Aline K. Wong
Singapore
“The ENABLE (Encouraging Achievement and Better Learning) programme gives additional support to those who are not achieving their potential. Our curriculum has given more emphasis to critical and creative thinking skills.”
“Can I just take one more second on the waiting list because Mr Ahmad Magad mentioned that the waiting list is long? There are 18 SPED schools now which cater to about 4,000 children. Of the 18 SPED schools, eight have waiting lists.”
“Sir, I am sure the Member in his meet-the-people sessions has also encountered cases where some families pleaded for priority to be admitted on grounds of, say, the child's sickness, or that the mother is working and is unable to bring the child to school, or that the grandparent cannot manage to take care of so many grandchildren.”
“I think he did not hear what I say. For both of these families, someone who lives within one kilometre or next door and someone who lives right on the border of this one kilometre, or of any delineation you choose to draw, my point is that for both of them, this is their nearest school.”
“Principals, as part of their duties, are always alert to what is happening in the school. They have also been given guidelines, in the Principals' Handbook, on discipline and the code of conduct which is expected of the teachers and staff members. But having said that, all these things are not foolproof.”
“It will continue to stagger the rental increase to market levels for assignment of tenancies, subletting cases and for tenants who are renewing their tenancies for the third time. Shop lessees can also apply to convert to shorter leases to reduce the cost of servicing their mortgage loans.”
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“Mr Speaker, Sir, the services of specialists are available equally to Class C and the subsidized patients in Class B2 wards. Upon admission, each patient will be reviewed by the consultant in charge of the unit, and then a specialist will be assigned to the patient according to the complexity of the case. As for the second question, Sir, the normal procedure is that when a patient is admitted, he will be given information on the range of charges at the Government and restructured hospitals by the counter clerk and, in addition, a pamphlet which publicises these charges and the range of facilities is made available also at the counter.”
“This Bill also gives the President three additional powers, ie, to oversee the implementation of the ISA and the Maintenance of Religious Harmony Bill after it becomes Law so that the power of the Minister will be subjected to some checks and balances. As for the power of the CPIB to carry out investigations, it is an extension of preserving the integrity of our public service. All these additional powers should be welcome. This Bill gives the President some extra power, but it also provides for some checks on his power. Generally speaking, this Bill is worthy of our support for three reasons: Firstly, it provides a safeguard for our national reserves and assets and to maintain the integrity of our public service. Secondly, it provides a check and balance on our political system. Thirdly, it does not contravene or violate the spirit of democracy and will not affect the operation of our parliamentary system. Of course, no system can be said to be perfect and flawless. The Elected President will further institutionalise our political system and will provide an additional level of safeguard to the future of our country. But it is not an absolute safeguard because the destiny of our country is determined largely on the quality of our people and the values upheld by our people. If we do not maintain our spirit of diligence and prudence, and continue to strive for better standard of living, and if we keep on thinking of how to dip into our more than $30 billion of reserves, then no system whatsoever will prevent our country from going down the hills. Therefore, I wish to reiterate that while we are discussing this Bill on the Elected President, we must reaffirm the importance of qualities of our people in nation building.”
“It would also mean the possibility of more friction and confrontation between the President and the Cabinet. Assessment and appointment of people are difficult taks and they always involve some subjective elements. Someone who is considered to be "cautious" by the Prime Minister may be considered to be "indecisive" by the President. Similarly, one who is thought to be "decisive" by the Prime Minister may be thought to be "rash and arbitrary" by the President. Of course, if the President and the Cabinet disagree about the appointment of the Chairman, PSC, it may be worth the while. But if they argue over the appointment of a director of Telecom, then I think it is not necessary. From among the statutory boards listed in the 1988 White Paper, SBC and CAAS have been deleted. However, I note that under the proposed Article 22(4) of the Bill the Elected President can declare by order in the Gazette that any statutory board with reserves of more than $100 million be subjected to the jurisdiction of Article 22. Thirdly, the 1990 White Paper pointed out that a substantial part of the assets of the Government is held in statutory boards and Government-owned companies. For this reason, the concurrence of the Elected President is required for key appointments and budgets of statutory boards and Government companies. But on the other hand, if the Government, through privatisation and reorganisation, reduces the reserves in any particular statutory board or capital in any particular Government company to below $100 million, then Articles 22 and Article 22A, 22B and 22C will not be applicable to them. In that case, will these Government-owned companies or statutory boards be subjected to the powers of the Elected President?”
“However, I feel that, apart from these three financial institutions, the concurrence of the Elected President will not be necessary for key appointments in the statutory boards and the Government-owned investment and holding companies. I do appreciate that we must have capable and honest people to hold key appointments in our civil service. The second function of the Elected President is to make sure that our public service will not be undermined by nepotism or political appointments. For this reason, I support the provisions under the proposed Article 21 whereby the concurrence of the Elected President will be necessary for key appointments in the civil service, judiciary and the armed forces, etc. However, the appointments in statutory boards and Government-owned companies are different from that of the civil service, judiciary or armed forces, etc. Let me elaborate: (1) The statutory boards have specific duties and functions in our economic or social development, such as providing infrastructure and public utilities. They enjoy great autonomy and flexibility in financial and operational management. So under the proposed Articles 22 and 22A of the Bill, will the function of the Elected President diminish the flexibility of these statutory boards, thereby affecting their efficiency? Similarly, apart from being owned by the Government, the Government-owned companies operate in the same way as the private companies and are subject to test of the market. Why must the President interfere with their key appointments, thus affecting their operations? Secondly, as the function of the Elected President is expanded to the appointment of key positions, the powers of the Cabinet will diminish.”
“From among the developing countries, there are many examples of government spending in an extravagant manner to attain short-term political objectives by providing subsidies and free services, thereby causing their economies to be ruined. Even among the developed countries there are many governments which have to face budgetary deficits because of their welfare policies. However, these countries have very rich natural resources which could be relied upon in times of economic crisis. But if we look at our country, our financial reserves can be said to be the only asset that we can rely upon in time of crisis. Therefore, we must have a safeguard so that our assets will not be spent away by any government through extravagant spending. Our Elected President will provide such a safeguard. When the Government's expenditure exceeds its income, there are three alternatives to finance its deficits: (1) by borrowing, (2) by withdrawing from reserves, and (3) by printing more money. Under this Bill, the first two alternatives would require the concurrence of the Elected President. As for the random issue of currency notes or printing more money, it would be more difficult to do under our Currency Board system. However, we must have people of high integrity to be the Chairman, Directors and Chief Executive Officers in our Currency Board and the Monetary Authority of Singapore. These two institutions are very important financial institutions. They are just like the Central Bank in other countries. For this reason, the consent of the Elected President is necessary for their budgets and key appointments in these two institutions. Similarly, the CPF Board manages the savings of our people and therefore it should also be included in the list of functions under the Elected President.”
“Before I end, I like to join other Members of the House in applauding the safeguarding roles of the Elected President vis-a-vis the Internal Security Act, the Maintenance of Religious Harmony Bill and CPIB investigations. These features are widely welcomed as additional checks and balances on the Executive body. Finally, Sir, the Bill proposed before us, as Dr Tony Tan pointed out, is a very complicated Bill. It is a very important Bill and it has tremendous consequences for the entire process of government in future. We must examine the Bill most thoroughly and I also hope that members of the public would come forward to present their views at the Select Committee stage. I am a little disturbed by the widespread lack of interest in the Bill at the grassroots level. These two days we also saw a very empty Strangers' Gallery. But ordinary Singaporeans must not forget that once these amendments are passed, they will be firmly entrenched. Any future amendments will take not just a two-thirds majority in this House to change, but also two-thirds of all the electors' votes in a national referendum. Thus, we must exer- cise the greatest care and introduce refinements to this Bill. I admit that some of the points I raised cannot be addressed by the Bill as such because some of the points are not procedural matters. I think we should give the system a trial and during the interim period I should hope that definitions and boundaries would become clearer in our minds. Dr Ow Chin Hock (Leng Kee)( In Mandarin): Mr Speaker, Sir, I support this Bill which provides for an Elected President and I understand the objectives and background of this Bill.”
“It all depends on the personalities involved. Therefore, it is most important that Presidential candidates must be of the highest calibre. I agree that qualifications for Presidential candidates must be very stringent. There are broadly two types of qualifications as prescribed by the Bill. One is personal integrity; the other is financial management experience. The two are not mutually exclusive. In fact, as seen from the list of eligibles, these qualities are expected to come together in the same person in most cases. However, this list seems to be too restrictive. In fact, has the government tried to estimate how many Singaporeans altogether can qualify to be Presidential candidates? Just now we heard from one Member of the House who speculated that we might be faced with a situation where there might be only one nomination. So along with others, I think there may be a need to include a larger pool, for example, to include prominent citizens who are known to have made contributions to our society but who may not have had the requisite experience with financial management, just as in the case of the Chief Justice, Speaker of Parliament, Attorney-General, High Court Judges, with due respect to the present ones. After all, the President will be assisted by his Council of Advisors. This brings me to a related point, nominees to the Presidential Council. At least, the majority of them should have the requisite financial experience in order to play their crucial role in advising the President on the matter of reserves. I should think this requisite financial experience is of more importance for the Presidential Council members than perhaps for the Elected President himself.”
“The effectiveness of any government depends to a very large extent on how it can move the civil bureaucracy along with its policies. Civil servants are supposed not to have personal pet ideas of their own, but are supposed to conduct themselves in the best tradition of the British civil service, ie, to work strictly according to the direction and policies set by Ministers. But is this always the case in reality? Anyone who has read the popular novels or watched the popular TV series on "Yes, Minister" and "Yes, Prime Minister" would have had a good laugh. But are these satires not somewhat close to life? Now, with the top civil servants' appointments being subject to the Elected President's approval, a troublesome scenario can be developed, if the Elected President holds very different views on policy matters from the Prime Minister. Perhaps we could think about putting a maximum on the number of times that the Elected President can reject the Prime Minister's nominations of the key civil service positions. Sir, one of the crucial things on which the success of the Elected Presidency mechanism hinges on is the question of whether there could be differences in policy viewpoints. In standing for general elections, a political party and its candidates will have to make known its views on policy matters. Does the same apply to candidates standing for election to the Presidency? Or is it sufficient already for the Presidential candidates to emphasise their personal integrity and financial prudence? Given the high qualifications which all the Presidential candidates must satisfy before being nominated, how can the people choose between which candidate to vote for? At the end, they may have to choose between personalities? Is this good or bad?”
“But the result is, the government is also likely to pursue conservative, even deflationary fiscal policies, which may not be appropriate at certain times, such as during recessions. Perhaps, there is also a philosophical problem involved in the continuous accumulation of reserves. No doubt we must take precautionary measures to guard our reserves. We must save for a rainy day. If every successive government turns out to be good and prudent, the amount of reserves will keep accumulating. The inter-generational transfer of wealth will keep going on. Which generation of Singaporeans will be able to benefit from all the previous generations' hard efforts? I have heard some remarks by our own citizens saying, "Singaporeans are like poor little people who live in a rich country." No doubt such remarks tend to come from people who wish for more Government subsidies and less taxes, and this would not do. But the question is still this: Do governments spend money or dip into reserves only to gain popularity with the electorate? Is there no possibility for governments to spend money in order to shape the society in directions which are in genuine accord with the population's deeply held values? In addition to his vetoing powers over budgetary matters, the Elected President can veto nominations to key offices within the civil service and the key statutory boards. I think this is good. It will prevent a Prime Minister from appointing his own cronies. The CPIB would take care of corruption cases. So the question is the possibility of a future Prime Minister appointing incompetent civil servants. I support the safeguard. However, there is something that we should bear in mind.”
“But if he has too much power, such as having too broad a portfolio, he may strangle the ordinary running of Government by the Prime Minister and his Cabinet. The Elected President can exercise his veto only where Government expenditures draw down the reserves accumulated during the terms of previous governments. Here, I think a crucial problem arises. How does one define the reserves accumulated by previous governments? It may appear to be a simple matter at the beginning. When a new government takes over, whatever it inherits from the previous government cannot be touched unless the Elected President agrees. But if he does not, then the government has to raise its own money. However, there will be arguments over whether some of the profits or savings generated from on-going projects, projects which were started by the previous government, belong to the new government, or cannot be touched still. Some projects started by a previous government cannot be self-financing from the beginning. It will take some years during which time the government subsidies are necessary. Will it mean that the next government would abolish such projects because they will be a burden to it? Examples that come to mind include restructured hospitals, independent schools, extensions of the MRT, the airport, new parks and public recreational facilities, new cultural centres, and so on and so forth. Of course, the Elected President is expected to act in the long-term interest of the nation. And long-term projects which are beneficial to the country will meet with his approval, and he will not block the spending of reserves for such purposes. The blocking mechanism will encourage the government to spend prudently within its term. This is good.”
“And I also feel that the number of Presidential Advisors should be enlarged somewhat, in order to provide for a broader range of views for the Elected President's consideration. I agree that the Elected President's power to approve the Government's budgets and those of the important statutory boards and Government-owned companies is necessary, because this is the more direct way of scrutinizing and preventing the Government from dipping into the reserves or warning the Government against the likelihood of dipping into the reserves should its way of spending continue. However, I believe the list of statutory board budgets that come under the President's purview should be limited only to those which have to do with the original purpose of the Elected Presidency proposal, ie, the protection of the nation's assets and reserves. During the August 1988 debate on the former White Paper, the House went down the list with the First Deputy Prime Minister. There were grey areas, such as the POSB, PSA, PUB and Telecom, SBC, CAAS. Some of these have now been struck off the list, but PUB and Telecom are still on; so are HDB and JTC. Are there not moves to privatise PUB and Telecom? Why the need to retain them on the list? With regard to HDB, do the flats not belong to the individual owners already, who have the right to sell their own flats for their own purposes? Maybe the First Deputy Prime Minister could clarify for us what constitute HDB's assets which are not privately owned, and which are not already included in MND Holdings which falls under the Elected President's purview in any case? Sir, the point is: Yes, the Elected President must be given the power to scrutinize Government expenditures.”
“The Elected President has extensive powers and he will make a great difference to the process of government. So I disagree with the views expressed yesterday by the Member for Fengshan that the political party affiliation of the Elected President does not matter. In my view, I think the candidates for the Elected President must be free of any political party affiliation first and foremost. The powers of the Elected President are extensive in that he will have the discretion to block the Government's annual budgets as well as those of the key statutory boards and Government-owned companies. If the majority of the members on the Presidential Council agree with the President to veto such budgets, the decision is final. But if we look at the composition of the Council, the Chairman and one other member are nominated by the President, two members are nominated by the Prime Minister, while the remaining two are nominated by the Chairman of PSC. But the appointment of the Chairman of PSC himself must have the concurrence of the President. Thus, there is a possibility that the President will approve of a Chairman of PSC whose views are like his own, hence ensuring that he will always have the majority view on the Presidential Council behind him from the very beginning. If the provision for the Chairman of PSC to nominate two members onto the Presidential Council is to allow members of the civil service to be nominated, then, which master are the two civil servants serving, the President or the Prime Minister? There may well be a conflict of interest. If the purpose is to have two members outside the civil service, then I see no reason why the Chairman of PSC should be involved in nominating them. I think we should look at this provision again.”
“Mr Speaker, Sir, I stand in support of the Bill. I would like to begin by noting that a nation's assets and reserves belong to the people. They belong to the people of Singapore, and not to any government, past, present or future. In democracies, the government is elected as representatives of the people to manage such assets judiciously and, hopefully, profitably as well. We have had the good fortune of having a good Government for the past 30 years, and I have no doubt the next Government is a good one also. Good governments will have no problem with the proposed Constitutional amendments, provided that a good President is elected, and a good Council of Presidential Advisors is appointed. Sir, the direct election of a President is to provide him with the moral authority or legitimacy to act in the entire nation's interest. The President is expected to rise above party politics. However, as the Bill stands, a Presidential candidate is not required to drop his membership in any political party. Sir, although the Elected President does not have executive powers, nevertheless, he is given tremendous discretion in blocking the Government's annual budgets. Therefore, an Elected President can cause a crisis of confidence in a government. The most worrisome scenario is where an Elected President belongs to a different political party from that of the ruling government. The President will be under pressure from his own party to block the government's budgets, force a general election, thereby giving his own party an early chance of forming the next government. I am aware of the arguments behind allowing the Nominated MPs to keep their political party affiliations. But the Elected President is not like the Nominated MPs.”
“But I hope the Minister would realise also that the general public, especially the lower educated ones, are not so well-versed with all these terms (deductible, co-insurance, co-payment) and many people have not taken out any insurance scheme before. They have no experience in these things and they may still be under the illusion that MediShield will pay for everything. The deductible of $600 per year for class C ward patients may seem fair at this moment, but there may still be patients who could not afford to cough up this $600 deductible, even though in the case of catastrophic illness $600 is actually not a very huge amount, considering the length of stay and the cost of treatment. So I hope the Minister could still assure the population that if they cannot afford to come up with this $600 deductible, there are still ways for them to apply for waivers. Finally, MediShield does not cover some forms of catastrophic illness, such as haemophilia or thalassaemia major. The plight and the financial burdens of these patients, no doubt the number is quite small, are enormous, and they should receive some special assistance from the Government. Recently, because of the risk of Aids, the price for manufacturing blood products has shot up tremendously and so the cost of treatment to this kind of patients who need blood transfusions regularly has gone up very sharply. No doubt, no insurance scheme is likely to cover congenital anomalies, just as MediShield does not. Still, we should try every means to help this small number of patients to cope with the financial burden of treating this kind of diseases. So with this, I would like to thank the Ministry for coming up with this scheme. We wish it every success.”
“We are glad to hear from the Minister that the Ministry will closely monitor the working of the scheme so that he would consider extending the coverage to beyond age 65 at the earliest opportunity. I do not know whether he would be able to give us any indication now on how many years the scheme would run before he will consider it sufficient time to take a decision on the matter. I think the people should not be asked to wait indefinitely. The third point I want to make is that MediShield can be extended to cover the dependent members of the family. Every effort must be made by the Ministry to publicise the scheme and let people think about extending the coverage to their dependants. At present, if you want to opt in, there is no need to go through a medical examination. The question may arise in future when the Ministry may want to impose a medical examination. What will be the period after which every new member who wants to join, or opt in, will have to go through this medical examination? This will be an important consideration for people who want to opt in their dependants. Some of them might be young and healthy now, but later on they might want to include them. Fourthly, the Minister said it very clearly and correctly that the public must not choose the class of wards indiscriminately, that is, irrespective of the ability to pay, even though MediShie1d now enables them to enjoy additional coverage for catastrophic illness. The MediShield scheme has a deductible as well as a co-insurance element. This is to prevent people from over-using or abusing medical services and prevent people from over-demanding services that will in the end inflate medical costs.”
“Mr Deputy Speaker, Sir, the GPC has been fully informed of the details of MediShield. We support it and wish it every success. We find the premiums to be low and reasonable. The scheme is going to be run at cost and it covers the major kinds of catastrophic illnesses, ie, heart disease, strokes, kidney failure and cancer. We also endorse the universal coverage feature of the scheme with an opting-out provision. The universal coverage is necessary in order to protect the low income groups. Personally, I would have preferred the scheme to be a compulsory one, except for people who have had adequate alternative coverage. As it stands now, the opting-out is very simple. People simply fill in the form and just send it back to the Ministry and he would be taken off the scheme. Of course, on the other hand, if we allow opting-out only for people with alternative coverage, this would bring quite a lot of administrative work to the Ministry. For one thing, for example, you have to keep track of what kinds of alternative coverage people have, approve them, and also make sure that people stay on them. And I think this would give the Ministry more work. Anyway I am glad at least that the initial response to the scheme has been very encouraging, which means that lots of people who should be covered are already covered. It is about 87%. The major weakness I see in the scheme, but which the Minister has already pointed out, is that it covers people only up to the age of 65. There has been quite a bit of feedback to the GPC from the senior citizens, some of whom express their views quite strongly. They feel that the society does not appreciate their past contributions by not recognising their needs. After retirement, they are now left out of MediShield.”
“Sir, I am not moving. The sum of $483,927,860 for Head P ordered to stand part of the Main Estimates. The sum of $112,125,400 for Head P ordered to stand part of the Development Estimates. Head W -”
“Sir, I beg leave to withdraw. Amendment, by leave, withdrawn.”
“So I still would like to see more Government funds going to help the Home Nursing Foundation. I had spoken on this before last year. I have seen some improvement in the situation, but I still like further efforts along this line. And I have already mentioned the fact that the number of home nursing visits has gone down, and I think this is something that the Ministry should really watch out for. Although we have been talking about the problems of the aging population for some years, I feel the Ministry is not yet giving sufficient attention to the health care services for the elderly on a comprehensive basis. No doubt, the hospitals are beginning to develop geriatric medicine; but what we need is a broad-based programme for the elderly at the community level. I would suggest that MOH should work closely with MCD to look into how more day care centres can be developed, with inputs from the volunteers and grassroots organisations. All these will involve a lot of hidden subsidies from the Government, and I would expect there would be a lot of reshuffling of paper accounts again. In order to facilitate Parliament in checking the record of development of health care for the elderly, may I suggest that this programme be treated separately from the Primary Health Programme for the purposes of budget presentation? In this way, I believe, we will be able to follow the progress of this programme much more effectively in future.”
“Sir, I beg to move, That the sum to be allocated for Head P be reduced by $10 in respect of Code PE 1500 of the Main Estimates. I have only a very brief observation on the community health services, including services for the elderly. Sir, I note with satisfaction that over the last two years, a higher proportion of the health budget has been allocated to primary care services, the development of polyclinics, health screening and health education. I think everybody in this House would agree with the fact that primary health care is probably the best strategy to fight the rising health care costs. Sir, a couple of the new polyclinics have senior citizens health care centres, com- plete with day care facilities and rehabilitation services. There is a great need for such services for the elderly. What I wish to see is a general extension of such services to all the polyclinics. However, to achieve this, certain infrastructure must be in place, and I would like to urge the Minister to look into two such kinds of supportive services especially. First, the Ministry must assign more medical officers to these centres. I understand right now there are only two medical officers assigned to this health care service for the elderly. I may be wrong, I stand corrected. Second, the Ministry must try to allocate more nursing staff and rehabilitation therapists to these senior citizens health care centres. Of course, I understand there is a general shortage of these staff. But if MOH is genuinely trying to promote health services for the elderly, there is no escaping from allocating more of these supportive staff to the health care centres. I also think that health care services to the elderly need to be provided on a broader front, including home nursing care.”
“Sir, I like to thank the Minister for his very detailed replies. I think he is patient with us. To be fair, the process of restructuring has just gone on for a short while in spite of the pilot project which has taken place with NUH. We really should give the officials a bit more time to see the results. As long as the Minister keeps telling us his frank opinions, gives us the statistics, I think we are happy. And to be fair to the Ministry officials, we are giving them a very tall order. We expect them to cut down on the need for subventions. We expect them to go for medical excellence and all of that within a short time. May I still impress on the Minister that, to help your officials accomplish their task, I think you should really convince the Cabinet to consider all capital costs, including investment in equipment where justified, to be sunk costs and not expect MOH to go for recovery of such expenditures. With this, I beg to withdraw my amendment. Amendment, by leave, withdrawn.”
“It is a natural progression that once they have all these and when they go into a hospital the few times in their lifetime, they would opt to do what is right for themselves, which is to go to the ward that they can best afford. Sir, I think we should be happy that Singaporeans can do that. Dr Aline Wong talked about surveys and whether we expect to get an honest survey and an honest reply. I think she missed the point. The surveys are not carried out on doctors. The survey forms are given to the patients themselves to fill in anonymously and to return. So I do not think they need to fear.”
“May I just ask another clarification, Sir. With regard to the kind of serveys that the Minister plans to carry out on doctors and inhouse staff, does he think that the doctors and inhouse staff will really give him true and honest answers to questions like whether you have taken care of subsidised patients and, whether you have told your patients that if you do not stay in B1 beds and A1 beds, I won't see you? Does he expect honest answers for these questions? Mr Yeo Cheow Tong: Sir, Dr Lee again has not waken up. He is still saying that people should be forced to go to C class. He asked whether people like to go to A, B1 and B2 because they like to pay more. Sir, on that he is right. People do not like to pay more than they can get away with. That is human nature. But Singaporeans have a choice of what service they want and how much they pay for that service. It is just like the difference between a taxi and a bus. Every Singaporean has a choice between a bus and a taxi. He wants a taxi, he takes a taxi and he pays more. He wants to pays less, he takes a bus. They are given a choice. Similarly, with the hospitals. If you want to pay less, the C class is very affordable, it is available. If they can afford more, they go to a better class. What we should be happy about, Sir, is that Singaporeans are more and more able to afford the better services. And this is the best reflection of what the Government has done for Singapore in the last 30 years - create, the environment for businesses to prosper, to grow, create the environment for jobs to be plentiful, and not just low-paying jobs but jobs which are high-paying and which allow Singaporeans to have a good standard of living.”
“But the figures from the budget document show that in fact even before those new polyclinics offered these day services and rehabilitation services for the elderly, the number of home visits has actually declined, starting in 1986, in fact it started to decline slightly earlier. But in 1986, there was a big drop. In 1985, for example, the number of home visits was 46,733. For FY 1986, it was 39,155, declining steadily to a projection of 25,680 for FY 1990. My point is, Toa Payoh Polyclinic was the first to have this kind of services. It was opened only two years ago. But the decline in the number of home visits has started even before the Toa Payoh Polyclinic had these services. So my question is, how much has this gradual decline to do with the fact that, beginning in 1986, patients receiving home visits had to pay a fee, whereas before it was free? I raised this point last year and I then asked the Goverment to look into the possibility of reducing the fee the patient has to pay for repeat visits. Surely the figures showing a decline in home visits must have something to do with the fee scheme and patients began to ask for less repeat visits because of the fee.”
“In other words, right now people can walk in and demand to see the specialist resulting in a waste of the specialist's time and resources. To rationalise resources and to make people go through the GP first before they seek a specialist's care, which will save the coun- try's health cost, would he not look into tightening up this referral system? Another question I have is with regard to the specialist consultancy fee scheme. He told the House that a comprehensive study has been made and it was found that the 4:7 sessions have indeed been adhered to. But I am not satisfied. I wish he could tell us a bit more about how this was done. He should give us a bit more details so that we can be rest more assured. Also, is he not aware that some specialists have been working overtime, so to speak, to see private patients? As a result, the supportive staff also have to work overtime. But we hear complaints that the supportive staff do not benefit from the increase in income of the specialists. So there is a bit of unhappiness there. It is not just unhappiness between surgeons and physicians about the different levels of income. But the supportive staff have to do this for the specialists who would be adding to their own income. Finally, I have a query on his statistics on the home visits to the elderly. He told us that actually there has been an increase in the number of elderly seen, although the number of home visits has declined, and he gave the explanation that since the senior citizens' health centres at polyclinics have been opened, more elderly people have gone to these centres instead of receiving home visits.”
“Can I seek a few clarifications from the Acting Minister? First of all, let me thank him for telling the House why the subventions for SGH and NUH had increased by such a hefty amount between FY 1988 and 1989. But my question is, if a large part of this increase is due to the accounting system, ie, these subsidies are now made more evident under the Ministry of Health and the restructured hospitals accounts, then will he not say that the large amount of Government subventions given over these two years were not real increases but were just paper transfers? So in that sense, was there any need to press for cost recovery to justify the increases in Government charges? I mean they were paper transfers. That amount as such has always been there. The increases were not real. So why should there be so much pressure for cost recovery based on this set of figures? The second question I have is with regard to Alexandra Hospital. If this is to be retained as a non-restructured hospital, and given the present state that Alexandra Hospital is in, it is old and its facilities are very inadequate, could he tell us a little bit more about the plans to bring up the quality of Alexandra Hospital so that it would definitely not be seen, and surely it will be seen if it is not done, as a second class hospital? The third query I have is with regard to the indirect advertisement practice. I agree that perhaps the best way is for people to develop a very close relationship with the family doctor so that in case of need for referrals to specialists he can actually seek an informed opinion. Then in this case, does he not think that SGH and the restructured hospitals should tighten up the system of referrals?”
“The Minister needs to assure the public that, with the specialisation amongst restructured hospitals, patients will still be transferred without much problem. Fourthly, with the restructured hospitals going for cost recovery and with the institution of the specialist consultancy fee scheme with no income ceiling, I think there may be some adverse effects on the teaching of medical students on medical research, and also on the care given to subsidised patients. I would like to ask the Minister what mechanisms has he instituted to ensure that the quality of teaching, research and the care of subsidised patients at the restructured hospitals, including NUH, has not been compromised. In his opinion, is the formula 4:7 sessions enforceable, ie, four sessions for private patients and seven sessions for subsidised patients?”
“Has this philosophy been changed to one that, as long as the hospital provides "enough" subsidised beds, they will be allowed to have other kinds of beds as much as they could? There is a big difference between 70% and what is considered to be "enough" subsidized beds, because we know Medisave has caused people to opt for higher class beds. This tendency has been noted. So unless and until we are very sure that this tendency is not a temporary phenomenon, I do not think we should leave this formula of 70% and 30% to the discretion of individual hospitals. A second related point is that, in upgrading the physical facilities of the restructured hospitals, we should be careful not to institute too great a difference in the physical facilities between the subsidised wards and the private wards. Because one problem faced by the subsidised patients now is the perception that the quality of medical care in subsidised beds is not as good as those in the private wards. If you accentuate the differences in the physical environment and the physical facilities between the two classes of wards too much, you would accentuate the tendency for the subsidised patients to think that the quality of medical care in the private wards is in fact better. This is not true and it leads to further enhancement of the preception, which would not be desirable. Thirdly, with the development of specialties and sub-specialties among the restructured hospitals, there is a rather clear division of labour emerging. What the Member for Ayer Rajah raised last year with regard to the problem faced by patients in terms of transfer between restructured hospitals, is worth looking into.”
“I feel very uncomfortable, Sir, with the large number of stories that come out in the press almost every week about the kinds of new acquisitions made by new medical centres and the wonders they can do. Although the names of the specialists who perform the state-of-art procedures are usually withheld from such reports, yet the names of the medical centres are identified, where it is said that these services can be obtained, sometimes even with telephone numbers. No doubt, this is a form of consumer information given by the press for the public's interest, yet the reports can be considered as indirect advertising in so far as the information is given by the medical centres themselves. But having said that the Government should play a greater regulatory role vis-a-vis the private sector, I hasten to add, Sir, that the Government's attitude towards the private sector should not be just that of control. On the contrary, the private sector should be encouraged to grow, albeit responsibly. The Government should try to tap the resources in the private sector, and arrive at a better integration between the two. As far as hospital restructuring is concerned, I have a few questions for the Minister. First of all, all the Members of the House are very happy that the Government has decided to re-install C class beds at SGH. On some issues at least, there is a possibility of a "happy ending". The fact that SGH was allowed to have no C class beds raises one very important question in my mind. About three years back, the GPC was given to understand that the proportion between subsidised and non-subsidized beds will stay at 70% and 30%. Are the hospitals allowed to vary their bed complements at their own discretion?”
“While it may goad the public sector onto greater efficiency and cost-effectiveness, yet fierce competition can also cause wasteful duplication and add to cost-inflation. This is because the market for medical services is imperfect. Patients do not have consumer sovereignty; specialists can create their own demand; and modern medical equipment is very expensive. One particular example of wasteful duplication is the IVF programme. There are seven such centres now in Singapore. The procedures are expensive and the success rate is not fantastic. Even though we are to encourage procreation, yet how many people can actually benefit from the programme and how many babies have been born from IVF procedures? Besides, the procedures are such that there are higher risks of multiple births and underweight babies, and neonatal intensive care for underweight babies is very expensive. Are the IVF programmes at private medical centres well-equipped with neonatal units? Or has there been a tendency for babies with birth problems to be referred to the Government hospitals and are therefore more or less dumped onto the cheaper hospitals? Sir, we must look into the question of the proper relationship between the public and the private sectors. The Government should concentrate on two important functions. First, to act as a dampener on the rise in costs in the private sector; second, to safeguard the quality of private sector medical services. With regard to the second point, MOH should think about checking the purchase of very expensive equipment in both the public and the private sectors, as well as restrain the practice of indirect advertising.”
“Otherwise, the increased Medisave monies would be vulnerable to abuse by profit-making hospitals. Also, there is right now some tendency among people to use multiple-Medisave accounts to settle bills. Although the present figures are low, yet if this continues as a trend, many people would have finished their Medisave accounts, and their family members' Medisave accounts. So I think we cannot over-emphasise the importance of watching the over-usage of Medisave. As for the relationship between the public and private sectors, Sir, the National Health Plan specifically entrusted the Government to coordinate the planning and development of both sectors in order to achieve a better distribution of health services and avoid wasteful duplication. Have we succeeded in doing so? In the past few years, it appears to me that the Government's attention has been focused mainly on the restructuring of hospitals and the financing of health costs, and rightly so, because these things must first be put in place. However, we cannot ignore the developments in the private sector, not only because our resources are limited, population base is finite, but also because what happens in the public sector affects the private sector and vice versa. In the past, there was a clear division of labour between the public and the private sectors. But with restructuring of Government hospitals, there is an increasing emphasis on cost-recovery and the line between the public and the private sectors has become blurred. The restructured hospitals are even said to be entering into competition with the private sector. Sir, competition is a double-edged instrument.”
“Instead, we are asked to approve in Parliament, almost in a blank cheque manner, the following GIAs (grants-in-aid) to five Government restructured hospitals, including NSC, that is $137.6 million, as well as a total of $33.8 million for development expenditure. How do we know whether these capital grants, including depreciation expenses attributable to subsidised patients, go to medical equipment or go to buildings and offices? To some people, the improvements in physical facilities and hotel services are extravagant and the money ill-spent. As for medical equipment, no doubt we have to aim for medical excellence, yet professionals who order such equipment should be fully aware of the cost-effectiveness of hi-tech machines. So my point is, first, accountability. If we do not know the establishment figures, nor the performance indicators, if we do not know where do these GIAs and capital expenditures go to, how do we know that these organisations have been well run? That is my point. High recurrent and development expenditures will cause medical costs to rise further. Hence, the paradox of a rising level of subsidies on the part of Government, and the rising charges paid by the patient. Sir, we do not object to the principle of making subsidised patients bear part of the cost. But the question is: can they afford the rise in charges? Since many MPs will speak on the question of affordability, I shall not dwell on this. Suffice it to say that Medisave, with the present upper ceiling of $15,000, will not last a person's lifetime needs for hospitalisation. But before we think about raising the ceiling of Medisave further, we must have in place very well-guarded mechanisms for Medisave auditing and for professional auditing.”
“Sir, I beg to move, That the total sum to be allocated for Head P of the Main Estimates be reduced by $100. On health expenditure, the FY 90 budget allocation to MOH is a total of $596 million. The present budget is 2.3 times that of FY 80. Government health expenditure has grown at 13-14% per annum. According to some calculations by NUS economists, the private health expenditure has grown at the rate of 12-13% per annum also. So Singaporeans must be prepared for a continuous rise in health expenditure. To slow down the rate of cost increase within the public sector, we must put more emphasis on efficiency. At the very least, efficiency should mean lower cost for the same quality of medical care. But our ultimate goal must be to raise the quality of medical care without disproportionate increases in cost. Towards these ends, the hospital restructuring programme has gone on at a rapid rate. What are the results so far? It may still be too early to judge, but I think there are some worrying signs. I have a few observations. First, on the rising level of subventions. The figures are quite puzzling. For SGH, the annual operating deficit prior to restructuring was $40 million. Since restructuring, the recurrent subvention for FY 89 was $65 to $66 million, and for FY 90, even higher, at $72 million. For NUH, the subvention in FY 89 was about $21 million, rising slightly to $23 million for FY 90. And in spite of these subventions, Sir, both hospitals have been making losses. What are these subventions for? With the restructuring of the hospitals, the expenditures and revenues are no longer reflected in the MOH's budget documents. So how are we to know whether the subventions are truly needed and the money wisely spent?”
“Sir, would the Minister tell us whether for the nurses who opt to stay in the Government service after all the hospitals have been restructured, would there be enough other kinds of posts for their redeployment so that they can still continue within the Government sector?”
“While the GPC would be urging the Minister for Health to look urgently for solutions to this problem of shortage of supportive staff in the health care services, I think a long term solution is to have a school of allied health sciences at the third polytechnic. In future, we should even think of having such courses at the university level. The allied health sciences include not only various branches of therapy but also radiography, nursing, social work, dietetics, biomedical technology and so on. If we recognise that all these disciplines have an inter-related knowledge base, and that we are faced not just with the shortage of therapists, then perhaps we have a much broader perspective and a broader basis for setting up a school of allied health sciences. This is to meet the long term needs of our ageing population for rehabilitation, especially after a serious illness, the needs of the younger population for rehabilitation from sports injuries as well as the general needs for nursing, and for technical manpower to maintain modern medicine's laboratories and equipment. With this, I would like to seek the Minister's responses to these concerns.”
“Of course, we can look to other sources, for example, UK. But we also realise that the good British academics are either staying at their own universities or going over to Canada, the United States and Australia. So with two universities, I think our problem of recruiting good, qualified staff will be exacerbated. So my question to the Minister is, what kind of plans does he have for the two universities to recruit good academic staff? Fourthly, with the shelving of the idea of a third University, I wonder if the Minister would still consider a national academy or a school of performing arts at either the National University of Singapore or the NTU. It is to be noted that the proposed National Institute of Education (NIE) will have courses in the performing and visual arts. NIE is going to be linked with NTU. However, such courses are mainly for the training of primary and secondary school teachers and this is not the same as having a separate school of performing arts where talented students can study for a degree in these subjects for their own interest. Let me come to the third polytechnic. It is a very welcomed addition. It will help to increase the number of skilled manpower for the needs of our industries and services. I particularly like the idea of having a school of design. This idea has been presented to the Government by people in the private sector for a number of years and finally the Government is adopting it and I really welcome it. What I wish to bring out is the need for a school at the polytechnic to train the necessary supportive staff for the health care services.”
“My second point is that the universities are supposed to be engaged in friendly competition for students, for staff, for current and capital grants, research grants and links with industries and services. My question to the Minister is this: how is this friendly competition to be carried out? At the beginning, I think NTU will suffer from a historical disadvantage because NUS is a much longer established university. Thus, the better students and better academic staff would naturally gravitate towards NUS. We do not want to see a replay of the Nanyang University scenario where, unfortunately, the Nanyang University graduates were not as well recognised as the Singapore University graduates by the members of society. So the question is, to what extent should there be friendly competition, to what extent should there be a division of labour between the two universities so that each of them can specialise in certain areas, attracting different kinds of students and different kinds of staff? Thirdly, to compete for good quality teaching and research staff is not easy. Not only because the pool of talents we have in Singapore is limited, but also because at this particular juncture in time we are competing with other major universities in the world. In the United States, for example, the post World War II baby boomers had caused a tremendous expansion of universities in the 1950s and 1960s followed by a contraction in the 1970s after this crop of students had finished college. But now the late 1980s have seen a reverse trend. This is because American universities are taking more and more mature students who are returning to college. In this sense we will be competing for good academic staff with these universities which are also expanding in the early 1990s.”
“Sir, I welcome the Government's decision to set up a full-fledged second university and a third polytechnic. I think this will go a long way towards meeting the demand of the population for more access to tertiary level education. With regard to the two universities, I wish to seek the Minister's clarification on a few points and perhaps to impress upon him some of my views. Firstly, while I agree that Singapore needs a second university, my concern is whether this sudden increase in student intake would lead to a decline in standards. The Government has long maintained that university admission standards cannot be compromised. And that in the past, one constraint in expanding the number of places available was the finite number of students with the required entry qualifications. Although the Minister had taken pains to explain at a press conference recently that now we have the critical mass of qualified students to form the base of two full-fledged universities, yet in my own personal experience as a lecturer, students who just meet the minimum admission criteria, particularly those falling within the band of the previous cut-off points, are not necessarily well-equipped for university education. They do not have the analytical or critical thinking ability which is the hallmark of a good university student. And even now the standard of written English among some students still leaves some room for improvement, in fact, something to be desired. I really think, therefore, that we should be cautious and not be too rushed into expanding student intake at the two universities too suddenly and over too short a period of time. Take a bit longer time before you expand both to their full strengths.”
“I would like to ask the Minister what are the companies, what are their roles, and how do they relate and, more importantly, how do they relate to the new functions of the HDB. Are they carrying on rather peripheral activities? Do they carry on inside the HDB because this is something for them to do, but with little relevance to the future tasks of the HDB? We must not forget that the HDB has rendered an invaluable service to the nation. I think much of its success had a lot to do with this past clear sense of mission and the dedication of its staff. Not too long ago, HDB celebrated its 25th anniversary and the House was full of praise for its work. With the coming of the town councils and the recent changes in internal organisation, I fear the staff morale among some of the HDB personnel has been quite adversely affected. To a certain extent, the sense of insecurity people feel about whether they might lose the job with the taking on of the estate management functions by town councils and private companies, is understandable. But it would seem to me that in pursuing the new goals and objectives, the new HDB management should pay more attention to its internal staff relations and staff welfare. I do not think we need to remind them that a caring organisation is not only a happier one but probably a more productive one. In summing up, I have three questions for the Minister. Firstly, what are the new directions for HDB's work after all the town councils have taken over the estate management functions? Secondly, what are the roles of the private companies within HDB? And thirdly, how have the interest and welfare of its existing staff been taken care of in the process of re-organisation?”
“Otherwise, I think HDB will lose its sense of mission and also the dedication of its staff. Looking ahead, it would seem that the major tasks faced by or to be taken on by the HDB in the next 10 to 15 years would be two-fold. First, to build more good quality housing for the expanding population and also to cater to the increase in number of households that will be formed. Second, HDB will upgrade the older existing housing estates. With regard to the second function, I can see some problems. If HDB is given a clear mandate to inject large sums of money to upgrade existing estates with 100% financial backing from the Government, then it can do its work smoothly and expeditiously. However, there is a hitch because the population will be required to participate in part-financing of such improvements and in future the town councils will have to determine whether at least 75% of the residents do opt for such upgrading exercises. Therefore, the work of the HDB will not be entirely up to its own planning. In other words, the kind of work HDB will do and the progress it makes will not be entirely up to itself to determine. So my question is: will HDB in future be judged by the progress of upgrading exercise that is in fact taken partly out of its purview? It is understood that HDB is now undergoing a vast revamping. It is trimming its internal organisation, streamlining rules and regulations, paying more attention to customer service, and injecting new blood into its management. All these, I think, are very good moves. One hears of some or several private companies which have been formed inside the HDB within the last couple of years.”
“Sir, I would like to talk about the changing functions of the HDB. HDB has evolved over the years from being a developer of massive public housing with only basic amenities in the 1960s to a developer of good quality housing in the 1970s and 1980s. Now with more than 85% of the population living in HDB flats, the HDB has also become the biggest landlord and estate manager in the country. Correspondingly, over the years the scope of work of its Resettlement Department has been reduced because there are very few remaining kampongs to be cleared. So over the last 2(r) decades one can say that HDB's functions have evolved naturally and also gradually, and HDB's functions in resettling, in developing and managing housing estates have been very well accepted by the people. In fact, people's contact with the HDB is on a monthly basis and people live daily under the rules and regulations as implemented by the HDB itself. However, with the phase by phase introduction of town councils over the last couple of years, this established pattern has been undergoing very rapid changes. Not only does the population need time to adjust, but I think the HDB must also re-orientate itself to some new goals and objectives. In the years ahead, what would be the major thrust of the HDB's operations? Is there a new clearly defined corporate vision for HDB and have the HDB staff been adequately prepared for the organisation's new objectives? To have a new or clearly defined corporate vision takes more than the refinement of some of the remaining old functions, such as improving the allocation procedures, putting up new designs or improving the quality and efficiency of services. There must be some clearly understood corporate objectives.”
“Can I seek a clarification from the Minister? Can he re-confirm that he has no intention to introduce the draft for women? And if in future should he change his mind before he makes any decision, could he ask every reservist who complains about reverse discrimination, whether they prefer their girlfriends, their sisters, their wives, and possibly mothers, to be doing reservist service? I think, Sir, this is not a question of rough justice. It is a question of what kind of consequences drafting women will have for the total social fabric of our society. Dr John Chen Seow Phun: Point of clarification, Sir. Does the Minister imply that when a reservist is paid make-up pay, there is therefore no sacrifice? Does he not agree that it is only when the make-up pay is high enough that a reservist willingly offers himself for reservist training and there is no sacrifice then? BG Lee Hsien Loong: Sir, I have no intention of drafting women nor of conducting a referendum on the subject. As for make-up pay, I am not suggesting that it results in no sacrifice. I know that it is still a considerable inconvenience to him, his family, his employer. But may I point out that reservists are not mercenaries, and we are not talking about increasing the make-up pay to such a point that people volunteer to serve.”
“Another supplementary question, Sir. With regard to the vacant land directly opposite the site, did the Ministry look into the possibility of having those new blocks built over that site rather than building in the existing site to avoid congesting the environment for the residents?”
“Sir, would the Senior Minister of State be kind enough to consider putting in a bit more recreational facilities after the area has been redeveloped because the residents used to enjoy a very congenial environment before the new development puts the environment into a rather congested state?”
“In fact, it is highly appreciative of what the religious groups have done in providing educational, welfare and other social services to the country. The feelings of religious groups aside, the Government should be aware of the reaction of some intellectuals who view this Bill as yet another layer of control by the Government. Perhaps these people should realise that this Bill is a far kinder, gentler approach and the Minister will only exercise his powers in keeping good faith with the people. Indeed it would be very foolish if the Minister does not exercise his powers with extreme caution in matters so sensitive as religion. What is needed is for the Minister to assure the country, the people, that this Bill indeed is to safeguard the long-term interests of the country and that the Minister himself or Ministers after him will actually exercise their powers with the most extreme caution. 2.45 pm”
“So far, the Government has only allowed religious dissent on the issue of abortion. This is taking too narrow a view of religious conscience. Other examples of moral conscience that have deep religious overtones include questions of social justice, human rights, stewardship of the earth's resources, chemical and nuclear weaponry, and biotechnology. Are these moral issues? Are these political issues? Will it be permissible for religious leaders to speak only on issues which have no relevance to Singapore? Sir, much anxiety has been generated among religious groups here because of the perception that this Bill may mean a strict policing of individual thought and action. Some of these feedback have already been given by Mr Chandra Das. Although the law is right in insisting that religious leaders should not use their positions of authority to sway their flocks towards their own political views, yet the law is equally applicable to any other person within the group. Is it not possible for the Government to consider allowing religious leaders to restrain their own followers, as is the customary practice in the past? Will we not be undermining the authority of religious leaders within their own groups? I think the Minister will have to clarify this point, ie, the need to apply this law equally to followers as to leaders of religious groups. Finally, Sir, some Christian groups tend to perceive this Bill as the Government's reaction to the Marxist plot in 1987. I believe they should look at the Bill from a broader and longer perspective. They should have faith in what the Government has repeatedly said, that it is not against the Church or any religious groups.”
“One estimate is that there are over 500 churches and parachurch organisations within the Protestant community. And that on the national level, only four organisations can claim fairly extensive support from these churches. How then can the diversity within the Protestant community be represented on the Presidential Council? Will this lead to an exclusion of representatives of the smaller, independent churches? Sir, had this Bill been aimed only at inter-religious harmony, I have little doubt that it will be widely supported by the religious groups. Even those groups which believe that active evangelising is part of their religious duty would support the Bill, because they understand the need for judicious restraint within our local context. However, where the Bill touches on politics and religion, and this is a significant half of the Bill, opinions are bound to differ widely between the secular and the religious authorities. Both Islam and Christianity hold comprehensive world views. To them, there is no possibility of separating moral responsibility from social responsibility. I shall not belabour this point. But we cannot ignore the widespread anxiety, especially among the Catholics and Protestants, that this Bill may be used by the Government as an instrument to quash political dissent that stems from moral convictions. Morals are not just matters of private conscience. They are part and parcel of a collective conscience that makes society possible in the first place. And when expressed in religious beliefs, what may appear to be private conscience becomes part of the collective conscience of the religious followers. Hence, the line dividing private conscience and collective conscience cannot be drawn.”
“So the question is how the public can be convinced that the evidences and the Minister's decisions are just and fair? I would also imagine where the case in point touches on inter-religious harmony only, the Minister would have more regard for the Council members' views, because the members are religious leaders themselves. On the other hand, where the case touches on politics so as to "excite disaffection against the President or the Government", I really do not know whether the religious leaders' opinions would be considered relevant. For the Council to be credible, members of the Council must be seen to represent all the major religious groups in Singapore. In addition to the Chairman, there will only be 15 other members including an unspecified number of persons who are not representing any religious group. Apart from their own religious views, are these lay persons really in a position to make recommendations on religious issues? Matters would be made more complicated if such persons are staunch non-believers and are strongly against any attempts at proselytising by any religious group. The Council's discussions then may turn into a debate over "territorial rights" between "religionists" and non-religionists". Again, in the case of mixing religion with politics, would such lay persons also have anything to say? I thus urge the Minister to reconsider the representation of lay persons. As for the other members who are religious leaders, how are they are going to be selected so as to ensure fair representation of all the major religions in Singapore? I think a particular problem would arise within Christianity itself. There are many different Protestant churches.”
“Mr Speaker, Sir, I support the Bill because the principles behind it are sound principles. In a pluralistic society like ours, I think no one would doubt the need for inter-religious harmony, nor the wisdom of separating religion from politics. I am also satisfied that this Bill has gone through a number of careful drafts and that discussions have been held with religious leaders. And there might also be public hearings if a Select Committee is appointed. Here, I only wish to concentrate on several points about the Bill itself which the Minister might want to reconsider. Like the Members from Cheng San GRC and Fengshan, I think first and foremost we should note the wide-ranging powers given to the Minister. In fact, he has the absolute power to decide who would be deemed as mixing religion with politics or causing religious disharmony. It is to be noted that the functions of the Presidential Council for Religious Harmony are purely advisory. The Minister is not bound by its recommendations and not even the courts can question the Minister's decision. The courts, in fact, can only decide on the penalty to be given out. Thus, in my opinion, even though this Bill is much less severe than the Internal Security Act, a fact which makes this Bill more palatable to many concerned people, yet it is still the case that the power of the courts is extremely limited. The Bill does not provide checks and balances in case the Minister abuses his powers. It may be said that the Presidential Council's deliberations on the evidences presented to it by the Minister are some kind of safeguard so that the Minister's decisions and actions are not out of misconception or even out of his prejudice. But then the proceedings of the Council are to be kept secret.”
“Sir, may I ask the Acting Minister for Health, when his Ministry has not really taken much action to institute programmes of local training for physiotherapists and other para-medical staff, how can he say that he is doing his best to ensure that the care of elderly patients will be indeed moving in that optimal direction?”