EDUCATION ON SARS

Mr Chiam See Tong asked the Minister for Health how much has been spent and disbursed by the Government since March this year on expenditures in connection with the SARS epidemic.

Mr Lim Hng Kiang: Singapore was declared SARS free by WHO on 31st May 2003. This was achieved by Singaporeans coming together to deal decisively with the disease. Our healthcare workers in particular rose to the challenge. The battle against SARS, however, has been costly. To date, 32 people, including five healthcare workers, have died as a result of SARS.

SARS has also imposed a high financial cost on Singapore. As of 31st May 2003, the Government has spent $192 million on direct SARS operating expenditure. The Government has also introduced a $230 million economic relief package to assist businesses adversely affected by the SARS outbreak.

The largest share of direct operating expenditure as a result of SARS has been incurred by my Ministry. MOH and its two healthcare clusters have up to 31st May 2003 spent about $117 million on items such as:

a) the purchase of medical supplies and protective gear for healthcare workers and patients (eg, gloves, gowns, masks);

b) provision of free medical screening for SARS at Tan Tock Seng Hospital (TTSH);

c) provision of free ambulance service for persons requiring SARS screening;

d) setting up of fever clinics at polyclinics;

e) the administration and enforcement of home quarantine orders; and

f) setting up of contact tracing centre and SARS-hotline centre.

MOH has also committed to fund the healthcare clusters' essential SARS-related development expenditure for the setting up of isolation facilities in the hospitals and retrofitting existing medical facilities for provision of SARS treatment. The SARS-related development cost is estimated at $105 million.

These estimates exclude the indirect costs associated with SARS, such as the designation of TTSH as a SARS hospital which resulted in the closure of hospital wards, cancellation of elective surgeries and outpatient appointments.

The financial impact of SARS will not be one-off. The changes that we are instituting in our hospitals are here to stay, to ensure that we have in place proper infection control processes and procedures to deal with future outbreaks, be it SARS, or any other disease. My Ministry, with inputs from the two healthcare clusters, is in the process of working out the financial impact of SARS on a steady state basis. The baseline operating costs of hospitals will need to be adjusted to take into consideration the changes in requirements for personal protective equipment and patient management and work processes that are necessary to prevent another spread of SARS or other infectious diseases in Singapore. We will lose some efficiency but we will gain in stronger infection control measures. We are conscious of the potential impact of these changes on patients' fees and will try to moderate the impact, especially on lower income patients.

Mdm Ho Geok Choo asked the Minister for Education in view of the emphasis placed on personal and collective responsibility and on personal and social hygiene in the attempt to combat SARS, (a) will his Ministry reinstate "Hygiene" as a subject or, at least as a component of an existing subject, in the school curriculum; and (b) how will his Ministry inculcate self-discipline on students and their parents so that the students will put on face masks in the event that they contract ordinary colds and influenza.

RAdm Teo Chee Hean: Topics relating to personal hygiene and social responsibility in hygiene matters are currently covered in the Health Education syllabus at the primary level. Pupils are taught how to take care of their body, maintain a healthy lifestyle, and keep the environment around them clean and safe. They also learn about germs and how diseases can be prevented. Since the outbreak of SARS, personal hygiene has been further emphasised at school assemblies and in classrooms.

All parents have been reminded, through an advisory, not to send their children to school if they are unwell. They should take their children to see a doctor immediately and return to school only when they are well. There is therefore no need for students to put on masks to attend school. If they have a common cold or flu, they should not come to school. Instead, they should see a doctor. And, they should put on a surgical mask when they proceed from home to see the doctor. This education message is being propagated at the national level by the Ministry of Health. The Ministry of Education will reinforce this message through the schools.

In the event that a student is discovered to have a cold or flu in school, and there is a need for the student to put on a surgical mask, the school will provide the mask and ask the student to put it on whilst waiting for his/her parents to fetch him to see the doctor.