Guidelines on Duration of Medical leave for Specific Injuries

14 Mr Louis Ng Kok Kwang asked the Minister for Health (a) what are the latest findings in the Ministry’s study on creating guidelines to help doctors determine the disability duration for specific injuries when issuing medical leave and light duties to injured workers; and (b) by what date does the Ministry expect to publish the results of this study.

The Senior Minister of State for Health (Dr Amy Khor Lean Suan) (for the Minister for Health): The Singapore Medical Council's Ethical Code and Ethical Guidelines (ECEG) requires the doctor to place the patient's welfare above all. Regarding medical leave, the doctor has to ensure that the duration and type of leave granted is based on medical grounds arrived at through proper clinical assessment by doctors.

The duration of medical leave is determined by a variety of factors including the type and severity of the injury, the period required for the treatment, rehabilitation and recovery, and the specific work requirements and workplace conditions.

Recent changes in the Work Injury Compensation Act (WICA) to require employers to report any instance of employees on medical leave or light duties due to a work injury, when effected, should reduce the risk of inadequate medical leave.

Therefore, for now, we do not think that guidelines for medical leave on work-related injuries are necessary. My Ministry will continue to monitor the situation.

Mr Louis Ng Kok Kwang (Nee Soon): I thank the Senior Minister of State for the reply. I think last year, MOH said that it would consult stakeholders on whether these guidelines were needed. Could I ask Senior Minister of State, which stakeholders were consulted and what their views are?

Second, I think that, while WICA amendments will close some of these loopholes, I think we can further strengthen it. So, I understand that under the MOM Return to Work Coordination Programme, all the public hospitals' Work Rehabilitation Therapists are required to complete and obtain certification before they are qualified to facilitate a worker's return to work. But this is not for the private hospital. So, can I ask whether MOH will work with MOM to ensure that this is made compulsory also for private hospitals' Work Rehabilitation Therapists.

Dr Amy Khor Lean Suan: First, I would like to say that we are as concerned as the Member for the welfare of the workers. Indeed, we have done some preliminary consultations as well as done a survey of the landscape of such issues in various countries, like New Zealand, Australia, UK. As I have noted earlier, I think the general view is that, because the duration and the type of medical leave or even light injury duties that are to be given, really varies widely depending on different persons, the different circumstances, whether it is the type and severity of the injury, the type of treatment required, rehabilitation, even the comorbidity and the fitness of the worker as well as the work requirements and work conditions. All these vary very greatly and it is actually difficult to have a set of prescriptive guidelines for prescribing medical leave and even light duties.

So, that is the reason why the Singapore Medical Council (SMC), in 2017, did issue some general guidelines on what doctors should take into account, as I have enumerated earlier, as well as the fact that they should not take into account extraneous factors like who is going to benefit, who is going to pay, impact on insurance claims and so on, as well as to consult their peers where they may not be sure.

We think that with the new WICA coming into effect from September of this year, where even light duties given – even if it is one day – will have to be reported, that will actually minimise this issue of under prescribing medical leave or light duties. And in fact, one of the benefits of WICA is to enhance protection for the employees. We will continue to consult with various relevant stakeholders as well as to monitor the situation.

With regard to the second question about the therapists, I think this is not quite related to the issue of issuance of medical leave or light duties by the doctors, but nonetheless, we will check and we will work with MOM where if it is needed, to work out the procedures and the process for this.