Speech by Parliamentary Secretary for Health, Mr Amrin Amin, at the MOH Committee of Supply Debate 2018

EMPOWERING SINGAPOREANS TO LIVE A HEALTHIER LIFESTYLE

1.    We are encouraging greater Personal Responsibility for healthy living, and Community Partnerships to make healthy living more accessible and sustainable for Singaporeans.

2.    I will touch on three key areas – the War on Diabetes, health promotion efforts for all, particularly seniors and ethnic minorities, and tobacco control.

War on Diabetes

3.    Mr Chen Show Mao and Mr Baey Yam Keng asked for updates on the War on Diabetes. Ms Cheryl Chan spoke about helping Singaporeans lead a healthy lifestyle. 

4.    We will continue to support all Singaporeans regardless of economic and socio-economic backgrounds to eat healthily, be screened, and exercise, as part of our war on diabetes.

A.    Supporting all Singaporeans to eat healthily

5.    HPB’s Healthier Dining Programme offers more affordable, delicious and nutritious food options. In addition to food court and restaurants, we have extended the Healthier Dining Programme to coffee shops and hawker centres in December 2016. More than 3,000 stalls in coffee shops and hawker centres, as well as over 2,000 F&B places, are under this Programme. We now have healthier mee soto, chapatti and carrot cake, just to name a few. So yes, you can have your cake – just make sure it’s a healthier cake – and eat it too. So eating healthy and well is possible.

Support for healthier food innovation

6.    Mr Chen Show Mao asked for an update on plans to develop low-sugared foods and drinks locally.

7.    In July 2017, HPB launched the Healthier Ingredients Development Scheme (HIDS) to build our food sector’s capabilities to innovate and produce new healthier food products, like healthier oils, rice and noodles.  As of December 2017, we now have 14 partners offering 37 healthier products supplied to over 2,000 food and beverage stalls.

8.    Let me share one success story. With the support from HIDS, Mr Desmond Goh from People Bee Hoon invested in R&D, marketing and trade promotion of new wholegrain, healthier bee hoon. Sales of Chilli Brand wholegrain bee hoon doubled over the past months.  This means that more families are buying, cooking and eating healthier bee hoon.

9.    We will be further extending the HIDS grant to include sugar-sweetened beverages, desserts and sauces. Such food products contribute to about 90% of total sugar intake in our diet. I am happy to announce that HPB will be providing an additional $15 million on top of the current $20 million grant to support innovation in healthier food categories. This is a potential game-changer, benefitting Singaporean families and could contribute to reducing sugar in Singaporeans’ diet by 25% by 2020.

10.    We are working with MTI, through EDB and SPRING, to align our industry efforts, including through the Industry Transformation Map (ITM) for food processing. Together, we will spur businesses to innovate and market new healthier food products.

Measures on sugar

11.    Ms Tin Pei Ling asked about efforts to promote lower consumption of sugar-sweetened beverages (SSBs) and to help young children develop healthier dietary habits.

12.    Current efforts such as the Healthier Choice Symbol (HCS) and the Healthy Meals in Pre-Schools Programme have shown encouraging results. The market share of lower sugar beverages marked with the HCS symbol has grown from 30% in 2012 to 43% in 2017.

13.    Under the NurtureSG initiative, we have partnered with the Early Childhood Development Agency to ensure that all pre-schools only serve drinks with the HCS symbol from 1 January 2018.

14.    We are studying sugar-reduction measures from other countries such as the UK and France.  UK and France have implemented colour-coded front-of-pack labels for food and drinks. The UK uses traffic light colours to tell consumers whether a food item has high, medium or low amount of nutrients, such as sugar and saturated fat. France has Nutri-Score which scores the nutrient content of food and drinks. 

15.    Some countries have implemented a tax on SSBs to encourage manufacturers to reformulate their drinks and reduce the sugar content.  In March 2016, the UK announced a 2-tiered levy on pre-packaged beverages. The purpose is not to raise revenue, but to encourage product reformulation.  Although the levy only takes effect in April 2018, the UK authorities have shared with us that more than 40% of affected products have been reformulated.

16.    MOH will carefully review this and other measures to encourage product reformulation and conduct a public consultation before deciding our next steps.

B.    Encouraging more Singaporeans to be screened regularly

17.    If discovered early, interventions such as diet and exercise can prevent pre-diabetes from worsening. Younger Singaporeans are advised to go for diabetes screening if they are at higher risk of having diabetes. Risk factors include a family history of Type 2 diabetes, overweight or high blood pressure.

18.    We are helping Singaporeans between 18 to 39 to assess their risk for diabetes through the Diabetes Risk Assessment (“DRA”) on HPB’s HealthHub app. To date, the DRA tool has been used about 116,000 times by younger Singaporeans. Those identified as high risk for diabetes should go for medical screening.

19.    For those above 40, they should go for regular diabetes screening once every 3 years. They can benefit from the subsidised screening under Screen for Life initiative.

C.    Stepping up to the challenge of an active lifestyle

20.    On active lifestyle, we have made strides in the first two seasons of the National Steps Challenge. HPB has rolled out the third season in October last year. More than 650,000 people have signed up and clocked more than 260 billion steps. This is equivalent to 200 million km or more than 5000 times around the equator!

21.    We are working with SportSG to organise more fun social physical activities for all ages, so that Singaporeans can have access to them at various community and workplace settings.

Focused Health Promotion Efforts for Seniors and Minorities

D.    Supporting our older generation in active ageing

22.    I agree with Ms Cheryl Chan that we need sustainable preventive health efforts to address the needs of an ageing population. We have stepped up efforts to improve healthier living in this aspect.

23.    Through the Community Network for Seniors, HPB, with support from Silver Generation Ambassadors, has implemented several active ageing programmes.

24.    Let me share some highlights.

a) Over 24,000 seniors have attended the Seniors’ Health Curriculum, a series of workshops to improve seniors’ physical, mental and functional health.

b) Community Health Posts located in the neighbourhoods offer health screenings, regular health coaching and lifestyle follow-up for seniors, to help manage chronic conditions better. As of December 2017, over 3,400 senior Singaporeans have benefitted from these health coaching sessions.

c) Thirdly, we have started senior-centric exercise programmes such as Zumba Gold and FIT+, and mass workout sessions under the Community Physical Activity Programmes (CPAP). Over 159,000 older residents have participated.

25.    Ms Joan Pereira suggested that the Ministry review the information on diabetes management and diet for elderly patients and their caregivers. The Patient Empowerment for Self-Care Framework aims to help Singaporeans with diabetes initiate and sustain lifestyle changes. Under the Framework, we will develop a national curriculum to equip persons with diabetes with knowledge and life skills to manage their condition. We will take on the good suggestions by Ms Periera and we will review the information on diabetes management and diet for elderly patients and their caregivers.

Enhancing health promotion among ethnic minorities

26.    We are seeing greater awareness among Malay and Indian communities on health matters.  But there is more to do.

Health Promotion (Malay community)

27.    Sir, allow me to share in Malay some of the initiatives for the Malay community.

28.    Pada Ogos tahun lalu, saya melawat pelawak terkenal Alias Kadir. Alias terpaksa menjalani pembedahan untuk memotong bahagian bawah kakinya kerana penyakit kencing manis. Beliau sebenarnya menghidap kencing manis pada usia 40-an tahun, tetapi tidak mendapatkan rawatan. Akibatnya, beliau mengalami komplikasi. Nasi sudah menjadi bubur. Sebelah kakinya ibarat sudah berpatah arang – tidak boleh disambung lagi.

29.    Namun selepas pembedahan tersebut Alias berazam mahu berubah. Beliau juga mahu kita semua mengambil iktibar daripada pengalamannya. Bahawa sesungguhnya kita harus beringat sebelum terkena. Dan jika sudah terkena, janganlah meremehkan pentingnya pengambilan ubat dan menjaga makan minum. Serta jangan tidak endah rawatan susulan dengan doktor untuk mengawal penyakit kencing manis.

30.    Penjagaan kesihatan adalah komitmen seumur hidup. Kami sedang bekerjasama dengan ramai rakan kongsi dalam masyarakat untuk membantu masyarakat Melayu kekal sihat pada setiap peringkat kehidupan. Saya akan berkongsi tiga bentuk kerjasama,.

a)    Langkah Pertama – Ke Arah Pemakanan Sihat

31.    Kami mengorak langkah kerjasama dengan pihak-pihak penyedia makanan untuk secara perlahan-lahan mengubah cara pemakanan kita di peringkat masyarakat.

32.    Misalnya, kami sedang bekerjasama dengan Persekutuan Kulinari Halal Singapura (SHCF), dan katerer majlis-majlis perkahwinan seperti Eternally Yours dan Jamil Catering, supaya mereka dapat menyediakan pilihan makanan halal yang lebih sihat.

33.    Jadi menerusi langkah ini, diharapkan masyarakat akan dapat secara bertahap-tahap mesra kepada makanan sihat tetapi masih sedap rasanya.

b) Langkah Kedua – Ke Arah Masjid-Masjid Penggerak Kesihatan

34.    Menjaga kesihatan dituntut oleh agama. Kami sedang bekerjasama dengan MUIS dan hasilnya, tercetuslah program Jaga Kesihatan, Jaga Ummah (JKJU) di mana HPB bekerjasama dengan masjid-masjid menganjurkan kegiatan gaya hidup sihat. Dan hasilnya juga, 15 buah masjid kini menyertai inisiatif kesihatan ini. Kami berharap initiatif ini akan berkembang dan menjangkau 20 masjid menjelang akhir tahun ini.

35.    Apa yang dilakukan di masjid-masjid tersebut? Ia menyediakan perkhidmatan-perkhidmatan bagi membantu para pesakit kencing manis mengawal keadaan mereka, memberi pemeriksaan kesihatan dan juga aktiviti fizikal dilaksanakan. Kami gembira melihat lebih banyak masjid menyertai inisiatif seperti ini.

36.    Contohnya, Masjid Al-Mawaddah menghantar kakitangan kantin mereka untuk latihan memasak anjuran HPB agar hidangan yang lebih sihat boleh disajikan di masjid. Harapan kami, makanan sihat dan tetap sedap menjadi santapan di semua masjid sama ada sempena majlis keramaian, berbuka puasa, sambutan Hari Raya dan sebagainya. Masjid harus menjadi penggerak kesihatan ummah.

c)  Langkah Ketiga – Ke Arah Masyarakat Cintakan Senaman

37.    Kami akan menambahkan lebih banyak ruang dan peluang untuk masyarakat Melayu kita melakukan pelbagai aktiviti-aktiviti senaman atau fizikal. Saya misalnya sudah melancarkan inisiatif “Get Fit For Umrah” – iaitu mengajak para Jemaah supaya membina kesihatan dahulu sebelum mengerjakan umrah. Ini dilakukan dengan sokongan syarikat TM Fouzy Travel and Tours tahun lepas.

38.    Kami akan mengembangkan lagi program ini supaya lebih ramai Jemaah umrah dan haji dapat meraih manfaatnya. HPB akan bekerjasama dengan Persatuan Agensi Pelancongan Muslim Singapura (AMTAS) untuk menyertakan lebih banyak agensi-agensi Muslim supaya menggerakkan juga inisiatif ini. Supaya selain terkenal sebagai Jemaah yang penuh disiplin di Makkah dan Madinah, Jemaah Singapura juga dikenali sebagai Jemaah yang sihat-sihat dan cergas belaka!

39.    Saya gembira dengan sokongan masyarakat yang kuat. Mereka yang turut serta di 4 sesi perbincangan kesihatan ‘Awak Ok’ di Geylang, Jurong, Tampines dan Woodlands; yang turut besenam bersama, contohnya di sesi zumba di Tampines Hub; dan yang turut menyinsing lengan – para doktor, jururawat dan rakan dari Persatuan Profesional Penjagaan Kesihatan Islam (MHPA). Ayuh kita sama-sama berusaha membina masyarakat yang cergas, sihat dan afiat!

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(In English)

28.    In August last year, I visited well-known comedian Alias Kadir. Alias was forced to undergo a surgery to amputate his lower leg due to diabetes. He actually had diabetes in his 40s but did not seek treatment. As a result, he had complications.

29.    Nevertheless, after the operation, Alias is determined to change. He also wants us all to take a lesson from his experience.  Indeed, we should remember before it hits us. And if it hits us, don’t underestimate the importance of taking medication and watching our food and drinks. And don’t forget follow-ups with doctors to manage diabetes.

30.    Staying healthy is a lifelong commitment. We are working with many community partners to help the Malay community stay healthy at each stage of life. I will share three areas of cooperation, that are among the steps towards a healthier life for our community.

a) FIRST STEP – TOWARDS HEALTHY EATING

31.    We are cooperating with food preparation organisations to slowly change the way we eat in the community.

32.    For example, we are working with Singapore Halal Chef Federation (SHCF), and caterers such as Eternally Yours Pte Ltd and Jamil Catering and Trading Services LLP to provide healthier halal food choices in their events.

33.    Through this step, we hope that the community can gradually enjoy healthy food without compromising on taste.

b) STEP TWO – TOWARDS MOSQUES AS HEALTH MOVERS

34.    Taking care of our health is part of our religious obligations. We are working together with MUIS and the result is the Jaga Kesihatan, Jaga Ummah (JKJU) programme where HPB works with mosques to organise healthy lifestyle activities. And also as a result, 15 mosques currently participate in this health initiative. We hope this initiative will reach 20 mosques by the end of this year.

35.    What will be done at these mosques? The mosques will provide diabetes support, health screening, and physical activity. We are happy to see more mosques taking the initiatives to promote healthy living.

36.    For example, Al-Mawaddah Mosque, has sent their canteen staff for HPB’s culinary training to serve healthier dishes in the mosque. Our hope is that healthy yet delicious food is served during gatherings, breaking of fast, Hari Raya celebrations and others. The mosques should be the health movers of the community.

c) STEP THREE – TOWARDS EXERCISE-LOVING COMMUNITY

37.    We will increase opportunities for the Malay Community to exercise and be physically active. I, for example, launched the “Get Fit for Umrah” initiative – which invites the pilgrims to build their health first before umrah. This is done together with the support of TM Fouzy Travel and Tours last year.

38.    We will be scaling up the programme so that more pilgrims to umrah and haji will benefit. HPB will be working with the Association of Muslim Travel Agents Singapore (AMTAS) to reach out to more agencies to offer the initiative. So that aside from being known for their discipline in Makkah and Madinah, our Singapore pilgrims will also be known for their health and fitness!

39.    I am happy with the strong support from the community. Those that participated in the 4 Health Conversation sessions “Awak Ok?” at Geylang, Jurong, Tampines and Woodlands; those that work out together, for example at Zumba sessions at Tampines Hub; and those that have also rolled up their sleeves – doctors, nurses and friends from Muslim Healthcare Professional Association (MHPA). Let’s work together to build a community that is fit and healthy.

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For the Indian community

40.    Indian community organisations like Hindu Endowment Board and SINDA are actively promoting healthy living to the Indian community. We want to complement and build on these efforts in three ways.

a) One, we will intensify health outreach to the Indian community through places of worship, Indian F&B outlets and Indian media to promote healthy eating, regular physical activity and regular health screening and follow-up.

b) Two, we are partnering Sikh and Indian temples to bring health programmes such as screening, exercise and healthy cooking programmes.

c) Three, we will leverage social networks to train Health Ambassadors and equip them with skills to actively reach out to and promote healthier living to their family and friends.

Tobacco Control

41.    The final key focus area of my speech is tobacco control.

42.    Dr Chia Shi Lu asked what other measures we are considering to reduce tobacco use in our population.

Public education

43.    This year, we will be launching a new public education campaign to encourage Singaporeans to live a tobacco-free lifestyle.  We will reemphasize the harms of environmental tobacco smoke and the harms of tobacco. We will have a ground-up campaign involving youths in schools and institutes of higher learning. HPB will also work with partners such as the Singapore Cancer Society and the Football Association of Singapore and other partners to reach out to all and, in particular, youths, on social media, in schools and in other places.

Smoking cessation

44.    We will continue to enhance our smoking cessation services to support smokers on their tobacco-free journey. HPB will engage more workplaces, such as taxi and bus transportation sectors to help their employees to quit smoking.  We hope to see more companies create a health promoting working environment for their staff.

45.    There continues to be a debate on e-cigarettes. We debated this last November. Our position is clear. Any product that contains nicotine can cause addiction and pose risks to health, including e-cigarettes. We want a nicotine-free and tobacco-free future. We will allow e-cigarettes only if they are scientifically proven to be effective nicotine replacement therapy products, for smoking cessation.

Standardised packaging

46.    MOH is also considering introducing standardised packaging. Singapore recently announced a public consultation to gather detailed views on a proposal for the introduction of standardised packaging together with enlarged graphic health warnings.

47.    The public consultation will end on 16 March 2018 and we invite interested parties to submit their views. A final decision on whether to introduce the standardised packaging proposal will be made only after the public consultation. We will ensure that any measures, if introduced, are consistent with Singapore’s domestic laws and international obligations.

F.    Conclusion

48.    MOH will continue to invest and promote good health. We will work closely with individuals, families, industry and community partners. But personal responsibility for healthy living remains key – each of us has to do our part.  Our goal is to realise a sustainable healthcare future where all Singaporeans enjoy Better Health, Better Care, Better Life. We ask for your support. Thank you.