Louis asked the Minister for Health (a) whether the Ministry monitors manpower policies in hospitals with respect to nurses’ and doctors' rest days and off days for compliance with the Employment Act; (b) whether the present Omicron COVID-19 wave constitutes a situation under section 38(2) of the Employment Act which allows an employer to require an employee to exceed the limit of hours worked and to work on a rest day; and (c) how it ensures nurses and doctors have sufficient rest.

Dr Koh Poh Koon (for the Minister of Health): Sir, rest day provisions and work hour limits for public healthcare workers are governed by the Employment Act. For those healthcare workers that are not covered by the Employment Act, their rest day provisions and work hour limits are set out in public healthcare clusters’ employment contracts. 

COVID-19 has stretched our healthcare resources and placed a heavy burden on healthcare staff. All our public healthcare workers have been working doubly hard in this time of crisis. Whenever there is essential and urgent need that requires overtime work, employers will accord overtime pay as required by section 38 of the Act.

We urge cooperation and understanding from everyone as the hospitals reduce non-urgent and non-life-threatening care treatments to manage workload, decant those who need less intensive care to Community Treatment Facilities and curtailed visitations to hospitals. Public healthcare clusters have allowed staff to rest and recharge by taking days off, including taking annual leave, whenever possible. MOH is supporting them by doing whatever we can and stepping up on vaccination. We hope to turn the corner soon from this current wave of COVID-19 infections.

Louis: Thank you, Sir. I thank the Senior Minister of State for the reply. Could I just check, specifically, whether MOH has studied this issue further? In terms of overtime hours, how much are the nurses working overtime, the doctors as well during the past few months or two years in this pandemic? Two, I think it is really a manpower crunch. So, is MOH also studying the resignation rate, especially among the experienced healthcare workers, whom I understand are, leaving more as compared to the junior staff? And also, what is MOH doing to try and retain these workers?

Dr Koh Poh Koon: I thank the Member for his concern on the workload of our healthcare workers. As I have said, this is a crisis of a generation and it is the truth that many of our healthcare workers are going above and beyond their call of duty, extended hours, also in the primary care sector, our GPs as well. But this is their commitment to respond to the crisis and pulling their weight to make sure they become a strong last line of defence for our safety and our health. 

In MOH's Committee of Supply (COS) in the next few days, we will be giving a fuller response on some of the strategies that MOH will look at to support our healthcare staff and also to look at boosting our manpower resources over the coming decade. So, I hope the Member will give us time and we will share more and details in the coming COS.

Source: Hansard (Parliament of Singapore)

Louis asked the Minister for Health for each year in the past five years, what are the mean and median overtime hours worked per month per nurse and per doctor respectively. 

Mr Ong Ye Kung (MOH): MOH does not track the data for overtime hours for doctors and nurses. These are operational arrangements by the healthcare clusters and involve exigencies of service. 

Nevertheless, we acknowledge the hard work and effort put in by all our healthcare workers. During the COVID-19 global pandemic crisis, the pressure on our healthcare workers has increased tremendously. This is especially so over the last few months, because due to the Omicron variant, all healthcare workers have put in an exceptional amount of extra effort and hours to take care of patients and keep our healthcare system running. Even before the pandemic, our healthcare workers have been the backbone supporting our healthcare system and enabling us to strengthen and increase our healthcare capacity over the past decade. 

As we now hopefully turn the corner from the current wave of COVID-19, our public healthcare clusters will do our best to allow staff the opportunity to rest and recharge and take vacation days and annual leave whenever possible. 

Source: Hansard (Parliament of Singapore)

Louis asked the Minister for Health (a) whether the Ministry intends to have a cap on the number of hours a (i) nurse and (ii) doctor can work for each shift; and (b) if not, why not.

Mr Ong Ye Kung (MOH): The Ministry does not intend to impose any additional caps on the working hours for healthcare workers beyond what is already stipulated in the Employment Act or the public healthcare cluster’s employment contracts. In addition, for junior doctors, there are existing hospital guidelines such as total allowable work hours per week and the provision of sufficient rest periods. Public healthcare institutions should put in the necessary efforts to adhere to these guidelines.

The experience with the pandemic has shown us that there will be times where healthcare workers will be subject to exigencies of service. Flexibility in deploying healthcare workers is important to ensure that our public healthcare clusters can manage the operational needs on the ground. The public healthcare clusters have established workgroups to look into enhancing the support to healthcare workers and care model transformation that will ensure a more sustainable work-life balance.

Source: Hansard (Parliament of Singapore)

Louis asked the Minister for Health for each year in the past five years, what is the number and percentage of doctors who resign from public hospitals (i) within one year of completing their bonds (ii) within two years of completing their bonds and (iii) within three years of completing their bonds respectively.

Mr Ong Ye Kung (MOH): MOH only has data on attrition of doctors by their age. Over the past five years:

Among 29 year olds, attrition rate went up from 4% in 2018 to 6% in 2019, then dropped to 2% in 2020 and 2021; 

Among the 30 year olds, it was 8% in 2018 to 10% in 2019, then 5% to 6% in the last two years; and

Among the 31 year olds, it was from 6% in 2017, 9% in 2018, then 3% to 4% in the last two years.

There are many factors that affect attrition, including morale, job satisfaction, work conditions, and most importantly, a sense of mission. This explains why during the COVID-19 pandemic during the past two years, attrition rate generally dropped for doctors. We will continue to monitor these factors closely, and engage with staff to improve them, and address any issues.

Source: Hansard (Parliament of Singapore)