the super-aged society that we are here now. In line with this, is the Ministry looking at new indicators or data points with regard to how the healthcare system is working in this new environment? For example, we have got healthcare institution statistics, which MOH helpfully releases now, attendance at emergency medicine departments, time for admission to wards and bed occupancy rates. I think these are helpful.
But could there be other indicators that also would be helpful for the public, for example, waiting times at polyclinics? And would there be other indicators that reflect on how well the healthcare system is doing, looking after, especially given the new environment that we are in?
My second clarification deals with the other cut I had about the additional withdrawal limits. I take the Minister's point about MediSave and the karma of MediSave, that there will always be greater demands on it to deal with expenditures. But, of course, with the basic healthcare sum also increasing year-on-year, this would be inevitable to some extent. To that end, can I enquire whether there would be some consideration as to increasing the additional withdrawal limits through MediSave as well?
Mr Ong Ye Kung : I will put Mr Pritam Singh's suggestion into our wish list, which is getting quite long. We review this every year and the next time, we will review the wish list entirely. But to manage the Member's expectation a little bit, the focus of MediSave, I totally get the tension between big lumpy episodes versus recurrent expenses. But all these are done in the context of ensuring subsidised healthcare is affordable and minimising out-of-pocket expenses for Singaporeans. Additional withdrawal limits are for private insurance. So, we will keep that in mind.
As for the Member's first question, there are so many indicators in MOH. If the Member files a Parliamentary Question, I will have so many indicators to tell him that we are monitoring and that includes waiting times, Emergency Departments, polyclinics, bed occupancy rates, average length of stay across different settings. These are the immediate operational indicators.
Medium-term, we are hoping to make some impact in terms of enrolment into Healthier SG, follow up with the check-ups, rate of screening, rate of vaccinations. And in the even longer term, the health of the population, in terms of prevalence of chronic diseases, mortality rate for cancer, for example. So, the range of key performance indicators (KPIs) runs into hundred and beyond, but we will continue to monitor all of them.
The Chairman : Mr Cai Yinzhou.
Mr Cai Yinzhou (Bishan-Toa Payoh) : Chairman. I have four supplementary questions. The first is for Senior Minister of State Koh. It was mentioned that there was a Masters in audiology. But my question is whether we have plans for a diploma or undergraduate in audiology, as well as podiatry, which I understand we do not have any localised courses as stated on the NUHS website.
My second clarification is for Senior Minister of State Tan on flexible work arrangements for supporting caregivers. I understand that flexible work arrangements are differing context to context and workplace to workplace. How can MOH help to formalise the caregiver status and legitimise their need for flexibility in a way that they can better demonstrate to their employer the need for that flexibility?
The third question is on the Integrated Community Care Provider arrangements. I thank Senior Minister of State Tan for sharing about the One Care Assessment Plan and one assessment, which is clinical. Would there be enhancements in the pipeline beyond clinical outcomes to also having access one financial assessments, as well as a one employment coordinator for seniors who might be looking for part time employment?
My last question is on social prescription. We do see the need for social prescription in combating loneliness, which, as Senior Minister of Tan had highlighted, is equivalent of smoking 15 cigarettes a day. My question is, as we measure medical prescriptions, how are social prescriptions therefore measured and interventions tracked?
My question also stems from how AAC participation is the current measure from a previous Parliamentary Question that I filed regarding attendance as well as participation. How can we better take into account other areas that the seniors might be active in, for example, in faith-based or Community Club or Centre events or course-based initiatives that they might be volunteering at? How do we take that into account? Senior Minister of State Tan also highlighted there were studies ongoing with schools and if he could share a bit more details about what that entails?
Dr Koh Poh Koon : Sir, I thank the Member for his question on audiologists. In general, a qualified audiologist in Singapore needs a higher level of certification because a diploma level may not be quite enough to perform the task. So, we will look and see whether there is a way to actually find an in-between. But ultimately, we cannot sacrifice standards just to meet the needs of people who want to take a shorter course to get there. The first thing is to maintain standards.
But there are actually some of these audiology programmes that are done at a lower level. For example, I do believe that there are some basic industrial audiometry course at Temasek Polytechnic, but that is really more for industrial application of technicians who are actually screening at the industry level, not so much as a clinical setting where you actually provide services at the hospital.
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Mr Ong Ye Kung : I will answer the last question and for the first two questions, Senior Minister of State Tan Kiat How will answer.
Social prescription, can it be tracked? Realistically, it cannot be tracked, because it is your life. We are there to provide the support, the funding, to make it as easy as you can come to the AAC to participate. But as to what you do with your life, I am afraid I cannot track it and I do not think I should track it. But please enrol for Healthy 365 – at least, the app will help you track.
Mr Tan Kiat How : Sir, I will try to answer the questions from Mr Cai. To Mr Cai, please correct me if I heard your questions wrongly, because I was trying to get all your four questions. One of the questions was, whether social prescriptions are part of the One Care Assessment Plan. That is actually part of the Healthier SG, where the care plan also includes the social prescription. For example, diet, lifestyle, exercise and many more other areas. So, certainly, that should be part of that care plan, but this goes beyond what the Integrated Community Care Provider does, which focuses more on seniors and the needs of those seniors.
Mr Cai also asked if the the Integrated Community Care Provider and Agency for Integrated Care could cater for different sorts of activities, like faith-based volunteering or maybe for seniors who are interested in gardening as a social activity.
I would say that we are just starting to roll out the the Integrated Community Care Provider framework starting this year and over the coming years, and this is a non-trivial exercise across 84 sub-regions in Singapore – bringing together different parties and partners. In each area, each sub-region, there are different providers, different parties providing different services – from befriending services, rehabilitation services and many more.
So, bringing the different partners together, having a common language in which to discuss, understand and reach out and provide services to a senior is non-trivial. Having a standardised tool based on this assessment, developing a care plan, implementing this care plan and getting our seniors to go through the care plan entirely is non-trivial. So, I would say, let us take one step at a time and there are already many activities and other partners in the community providing different services and volunteering opportunities for seniors. We welcome it. It is really part of the fabric of a diverse community and very much part of the "we first" society.
The Chairman : Mr Fadli Fawzi.
Mr Fadli Fawzi (Aljunied) : Chairman, I have a clarification for Minister of State Tan Kiat How. I would like him to confirm whether MOH will take up my suggestion of a caregiver passport and whether MOH has any considerations which may prevent the suggestion from being adopted.
Mr Tan Kiat How : Sir, let me take the opportunity to also answer Mr Cai's question that I missed out earlier about flexible work arrangements and how can we work with different partners on that. I mentioned in my speech the different Ministries' efforts to support caregivers, and we understand the challenges that caregivers face, juggling between work and care. This is something they are working on, including flexible work arrangements and other initiatives. We will continue to work with our colleagues and other partners in the community.
And Mr Fadli Fawzi's question around the caregiver passport, if I get it correctly, that he has referenced in his cut, from the UK. As I mentioned in my speech earlier, I think Mr Fawzi was not in the room, we certainly welcome all suggestions from Members, including suggestions that other Members have raised as part of this MOH COS and in other occasions.
Specifically to his suggestion, I looked at it online. I must caveat to say that the information I got was what I could glean from online resources. It is a ground-up initiative in the UK and it is a way for the different parties involved ranging from hospitals to supermarkets he mentioned supermarkets earlier – to show care and support for caregivers. For example, some hospitals may provide longer visiting times. The hospital canteen may give some discounts to caregivers eating there and some supermarkets might give some discounts too. It is a ground-up initiative, where different parties come in.
Because it is a ground-up initiative, I understand that the implementation can be quite uneven. Caregivers going to different parts of the city in the UK may have different experiences. Going to different supermarkets will have different experiences. Some supermarkets do provide the support, some do not. It is a voluntary effort. And like many ground-up initiatives, we certainly welcome them. And there are many funding schemes in Government to support ground-up initiatives. If Mr Fadli Fawzi knows of individuals or parties who want to support our caregivers and organise a ground-up effort, we will look at those proposals.
The Chairman : Dr Wan Rizal.
Dr Wan Rizal (Jalan Besar) : Thank you, Chairman. Three clarifications for Senior Minister of State Koh. Senior Minister of State had shared earlier about the NMHO that was established to coordinate multi-agency initiatives. What would the Senior Minister of State Koh be able to share what are their KPIs, for example, whether there is a reduction in average wait times, improve care continuity, reduce crisis presentations? And how often will this, if any, be reported?
Senior Minister of State also mentioned that tied care and a no-wrong door approach, which I welcome. Will MOH share the desired service standards, for example, maximum time to first contact, maximum time to first clinical appointment for moderate or high risk cases and escalation protocols across settings?
And my third and final one is Senior Minister of State spoke about retention measures for nurses and allied health staff. Are there any retention levels for psychologists specifically? For example, specialist track, progression and the public sector pay competitiveness.
Dr Koh Poh Koon : Sir, on the first question regarding KPIs for the NMHO, I did mention in my earlier Parliamentary Question replies a few days ago that our key focus now is on building capacity, because in ensuring enough capacity to meet the needs of those who may need to seek help, naturally, it will reduce many of these waiting times. But what is important is that putting forth the First Stops for Mental Health, which is accessible – for example, mindline.sg is 24 hours and is accessible and it is anonymous – would really remove the key barriers that are holding everyone back from seeking at least the first contact point to get some advice and seek further help.
And in terms of KPIs, therefore, the First Stops would not have waiting time. There is a 24/7 available chatbot. There are counsellors who are manning the phone lines that you can actually call anytime to speak to them or to text them on WhatsApp. So, I think from that first touchpoint, there is really no waiting time.
But what is important is to make sure that the individual who gets into the first touchpoint, is prepared to also receive help from higher tiers of care if they need to. Often time, this is where the challenge is. Many of them will be reluctant to move on to the next tier of care, because as all of us have dealt with in a community on challenging individuals with mental health issues, sometimes getting them to even come forward to seek help is the problem. It is not that the resources are not there, but they are not willing to come forward.
And it is multi-factorial. It is difficult, so it is really about convincing them, working with them, earning their trust. And we hope that some of the First Stop resources we put forth will be a way in which our counsellors can convince the individual through a phone call to be prepared to step forward and receive care.
Having said that, that will flow into the second question on the Tiered Care Model, on whether there are ways to monitor those who are at high risk and whether they receive care. Again and following from the train of thought, I would want to assure the Member that those who are deemed to be high risk will always be prioritised. So, for example, if they receive counselling online or through a phone call and the counsellor assesses that this individual is at risk of suicide ideation, they will try their very best to convince the individual to step forward and receive care. And if the person is prepared to come forth, there will be a protocol to fast track them to make sure that they receive immediate attention from a qualified psychiatrist or even present at the A&E in IMH, where care can be immediately rendered.
Like I said, the biggest hurdle is whether they are prepared to step forward and not really the care capacity per se.
So, I hope this is something that the Member can understand, why it is not meaningful for us to track some of these timelines, because the counterfactual is unmeasurable. There is no way to measure who are at risk and whether they turn up or eventually they become a suicide case. The counterfactual is unable to be validated. So, we will therefore, focus on putting forth resources, to make sure that if they are prepared to step forward, the resources will be available.
On the third question on retention for psychologists. I think let us take one step at a time. We are starting with registration to give formal recognition to those who are practising in higher risk sub-sectors in psychology and making sure that the quality, the standards and the support is given to them to deliver the care that the clients and the patients need.
At the moment, we are not looking at anything more than that for now. But let us take it one step at a time.
Certainly, in the healthcare sector, we also have given out retention and measures to AHPs, I think it was in just about 2025, if I am not wrong. So, we will look at it holistically as part of supporting our AHPs.
The Chairman : Assoc Prof Jamus Lim.
Assoc Prof Jamus Jerome Lim (Sengkang) : My question is for Minister Ong. Sir, I mentioned lumpy medical expenditure in my cut, not just in the context of end of life care, but actually also on an ongoing basis. And this is based on feedback that I have received from residents.
At the same time, I am keenly aware of what Minister mentioned about the inherent tension between current and future usage, and that is why my suggestion to allow a carry over of unused annual limits for just up to three years, may actually balance the prudent drawdown constraints, while also permitting a flexible usage to meet lumpy needs.
So, if I may frame my question posed in my cut another way: what does the Minister perceive might be the logistical or behavioural difficulties that is associated with allowing this sort of limited carry-over of annual MediSave limits?
Mr Ong Ye Kung : I am not going to immediately say "Yes, good idea", or "No, we will reject it". I think it is an interesting idea. As I say, we review the scheme every year. I do want to see how we can create more flexibility and we will take your suggestion into account.
The Chairman : Mr Yip Hon Weng.
Mr Yip Hon Weng (Yio Chu Kang) : Thank you, Mr Chairman. My clarification is on ageing and the super-aged society. Of the seniors living within the vicinity of the AACs, what proportion of them are actually actively engaged? That is the first clarification.
And secondly, I understand that offices, like the SGO, do proactively engage seniors in their premises, but what else are we doing differently to engage seniors who are socially isolated who may not voluntarily step forward to join the AAC activities?
Mr Tan Kiat How : Sir, as I mentioned in my speech earlier, we have expanded the footprint of the AACs to about 230 centres. We have done so over the last two years. We serve about 100,000 seniors now and we want to do more in a few aspects.
First, it is not just the number of the AACs; which is one thing. The number of AACs make it more convenient, easier for seniors to come by to an AAC near their home and in an environment they are familiar with, in a neighbourhood they are familiar with. That is why we have expanded the footprint.
But beyond the number of AACs, it is also the activities that the AACs do to make it meaningful for the seniors, so that they come by and they are not socially isolated. They come by, they participate, they are engaged, they make new friends. And hopefully, they also can make changes to their lifestyle so that they can be healthier and happier.
And in the coming years, we will do more to expand the number of activities that AACs do, going beyond maybe just doing, for example, activities like healthy rumba and so on, to also create more awareness about health and also having CHPs within the AACs to provide services to our seniors. And we will continue to explore how we can do more. So that it is not just quantity, but the kind of activities.
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Thirdly, at the SGO, we have Silver Generation Ambassadors who reach out to seniors. As I mentioned, since 2022, they have engaged more than 600,000 seniors. They do so not just to reach out and speak to the seniors – they do befriending as well as preventive health visits – understanding the circumstances of the seniors that they visit at home, what kind of needs the seniors have, what kind of family circumstances are behind the closed door, and identify services, especially those near the seniors' homes, that are relevant to them and connect them to those services – whether it is AACs, SCCs or even mental health services.
The Silver Generation Ambassadors go beyond just doing visitations. They also provide a valuable touchpoint to the community and a connector to services that are around the vicinity of the senior.
We will want to do more for seniors who are socially isolated. We have been working with community partners, not just AACs and SCCs, but also other organisations in the community, including faith-based organisations and voluntary organisations to reach out to those seniors. We are working very closely with them.
That is where the ICCP comes in. For seniors who are discharged from public health institutions, that is, hospitals, how can we make sure that those seniors are not left alone, are not forgotten? That is where the referral process comes in with the ICCP. ICCP will work out the assessment and care plan for those seniors and crowd in partners to reach out to those seniors, especially those who live by themselves.
So, to the Member's point, I welcome any suggestions. This is an important priority for MOH in the coming years.
The Chairman : Ms Sylvia Lim.
Ms Sylvia Lim (Aljunied) : Thank you, Sir. I would like to return to the Minister's TikTok video. I should clarify that I do not usually watch his TikTok videos, but that particular one was referred to me.
I heard feedback from some people in the insurance industry that that video on IPs and riders created an impression in some members of the public that riders were not really necessary. In the video, riders were symbolised by a wooden horse. I think at one point in time, the Minister flicked the horse off the table.
I do not know whether the Minister is aware of that feedback that that video may have given the impression to members of the public that riders are not really that useful. Could he take this opportunity to reaffirm again that riders are indeed prudent for the reasons that I have mentioned in my cut?
Mr Ong Ye Kung : It is a challenge when attention span is so short and you try to put so much information in a short video.
I am not surprised the insurance industry gave you that feedback, but I think the video and the information that we have been putting out is a serious one, which is you have to examine if you really need a rider.
Let us go back a bit. The purpose of insurance is to cover expenses that we cannot afford. For most of us, it is because if we have a big inpatient episode running into tens of thousands, hundreds of thousands of dollars, a big bill, the insurance plus subsidy can cover it.
The rider does not do that job. We put cancer aside, the rider covers co-payment. The rider covers deductibles and the 5% co-payment. That is the core purpose of the rider.
Therefore, look at it carefully. Talk to your financial advisor. Given your premium, as you get older, the rider premium goes up the most, balance the cost and benefit to see if a rider is suitable for you.
I think the core message of the video continues to be accurate, that we should really take a look at our financial needs, what risks are we trying to protect and examine – do I need a rider? If I need a rider, will the new riders that the insurance companies are introducing in April, where you cover less of co-payment but at a much lower cost, are they more suitable for me? Take those steps.
Needs are varying. Different people have different needs. Some really wish to pay more premium in order to cover as much as you can. So be it. But for others, especially those who use public health institutions, use subsidised care, take a close look if you really need the rider.
The Chairman : Ms Lim. A quick one.
Ms Sylvia Lim : Thank you, Sir. To follow up with the Minister, is it not the case that if you do not have a rider, there is an exposure that the patient will have to pay hospitalisation bills at 10% without any cap? That is one of the concerns about loss limits in that sense.
Mr Ong Ye Kung : That is not quite accurate. If you are talking about riders, if you do not have a rider at all, yes, you do co-pay the 10%. If you are considering, I go to a private hospital where my bill may run up to hundreds of thousands of dollars and I want to protect myself against that 10% co-payment, yes, a rider may be suitable for you.
But do remember, as you get older, in your 70s, in your 80s, premium runs up to $10,000 a year. Without that rider, you are saving that premium. So, do your calculations. Talk to your financial advisor.
But if you are always seeking care in a subsidised public health setting, MediShield Life kicks in, plus subsidies, it is very unlikely you are exposed to tens, hundreds of thousands of dollars of exposure should you fall sick. Then, consider whether a rider is suitable for you. Remember, that in a public health institution, when you cannot afford it, there is MediFund that you can always apply for.
The Chairman : On that note, I think all clarifications have been asked and responded to. Can I invite Ms Mariam Jaafar, if you would like to withdraw your amendment?
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Ms Mariam Jaafar : I thank Members for the robust debate. I think healthcare is probably one of the most complex Ministries. On behalf of this Health Government Parliamentary Committee, I would like to say thank you to the healthcare family, from everyone at MOH to the frontliners in the hospitals and community. With that, I seek to withdraw my amendment.
[(proc text) Amendment, by leave, withdrawn. (proc text)]
[(proc text) The sum of $20,035,377,700 for Head O ordered to stand part of the Main Estimates. (proc text)]
[(proc text) The sum of $2,467,566,400 for Head O ordered to stand part of the Development Estimates. (proc text)]