Toddlers fall sick. Childcare sends them home. Then what is childcare for?

My position: We keep compensating parents for childcare disruption with more childcare leave instead of redesigning the system to actually solve the problem. If full-day childcare exists partly so parents can work, then childcare, healthcare and employment need to work as one system when children inevitably fall sick.

Monday morning.

My son had diarrhoea two or three times.

There had already been gastroenteritis cases in his Playgroup class. He was otherwise eating, playing and running around quite normally.

But he could not go to childcare.

We were subsequently told he needed medical clearance and had to be diarrhoea-free before he could return.

In practical terms?

Almost the entire working week gone.

Now, before anyone jumps, I am not saying the centre should have kept him that week.

Gastroenteritis spreads. If my son is genuinely infectious, vomiting, running a high fever or simply too unwell to participate, call me.

I will come.

He is my son.

I chose to have him.

But this was hardly the first time we received that phone call.

Your child is unwell. Please come and collect him.

Every working parent knows what happens next.

Meeting?

Cancel.

Work?

Figure it out.

Boss?

Sorry.

One parent disappears.

And after enough of these calls, I started wondering:

If childcare exists partly so parents can work, and toddlers fall sick all the time, then why does the system still end with “Parent, you settle” every time illness happens?

Then what exactly is the “care” in childcare?

Singapore’s childcare system was not created purely because toddlers needed somewhere to learn their ABCs from morning until evening.

During Singapore’s industrialisation, more women entered the workforce and childcare became an increasingly important part of enabling mothers to remain employed. NTUC Childcare was established in 1977 specifically in response to the needs of working mothers.

Of course childcare has evolved.

Today it is also about education, development and socialisation.

Good.

But it is still called childcare.

I pay for full-day childcare because, somewhere between breakfast and dinner, another responsible adult needs to care for my child while his parents work.

So when ordinary childhood illness repeatedly removes that care for days at a time, I think we are entitled to ask whether the surrounding system is still doing the job it was partly designed to do.

Not because children should never go home sick.

But because toddlers getting sick is not an exception. It is practically part of the operating model.

Children cannot grow up in sterile bubbles

I want sensible infection control.

I don’t want another parent dumping a genuinely sick child beside mine just because he has a meeting at 4pm.

Teachers are not nurses.

Preschools should not become infectious-disease holding centres.

But there is still a question worth asking:

Does every borderline symptom need to move immediately from “childcare” to “parent stops working”?

I am not proposing that centres simply loosen illness rules.

I am proposing that we test whether medically supported assessment can create a safe middle ground for cases that do not clearly require exclusion.

A runny nose but otherwise well?

Maybe observation is enough.

A mild cough but active?

Maybe observation is enough.

Something borderline?

Assess it.

Clearly infectious or too unwell to participate?

Call the parents.

I come.

The point is not to keep sick children in school at all costs.

The point is to stop pretending that the only two states are:

Normal classroom

and

Mum or Dad, come now.

The sick bay already exists. Build a proper care pathway around it.

ECDA already requires childcare centres to have a designated sick bay or isolation area for unwell children. Current guidance says an unwell child should be separated there while waiting for a parent to bring the child home or for medical treatment.

So the physical concept already exists.

Right now, however, the sick bay is mainly an isolation and waiting area.

I am not suggesting teachers should suddenly become medical staff.

I think we should test whether the sick bay can become one part of a broader, clinically supported pathway.

Not by putting a paediatrician permanently inside every preschool.

Build cluster-based medical support.

A group of preschools can share access to trained paediatric healthcare support.

Nurses.

Doctors when necessary.

Telemedicine.

Physical assessment where clinically required.

Centre sees something borderline?

Get it assessed.

Child is medically safe to remain for a period?

Separate and monitor under a defined protocol.

Clearly infectious or genuinely unwell?

Call me.

I come.

And yes—telemedicine lah.

Adults already use remote healthcare. KKH itself already provides digital paediatric guidance for common childhood conditions including fever, diarrhoea and vomiting, while PaedsENGAGE trains community GPs to manage common mild and moderate paediatric illnesses.

Not everything can be diagnosed remotely.

Fine.

Then send those children for physical assessment.

The point is not that every mildly sick toddler must stay in school.

The point is:

Create a medically safe middle ground between “completely well” and “parent must stop working now”.

Also, can we please have one bloody set of rules?

This experience became even more annoying after I read the national guidance.

ECDA says children who do not appear well enough to participate should not attend, and children who become unwell should be separated while parents are informed.

Fair.

But in the national ECDA guidance I reviewed, I could not find a universal rule saying every unwell child must be collected within two hours.

Nor did I find one blanket rule saying every diarrhoea episode requires exactly 48 symptom-free hours plus a doctor’s memo before returning.

Different diseases and outbreaks obviously need different precautions.

Operators may also need discretion.

But parents should know the basic rules before their kid falls sick.

How many episodes trigger exclusion?

When is observation enough?

When is immediate pickup mandatory?

When is medical assessment needed?

When can the child return?

How much discretion does an individual operator have?

Today it can feel like eating at a restaurant with no menu and no price tag.

You only discover the rules after you order.

Singapore standardised far more complicated things than this.

Give preschools nationally clear categories:

Observe.

Isolate and assess.

Mandatory pickup.

Medical review.

Return.

Allow disease-specific and outbreak exceptions where necessary.

Then make the baseline clear.

Parents know what to expect.

Centres know what they are responsible for.

Employers know what happens when a child is excluded.

Much less argument.

Parents: don’t abuse this either

Now my turn to whack parents.

I have written before about why I think Singapore needs to make a more sustainable career compatible with raising a family. If Singapore wants families, a modest career must be enough.

But being pro-family does not mean parents should be protected from every inconvenience that comes with the children we chose to have.

You miss your kid?

Take annual leave.

Preschool administrative day?

Take annual leave.

Want to attend something with your child?

Take annual leave.

Vaccination appointment?

Take annual leave.

Who asked us to have children?

Before kids, your annual leave might mean Tokyo.

After kids, sometimes Tokyo gets replaced by taking your toddler for his vaccination and spending the afternoon together.

That’s the deal.

Parenthood is a choice. Illness is not.

When my two-year-old is medically unable to attend childcare, he obviously cannot stay home by himself.

One parent’s ability to work has disappeared whether the employer, parent or Government likes it or not.

That is not leisure.

That is medical caregiving.

So call it what it is.

Give the child medical leave

Today, eligible working parents of Singaporean children below seven receive six days of paid childcare leave each, regardless of the number of children. NDR 2026 has announced future enhancements, but as of writing the current statutory entitlement remains six days.

I would redesign it.

Pilot 14 days of child medical leave per child, shared between both parents, paid by the Government.

Not 14 for Mum plus another 14 for Dad.

One child.

One pool.

The parents decide who uses it.

Child genuinely sick?

Doctor certifies it—including telemedicine where clinically appropriate.

Preschool excludes the child under the national illness protocol?

The centre can issue an official exclusion notice.

Employer honours either.

Everything else?

Annual leave.

Why 14?

I don’t know.

Maybe toddlers need 20.

Maybe older children average five.

Fourteen is not a magic number. It is a starting parameter for a pilot.

Collect the data.

Adjust it.

The more important principle is this:

Medical leave should follow the sick child, not an arbitrary household-level annual allowance.

Interestingly, Government already recognises the underlying idea. The Civil Service provides childcare sick leave on a per-child basis, and MSF has previously encouraged private employers to consider similar arrangements.

So hello.

We already know this isn’t some crazy concept.

We keep compensating parents for disruption instead of designing around the disruption

This is really what pisses me off.

Singapore says it wants to support families.

I believe it.

The Government spends serious money doing so.

My problem is not that Government doesn’t understand parents.

My problem is that we keep reaching for compensation before redesign.

Childcare costs money?

Subsidise.

Parents lose working time?

Give more leave.

Employers bear leave costs?

Government reimburses.

All useful.

Thank you.

But look at the actual journey when a toddler falls sick.

Preschool detects symptoms.

Healthcare determines what is wrong.

Employment absorbs the parent’s absence.

Preschool decides when the child returns.

These are four parts of ONE EVENT.

Yet they behave like completely separate systems.

And who connects all of them?

Me.

The parent becomes the integration layer.

I collect the child.

I find the doctor.

I tell my employer.

I get the document.

I send the document.

I ask the preschool whether the document is acceptable.

I ask when he can return.

Then I rearrange everything I was supposed to do at work.

For a country that is damn proud of process design, this is bloody clumsy.

Stop just compensating parents for childcare disruption. Design around the disruption.

And please, pilot faster

This is where I have even less patience.

Need more research.

Need consultation.

Need manpower studies.

Need cost analysis.

Need stakeholder engagement.

Yes lah.

Obviously don’t anyhow change infection-control rules for thousands of toddlers tomorrow.

But uncertainty should be a reason to pilot, not an excuse to move forever at committee speed.

Singapore has already demonstrated that it knows how to do this.

MOH’s preschool Health Plan was piloted in just six preschools in 2025. Feedback was collected, the approach was validated, and it is now being rolled out towards about 1,800 preschools by the end of 2026.

Exactly.

Do that.

Pick several preschool clusters.

Link them to a public healthcare provider.

Standardise the illness protocol.

Test cluster-based medical support.

Use telemedicine.

Create digital exclusion certification.

Trial the per-child medical-leave pool.

Then have one Government ministry or agency participate as an employer and lead by example.

Run the whole parent journey.

Six months.

One year.

What happened?

Did infections increase?

Did teachers get sick more?

How many pickups were avoided?

How much child medical leave did families actually use?

How many unnecessary GP visits disappeared?

Did employers cope?

Did parents abuse it?

Works?

Scale.

Doesn’t work?

Kill it.

Something partly works?

Keep that part.

Try again.

Sometimes the pilot should be the research.

We are not deciding whether Singapore should go to war.

This is domestic family infrastructure.

Keep the sample small.

Control the downside.

Just bloody try it.

When the phone rings

I am not asking preschool teachers to become doctors.

I am not asking employers to pretend parents never inconvenience them.

And I am not asking society to protect parents from every sacrifice that comes with having children.

We chose them.

We own plenty of the inconvenience.

But Singapore wants families.

Singapore wants those parents economically active.

Singapore built full-day childcare partly so parents can work.

Singapore also—correctly—wants infectious children kept away from other children.

Fine.

Then make those objectives work together.

Childcare protects the children.

Healthcare assesses them.

Employers respect genuine medical caregiving.

Parents own everything else.

Government makes the systems connect.

Toddlers falling sick is not some rare surprise we failed to foresee.

It is basically guaranteed.

Yet after all the childcare centres, subsidies, healthcare infrastructure, leave policies and pro-family messaging, when that phone rings the final operating procedure still too often becomes:

Which parent can stop working?

That cannot be where the design ends.

Because if full-day childcare is meant to help parents work, but ordinary childhood illness repeatedly sends the child home for days at a time with no proper bridge between childcare and employment, eventually every working parent is entitled to ask the obvious question:

Then we have childcare for what?