Singapore's Minister of Health: These policies make hospital bills cheaper

新加坡卫生部长王乙康，新加坡卫生部兼通讯及新闻部高级政务部长普杰立医生回答官委议员赛义德哈伦医生有关的医疗问题。

以下内容为新加坡眼根据国会英文资料翻译整理：

赛义德哈伦医生：谢谢主席。我有两个问题要问部长。

首先是有关“居家病房”计划（MIC@Home）的事情：我很高兴看到现在的安全性和结果与目前相当，但是部长也提到，定价方面预计会和现在一样或更少。我只是想知道，考虑到现在护理是在家里进行的，一些辅助服务比如床铺、更换床单、餐食、公共设施都会减少很多。我知道还有其他成本，但是我想问部长能否澄清一下。

第二个问题是关于社区辅助小组（COMIT）和邻里咨询小组（CREST）计划增加的事情。我想问问部门是否会考虑以更大的比例增加数量，因为心理健康的重点将放在社区。我觉得增加社区辅助小组（COMIT）和邻里咨询小组（CREST）团队的数量会增强我们基层家庭医生的信心，他们可以更好地处理社区里的心理健康问题。

王乙康先生：我会请高级政务部长就社区辅助小组（COMIT）和邻里咨询小组（CREST）发表评论。至于“居家病房”计划（MIC@Home），我同意你的观点。我认为，即使在定价政策上，你也希望通过定价给患者一个明确的信号。在“居家病房”计划（MIC@Home），我支付更少；而且我有S+3M基本健保制度，医院账单会更少。所以我们的公共卫生机构会认真对待这一点，他们理解我希望他们已经准备好这样做。但是我写了一份谨慎的声明，即价格将相等或更少，这样他们有些空间。

普杰立医生：我感谢你提出关于邻里咨询小组（CREST）和社区辅助小组（COMIT）团队的问题。我同意我们需要确保我们的初级护理从业者和整个社区护理从业者得到足够的支持。我们还没有达到我们计划的增长水平，所以我们正在增加团队。

我们真的不知道接下来的10到15年里，患者和居民的行为会如何改变，尤其是那些关心心理健康的人。我们增加邻里咨询小组（CREST）和社区辅助小组（COMIT）团队的同时，我们还没有完全了解。我们已经制定了计划。我认为我们需要加强对社区私人和公共部门从业者的支持，增加团队数量，提高现有团队的能力。但是随着患者和居民健康寻求行为的变化，有些人担心，有些人需要干预，还有些人曾在机构接受护理，现在需要社区支持。这些是我们将通过全国心理健康办公室（NMHO）密切监测和观察的事情，并与我们的合作伙伴一起工作，然后评估我们是否提供了正确的支持水平。所以我同意你的观点，但我认为现在说到2030年我们会采取什么行动还为时过早。我们先执行我们当前的计划。

主席：我没看到其他人有问题。总共有11位成员提出了问题。你们的问题和回答都很简洁。那么，我可以请陈医生你是否愿意更改你的提案？

陈有明医生：主席，我想感谢所有参与了COS辩论的人，包括我们的卫生部领导、国会议员和发言人。最感谢的还是我们整个医疗保健团队，包括医护人员、社区护理人员和公务员们，无论是在疾病还是健康时刻都在照顾新加坡人。主席，我请求撤回我的提案。

提案经允许后被撤回。

$17,400,129,600新币的O部门主要估算款项获得通过。

$1,374,852,500新币的O部门发展估算款项获得通过。

以下是英文质询内容：

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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