Safeguarding Singaporeans’ health during occurrence of haze

On 8 July 2013, Parliament debated the Government’s response to the perennial haze problem. These are the questions I asked the Health Minister and his responses (Part 2 of 3).

On 8 July 2013, Parliament debated the Government’s response to the perennial haze problem. These are the questions I asked the Health Minister and his responses (Part 2 of 3).


Mr Gerald Giam Yean Song asked the Minister for Health (a) what is the increase in the weekly number of respiratory, heart, eye and skin problems reported at polyclinics, private clinics and hospitals since the onset of the current haze situation compared to the weekly average in the month before; (b) how many private clinics have signed up for the Government scheme which offers subsidised treatment for haze-related illnesses; (c) what is the Ministry doing to ensure that more private clinics participate in this scheme so that more Singaporeans can benefit from it; and (d) what are the details of the Ministry’s contingency plans to cope with the expected surge of patients with illnesses caused by the haze.

The Minister for Health (Mr Gan Kim Yong): Mdm Speaker, may I have your permission to take Question Nos 21 to 23 together?

Mdm Speaker: Yes, please.

Mr Gan Kim Yong: Madam, Dr Lam asked about the short and long-term effects of air pollution. For healthy individuals, short-term exposure to haze may cause temporary minor irritation of the eyes, nose, throat and skin. Such irritation typically resolves on its own in most cases.

However, the haze particles can aggravate lung diseases, cause asthma attacks and acute bronchitis in people who already have chronic lung diseases, and trigger off heart attacks and irregular heartbeat in people with heart problems. Thus far, there has been no clear evidence of long-term health effects of short-term haze, like that we have experienced.

Mr Gerald Giam asked about the impact of the haze on healthcare services. So far, the impact has been manageable. When the haze was more severe in the week of 17 to 23 June, we saw a 16% increase in polyclinic attendances for relevant conditions compared to the week before, but attendances at hospital accident and emergency department did not show any significant increase. The air quality improved in the last week of June and polyclinic attendances correspondingly decreased to just 4% higher than the level before the onset of haze. Attendance at A&E departments for the relevant conditions actually decreased by 23% in the last week of June.

Ms Lee asked about N95 masks. The N95 masks are not specifically designed for use by children, nor have they been certified for effectiveness for such use. To be effective, N95 masks need to maintain a well-fitted seal at all times, which may be difficult to achieve in young children who are smaller and of varying sizes. It is possible for the older children who may be able to fit smaller sized N95 masks for adults. Parents who wish to buy these masks for their children should ensure proper fit and usage of the mask.
When haze reaches unhealthy levels, children should really be kept indoors as much as possible. This has been communicated to the public through various platforms including the mass media and online media. Since schools reopened last week, MOH has been working with the Ministry of Education and schools on the various mitigation measures, based on the health advisory of the day.

Dr Lam and Mr Giam asked about long-term measures to protect the health of Singaporeans. The Ministry of Health has worked with our healthcare institutions to put in place plans in three areas, to ensure that we are “haze ready”.

First, managing the expected surge of patients at our polyclinics and hospitals for haze-related conditions. The Ministry has already implemented a special scheme where those who suffer from respiratory problems or conjunctivitis because of the haze need only pay $10 when they seek treatment at participating GPs. The scheme applies to Singaporeans aged 18 years and below, or 65 years and above, and those in low-income groups. The scheme will enhance the accessibility and affordability of primary care for haze-related conditions.

There are now more than 600 GP clinics participating in this scheme. Information on the participating GP clinics is on the MOH website, and also shared through community organisations. The Agency of Integrated Care (AIC) has been actively reaching out to individual GP clinics to encourage them to sign on. To increase awareness amongst members of the public, posters have been distributed to GPs so that the participating clinics can be easily identified.

The Ministry of Health had also earlier worked with the hospitals to retrofit suitable spaces within the hospital campuses to ready additional bed capacity in the event of a demand surge due to an increase in dengue cases. We have stepped up efforts to transfer stable patients from the hospitals into community hospitals and nursing homes to free up acute bed capacity.

Should the haze worsen and there is a need to free up bed capacity further, non-urgent services and elective cases at the hospitals may be scaled back.

Secondly, we will take care of the patients in our public sector hospitals and healthcare institutions so that they are not adversely affected by the haze. If the haze situation is bad, these institutions will close their windows and doors to reduce the inflow of dust particles. And if necessary, air coolers and fans will also be used to improve the ventilation for patients in non-air conditioned wards.

For especially vulnerable patients, we will put in place air purifiers to help reduce the impact of the haze on these patients during significant haze.

We will also facilitate home delivery of medication for chronic patients if necessary so that they can get their needed medication without having to visit our clinics.

Third, our hospitals and polyclinics have adequate equipment and supplies, including adequate medication stocks, on standby to support the continuation of critical services. Our hospitals also have plans in place to ensure adequate manpower to staff critical services such as the A&E, Intensive Care Unit and operating theatres.

At the national level, we are re-building our stockpile of N95 masks so that we will be ready should there be a disease outbreak during this period.


Mr Gerald Giam Yean Song: Madam, now that the haze seems to be behind us at least for this year, will the scheme offering subsidised treatments for haze-related illnesses continue or will it be revived when the haze comes back again? Is there a certain threshold PSI that will trigger off the scheme and will the GPs who have signed up this year continue to be on the scheme next year?

Mr Gan Kim Yong: Mdm Speaker, I would hesitate to say that the haze is over for this year as I think Dr Vivian Balakrishnan has reminded us all that the dry season is not yet over so we have to remain vigilant and to be well prepared. So, for the time being, the scheme will still remain in place and will be reviewed again at the end of the dry season to see whether it is necessary to be continued, whether we will re-introduce it next year or we could refine the scheme to make it a better scheme when the haze does return. We hope it does not, but in the event that it does return, whether we will need the scheme or whether we need a different scheme. We will look at the situation at that point in time but for the time being, this being the dry season, the scheme will remain in place.


Source: Singapore Parliament Reports (Hansard)

Foreigners pay more, but what’s in it for Singaporeans?

In its latest political move in preparation for the election, the PAP government has decided to reduce health subsidies given to Singapore permanent residents (PRs) by 10% this year and another 10% in 2011.

This comes hot on the heels of the recent increase in fees for PRs and foreigners studying in local schools. Back in 2008, the Ministry of Health had already reduced the PR subsidy in hospitals by 10% and completely eliminated the subsidies for non-PR foreigners. The government claims that these moves are to “make a sharper distinction between the privileges a citizen is entitled to, as compared to a PR”.

I fail to see how all this benefits Singaporeans. Are Singapore citizens now going to pay less when they are admitted to hospital or attend local schools? No. Is the PAP expecting Singaporeans to rub their hands with sinister glee, as they rejoice that their PR counterparts are paying more? I don’t think Singaporeans are that vindictive.

Therefore my conclusion is that this is simply a pathetic attempt to lull Singaporeans into thinking there is actually a significant distinction between the position of foreigners and Singaporeans in this country. Secondly, it seems this is another revenue-raising exercise for the government, since there has been no mention that the money saved in subsidies is going to feed into any programme that benefits Singaporeans.

If the government was really sincere about treating Singaporeans better, they would reduce the fees that Singaporeans are paying for government services, instead of punishing foreigners for political gain.

Reduce abortions by helping pregnant mothers financially

Medical doctor Ng Liang Wei wrote a letter to the Straits Times forum today suggesting that a fund be set up to help mothers to defray the cost of their pregnancies so as to give them less reasons to abort their babies.

I fully support this idea. I have blogged about the issue of the staggering number of abortions in Singapore before. I think for too long, the debate on abortion (at least in the US — we haven’t debated much about it in Singapore) has been centred on pro-life vs pro-choice. Pro-lifers say abortionist are killing babies, while pro-choicers say anti-abortionists are restricting the freedom of women to do what they want with their own bodies. The argument goes on and any attempt to find common ground is squashed.

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Abortions in S’pore must be reduced

I feel sad to learn that the number of abortions in Singapore increased again last year to 12,222, compared to 11,933 in 2007 and 12,032 in 2006. Prior to 2006, it had been on a decline since 2000. About one in four pregnancies in Singapore is terminated through abortion. In Singapore, pregnancies can legally terminated up to 5 months (24 weeks) into gestation.

Singapore has one of the most liberal abortion laws in the world, thanks to the Abortion Act of 1969 and an amended Act of 1974, both of which — especially the second, more liberal law — passed easily in an all-PAP Parliament, despite the Whip being lifted to allow MPs to vote according to their consciences.

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Food contamination alert system is possible

Firstly, a correction to my previous post: The authorities took not 2 days, but 3 days, to shut down the stall. It was revealed in TODAY on Thursday that the first reports of food poisoning from that stall appeared on a Wed 1 Apr. The stall was not ordered closed by NEA until Sat 4 Apr morning.

I’ve received some useful feedback from friends regarding my previous post, where I questioned why NEA officers took so long to shut down the Geylang Serai rojak stall that was allegedly responsible for three deaths and over 150 cases of food poisoning.

Some felt that I was being unfair by expecting NEA to react faster than it did, and that I appeared to be pinning the blame on NEA for the food poisoning.

While I don’t think NEA is completely blameless, I never said that they are entirely to blame. The NEA, Ministry of Health (MOH), the stall holder, doctors and even some of stall patrons could have played a part to avert this tragedy, or at least prevent it from ballooning into this nightmare involving over 150 people. Most of all, I feel it is “the system” which is to blame, and not any individual person or agency. I am not interested in playing any finger-pointing games at this point, but to suggest how the system can be improved to avert future mass outbreaks of food poisoning.

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