預算辯論 · 2026-03-05 · 屆國會 15
2026衛生部供給委員會辯論：預防醫療與AI
衛生部長王乙康在供給委員會辯論中宣佈新加坡正式成為超老齡社會（65歲以上人口超21%），推出ACE-AI預測工具（由Synapxe開發）用於糖尿病及高脂血症風險篩查，強調"AI增強而非AI決定"原則，2027年初推廣至所有Healthier SG診所。同時宣佈BRCA1/2基因檢測補貼（2026年12月起，最高70%補貼），MediShield Life將覆蓋預防性手術（乳房切除術Q3 2026、輸卵管卵巢切除術Q4 2026），MediSave慢性病與預防護理限額提升（2027年1月起500/700提至700/1000），惠及91萬+患者。
關鍵要點
- • 新加坡正式成為超老齡社會
- • ACE-AI預測糖尿病/高脂血症風險
- • AI增強而非AI決定原則
- • BRCA1/2基因檢測補貼
- • MediSave限額提升惠及91萬+患者
推動AI預防醫療，強調臨床醫生把關
醫療AI預防性應用與健保制度改革
“AI-enhanced, not AI-decided — clinicians remain in the loop.”
參與人員 (1)
完整譯文（中文）
Hansard 原始記錄 · 2026-05-02
[(程式文本) 預算總目O（續）‒ (程式文本)]
[(程式文本) 繼續辯論問題 [2026年3月4日] (程式文本)]
[(程式文本) “將預算總目O的撥款總額減少100元。” ‒ [瑪麗亞姆·賈法爾女士]。(程式文本)]
[(程式文本) 再次提出問題。(程式文本)]
主席：衛生國務部長拉哈尤·馬哈贊。
上午10時33分
衛生國務部長（拉哈尤·馬哈贊女士）：主席先生，我的發言涵蓋了本部將護理服務更貼近社群的舉措，我們如何加強健康生活的環境和生態系統，以及我們改善人口健康的努力。
隨著社會老齡化，改善人口健康和預防保健對於實現更長壽、更健康的生活至關重要。我們通過“健康新加坡”和“樂齡新加坡”將預防醫療嵌入社群，支援居民在仍相對年輕健康時，以及隨著年齡增長時的健康需求。
亞歷克斯·楊先生和哈米德·拉扎克醫生會高興地知道，關於衰弱和功能健康（如骨質疏鬆和痴呆症）的“健康新加坡”護理協議正在順利制定，預計於2028年推出。這些護理協議將確保通過“健康新加坡”的全科醫生（GP）更一致地提供循證護理。
瑪麗亞姆·賈法爾女士也談到了改善社群健康，特別是北部地區。我們的資料顯示，北部地區糖尿病和高血壓的患病率高於全國平均水平，居民的體育活動較少。我們在持續審視這些趨勢的原因的同時，也在加大該地區的預防保健力度。
我們將從兀蘭鎮開始。首先，我們將提升該鎮的社群健康站（CHP）。其次，我們將改善社群內由專科醫生支援的護理服務的可及性。第三，我們將通過開放社群空間開展鍛鍊專案、在“健康365”中引入數字導覽功能以及賦能本地社群健康倡導者，支援居民參與健康生活活動。
隨著老年人年齡增長，因行動不便，前往多科診所和醫院變得困難。許多人也忽視尚未嚴重或緊急的症狀。及早諮詢醫療專業人員可以更早發現問題，從而實現更早干預和更好的健康結果。我們贊同哈雷什·辛加拉朱醫生的觀點，即將患者與社群資源連線起來非常重要，我們正通過將護理直接帶入社群來提升醫療服務的可及性。
我很高興宣佈，自今年初起，國大醫院集團健康部門已逐步提升兀蘭鎮的11個社群健康站。這些位於活躍老齡中心（AAC）內的升級社群健康站將每週開放一次。所有居民，包括非老年人，都可以隨時前往這些升級社群健康站，獲得諸如一般健康諮詢、基本健康評估和社會處方服務（包括將居民與社群專案和資源連線）、預防健康和疾病管理支援（包括健康指導、用藥評估以及慢性病和衰弱管理專案）、照護者支援及出院後隨訪等服務。
這些服務由國大醫院集團健康部門的社群健康團隊提供，團隊成員包括社群護士和健康指導員，並根據居民需求引入藥劑師、營養師和治療師。他們還與該地區的全科醫生及醫院的醫療專業人員密切合作，為患有慢性病和衰弱的居民提供協調護理。例如，糖尿病患者可在升級社群健康站獲得持續支援，包括血糖監測和個性化健康諮詢，社群健康團隊會定期向患者的專科醫生更新其進展和病情變化，確保必要時能及早採取干預措施。
對於已經在活躍老齡中心參加專案的老年人，他們也可以方便地諮詢醫療人員，無需另行訪問。我們還注意到，一些患者因工作安排或行動不便而錯過專科預約。為此，兀蘭醫院將於本月底啟動一項新舉措，通過兀蘭鎮的升級社群健康站和與個人的遠端會診，為社群患者提供專科醫生支援的護理。
從糖尿病和哮喘開始，選定患者可以選擇通過遠端會診，在升級社群健康站接受專科醫生支援的門診護理。患者無需前往兀蘭醫院，而是在升級社群健康站見健康指導員或護士管理病情，並通過遠端會診獲得專科醫生的支援。通過定期監測健康狀況，護士能夠及早發現控制不佳的跡象，與專科醫生合作進行早期治療，幫助患者避免不必要的住院。
兀蘭醫院還開始為接受結腸鏡篩查且篩查結果低風險的選定患者推廣遠端會診。患者無需親自前往兀蘭醫院，如需幫助，可選擇在任何地點（包括社群健康站）遠端會診專科醫生。此項服務將進一步擴充套件至兀蘭醫院的其他專科和程式。
通過這些服務，患者將在社群護理團隊的支援下，在鄰里中獲得更好的照護，同時減少前往兀蘭醫院的次數。這將幫助患者以更靈活的方式獲得所需護理，同時兼顧其他事務。國大醫院集團健康部門估計，此舉將節省約500次專科門診的實體就診，隨著該舉措的推廣，節省次數預計將進一步增加。
即使我們將醫療服務更貼近社群以提升可及性，我們也認同瑪麗亞姆·賈法爾女士的觀點，即健康始於個人選擇，我們可以設計更健康的生態系統，支援個人在不同環境中做出更好的健康選擇。
一個關鍵環境是居民所居住的鄰里。健康促進局（HPB）進行的一項研究發現，居民更願意參與在日常環境中舉辦的健康活動，這些環境應當便捷、綠化良好且能無縫融入他們繁忙的生活。他們也重視有趣且由社群驅動的社交體驗。
這些見解表明，需要與本地社群合作伙伴採取協作的自下而上的方法。他們既瞭解居民的需求和偏好，也熟悉鄰里的社群空間。他們在促進鄰里設施和空間的使用、鼓勵參與活動以及建立社交聯絡方面發揮關鍵作用，使健康生活既吸引人又可持續。
因此，健康促進局將與本地社群合作伙伴合作，使居民更容易參與健康生活活動。從2026年4月起，更多居民將能在熟悉、便利且寬敞的地點參加鍛鍊和運動課程，這些地點包括社群大廳、廣場和鄰近住宅的商場，如888廣場和富春社群中心。
在社群舉辦更多活動的同時，我們將幫助居民探索並更好地利用現有的鄰里設施。健康促進局將增強“健康365”手機應用，加入導覽和遊戲化功能，連線居民與附近的健康和活躍機會。例如，居民可能會被提示完成鄰里內公園連線道或步道的快走，並在指定點完成數字“簽到”。該功能將於2026年6月起逐步推出。居民通過“健康365”應用追蹤參與情況時，仍可獲得獎勵。
除了基礎設施，關鍵還在於軟體——社群的網路和紐帶。我們希望居民彼此關心，鼓勵親友、鄰居參與更健康的生活方式，建設更健康的人群和更健康的城鎮。
健康促進局將支援深刻理解居民需求和社群資源的本地社群利益相關者，共同設計健康生活方式專案。這包括從2026年6月起開發以公民為中心的操作手冊，幫助合作伙伴有效規劃適合居民的相關活動。
通過集體所有權，居民將受益於為他們量身定製的健康生活方式計劃和活動。我們還將共同監測進展，不斷完善和改進這些舉措。健康促進局（HPB）將探索如何將成功的元素推廣到其他城鎮。
除了自下而上、社群主導的倡議外，我們還在尋找減輕生活方式風險因素、改善人民健康的方法。一個例子是何亭如女士提到的世代禁菸或無煙世代政策。這意味著從特定出生世代開始限制所有菸草產品的獲取。
通過我們目前多管齊下的政策措施、公眾教育和戒菸支援，我們在降低吸菸率方面取得了良好進展。吸菸率多年來持續下降，2024年降至8.4%，18至29歲年輕成人的吸菸率更低，約為5%。
我們也在不斷審視我們的菸草控制政策，包括一些其他國家正在探索的無煙世代政策。採用世代禁菸政策需要認真考慮。我們對該政策持開放態度，將研究其有效性、影響以及如何在新加坡的背景下實施。
衛生部（MOH）正集中精力打擊電子煙的禍害。因此，目前我們將繼續關注國際動態，借鑑其他國家實施世代禁菸政策的經驗。主席先生，請允許我用馬來語說幾句話。
（馬來語）：[請參閱本地語演講。] 採用更健康的生活方式是我們社群需要共同努力的目標。2024年全國人口健康調查顯示，我們的馬來/穆斯林社群在某些方面還有提升空間。首先是健康篩查。馬來族群的慢性病篩查率下降了近10個百分點，從2019年的64%降至2024年的55%。乳腺癌篩查率從2019年的29%降至2024年的僅18%。當慢性病和癌症未能早期發現時，可能會出現嚴重併發症，需要更密集且昂貴的治療。
我理解健康話題，如篩查，可能讓人感到畏懼。因此，能夠在熟悉的環境中與值得信賴的醫療工作者交談以獲得指導非常有幫助。對我們社群的許多人來說，清真寺就是提供這種支援的場所。因此，我很高興宣佈，位於兀蘭的兩座清真寺——安努爾清真寺和尤索夫·伊沙克清真寺，將於2026年9月與國大醫院集團（NHG Health）合作，提供社群健康計劃（CHP）服務。將提供一系列服務，從一般健康諮詢和基礎健康評估，到預防健康、疾病管理和出院後跟進支援。
上午10點45分
我們將根據社群需求定製這些服務，例如，諮詢可由流利馬來語的社群護士和健康教練進行，以幫助減少溝通障礙，尤其是對老年人。NHG Health還將徵求阿薩提扎（伊斯蘭教教師）的反饋，將信仰指導納入健康講座。通過將醫療服務帶到社群常去的熟悉場所，並與宗教及社群領袖合作，醫療服務將更易於社群獲得。
為了進一步鼓勵馬來/穆斯林社群進行健康篩查，自2025年5月起，健康促進局試點了“Jom Check!”（讓我們檢查！）計劃。該計劃在小組環境中提供個別支援，幫助居民註冊“更健康的新加坡”（Healthier SG）並預約健康篩查。這是與多家醫療合作伙伴共同開展的。截至目前，已在全島組織了16場活動，覆蓋超過300名居民，反饋積極。因此，健康促進局將擴大“Jom Check!”計劃，惠及更多居民。
像現在定期進行健康篩查這樣的小行動，可以預防未來更大的健康問題。通過“更健康的新加坡”，這更容易實現，符合條件的註冊者可享受健康篩查的特別補貼。目前，約57%的符合條件居民已註冊“更健康的新加坡”，60歲及以上人群的註冊率更高，約為70%。我們的社群在過去一年中註冊增長最高，這非常令人鼓舞。對於尚未註冊的人，我強烈鼓勵你們邁出關鍵一步，今天就註冊。
第二個關鍵問題是肥胖。我們社群中有32%，約三分之一的人肥胖，較2020年的24%上升了近10個百分點。這是一個重大關切，因為肥胖增加了患多種慢性病的風險。全國營養調查顯示，我們社群的熱量攝入以及甜食和飲料的消費量最高。我們還攝入大量飽和脂肪，這可能與過量使用食用油有關。然而，我相信我們可以做出符合生活方式和文化的小而可持續的改變。事實上，在我們的文化和宗教中，平衡非常重要。照顧好我們的身體是一項神聖的責任。讓我們減少糖、鈉和飽和脂肪的攝入，吃健康均衡的飲食。
政府與伊斯蘭宗教理事會（MUIS）、馬來族群教育與發展理事會（MENDAKI）、人民協會親善坊（PA MESRA）及“守護健康，守護社群”網路（JKJU）合作，將繼續支援提升社群健康和福祉的努力。看到社群穩步進步，我感到欣慰。通過重點領域五（FA5）的努力，2025年已有超過9萬人參與各類專案。
我們正值齋戒月，這是我們社群決心過更健康生活的理想時機。我們將繼續與合作伙伴攜手，走進社群。來吧，讓我們今天就邁出第一步，報名參加健康計劃。
（英文）：主席先生，我們的目標是確保通往更健康生活的道路足夠寬廣，讓每個人都能行走。通過我們的舉措，沒有人需要獨自面對健康之旅。通過與社群合作伙伴和居民攜手合作，我們可以建設一個健康生活包容、可及且成為每個人現實的新加坡。
主席：王乙康部長。
社會政策協調部長兼衛生部長（王乙康先生）：主席先生，三年前，即2023年4月，我曾向議會通報，新加坡將在2026年——也就是今年——成為超級老齡社會。屆時，65歲及以上人口將達到21%或以上。
如果你考慮到，2025年6月，也就是去年，65歲及以上人口已達20.7%。這一比例每年大約增長一個百分點。因此，我們現在應該已經超過21%。所以，當我發言時，新加坡已經是超級老齡社會。歡迎來到超級老齡的新加坡。
具體轉變的時間點是什麼時候？實際上，我認為沒人知道。我們可以做個估算。那一刻發生了什麼？沒有什麼戲劇性的事情。沒有新加坡民防部隊的警報聲或其他。它悄然來臨，也悄然過去。
老齡化不是轟然到來，也不是輕聲細語。它悄然進展，帶來真實而深遠的影響。在衛生部，我們在醫院、急診科、護理院深切感受到這一點，我們正盡最大努力管理工作量，照顧所有病人。
更重要的是，我們多年前就預見了這一人口結構轉變，並採取了儘可能多的早期行動。這包括提高商品及服務稅以加強財政狀況；提高退休和再就業年齡；建設更多適合老年人的街道和兩房靈活式及長者公寓；通過銀髮支援計劃、公積金終身計劃（CPF LIFE）和醫療保險終身計劃（MediShield Life）增強長者的財務保障。
這些政策醞釀已久，幫助緩衝了這一深刻人口轉變的影響。
但可以說，準備應對老齡人口最複雜的任務是維持和轉型醫療系統。這是我今天想談的兩個主題——維持和轉型。讓我先談談維持醫療系統。
護理需求的增加意味著醫療系統必須擴大容量。我們將變得更大，我們正在這樣做。在本屆議會開幕時，衛生部補充檔案設定了2025年至2030年間新增2800張公立急症及社群醫院床位的目標。我們正按計劃推進。
然而，滿足不斷增長的需求並運營更大的系統將花費更多。如果不加以謹慎管理，醫療支出的增加可能會給公共財政和家庭預算帶來壓力。事實上，如果我們過於奢侈，不加節制，可能會使我們的系統陷入癱瘓。
我們如何確保醫療保健保持負擔得起？我認為我們需要從最高層開始，確保國家醫療賬單得到控制。否則，這就像泰坦尼克號沉沒，而你卻在甲板上舀水。它必須保持漂浮。
國家醫療支出——也就是國家的醫院賬單。記住，這筆賬單最終總是由人民支付，無論是通過醫療費用、稅收、保險費還是醫療保障繳款。歸根結底，始終是人民在買單。
所以，政府可以聲稱“我們提供廉價甚至免費的醫療保健”。這其實並不完全正確。事實是，醫療保健從來不是真正免費的，即使患者在服務點不支付任何費用，他們也會以其他方式支付。一個無節制消耗醫療資源的病態國家將產生龐大且浪費的賬單，這對人口、家庭、患者和人民來說代價非常高昂。
主席先生，徵求您的許可，我可以在螢幕上展示幾張幻燈片嗎？
主席：請講。[幻燈片已展示給尊敬的議員們。請參見附件1。]
王乙康先生：謝謝。這是一張不同國家的散點圖，你們可以看到新加坡是一個異常值，位於右下角。讓我來解讀這張圖。縱軸衡量的是人口在醫療保健上的支出。發達經濟體，如螢幕上的不同點，通常在醫療保健上花費約佔國內生產總值（GDP）的9%至12%，美國是另一個極端，支出達17%。新加坡的支出低於5%。
橫軸是平均壽命。這是國際公認的健康結果的通用衡量標準。新加坡擁有世界上最高的壽命之一。當然，除了壽命之外，還有許多其他健康結果的衡量標準，在所有這些指標上，新加坡都與許多發達經濟體相當甚至更好。
那麼，我們是如何成為這樣的異常值的？我認為這與議員們熟悉的S+3M醫療融資體系密切相關。MediSave是該體系的關鍵。
新加坡人和我們的僱主將每月收入的一部分存入MediSave。政府也會不時為不同群體提供補貼，我們在本次預算中再次這樣做。然後我們用MediSave直接共同支付醫療費用的一小部分。因此，即使是適度的共同支付，也能極大地培養紀律性，減少供應和需求雙方的不必要消費。
我們不必走得太遠就能想象當這種紀律被削弱時會發生什麼。看看新加坡的私人醫療。由於過於慷慨的保險，包括住院保險附加條款，共同支付的紀律被削弱。因此，私人醫院賬單迅速上升，私人保險費也迅速攀升。一旦魔鬼出瓶，就很難再放回去。但這不會阻止我們嘗試，我們會努力。
在我們的S+3M體系中，多方支付者共同承擔國家醫療賬單。除了共同支付，我們還有像MediShield Life這樣的保險計劃，它發揮著重要作用。很大一部分費用也由慈善資金支付。我們感謝所有捐贈者和慈善組織。
但最大的比例，約佔國家醫療賬單的一半，是通過稅收收入支付的，作為政府醫療補貼再分配。政府的醫療預算今年約佔GDP的2.7%，預計到2030年將升至約3.5%。這0.8個百分點的增長實際上非常顯著。這意味著政府的醫療預算將從今年約225億新元增加到2030年的約300億新元。
2030年以後，政府的醫療預算可能還會繼續增長。我們必須確保這種增長能夠由經濟增長和稅收收入的增加支援。同時，我們必須繼續保持這種紀律，避免出現其他地方看到的不可持續的醫療支出水平。
我接下來想談談醫療系統的轉型。為年輕人口設計的醫療系統與為老齡人口、超級老齡社會設計的系統截然不同。
對於年輕人來說，疾病往往是偶發性的。你住院治療，接受治療，出院，然後康復。良好的健康是預設狀態。另一方面，老年人的護理過程複雜且持續。當健康時，他們需要預防性護理；生病時，他們需要協調護理，因為他們往往患有多種疾病；出院後，他們需要康復護理和社群隨訪護理。良好的健康不是預設的，而是老年人持續追求的目標。
因此，我們需要從偶發的醫院護理轉向跨場所的持續多學科護理。這一轉變反映在我們隨時間分配醫療資金的方式上。讓我在螢幕上展示另一張圖表。[請參見附件2。]
上午11點
左側的圖表顯示的是我們2021年的政府醫療預算高度。右側的柱狀圖是2024年。議員們可以看到，總體預算增加了1.5倍。但我想提醒大家注意組成部分。
在本十年初，即2021年，我們醫療部門約四分之三的運營資金用於急性醫院護理——即柱狀圖中的白色部分。剩下的四分之一用於老年護理和人口健康，包括預防和初級護理。
今天，向右看，2024年。預算是2021年的1.5倍，但急性醫院護理的比例從四分之三下降到近三分之二——剩餘三分之一用於老年護理和人口健康。
具體來說，老年護理的資金比例從2021年的11%上升到2024年的13%——即綠色部分。在同一時期，人口健康的比例從14%增長到19%。這些變化主要由我們的國家專案“更健康的新加坡”和“安享新加坡”推動。
展望未來，這張圖表會如何變化？我認為，老年護理的支出比例幾乎肯定會進一步增長，因為我們需要更多的護理院、老年護理中心、康復服務和臨終關懷。至於人口健康，我們盡力保持其比例在19%左右。隨著總支出的增加，僅僅維持這一比例就需要強烈的承諾，繼續投資於人口健康。
主席先生，今天，我和衛生部的同事們將談論進一步轉型醫療保健和為未來做好準備的措施。高階國務部長許文遠將談論人力資源。這是一個關鍵議題，包括我們如何大幅縮短臨床心理學家的培訓時間。目前需要七到八年，我們將縮短到約五年。高階國務部長陳杰厚將談論通過技術將護理錨定在社群。
議員們聽到拉哈尤國務部長談論人口健康和預防護理，包括我們在北部地區的工作，那裡的慢性病患病率較高。瑪麗亞姆·賈法爾女士提出了問題，她錯過了那部分發言。
我必須強調——以防她之後提出許多澄清問題——預防護理和人口健康仍然是我們工作的總體戰略重點，由“更健康的新加坡”和“安享新加坡”支撐。我感謝瑪麗亞姆·賈法爾女士和哈雷什·辛加拉朱博士對此的發言。這是醫療轉型的核心，衛生部同意他們提出的許多觀點。
我現在將談論支援醫療轉型的三項新舉措。
本屆供應委員會（COS）和預算辯論的第一個共同話題——人工智慧，再次出現。瑪麗亞姆·賈法爾女士和朱佩玲博士談到了人工智慧如何加強醫療服務，我們表示贊同。
談到醫療中的人工智慧，我們遵循兩個原則。
第一，護理應是人工智慧增強的，而非人工智慧決定的。臨床醫生始終參與其中，醫療保健依然是深具人文關懷的事業。
第二，我們採取實用的、基於用例的方法。人工智慧不應是尋找釘子的錘子，也不是尋找問題的解決方案。我們在知道它能改善患者結果或護理服務且成本效益合理的地方部署人工智慧。
其中一個用例是健康篩查。全球許多人工智慧模型已被訓練用來預測健康人群在近期內是否可能發展成嚴重疾病。如果我們適當且負責任地使用，這類工具非常有用。它幫助臨床醫生更早介入，可以延緩甚至預防嚴重疾病的發生。
衛生部利用匿名患者資料為本地環境開發了這樣一個模型。通過該模型，審查個人當前的健康狀況，可以識別他/她在未來三年內患慢性疾病（如糖尿病或高膽固醇）的高風險——高風險定義為75%及以上。
我們選擇糖尿病和高膽固醇是因為它們是中風和心臟病發作的主要驅動因素，每天有60名新加坡人受到影響——每天有60名新加坡人發生心臟病發作或中風。如果採取早期行動，如調整生活方式和服用藥物，許多病例是可以預防的。
這款人工智慧風險評估工具將於2027年初向所有“更健康新加坡”計劃的註冊醫生推廣。如果工具將患者標記為高風險，醫生可能會建議更顯著的生活方式調整，並將三年一次的檢查改為每年檢查。這些額外的篩查將繼續在“更健康新加坡”計劃下獲得補貼。
第二項舉措，我認為是令人興奮且重要的突破，即利用基因組學加強預防護理。哈米德·拉扎克醫生對此提出了問題。
我們生來就帶有基因。它們塑造了我們的生物藍圖，確實，許多疾病與我們的遺傳特徵有關。但我們不必對此抱有宿命論態度。基因不是我們的命運。我們的生活方式和風險管理非常重要。
因此，我們不會盲目地翻查我們的基因藍圖，尋找我們知之甚少的瑕疵和可能的突變。這會給我們所有人帶來很多焦慮，我們將成為一個疑病症氾濫的國家！
所以，我們不應盲目猜測，而應聚焦於科學所揭示的藍圖部分。
這意味著採取疾病特異性的方法，識別我們已知會導致某些疾病的遺傳特徵，並且對這些疾病已有成熟的預防干預和治療路徑。
這正是我們去年針對家族性高膽固醇血癥（FH）所做的。FH是一種遺傳性疾病，即使在年輕人中也會增加心臟病發作的風險。
FH基因檢測專案為膽固醇異常升高的個人提供補貼基因檢測。如果檢測呈陽性，我們將為其直系親屬提供相同的檢測。這就是所謂的級聯檢測。通過這樣做，我們盡力識別新加坡儘可能多的攜帶FH基因突變的個體，然後採取措施降低他們未來心臟病發作和中風的風險。
接下來我們將介紹另一種遺傳疾病，即遺傳性乳腺癌和卵巢癌（HBOC）。
據估計，新加坡每150人中就有1人攜帶與HBOC相關的基因突變，如BRCA1或BRCA2。這些突變顯著增加女性一生中患乳腺癌和卵巢癌的風險。
從今年12月起，我們將為有HBOC風險的個體（如有HBOC家族史者）提供補貼基因檢測。他們將在檢測前後接受遺傳諮詢。如果檢測呈陽性，我們也將為其直系親屬提供檢測——級聯檢測。
預計每年將有超過2000人符合檢測資格。
我們將使檢測費用負擔得起。除了補貼外，檢測費用還可使用醫療儲蓄（MediSave）抵扣。
對於檢測出攜帶突變者，將提供適當的預防干預。通常包括更頻繁的乳腺MRI或乳房X光檢查，或口服藥物。
患者最終將在醫生的諮詢下決定適合的干預措施。少數患者可能選擇手術干預。議員們可能還記得，著名女演員安吉麗娜·朱莉在發現自己攜帶BRCA1基因突變後，進行了雙側預防性乳房切除術。
我遇到過新加坡選擇預防性乳房切除術以降低乳腺癌風險的女性，如Gwendalyn Too女士，這些女性表現出了極大的勇氣。
遺憾的是，她們抱怨無法為此類手術申請保險理賠，因為醫療保險（MediShield Life）通常不覆蓋預防性手術。設計如此是有充分理由的，目的是保持保障的重點和保費的可負擔性。私人保險則在醫療保險基礎上提供補充保障。
哈米德·拉扎克醫生和林秀儀女士對此提出了問題。事實上，非營利組織“新加坡她賦權”（SG Her Empowerment，簡稱SHE）創始人施蒂芬妮·張女士多次向我反映此問題。
我理解這些關切。
隨著醫學科學的進步，預防護理與治療護理的界限日益模糊。如果高風險個體無法接受預防性乳房切除術，她很可能最終需要癌症治療，包括切除乳腺癌細胞或癌變組織的治療性乳房切除術。
因此，有理由在醫療保險中謹慎擴充套件覆蓋某些選定的預防性手術。我們準備在臨床需求明確、濫用風險極低、適合通過保險進行風險分攤且不會給醫療保險計劃帶來財務負擔的情況下實施。
降低乳腺癌風險的預防性乳房切除術，以及預防卵巢癌的雙側輸卵管和卵巢切除術，符合這些標準。
因此，我們將於今年晚些時候將醫療保險和醫療儲蓄擴充套件至覆蓋HBOC的預防性手術。我還應補充，乳房重建手術也將繼續覆蓋，與現行政策無異。這將更好地支援女性利用基因組學更好地照顧自身健康。
我認為這是在3月8日國際婦女節前夕一項有意義的政策變革。[掌聲]
第三項舉措是增加醫療儲蓄的使用靈活性，以鼓勵早期干預，減少後續併發症。
林志明副教授正確地描述了醫療費用的“塊狀”特性。確實，有大量文獻表明，臨終前的醫院費用幾乎呈垂直上升趨勢。因此，即使考慮通脹，平均新加坡人在生命最後10年內的醫院費用幾乎是前10年的四倍。
這也解釋了醫療儲蓄提款系統的現有設計及其原因。該系統對複雜治療和長期住院設有更高的提款限額，且可根據需要提取。這符合醫療儲蓄的初衷，即為重大住院事件共同支付費用，無論是突發還是老年時發生。
通過這種設計，扣除補貼、醫療保險和醫療儲蓄後，九成新加坡人的補貼住院賬單自付費用低於500新元。
然而，人們天性更擔心當前的醫療費用，而非潛在的、意外的或未來的“塊狀”住院賬單。
因此，作為緩衝措施，我們設有靈活醫療儲蓄（Flexi-MediSave）和醫療儲蓄500/700計劃，為慢性病管理、掃描、牙科就診等提供靈活性，同時不過度削弱醫療儲蓄應對老年或緊急重大住院賬單的初衷。
但自1984年醫療儲蓄實施以來，情況已發生變化。那時，新加坡人平均壽命約為73歲。如今，我們活到85歲甚至更長。
一方面，保留醫療儲蓄應對重大住院賬單仍然重要；另一方面，隨著壽命延長，預防護理和慢性病管理的支出需求也增加。
因此，我理解議員們多次提出的各種呼籲，即允許醫療儲蓄更靈活使用，涵蓋更多慢性病，或者如普里塔姆·辛格先生建議，用於支付更高的私人保險保費。
上午11點15分
但我也持現實觀點，無論衛生部多頻繁審查醫療儲蓄計劃，無論我們多大程度放寬和擴大其使用範圍，公眾和議員們每年在預算辯論期間，甚至預算辯論之外，仍會不斷敦促我和衛生部進一步放寬該計劃。
這是該計劃的“業力”——因為它被設計為醫療融資體系的核心。它必須始終在當前與未來醫療需求之間、慢性病管理與重大住院事件之間權衡。
醫療儲蓄計劃本質上存在權衡，是零和遊戲。更多餘額用於反覆醫療費用意味著未來住院時餘額減少，反之亦然。當這種緊張關係過於嚴重時，我們將不得不考慮提高繳費率，以便擁有更大的資金池可用。
因此，這種緊張關係是刻意為之，是設計的一部分。我們必須不斷且謹慎地管理這種平衡，以確保共付制度得以維繫，同時確保負擔得起，並保持公積金繳費率對所有人來說合理。
因此，我們持續進行定期審查，研究如何擴大醫療儲蓄（MediSave）的使用範圍，並提供更靈活的提取方式。例如，我們最近提高了老年人的靈活醫療儲蓄限額，並將診斷掃描的年度限額翻倍。
這一次，我們將對MediSave500/700計劃進行進一步調整。該計劃幫助患者支付慢性病管理計劃（CDMP）中疾病的經常性費用。蔡銀洲先生和賈瑞德先生對此提出了問題。
目前，患有簡單慢性病的個人每年可使用最多500新元，而患有複雜慢性病的個人每年可提取最多700新元。
為了在社群中為預防和慢性護理提供更多支援，我們將把醫療儲蓄限額從500/700新元提高到700/1,000新元。這將惠及目前約有91萬名使用該計劃的患者，其中約20%的患者年度賬單超過提取限額。
我們還將擴大CDMP涵蓋的疾病清單，新增甲狀腺功能亢進症和甲狀腺功能減退症。此外，我們正在研究是否可以將其他慢性疾病，如溼疹，納入CDMP。
隨著上述改進，我們將重新命名“MediSave500/700”。這個名字實際上很笨重，每次調整限額都要改名。我們將其更名為“MediSave慢性及預防護理計劃”，以反映其覆蓋範圍。該變更將於2027年1月生效。
在結束這一部分之前，請允許我回應林秀娟女士提出的問題。
感謝她觀看我的抖音影片。她提到了附加保險（riders）在為癌症藥物清單（CDL）之外的癌症治療提供額外保障方面的作用。近期對住院附加保險（IP riders）的調整，目的是防止共付額過度減少，因為這會引發“自助餐綜合症”，進而導致私立醫院賬單迅速攀升。涵蓋非CDL門診藥物的住院附加保險不會導致這種共付額的侵蝕，因此該功能不會受到調整影響。我還要指出，住院附加保險的調整僅影響新投保人，現有投保人不受影響。我們在調整住院附加保險時，會始終關注癌症患者的利益。主席先生，請用中文發言。
（中文）：[請參閱方言發言。]2026年標誌著新加坡進入超高齡社會階段。我們應以冷靜和理智的心態看待這一里程碑，就像慶祝生日一樣。雖然作為社會我們集體年齡增長了一歲，但生活照常，沒有突發或劇烈變化。
新加坡一向為雨天做準備，我們早已為老齡化社會做好準備。在過去十年中，政府在多個領域逐步調整政策，目標是確保每位新加坡人在老年時獲得支援，生病時獲得醫療照顧，並擁有住所。
最重要的是確保我們的人民即使身體變老，內心依然年輕。因此，預防醫療已成為衛生部的核心政策重點。
說到衛生部（MOH）或中文“衛生部”，我對這個中文名稱有些想法。嚴格來說，“衛生”更常與衛生清潔相關，但衛生部並不管理衛生清潔事務。衛生清潔事務由可持續發展與環境部管理，該部由傅瑾萱部長領導。然而，從醫學角度看，大家都理解“衛生”概念是關於預防、抗擊和治療各種傳染病，這仍是我們的重要使命。
然而，現代社會的醫療挑戰與過去不同。非傳染性疾病，如癌症、心臟病和糖尿病，現在造成的危害遠超過傳染病。為了更好地反映衛生部的核心政策重點，我們將把衛生部的中文名稱改為“保健衛生部”，在名稱中加入“保健”二字。當我們的名稱反映核心政策重點時，部門的言行自然會隨之調整。
有人可能會問，改名是否會花費大量資金。請放心，不會，因為我們的標誌、法律檔案、文件、網站等大多隻使用英文名稱。這也凸顯了另一個問題。名稱變更主要影響未來的媒體報道，開支極少，但其傳達的意義非常重要。
我還剛剛宣佈了幾項新政策。
第一，為了讓慢性病醫療費用更負擔得起，我們將從明年起把年度醫療儲蓄提取限額從500新元提高到700新元，而複雜慢性病患者的年度限額將從700新元提高到1,000新元。
第二，我們將從今年年底開始，為高風險女性提供補貼的遺傳檢測，檢測遺傳性乳腺癌和卵巢癌。
第三，我們將利用人工智慧（AI）輔助醫生預測個人患慢性病的風險，如高膽固醇和糖尿病。對於高風險的新加坡人，我們將通過“更健康的新加坡”計劃鼓勵他們採取預防措施。
說到人工智慧，過去一年，我與衛生部團隊訪問了美國和中國，學習他們在醫療技術應用方面的經驗和做法。在美國，我們參觀了幾家知名醫院。當我問他們哪種AI應用場景最有效時，他們一致認為，利用AI記錄患者病史既節省時間又省力，是最佳應用場景。
我贊同這種做法。雖然用例看似簡單，但它讓每個人都能受益。它鼓勵大家接受新技術，理解新技術是幫助我們的，而非威脅我們。
在我們的公立醫院，我們已經開始使用AI記錄病史。我們的AI能理解英語、普通話、馬來語、泰米爾語和粵語。我不確定為什麼只有粵語在方言中被支援，但它目前正努力學習其他方言。
有人曾開玩笑說，最有經驗的醫生會看人或患者；有經驗的醫生會看病症；經驗較少的醫生會看電腦。我相信在不久的將來，在AI的幫助下，大多數醫生將能更多地關注患者本人，而不僅僅是電腦。
今年，我還訪問了中國，參觀了一些醫院和科技公司。我發現中國醫院也大膽嘗試新技術，他們的創新勇氣值得我們學習。
然而，我們也必須認識到中國和新加坡之間存在差異。例如，在我訪問的中國醫院，一些傳統手術已被機器人手術取代。但機器人手術成本很高，這些費用通常由患者自負，導致醫療保險費上漲。
因此，在新加坡，我們在推廣機器人手術或其他技術時非常謹慎。我們必須考慮成本效益和患者的負擔能力。
從希波克拉底到華佗，再到人工智慧和機器人手術，醫療領域發展迅速。我們將採取多管齊下的方法，制定長期政策，利用高質量醫療團隊和具成本效益的技術，為人民帶來更好的醫療服務。
（英文）：主席先生，三年前我向議會通報，今年我們將成為超高齡社會，這不是為了製造恐慌，而是為了做好準備。
我們向超高齡社會的過渡是穩步的，而非劇烈的。這反映了有計劃的長期規劃，包括醫療體系的轉型。
事實上，醫療轉型本質上是一個長期事業，而非一次性改革。它是無數小步驟的積累，每一步都經過判斷和目的性規劃，精心執行。今天，我們宣佈了進一步的有計劃步驟。
主席先生，我希望議會繼續支援我們長期規劃、長期治理的方法，提前預見未來挑戰，並在挑戰壓倒我們之前採取行動。如果我們這樣做，就無需害怕成為超高齡社會。我們可以擁抱它，並充分利用它。
歸根結底，定義我們的不是65歲以上新加坡人的比例。我們可以運用更智慧的頭腦，少為年齡帶走的東西哀悼，多為它留下的東西慶幸。
重要的是，新加坡人不僅壽命更長，而且健康壽命也更長。我們不僅是一個超級老齡化社會，也在努力成為一個超級健康的社會。[掌聲]
主席：高階國務部長許寶琨。
衛生部高階國務部長（許寶琨博士）：主席先生，當部長談到我們邁向超級老齡化國家的旅程時，他強調了一個根本點，那就是我們的人民是醫療轉型的核心。我將談談我們在醫療領域通過三大支柱推進的人力和護理轉型方法。
首先，我們重新設計角色和合理配置護理場所。其次，我們建立人才培養渠道以確保人力資源的可持續性。第三，我們發展一個靈活且敏捷的醫療系統。
請想象這樣一個場景：一位患有糖尿病、心臟病和行動不便的患者，需要在不同診所之間安排多個預約，每次就診都需要請假，不僅患者本人，有時照顧者也需請假，還需特殊交通安排，且通常需要照顧者陪同。這種支離破碎的體驗不僅不便，而且隨著人口老齡化和醫療需求日益複雜，這種模式是不可持續的。
我們如何滿足老齡化人口日益增長的醫療需求，改善護理體驗，同時保持護理質量和標準？
首先，我們重新設計角色和合理配置護理場所。如今，在醫院病房中，患者通過由主治醫生（PD）領導的團隊接受協調護理，主治醫生對患者的整體護理計劃負責。在新的護理團隊模式下，主治醫生不必是專科醫生。一旦經過培訓並評估合格，醫院臨床醫生可以擔任主治醫生角色，監督、管理和協調護理，整合各類醫療專業人員的意見。患者不必為每種病症見不同醫生，從而減少住院期間轉診至其他專科醫生的次數。
上午11時30分
出院後，此類患者的護理可以交由其家庭醫生負責管理，其中一些家庭醫生已接受家庭醫學專科培訓，能夠管理更復雜的病情。
同樣，自2015年和2018年起，團隊護理模式已在多診所和初級保健網路中引入。在這種模式下，慢性病患者由由醫生、護士和護理協調員組成的多學科護理團隊管理。這確保了護理的連續性，並建立了患者與護理團隊之間的信任。
針對蔡銀洲議員關於在社群提供專科牙科、聽力學和足病學服務的詢問，我們最近提升了社群健康援助計劃（CHAS）牙科補貼，正在擴充套件多診所的牙科服務，並加強與社群牙科服務提供者的合作——這些舉措將使負擔得起的牙科護理更接近我們的老年人居住地。
大多數老年牙科需求可由多診所和CHAS牙科診所管理。對於更復雜的病情，專科護理可在醫院牙科診所以及兩個國家級專科牙科中心——新加坡國家牙科中心和國立大學口腔健康中心獲得。
此外，雖然足病學服務僅在部分多診所提供，但糖尿病患者的足部篩查服務在所有多診所及通過各自初級保健網路的“更健康新加坡”全科醫生處均可獲得。
除了在醫院轉型護理團隊並將護理合理配置到社群外，我們還希望賦能人民，讓他們對自身健康負責。我們贊同Haresh Singaraju博士關於社會處方是預防護理和“更健康新加坡”不可或缺部分的願景。因此，“更健康新加坡”中的健康計劃鼓勵患者採取生活方式改變，增加運動，減少不健康飲食。
然而，我們承認社會處方尚未普遍採用，我們還有更多工作可以共同推動。我們將與社群合作伙伴合作，使這些干預措施惠及居民。特別是對於老年人，輔助活動中心（AAC）網路將支援他們。國務部長拉哈尤在她的發言中已詳細說明。
此外，醫院也有各自的社會處方舉措。我還想向Pritam Singh議員保證，我們的公立醫院已制定加快急診科緊急病例處理和初級保健向專科門診緊急轉診的協議。僅憑等待時間不能反映醫療服務質量。患者病情嚴重程度不同。在世界頂級醫院中，病情更緊急和嚴重的患者會被優先分診，提前就診並接受必要的搶救。這就是醫療系統的運作方式。
根據多個來源，議員們也可以自行搜尋，新加坡的醫療系統始終排名全球前20。2000年，世界衛生組織將新加坡評為全球第六。我們的公立醫療機構也一直被公認為世界一流。2026年，Newsweek和全球資料平臺Statista將新加坡中央醫院排名第十，國立大學和陳篤生醫院也進入前100。
新加坡醫療系統以可負擔的成本實現了良好的健康成果。根據健康指標與評估研究所的資料，我們的預期壽命約為86歲，領先於許多國家，如日本、瑞士、澳大利亞、韓國、英國和美國。另一方面，我們的國家醫療支出佔GDP的4.4%，不到其他國家的一半。世界銀行2019年報告了這一資料，正如部長之前展示的圖表所示，我們確實以遠低於其他國家的成本實現了良好的健康成果。
此外，我們的醫院有應對床位需求激增的應急措施，包括增加床位、加快臨床適宜的出院流程以及推遲非緊急擇期手術，以釋放急性病床容量。如果需要，醫院還可以利用過渡護理設施和移動住院護理@家等設施，增強整體容量。
即使在擴充容量的同時，我們的人民仍是醫療系統的核心。公立醫療機構安排員工輪班，確保員工有足夠休息時間，並監測員工在照顧患者過程中的身心健康。這些經驗也是我們從近期新冠疫情中學到的。
隨著心理健康服務需求增加，心理健康研究所（IMH）將繼續作為國家精神科服務中心，重點為複雜精神健康需求患者提供四級護理。Patrick Tay議員會高興地知道，衛生部已向IMH提供額外資金，提升精神科服務和基礎設施，以改善患者護理，打造領先的心理健康培訓和教育中心，並確立其在三級和四級精神健康研究中的地位。
我們還在持續提升公立醫療機構的精神科住院、門診和危機護理能力，以支援患者在同一醫院同時獲得身心健康服務。在這些方面，護理團隊轉型提供綜合護理——推動團隊護理，將護理合理配置到社群，使其更易獲得且負擔得起，並重新設計角色，使專業人員能夠安全地晉升並在頂級崗位發揮作用。
第二大支柱是建立可持續的人力資源渠道。我們當前的醫療人力大致能滿足人口的醫療需求。到2030年，我們需要將醫療人力增加20%，以滿足預計的人力需求。我們正與高等院校密切合作，推出更多培訓路徑，通過就業前培訓建立強大的本地人才儲備。
蔡銀洲議員會高興地知道，國立大學的碩士（聽力學）研究生入學課程每兩年開設一次，每屆平均有13名畢業生。對於足病學，需求通過為本地人才提供海外足病學獎學金和招聘海外培訓的足病醫生來滿足。
針對溫立扎爾醫生關於在保持專業標準的同時加強本地臨床心理學家人才培養管道的提問，我們已與教育部和國大合作，為符合條件的本科生提供加速路徑，使其能夠在碩士階段專攻臨床心理學，首批招生將於2026年開始。
與現行培訓模式不同，現行模式下本科生至少需要七年時間才能成為合格的臨床心理學家，其中包括四年心理學學士學位學習，隨後一至兩年工作經驗，然後進入為期兩年的心理學（臨床）碩士課程。新的本科直升碩士加速路徑可在五年內完成。
這將使那些較早確定志向的本科生通過精心設計的課程接受臨床心理學培訓。該課程包括本科階段的理論學習和臨床訓練，培養具備照顧患者所需知識和技能的從業者。
完成該五年課程的畢業生將同時獲得榮譽學士學位和碩士學位。
國大新的本科直升碩士加速路徑將補充現有的研究生培訓管道，包括為具備相關臨床工作經驗者開設的獨立兩年制心理學（臨床）碩士課程。這些課程共同擴大了我們臨床心理學家的人才儲備，以滿足日益增長的心理健康需求。
醫療工作者依然是我們醫療體系的基石。即使我們開闢了新的培訓路徑，也實施了多項策略以提升醫療工作者的留任率。
我們曾在本院討論過吸引和招聘護士的挑戰，尤其是在新冠疫情期間。雖然護士流失率已回落至疫情前約7%的水平，但我們將繼續努力鼓勵更多護士留任併為公共醫療系統貢獻力量，同時吸引有志者投身該行業。
2024年，我們推出了“護士恩典、卓越與忠誠獎”計劃，並於2025年審查並調整了護士薪酬。2025年，我們還將公共醫療機構的輔助醫療專業人員（AHPs）、藥劑師及行政、輔助和支援人員的薪資提高了最多7%。
但僅靠留住醫療工作者不足以構建強健的醫療體系。我們需要不斷提升醫療人員技能，以承擔新的和擴充套件的職責。現代醫療不再侷限於傳統的專業分工。患有多種疾病的患者需要能夠無縫協作的專業人員。因此，我們正從僵化的專業培訓轉向靈活的、基於能力的學習，通過可疊加模組以工學結合的形式進行，儘可能減少離崗時間和對患者護理的影響。
針對輔助醫療專業人員，我們正與高等院校合作，建立相關輔助醫療培訓專案的共享能力，以更好支援團隊協作的共享護理模式。這些將逐步推行，首先針對2027學年開始學習的學生。
針對心理健康領域，共享能力已在國家心理健康能力培訓框架中明確，旨在為輔助醫療專業人員創造“共同語言”。藉此，我們的輔助醫療專業人員將更具多功能性，能夠更協作地提供整體護理。
針對護理，我們正與理工學院合作，將現有護理專科文憑後課程重新設計為工學結合模式。此舉使護士能夠在真實工作環境中學習和實踐，培訓內容直接基於工作活動，幫助護士更快達到勝任和高效水平。
兩個高階護理文憑課程——姑息護理和社群健康——將優先以工學結合形式推出。通過提升能力，我們的醫療隊伍將更好地提供全面護理。
何亭如女士詢問了心理健康專業人員的監管情況。我們將對五個高風險心理學子領域進行註冊，以確保高標準的執業、倫理和專業行為，保障公眾獲得更安全、更高質量的心理服務。這五個領域是臨床心理學、臨床神經心理學、諮詢心理學、教育心理學和法醫心理學。
衛生部及合作部委將與新加坡心理學會合作，提高公眾對心理學專業的認知，並支援專業人員及相關利益方順利完成註冊流程。詳細的註冊時間表、要求和路線圖將於2027年初公佈。
第三個也是最後一個支柱是發展靈活且敏捷的醫療體系，以應對快速變化的醫療需求。心理健康是其中一個例子。
心理健康問題在新冠疫情期間凸顯，且仍是衛生部的重要國家議題。何亭如女士和楊偉倫先生對此提出了問題。
自2023年啟動國家心理健康與福祉戰略以來，我們於2024年成立了國家心理健康辦公室，負責協調和監督多機構的心理健康舉措。
首先，我們指導心理健康服務提供者採用分層護理模式，改善不同服務提供者間的護理協調，使客戶能在最合適的護理環境中獲得無縫服務。
其次，我們擴大了初級、社群、急性及長期護理領域的心理健康服務能力。多科診所和全科醫生配備能力，為輕度至中度心理健康狀況（如焦慮和抑鬱）患者提供護理。社群心理健康團隊為有心理健康需求的個人提供多樣化支援。
目前，我們擁有71個社群外展團隊（CREST）和26個社群干預團隊（COMIT），負責為有心理健康需求或痴呆症的老年人及其照護者開展外展、篩查評估、心理干預及服務聯結。到2030年，CREST和COMIT團隊數量將分別擴大至75個和35個。我們還設立了心理健康一站式服務，方便公眾輕鬆獲取和導航心理健康服務。
第三，我們加強了鼓勵青少年尋求幫助的支援。青少年可通過社群設點的CREST-Youth和CHAT獲得服務。需要心理社會干預者可轉介至青少年綜合團隊。
新近在*Scape推出的Grovve（拼寫為g-r-o-v-v-e）也為青少年提供心理健康服務，方便他們在聚集地獲得幫助，提升可及性，減少障礙和汙名。青少年自助服務如“Let's Talk”和“Ask-a-Therapist”也可通過mindline.sg訪問。
上午11點45分
除上述服務外，教育系統內也建立了支援生態。教育工作者和員工接受培訓，關注學生的困擾跡象，並將需要進一步支援的學生轉介至學校或高等院校的輔導員及社群心理健康專業人員。學生間設有同伴支援結構，互相關注並鼓勵有困擾的同學向可信賴的成年人尋求幫助。
青少年還通過學校的品格與公民教育課程及高等院校的心理健康專案，學習建立心理健康和韌性的方法。
第四，我們通過國家心理健康能力培訓框架提升社群服務提供者能力，已培訓超過16萬名前線人員和志願者，幫助他們識別並引導心理困擾者尋求支援渠道。
第五，我們通過“超越標籤”等宣傳活動及“健康育兒”和“積極使用指南”等資源，促進公眾、家長和青少年的心理健康與福祉教育。
最後，我們與人力部及職安局合作，加強職場心理健康支援。過去兩年，心理健康冠軍網路成員從54個創始組織增長至800個。
鑑於心理健康問題複雜多面，我們持續與各機構合作，追蹤和監測中長期趨勢，包括人口整體心理健康與福祉狀況，以評估基線以來的改善情況。採用“無錯門”策略，促進服務獲取和在初級及社群環境中合理安置護理，鼓勵個人在無汙名的環境中及早尋求幫助，同時避免對心理健康需求的過度醫療化。
我們也聽到了蔡艾立先生關於我們的人民為對露骨材料的無聲成癮買單的擔憂。對此，我們認識到成癮不僅影響個人健康，還會影響家庭和更廣泛的社會。個人也可能面臨潛在的困難，如經濟困難和缺乏社會支援。
設在心理健康研究所（IMH）內的國家成癮管理服務，旨在為尋求成癮幫助的個人提供治療和援助。國家成癮管理服務專注於成癮醫學研究，包括使用致醉物質和網際網路及遊戲等新興關注領域。
衛生部（MOH）與社會及家庭發展部、國家社會服務理事會及跨部門其他利益相關者，將繼續發展和提升社群成癮服務的可及性。
先生，醫療保健高度動態且流動性強，患者人口結構和需求不斷變化。隨著我們共同應對未來的道路和挑戰，這三大支柱將協同工作，加強我們醫療體系的核心基礎。
我們不僅是在填補職位空缺——我們是在建設一個可持續的勞動力和系統，能夠適應、協作併為所有新加坡人提供優質護理。
主席：高階國務部長陳杰豪。
衛生部高階國務部長（陳杰豪先生）：先生，正如翁部長早前在議會所分享，歡迎來到超級老齡化的新加坡。
這一趨勢將加速。到2030年，每四個新加坡人中就有一人年齡在65歲及以上，其中四分之一年齡在80歲及以上。在未來十年內，到2040年，每三個老年人中就有一人年齡在80歲及以上。
老年人可能需要更多支援。例如，老年人使用的醫院護理量是年輕人的八倍。
因此，我同意許多議員關於其影響的看法。
首先，關於照顧者。如今，看到一位在職成年人支援60多歲的年邁父母，而這些父母又照顧80多歲的祖父母，這種情況並不罕見。我在我的選區確實看到許多這樣的家庭。隨著家庭規模持續縮小，照顧者的負擔將加重。
其次，醫療系統將面臨越來越大的壓力。如果一半的老年人至少患有一種慢性疾病，到2030年我們將需要照顧近50萬名老年人，而去年約為40萬人。
這就是為什麼我們希望老年人儘可能保持健康。正如部長所說，這不僅僅是活得更長，而是活得更健康更長久。
今天，我將概述我們如何做到這一點，以技術為助力。首先，讓老年人在社群中健康老齡化。其次，為他們提供全方位照護。第三，支援醫療服務提供者實現更好成果。
正如多位議員指出，許多老年人面臨社會孤立。一項研究估計，這種風險相當於每天吸15支香菸。
議員們應該熟悉銀髮一代辦公室（SGO）。自2022年以來，SGO已開始預防性健康訪問，接觸了超過60萬名老年人，並將有需要者連線到輔助活動中心（AACs）、老年護理中心（SCCs）和社群心理健康服務等。
鑑於較年輕的老年人更懂數字技術，SGO通過LifeSG應用程式接觸這部分群體。自去年12月以來，已有超過3,000名老年人收到個性化的服務推薦。尚未使用該服務的老年人，請下載LifeSG應用程式瞭解詳情。
過去兩年，我們將輔助活動中心網路從154個擴大到230多個，目前服務約10萬名老年人。超過150個老年護理中心提供日間護理服務，包括痴呆症患者和臨時照護，90多個社群外展和干預團隊提供心理社會支援。我們將繼續擴大這些服務。
黃志明先生、葉漢榮先生和法茲裡·法茲維先生為照顧者發聲，並提及其他國家如何認可和支援照顧者。
與議員們一樣，我們相信照顧者扮演著重要角色，我們正在加大支援力度。我們正在提升長期護理補貼和資助。今年，我們將人均家庭收入（PCHI）門檻從3,600新元提高到4,800新元，覆蓋約七成家庭。我想向黃志明先生和瑪麗亞姆·賈法爾女士保證，這些補貼不依賴於日常生活活動需求的數量。
去年，超過14,000名老年人的照顧者受益於補貼的居家和中心臨時照護服務。我們將做得更多。
從4月1日起，超過5,600名符合條件的老年人及其照顧者可享受升級的居家個人護理服務，包括居家臨時照護、用藥提醒及24/7技術支援的跌倒檢測和事件報告。
議員們還談到了兼顧工作和照護的照顧者。我們理解他們的挑戰。各部委提供支援，例如彈性工作安排和照顧者培訓補助，幫助抵消家庭照顧者和外籍家庭傭工的培訓費用。符合條件的照顧者還可享受增強的育嬰假政策，如新的共享育嬰假和無薪嬰兒護理假。
我們將繼續研究議員們的建議，探索更好支援照顧者的方法。
賴偉強先生談到了依賴PCHI評估家庭照護情況可能帶來的意外後果。我理解他的擔憂。PCHI的收入測試方法已在上週預算辯論中討論。衛生部將參考該框架。然而，處於困難境地且需要額外支援的個人可聯絡醫療社會工作者。
賴先生提出了幾項改進現有框架的建議。衛生部將與財政部共同研究這些建議。
何德仁副教授和蔡艾立先生倡導老年人參與社群貢獻，包括幫助其他老年人。我同意。這種參與賦予老年人目標感。老年人可參與志願服務，一些組織提供培訓和津貼。
例如，作為銀髮一代大使，他們幫助開展對其他老年人的外展活動。老年人還可加入新加坡醫療志願軍，協助基本患者護理。50歲及以上者佔這些專案志願者的20%至40%。我們歡迎更多合作伙伴加入此項工作。
讓我轉向生命終結的話題。
我同意葉漢榮先生的觀點，我們希望老年人“善終”，或如中文所說，“安然離去”。自2023年以來，我們大幅擴充套件了社群姑息治療服務，提升補貼並促進臨終出院。我們希望更多新加坡人在家中度過最後時光，在舒適的環境中，身邊有親人陪伴。
反響積極。截至2025年6月，居家姑息治療的使用率約為90%。隨著需求增長，我們將擴大容量。我們希望繼續支援希望在家陪伴親人走完最後旅程的家庭。
接下來，我向蔡銀洲先生和葉漢榮先生保證，我們確實跟蹤專案成果，如虛弱患病率、社會參與和照顧者福祉。我們與包括研究機構在內的不同方合作進行跟蹤。
現在讓我談談護理服務轉型。到2030年，約有10萬名老年人需要至少一項日常活動幫助，如進食或洗澡。他們可能需要來自不同服務提供者的服務。我們希望他們的體驗儘可能無縫，不必東奔西跑才能獲得服務。技術將是實現更緊密護理協調的關鍵助力。
我同意蔡先生的觀點，我們希望讓老年人更容易獲得社會和健康服務。
首先，我們在新加坡84個子區域引入了綜合社群護理提供者。這意味著每個區域有單一方協調老年人的護理。目前，老年人接受多個服務提供者的多次護理評估。這不僅造成服務提供者的重複工作，也給老年人帶來不便，且可能因不同護理計劃導致護理不協調。
我們將簡化整個流程。從下個月起，需要多項長期護理服務的老年人只需由綜合社群護理提供者使用標準化、國際認可的工具進行一次全面評估。每位老年人將基於該評估制定單一社群護理計劃。老年人所訪問的每個服務提供者都將參考該護理計劃。
這種方法將確保老年人享受到無縫的體驗和更好協調的護理。我們將從今年十月開始逐步推行這一舉措。我們通過為社群護理提供者建立一個通用的資訊科技平臺，來實現這種新的協調和服務交付方式。
阿扎爾·奧斯曼先生詢問了遠端會診的問題。我請該議員參考高階國務部長許寶琨最近對國會提問的回應。基本上，衛生部同意議員的觀點，利用科技改善患者的醫療體驗。
中午12點
例如，2022年推出的生產力與數字化補助金已支援了240多個專案，如自動化淋浴和生命體徵監測系統。我們打算加強該補助金，以更好地利用醫療保健領域的技術解決方案，包括利用機器人技術和人工智慧。
先生，當我在一月份向本院介紹《健康資訊法案》時，我曾表示衛生部將協助醫療服務提供者遵守相關條款。我很高興提供最新進展。
首先，我們正在與醫療服務提供者使用的健康資訊管理系統供應商合作，以確保符合必要的要求。其次，我們將提供資源指南和培訓，幫助醫療服務提供者及其員工理解並實施這些要求。第三，我們將啟動國家電子健康記錄（NEHR）連線補助金，並於今年七月開放申請。
該補助金將抵消醫療服務提供者接入全國電子健康記錄（NEHR）的費用。對於典型的醫療服務提供者，該補助金將覆蓋健康資訊管理系統最多兩年的訂閱費用。對於擁有內部系統的提供者，資金支援將覆蓋最多40%的系統升級費用。衛生部將撥出最多4500萬新元用於此項工作。
讓我舉例說明這項工作如何適用於一個擁有五名員工的典型診所。他們中的大多數已經訂閱了健康資訊管理系統。他們可以申請並受益於國家電子健康記錄連線補助金。除了國家電子健康記錄連線補助金外，診所還可以獲得新加坡網路安全域性高達70%的共同資助，以聘請網路安全顧問。他們還可以獲得新加坡企業發展局高達50%的資金支援，用於採用網路安全解決方案，例如反惡意軟體解決方案。總的來說，診所可以獲得大約20,000新元的補助金。先生，請用普通話講。
（用普通話）：[請參閱方言發言。] 在農曆新年期間，互致問候時，我注意到長輩們現在說“恭喜發財”的少了。取而代之的是，他們經常說“身體健康！”。他們明白保持健康的重要性，尤其是在疫情之後。
為了鼓勵老年人保持身心健康，我們已經建立了230多個輔助活動中心。今年，我們還將指定綜合社群護理服務提供者。
護理團隊將根據老年人的需求協調和規劃更全面的醫療保健。例如，如果老年人需要家庭個人護理服務以及訪問老年護理中心，他們只需聯絡一個護理團隊，減少了與不同社群護理提供者聯絡的麻煩。
我們也在積極利用科技，為新加坡人提供更精準、更便捷的護理體驗。例如，面臨跌倒風險的長者可以享受增強版居家個人護理服務下的24小時智慧監測。如果不幸發生意外，系統能夠及時通知相關人員提供幫助。這樣，家屬也能安心。
如今，越來越多的老年人變得精通科技。因此，我們推出了LifeSG應用程式。通過LifeSG，新加坡老年人理事會（SGO）可以與老年人互動，併為他們制定個性化的健康計劃。
自去年十二月以來，已有超過3,000名老年人受益。從今年七月起，全科醫生可以在其計算機系統中檢視由專科醫生、醫院及其他醫療機構之前記錄的患者健康檔案。通過這種方式，醫生能夠更全面地瞭解患者的狀況，為他們制定最合適的個性化健康計劃，並免去患者重複敘述病史的麻煩。老年人無需擔心記住醫生所診斷的疾病或所開具的藥物。
俗話說，“家有一老，如有一寶”。我們將利用科技提升護理質量，確保長者在熟悉的環境中接受治療。我們也將繼續擴大這些服務，讓每位長者都能獲得所需的關懷和支援。我們希望我們的寶貝——家中的長者——能夠幸福地生活，在家中安享晚年。
（英文）：通過《健康資訊法》和其他數字健康優先事項，我們正在建設一個更加互聯、響應迅速且安全的醫療系統。這是為了支援我們更廣泛的醫療轉型，將護理紮根於社群，提供更多圍繞老年人的協調服務。重要的是，一個以人為本的醫療系統。
主席：我們有時間進行澄清。瑪麗亞姆·賈法爾女士。
瑪麗亞姆·賈法爾女士（實龍崗）：謝謝您，先生。部長實際上並沒有直接回應我在發言中提出的許多具體問題，但他確實承認有許多好點子。因此，我期待未來能看到其中一些想法的落實，但今天我想重點澄清三點。
第一個問題是關於拉哈尤國務部長在兀蘭試點專案上的發言。感謝她的分享。我的澄清是，衛生部如何與其他機構合作，以最大限度地發揮該試點專案的效果？擁有健康促進局的數字導航系統來尋找健康食品選項是一回事，另一件事是增加健康食品選項的數量，特別是清真食品選項。這就需要與國家發展部等部門合作。因為當我們在一個咖啡店裡只有一家清真店鋪，且只供應印度煎餅和炒麵時，依賴這些食品很難維持健康的生活方式。
我第二個澄清是關於人工智慧話題，想請教部長。作為一名顧問，我完全支援實用案例的方法。重要的是這些用例必須能夠規模化；他提到的一些內容確實做到了這一點。但規模化也需要在基礎設施、治理和人才方面做大量工作，這些我在即席發言中也提到了。所以，我想知道他是否能就此發表一些看法。
我的第三個澄清問題也是給部長的，我很高興聽到關於MediSave500/700的變化，或者我們現在稱之為MediSave慢性病和MediSave預防護理。這實際上完全是我關於MediSave靈活使用建議的核心。部長分享了關於預防護理醫療支出的資料，例如，但目前有多少MediSave被用於慢性病和預防護理？衛生部是否做過任何模型分析，如果我們基於餘額設立MediSave慢性病和MediSave預防護理，這將如何影響可持續性？
王乙康先生：我先從第二個問題——人工智慧規模化開始。她提出的觀點，我們都同意。所以，我沒有太多補充，但我想瑪麗亞姆·賈法爾女士也知道我們採取的所有措施，她在發言中也提到了。就資訊科技基礎設施而言，國家電子健康記錄（NEHR）、下一代電子病歷、HEALIX、新加坡公共醫療的人工智慧醫學影像平臺。我們在幕後默默搭建了這些系統，同時加強了網路安全。因此，已經完成了大量的基礎工作。
因此，我們現在已經處於一個階段，如果某個用例在特定沙盒中的醫院被證明是有用的，我們可以將其規模擴大。這花費了多年的準備時間。我認為我們現在已經準備好以非常積極的方式去做這件事。
至於醫療儲蓄賬戶（MediSave），進行建模是很困難的。我們可以做，但事實是，不同人群的需求差異非常大。
前段時間，我們在議會中回答了一個問題，即85歲及以上的人去世時，其醫療儲蓄賬戶（MediSave）餘額是多少。我們整理了2017年至2021年的資料。結果顯示，20%的人餘額少於1,000新元；50%的人餘額在1,000至10,000新元之間；30%的人餘額超過10,000新元。那麼，這是否過多？這取決於我們談論的是誰。那些擁有10,000至30,000新元的人，我認為這已經很多了。那些餘額少於1,000新元的人，我認為幾乎不夠用。
我們確實需要為他們的老年儲蓄醫療儲蓄賬戶。因此，我認為有些議員提出了這個建議：我們是否可以根據餘額給予更多的靈活性？我們能否放寬一些規則？從概念上講這是正確的，但實際上並不容易。這不僅僅是建模的問題，而是能夠滿足個別情況的需求。
對於適用於全體人口的計劃來說，制定精準的政策從來都不容易。但我們會嘗試。我們會努力。我們會採納建議，盡力而為。
既然我站在這裡，我就代表拉哈尤國務部長回答。針對北部地區，我們可能會與社群內的其他機構合作，考慮不同的事項。關於更多的清真食品選擇和健康選擇，讓我們坐下來看看是否能與包括國家環境局在內的其他機構合作。
但我們考慮的實際上是一個護理模式，而不僅僅是食物。我們會對此進行研究。這個護理模式鼓勵居民進行早期檢查，註冊“更健康的新加坡”計劃，並在社群醫療夥伴（CHP）的支援下，使流程非常簡單，提供非常便捷的接觸點。我們將與當地國會議員和顧問一起，確保更多人響應我們的預防護理推動。
主席：哈雷什·辛加拉朱博士。
哈雷什·辛加拉朱博士（提名議員）：主席，我有兩個問題，圍繞臨床能力。首先是關於團隊護理，正如高階國務部長所提，這一模式自2015年起已存在，叢集醫療機構在這方面做了大量工作並建立了框架。
然而，許多由護士、藥劑師和輔助醫療人員主導的服務利用率偏低。衛生部將如何在國家層面幫助患者和公民理解並信任這些服務提供者所提供的護理？第二個問題是關於“更健康的新加坡”計劃的註冊，我們有居民在公私部門均有註冊。我們是否研究過如何加強這種關係，避免患者在不同提供者間漂移？
許寶琨博士：先生，感謝議員的兩個問題。關於第一個問題，團隊護理及某些輔助醫療人員主導服務利用率偏低，我們承認這是我們必須持續應對的挑戰，因為患者有自主權選擇最終接受護理的專業人員。因此，我們無法強制患者必須看特定專業人士，這就是為什麼建立信任關係非常重要。
同時，我們也在傳遞這些專業人員經過培訓並獲得認證，能夠提供更高水平的服務。隨著時間推移，我們希望患者的實際體驗能夠驗證他們所期望的護理效果，從而逐步在社群中建立信心和信任，患者也會逐漸接受我們所引導的轉診路徑。
我們在社群醫療夥伴中採取的措施之一是讓更多護士成為許多老年人對話的主導者。這是向老年人和患者普及護士能夠提供許多所需護理的好方法。因此，這需要多管齊下的方式，也需要時間。但我們也越來越看到，這種能力將被更好地利用。
關於第二個問題，尤其是在“更健康的新加坡”計劃中不同提供者的註冊情況，這確實是我們需要持續努力的方向。因為除了註冊之外，還涉及患者是否能很好地跟進護理計劃的實施。我們並不幻想僅憑推出“更健康的新加坡”計劃，初期一切就會非常順利。
這不僅需要提供者、醫生和護理團隊的系統變革，也需要我們人口心態的逐步轉變。因此，這是一個持續的過程，沒有靈丹妙藥，也不是一蹴而就的。
12點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，我想提出兩個澄清問題。首先，針對拉哈尤國務部長。我非常歡迎2028年起針對骨質疏鬆症等虛弱症的護理協議。我想問，作為護理協議的一部分，是否會有有意的策略，將早期教育納入30至40歲人群，正因為骨量峰值和肌肉峰值發生較早，通過生活方式干預如營養、抗阻訓練和維生素D，是否會將其納入策略，以便我們不僅將其視為老齡化問題，而是作為全生命週期的預防策略？
第二個澄清給部長。我認為許多醫生會歡迎將遺傳性癌症納入保障範圍。我想問，因為這是高風險群體，風險降低治療成本肯定很高，而“醫療保險生命”（MediShield Life）是風險共擔原則，這可能存在利益衝突。衛生部是否會考慮為“醫療保險生命”的設計及高風險個體的治療費用採用單一概念，而非零散治療？因為健康乳房的風險降低治療與已檢測出癌症的乳房治療之間可能存在時間差，這將是個人一生的額外成本。
拉哈尤·馬哈贊女士：感謝您的提問。護理協議仍在制定中。感謝議員的建議——這是我們可以考慮的內容。我們會參考篩查測試審查委員會和護理效果機構的臨床指南，利用相關證據和資料來確定協議內容。議員提出的建議我們會帶回去考慮納入。
王乙康先生：關於遺傳性乳腺卵巢癌（HBOC），希望我理解議員的問題正確。我們實際上做過模型分析，因為風險降低性乳房切除術能節省未來治療費用，整體對“醫療保險生命”的影響非常小，這也是我們願意推行的原因。
主席：朱佩玲博士。
朱佩玲博士（蔡厝港）：主席，感謝部長詳盡的回應。在新加坡最新的城鎮——中大鎮，許多年輕家庭正在發生一件非常特別的事情。自去年以來，我在居民中遇到了19對雙胞胎。這反映了許多中大鎮夫婦正處於組建家庭的階段。
正如部長所指出，年輕人口的醫療需求往往是偶發性的。但像中大鎮這樣的城鎮也為我們提供了一個難得的機會，可以從早期開始預防。部長能否分享衛生部如何與其他機構合作，將預防健康納入新城鎮建設，從一開始就融入，而不是等人口老齡化後才引入？
王乙康先生：一些基本步驟——就像果樹，我們先摘低垂的果實，然後逐漸摘更高的。有時我們會先考慮最高的。最低的就是哈雷什博士提到的，我們必須堅持一個醫生，一個全科醫生，他成為我們的家庭醫生，為我們的家庭健康提供建議。因此，有了“更健康的新加坡”計劃。
所以，對於像中大鎮這樣的新城鎮，請儘可能多地讓居民註冊“更健康的新加坡”計劃。之後，確保他們跟進體檢、疫苗接種和健康篩查。如果議員能推廣戒菸，打擊電子煙，這些都是確保健康的基本步驟。把這些都落實好。
除此之外，我們非常樂意與朱博士及其他機構合作，看看還能在中大鎮實施哪些健康專案。
主席：何亭如女士。
何亭如女士（盛港）：先生，我有三個澄清問題要問高階國務部長許寶琨。第一個是關於臨床心理學家的新加速路徑。我的澄清是，預計未來通過該路徑進入該職業的人數會增加多少？
我的下一個澄清是關於心理學家註冊的宣佈。我感謝衛生部的宣佈。我知道該職業中有很多人非常期待這個訊息，他們聽到後非常高興。我有兩個澄清問題，實際上這兩個問題是我發言時被刪減的部分。
第一個問題是，對於有志進入該行業的人士，有什麼支援措施？因為正如我提到的，實習和監督費用可能相當高昂。我的澄清是，衛生部正在做什麼，或者衛生部如何看待解決那些有志進入該行業的專業人士面臨的入行障礙問題？第二點是，對於那些實際上尋求這些服務的客戶來說，在這些註冊要求生效之前，如果他們對專業倫理和標準有疑慮，他們有什麼申訴途徑和支援？
許寶琨醫生：先生，感謝議員提出的三個澄清問題。關於第一個問題，即最終會有多少心理學家進入系統，以及新路徑在增加人數方面意味著什麼，我認為目前很難判斷。該課程的初期招生人數大約只有10人。因此，我們也將觀察首批招生的反應。但請注意，現有心理學家也有升級的途徑，這是現有的路徑。我們需要感知本科生以及在職心理學家整體的需求情況。
挑戰還在於，因為我們之前沒有對心理學家進行註冊，所以我們沒有準確的資料知道有多少心理學家。但據我所知，新加坡心理學會大約有1700名會員，其中大多數也在臨床領域執業。如果以此作為大致估計，這大概就是我們正式進行註冊時的起始人數。但隨著註冊的實施，我們將更好地掌握實際情況。
關於第二個問題，即對有志報讀該課程的學生會提供什麼支援，我們仍在與相關院校討論中。但我認為，最低要求是他們必須符合入學標準，因為這是我們不能降低的標準。除此之外，其他支援措施，比如是否會對學費提供補貼，據我瞭解，大致會與現有高等院校的政策保持一致。因此，如果你是新加坡學生，預計會有一定的學費補貼。
第三個問題是，公眾如果想尋求心理護理，如何辨別誰是合法的。在註冊生效之前，我們很難提供詳細的個別專家或心理學家的名單。但他們可以先查驗該人士是否至少註冊於新加坡心理學會。因為至少這是一個被認可的同行專業社群，所以這是目前的一個起點。當然，對於在我們公共醫療機構執業的心理學家，已經有治理框架，公眾至少可以放心，這些心理學家已經接受監督並被公共醫療機構認可。
主席：普里塔姆·辛格先生。
普里塔姆·辛格先生（阿裕尼）：我有兩個問題。第一個與我對醫療人力的關注有關。我也注意到多位官員提到我們已進入超級老齡社會。針對這一點，衛生部是否在考慮新的指標或資料點，以反映醫療系統在這一新環境下的執行情況？例如，衛生部現在釋出的醫療機構統計資料，包括急診科就診人數、入院時間和床位佔用率，我認為這些資料很有幫助。
但是否還有其他指標也對公眾有幫助，比如診所的等候時間？是否有其他指標能反映醫療系統的表現，尤其是在我們所處的新環境下？
我的第二個澄清問題涉及我之前提到的額外提款限額。我理解部長關於醫療儲蓄賬戶（MediSave）及其“因果報應”的觀點，即對醫療儲蓄的需求總是很大，以應對開支。當然，隨著基本醫療保障金額逐年增加，這在某種程度上是不可避免的。基於此，我想詢問是否會考慮通過醫療儲蓄賬戶提高額外提款限額？
王乙康先生：我會把普里塔姆·辛格先生的建議放入我們的願望清單，這個清單已經相當長了。我們每年都會審查，下一次會全面審視願望清單。但為了管理議員的期望，我想說醫療儲蓄賬戶的重點，我完全理解大額一次性支出與經常性開支之間的矛盾。但所有這些都是在確保補貼醫療可負擔且最大限度減少新加坡人自付費用的背景下進行的。額外提款限額是針對私人保險的，我們會記住這一點。
至於議員的第一個問題，衛生部有很多指標。如果議員提交國會質詢，我可以提供很多指標，告訴他我們正在監控的內容，包括等候時間、急診科、診所、床位佔用率、不同環境下的平均住院時間等，這些都是即時的運營指標。
中期來看，我們希望在“更健康的新加坡”計劃的註冊人數、隨訪檢查、篩查率、疫苗接種率等方面取得成效。長期來看，則關注人口健康狀況，比如慢性病患病率、癌症死亡率等。關鍵績效指標（KPI）數量達到數百個，我們會持續監控所有這些指標。
主席：蔡銀洲先生。
蔡銀洲先生（碧山-大巴窯）：主席，我有四個補充問題。第一個是給許寶琨高階國務部長。提到有聽力學碩士課程，但我想問是否有計劃開設聽力學文憑或本科課程，以及足病學課程，據我瞭解，國大醫學院網站上顯示我們沒有本地相關課程。
第二個澄清問題是給陳振聲高階國務部長，關於支援照顧者的靈活工作安排。我理解靈活工作安排因情境和工作場所不同而異。衛生部如何幫助正式確認照顧者身份，併合法化他們對靈活性的需求，使他們能更好地向僱主說明需要靈活工作的理由？
第三個問題是關於綜合社群護理提供者安排。感謝陳振聲高階國務部長分享“一次護理評估計劃”和一次臨床評估。未來是否會有改進，除了臨床結果外，還能進行一次財務評估，以及為可能尋找兼職工作的長者提供一名就業協調員？
最後一個問題是關於社會處方。我們確實看到社會處方在對抗孤獨感方面的需求，正如陳振聲高階國務部長所強調，孤獨感相當於每天吸15支菸。我的問題是，既然我們衡量醫療處方，那麼社會處方如何被衡量，干預措施如何被追蹤？
我的問題還源於我之前提交的國會質詢中提到的輔助活動中心（AAC）參與度作為衡量標準。我們如何更好地考慮長者可能活躍的其他領域，比如信仰團體、社群俱樂部或中心活動，或他們可能參與的課程志願服務？我們如何將這些納入考量？陳振聲高階國務部長也提到正在與學校進行研究，如果他能分享更多細節，將不勝感激。
許寶琨醫生：先生，感謝議員關於聽力學家的提問。一般來說，新加坡合格的聽力學家需要較高的資格認證，因為文憑水平可能不足以勝任相關工作。我們會考慮是否有辦法找到一箇中間方案。但最終，我們不能為了滿足想通過短期課程進入該領域的人的需求而犧牲標準。首要任務是保持標準。
但實際上，有些聽力學課程是在較低層次進行的。例如，我確實相信淡馬錫理工學院有一些基礎的工業聽力測量課程，但那更多是針對工業應用，供實際在工業層面進行篩查的技術人員使用，而不是臨床環境中在醫院提供服務的那種。
中午12點30分
王乙康先生：我來回答最後一個問題，前兩個問題由高階國務部長陳杰豪回答。
社會處方，能被追蹤嗎？現實情況是，不能被追蹤，因為那是你的生活。我們在這裡提供支援和資金，讓你儘可能輕鬆地來到輔助活動中心參與。但至於你如何生活，我恐怕無法追蹤，也不認為我應該追蹤。但請至少註冊使用Healthy 365——這個應用程式會幫助你追蹤。
陳杰豪先生：主席，我會嘗試回答蔡先生的問題。蔡先生，如果我聽錯了你的問題，請糾正我，因為我試圖理解你的四個問題。其中一個問題是，社會處方是否是“一站式關懷評估計劃”的一部分。實際上，這是“更健康的新加坡”計劃的一部分，關懷計劃也包括社會處方。例如，飲食、生活方式、鍛鍊以及許多其他方面。所以，這當然應該是該關懷計劃的一部分，但這超出了綜合社群關懷服務提供者的職責範圍，後者更關注老年人及其需求。
蔡先生還問綜合社群關懷服務提供者和綜合關懷機構是否能滿足不同型別的活動需求，比如基於信仰的志願服務，或者對園藝感興趣的老年人作為社交活動。
我想說的是，我們今年開始推出綜合社群關懷服務提供者框架，並將在未來幾年持續推進。這是一個涵蓋新加坡84個子區域的非凡工程——將不同的各方和合作夥伴聚集在一起。在每個區域、每個子區域，都有不同的服務提供者和各方提供不同的服務——從陪伴服務、康復服務到更多其他服務。
因此，將不同的合作伙伴聚集在一起，形成共同的語言來討論、理解、接觸併為老年人提供服務，這並非易事。基於此評估開發標準化工具，制定關懷計劃，實施關懷計劃，並讓我們的老年人完整經歷該關懷計劃，也都不簡單。所以，我想說，讓我們一步步來，社群中已經有許多活動和其他合作伙伴提供不同的服務和志願機會給老年人。我們歡迎這些，這確實是多元社群結構的一部分，也是“我們優先”社會的重要組成部分。
主席：法茲利·法茲維先生。
法茲利·法茲維先生（阿裕尼）：主席，我有一個問題想向陳杰豪高階國務部長澄清。我想請他確認衛生部是否會採納我關於照顧者護照的建議，以及衛生部是否有任何考慮可能阻止該建議被採納。
陳杰豪先生：主席，請允許我藉此機會回答蔡先生之前我未及回答的關於靈活工作安排的問題，以及我們如何與不同合作伙伴合作。我在發言中提到各部委支援照顧者的努力，我們理解照顧者在工作與照顧之間的挑戰。這是他們正在努力解決的，包括靈活工作安排和其他舉措。我們將繼續與同事及社群其他合作伙伴合作。
關於法茲利·法茲維先生提到的照顧者護照問題，如果我理解正確，他提到的是英國的做法。正如我之前發言所說（法茲維先生當時不在場），我們當然歡迎議員們的所有建議，包括其他議員在衛生部部長答問會及其他場合提出的建議。
針對他的建議，我在網上查閱過相關資訊。我必須宣告，我獲得的資訊僅來自網路資源。這是英國的一個自下而上的倡議，旨在讓涉及的不同方——從醫院到他之前提到的超市——表達對照顧者的關懷和支援。例如，一些醫院可能提供更長的探視時間，醫院餐廳可能給照顧者用餐折扣，一些超市也可能提供折扣。這是一個自發的倡議，由不同方參與。
由於是自下而上的倡議，我瞭解到實施情況可能不均衡。照顧者在英國不同地區可能有不同體驗，去不同超市也會有不同體驗。有些超市提供支援，有些則沒有。這是自願性質的努力。像許多自下而上的倡議一樣，我們當然歡迎它們。政府也有許多資助計劃支援自下而上的倡議。如果法茲利·法茲維先生知道有個人或團體願意支援我們的照顧者並組織自下而上的努力，我們會考慮這些提案。
主席：萬立駿醫生。
萬立駿醫生（惹蘭勿剎）：謝謝主席。我有三個問題想向高階國務部長許文遠澄清。高階國務部長之前提到成立了國家心理健康辦公室（NMHO）以協調多機構舉措。請問高階國務部長能否分享他們的關鍵績效指標（KPI），例如是否減少了平均等待時間、改善了護理連續性、減少了危機就診？如果有，這些資料多久報告一次？
高階國務部長還提到“繫結護理”和“無錯門”方法，我對此表示歡迎。衛生部是否會分享期望的服務標準，例如首次聯絡的最長時間、中高風險病例首次臨床預約的最長時間，以及跨機構的升級協議？
第三個問題是，高階國務部長談及護士和輔助醫療人員的留任措施。針對心理學家，是否有具體的留任水平？例如，專科路徑、晉升以及公共部門薪酬競爭力等方面。
許文遠博士：主席，關於第一個問題，即國家心理健康辦公室的KPI，我在幾天前的議會質詢答覆中提到，我們目前的重點是建設能力，因為確保有足夠能力滿足需要幫助者的需求，自然會減少許多等待時間。但重要的是推出“心理健康第一站”，它是可及的——例如，mindline.sg全天候開放，且匿名——這將真正消除阻礙大家至少尋求首次接觸點以獲得建議和進一步幫助的關鍵障礙。
因此，在KPI方面，第一站不會有等待時間。它有24/7的聊天機器人，還有值班的輔導員，你可以隨時打電話或通過WhatsApp發信息與他們交流。所以，我認為從首次接觸點來說，實際上沒有等待時間。
但重要的是確保進入首次接觸點的個人準備好接受更高級別的護理幫助（如果需要）。這往往是挑戰所在。許多人不願意進入下一層級的護理，因為我們在社群中處理有心理健康問題的挑戰個體時都知道，有時讓他們主動尋求幫助本身就是問題。不是資源不足，而是他們不願意主動尋求。
這涉及多種因素，非常困難，因此關鍵是說服他們、與他們合作、贏得他們的信任。我們希望推出的一些第一站資源能成為輔導員通過電話說服個人準備邁出步伐接受護理的途徑。
話雖如此，這也引出了第二個關於分層護理模式的問題，即是否有方法監測那些高風險人群及其是否獲得護理。同樣，沿著這個思路，我想向議員保證，那些被認為是高風險的人群將始終被優先考慮。例如，如果他們通過線上或電話諮詢，諮詢師評估該個人有自殺意念的風險，他們會盡最大努力說服該個人主動尋求護理。如果該人願意主動求助，將有一套快速通道協議，確保他們能立即獲得合資格精神科醫生的關注，甚至直接到精神健康院急診部接受即時治療。
正如我所說，最大的障礙是他們是否願意主動求助，而不是真正的護理能力本身。
所以，我希望議員能理解，為什麼我們追蹤某些時間線並沒有太大意義，因為反事實是無法衡量的。沒有辦法測量誰處於風險中，誰會出現，或者最終成為自殺案例。反事實無法驗證。因此，我們將重點投入資源，確保如果他們願意主動求助，資源是可用的。
關於第三個問題，即心理學家的留任問題。我認為我們應該一步一步來。我們首先從註冊開始，給予那些在心理學高風險子領域執業者正式認可，確保他們獲得質量、標準和支援，以提供客戶和患者所需的護理。
目前，我們暫時不會考慮更多其他措施，但讓我們一步步來。
當然，在醫療保健領域，我們也為輔助醫療專業人員（AHPs）提供了留任措施，我記得大約是在2025年，如果我沒記錯的話。所以，我們會整體考慮，作為支援輔助醫療專業人員的一部分。
主席：副教授林佔武。
副教授林佔武（盛港）：我的問題是給王部長的。部長先生，我在發言中提到了醫療支出的不均勻性，不僅僅是在臨終關懷的背景下，也是在持續的基礎上。這是基於我從居民那裡收到的反饋。
同時，我也非常清楚部長提到的當前使用與未來使用之間的內在矛盾，這也是為什麼我建議允許未用完的年度限額最多結轉三年，這樣可能在謹慎提款限制和靈活使用以滿足不均勻需求之間取得平衡。
所以，如果我可以換個方式提出我的問題：部長認為允許這種有限的年度醫療儲蓄限額結轉，可能會遇到哪些後勤或行為上的困難？
王乙康先生：我不會立即說“是，好主意”，或者“否，我們會拒絕”。我認為這是一個有趣的想法。正如我所說，我們每年都會審查該計劃。我確實想看看如何創造更多靈活性，我們會考慮你的建議。
主席：葉漢榮先生。
葉漢榮先生（耀祖康）：謝謝主席。我想澄清關於老齡化和超級老齡社會的問題。在老年活動中心（AAC）附近居住的老年人中，有多少比例是積極參與的？這是第一個澄清。
其次，我瞭解到像銀髮世代辦公室（SGO）這樣的機構會主動在其場所與老年人互動，但我們還有什麼不同的做法來接觸那些社會孤立、可能不會主動參與AAC活動的老年人？
陳杰豪先生：部長先生，正如我之前演講中提到的，我們已將老年活動中心的覆蓋範圍擴大到約230箇中心。這是在過去兩年內完成的。我們現在服務約10萬名老年人，並希望在幾個方面做得更多。
首先，不僅僅是老年活動中心的數量，這是一個方面。更多的老年活動中心使老年人更方便、更容易到家附近的老年活動中心，在他們熟悉的環境和社群中。這就是我們擴大覆蓋範圍的原因。
但除了老年活動中心的數量，老年活動中心開展的活動也很重要，使老年人覺得有意義，願意來參與，不至於社會孤立。他們來參與，參與活動，建立新朋友。希望他們也能改變生活方式，變得更健康、更快樂。
未來幾年，我們將擴大老年活動中心的活動種類，不僅僅是做健康倫巴等活動，還會提高健康意識，並在老年活動中心內設立社群健康夥伴（CHP），為老年人提供服務。我們將繼續探索更多可能性，不僅僅是數量，更是活動的質量。
12點45分
第三，銀髮世代辦公室有銀髮世代大使，他們主動接觸老年人。正如我提到的，自2022年以來，他們已接觸超過60萬名老年人。他們不僅僅是走訪和交談，還進行友誼訪問和預防性健康訪問，瞭解老年人在家中的情況、需求以及家庭背景，識別適合他們的服務，尤其是靠近他們住所的服務，並將他們連線到這些服務——無論是老年活動中心、社群俱樂部還是心理健康服務。
銀髮世代大使不僅僅是走訪者，他們也是社群的重要接觸點和服務連線者。
我們希望為社會孤立的老年人做更多工作。我們一直與社群夥伴合作，不僅是老年活動中心和社群俱樂部，還有其他社群組織，包括信仰團體和志願組織，主動接觸這些老年人。我們與他們緊密合作。
這就是綜合社群護理計劃（ICCP）的作用。對於從公共醫療機構（即醫院）出院的老年人，我們如何確保他們不被遺忘、不被孤立？這就是ICCP的轉介流程。ICCP會為這些老年人制定評估和護理計劃，並聯合合作夥伴主動接觸這些老年人，尤其是獨居老人。
所以，針對議員的問題，我歡迎任何建議。這是衛生部未來幾年的重要優先事項。
主席：林秀儀女士。
林秀儀女士（亞歷山大）：謝謝主席。我想回到部長的抖音影片。我應該澄清，我平時不常看他的抖音影片，但那段影片是有人推薦給我的。
我聽到保險業的一些反饋，說那段關於住院保險（IP）和附加險的影片給部分公眾留下了附加險不太必要的印象。影片中，附加險被象徵為一匹木馬。我記得影片中部長有一幕把木馬從桌上彈開。
我不知道部長是否知道這種反饋，即該影片可能給公眾留下附加險不太有用的印象。部長能否藉此機會再次重申，附加險確實是謹慎的選擇，理由正如我在發言中提到的？
王乙康先生：當注意力持續時間如此短暫，而你又試圖在短影片中傳遞大量資訊時，這確實是個挑戰。
我不驚訝保險業給出這樣的反饋，但我認為影片和我們釋出的資訊是嚴肅的，即你必須審視自己是否真的需要附加險。
我們回顧一下，保險的目的是覆蓋我們無法承擔的費用。對大多數人來說，如果我們有一次住院，費用可能高達數萬甚至數十萬，保險加補貼可以覆蓋這部分費用。
附加險不承擔這部分費用。撇開癌症不談，附加險覆蓋的是共付額。附加險覆蓋的是自付額和5%的共付部分。這是附加險的核心目的。
因此，請仔細考慮。與您的理財顧問溝通。隨著年齡增長，附加險的保費漲幅最大，權衡成本和收益，看看附加險是否適合您。
我認為影片的核心資訊依然準確，我們應該認真審視自己的財務需求，評估我們想要保護的風險，並檢查——我是否需要附加險？如果需要，保險公司4月份推出的新附加險，雖然覆蓋的共付額較少，但費用更低，是否更適合我？採取這些步驟。
需求各不相同。不同的人有不同的需求。有些人確實希望支付更高的保費，以便獲得儘可能多的保障。那也無妨。但對於其他人，尤其是那些使用公共醫療機構、享受補貼醫療的人來說，要仔細考慮你是否真的需要附加險。
主席：林女士。請簡短髮言。
林秀玉女士：謝謝您，主席。跟進部長的問題，是否存在這樣一種情況：如果沒有附加險，患者需要自付10%的住院費用，且沒有上限？這就是關於賠付限額的一個擔憂。
王乙康先生：這說法不太準確。如果你說的是附加險，如果你根本沒有附加險，是的，你需要支付10%的共付額。如果你考慮去私立醫院，賬單可能高達數十萬新元，而你想防範這10%的共付額，那麼附加險可能適合你。
但請記住，隨著年齡增長，到了七八十歲，保費可能高達每年一萬新元。沒有附加險，你就節省了這筆保費。所以，請自行計算，諮詢你的理財顧問。
但如果你總是在補貼的公共醫療環境中接受治療，MediShield Life會介入，加上補貼，如果你生病，暴露於數萬甚至數十萬新元的風險非常不可能。然後，再考慮附加險是否適合你。記住，在公共醫療機構，如果你負擔不起，還有MediFund可以申請。
主席：說到這裡，我認為所有澄清問題都已提出並得到回應。請問瑪麗亞姆·賈法爾女士，您是否願意撤回您的修正案？
下午12時51分
瑪麗亞姆·賈法爾女士：感謝各位議員的激烈討論。我認為醫療保健可能是最複雜的部委之一。我代表衛生政府議會委員會，感謝醫療大家庭，從衛生部的每一位工作人員到醫院和社群的前線人員。基於此，我請求撤回我的修正案。
[(程式文本) 經許可，修正案撤回。 (程式文本)]
[(程式文本) 頭O項下的20,035,377,700新元被批准作為主要預算的一部分。 (程式文本)]
[(程式文本) 頭O項下的2,467,566,400新元被批准作為發展預算的一部分。 (程式文本)]
英文原文
SPRS Hansard · Fetched: 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.
10.33 am
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 . ]
11.00 am
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.
11.15 am
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.
11.30 am
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.
11.45 am
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.
12.00 pm
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.
12.15 pm
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.
12.30 pm
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.
12.45 pm
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?
12.51 pm
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)]