Amy Khor Lean Suan
Singapore
“Sir, NEA does conduct inspections of these premises from time to time. For this particular premises, they actually did six inspections since 2021.”
“The Land Transport Authority (LTA) conducts enforcement actions against drivers who are found to have provided illegal car-pooling services. An individual who provides an illegal car-pooling service may face a fine of up to $3,000, up to six months' imprisonment, or both.”
“We will also provide the first 500 private heavy vehicle chargers co-funding of up to 50% of the charger installation cost, capped at $30,000 per charger. These measures will narrow the lifecycle cost gap between an electric and internal combustion engine heavy vehicle and spur adoption of electric heavy vehicles.”
“With regard to the extension of the lower speed limit to school zones for full day, we will work with the relevant agencies on the enhanced enforcements.”
“They will provide a certain amount of protection to the pedestrians because, as I have said, the bollards will absorb the impact of the collision from the vehicles. So, there is a protection. But ultimately, of course, road safety really depends on a multitude of factors, including road user behaviour.”
“The bollards installed at pedestrian crossings by the Land Transport Authority (LTA) are not of the K4, K8 or K12 standards stated by the Member. Bollards of these standards are typically security bollards. They are installed to protect critical infrastructure or at high security areas, such as Changi Airport, to be unyielding.”
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“It is for care-givers who need respite because they need rest, and so it is for all kinds of mental illness as well as other kinds of illness. Page: 134”
“I would like to share that within my own constituency, we have helped a case like this. In fact, I just received an email of a case that we have just solved. Some patience is required in order to identify ways where we can actually bring this resident for treatment and follow-up. And sometimes they are ex-mental health patients; all they need really is help to get them back onto their treatment regime, medication and so on, and then they will get well again. With regard to using mass media to reduce or mitigate stigmatisation, HPB does work very closely with the broadcast media – radio or TV – to try and weave mental health messages into some of their programmes. Recently, for instance, they worked with the Radio DJs to weave some of these messages into their programmes. I understand that HPB has also recently worked with Channel 8 on a drama serial called "It's a Wonderful Life" and they have worked with them to weave some of these mental health messages into the drama serial. Where possible, we will continue to look at ways to see how we can promote awareness of mental illness, mental well-being, using mass media and other avenues. For employment, there is a Job Club that IMH has set up to help mental patients who have recovered to find jobs by preparing them for jobs as well as setting up a network for them to get jobs. There are also other services like Temasek Cares-Employment Support Services which also does the same thing. The CDCs also pitch in and help wherever possible, even organising job fairs specifically for this group of people. And the last question was on respite care. Respite care is not just for caregivers of patients who are mentally ill or suffer from depression or dementia specifically.”
“Firstly, on the question of someone who might be an ex-mental patient or potential patient who is causing disturbances, I think quite a number of us have experienced this at one time or another. If they are uncontrollable, violent, pose a danger to themselves or to the community, then, you can call the Police. The Police will then bring this particular person into IMH for assessment and follow-up treatment. But in many instances, they are not violent. They cause disturbances and nuisance to neighbours and so on. For cases like these, the resident or the grassroots or the advisor can link up with the FSC or SAC. By the end of this month, all FSCs and SACs will have staff that have been trained in call protocol as well as linking up with the Institute of Mental Health helpline. The staff can then assess this situation together with the IMH staff, and decide if they need to activate a mobile team from IMH which comprises generally of two nurses who are trained in mental health as well as crisis management to go down to the house for onsite assessment or house visit. And then decide if they need to bring the person for follow-up treatment at IMH or at restructured hospitals. Page: 133 Now, I need to say that under the Mental Healthcare and Treatment Act, unless the person is violent, pose a danger to himself or the community and so on, the Act does not allow us to compel this person to be brought to IMH for treatment. So, in many instances, the mobile team will have to work perhaps together with the grassroots or people who know the resident or work with the family if there is some form of family support, and conduct sometimes multiple visits to persuade this resident to be brought for follow-up treatment. In that sense, some patience is needed.”
“What we are trying to do really is to have a seamless and integrated care within the community and help them to re-integrate as much as possible. 5.00 pm”
“Madam, I thank the Member for her clarifications. As I have said earlier in my main speech, the focus of mental health now really is to shift the locus of mental healthcare from an institutional setting, that is, hospital setting, to community-based care as far as possible, and Page: 131 that is really to allow them to integrate back into the community and continue to lead meaningful lives because many of them, actually with medications and proper treatment and follow-up, can work and lead meaningful lives. I think it is a common concern about the lack of supervision or the fact that they may not follow up on their treatment or continue with their medication. What we have done is to set up community-based mental healthcare services through, for instance, the Assessment and Shared Care Teams (ASCAT). As I have shared in the main speech, we have two now, but we will be expanding this to six across the island. They will work together with the hospitals, particularly IMH, as well as the restructured hospitals that have got psychiatric departments, and with GPs. So, when the patient is discharged, say, from IMH, and they go into the community, the ASCAT teams can follow up with these patients, together with the GPs. The GPs are actually trained – the 70 GPs who are now in partnership with IMH. If these GPs need specialist advice, for instance, they can refer the case to ASCAT. There is also another level, we call Community Mental Health Intervention Teams (COMIT) which is not physician-led, unlike ASCAT, but they are actually led by allied health professionals and they can also do follow-up as well as the education of the caregivers in order to help them manage the patients in the community.”
“Can I just seek a clarification to the Member's second question about psychiatric patients? The Member is saying that they are under-treated?”
“What we will do really is to closely monitor the impact once the enhanced guidelines are implemented, to see if there is any impact on cost and to ensure that nursing home fees will continue to be affordable for those who need the services. With regard to the Seniors' Mobility and Enabling Fund (SMF), yes, the Senior Minister of State Ms Indranee Rajah has been a real champion for the SMF, going door-to-door, and I am sure many of the other Members are doing it to publicise and create awareness amongst the elderly as well as residents who may have elderly relatives or who know of others who would be able to benefit from the SMF. What we are going to do for the enhanced SMF would be, firstly, to publicise it through the mass media – radio, print advertisements and, of course, on social media. It is not just to reach out to the elderly. It is really to reach out to the public, create awareness and encourage the public to refer potential residents who can benefit from the SMF. We would also be working through AIC with the grassroots to again do an outreach in the heartlands, through roadshows, through house visits and so on because I think actually, that is really very useful. The grassroots, together with the advisors, understand the residents and may know of residents who actually will benefit from the enhanced SMF, not just in terms of assistive devices but also the transport subsidies as well as consumables if they are very frail elderly who are cared for at home. AIC will also be working with the eldercare centre operators as well as other VWOs to get them to recommend and sign on eligible clients for the enhanced SMF.”
“First, I would like to thank Dr Chia for his clarifications. With regard to cost, I think it is a fair and genuine concern that Members would raise this. As mentioned in my speech, the enhanced guidelines are a result of discussions by the nursing home representatives in the Nursing Home Standards Workgroup. In fact, these enhanced guidelines reflect current good practices that exist today among the nursing home operators. We do not expect this to lead to a significant increase in cost. Secondly, the way we have phrased the enhanced set of guidelines – which will be put out for public consultation with the nursing home operators particularly – it is outcome-based. It does not list specifically input requirements. This is to give flexibility to the nursing home operators so that they can innovate in order to achieve the outcomes. So, it is a set of outcome-based guidelines instead of something that is very, very prescriptive. Thirdly, we are pacing the change, so we are not implementing it today or at the end of this year. In fact, we hope to finalise the enhanced set of guidelines into a set of licensing standards by the end of this year, after public consultation. And then, we will give the nursing home operators a year to prepare for and to be able to develop their staff to achieve the licensing standards once they come into effect in fiscal year 2015. Finally, AIC is going to develop an interpretation guide to help the nursing home operators understand the requirements of this enhanced set of guidelines as well as to invest in resources to train and upgrade the skills of the workforce in the nursing home sector so that they will be able to achieve the outcomes. Page: 128 Nonetheless, we share the Member's concerns.”
“So, I assure Mr Low that the TCM Practitioners Board will carefully consider all the feedback received during this pilot phase when they review the programme. Mdm Chair, every Singaporean wants to live healthily and age gracefully – to add life to our years as we add years to our lives. As a Government, we must help our people to reach this goal. Besides our aged care services, we must also encourage Singaporeans to lead healthier lifestyles. After all, a healthy lifestyle today is critical for healthy ageing tomorrow. Page: 113”
“To encourage working women to adopt healthy habits, HPB will expand the existing $15,000 annual Workplace Health Grant by another $5,000 a year for employers to create a supportive work environment to promote health, especially among working women. Employers can use the additional grant to organise health promotion programmes tailored for working women, such as talks on child and maternal health, workshops on managing work and family, and classes on healthy cooking. But, of course, the men would be welcome, too, if they want to join these programmes. The grant can also be used to subsidise costs of breast and cervical cancer screening. Before I conclude, let me thank Mr Low Thia Khiang for his feedback on the Continuing Traditional Chinese Medicine Education Programme. The objective of the programme is to help TCM practitioners raise their professional standards and acquire new skills to better serve their patients. We believe that continuing education is integral to their professional development, just as it is for doctors, nurses and pharmacists. Let me clarify also that the TCM Practitioners Board has put this in place after discussions and town hall sessions with TCM organisations and practitioners. The Continuing TCM Education Programme is currently on a voluntary basis. I would also like to point out that we are not the first country to introduce Continuing TCM Education Programme. Participation in CTE for TCM practitioners is, in fact, compulsory for the renewal of their licence in countries like Taiwan since 1993; Hong Kong since 2005; China, 2006; and Australia, 2012. We have received feedback, similar to the ones raised by Mr Low earlier. This is a fairly new pilot, on a voluntary basis, having only started in January this year, just about two months ago.”
“In September last year, we introduced a resource kit called "My Journey to Better Health" to provide women with important health information on issues, such as starting a family, weight management and breast and cervical cancer across various stages of their life. To date, the kit has been distributed to more than 30,000 women. We target to reach 200,000 women by the end of this year. The Committee and HPB also work closely with healthcare providers and grassroots organisations to increase public awareness of breast and cervical cancer through regular exhibitions and road shows held in the community during the Breast Cancer Awareness Month (BCAM) and the World Cancer Day (WCD). This year, we aim to make cancer screening more affordable for women, particularly those from lower-income households. The Committee and HPB will, over the next two years, work with VWOs and the private sector to help cover the cost of breast cancer screening for 15,000 women from low-income households. Eligible women will only need to pay up to $2 for a mammogram, compared to the existing subsidised rate of $50 under BreastScreen Singapore. This two-year project will be introduced from 17 March this year. Eligible women will receive an invitation letter to go for screening at a participating polyclinic X-ray centre. In addition, we are making screening more accessible by expanding the coverage of BreastScreen Singapore's mobile mammogram screening service, the Mammobus, to more estates. As noted by Ms Ellen Lee earlier, it may not Page: 112 just be an issue of affordability. We will also be organising ferry services at selected estates to bring women to the screening centres.”
“is now providing one-stop information and referral services for senior-related issues. The centre also links up with the Agency for Integrated Care or AIC to provide outreach and public education on dementia and depression, and works with the Changi General Hospital to provide social support for recently-discharged seniors. A group of volunteers has also been formed to befriend seniors living alone in Marine Parade. And the oldest volunteer you see here is Uncle Wai Chong and he is all of 83 years old! We want to continue this positive momentum. I am pleased to inform the House that MOH plans to expand the CFAA project to another five to 10 more constituencies over the next three years, and will provide an award of up to $80,000 for each constituency which wants to start its own CFAA project. Page: 111 Mdm Chair, our seniors have contributed much to Singapore. Now that they are old, we should create an environment that allows them to age happily and with dignity, in our midst. Our aspiration is to create a people movement across the island in every town, to make our city a senior-friendly one, and the best place for our seniors to grow old in. Ms Ellen Lee asked about health screening rates among Singaporean women. I agree with Ms Lee that more can be done to improve on our women's cancer screening rates. According to the National Health Survey conducted in 2010, only about 48% of women aged 25 to 69 undergo regular cervical cancer screening and about 40% of women aged 50 to 69 go for regular breast cancer screening. The Women's Health Advisory Committee (WHAC), which I chair, aims to encourage more women to undergo screening and to promote health among our women.”
“There will be staff and volunteers in the Home to engage these dementia patients in meaningful activities through the night. Mdm Chair, MOH hopes to engage the community at large, to build an inclusive and caring Singapore for our people. In the past year, reports of Page: 110 "NIMBYism" have made the news. But being an optimist and having confidence in Singaporeans, I think these isolated incidents are hardly representative of the majority of Singaporeans. Dr Chia asked about the City for All Ages (CFAA) project. I am pleased to inform him that the project is progressing well in its four pilot sites of Marine Parade, Bedok, Whampoa and Taman Jurong. While the project started with the objective of innovating new solutions to create senior-friendly communities, we were pleasantly surprised to see how the project has served as a platform to garner community action for seniors. The energy I see on the ground is incredible. I see many volunteers, both young and old, walking their towns in the hot sun to identify areas of improvements to the town infrastructure that will make it safer for seniors to move around. In Marine Parade, as a result of volunteers' efforts, the Town Council and the LTA, improvements to the town hardware are being systematically rolled out, such as levelling of void deck aprons and longer traffic light crossings. On top of that, over 50 new rest stops will be installed across the town so that our seniors can sit down and rest when they feel tired. This rest stop is a suggestion from Marine Parade residents themselves. Even the design is chosen after a vote among the residents! The software of Marine Parade has also been enhanced. For instance, the local senior activity centre called Goodlife!”
“By 2016, we intend to set up a total of 10 COMIT teams to serve up to 10,000 patients. To further combat stigmatisation, we are increasing community outreach and education on mental health. Today, AIC works with a few senior activity centres to start up teams of volunteers in the community who can identify seniors with symptoms of dementia and depression, and refer them for early treatment, which is similar to what Ms Tin had proposed earlier. HPB is also working with community partners, such as Silver Ribbon (Singapore), Singapore Association of Mental Health and grassroots organisations, to promote awareness of mental well-being. In 2012, over 30 such events were organised, reaching out to about 25,000 people in the community. 3.30 pm Ms Tin asked for more support for caregivers of patients with mental illness. The enhanced SMF and the residential respite pilot I described earlier will be able to support these caregivers. In addition, we are working with VWOs to provide support targeted at caregivers of dementia patients. The Alzheimer's Disease Association (ADA), for instance, offers elder-sitting services. Seniors can be brought to ADA's centre or be visited at home, where the elder-sitters will befriend and engage them in simple mind-stimulating activities, giving their caregivers a few hours of respite. Another example is the "Dusk to Dawn" programme at St Joseph's Home. Some dementia patients have what we call "sundown" syndrome, where they cannot sleep at night, thinking it is day. This is a programme whereby caregivers can leave their loved ones with dementia at the Home at night, so that they can catch up on sleep and bring them home again the next morning.”
“We also have two psychiatric rehabilitation homes with 280 beds for those who need temporary residential care to help them reintegrate into the community. We will be increasing this to about 400 beds by 2016. I agree with Ms Tin Pei Ling and Ms Ellen Lee about the need to reduce the stigma of mental illness. Because of this stigma, many people who need help do not come forward for treatment. To address this, our strategy is to shift the locus of mental healthcare from institutions into community-based settings that are more accessible and to integrate mental health services with those for physical health. We piloted two Assessment and Shared Care Teams, or ASCAT in short, last year to provide mental health treatment in the community. One team is located at Ang Mo Kio Polyclinic and the other, which is temporarily sited in Khoo Teck Puat Hospital, will be moving out to a community location later this year. The two teams have helped around 400 patients to date. We intend to set up a total of six ASCAT teams across Singapore by 2016 to support up to 9,500 patients at any point in time. General Practitioners (GPs), too, play a crucial role in encouraging people to seek treatment for mental health, as they are often the first point of contact. Today, we have about 70 GPs collaborating with IMH to provide mental health care in the community. We hope to recruit a total of 100 GPs by 2016. Page: 109 To support the GPs, we also worked with VWOs to pilot Community Mental Health Intervention Teams or COMIT teams last year. COMIT teams provide counselling and psychotherapy services to support GPs in managing patients with mental illness. There are two COMIT teams today, in Upper Boon Keng and Yishun, and they have helped over 100 patients to date.”
“The seven-day respite will also give Mr Koh a chance to rest and replenish, so that he can take even better care of Mdm Choo when she returns home. Mr Sitoh and Mr Patrick Tay asked about the capacity and capability of our long-term care facilities to cater for seniors with dementia. I would like to inform them that our new nursing homes will include wards for dementia patients. Today, we have about 515 nursing home beds dedicated for seniors with dementia. By 2016, we will increase this by more than 400 beds. We will also increase our support to help nursing homes develop the right capabilities to manage these seniors. For instance, CGH and IMH have been providing training to staff from eldercare organisations, including nursing homes, on dementia Page: 108 care and behavioural management. Besides nursing homes, we also have 12 dementia day care centres which can serve more than 300 seniors per day. In addition, we will be developing more senior care centres by 2016 which will have the capability to provide dementia day care services. Ms Tin Pei Ling also asked about the capacity of our public mental health sector. Today, the IMH has about 2,000 hospital beds for patients who require inpatient care, with an average occupancy of 84% over the past three years. So far, this is sufficient but we will continue to monitor the situation. Our objective is, as far as possible, to have persons with mental illness reintegrated with society. But as Ms Tin pointed out, some with more severe illness may need longer term care. Today, there are three psychiatric nursing homes with a capacity of about 650 beds. We will be expanding the capacity to 1,200 beds by 2020.”
“Her father suffered a stroke a few years back and is now bed-bound; while her mother suffers from diabetes and kidney failure. Both her parents are receiving home nursing services from TOUCH Home Care and require consumables, such as diapers, milk feed and dressings. With the enhanced SMF, they will receive 80% subsidies on the cost of consumables, saving up to $4,000 a year. Several Members also pointed out that caregiving can be tiring. Indeed, we recognise that caregivers cannot do it for 24 hours a day, 365 days a year. At some point, the caregiver may fall ill or simply need a break, and will need someone else to take over the caregiving temporarily. To relieve the stress of caregiving, MOH is working to make respite services more accessible and affordable. We are starting a pilot project by working with a few nursing homes to set aside some beds that can cater to respite services. Caregivers who need a temporary reprieve can place their elderly to be cared for in the nursing homes for a short period and enjoy up to 75% subsidy subject to means testing. This pilot will support caregivers like 63-year-old Mr Koh Kok Heng. Mr Koh has been taking care of his 60-year-old wife, Mdm Choo Ngee Neo, after she suffered a head injury that rendered her bed-bound. Recently, due to a toilet leakage, their flat will need to undergo a week of renovation work next month. The noise and dust from the renovation will make it not conducive for Mdm Choo to be cared for at home. With this new pilot, Mr Koh can admit Mdm Choo into a nursing home for seven days of respite care at a subsidy rate of 75%, while the renovation works are being carried out.”
“For instance, our Community Development Councils (CDCs) work with a non-profit organisation, Caring Fleet Services, to provide dedicated transportation services to people with mobility difficulties, by giving them vouchers to pay for transportation to hospitals, polyclinics or SOCs. In effect, they use retrofitted vehicles that can accommodate these wheelchair-bound residents. So, they really do not need to use ambulance which, by its nature, is really for emergency cases. In addition, through the "SMRT Gift of Mobility Programme", our CDCs also give out taxi vouchers to needy seniors to travel to hospitals and polyclinics. So wearing my other hat, as a Mayor of Southwest CDC, let me assure Mr Muhamad Faisal Abdul Manap that help is already available for the family of three that he mentioned earlier. In fact, the CDCs have helped such families in similar situations. So, I would like to request Mr Faisal to give either MOH or the Northeast CDC, if the resident is within his Aljunied GRC, details of the case, so that we can follow up on the case and provide help as soon as possible. Under the enhanced SMF, we will also expand our support to help seniors accessing day services. We will provide transport subsidies for wheelchair-ambulant seniors receiving treatment at day rehabilitation centres and renal dialysis centres funded by MOH, as well as seniors receiving care at MOH-funded dementia day care centres, as I have said. I thank Members for your positive feedback on the enhanced SMF. When the changes take effect from the third quarter of this year, we believe that the Page: 107 enhanced SMF can benefit caregivers like Ms Masni Bte Jaafar. Ms Masni and her husband not only have to support their six children, but also needs to care for her elderly parents.”
“We can help them relieve the cost of caregiving at home. The Deputy Prime Minister and Minister for Finance announced in his Budget Statement that we will expand the Senior's Mobility Fund (SMF) into the $50 million "Senior's Mobility and Enabling Fund". The SMF will go beyond a fund to promote mobility, to a fund that supports our seniors to live independently in the community. Mr Tay asked how the fund will be enhanced. First, we will expand subsidies beyond mobility devices to cover other assistive devices. Seniors can receive subsidies for more items, such as motorised wheelchairs, commodes, geriatric chairs and pressure-relief Page: 106 mattresses. The fund will also cover spectacles and hearing aids. In response to feedback from VWOs and social workers, we will also simplify the application process for subsidies. Any senior living in a 3-room HDB flat or smaller will automatically qualify for 90% subsidy for devices that cost less than $350. There is no need for a detailed household income means test. Second, for seniors receiving Government-subsidised home nursing or home medical services, and with per capita monthly household income of $1,500 or less, the enhanced SMF will provide between 50% and 80% subsidy for the cost of consumables, such as dressings, diapers and milk feeds. Third, the enhanced SMF can also be used to subsidise transport costs for more seniors who are community ambulant, to attend day rehabilitation, dementia day care and renal dialysis centres. Dr Chia Shi-Lu and Mr Muhamad Faisal Abdul Manap also asked specifically about transport subsidies to and from hospitals for medical appointments. There are, in fact, already schemes for this.”
“Her family initially Page: 105 considered placing her in a nursing home, but opted to take care of her at home instead. Today, Mdm Yap lives in the comfort of her own home with her daughter-in-law and two grandsons, through the support of home care visits by the Home Nursing Foundation (HNF). HNF also provided training to Mdm Yap's family members and foreign domestic helper so that they can better care for Mdm Yap at home. After the subsidy framework was enhanced last year, Mdm Yap now receives an increased subsidy of 80% to help cover the costs of her home care visits. And because her foreign domestic helper has been trained in caregiving, Mdm Yap's family is eligible to receive an additional cash grant of $120 per month to offset the cost of hiring the helper. They will also receive a concession on their foreign domestic worker levy and have to pay only $120 instead of the normal rate of $265 per month. MOH will be going a step further. To encourage and facilitate home care, as my Minister had noted earlier, we will be convening an industry-led committee to review and chart new standards and strategies for the development of the home care sector in Singapore. The committee is tasked to recommend a common system to assess the care needs of home care patients, articulate common standards of home care and identify new home care services that can be developed to meet unfulfilled needs today. We are also beefing up support for our seniors' caregivers. Mr Christopher de Souza, during the Budget debate, suggested giving an allowance to caregivers. We do want to give families support in caring for their seniors. But we must not inadvertently monetise family ties and filial piety which come from the heart, and they are intangible. There are practical ways to help caregivers.”
“Second, the committee has enhanced standards in the social aspects of nursing home care, such as respecting residents' dignity and caring for their emotional well-being. Third, the committee has added new standards in organisational excellence, covering the areas of human resource and financial management. This stems from the committee's belief that good care must be underpinned by good governance. The set of standards is a first draft for consultation. We will engage the nursing home sector in the months ahead, to discuss these enhanced standards. These standards largely reflect the good practices existing in the sector today, so we do not expect a significant increase in costs. Nevertheless, MOH will continue to invest to develop the capability of the sector and allow ample time for nursing home operators to achieve these enhanced standards. 3.15 pm Mr Patrick Tay also asked about setting standards for day rehabilitation, day care and the upcoming senior care centres. I would like to inform him that we have similarly set up an industry-driven committee to review and set standards for the centre-based care sector. The committee started work in September last year and is expected to complete the standards by the end of this year. Let me now move on to the second area of focus, which is to develop more options for seniors to be cared for at home and in the community. We are stepping up our efforts to develop home care services, to support caregivers who would like to care for their seniors at home rather than in a nursing home. Last year, we added 750 new home healthcare places, bringing the total capacity to more than 4,500. Take, for example, 94-year-old Mdm Yap Leng Im. Mdm Yap suffered a stroke seven years ago and was wheelchair-bound since.”
“Beyond the hardware, we are evolving our nursing homes to be eldercare hubs that can benefit a wider community of seniors and their caregivers. Where space allows, we will expand their suite of services beyond nursing home care to include day care and other services for caregivers. The Man Fut Tong Nursing Home in Woodlands, for instance, offers day care, day rehab and home therapy services to seniors in the community. Sixty-nine-year-old Mdm Ahesah Bte Abdullah is one of those who have benefited from Man Fut Tong's expanded services. In 2011, she suffered a stroke that rendered her wheelchair-bound and she needed to undergo physiotherapy. Because she lives near Man Fut Tong, her caregiver can wheel her to the Home three times a week for her therapy sessions. Mdm Ahesah's condition has improved vastly and she is now able to walk again, as shown in the slide. Second, we want to set clearer standards for different aged care services. Dr Chia asked about nursing home standards. I am pleased to inform him that MOH intends to introduce an enhanced set of nursing home licensing standards by 2015. Last year, we set up an industry-driven committee, comprising nursing home operators and healthcare professionals, to review our existing licensing standards and identify areas that can be enhanced. The committee has since Page: 104 drafted an enhanced set of standards for the nursing home sector. These enhanced standards differ from the current licensing conditions in a few areas. First, there is more specific articulation of standards in various aspects of clinical care, such as oral hygiene, continence management and falls prevention. Currently, these areas are implied but not specifically articulated in the licensing conditions.”
“In 2012, we enhanced training allowances to encourage mid-career professionals to make the switch to nursing and allied health professions under WDA's Healthcare Professional Conversion and Place-and-Train Programmes. This has led to an increase in enrolment from about 30 in 2011 to more than 50 this year. This year, we will place emphasis in two more areas: one, enhancing the quality of aged care; and, two, developing more options for seniors to be cared for at home and in the community. Let me start with enhancing the quality of Page: 103 care, an issue raised by Dr Chia. First, we want to remake our nursing homes. We are actively engaging Singaporeans and tapping on the creativity of architects to build nursing homes that are not just clinical care facilities, but welcoming, serene and modern homes for our seniors to recuperate. For the new nursing homes that we are planning, we give careful thought to the design to make them aesthetically pleasing yet functional. An example is the future nursing home in Jurong East. Instead of a squarish residential block, the architect "breaks up" the massing to create a more interesting form. Green balconies are injected in between the towers, making the whole development more visually pleasing to the surrounding community. This will not look out of place within a residential area. Another example is the new Lions Home in Bishan East. As you can see, lush greenery features prominently to enhance natural cooling and to be aesthetically pleasing. From the outside, the effect is one of a waterfall of greenery. On the inside, there is also a garden and communal spaces on the ground floor where people living in the surrounding estate can enjoy.”
“Madam, I will first address Members' questions on ageing and mental health before updating Members on the issue of women's health. Let me start with ageing. Our population is ageing rapidly. We need to make sure that Singapore is ready to support our ageing population in every way. Our goal is simple: for our seniors to live happy and fulfilling lives, and to age gracefully. Last year, the Government introduced a suite of initiatives to make Singapore "ageing ready". We raised the subsidies for intermediate and long term care (ILTC) substantially; and we announced that we will build more than 100 aged care facilities over the next five years to meet both the social and healthcare needs of our seniors. To support the expanding aged care sector, we project a need to increase manpower from 4,000 in 2010 to 15,000 in 2020. Dr Chia Shi-Lu asked about our manpower efforts. Last year, we provided additional funding to support the sector to raise salaries and to enhance staffing ratios. With these initiatives, we grew the workforce in the aged care sector by about 30% over the last two years to about 5,600 in 2012. As mentioned by Deputy Prime Minister and Minister for Finance in his Budget Speech, even as we expand our local supply of healthcare manpower, we will still need a significant pool of foreign healthcare staff. We will, therefore, continue to ensure flexibility in terms of our foreign worker policy so that healthcare institutions are able to fulfil their staffing needs. Separately, Dr Chia also asked for an update on the Healthcare Professional Conversion Programme.”
“To do this, spending, for instance, in our preschool sector, will be more than doubled over the next five years to more than $3 billion, the learning support programme will be extended beyond primary one and two and the Opportunity Fund will be expanded and extended to cover Polytechnic students. Madam, no Budget in a single year can satisfy all the diverse and often opposing needs of Singaporeans. There will always be some trade-offs and, I submit, "trade-offs" is not a bad word or an excuse for poor thinking or a lack of fresh ideas. In my view, Budget 2013 is a well calibrated Budget that builds on our efforts to transform our economy to achieve quality growth that will provide all Singaporeans with a better life and at the same time tackle the short term pains and challenges faced. Madam, I support the Budget. Page: 98 4.33 pm”
“But in this regard, even as we may explore the expansion of a more progressive tax Page: 97 system as a means to ameliorate income inequity and forge a stronger social compact, we must be mindful that we do not unwittingly reduce our international competitiveness. I would like to quote Leonard Lim from his Straits Times article dated 2 March in this regard. He noted that studies have shown that the top 11% of earners in Singapore already contribute almost 80% of the total tax takings as compared with 45.1% for the US and 31.6% for OECD countries. Hence, Singapore is already far more progressive than the US and OECD average in terms of personal income tax. So, there may not be much scope to raise income taxes here without affecting Singapore's international competitiveness. He notes that at 20%, Singapore's top marginal income tax rate is one of the friendliest in the world, but is above our close competitor Hong Kong's top marginal tax rate of 17%. Hence, we need to be careful when we consider options and their possible impact on the economy and our competitiveness before deciding what more we can do going forward to tackle the challenge of social income inequity. But, in addition to this, it is nonetheless that the progressive structure, as announced in Budget 2013, will not have a crippling effect on the upper income groups. This Budget explicitly recognises that social mobility becomes more difficult to sustain beyond the first few generations who have benefited from our good education system. Efforts in this Budget to promote social mobility and allow everyone a fair chance to move up the social ladder is not confined to only the low income but also extended to the middle income.”
“We need to do this without diminishing the incentive for them to be self-reliant. In a limited sense, we need quasi affirmative action for the poor. Slower or stagnating incomes, especially for those who work in jobs at the lower rungs of the income ladder, are a real challenge not just for Singapore but many economies around the world. It is a problem we have to work hard to tackle in order to give every Singaporean a real chance to do well and build a truly inclusive society. In this regard, I am happy to note that the Opposition also has noted its support for Budget 2013's initiatives to tackle the challenges of the income divide. Budget 2013 does not only continue but redouble our efforts to focus on social equity and uplift the lives of our low-wage workers and the vulnerable elderly. Among others, the income ceiling for Workfare Income Supplement is increased to $1,900 per month to benefit some 480,000 Singaporeans or 30% of our citizen workforce. Furthermore, the maximum WIS payout has also been increased by 25% to 30%, and the cash component is increased to 40%. This is a welcome move as it will cover more workers and help them with their immediate expenses. It is, in fact, something I had appealed for previously. We should continue to monitor and review the qualifying income ceiling for WIS to account for inflation and income growth for the different segments of the population. The introduction of a more progressive tax structure through tiered property tax rates and Additional Registration Fee for Cars (ARF) would help to redistribute the fruits of economic growth not just to the low income but also the middle income groups and the sandwich class. This is welcome.”
“In the short term, it hurts the sector, but it can help to prevent a much more painful crash that ripples across many more sectors. Nevertheless, MTI and other relevant agencies should pay special attention to the vulnerable sectors and formulate strategies, tapping on associations and other groupings to help the companies and, especially SMEs, to upgrade their strategies and tap funding. The Government will also continue to do all it can to grow our local workforce and improve our Labour Force Participation Rate for older workers and economically inactives through various programmes and incentive schemes. Nonetheless, it must be noted that our total LFPR is already one of the highest in the world and, in fact, higher than many OECD countries. Our male LFPR at 75.6% in 2011 for those aged 15 and above is in fact higher than that of Sweden at 73.9%. Hence, over time, raising the LFPR will have its limits. LFPR for older Singaporeans tends to be lower than that of younger segments Page: 96 of the workforce. As our workforce is becoming older, and with a low TFR, our overall LFPR will decrease over time despite improvements across age groups. Hence, the Workers' Party's proposal in its Population Paper to raise LFPR for those aged between 15 and 69 by 0.5% per annum till 2025 to reach some 78.7% is hopeful but unrealistic, as that rate is even higher than Sweden's current 74.8%. Third, closing the income gap. It is acknowledged that we need to continue to do more to strengthen the social safety net and address the widening income gap. We need to create, and widen, opportunities for Singaporeans to move up the income ladder and attain a higher standard of living for every segment, but especially the lower tiers of our society.”
“He says that if he folds, it is not just the foreign workers but he and his other Singaporean employees who will lose their rice bowl. Page: 95 The tightening of our foreign worker policies will inevitably affect our SMEs, which are mostly owned by Singaporeans. These SMEs contribute more than 50% to GDP and employ some seven in 10 Singaporean workers. They will be affected more than the MNCs. As noted by Assoc Prof Randolph Tan in a Straits Times article as well as by Minister Lim Swee Say, whilst we restructure to ensure that we remain competitive, we need to carefully manage the pace of change as we are walking on a tightrope. While cognisant of the social downside of having a large number of foreign workers, if the pace of change is too hurried, for example, by freezing the foreign worker growth immediately, as some are championing, the consolidation may be too drastic and the job losses due to company failures, many of which are owned by Singaporeans, may be irreparable. The ultimate victim may be the Singaporean worker. Hence, the Government has chosen to adopt a calibrated approach to the tightening of the foreign worker policy. The sectors that rely heaviest on foreign workers like construction and services also tend to have lower levels of productivity and pay the lowest wages. These will be the sectors that find the medicine most bitter. The medicine forces restructuring, but the truth is that some of these sectors like F&B are highly fragmented, low technology oriented, and low skilled. Leaving them alone will only accentuate and prolong the need for painful adjustment later. It is analogous to poking the property asset bubble with the series of cooling measures against the backdrop of excessive liquidity.”
“Nonetheless, to ensure that Singaporean workers do benefit from the scheme, the Government should monitor how effective the firms are in utilising the scheme to upgrade and share productivity gains with their Singaporean workers and, if necessary, give guidance to these firms. More importantly, to spur more firms to take advantage of the WCS, PIC and other productivity initiatives, the Government, say through the Enterprise Development Centre (EDC), should proactively work with business associations like ASME and specific trade organisations to make every effort to reach out to the businesses, especially the SMEs, who would need the most assistance. Firms should also step forward to avail themselves of the scheme to restructure, as otherwise they will lose their competitive edge. The Government may consider crediting the companies with WCS on a half-yearly instead of annual basis as this would be more helpful to SMEs who may be grappling with their cash flow due to cost pressures resulting from a tight labour market. Indeed, this is one of the feedback that I have received. Secondly, foreign worker tightening policy. Firms, especially the SMEs, have voiced serious concerns over further increases in foreign worker levies, cuts in DRCs and the higher qualifying salary for S Passes. Many lament that it is going to get tougher for them to do business in Singapore and some would be forced to shut down, relocate or consolidate their businesses. A Singaporean resident of mine, who is a renovation contractor whom I met at a house visit, asked me to appeal to the Government not to increase the foreign worker levy further as his margins are already very low. He fears that he will not be able to survive if levies are raised.”
“Instead, the WCS, together with the other productivity initiatives announced, seeks to provide every help possible to enable firms to transit into higher value, less labour intensive operations and continue to root themselves in Singapore for the benefit of Singaporeans, particularly the Singaporean workers they hire. Some have, however, criticised the scheme as being too liberal and too blunt a tool. The benefits may be skewed less toward SMEs and more toward MNCs with a larger number of employees that may not be affected by restructuring. They worry that there could be abuses of the scheme by firms. Others have questioned if productivity would actually be raised by WCS since the scheme is not tied to any actual productivity gains. Moreover, it is argued that the tight labour market might mean that companies might have to raise pay to retain their workers anyway, whether the worker is more productive or not. As the WCS works on a "co-payment" basis, the fundamental premise of productivity improvements and gains sharing is not compromised as the employer still has to bear the remaining 60%. The WCS must be seen in tandem Page: 94 with the tightening of foreign workers, PIC Bonus and enhanced incentive schemes as a package to nudge firms to raise productivity while minimising the pain when doing so and in favour of Singaporean workers. As a three-year programme, it recognises that some long-term investment in innovation, transformation and productivity that a company puts in, may take a few years to bear fruit, whilst the labour market remains tight and employers have to continue to be competitive in remuneration in order to retain staff.”
“There are structural impediments that may prevent the able from accessing opportunities. Hence, more needs to be done to strengthen the social safety net, remove these impediments and address the widening income divide. Page: 93 I would now like to touch on three key topics of discussion arising from the initiatives announced in Budget 2013. Firstly, the Wage Credit Scheme (WCS). The Scheme, arguably the centrepiece of the Government's three-year $5.3 billion Transition Support Package to help businesses through this period of restructuring, has been the most widely discussed. MOF estimates that, currently, about seven in 10 Singaporean workers could benefit from the scheme. It is pro-business because it helps to relieve some of the cost burden of businesses by co-funding 40% of the wage increase of their Singaporean employees as they restructure in a tight labour market. It also incentivises firms to share productivity gains with their employees. It is also pro-Singaporean worker, in making it more attractive to hire Singaporeans. With the WCS in place for a period of three years, it will give firms, especially SMEs, some breathing space and more time for the productivity improvements they are pursuing to catch up with wage increases, thus benefitting the firms, workers and the economy. The WCS, which, to begin with, is only transitional in nature, is not primarily intended to be a wage supplement or a wage subsidy and is primarily not meant as a tool to close the income gap. For that, we have the WIS and many other schemes.”
“Mdm Speaker, Budget 2013 is a bold Budget. In my view, it reflects a courageous shift in economic and social policy that started some years ago, but which has gathered pace in recent times. It is bold on two counts. Firstly, it shows the Government's resolve in pressing ahead, despite strident voices from the business sector arguing against the pace of it, with economic restructuring and further tightening of our foreign worker policies. The steps we are taking, of moving the entire economy up the productivity ladder, away from over-reliance on foreign workers can be risky, but is imperative. There are decreasing scale economies from adding more labour to the other factors of production. It was effective for a season, but not any longer. Adding labour to land, raw materials and capital will steadily lose its efficacy simply because many of the labour surplus economies like India and China can do it much more cheaply and better. Technology and innovation offer a different and more expansive growth strategy, one that supports quality growth with an emphasis on higher productivity, or output per worker. The competitive advantage from this strategy is much harder to attain, and once Singapore takes that path, there is no turning back to a labour-driven growth model. But that kind of innovation and productivity-led growth is a more enduring way to raise wages, especially for the vulnerable income groups, and in a fairly constricted labour environment such as the one we have. Secondly, Budget 2013 is bold is because it acknowledges that meritocracy alone can no longer ensure social mobility. Meritocracy is necessary as it allows the able to rise unimpeded, and, in doing so, they will buoy up the rest. But meritocracy is insufficient.”
“Certainly. We will take the feedback and the suggestions of the Member's into consideration. In fact, MSF as well as MOM and other agencies do work together on such multi-agency and multi-Ministry issues. Childcare centres – the topic would be better posed to MSF perhaps in Page: 18 a future PQ. But certainly we will also consider what we can do to improve the range of flexi-work available to economically-inactive residents, including women.”
“I thank the Member for his supplementary question. The ADVANTAGE! scheme, Flexi-Works! scheme and WoW! Fund, together with other programmes like Workfare, SEC, the re-employment legislation, as well as our outreach to employers, have helped us to make progress in promoting flexible work arrangements and supporting the employment of mature workers and economically-inactive residents. There are a few indications for this. In 2012, as I have noted earlier, 41% of establishments offered at least one form of flexible work arrangement to their employees, up from 25% in 2007. The employment rate of older workers aged 55 to 64 has also risen to 64% in 2012, up from 45.2% in 2003. This is comparable to the standards of advanced economies. In fact, it is only 1% away from our target of 65% in 2015. The female labour force participation rate for those aged 50 to 64 has also increased from 50.9% in 2003 to 57.7% as at June 2012. But we acknowledge that more can be done and we will continue to review and enhance the schemes by working closely with our tripartite partners, taking into consideration the feedback, as well as the many feedback we have received from MPs in this House. As I have noted earlier, we will be announcing revisions to the schemes in the coming Committee of Supply debates in March.”
“While we have put in place these various measures, employers also have an important role to play to create more progressive workplaces to attract and retain locals. We hope that employers will take advantage of the Government's support and play a key role in supporting local employment. Page: 17”
“On average, each company received funding support of about $11,000. Another scheme which helps employers improve work-life harmony is the WoW! Fund. Since its introduction in 2004, over $15 million has been disbursed in total, or about $1.9 million annually on average. To date, about 860 companies have benefitted from the WoW! Fund. This works out to an average funding support of around $19,000 per company. Through these schemes and our tripartite approach to employers, we have made progress in promoting flexible work arrangements, and supporting the employment of mature workers and economically inactive residents. In 2012, 41% of establishments offered at least one form of flexible work arrangements to their employees, up from 25% in 2007. Nevertheless, more can be done and we will continue to encourage better working environments and more progressive workplace practices, as well as support employment for locals. We have, and will continue to work closely with our tripartite partners to collect feedback on ways to improve these schemes. We will be enhancing these schemes and more details will be announced at the Committee of Supply debates in March as part of our overall efforts to help employers and workers cope with an ageing workforce and the tight labour market. Together with ADVANTAGE!, Flexi-Works! and WoW! Fund, the Special Employment Credit (SEC) scheme and Workfare programme encourage local workers to return and remain in the workforce, including the more vulnerable groups of the population. The support that we provide is not restricted to financial assistance alone. Our WDA career centres and tripartite partners also offer guidance and counselling workshops to help jobseekers overcome the social and psychological barriers to employment.”
“The Government has put in place various policies and programmes over the years, aimed at providing more job opportunities for locals and encouraging locals to work. The ADVANTAGE! scheme, Flexi-Works! scheme and the Work-Life Works! (WoW!) Fund form part of these programmes and are targeted at supporting the employment of older workers and economically inactives, as well as improving work-life harmony for all workers. We have worked closely with our tripartite partners to administer these programmes, which have allowed us to have better outreach and adoption. The ADVANTAGE! Scheme was introduced in 2005 to help companies recruit, retain and re-employ mature workers aged 40 and above. The scheme offers funding support for companies to enhance the employability of mature workers through training support as well as job and workplace redesign. Over the years, the scheme has also helped companies, especially SMEs, to be ready to implement re-employment. Close to $57 million has been disbursed under the scheme since its inception, benefiting around 3,500 companies. This works out to an average of about $16,000 per company. In particular, $24 million went towards supporting companies in their job redesign efforts, which improved the employability and productivity of mature workers. Overall, the ADVANTAGE! scheme has benefited more than 25,000 mature workers. Page: 16 The Flexi-Works! scheme was introduced in 2007 to help companies recruit economically inactive residents who want to re-enter the workforce, by supporting the costs of implementing flexible work arrangements. In total, more than $3.9 million has been disbursed, benefitting over 360 companies and placing over 3,500 residents into jobs with flexible work arrangements.”
“Mdm Speaker, first, I have noted in my reply earlier that the Ministry adopts a risk-based approach under the relevant Act to protect against health risks and to ensure patient safety. We would enforce against serious medical claims for treatments that will affect patient safety, in terms of causing harm, whether directly or indirectly. In addition to that, we are considering now looking at revising the list of medical conditions as well as diseases listed in the Schedule to the Medicine Sale and Advertisement Act in relation to claims for treatments, services and products. There is a list in the Schedule of the Act, and we are looking at revising this to include medical conditions as well as diseases on services and products offered by alternative medicine practitioners that will be prohibited in the advertisements to the public. That is to take into account the new and emerging alternative medicine treatments and the risks that they can pose to the public.”
“5 million or lower, there is no reason to go higher. But it is prudent to plan our infrastructure at the upper end of the range so that we do not get caught out. Page: 45 Moreover, the Singaporean Core itself is not homogenous like the Middle East or Japan. The core, in fact, comprises several ethnic groups with distinct characteristics but which are bound together by common experiences and shared values. It has always been porous, allowing others to enter and enlarge the core. We should be mindful of not creating an "us" and "them" mentality. Mdm Speaker, the polarised reactions to the Population White Paper by individual Singaporeans and businesses show dilemmas that both the Government and all Singaporeans have to grapple with. The Government is taking a bold step to bring this highly contentious topic to the table for Singaporeans to debate, fully cognisant that it will generate much heat – as, indeed, it has – when many other governments have largely chosen to shy away from the issue. This goes to show that our ageing and shrinking population that will affect the future of Singaporeans and Singapore is a matter of grave concern to the Government. We do not want to shirk from our responsibility by sidelining strategic issues. It is important to surface this issue early and plan ahead. The White Paper lays the foundation and guides the demographic course for our nation so that our young people today can have a good future tomorrow. It is as much about building a sustainable population for a dynamic Singapore as it is about a dynamic population for a sustainable Singapore. The two are intertwined. Madam, I support the Motion. 2.19 pm”
“Moreover, while Singapore is a city-state, South Korea is a large country, and one would expect that the TFR within a major city like Seoul could well be lower. Undoubtedly, the Government will continue with its efforts to promote marriage and parenthood as a fundamental means to strengthen the Singaporean Core, but, clearly, based on the experiences of other countries, reversal in TFR is a challenge and will take time. We will need all Singaporeans to do their part for this to happen. Many Singaporeans have expressed discomfort not just with the projected upper bound population of 6.9 million in 2030 but also that the Singapore citizen population is estimated to comprise only 55% of the total population in 2030. Will we Singaporeans be strangers in our own land? Will this irrevocably change the character of our society and dilute our national identity, as the Workers' Party has also argued? Will we eventually become like the Middle East oil states where locals constitute only 10% of the entire population and the rest are contract workers, with all the attendent social problems this might bring? This is a legitimate concern, but somewhat misplaced, because, as noted by Deputy Prime Minister Teo, the 6.5 million to 6.9 million population figures are estimates, with the 6.9 million as the worst-case scenario necessary for planning purposes. If we succeed in reversing the TFR, improving productivity beyond our targets, harnessing technology and innovation, as well as getting more older workers and women to join the workforce, then our population may not reach 6.9 million and the number of foreigners allowed in will be lower. As Deputy Prime Minister Teo noted, if we can ensure the well-being of Singaporeans with a smaller population, whether 6.”
“The latest round of new measures and enhancements announced is the third incarnation of the Marriage and Parenthood Package and has taken extensive feedback received from Singaporeans over the past year. It will increase the cost of the package from $1.6 billion to $2 billion a year. The enhanced package includes measures which signal paradigm shifts, such as paternity leave and MediShield for newly-diagnosed congenital and neonatal conditions. Hence, far from being half-hearted in promoting Marriage and Parenthood, as the hon Members Ms Sylvia Lim and Mr Faishal Manap have claimed, I would say that the Government has put much effort and heart to promote Marriage and Parenthood. The hon Member Ms Sylvia Lim brought up the example of South Korea as a country that has successfully reversed their falling TFR from 1.08 in 2005 to 1.23 in 2010. She highlighted some measures adopted by the Korean Page: 44 government which could have contributed to their success, such as institutional support for family life and promoting gender equality within the family. I thank her for highlighting this example but I would like to note that the NPTD, in crafting the Marriage and Parenthood Package, has, in fact, looked quite exhaustively at the policies of many countries, including South Korea, and will continue to monitor them. Whilst it is commendable that South Korea has managed to raise its TFR to 1.23 in 2010 and, in fact, 1.24 in 2011, this is still far below the replacement rate, and not much higher than that of Singapore's 1.2 in 2011. In fact, I understand that the preliminary estimate of the TFR for 2012 in Korea is 1.23. This compares to our estimate of between 1.28 and 1.3 for 2012, due to the dragon year effect.”
“Indeed, Singapore would not be the thriving city it is without the contributions of our forefathers, most of whom were migrants. Many new citizens continue Page: 43 to make good contributions to Singapore. Hence, all citizens should be treated equally and with respect, as they have made the conscious decision to take up the pink identity card and forge a common future with us here. It is unhelpful and unfair to distinguish between local-born Singaporeans – or, as the hon Member for Aljunied said yesterday, "indigenous Singaporeans" – and new citizens and cast doubts on the loyalty of the latter. To do so will generate a sense of unwelcome to future groups of people who seek to build their lives and families here. Like many in this House, I myself was not born in Singapore, but I decided to cast my lot with Singaporeans. So, does that make me any less of a Singapore citizen than someone born in Singapore? As much as any new citizen could pack up and leave Singapore, so could any other Singaporean. Instead, we should continue to enhance our integration efforts to help new citizens adapt to our Singaporean way of life and sink deep roots while adding to Singapore's rich diversity. It will take time, perhaps one generation, for the children of these new citizens to undergo the same rites of passage as our home-grown children – schooling and National Service – to develop a stronger Singapore identity. As Deputy Prime Minister Teo and many others in this House have noted, the best way to strengthen the Singaporean Core must be to encourage Singaporeans – new and old – to marry and have children. The Marriage and Parenthood Package was first introduced in 2001 and then enhanced in 2005 and 2008 to strengthen the pro-family environment in Singapore.”
“It will be instructive to find out from our Workers' Party Members of Parliament what this proposed 0.5% per annum workforce growth will translate into in terms of growth in resident and foreign workforce, as well as the number of new citizens and PRs per year. Be that as it may be, we are also committed to continue to look at ways to further improve productivity, increase our resident labour force participation rate and, of course, increase our TFR so that we can reduce the need to augment our population and workforce with new immigrants and foreign workers. This could then result in a lower population than projected in the future. One of the key goals of the Population White Paper is to maintain a strong Singaporean Core. But what does it mean to maintain a strong Singaporean Core? Who forms the Singaporean Core? I submit that the Singaporean Core must comprise all Singapore citizens, local-born or otherwise, who have pledged allegiance to Singapore and share our key values, such as hard work, meritocracy and multiculturalism. Singapore has historically been an immigrant society and has benefited from the diversity and energy that new citizens bring. New citizens, drawn to the peace, harmony and security Singapore has to offer, will need time to adjust to life here. As strangers in a strange land, they will continue to seek comfort among their own kind in as much as we Singaporeans tend to cluster when we live or work overseas. Their backgrounds, habits and cultural norms may sometimes puzzle us, or even grate us. We need to develop a healthy sense of mutual respect not to allow differences to divide us. This should also not detract us from what they can offer.”
“Businesses are already feeling the pain of tighter foreign manpower restrictions over the last few years. They have collectively expressed horror over the White Paper's projected slowdown in workforce growth to about 1% to 2% in this decade and then to 1% in the next decade. Many companies, especially SMEs, are reportedly scrapping expansion plans or thinking of moving out their plants. They are understandably worried that further foreign manpower restrictions will cripple their businesses. Whilst raising productivity through innovation, technology and process improvement can help reduce their dependence on labour, there is also a limit as to how far this can go. Already, the productivity targets of 2% to 3% per annum till 2020, and then 1% to 2% after 2020 to 2030 are stretch targets. By comparison, we have, on average, only managed productivity growth of just 1.8% per annum over the last decade. This is despite generous incentives for companies to take advantage of and numerous discussions with business groups and employers to refine the schemes and ease the path for firms to Page: 42 access them. Hence, the Workers' Party's proposal to sharply cut workforce growth to 0.5% per annum would exact punishing cost on our local businesses and even some MNCs and, in fact, there will be a flow-through on cost to the average Singaporeans. Under this scenario, many companies are likely to fold or move out of Singapore whilst others will not be attracted to set up shop here, resulting in fewer jobs for Singaporeans. Hence, to curb immigration or foreign workforce growth with such a proposal in order to help safeguard Singaporeans could, in an ironic twist, hurt the very people this reversal is intended to help.”
“And will continue to strengthen these schemes. The employment of older workers aged 65 to 69 years, for instance, at 36.9% as at 2012, is one of the highest in the world and behind only South Korea and Japan. In fact, our assumptions for the resident workforce's percentage point contribution to total workforce growth, which is at 0.7% for the rest of this decade, have already taken into account that more older workers, women and so on, will continue to work or return to work. So, one doubts how much more we could increase the Page: 41 workforce through this means. In the next decade, our projections of the resident workforce growth are close to zero, as the number of Singaporeans expected to join the workforce is barely enough to offset the numbers expected to leave the workforce. Any increase in TFR, if we are successful in our efforts to this end, will only be felt after 2030 since babies born this year would only be 17 years of age by 2030. Hence, it will be useful to understand how the Workers' Party proposes to grow the resident workforce by at least 1% per annum. Based on the Workers' Party's proposal of moderating GDP growth, the corresponding total workforce growth actually works out to 0.5 % per annum for the next two decades. This is less than one sixth of the 3.3% total workforce growth over the last 30 years. Based on our estimates, our resident workforce's contribution to total labour force growth could reach 0.7% per annum up to 2020, whilst the Workers' Party proposes to grow this by at least 1% per annum, and yet only have 0.5% total workforce growth from now till 2030. If this were so, is the Workers' Party proposing having no or negative growth in foreign workers each year from now till 2030?”
“By any account, the Paper's assumption of GDP growth of 3% to 5% up to 2020, falling to 2% to 3% in the next decade, is less than half of the 5.6% average annual growth in the 2000s and the 7% growth in the two decades prior. Partly, the reduced GDP numbers recognise that with a higher base today, and as we mature further, our economy cannot grow at the elevated levels we had enjoyed previously. Equally important, it also highlights that the premise of the White Paper is not a "growth at all costs" strategy. That growth, and the increase in foreign workforce accompanying that growth, must be socially sustainable. The Workers' Party has proposed to moderate the GDP growth projections in the White Paper down by 0.5% to 1%, thereby bringing the GDP growth to 2.5% to 3.5% per year up to 2020, and 1.5% to 2.5% per year in the next decade. They assume similar productivity growth assumptions of 2% to 3% per annum this decade and 1% to 2% per annum next decade. But – and this seems to be the key plank of their programme – they propose to grow the resident workforce by at least 1% per annum by encouraging older workers, foreign spouses and economically inactive women to join the workforce. With this, they project that the population in 2030 will be 5.9 million, or one million less than the 6.9 million figure in the Paper. The hon Member for Aljunied has a point. We should tap on the pool of older workers, back-to-work women and foreign spouses for our workforce. Already, foreign spouses who are on LTVP-Plus are allowed to work. Also, we have been promoting the employment of older workers and encouraging economically inactive women to return to work with a host of initiatives, such as the Special Employment Credit, Advantage, Flexi Works! and WoW!”
“Mdm Speaker, at the risk of over simplification, this debate is a bit of an anomaly. In many parts of the world, countries are struggling with little or no economic growth. Governments are racking their best brains on how to spur growth, create jobs and balance their books. Here, despite economic slowdown in countries like the US and the EU, we are in a happy position of having a generally tight labour market, a sound fiscal position and substantial household wealth. Yet, there are many voices urging the Government to pursue lower growth targets while many elsewhere are crying out for a diametrically opposite outcome. The reason is that many Singaporeans think that the cost of growth is too much to bear and prefer less to more – less growth, lower immigration, lower house prices, less congestion and so on. These are real concerns that must be addressed. At the same time, we are facing a demographic time bomb that creates a conundrum for us – how and to what extent can we reverse the population decline from low TFR while safeguarding Singaporeans' interests and maintaining an environment that supports a high quality of life? Underlying this conundrum is the fundamental question implicit in the Population White Paper – what kind of Singapore do we want? Page: 40 Contrary to what some critics have charged, the Population White Paper is not fixated with economic growth per se. Economic growth is never and should never be an end in itself. The White Paper is, in fact, about Singaporeans – about ensuring Singaporeans' well-being into the future. It seeks to enable Singaporeans to continue to live in a harmonious society, with strong supportive families, good jobs and a good quality of life.”
“Notwithstanding this, MOH is reviewing the medical, scientific and ethical implications of egg-freezing with the aim to establish a policy position to develop a regulatory framework with the necessary safeguards, if the eventual policy position is to allow social egg-freezing. Having said that, it is still important to reiterate that egg-freezing, like other AR-related techniques, is really not a foolproof or guaranteed solution. There is no better substitute to natural child-bearing within marriage for women when they are relatively young and healthy. Lest the men in this House think that age-related fertility problem is a women's issue, let me say that the men are also not spared the ticking of the biological clock and they do suffer from age-related fertility problems. Page: 1208”
“Firstly, let me say that I share the Member's concerns about age-related fertility as more men and women delay marriage and parenthood. However, it must be noted that advanced technology, such as IVF, can help women solve their fertility-related problems only to a certain extent. It is not a foolproof or guaranteed solution. Besides the conventional IVF, as the Member has rightly pointed out, there has been an increase in interest in vitrification or ultra rapid egg-freezing, which is a new technology. It is a technique that can help unmarried women to freeze their eggs and store them for future use to overcome the reproductive or ovarian ageing problem. Currently, MOH only allows egg-freezing for medical reasons, such as women who have to undergo certain treatment, for example, chemotherapy and radiotherapy, which will damage their fertility. There are various reasons why egg-freezing has not been allowed other than for such medical reasons, and they include the fact that there are inherent risks to the women who undergo the egg-freezing procedure, such as ovarian hyper-stimulation syndrome, bleeding and infection. Furthermore, because the technology is relatively new, there is limited information available on the perinatal outcomes of the procedure, for instance, the success rate, live births, pregnancies, and so on. There is also no information on the long-term effects on children born through AR using vitrified eggs. Besides these medical implications, there are also potential social and ethical implications, for example, the misconception of the use of egg-freezing as guaranteed fertility preservation as well as over-commercialisation.”