Committee of Supply – Head O (Ministry of Health)

The Chairman: Head O, Ministry of Health. Ms Mariam Jaafar.

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From Financing Care to Financing Health

Ms Mariam Jaafar (Sembawang): Chairman, I move, "That the total sum allocated to Head O of the Estimates be reduced by $100."

S+3M, subsidies Medisave, MediShield and MediFund, is one of our nation's quiet triumphs. It has protected generations of Singaporeans from catastrophic bills. It has preserved system sustainability. It has embedded shared responsibility, personal ownership and equity.

But it was built for yesterday's risks. S+3M was designed for acute hospital episodes. A surgery, a stroke, a sudden hospitalisation.

Today, our dominant risks are chronic, progressive, community-based: diabetes, dementia, frailty, mental health conditions. They do not bankrupt a family overnight, but they exhaust a family slowly.

Dementia day care costs about $63 per session. Even with the latest subsidies, a middle-income family still pays over $12,000 per year, before transport, home care, medications, and lost caregiver income. At my Woodlands Meet-the-People Sessions, I often hear two concerns: one, why can't I use my Medisave? It's my money; and two, I already used up all my MediSave for chronic care.

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Mrs L, a retiree, cares for her husband with early dementia, while managing her own diabetes. She told me, "I saved all my life. Why does it still feel like my money isn't enough to stay independent?" Or K, 24, pays out of pocket for mental health care because her condition is not officially chronic. "I'm probably going to need this for the rest of my life. How is that not chronic?" These are the lived realities faced by our fellow Singaporeans.

Incremental cap adjustments and coverage expansions help, but they do not fundamentally reshape incentives. Our system still signals we pay more attention when you are already very sick. That must change. Our lifestyle risks are rising faster than our population ages. More sedentary work. More screen time. Richer diets. Chronic conditions appearing earlier.

Singapore is investing in population-level prevention – 6 % of our healthcare Budget, with plans to double. Healthier SG fully subsidises routine screenings and immunisation programmes. Active-living infrastructure like parks, fitness corners, cycling paths, Active Ageing Centres and community health programmes encourage functional health. These are centrally funded.

But prevention is more than screening. Some seniors need physiotherapy to prevent a fall. Some need home rehabilitation to prevent a readmission. Some need cognitive stimulation to prevent the onset of dementia. Some adults need weight management programme to prevent diabetes progression. Some youths need early mental health interventions to prevent a spiral. These are investments in independence, not discretionary lifestyle perks. S+3M must evolve, not just to pay bills, but to shape behaviour, support prevention and sustain independence.

Subsidies. I propose three upstream shifts.

One, early disability support. Many schemes require three Activities of Daily Living (ADLs). Introduce an early intervention tier for "pre-frail" seniors – funding physiotherapy, balance training, and strength exercises. One month of rehab today can prevent a decade of nursing home care tomorrow.

Two, subsidised diagnostic pathway. When referred by a Healthier SG general practitioner (GP), the first specialist consultation and primary diagnostic scan, CT or MRI, public or private, should be subsidised. A treatable condition should never become a terminal one because someone hesitated over the cost.

Three, fairer means testing for sandwiched families. Two households may have the same per capita household income (PCHI), but the one supporting elderly parents and young children carries a heavier burden. Adjust subsidy tiers for households with multiple dependents.

Subsidies must be easy to use, visible and structured to encourage early preventive action. Automatic enrolment, co-payment reductions, integrated Medisave bonuses and seamless digital claims are ways to nudge behaviour.

MediSave. Even with subsidies, Singaporeans face costs over the long term. MediSave must evolve. I propose MediSave flex where the annual withdrawal limit is linked to balances, with an upper cap to maintain sustainability. Let it fund chronic disease management, broader preventive screenings, evidence-based doctor-referred functional health or nutrition programmes, early rehabilitation after minor injuries or hospital stays, early interventions for dementia or frailty, expanded mental health support. Keep the remainder MediSave core for major episodes. Unused flex balances roll over, rewarding responsible early actions. Bonuses can be awarded, tied to improvements in chronic disease management and functional assessments.

Together subsidies and MediSave flex nudge Singaporeans to act early, adhere to chronic care, and engage in preventive programmes. Singaporeans get more flexibility while the systems preserve catastrophic coverage. MediShield Life remains for rare, high-cost hospitalisation, keeping premiums affordable. Explore premium credits for preventive prescriptions if they are shown to save costs. MediFund remains the final safety net for those genuinely in need.

S+3M actually has been a safety net catching us when we fall. But in an ageing society, we need a springboard that keeps us standing, strong, independent and healthy. We must adapt S+3M: financing not only healthcare, but health itself, not by abandoning the principles, but by fulfilling them fully.

Shared responsibility must include shared prevention. Personal ownership must empower early action. Equity must recognise cumulative burden. This is not about spending more. It is about spending earlier, so that we spend less later – financially, socially, emotionally.

And, Sir, none of these changes one thing. The Government must do everything in its power to keep healthcare affordable and rein in healthcare inflation. If we get this right, we will not only treat illness. We will preserve independence and dignity. We will not only pay bills. We will invest in health.

Will the Ministry commit to studying and reporting, ideally before the next Budget, how S+3M can be recalibrated to better support chronic and preventive care?

Question proposed.

Personal versus Collective Responsibility

Ms Mariam Jaafar: Healthcare is often framed as personal responsibility. Individuals matter, yes, but in Singapore, healthcare risk is shared. Premiums are pooled. Subsidies are pooled. Caregiving burdens are shared. There is no such thing as a purely private health cost.

When preventable illnesses rise, premiums rise, taxes rise. Families feel the strain. Caregivers leave the workforce. Yet today, only about six in 10 eligible residents participate regularly in recommended chronic disease screenings. Four in 10 remain unprotected.

Preventive care saves lives and reduces costs, but only if people participate. If prevention is essential, it should not depend on who remembers to click a link. Opt-in assumes time, awareness and confidence – luxuries not everyone has. Prevention must be the default. I propose: move to opt-out screenings, proactive, personalised health coaching supported by digital nudges.

Collective responsibility is not about blame. It is about design. And design does not sit with the Ministry of Health alone. It is about what our children eat in school. What is affordable at the hawker centre? How workplaces structure time and stress? Whether our neighbourhoods invite movement or discourage it? The healthy choice must be the easy choice.

If we design upstream, we save downstream. Will the Ministry consider making key preventive programmes opt-out and outline how the Ministry will work across Government to embed preventive defaults in daily life?

Improving Health in the North

Healthier communities do not just happen by chance – they are designed. The Ministry of Health (MOH) has launched a programme to improve health in the North, and Woodlands, my Constituency, is piloting an integrated preventive health model.

The North is well placed for this. We have a diverse mix of seniors and families, the full range of housing types, strong community institutions, and opportunities to strengthen chronic care. With two hospitals, several polyclinics, and active ageing centres within easy reach, we can test how to bring care closer to home and refine integrated care team models.

The pilot rests on four pillars: first, stronger referral pathways and chronic disease support. Second, moving care closer to home, with smoother transitions; third, redesigning neighbourhoods so that the healthy choice is the easy choice; and fourth, activating communities as health advocates.

I support this initiative. But it cannot be policy on paper – it must be about real people, living healthier lives, every day. I therefore have two questions and three requests for the Minister.

The questions: one, how will success be measured? Two, what resources will be available for grassroots activation?

The requests: ensure town-level care hubs are fully integrated and consistently staffed so residents can access services without delay; expand the scope of community-based care and caregiver support, to cover more conditions and families; and involve my residents directly in co-designing interventions so solutions reflect their real needs and let us avoid stigmatising any community.

Health outcomes are shaped by the systems – transport, food, work patterns as well as socio-economic factors, not moral failings.

Imagine this. Mdm S, 54, does strength training three days a week at the Active Ageing Woodlands Gym under the watchful eyes of a volunteer buddy. When she does not feel like cooking, there are plentiful healthy and affordable Halal options at Kampung Admiralty Hawker Centre. With care and support closer to home, her diabetes is under control and she stays independent.

If we can redesign a town for health, we can redesign a nation.

AI in Healthcare

First, I declare my interest as Managing Director of a management consulting firm that works in AI and healthcare.

AI in healthcare is often discussed in terms of use cases – detecting disease earlier, automating paperwork, predicting risk, personalised medicine. These are impressive. But today, I want to ask the Minister a bigger question: what is our ambition? If healthcare is truly a national AI mission, our goal cannot be incremental adoption. We must build a system – the infrastructure, the governance, the talent, the plumbing that lets AI transform care safely, effectively and at scale, with better outcomes for every patient in Singapore.

Once we show that AI delivers real patient benefit safely and reliably at scale, Singapore will naturally move from adopter to a global leader in trusted healthcare AI. Singapore has laid strong foundations: HEALIX enables analytics across clusters; the National Electronic Health Record (NEHR) aggregates patient records; the Health Information Bill clarifies rights, responsibilities and safeguards; and early AI pilots are already easing clinician workload and improving patient outcomes.

But infrastructure alone does not make us a leader. Much of our data is still fragmented. Interoperability supports care delivery, but safe access for innovation and AI development, including with third parties, remains rather limited.

To lead globally, three things matter.

One, stronger data frameworks – national data architecture, secure sandboxes, synthetic datasets, and federated learning that enable AI innovation without compromising patient privacy.

Two, interoperable systems that allow AI models to learn across institutions while keeping clinicians in control.

Three, governance rules: every AI recommendation must be explainable, auditable, accountable. Clear innovation governance; top down or bottom up.

On global collaboration, our stance must be clear: we welcome expertise, but only under frameworks that protect our data, preserve sovereignty, build local capability and benefit patients.

Regulations must also keep pace. AI evolves quickly. We need national validation, certification, and post-deployment monitoring – standards for bias, explainability, and real-world performance, so patients and clinicians can trust every AI decision.

Finally, talent. AI in healthcare is a translation problem. We need professionals fluent in both clinical realities and machine learning.

Sir, we are on track to drive efficiency with AI. But Singapore must be a place where AI solutions are built, tested, certified, and scaled safely, and where patient outcomes improve at every step. Healthcare should not merely adopt AI. Singapore must set the standards for trusted, safe and effective AI.

Will the Ministry outline a clear roadmap, with timelines, for strengthening data access frameworks, validation standards, and talent development, so Singapore leads in trusted healthcare AI?

Integrated Shield Plans – Additional Withdrawal Limits

Mr Pritam Singh (Aljunied): The MediSave contribution ceiling in 2015 was $48,500. Today, its equivalent – the Basic Healthcare Sum of the maximum amount in the MediSave account – is $79,000, an increase of about $30,000 in a period of about 10 years. With close to 70% of locals holding an Integrated Shield Plan (IP), there has been no increase for close to 10 years since the introduction of MediShield Life with respect to the maximum amount one could use from MediSave to service IP premiums, or what is referred to as annual withdrawal limits.

With out-of-pocket expenses a consistent bugbear for many Singaporeans over the last few years, and the basic healthcare sum rising exponentially year-on-year, there is an expectation that the additional withdrawal limits that allow Central Provident Fund (CPF) members to use more of their MediSave money to service their IP premiums, are in need of a revision. It cannot be reasonably expected that this number or the amount of money that can be used should remain the same after so many years.

Does the Ministry plan to review this in the immediate term? And if not, why not?

Healthcare Manpower

The headline of an opinion piece last month in The Straits Times expressed a major anxiety of the health system succinctly: "Singapore as a super-aged society: can its health system cope?" The author, an academic with a specialty in public health, observed what is commonplace for many Singaporeans when they visit our public hospitals and healthcare institutions – a large number of seniors in wheelchairs, visibly frail, or struggling with mobility.

The Ministry has shared that the healthcare workforce is projected to grow by 20% from 129,000 in 2024 to about 156,000 in 2030. The assessment is that this number would be broadly adequate for the population's healthcare demands for the years to come.

The intersection of a rapidly ageing population and higher demand for healthcare services will bring the adequacy of the healthcare workforce into distinct focus and any shortages or perceived shortages will be reflected most acutely in service quality, waiting times for specialist care and waiting times to see a healthcare professional, amongst others.

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In parallel, there are real concerns and worries about the welfare of our healthcare workers, from allied health professionals to nurses and doctors, in view of heavier patient loads that are anticipated. Separately, the projected increase in healthcare manpower begs the question of how much allowance or buffer is being factored into the healthcare system, including in the event of Disease X type scenarios – a key lesson learned from the COVID-19 experience.

Second, there are deep concerns that the addition of 100,000 policyholders converting their insurance coverage from the private to public healthcare sector each year may significantly strain the public healthcare system. This is a number which the Minister has said he expects to increase.

First, what is the scope of the surge capacity when our healthcare system reaches the upper end of 156,000 healthcare workers? Does the surge capacity account for an additional buffer of doctors, nurses and allied health workers? If so, how much? Or is the surge capacity a case of restructuring processes to do more with less in times of surge demands? If it is the latter, for how long can the healthcare system operate at an optimum level of performance?

Second, does the Ministry plan to increase the range of publicly reportable statistics from what is currently available to waiting times at hospital emergency departments, polyclinics and specialist outpatient clinics, amongst others?

We should carefully track the capacity of the system to cope with the significant demands our demographic shift imposes on it. It is useful to remember that healthcare is a very unique public service. The Prime Minister identified healthcare as one of four National AI Missions. AI indeed stands to inject new productivity possibilities into healthcare at the ecosystem level.

However, at the level of a Singaporean who needs healthcare, what makes healthcare, healthcare, are the people – the doctors, the nurses, the allied health workers – who look after us when we are at our lowest. In that context, the human touch and the personal connection will never be fully replaced by AI.

So, if it means that our healthcare manpower in the years to come would require additional buffers, we should devote more fiscal resources towards it accordingly.

The Chairman: Dr Hamid Razak, you can take your two cuts together.

Cost Complexity in Hereditary Cancers

Dr Hamid Razak (West Coast-Jurong West): Mr Chairman, Sir, for some Singaporeans, healthcare is not just confined to a bill. It is a lifetime of risk.

Today in this House, I want to share the story of a young Singaporean I met – Gwendalyn. In her early 20s, she was diagnosed with hereditary breast cancer. Overnight, her life changed. She faced surgery, complications of surgery and continued chemotherapy for her condition. She underwent reconstruction, but parts of her reconstruction were not covered because it was deemed to be cosmetic.

For a young cancer survivor, reconstruction is not cosmetic. It is about dignity. It is about mental healing.

There are many such Gwendalyns in our society today. People I speak about are those with hereditary risk of cancer. Her story points to a wider gap.

Cancer care today is not only clinically complex, it is also financially and psychologically complex, especially for hereditary disease. So, the policy question is this: how do we support people who may not be sick today, but are clearly at elevated risk? To that end, I would like to ask the Minister three broad questions.

First, how can we integrate hereditary risk assessment and genetic counselling into primary care and connect it to Healthier SG so that prevention becomes upstream?

Second, will the Ministry review how we finance medically indicated preventive procedures and the reconstruction, including high-risk situations involving a currently healthy organ, so that support is consistent and understandable? For example, in the case of Gwendalyn, if a mass was found on one breast and was found to be diseased, she undergoes mastectomy, what about the contralateral breast, which at current state is healthy but we know she carries the gene for breast cancer? How can the system be seamless when caring for such individuals?

Third, how do we strengthen survivorship pathways for young cancer patients, including psychological and social support, not just medical follow-up?

Mr Chairman, Sir, the test is not just about survival, but about how survivors can return to life.

Precision Medicine and Functional Health

Mr Chairman, Sir, if hereditary cancers speak about how complex medical care is, then precision medicine tells us how intelligently we can respond to the challenge.

We already see the direction. At National University Health System (NUHS), the Centre for Healthy Longevity is building programmes that strengthen healthspan, not just treat illness, helping Singaporeans stay physically strong, cognitively sharp and metabolically well as we age.

This matters because the public demand is already there. People are seeking tests and optimisation outside the mainstream system. If our public pathways do not keep pace with the credible evidence, we risk two things – fragmented care with uneven quality, with widening inequality and a missed opportunity for Singapore to lead responsibly as a trusted regional centre.

While we focus on taking care of our seniors and our elderly, which is important, the key question as we go about with our society is how do we optimise every Singaporean, regardless of age, to reach the highest potential health for their age? So, Mr Chairman, Sir, may I ask the Minister three questions.

First, what is the Ministry's pathway to evaluate and adopt emerging evidence in precision and longevity-related medicine with clear safeguards for safety and value? Second, how can Healthier SG progressively add functional health markers, including metabolic, cognitive and frailty indicators, so that prevention becomes personalised and not just generic? Third, how will we enable responsible innovation so that we remain evidence-based, future-ready and trusted, so that our policies can keep pace as the evidence emerge, and we do not wait for two to three years after the evidence has already become mainstream?

Because the goal obviously is not just longer life, the goal is delayed decline, preserved independence and dignified ageing.

Cancer Treatment Costs and Coverage

Ms Sylvia Lim (Aljunied): Sir, Singapore's medical cost inflation is projected to reach nearly 17% this year, significantly higher than general inflation, which is under 2%.

I recognise and agree that there is a need for cost containment and management of insurance premiums. On cancer specifically, MOH has made significant moves. For instance, the Cancer Drug List now has about 394 drugs listed that are eligible for subsidies and claims under MediShield Life and integrated plans.

Three months ago, MOH announced a key policy change in hospitalisation insurance. With effect from April this year, new riders on integrated plans can no longer cover the minimum deductible set by MOH while the co-payment of bills at 5% of the total bill will be capped at $6,000 per year instead of $3,000. With these changes, the premiums for the new riders are expected to be about 30% lower than for the existing riders.

Sir, the Minister for Health has put up various videos on TikTok to explain the change. In one of them, he appeared to suggest that the only use of the existing rider was to reduce the deductible and co-insurance, and the public should consider whether they need a rider at all.

However, my understanding is that riders may be essential, especially to cancer patients for other reasons.

First, riders help to pay for costly cancer drugs that are not on the Cancer Drug List, which could be critical for the patient's treatment. Second, there is the issue of loss limits. Without a rider, the patient would need to pay 10% of a hospitalisation bill without any cap.

The second more general issue relates to preventive medical interventions which may not be covered by insurance.

A young breast cancer patient wrote about her plight to the Straits Times' forum page on 28 January. She followed the doctor's advice to remove both breasts even though only one was cancerous. Her hospitalisation insurance covered surgery for the cancerous breast, but only partially for the non-cancerous one.

In April last year, MOH recognised that the line between preventive and diagnostic care was increasingly nuanced, particularly in cases involving genetic predisposition to serious conditions, like breast cancer. MOH mentioned that it would issue claim rules to guide practitioners on breast-related surgical claims later that year.

What is the present status of this review?

Means Testing and Filial Paradox

Mr Victor Lye (Ang Mo Kio): Mr Chairman, adult children are often the default caregivers for ageing parents. It is a good thing when adult children want their parents to stay with them, even better when the parents are active and in pink of health. Nonetheless, some Singaporeans feel penalised for doing the right thing. This is what I call the filial care paradox.

When children bring ageing parents into their homes, the parents often lose their benefits, such as the Community Health Assist Scheme (CHAS), Silver Support or other subsidies. The parents are now seen as part of a higher-income household or living in a housing type with a higher annual value.

Sir, to support caregiving and encourage filial piety, we need to recognise that the caregiving responsibilities can weigh more proportionately than housing income or housing type. I am not suggesting that we abandon means testing in our healthcare and social assistance architecture. But we can recognise caregiving households more explicitly. I have three suggestions.

First, consider a caregiver housing carve-out. Seniors moving into an adult child's home for caregiving should be assessed independently instead of being lumped into the entire household. Second, consider a transitional period. This is a grace period so that the seniors' benefits do not immediately disappear when caregiving arrangements change. Third, explore functional needs assessment, where we assess the social assistance based on actual needs rather than looking solely at household income or housing type.

Mr Chairman, when adult children bring their ageing parents into their home and care for them, we should give them more support, not less.

Lumpy Medical Spending and MediSave Limits

Assoc Prof Jamus Jerome Lim (Sengkang): Those of us who have fallen seriously ill at one point or another will be keenly aware of how our healthcare expenditures are lumpy. That is, we may go one year without any medical expenses, but in another year, we may end up spending far more than we would have anticipated.

This is often the case even for chronic conditions since new diagnostic or treatment procedures may only be required on occasion. The reality of spending spikes is corroborated by more systematic research in health economics. Moreover, it is also well-known that end-of-life spending tends to be elevated. This is another manifestation of lumpiness. Patients tend to spend most in the final years of their life.

MediSave currently faces annual withdrawal limits of several types of care. The policy is well-meaning. One does not wish for patient to exhaust their MediSave funds, especially knowing that most of their care costs will indeed be incurred at the tail end.

But this is problematic because the policy is not aligned with the lumpy nature of medical expenses. It also glosses over the role that insurance, including public ones, such as MediShield Life, plays in such instances, since these are more likely to pay out for major illnesses that will otherwise exhaust their MediSave.

Actual data from the CPF supports this notion that there may be excess for saving in our MediSave accounts. In response to a Parliamentary Question posed in 2022, Minister Tan See Leng reported that MediSave account balances for members significantly exceed their Retirement Accounts, with the ratio for those aged 85 and above close to five times larger.

There are two ways to better calibrate MediSave limits.

First, we can permit carrying over of unspent limits for up to three years. This will allow those who incur larger than expected bills to not have to rely on out-of-pocket funds, which, especially for retirees, are frequently paid for by working-age family members so as to be able to top up their medical expenses.

Second, we can have a tiered system of claim limits, with the amounts allowed for claims gradually raised according to age. While nobody can accurately predict when an individual's demise might be, we can rely on aggregate statistics on mortality by gender to adjust claim limits accordingly. It is intuitive to allow more spending at later ages where individuals' health will have deteriorated more.

Sir, these simple steps will help better align the actual usage of MediSave, with the well-meaning constraints imposed to ensure sufficiency in time of medical need, whether they may be today or tomorrow.

Outpatient MediSave Use

Mr Gerald Giam Yean Song (Aljunied): Sir, I repeat my call for MOH to extend coverage for all chronic diseases under the Chronic Disease Management Programme (CDMP) and not just the 23 approved conditions. This would ensure any condition requiring long-term management can be subsidised under CHAS and paid for via MediSave.

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Even for conditions on the CDMP list, the MediSave 500/700 withdrawal limits can be restrictive. I last raised this issue in 2021 and the Senior Minister of State argued that the risk of overconsumption necessitates these caps. However, how does this apply to public healthcare institutions, where salaried doctors follow strict protocols? The real risk is not overconsumption but undertreatment. When patients are forced to choose between their cash and their care, some may choose to skip medications or appointments to save money.

Self-rationing today can lead to a massive bill tomorrow and emergency hospitalisation. This is a tremendous cost to both the individual patients and the healthcare system. Has the Ministry assessed the clinical cost of medical non-compliance caused by rigid MediSave withdrawal limits? Singaporeans want to be self-reliant and not have to appeal for subsidies or medical assistance. The Ministry should allow for more flexible MediSave withdrawals at public healthcare institutions for patients over 60, especially for those with significant MediSave balances.

Funding and Supporting Mental Health

Mr Patrick Tay Teck Guan (Pioneer): Chairman, I declare my interest as Chairman of the Mental Health Board, NHG. I rise to make the case that Singapore should position the Institute of Mental Health (IMH) as the true Centre of Excellence in psychiatric treatment and care, and to ask the Minister three questions towards that goal.

IMH is our only dedicated psychiatric hospital, housing our most experienced psychiatrists and specialised teams. Yet it remains stretched across the full spectrum of acuity. If we are serious about building a Centre of Excellence, we must free IMH to focus on what it does best – leading research, training the next generation of mental health professionals and managing our most complex cases.

My first question concerns manpower. Is IMH better resourced than our acute hospitals to handle complex psychiatric patients? And a Centre of Excellence should not merely treat; it should set clinical standards across our entire healthcare system and across all three public healthcare clusters. How is IMH’s specialist expertise being leveraged across the three clusters to uplift psychiatric treatment and care in all our acute hospitals and in the community, so that IMH is not bogged down by excessive referrals beyond what they can handle effectively and efficiently.

My second question concerns care pathways. Will the Minister share data on polyclinic acceptance rates for patients discharged from IMH and acute hospitals with psychiatric diagnoses? A Centre of Excellence cannot function if its beds are occupied by patients ready for step-down care. Are there plans to expand polyclinic capacity for psychiatric cases, so that IMH can focus its resources on those who truly need specialist care? Stable psychiatric patients often remain at IMH simply because there are no community facilities to receive them.

My third question is whether there are plans to develop more custodial care and step-down facilities – sheltered homes, supported living – so that IMH’s beds are reserved for those who need its full clinical expertise?

Mental Health

Dr Wan Rizal (Jalan Besar): Chairman, mental health is a national priority. Over the past few years, we have made significant progress in recognising that mental well-being is foundational to our social and economic resilience. We see growing demands across young people, working adults and seniors. More people are coming forward to seek help and that is a good sign.

But the pressures are real. Mental health conditions cost Singapore around $16 billion annually, largely from lost productivity due to absenteeism and presenteeism. That figure reminds us that mental health is not just a healthcare issue. It affects our workers, families and national resilience.

So, the question is not whether mental health matters. The question is whether our system is built to sustain the demand ahead.

We launched the National Mental Health and Well-being Strategy. We expanded community services and strengthened primary care. As we move into the next phase, could the Minister update us on its progress? Are we seeing measurable improvements in early intervention? Are the wait times stabilising, particularly for moderate and higher-risk cases? Are community providers adequately supported as the demand continually grows?

Every strategy eventually reaches a point where expansion alone is not enough. It requires structural strengthening. Mental health also cuts across healthcare, education, workplaces and the social sector. Could the Minister elaborate on the role and mandate of the Mental Health Office? How does it coordinate across agencies, track system-level outcomes and ensure accountability? If this is truly a whole-of-society effort, then governance must be deliberate and clear.

Sir, access ultimately depends on people. Clinical psychologists and other higher-risk psychology disciplines undergo years of rigorous postgraduate training and supervised practice. Standards must remain high. Patient safety depends on it.

At the same time, demand is growing. How is MOH projecting manpower needs for clinical psychologists and allied mental health professionals over the next five to 10 years? Are there plans to strengthen the local training pipeline and supervision capacity to build a strong local core while maintaining professional standards? And does the Ministry see scope to strengthen professional regulation at higher-risk psychological practice to safeguard patients and reinforce public confidence?

Sir, mental health care must operate as one integrated system. Psychologists, counsellors, social workers, occupational therapists and peer support specialists each play important and complementary roles. How will workforce planning and training reforms ensure stronger integration across these professions and better coordination between primary care, hospitals and community providers? Patients should not experience fragmentation. They should experience continuity.

Sir, as we look ahead, we should also be mindful of the growing use of AI in mental health support. AI tools may be useful for self-help psychoeducational early screening, but we should be cautious. If such technologies begin to substitute professional care, mental health treatment often involves complex clinical judgement and ability to respond appropriately in crisis situations. Could the Minister share how MOH is thinking about the role of AI in mental healthcare and what safeguards may be needed to ensure that technology compliments, rather than replaces, trained professionals?

Sir, if mental health is a national infrastructure, then we must build it with strong foundations, clear standards and long-term sustainability. I look forward to the Minister’s response.

The Chairman: Ms He Ting Ru. Please take your three cuts together.

Mental Health Professionals Regulation

Ms He Ting Ru (Sengkang): Mr Chairman, I declare my interest as a practitioner in the well-being space. With the mental health crisis showing no signs of abating, would the Ministry provide an update along with a firm commitment to fixed timelines to regulate mental health professionals?

I would like to repeat my call to regulate professionals, such as therapists and counsellors, who play key roles in supporting individuals with mental health conditions. Regulation is important as clients may not know where to go for help if they have concerns about professional standards or ethics.

At the same time, we must also ensure entry barriers are not prohibitive for professionals. Most therapy and counselling qualifications require minimum supervision hours and practicums costing upwards of $200 an hour, which can be difficult for fresh graduates and mid-career entrants. I hope we can explore more ways to reduce such barriers. Beyond subsidies, could the Ministry also consider the use of SkillsFuture credits?

Mental Health and Well-being Strategy

The set-up of the National Mental Health Office (NMHO) is a first step to a vision where mental health sits on a continuum with socio-economic determinants and is not merely the absence of illness.

That said, we still have to work towards a clear vision to improve Singaporeans' mental health. For example, Scotland's Mental Health Strategy 2017 focuses on reducing inequalities for mental health and treatment and access using a life stage model and Malaysia's National Strategic Plan for Mental Health aim to reduce adolescent depression rates from 18% to 10%. These strategies clearly outline a vision of success for improving mental health and well-being, describing what a mentally healthy population looks like. They also include time-bound targets and outcomes beyond broad focus areas.

This aligns with recent World Health Organization guidance on policy and strategic actions to promote and protect mental health and well-being across Government sectors. The guidance calls for: one, active engagement with all stakeholders and ensure meaningful participation of those with lived experiences; two, regular reporting and clear commitments; three, allocating fully costed and dedicated funding to support policy directives and strategic actions to prevent implementation delays.

I would like to seek four clarifications. First, what is the picture of success of the National Mental Health and Well-being strategy? To coordinate efforts across policy areas and sectors, the strategy should outline a few key outcomes and have clear targets.

Second, how does the NMHO plan to work with Ministries and agencies to engage Singaporeans on current initiatives and future plans? Incorporating ongoing feedback from those with lived experience, communities and civil society will ensure the strategy remains relevant and grounded in real needs.

Third, how will the NMHO coordinate reporting, monitoring and evaluation through regular updates? For instance, Scotland's January 2026 monitoring report track key performance indicators across nine strategic outcomes to enhance agency accountability, responsiveness and effectiveness.

Fourth, is there dedicated funding for mental health and well-being initiatives to support the strategy? If so, what is it? Between 2020 and 2022, MOH dedicated around 3% of its healthcare expenditure towards mental health treatment, promotion and prevention. Has this amount increased, and what are the projected amounts going forward?

Smoke-free Generation

For years now, the Government has been studying the possible roll-out of a tobacco-free generation policy. Earlier this year, the Minister of State for Health said in an exchange with me that the effectiveness of implementing such a policy is not straightforward and that we are already at an all-time low smoking rate of 8.4% with the existing suite of measures.

Mr Chairman, I agree that implementation of a tobacco-free generation policy is not straightforward. Black markets already stop Singapore from being completely drug-free and vape-free. Similarly, places where smoking is banned are not completely smoke-free despite the efforts of our enforcement officers.

Nevertheless, while New Zealand repeals its laws partly on grounds of political ideology, we should continue to study how to roll out a tobacco-free generation policy once there is real-world evidence on its efficacy and implementability. Maldives' policy has already come into effect, while the United Kingdom (UK) Bill is on track to becoming law, is set to be implemented at the start of 2027.

Like the UK, we are well-placed to introduce a similar policy precisely because our smoking rate is already low. The latest studies, including a Nottingham University study published in January, suggest that a cohort ban will bring forward by decades a smoking prevalence of under 5%, which is defined as an effective endgame for tobacco.

I highlight the endgame because it sets out a target I hope we can work as fast as possible to achieve. Although associated with the smoke-free generation policy, we should state the endgame as an overarching policy objective. With decisions like periodic increases to tobacco duties, I hope we are seeking to maximise the sin tax impact instead of considering its revenue impact.

Similarly, we should be doing more to curb the health impacts of public smoking, for instance, by tackling smoking while walking. Singapore takes a zero-tolerance approach to drugs and vaping. We must do the same with tobacco. Thank you.

The Chairman: Mr Cai Yinzhou, you may take your two cuts together.

Invisible Medical Conditions

Mr Cai Yinzhou (Bishan-Toa Payoh): Thank you, Chairman. Following the invisible costs highlighted in my Budget speech, I want to address the struggles of those with invisible conditions.

With the helping hands scheme supporting those on public transport, many with hidden medical, autoimmune or chronic diseases still face judgment in daily life. Will the Ministry consider expanding these initiatives outside of public transport to more settings like hawker centres and libraries to fostering a society that leads with patience rather than suspicion?

In Singapore, one in five children and one in 10 adults endure the constant, debilitating itch of this atopic eczema. While manageable, the cost of continuous treatment, including wet wraps and phototherapy, is a significant financial and emotional burden. Will the Ministry consider adding atopic eczema to the Chronic Disease Management Programme, which already covers similar conditions like psoriasis?

Lastly, some youths are deterred from sharing suicidal thoughts with school counselors because they fear an automatic, mandatory reporting to their parents, especially when those thoughts might stem from family circumstances. To encourage greater help-seeking while ensuring safety, will the Ministry implement a tiered reporting framework that allows for greater confidentiality in a risk-proportionate manner?

Chairman, we must ensure our infrastructure of care is robust enough to support the struggles we cannot see. I look forward to the Ministry’s vision for a more inclusive and empathetic healthcare landscape.

One Touchpoint for Seniors

My second cut addresses the age-old question: what is a life well lived? For many seniors I have spoke with in Bishan-Toa Payoh, the answer is not just more handouts, but dignity, choice and the agency to live their golden years on their own terms.

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To this end, I have four proposals.

First, expanding the Integrated Community Care Providers (ICCPs) into a "Senior Concierge". Minister Ong has spoken about a single coordination point for care and 85 sub-regions, which will soon provide coordination across Regional Health System (RHS), Home Personal Care Plus (HPC+), Singapore Counselling Centre (SCC), Drug Rehabilitation Centre (DRC) and Active Ageing Centres (AACs) with One Ring to Rule… excuse me, One Care Plan to coordinate them all.

I propose beyond clinical outcomes, to further centralise touchpoints for participating in Employment and Employability Institute (e2i) for job search, People's Association (PA) for community events and Social Service Offices (SSOs) for financial aid applications. One contact, one coordinator, for the whole senior as a person and being.

Second, to measure what truly matters. In our October Sitting, the Ministry's reply on tracking social isolation focused on attendance and outreach numbers. Loneliness cuts deeper and these numbers only scratch the surface. I ask the Ministry to partner with our educational institutes to conduct regular, widespread surveys on the social determinants of health. We need a localised version of "Quality of Life" indicators to understand how our efforts are truly reducing isolation.

Third, bringing specialist healthcare to the heartlands. Not being able to eat, hear or walk, is directly linked to cognitive decline and increased mortality. Yet, access to specialised help remains a hurdle. I ask the Ministry to ramp up dental, audiology and podiatry facilities, specifically to estates with high concentrations of seniors. We must catch these impairments before the rapid decline in quality of life.

Fourth, I ask the Ministry to consider introducing degree or diploma courses for audiology and podiatry in tertiary institutions, to increase the number of Singaporeans specialising in these areas and in turn, be better able to serve our seniors who require such specialised care.

By streamlining access, measuring what matters, expanding specialist care and building local expertise, we ensure our seniors are not just "ageing", but are living with agency.

Enhancing Elderly Care and Support

Mr Yip Hon Weng (Yio Chu Kang): Mr Chairman, Singaporeans enjoy a long-life expectancy. But are we adding life to years or merely years to life? As healthcare shifts from hospital to home, the real test lies not only in infrastructure, but in the relationships we nurture, the support we organise and the dignity we uphold.

First, social isolation. In our dense estates, many seniors live in loneliness, surrounded by neighbours, yet separated by silence. Countries, like the Netherlands and Denmark, embed social prescribing into primary care, recognising that a prescription can be a person, a purpose and a place to belong.

Mental health support for depression, anxiety and grief remains under-resourced. Suffering in old age is often invisible, yet deeply felt. Can MOH update us on formalising social prescribing in primary care and outcomes under Healthier SG? How are we integrating routine mental health screening into community eldercare, so distress is detected early?

Under Age Well SG, AACs are expanding to anchor seniors in their communities. Can the Ministry share whether reductions in social isolation and improvements in well-being are being observed?

Second, dementia. Families still struggle to access dementia-specific day care and respite services. Dementia-friendly communities, where confusion is met with compassion rather than stigma, remains uneven. How will MOH accelerate dementia day care and respite capacity? How are we strengthening public education, so stigma recedes and inclusion grows? If we are to age well, we must care well for those who can no longer remember for themselves.

Third, caregivers. Many caregivers face financial strain and burnout despite subsidies. Caregiving should not mean declining health, depleted savings or isolation. Will MOH review respite care so it becomes a standard, easily claimable entitlement? As Age Well SG rolls out integrated community models, how will caregiver burden and coordination outcomes be measured to ensure families experience relief?

Fourth, palliative care. Living well includes dying well. Though many prefer to pass on at home, many still die in hospitals because families lack support. What steps are being taken to expand home-based palliative capacity and equip GPs to provide sustained medical and psychosocial support?

Finally, with the expanded EASE scheme allowing seniors in private homes to tap subsidies for age-friendly fittings, how does this complement Age Well SG's ageing-in-place strategy, and how uptake and impact be tracked?

Mr Chairman, we must now build a community of care that ensures every senior lives not only longer, but with dignity at the end.

Supporting and Recognising Caregivers

Mr Fadli Fawzi (Aljunied): Mr Chairman, Singapore is becoming a nation of caregivers. Our ageing society means more Singaporeans will spend a significant part of our lives caring for a spouse, sibling, parent or grandparent who becomes frail, disabled or chronically ill. Support exists, but caregivers still experience it as fragmented. Many repeat their story across hospitals and agencies, with no common way to be recognised as a caregiver and no simple front door that follows them across settings.

Unpaid caregiving is not a small matter. A Duke-National University of Singapore study estimated the monetary value of informal caregiving time for seniors, aged 75 and above, who require human assistance, at about $1.28 billion a year.

As it focuses on 75-year-old-plus seniors needing assistance, it likely understates the wider burden. This is why early identification matters. Local integrated care research found that distressed caregivers at baseline had about a one in four chance of remaining distressed 12 months later, and highlighted the importance of assessing and supporting caregivers early, including during hospital discharge planning.

Budget 2026 strengthens long-term care financing, including a $400 million top-up to the Long-term Care Support Fund to fund additional subsidies from CareShield Life enhancements. But financing alone will not solve the recognition and navigation problem, so I asked the Minister to study and pilot a simple tool used in parts of the United Kingdom (UK) – a carer passport. Once a person is verified as a caregiver, they receive a physical and digital credential that enables recognition across touch points and triggers practical support.

What I have in mind is a Singapore-adapted caregiver passport that would allow some discounts at supermarkets, pharmacies and other caregiving-related outlets. More importantly, the caregiver passport should also allow caregivers to be involved in discharge and care planning, speed up linkage to respite and training, enable structured workplace flexibility conversations and support daily life participation through community partners.

I propose starting with two to three precinct pilots, for six to nine months, enrolling about 100 caregivers per pilot, followed by an evaluation to measure take up, navigation outcomes and changes to caregiver strain.

I have three questions for the Minister. First, will MOH seed a caregiver recognition pilot fund to support these pilots, including evaluation, so we can scale up works?

Second, will MOH support a low burden verification model during pilots, such as self-declaration with validation through healthcare or social service touch points?

Third, will MOH fund the minimum operating pieces: coordination, simple QR infrastructure, partner onboarding and modest activation support, so that pilots produce evidence for national adoption?

Mr Speaker, recognising caregivers is about strengthening our social infrastructure, so that we can relieve the burden on our caregivers and make support consistent and easy to access for all.

The Chairman: Senior Parliamentary Secretary Eric Chua, you may take your two cuts together.

Unlocking Our Silver Dividend

Mr Eric Chua (Queenstown): Sir, by 2030, one in four Singaporeans will be 65 or older. This presents both a challenge as well as a tremendous opportunity. Too often, we focus on what seniors lack. It is time to shift that view. Seniors are not liabilities: many are eager and able to contribute meaningfully to society. We must move beyond a deficit mindset and embrace their full potential.

I recently met Prof Linda Fried, distinguished geriatrician, epidemiologist and the first female Dean at Columbia University's Mailman School of Public Health. She is also a trailblazer for co-designing Experience Corps, an inter-generational volunteer programme that engages seniors in their fifties as tutors and mentors for children in public elementary schools, while promoting the health and well-being of the volunteers themselves.

The programme aims for "triple wins": first, to help children succeed academically, especially in early literacy; two, boost the physical, mental and social well-being of older adults; and three, strengthen communities by connecting generations.

The results are striking. Students show improved literacy, better engagement and fewer behavioural issues. Volunteers experience reduced depression, enhanced cognitive function and stronger social connections. Schools report enriched learning environments and deeper community ties.

It seems simple: an engaged senior is a healthy senior. Yet, while we understand the science of social determinants of health, activating it is quite another challenge. MOH's Silver Guardian programme encourages seniors to volunteer at AACs. It is a great start, but we can do more. Empowered seniors do not just enrich their own lives; they strengthen families, schools and communities, shaping a Singapore where every generation thrives. I suggest three ways seniors can contribute.

First, on social mobility. Seniors can help ComLink+ families facing financial, social and emotional strain. Many parents are stretched by work and caregiving, while children may lag behind in literacy and numeracy. Inspired by the Experience Corps, seniors with teaching or professional experience can tutor children, offer knowledge, patience and encouragement. Beyond academics, seniors can also mentor parents, share perspective and life wisdom. In so doing, they provide not just help, but lend stability and hope.

Second, mental health. A peer-reviewed Singapore study of adults aged 21 to 89 found that seniors reported significantly lower levels of depression, anxiety and stress than younger adults during the 2020 pandemic lockdown. By contrast, about one in three youths reports internalising symptoms, such as anxiety, loneliness or depression. Many young people hesitate to involve parents or families in their struggles. Seniors, with their steady, non-judgemental presence and life experience, can offer guidance, comfort and hope; helping young people feel less isolated and more resilient.

Lastly, our heritage. History is most powerful when told through lived experiences. Projects, like Humans of New York, resonate because they are real, unfiltered, human. Our seniors often hold the most meaningful stories of our communities. As community docents, they become living bridges to moments that may never appear in textbooks, but remain a crucial part of our shared memory. Through their stories, we preserve not just events, but the struggles, values and quiet triumphs that shape our heritage and collective humanity.

Sir, our seniors built the Singapore we know today. Their sacrifices laid our foundations, their resilience carried us forward and their wisdom continues to guide us. Let us see seniors not through the lens of limitation, but of possibility. As mentors, tutors, caregivers and docents, they can shape lives and strengthen communities.

Let us build a Singapore where ageing is not feared but celebrated; where every senior feels valued, empowered and connected. For when we uplift our seniors, we honour our past and secure a future defined not only by success, but by dignity, compassion and shared humanity.

Our Dangerous Dalliance with Dopamine

Let me begin this speech not with statistics or policy, but with three simple introductions.

"Hi, I'm Benny. I'm sober and I have stayed away from drugs for the past five years." Most of us would respond with admiration. We understand the discipline required to overcome chemical dependency.

"Hi, I'm Benny. I'm sober and I have stayed away from alcohol for the past five years." Again, we nod silently. We know the toll addiction can take on health, on families, on livelihoods.

But what if I said: "Hi, I'm Benny. I'm sober and I have stayed away from pornography for the past five years." What happens inside us? Do we shift uncomfortably? Suppress a smirk? Or question whether that even counts as sobriety?

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This reaction tells us something important. While we are prepared to discuss substance addictions openly, we remain uneasy when the addiction is behavioural, private and sexual in nature. Pornography addiction is often dismissed as indulgence or simply part of growing up in a digital age. Yet for some individuals, consumption becomes compulsive, distressing and disruptive to daily life.

Today, I rise not to moralise or to condemn desire. I rise to ask whether we are paying sufficient attention to a behavioural addiction that may be quietly emerging, particularly amongst our young people, and to consider what role public health can and should play.

To be sure, dopamine is not the enemy. It is a neurotransmitter essential to how our brains function. It motivates us, reinforces learning and gives us satisfaction after effort and achievement. But dopamine also plays a central role in addiction.

When certain substances or behaviours repeatedly trigger intense reward signals, the brain adapts. Neural pathways strengthen. Over time, the brain begins to prioritise the behaviour associated with that reward. What begins as voluntary can, for some, become difficult to control. Addictive substances, such as drugs and alcohol, are well recognised for this effect. Increasingly, research has examined behavioural addictions, including gambling disorder, gaming disorder and compulsive sexual behaviours, which engage similar reward pathways.

Pornography today is instant, anonymous, inexpensive and available through smartphones at any hour. There are no physical barriers and few natural stopping points. For a subset of individuals, repeated exposure and escalating consumption can entrench patterns that are hard to reverse.

Some international studies suggest that problematic pornography use may affect figures in the low double digits, depending on definitions used. Methodologies differ, but the emerging literature suggests this is not an isolated phenomenon.

Even if prevalence in Singapore is lower, the absolute number affected could still be significant.

We must also situate this issue within the broader digital ecosystem. Modern life is structured around reward cycles. Social media notifications, online gaming achievements, gambling wins, auto-play streaming. Our attention economy is engineered to keep us engaged.

Pornography exists within this larger environment. It is one of many digital stimuli competing for our attention. But it differs in one important aspect: it can shape expectations about intimacy, about consent and about relationships. When exposure begins early, often before emotional maturity has developed, the lessons absorbed may not reflect mutual respect or healthy communication.

In Singapore, conversations about sexuality are often cautious. Families may find them difficult to initiate. Schools approach the topic carefully. Public discourse remains restrained. But silence does not mean protection. When guidance is absent, young people may turn to the Internet as their primary educator, and we all know that the Internet is not designed to teach values.

Technology has industrialised temptation. What once required effort, patience and real human interaction now arrives instantly on screens engineered to capture attention. If our public health response focuses only on treatment after harm, we will always be reacting to damage, rather than building resilience.

Sir, some may ask, why is this a healthcare issue?

Because behavioural addiction reshapes neural pathways. It co-occurs with anxiety and depression. It drives demand for counselling, psychiatric care and family therapy. If we ignore it, it does not disappear. It presents later in our clinics, our IMH wards and our social service agencies.

This is a health issue because it affects brain function, mental health, relational stability and drives demand for counselling and psychiatric services. Individuals struggling with compulsive pornography use often report difficulty concentrating at school or work, escalating consumption despite attempts to stop, secrecy and emotional withdrawal, strained relationships, persistent shame and low self-worth.

This behaviour may begin as stress relief, but over time it can worsen distress. When relationships deteriorate and emotional health declines, the impact is not confined to the private sphere. It affects families, workplaces and communities.

So, as policymakers concerned with mental health, we cannot ignore emerging behavioural addictions simply because they are uncomfortable to discuss.

Locally, community organisations, such as We Care Community Services, have observed an increase in the number of individuals seeking help for compulsive sexual behaviours, including problematic pornography use. Reporting cases relating to sex, porn and love addiction have risen significantly in recent years. Post-pandemic, those seeking help for online pornography behaviours more than doubled compared with pre-COVID levels.

Most clients are in their 20s. Some cases have also appeared among teenagers, with some of them as young as 12; 12, Sir! These are only the individuals who have come forward. Many more may remain silent due to stigma or uncertainty about who or where to seek help.

Youths today are exposed to explicit content at younger ages, often unintentionally through peer sharing or algorithmic feeds.

In 2024, more than 460 youths aged 19 and below were arrested for sexual crimes. Authorities have noted that early and repeated exposure to sexually explicit materials can be one of several contributing influences shaping young people's understanding of consent and healthy relationships.

Counsellors have also pointed out that without meaningful guidance on boundaries and respect, young people may misinterpret what they see online as normal and acceptable behaviour.

To be sure, we must avoid simplistic conclusions. Family dynamics, peer influence, trauma and broader cultural factors all play roles. But we should not dismiss the potential impact of repeated exposure during formative years.

These are not purely moral questions. These are public health and social stability questions we need to address.

Let me take some time to share one Singaporean's story. Let us call him Dale.

It all began innocently; magazines shared among schoolmates. Then came the Internet, and then a pirated DVD. The images Dale saw disturbed him, yet something in his young mind shifted. Curiosity became habit. Habit became compulsion. Outwardly, Dale functioned: studied, worked, served National Service. Inwardly, he was trapped in a cycle. Stress, rejection, celebration all became triggers. After acting out came the crash: shame, disgust, promises to stop.

He described living a double life. Church on Sundays, alone with his addiction at night. And guilt was crushing. At one point he said, "I think I am born without the capacity to love."

Pornography had shaped intimacy into fantasy and control.

The turning point came when Dale walked into a Sexaholics Anonymous meeting. Ordinary men – fathers, professionals – shared their stories. Dale then realised he was not the only one struggling. Isolation began to break.

With support from We Care, Dale learned to trace his triggers, sit with discomfort and name his emotions instead of numbing them. Recovery was slow and imperfect but deeply human.

Sir, to be sure, this is not a story of moral failure. It is a story of early exposure, silent conditioning, secrecy, shame and courage. Behind the label of "addict" is a human being, once a curious boy, trapped in silence, who needed understanding, community and support.

If we are serious about addressing this issue, we must move from discomfort to evidence-based strategy.

Today, we operate with limited national data. Much of our understanding is extrapolated from international research and community case reports. I propose three steps.

First, commission a rigorous, interdisciplinary national study on problematic pornography use in Singapore. We need to understand prevalence, mental health associations, relational impacts and risk factors. With evidence, we can calibrate responses proportionately and responsibly.

Second, review our digital and sexuality education frameworks. Young people need emotional literacy, digital resilience and grounded understanding of consent and healthy intimacy. Parents too may need support navigating conversations in a rapidly evolving digital landscape. If exposure is increasingly common, then equipping youths and their families with tools to interpret what they encounter responsibly becomes essential.

Third, expanding funding and capacity for community addiction services. If demand for counselling related to behavioural addictions is rising, our support ecosystem must keep pace. Those who seek help should encounter accessible and timely support.

Early intervention is humane, preventive and cost-effective.

Sir, this is not about digital content. It is about mental health. It is about how young people form expectations about relationships. It is about how couples build trust over time. If we want strong families and resilient youths, then we cannot treat this problem as unspeakable. We must treat it as solvable.

We cannot eliminate temptation, but we should not normalise harm. If technology has industrialised temptation, then our response must be to industrialise resilience: thoughtfully, proportionately, with care.

Let us not hesitate simply because the subject is uncomfortable. Let us choose evidence over denial, courage over avoidance and support over stigma. Because the question before us is not whether this issue exists, but whether we can address it together head on.

Debate resumed.

The Chairman: Assoc Prof Terence Ho.

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Community Caregiving for Seniors

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

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

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

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

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

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

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

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

Refreshing Caregiver Support Action Plan

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

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

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

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

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

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

Preventive Healthcare in the Community

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

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

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

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

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

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

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

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

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

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

Video Calls with Doctors

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

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

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

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

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

Clinical Capacity and Social Prescribing

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Technology and AI in Healthcare

8.30 pm

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

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

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

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

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

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

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

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

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

Second, from labour intensity to capability amplification.

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

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

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

Third, from throughput to meaningful outcomes.

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

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

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

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

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

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

The Chairman: Minister of State Rahayu.