2026衛生部供給委員會辯論：生成式AI輔助臨床文件

[(proc text) Debate resumed. (proc text)]

The Chairman : Assoc Prof Terence Ho.

8.12 pm

Community Caregiving for Seniors

Assoc Prof Terence Ho (Nominated Member) : Mr Chairman, Singapore is expected to become a super-aged society this year as the proportion of citizens aged 65 and above reaches 21%. While we have prepared for an ageing population for many years, we need to accelerate our efforts across infrastructure, systems and people. I would like to offer one suggestion, which is to establish a community-based caregiving corps.

Today, many Singaporeans acquire caregiving knowledge and skills only when their parents or loved ones fall ill, become bedridden or need help with the activities of daily living. We should consider large-scale training of caregivers ahead of time as most adult Singaporeans will at some point become caregivers to family members or supervise caregivers at home.

Those who are trained to a certain proficiency can form a community caregiving corps. It is costly both to the state and individuals for patients to rely only on hospitals or clinics for basic services, such as injections, wound care or physiotherapy. Where appropriate, self-care and community-based support can complement institutional healthcare services, with a caregiving corps within each neighbourhood playing a part.

Services provided by the caregiving corps could include basic clinical care, personal care, therapy, psychosocial support and related assistance within clearly defined care protocols. The corps could include young seniors trained to support older seniors. This would keep younger seniors active and engaged in the community, while at the same time, earning some supplemental income.

Caregivers in this programme would need to periodically refresh their skills, with competencies validated or accredited by healthcare institutions. An online directory or mobile application could help residents find the help they need within their neighbourhood.

We should similarly scale up training for domestic helpers ahead of demand. This would expand caregiving capacity across households, relieve pressure on the formal healthcare system and equip helpers with skills that enhance their employability and earning potential.

Community caregiving should be complemented by scaling up the deployment of technology within homes to help monitor the physical and emotional well-being of seniors, particularly those living alone. Such tools would enable care workers or small neighbourhood teams to keep track of seniors and coordinate services, like community nursing, cleaning and transport to polyclinics.

In this regard I would like to ask if the Ministry could elaborate on plans to scale up technology deployment through the Enhanced Home Personal Care service and other programmes.

Refreshing Caregiver Support Action Plan

Mr Ng Chee Meng (Jalan Kayu) : Chairman, Singapore will become a super-aged society this year. One in two who are healthy at 65 years old, are expected to develop severe disability at some point in their lifetime. This means that many Singaporeans will become caregivers at some point. Our families, especially those who are middle income and sandwiched between young and old, will come under increasing pressure and strain.

8.15 pm

Our women, who traditionally shoulder a more of the caregiving load, will be disproportionately impacted. I thank the Ministry for providing more support for our caregivers under the Caregiver Support Action Plan. Launched in 2019, caregiver support has been enhanced in a few areas, including respite care, subsidy levels and the Home Caregiving Grant. Further, through Age Well Singapore programme, we will help more seniors age well in the community.

I have a few clarifications and would like to provide some suggestions on how we can refresh our Caregiver Support Action Plan in the next bound.

First, what are the critical gaps in accessibility, affordability and quality of eldercare services that our middle-income families continue to face? And what are the Ministry's plans to address these gaps? Addressing these gaps are important, so that working caregivers can continue working with peace of mind that their loved ones are well-cared for.

Second, whether the Ministry will consider expanding the means-tested Home Caregiving Grant to provide more support for more caregivers, including those who care for family members who require assistance with one to two Activities of Daily Living (ADL), below the current eligibility of three ADL today.

Family members who have mental health conditions or degenerative diseases, such as dementia, which is becoming more common, who may require high supervision but may not necessarily qualify for the three ADL criteria today.

Preventive Healthcare in the Community

Mr Alex Yeo (Potong Pasir) : Sir, in my speech during the debate on the Motion of Thanks for the President's Address last year, I had highlighted that, while we now live longer, the years that we live in good health is on average 10 years shorter. Ideally, our life-span and our health-span should be closer. The concern that we live long but not well, is real.

Preventive healthcare is therefore vital to help our seniors reduce years of bad health and increase their quality of life in retirement. The Healthier SG Programme was launched to address this. However, I wish to advocate for the Ministry to do more and expand the range of preventative healthcare for our seniors.

I will address two areas related to the Healthier SG Programme.

First, based on 2023 data, 11% of those above the age of 70 have dementia and 16% above the age of 70 have osteoporosis. We can expect the numbers to have increased and continue to increase in our ageing society. Dementia is both debilitating and scary for seniors. Poor bone health on the other hand, leads to deteriorating mobility and overall health in seniors, especially after a fall.

Both conditions take a tremendous toll on caregivers in the family. Pre-dementia screening and Bone Density Tests allow for: one, early detection; two, timely intervention which can slow down the progression; and three, better long-term planning, which gives our seniors and their families the time and opportunity to make necessary adjustments.

I had asked a Parliamentary Question in September 2025 on whether the Ministry had plans to include as part of the Healthier SG Programme, screenings for pre-dementia and osteoporosis. I was heartened when the Ministry had indicated that Care Protocols for Dementia and Osteoporosis were being developed under Healthier SG.

I would like to seek an update from the Minister on the progress in including Care Protocols for Dementia and Osteoporosis under the Healthier SG Programme, including the timelines of the roll-out of the screening assessments and whether they will cover all seniors above a certain age.

Second, according to the National Population Health Survey 2024 conducted by the Health Promotion Board, 54.7% of Singapore residents in the oldest age band, 60 to 74 years, were least willing to seek help from healthcare professionals, while 70.9% of those aged 30 to 39 were the most willing to do so. Our seniors can face loneliness, grief, loss of purpose after retirement and the anxiety of declining health and independence. They also belong to a generation that may not often have the vocabulary to convey their mental well-being needs.

In the Committee of Supply 2025 debates, it was announced at that Healthier SG care protocols for major depressive disorder and general anxiety disorder would be rolled out. With the increased emphasis on mental wellness, I would like to enquire on the status and ambit of this roll-out, particularly for our seniors and whether it would expand to other mental ailments.

Relatedly, I would also like to ask the Minister if he can provide our Active Ageing Centre Teams or even our Silver Generation Ambassadors, structured training in basic mental health first aid, so they can be first responders for emotional well-being in the community.

Video Calls with Doctors

Mr Azhar Othman (Nominated Member) : Visiting hospitals can often be an unpleasant experience, unless one is expecting a newborn. I want to address the challenges faced by many individuals, including my own experiences. As many are aware, when our elderly parents go for check-ups, they often require the assistance of their children. This process typically involves several tests, followed by consultation with a doctor regarding the next steps.

I am aware that certain medical institutions offer video consultations. If I may propose that we utilise video calls to all hospitals and polyclinics and minimise waiting times and the hassle of hospital visits for simple updates. While I understand that some situations necessitate in person consultation, technology can significantly enhance the overall experience. By leveraging available technology, and now with AI, we can support especially the sandwich generation who juggle responsibilities for both their children and ageing parents.

These caregivers often need to take time off from work for medical appointments and the lengthy waits sometimes over an hour; even two or three hours for brief updates can be frustrating.

For instance, when my son had a football injury, we faced a similar situation. After waiting for over an hour, the doctor's update lasted for only for five to 10 minutes. Such interaction could be efficiently handled through video calls, which would also allow for real time updates on waiting times for treatments.

The time and energy required for parents to attend these appointments can be overwhelming. I hope the Ministry considers implementing solution that facilitate a similar experience for those caring for both elderly parents and young children.

Clinical Capacity and Social Prescribing

Dr Haresh Singaraju (Nominated Member) : Mr Chairman, I address the Minister on two fronts: strengthening social prescribing and optimising clinical capacity. Beneath both lies one observation. We have built the parts of a better healthcare system, including social programmes, trained professionals and enrolment infrastructure. My three asks are about making them work together.

I welcome that social prescribing is already part of our system under Healthier SG, but the referral options remain narrow, largely involving Active Ageing Centres and Sports SG, while the ecosystem around is wide. This limits the match to what matters to the patient and when we match well, they go. To match well, our care teams need a maintained real time directory of what exists in each neighbourhood.

We are not starting from scratch. SingHealth Community Hospitals are the world's first World Health Organization Collaborating Centre for Social Prescribing with trained well being coordinators and proven outcomes. The Living Asset Map developed by SingHealth Community Hospitals with the Ministry of Culture, Community and Youth and Singapore Land Authority already captures community assets in real time, updated by practitioners on the ground. The evidence is there.

The Minister himself said in Geneva in May 2023, that 60% of health is socially determined, not in hospitals, but in homes and in communities. My first ask follows from his words: scale the Living Asset Map across all three clusters. Map the full ecosystem: arts, culture, heritage, nature, sports, informal community partners and interest groups and resource link workers to close the last mile.

Some may worry that widening referrals could overwhelm social partners. That is precisely why the ask is not an open floodgate, but a mapped, maintained and matched pathway resourced to sustain. But a pathway only works if patients stay long enough to use it.

Healthier SG has enrolled over 1.3 million Singaporeans as of August 2025, but enrolment is not yet activation.

From what I see in practice, not all enrolled patients have completed even a first health plan. They have signed up, but never sat down. Enrolled patients can still seek care elsewhere. Some will ask, is this not about patient choice? It is. But continuity is not exclusivity. No one loses the right to see another doctor. What changes is the default that one doctor, one team knows you. Subsidies encouraged the first step, but a subsidy is not a relationship. Without activation, patients drift and the social needs that only surface over time never do.

My second ask activate what enrolment promises. Publish how many enrolled patients stay and how many actively engaged through follow-ups, screenings and care team visits? We must continuously learn what make patients stay. The Ministry consulted widely before Healthier SG launched; continue that rigour. And resource are providers GPs and polyclinics alike to keep them.

Keeping them takes a team. Team-based care is the direction our system has committed to, our clusters have built the frameworks. We have trained nurses, pharmacists and allied health professionals to practise at the top of licence. But without familiarity, many patients choose otherwise and never benefit. What we hear on the ground suggests utilisation is not where it should be. If we build capacity and fail to activate it, the system pays twice: once to train; once when the doctor does the same work. As we prepare to inject more professionals into the system, getting this right is not optional. It is the condition for that investment to pay off.

Some will say patient preference for doctors is too strong, but care is growing more complex and no single pair of hands can manage it alone. That is why we have trained these professionals in the first place, not to replace the doctor, but to surround the patient. Preference follows familiarity, but familiarity requires introductions and reminders. That is the national effort I asked for.

Think of aviation. Co-pilots were trained, but deferential. The captain made every call. The industry changed the default to structured team functioning. Every professional's input carried weight. Accident rates fell. The same principle applies. The clusters can build the frameworks, but shifting public expectation requires more than any single cluster can do alone.

My third ask: lead that national effort to help Singaporeans understand and trust the care that nurses, pharmacists and allied health professionals provide. Support the clusters in ensuring investment in training translates into care.

Three asks each with a metric, each building on what already exists. Mr Chairman, let me show you what this looks like when all three asks work.

A senior enrols at her neighbourhood clinic. Because she stays, her doctor learns her story.

Over months, he stabilises her chronic conditions. Once stable, her nurse takes over, adjusting medications, coaching on lifestyle and function preservation. Her care coordinator tightens preventive care. She remains well for a year, then two, then her blood pressure climbs. The nurse titrates. It climbs again. She misses an appointment. The care coordinator calls and brings her back. She misses another. The nurse flags it. Something else is going on. She comes in this time. She tells the doctor that her husband died last year. She has not left the flat since.

He refers her through the social prescribing pathway and a link worker to a gardening group three blocks away. She liked gardening. She goes and she goes again. Her blood pressure finally holds. She did not need a new programme. She needed a care team alongside her and a community partner that mattered to her. Let us build that environment.

8.30 pm

Technology and AI in Healthcare

Dr Choo Pei Ling (Chua Chu Kang) : Mr Chairman, in healthcare, technology is often discussed in terms of speed, scale and innovation. But for patients, it is much simpler. It is about whether they can return home.

In stroke rehabilitation, I often meet patients who ask a single question, "Will I be able to walk independently again?"

They are not asking about algorithms or processing power. They are asking about dignity and whether their lives can resume some sense of normalcy.

As Singapore becomes a super-aged society, the question before us is not whether we embrace technology in healthcare. The question is whether we deploy it in ways that strengthen independence, reinforce our workforce and preserve sustainability in the long term.

Three shifts will determine whether technology becomes transformational or merely incremental.

First, from extending lifespan to extending healthspan. Singaporeans are living longer, but longevity without independence places strain on families, caregivers and the system itself.

AI-assisted imaging, predictive analytics under Healthier SG, earlier risk stratification for cardiovascular disease and remote monitoring of chronic conditions allow us to intervene before deterioration becomes crisis. Fall-risk modelling can prevent fractures. Early detection can reduce severe complications. Predictive bed management can smooth demand pressures.

But the true measure of progress is not technological sophistication. It is whether fewer seniors lose mobility, whether fewer families experience preventable emergencies, whether more Singaporeans can age confidently in their own homes.

When we predict earlier, we intervene earlier. When we intervene earlier, we preserve independence longer. That is not only clinical progress. It is social stability and fiscal resilience in an ageing nation.

Second, from labour intensity to capability amplification.

Healthcare will always be human, but our professionals today face rising clinical complexity alongside administrative burden and coordination demands.

Generative AI can assist with documentation. Clinical decision-support systems can synthesise complex patient histories. Digital triage tools can prioritise risk more effectively. In rehabilitation, sensor-guided therapy systems and carefully deployed robotic technologies, including exoskeleton-assisted gait training for selected patients, can increase therapy intensity safely and consistently, particularly in early recovery. This allows therapists to focus on assessment, clinical reasoning and patient engagement rather than repetitive supervision.

Technology must give clinicians back time, not take professional judgement away. If technology reduces cognitive overload and unnecessary administrative friction, it sustains morale, protects professional standards and helps us retain the workforce our system depends on. A sustainable healthcare system ultimately depends on a sustainable healthcare workforce.

Third, from throughput to meaningful outcomes. Healthcare systems often measure performance in terms of waiting times, bed occupancy and utilisation volumes. These indicators are important for operational management.

But patients measure success differently. Can I climb the stairs to my flat? Can I return to work? Can I care for my grandchildren? Can I live independently without becoming a burden to my family?

As we scale AI and rehabilitation technologies, we should continue embedding functional indicators – mobility, independence, caregiver burden, re-admission reduction and return-to-community participation – alongside utilisation metrics. Technology should improve outcomes that patients feel, not just metrics we report.

Mr Chairman, Singapore's strength has never been blind adoption of new tools. It has been discipline in the implementation. In healthcare, that discipline means scaling technologies that demonstrably improve independence, strengthen professional capability and remain financially sustainable in a super-aged society.

As Singaporeans live longer, our ambition must be clear – not merely to extend years of life, but to extend years of mobility, confidence and participation. Because ultimately, the goal of healthcare is not activity, it is dignity across the life cycle.

If we deploy technology wisely, we will ensure that Singapore's healthcare system remains advanced and not only that, but also humane, resilient and sustainable.

The Chairman : Minister of State Rahayu.