2024年3月6日，新加坡衛生部長王乙康在國會答覆議員關於健康SG計劃所取得的成效，以及接下來的方向。

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以下內容為新加坡眼根據國會英文資料翻譯整理：

主席先生，雖然我們解決了這些眼前的問題，但我們不應忽視醫療保健的長遠戰略方向。也就是說，繼續促進健康，而不僅僅是治療疾病。

我們已經明確了這一戰略，即以健康SG計劃為中心。黃玲玲女士、葉漢榮先生和賽義德哈倫醫生要求健康SG計劃進行更新。我非常高興地說，它的進展是令人鼓舞的。

讓我報告一些數據。自去年7月啟動該計劃以來，我們已經邀請了240萬年齡40歲及以上的新加坡居民參加。截至上個月，有76.5萬人選擇了他們選擇的家庭醫生。60%的人選擇了全科醫生，其餘的選擇綜合診療所。這是一個良好的分配，因為健康SG計劃的一個關鍵重點是賦予我們的全科醫生在人群健康中扮演更重要的角色。

超過一半的註冊者已經開始諮詢他們的醫生，制定個人健康計劃，並因此獲得了價值20新元的健康積分。超過124,000名註冊者已經接受了免費的疫苗接種和健康檢查。

在過去一年裡，由保健促進局組織的活動參與人數增加了16%，從133,000人增至154,000人。由人民協會組織的活動參與人數增加了12%，從約400,000人增至450,000人。而由新加坡體育局組織的活動參與人數增加了20%，從117,000人增至140,000人。

因此，我們看到人們變得更加積極地參與，他們在進行自己私人活動也顯得活躍。我認為這種變化是明顯可感知的。這就是新的活躍新加坡。

黃玲玲女士問到我們是否預期健康SG計劃患慢性疾病的患病率會下降。這確實是我們的目標。隨著健康SG計劃的良好開端，我們當然希望會實現這一目標，但這需要時間。

我們最近給尋求治療的健康SG計劃參與者提高了慢性疾病藥物補貼。在接下來的一年裡，我們或進一步改進該計劃。

首先，擴大健康協議的範圍。全科醫生根據健康SG計劃協議進行指導，以確保居民享受到一致和高質量的護理。目前已有12個協議，包括篩查、疫苗接種和常見慢性疾病管理。

衛生部將擴大協議的範圍，涵蓋更多的疾病，例如穩定性缺血性心臟病和穩定性中風。我們計劃從2025年初開始逐步推出這些協議。正如之前宣布的，我們也開始著手將心理健康的方面納入協議中。

其次，我們將改進健康計劃。目前，註冊醫生將共同制定健康計劃，作為預防保健諮詢的一部分。它涵蓋了一些必要的行動項目，如定期健康篩查和疫苗接種。但在生活方式方面，建議通常相當籠統，例如「多鍛鍊」，「健康飲食」。在2024年，我們將開始更加具體建議。例如，它可能建議你每周進行有氧運動三次。然後，可以使用Healthy 365應用程式找到住家附近合適的運動活動。Healthy 365也將提供多語言支持。

第三，我們將繼續通過樂齡SG計劃為長者推出干預措施，正如衛生部第二部長馬善高所詳細闡述的那樣。

第四，我們將繼續對抗糖和鈉的過度消耗。我們對預包裝飲料進行的營養評級標籤已經在改變消費者行為方面發揮了作用。我將定期親自檢查會員室中的飲料。有些人見過我這樣做。我很高興地告訴大家，它們全部都評級為「A」和「B」，並通過了衛生部的檢查。

然而，有一種飲料，「零糖咸荔枝味」。我給我的員工發了簡訊，問應該如何標籤這個飲料？是標為糖分還是鈉？他們告訴我只管喝就行。

我還遇到了一些學生，他們要求珍珠奶茶的糖分少一些，這樣就能達到營養等級「B」。作為教育部長，我總是告訴學生，不要太在意分數。但在這種情況下，注重分數並爭取「A」和「B」是好事。

最近我們已經將營養等級擴展到現調飲料上。我最近會見了兩個咖啡店協會並尋求他們的支持。協會領導人完全支持。他們代表新加坡一半以上的咖啡店，並打算提供少糖飲料，即使食客沒有特別說明。未來，如果點一杯咖啡，他們會給少糖的咖啡。如果想要更少糖分，我建議喝不加糖的咖啡。

如果攝入過量鈉可能導致心臟疾病和中風。它存在於鹽、醬油、蝦醬和其他調味醬中。在保健促進局的大力推動下，現在有超過60%的鹽批發商供應低鈉鹽。自從去年底推出「少鹽多味」運動以來，約有30%的餐飲行業支持該運動。食品飲料行業也有20%左右的企業支持。

最近我在8頻道看到了一個鼓舞人心的節目。有兩位女主持人，她們進行了為期21天的挑戰，減少食鹽和醬油的攝入量。在21天結束時，她們的血壓測量略有改善，但更重要的是，她們對鹽的味覺變得更加敏感。現在她們能夠更好地品嘗食材，她們以前不知道在品嘗食物時，還有大蒜、姜、香料的味道。她們以前只能嘗到醬油和蝦醬的味道，現在她們更喜歡少吃鹽。改變一個終身習慣需要21天的時間。

因為我們每天都要吃東西，食物的影響會在我們一生中逐漸累積。在我們的一生中，食物可以是良藥，也可以是毒藥。一位明智的中醫曾經告訴我，如果你吃得好，就不需要藥物；如果你吃得不好，藥物也沒什麼用。

以下是英文質詢內容：

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Mr Chair, while we address these immediate concerns, we should not lose sight of the longer-term, strategic direction of healthcare. That is, continue to build health, and not just treat illnesses.

We have crystalised this strategy around Healthier SG. Ms Ng Ling Ling, Mr Yip Hon Weng and Dr Syed Harun asked for an update on Healthier SG. I am very glad to say that it has been progressing encouragingly.

Let me report some data. Since the programme was launched in July last year, we have invited 2.4 million Singapore residents, aged 40 and above, to participate. As of last month, 765,000 have enrolled with a family doctor of their choice. Sir, 60% are enrolled with General Practitioners (GPs) and the remaining with polyclinics. This is a good split, because a key thrust of Healthier SG is to empower our GPs to play a greater role in population health.

Over half of the enrollees have started consulting their chosen doctors to develop a personal Health Plan and they have been rewarded S$20 worth of Healthpoints. More than 124,000 enrollees have received their free vaccinations and health screenings.

Over the past year, the number of participants in exercise sessions organised by the Health Promotion Board (HPB) has increased by 16%, from 133,000 to 154,000. For sessions organised by PA, participation has gone up 12%, from about 400,000 to 450,000. For SportSG's sessions, it has increased by 20%, from 117,000 to 140,000.

So, we see a discernible increase in people becoming active and individuals are also up and about on their own. The change, I think, is somewhat palpable. This is the new Active Singapore.

Ms Ng Ling Ling asked if we expect prevalence rate of chronic illnesses to come down due to Healthier SG. That is certainly our aim. With a strong start to Healthier SG, we certainly hope this will happen. But it will take time.

We have recently raised chronic drug subsidies for Healthier SG enrollees seeking care at their Healthier SG GP clinics. In the coming year, we plan to implement further improvements to the scheme.

First, expand the range of health protocols. GPs are guided by Healthier SG Protocols, to ensure that residents enjoy consistent and quality care. There are 12 protocols so far, which include screening, vaccination and management of common chronic diseases.

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MOH will expand the range of protocols to cover more conditions, such as stable ischemic heart diseases and stable stroke. We will start to roll them out in early 2025. As announced earlier, we are also starting to work on including aspects of mental health into the protocols.

Second, we will improve the health plans. Currently, your enrolled doctor will co-develop a health plan with you as part of the preventive care consultation. It covers essential action items, such as regular health screening and vaccinations. But on the lifestyle, the advice is always quite generic, such as "exercise more", "eat better". In 2024, we will start to make the advice more specific. For example, it may recommend you do aerobic exercise three times a week. You can then use the Healthy 365 app to identify suitable exercise activities near your home. Key features in Healthy 365 will be made multilingual.

Third, we will continue to roll out interventions for our seniors through the Age Well SG programme, which Second Minister Masagos has elaborated.

Fourth, we will continue to fight against overconsumption of sugar and sodium. Our Nutri-Grade labelling of pre-packaged drinks have been useful in changing consumer behaviour. I will regularly and personally inspect the drinks in the Members' Room. Some of you saw me do it. [Laughter.] I am glad to report they are all graded "A" and "B", and passed the MOH Ministerial inspection.

There is one drink, however, "zero sugar salty lychee". So, I texted my staff to say what do we label this for? For sugar or for sodium? They told me to just drink it.

I also encountered students who are asking for less sugar in their bubble tea, so that it qualifies for Nutri-Grade "B". As the Minister for Education, I always tell students, do not be so grade conscious. But in this case, it is good to be grade conscious and go for "A" and "B".

We have recently extended Nutri-Grade to freshly made beverages. I met the two key coffee shop associations recently and sought their support. The association leaders are fully on board. Together they represent over half of the coffee shops in Singapore, and they intend to start serving "siu dai" or less sugar beverages by default. This means when you order a kopi in future, they give you "siu dai", even though you do not say it. If you want even less sugar, I recommend just drink "kosong".

Sodium is the other culprit that can lead to heart diseases and strokes, if over-consumed. It is found in salt, soya sauce, belachan and other sauces. With much effort from the HPB, over 60% of wholesalers of salt are now supplying lower-sodium salt. About 30% of the catering industry are supporting our "Less Salt, More Taste" movement since it was launched late last year. 20% of the food and beverage industry are also doing so.

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I recently saw an encouraging programme on Channel 8. There were two lady hosts, they went on a 21-day challenge to take less salt and less soya sauce. At the end of the 21 days, their blood pressure measurements had moderated somewhat, but more importantly, their taste buds had become much more sensitive to salt. They could now taste the ingredients better, they never knew when they taste something, there are undertones of garlic, ginger, spices. They used to just taste soya sauce and belachan, and they prefer to eat less salt now. It took 21 days to change a lifelong habit.

Remember, because we eat every day, the effect of food accumulates through our lifetimes. Over our lifetimes, food can be medicine, food can also be poison. As a wise Traditional Chinese Medicine (TCM) physician once told me, if you eat well, there is no need for medicine; if you do not eat well, medicine is of little use.

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