Speeches
SPEECH BY MS RAHAYU MAHZAM, SENIOR PARLIAMENTARY SECRETARY, MINISTRY OF HEALTH, AT THE HEALTHIER SG WHITE PAPER DEBATE 2022, ON WEDNESDAY, 5 OCTOBER 2022
5 October 2022
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Mr Speaker, Sir. We all want to be healthy, but with many competing demands in our hectic lives, it can be challenging for us to do so. This is why, as part of the Healthier SG strategy, it is important to build an ecosystem and rally the community as part of that ecosystem to facilitate healthy living, making it easier for us to make better, healthier choices. Today, I would like to address various members’ questions related to preventive health and encouraging healthy lifestyles in the community.
2. Our efforts can be summarised with the acronym “HEALTH” – H for harnessing existing health initiatives, E for enhanced suite of health programmes, A for active collaboration with community partners, L for looking out for caregivers, T for tracking health activities via technology, and the last H for health-related lifestyle nudges. Let me elaborate on each of these in turn.
H – Harnessing existing health initiatives
3. The first “H” is for harnessing existing health initiatives. Currently, there are a wide range of national initiatives to support us in adopting and prioritising healthy living.
4. To promote physical activity, there are self-directed programmes such as the National Steps Challenge where you can participate at your own pace anytime and anywhere, to virtual or on-ground MOVE IT leisure-time physical activity programmes for those who prefer guided exercise sessions.
5. Good nutrition is also a key component of living healthily, and we actively encourage Singaporeans to adopt a healthier diet, particularly by reducing sugar and salt consumption. Ms Hazel Poa and Ms Sylvia Lim had spoken about this earlier, in particular about improving affordability of healthier food choices. Ms Hazel Poa had gone so far as to suggest taxes on unhealthy food. Mr Xie Yao Quan had sought clarification from her yesterday during his speech. So Tthe specifics of her proposals are not clear. In any case, let me share about our ongoing initiatives.
6. To reduce the intake of sugar, beverages sold in Singapore in prepacked form and from automatic beverage dispensers will be subject to new Nutri-Grade labelling requirements and advertising prohibitions from 30 December 2022. Similar measures for freshly prepared beverages will come into effect by end of 2023.
7. Some of you may have heard that we are working with retailers to introduce lower-sodium alternatives which are healthier than regular salt. In fact, supermarket chains FairPrice and Sheng Siong will start selling lower-sodium salt products starting from this week.
8. In addition, the Health Promotion Board (HPB) supports food manufacturers and suppliers to develop healthier products through the Healthier Ingredient Development Scheme (HIDS), and partners food and beverage establishments, including hawker centres and coffeeshops, to offer healthier meal options. HPB also works actively with supermarket chains to introduce more Healthier Choice Symbol (HCS) products to increase the variety of HCS house brand products which are typically more affordable than branded alternatives.
9. The Ministry of Health (MOH) also has a multi-pronged strategy to reduce the prevalence of use of tobacco products. In his speech, Mr Sharael Taha highlighted the use of vaping. To address the use of vaporisers, we are working with various partners to strengthen enforcement measures and public education efforts. We will step up enforcement at borders, social media platforms such as Telegram and public areas.
10. MOH and the Ministry of Education are also working together to address vaping in schools. These efforts will be complemented by the roll out of a vape-free campaign in 2023 targeted at youths and younger adults through popular digital platforms, to communicate that vaping is harmful and illegal.
11. These are just some of the many initiatives we have, and I am happy to note that they have impacted the lives of our residents.
12. One such resident is 84-year-old Mr Louis Loh. Diagnosed with diabetes 10 years ago, Mr Loh remained largely sedentary. He only grew more motivated and began exercising regularly after joining National Steps Challenge Season 4 in 2018.
13. Brisk-walking became his everyday routine, and this enabled him to accumulate a daily average of 60 minutes of moderate-intensity physical activity.
14. Keeping active has helped Mr Loh achieve a healthier body mass index (BMI) after losing about 10 kg in the last three years, and his health conditions are now better managed and controlled. Mr Loh’s improved health outcomes have encouraged him to keep to his walking regime even outside of the Challenge. Today, he continues to track his daily physical activity for the benefit of his health.
15. Another example is 63-year-old Madam Rahimah. When her family members were diagnosed with diabetes and hypertension, she realised the importance of having good health and decided to take steps towards a healthier lifestyle.
16. To encourage healthier eating habits, Madam Rahimah cooks healthy meals at home and packs them for her children to bring to work. The HPB’s Healthier Choice Symbol made it easier for her to choose healthier ingredients and the information on how to cook healthier meals has also been useful. She opts for wholegrains such as brown rice and brown rice bee hoon. When making desserts like “bubur kacang” for the family, she uses low fat milk instead of coconut milk. In her cooking, she uses healthier oil and includes more vegetables, as well as healthier cooking methods such as grilling and stir-frying instead of deep frying.
17. Besides eating healthily, Madam Rahimah also incorporates physical activity in her daily routine to stay active. Madam Rahimah has noticed a big difference in herself ever since she started to lead a healthier lifestyle. She is more energetic and does not feel tired easily.
18. Mr Loh and Madam Rahimah took ownership of their health and harnessed existing health initiatives to improve their lifestyle.
19. Through Healthier SG, your family doctor will support you in this journey, managing your health holistically and guiding you to develop a personal Health Plan. This includes not only recommended health screening and vaccinations, but also lifestyle adjustments. Your doctor can also recommend existing health-related activities and services in your community that will be suitable for you.
E – Enhanced suite of health programmes
20. Second, “E” refers to enhancing our existing suite of health programmes.
21. Under Healthier SG, you will be able to easily identify programmes suitable for your health status and sign up for these programmes more conveniently through one app, Healthy 365.
22. We will collate community partners’ programmes and house these on Healthy 365 app over time – to cover the range from self-directed programmes to targeted weight management interventions for residents with well-controlled chronic disease, and practical nutrition workshops on preparing a well-balanced healthy meal.
23. Mr Xie Yao Quan called for a wider variety of community programmes so that every local community is abuzz with exercise groups and health-promoting activities, catering to different needs. We do want a vibrant and robust slate of programmes but not all programmes need to be HPB or MOH driven programmes. To optimise resources, we will have to channel resources towards programmes that are well-received and impactful. However, we encourage community partners to play a part in this. It is heartening therefore to hear Ms Hany Soh share about the ground-up initiatives in her constituency.
24. Ground partners can supplement existing health promotion efforts and programmes, and I would like to thank Ms Hany Soh for her ideas in this area. To encourage more residents to champion their interest groups and support Healthier SG, HPB provides our Healthy Singapore Fund for individuals or organisations to self-organise activities that meet their communities’ needs. We hope these efforts will continue to bloom and add to the existing suite of offerings that residents can tap on to sustain healthy lifestyles.
25. I would like to assure Mr Edward Chia that we will continually explore ways in which private sector partners can play a role under Healthier SG. For example, we will explore how a more comprehensive range of physical activities may be made available to residents across the island through collaborations with private partners such as physical activity providers.
26. HPB’s Healthy 365 app will be the lifestyle application that you can use to easily access lifestyle programmes offered by community partners near you. I agree with Dr Tan Wu Meng’s and Ms Denise Phua’s comment on the need to assist seniors or those who are not digitally savvy. For those who need help navigating the programmes, there will be support provided, such as through the Eldercare Centres and Community Centres. With these features in place, you will be able to access and select suitable programmes that support your health and lifestyle goals.
A – Active collaboration with community partners
27. Next is “A” for active collaboration with community partners. Over the years, we have worked closely with the community to extend our preventive health efforts. One example is the formation of the Malay Community Outreach Workgroup (MCO), which comprises Malay community leaders with wide ranging experience, including PA MESRA, MUIS, Mendaki (under the M3@Towns committees), and Muslim Health Professionals Association (MHPA).
28. At this point, Mr Deputy Speaker, please allow me to say a few words in Malay.
29. Kami telah bekerja rapat dengan masjid-masjid selama beberapa tahun untuk menggalakkan para jemaah mengamalkan gaya hidup aktif melalui program Jaga Kesihatan, Jaga Ummah (JKJU). Lembaga Penggalakan Kesihatan (HPB) secara berterusan melebarkan rangkaian JKJU dengan melibatkan lebih banyak pertubuhan-pertubuhan selain masjid untuk mengembangkan program-program gaya hidup sihat, dan mesej gaya hidup sihat yang bernuansa budaya, untuk masyarakat Melayu.
30. Baru-baru ini, kami juga telah melancarkan inisiatif Saham Kesihatan, satu usaha Bersama antara HPB dan pertubuhan-pertubuhan masyarakat, termasuk M3@Bandar, ActiveSG dan Persatuan Rakyat (PA). Inisiatif ini bertujuan untuk menggalakkan lebih ramai penduduk Melayu-Islam untuk mengekalkan kesihatan mereka melalui kumpulan berkesepentingan atau “interest groups” yang dipimpin masyarakat.
31. Kumpulan-kumpulan ini boleh melakarkan sendiri program-program kesihatan tempatan, dengan menggunakan pelbagai kemudahan dan perkhidmatan penjagaan kesihatan yang ditawarkan oleh pertubuhan-pertubuhan masyarakat dan organisasi seluruh pemerintah. Program perintis Saham Kesihatan telah dilancarkan di M3@Bandar di Jurong dan Tampines. Kami berharap untuk memupuk sekurang-kurangnya satu kumpulan berkesepentingan atau “interest group” yang dipimpin masyarakat di setiap M3@Bandarmenjelang 2023. Kami juga akan terus mempertingkatkan program-program yang sedia ada dan menyokong masyarakat Melayu dengan pelbagai program-program kehidupan sihat, untuk menggalakkan lagi mereka megamalkan gaya hidup sihat.
32. In her speech, Ms He Ting Ru touched on the gender health gap for women. The feminisation of ageing is a well-recognised phenomenon, where women face a greater risk and duration of loneliness as those who are married tend to live longer than their husbands. They also have greater financial insecurity than men and carry a greater burden of the challenges and stresses of caregiving.
33. MOH is cognisant of these concerns. In fact, I chair a Women’s Health Committee which comprises community partners championing for women’s health issues. Together with our partners, we will continue to increase awareness of women’s health issues and promote healthier lifestyle practices amongst women. Sustained education efforts and support for women are important in addressing this long-term phenomenon.
34. The efforts of the Committee will complement Healthier SG in supporting women in their preventive health journey so that they may live longer, healthier.
35. I agree with Ms Ng Ling Ling’s point on the importance of adopting a community participatory approach under Healthier SG, and this is in line with our plans.
36. Under Healthier SG, we and our healthcare clusters will continue to work closely with agencies to explore these suggestions, and we look forward to the support of all our partners to achieve the vision of Healthier SG.
L – Looking out for caregivers
37. Moving on, we have “L” which stands for looking out for caregivers.
38. As we seek to empower fellow Singaporeans to stay healthy, we recognise that some of our seniors are already frail, living with dementia, or approaching end of life. These seniors and their caregivers also need our support. Second Minister for Health, Mr Masagos Zulkifli, will speak more about our commitment to enabling seniors to live and age well in the community.
39. Over the years, we have enhanced our support for caregivers, with a range of initiatives under the Caregiver Support Action Plan and the White Paper on Women’s Development. If you are a caregiver, there is a range of care options to help ease your burden, such as the Dementia Day Care and the Night Respite Care pilot to help caregivers of persons living with dementia, and home-based respite care for caregivers of those approaching the end of life. We will also provide more help to ease caregiving costs, with an enhanced Home Caregiving Grant in 2023.
40. Ground-up community efforts can also let caregivers know that they are not alone in this journey. For example, peer support networks under the People’s Association’s WIN Caregivers Network and Project 3i empower caregivers to learn skills and receive social-emotional support.
41. We recognise that caregivers also need even more support as their loved ones approach the end of life. Palliative care comes in here to provide not just physical, but also emotional, psychosocial, and spiritual support to patients and their families. I would like to encourage caregivers to join and benefit from these initiatives.
42. In their speeches, Dr Wan Rizal and Ms Hany Soh touched on enabling caregivers to better support their loved ones. Currently, nominated caregivers can already conveniently access the health records and appointments of their loved ones in HealthHub. Next year, caregivers will also be able to use HealthHub to help their loved ones enrol to Healthier SG.
43. I would also like to acknowledge Ms Janet Ang’s point on leveraging digital technology to engage caregivers, and we will continue to work with partners to engage caregivers through various channels, including digital channels.
T – Tracking health activities via technology
44. So far, I have covered how the government and community can play a role in supporting our healthy living journey. For my last two points, I will cover how technology can be used to empower and motivate you to take charge of your own health journey. The letter “T” is for tracking of your health activities.
45. In between visits to your family doctor under Heathier SG, you can access relevant, up-to-date advice via the Healthy 365 app and the HealthHub app on your personal devices. Healthy 365 enables easy tracking of different lifestyle behaviours such as physical activity, healthier food purchase and consumption. You will also be able to share your lifestyle data by showing the app to your family doctor, enabling the doctor to have a holistic view of your progress and discuss what lifestyle goals and programmes can help you.
46. In addition to monitoring of physical activity, sleep and healthy food purchases, the Healthy 365 app will be enhanced with new features such as diet logging. The diet logging tool will help you easily monitor and be aware of your daily caloric intake from food and drinks consumed, so you can work towards achieving your daily recommended caloric intake.
47. This tool will have a photo recognition function that Minister Ong described so that we can simply take a picture of our meal, which could comprise of local food and drinks such as chicken rice and kopi-o for the app to estimate the caloric intake.
48. There will also be ways to support those who are not digitally fluent, for example, by enabling patients’ caregivers or family to assist.
H – Health-related lifestyle nudges
49. Finally, the last “H” refers to health-related lifestyle nudges, personalised recommendations, and rewards to sustain healthy behaviours.
50. At the heart of Healthier SG is empowering residents to choose health for themselves, while the system supports them. We know that lifestyle behavioural change is a long-term journey – requiring both strong motivation and regular participation.
51. While we may interact with our family doctors once every six to twelve months and participate in community activities a couple of times a week, personalised recommendations and nudges delivered via digital technology can be a constant support to help us stay engaged on our healthy journeys.
52. We will enhance Healthy 365 to deliver more personalised nudges – such as through recommending suitable lifestyle activities, achievement of health goals, and improving adoption of healthy lifestyle behaviours.
53. Many private companies have been developing such technologies and some have built deep expertise in nudging health behaviour change. We will continue to explore collaborations with them to harness technology and insights to help us all take better ownership of our health.
54. We have also made healthy living rewarding with HPB Healthpoints. You can earn Healthpoints under programmes such as the National Steps Challenge. You will also receive Healthpoints after enrolling and completing the first consultation with your enrolled family doctor. We will continue to improve on this to encourage all of us as we choose better health.
Conclusion
55. With Healthier SG, it will be easier for everyone to start and sustain healthy living. Let me share a fictional example of how your health journey can look like.
56. Madam Anna, a 60-year-old resident in Jurong, meets her family doctor to discuss her health plan after getting her screening results. As Madam Anna is overweight and has high blood pressure and pre-diabetes, her family doctor recommends that she attends the “Live Well Age Well” programme to stay active and pick up nutrition tips to avert diabetes.
57. Madam Anna can scroll through the Healthy 365 app to find the “Live Well Age Well” programme nearest to her friend, so that they can attend together. She is also automatically registered for the “National Steps Challenge” and “Eat Drink Shop Healthy Challenge” where her daily healthy lifestyle activities help her earn Healthpoints to exchange for vouchers. The Healthy 365 app will also remind her to clock more steps, complete more moderate to vigorous physical activity (MVPA) minutes and offer other suitable activities to add variety.
58. During Madam Anna’s next half yearly check in with her family doctor, she proudly shares that she has become more active and has reduced her caloric intake by using the Healthy 365 diet logging tool to monitor her meals. The family doctor notes that Madam Anna has lost 2 kg in the past 6 months. Her high blood pressure is also under control. If Madam Anna continues to sustain her healthy lifestyle and manage her chronic condition well, the family doctor may consider reducing her regular medication at her next health consult.
59. Although Madam Anna is a fictional character, as demonstrated by Mr Loh and Madam Rahimah in my earlier example, it is possible to start and sustain a healthy lifestyle, and Healthier SG would make it easier for you to do so.
60. Enrolment for Healthier SG will start in the second half of 2023 for those aged 60 and above. In the meantime, you may download and explore HealthHub and Healthy 365 to access a wide range of preventive health resources and programmes.
61. Healthy living starts with you and me. Thus, as the Government strengthens support for preventive health under Healthier SG, I would also like to urge all of us to make a conscious decision to invest in our health. Let us strive towards living healthier and better lives.