Subsidies for Fertility Screening and Introduction of New Category of Fertility Screening for Use of MediSave

12 Mr Louis Ng Kok Kwang asked the Minister for Health whether the Government can (i) provide subsidies for fertility screening and (ii) introduce a new specific category of fertility screening for the use of MediSave.

The Senior Parliamentary Secretary to the Minister for Health (Ms Rahayu Mahzam) (for the Minister for Health): Mr Speaker, the Government provides means-tested subsidies of up to 70% for fertility tests that are medically indicated. This helps to keep fertility tests affordable for all patients.

There are many requests for tests and treatments to be eligible for MediSave deduction. They need to be prioritised and carefully considered, to strike a balance between improving healthcare affordability, ensuring MediSave adequacy and keeping CPF contribution rates reasonable for all. The Ministry of Health (MOH) will continue to review our financing schemes including MediSave to ensure fertility healthcare services remain affordable.

Mr Speaker: Mr Louis Ng.

Mr Louis Ng Kok Kwang (Nee Soon): Thank you, Sir. And I thank the Senior Parliamentary Secretary for the reply. I think there was a recent report which showed that Singaporeans, in general, spend about 3.4 years of trying to conceive before finally getting help when they cannot. And we know as well that the trend is that Singaporeans are getting married later in life. So, time is of the essence here.

Could I ask: one, whether MOH is looking into how to create more awareness about the importance and the need for fertility testing at a younger age; and two, I really think that price might be a factor and so I am hoping that subsidies can be extended to all, rather than a selective few?

Ms Rahayu Mahzam: I thank the Member for his question and his consistent and persistent advocacy on this issue. I note the concerns. I will answer his second question first in respect of the funds and subsidies. As I have mentioned, these tests are medically indicated. It means that, if the patient or the couple goes to the doctor, they will then recommend the specific test that the patient requires, based on their conditions. It is very couple-centric. I think that is important because then, you are sizing the subsidy and support for that.

And when they are medically indicated and refer to the specialists outpatient clinics in our public healthcare institutions, they get subsidies and it is up to 70%. So, in that sense, there are already sufficient subsidies that ensure that if they need the support, they need the help, they will get the subsidies needed.

There is a problem then. The issue is they are not going to get the help needed and I think that is an important point you raised. It is something that we need to continue looking at. Already, as it stands, we have the guideline for couples, especially for women, who are below 35 years old, if they are below 35 years old and they have been trying to conceive for a year and have not been able to conceive, they are encouraged to go to see a doctor. If they are above 35 years old and they have been trying to conceive for six months, they are asked to already go.

I believe that with various efforts by different partners who are also supporting this message, hopefully, there will be greater awareness. I think there are a few things that we can perhaps leverage on. We have organisations, like "I Love Children", which also encourages checking for fertility treatments. And as we are also rolling out our Marriage and Parenthood packages, these also opportunities for us to encourage couples to take note of these things. I am also thinking that with Healthier SG, especially if it continues to be rolled out to the younger groups, you have opportunity for more individualised healthcare plan.

Through these channels, we hope to see better awareness and people are more encouraged to then check on their fertility status.

Mr Speaker: Mr Louis Ng.

Mr Louis Ng Kok Kwang: Sir, just one more quick question. It is back to the subsidies again because I do think it is important. Could I just ask whether MOH has done a cost benefit analysis? I know I am always asking Government to spend more, but perhaps, if we spend more in getting people to do their fertility screening at a younger age, we might then spend less in providing subsidies for IVF treatment, which is even more expensive and which costs the Government quite a fair bit currently.

Ms Rahayu Mahzam: I am glad the Member asked that question. As I have mentioned, this is something that we continually review. But, as it stands, currently, there are no evidence-based population level fertility screening tests because it makes more sense for the test to be ordered and recommended when they are medically indicated, rather than to give a screening to the whole group. So, in that sense, there is no cost-effectiveness to roll it out at that level. I think it is something we will continue to monitor and when the evidence changes or if there is some data to the contrary, these are the things that we can look at.