Chia Shi-Lu
Singapore
“Chairman, I wish to thank all Members who have taken part in this debate and, of course, Minister Gan, Senior Ministers of State Amy Khor and Dr Lam Pin Min and Mr Edwin Tong and also Senior Parliamentary Secretary Amrin Amin, together with all the staff at MOH for their replies and the work they have put in for the healthcare system for…”
“Nonetheless, I believe that a united society will be a key piece to this puzzle, and I look forward to the Ministry of Health's stewardship in this regard. May we all live long, live well and grow old together as one people. Thank you, and I beg to move. [(proc text) Question proposed.”
“Mr Chairman, high usage of air-conditioning and refrigerators contributes to global warming, and none more so than in Singapore where we love our climate control and air-conditioning. But as a responsible member of the global community, we should do our best to reduce our carbon footprint.”
“Management of E-waste Last cut. With the introduction of the Resource Sustainability Act last year, the EPR scheme will commence and a PRS operator I alluded to earlier will be appointed to collect and ensure proper disposal of electrical and electronic consumer products.”
“I thank the Minister for the update. I just have two clarifications about the Disease Outbreak Response System Condition (DORSCON) level – the acronym of the year, so far! First, some clarification about how this DORSCON is arrived at. Is it by independent committee that makes this decision and recommends to the Minister?”
“I just want to echo and express my thanks to Minister Gan Kim Yong for his statement of thanks and support for healthcare workers. Two short but slightly technical questions, I apologise. The first, the Minister touched about it earlier.”
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“Aside from media initiatives, perhaps a more directed and targeted approach to engage small businesses should be developed. Helping SMEs as they Restructure”
“Mdm Chair, the business environment is challenging and the Government has, over the years unveiled many comprehensive and generous support measures to assist existing SMEs, and encourage entrepreneurs and innovators. However, many businesspeople that I have spoken to, although being happy with these measures, still find it difficult to properly leverage on all these schemes and incorporate them into their business model, and there are still many who may not actually know about the multiplicity of such schemes. Also, many business owners and aspiring business owners are still unsure about where they can obtain help for their businesses when they need them. To the Government's credit, the Government has supported the setting up of many programmes, such as the Enterprise Development Centres and similar programmes such as the SME Infocomm Resource Centres, which aim to help SMEs grow and improve their efficiency. I would, however, propose that the Government further refines and expands on these programmes to make these centres truly comprehensive and one-stop and, therefore, more accessible and effective. Such SME-centric centres can become even more efficient and targeted in their approaches, and are found in many other jurisdictions, such as Hong Kong, Penang and the EU. These centres should also complement existing EDC functions which serve to guide and promote entrepreneurship and innovation amongst our citizens of all ages in their working life. Page: 98 I also urge the Ministry to do more in terms of outreach, not just to our existing SMEs, but also to the smaller SMEs or micro-enterprises which, although small, are still numerous in our high street economy.”
“So, I would like to request an update on the programmes that are in place to ensure that lower income families, particularly those with children, gain regular access to computers or smart devices, since I fully believe that equal access to ICT technology is critical for inclusive growth and social mobility. ICT as an Enabler”
“Mdm Chairwoman, I think we all agree that we live in a digital age where infocomm technology or ICT has become an essential and inescapable part of our lives. 3.00 pm I remember when the Intelligent Nation 2015 master plan was unveiled in 2005 and I was dazzled by the vision of how Singapore will transform into a smart nation and a smart city. I was thinking that 2015 is quite a long time away, but being 2013 as it is now, it is only two years in the future. So, I would like to request that MCI provide us with an update on the progress that we are making towards achieving the goals of this iN2015 master plan, and particularly, with relation to a few vulnerable groups – seniors, the disabled and the needy. Now, our seniors would mostly have lived their lives in a bricks-and-mortar world, they would have been familiar with things like bookshops, CD shops and going to the bank. But as we spend more and more of our lives in the online world, whether it is learning, working, shopping or banking, how do we make sure that our seniors can make sense of this brave new world and so remain active and engaged in our community? I mean the same question also applies to the disabled. So, what measures are being taken to ensure that they remain Page: 66 a part of our intelligent nation and smart city vision? Finally, one stated goal of the iN2015 master plan was that there should be 100% computer ownership or access in families with school-going children. I note that as of 2011, only 86% and 85% of households respectively had access to a computer and the Internet.”
“Finally, I would support expanded recognition and benefits for volunteers who help to promote healthy lifestyle choices. For instance, the Health Promotion Board has a network of health ambassadors who are volunteers who go about promoting a healthy lifestyle. They could have a system of benefits perhaps similar to the system for frequent blood donors. In closing, the title of the article with which described the results of the survey on where to be born in 2013, which I mentioned at the start of this speech, was actually entitled "The Lottery of Life". Although where we are born can be likened to a lottery, the lofty position Singapore has achieved on this list did not happen by chance. A good life with good prospects is predicated on many Page: 30 factors. But, surely, the ability to find and hold on to a good job with a good wage, and to be in possession of good health, are two very important determinants. Although I am asking for more in this Budget, I do support this Budget, because it continues the fiscal and social narrative that ensures that Singapore will remain a choice place to be born in, and to live your life in, for many years to come. 1.05 pm”
“Health maintenance and promotion is a key strategy for ensuring the continued wellness of Singaporeans while ensuring that healthcare costs do not spiral out of control, even given the challenges that an ageing population presents us. Much of the expenditure on health promotion and maintenance may not be captured under the key numbers for healthcare spending, which thus may lead to an underestimation of how much a country spends on health rather than healthcare. Given that fiscal measures can be strong behavioural modifiers, I hope that this Budget and future Budgets will support a wider range of wellness and health promotion initiatives that will result in not only a stronger but healthier Singaporean Core. There is much that can be done to nudge Singaporeans to take greater ownership of their health. Anti-tobacco measures should be stepped up, and while some may argue that unhealthy behaviours should be penalised, by the same token, healthy choices can be incentivised. I have previously asked that we consider the imposition of a "junk food tax" on sweet, sugary and high-fat junk foods and beverages, but by the same token, we can perhaps make healthy foods like fresh fruits and vegetables cheaper through targeted subsidies. In schools, the foods that are sold in the canteen could be more closely regulated to help stem the menace of childhood obesity. Singaporeans who participate regularly in approved wellness programmes or can demonstrate that they adhere to a healthy lifestyle with regular exercise, for instance, could receive tax rebates or pay discounted rates at public healthcare institutions. Similarly, patients with chronic diseases who adhere to their treatment programmes and clinical pathway could receive extra credit for their medical expenses.”
“Many of these diseases need regular laboratory tests for optimum management, and these tests can be costly. Hence, I would like to call once again for CDMP financing to be further individualised to the needs of the patient and be calibrated to the age of the patients. I again renew my call that the Government consider adjusting subsidies according to the age of the patients, meaning that older Singaporeans should be able to receive more heavily discounted healthcare. This serves to recognise the contributions of older Singaporeans to nation building, and takes into account that older Singaporeans with chronic illnesses are more likely to have less in their Medisave accounts and would also be more likely to be limited financially. Some have criticised our country for spending too little on healthcare, having too few hospital beds and so on. While I fully agree that we need to pay attention to infrastructure and forward planning, I think that this misses the point somewhat. Amongst developed nations, there is actually a poor correlation between healthcare expenditure or indeed infrastructure volume, and the overall health of the citizens. Again, I draw your attention to another list where in a well-respected and widely-cited report by Bloomberg published last year, Singapore actually topped the list of the world's healthiest countries, Page: 29 comfortably trumping many other developed countries with significantly higher per capita healthcare expenditures. The key here is that in the long run, it depends less on how well you treat sick people, but more on how you keep people from falling sick.”
“Such measures, if applied in a sensitive and sensible manner and on a sectoral approach, should not adversely affect the autonomy or competitiveness of businesses, but will nudge them towards a reduced reliance on foreign employees, and I believe this will leave them in a more robust position in the final analysis. Page: 28 Additionally, I would also support the creation of a fund to specifically support Singaporean PMEs who are in transition, between jobs. Finally, part of what it means to be an ideal place to be born in, and to live out a full and fulfilling life, is to stay healthy. I have spoken in this House on several occasions about how we can refine our healthcare system to better serve Singaporeans. I believe that, as many do, the public healthcare system in Singapore is of a quality that is world-class, and is both accessible and affordable to all. We have a "Heal First" policy in our public healthcare institutions which guarantees that all Singaporeans receive the medical care they need even if they are ultimately unable to pay for it. However, some Singaporeans are still concerned about affordability, and I welcome the announcements made earlier about top-ups to MediSave and Medifund, and eagerly await further announcements regarding the fine-tuning of the healthcare financing framework. One key issue concerns the cost of outpatient care for chronic conditions. Although the Chronic Disease Management Programme has gradually been liberalised in terms of the use of Medisave for chronic conditions, and the Community Health Assistance Scheme helps Singaporeans who wish to remain under private care with their family doctors, many patients actually suffer from multiple chronic diseases, which unfortunately also means multiple costs.”
“I share Mr Alex Yam's concerns for young Singaporeans entering the workforce, as younger workers could become relatively more expensive to hire in the beginning, but we would expect these younger workers to be more adept at improving themselves and becoming more productive, so that their future wage growth would be more dependent on their own self-improvement, rather than due to Government aid. As part of the efforts to strengthen our Singaporean Core, I also applaud the moves to raise the S Pass salary qualification to over $2,200 per month, as this would ensure that young Singaporeans just entering the workforce will be suitably advantaged when looking for a job. Like my colleague Er Dr Lee Bee Wah, Mr Patrick Tay and other Members of Parliament, I would also like to renew the call that we take a relook at labour market affirmation and testing for Employment Pass applicants, to ensure that PME jobs for citizens are suitably safeguarded. While there are already fair employment practice guidelines in place and the unions are working overtime with employers to advance such fair hiring practices, I believe that some degree of legislation mandating that companies consider Singaporean Citizens first for PME positions should be enacted. Many developed countries − the US, the UK, Canada, Australia and Hong Kong, to name a few – already have some form of legislation to this end, but this has not led to significant drops in workplace vibrancy or competitiveness, and has not resulted in these countries being labelled as closed or anti-foreigner.”
“So much so that some workers I have spoken to are sometimes hesitant about wage increases at the inflexion point, as the increase in their salary may push them over the ceiling such that they no longer qualify for some of these benefits, which could be worth more than the salary increments that they have earned. I would like to propose that the WCS be expanded to support the progressive wage model championed by our trade unions, and that part of these Government transfers, such as the WIS and others, be used to support a minimum wage for certain segments where wage growth is in fact lagging. This may not mean an unsustainable increase in Government expenditure since it already leverages on transfers that are already in place. Here I support many of the points that have already been raised by the hon Member Mr Inderjit Singh Page: 27 yesterday. This is not your normal minimum wage system, where a blanket wage guideline is summarily imposed, leaving employers to comply. This is a fair wage system on steroids, grounded on a sectoral approach, and supported by a wise and just Government, determined to uplift the wages of the lower salaried members of our Singaporean workforce. This fair wage support system can buffer employers and safeguard jobs for Singaporeans as we transition into a higher wage workforce across the board. This fair wage support system also honours our workers by allowing them to earn a decent wage without needing to always rely on Government transfers directly. This fair wage support system can be calibrated to different age groups as is the case with the Workfare system, with bigger transfers for older workers.”
“I was particularly heartened by the announcement of the Wage Credit Scheme − like many of my Parliamentary colleagues – which I see as a proactive step by the Government to support wage increases for the majority of Singaporean citizens, covering up to the 70th percentile in terms of salary. During last year's Budget proceedings, I expressed my concern that when companies did well due to the improved innovation and productivity of their workers and with support from the Government, it sometimes seemed that improvements in profitability did not translate into significant wage increases for the employees, and I asked the Government to do more to support initiatives to boost wages, especially for the lower income employees. The Wage Credit Scheme (WCS) is a good start, but I also think that it has the potential to be so much more. Right now, there are already many Government transfers, such as Workfare, various vouchers and rebates that significantly raise the real wages of lower income workers and families in Singapore. And I also welcome the broad and generous improvements to the WIS scheme which has just been announced. This is something which indices of income inequality, such as the often quoted but often incompletely understood Gini index, frequently fail to fully address. The headline wages of lower income Singaporeans in certain sectors do appear low and may not have increased as much as we would have liked over the past few years but, in real terms, many of these workers are the beneficiaries of substantial Government transfers.”
“Mdm Speaker, life must surely be more than just about ranking and lists alone, but today I am not going against the grains, so here is yet another one for us to ponder. In the list that was recently published in the Economist magazine, Singapore was ranked as the best country in Asia to be born in, and was named sixth overall, losing out only to Switzerland, Australia, Norway, Sweden and Denmark. Hong Kong came in at 10th, Japan at number 25. Fundamentally, this list tries to predict the countries that "provide the best opportunities for a healthy, safe and prosperous life in the years ahead", and looks beyond economics, focusing equally on such diverse factors as security and the health of family life. I think particularly that this list is remarkable, because while most lists focus on the here and now – how competitive you are, how happy we are, or how unhappy we are − this survey attempts to quantify the future prospects of a newborn child in any given country. So, I see this Budget as an important step in ensuring that Singapore remains a great place to live in, and a place where our children can look forward Page: 26 to a future where they can realise their full potential and lead fruitful and fulfilling lives. Some of the ways towards securing this future are enunciated clearly in this Budget, which is focused on promoting quality growth while still ensuring that such growth is inclusive and social mobility is encouraged. This Budget sets forth further measures to nurture the young, support workers and families, and look after the needs of our growing cohort of seniors.”
“And I have Page: 27 the confidence that it will. 1.21 pm”
“Which brings me to my final point and what I think is the other remarkable aspect of this Paper, which is, why is this Government putting this paper out after all? I think this has already been answered over the past few days. It seems that after so many days of debate, and no matter which side of the House you sit on, we seem to be aligned on two points which are self-evident: (1) that Singapore Citizens are the core of any development plans; and (2) that the population and economy should grow, but with as little foreigner influx as possible. As some pundits have remarked, "This is a wise and just Government, it has done so many good things for the country, so why does it have to set out such a potentially divisive and unpopular Paper?" After all, if you look through the literature in virtually every developed country that has tried to debate addressing demographic challenges through population modulation, the initial reaction has almost always been significantly guarded, if not negative. But I believe that the answer lies in the fact that this is a just Government, a responsible Government, and a caring Government that it must do what has to be done. This, to a large extent, should be above politics. Now, more than ever, as an adolescent nation striving towards greater maturity, our people need to be kept informed of our internal as well as external changes, possible scenarios, roadmaps to the future, their views and concerns must be collated, they must be sought in order to refine this plan and all the alternative trade-offs and not just any single plan presented to the voting public. This Government will have to be fleet, astute and hardworking to encourage the needed trust and support from the people in order for us to move forward as a nation.”
“In recent more challenging times, the Government has still managed to maintain us on an even keel, and we even prospered whilst many countries around us are in crisis, but relative deficiencies in keeping the infrastructure growth apace of population expansion has led to many expectations not being met. My residents have expressed their concerns to me about overcrowding, the perception that Singaporean wage increases and opportunities are compromised by foreign labour, and a cost of living that appears to be climbing ever upwards. It is thus not surprising that many are less than enthusiastic about a new plan in which any degree of population expansion is considered. One resident remarked that notwithstanding everything else, "the bread-and-butter issues of today must be resolved first". This is a sentiment that I can sympathise with, and echoes many of the views expressed in this House over the past few days. So, the Government has its work cut out to strengthen the public's trust that it can meet its citizens' high but reasonable expectations regarding their quality of life, otherwise many will remain unconvinced that we will be able to realise this vision. Page: 26 As such, I would like to state my support for the hon Member Mr Liang Eng Hwa's proposed amendment to this Motion, which explicitly states that: (1) this is a Motion that calls for uplifting of all Singaporeans while being cognisant of the demographic challenges ahead; (2) emphasises that there are, indeed, no pre-mediated population targets; and (3) reinforces the primary duty of Government to solve the current bread-and-butter issues while ensuring that benefits continue to accrue to Singaporeans first.”
“My first specific request is that special consideration should always be made to ensure adequate manpower provisions for eldercare services. Second, I was very happy to see the development plans for the Dawson Estate in Queenstown mentioned in the Page: 25 Land Use Plan, but just as Ms Faizah Jamal before me has called for greater attention to be paid to the environment, I would also like to call for continued attention to be paid to our urban heritage. As our population grows and our towns develop, an appreciation of our heritage in its various forms could be an important part of connecting residents both new and old, and this would reinforce the third pillar of the White Paper, namely, keeping Singapore a good home. (In English): Mdm Speaker, I feel that moving forward, the Government will have to do a lot more to assure Singaporeans that whatever development trajectory that we take, we will be adequately prepared to deal with these changes such that our quality of life is not only maintained but continues to improve, and that our citizens will continue to have the right to first refusal of all opportunities that arise. Citizenship has its responsibilities, but it also has its privileges. During the early days of nation building, the nascent PAP Government entreated the people to work with them and endure sea changes so that their lives could improve. It was a big task, but Singaporeans believed in the call, and we grew to be a nation to be proud of and which other nations envied.”
“I am a firm believer that our seniors can continue to contribute both socially and economically, but I also feel it is not sustainable for us, as a nation, to ask of our citizens to postpone their retirement and continue working well into their later years. No disrespect to the hon Mr Yee, but I object to our Singaporean workforce being likened to a tap that can be turned on and off. He starts off stating that Singapore should not be looked upon as a company, which we all agree is well and good, but, later, reduces Singapore workers to so many drops of water from a faucet. Mr Yee, we are not a people that can be turned on or off like an ordinary tap. Other documented examples of successes in promoting resident workforce participation seem even more draconian: for example, Poland has been credited with significant success in this area by cutting welfare and social safety nets. The Government is listening to the aspirations of our younger generation by setting ambitious targets for moving a significant proportion of our citizen population to high-value high-paying jobs by 2030, aiming for two out of every three citizens to hold such jobs: this will be an incredible achievement, but who then will take up the lower-skilled, lower-paying but equally important jobs, such as care-giving, senior facilitators, therapy assistants and so on? I represent the good people of Queenstown, where close to 20% of residents are above the age of 60, and, so, it already provides a snapshot of what Singapore will be like in 2030. The elderly in Queenstown are generally happy and healthy and lead good lives, but they still require more labour-intensive resources than the younger residents. I would like to put up two requests here.”
“Similarly, what a responsible government has to do is to make all the facts available to the population and not sugarcoat any of it and begin a debate as to the choices and the alternatives that are in front of us. This is not an end of any policy that has a defined end point. This is the start of the debate. There are alternatives, choices and trade-offs, and I think it is well and good that we begin to discuss this right now rather than trying to defer the issue or to "kick the can down the road", as has been mentioned previously. We have to be realistic about the twin internal challenges that face us, which are a stubbornly low TFR and an ageing population and acknowledge that dealing with these problems is not easy and there are few success stories out there to this day. Mdm Speaker, in Mandarin, please. (In Mandarin): [Please refer to Vernacular Speech.] We have to be realistic about the twin internal challenges that face us, which are a stubbornly low TFR and an ageing population. As I see it, the Government has already given assurances that it will never give up on tackling these issues, but one has to be practical enough to Page: 24 appreciate that we need time to resolve these issues, and also to be realistic enough to appreciate that despite our best efforts, we may not be able to address these problems adequately. Certainly, in the near to mid term, to achieve the growth in citizen workforce without relying on non-Citizens might very well mean that our children will need to enter the workforce at a younger age, and we may only be able to retire to enjoy our senior years at a much older age. Is this the sort of Singapore we desire for ourselves and our children?”
“This is typically an elderly patient, and the most common diagnosis is that of arthritis of the knee. Arthritis of the knee merely means that the cartilage or the tissues in the knee are wearing out. So, my duty as a doctor is to fully explain the diagnosis to the patient, tell him what the problem is and also what the problem may be like in the future. Sometimes, the patient does not want to know, but I may also have a duty of care to explain the facts to the caregivers, the children and so on. Once all this is done, then my next job is to explain all the choices that this patient can make to deal with his particular problem. In many cases, I may have to prescribe or recommend surgery. But, of course, there are trade-offs with this. Surgery is an uncomfortable process, at least in the beginning. The caregivers must give special attention to deal with this period of hospitalisation or aftercare. But the final expectation is that the patient would have a good quality of life once he or she is fully recovered. However, an equally valid proposition or choice for this patient is to say, "Well, I would be prepared to accept that, as I grow older, I will be less mobile, I may have a little bit more pain and be less active in my life." This is an equally valid proposition and deals away with the pains of surgery. But, as a doctor, I would also have an opinion as to what I think would be the best treatment for this patient because if I have my patient's best interest at heart, then what I would want for this patient is to allow this "Ah Mah" or "Ah Pek" to go back to the way he or she was before he or she had this condition. And this is what a responsible doctor has to do.”
“And I am sure that no one would disagree with this, so I am more than a little disturbed that Members from the other side of the House have not come to fully appreciate this point but have chosen instead to concentrate on numbers rather than truly providing constructive and realistic ideas about how we can improve the quality of our lives while moderating population expansion, because this is exactly what this White Paper is really about. As it has already been established, and contrary to what some detractors had tried to portray, the Government is not trying to target any population target or any population composition. But we are trying to impress on Singaporeans the gravity of the challenges facing us, of which population expansion is just one key consideration. There has been no attempt, I am glad to note, to sugarcoat the stark realities that face us, although there are concrete proposals as to how to deal with them. In fact, it reflects a recalibration to acknowledge lower growth expectations and pushes for lower population growth rates and foreigner influx, rather than the other way around. If we are able to assure a good quality of life and the continued survival of our city state in 2030, 2040 and beyond with a population of – well, we can paint any figure, for example, 5.5 million, 5.7 million, 5.8 million, 6 million, 6.5 million, then so be it, because nowhere in the White Paper does it say that there is any pre-ordained economic growth or population figure to be pursued at all costs. If you would allow me the indulgence to perhaps draw a parallel from my profession as a doctor, as a responsible doctor. What I see most days are Page: 23 patients, for example, who come into my clinic with pain in the knee.”
“Mdm Speaker, when this White Paper was released, like most Members of this House, I received a lot of feedback from Singaporeans from all walks of life. Many were concerned about the headline Page: 22 population projections, wondering if it could be achieved and, more importantly, at what cost. Others opined that the exact figures were unimportant as long as Singaporeans could continue to enjoy a good standard of living. There were even a few bullish ones who remarked that perhaps the figures were even too conservative, and a larger population was needed. I believe that everyone holds an opinion on this, and that is the first remarkable aspect of this White Paper that I would like to highlight, that it has encouraged all Singaporeans to really begin thinking about the directions that our country should take, and the preparations that are needed to achieve this. I hope that all Singaporeans will take the time to read through the White Paper in an open and considered manner, and realise that, far from being a means to an end, it actually represents a means to a beginning. This White Paper presents a bold vision. But we are all heartened to note that, at its very foundation, if you read it closely, is its aim to, first and foremost, affirm the position of Singaporeans as the focus of this vision, no matter what future challenges await us.”
“Yes, Madam, I will come to that. The worker is seen by one practitioner and he fails the examination and he is seen by another one, and he passes. I would like to ask whether the Ministry is going to look at any way of preventing this, for example, perhaps by setting up a central database where every single examination is recorded, so that if this worker goes to another practitioner, then there is a record that can be verified.”
“I thank the Senior Parliamentary Secretary for his answer. This question was posed in relation to a similar question that was posed during this sitting by the hon Member, Dr Lam Pin Min, to MOH. This was in relation to a recent complaint against two clinics who were conducting these medical screenings and there were some questions raised about the adequacy of the screenings. As I understand from the answer, it is still under investigation. My first question relates to a concern that has been raised previously, which is that there have been some concerns about how robust the manner in which these medical examinations are being carried out. My first question to the Senior Parliamentary Secretary is: what is the procedure by which the criteria are formulated and reviewed? I understand this would be done by MOH but perhaps I could just get some understanding about how this process is carried Page: 23 out. The second question relates to another observation. Because the definition for passing a particular medical examination is perhaps not entirely definite, that is to say that when the worker sees one medical practitioner, and he sees another one, there may be a difference in the opinion about his fitness to work. This is not due to any wrongdoing but, certainly, depending on the criteria and the way it is set out, there could be some difference in opinion. So, there have been cases where a worker is seen by one practitioner —”
“Perhaps the application by the caregiver itself should also be supported by a social worker's report in addition to the doctor's support, or the court should stipulate as such before making judgment. Page: 997 In conclusion, I support this amendment that strengthens the legal framework and protection afforded to persons with mental disabilities with respect to voluntary sexual sterilization. That the courts now have the final say in deciding whether sterilization should be carried out in those who cannot decide for themselves, does not in any way, however, diminish the rights and responsibilities of their caregivers and doctors in these situations. I support the amendment to the Bill. 4.37 pm”
“However, the welfare of those with mental disabilities, and also of minors, should not and does not depend on legislation alone. There have been many calls in this House so far about, perhaps, stricter regulation, and consultations, both within and without this House, have also seen many expressions that a higher bar should be set. However, if you just speak to people who look after those with mental disabilities, you would see that their responses are a bit less extreme and most of them actually express a wish that they retain some form of control over the medical decision-making of their charges. It is critical that caregivers, doctors and other healthcare providers continue to act in concert in the best interests of the person with reduced mental capability. I have to say that the rights of caregivers to play a part in decisions regarding the medical care of their charges, have to be respected and protected as well, and medical directives regarding the conduct of doctors and healthcare professionals in the assessment of such cases have to be both robust and rigorous, in addition to being ethically beyond reproach. Caregivers and doctors in particular, have to carefully deliberate whether, first, conception would truly be detrimental to the patient and offspring thus requiring a permanent prevention of reproduction, and second, whether sterilization is the least restrictive and most practical contraceptive option available. Although not explicitly required in the law, I would support the inclusion of psychologists, counsellors, welfare workers and such in the decision making process, to be as sure as possible that this recourse is truly in the patient's best interests.”
“Mr Speaker, Sir, human procreation is recognised as a basic human right, and I welcome this amendment to the Bill, which significantly re-affirms the rights of those with mental disabilities. This amendment to the Bill will also allow Singapore to accede to the UN Convention on the Rights of Persons with Disabilities, joining the 103 other nations which have already ratified it. Page: 996 I wish to just highlight two aspects of the amendment, and make one observation. First, the amended Bill now fully recognises that those with mental disabilities often still possess the ability to make informed decisions regarding their own health, and this should be duly respected. The American Academy of Paediatrics Committee on Bioethics puts it both elegantly and forcefully when they say that "persons who have adequate mental capacity to make a decision about their health and health care are entitled to do so, based on their own interpretations of their interests, without undue influence from health care professionals, family members, or others." However, for those who lack the mental capacity to do so, the court will now act as an additional safeguard in their interests, and caregivers and doctors alike will have to provide good reasons to the court why sexual sterilization will be ultimately in the patient's best interests. This is a fundamental change to the law, such that the rights of individuals with diminished mental capacity are better protected, and brings this Bill into alignment with the existing Mental Capacity Act. The second point is that the previous implication in section 3 that sterilization can be performed in the interest of society is both woefully dated and irrelevant, and its removal from this Bill is certainly in our society's best interest.”