Choo Wee Khiang
Singapore
“Sir, bearing in mind the problem we have with Malaysia pertaining to the CIQ matter, would the Minister envisage any problem with our negotiations with Malaysia and will the Minister tell us whether there is going to be a deadline in terms of finalising the negotiations?”
“Sir, in today's Straits Times, it is reported that, "Singapore should not decide unilaterally on the relocation of CIQ facilities from Tanjong Pagar to Woodlands." It was mentioned by UMNO Vice-President, Dato Sri Najib Tun Razak. I take it that Dato Sri Najib had said that we should not move to Woodlands.”
“That is most important and let us not take the emotional aspect of it in dealing with this particular Bill. Let us be really focused. Let us take into consideration the well-being of the great majority of Singaporeans and the progress and prosperity of Singapore into consideration.”
“I thank the Minister for his reply. If we recognise the importance of sports, I think he should consider re-naming his Ministry to "MCDS", Ministry of Community Development and Sports. Dr Vasoo: Sir, as usual, Members have stretched their viewpoints. The Minister has given very elaborate replies.”
“Sir, I will be equally brief. The Singapore Sports Council has done a very good job and it has been transformed. But I understand from many National Sports Associations that they are all running into financial difficulties. They have a lot of good and great plans, but they need funds.”
“If they are working in the city, and you want them to buy a flat in the suburban area, they will have to spend a lot of time travelling to-and-fro. It is too troublesome and inconvenient. I have also come across a case where a resident wanted to sell back the 3-room flat to HDB in order to buy a bigger flat.”
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“Sir, our hospitals provide inadequate sports medical services. There are only seven medical doctors in Singapore who have specialised degrees in sports medicine - three in the Singapore Armed Forces, two in the Singapore Sports Council, one in the Singapore General Hospital and another one in private practice. I think it is grossly inadequate. Sir, the Ministry of Health is placing a greater emphasis on health maintenance which is expected to reduce health care cost. The Health Minister, Mr Yeo Cheow Tong, in announcing the setting up of the National Institute of Health, has said, and I quote: 'The most effective way of keeping down rising health costs is for everyone to know how to stay healthy.' Sir, sports medicine was clearly defined by the Council of Europe in 1973 and I hope the Ministry of Health will adopt this particular definition which places an important emphasis on health maintenance. Sports medicine should not be considered as a branch of medicine which only manages sports injuries in competitive athletes. To enable sports medicine to further assist in the area of health maintenance, the Health Ministry is urged to look into the following so as to be able to recruit and retain the necessary manpower: 1) Recognition of sports medicine as a separate medical specialty or sub-specialty and full recognition of specialist degrees in sports medicine for doctors, for example, Diploma of Doctor of Sports Medicine from West Germany and Master of Science in Sports Medicine from the United States. These two degrees are currently recognised only by the SAF and the Singapore Sports Council.”
“Sir, point of clarification. When the Minister of State mentioned that prevention is better than cure, I would like to know how the Ministry will incorporate mental health care into our prevention and primary health care system. I would also like to know whether the Ministry is going to have any campaign on mental health care.”
“Sir, the Minister has not answered my question on whether he will allow Dr Tan Cheng Bock to run the Alexandra Hospital.”
“Sir, a hospital is not only labour intensive but also capital intensive. I was told that it costs about $400,000 per bed in the acute hospital, taking into account the cost of land, building, equipment and all the support facilities. I am glad to note that the Government is launching a major hospital redevelopment programme to improve the standard of hospital services for all Singaporeans. However, I am concerned that this may further increase the burden of the patients on the rising health care costs, if they are required to pay for the cost of such developments. In my view, public hospitals are basic physical infrastructures that should be provided by the Government just like roads, MRT, schools and the universities. These are necessary investments for our future and therefore should be fully funded by the Government. Training of doctors, nurses as well as research and development are also important if we are to continue to improve and upgrade the standard of our medical services. This is in the interest of our nation. We should not leave it to individual hospitals to decide. The Government should take the lead to ensure that there will be sufficient doctors and nurses to meet the needs of its people for years to come. Sir, I would therefore like the Minister to clarify the basis of the costing of hospital services and whether the patients, in particular, the Class B2 and Class C patients, would be asked to bear the cost of capital development, training and R&D. Also, I would like to ask the Minister whether he has decided to allow Dr Tan Cheng Bock and company to run Alexandra Hospital. 2.15 pm”
“Finally, I would like to deal with the points raised by Mr Choo Wee Khiang. Listening to him I got the impression, although probably unintended, that he felt that our industrial health services have been fossilised since the colonial times. I can assure him that this is not so. In fact, our officers have been keeping up with the times in terms of looking after workers exposed to the different kinds of hazards as our economy restructures and upgrades. The tendency, in fact, is for the working environment to become safer with the passage of time. For example, in the field of industrial health, the most common problems are noise-induced deafness and industrial dermatitis. The other hazards like exposure to poisons are in fact very few. My Ministry has already set up a system, for example, of designated factory doctors to train doctors not only to diagnose and cure cases of workers who have incurred illnesses arising from hazards at the workplace but also to know how to advise the employers on what kind of precautions to take. So in this field, I think the coverage is already fairly good and we have been working with the Ministry of Health. We have qualified doctors but at the same time we also check with the Ministry of Health, and we do work closely with them. I think the problem is well in hand but I would, nevertheless, ask my officers to study his speech more carefully, and where there are ideas which we can adopt, we will certainly do so.”
“Members may be aware that recently my Ministry decided that we should extend the scope of the Factories Act to cover also the safety of workers who have to work in manholes, for example, Ministry of Environment projects and so on. Over the last 14 years, there have been 22 incidents of workers who were overcome by fumes and other problems when they were working in manholes. This works out to an average of about one and a half cases a year. In these incidents, nine workers were killed. Fortunately, in the other cases, the workers recovered. We have to set priorities, and so far the priority of the Ministry has been to look after the areas which are very hazardous, for example, construction sites and the shipyards. But now that the problems there have improved, we feel that we should divert our resources partially to the other areas, and that is the reason that we are now doing this. With the coverage extended through an order, there is no need to amend the law. We can just make an order to extend it. The workers will then have to be trained. There will have to be proper precautions, for example, testing to see whether there are poisonous gases in the manholes and proper use of gas masks and so on. If the employers do not take the necessary precautions, and as a result some workers are killed, then the employer will be fined up to $25,000 and/or jailed up to one year. But the main thing is not so much the punitive element but the fact that we want to make clear to the employers that they should look after the safety of their workers. We will also be having an orientation programme for workers who are involved in this field. I expect this new order to be made soon, and to bring it into effect on 1st May.”
“One way to do so is of course to provide better amenities for the workers. In fact, some of the large employers which are able to afford it are already doing so, not only in the private sector but also some of the larger Government Ministries and departments, statutory boards, and so on. In addition, our workers also have access to the NTUC facilities. So on the whole, I think our workers are well catered for in the area of recreation. But the important point is that we should not take industrial peace and harmony for granted, and both parties should work constantly at ensuring this through various means. Next, I would like to respond to Mrs Yu-Foo Yee Shoon who has asked two questions. One is concerning the safety committees. In Singapore, the companies which employ more than 50 workers have to establish safety committees. Our records show that about 90-plus per cent of companies in fact do have safety committees and they are operating, having meetings regularly, and so on. For the remainder, which are mostly new companies, my Ministry is working with them to try and help them to establish proper committees and to go about their jobs. We make sure that the committees are functioning by having our inspectors go round, not only to check on the safety of the factories but also to check their records, whether they have been meeting regularly, whether they have been following up on suggestions and so on. In fact, if companies have been inactive or have neglected this aspect of their work, then a fine can be imposed, and we have done so in some cases. The other issue concerns safety in manholes.”
“Second, establish the principle that emphasis be placed on the preventive component of occupational health services for all persons at work. Third, the Ministry of Health accepts formal responsibility for policy development for the provision of occupational health services. An inter-ministerial committee between the Ministry of Health and Ministry of Labour be set up to coordinate activities. Fourth, each of the polyclinics in Singapore should have at least one medical officer trained in occupational health. Fifth, there is a need to train general practitioners in occupational health because a considerable saving can be effected by incorporating preventive occupational health services to the current task undertaken by the general practitioners. To achieve these objectives, it is necessary that the general practitioners be trained in occupational health. A scheme is therefore required to be developed whereby general practitioners are encouraged to take time off to undergo training in occupational health. A possibility is the use of the Skills Development Fund for this particular purpose. Lastly, in Singapore at present, there exist a number of specialists trained and interested in occupational health. These specialists can be used as referral points for the occupational health services provided at the primary care level. Sir, providing health care for the working population is particularly important for Singapore as a NIC. Singapore has the expertise and all that is required. It is some reorganisation, support and recognition of the problem. May I have the Minister's comments? Mr Lee Yock Suan: Sir, first, concerning the comments by Encik Abbas, I fully agree with him that it is very important for companies to show their care and concern for their workers.”
“Sir, in Singapore the health of the working population is an important consideration for several reasons. First, the workplace constitutes a large segment of the total working population, approximately 1.3 million. Second, working conditions have a direct as well as indirect influence on health. Third, the health of the working population has a direct impact on the productivity and efficiency of the workforce. Fourth, often the problem of environmental pollution is a direct result of poor industrial hygiene practices due to lack of effective occupational health services. For these reasons, Sir, an effective occupational health service becomes important and relevant. Unfortunately, we do not have an occupational health service as defined today. What we have is the remnant of our colonial heritage whereby occupational health service is largely governed by the Factories Act, but the Factories Act covers only 25% of the total working population in Singapore. It is for this reason, Sir, that most industrialised nations of the world today understand occupational health as the provision of health care to all persons at work, and not merely to those in factories. Therefore, the thrust of modern occupational health services is the need to develop a national system of health care services for all persons at work. Here, Sir, I would like to make the following developmental proposals for occupational health services. The first proposal is that the Government should consider the setting up of a national occupational health advisory council under the Ministry of Labour with representations from the Ministry of Health and other relevant parties, namely, unions, employers, and medical associations.”
“Sir, I hope also that the Minister will consider setting up a more comprehensive training and educational programme for users and the public at large, especially in the non-ionising radiation area as it is rather new and unfamiliar to most of us. I am sure the Bill will further strengthen Singapore's radiation protection and the health and safety of our workers and the public at large. Sir, I support the Bill.”
“Sir, after listening to the Minister's speech, I am fully convinced that the Bill is very much useful for the workers and with this particular Bill, the workers and public at large will be protected. I am convinced that this particular Bill when enacted will ensure that Singaporeans will have a safer place to work and a safer place to live. Sir, the rapid growth of beneficial applications of non-ionising radiation carries along with it some adverse health effects. Therefore, protection measures and standards are necessary to ensure that our environment is safe for living and work without at the same time restricting the applications of such technology. Here I am happy to note that those who wish to possess such apparatus or materials will have to apply for a licence and this will last for two years or less. But, Sir, I hope the Ministry will make sure that such materials and equipment are properly maintained, serviced and kept. And therefore I hope the Ministry will continuously send out their officials to check on the owners and users. Recently, there was concern over the use of cosmetic lasers, microwave ovens and machines emitting ultrasound. The Health Ministry, I hope, will look into problems associated with the improper use of such hazardous devices in establishments. Sir, it is known that poorly maintained microwave ovens do present some radiation hazard to the users. Guidelines could be issued to the domestic users on how to maintain their microwave ovens properly and how to check on their safety. This is especially important as there are a large number of microwave oven users, both in restaurants and in the homes.”
“I thank the Minister. The Minister sounds like an engine specialist. My concern would be the general concern of the motorists and I hope the Ministry will further promote and market this particular idea so that unleaded petrol will be widely accepted by Singapore motorists. BILL INTRODUCED PARKING PLACES (AMENDMENT) BILL "to amend the Parking Places Act (Chapter 214 of the 1985 Revised Edition)", presented by the Minister for National Development (Mr S. Dhanabalan); read the First time; to be read a Second time on the next available sitting of Parliament, and to be printed. ARCHITECTS BILL Order for Second Reading read. 1.20 pm”
“Mr Speaker, Sir, I wonder whether the Minister could clarify to the House. By switching from leaded to unleaded petrol, the fuel consumption of vehicles will definitely go up. Secondly, from my experience, if you were to change from leaded to unleaded petrol without a converter, the engine will give rise to a knocking sound which will damage the car engine. Dr Ahmad Mattar: Mr Speaker, Sir, I think Mr Choo Wee Khiang has got the whole thing mixed up. Unleaded petrol is petrol which does not contain any lead additive. Lead has traditionally been added to petrol as an anti-knock compound to boost its octane quality. And octane is a measure of a petrol's ability to effectively fuel modern automotive engines. By using advanced petroleum technology, we no longer need to rely on lead to achieve the octane needed by a particular engine. So switching from leaded to unleaded petrol will not in any way affect the consumption of the car. It is a matter of whether we still need to rely on lead to achieve the octane number required or not. We now have substitutes which are safe and therefore we do not need to rely on lead any more. In fact, unleaded petrol will provide all the benefits of power and performance without emitting lead into the atmosphere.”
“Sir, will such usage give rise to mechanical problems for motor vehicles?”
“Sir, I would like to ask the Minister whether he is implying that the majority of the existing motor vehicles will not need a converter to use unleaded petrol. Is the Minister suggesting that?”
“Sir, I support his view, but the point is that we should encourage motorists to use unleaded petrol. The price of leaded petrol should remain as it is. In fact, the price should be reduced to induce more motorists to convert their cars to use unleaded petrol and not at the expense of penalising the existing motorists.”
“Sir, I support the Minister's view. But I am wondering why we must encourage motorists to use unleaded petrol at the expense of penalising people who will continue to use leaded petrol because it is expensive to convert to unleaded petrol and it is also not easy to convert too.”
“Has the Ministry any plans to enlarge the size of Class C wards in future, in view of the expected overwhelming response from patients to get into Class C wards in SGH?”
“Sir, I thank him for his reply. I beg leave to withdraw. Amendment, by leave, withdrawn.”
“The last point, Sir, regarding car parks. I must thank the Minister for telling me that it was already introduced before restructuring. But then, Sir, my point is this. People do not go to hospitals for fun. They go there to visit their friends and relatives who are sick. So I would like the Minister to consider, in order to avoid unnecessary summons, coming up with some kind of scheme to give waivers to people who genuinely visit their friends and relatives. That's all.”
“Sir, I would just like to clarify. When the Minister mentioned about the medicine and drugs available at the National Skin Centre for non-subsidised patients, obviously it is going to make some profit. My argument is, make profit, yes, but it should be comparable to the outside pharmacy. That is one point. Secondly, as far as the staggering size of the bill is concerned, I support what he said earlier on. But I would like to request that there must be some kind of checking, so that patients know what they are paying for.”
“Sir, I thank Dr Tan for being such a nice and compassionate person. He is full of sympathy. At least I am wrong once. Actually, I was trying to substantiate my point that medical care is not cheap. I am in full agreement with the Minister. My main point was to ask the Minister to set up some kind of counselling system to ensure that people who cannot afford to go to more expensive wards should instead go to B2 or C class. I was trying to help him promote the idea. So I think he has been very harsh on me, which is very unfair to me.”
“Sir, according to the bill it is stated as ward B1.”
“Thank you. You are being very compassionate and patient. Sir, as far as the audit on Medisave is concerned, the Ministry of Health established a Medisave audit unit in June 1988 to check on Medisave claims. I would like to ask the Minister to enlighten the House on the development and progress of Medisave audit. I have a few questions: How many cases have been examined and what was the sample size? And also in terms of percentages, what methods were used in arriving at such samples and what methodology was adopted to test these cases? How many abuses have been found? How many exceptional and extraordinary items have been noticed and whether actions have been taken? Does the Ministry intend to enlarge the Medisave audit unit so that it can perform and function more professionally and comprehensively? Sir, most importantly, the unit should comes out with some kind of preventive audit programme so that we will be able to monitor and ensure patients will not be wrongly charged and abuses will not take place.”
“Sir, on medical bills, apart from consultation fees and others, I like to draw the attention of the Minister to look at two bills which I have here. The first bill is from the National Skin Centre (Singapore) Pte Ltd. The total cost of the bill is only $11.30, but to my surprise this particular patient is able to get similar medicine at a commercial pharmacy for one-third less than this particular price. Another bill, which is not from the National Skin Centre, is from NUH. The total bill for this particular patient amounted to $27,576 and paid by three persons. I suppose they are relatives of this particular patient and the amounts were $12,215, $7,500, and $1,255. Sir, the amount is staggering. I really wish the Government would look into the medical bills and see that all bills are checked properly to make sure that patients are not overcharged. Like the medicine from the National Skin Centre, I can see the rationale of making some money, but I would imagine that if it were to make money it would be at the normal commercial rate rather than at a super-profit. Sir, may I take the other amendment on audit on Medisave.”
“Sir, I was told by my friend that if you were to go to a hospital regularly enough, you would hear stories about how families are having difficulties in paying $3,000 medical bills that are still going up because their loved ones have not been discharged. Indeed, a friend of mine witnessed a patient in one intensive care unit, threatening to pull out his life sustaining tube and to leap off the top most floor of the hospital when his wife informed him that his medical expenses at the point in time had reached $10,000. Eventually, the medical bill was settled through his daughter's Medisave account and borrowed money. Sir, I am truly pleased that the Government has introduced Medishield, because the Government realise that our people's average Medisave account is slightly more than $3,000 only. It is grossly inadequate to cover expensive medical care. But then why should Medishield stop at 65 years old? Earlier on, the Minister gave an explanation which I think is truly not satisfactory and I wish the Minister could look into this very seriously, because the life span of Singaporeans has now prolonged to beyond 65 years. And why do you want to be not so equitable towards people who are more than 65 years old? In terms of using Medisave, I hope the Minister will look into ways and means to ensure that patients and their relatives will not over-withdraw their Medisave nothwithstanding the fact that there are so-called overdraft facilities available. Maybe you should give a particular patient some kind of quotation or rough estimate and look into their Medisave account and tell them, "Please don't over-use it." Otherwise many sad stories will happen again.”
“Sir, I beg to move, That the sum to be allocated for Head P be reduced by $10 in respect of Code PA 1500 of the Main Estimates. Sir, credit card holders usually receive a lot of brochures and I happen to be one of them when I received a letter which says: 'Nowadays the cost of a hospital confinement can be staggering. Medical and hospitalisation costs have been rising as more hospitals privatise and upgrade their facilities to provide better medical care. Just ask any one who has been hospitalised recently they would tell you how much more they had to pay out of their own pockets despite employer provided benefits.' Sir, from this letter, we can understand that not only we MPs feel that the cost of medical care is so expensive, but it is a general perception of people. I think the role of the Government is to provide good medical care to people in Singapore and also to make sure that charges are being kept at a very reasonable level so that even private hospitals will not capitalise on the rising cost. Sir, when it comes to restructured or privatised hospitals, the first impression one gets is the rising costs. Let me give an example, car parks. People who used to visit patients in the restructured hospitals did not pay a single cent for car parking. But now, immediately after restructuring, people who genuinely visit their friends and relatives have to pay. I think the Minister has to look into it and see that people who are genuinely visiting their friends and relatives will get a waiver of parking fees. Only the doctors and nurses will know and the relatives who are patients.”
“Can I make a small point, Sir? In replying to my point on lack of compassion, the Minister implied that I am saying all the doctors and nurses lack compassion, which is not quite the case. I said "many". It is not all. The way the Acting Minister put it, he is going to make all the doctors and nurses dislike me!”
“I would urge the Minister to consider taking one step at a time in terms of restructuring our hospitals. For example, let Alexandra Hospital remain as a Government hospital. And I would like the Minister to make sure that all the facilities and resources among the hospitals are available to all, and give every hospital a fair chance of having highly skilled specialists.”
“No. That is not a translation. I think we have a simultaneous interpreter up there. Sir, we have given a lot of incentives to younger couples so that they can have their babies early. But I feel that if we do it this way, it is only going to benefit higher wage earners. In order to show care and concern for those lower income group couples, I really feel that we must give free medical services to all C class patients in the children's wing. Dr Aline Wong mentioned about IVF, and I would like to ask the following questions. What are the capital and maintenance costs of our IVF centre and how much revenue does the centre generate per year? Is there a net gain or net loss by running such a centre and what is the percentage of patients who are non-citizens? I would also like to, ask about the restructured hospitals in terms of staff shortages. Mr Yeo Toon Chia raised a few days ago about the number of existing staff - medical, nursing, administrative, pharmacy staff - who have joined the restructured hospitals, especially in Kandang Kerbau Hospital and Toa Payoh Hospital. I would like to know how the Ministry will ensure that these hospitals function with sufficient staff and how many posts are now vacant. Sir, now that doctors are allowed to receive more than 60% of their salaries as consultancy fees, I would like to know how the Ministry will ensure that doctors are not spending too much time earning money and too little time teaching medical staff, nurses, etc, I would like to know whether the Ministry has some kind of monitoring system to monitor this aspect, and also whether these specialist doctors are now doing less research work or publishing their academic papers.”
“Thank you. (In Mandarin) But the Minister forgets that poor parents also have children and they find it difficult to pay for the hospital bills ---. (In English) Sir, let me remind the Health Minister --- An hon. Member: You are translating.”
“It is finishing. Two more sentences and it will be completed, if you will allow me, Sir?”
“Yes, Sir. It is not a very long quotation. (In Mandarin): Last year I mentioned that we should let the children who stay in the C wards enjoy free medical services, but the Minister refused. He said that it does not fit the Government's policy. Govern- ment encourages people who can afford to ---”
“Sir, thank you for allowing me to join in. Earlier on, other MPs spoke about affordability in terms of dollars and cents. I would now like to talk about something which is non-dollars and cents. Sir, people in the caring profession need two critical characteristics to put the health service in Singapore as one of the best in the world. These are competence and compassion. In terms of competence, we have some of the most competent doctors and nurses in the Asia Pacific because of our rigorous training programmes and continuous efforts put in by the Health Ministry in achieving medical excellence. However, Sir, as far as compassion is concerned it is in short supply. Sick patients are very taxing to look after. However, a smile, a gentle word of assurance, a voice devoid of irritation, together or singly, go a long way to calming the anxiety of patients and their family members. Many of our doctors and nurses have also lost the act of touching the patient by the hand or shoulder. This is indeed a powerful way of demonstrating care and concern. If competence requires years of training, how much attention are we paying to training for compassion? The latter, if practised, would certainly contribute to the much touted quality of life. There is a Chinese saying: Yi cher fu mu sin and I sincerely wish the Minister will look into this matter so that our medical care can be further enhanced. Sir, as far as a children's hospital is concerned, I mentioned it last year and I would like to bring it up again this year. I quote briefly in Mandarin what I said last year. (In Mandarin): Last year ---”
“Sir, thank you for allowing me to join in the debate. After listening to Dr Lee Siew-Choh's comments, he really gives me the impression that he is actually over respecting our neighbouring country. Being a patriotic Singaporean, I do not think he should act in this manner. We should give each other an equal opportunity to respect each other. Whatever we have done so far, giving rise to suspicions and adverse comments, whatever we do, the Prime Minister said, "Please, go and visit Malaysia". But they said that it is something fishy, not honest, not sincere. Having a long queue at the Causeway is also our fault. I like to ask the Minister: what fault or what wrong have we done? If we have done nothing wrong, why are we so soft? I do not want to learn Mr Peh Chin Hua's style, by giving people a left hook. I do not think we would like to do that kind of thing. I think we have really to be firm. I do not think we need to fight to that extent. We have to be firm and tell them honestly what we think of them. Going across Malaysia to visit them and being friendly is one thing. But at times when the junior members of UMNO or the junior Ministers or MPs of our neighbouring country comment about us, I think we MPs, or some of our Ministers, must give a proper reply to them.”
“Sir, I would like to comment on what Dr Ow Chin Hock said earlier on about the foreign worker quota system. I must declare my interest because I am a businessman. If you were to ask around, businessmen would usually react in the same manner, as I said earlier, ie, there is a serious shortage of labour in Singapore. Most businessmen would really like to employ foreign workers because there are just not enough local workers around. But then the foreign worker quota system is unlike a car quota system. Human resource is different from vehicles. If you do not drive a car you can go by MRT or by bus, or you walk. But if you do not have workers, how are you going to produce? Well, I know labour MPs would not be very pleased to hear that. I would like to make a few suggestions, Sir. First, we should allow short-term workers to come in, maybe on a three-month or six-month basis. We want to control the number of foreign workers. With the expertise of the Ministry of Labour, I am sure they can control it. We should also allow those export-oriented companies and factories to employ more workers because I think it is important for Singapore factories and Singapore businessmen to build up their goodwill by fulfilling orders and by ensuring that goods are completed on time. I hope the Ministry will look into these suggestions.”
“Same speech. Okay. (In Mandarin): Sir, with regard to the licence issued by SBC and the requirement for motorists to pay the licence fees, I have some views on this. Very often, there is some trouble with the collection of the fees. Some motorists who had already paid their licence fees were subsequently wrongly accused by SBC for non-payment of fees and were charged in court. This is indeed very regrettable! I hope that the relevant authority would accept my humble suggestion on this matter. I hope that the authority would consider merging the collection of road tax and the licence fees. Then it can be shown clearly on the road tax disc whether or not the car-owner has installed a radio set in his car.”
“Sir, may I ask the Acting Minister what steps the Ministry of Health will take after all the hospitals have been restructured as far as the pensionable nurses are concerned?”
“Will the Minister agree that it would be better for the old car owners to make use of the surcharge on the road tax to maintain their cars rather than pay to the ROV for the use of old cars on the road? Also, will the Minister agree that preventive measures would be better than penalising the old car owners by way of surcharge?”
“Indeed taxi operators not only decide fares, they also decide the number of taxis, contrary to what Dr Wan said. The number of taxis is not controlled by ROV. Yes, ROV maintains the records. At the moment, ROV has issued 14,000 taxi licences to the various taxi operators. However, there are only 11,000 taxis on the road. Taxi operators decide when they want to add on to their fleet and how many more taxis they want, not the Government. Sir, I now come to the question by Mr Chiam See Tong. He asked for an estimate of the amount of revenue expected over the next three years assuming that the quota premium is $5,000. The amount can be derived quite easily. There are about 500,000 vehicles on the road. Assuming they have an average lifespan of 10 years, so each year, about 50,000 vehicles would be scrapped. Multiply that by $5,000 to get one year's revenue. It is simple arithmetic.”
“Because it does not serve much purpose if we are to prevent congestion caused by cars only to replace it with congestion caused by taxis. Mr Lew has suggested that changes should be made gradually. Yes, I agree. Changes will be made gradually. In fact, they have been made very gradually. I have shown the figures many, many times to Members of this House, that even if we assume a figure of $5,000 for the quota premium, it will only add another 0.4 cents per kilometre to the operating cost of the taxi driver. So it is a small step, a small increase, and therefore manageable. Yes, taxis provide personal door-to-door service, as Mr Lew rightly pointed out. Therefore, for that quality of service, the public should be prepared to pay something more than what they are prepared to pay for a bus ride or for a MRT ride. Taxi fares are determined by taxi operators, not by the Government. As recommended by the previous GPC for Communications and Information, the Public Transport Council acts as a watchdog body, to ensure that nobody - not taxi operators, not bus operators, not MRT operators - can charge artificially high fares. The PTC plays a moderating role and ensure that fares are acceptable, both to the consumers as well as to the operators. If the taxi operators are able to provide good figures to justify any fare increase, I have no doubt that the Public Transport Council, made up of ordinary Singaporeans, unionists consumers and employers, would only be too happy to look at the figures provided by the taxi operators and make the adjustments accordingly. In fact, so far, all applications for fare increases have been acceded to, sometimes with minor modifications. So fares are decided by the taxi operators.”
“Sir, I would like to talk about road tax on old cars. I would also like to declare my interest. Sir, the Minister for Communications and Information lately announced that old cars which are more than 10 years old will be subject to a 10% surcharge and up to a maximum of 50%. I would like to appeal to the Minister that old cars are not necessarily bad, and bad cars are not necessarily old. Unless the Ministry is able to produce figures showing that old cars are actually causing a lot of congestion in Singapore, I would tend to agree with him. Because from statistics by the Ministry, it was shown that old cars which had gone through Vicom or AA inspections, most of them had some kind of problem one way or another. But the very fact that these cars are able to get through Vicom or AA inspections shows that the cars are not bad either. I would like to appeal to the Minister to consider again whether it is possible to waive this 10% surcharge. If that is possible, it will make a lot of old car owners very happy. Dr Yeo Ning Hong: Sir, I want to thank Mr Lew Syn Pau and Dr Wan Soon Bee for their concern for the taxi drivers and their livelihood. The Government is also very concerned with the livelihood of the taxi drivers. Hence when policies are made we bear in mind their impact on the livelihood of taxi drivers in Singapore. But as Dr Wan rightly pointed out, a taxi is a car. It has taken a long time for Dr Wan and Mr Lew to come to that conclusion, and I am very pleased that they have finally agreed a taxi is a car and, therefore, taxis are likely to cause the same amount of congestion as an ordinary car. Hence we should try to strike a balance to ensure that we do not have congestion caused by taxis.”
“Yes, I will ask my question. Sir, patients are referred to 'A' class services rather than 'B' class services, and invariably when patients want to opt for the 'B' class wards, they are forced to go to the 'A' class. Would the Minister explain?”
“I am very pleased to hear from the Acting Minister that for the 'B' class and 'C' class, the basic facilities are bare and are not as good as the 'A' class. However, the medical services will be exactly the same as the 'A' class. But I would like to bring to the attention of the Minister that yesterday on the Forum Page, he would see ---”
“I just like to add a point before I withdraw my amendment, Sir. We always say that we have no natural resources and the only resource that we have is human resource. If we want more people to produce more children, and those who can afford are not going to produce more, I think we really have to look at the borderline cases. By providing free paediatric services for all children in Class C beds, I think it will help. It will go in a very small way to increase our population growth. Sir, I beg leave to withdraw my amendment. Amendment, by leave, withdrawn.”
“Sir, I beg to move, That the sum to be allocated for Head P be reduced by $10 in respect of Code PD 5100 of the Development Estimates. Sir, the children of today are the citizens of tomorrow. We need to provide the highest possible paediatric care to ensure healthy population for the future. Therefore, I am so pleased to learn that the Government will build not a hospital but a children's wing with 400 beds, which will no doubt provide the best standard possible for the care of our children. I hope the Minister will enlighten the House as to the detailed plans in terms of manpower, size of wards, charges and the amount involved in building such a children's wing. In a way, children's hospital or children's wing will help the young parents to have more children if they can afford to. Because they are assured of excellent paediatric care for the kids. However, the cost of bringing up children and the cost of medical care are the two main reasons for Singaporeans to opt for fewer kids. If you look at today's newspaper, Sir, at the forum page, it says, "Self centred Singaporeans may opt for fewer kids". Two main reasons have been highlighted, one is the cost of bringing up children and the other is the cost of medical care. In helping the younger parents to have more kids, I would like to make a suggestion, ie, to provide free paediatric service for children in Class C wards. In such a case, I think the younger parents will be eased off with the load, lesser burden in terms of finance and care for the children. Therefore, I think they will go for more kids. Lastly, I would like to ask the Minister whether he has any plan to so-call corporatize the children's wing in future.”
“I am coming to the point of subventions. Therefore, in order to upgrade class C beds, there should be more subsidies, more funds given. I hope the Government will consider giving more money to various privatized hospitals to enable them to buy more equipment, train more staff and not at the expense of raising hospital charges.”
“Sir, in terms of subventions I recall what the Minister said earlier on. As far as class C beds are concerned, I do not think I would like to rename class C to class B, but I would really like to see that in line with economic growth we should actually upgrade the class C beds. He said that class C should be very basic and with no frills. In my opinion, if you were to upgrade ---”
“The other thing is conflict between having to serve the hospital and serving the patient. I give Members a very simple example. There are four surgeons, all working pretty hard. Three surgeons, let us say, make plenty of money for the hospital but the fourth surgeon works very hard and he is prepared to see C class patients. Therefore, he would not make money for the hospital. Will his head be chopped at the end of the day when accountability is important? So either he joins the three surgeons and continues to make money for the hospital, or he quits. Then what happens to those departments that are not profitable? For example, Pathology department, Forensic department? They do not make money but they provide a service. What do you do? Chop them also? Maybe the Forensic department will be hived off to the Ministry of Home Affairs. They have to do some police work too. SGH has got no C class beds. This is unfortunate. But you expect the other hos- pitals, Alexandra Hospital, Tan Tock Seng Hospital, and Toa Payoh Hospital to have C class beds. If I am in charge of TTSH or the other hospitals outside SGH, I will have to show profits also at the end of the day. And I will surely make my C class beds less attractive to Singaporeans. TTSH will have to finally close the C class beds and opt for B2. I think Dr Goh Keng Swee's principle of equal misery should also be applied here. Lastly, my concern is the teaching of medical students will be a problem if all the hospitals are restructured. How much time must a lecturer give to teaching, at the same time not losing his post by not earning enough for the hospital? I hope the Minister will respond to all these comments I have made.”
“At present specialist doctors can move from hospital to hospital so that the hospitals that do not have a particular speciality do get this speciality expertise by way of secondment of the doctors to the hospital concerned. And also, patients can move from one hospital to another hospital. For example, if a patient from TTSH has a need for radio-therapy treatment, he will just be sent across to SGH for his radio-therapy treatment. I think that is a very good arrangement. But what disturbs me is that recently I met a couple of doctors who spoke to me and said that this present arrangement will not continue after restructuring. I asked them to give me an example and one of the doctors said there was a case of a patient who needed some specialist opinion from SGH concerning a renal problem or a kidney problem, but the response from this particular doctor in SGH was, "Look, now we are a different body altogether. We are restructured. We need to get permission and, of course, cost is going to be different." This is very worrying because I think the present arrangement is quite fair and patients do get a chance to get expertise management and advice. So I do hope the Minister will look into this. My next question is, how do you ensure integration of hospitals? Privatization, restructuring - I fear you might cause some disintegration. Integration of hospitals, to me, is very fundamental because there will be no duplication of services, no duplication of manpower and, in so doing, health cost will come down. Of course, the ideal would be to allow each hospital to specialize in a particular branch of medicine. But then do you leave it to market forces to decide? Or do you in the Ministry decide for the hospital which particular speciality that the hospital should move into?”