Hansard Explorer

Mr Yip Hon Weng asked the Coordinating Minister for Social Policies and Minister for Health regarding the multi-cluster healthcare system disruptions on 13 October 2026 (a) how will the Ministry monitor and resolve longer-term impacts on patient care; (b) why critical healthcare infrastructure lacked real-time redundancy to prevent operational disruption; and (c) what accountability frameworks will be enforced against institutions and their vendors to uphold service standards.

Ms Poh Li San asked the Coordinating Minister for Social Policies and Minister for Health (a) what are the findings on the cause of disruptions to multiple healthcare services on 13 October 2026 that affected all three public healthcare cluster; (b) what is the reason for the prolonged nine-hour duration before services were recovered; (c) whether there are backup systems that can be activated; and (d) how many appointments have been missed or cancelled as a result.

Ms Joan Pereira asked the Coordinating Minister for Social Policies and Minister for Health regarding the widespread system disruptions across all three public healthcare clusters on 13 October 2026 (a) what are the causes; (b) what is the estimated number of patients affected; (c) whether there is backup infrastructure in place; (d) if so, why did the backup infrastructure fail to prevent this disruption; and (e) what remediation steps are being taken to strengthen operational resilience.

Ms Cassandra Lee asked the Coordinating Minister for Social Policies and Minister for Health (a) whether the investigation into the 13 October 2026 service disruptions across the three public healthcare clusters has been completed; and (b) whether the Ministry is considering measures, such as redundancy systems, to mitigate future disruptions to digital services.

The Minister for Sustainability and the Environment (Ms Grace Fu Hai Yien): Mr Speaker, may I address Question Nos 45 to 48, and written questions —

Mr Speaker: Minister Fu, sorry, we will come to your Parliamentary Question next. For now, it is Senior Minister of State Tan. We are at Question No 41.

The Senior Minister of State for Health (Mr Tan Kiat How) (for the Coordinating Minister for Social Policies and Minister for Health): Mr Speaker, Sir, may I have your permission to address Question Nos 41 to 44 in the Order Paper together?

Mr Speaker: Please proceed.

Mr Tan Kiat How: Sir, my reply will also cover the related written questions on today's Order Paper, as well as the questions filed for a subsequent Sitting.

The disruption on 13 October caused inconvenience and concern to patients and their families, and created additional work for our healthcare workers. We apologise. It should not have happened.

The investigation found that this was not a cyber attack and there was no unauthorised access to, compromise or loss of patient data. The cause was a required security update to a shared Domain Name System (DNS) service that was not completed before a scheduled global change. DNS works like an internet address book, helping systems locate and connect to applications. This was a known change and a preventable lapse.

Synapxe had contracted a service provider to manage the necessary update, but it was not carried out. Synapxe is reviewing the provider's contractual obligations and will take appropriate action for any established lapses.

Regardless of the outsourcing arrangement, Synapxe remains accountable for the resilience of its critical systems.

The disruption lasted about nine and a half hours. Monitoring detected abnormal activity, but it took time to identify the underlying problem and restore services safely. Synapxe is strengthening monitoring and fault diagnosis to enable faster recovery.

Our public healthcare systems have back-up infrastructure, including two data centres. However, both depended on the same underlying DNS service and security configuration. Switching between them would therefore not have resolved this particular disruption. Synapxe will review such shared dependencies and strengthen alternative recovery arrangements.

Services affected included appointment bookings, visitor registration, medication dispensing and billing.

Healthcare institutions activated downtime procedures, with additional staff supporting operations and clinicians using selected read-only patient records and manual workflows to continue essential care. About 4,000 outpatient appointments were rescheduled and some patients experienced delays of up to two hours. No adverse patient-safety incidents were attributed to the disruption, in this case.

We are strengthening resilience in three areas: one, prevention, by improving the tracking and verification of critical technical changes; second, containment, by addressing shared dependencies and improving recovery arrangements; and third, ensuring continuity of care, by improving downtime systems, staff readiness and regular exercises, including for partial outages.

The Ministry of Health (MOH) will oversee the corrective actions and verify that they are effective. Synapxe has appointed an expert panel comprising representatives from other organisations that have similar engineering profiles to review the investigation findings, and propose remediation measures and identify further improvements.

Sir, digitalisation brings important benefits to healthcare. But as our systems become more interconnected, resilience must improve too. We must make our technology more reliable, while ensuring healthcare workers can continue caring for patients safely, even when technology fails.

Mr Speaker: Mr Yip.

Mr Yip Hon Weng (Yio Chu Kang): Thank you, Mr Speaker. I thank the Senior Minister of State for his response. My supplementary question is on concentration risk. Just five weeks before this incident, MOH said that having Synapxe as the public healthcare systems’ corporate IT function should not be regarded as presenting concentration risk. Yet, on 13 October, a single network connectivity issue affected all three healthcare clusters. So, what has this incident taught us about the common points of failure across our healthcare system? And does MOH still assess that there is no material concentration risk?

And I also want to ask the second supplementary question on the Epic system, which has been used by private clinics – will they be affected by this concentration risk as well?

Mr Tan Kiat How: Sir, we are mindful of any concentration risk and dependencies. But in this case, all three clusters and systems use the same global DNS service. It is a security trust anchor, and it is a global DNS route. In this case, even if you have three cluster services, you will still be back to the same dependencies, and in actual fact, for this disruption, decentralising the healthcare IT systems would therefore not necessarily have prevented the disruption. It could have made the diagnosis and recovery much more difficult.

On the question around Epic, it is an important point. We are very mindful of how to make sure that we look at some of the concentration risk and vendor dependencies as we embark on a common electronic medical record system across our healthcare clusters.

Mr Speaker: Ms Poh Li San.

Ms Poh Li San (Sembawang West): Thank you, Speaker. I thank the Senior Minister of State. I have two supplementary questions. First one, are the staff of the healthcare institutions currently trained to promptly switch to the manual systems to inform and reschedule appointments for such total disruption situations, so that both the patients and the doctors are not severely affected?

And the second supplementary question, in the longer term, are there plans to decentralise healthcare IT services to individual public healthcare clusters, to prevent a total failure situation across all three clusters in the future?

Mr Tan Kiat How: Sir, I thank the Member for her two supplementary questions. They are somewhat related. I will deal with them together.

Firstly, let me reiterate and thank our healthcare professionals, especially those at the frontline, for their understanding, patience and for taking on additional workload during the disruption of the IT services. They switched to downtime procedures, including activating additional staff and volunteers to support patient flows, registration, payments and appointments. And they used manual procedures and established workarounds, even if they were unable to have timely access to the IT systems.

So, these back-up plans and downtime procedures were activated and worked as planned. This is the result of the clusters doing their exercises on a regular basis. So, on that note, I wish to thank all the healthcare professionals and frontline staff for their understanding and patience.

As we look at deploying more digital systems in the healthcare sector, we will continue to look at how we can minimise concentration risk, build up redundancy and resilience efforts, and more importantly, have an approach in which there are common platforms that are provided by Synapxe as a central IT agency within MOH, to continue supporting the clusters and having systems that are actually closer to the frontline, closer to the healthcare professionals, for them to use.

So, it is not entirely centralised, but it is a hybrid between central systems, common platforms and decentralised services at the healthcare clusters. So, it is a balance of both.