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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“While it is laudable that we should want to extend more protection to victims of abuse, I think in our eagerness we must not make matters worse for the family. It is here that I find the recommendations of the Select Committee on the Maintenance of Parents Bill both sensible and sensitive. The approach taken is conciliatory and, even where mediation fails, a Tribunal will hear the case in chambers. Open litigation is avoided. I would recommend a similar approach to be adopted for domestic violence when the Women's Charter is revised. Finally, do we need a new piece of legislation to extend protection to victims of domestic violence? I would not go so far as to say that, if child abuse can be covered by the Children and Young Persons Act, and if elderly abuse should not be lumped together with spousal violence, then the Family Violence Bill is really about spousal abuse, and mainly about wife abuse, and hence its provisions can very well be accommodated within the Women's Charter. Let us not preclude these two other groups of victims for the moment. Let us still consider the question whether there should be a single piece of legislation to deal with domestic violence, including child abuse and elderly abuse. Mr Speaker, a separate law such as the Bill has the advantage of sending a strong signal that our society does not condone family violence. But what I am worried about is that it will send too strong a signal or, worse still, send a wrong signal. It is not just that the Bill may give a wrong impression that domestic violence is a very serious problem in Singapore. It is also that, by highlighting such a problem through having a distinct piece of legislation, we may begin to change the way family members look at their own relationships.”
“This is because many victims do not want to lose a breadwinner or be blamed for breaking up the family, as after all he is the father of her children. Typically, the victims only want the police to deter the abuser and help him to cool down. But under the Bill, a police officer will be required to investigate and prosecute upon receiving a report, unless the abuser goes for voluntary counselling after the occurrence of the first report. Thereafter, prosecution cannot be avoided. Thus, even though the intention of the Bill is to break the cycle of violence at an early stage, it may have the unintended consequence of deterring women from seeking help if they still desire to maintain their family relationship. Viewed against the above, a proposed amendment to the Women's Charter is to empower the court to impose additional orders when granting PPOs such as requiring the abuser to attend counselling. This is a more discretionary approach. Counselling will be employed where it is judged to be effective or where there are chances that the marriage can still be saved. I am more for this discretionary approach. Sir, the lack of discretion in the hands of the law enforcement officer is the single most troubling proposal under the Bill. I think this would lead to more problems than it would resolve. Like Mrs Yu-Foo, I also feel uncomfortable with widening the definition of "domestic violence" to include marital rape. Even in some countries where marital rape is recognised in law, it applies only to specific circumstances such as when the couple is already separated. Mr Speaker, family relationships are highly emotional personal matters. Hence, they should be treated with the greatest sensitivity.”
“As the Minister for Home Affairs said yesterday, he is concerned that with a sudden surge in demand for counselling and investigation, a disproportionately large amount of police energy and resources would be absorbed by a relatively small number of cases of family violence. I understand that this Bill is closely modelled on the Domestic Violence Act of Malaysia. There, implementation has been delayed because the necessary machinery has yet to be established. Similarly, countries like Australia which have domestic violence laws took a few years to put in place a machinery of relevant judicial, social and community services before introducing their domestic violence laws. So, why should we rush into passing a law that cannot be implemented effectively straightaway? Furthermore, the effectiveness of counselling depends very much on the stage at which family disputes are subjected to outside intervention. Given our Asian culture, most people prefer not to wash the family's dirty linen in public. While this preference is a good thing as it helps to keep the family intact, by the time a wife reports spousal violence to the police, it is likely that the situation has already deteriorated to such a serious level that third party intervention would be unable to do much for them, just as Dr Vasoo has mentioned. But in my mind, an opposite scenario is more likely to take place under the Bill. It is that a family may be locked into a situation where it cannot retrieve itself once a report is made to the police. Police officers who have been handling family disputes under the existing law have found that many women are not willing to press charges against their husbands even where grievous hurt has been committed.”
“Here, I should add that even where the proposed amendments to the Women's Charter provide for the protection of parents and adoptive parents, the question still remains as to whether we should treat the parents on the same moral plane as spouse, siblings, children and so on. Let me now discuss spousal violence. Available statistics on family violence are very patchy. They come from different sources and these show conflicting trends with regard to child abuse and elderly abuse. The signs appear to be clearer on spousal violence, the greatest majority of which are wife beating. The number of Protection Orders, Expedited Orders and Domestic Exclusion Orders issued by the courts has nearly doubled over the last five years. Nevertheless, this does not necessarily mean that more men are beating up their wives now as compared to five years ago. This definitely has to do with the fact that more women are now willing to come out and make reports and that the police are now more helpful to the victims. There is enough literature as well as field experience to show that wife abuse is the result of a complex web of social, emotional and psychological factors which are often compounded by financial difficulties and such irresponsible behaviour as drinking and gambling. Thus, legislation alone cannot help the victim or the abuser over the long run. There must be enough counselling and support services to help the family break out of the cycle of violence. A prominent feature of the Bill is to make investigation by the police mandatory and counselling compulsory. The question is: do we have enough resources to cope with a sudden surge in demand for investigation and counselling?”
“While this may ensure a quick relief to the victim, my question is: would third party intervention make it more difficult for the parent to be eventually reconciled with his own children, thereby preserving the family unit? How can we strike a careful balance between the ideal of preserving the parent/child relationship with sufficient protection for the weaker members of the family? There is no easy answer to this question. But what bothers me besides this nagging question is that this Bill lumps the issue of elderly abuse together with child abuse and spousal abuse under one legislation. I am of the view that these three types of violence should not be lumped together, especially where the elderly are the parents or adopted parents or relatives who have taken care of the family, in much the same way as the parent does. This is because parents gave birth to us, brought us up and provided for us. We must treat them with the utmost respect and provide for them in their old age. This same moral precept underlies the Maintenance of Parents Bill. The parent/child relationship is really on a different moral plane from that of the spousal relationship. While husbands and wives should respect each other as individuals and should care for each other, they can seek divorce if the marriage does not work out. But we can never divorce our parents. I therefore feel that we should not lump the issue of parental abuse together with spousal violence. Whether the existing Penal Code should make the penalty more severe for parental abuse or whether there should ideally be a separate legislation altogether to deal with parental abuse can be a matter for further discussion.”
“Also, the provision under clause 19 of the Bill for "any persons" to report to an enforcement officer is useful in the case of child sexual abuse, since the family is unlikely to want to report to the police on its own. However, whether these two useful aspects of the Bill can be adopted expeditiously by the existing Children and Young Persons Act, or should they be incorporated in a new piece of legislation dealing exclusively with domestic violence, I think we should leave it to the legal experts to decide. My point is extending the coverage of children by itself is not a sufficient justification for having a separate piece of legislation. Let me come to elderly abuse. The present legislation does not enable the elderly to apply for a Personal Protection Order under the Women's Charter even if the elderly concerned are women. The Penal Code protects the elderly against physical abuse. However, it does not appear to protect them against psychological harm or harassment where there is no criminal intimidation. By comparison, the Bill provides for Protection Orders as well as covers harassment. So on these counts, the Bill can extend wider protection to the elderly. Under the existing law, the elderly have to cross several hurdles before protection can be sought. They have to make a police report. They have to take a medical examination and take out a summons against the abuser. These are formidable hurdles for the elderly persons. Apart from these hurdles, we know that most parents are unwilling to report their children to the police. The Bill proposes to make it easier for a third party such as the police to intervene.”
“When I first heard about the Family Violence Bill and saw its first draft, I thought it was a pretty good idea to have a piece of legislation to bring all members of the family under one law. However, after I studied the Bill and its successive drafts, I am no longer sure about its various provisions and am in doubt as to the wisdom of having a separate piece of legislation that has such a wide coverage. Let me start with protection of the child first. The Bill proposes to extend protection of young persons against domestic abuse by covering children above the age of 16 who are not protected by the Children and Young Persons Act. This appears to be a useful extension. However, it is difficult to view a young person between age 16 and 21 as requiring the kind of legal protection intended by the Bill. Some of these young people may already be working, or are in national service. I should think therefore the extension of coverage under this Bill would, in practice, apply mainly to the disabled child who is especially vulnerable to domestic abuse, including sexual abuse. A Sunday Times article on 24th September 1995, entitled "Families do not want to talk about child sexual abuse" mentioned that most child sexual abuse victims were usually girls, and they were usually under the age of 10. This would appear to confirm that the existing legislation is adequate to protect young children. Nevertheless, the newspaper report pointed out that intellectually disabled children were especially at risk. I think, for these children, there is a case for extending protection beyond age 16.”
“Mr Speaker, I support the intention of the Bill which is to curb family violence and to give more protection to the victims. Family violence is a problem that exists throughout the ages and across cultures and societies. I know all of us put a great deal of emphasis on family values, moral education and so on. But the reality is no moral exhortation can eliminate it. Countries that have domestic violence laws have not seen a fall in cases committed either. The law can only protect the victims, but not solve the root problems that cause domestic violence. We all agree that the victims should be protected and that the abusers should be deterred from repeating the offence and, where they still persist, bring them to justice. So the question is how can this be done without destroying the fragile family relationships. In discussing the Bill, we have to bear in mind there are two different types of issues involved here. First, what are the specific measures proposed and how effective are these measures? Second, should these measures be incorporated into a single piece of new legislation, or should they be incorporated into existing legislation? Since the Acting Minister for Community Development has already made known how the Women's Charter is going to be changed to give greater protection to victims of domestic violence, I think we should discuss the above questions by comparing the provisions in the Bill with the changes that the Minister said would be effected to the Women's Charter. The details disclosed by the Minister are sufficient already for us to discuss the merits of the Bill.”
“Deferment is generally not given on grounds of work commitment as NSmen are given the notification for in-camp training at least six months in advance. Only in cases of NSmen who are establishing a new business or starting on a new job would deferment be granted. Our current deferment policy meets the twin objectives of ensuring the operational readiness of the SAF and giving due consideration to the civilian obligations of individual NSman where possible. MINDEF will continue to fine-tune our deferment policy to meet changing circumstances where necessary.”
“I am afraid I do not have the figures of the expected enrolment of each of these two special schools. But when completed, together with three others, the capacity of these special schools would reach about 3,000, which is more than sufficient to cover the present enrolment and those on the waiting list. NSMEN (Application for deferment from in-camp training) 5. Mr Teo Chong Tee asked the Minister for Defence (a) how many NSmen applied for deferment from in-camp training in 1994 and the first six months of 1995 and how many of such applications were approved; and (b) what are the criteria for granting such approvals and whether the rules will be liberalised. The Senior Parliamentary Secretary to the Minister for Defence (Mr Matthias Yao Chih) (for the Minister for Defence): Mr Speaker, Sir, in 1994, 10,213 NSmen applied for deferment from their in-camp training. Of these, 6,842 applicants or 67% were granted deferment. In the first six months of 1995, 4,813 applied and 2,810 or 58% were granted deferment. For the SAF to be an effective fighting force, NSmen should always train together in their own unit throughout their NS training cycle. When an NSman is absent from a particular training programme, the effectiveness of his unit is reduced. Unit cohesion is also degraded. As a result, operational readiness suffers. MINDEF therefore does not grant deferment from in-camp training unless there are good and valid reasons for such deferment. Applications for deferment are considered on the merits of each case. Grounds for deferment include marriage and honeymoon, birth of a child, medical reasons, examinations and compassionate reasons, such as serious illness or death of a next-of-kin.”
“The curriculum in these special schools consists of language development, social and self-help, basic numeracy, physical education and art and craft. The programme aims to develop each child to his fullest potential. On graduation, these students are emplaced either in open employment, or they may continue further training in vocational/sheltered workshops. Besides providing funds, the Ministry of Education (MOE) seconds teachers and principals to the special schools as well as monitors the programmes through the inspectors in the Special Education Unit. The inspectors work with the schools to review and develop their curriculum and evaluation instruments. They also conduct in-service courses/workshops for teachers in the special schools. The National Institute of Education also provides training courses for teachers in special education at both the Certificate and Diploma levels. MOE actively helps the voluntary welfare organisations to find premises either by providing disused school buildings, which are renovated at Government's expense, or help the VWOs build purpose-built schools. Funding of these purpose-built schools is on a 80-20 basis with MOE providing 80% of the construction and equipment cost. Currently, two such purpose-built schools, one of which is for MINDS, are at the various stages of planning and development. There are plans to build more purpose-built schools for children requiring special education.”
“Mr Speaker, Sir, there were between 55 and 60 babies born with Down's Syndrome each year between 1990 and 1994. The Ministry of Health has set up a National Birth Defects Registry in 1993 to capture information on birth defects occurring in children in Singapore. Parents of children with Down's Syndrome receive counselling and guidance on the upbringing of these children. Expert advice is given to the parents by the paediatrician soon after birth. The advice is related to the overall care that the child requires and for associated problems found, like congenital heart defects. All Down's Syndrome children are also referred to the hospital's Medical Social Worker for placement in special schools and for other specialised services that the children require. Medical problems detected are followed up by paediatricians in the hospitals. The School Health Services carry out immunization and annual medical checkups, including eye-screening, on Down's Syndrome children attending the special schools in Singapore. Down's Syndrome children together with other mentally handicapped children are provided with special education either at the five MINDS (Movement for the Intellectually Disabled of Singapore) or the three AESN (Association for Educationally Subnormal Children) schools. Down's Syndrome children, like all the other mentally handicapped children, are placed in these special schools according to their developmental level. As at lst October 1995, there is a waiting list of 48 for MINDS schools and 63 for the AESN schools. The list includes some Down's Syndrome children. However, we understand from the MINDS and AESN schools that the 111 children will be admitted in the course of the new school year, 1996.”
“Sir, as I mentioned, the Ministry provides both financial and professional support to the VWOs. Yes, some of the VWOs find that it is not easy to raise a certain proportion of the operating cost. We are looking into ways of helping them further. But these things have to go across the board and we need some time to work out better schemes to help in financing them. As far as professional support staff is concerned, there is a shortage of paramedics all over Singapore. So the VWOs are also finding it difficult to find volunteers as well as these staff. My Ministry is doing its best to help them find these people. CHILDREN BORN WITH DOWN'S SYNDROME 4. Mr Imram bin Mohamed asked the Minister for Health (a) how many children were born with Down's Syndrome each year from 1990 to 1994; (b) whether the Government maintains a register of babies born with Down's Syndrome and other birth defects; (c) whether parents of children born with Down's Syndrome receive counselling and expert guidance in the upbringing of their children: (d) whether all such children receive proper schooling and are given the opportunity to develop to their fullest potential; and (e) whether the Government intends to take a more active involvement in the development and education of such children than its current involvement via the National Council of Social Service.”
“Sir, I would like to thank Mr Loh Meng See, Chairman of the GPC for Health, for his support for this Bill and the step-by-step approach my Ministry has taken to balance the interest of the public as well as the cost implications. He asked what we intend to do should disposable contact lens become widely used in Singapore. I am aware that some people wear contact lens for aesthetic reasons. But whether it is worn to correct vision, or because some people need them for certain types of occupations, or wear them mainly for fashionable reasons such as to change the colour of their eyes, as Mr Loh pointed out, the fact is, contact lens are in contact with the eyeballs, in contact with the cornea. So for all practical purposes, the dispensing of all contact lens should be brought under this Bill. I think it is far safer for members of the public to see a qualified optometrist to have the contact lens fitted and to have proper checks done periodically in order to prevent any infections from arising or to detect any injuries that might have resulted from the improper use of the lens. Question put, and agreed to. Bill accordingly read a Second time and committed to a Committee of the whole House. The House immediately resolved itself into a Committee on the Bill. - [Dr Aline K. Wong]. Bill considered in Committee; reported without amendment; read a Third time and passed. EXEMPTED BUSINESS (Motion) Resolved, That the proceedings on the business set down on the Order Paper for today be exempted at this day's sitting from the provisions of Standing Order No. 1. - [Mr Wong Kan Seng]. JURONG TOWN CORPORATION (AMENDMENT) BILL Order for Second Reading read. 3.48 pm”
“The penalty for selling or supplying contact lens without being a registered contact lens practitioner is a fine of not exceeding $5,000 or a jail term of not exceeding six months, or both. However, manufacturers and wholesalers are allowed to supply contact lens to registered contact lens practitioners, or for export. Referral of Eye Injuries and Diseases To ensure that proper medical care is provided for eye injuries and diseases, registered contact lens practitioners are required under clause 19 of the Bill to refer clients who are suffering from an injury or disease of the eye to ophthalmologists for medical advice and treatment. Power of Board to Discipline Clauses 12 and 13 stipulate the power of the Board. This includes removal of names from the register, caution, censure, suspension or fine. Any person who is aggrieved by the decision of the Board may appeal to the Minister within one month. In summary, Mr Speaker, Sir, the Contact Lens Practitioners Bill will ensure safe and competent contact lens services to the public and prevent injuries to the eyes from contact lenses which are improperly fitted or used. Sir, I beg to move. Question proposed.”
“Too much regulation will also create market inefficiency. Mr Speaker, Sir, I will now deal with the major provisions of the Bill. Contact Lens Practitioners Board Under this proposed Bill, a Contact Lens Practitioners Board will be set up. Its major functions are to maintain a register of persons qualified to prescribe, dispense and fit contact lens; to approve acceptable qualifications and training; and to regulate the practice and institute disciplinary proceedings. Qualifications for Registration The Board may approve any qualifications or training including the Singapore Polytechnic's certificate and diploma, as well as specific overseas qualifications, as acceptable qualifications for registration. Annual Licences The Registrar of the Board will grant annual licences to all registered contact lens practitioners. Provisional Licences Clause 10 of the Bill provides for a transitional arrangement. Those practitioners who have registered to undergo or are still undergoing the Singapore Polytechnic's Certificate Course or any other approved course will be granted provisional licences to continue their practice. Offences and Penalties Clauses 16, 18 and 20 specify the offences and penalties under the Bill. Offences include engaging in the practice of contact lens fitting without a valid licence or allowing premises to be used by such persons to practise. For such offence, the penalties are a fine of not exceeding $10,000 or a jail term of not exceeding six months, or both. The penalty for administering any prescription containing any poison or controlled drug without authorization is a fine not exceeding $5,000 or a jail term not exceeding two years, or both.”
“In larger countries, where geographical distance is a problem, some medical personnel such as nurse practitioners are allowed to undertake certain diagnostic and curative procedures where the services of a medical doctor are either not required or not readily available. In contrast, Singapore is small and our doctors and ophthalmologists are easily accessible to the population to deal with any eye injuries and diseases. Granted that we do need a number of graduate nurses and optometrists to provide leadership in these professions, there is no special need at present for us to train all our nurses and all our optometrists to University level. Thirdly, upgrading of any profession must be done in a step-by-step fashion and in a practical way. For example, we went through similar steps in the training of dentists, nurses, physiotherapists, occupational therapists and radiographers. Most professions started with some kind of certificate course and may progress to diplomas and degrees as appropriate in stages. These diploma and certificate courses would serve to upgrade the training of these healthcare personnel and would help us meet the manpower needs of the country. They are the necessary steps we need to take in upgrading these services. Finally, we must consider the practical effects of upgrading. Too fast a pace of upgrading will have a disruptive effect on existing practitioners and will have serious cost-implications to the general public. Within safety limits, we should not unduly confine the public's choice by restricting optometry and contact lens practice only to University graduates. In short, we will continue to encourage upgrading, but this must be done in a way which is practical and does not raise costs unnecessarily to members of the public.”
“Grandfather's Clause As to the request for a "grandfather's clause", this would be defeating the purpose of the Singapore Polytechnic's upgrading certificate course, and would be manifestly unfair to all those who have undergone this course since 1990. It would also defeat the purpose of the Bill which seeks to ensure competence in contact lens practice for the safety of the public. Optometry Diploma Course Sir, the adequacy of the Singapore Polytechnic's Optometry Diploma Course has also been criticised by some who advocate a University degree course in optometry. I would like to reiterate that the Singapore Polytechnic's Diploma in Optometry is recognised by my Ministry as adequate training for optometry in Singapore, and is also acceptable under the proposed Bill for contact lens practice. University Degree The question of setting up a University course in optometry in Singapore has been repeatedly raised by the Singapore Optometric Association and the Singapore Contact Lens Society. They have even lobbied for support from overseas professional organisations. They have written to the press and to my Ministry to urge us to adopt their approach in this matter. I think it is useful for me to elaborate on why this approach is not as necessary or as sound as it appears. Firstly, eyecare is provided by a whole range of providers ranging from opticians, contact lens practitioners, optometrists, general practice doctors to ophthalmologists. This wide range of providers caters to the many different needs for different levels of eyecare services, and not all of them need to be University trained. Secondly, we need to consider the local situation and requirements in Singapore.”
“We have sought their views, as well as those of ophthalmologists, academicians and so on, on various aspects of the proposed legislation. From these discussions, it was clear that while there is general support for the legislation, there are some who advocate a comprehensive control of all opticians, contact lens practitioners, as well as optometrists. There are also others who are apprehensive of the extent of control and have asked for special exemptions and a "grandfather's clause" to allow existing opticians to continue their practice in contact lens without having to pass examinations or attend the Singapore Polytechnic's certificate course. My Ministry has considered all these proposals very carefully in drafting the Bill. However, after thorough consideration, we have come to the conclusion that these additional proposals cannot be accepted. I will now explain the reasons. First of all, to extend the control to cover all opticians and optometrists will be outside the scope of this programme, which is to prevent the danger of injuries posed by the improper use of contact lens. As I have explained earlier, spectacles do not come into direct contact with the eyes and do not pose the same dangers as contact lens to the eyes. It is not the intention of my Ministry to legislate all activities and services that are related to health unless there is clear evidence of hazard, abuse or misuse. Otherwise, we will raise the costs to the public unnecessarily. There is at present no compelling reason to register opticians who do not deal in contact lens.”
“After we started the contact lens upgrading course in 1990, we have worked with the Registry of Companies and Businesses to prevent unqualified persons from setting up new contact lens practices. Regulations under the Medicines Act have also been introduced to control the quality and sterility of contact lens solutions sold in Singapore. In addition, my Ministry has worked with SISIR to come up with a Singapore Standard on Contact Lens to set quality specifications for contact lens. With these programmes in place, the time is now right for legislation to control contact lens practice in Singapore. This Bill is specifically drafted to meet this objective. Sir, I must stress at this point that this new legislation is not intended to control the dispensing and fitting of spectacles. Existing opticians who are not qualified to deal with or fit contact lens will still be allowed to continue their business in the fitting and selling of spectacles. This is because spectacles do not come into direct contact with the eyes and do not pose the same level of hazard as contact lenses. So, optical shops that deal only with spectacles need not fear that this new legislation may jeopardise their livelihood. Those who also deal with contact lenses will, however, have to ensure that they have qualified contact lens practitioners to continue to provide this service. Scope of Control In considering the scope of this control, my Ministry has received feedback and submissions from various optical and optometric bodies. We have met with representatives of the Singapore Optometric Association, Singapore Contact Lens Society and Singapore Society of Optometrists.”
“This course was started in 1990 and attracted a total of 303 applications from 278 optical shops. Of these, about 180 candidates met the entrance requirements and were accepted into the course in batches from 1990 onwards. The CCLP course has since produced 133 qualified contact lens practitioners. A final batch of about 20 will obtain their certificates this year. In addition, another group of 20 private students had also passed the examination at the Singapore Polytechnic. So the total number of existing practitioners who have benefitted from the programme is about 170. Besides these, there are also at present about 70 existing qualified optometrists in Singapore who have the necessary training to practise contact lens. Altogether, these 240 or so qualified persons would form the core of qualified persons who can carry out contact lens practice under the proposed legislation. Diploma in Optometry As a follow-up to this upgrading certificate course, my Ministry had also arranged with the Singapore Polytechnic to start an optometry diploma course at the Singapore Polytechnic to meet the future requirements of optometrists and contact lens practitioners. This 3-year full-time diploma course has formalised the optometric education in Singapore with yearly intakes of about 40 students who have good "O" level qualifications. The first batch for this diploma course was enroled in 1994 and is expected to graduate in 1997. With this course, we can expect to have a steady supply of about 40 qualified optometrists and contact lens practitioners each year from 1997 onwards. Other Safety Measures As a third measure, we have been promoting patient vision care through the Singapore National Eye Centre and other departments under my Ministry.”
“Mr Speaker, Sir, I beg to move, "That the Bill be now read a Second time." My Ministry had announced in a press statement in February 1990 that we intend to introduce legislation to control the practice of contact lens in Singapore by 1995. This was prompted by a number of reports of eye injuries and infections from the improper use of contact lens. A survey conducted by my Ministry in 1988 had revealed 320 cases of eye complications from contact lens, 23 of which were corneal ulcers which could have led to blindness if they had not been diagnosed and treated early. Another survey in 1992 showed that out of 194 cases of contact lens related complications seen within a 6-month period at the Singapore National Eye Centre, six cases required hospitalisation for complications including corneal ulcers, corneal abscesses and corneal abrasions. The Eye Clinic at the Tan Tock Seng Hospital also reported three cases of corneal abscesses from contact lens use in the same year. However, my Ministry realised that at that time the number of qualified contact lens practitioners and optometrists in Singapore was not sufficiently large to meet the demands of the large number of contact lens users (estimated at 150,000 to 200,000) and that immediate legislation could cause hardship to the existing practitioners and inconveniences to the public. So my Ministry embarked on a step-by-step approach to address this problem. I shall now outline the steps that we have taken since then. Part-time Certificate Courses Firstly, my Ministry arranged with the Singapore Polytechnic for the Polytechnic to offer a special 2-year part-time certificate course on contact lens practice (CCLP) to upgrade the existing practitioners.”
“We will have less control over the development impact of our contribution if the funds are channelled through a multilateral aid agency. Even if we start by donating a token sum to the ADF, as suggested by Dr Soin, the commitment will not be "one-off". It will grow with time as the funding needs of developing countries increase. We must ensure that the money we spend in aid, like all other items of public expenditure, is cost effective and produces the desired results. Dr Kanwaljit Soin: Sir, does the Deputy Prime Minister remember that Singapore borrowed money from the ADF loan facility between 1968 and 1972? We were recipients of that. Should we not consider helping other countries since we have made use of that loan? BG Lee Hsien Loong: We borrowed very small sums, Mr Speaker. We have prospered and developed through our own efforts by lifting ourselves up because really that is the way to prosper. If you want to do well, you do not do well through aid or cheap loans. You do well by working harder and uplifting yourself. You need assistance, technical training, that is helpful. We benefited from the Colombo Plan, and schemes like that. We believe that the best contribution we can make is similarly by offering technical training to developing countries in the region, and we have a substantial programme. Every year about 800 foreign people come to be trained in Singapore on various activities. Some longer, some shorter. And we believe that is the most cost effective way of doing it.”
“Mr Speaker, Sir, a self-employed person is only required to contribute to Medisave if his net trade income exceeds $2,400 a year. If a full-time employee holds a vocational licence as a contingency measure against unemployment and earns less than $2,400 a year from driving a taxi, there is no need for him to make additional contributions to Medisave. However, if a full-time employee also derives income exceeding $2,400 a year from self-employment, he will have to contribute to Medisave based on all the sources of income. This is similar to employees who hold multiple employment. ASIAN DEVELOPMENT FUND (Financial loan) 15. Dr Kanwaljit Soin asked the Minister for Finance if he will consider a change in Singapore's policy so that besides giving technical assistance to other Asian countries through the auspices of the Asian Development Bank, we begin to contribute a small amount as a financial loan to the Asian Development Fund for soft loans to Asia's poorer countries. BG Lee Hsien Loong: Mr Speaker, Sir, Singapore offers technical assistance to developing Asian countries both on a bilateral basis such as through the Singapore-ASEAN Training Awards and the Indochina Assistance Fund, as well as multilaterally through international organisations like the ADB. Under these programmes, we have conducted courses in civil aviation and port management, among others, that are relevant to the needs of the developing countries. We believe that this approach to assisting developing countries is more effective and better targeted than contributing soft loans to multilateral development agencies like the ADB and World Bank. Through our training programmes, we have been sharing our knowledge and skills directly with the countries to develop their human resources.”
“If we receive requests of this nature, we could consider them within the resources that we have. SIXTH AVENUE (Widening or provision of bus bays) 3. Mr Yeo Toon Chia asked the Acting Minister for National Development whether there are any plans to widen or to provide bus bays along Sixth Avenue to ease traffic flow. The Senior Parliamentary Secretary to the Acting Minister for National Development (Mr Matthias Yao Chih) (for the Acting Minister for National Development): Mr Speaker, Sir, Sixth Avenue is a collector road serving the residents in the area. However, there is considerable extraneous traffic using the road. There are two bus services along Sixth Avenue. Some congestion is observed along the road during the peak hours, especially at its junctions with Bukit Timah Road and Holland Road. Recently, some improvements were carried out to Sixth Avenue at its junction with Bukit Timah Road. There are no plans to widen the road or provide bus bays along Sixth Avenue as such work would require acquisition of private land. Sixth Avenue is intended to serve as a collector road for the residents in the area, and not as an arterial road linking Bukit Timah Road to Holland Road and Ulu Pandan Road. For the latter purpose, Farrer Road and Clementi Road have been widened to dual 3-lane arterial roads.”
“A more immediate concern for us is the inadequate coverage of dependent children in MediShield. Unlike Medisave, account holders are automatically covered by MediShield unless they opt out, dependent children need to be opted in by their parents in order to be covered. Our statistics show that only about 25% of the 800,000 dependent children below the age of 18 years are presently covered under MediShield or MediShield Plus. This is the problem. We will run a publicity campaign to urge parents to opt in their new-born and other dependent children as early as possible under MediShield or MediShield Plus so that they can have some protection against the high cost of some medical treatment, particularly those suffering from prolonged illnesses. The premium is very affordable. It is only $1 per month for the basic MediShield scheme. If, however, the voluntary approach fails, we may have to consider changing the legislation to provide automatic coverage of dependent children unless their parents opt out.”
“For FY93, 18,500 applications for help from Medifund were approved. The estimated figure for 1994 is 22,600. These represent 99.6% of the applications. For bad debts, the Singapore General Hospital started using the services of legal debt collectors in 1991, Tan Tock Seng Hospital in 1992 and Kandang Kerbau Hospital in 1993. For Government hospitals, cases of bad debts have always been referred to the Attorney-General's Chambers for assistance in debt collection. The criteria for the selection of legal debt collectors are purely based on cost and effectiveness. Generally, the hospitals use the services of legal debt collectors only as a last resort. This means that the hospitals assign bad debts to the agencies for collection only after all normal procedures on debt collection have been exhausted, and these include at least three follow-up reminders after the first billing and numerous phone calls to the patient or family members, but all these attempts produce no response. The hospitals have decided to use legal debt collectors as they do not have the resources to proceed further with debt collection given the volume of bills generated. Again, I do not have the specifics of the particular case that Mr Chng talked about. I agree with him that hospitals should not resort to this course of action unless it is absolutely necessary and unless the families have not been cooperating with the hospitals' reminders and so forth. The hospitals do investigate the circumstances if the family comes forward and explains the financial situation to them. BG George Yong-Boon Yeo: Sir, with your permission, I would like to make an additional point in response to Dr Kanwaljit Soin's point earlier about MediShield.”
“Under our monitoring system, the hospitals which show any significant increase in the average length of stay will be asked to explain the variation to us. So far, the average length of stay in the hospitals has remained fairly constant. There is no indication of abuse of the revenue cap system by the hospital in this manner. My Ministry is considering some incentive arrangements which will reward the hospitals for reducing the average length of stay and penalise those which increase the length of stay of patients. At present, the Ministry has no plans to move towards control of hospital charges by the DRG system, as mentioned by Dr Chen. However, it remains an option for the future. As my Minister explained last year, the DRG reimbursement system is not without problems. It could lead to a lower quality of care and hospitals may shunt patients with acute medical problems where the DRG reimbursement may not be adequate. The system is also complicated and costly to administer. In fact, it is estimated that in the United States the cost of administering the DRG amounts to 8-10% of the total reimbursement from Medicare. Therefore, we have to weigh the cost and benefits very carefully before we decide to implement this system. Mr Chng Hee Kok raised the question of some restructured hospitals using legal debt collectors. Let me say from the start that persons owing bad debts who are referred by the hospitals to legal debt collectors are usually not destitute. In the hospitals, patients who are unable to pay the bills because they are poor are referred to the medical social worker and they will have recourse to assistance from Medifund. All applications for remission of charges or to pay by instalments are considered sympathetically.”
“I understand that the average time within which the ambulances were able to reach the location of the accident has not increased as compared to last year. So there has been no slackening in the response to such emergency calls. The Civil Defence Force continues to find ways to enhance the skills of the ambulance officers so that they can give a higher level of care to the casualties before reaching the hospitals. For example, the ambulances are now equipped with semi-automatic defibrillators. With the professional support from my Ministry, all the ambulance officers have now been trained to operate the device. So with this capability a patient, say, with a major heart attack, has a much greater chance of survival before reaching the hospital. All these measures have enhanced the performance of the Civil Defence Emergency Ambulance Service to serve the public better. Dr John Chen raised the point that a revenue cap imposed on the public sector hospitals may have some undesirable consequences in terms of the type of service given to patients. One example is that it may result in a longer length of stay than is necessary. Yes, it is possible that capping revenue by patient day could result in a longer length of stay than is necessary, especially if a hospital has too many beds. However, currently there is no excess bed capacity in our public hospitals. Bed occupancy is generally quite high, about 80% and over, except for Alexandra Hospital and Changi Hospital which have an occupancy rate of around 60%. 80% is high because of the need for turnover time. My Ministry closely monitors the average length of stay of the patients in the public sector hospitals. For acute hospitals, the average length of stay is short, about five days.”
“Sir, Mr Peh mentioned two cases at NUH where the patients did not receive prompt medical care as expected. Let me explain to the House that in our public sector hospitals, including NUH, we employ a team concept for the provision of medical care for the patients. Every patient is admitted under the care of a consultant who is assisted by specialists of Registrar and/or Senior Registrar grade and by medical officers. All the inpatients are seen by the attending specialist within 24 hours of admission. And ward rounds to review all patients in the ward are conducted daily by the specialists and the medical officers. Patients who are very ill are brought to the attention of the consultant in charge who will review the patient immediately. For patients in the intensive care unit and high dependency beds, the consultant in charge reviews the patients daily. This is the general practice in all our public sector hospitals. I do not know whether there could have been a misunderstanding or miscommunication in these two cases. I am very sorry to hear that these two cases have occurred, as quoted by Mr Peh, and if he can provide me with the details of these two specific cases, my Ministry will investigate the matter. I must say that health care is a very intensive personalised service. So the challenge is for all the hospitals to keep the number of such cases to a minimum. 3.45 pm As for Emergency Ambulance Service, last year the Singapore Civil Defence Force Emergency Ambulance Service responded to a total of 58,400 calls. In spite of this huge number of calls, their ambulances have been able to reach the location of the accident within 11 minutes from the time of call.”
“Hospitals have to work within this revenue cap. This would exercise quite a bit of pressure on them to control costs.”
“I like to point out that the cost figures given in the Budget book refer only to Government acute hospitals, that is, Alexandra Hospital, Changi Hospital and the Communicable Diseases Centre. They do not include the restructured hospitals. These figures, as quoted by Mr Othman, do show an increase in the cost per patient day, cost per outpatient attendance and cost per A&E attendance for Government hospitals. What has happened is that there is a technical problem involved. The figure for FY90 included Tan Tock Seng Hospital which was not restructured then. It was still a Government hospital. So when Tan Tock Seng Hospital was restructured, and because it is a large hospital with a very high patientload, and when you take it out from the statistics, the rest of the hospitals' costs would appear to have increased, because they have a lower workload, but the same fixed overheads. As for the restructured hospitals, the increase in cost per adjusted patient day between 1990 and 1994 actually ranged from 3% to 8% a year. So cost increases are generally under control. As you know, the restructured hospitals have been trying to cut cost by streamlining the management and administration, subcontracting out auxiliary services, and adopting commercial accounting procedures and so on. My Ministry also coordinates the introduction of new medical technology to avoid unnecessary duplication of expensive facilities. We also control the ambience, the service norms and the standard of service given by the restructured hospitals. Furthermore, with the recent introduction of the revenue cap system in 1993, hospitals are not allowed to increase the revenue per patient day by more than CPI plus X. In 1993 and 1994, CPI plus X was fixed at 5% a year.”
“15 pm The idea suggested by Dr Lim is that there should be more day-care centres providing personal care, simple rehabilitation and simple nursing care. We can draw on the local neighbourhood community to help us provide these facilities. It is already successfully done by the Ayer Rajah CCC and the Yuhua PAP Community Foundation in their respective constituencies. This is an area where we would welcome a lot more participation by local neighbourhood groups and community organisations to deliver care services to the elderly right where they live. So community-based services constitute the third strategic direction that we are moving into. But in the long run, we must also make sure that the services are quite well distributed throughout the island. That is why my Ministry is working on the idea of three regional networks that would link up the services available for the elderly sick within a certain region. The Alexandra Geriatric Centre is the first regional centre we have set up to link up services provided by polyclinics, rehabilitation centres, home nursing, domiciliary medical care, and so on. Mr Loh Meng See asked if more Medifund could be provided for B2 patients. B2 patients are eligible to apply for Medifund. But I must emphasise that Medifund is a help of last resort. "Last resort" means that the applicant must have used up his Medisave first and the Medisave of his immediate family members before he is qualified to apply. But depending on the circumstances, B2 patients are also eligible for Medifund help and we would definitely look at each case sympathetically. Finally, the point raised by Mr Othman Haron Eusofe on the performance indicators given on page 390 of the Budget book.”
“So the other strategic direction in which we must move is to provide early treatment and rehabilitation so that any functional disability or residual disability would be minimised. The third strategic direction is to develop community-based services to support the family care givers. As Dr Michael Lim noted, the family size is getting smaller and more couples are working. So in future it would be more difficult to take care of the elderly members in the family setting. Yes, that is why it is important for us to provide support to the family care givers so that they can discharge their obligation towards the older generation. On community-based care, which is the main point raised by Dr Michael Lim, our approach has always been one of partnership with the voluntary welfare organisations, religious and civic bodies, even with grassroots organisations. This partnership has worked very well as seen in the number of voluntary nursing homes which have been set up by these associations with direct funding from the MOH, as well as from the number of day rehabilitation centres and day-care centres run by these associations. Dr Lim mentioned that we should aim to locate the day-care centres right in the population concentration areas. This is, in fact, what we have done. All the day rehabilitation centres and day care centres are presently located in the housing estates, such as in Tampines, Hougang, Toa Payoh and Bukit Batok. I agree with him that day-care centres should be easily accessible to the population. As such, HDB void decks are the preferred locations and my Ministry will continue to work closely with HDB and URA to identify suitable void decks to site future centres. 3.”
“Mr Loh Meng See and Dr Michael Lim have talked about the need for more health care services for the elderly, in view of our ageing population. First of all, let me say that I completely agree with Mr Loh that we need to take a total approach to the needs of the elderly in the areas of employment, financial security, health and social services. Thus, the responsibility is not that of my Ministry alone. But allow me to talk a little bit about what my Ministry has been doing for the elderly sick over the last few years. We have over the last few years put in place a number of programmes for the elderly sick. These programmes follow from a broader conceptual framework which provides directions for the planning and delivery of services for the elderly. Fundamental to our approach is the objective of keeping the elderly as functionally independent as possible, so that they can be cared for in the familiar environment of their own home and community for as long as possible. We believe that the elderly belong to the families and therefore we must encourage the family unit to take a major responsibility in looking after their frail and sick elderly members. Our aim is to provide the family with the necessary support services to enable it to fulfil its obligation towards the older generation. Mr Loh made a very good point, that is, we must try to keep the elderly population as healthy as possible. I agree with him. Promoting good health among the elderly to prevent and delay the onset of disease is one of our strategic goals. But as we all know, as one gets older and older, the probability of falling sick increases, and even if one is not sick, one becomes more and more frail.”
“The TPE will be linked to the Seletar Expressway (SLE) and Central Expressway (CTE) with the completion of the interchange at Lorong Halus in 1997. ESTIMATES OF EXPENDITURE FOR THE FINANCIAL YEAR 1ST APRIL, 1995 TO 31ST MARCH, 1996 Order read for consideration in Committee of Supply [4th Allotted Day]. [Mr Speaker in the Chair] Head R (cont.) - Resumption of Debate on Question [17th March, 1995], "That the total sum to be allocated for Head R of the Main Estimates be reduced by $100." - [Mr Peter Sung]. Question again proposed.”
“Sir, the Ministry would be able to post more doctors to polyclinics by the middle of this year. This would help to reduce waiting time somewhat. However, waiting time at the polyclinics depends not only on the number of doctors but also on the arrival time of the patients. The waiting time at peak hours is longer than at non-peak hours. In general, the median waiting time to see the polyclinic doctor after registration, as shown in a January 1994 survey, was 19 minutes. Patients who require repeat visits to the polyclinics are given appointments during off-peak hours. We have been educating polyclinic patients to keep to their appointments. LOYANG AVENUE/TAMPINES EXPRESSWAY/UPPER CHANGI ROAD NORTH (Improvement to roads) 5. Mr Teo Chong Tee asked the Acting Minister for National Development whether the roads in the vicinity of Loyang Avenue, Tampines Expressway and Upper Changi Road North will be improved to accommodate the increasing vehicular traffic during peak hours. The Senior Parliamentary Secretary to the Acting Minister for National Development (Mr Matthias Yao Chih) (for the Acting Minister for National Development): Mr Speaker, Sir, the Public Works Department has plans for improvement projects to accommodate the increasing vehicular traffic in the vicinity of Loyang Avenue, Tampines Expressway (TPE) and Upper Changi Road North. A section of Loyang Avenue from Pasir Ris Drive 3 to TPE will be widened in 1996. Loyang Avenue's junction with Pasir Ris Drive 1 and Drive 3 will be improved as part of the road widening project. The present interchange of the TPE with the Pan-Island Expressway (PIE) will be upgraded in 1997. In the upgrading, new flyovers will link the PIE with the TPE.”
“As I said just now, the private clinics are also required under the licensing Act to display their charges. A survey conducted in 1993 by the Ministry's Medical Audit and Accreditation Unit to assess the status of display of charges at the medical clinics prior to the implementation of the Private Hospitals and Medical Clinics Act at 100 randomly selected private medical clinics showed that at that time only 40% of the clinics displayed information on charges. However, by the end of 1994, information obtained during the licensing of medical and dental clinics showed that 100% of them have complied with this requirement of display of charges in the clinics. MEDICAL STAFF IN POLYCLINICS (Increase in number) 4. Mr Yeo Toon Chia asked the Minister for Health if his Ministry will consider increasing the medical staff in polyclinics so as to reduce the present waiting time.”
“Sir, the Private Hospitals and Medical Clinics Act, implemented in 1994, requires all private and public health care establishments to inform every patient on or before admission of the estimated charges which are likely to be incurred for hospitalisation, investigation and treatment. Every medical practitioner is required to provide information to the patient on the consultation, investigation and treatment charges. Every licensed clinical laboratory must provide a printed list of charges to doctors or patients on the laboratory tests to be performed. The Ministry ensures that these requirements are complied with during licensing. Regular inspection of health care establishments has shown that the hospitals are complying with this requirement. The public is also provided with additional information on hospital charges through displays of notices, brochures and pamphlets which are freely available at the A&E, outpatient, wards and other public areas of the hospitals. To prevent over-prescription or over-investigation, hospitals are required to conduct regular in-house medical audits of the doctor's prescribing practices.”
“At present, the Ministry is assuming half of the financial responsibility for the special schools, the other half being borne by the NCSS. I do not fully agree with Dr Soin's view that special education should entirely be the responsibility of the MOE. I think it should be a responsiblity shared with the community. This approach has always been the case and has worked out well. The Ministry helps the special schools with finance and curriculum development. We loan teachers to the schools. The financial cap that we have adopted is quite generous, up to four times the cost of educating primary school students in ordinary schools, and as far as I know many of the special schools have not required financing up to this maximum cap. In fact, some of them still have quite a distance to go. So the financial arrangement, so far, is fine.”
“Kindergartens should rightly be for the education of the child and, in practice, you will find that many kindergartens run very short programmes, either two hours or four hours, and this is by no means a solution to enable married women to work. Then he said that perhaps if we have these kindergartens run by the Government with grants and so forth, we can also provide opportunities for retired teachers. While this may seem attractive, I think for pre-school education you also need some specialised training. It is not that everybody who is interested in doing so can do so. You need to receive specialised training in pre-school education such as those offered by the NIE. And also you will notice that a lot of the teachers in kindergartens are young girls rather than people who are middle-aged and above. So it may take a special type of personality and interest as well as training. We should not look at the amount of surplus the Government has and say that given this $5 billion surplus, why do we not spend some more on pre-school education. The question must be for what purpose - is it necessary, would it be beneficial? In my opinion, pre-school education is best left to the private sector. In fact, they can do a good job in offering a wide range of programmes. If the centres come under Government, the tendency is to have uniform programmes, prescribed curriculum, all kinds of rules and regulations, restrictions on what they can do, what they cannot do. This is not desirable. The present situation is satisfactory. The Ministry's job is to concentrate on formal schooling from six years onwards, and many countries, many governments in the world, are doing the same thing. So why should we do something entirely different?”
“Sir, allow me to reply to Mr Cheo's point about Government providing for pre-school education. The Government's policy is to concentrate on formal education from Primary One onwards. The provision of pre-school education should be left to the private enterprises. We have pronounced this policy quite clearly in the past. At the moment, there are already 422 education centres and private kindergartens providing pre-school education. They are generally doing a good job and in spite of what Mr Cheo said, a lot of them charge quite affordable fees, especially the PCF kindergartens, many of which charge in the range of $20 to $25. Only some, which have been recently renovated and offer very much upgraded facilities and programmes, charge higher fees, in the region of $75 to $80. Of course, some private kindergartens charge much more but this is up to the parents' choice. The general philosophy should be that the Government should concentrate resources in teaching children of the formal schooling age, and where the private sector can do a good job in pre-school education, the Government should allow them the freedom to do so. The role of the Ministry of Education in pre-school education is to regulate the operation of the kindergartens in accordance with the provisions of the Education Act. We try to ensure that they provide safe and adequate facilities, that they have suitably qualified principals and teachers and also run an acceptable curriculum. Mr Cheo's proposal seems to suggest that pre-school kindergartens should be used as a child care facility in order to enable married women to work. I think that is a wrong use of kindergartens.”
“Sir, I am sorry I forgot to answer one point raised by Mr Sinnakaruppan. Now that we have more money in the Edusave Endowment Fund, we have in fact an additional $1 billion, he asked whether we intend to extend the Edusave grant to primary schools. Yes, the Ministry is planning to extend the Edusave grant to primary schools from next year. The amount has still to be determined. We will see how much income this additional $1 billion would generate before we know how much we can disburse.”
“In fact, each school has a learning support coordinator who would administer a screening test to see what kind of specialised help they need. The selected children would be withdrawn from the classes to be taught in small groups, during curriculum time but in withdrawn classes. The progress is closely monitored by the learning support coordinator, the classroom teacher as well as by our educational psychologists. Once the children can perform up to standard, they are transferred back to study in the main class with their peers. We also run workshops for parents to provide home support and teach parents how to supervise and help the children with the school work. The remediation programme is given mainly to primary one children but in some places, where there is a need, we also give it up to primary three level. As I said, depending on the results of the current pilot project, we may extend this programme to even more schools in future. Since the Ministry runs the special programmes at no extra cost to the pupils, as we give the additional teachers, the question of using Edusave fund for such purpose does not arise.”
“Finally, let me come to Encik Imram's question on what the schools are doing for the below average students. As Encik Imram pointed out, many of the children who perform below average in schools come from low income families or broken homes, and if we do not help them at an early age, they stand at risk of failing in school with social consequences for themselves and the community. We have instituted special programmes for children with learning difficulties. Generally speaking, there are two broad groups of students for whom we have devised specialised programmes. One is the group that he talked about, ie, the students who are slow learners. They are the below average students. The other group is students who have average and above average ability but they are not performing up to the potential. So we have specialised programmes for these two groups of students. For the below average students, to-date, there are already 80 primary schools which have a specialised programme to cater to them. But right now, we are running a pilot project in 20 schools where we want to streamline the two specialised programmes that I have just talked about, ie, catering to the two different groups of students, trying to pool resources, streamline procedures and so on, in order to improve further these programmes that we provide for them. So depending on the results of this pilot study this year, we would consider extending the specialised programme for below average students to more primary schools in future. In the programme for the below average pupils, the thrust is on the early identification and remediation of the bottom 20-30% of primary one children who are considered to be at risk of failing in school. The Ministry has given additional resources to teach these students.”
“The content provides pupils with knowledge of the physical changes and aims to help them cope with the physical and emotional changes arising from adolescence. At the lower secondary level, sex education is given greater breadth of treatment through the topic "sexual reproduction in human beings" in the science syllabus. Home economics also teaches about the developing stages into womanhood and manhood, and personal hygiene, including menstruation and so on. In science and home economics, the teachers are to convey the moral attitudes and responsibilities related to sex and to emphasise responsible sexual behaviour. So it is not taught out of the social or moral context. Of course, in civics and moral education, responsible behaviour and moral values are the main focus of this separate subject. The topic on "boy-girl relationship" is included in the formal curriculum of civics and moral education. This includes themes on coming to terms with one's own sexuality, developing healthy relationships with members of the opposite sex and taking and accepting responsibility for one's actions as well as responsibility in marriage and parenthood. Apart from this cross-curricular approach, there are ECA activities which reinforce self-discipline, moral fortitude, responsibility, and so on. I think it is a matter of opinion whether sex education should be taught as a separate subject or whether it could be taught in a cross-curricular manner. Occasionally, these topics are brought together when Ministry of Health officials visit schools and give talks on sex education. But these are necessarily of short duration and are rather focused lectures. We have actually included all the topics that she thinks we should include in the broad definition of sex education.”
“I agree completely with Dr Ow that the teaching of Civics and Moral Education should not just be based on book knowledge. It should come from the teachers acting as role models. It should also be reinforced in extra-curricular activities, group activities and community service projects, and so on. We are implementing that with every intention to teach our children, each and every one of them, to become a good citizen with upright character and of use to the society. Let me come to sex education. I would like to thank Mr Peh and Dr Soin for supporting the teaching of sex education in schools. For a long, long time the Ministry of Education has been very cautious about teaching this subject. As Members know, our population is a rather conservative one. But in the face of rapidly changing social values and exposure to all kinds of external influences, we cannot but incorporate sex education as part of our school curriculum. But sex education is not taught as a subject on its own, as Dr Soin has rightly pointed out. The approach we have adopted in the teaching of sex education is cross-curricular where aspects of sex education are covered in several relevant subjects. I would not say that they are irrelevant. They are relevant. They may seem disconnected but they are actually not, if you know about the contents and the way we teach sex education in progression. The relevant subjects include health education in the primary schools and science, home economics and civics and moral education in the secondary schools. Both factual and social aspects are covered in these subjects. At the upper primary level, through health education, pupils are taught to prepare for puberty and early adolescence.”
“Therefore, Edusave is not extended to the fourth child. As for disabled children, again she knew from last year's debate that the Ministry's stand is that disabled children already enjoy four times the per capita grant as compared to primary school children in the ordinary schools. In that sense, they are given very special treatment already. Let me move on to Dr Ow Chin Hock's question on moral education. Yes, it is an old and long story. But occasionally it is salutary for us to remember the rationale for our policy. Moral education has been introduced in our schools in one way or another way back since 1959. Dr Ow mentioned the Report on Moral Education under the chairmanship of Mr Ong Teng Cheong and some developments since then. Yes, we adopted the recommendations of that Report as seen in the textbook series on "Good Citizens" and "Being and Becoming". These two series were replaced somewhat later because we introduced Religious Knowledge in the schools. Then Religious Knowledge was reviewed and replaced by a new syllabus on Civics and Moral Education. Beginning in 1992, the new Civics and Moral Education has been introduced in secondary schools and the whole programme would be completely phased in by 1996. As for the primary schools, the "Good Citizens" series have been revised and already fully implemented two years ago. In this new syllabus on Civics and Moral Education, we have included all the basic tenets that were recommended by the Ong Teng Cheong Report and more. We have moved beyond that to include the five national core values as well as the more recent prominence given to family values. I like to say that the curriculum has been very carefully designed and based on very sound pedagogical principles.”
“The participation rate by accounts is much higher. We have seen an increase in the participation rate. He asked whether the Minister could consider extending the use of the Edusave Pupils' Fund to, say, activities carried out by self-help groups. Again, the original purpose of the Edusave account is for enrichment programmes organised by the schools. They are meant for the programmes which are school-based. I understand that many of the self-help groups are running mainly tuition classes at the present. They may have some plans to offer enrichment programmes to the students. These students can already participate in the enrichment programmes run by their own schools by using the Edusave Pupils' Fund. There is nothing to prevent them from joining those school-based activities. I do not know whether Mr Sinnakaruppan is thinking of having these self-help groups organise school holiday camps, museum visits and so forth. What kind of enrichment programmes is he thinking of? Edusave is for school-based enrichment programmes. However, we are not entirely closed to the idea. I think we can discuss this further, but there may be practical difficulties in implementation, administration and so forth. I think this can be considered and we are not entirely closed to the idea. 2.30 pm Dr Kanwaljit Soin raised two questions on Edusave for the fourth child as well as for disabled children. She had raised these questions last year. The position of the Ministry is still the same at this point. We are not giving Edusave to the fourth child because we have this population policy to discourage parents who cannot afford to have more than three children not to have a fourth. We must adhere to the objective of our national population policy.”
“I must emphasise that the underlying philosophy of Edusave is that parents should pay for some part of the expenses for basic education of their children. So every parent is required to pay the school fees as well as the miscellaneous fees. Edusave funds can only be used for the second tier miscellaneous fees and for the autonomous schools' additional miscellaneous fees that they can charge if they need to. The school fees and miscellaneous fees are quite small, even for autonomous schools. For secondary schools, it is $5 for school fees and $7 for miscellaneous fees. The second tier miscellaneous fee is only $2.10 maximum. The autonomous schools charge an additional miscellaneous fee of $3. Over and above this, they can levy a discretionary amount up to $15, but no autonomous school is charging that. Edusave is allowed to pay for the second-tier and additional miscellaneous fees in autonomous schools. As for independent schools, the same principle applies. In fact, the Edusave scholarships in independent schools help pupils pay for the independent school fees over and above what other pupils would be paying for the standard school and miscellaneous fees. If students have difficulty in paying for school fees in the independent schools and they are not on the scholarship scheme, the financial assistance schemes are still operational in independent schools. They can apply for these financial assistance schemes. There should be no problem to their applications if they meet certain income criteria. Mr Sinnakaruppan commented that there is actually a rather low withdrawal rate for the Edusave Pupils' Fund. This is true. But the percentages of 3.5% for primary schools and 16.9% for secondary schools he quoted actually refer to the amount of money withdrawn.”