Singapore's healthcare landscape and its stakeholders involved have seen a few changes this past year. Here, the top seven stories that made the headlines this year are listed.

1. Singaporean surgeon given a week's jail after refusing to pay S$538,000 fine to SMC

Dr. Pang Ah San, 58, a general surgeon in private practice disobeyed court orders - to pay the Singapore Medical Council (SMC) S$538,000 in legal costs - after he was found twice guilty of breaching ethical guidelines by offering remedies that were only approved in clinical trials.

Prior to that, he was given two weeks to pay the SMC but he told the court that he was "as constrained as an impecunious debtor". Therefore, he was sentenced to a week's jail for contempt of court in September.

2. SMC updates ethical code and guidelines after 14 years

The SMC has released ethical code and guidelines for doctors that has not been updated in 14 years. This comes after six years of researching and collecting feedback.

The guideline is effective as of January 2017 and is the primary document that the SMC's disciplinary process will refer to, in combination with other documents such as the Medical Registration Act. It is stressed that it was not to restrict doctors in what they do, but to be used as a reference instead.

The revised code and guidelines emphasise on new areas of focus such as alternative medicine, telemedicine and end-of-life care, as well as updated guidelines on the granting of medical certificates (MCs) and doctor-patient conduct.

3. 56 cases of locally transmitted Zika virus in Singapore, new complication linked to virus

On 27th August, the Singapore government reported the first locally transmitted case of the Zika virus, a 47-year-old Malaysian woman resident. The following day, 40 more cases were reported, mostly localised within foreign workers are a construction site. As of 29th August there were 15 additional cases.

The community transmission of the virus is within the Aljunied Crescent and Sims Drive area, which caters to some industries and high-rise residential blocks. Clinics and hospitals were alerted by the Ministry of Health (MOH) to be "extra vigilant" and to report patients with symptoms associated with the virus - fever and rash.

As of end October, 415 cases were reported and Singapore declared that there were no more clusters.

4. Singaporean pharmacist jailed for illegally selling 20,440 bottles of cough syrup

For almost two years, a pharmacist falsified records in order to sell excessive quantities of cough syrup to individuals, and pocketed more than S$200,000 in profit.

Pharmacists are not allowed to sell more than two bottles or 240ml of codeine-based cough syrup at any one time, and are required to record the particulars of the customer who bought them. Codeine is listed as a poison under the Poisons Act as prolonged abuse can lead to addiction and side effects such as hallucinations and vomiting.

William Woo Tat Meng, 58, was sentenced to eight months and three weeks in jail for selling almost 2500L of codeine-based cough syrup illegally, making him the first pharmacist to be convicted of the offence under the Poisons Act.

5. New ethics code bans TPAs from being paid a percentage of doctors' fees

The SMC announced on 13 December that doctors are no longer allowed to pay a third-party agent (TPA) a percentage of the fee they get from patients as it will infringe the new medical code of ethics, which goes into force next month January 2017.

Previously, the SMC stated that fees should not be "primarily" based on the work done by doctors, or be "so high" to allow fee splitting, remaining ambivalent on this issue. The announcement comes after many doctors have complained in recent months that some TPAs have charged up to 25% of doctor's professional fees, especially medical concierges who demand payments just for referring a patient on a particular insurance scheme or panel.

6. MOH: Green light for pilot IVF embryo-screening in Singapore

Screening of in-vitro (IVF) embryos for chromosomal abnormalities before implantation will soon be allowed in Singapore at the National University Hospital (NUH). The three-year pilot Pre-Implantation Genetic Screening (PGS) programme will begin in early 2017 according to Senior Minister of State for Health Dr. Amy Khor.

Such screening is currently not allowed in Singapore, as many fear that the technique will be abused for selection of desirable genetic traits. However, the MOH is conducting the pilot programme to see if it "can improve the outcome of an IVF cycle in our local population, by increasing the live birth rate and reducing the risk of miscarriage and chromosomal abnormalities".

7. Doctors perform TAVR for Tetrology of Fallot patient for the first time in Singapore

Tetralogy of Fallot a congenital heart defect, affects two in 1,000 live births in Singapore and for the first time, doctors are able to treat it without open heart surgery.

The process known as trans-catheter aortic valve replacement (TAVR) sees a specially designed heart valve delivered into the patient via a leg vein near the groin. The procedure has been successfully carried out on two patients in Singapore since August, by a team of congenital heart specialists from the National University Heart Centre Singapore (NUHCS) and the department of paediatrics at National Hospital (NUH).

The procedure takes up to a few hours and improves heart function, delaying the need for an open heart surgery. MIMS

Read more:
Singaporean surgeon given a week’s jail after refusing to pay S$538,000 fine to SMC
New Zika cluster in Singapore, while company in Malaysia charged for breeding Aedes mosquitoes
Singaporean pharmacist jailed for illegally selling 20,440 bottles of cough syrup
New ethics code bans TPAs from being paid a percentage of doctors' fees
MOH: Green light for pilot IVF embryo-screening in Singapore
Doctors perform TAVR for Tetralogy of Fallot patient for the first time in Singapore