Committee of Supply – Head O (Ministry of Health)

Head O (Cont) ‒

Resumption of Debate on Question [4 March 2026]

"That the total sum to be allocated for Head O of the Estimates be reduced by $100." ‒ [Ms Mariam Jaafar].

Question again proposed.

The Chairman: Minister of State Rahayu Mahzam.

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The Minister of State for Health (Ms Rahayu Mahzam): Mr Chairman, my speech covers the Ministry's initiatives to bring care closer to the community, how we are strengthening our environment and ecosystem for healthy living and our efforts to improve our population's health.

As our society ages, improving our population's health and preventive care is critical for longer, healthier lives. We have embedded preventive healthcare into the community through Healthier SG and AgeWell SG to support residents while they are still relatively young and healthy, and as they age.

Mr Alex Yeo and Dr Hamid Razak would be pleased to know that the development of Healthier SG Care Protocols related to frailty and functional health, such as for osteoporosis and dementia are progressing well and would be rolled out in 2028. These care protocols will ensure evidence-based care is provided more consistently through Healthier SG general practitioners (GPs).

Ms Mariam Jaafar also spoke about improving community health, in particular the north region. Our data shows that in the north, the prevalence of diabetes and hypertension is above the national average, and residents engage in less physical activity. While we continue to review reasons for these trends, we are simultaneously stepping up our preventive care efforts in the region.

We will start off with Woodlands Town. First, we will enhance the Community Health Posts (CHPs) in the town. Secondly, we will improve access to specialist-supported care in the community. Thirdly, we will support residents to engage in healthy living activities by opening up community spaces for exercise programmes, introducing digital wayfinding in Healthy 365 and empowering local community health advocates.

As seniors age, visiting polyclinics and hospitals can be difficult due to mobility issues. Many also ignore symptoms that are not yet serious or urgent. Consulting a healthcare professional early can lead to earlier identification of issues, which in turn leads to earlier intervention and better health outcomes. We agree with Dr Haresh Singaraju's view that it is important to connect patients to community resources, and we are enhancing accessibility of health services by bringing care directly into the community.

I am pleased to announce that National Healthcare Group (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): 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.

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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. 32%, 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 M³ and partners from the Jaga Kesihatan, Jaga Ummah network (JKJU), will continue to support efforts to enhance our community's health and well-being. I am heartened when I see our community making steady progress. Through the efforts of Focus Area Five (FA5), more than 90,000 people have participated in various programmes in 2025.

We are now in the holy month of Ramadan which is an ideal time for our community to resolve to lead a healthier lifestyle. We will continue to work with our partners to reach out to the community. Come, let us all take the first step today and enrol in a health programme.

(In English): Mr Chairman, our goal is to ensure that the path to a healthier life is wide enough for everyone to walk on. Through our initiatives, no one has to navigate their health journey alone. By working hand-in-hand with our community partners and residents, we can build a Singapore where healthy living is inclusive, accessible and a lived reality for every one of us.

The Chairman: Minister Ong Ye Kung.

The Coordinating Minister for Social Policies and Minister for Health (Mr Ong Ye Kung): Mr Chairman, three years ago, in April 2023, I informed the House that Singapore would become a super-aged society in 2026 – this year. This is when 21% or more of our population will be 65 and above.

So, if you consider, in June 2025, last year, already 20.7% of our population was 65 and above. And that percentage has been going up by about one percentage point every year. So, we should have crossed 21% by now. So, as I speak, Singapore is a super-aged society. So, welcome to super-aged Singapore.

When was the exact point of transition? Actually, I do not think anybody knows. We can do an estimation. What happened at that exact moment? Nothing dramatic. There was not a Singapore Civil Defence Force siren or anything. It came and went.

Ageing does not arrive with a bang. Neither is it a whimper. It progresses quietly, with a real and profound impact. And at MOH, we feel it very strongly in the hospitals, in the emergency department, in nursing homes, and we are doing our best to manage the workload and care for all our patients.

More importantly, we foresaw this demographic transition years ago and took as many early actions as we can. This includes raising the Goods and Services Tax to strengthen our fiscal position; increasing the retirement and re-employment ages; building many more age-friendly streets and 2-room Flexi and senior apartments; and bolstering financial security for seniors through Silver Support, Central Provident Fund (CPF) LIFE and MediShield Life.

These policies are long in the making. They have helped cushion the impact of this very profound demographic transition.

But arguably, the most complex task to prepare for an older population is to sustain and to transform the healthcare system. These are the two topics I want to talk about today – sustain and transform. Let me first touch on sustaining the healthcare system.

Rising demand for care means the healthcare system must expand its capacity. We will become bigger, which we are doing. At the Opening of this term of Parliament, the MOH Addendum set out the target of adding 2,800 more public acute and community hospital beds between 2025 and 2030. We are on track.

However, meeting rising demand and running a larger system will cost more. And if we do not manage this carefully, rising healthcare spending can strain public finances and household budgets alike. In fact, if we are really extravagant, if we are not careful about it, it will cripple our system.

How do we ensure healthcare remains affordable? I think we need to start at the very top to ensure that the national healthcare bill is under control. Otherwise, it is like the Titanic sinking, and you are pouring water out of the deck. It must be floating.

National healthcare expenditure – that is the hospital bill of the nation. That bill, remember this, is always and ultimately paid by the people, whether through healthcare charges, through taxes, through insurance premiums, through medical security contributions. Ultimately, it is always paid by the people.

So, a government can claim that "we provide cheap or even free healthcare". It is actually not very true. The truth is healthcare is never really free, even if patients do not pay anything at the point of delivery. They will just pay in some other ways. A sick nation that consumes healthcare indiscriminately will incur a large and wasteful bill and it will be very costly to the population, to the households, to the patients, to the people.

With your permission, Mr Chairman, may I display a couple of slides on the screens, please?

The Chairman: Go ahead. [Slides were displayed for hon Members. Please refer to Annex 1.]

Mr Ong Ye Kung: Thank you. This is a scatter chart of different countries and you can see Singapore is an outlier, in the bottom right corner. Let me interpret this chart. The vertical axis measures how much the population spends on healthcare. Developed economies, shown by the different dots on screen, typically spend around 9% to 12% of gross domestic product (GDP) on healthcare, with the United States (US) – outlier in the other direction – spending 17%. Singapore spends below 5%.

The horizontal axis is average lifespan. This is an internationally accepted and generic measure of health outcomes. And Singapore has one of the highest lifespans in the world. But of course, beyond lifespan, there are many other measures of health outcomes and across all these measures, Singapore is comparable to or even better than many developed economies.

So, how did we become an outlier like this? I think it has a lot to do with our S+3M healthcare financing system that Members are familiar with. And MediSave is the linchpin of that system.

Singaporeans and our employers set aside part of our monthly income into MediSave. The Government also provides top-ups from time to time for various segments of the population, and we did that again this Budget. And we then use MediSave to co-pay directly for a small part of the cost of healthcare. So, even for a modest co-payment, it goes a long way to instil discipline and reduce unnecessary consumption on both the supply as well as the demand sides.

We do not have to look very far to imagine what happens when that discipline is eroded. You just look at private healthcare in Singapore. The discipline of co-payment was weakened because of overly generous insurance, including the IP riders. As a result, private hospital bill sizes have been rising rapidly, and private insurance premiums have been escalating very quickly. Once that genie is out of the bottle, it is difficult to put it back. But it will not stop us from trying. We will try.

In our S+3M system, multiple payers pull their weight to pay for this national healthcare bill. Apart from co-payment, we have insurance schemes like MediShield Life. It plays a sizeable role. A big part of it is also paid by charity dollars. We thank all the donors and philanthropic organisations.

But the biggest proportion, about half. of the national healthcare bill is paid through tax revenues, redistributed as Government healthcare subsidies. The Government health budget today is about 2.7% of GDP this year, and it is expected to rise to about 3.5% of GDP by 2030. This 0.8 percentage point increase is actually very significant. It means increasing the Government's health budget from about $22.5 billion this year to about $30 billion in 2030.

And beyond 2030, the Government's health budget will likely continue to grow. We must ensure that the increase can be supported by economic growth and by rising tax revenues. And at the same time, we must continue to maintain that discipline and avoid unsustainable levels of healthcare spending that we see elsewhere.

The next topic I want to talk about is transforming the healthcare system. A healthcare system for a young population is very different from one for an older population, for a super-aged society.

For a young person, sickness tends to be episodic. You are admitted to hospital, you get treatment, you get discharged and then you recover. Good health is the default. On the other hand, an older person's care journey is complicated and continuous. When well, they need preventive care; when sick, they need coordinated care because they tend to have multiple conditions; post discharge, they need rehabilitative care and follow-up care in the community. Good health is not a default; it is a continuous quest for an old person.

So, from episodic hospital care, we now need continuous multi-disciplinary care across settings. This shift is reflected in how we have allocated healthcare funding over time. Let me show another chart on screen. [Please refer to Annex 2.]

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The chart on the left, the height of the chart is our Government healthcare budget in 2021. The right bar is 2024. Members can see that, overall, budget has increased by 1.5 times. But I want to draw Members' attention to the composition.

At the start of this decade, 2021, around three-quarters of our operational funding for the healthcare sector went towards acute hospital care – that is the white portion of the bar. The remaining one-quarter was spent on aged care and population health, including preventive and primary care.

Today, we move to the right, 2024. The budget is 1.5 times that of 2021, but the share of acute hospital care has fallen, from three-quarters to almost two-thirds – the remaining one-third going to aged care and population health.

Specifically, the share of funding for aged care rose from 11% to 13% – that is the green portion – between 2021 and 2024. Over the same period, the share for population health grew from 14% to 19%. These shifts are driven largely by our national programmes, Healthier SG and Age Well SG.

Looking ahead, how would this chart go? I think, almost certainly, the share of spending on aged care will grow further, because we need more nursing homes, senior care centres, rehabilitation services and hospice care. As for population health, we do our best to maintain this share at around 19%. With total spending rising, maintaining the share alone requires a strong commitment to continue to invest in population health.

Mr Chairman, today, my MOH colleagues and I will be speaking on further steps to transform healthcare and get ready for the future. Senior Minister of State Koh will speak about manpower. It is a key agenda, including how we will significantly shorten the time to train clinical psychologists. We are taking seven to eight years currently; we will reduce it to about five years. Senior Minister of State Tan Kiat How will speak about anchoring care in the community through technology.

And Members heard Minister of State Rahayu speaking about population health and preventive care, including what we are doing in the north, where prevalence of chronic diseases is higher. There was a question by Ms Mariam Jaafar, she missed that part of the speech.

I should emphasise – this is in case she asks many clarifications later – preventive care and population health remain the overarching strategic thrust of what we are doing, anchored by Healthier SG and Age Well SG. I thank Ms Mariam Jaafar and Dr Haresh Singaraju for speaking about this. This is at the core of healthcare transformation and MOH agrees with many of the points they have raised.

I will now speak about three new initiatives to support healthcare transformation.

The first common topic this whole Committee of Supply (COS) and Budget debate – AI, once again. Ms Mariam Jaafar and Dr Choo Pei Ling spoke about how AI can strengthen healthcare delivery and we agree.

When it comes to AI in healthcare, we are guided by two principles.

One, care should be AI-enhanced, not AI-decided. Clinicians remain in the loop and healthcare remains a profoundly human endeavour.

Two, we take a practical, use case approach. AI should not be a hammer looking for a nail, a solution looking for a problem. We deploy AI where we know it will improve patient outcomes or the delivery of care, and where it can do so cost-effectively.

One such use case is in health screening. Around the world, many AI models have been trained to predict if a well person is likely to develop severe diseases in the near future. If we use it appropriately and responsibly, such tools are very useful. It helps the clinicians intervene earlier; it can delay or even prevent the onset of serious diseases.

MOH has developed such a model for our local context using anonymised patient data. With this model, by reviewing an individual's current health status, it can identify if he/she has a high risk – high risk defined by 75% or above – of developing chronic diseases, such as diabetes or high cholesterol, within the next three years.

We chose diabetes and high cholesterol because they are the key drivers of strokes and heart attacks, which affect 60 Singaporeans every day – every day, 60 Singaporeans either have a heart attack or a stroke. Many of these cases can be prevented if early actions were taken, such as through lifestyle adjustments and medication.

This AI risk assessment tool will be rolled out to doctors for all Healthier SG enrolees from early 2027. If the tool flags a patient as high risk, the doctor may recommend more significant lifestyle adjustments and instead of three-yearly check-ups, maybe annual check-ups. These additional screenings will continue to be subsidised under Healthier SG.

The second initiative, I think is an exciting and significant one, and a breakthrough, which is to use genomics to strengthen preventive care. Dr Hamid Razak asked about this.

We are born with our genes. They shape our biological blueprint and indeed, many diseases are linked to our genetic characteristics. But we need not be fatalistic about it. Genes are not our destiny. How we live, how we manage risk matters a lot.

So, we do not go fumbling through our genetic blueprint, hunting for blemishes and possible mutations that we know little about. It will create a lot of anxiety in all of us, and we will become a nation of hypochondriacs!

So, instead of shooting in the dark, we should focus on the parts of the blueprints that are illuminated by science.

This means taking a disease-specific approach, identifying genetic characteristics that we know drive certain diseases and for which we know there are established preventive interventions and treatment pathways.

This is what we did for familial hypercholesterolemia (FH). We did that last year. FH is a genetic condition that increases the risk of heart attacks even amongst young people.

The FH genetic testing programme offers subsidised genetic testing for individuals with abnormally high cholesterol levels. And if they are tested positive, we will offer the same test to their immediate family members. This is what we call cascade testing. By doing so, we try to identify as many individuals as we can in Singapore with the FH genetic mutation. And then, we take steps to reduce their risk of future heart attacks and strokes.

We will now move on to our next genetic condition, which is hereditary breast and ovarian cancer (HBOC).

In Singapore, it is estimated that one in 150 individuals carry a gene mutation, such as the BRCA1 or 2, that are associated with HBOC. Such mutations substantially increase a woman's lifetime risk of developing breast and ovarian cancer.

From December this year, we will offer subsidised genetic testing to at risk individuals for HBOC, such as individuals with a family history of HBOC. They will undergo genetic counselling before and after the test. And if they test positive, we will also offer the test to their immediate family members – cascade testing.

We expect over 2,000 individuals to be eligible for the test annually.

We will make the test affordable. In addition to subsidies, the cost of the test can also be offset using MediSave.

For those found to have the mutation, they will be offered suitable preventive interventions. Typically, this means more frequent breast MRIs or mammograms or oral medication.

Patients will ultimately decide, in consultation with their doctors, which intervention is appropriate. A minority may opt for surgical interventions. Members may recall celebrity actress, Angelina Jolie, after she discovered she had the BRCA1 gene mutation, she underwent a double preventive mastectomy.

I came across women in Singapore who chose to undergo preventive mastectomy to reduce their risk of breast cancer, such as Ms Gwendalyn Too, and these women have demonstrated great courage.

Unfortunately, they lament that they cannot claim insurance for such surgeries, because MediShield Life generally does not cover prevention. And it is designed to be so for a good reason. It is to keep coverage focused and premiums affordable. Then private insurance takes dressing from MediShield Life.

Dr Hamid Razak and Ms Sylvia Lim asked about this. In fact, Ms Stefanie Thio – she is the founder of the non-profit organisation SG Her Empowerment (SHE) – has raised this issue with me several times.

I share the concerns.

With advances in medical science, the boundary between preventive and curative care is increasingly blurred. If a high-risk individual is unable to undergo preventive mastectomy, she has a high chance of eventually needing cancer treatments, including a curative mastectomy to remove cancerous cells in her breast or cancerous tissue in her breast.

There is, hence, a case for MediShield Life to be judiciously extended to cover certain selected preventive surgeries. We are prepared to do so when there is a clear clinical need, minimal risk of abuse, the procedure is suitable for risk-pooling, through insurance, and it does not financially burden the MediShield Life scheme.

Risk-reducing mastectomies for breast cancer prevention, and the removal of both fallopian tubes and ovaries for ovarian cancer prevention, fall within these criteria.

We will therefore extend MediShield Life and MediSave to cover preventive surgeries for HBOC later this year. I should add that breast reconstruction is also covered, no different from today. This will better support women to harness genomics to better take care of their health.

I think this is a meaningful policy change ahead of International Women's Day on 8 March. [Applause.]

The third initiative is to inject more flexibility in the use of MediSave to encourage early intervention and reduce downstream complications.

Assoc Prof James Lim was right to describe medical expenses as lumpy. Indeed, it is very well documented that hospital expenses escalate almost like a vertical wall towards the end of life. And so, even after accounting for inflation, the average Singaporean living up to their mid-80s spends almost four times as much on hospital expenses in the last 10 years of their life compared to the previous 10 years.

But that explains the existing design of the MediSave withdrawal system, and why the system is designed like that, why the scheme is designed like that. It has higher limits for more complex treatments and longer hospital stays, and you can draw on it as and when you need it. This meets the original objective of MediSave, which is to co-pay for major in-patient episodes, whether they happen unexpectedly or in old age.

With this design, after subsidies, MediShield Life and MediSave, nine in 10 Singaporeans pay less than $500 out-of-pocket for their subsidised in-patient bills.

However, it is human nature to worry about present medical expenses rather than lumpy potential, unexpected or future hospital bills.

Hence, as a relief valve, we have schemes, like Flexi-MediSave and MediSave500/700, to provide flexibility for chronic disease management for scans, for dentist visits, and so forth, without overly diluting MediSave's original objective of catering for these big lumpy hospital bills in old age or during emergencies.

But the situation has changed since MediSave was implemented in 1984. At that time, people in Singapore lived to about 73 on average. Today, we live to 85 and beyond.

On one hand, it continues to be important to preserve MediSave for big hospital bills. On the other hand, as people live longer, the need to spend on preventive care and chronic disease management also go up.

Hence, I can appreciate the repeated and various calls by Members to allow MediSave to be used more flexibly, to cover more chronic diseases, or as Mr Pritam Singh suggested, to pay for higher private insurance premiums.

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But I also hold the realistic view that no matter how frequently MOH reviews the MediSave scheme, how much we liberalise and expand its usage, the public and Members of the House will continue to press me and MOH to liberalise the scheme every year during the COS and probably, outside of the COS.

It is the karma of the scheme – because it is designed to be the linchpin of the healthcare financing system. It must always navigate between present and future healthcare needs, between recurring disease management and the major hospitalisation episodes.

Trade-offs are inherent in the MediSave scheme. It is zero sum. Using more balances for recurrent medical expenses means having less in the future when we are hospitalised and vice versa. And when the tension becomes too severe, we will have to consider raising contribution rates so that you have a bigger pot to spend.

The tension is therefore deliberate and a design feature. It is a balance we must constantly and carefully manage, to ensure the system of co-payment is held together while ensuring affordability and keeping CPF contribution rates reasonable for everybody.

Hence, we continue to have ongoing, regular reviews to study where we can expand the use of MediSave and provide more flexible withdrawals. For example, we recently increased the Flexi-MediSave limit for seniors, and we doubled the annual limit for diagnostic scans.

This time, we will make further changes to the MediSave500/700 scheme. This scheme helps patients pay for their recurring costs of managing conditions on the Chronic Disease Management Programme (CDMP). Mr Cai Yinzhou and Mr Gerald Giam asked about this.

Today, individuals with a simple chronic condition can use up to $500 a year, while those with complex chronic conditions can withdraw up to $700 per year.

To provide more support for preventive and chronic care in the community, we will raise MediSave limits from $500/$700 to $700/$1,000. This will benefit over 910,000 patients who currently tap on the scheme, roughly 20% of whom have annual bills exceeding the withdrawal limits.

We will also expand the list of conditions covered under the CDMP to include hyperthyroidism and hypothyroidism. In addition, we are studying whether we can include other chronic conditions, such as eczema, in the CDMP.

With the above enhancements, we will rename "MediSave500/700". It is actually a cumbersome name. Every time you change the limit, you change the name. We will rename it to "MediSave Chronic and Preventive Care Scheme", to reflect its scope of coverage. The changes will be effective January 2027.

Before I end this section, let me address the question posed by Ms Sylvia Lim.

I thank her for watching my TikTok videos. She mentioned the role of riders in providing additional coverage for cancer treatments not on the Cancer Drug List (CDL). The objective of the recent changes to IP riders is to prevent over-erosion of co-payment because that sets off a "buffet syndrome" and then that leads to rapid escalation of private hospital bills. IP riders covering non-CDL drugs for outpatient treatment, do not contribute to this erosion and therefore, this feature will not be affected by the changes. I should also point out that the changes to IP riders affect only new policy holders, but not existing policyholders. We will always watch out for the cancer patients when we make changes to IP riders. Mr Chairman, in Mandarin, please.

(In Mandarin): 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, to AI and robotic surgery, the medical field has been advancing rapidly. We will take a multi-pronged approach to adopt long-term policies and make use of high-quality medical teams and cost-effective technology to bring better medical services to our people.

(In English): Mr Chairman, when I informed the House three years ago that we would be a super-aged society this year, it was not to instil fear, but to prepare ourselves.

Our transition to a super-aged society has been steady rather than dramatic. It reflects deliberate, long-term planning, including transforming the healthcare system.

Indeed, healthcare transformation is fundamentally a long-term endeavour, not one sweeping reform. It is the accumulation of numerous small steps, each taken with judgement and purpose, each carefully planned and executed. And today, we announced further deliberate steps.

Mr Chairman, it is my hope that this House continues to support our approach of long-term planning, long-term governance, to anticipate future challenges early and act before they overwhelm us. If we do so, we need not fear being a super-aged society. We can embrace it and we make the best of it.

Ultimately, it is not the percentage of Singaporeans above 65 that defines us. We can exercise our wiser minds, to mourn less for what age takes away from us than what it leaves behind.

What matters is that Singaporeans are not just living for longer; we are living healthier for longer. We are not just a super-aged society, but we are striving to be a super-healthy one as well. [Applause.]

The Chairman: Senior Minister of State Koh Poh Koon.

The Senior Minister of State for Health (Dr Koh Poh Koon): Mr Chairman, when Minister spoke about our journey towards becoming a super-aged nation, he highlighted something fundamental, that our people are at the heart of healthcare transformation. I will speak on our approach to workforce and care transformation in healthcare, which is carried out via three pillars.

First, we redesign roles and right-site care. Second, we build pipeline to ensure manpower sustainability. And third, we develop a flexible and agile healthcare system.

Picture this: a patient with diabetes, heart conditions and mobility challenges, juggling multiple appointments across different clinics, each visit requiring time off work, not just for the patient but for the caregiver sometimes, special transport arrangements and often, a caregiver's support to accompany them for these visits. This fragmented experience is not just inconvenient. It is unsustainable as our population ages and our healthcare needs become more complex.

How can we meet the rising healthcare needs of an ageing population, improve the care experience while maintaining the quality and standards of care?

First, we redesign roles and right-site care. Today in a hospital ward, a patient receives coordinated care through a team led by a principal doctor (PD) who is accountable for the patient's overall care plan. Under the new care team model, a PD need not be a specialist. Once they are trained and assessed to be competent, a Hospital Clinician may take on the role of a PD to supervise, oversee and coordinate care, incorporating the inputs of various healthcare professionals. Patients need not be seen by different doctors for each condition, thus reducing the number of referrals to other specialists during their stay.

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And upon discharge, the care of such a patient could then be handed over to their family physician, some of whom are now trained as family medicine specialists, to manage patients with more complex medical conditions.

Likewise, team-based care has been introduced in the polyclinics and Primary Care Networks (PCNs) 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 PCNs.

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 United States of America. On the other hand, our national healthcare expenditure is at 4.4% of our GDP, which is less than half of what other countries spent. This was reported by the World Bank in 2019, and you saw earlier from the charts that Minister has shown that indeed we were able to achieve good health outcomes at a fraction of the cost relative to other countries.

In addition, our hospitals have contingency measures to respond to surge in bed demand. These include adding beds, expediting clinically appropriate discharges and deferring non-urgent electives to free up acute capacity for incoming patients. If required, hospitals can also tap on facilities, like the Transitional Care Facilities and the Mobile Inpatient Care @ Home, to augment overall capacity.

Even as we augment capacity, our people are at the heart of the healthcare system. Public healthcare institutions roster staff to ensure adequate rest in between shifts and also monitor the well-being of our staff as they care for our people. These are experiences we learnt also from the recent COVID-19 pandemic.

With the increased demand in mental health services, the Institute of Mental Health (IMH) will continue to serve as national centre for psychiatric services and focus on providing quaternary care to patients with more complex mental health needs. Mr Patrick Tay will be pleased to know that MOH has been giving IMH additional funding to enhance the psychiatric services and upgrade its infrastructure for better patient care, to be a leading hub for mental health training and education, and establish its position in tertiary and quaternary mental health research.

There are also ongoing efforts to enhance psychiatric in-patient, outpatient and crisis care capabilities across our public healthcare institutions to support individuals with both physical and mental health services in the same hospital. In each of these, care team transformation provides integrated care for patients – promoting team-based care, right-siting of care to the community so that it is more accessible and affordable for our people, and redesigning roles so that professionals are allowed to advance and perform at the apex roles in a safe manner.

The second pillar is to build a sustainable manpower pipeline. Our current healthcare workforce is broadly adequate for the population's healthcare demand. We will need to grow our healthcare workforce by 20% by 2030 to meet the projected manpower demand. We are working closely with Institutes of Higher Learning (IHLs) to introduce more training pathways to build up a strong local pipeline through Pre-Employment Training.

Mr Cai Yinzhou would be pleased to know that the graduate-entry Master of Science (Audiology) programme at NUS runs biennially and has an average of 13 graduates per cohort. For podiatrists, demand is being met through scholarships for local talents to pursue podiatry studies overseas and recruitment of overseas-trained podiatrists.

To Dr Wan Rizal's query on strengthening the local pipeline of clinical psychologists while maintaining professional standards, we have worked with the Ministry of Education and NUS to offer eligible undergraduate students an accelerated pathway to specialise in Clinical Psychology at Master's level, with the first intake in 2026.

Unlike the current training model, where an undergraduate needs at least seven years to be qualified as a clinical psychologist, this includes four years for their Bachelor's degree in Psychology, followed by one or two years of work experience before enrolling in the two-year Master of Psychology (Clinical) programme, this new accelerated pathway for undergraduate-to-Masters pathway can be completed in five years.

It would enable aspiring undergraduates, who set their minds fairly early, to be trained as clinical psychologists through a carefully curated curriculum. This curriculum comprises didactic learning and clinical training during the undergraduate years, developing practitioners with knowledge and skills to care for their patients.

Graduates of this five-year programme will receive both a Bachelor's degree with Honours and a Master's degree.

NUS' new accelerated undergraduate-to-Masters pathway will complement existing postgraduate training pipelines, including its existing standalone two-year Master of Psychology (Clinical) programme for those with relevant clinical work experience. Together, these programmes expand our clinical psychologist manpower pipeline to meet increasing mental health needs.

Healthcare workers remain the bedrock of our healthcare system. Even as we create new training pathways, we have implemented strategies to improve retention of our healthcare workers.

We have spoken in this House before about the challenges in attracting and recruiting nurses, especially during the COVID-19 pandemic. While the attrition of nurses has since fallen back to pre-COVID-19 levels of around 7%, we will continue our efforts to encourage more nurses to stay and contribute to the public healthcare system, as well as attract aspiring individuals to build a career in this sector.

In 2024, we rolled out the Award for Nurses' Grace, Excellence and Loyalty scheme, and reviewed and adjusted nursing salaries in 2025. In 2025, we have also increased the salaries of allied health professionals (AHPs), pharmacists and administrative, ancillary and support staff in public healthcare institutions by up to 7%.

But retention of healthcare workers is not enough to build a robust healthcare system. We need to continuously upskill our healthcare workforce to take on new and expanded roles. Healthcare today does not fit neatly into traditional silos. A patient with multiple conditions needs professionals who can work seamlessly together. That is why we are moving from rigid, specialty-focused training to flexible, competency-based learning delivered via stackable modules in a work-study format where possible. This reduces time away from work and the impact on patient care.

For AHPs, we are working with IHLs to build up shared competencies across relevant allied health training programmes to better support a team-based shared-care model. These will be rolled out progressively, starting with students who begin their studies from Academic Year 2027 onwards.

Separately for mental health, the shared competencies are outlined under the National Mental Health Competency Training Framework to create a "common language" among our AHPs. With this, our AHPs will be more versatile and able to work more collaboratively to deliver care holistically.

For nursing, we are working with the polytechnics to redesign existing nursing post-diploma specialty programmes into a work-study format. This allows the nurses to learn and practise in real-world settings as training is based directly on job activities, enabling nurses to become competent and productive more quickly.

Two Advanced Diploma in Nursing programmes – Palliative Care and Community Health – will be prioritised for initial launch in a work-study format. With enhanced capabilities, our healthcare workforce is better positioned to deliver comprehensive care.

Ms He Ting Ru has asked for an update on the regulation of mental health professionals. We will be registering five higher risk sub-disciplines of psychologists to ensure high standards of practice, ethics and professional conduct so that our people receive safer and higher quality psychological services. These are clinical, clinical neuropsychology, counselling, educational and forensic psychologists.

MOH and partner Ministries will work with Singapore Psychological Society to raise public awareness of the psychologist professions and support our professionals and stakeholders in navigating the registration process. The detailed registration schedule, requirements and roadmaps will be announced by early 2027.

The third and last pillar is to develop a flexible and agile healthcare system that can respond to fast-evolving healthcare needs. One example is in mental health.

Mental health concerns came to the fore during the COVID-19 pandemic and remains a key national agenda in MOH. Ms He Ting Ru and Mr Alex Yeo asked about this.

Since the launch of the National Mental Health and Well-being Strategy in 2023, we have established the National Mental Health Office in 2024 to coordinate and oversee multi-agency mental health initiatives.

First, we have guided mental health service providers to adopt the Tiered Care Model and improve care coordination across different providers, enabling clients to receive seamless care at the most appropriate care setting.

Second, we have expanded the capacity of mental health services across the primary, community, acute and long-term care sectors. Polyclinics and GPs are equipped to provide care to individuals with mild to moderate mental health conditions, such as anxiety and depression. Community mental health teams provide a range of mental health support to individuals with mental health needs.

Today, we have 71 Community Outreach Teams (CREST) and 26 Community Intervention Teams (COMIT) to conduct outreach, screening and assessment, psychological intervention and service linkages for seniors with mental health needs or dementia and their caregivers. By 2030, we will expand the number of CREST and COMIT to 75 and 35 respectively. We have also established the First Stop for Mental Health services to facilitate easy access and navigation of mental health services.

Third, we expanded support in encouraging help-seeking amongst youths. Youths can access CREST-Youth and CHAT, which are sited in the community. Those who need psychosocial interventions may then be referred to the Youth Integrated Teams.

The recently launched Grovve – spelled g-r-o-v-v-e – at *Scape also provides mental health services to youths where they gather, to improve access and reduce barriers and stigma. Youth-oriented self-help services, such as Let's Talk and Ask-a-Therapist, can also be accessed on mindline.sg.

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In addition to these services, an ecosystem of support is available within the education system. Educators and staff are trained to look out for signs of distress in students, and refer those who require further support to counsellors in schools or IHLs as well as community mental health professionals. Peer support structures are in place for students to look out for one another and encourage distressed peers to seek help from trusted adults.

Youths are also taught ways to build mental wellness and resilience through the Character and Citizenship Education curriculum in schools and mental well-being programmes in the IHLs.

Fourth, we are enhancing capabilities of community service providers through the National Mental Health Competency Training Framework and have trained over 160,000 frontline personnel and volunteers to identify and guide individuals in mental distress to support avenues.

Fifth, we have promoted mental health and wellbeing through educational efforts for the general public, parents and youths through campaigns such as Beyond the Label and resources like Parenting for Wellness and the Positive Use Guide.

Lastly, we have strengthened workplace mental health support in collaboration with the Ministry of Manpower and Workplace Safety and Health Council. The Well-Being Champions Network has grown from 54 founding member organisations to 800 over the last two years.

As mental health is a complex and multi-faceted issue, we continue to work with various agencies to track and monitor medium- to long-term trends, including overall state of mental health and well-being of our population, for evidence of improvements from the baseline. Adopting a "no wrong door" approach to facilitate access to services and right-siting care in primary and community settings encourage individuals to seek help early in non-stigmatising environments while avoiding over-medicalising mental health needs.

We also hear Mr Eric Chua's concerns about our people paying for the silent addiction to explicit materials. On this, we recognise that addiction extends beyond individual health to affect families and the broader society. Individuals may also face underlying difficulties such as financial hardship and lack of social support.

The National Addiction Management Service (NAMS), situated within the IMH, was established to provide treatment and assistance for individuals seeking help for addictions. NAMS 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 wellbeing. 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 (ICCPs) 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 ICCP using a standardised, internationally recognised tool. Each senior will have a single community care plan developed based on this assessment. Every provider that the senior goes to will take reference from this care plan.

Such an approach will ensure seniors benefit from a seamless experience and better coordinated care. We will progressively roll this out from October this year. We are enabling this new way of coordinating and delivering services through a common IT platform for community care providers.

Mr Azhar Othman asked about teleconsultations. I refer the Member to Senior Minister of State Koh Poh Koon's recent response to a Parliamentary Question on this matter. Fundamentally, MOH agrees with the Member to make good use of technology to improve the healthcare experiences for our patients.

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For example, the Productivity and Digitalisation Grant launched in 2022 has supported more than 240 projects, such as systems to automate showering and vital signs monitoring. We intend to enhance the grant to make better use of technology solutions in the healthcare sector, including harnessing robotics and AI.

Sir, when I brought this House through the Health Information Bill in January, I said that MOH will help healthcare providers meet the provisions. I am pleased to provide an update.

First, we are working with the vendors for health information management systems used by healthcare providers to comply with the necessary requirements. Second, we will provide resource guides and training to help healthcare providers and their staff understand and implement these requirements. Third, we will launch the National Electronic Health Record (NEHR) Connect Grant (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): 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 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, and 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 introduced 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 ICCP 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/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 ICCP does, which focuses more on seniors and the needs of those seniors.

Mr Cai also asked if the ICCP 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 ICCP 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.

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.

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 National Mental Health office that was established to coordinate multiagency 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 National Mental Health Office, 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 carryover 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, 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.

Amendment, by leave, withdrawn.

The sum of $20,035,377,700 for Head O ordered to stand part of the Main Estimates.

The sum of $2,467,566,400 for Head O ordered to stand part of the Development Estimates.