2. MINDEF treats every death of a serviceman with utmost seriousness. For each case, we conduct a thorough investigation to determine the cause and also to enable us to take all necessary preventive measures in the future. MINDEF has convened two separate inquiries to investigate the deaths of the 2 servicemen. As the investigation process has yet to be completed, it would not be appropriate for me to comment on their outcomes at this point in time.

3. Ms Indranee Rajah asked about the need for any consequential actions to be adopted by the SAF. Sir, the SAF did not wait for the outcome of the investigations but took immediate action by imposing a three-day time-out for all physical and endurance training to review their systems, processes and procedures. The review confirmed that the systems are good and sound, and that proper processes and procedures are in place and are being followed. The time-out allowed both commanders and soldiers themselves to re-focus on safety.

4. Ms Indranee Rajah and Mr Siew Kum Hong both asked about medical screening in the SAF. The investigation process have not yet been completed. It would therefore be premature to draw conclusions about whether medical conditions that might have been detected in pre-enlistment medical screening were factors in the incidents. Nevertheless, let me take the opportunity to describe the SAF's medical screening process.

5. The SAF carries out medical screening of our servicemen carefully. Medical screening takes place at several key junctures – before enlistment, before attending specialised courses, before strenuous training or deployment, and periodically after the age of 25.

6. A 12-lead resting electrocardiogram (ECG) screening is conducted for all pre-enlistees, and the SAF has 28 different protocols to address the different cardiac conditions based on their ECG findings. If abnormalities are found, the pre-enlistees will be sent for additional testing, which may include the stress ECG test or the 2D echo-cardiogram and referral to a cardiologist.

7. The 12-lead resting ECG screening was introduced in November 2000 on the recommendation by our panel of medical experts. The panel concluded that the findings of a study on the screening of competitive athletes in Italy were appropriate for the SAF and ought to be adopted by the SAF. The comprehensive study, published in 1998, showed that resting ECG was a reliable tool for screening for Hypertrophic Cardiomyopathy (HCM), which is one of the more common causes of sudden cardiac death among young adults. HCM is a disease of the heart muscle in which a portion of the muscle is thickened.

8. Sir, the introduction of the 12-lead resting ECG screening is an example of how the SAF keeps up with the best and most appropriate screening practices. It is guided by an independent panel consisting of top medical consultants and specialists in Singapore that sits regularly to review our medical screening regimes. In a recent review concluded last September, the SAF medical screening protocols were found to be comprehensive, robust and in line with good clinical practice. In fact, the SAF's routine screening for heart disease in pre-enlistees is equivalent to the standards recommended by the European Society of Cardiology and International Olympic Committee, and higher than the standards recommended by the American Heart Association. The SAF's screening protocols are also more comprehensive than those used by many other established armed forces.

9. Mr Siew Kum Hong asked for figures on SCD in the SAF since 1965, and how many of these were full-time national servicemen (NSFs). Sir, I am unable to cite figures starting from 1995. Specific data on SCD for the years before 1995 was not systematically collected as SCD in young adults then was not a well understood phenomenon in the medical community. The figures for 1995 to 2008 show that there were a total of 23 SCD cases in the SAF. Seven of them were of Full-time National Servicemen or NSFs, three of which occurred during training.

10. Mr Siew also asked whether any of these could have been detected by exercise ECGs or echocardiograms, and whether the SAF was going to introduce additional screening such as these. Of the seven NSFs who died from SCD, six were due to conditions that were most unlikely to be picked up by exercise ECGs or echocardiograms. The remaining one had a condition that could have been detected by exercise ECGs or echocardiograms. However, it occurred in 1999, a year before the SAF began conducting ECG screening for pre-enlistees. His condition could have been picked up by the 12-lead resting ECG that was introduced in 2000, and this pick-up would have led to him being referred to a cardiologist and subjected to an exercise ECG or echocardiogram.

11. Sir, MINDEF will continue to review our medical screening procedures, and amend the protocols or adopt new procedures should the SAF's panel of medical experts advise that it is appropriate to do so.

12. Thank you.

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