District Judge Christopher Tan:
The Accused is a 49-year-old male. He claimed trial to a total of 24 charges, comprising: 13 charges under s 420 of the Penal Code (Cap 224, 2008 Rev Ed) (“Penal Code”), for cheating and thereby dishonestly inducing the delivery of property (“cheating charges”); and 11 charges under s 468 of the Penal Code, for forgery for the purpose of cheating (“forgery charges”).
At the end of the trial, I find the Accused guilty and convict him of: seven of the cheating charges, one of which (DAC 922412/2018) was amended by me prior to conviction; and seven of the forgery charges. I also acquit the Accused of the remaining six cheating charges and four forgery charges.
This trial took over three years to complete, in large part because of the COVID pandemic. Apart from necessitating the vacation of trial dates in the second quarter of 2020, the pandemic also engendered travel restrictions that prevented one of the Defence experts, Dr Alfred Lau Sze Lok (“Dr Alfred Lau”), from flying down to complete his evidence-in-chief. As will be seen, the key physical exhibits in this case included radiographs, some of which had distinct scratches and indentations on their surface that were central to the Prosecution’s case on the forgery charges. The Defence wanted Dr Alfred Lau to physically handle the radiograph films while answering questions on the stand. By November 2020, the Defence had completed adducing the evidence of all its witnesses, save for Dr Alfred Lau. Those aspects of Dr Alfred Lau’s evidence-in-chief which could be given remotely were completed via videoconferencing, leaving only those portions of his testimony which required him to handle the radiograph films while on the stand. Thereafter, the Defence made multiple attempts to fly Dr Alfred Lau from Hong Kong to complete his examination-in-chief, but these were repeatedly frustrated by the evolving restrictions on cross-border travel. After a year of trying, the Defence gave up and agreed to let Dr Alfred Lau complete the rest of his testimony remotely. In early March 2022, the Defence picked up on Dr Alfred Lau’s evidence in-chief, from where it left off some 15 months earlier. Dr Alfred Lau’s entire testimony (including cross-examination) was thus concluded over videoconferencing, without him physically handling the radiograph films while on the stand.
Upon conclusion of Dr Alfred Lau’s testimony in March 2022, the Defence was supposed to have closed its case. However, the Defence argued that the Accused had been prejudiced by Dr Alfred Lau’s inability to physically handle the radiograph films while on the witness stand. The Defence thus sought to call an additional expert (also from overseas) −this led to a further delay of about five months. When the Defence’s additional expert, Dr Firdaus Hariri (“Dr Firdaus”) finally took the stand, it was already August 2022.
Outline of this case
The Accused essentially faces two categories of charges: the cheating charges and the forgery charges. Both categories are factually related.
The Accused filed 13 Medisave claims with the Central Provident Fund (“CPF”) Board for clinical procedures purportedly performed by him on nine patients. The cheating charges alleged that the claims were false, on account of the procedures never having been performed.
The allegedly false Medisave claims related to three types of procedures: Mandible or Maxilla Alveolar Defect/Deformity, Complex Alveoloplasty: This is a procedure where granules of bone or bone substitutes are grafted onto the patient’s jaw to buttress the bone line, typically to ensure that there is sufficient foundation for a dental implant to be inserted later. The specific type of bone graft at issue in this case is the Autogenous Bone Graft, referred to as “ABG” for short. The word “autogenous” connotes that the graft material comprises bone harvested from a donor site within the patient’s body (as opposed to bone from extraneous sources). Mouth, Foreign Body (superficial), Removal: This is a procedure where a foreign body trapped in the patient’s gum is removed. This procedure for foreign body removal is referred to as “FBR” for short. Insertion of Endosseous Implant: This is a procedure where an implant is inserted into the patient’s jawbone and is referred to as “implant” for short. After the Accused made the allegedly false Medisave claims, the Ministry of Health (“MoH”) conducted an audit requiring him to submit documents showing that the procedures (for which the Medisave claims were made) had in fact been performed. The Accused duly submitted the documents, which included photographs of radiographs that had purportedly been taken of the patients’ mouths, both before and after the procedures.
The forgery charges allege that 11 of these photographs, which related to four of the nine patients above, were forged. The Prosecution’s case is that the Accused took photographs of actual radiographs, before altering the captured images so that the photographs that were printed out gave the impression that the procedures had been performed.
The charges
The nine patients to whom the cheating charges related were called as Prosecution witnesses: Chia Ching Choo, Catherine (PW3) (“Catherine Chia”); Chong Moh Chin (PW7); Neo Kheng Yew (PW4); Juliann Rick (PW5); Sum Marn Peng (PW6); Lee Kian Peng, Russel (PW2) (“Russel Lee”); Lee Chee Hung, James (PW13) (“James Lee”); Ng Pei Fen (PW11); and Tay Sai Gek (PW8). The forgery charges centred on photographs of the first four patients listed above (in bold), submitted by the Accused to MoH for the audit.
The key aspects of the charges are set out below:
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| No. | Patient | Offence | Charge | Summary of Alleged Conduct | Offence Date |
| 1. | Catherine Chia | s 420 Penal Code | DAC 922412 /2018 | Cheating the CPF Board by submitting a Medisave claim for ABG and FBR, when these procedures had not been performed, thereby dishonestly inducing the CPF Board to pay $1,900. | 28 Jun 2014 |
| s 468 Penal Code | DAC 922428 /2018 | Forgery by dishonestly altering a photograph of a radiograph by adding a white dot to the photograph, with the purpose of cheating MoH during an audit. | 24 Jul – 19 Aug 2014 |
| DAC 922429 /2018 | Forgery by dishonestly altering a photograph of a radiograph by altering the photograph to make a tooth socket appear more distinct, with the purpose of cheating MoH during an audit. |
| DAC 922430 /2018 | Forgery by dishonestly altering a photograph of a radiograph by adding white dots to the photograph, with the purpose of cheating MoH during an audit. |
| 2. | Chong Moh Chin | s 420 Penal Code | DAC 922413 /2018 | Cheating the CPF Board by submitting a Medisave claim for ABG and FBR, when these procedures had not been performed, thereby dishonestly inducing the CPF Board to pay $1,900. | 19 Jun 2014 |
| s 468 Penal Code | DAC 922431 /2018 | Forgery by dishonestly altering a photograph of a radiograph by adding a white dot to the photograph, with the purpose of cheating MoH during an audit | 24 Jul – 19 Aug 2014 |
| DAC 922432 /2018 | Forgery by dishonestly altering a photograph of a radiograph by labelling it with a date in 2014 when the radiograph was actually taken in 2007, with the purpose of cheating MoH during an audit. |
| DAC 922433 /2018 | Forgery by dishonestly altering a photograph of a radiograph by altering the photograph to make a tooth socket appear more distinct, with the purpose of cheating MoH during an audit. |
| DAC 922434 /2018 | Forgery by dishonestly altering a photograph of a radiograph by adding white dots to the photograph, with the purpose of cheating MoH during an audit. |
| 3. | Neo Kheng Yew | s 420 Penal Code | DAC 922414 /2018 | Cheating the CPF Board by submitting a Medisave claim for ABG and FBR, when these procedures had not been performed, thereby dishonestly inducing the CPF Board to pay $1,900. | 19 Jun 2014 |
| s 468 Penal Code | DAC 922435 /2018 | Forgery by dishonestly altering a photograph of a radiograph by adding a white dot to the photograph, with the purpose of cheating MoH during an audit. | 24 Jul – 19 Aug 2014 |
| DAC 922436 /2018 | Forgery by dishonestly altering a photograph of a radiograph by altering the photograph to make a tooth socket appear more distinct, with the purpose of cheating MoH during an audit. |
| DAC 922437 /2018 | Forgery by dishonestly altering a photograph of a radiograph by adding white dots to the photograph, with the purpose of cheating MoH during an audit. |
| 4. | Juliann Rick | s 420 Penal Code | DAC 922415 /2018 | Cheating the CPF Board by submitting a Medisave claim for ABG and FBR, when these procedures had not been performed, thereby dishonestly inducing the CPF Board to pay $1,900. | 13 May 2014 |
| s 468 Penal Code | DAC 922438 /2018 | Forgery by dishonestly altering a photograph of a radiograph by adding a white dot to the photograph, with the purpose of cheating MoH during an audit. | 24 Jul – 19 Aug 2014 |
| 5. | Sum Marn Peng | s 420 Penal Code | DAC 922416 /2018 | Cheating the CPF Board by submitting a Medisave claim for ABG and FBR, when these procedures had not been performed, thereby dishonestly inducing the CPF Board to pay $1,900. | 19 May 2014 |
| 6. | Russel Lee | s 420 Penal Code | DAC 922417 /2018 | Cheating the CPF Board by submitting a Medisave claim for ABG and FBR, when these procedures had not been performed, thereby dishonestly inducing the CPF Board to pay $1,900. | 19 Oct 2014 |
| 7. | Ng Pei Fen | s 420 Penal Code | DAC 922422 /2018 | Cheating the CPF Board by submitting a Medisave claim for ABG and FBR, when these procedures had not been performed, thereby
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