Chau Sik Ting
Singapore
“Sir, approximately when will the project be completed? Mr Teh Cheang Wan: Mr Deputy Speaker, Sir, I think tenders will be called sometime next year. It usually takes about two years to complete a flyover because it is quite a large one. HONG SAN TEMPLE (TOL fee) 2.”
“I agree with what the Minister has said. It is my hope that Government will make more financial provision in this area. My second point is that a larger pool of dialysed patients will make it more likely for a donated kidney to find a good match; and the better the match is, the lesser the risk to the recipient and the better the quality…”
“However, from well documented scientific evidence, few can deny that such transmission of communicable infections can and do occur. Be that as it may, perhaps it is timely for us to bring our now famous "Keep Clean" campaign one step further and focus public attention at this spitting habit in public places with the objective of inculcati…”
“As to whether this move would lead to increased lending costs to commercial enterprises, in particular the small ones, since the banks would be deprived of the so-called "free funds", keen competition in the market-place may, however, dictate otherwise.”
“Member for Anson would like to include regular inspection of factory toilets. Sir, that is not the priority area I mean. Safety, as the Hon. Minister has indicated, is the priority. Nevertheless, I hope that at the appropriate time when circumstances warrant it, the Hon. Minister will bring about such a change.”
“But its inclusion will not only enhance the reputation of the National Health Plan but more importantly, it will guide the direction and development of proper preventive rather than solely curative health care programmes at the local factory level in the years to come.”
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“Sir, approximately when will the project be completed? Mr Teh Cheang Wan: Mr Deputy Speaker, Sir, I think tenders will be called sometime next year. It usually takes about two years to complete a flyover because it is quite a large one. HONG SAN TEMPLE (TOL fee) 2.”
“That is the reverse of it. It is the same book.”
“13% of the Singaporean Chinese males are not expected to live beyond 55 and 42% of the Singaporean Indian males are not expected to live beyond 65 years of age.”
“What concrete plans are being made to improve the present system of medical care so that the proposed health maintenance programme can be successfully implemented? While providing increased screening and health information to the elderly, what steps are being taken to ensure that the additional demand for health care thus generated can be met by existing health resources? 3. And just how does this health maintenance programme fit into the National Health Plan and the Medisave Scheme? Medisave is meant for acute hospitalization and does not cover outpatient charges. Can elderly patients who are poor, especially those requiring long-term chronic care, afford the increasing prices? 4. While community and voluntary organizations assist in the provision of health and recreational programmes for the aged, can further incentives and rewards be devised to encourage such community-based participation? In this regard, I am glad to note that the Report has suggested some ways to strengthen the administrative machinery and to contribute to the recruitment, training and continued motivation of the community and voluntary workers for the effective care of the aged. 5. Finally, Sir, would it be feasible for a structure to be formalized to involve existing organizations,:.such as the Home Nursing Foundation, and professional and other bodies concerned with the problems of the aged? If so, then systematic and detailed programmes ,for specialized training on the care of the aged can be effected from this focus. Sir, I hope the Committee will look into these questions if it has not already done so and will present answers to this House in due course. 4.16 pm”
“The third point I would like to make is that if this recommendation to raise the CPF withdrawal age is adopted and at the same time free and voluntary negotiations between labour and management over raising the retirement age are allowed, problems could be caused to certain groups who may find themselves jobless after 55 and yet quite unable to withdraw their CPF savings. Under the present economic situation it is not possible, for any employer to guarantee continuous employment up to 55, not to mention 60 or 65 years of age. The proposal to raise the CPF withdrawal age should be abandoned until such time when the life expectancy is further improved to a level where at least 90% of all contributors can be expected to live for a reasonable period beyond the age of 65 to enjoy their life-long savings. We should in the meantime not only encourage but also do everything in our power to make it possible for employees to work up to the age of 60 or 65. Until then, CPF contributions should remain as old age savings meant for the savers when they cease employment at the age of 55. Sir, now let me dwell on another issue, that is, the issue of the health and recreational needs of the aged. On this issue, the National Survey of Senior Citizens, 1982, quoted in the Report, presented an optimistic outlook. It revealed a majority who are healthy and have few problems. However, I have a few questions. 1. Are the needs of the minority (8.2% requiring hospitalization and 0.6% bedridden) being adequately met? These growing problems must be anticipated, whether as an increase in actual numbers of the needy or in the nature of their needs. 2.”
“Let me try to state some of the arguments against raising the CPF withdrawal age which surfaced in my discussions with community leaders in my con- stituency. The first point is that at the time of the publication of the Report, CPF contributions have been made with the clear understanding that they can be withdrawn at 55. It would be a breach of faith to adopt this recommendation and many of those affected will feel let down. It has been suggested that if the CPF withdrawal age has to be raised, it should only affect contributions made after Parliament adopts the Report. In other words, all past contributions to CPF should be allowed to be withdrawn at age 55. This appears to be a good compromise made in the belief that a Blue Paper by a Ministerial Committee is almost certain to be adopted in toto. Another point against raising the CPF withdrawal age is that a significant proportion of contributors will not live beyond 65 years of age to enjoy their hard-earned life-long savings as borne out by statistical data. The increased life expectancy of 68.7 years for Singaporean males is only an average figure. Statistics on population groups who will not live beyond 55, 60 and 65 years of age have been computed and ranges from 13% for Chinese males at age 55 to 42% for Indian males at age 65. Just imagine, about 42% of the Indian males withdrawing their CPF savings at age 65 will not live to enjoy their money. Is it fair?”
“Mr Speaker, Sir, under the combined effects of a failing birth rate and an improved life expectancy, Singapore's population is fast growing older. It is against this background that the Committee on the Problems of the Aged, led by the Hon. Minister for Health, took a detailed look into the financial, emotional, recreational, social and health needs of the aged. The Committee in its Report made recommendations suggesting how the nation as a whole can come to grips with the problems likely to loom large in the years ahead. It includes specific recommendations aimed at keeping the aged out of old folks homes and providing means for them to support themselves. It is a good and thorough Report with suggestions for far-reaching changes in laws and attitudes. But, like many Members of this House, I have strong reservations about the proposal to raise the CPF withdrawal age. First, let me try to restate the arguments for raising the CPF withdrawal age as found in the Report. One of the important points in favour is, and I quote: 'Many are known to have lost their savings overnight through speculation.' My question is: Approximately how many such cases over, say, the last 10 years are known to the Hon. Minister? Are there 10; 100 or 1,000? I would be surprised if there are more than a thousand cases. Let us assume for a moment there are a number of such cases who have lost their savings through speculation. Have not these individuals the right to utilize their money the way they want to? Should the State interfere and limit this right if the numbers are not great? That there cannot be many of such cases is evident from the fact that the vast majority of CPF contributors are in fact making use of their money in the purchase of properties as well as for other approved uses.”
“I agree with what the Minister has said. It is my hope that Government will make more financial provision in this area. My second point is that a larger pool of dialysed patients will make it more likely for a donated kidney to find a good match; and the better the match is, the lesser the risk to the recipient and the better the quality of life. With that, Sir, I beg leave to withdraw my amendment. Amendment, by leave, withdrawn. The sum of $387,807,210 for Head P ordered to stand part of the Main Estimates. The sum of $92,685,400 for Head P ordered to stand part of the Development Estimates.”
“Be that as it may, we cannot ignore the fact that if the present trend continues, on the average, three out of four new cases requiring renal dialysis or transplant treatment are turned away. It is a depressing situation. The need is to have four Government satellite centres with 20 stations each for self-dialysis, two more to complement the existing ones at Alexandra and Tan Tock Seng Hospitals so that not only the younger economically productive group could be better covered but that the consequent larger pool of dialysed patients will make it more likely for a donated kidney to find a good match. The more perfect the match is, the lesser the risk to the recipient and also the better the quality of life. Sir, in view of the healthy state of our economy, the Finance Minister who has been giving away a fair sum of money these past three years in the form of tax rebates may yet feel generous enough to accede to the request of the Minister for Health for more funds to be allocated for this, unfortunate group of people who, through no fault of their own, are stricken down with chronic renal failure and are awaiting death. Finally, Sir, I would also like to urge the public to support the effort of the National Kidney Foundation in running their pre- sent self-dependency dialysis centre at Kwong Wai Shiu Hospital. Though this centre, I understand, has 12 stations it is, in fact, operating below its full potential because of financial constraints. Additional funds are needed to meet recurrent expenditure to enable the Foundation to effectively complement the effort of the Ministry of Health in this area. Sir, the National Kidney Foundation deserves public support.”
“Sir, I beg to move, That the sum to be allocated for Head P be reduced by $10 in respect of Subhead PC-02 of the Main Estimates. Sir, in my address in this House on 24th March, 1982, I made a plea that the Government should look seriously into increasing the renal dialysis facilities both within and outside our hospitals. I agree with both the Ministers for Health that it is a difficult area of medicine where we can never do enough because of the magnitude of the problem. The pattern then and now remains the same, about 200 new cases of chronic renal failure each year, 50% of whom are between the economically productive age of 15 and 45 years. I am glad to say that the Hon. Minister has not only taken note of my suggestion but has implemented them to a certain extent. 7.45 pm True to his word, the self-dependency dialysis unit at Alexandra Hospital has since then mounted an additional shift to look after another 22 more patients. Furthermore, a new satellite centre for dialysis at Tan Tock Seng Hospital has been set up. It has 10 stations and can cope with another 40 patients with provision for further expansion. Sir, the public must be made aware that haemodialysis is no substitute for kidney transplant. The Ministry of Health together with the National Kidney Foundation have put up a concerted effort to convince the public to support the Kidney Donation Campaign. It has been mentioned in this House before but it must be further reiterated that each successful kidney transplant will not only ensure a better lease of life to the recipient but will also create a vacancy for those waiting their turn for dialysis. So far, the efforts of the Ministry's persuader teams, I am told, are producing encouraging results.”
“Sir, in view of the positive response from the Parliamentary Secretary, I beg leave to withdraw my amendment. Amendment, by leave, withdrawn.”
“However, from well documented scientific evidence, few can deny that such transmission of communicable infections can and do occur. Be that as it may, perhaps it is timely for us to bring our now famous "Keep Clean" campaign one step further and focus public attention at this spitting habit in public places with the objective of inculcating self-control over the indiscriminate discharge of pharyngal fluids in public. Would the Minister for the Environment consider introducing measures against indiscriminate spitting and help bring about a change in habit when most people will spit into a tissue paper or a handkerchief when the urge to do so takes hold of them?”
“Sir, I beg to move, That the sum to be allocated for Head M be reduced by $10 in respect of Subhead MB-01 of the Main Estimates. Sir, the first "Keep Singapore Clean" campaign was launched in 1968, and with the sustained vigour over the last 15 years, the clean and green image of Singapore city has become renowned beyond our shores. There has, no doubt, been a recognizable behavioral change in the general populace from a people who literally scatter litter in public places without second thought to one who are now cautious and would look for a convenient public dustbin around to deposit whatever refuse they may have to throw. The inculcation of such a good habit in the majority of our people is commendable. But this could not be said of another offensive habit. I am referring to the act of indiscriminate spitting in public places. Such a 'filthy' habit has been observed not only by our own people, but unfortunately even by the many tourists who visit Singapore each year. In a moment when one's throat is irritated or nasal congestion takes place from a head cold, there is the inevitable stimulus to discharge phlegm, spittum or pharyngal fluids from the upper respiratory passages. The present habit is to assuage the urge by spitting or clearing the nose wherever one is at the moment, even in a public place in the gaze of everyone, There is apparently no self-control and the need to expel the pharyngal fluids into a tissue paper or a handkerchief just does not occur to the offender. There is no pressure in the form of a fine or social disapproval from the general community. Sir, I do not wish to overstate the case against public spitting on grounds of the spread of communicable diseases like tuberculosis or other viral infections through droplets.”
“We have laid a strong foundation for Singapore to progress and expand into the 90's. Mr Speaker, Sir, I support the motion. 6.41 pm”
“As to our Budget, we are optimistic that it is going to provide the necessary impetus for our future growth. It is a progressive Budget. It encourages the creation of wealth and hence the production of a larger national cake so that everyone can have a bigger slice of the cake. Furthermore, the Budget encourages savings and discourages the break-up of family businesses and family units. In the past, because of the high estate duty, family businesses and family wealth are likely to be divided and distributed early to avoid such payments, leading to the disintegration of family businesses and family units. With the reduction of estate duty to the new 2-tier system, many family businesses and family units are more likely to continue for decades. This will encourage people to save, to accumulate savings, to work harder and to continue to expand their businesses. Moreover, a taxpayer has been taxed directly and indirectly throughout his life. He certainly deserves such a break when he is dying so that he can die in peace. In fact, I am in favour of the abolition of estate duty altogether. Sir, the generous reduction of income tax will, hopefully, have the same effect of encouraging hard work and greater enterprise among the individuals. Mr Speaker, Sir, the benefit of enhanced child relief has been extended to married women with five 'O' levels. By so doing, our Government is not only sensitive to the pleas of Backbenchers but is, in fact, pragmatic in its orientation. The emphasis is on the importance of education which is the key to upgrading our manpower resources. As can be seen clearly in the Budget, it has all the ingredients to make Singapore a better place to work and to live in. It gives a fair share to those who are prepared to work hard and are enterprising.”
“Mr Speaker, Sir, like my colleagues before me, I would like to congratulate the Minister for Finance and Minister for Trade and Industry for a Budget that is welcomed by all. Sir, technological and economic changes are taking place rapidly in the world today. World attention is now focusing on the economies of the Asia-Pacific region which are among the fastest growing in the world today and the high rates of growth are expected to continue into the 90's. The underlying strength of the whole region is that the economies are complementary to each other. Each country has its own potential for development based on its own strength and resources in different economic sectors. We, in Singapore, have to map out our own economic strategy taking into account our limited resources. When we encourage and promote economic restructuring more than three years ago, there were strong complaints and discontent among the business sectors. Today the complaints have lessened. Our economic restructuring policies have proved correct. If we had not restructured, Singapore would be worse off, having had to face stiffer competition in the world market. With the restructuring we now see industries being upgraded and some are diversifying into other areas of technology. New investments coming to Singapore are also moving into new areas of skills and technology better suited to our economy. Our investments in human resources and in upgrading skills and education have now provided Singapore with a larger pool of skilled work force to manage and man our new industries. Sir, we are aware that we have made progress but such awareness will be enhanced if we could have a progress report on our economic restructuring programme.”
“As to whether this move would lead to increased lending costs to commercial enterprises, in particular the small ones, since the banks would be deprived of the so-called "free funds", keen competition in the market-place may, however, dictate otherwise. After all, some commercial banks, such as DBS, are already paying interest on current accounts through something known as the Autosave. Finally, Sir, I would like the Minister of State for Finance to elaborate on clause 7 of the Post Office Savings Bank of Singapore (Amendment) Bill. Sir, I support the Bill.”
“Mr Speaker, Sir, I rise to support this Bill. As explained by the Minister of State for Finance, the POSB should retain its unique role as a national savings bank by providing a convenient banking service for the personal depositor. The need to encourage thrift and mobilise domestic savings for public development is still as relevant today as it was when the POSB was first established. These objectives must continue to be pursued, POSB has performed creditably so far. But should POSB go commercial, it could lose sight of the needs and interests of its personal depositors and would therefore be diverted from its initial objectives. Sir, we are glad to hear that POSB will offer personal current accounts, personal fixed deposits and sale of travellers' cheques. The public will certainly welcome these additional services. Commercial banks and finance companies must therefore continually ensure a high standard of personal services in view of the potential competition from the POSB. The public will benefit from such a competition. As a statutory board, POSB remains severely restricted in its lending and investment policy and therefore should retain all its existing privileges, namely:- i) exemption from income tax of interest earned on savings deposit; ii) a Government guarantee of deposits; and iii) exemption from the provisions of the Banking Act, particularly the reserve requirements. Should tax exemption on interest of savings deposit be discontinued, POSB would lose its inherent attractiveness to personal depositors. I am, moreover, in favour of payment of interest on POSB current accounts as it is in the interest of the public. The general public will welcome this.”
“I can foresee practical difficulties arising from this policy, such as the definition of "chronic illnesses". May I suggest that the Ministry with its panoply of experts could easily draw up a schedule of "chronic illnesses" along similar lines as the Schedule of Compensable Diseases under the Workmen's Compensation Act. Any person who is so diagnosed as suffering from one of the illnesses listed in the schedule of chronic illnesses would then qualify to be taken care of by the Ministry's subsidized and sponsored "other programmes". In cases of dispute, the Ministry could set up Medical Panels, again along the lines of Medical Panels provided under the Workmen's Compensation Act to decide on such issues. Conclusion Finally, let me say that, despite what has been said earlier in this House, I fully support the Medisave Scheme in its broad principles and with some modifications as I have elaborated earlier. As it is a uniquely Singaporean scheme, its success or failure will depend on its implementation. My plea is that we should give it a try. And if we are to be what we have been so far, then with the will and determination to succeed, and coupled with humanity and fairness in its implementation, the passage of time will be the better judge of its outcome, say, ten years from now. Mr Speaker, Sir, I support the Motion. Thank you.”
“First, it states that "chronic illnesses affect a small minority" and "such patients are best taken care of by other programmes outside of MEDISAVE". I am in entire agreement with this on the principle that the Medisave Scheme places financial restraint on the patient and, in any case, the amount saved would be inadequate. It would be better if such cases were outside the Scheme but taken care of by other programmes which would not lay the burden of hospitalization and medical fees on them. I seem to read some support for this line of thinking in the solitary example of the "other programmes outside the Medisave" cited as in the case of the mentally ill. As one instance of such other programmes, paragraph 53 states that the mentally ill are heavily subsidized by the Ministry when they receive treatment at the Government hospitals and clinics. They only pay a nominal fee. It may therefore not be incorrect to infer from the example quoted that since this programme for the mentally ill is heavily subsidized by the Ministry, other programmes for other chronic illnesses would also as a matter of principle, be equally so subsidized by the Ministry when the Medisave Scheme is introduced. What I would like to see promulgated is a broad policy direction, where the public could be clearly assured that in cases of those suffering from chronic illnesses and catastrophic illnesses requiring prolonged hospitalization and expensive medical procedures, they would be covered by other programmes which are largely Government subsidized and sponsored, so that they would be duly cared for and be relieved from financial anxieties. I am glad that the Minister in his earlier address has given us a categorical assurance on this.”
“There is an encouragement for individuals to stay healthy and prevents him from unnecessary abuse of public medical services. Chronic Illnesses Programmes However, on looking at the Medisave Scheme as a whole, let me now focus attention on one deficient area which has caused widespread concern, namely, the area of chronic illnesses (paras. 52 and 53). It is plainly stated in para. 52 that Medisave does not cover chronic illnesses such as, I quote, "the mentally ill or those who need dialysis for their kidney failure." And the reason proffered for this exclusion is the inadequacy of the 6% contribution. The apparent implication from this statement is that the sufferers of such chronic illnesses who by and large require prolonged hospitalization and often expensive forms of medical procedures (e.g. dialysis for kidney failure), will have to bear the enormous expenses themselves. This certainly places upon them an unbearable financial burden, particularly if they belong to the average wage earner class. Many have contracted such chronic illnesses through no fault of their own and in most cases, there is little dispute about the necessity of their hospitalization or their use of expensive medical procedures. In other words, virtually no abuse would pertain to such cases. If this were so, then they surely deserve assistance and it is strongly recommended that cases of chronic illnesses should be excluded from any financial restraint placed on them but be assisted by the community through Government sponsored programmes. In fact, if my interpretation of it is correct, this is how I understand paragraph 53 to mean. I stand to be corrected by the Second Minister for Health on this. Let me now try to interpret paragraph 53.”
“But to my utter disappointment, only a few brief lines in paragraphs 7 and 41 were all one could find mentioning preventive medicine and nothing at all on the health care of the working population. Let me re-emphasize what I said before, that the exclusion of the health care of so important a segment of our population, namely, the industrial population, from the pages of Part I of the National Health Plan appropriately entitled: "Health Development Strategies" would so reduce the scope of the coverage as to render it not comprehensive enough to qualify it as "national". If only a few paragraphs were included in the Blue Paper, this will not only enhance the standing of the National Health Plan but more importantly, it will guide the direction and development of proper preventive rather than solely curative health care programmes at the local factory level in the years ahead. My plea at this late stage is for some mention on "Health Care of the Working Population" to be included in Part I of the National Health Plan. Concept of Medisave Now, coming to the substantive Motion on the Medisave Scheme as outlined in Part 11 of the Blue Paper, I wish to support in principle the introduction of the Scheme for it is a uniquely Singapore generated scheme, entirely different from the various prepaid health care systems financed either by tax revenue as in the UK and USSR or supported by compulsory insurance of the European social democracies or the free enterprise systems, as in the USA. In all these countries, a political decision has been made to do away with financial restraints on individual demands, whereas the Medisave Scheme shifts the payment of service from a pooled resource to the point of consumption, ie on to the individual.”
“Mr Speaker, Sir, having heard the Member for Rochore, I do not consider myself unlucky for not being the first speaker. I suppose I have to declare my interest in that I am a private practitioner with special interest in occupational safety and health. The preamble of the Motion has these words, "having noted the National Health Plan - A Blue Paper by the Ministry of Health etc". Sir, I have some misgivings about this phrase because the debate is only confined to Part 11 of the National Health Plan ie, Medisave Scheme, and I am uncertain whether Part 1, ie "Health Development Strategies" will ever be debated in a future sitting of this House. Let me first make a brief point on Part I of the National Health Plan before embarking on Part 11 - Medisave Scheme. The Second Minister for Health may recall that on 24th March, 1982, in the Committee of Supply Debate on his Ministry (Hansard, cols. 1595 and 1596) he gave this House an undertaking that his Ministry would take up my timely suggestion, "to make mention of the comprehensive ... preventive occupational health programme in the National Health Plan". This was in response to my suggestion at that time that when the National Health Plan details were announced in the future, I would like to see a substantial portion of its contents devoted to a developmental strategy for preventive medicine and not a skimpy and hackneyed statement of intention that the Ministry would emphasize on preventive medicine but lacking direction and substance for implementation. Hence, it was with a keen eagerness when I first received a copy of the Blue Paper to see whether my suggestion had been included.”
“Sir, I beg leave to withdraw my amendment. Amendment, by leave, withdrawn. Mr S. Chandra Das (Chong Boon): Sir, I beg to move, That the sum to be allocated for Head R be reduced by $10 in respect of Subhead RD-04 of the Main Estimates.* Sir, according to the Labour Ministry, there were 577 reported cases of industrial occupational diseases last year. I am told that this represents an increase from 174 cases reported in the year 1979. More importantly, we may not know the extent of industrial diseases among our workers, possibly for two reasons. First, I am sure that not all cases are reported. Secondly, there may not be enough specialists to detect such diseases. Sir, the recent move by the National Productivity Board to introduce a part-time 95 hours certificate course for doctors to attain specialist skill is indeed welcome. I am sure this will go a long way to fulfilling the present shortage of specially trained doctors for industrial health. Sir, whilst this short-term measure is necessary, I am a little concerned whether this short certificate course of 95 hours is really adequate. Perhaps the Hon. Minister for Labour would inform this House whether this is the practice in other countries. Would the Minister also like to assure this House that the long-term health and safety of our workers could not be compromised by this short-term measure?”
“Member for Anson would like to include regular inspection of factory toilets. Sir, that is not the priority area I mean. Safety, as the Hon. Minister has indicated, is the priority. Nevertheless, I hope that at the appropriate time when circumstances warrant it, the Hon. Minister will bring about such a change.”
“Sir, I should perhaps at the outset say that I had wanted to speak on this subject in the Committee of Supply last year, but there was no particular opportunity then. The current dispute between the Ministry of Labour and the Singapore Dental Association, however, has focused attention on this subject. It is, therefore, appropriate for me to direct the Hon. Minister's attention to this area. The Hon. Minister has just said that he visited a Government dental workshop to see if it needed to be registered under the Factories Act. A Health and Safety at Work Act will, in fact, enable the Hon. Minister to require any workplace which, in his opinion, has more than acceptable occupational health and safety risks to be registered without any misunderstanding whatsoever. Sir, the registration of dental workshops or clinics under the Factories Act, for example, is possible under section 6 of the Act. But it is like squeezing square pegs into round holes. A dental workshop within a shopping centre is a factory, but I am sure the Building Control Division will not have a factory in a shopping centre. Under the proposed Health and Safety at Work Act, not only will all the existing registered factories be included but all the other priority areas with more than the acceptable risk will also be registered. in other words, the scope of coverage will be widened from time to time at the discretion of the Hon. Minister. It is, however, not necessary to register all work places. It is an enabling legislation. Sir, understandably, the Hon. Minister does not sound enthusiastic about the proposal, particularly in view of the limited resources in the Factory Inspectorate, among whose important duties, Members of this House will recall, the Hon.”
“But with the progress in industrialization involving the use of numerous chemicals and hazardous materials, there are now many other work places which should come under the umbrella of this type of legislation. What I am suggesting is that the Ministry of Labour should now, at this point of our industrialization process and development where occupational safety and health issues are likely to come into greater prominence, consider improving the Factories Act and broaden it to a "Health and Safety at Work Act" with the main objective of widening the scope of the health and safety protective coverage to include work places other than "factories". This is not a new idea. The industrialized countries of the West have already done this. For example, the United States does not have a Factories Act. In 1970 Congress introduced a comprehensive Occupational Safety and Health Act which covers all types of work places besides factories which have hazards. In the U.K. there is the Health and Safety at Work Act passed by the British Parliament in 1974. This is an enabling legislation which covers all work places. This is a new trend in the development of occupational safety and health legislation. It is a good trend which, if followed, will increase the health and safety protection benefits presently covering an estimated 200,000 workers in "factories" to at least 300,000 or more work people in all work places. I hope I have been able to make out a case for the Ministry of Labour to consider changes to the present "Factory" legislation from a narrow to a wider application of Health and Safety protection which will benefit a greater number of an important productive segment of our Singapore working population.”
“The point I would like to make is that I do not think the Singapore Dental Association would object to calling a dental workshop a work place with air receivers and air compressors. What they are vigorously objecting to is that a dental clinic is being equated with a factory. It would appear from the statements made by the Ministry of Labour that there are work places other than what are normally understood as factories which may have serious hazards, actual or potential. It is the declared intention of the Ministry to move into these areas to protect the health and safety of workers. This is a laudable aim. Taking this cue, I would now wish to concur that indeed, there are other work places such as laboratories, tyre shops, petrol kiosks, warehouses, to name just a few, which are not normally included in the common meaning of the term "factories" but which do have hazards worthy of attention. In other words, the scope of safety and health protection of workers under the Factories Act should be widened to cover workers in hazardous work places other than "factories". If one goes into the history of the Factories Act, one will come to the conclusion that essentially it is a good piece of legislation. But the name "factory" only refers to the locale of the operation of the law. The subject matter, however, is really the safety and health of workers. If that is so, why not just name that piece of legislation as "Health and Safety at Work Act" rather than "Factories Act"? In the early stages of the evolution of the Factories Act, coming directly from the British Factories Ordinance, it is well to call it or to label it a Factories Act to emphasize its focus on factories.”
“They cannot accept the idea that a clinic for the treatment of dental patients relating to the dental profession could by any stretch of the imagination be construed as a "factory" manufacturing goods or associated with serious occupational hazards. A deadlock seems to have been reached with the Ministry of Labour insisting that a "dental clinic" could be considered a "factory" because of the definition in the Factories Act, and with the Singapore Dental Association just as vigorously protesting that a clinic cannot by any stretch of the imagination be equated to a factory. Fortunately, both parties do not disagree on the subject of safety. Only in the definition of clinic as a factory is where the sharp differences arise. The drift of argument can be reduced to simple terms like this. A factory, by definition, is a type of work place which has certain conditions, including having an air receiver and air compressor. Since a dental clinic is a work place where there is an air receiver and air compressor, the conclusion is that the dental clinic is a "factory". The Singapore Dental Association's counter assertion is that the conclusion cannot be that a dental clinic is a factory. The argument is that if A=B because of certain features where A is a factory and B is a work place and C=B because of similar features where C is a dental clinic, this does not necessarily mean that since A and C are both equal to B, A must be equal to C. In other words, all factories are work places but not all work places are factories. A dental clinic is a work place but it is not a factory. There is some merit in this type of argument.”
“Sir, I beg to move, That the sum to be allocated for Head R be reduced by $10 in respect of Subhead RD-03 of the Main Estimates.* In moving this amendment, I am taking the opportunity to highlight the need for a change in our existing Factories Act. The recent argument between the Ministry of Labour and the Singapore Dental Association over the registration of dental clinics under the Factories Act has generated a lot of public interest. The adage, "fools rush in where angels fear to tread" may make me seem foolhardy enough to enter into this particular controversy. However, I hope to make a positive contribution. The Ministry of Labour's viewpoint on the issue runs something like this. Air receivers or air compressors have the potential to explode and they can be considered dangerous. People who are working with such air receivers and air compressors need to be protected. Dental workshops do have these air receivers, air compressors, and dental technicians working with them. According to the definition of the Factories Act, such a work place may be deemed to be a "factory" and, therefore, the argument goes, a dental workshop attached to a dental clinic can be registered as a factory for the purpose of the legal requirements of the Factories Act. On the other hand, the Singapore Dental Association's viewpoint seems to be this. The safety issue of the air receivers and air compressors in dental workshops is not in question. They apparently concede that there is a need to protect the workers handling such air receivers but they vehemently protest at the thought of registering "dental clinics" as "factories" under the Factories Act.”
“Another item of tax concession offered by the Government is permitting 100% depreciation allowance on computers and automation equipment in the first year. This measure of encouragement for computerization is most welcome. In order to improve our work efficiency arid productivity we must actively promote automation and computerization. Our employers must understand that the implementation of automation will not only save labour but also, more importantly, raise work efficiency and the quality of products. Even in England, although the problem of unemployment is extremely serious as thousands of workers cannot find jobs, the British government is strongly encouraging automation in order to improve productivity. For instance, the government is prepared to subsidize as much as onethird of the total cost of the purchase of industrial robots. Evidently if the manufacturers want to increase productivity and maintain its competitiveness, they must incessantly improve on their production processes. At present, Singapore still depends a lot on foreign labour. We must make good use of this period of labour shortage to expedite our modernization and mechanization programme and train our workers to handle the new machines and to learn new techniques. This will not only raise the income and the standard of living of our people, but can also alleviate our dependence on foreign workers, thus achieving our objective of building up a quality and highly efficient Singaporean workforce. Mr Speaker, Sir, I support the motion on the financial policy of the Government. 6.14 p.m.”
“I am not begrudging the high pay drawn by the professionals and the administrators. In Singapore, our professionals are in short supply and therefore command high wages. What I am worried about is that if we want to attract industries of high technology to come to Singapore, we must have quality technicians, engineers and graduates who are prepared to draw reasonable wages. If these people want wages higher than that of their counterparts in the advanced countries, how can we successfully attract these industries to invest here? How can we successfully attract foreign companies to bring their research work to Singapore? Compared with Taiwan and South Korea, are we not losing our competitiveness in this respect? I hope the Minister for Trade and Industry will carefully consider these problems. Another matter which I would like to bring up to the attention of the Minister is that besides wages, the Government must also exercise restraint over such things as rentals of industrial land and utility charges. Sir, I want to make some comments on the tax policy this year. The new tax policy gives specially qualified married women a special tax concession on their children. This is to encourage these qualified women to remain in the work-force by increasing their child's relief. I agree to the suggestions made by some Members that when we are faced with labour shortage, we should not only encourage these qualified professional women to come out and work, but must also encourage all the other women who can contribute to our nation's economy to come out to work. This will not only increase the income of the family but will also alleviate our dependence on imported labour. This tax relief should be applied to all working women and not limited to some professional women.”
“I am glad that the Government has paid serious attention to this scheme and I hope that many more companies will set up such classes in their establishments to train their workers, and I also hope that more workers will avail themselves of the opportunity to attend such courses conducted by NTUC and their factories. With regard to employees' salaries, from 1979 to 1981, the National Wages Council has for the three-year duration recommended high wage increases in line with the policy of economic restructuring. In 1982, the NWC recommendations were more realistic in reflecting the growth and prospect of our economy and productivity. Some people doubt that after being used to receiving high wage increase over the last three years, whether our workers will be able to adapt to the new situation where there will be lower wage increase. Facts have proved that trade unions and workers of Singapore are realistic and responsible. We are able to face the challenges and, with concerted effort, to ensure the competitiveness of our products in local and foreign markets. But we must point out that while our workers are exhorted to tighten their belts, exercise self-restraint and increase productivity, our management personnel and professionals as well as executives should also exercise the same kind of restraint. Their salaries have increased by leaps and bounds in recent years. In an attempt to attract and retain talents, the Government has continually increased the salary of senior officers. As a result, the private sector also followed suit. If this competition goes on indefinitely, pushing salaries up to unrealistic levels, it will create an unfavourable effect on our effort to attract foreign capital and on our commercial and industrial development.”
“After their retrenchment it would be very difficult for them to get another job with similar pay, as employers would be hesitant to employ such workers with higher salary. 6.05 p.m. [Mr Deputy Speaker in the Chair] Moreover, their past experience and skill may not be of any use in their new jobs and will go to waste. The Budget Statement has stressed the importance of skills training in order to ensure the success of our economic restructuring. I feel that we should make sure that retrenched workers are given the opportunity to be trained in order to facilitate them to get new jobs. The question is whether those who have a family burden can afford to attend full time training without getting any salary. Although the Skills Development Fund provides grants to assist companies in the training of workers, this mainly applies to workers who are already in employment and is of no use to workers who are out of job. Thus they have no chance to be re-trained. I hope the Government will pay close attention to this point. The Government should map out the overall manpower plan and identify the types of skills that will be required in Singapore in the coming years. It should encourage those unemployed workers to enrol for skill training in such approved courses and at the same time give them financial assistance to enable them to receive re-training. When our country is advancing towards higher technology industries, we must continually try to raise the educational level of our people. Last year the NTUC introduced the BEST programme for the training of workers in English and Mathematics. With the assistance of the Government, this programme has now become part of a nation-wide system of continuing education.”
“m Mr Goh Chee Wee (Boon Lay)( In Mandarin): Mr Speaker, Sir, in the past few days several Members of Parliament had given their refined opinions on the financial policy of the Government. Allow me to touch on certain policies of the Government particularly those which concern our workers. Sir, compared with the past few years, 1982 is a year when our economic growth was the lowest. Almost every sector of our economy had been affected by world economic recession, in particular the manufacturing sector. Total industrial production has in fact been reduced by 6%. Last year 7,500 workers were retrenched, among whom 90% were employed in the manufacturing sector. What should be noted is that the number of retrenchments does not entirely reflect the effect of economic recession on the income of our people. Because of a reduction of overtime and shorter work-week, many workers have, in fact, had their income reduced to a great extent. Some critics say that Singapore workers are not loyal to their jobs and are wont to job-hop. I feel this is an unfair criticism on the majority of our workers. In fact, older workers who have family burden to bear all hope to have a stable job and are willing to accept overtime work to augment family income. To such workers, economic recession and retrenchment are a great blow to them. Even though there are vacancies available, companies are generally more willing to employ,younger employees because they are lower paid. For a young worker who gets $300-odd per month, it is not difficult for him to get new employment with the same pay after retrenchment. But the same cannot be said of those older workers who have families to support and who are earning $800-$1,000 per month.”
“One can make an educated guess that there might be more than 600 of them who, because of their children, are not able to get to work. While I do not think that by including them for the tax concession would induce all of them to return to work as nurses, it would certainly make those contemplating to resign to think twice before doing so. From the figures of the National Health Plan, it is quite obvious that with the proposed increase in the development of hospitals, both in the private and public sectors in the next 10 years, the need for active working nurses is very great. This would then be an added reason why such married nurses who are presently not working should be encouraged to do so by being included in the categories for enhanced child relief. The same line of argument could be applied to those teachers who have undergone certain tertiary training at the Institute of Education or the former Teachers Training College not amounting to University level degree. There may be even more non-working married women among female teachers from the figures I have obtained. For example, there are now over 21,000 trained teachers of both sexes of whom only 4,293 are university graduates. Over the last 10 years over 3,000 teachers of both sexes have resigned. It is possible that some might have changed their occupation. Nevertheless among this group of trained female teachers, there are over 2,000 who are not working because of their marital status. I believe the Ministry of Education requires at least an additional 1,000 teachers at present. These non-work- ing trained teachers should also be encouraged to work by including them in this enhanced child relief concession. Sir, I fully support the motion. 6.00 p.”
“As mentioned in this House yesterday by the Member for Whampoa, the returns on such investment had been grossly under-estimated for FY 82. There is no doubt that we have made sound investments and that our reserves are well maintained. It may, however, be useful for our Government to further look out for similar investment opportunities in the ASEAN region, which is expected to be one of the fastest growing regions in the world in the years to come. At the same time, this will enhance our existing close cooperation with the ASEAN countries. Finally, Sir, I wish to comment on another point regarding enhanced child relief for specially qualified married women. According to the Minister in his Budget Statement, from the next financial year, apart from the normal tax relief, they will enjoy an additional relief of 5% of their annual earned income for each of their children, subject to a maximum of three. I understand that at present the term "specially qualified married women" refers only to women who are University graduates and the idea is to encourage such married women who have gone through some years of tertiary university education to continue to work even after they have children. If this is the rationale behind the move to allow enhanced child relief for such women, there are other categories of married women who have some form of tertiary training and education but it is not at the university level. These categories of women also ought to be included for such a concession of enhanced child relief. Among others, I am referring to the fairly large numbers of such women in two occupations, namely, the trained nurses and the non-graduate teachers. My information is that at present there are 5,124 trained nurses registered in Singapore.”
“As for Skills Development Fund, I agree with the hon. Member for Chong Boon that it is a heavy cost burden for our manufacturers. Since only 8.8% (or $27.5 million) of the total contribution of $313.8 million had been disbursed as at 31st December, 1982, it would appear that at the present rate of disbursement and contribution, the interest accrued will be adequate to meet the current disbursements. It is perhaps timely, under the present economic environment, to review the necessity to maintain the current rate of contribution. As we are noted for our pragmatism, we should be realistic enough to make suitable adjustments when necessary. Any reduction of the SDF levy can always be readjusted when our economy improves. I disagree with the hon. Member for Kebun Baru when he stated that since corporate profits showed an increase last year, our industries therefore did not appear to be affected by SDF levy. In fact, total manufacturing output for 1982 has dropped by 6% and its contribution to our GDP has correspondingly dropped. The success of our industries in Singapore will depend on its competitiveness and its ability to secure contracts overseas. The competitiveness of selling prices of our products for both domestic and overseas markets is the deciding factor. Unless we provide greater assistance to make our industries more competitive, our hope to see the 31% contribution to GDP by the manufacturing sector by the end of this decade will not materialize. On ASEAN, the Hon. Minister has reported that our regional trade under the ASEAN Preferential Trading Arrangements has continued to grow. From press reports, it is noted that our Government is investing in Australia, and USA particularly in real estate.”
“Presently, the various incentive schemes seem to be geared primarily for new industries, thus somewhat neglecting the existing industries which have the potential for further expansion, growth and diversification. Our industrial base has expanded substantially over the years and today, the existing industries provide the bulk of our new industrial investments in Singapore. If more assistance, in terms of incentives, can be given to these industries to encourage them to expand, diversify and, equally important, to develop markets, these industries are likely to invest more and should provide us with the additional growth so necessary to meet our long-term objectives. Industries today complain about our strong Singapore dollar and high overheads. A strong and stable currency, as we all know, has both advantages and disadvantages. But certainly a strong and stable currency is much preferred over a weak and unstable currency. Our Government, however, will continue to ensure that our traders and export-oriented manufacturing firms are not handicapped by an overvalued Singapore dollar. As for overhead costs, such as land, factory premises, utilities, wages, skill development fund, and property taxes, etc., I am glad that our Government is now doing its best to moderate such increases. In fact, with the present economic downturn such increases, if any, should be minimal. Here, I am in agreement with the Member for Anson that statutory boards need to assist our manufacturers. The Jurong Town Corporation, for example, needs to rethink about its intended upward revision of up to 50% of industrial land rentals applicable this year. Likewise, the tariffs on utility charges should be reduced proportionately in view of the reduced fuel price.”
“Mr Speaker, Sir, I join my colleagues in sup- port of the motion standing in the name of the Minister for Trade and Industry. I must congratulate the Hon. Minister for Trade and Industry for giving the citizens of Singapore yet another breather, so to speak. It is a serious but painless budget. Even the habitual smokers and drinkers will not feel the pain. If they do, it is goo.d for them. In the current world-wide recession, certain sectors of the economy have performed below expectation. The Budget should provide greater encouragement and inducements to sectors of the economy which are in the doldrums, specifically the manufacturing sector. Among the pillars of growth in the Eighties, the manufacturing sector is supposed to be the dynamic prime mover for high and sustained rates of economic growth with its expected share of contribution to the GDP lifted to 31% by the end of this decade. Growth in the manufacturing sector, unfortunately, has stagnated in the last two years and for 1982, it registered a negative growth. Our Government should be prepared to provide in greater depth the incentives that are now available to the manufacturing sector. Today, we have a sizable industrial base in Singapore with capacity for further growth. Singapore has built up a good name in a number of industries, including ship-building and ship-repairing, oil rigs and ancillary equipment, electronic components, petroleum-based products, iron and steel, food and plastic products. We should, therefore, capitalize on the strength of our existing industries which have room for further growth and expansion when the economic situation improves. There appears to be a need to review the role and scope of the incentive schemes for industries.”
“Mr Speaker, Sir, with oil being a depleting natural resource, and the Minister mentioning coal as a possible alternative, does the PUB, in fact, intend to switch to alternative sources of energy?”
“But its inclusion will not only enhance the reputation of the National Health Plan but more importantly, it will guide the direction and development of proper preventive rather than solely curative health care programmes at the local factory level in the years to come. What I am really advocating is that when the National Health Plan details are announced in the near future, I would like to see a substantial portion of its contents devoted to a developmental strategy for preventive medicine programmes and not a skimpy and hackneyed statement of intention that the Ministry will emphasize on preventive medicine but lacking direction and substance for implementation. 7.45 p.m.”
“Sir, I beg to move, That the sum to be allocated for Head P be reduced by $10 in respect of Subhead PF-01 of the Main Estimates. Sir, in spite of what I said earlier, let there be no doubts in the minds of all that ours is a caring Government. I have never had any difficulty with fee remissions on hospitalization for my needy constituents. I would not use the word "poor". We do have a very compassionate Minister for Health who is sensitive to the health problems of the needy. Here I am not referring to his free offer of a bed in Woodbridge Hospital but rather to his positive reply to my earlier amendment. Sir, I shall be brief. An important area where preventive medicine programmes can be developed is in the health care of the working population. In the Ministry of Health, we have the Maternal and Child Health service for mothers and children, the School Health Service for the school children but none for the working population. I am aware that the Ministry of Labour is responsible for the health of the workers and, at the plant level, the companies through their contracted company doctors directly take care of workers' health. I am not suggesting that the Ministry of Health create another department to be responsible for workers' health. What I am suggesting is that at the national level, say, in the 20-year National Health Plan, thought and directions on preventive health care programme for workers over the next 20 years be outlined and detailed, if possible. The exclusion of the health care of so important a segment of our population, namely, the industrial population, from the pages of a National Health Plan would so reduce the scope of coverage as to render it not comprehensive enough to qualify as "national".”
“(7) That the sum to be allocated for Head P be reduced by $10 in respect of Subhead PF-01 of the Main Estimates.”
“Sir, I am happy with the Minister's positive reply, except that I would like to add this. The big difference between the aged sick and chronic renal failure cases is that the latter can still be economically productive. With that, Sir, I beg to withdraw my amendment. Amendment, by leave, withdrawn.”
“May I conclude by stressing the point that the Government should look seriously into increasing the renal dialysis facilities both within and outside our hospitals so as to show real compassion by actual deeds in taking care of these people to enable them to live as far as possible a normal active life pending kidney transplant or other breakthroughs in medical research whereby a cure could be effected. 6.30 p.m.”
“Secondly, I would like to suggest the establishment of small satellite dialysis centres in different housing estates, each manned by a specially trained staff nurse, where patients from the immediate neighbourhood can go for self-dialysis. It is a very economical way to deal with this seemingly hopeless situation for these unfortunate people for whom real compassion must be shown. I specifically mention the word "unfortunate" because the most important cause of end-stage kidney failure universally is a condition known as chronic glomerulonephritis. There is still no effective treatment for most forms of glomerulo-nephri- tis despite progress in the understanding of the disease. In other words, prevention of end-stage renal disease for this large group is not possible. Finally, may I venture to suggest that the equipment at the renal centre at Alexandra Hospital is under-utilized. It would be more cost effective and efficient to have two shifts instead of the present one shift so that 44 patients, instead of 22, can be treated at the Alexandra Hospital. Only one additional trained staff nurse is required. The really effective long-term solution to this difficult problem is to encourage our citizens to donate their kidneys, thereby enabling more kidney transplantations to take place. The success rate of kidney transplantation involving living-related donors is in the region of 87% and for cadaveric donors it is about 50%.”
“The Renal Centre at Alexandra Hospital, the capital outlay of which was funded by the National Kidney Foundation, can only handle 22 cases under its present one-shift system. The total number of cases who can be treated is therefore only 62. These are the more fortunate of the unfortunate group of Singaporeans. One of the important criteria for their selection for regular dialysis is that they have more dependants to support than the others not so selected. Those who are not fortunate enough to be selected for regular dialysis at the Government hospitals will have to fend for themselves. Among them, even those who can afford treatment at the private hospitals and these belong to a very small minority, are finding the financial strain unbearable. Self-dialysis at home is another alternative. The capital cost of the dialysis machine, including a water treatment unit, amounts to $30,000 but the recurrent expenditure per month is about $800. Again, not many patients can afford this alternative. I realize that it is almost impossible for any government to maintain a huge dialysis centre to treat every case of end-stage chronic renal failure. But then, are we doing enough? Sir, some selection of cases appear inevitable. The Government, however, has the obligation to provide free medical care to its indigent citizens, as the Minister has just stated. May I venture to suggest some cost-effective ways to deal with this problem? [Mr Deputy Speaker in the Chair] 6.25 p.m. First, we have the hospital dialysis centre which should concentrate on training patients on self-dialysis and on treatment of complicated cases.”
“Sir, I beg to move, That the sum to be allocated for Head P be reduced by $10 in respect of Subhead PC-02 Object Group 2210 of the Main Estimates. The Minister for Health in his talk to the Singapore Professional Centre's 10th Anniversary Charity Banquet on 25th September 1981 ended his speech by saying that he was fully aware that there would always be a group of Singaporeans who through no fault of their own were unable to fend for themselves and have no friends or relatives to look after them, such as the mentally ill, the chronic sick, the aged and the disabled. He further stated that they would be looked after, and they belonged to a special category for whom real compassion must be shown. Sir, I would like to draw attention to one category of the chronic sick group, namely, the end-stage kidney failure cases. The incidence of end-stage chronic kidney failure cases in Singapore, as far as I understand, is very similar to those reported in other countries, i.e. approximately 40-60 per million of the population each year. This works out to be about 100 to 150 new cases for Singapore each year. The majority of these chronic kidney failure cases will require regular dialysis procedure in order to live a life of ordinary activities in their workplace and at home. However, as far as I understand it, the facilities for renal dialysis in the Government hospitals can only cater to a very small proportion of these cases. Many of these chronic kidney failure cases are between the ages 15 and 50. It is a great pity that the majority of them are left to die slowly. In fact, the renal unit of the Singapore General Hospital can cope with only 40 cases, maybe more, of kidney failure requiring regular renal dialysis.”
“Sir, in view of the Hon. Minister of State's brief but very positive answers, I beg leave to withdraw my amendment. Amendment, by leave, withdrawn.”