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Singapore’s MOH looking for recruitment agency to help recruit 240 doctors from India

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The Singapore Ministry of Health (MOH) through its company, MOH Holdings Pte Ltd, has put up a tender asking for a proposal for the “Appointment of a Recruitment Agency to Provide Services for the Recruitment of Doctors in India“.

The tender was put up earlier this month on 6 Sep. It closes next month on 10 Oct.

MOH Holdings (MOHH) is the holding company of Singapore’s public healthcare clusters – National University Health System, National Healthcare Group and Singapore Health Services.

On its website, the company said:

“Sharing the Ministry of Health’s vision to champion a healthy nation and ensure that our people live well, live long and with peace of mind, our role is to enhance public healthcare sector performance by unlocking synergies and economies of scale.”

In its tender document, it said that MOHH “intends to recruit doctors from India to work as Medical Officers in Singapore.” It said that the recruitment agency needs to “participate in and assist with” MOHH’s recruitment trips to India. The responsibility of the agency is to source viable doctors from India.

MOHH added that it hopes to recruit 60 Medical Officers from India annually from 2022 to 2024, with the option to extend “this project” for an additional year to 2025. In other words, MOHH wants to recruit as many as 240 Indian doctors from this tender project over 4 years.

In a separate tender, MOH is looking for recruitment agencies to provide services for a period of two years to hire medical staff such as nurses from overseas, not limited to India.

Number Of Approved Medical Universities In India Shrinks

MOH is going ahead with the recruitment of Indian doctors despite the fact that the number of Indian medical universities approved by the Singapore Medical Council (SMC) has been drastically reduced over the years.

The recognition of Indian medical schools by the Singapore authorities started after Singapore and India signed the Comprehensive Economic Cooperation Agreement (CECA) in 2005 between Indian PM Manmohan Singh and Singapore PM Lee Hsien Loong. On the 2006 SMC Annual Report, it proudly stated:

By the end of 2008, the number of approved Indian medical schools had gradually increased to 9.

Then in 2009, one of the universities was quietly removed from the list through a government gazette. It was the “Maulana Azad Medical College, Delhi University” which was removed from the approved list on 30 Oct 2009. No explanation was given. Since then, there were only eight medical schools from India recognized in Singapore:

However, on 18 Apr 2019, MOH suddenly announced that it would reduce the number of recognized foreign medical schools with effect from 1 Jan 2020. Only 2 Indian medical schools are left on the approved list:

Presumably, the 240 Indian doctors MOH would like to recruit would be coming from these two schools.

Would Singapore Get The Cream Of The Crop From India’s Medical Workforce?

It’s common knowledge that the medical education system in India is frequently filled with fraud and scandals. Top medical schools like the All‑India Institute of Medical Sciences (AIIMS) in New Delhi is no exception.

For example, in 2011, fraud was discovered in AIIMS’ entrance exams. A medical doctor who graduated from AIIMS together with others had been running a racket manipulating the answer sheets. Candidates would pay the gang several hundred thousands rupees to cheat in AIIMS’ entrance exams.

In 2014, AIIMS landed itself in a controversy over embezzlement of funds to the tune of 1 billion rupees. The revelation came after the Indian Health Ministry conducted an audit of AIIMS’s records over the past 5 years. It found that AIIMS had not refunded at least 530 million rupees to poor patients, who paid for various tests and treatment in advance. Irregularities were also found in the receipts for special procedures undertaken by patients. Furthermore, AIIMS had procured goods worth more than 330 million rupees without issuing any tenders.

In an investigative report, Reuters documented the full extent of fraud in India’s medical-education system. It found, among other things, that more than one out of every six of the country’s 398 medical schools has been accused of cheating. Rigging entrance exams or accepting bribes to admit students are common occurrences in India. Paying bribes – often in the guise of “donations” – to gain admission to Indian medical schools is widespread, as even the Indian Health Ministry admitted.

However, despite the negative news surrounding its medical graduates, India has nevertheless been the world’s largest source for immigrant physicians — particularly English-speaking OECD countries — since its independence.

Top Five Countries of Destination for India-Trained Doctors, 2014-16

According to data from OECD, United Kingdom had 18,953 India trained doctors in 2021, which is significantly more than any other source country, the second being Pakistan at 8,026. This trend had persisted for decades.

The foreign doctors who managed to find work in UK, would also be well-paid, with the average annual pay for a general practitioner in UK’s National Health System said to be £65,070 to £98,194 in 2022.

Now going back to Singapore, Dr Paul Tambyah, a senior consultant at the Singapore’s National University Hospital, who was speaking in his personal capacity at a forum back in 2017, shared that junior doctors had told him that every time they complain about conditions in public hospitals, the administrators don’t seem perturbed by it.

The public hospital administrators were said to have warned junior doctors who complained that they can be replaced with someone from the south or south-east Asia who is willing to work for S$3,000 a month (or annual salary of S$39,000 including the 13th month).

In support of the description made by Dr Tambyah, Singapore publication, Rice Media recently published an article talking about how young local doctors in the country are drained and gaslit through their work, with toxic working culture in hospitals and gaslighting via feedback when complaints from doctors are being made.

Suppose the shortage of medical doctors is due to poor working culture on top of the supposedly low pay. What quality of doctors would Singapore be expecting to be hired through its recruitment scheme in India with competition coming from those OECD countries such as the UK?

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Singaporeans to pay more for MediShield Life insurance from April 2025

Singaporeans will face higher MediShield Life premiums from April 2025, with rates increasing by up to 35% over three years. The government will provide S$4.1 billion in subsidies and MediSave top-ups to offset the impact, ensuring better healthcare protection against large medical bills.

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Singaporeans will face higher health insurance premiums from April 2025 as the government implements changes to the MediShield Life scheme.

The announced revisions on Tuesday (15 Oct) are part of an effort to enhance coverage and protect citizens from large medical bills, following recommendations from the MediShield Life Council after its 2024 review.

The government has accepted these recommendations, which aim to address the rising cost of healthcare and provide support for new types of care and treatments.

Premiums could increase by as much as 35%, with hikes being phased over three years, from April 2025 to March 2028.

By the end of this period, the average increase per policyholder is expected to be around 22%. A one-off S$600 million release from the MediShield Life Fund will be used to cap the premium increase at 35%, and the increases will be phased evenly.

Key MediShield Life Enhancements

The higher premiums will fund several improvements to the scheme. Among the most notable changes is an increase in the policy year claim limit from S$150,000 to S$200,000.

This adjustment provides greater assurance for patients with exceptionally large bills, particularly those requiring extended hospital stays. Additionally, daily claim limits for inpatient treatments will be raised.

For example, the claim limit for the first two days of a hospital stay will increase from S$1,000 to S$1,630, while limits for Intensive Care Unit (ICU) stays will more than double, rising from S$2,200 to S$5,140.

Outpatient care is also a focus of the reforms. The claim limits for treatments such as kidney dialysis will rise from S$1,100 to S$1,750 per month. In addition, new outpatient treatments, including home-based care and therapies such as repetitive Transcranial Magnetic Stimulation for depression, will be covered.

A new outpatient deductible of S$500 per year will be introduced on 1 January 2026, and co-insurance rates for outpatient treatments will shift from a flat 10% to a tiered structure ranging from 3% to 10%, depending on the size of the bill.

These changes aim to keep coverage focused on larger, more expensive bills, helping to moderate the extent of premium growth.

Expanded Coverage for High-Cost Treatments

MediShield Life will also begin covering high-cost treatments that are both clinically effective and cost-effective. This includes Cell, Tissue, and Gene Therapy Products (CTGTPs) for the treatment of cancers and other serious conditions.

Starting in October 2025, the government will extend MediShield Life and MediSave coverage to CTGTPs on the Ministry of Health’s approved list. The coverage limits will be sized to fully support two-thirds of subsidised patients, helping to make these cutting-edge therapies more accessible.

In addition, high-cost drugs for blood conditions and childhood-onset diseases will now be covered under the scheme. This expansion aims to improve affordability for Singaporeans needing expensive, life-saving treatments.

Premium Adjustments and Support Measures

The total premium increases over the next review cycle of three years will amount to S$1.8 billion, largely driven by the higher claims limits and expanded coverage. Older Singaporeans will experience larger premium increases, with adjustments reflecting the growing costs of healthcare.

To mitigate the impact of these increases, the government will provide an additional S$4.1 billion in support over the next three years. This support package includes S$3.4 billion in MediSave top-ups and S$700 million in premium subsidies. For the vast majority of Singaporeans—more than nine in ten—the combination of these top-ups and subsidies will more than offset the premium increases.

Premium subsidies will be enhanced by five to ten percentage points for lower- and middle-income Singaporeans in older age groups, allowing them to receive subsidies of up to 60%, up from the current cap of 50%.

The government will also provide MediSave top-ups for various groups, including an increase of S$300 in annual top-ups for the Pioneer Generation, bringing the maximum annual top-up to S$1,200.

Other one-time bonuses and top-ups will be provided as part of the Majulah Package. Singaporeans born in 1973 or earlier will receive a S$1,500 MediSave Bonus in December 2024, which has been enhanced by S$500.

Similarly, seniors from the Merdeka Generation and younger will receive an additional S$500 MediSave Bonus in 2025, aimed at helping those with lower balances cover rising premiums. For newborns, the MediSave grant will increase from S$4,000 to S$5,000 from April 2025, ensuring their premiums are fully covered until age 21.

Healthier SG: Incentives for Leading a Healthy Lifestyle

In support of the Healthier SG initiative, policyholders aged 40 and above will be able to redeem MediShield Life premium discounts via the Health Promotion Board’s Healthy 365 app.

Participants can earn Healthpoints by engaging in healthy activities, which can then be converted into premium discounts. For instance, an individual who engages in 30 minutes of moderate physical activity daily could redeem up to S$80 in premium discounts. The programme will start in the third quarter of 2025 as a three-year pilot.

The government will review the pilot’s outcomes before deciding whether to make it a permanent feature of MediShield Life.

Adjustments to Deductibles and Withdrawal Limits

The government will also adjust MediSave withdrawal limits so that patients can use MediSave to cover both the co-insurance and the revised deductibles.

This adjustment will help to alleviate the financial burden on patients as the first phase of the inpatient deductible increase is implemented in April 2025. The outpatient deductible will take effect on 1 January 2026, with the second phase of inpatient deductible increases following in April 2027.

Looking Ahead: The Future of MediShield Life

The changes to MediShield Life are designed to restore the scheme’s original mandate of fully covering nine in ten subsidised bills in public healthcare institutions.

With the growing shift in healthcare delivery towards outpatient, community, and home settings, as well as the rising costs of medical treatments, the council’s recommendations ensure that MediShield Life remains sustainable and continues to offer meaningful protection for Singaporeans.

As noted by the MediShield Life Council, these updates are essential to keep the scheme effective in the face of rising healthcare costs and evolving medical technology.

The government has assured that no one will be denied coverage due to an inability to pay.

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Survey reveals one-third of Singaporean youth struggle with severe mental health issues

A national study by the Institute of Mental Health reveals that 30.6% of Singaporean youth suffer from severe symptoms of depression, anxiety, or stress, driven by factors like excessive social media use, body image concerns, and cyberbullying. The findings emphasize the need for early intervention and targeted mental health strategies.

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A significant portion of Singapore’s youth are experiencing severe mental health challenges, according to a comprehensive national survey conducted by the Institute of Mental Health (IMH).

The National Youth Mental Health Study (NYMHS), released on 19 September 2023, found that 30.6% of individuals aged 15 to 35 reported severe or extremely severe symptoms of depression, anxiety, or stress, with key risk factors including excessive social media use, body shape concerns, and experiences of cyberbullying.

The study, which surveyed 2,600 Singaporean citizens and permanent residents, highlights the growing mental health concerns among Singaporean youth and suggests the need for more targeted interventions and support systems.

Mental Health Issues Prevalent Among Youth

Anxiety was the most common mental health issue, with 27% of respondents reporting severe or extremely severe symptoms, followed by depression (14.9%) and stress (12.9%).

These findings underscore the high prevalence of mental health issues among young people, particularly in those aged 15 to 24, who were more likely to report severe symptoms compared to older participants.

According to the IMH, young people who were female, single, unemployed, or had lower levels of education or household income were more prone to severe mental health symptoms.

For example, youth with monthly household incomes below S$5,000 were more likely to experience severe anxiety​.

Key Risk Factors: Social Media, Body Image, and Cyberbullying

The study identified three major factors linked to severe mental health symptoms:

  1. Excessive Social Media Use: Around 27% of respondents reported using social media for more than three hours daily, which was associated with a significantly higher likelihood of severe mental health issues. Youth with excessive social media use were 1.5 to 1.6 times more likely to experience severe symptoms of depression, anxiety, or stress​.
  2. Body Shape Concerns: About 20.2% of youth had moderate to severe concerns about their body image. These individuals were 4.9 times more likely to experience severe depression, 4.3 times more likely to experience severe anxiety, and 4.5 times more likely to suffer from severe stress​. Such concerns were often linked to social media exposure, which can perpetuate unrealistic beauty standards and increase dissatisfaction with one’s body.
  3. Cyberbullying: One in five youth (21%) reported being victims of cyberbullying. These individuals were approximately twice as likely to report severe mental health symptoms compared to those who had not experienced such harassment​. The anonymity and pervasive nature of online bullying exacerbates the mental health toll on young people, according to the study.

Demographics at Higher Risk

The study found that specific demographics were more vulnerable to mental health issues. Young people aged 15 to 24 were more likely to experience anxiety, depression, and stress, particularly females, those who were single, and those with lower levels of education, such as junior college or vocational qualifications​.

The Malay ethnic group was also found to have a higher prevalence of severe mental health symptoms compared to other ethnic groups​.

Barriers to Seeking Help and Sources of Support

Although about 69.1% of those with severe mental health symptoms sought help—primarily from family and friends—a significant portion of young people hesitated to seek professional support.

The top reasons included concerns about privacy, fear of judgment, and doubts about the effectiveness of professional services​.

Among those who sought help, family and friends were the most common sources of support (57.9%), followed by self-help measures (31.1%) and medical services (20.1%)​.

However, the reluctance to seek professional help highlights the need for continued efforts to destigmatize mental health treatment and increase awareness of available services.

Protective Factors: Resilience, Social Support, and Self-Esteem

The study also identified factors that helped mitigate mental health challenges. Youth who reported higher levels of resilience, perceived social support, and self-esteem were significantly less likely to experience severe symptoms of depression, anxiety, or stress.

This suggests that fostering strong support networks and building resilience in youth could play a critical role in improving their mental well-being​.

Government Response and Preventive Measures

The findings of the NYMHS support Singapore’s broader National Mental Health and Well-Being Strategy, launched in October 2023, which adopts a whole-of-government and whole-of-society approach to addressing mental health concerns. Schools have already begun integrating mental health education into their curricula, equipping students with the knowledge and skills to manage their well-being.

Additionally, the government introduced the Parenting for Wellness toolbox in September 2023 to help parents manage their children’s screen time and promote healthy social media usage.

A guide on responsible social media use, expected to be released by mid-2025, will offer further strategies to mitigate the negative impacts of excessive screen time and online harassment​.

Future Implications and Policy Development

Associate Professor Swapna Verma, chairman of IMH’s medical board and co-principal investigator of the study, emphasized the importance of early intervention.

“Not all individuals with severe or extremely severe symptoms of depression or anxiety have a clinical condition, but being in such states for a prolonged period of time can be detrimental to their well-being,” she said​.

The study’s data will help policymakers and healthcare providers develop more targeted approaches to address the mental health needs of Singapore’s youth, especially those most at risk.

Associate Professor Mythily Subramaniam, IMH’s assistant chairman of medical board (research), stressed the need to pay attention to issues like excessive social media use and cyberbullying, noting their “tremendous impact on youth mental health” and the importance of preventive measures​.

Support for Youth Facing Mental Health Challenges

Young people dealing with mental health challenges in Singapore have access to various resources:

  • CHAT (Centre of Excellence for Youth Mental Health): CHAT offers a safe and confidential space for youth to seek help through online and face-to-face mental health assessments and support.
  • Institute of Mental Health (IMH): IMH provides a comprehensive range of mental health services, including outpatient consultations and inpatient care. Youth in crisis can also seek immediate assistance from the 24-hour Mental Health Helpline at 6389 2222.
  • Samaritans of Singapore (SOS): SOS offers emotional support for those feeling distressed or experiencing suicidal thoughts. Their 24-hour hotline is 1767.
  • Health Promotion Board’s National Care Hotline: This hotline provides immediate emotional support for those in need and can be reached at 1800-202-6868.
  • Counselling Services: School-based counsellors, as well as community-based services such as TOUCH Youth, provide further avenues of support for young people grappling with mental health issues.
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