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Singapore's Ministry of Health Tightens Rules on Medical Certificates Amid Concerns Over Misuse

In Singapore, the ease of obtaining a medical certificate (MC) for a day off from work or school through teleconsultations has sparked concerns within the Ministry of Health (MOH). The ministry fears that some individuals are exploiting this system, and doctors may be too lenient in issuing MCs without proper medical grounds.


medical teleconsultation

Image: Freepik


A circular sent to doctors on 22 April 2024 by the MOH underscored the importance of maintaining the integrity of the patient-doctor relationship in MC issuance. It emphasized that an MC should be based on a genuine medical need, not on a patient's desire to skip responsibilities. Feedback from various employers and government agencies pointed to instances where MCs were given for non-medical reasons, leading to concerns about malingering and misuse of medical leave privileges.


The allegations included cases where MCs were repeatedly issued without further physical consultations to assess the patient's health status properly. Additionally, some MCs were issued solely based on self-reported reasons without adequate clinical assessment, violating ethical guidelines set by the Singapore Medical Council (SMC).


In response, MOH is considering amendments to the Healthcare Services Act to tighten the conditions for issuing MCs. Proposed changes include mandating the inclusion of the issuing medical practitioner's name and registration number on every MC and requiring prior medical or dental care for MC issuance.


The proposed amendments aim to ensure that MCs are issued responsibly and ethically, reflecting the duty of care that doctors owe to their patients. Furthermore, MOH may conduct inspections or audits to enforce compliance with ethical guidelines, with potential penalties for violators, including fines, license suspension, or revocation.


Teleconsultation services, which have become increasingly popular, are also under scrutiny. While they provide convenient access to medical advice, regulations implemented under the Healthcare Services Act aim to prevent the remote provision of medical services to first-time patients without prior in-person consultation.


medical teleconsultation

Image: Freepik


As Singapore moves towards tighter regulations on MC issuance and teleconsultations, the focus remains on maintaining the professionalism and integrity of medical practices while ensuring that patients receive appropriate care based on genuine medical needs.