新加坡衛生部長：這些政策讓醫院賬單更便宜

新加坡衛生部長王乙康，新加坡衛生部兼通訊及新聞部進階政務部長普傑立醫生回答官委議員賽義德哈倫醫生有關的醫療問題。

以下内容為新加坡眼根據國會英文資料翻譯整理：

賽義德哈倫醫生：謝謝主席。我有兩個問題要問部長。

首先是有關“居家病房”計劃（MIC@Home）的事情：我很高興看到現在的安全性和結果與目前相當，但是部長也提到，定價方面預計會和現在一樣或更少。我隻是想知道，考慮到現在護理是在家裡進行的，一些輔助服務比如床鋪、更換床單、餐食、公共設施都會減少很多。我知道還有其他成本，但是我想問部長能否澄清一下。

第二個問題是關于社群輔助小組（COMIT）和鄰裡咨詢小組（CREST）計劃增加的事情。我想問問部門是否會考慮以更大的比例增加數量，因為心理健康的重點将放在社群。我覺得增加社群輔助小組（COMIT）和鄰裡咨詢小組（CREST）團隊的數量會增強我們基層家庭醫生的信心，他們可以更好地處理社群裡的心理健康問題。

王乙康先生：我會請進階政務部長就社群輔助小組（COMIT）和鄰裡咨詢小組（CREST）發表評論。至于“居家病房”計劃（MIC@Home），我同意你的觀點。我認為，即使在定價政策上，你也希望通過定價給患者一個明确的信号。在“居家病房”計劃（MIC@Home），我支付更少；而且我有S+3M基本健保制度，醫院賬單會更少。是以我們的公共衛生機構會認真對待這一點，他們了解我希望他們已經準備好這樣做。但是我寫了一份謹慎的聲明，即價格将相等或更少，這樣他們有些空間。

普傑立醫生：我感謝你提出關于鄰裡咨詢小組（CREST）和社群輔助小組（COMIT）團隊的問題。我同意我們需要確定我們的初級護理從業者和整個社群護理從業者得到足夠的支援。我們還沒有達到我們計劃的增長水準，是以我們正在增加團隊。

我們真的不知道接下來的10到15年裡，患者和居民的行為會如何改變，尤其是那些關心心理健康的人。我們增加鄰裡咨詢小組（CREST）和社群輔助小組（COMIT）團隊的同時，我們還沒有完全了解。我們已經制定了計劃。我認為我們需要加強對社群私人和公共部門從業者的支援，增加團隊數量，提高現有團隊的能力。但是随着患者和居民健康尋求行為的變化，有些人擔心，有些人需要幹預，還有些人曾在機構接受護理，現在需要社群支援。這些是我們将通過全國心理健康辦公室（NMHO）密切監測和觀察的事情，并與我們的合作夥伴一起工作，然後評估我們是否提供了正确的支援水準。是以我同意你的觀點，但我認為現在說到2030年我們會采取什麼行動還為時過早。我們先執行我們目前的計劃。

主席：我沒看到其他人有問題。總共有11位成員提出了問題。你們的問題和回答都很簡潔。那麼，我可以請陳醫生你是否願意更改你的提案？

陳有明醫生：主席，我想感謝所有參與了COS辯論的人，包括我們的衛生部上司、國會議員和發言人。最感謝的還是我們整個醫療保健團隊，包括醫護人員、社群護理人員和公務員們，無論是在疾病還是健康時刻都在照顧新加坡人。主席，我請求撤回我的提案。

提案經允許後被撤回。

$17,400,129,600新币的O部門主要估算款項獲得通過。

$1,374,852,500新币的O部門發展估算款項獲得通過。

以下是英文質詢内容：

Dr Syed Harun Alhabsyi (Nominated Member): Thank you, Chairman. I have two clarifications, mainly towards Minister.

The first is regarding MIC@Home. Heartened to see that safety as well as outcomes are comparable as it stands today, but Minister also mentioned that in terms of pricing, it is expected to be the same or less. I am just wondering whether, at least in my mind, should it not be less pricing in absolute terms, given that the care is based now at home and auxiliary services, such as the bed, change in linen, meals, utilities would be much less. I appreciate there are other costs, but I wonder whether the Minister could clarify that.

The second is on the planned increase for COMIT as well as CREST. I would like to ask the Ministry whether they would consider increasing the number in greater proportions, given that the emphasis on mental health will be towards the community. I think a greater increase of COMIT and CREST teams would give some confidence to our GPs on the ground, in terms of dealing with mental health issues in the community.

Mr Ong Ye Kung: I will ask Senior Minister of State to comment on COMIT and CREST. As for MIC@Home, I agree with you. I think even as a policy of pricing, you want to price it at a gradient so that patients get a strong signal. MIC@Home, I pay less; plus I have S+3M, hospital bill will be less. So our public health institutions take this to heart, they understand and I think they are prepared to do so. But I wrote a careful statement that the price will be equal or less, so to give them some room.

Dr Janil Puthucheary: I thank Dr Syed Harun for his question on the CREST and COMIT teams. I agree with the sentiment that we need to make sure that our primary care practitioners and the whole community of community care practitioners is adequately supported. We have not yet achieved the increase that we are planning for, so we are increasing the teams.

What we do not really know is what the behaviour of patients and residents, people who are concerned about mental health behaviour; how that will change over the next 10 to 15 years as we are increasing our CREST and COMIT teams. We have put these plans in place. I think we need to ramp up the support available for the private and public sector practitioners in the community space, increase the number of teams, the capability of the teams that we have. But how that goes and how that matches with health-seeking behaviour, the worried well, the people who need interventions, people who have been in institutional care, who now need to come into the community; these are things that we will be monitoring and watching very closely through the NMHO and working with our partners and then assessing whether we have the right level of support. So I agree with the sentiment, but I think it is a little bit too early to say now what we will be doing in 2030. We get going with our current plans first.

The Chairman: I do not see any more hands. 11 Members raised their clarifications. Your clarifications were concise and so, too, were the responses. So, can I invite Dr Tan if you would like to draw your amendment?

Dr Tan Wu Meng (Jurong): Mr Chairman, I want to thank all who contributed to the COS debate, our MOH leadership and office holders and our Members of Parliament, our Members of Parliament who spoke as well. Deepest thanks to our entire healthcare family as well, our healthcare workers; our sisters and brothers, who care for patients and residents in the community; our public officers, who worked tirelessly behind the scenes looking after Singaporeans, in sickness and in health. Mr Chairman, I beg leave to withdraw my amendment.

Amendment, by leave, withdrawn.

The sum of $17,400,129,600 for Head O ordered to stand part of the Main Estimates.

The sum of $1,374,852,500 for Head O ordered to stand part of the Development Estimates.

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