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 Peh Chin Hua mentioned that because the Edusave scheme is relatively new, parents and the public do not fully understand its purpose and usage. I think he has a point there. I think we need to do more to inform the public on what the Edusave fund is for, as well as to dispel some of the misunderstandings that they may have already got. One such misunderstanding is that Edusave may be used as donations towards school building or extension funds. In fact, this is not the case. MOE has instructed the schools that the Edusave Pupils' Fund cannot be used for the building of school facilities. But if the students voluntarily, and with the consent of their parents, want to donate the fund to the school, it is only for the purpose of the Edusave scheme itself, which is for enrichment activities. I do not think many students have done that. There are some misconceptions about the use of Edusave funds and I think we need to do a bit more publicity work. I do not entirely understand the point made by Mr Peh that we should allow the constituency bursary and scholarship funds to run in parallel with Edusave scholarships. I think they run in parallel anyway. If he is suggesting that perhaps to publicise the Edusave scheme, we could have, say, a concomitant giving-out ceremony in the constituencies, it can be considered. But there may be some practical problems, because some students who receive Edusave scholarships may not go to a school in the constituency which gives him a bursary, and so on. I think there are practical problems here. Mr Chew Heng Ching also asked if the Edusave fund can be used for activities which could help to reduce school fees in autonomous and independent schools, because he is of the opinion that these school fees are rather high.”
“The other is the yearly awards for pupils in the top 5% based on the school examination results each year, and these pupils are not on the 4-year scholarship scheme. In 1993, a total of 705 students have benefited from these scholarships in independent schools. In 1994, the numbers have gone up because the 4-year scholarships are cumulative. The total number has gone up to 913. As for Edusave scholarships in Government and Government-aided schools, these are given to the top 10% of the pupils based on school examination results. In 1993, a total of 3,347 students in Government and Government-aided schools received these scholarships. In 1994, the number has increased to 8,485. So you can see a large number of students have benefited from these scholarships. Scholarships for independent schools and scholarships for Government and Government-aided schools together took up a total amount of $2.48 million in 1993 and $6.1 million in 1994. Finally, there is the Edusave Pupils' Fund. These are contributions by the Government to each pupil's Edusave account. In 1993, each pupil received $50; in 1994, $100; 1995, $110. Because this is for every student in the mainstream schools, the number of pupils who benefited is very huge. In 1993, a total of 349,000 students received contributions in their Edusave accounts. In 1994, 358,000 students received contributions. The total amount given out in 1993 was $17.5 million. In 1994, it was $35.9 million. Thus, the income from the Edusave Endowment Fund has benefited both schools and students alike. We are conscious of the fact that we need to exercise tight control over the way the schools spend the grants and students use their Edusave money.”
“Sir, I would like to take the questions on Edusave first. Mr Peh Chin Hua, Mr Chew Heng Ching, Mr Sinnakaruppan and Dr Kanwaljit Soin have spoken on the topic. And questions have been raised as to how the funds have been used, how many people have benefited, and whether the money has been put to good use. So I will take this group of queries first. There are three schemes to the Edusave Fund. First, there is the grant to Government and aided secondary schools. Second is the scholarships scheme to top pupils in independent schools and in Government and aided secondary schools. Third, the pupils' Edusave accounts. Edusave grants to Government and Government-aided secondary schools are given to the schools to enable them to buy services and resources and to introduce programmes that would enhance the quality of teaching and learning. The amount of the grant is pegged at $90 per pupil. Roughly, each school will get up to an average of $100,000. In 1993, the total amount which had been allocated to the schools was $12.4 million but, in fact, only $6.8 million was used, giving a utilisation rate of 55%. In the second year of implementation, 1994, the utilisation rate has improved quite a great deal. The amount allocated was $14.5 million. The total amount used or expended was $11.5 million. The take-up rate or utilisation rate was thus 80%. The schools have been making quite good use of these Edusave grants. As for the Edusave scholarships, as I said, there are two types. One is for independent schools. The other is for Government and Government-aided schools. Edusave scholarships for independent schools fall into two categories: one is the 4-year scholarships which are awarded to the top 25% of Secondary One students in the independent schools based on the PSLE results.”
“Yishun is a big town and the population is not yet stabilised. Currently, there are already 40 GP clinics and 15 dental clinics in Yishun New Town. So there is already adequate provision of primary health care in Yishun. HI-TEK VEGETABLE FARMS PTE LTD (Bankruptcy) 2. Mr Cheo Chai Chen asked the Minister for Labour whether his Ministry is aware that a company named Hi-Tek Vegetable Farms Pte Ltd, of which the Economic Development Board is one of the shareholders, has been declared bankrupt and that it is still owing a few employees their salaries and, if so, whether his Ministry has taken any action to assist these employees.”
“Sir, a polyclinic and a community hospital serve very different types of clients. One is on an outpatient basis and the other is on an inpatient basis. Right now, the Ang Mo Kio Community Hospital is the first prototype community hospital we have built. We would like to see for a longer while how it works out before we consider building another one anywhere else in Singapore. Mr Cheo Chai Chen: Sir, does the Minister agree that Yishun Town is a very big town and such a big town should have a Government polyclinic to serve the residents?”
“They function like independent schools in having more flexibility and resources to introduce innovative programmes. However, they remain as Government or Government-aided schools and follow the same norms in class size and staffing set for these schools. The Government gives the autonomous schools 10% to 15% more funding per pupil as compared to other secondary schools. Pupils in the autonomous schools pay slightly higher fees than those in other Government and Government-aided schools. With the establishment of the independent and autonomous schools, parents have a wider choice of schools for their children. My Ministry is planning to designate six more schools as autonomous schools in 1996, making a total of 18 autonomous schools. This is likely to be the maximum number.”
“There is no cut-off point for Medifund as such. It depends on the circumstances of the case. If the patient's Medisave is not sufficient to cover the hospital bills and so on, he can actually seek and use the Medisave balance of his family members because this is the principle of family self-help. But if the family members together still cannot meet the bills, then the patient can apply for support from Medifund. AUTONOMOUS AND INDEPENDENT SCHOOLS 9. Mrs Yu-Foo Yee Shoon asked the Minister for Education what is (i) the difference between autonomous and independent schools and (ii) the targeted number of autonomous schools. The Minister for Education (Mr Lee Yock Suan): My Ministry has allowed eight secondary schools to be converted to independent schools so that they can have greater flexibility to try out innovative programmes to improve the quality of education. The Ministry will then apply the lessons learnt from the experience of the independent schools to other schools. The independent schools follow the bilingual policy and offer the core curriculum like other schools. The boards of management of the independent schools have the power to appoint and dismiss their staff and decide on staff salaries. The independent schools have enhanced facilities for which they raise 20% of the cost. The Government gives the independent schools the same per capita subsidy as it gives other Government and Government-aided secondary schools. Additional costs per pupil of extra staff and programmes are charged to parents as increased school fees. With the experience gained from the independent schools, my Ministry has designated 12 secondary schools as autonomous schools.”
“Yes, of course. We have repeatedly said so in this House many times. For A&E cases especially, there is no question whether you need to have a Medisave account or deposit. But if you go in as an inpatient and it is an elective surgery situation, I think all these processes would have been done before the patient is admitted. This is actually to expedite the processing of admission.”
“Mr Speaker, Sir, the supplementary questions are not entirely related to the main question. The main question is on application for Medifund. If the Member would like to ask about the use of legal debt collectors, I think he should file another question.”
“I do not have the statistics on what is the average length of time it takes for an application to be processed. I believe it is done very expeditiously. It also depends on the circumstances of the case. It is not true that people who have no Medisave would be turned away. Medifund is based on the principle that those people who have consistently contributed to Medisave would be given somewhat better consideration. But for those who have not, again depending on the circumstances of the case, they would be considered.”
“There are some administrative criteria used. Being a main breadwinner of the family does give some consideration for priority. URUGUAY ROUND OF GATT AND WTO (Ratification of acceptance by Parliament) 11. Dr Kanwaljit Soin asked the Minister for Trade and Industry why Singapore's acceptance of the Uruguay Round of the General Agreement on Tariffs and Trade and the World Trade Organisation need not be ratified by Parliament.”
“Mr Speaker, Sir, between 1986 and 1993, a total of 172 patients went overseas for kidney transplants. The transplants were done mainly in India and China. About half of them acquired various types of infections following their transplants, of whom four persons contracted the Human Immunodeficiency Virus (HIV) infection. So far, 11 have died and another 11 have lost their grafts after returning to Singapore. As at January 1994, 429 patients are on the Transplant Register awaiting kidney transplants. Of these, 150 are new patients registered in 1993. The median waiting time for transplants is three years.”
“I can assure the House that the increased enrolment of 9,000-plus students in Primary 1 can be accommodated quite comfortably within our present primary school resources because, within the primary schools, teachers can be deployed to teach subjects quite easily and the classrooms and facilities are already available. After 1996, would there be a drastic contraction? This is not the case. The Member will note that the number of students who enter Primary 1 every year is dependent on the birth rate six years ago. In 1986, I think we reached a historic low in the number of births. After that, the number of births rose. In 1988, we had a bumper crop, the Dragon Year babies. From 1996 onwards, we will begin to take in babies born in 1989 and the years after. The number of babies born every year since 1989 has been over and above those born six years ago. So every year, for the number of primary school students who would leave Primary 6, there would be more number of students in Primary 1 to fill the places. So there is no contraction. DOMESTIC VIOLENCE AND PROSECUTIONS (Statistics) 5. Mr Chng Hee Kok asked the Minister for Home Affairs if he will provide the latest statistics of reports on domestic violence and prosecutions and whether domestic violence is on the increase.”
“Sir, although there will be an increase of about 9,500 pupils in 1995, mainly attributed to the Dragon Year baby boom, the total primary school enrolment in 1995 will still be below the total enrolment in 1993. This is because the enrolments before 1995 included the Primary 7 and 8 streams. The reduced total enrolment for 1995 means that staffing position in primary schools will be comfortable. The total enrolment in primary schools is projected to increase steadily from 259,000 in 1995 to 298,000 in the year 2000. The question of contracting the capacity for 1996 therefore does not arise.”
“There are currently more than 100 VWOs providing regular direct welfare services. Of these, 80 work closely with MCD. Direct service VWOs are autonomous in running their services and programmes. Government supports them by providing premises, finance and other resources. In addition to the VWOs, there are various civic groups (there are about 40 of them) or services clubs, such as Lions, Apex and Rotary Clubs. These groups also provide the volunteers who run programmes and services, and they also run a wide range of services too.”
“Mr Speaker, Sir, the eight former second language teachers who were promoted to the grades of Senior Education Officers I and II last year happened to be all Chinese language teachers. Among those who were promoted to Principals and Vice-Principals in secondary and primary schools, as I said, three of them were former second language teachers, and all of them also happened to be Chinese language teachers. The promotion of Education Officers to senior positions or leadership positions in schools is based on merit, as is within our system of meritocracy. People who are eligible for consideration for promotion are assessed systematically and no regard is given to ethnicity or other attributes. So the question raised by the Member for Hong Kah GRC does not arise. Our promotions are fair. Consideration is based on objective criteria. For his information, sometimes General Education Officers can be appointed as Principals and Vice-Principals. They hold such appointments and are paid a responsibility allowance. After being tested in these appointments for a number of years, they can be put up for promotion to the substantive grades of Principals and Vice-Principals. MINISTRY OF COMMUNITY DEVELOPMENT (Services and programmes run by civic organisations) 10. Mrs Yu-Foo Yee Shoon asked the Acting Minister for Community Development what services and programmes under his Ministry are run by civic organisations and what is the nature and extent of involvement of these organisations. The Acting Minister for Community Development (Mr Abdullah Tarmugi): Mr Speaker, Sir, the Ministry of Community Development (MCD) provides a wide range of social services and programmes both directly and in conjunction with the Voluntary Welfare Organisations (VWOs).”
“But since it is so affordable, we should bear the cost out of pocket, instead of opening up Medisave for all kinds of requests and, in the end, we find we do not have enough for ourselves, for our family, and for our old age.”
“Yes, I certainly said in a speech, and probably in many more speeches, about dental health and that people should go for regular dental checkups. My position is that dental health is very much a part of the total health of a person and that is why in our public education on healthy lifestyle, and so on, we have never left out dental health. But I do not think Medisave should be used for dental checkups, and for good reasons. Dental checkups are quite cheap and affordable. Even in the private sector, if you go for a consultation, the average charge is only about $15. Should you need dental X-rays, small ones, $10, scaling, $25. This is within the affordability of most people. Members know that Medisave is meant for hospitalisation expenses. A person should use it wisely and conserve it as far as possible. For some major dental procedures for which a person has to be hospitalised, we have already allowed for Medisave deduction. But if you were to extend Medisave to dental checkups and, for the same reason, regular health checkups, I am afraid the Medisave balance would be used up much faster and some people may not have enough for old age. If you extend it to dental checkup, then what is there to prevent people from asking that Medisave should also be extended to annual health checkups? Health professionals believe that it is not absolutely necessary that everyone should go for an annual health screening. You should go for opportunistic screening. Comprehensive health screening should be done only once every two to three years. Dental checkup, yes, every year you should go for one.”
“They say they saw a dip last year, but this year, it goes up again. What happens is that you can have additional exercise sessions for the children in school, you can control the quality of the food sold in school canteens, but during the school holidays, the parents feed them the usual food. Once they are out from school, they just go across to the corner where they sell fried chicken wings. So the teachers are saying that they need the cooperation of parents and the public. Our approach to healthy food is, more healthy food is better for everybody. I do not mean to say that we should be so conscious and aware of every bit that we are eating that we should abstain from, say, all eggs because of cholesterol, because they will do harm to our heart. I think we should be able to enjoy eating, but eat moderately.”
“The health care services programmes for the elderly all over the world know that getting the elderly to the places where service are rendered is a difficult thing to do. So we are trying to further improve on this. But the constraint is mainly our manpower resources. Hygiene for food handlers, cooks and stallholders - yes, they are under the purview of the Ministry of the Environment. The hawkers, whenever they have to renew their licences, are now required to go through a course on hygiene in food handling. And MOH has taken the opportunity to latch on and make them sit through a talk on nutrition and healthy cooking. But this is only part of the effort to educate food handlers in cooking more nutritious food, more healthy diet, and so forth. We have been trying to reach out to food retailers, food distributors, fast food restaurant outlets, and we even go down to school canteens, workplace canteens, and help them monitor the quality and nutrition value of the food. Ultimately, I think we have to depend on the population changing their food eating habits towards more nutritious contents. The Minister has just said earlier on that more education is not necessarily a better thing. But as far as food education and nutrition are concerned, I think there should be more education. The problem is that even after educating them, the people do not necessarily follow. I give you an example. As part of my new responsibilities in the Ministry of Education, I have been going around and visiting schools. One programme I am interested in is nutrition, obesity and the TAF programme. Some schools over the last year have been able to raise the physical fitness of the children. But as far as the percentage of obesity is concerned, they have a hard time in reducing it.”
“The $38 million that the MOH will be expending is to help mainly the voluntary welfare organisations which run nursing homes, day care centres and community hospitals. Over the years, especially since we have taken over the administration and supervision of nursing homes, the Ministry of Health has been coordinating the work of these voluntary organisations and we have been granting them financial assistance to the tune of 80% of capital cost and 50% of the recurrent cost. So the $38 million is used mainly for the capital cost of upgrading some nursing homes and also to finance the recurrent cost of others. Actually this is only a part of the overall development plan that we have worked out with the voluntary organisations. Between 1993 and 1996, we will be helping in the redevelopment of 10 projects carried out by the VWOs, and the amount the Government will eventually expend will be much more. As for the polyclinics and more resources for helping the elderly, Mr Loh knows about the work of our Senior Citizens' Health Care Centres in the polyclinics. These are run by the Home Nursing Foundation but with tremendous support from the Ministry. Yes, we have been able to increase the number of home visits by quite a lot over the last three years, from something like 29,000 to about 40,000. But we have somehow reached a plateau. I think we are already reaching the capacity of our resources. One major constraint is nurses. We need home visiting nurses but we do not have them, even though MOH is able to second 35 or so nurses to the Home Nursing Foundation. Another constraint which we were able to resolve and therefore raise the number of nursing visits was the transport problem.”
“If it is back payments for patients load, it is self-explanatory. Every year, the restructured hospitals receive a lump sum subvention which is based on the previous year's patient load. So if at the end of year, you have more patients, the Government has to pay back.”
“Can I suggest that the Member table a question and I will answer him?”
“I am afraid I would not be able to answer him outright. Which figure is he referring to? If he wants to, he could submit a written question on clarification of a particular item in the Budget book.”
“When the Member talks about the operating costs, he cannot just talk about the absolute amount of operating costs. A better way is to look at the cost per patient, as expressed by the cost per adjusted patient day. Over the last four years, this cost has increased only by about 7%. So the increase is not drastic. The whole subsidy amount has increased significantly because the number of patients has increased significantly in the restructured hospitals. If the Member would like to know the increase in patient load for the restructured hospitals, I would be able to show him the figures another time. As for the $40 million that he referred to, I wonder if he could show me which page it appeared in the Budget book.”
“With restructuring, we have been able to improve the level of services, including waiting time, and you can also see there is not much difference between the time in which the subsidised patients and the private patients are served. 5.15 pm”
“In this way, nurses can be released for more professional work. So they have introduced various cost-cutting measures. I believe the Member's concern is that the rise in cost should not go beyond the affordability of the population. Now, we have introduced the concept of capping the revenue. With the capping of the revenue and fixing it at CPI plus X, in future we will be able to control the rise in cost and moderate it. The Member was a member of the Cost Review Committee. He knew the mechanics of how the restructured hospitals work, and he has also read the White Paper and we debated it. So all these cost control measures are in place. It is not that he does not know what we are doing. As for the standard of medical care, he asked for the waiting time. I am afraid I do not have the figures for the shortest and longest waiting time. I only have the figures for the median, and it is not entirely a satisfactory measure of the amount of waiting time at NUH, SGH and so on. For the restructured hospitals as a whole, the median, I emphasise this is a median, ie, 50% of the patients wait less than this length of time for obtaining specialist outpatient appointments, the median patient waiting time in 1993 was eight days for subsidised patients and six days for private patients. For specialist outpatient clinic consultation, that is, actual waiting in the clinic, the median waiting time was 27 minutes for subsidised patients and 29 minutes for private patients. For elective surgical operations, it was 10 days for subsidised patients, and also 10 days for private patients.”
“Sir, the purpose of restructuring is to allow the hospitals to have more autonomy so that they can respond more readily to patient demand and come out with more innovative programmes to meet the needs of the patients. Among the hospitals, there is some degree of specialisation. So they have differences in their patient base, so to speak. The process of restructuring has gone on for almost 10 years, since 1985. NUH was the first hospital to be restructured. Stage by stage, we have restructured all the major Government hospitals already. What is the reason for the increase in subvention year after year? This is because health care costs have increased, the demand has increased, labour costs have increased, more modern equipment and facilities have been introduced, and we have better quality medical services in the restructured hospitals. Thus, even after we have decided on the target subsidy rates, the absolute amount of subsidy will rise year after year. There is no question about that. What kind of cost-cutting measures have we introduced in the restructuring process? For instance, we have utilised space more effectively. In building new hospitals, we are going highrise because land is expensive. In introducing services, we have streamlined the staff line relationships. So we pay more attention to cost effectiveness of doing things. We have been short of nurses. So what do the restructured hospitals do? Under the civil service system, they cannot hire nurses at different kinds of salary scales. So they have gone into pooling resources, such as sponsoring nursing students at the Nanyang Polytechnic. They have also used more ward assistants and more clerks to take care of administrative work which has hitherto been done by nurses.”
“In fact, the National Computer Board is initiating a study to identify a suitable approach to adopt the smart card technology so that we could have in future an electronic medical record system that would include information on drugs and so on. With that, it will be far more convenient for a patient, and wherever he goes he would be able to allow pharmacists or doctors to access his medical record, drug history and so on. But, first of all, we must see whether these cards exist in other countries and whether it is also feasible for us. So, for the moment, we do not find it necessary to have a drug network.”
“If a patient goes to an outside retail pharmacy for over-the-counter drugs, the pharmacist can obtain the names of the drugs that he is already taking because now, by law, all drugs which are dispensed must be labelled. So the patient is able to show the pharmacist what drugs he has been taking. On top of that, we have already a drug allergy alert system called the Medik Awas card. So if there are patients who have certain conditions that would render them very susceptible to certain drug reactions, allergies and so forth, they also carry this Medik Awas card with them. [Mr Deputy Speaker in the Chair] 5.09 pm Overall, if we want to computerise the patients' drug profiles, I think the more practical solution is to use the so-called smart card technology so that the patients can carry on their own person a card which gives the medical record with a history of the medicines they have taken and other kinds of data. Unfortunately, this technology is only at some experimental stage, although in some countries it is in a pretty advanced testing stage. For example, there are pilot projects in France, Japan, Canada, USA, UK, Sweden, Italy and Spain. They are still carrying out the evaluations of this kind of technology. I believe some of the main problems connected with this kind of smart card technology include not just the question of medical and legal implications, confidentiality and data security, but they have found it very difficult to standardise the type of information to put in. So we are watching the development of their experiments.”
“Sir, the Ministry of Health and the National Computer Board have already set up a medical network called MediNet which Mr Tong referred to. MediNet provides a wide range of information for all health care professionals. Our Government hospitals as well as health establishments are subscribing to this system. Most of the information which is relevant for pharmacy operations has already been identified for inclusion in MediNet. Some of the information is already on-line, others would be included at a later stage. Already in operation is prescribing and product information which is listed in the Drug Index of Malaysia and Singapore as well as information on poisons which are commonly found in households as well as in industries. The next step we will take is to facilitate the electronic procurement of pharmaceutical items and medical supplies and so on. Later on, if we want to, we would be looking into the establishment of a register of western drugs and so forth. But Mr Tong's suggestion is to have a computer network to link up the patient's drug profile so that the pharmacist, in dispensing a drug, would have immediate access to whatever drugs the patient has taken before and, therefore, will be able to tell whether there could be drug interaction, adverse effects of new prescriptions and so on. At the moment, the Ministry does not think that such a drug network is necessary for the following reasons: Presently, most of the prescriptions are dispensed at the clinics or hospitals visited by the patient, as Mr Tong rightly pointed out. The information on previous drugs is actually on the patient's records and it is available to the pharmacist.”
“Perhaps, the public seems to think that it is a vast amount of money that has to be distributed and therefore if the Ministry of Education is not distributing all the money, maybe other groups can also help the Ministry to disburse the money. It is not the case. As I have explained to Mr Lew earlier on, the transfer of Government fund into the Edusave Endowment Fund is to help build up the fund. Only the income from the fund will be disbursed to pupils' accounts, to give grants to secondary schools and also to give out scholarships in both independent and Government and Government-aided schools. The Edusave Pupils' Accounts are meant for the students to use for school-based activities that would help to enrich and broaden their education. So it is not meant to pay for tuition. Since we are building up the account, whether we would be giving out more scholarships or more grants to the secondary schools, it is a bit too early to say. In my reply to Mr Lew, I said that quite a sizeable proportion of the schools still have not used up the initial grants given to them. They are allowed to keep the surplus this year, and we will see how the pattern goes. Scholarships, by definition, must be given to the top few percent of the students as an encouragement. So for independent schools, the proportion of scholarships would be 25% of the enrolment, and for secondary schools, it is 10%. I think we should keep it that way for some time.”
“The teachers help to check the eyesight annually, six months after the school health team's visit, in order to complement the annual vision screening for all the students carried out by the School Health Service. With effect from this year, the eye care programme will also be extended to junior colleges and the centralised institutes. Meanwhile, the School Health Service of the Ministry of Health has been conducting a pilot project on eye exercise among some primary schools. If this kind of exercise proves to be of benefit, I think we may want to extend this to more primary schools later. On the other hand, the Ministry of Education intends to carry out re-lighting works for primary schools as the first priority because the problem of myopia should best be tackled when the children are young. So far, the pilot re-lighting project has been carried out in three primary schools. The aim of the pilot project is to enable the PWD to determine the cost of the renovation work as well as the time required for all the primary schools to have the lighting work done. For new schools under the Fourth School Building Programme, PWD has already incorporated the guidelines on vision care in the building specifications. I do not think that the energy saving campaigns that we had have anything to do with the parents dimming the light when they watch television or whatever. But surely we are aware of the fact that, given proper lighting students' vision should improve. Mr Umar Abdul Hamid asks several questions on Edusave. There seems to be a lack of understanding on Edusave fund.”
“Sir, Mr Peh spoke about the problem of short-sightedness among our students. The increasing prevalence of defective vision which includes myopia among the student population has been an area of concern for both the Ministry of Health and Ministry of Education. We have noted this trend whereby the students have been developing poor vision earlier in life, and the severity has also been progressing steadily as they move up to the higher grades. So Mr Peh is correct in pointing out a worrying trend. Unfortunately, we do not know what is the cause of myopia or short-sightedness. The exact cause is not known. But I can definitely say that when more and more students are wearing glasses, it is not because it is a fashionable trend. I think he is just saying that to provoke our thought. Definitely, they need the glasses. Definitely, there is an increase in the incidence of defective vision. According to the eye doctors, short-sightedness has to do with genetic pre-disposition. But another important contributing factor is prolonged near-vision work. For example, when students read at close distance for too long, watch television for too long, look at computer screen for too long, then the eye muscles cannot adjust when the person looks at far away things. The correct approach to control the problem is to prevent the problem from occurring too soon and try to prevent it from progressing too fast. I am glad to inform Mr Peh that between the Ministry of Health and Ministry of Education, we have already implemented a comprehensive set of guidelines on vision care since April 1992. The teachers in the primary and secondary schools have been trained to conduct vision testing for students as part of the regular health education classes in schools.”
“So I asked the officials: does it show discrimination? They said no, there is a universal preponderance of boys over girls in the ratio of 2:1, among the top, the gifted children. Are we going to continue with this programme? Definitely yes, but we have in the past deliberately expanded the programme slowly because we want to see the results. And we do not envisage any sudden increase in enrolment or expenditure on the programme within the next few years. We will do so, but very slowly and steadily.”
“For example, in 1993, at the PSLE level, the percentage of pupils who were in the programme who scored three "A" stars was 52%, as compared to the top performers among the other students in the same GEP schools. Among these other students who were not in the programme itself, the percentage of pupils who scored three "A" stars was 40%. You have to compare like with like. You have to compare with the top percentage of the pupils. Among the students in the GEP, 37% of the students scored four "A" stars, as compared to 25% of the top pupils who were not in the programme but in the same school. For the 1993 "0" level results, the mean number of "A1s" scored by GEP students was 5.6, as compared to 4.4 among the Express students in two top schools, that is, RI and RGS, both of which have GEP programmes. For "A" level results, the mean number of "A" level distinctions for the GEP students was 2.7 as compared to 1.8 among the students in four top JCs. The mean number of "S" papers taken by GEP students was 0.9 as compared to 0.4 among those in the four top JCs. So these results clearly show that the GEP students have been able to benefit from the much expanded academic as well as extra-curricular activities that we have provided for them in the programme. Many of them have also won local and overseas awards. I must say that the Ministry is quite happy with the results of this programme and from our feedback, the parents are happy also. What is the proportion of boys and girls among the students in the GEP programme? In 1994, and this is actually quite a steady trend in the last 10 years, the proportion of boys among the GEP pupils is 64%; girls, 36%. So the ratio of boys to girls is roughly 2:1. I was quite intrigued by this ratio.”
“Mr Lew Syn Pau asked about the progress of the Gifted Education Programme (GEP). Yes, the Gifted Education Programme has entered its 10th year. It now caters for 1,500 pupils in four primary schools and three secondary schools. The number of primary school students in 1993 was 583. For secondary schools, it was 853. This Gifted Education Programme offers pupils a stimulating and enriching programme in the schools. We have also succeeded in developing a network with institutions of higher learning to provide special mentorship programmes in Science, Creative Writing, Mathematics and the Humanities for these pupils. Evaluation of the programme shows that it has achieved its goal of developing the pupils intellectually and socially as well as in terms of the pupils' performance at national examinations. The pupils not only have broadened their knowledge base but also developed leadership qualities and thinking skills which enable them to be more critical and creative in problem solving. The programme has also been successful in teaching pupils to become independent, self-directed learners. At the same time, they learn to be concerned about moral and social issues and are actively involved in community and charity work. Mr Lew asked how much we are spending on a per student basis. The education grant for a primary school student in the programme is $4,300 a year; for a secondary student, it is $6,100 per year. I think what I have told him would be part of the concrete results, although he would probably like to know more specifically about the examination results. Indeed, as a group, they have performed very well at both the Primary School Leaving Examination level, the GCE "0" and "A" levels.”
“Sir, Mr Sinnakaruppan asked about the Edusave grant to primary schools. Let me clarify that the Edusave grant to schools at the present is applied only to secondary schools. This is because the Edusave Endowment Fund takes some time to build up. So far, we have only received $2 billion and only the income from this Endowment Fund can be used. For 1993, the total income was $58 million. Out of this $58 million, we have already given $13 million to secondary schools and $37 million to pupils' Edusave accounts. So we have to wait a while before we can extend this to primary schools. In the same way, I think we can consider whether we could extend this to the ITE at a more appropriate time.”
“So the word list must also be changed. The second point on whether Geography and History have been included or not is a question beyond the scope of the recommendations of the Committee. In so far as what I know, the Ministry of Education has also been reviewing the content of the curricula of History and Geography. History lessons will be extended to cover the whole region and not just confined to Southeast Asia. For Geography, apart from Physical Geography, Human Geography will also be included. On the question of retention of students, I think Dr Aline Wong has already replied. Dr Ow asked what did he say yesterday that could have given the wrong impression that the Government had not been implementing the recommendations of Chinese Language Review Committee. I watched the TV news last night to ensure that I have the correct impression of what he said. Dr Ow asked me to answer him "positively". That would imply that I have been evading his questions. I remember correctly he also said that, as of now, there had been no implementation in concrete terms. These may not be his exact words, but this is the impression I gather from the debate in this House and again from watching the TV news. That gives people the impression that the Ministry, or the Government, has not been implementing the recommendations. Dr Ow Chin Hock( In Mandarin): Let me repeat what I said yesterday: "Over the past one year, what progress has the Ministry of Education made? What is the effect? I like the Minister for Education or the Minister of State for Education to answer me in positive and concrete terms." So if he does not answer me in positive and concrete terms, then the mistake is his. I did not say that the Ministry of Education has not been implementing the recommendations.”
“I think it is best that we let streaming sort out students according to their learning abilities. In streaming, both boys and girls can benefit from a curriculum catered to their ability. As far as the study quoted by Dr Soin is concerned, I think it is best to leave this particular subject to academic curiosity. Mr Peh Chin Hua( In Mandarin): Sir, I have three questions to ask the Minister. I am glad to know that there will be more schools offering Higher Chinese. With the trend in regionalisation, will the number of words in our students' Chinese word list be increased? Will the mother-tongue curriculum be extended to include the cultures of countries in the region such as Malaysia, Indonesia, India, etc? With regard to retention of students, can a student be retained in the same grade if he fails in his examinations? 3.15 pm Dr Ow Chin Hock (Leng Kee)( In Mandarin): I would like to thank the Minister for Education for his flexibility in dealing with the non-Chinese students in opting for Chinese as a third language. He said that if there were enough students he would start the classes. Would 20 or 30 students constitute a suitable class? What is the number of pupils in a Japanese or French class? As for the Minister of State, I would like to thank him for the details on the implementation of the recommendations of the Ong Teng Cheong Committee. I have some specific questions on the details. But for now, I would like to ask him one question: what was it I said yesterday that could have led to the misunderstanding? Dr Ker Sin Tze( In Mandarin): Sir, let me first reply to Mr Peh Chin Hua's question. On the word list, we have carried out a review to determine the actual needs for changing the word list. Times have changed and a new vocabulary has emerged.”
“I think in her argument there is a series of jumps. From the beginning to the end, there is a series of inferences which are open to a lot of questions. We must be very careful about drawing such quick conclusions and suggesting rather simplistic solutions. It is well known in social science research that cause-effect relations are very, very difficult to establish. There are many more factors besides the classroom situation, that is, the way teachers teach and treat boys and girls, which account for the girls' performance in Mathematics and Science. To put the question in a proper perspective, I asked for some statistics on how the boys and girls progress in terms of grades later on, not just at the PSLE level. Yes, at the PSLE level, 1992 results, the percentage of boys who passed Mathematics was higher than the percentage for girls. The difference was about 3.6%. For Science, the difference was only 1.5%. Then when it comes to the 1992 GCE `0' level results, for Mathematics, the difference in terms of pass rate was only 1%. The interesting thing is that for Additional Mathematics, the situation is reversed. Girls did somewhat better than boys in Additional Mathematics. And for `A' level Mathematics C, girls also did slightly better than boys. So how do you explain? No doubt these data are also very crude. But my point is, given this type of differences, the size of the differences, is it worth our while to make all kinds of rearrangement in order to implement the suggestion of Dr Soin? We have to double the number of classrooms, double the number of teachers, teaching materials, equipment, and so on. And do not forget we have different streams in the schools now. So the whole matter is very complicated.”
“These schools receive a much bigger per capita grant from the Government as well as from the National Council of Social Service, as much as up to four times the grant given to the students in the normal school. In 1993 alone, the Ministry gave $11 million for recurrent expenditure and this year we have budgeted for $13 million for recurrent expenditure by these special schools. The Ministry also caters to the development projects of these schools up to 80% of the capital cost. And if we renovate old schools for them, we pay for all the renovations plus 80% of whatever standard facilities they require. Lastly, on the novel suggestion that she made in the House yesterday about segregating boys and girls into different classes in mixed schools. First of all, let me clarify that the study done by the MOE in 1988 that she referred to refers only to sex differences at the PSLE level, that is, the sex difference in terms of boys and girls' achievement in Mathematics and Science at the PSLE level. The findings on the Primary Three results on Mathematics and Science that she cited, I think, come from a Master of Education thesis. Not having read the thesis, I cannot comment on whether the author's research was done with rigour, whether her sample size and her control groups were selected appropriately, and so on. But even if we can confirm that there are differences between the sexes at the Primary Three level, it is a big jump to conclude that to help girls improve on Mathematics and Science results, we should therefore segregate boys and girls in separate classes simply because, as Dr Soin put it, it is observed that teachers tend to pay more attention to boys. She said, as a result of that, girls suffer a loss of self-esteem and their Mathematics and Science grades suffer.”
“Dr Kanwaljit Soin raised three points. One is about pre-primary education. She wanted the Ministry of Education to provide for two-year pre-primary education for our children. When the Ministry decided to discontinue our preparatory year programme in 1992, the Minister stated very clearly in the House that the role of the Ministry is to concentrate on formal education, starting from Primary One for six-year old children. This is the case with many other countries and many other governments in the world. Kindergarten education should be left to the private sector, and the private sector is doing a very good job. At most of these centres, they are charging very affordable fees and, based on the data collected by my Ministry between 1991 and 1994, about 99% of our Primary One pupils had actually attended kindergartens before joining Primary One. So the greatest majority of them had benefitted from a pre-primary education. Although we do not provide pre-school education, I am sure the Member knows that we do give grants to charitable, non-profit making organisations which run kindergartens. We also help to run training courses for kindergarten teachers at the National Institute of Education. There is nothing to stop these kindergartens from sending their teachers for training to upgrade the level of services they provide. A second question she raised was on Edusave for special schools. Again, this question has been raised in the House before and our position still remains, that is, Edusave is meant to improve the educational programme in our mainstream schools. Therefore, we are excluding all special schools. The Government has made it clear that it will assist the special schools through a different arrangement.”
“Additionally, a pupil in the Primary Five (EM2) stream may be retained if such retention is of benefit to him. On the other hand, a pupil in the Primary Five (EM3) stream who has done well in his examinations can be transferred to the more demanding Primary Five (EM2) course. So in a way, it is a repeat of the Primary Five but it is in a different stream. Between 1991 and 1993, a small number of Primary One to Primary Five pupils were retained. Last year, after we have the modified Primary School Leaving Examination, 3,730 pupils were retained at Primary Six because their performance was such that they were not ready for secondary education. This group was largely made up of the students from the former extended and monolingual courses. So last year's retention rate should not be taken as a typical year's. In the secondary schools, Secondary One and Two pupils in the Special and Express courses may also be retained under extenuating circumstances. Secondary Three students, if they do not do well, can be retained. Principals have the flexibility to decide, with the concurrence of the Ministry of Education, to retain students if they think that such retention is of benefit to the students. Mr Koo is not here. But yesterday he spoke very enthusiastically about the introduction of the abacus. I am not sure I entirely agree with him that the learning of the abacus is the single most important reason for making the Japanese smart. There may be something in the learning of abacus and we believe that it may help students to improve on their mental arithmetic skills. That is why we are introducing it as a pilot project. We will see how this pilot project progresses and, if the results are positive, we may decide to extend the teaching of abacus to more primary schools later.”
“So parents who can afford to have more than three children should be able to pay for the enrichment activities of the additional children. Mr Peh Chin Hua asked about the system of retention. He suggested that we should revert to the previous system of retention that we had in order to help some slow children to progress in school. I think he should remember that a key feature of our present education system is the streaming of pupils in both primary and secondary schools according to their abilities. In other words, these streams are catered to the learning abilities of these students. If students can learn according to their own pace, there is no longer any need for general retention. In the past, there was a system of general retention. But it was found that it was not very effective because for many of those students who have academic or linguistic inadequacies, retention was of no help to them. After one retention, two retentions, they still could not pass examinations. So it was not a very effective way of helping these children. Then we adopted streaming and, as I said, streaming caters to the different learning abilities of the students, and at the end you have different career or academic paths. As a result of streaming, the attrition rate has been reduced very significantly. The Minister yesterday gave the House a full picture on the decline in the attrition rates. We already have very low attrition rates and they are still falling. Although there is no system of general retention now, we do allow for selective retention of a small group of pupils. At the primary level where extenuating circumstances are present such as the student has been absent from school because of illness or other family reasons, he is allowed to repeat.”
“I would like to respond to Mr Lew Syn Pau's two questions on the use of Edusave funds. As far as the Edusave accounts for pupils are concerned, last year the Ministry paid out $17.7 million into pupils' Edusave accounts. The total number of accounts was 349,000. The number of withdrawals made from these accounts in 1993 was 52,100, which means a participation rate of 15%. The total sum withdrawn from these accounts by pupils amounted to $1.08 million. Of this amount, the bulk of the money was used to pay for various enrichment programmes and activities, accounting for about 58% of the total withdrawal. These activities included things like educational visits, leadership camps, arts and craft courses, academic projects, dance, drama, music, sports, and other kinds of activities. Another 42% was spent for the second-tier miscellaneous fees which also go towards paying for school activities. The Edusave grant for secondary schools last year came up to $13 million. A total of $6.8 million was spent by the schools last year, which amounts to 52% of the total allocation, and the bulk of this allocation was used for the purchase of teaching materials (46%), followed by innovative programmes (31%), engagement of part-time specialist instructors (17%), and the rest are for miscellaneous items and for non-teaching staff services. Mr Lew also raised the question of Edusave for the fourth and subsequent child. I think this question was raised in the House before. The position of the Ministry has not changed. The Government has decided to limit the Edusave scheme to three children per mother because this is in keeping with our population policy of "three children or more, if you can afford it".”
“PRESIDENT'S ADDRESS Debate on the Address (Third Allotted Day) Order read for Resumption of Debate on Question [13th January, 1994], 'That the following Address in reply to the Speech of the President be agreed to:- "We, the Parliament of the Republic of Singapore, express our thanks to the President for the Speech which he delivered on behalf of the Government at the Opening of the Second Session of this Parliament.".' - [Mr Loh Meng See]. Question again proposed. 1.35 pm”
“But it is impossible to address many of the concerns raised without going into details and, in fact, after this, we are going to hold a press conference to answer more specific questions, including some of those raised by Members earlier. PSD, Health officials, and NTUC Income officers will be there. Let me clarify that the Ministry of Health is not, I repeat, is not the insurance agent for NTUC Income. But we have to address the concerns that the Comprehensive Co-payment Scheme somehow short-changes civil servants of the medical benefits they are used to. So our point is that if they wish, if they want to be spared the pain of having to make the choice, they can always go back to status quo ante by opting for this Co-pay Assist plan. But if they do not wish to, if they want to structure something more for their own needs, they are free to do so for as many dependants as they wish. So on that note, Mr Speaker, Sir, I like to withdraw the motion. Motion, by leave, withdrawn. BILL INTRODUCED JUDICIAL COMMITTEE (REPEAL) BILL "to repeal the Judicial Committee Act (Chapter 148 of the 1985 Revised Edition) and to make consequential amendments to certain other Acts", presented by the Parliamentary Secretary to the Minister for Law (Assoc. Prof. Ho Peng Kee) (on behalf of the Minister for Law); read the First time; to be read a Second time on the next available sitting of Parliament, and to be printed.”
“They can come into MediShield Plus also if they want, but they can only opt for either Basic MediShield or MediShield Plus. Since NTUC Income is coming out with a supplementary insurance scheme to cover the co-payment, does it mean that we will allow other insurance schemes to cover co-payments and deductibles? I think you must be very clear in your mind that NTUC Income's Co-pay Assist scheme is designed only for civil servants on Option B who want to pay no more than what they have been paying before as co-payment. In the Ministerial Statement, it is already said that NTUC Income may come up soon with some scheme similar to MediShield, with a structure that will ensure there is no excessive demand for health services, which means deductibles, co-insurance, and such features should be built in. After NTUC Income's scheme has come into operation for a certain period of time, we will think about whether other insurance companies will be allowed to follow. The age limit for both MediShield and MediShield Plus is 70 years. The NTUC Income insurance scheme covers beyond age 70. MediShield and MediShield Plus, at the moment, do not go beyond 70 years. As Government schemes, we have to be very careful. We have already raised the age limit once. MediShield was introduced in 1990, and in 1992, we raised the age limit from 65 years to 70 years already. We better proceed more cautiously. For commercial schemes, it is up to them. They have to do their sums. Thank you for your indulgence. [Applause]. BG George Yong-Boon Yeo: Mr Speaker, Sir, before I withdraw the motion, can I beg Members' indulgence for swamping them with so many details.”
“MediShield Plus is designed for them as well as for those civil servants who opt for the MSO scheme, or for the new recruits into the civil service who must go on the MSO scheme. If serving civil servants choose Option B and if they also choose MediShield Plus, then they will be over-insured. PSD will be issuing a booklet soon. In fact, it is done in this form [indicating]. I hope they will be improving on its format, and not just come out with this. And for the Members' information, I have asked for copies to be distributed to you. There will be more examples. So if Members want, they can study all these examples at their own leisure. I understand the PSD will be briefing the individual Ministries and Departments and, in turn, they will brief their officers and explain to them the examples contained in the booklet. And if labour MPs and union leaders would also like to be briefed, I think arrangements can also be made for them. A final assurance for those people who already have chronic illness, which is one of the points raised. My explanation has shown that civil servants generally will be better off. They will be fully covered, they have salary increase and they should opt for Option B. However, if any of them face financial hardship due to serious pre-existing illness, for example, if they are already on renal dialysis or if they already have cancer, PSD is willing to consider helping them on a case-by-case basis. A few short answers to the points raised by Members. What happens to the 12% of CPF members who have not opted for MediShield? What can we do to help them now that they can see the benefit of MediShield much clearer? We will have more publicity to persuade them to opt in. They can come in.”