Chua Sian Chin
Singapore
“Mr Speaker, Sir, I rise to speak on this Bill as a person who had been in Government for many years and before that in legal practice for more than eight years and now back in legal practice. While I was in Government, I had cognizance of the shortcomings of the legal profession.”
“It is 62 members out of a total of 1,335 practising lawyers. This has brought about a situation which no responsible government can let it pass in the public interest. The Government has good reasons to deal with this situation firmly. In fact, the present amendments have only made a small inroad in self-regulation.”
“At the same time, a minority group of activists has also chosen to take on the Government by calling an Extraordinary General Meeting of the Law Society to pass fierce resolutions against the Government. This group comprised only 62 members.”
“Though he has only limited Constitutional powers and acts on the advice of the Cabinet, he is the symbol of the unity, loyalty and aspirations of the people of Singapore.”
“- to hold classes for children of his constituents. What right has he got? The PAP MPs equally have no such rights. It is the right of the Government, if they think so, to have such classes. In fact, through the People's Association, they have been holding kindergarten classes in the community centres.”
“It is the Government who says that, and the Government has the right to say it because they are responsible for the Government of Singapore. And it is not what I say or what you say. Let me turn to the Member for Potong Pasir. He also produced some exhibits which are equally bogus.”
The complete record
Every one of 1,639 lines we hold for Chua Sian Chin, in date order, each linked to its source. Free to read, in full, without an account. Page 33 of 33.
“Mr Speaker, Sir, first of all, I wish to thank all the hon. Members who have spoken giving ardent support for this Bill. I would also like to make some general comments on what they have said. First, I would like to deal with what the Member for Sembawang has stated. He says that the problem of mosquitoes and flies can only be tackled by a two-pronged attack on it. Firstly, the public health workers must be a disciplined and efficient force. Secondly, there must be co-operation from members of the public. I could not agree with him more because I myself have stated in this House that that is the only way to solve this very big problem in our Republic. As regards the reorganisation of the public health cleansing force, I wish to tell hon. Members that this is now nearing completion. The reorganised set-up will be in force as from 15th August this year. Reorganisation started less than four months ago. But I assure hon. Members that after 15th August, there should be some results because the reorganisation will then have been implemented. The other matter about which I wish to inform hon. Members is that with the passing of the Employment Bill yesterday, it is now possible for the Ministry of Health to implement another very important programme, i.e., to get its public cleansing workers to work 365 days a year, including Sundays and holidays. I assure hon. Members that this will also have its effect on the problem of flies and mosquitoes. The Member for Joo Chiat has mentioned two specific problems posed by rats and cockroaches. I would like to correct him by saying that although I did not specifically mention that cockroaches are also included in the Bill, the Bill covers all disease-bearing insects.”
“Clause 26 repeats the previous provision in the Destruction of Mosquitoes Ordinance, making the Bill applicable to all property, including that of Government. This Bill will provide the legal foundation to enable more effective control of disease-bearing insects, so that we shall be able to prevent the creation of foci of infections, the wastage of manpower through ill health and the needless expenditure of large amounts f public money to correct many situations which need not have arisen in the first place. A new outlook is called for. The Environmental Health Services must be considered on a broad and integrated basis with the emphasis placed on preventive rather than on remedial action. Mr Deputy Speaker, Sir, I beg to move. Question proposed. 6.56 p.m.”
“Clause 11 sets out the general measures which may be taken by the Commissioner or the Medical Officer of Health, or the Public Health Auxiliary with the consent of the occupier of any premises to whom due notice has been given. The newer method of spraying premises or vessels with residual insecticides is provided for in clause 13. The power to examine medically any person who is infected or suspected of being infected with an insect-borne disease is provided for in clause 12. Epidemiological investigations of insect-borne diseases will be facilitated by clause 14 which enables the Commissioner or a Medical Officer of Health to demand relevant information. The procedure for enforcement and service of orders under the Bill is dealt with in clauses 15 and 16 respectively. Any owner or occupier who is dissatisfied with any of the measures specified in the notice may, by clause 17, appeal to the Minister within 14 days of the date of such order. Clause 20 places the responsibility on the owner or occupier of premises to look after any works which have been executed by the Government with the object of preventing the breeding of disease-bearing insects. Clauses 21, 22 and 23 provide penalties for offences under the Bill, while clause 24 provides for police assistance where needed. These penalties have been enhanced. In order to deal with offenders more expeditious1y, clause 25 gives power to the Commissioner or any public officer authorised in writing on that behalf by the Minister, to compound any offence committed under clauses 6, 7, 8, 10 and 13 by accepting from a person reasonably suspected of having committed such offence a sum of money not exceeding $500.”
“Clause 7 prohibits the breeding, collecting, distributing, importing or exporting of any disease-bearing insects without the express written permission of the Commissioner or Medical Officer of Health. Such permission may be granted at the discretion of the Commissioner or Medical Officer of Health, if he is satisfied that the application is made for the purposes of science, education or research and shall be subject to such conditions as the Commissioner or Medical Officer of Health may deem fit to impose. Any person who undertakes or carries out any operation likely to create conditions which may be favourable to the propagation or harbouring of disease-bearing insects must have his plans approved under clause 8. Clause 9 specifies the powers of the Commissioner or Medical Officer of Health to direct any owner or occupier of premises to carry out specified mea sures with regard to the premises for the treatment, destruction or removal of anything therein as may bring them into a condition unfavourable to the propagation or harbourage of disease-bearing insects. If the circumstances so warrant, discretionary power is given to tile Commissioner or the Medical Officer of Health to execute the necessary measures himself. The costs and expenses will, of course, be charged to the owner or occupier, as the case may be. This is an important power that gives tile authorities a speedy means to bring about the destruction and removal of conditions favourable to the propagation and harbouring of disease-bearing insects and charge the occupiers or owners for the costs and expenses incurred. The clearing of undergrowth under certain conditions without the previous sanction of the Commissioner or Medical Officer of Health is prohibited under clause 10.”
“The Minister may also, by clause 3, invest any other medical practitioner in the service of the Government with all or any of the powers conferred on a Medical Officer of Health. Clause 5 provides that the Commissioner, or the Medical Officer of Health, or a Public Health Auxiliary may enter and examine any premises or vessel between the hours of 6 o'clock in the morning and 6 o'clock in the evening to ascertain whether such premises or vessel or anything therein is in a condition favourable to the propagation or harbouring of disease-bearing insects and further to carry out, if necessary, the spraying of such premises or vessel with insecticide. The Medical Officer of Health may, in addition, examine any person from such premises or vessel to ascertain whether such person is suffering from or is a carrier of any insect-borne disease. If so, he is empowered to treat medically such person or to cause a post-mortem examination to be performed on any corpse found in such premises or vessel. Mr Deputy Speaker, Sir, this power is absolutely neces sary since we know that it is quite a fashion among some youths in this country to grow long hair that may harbour the flea that may carry the plague. Where it is expedient for inspection of premises to be made after the prescribed hours, at least 24 hours' prior notice shall be given to the occupiers thereof. Clause 6 prohibits any person from taking, doing or performing any act or thing which may or is liable to create conditions favourable to the propagation and harbouring of disease-bearing insects. Every person shall comply with all such reasonable directions as may he given by the Commissioner, or Medical Officer of Health or a Public Health Auxiliary.”
“The main features of the Bill are: (a) It retains the basic provisions in the old Ordinance that are required for the control of malaria - transmitting mosquitoes. (b) It streamlines the administrative lines consequent on the integration of the local authorities; defines the functions and powers to be exercised at different levels - the Minister, the Director of Medical Services, the Commissioner of Public Health and/or the Medical Officer of Health and the Public Health Auxiliary. (c) It broadens the powers to take action to cover all disease-bearing insects and vests new powers for summary action, medical examination of infected persons, blood examination and insecticide spraying. (d) It provides powers to obtain information necessary for epidemiological investigations and control measures. (e) Ships and aircraft are for the first time brought within the scope of this Bill, as they are now regarded as a potential source of introduction of new vectors of diseases from some other territories. Distinction is made between the overall policy direction and the routine implementation and execution of the various provisions in the Bill. Clause 3 provides that the Director of Medical Services shall have general superintendence of all matters relating to this Bill, subject to the general or special directions of the Minister. The task of administering the Bill will be largely in the hands of the Commissioner of Public Health and/or Medical Officers of Health (as defined), who are to be assisted by Public Health Auxiliaries. The Commissioner of Public Health and such number of Deputy Commissioners and Assistant Commissioners of Public Health shall under clause 4 be appointed by the President.”
“The evolution of Singapore as the fourth largest port in the world and the increasing air traffic at our Paya Lebar International Airport require adequate provision to deal with the disease-bearing insects likely to be brought into the country from ships and ocean-going vessels and from aircraft. Singapore is a "yellow fever receptive area", which means that conditions exist under which this disease can be introduced into the country. Effective powers to deal with aircraft and to carry out disinsectisation when indicated are therefore necessary. [Mr Deputy Speaker in the Chair] 6.40 p.m. In the light of the seriousness of the mosquito and other insect vector problems, as well as the recognition of the fact that much of this is man-made, new powers and methods to cope with the situation are needed. These insects cannot be allowed to proliferate unchecked as they will constitute a serious danger to public health. Effective legislation, based on modern scientific methods of eliminating and controlling these insect vectors, need to be enacted to cope with this growing problem. In framing this new piece of legislation, the opportunity has been taken to enhance the preventive and control measures and its enforcement by providing for more effective action and deterrent penalties. Powers for summary action and for composition of the lesser offences have been included in this Bill. The emphasis is on preventing the creation of harmful conditions rather than allowing the conditions to occur and then taking remedial action. The Bill also aims to recognise the changes in the administrative structure since the integration of local authorities by adopting the styles of titles and form consistent with the present and proposed administrative organisation of public health services.”
“The common house-fly is a carrier of food and water-borne diseases of the gastro-intestinal tract, namely, cholera, typhoid, food poisoning, enteritis in children and poliomyelitis The flea is a parasite which lives on the rat and is responsible for rodent plague, a disease which has shown recrudescence in some countries in Southeast Asia. Complaints of mosquito nuisances have remained consistently high over the last ten years. Factors such as the efficiency of the Health Ministry's work force and the quality of the supervision and discipline are important but not enough to effect a reduction or elimination of these nuisances. Effective action against all the creators of these nuisances is not possible under the existing Destruction of Mosquitoes Ordinance or the Local Government Integration Ordinance because of its limited provisions aimed essentially, despite its title, at malarial control. The rapid urbanisation and other physical development in Singapore in the form of vast building schemes and land reclamation have led to the indiscriminate dumping and storage of building materials and the blocking of natural drainage. As a result of these activities, ideal conditions are created under which disease-bearing insects can harbour and propagate, unless the necessary precautions are taken by those responsible for these activities. The high incidence of haemorrhagic fever with 815 cases, including 21 deaths, in 1967 reflects a serious health hazard which makes it vital that there be effective urban control of mosquitoes which can no longer be regarded merely as nuisances.”
“Mr Speaker, Sir, I beg to move, "That the Bill be now read a Second time." In the Addendum to the President's Speech at the opening of Parliament, it was stated that public health legislation is being consolidated into a comprehensive Environmental Health Code, capable of maintaining the highest standards of public health required in a modern complex urban society. This Bill before the House is the first of such codified new laws which will be introduced to bring about effective control over public health. In this case, it covers disease-bearing insect vectors, principally mosquitoes and flies. This Bill replaces the 50-year old Destruction of Mosquitoes Ordinance (Cap. 139) which was mainly for the control of malaria by measures specifically aimed against malarial mosquitoes. The control and destruction of what are commonly known as "nuisance" mosquitoes has become a major problem in recent years. The laws, however, have been inadequate to cope with the health problems created by these "nuisance" mosquitoes, such as the Aedes and Culex mosquitoes which are now established to be capable of transmitting diseases. Similarly, the laws are also found to be inadequate to deal with health problems created by disease-bearing insect vectors, like flies, fleas, etc. The Aedes aegypti mosquito, which breeds in artificial water-bearing receptacles, is the vector responsible for the transmission of haemorrhagic fever, dengue fever and yellow fever. There is also the danger of bancroftian filariasis which is transmitted by Culex fatigans, a mosquito which breeds in polluted stagnant water in blocked drains.”
“Mr Speaker, Sir, the Ministry of Health is aware of the damage referred to by the Member for Mountbatten. The cost of repairs was estimated to be $9,800 and this was submitted to the Development Planning Sub-Committee in February 1968. This Ministry has been informed that this work will be done by the Public Works Department and will be completed in about two or three weeks' time.”
“I am only going to give the figures for six areas. They are: Constituency Non-citizen Citizen hawkers not hawkers registered registered Geylang West 54 as against 540 Anson 75 as against 493 Tanjong Pagar 15 as against 342 Telok Ayer 41 as against 772 Part of Geylang Serai/Joo Chiat 8 as against 419 Hong Lim 22 as against 908 --- ----- Total 215 3,474 === ===== Further, there are at the moment an estimated 20,000 hawkers still unlicensed in the Republic, and it is not possible at the moment to determine what proportions of these are non-citizens. Owing to the serious situation in regard to employment, the policy of this Ministry is to register and license our own citizens who want to take up hawking as a means of livelihood and to accommodate them in the limited sites which are available. In view of the above, it is not possible to relax this policy of allowing only our own citizens to hawk legitimately in the Republic. SINGAPORE STOCK EXCHANGE (Legislation to set up independent commission to supervise operation) 9. Mr Hwang Soo Jin asked the Minister for Finance if he will consider introducing legislation to set up an independent commission to supervise the operation of the Singapore Stock Exchange.”
“Mr Speaker, Sir, the Hawkers Re-organisation Programme began in February 1966 with the objective of registration of all hawkers in streets by constituencies, it was then that the policy of not registering non-citizen hawkers was strictly applied. The following are the numbers of "non-citizen hawkers" who had been given notices to cease hawking, as well as the numbers of "citizen hawkers" registered by constituencies ---”
“Mr Low Guan Onn asked the Minister for Health if he will consider a relaxation of the policy not to issue hawkers' licences to non-citizens, in the case of those non-citizens who have resided in the Republic for more than ten years, in the light of (i) the decision of the Government not to grant citizenship freely, and (ii) the large number of non-citizen workers, who will become unemployed with the run-down of the British military bases and who may wish to take to hawking as a means of livelihood.”
“Mr Speaker, Sir, the need for the sanitary disposal of both domestic refuse and trade waste from the Jurong New Town and the Jurong Industrial Estate has been envisaged in the health planning requirements of the Ministry of Health. It is realised that the long haulage for disposal at the Tampines Dumping Ground for refuse collected in the Jurong Industrial Estate has caused inconvenience and extra expense to the Jurong factory owners. The problem of distance has been aggravated by the closure of the former dumping ground at Clementi Road in 1966 by an important Government development near this Clementi Road site. Planning approval has already been obtained from the Planning Department for the development of a refuse dumping ground, conveniently located for the Jurong Industrial Estate, off 16 ms. Chua Chu Kang Road. Necessary steps for revoking the temporary occupation licences of this site and for the re-settlement of persons affected are being taken by the Commissioner of Lands. Development of supporting facilities at the dumping ground is being processed. Among these is the provision of a bulldozer, for which approval for the purchase has only just been approved by the Ministry of Finance. Complementary facilities like a site office and stores are also required. The provision of a vehicle weighbridge for the purpose of work control will be included in the development of this site. It is expected that before the end of the year this new dumping ground will be in operation. HAWKERS' LICENCES FOR NON-CITIZENS (Relaxation of policy) 8.”
“But it is to be appreciated that while the Government can provide refuse bins and litter bins, the provision of such facilities alone would not prevent littering if the public were not to make use of them, in order that Singapore can be the cleanest city in South-east Asia, such indiscriminate throwing of litter should he actively discouraged, and more effective use would have to be made of the litter bins that have been provided by the Public Health Division. DUMPING GROUND FOR BULK REFUSE FOR JURONG INDUSTRIAL ESTATE 7. Mr Low Guan Onn asked the Minister for Health if a dumping ground for bulk refuse can be provided near to the Jurong Industrial Estate, as great expense is at present being caused to Jurong factory owners on haulage of bulk refuse to the nearest dumping ground at Tampines which is about 25 miles from Jurong Town, and as more and more industries are being established in the Estate.”
“Sir, the indiscriminate throwing of refuse and littering are usually the result of a lack of civic pride or a sense of civic consciousness. However, it has been realised that an insufficiency of suitable refuse bins or containers may be a contributory factor to such indiscriminate littering. Accordingly, in 1967 the Public Health Division took steps to design and to provide a large number of proper litter bins so as to reduce the tendency among the public to throw refuse about indiscriminately. Due to the large numbers of such litter bins that must be bought and fixed, the provision of such litter bins is being done in phases. It was decided to give priority to the fixing of litter bins at bus stops. The fixing of such litter bins to all the bus stops in the city area has been completed, and similarly all bus stops in the main thoroughfares in the rural areas have also been provided with such litter bins. At the moment, the next phase of the operation is under way, in which litter bins are being fixed at road junctions and along busy streets especially in the shopping areas and near and around cinemas and picture halls. To date, a total of 1,660 litter bins have been installed in such places. Being aware that a lot of littering is taking place in areas where hawkers congregate, hawkers are now required to provide refuse bins; collection bins for such refuse exist at all authorised hawker congregations. In the city area, 63 congested hawker sites have been so provided and 300 refuse bins are now in use. This year, the Public Health Division has placed orders for another 2,000 litter bins which will be fixed at closer intervals along all busy streets and shopping areas.”
“With these revised public health regulations, there should be very little need for drain flushing, and there should be a new consciousness among the public cleansing workers and the members of the public alike to make and keep Singapore the cleanest city in Southeast Asia. DUST-BINS IN PUBLIC PLACES (Increased provision) 6. Mr Ho Kah Leong asked the Minister for Health whether he will consider increasing the number of dust-bins provided in public places and placing them at closer intervals as a means to reduce indiscriminate throwing of litter.”
“It is estimated that only about 10 per cent of all drains in built-up areas in Singapore are being flushed as proper cleansing work cannot be done because of obstructions or hindrances on or over these drains, using about 350,000 gallons of water per day. If all drains, including outlet drains, in Singapore were to he flushed, as suggested by the hon. Member for Joo Chiat, this would require at least 3.5 million gallons of water every day going down the drain. This would cost the Government $3,500 in water bills per day; an expenditure which is not only unnecessary, but completely unjustifiable as the precious water in our island republic should never be allowed to be wasted in this way. The flushing of drains, accordingly, is not the answer. The solution, therefore, is not to allow drains to be choked with ref use, thrown indiscriminately and thoughtlessly by hawkers, shopkeepers and householders alike. Refuse should he placed in properly covered dust-bins for removal by public cleansing workmen. Drains should not be slabbed and covered over so that there will be no obstructions or hindrances to public cleansing workers cleaning and removing refuse from drains. Under the new Conservancy Regulations which came into force on 1st July, 1968 - I hope hon. Members are quite familiar with the provisions - every householder, hawker and stall-holder will be required to have a dustbin or be provided with a dustbin by the Cleansing Department, and the cost recovered from them through the P.U.B. Consolidated Accounts. Heavy fines of up to $150 for the first offence, $500 for the second offence, and $1,000 for the third and subsequent offences will be imposed on anyone depositing refuse on to the roadsides, backlanes, vacant grounds, or into drains.”
“Mr Speaker, Sir, where there are regular obstructions to the flow of water in drains due to refuse being thoughtlessly thrown into them causing stagnation of water, smell, and the breeding of flies and mosquitoes, especially where such drains are small and narrow, structurally defective, or are covered by slabs or hawkers' paraphernalia, thus actually hindering and physically preventing the proper cleansing of and the removal of refuse from such drains, then, as a public health measure, the flushing of such drains is carried out. The flushing of a drain so as to remove obstruction caused by refuse and to provide some measure of flow of water through it, is, therefore, only a temporary palliative measure which is resorted to only when there is no access or there are obstructions over the drain preventing physical entry into the drain for cleansing work. Accordingly, the small drains around congested hawker areas in Joo Chiat and Katong are flushed every day, while in some less congested shop-houses and residential areas, flushing of the drains once or twice a week is carried out. Storm water drains receiving no sullage water do not require any flushing, while in big outlet drains, flushing is not effective, as the small jets of water from the flushing hoses cannot move the refuse in big drains, let alone dislodge obstructions in them. This is because the combined inertia of the great volume of water and the big mass of refuse in such big outlet drains rapidly dissipates the energy of the small water jets of the flushing hoses.”
“Mr Speaker, Sir, I do not propose to reply to the comments made since all hon. Members who have spoken on this Bill have supported it. Not only have hon. Members supported it but some of them have, in a very picturesque manner, given vivid examples of the malpractices that are going on in respect of medical advertisements. Question put, and agreed to. Bill accordingly read a Second time. Resolved, "That the Bill be committed to a Select Committee consisting of Mr Speaker as Chairman and seven Members to be nominated by the Committee of Selection." - [Mr Chua Sian Chin]. ADJOURNMENT Resolved, "That Parliament do now adjourn to a date to be fixed." -[Inche Othman Bin Wok]. Adjourned accordingly at Three minutes to Seven o'clock p.m. to a date to be fixed.”
“This Schedule reviews the list of the various diseases and conditions mentioned in section 4 of the Ordinance. The list is now extended to include insanity, menstrual disorders, sexual function, infertility, impotency and frigidity. The study by the Committee under Dr Gwee Ah Leng has indicated that the diseases and conditions mentioned in the Schedule constitute the happy hunting-ground of those unscrupulous advertisers who seek to get rich quickly by preying on the anxiety and desperation of the unfortunate victims of these diseases and conditions. As there are a number of parties likely to be interested in the proposals contained in the Bill, such as doctors, physicians, pharmacists, dentists, importers of drugs and advertising agencies, it has been decided that the Bill should be referred to a Select Committee if the Second Reading is approved, so that wider 'consideration might be given to the suggested amendments. Finally, as my predecessor in the Ministry of Health has stressed, may I say that we owe a duty to the people of Singapore to protect them from the unscrupulous exploitation of the quacks and others of the kind who make money out of the sufferings and despair of those who are not in a position to judge wisely. These amendments will translate a universally accepted principle in the medical code of ethics into a provision of the law of the land. I am confident that hon. Members of this House will give their support for the enactment of this proposed legislation. Mr Speaker, Sir, I beg to move. Question proposed. 6.37 p.m.”
“The Chinese Physicians' Association have also officially declared its stand in public against advertisements by medical practitioners of the Chinese school. However, in their case, they are handicapped by lack of a disciplinary board, The amendment in this new section will, therefore, reinforce the hand of medical practitioners of the Chinese school who will now be able to see their stand reinforced by law. This prohibition will financially affect a number of publications in the Chinese medium, but public interest must supersede private interest, however much we may regret the loss of income to these establishments. Clause 4 amends section 5 of the Ordinance so that the prohibition of advertisements on articles relating to abortion is extended to prohibit advertisements referring to medical skill or service relating to abortion. Clause 5, which amends section 6 of the Ordinance, is consequential on the preceding sections. It tidies up the references made to various prohibitions so that these are correctly referred to. As part of the tidying-up process, a new subsection is added to provide for reference to the new prohibition of advertisments referring to medical skill or service within this section which sets Out provisions as to offences under the preceding sections. Clause 6 amends section 7 of the Ordinance so as to clarify that where the required disclosure of composition of a medicine is written in a language other than the English language, such disclosure must be made in the English language as well as in any other language that may be used in addition to the English language. Clause 7 creates a Schedule of diseases and conditions in respect of which advertisements are to be controlled.”
“Subsequently, in 1966, the Committee was resuscitated under the same Chairman, Dr Gwee Ah Leng, with the following terms of reference: 'To study the current unethical, dishonest and undesirable advertisements pertaining to treatment, cures, and to the medical, skills of unqualified persons and to suggest measures of effective control.' The unanimous conclusions of this Committee extended the recommendations of the previous Committee by reviewing and adding to the list of diseases prohibited for general advertising and by recommending a general ban on all advertisements pertaining' to medical skills. The Committee also made certain recommendations for the effective control of labelling and importation of drugs which are being separately dealt with by the Controller of Imports and Exports as they relate to his control measures. Copies of the Committee's report have been distributed to Members of this House through the Clerk of Parliament. I would now like to elaborate on the Bill, clause by clause. Clause 1 sets out the short title and commencement. Clause 2 amends section 4 of the Ordinance by substituting a Schedule in place of the list of conditions and diseases mentioned in respect of which advertisements are prohibited. The Schedule may be amended by notification in the Gazette. This arrangement is obviously less cumbersome than having to amend the Ordinance whenever circumstances make it necessary to amend the list. Clause 3 creates a new section aimed at prohibiting advertisements relating to medical skill or service. Medical practitioners of the Western school are forbidden to advertise by their ethics and this is controlled by a disciplinary body of the profession itself, namely, the Singapore Medical Council.”
“Mr Speaker, Sir, I beg to move, "That the Bill be now read a Second time." This Bill was introduced in the last Parliament but has since lapsed in view of the dissolution of Parliament on 8th February, 1968. The Bill makes a number of significant amendments to the Medicines (Advertisement and Sale) Ordinance, 1955. For the past few years, the Ministry of Health has been receiving numerous complaints regarding undesirable advertisements appearing in local newspapers concerning medicines or unqualified persons claiming cures for a wide range of conditions, from sexual weakness, chronic sterility, menstrual disorders to kidney diseases, etc. In general, these advertisements are deceitful, misleading and are calculated to dupe the uninformed and gullible members of the public, so that they can part with their money to purchase these so-called "miraculous cures" for all their ills. Existing Ordinances for the control of such advertisements, namely, the Medicines (Advertisement and Sale) Ordinance, 1955, and the Indecent Advertisement Ordinance (Cap. 142), are inadequate and prosecutions under these Ordinances have proved difficult and unsuccessful, particularly as advertisers have got round the restrictions by using homonyms and synonyms, or by claiming to advertise medical skills instead of medicines. My Ministry has given very careful consideration to this problem before this present stage of proposing an Amendment Bill to this House. As far back as 1962, a Committee was formed to examine the problem and suggest measures of control with the following terms of reference:- 'To study the current undesirable and unethical "cures" and "advertisement of cures", and to suggest measures of control.' This Committee made certain recommendations for control.”
“He should first study the provisions of the Bill before he attempts to abort the Bill! [Interruption.]”
“Mr Speaker, Sir, the Bill will be placed before Parliament soon and I urge hon. Members to study the provisions first before they decide to support or oppose the Bill and to be guided more by their reason than by their emotions and prejudices when making up their minds. Mr Speaker, Sir, may I suggest to the Member for Punggol that he should first study the provisions of the Bill before he begins -”
“Lastly, may I turn to the Member for Punggol who touched cursorily on the proposed Abortion Bill. The interesting point about it is that the Member had categorically stated that he opposed the Bill even before he had the opportunity to look at its provisions!”
“If members of the public did not see these malpractices, I am quite sure that the complaints would not have come in.”
“The Member for Geylang Serai in his speech referred to some malpractices by some members of the Anti-Mosquito Unit of my Ministry who, instead of doing their rounds of oiling of drains, etc, in his constituency, sell the oil for profit. This is indeed a very serious malpractice. But I must say with regret that the hon. Member had not thought fit to come and see me about it with the necessary information so that the culprits concerned can be dealt with as they deserve. The hon. Member, being a trade unionist, should know that before any Government employee is sacked, there is such a thing called a disciplinary enquiry conducted under the Disciplinary Enquiry Code in which evidence must be brought forward. Unless hon. Members and members of the public who witness such malpractices come forward to provide the evidence, we can never bring the culprits to book.”
“My Ministry is doing its best to tackle the hawker problem in Singapore, which hon. Members know very well has been defying solution. May I now turn to the Member for Geylang Serai?”
“Well, I hope the hon. Member for Katong will agree with me that he did say that it is all very well to urge school children to brush their teeth, but what about those poor children who do not possess a toothbrush? My answer to this is quite simple. Surely the parent of every school-going child can afford to buy a toothbrush in the same way as he can afford to buy a pair of shoes, which is more expensive. I understand that toothbrushes, if bought in bulk, might be obtained for only 10 cents each, which hon. Members know is the price of only a glass of ice-water. Of course, whatever preventive measures are undertaken, there will remain a large proportion of the population who missed being exposed to dental health propaganda. For these people, a dental care service will be provided. The dental care services will be expanded as rapidly as resources are available. Priority will, of course, be given to the further establishment of more dental clinics for school children. May I now turn to deal with some of the points raised by hon. Members in the course of this debate. May I refer to what the Member for Ulu Pandan said in his usual picturesque manner and with some vehemence? He did say some unkind things of the actions so far taken by the Hawkers Department of my Ministry. He also suggested that the Health Ministry should construct more markets and hawkers stalls before they begin to resite hawkers. The Hawkers Department of my Ministry has always done its best to provide alternative sites for hawkers when clearing them, if such sites are available. But as hon. Members very well know, in Singapore today, such vacant plots of land suitable for hawker resiting in the crowded areas of Singapore are quite difficult to come by.”
“The other priority problem is the problem of dental health in Singapore. The poor dental health of our population was brought into focus when the new recruits of our national servicemen underwent dental examination. These young adults between the ages of 18 and 21 years did not enjoy the benefits of fluoridation of our water supplies which started in 1958. They had received little or no dental attention from the school dental service while they were in the primary schools, and no dental treatment other than extraction of decayed or aching teeth during their adolescent years in secondary schools. Most of them do not visit their dentists regularly mainly because of their ignorance of dental hygiene. Mr Speaker, Sir, it is important that our young population maintain good dental health because lack of good sound teeth can greatly handicap the building of a robust constitution. Here again, to tackle the problem, my Ministry places more emphasis on preventive measures, not only because they are financially less costly, but because they are based on the sound principle that "Prevention is better than cure". The first thing that we shall do will be to launch a Dental Health Education Programme. This will be directed particularly at the school children. A more specific and active action plan must be devised. For example, there should be compulsory brushing of teeth by school children as part of the school curriculum after their physical training classes. This brings me to mind a remark made by the hon. Member for Katong who quite cynically said that it is all very well to urge school children to brush their teeth -”
“All these efforts, however, can come to naught if certain sections of the public continue with the old bad habits of indiscriminate throwing of litter and rubbish and allowing their little children to use our public drains as a place for the evacuation of their bowels while others continue to breed mosquitoes in discarded empty receptacles in the compounds of their houses. Therefore, along with the reorganisation of our public health services to lick it into shape, it is necessary at the same time to launch a mass nation-wide campaign to appeal to the civic-mindedness of the people of Singapore to keep Singapore clean. This will involve the participation of thousands of voluntary workers who will be trained before they go out and exhort members of the public not to throw litter and so on. In this mass campaign, which will have to be worked out very carefully, I shall require not only the sympathetic but also the active co-operation of hon. Members. It is only after this mass health education campaign that the new laws will be enforced with vigour to deal firmly but fairly with the small percentage of incorrigible litter-bugs and persistent breeders of disease-bearing insects, like mosquitoes and flies. These new laws are now being very carefully drafted, loopholes are being plugged in order to make for effective enforcement against the wrongdoer. On the cleansing side which is the responsibility of my Ministry, a new roster system will be introduced to allow the cleansing, the collection and disposal of rubbish to be done all the year round irrespective of Sundays and public holidays. A sustained effort with this two-pronged attack on this extremely difficult problem should see us through to a cleaner and healthier Singapore.”
“This has imposed a strain on their services and they are running short of supplies and they had indicated that they might either turn back travellers arriving without vaccination certificates or quarantine them on arrival. For this reason a third centre was opened at Kranji Maternal and Child Health Centre (l3½ m.s. Woodlands just south of the Causeway). The number of attendances at this centre is small, which probably indicates that the majority of travellers have already been vaccinated and possess certificates. It is not proposed, however, to set up a centre at the railway station. From experience in the last outbreak, railway travellers came just about time for boarding the train and expected to be vaccinated. Since everybody had the same idea, the rush created unruly scenes. Passengers travelling by train should, therefore, take their vaccination from the North Canal Road centre in good time before travel. Mr Speaker, Sir, may I now turn to elaborate on one or two aspects of the policy of my Ministry as outlined in the Addendum to the President's Speech. Needless to say, with this outbreak of cholera, the environmental aspect of health has become the more pressing problem. It is a very complex problem particularly because the people are involved. To tackle this problem successfully, an aggressive and concerted planned effort is necessary. The plan must involve the mass participation of the public. It is true that our cleansing services and Anti-Mosquito Unit need further re-organisation for better efficiency and discipline.”
“Fourthly, such a mass inoculation campaign will require the turning of all our outpatient dispensaries and maternal and child health centres into vaccination centres, and this will involve not only the posting of additional staff to these centres but also the curtailment of routine medical services in these centres during the course of the campaign, which will take at least one to two months. Lastly, there are complications following vaccination. The serious one is serum jaundice. Even at a very small rate of incidence in the mass, the total number who will succumb to this infection would be significant. However, the situation will be carefully watched. In any case, may I assure hon. Members that my Ministry is ready to launch such a mass inoculation campaign in the unlikely event of the situation meriting it. We have at the moment in stock nearly one million doses of anti-cholera vaccine and this can be easily increased by our manufacturing some more if we so require. Therefore, vaccination to date has been offered only because it is required for travellers outside of Singapore. For this purpose, the vaccination centre at North Canal Road has been enlarged to deaf with the additional persons attending at the centre. The Airport Centre deals with passengers leaving Singapore who might have missed getting vaccination certificates before take-off. Following the third case the Director of Medical Services, Malaysia, indicated that more stringent measures might be taken for travellers across the Causeway. The Malaysian health authorities vaccinate every person coming from Singapore unless they have valid vaccination certificates.”
“But what about the unknown number who have managed to slip in undetected? We can therefore expect quite a number of carriers of the cholera bacteria to have come into Singapore. The relevant authorities in my Ministry have been keeping a strict check on the international health certificates of every traveller that comes into Singapore. But whom we have no control over are the illegal immigrants that have been slipping into Singapore. However, I assure hon. Members that strict vigilance will be maintained. In the long term, eradication of the disease can only be achieved if the people are scrupulously clean in their habits and the standard of sanitation is improved. I am sure a question which is uppermost in the minds of hon. Members is the question of mass inoculation of the whole population of Singapore as a measure of control, and whether my Ministry will be launching such a mass campaign. My officials and I have considered this very carefully and we have decided that the situation at the moment does not warrant such a measure. The reasons for our decision are as follows:- Firstly, although inoculation is one of the measures of control, it is of minor importance in endemic outbreaks. The present outbreak is a small one and represents an endemic situation rather than a build-up towards an epidemic. Secondly, the vaccination confers at best immunity of short duration. Thirdly, the cost for the inoculation of our two million population will be high.”
“The sporadic occurrence without a detectable pattern indicates the transmission by carriers. While it is fortunate that the outbreaks will not be of epidemic proportions the presence of carriers (none detected in the present outbreak) means that small outbreaks of the disease will occur sporadically indicating the endemic state. Eradication in the circumstances is extremely difficult. May I also stress the important fact that Singapore is an open international port. Every day thousands of people come in and out of Singapore not only from the surrounding areas but also from every nook and corner of the world. I am told that another great port, the port of Rotterdam, has its occasional outbreaks of cholera. Furthermore, Singapore, as hon. Members know, is an extremely attractive and desirable place for people of the surrounding economically depressed areas to come to and, if possible, to settle down in. Our immigration authorities have been hard put to it to deal with the ever-increasing number of illegal immigrants into Singapore. I am told that in recent months some 300 illegal immigrants had to be deported back to the place where they came from.”
“Of course, for these measures to be effective we need the maximum co-operation of the members of the public who live in each such area. In this respect hon. Members in whose constituencies these areas happen to be can do a lot to set the lead. The residents in these areas need to be advised that there is no cause for alarm so long as they scrupulously observe the simple rules of hygiene of washing their hands before they handle any eatables, boiling water before they drink it, washing any cut fruit which had been left exposed before eating it and so on. Mr Speaker, Sir, let me now give hon. Members some facts concerning the outbreak. The four cases of cholera have occurred in four different places. They are as follows: The first case occurred on 17-4-68 to a 66-year old odd job wood-worker living at Lorong 3, Geylang. The second case on 4-5-68 to a 39-year old store-keeper with the Port of Singapore Authority living at Jalan Minggu (Thomson Road Estate). The third case on 6-5-68 to a 9-year old school boy living at Peng Ghee Road, Kampong Chai Chee. The fourth case on 7-5-68 to a 68-year old car washer living at Verdun Road. All patients have recovered. The pattern of the outbreak has similarities with the previous outbreak of 1963 - 1964. There was initially a latent period between the first case before the others occurred. All were isolated cases: no link was discovered between any one of the cases. The bacterial strain of the present outbreak is El Tor Inaba. A common feature is the attack on the old and insanitary living conditions of the patients. But the small number of cases and the lack of a link between cases rule out water-borne infection. Indeed, it is unlikely that the disease will develop into any proportions because of our extensive safe water supply.”
“Mr Speaker, Sir, before I deal with one or two aspects of the policy of my Ministry as outlined in the Addendum to the President's Speech and elaborate on them and perhaps reply to some points raised by some hon. Members in this debate, I wish to speak on the present cholera situation in Singapore. I am sure hon. Members of this House will be keen to hear me on this. After four cholera-free years, a single case of cholera was discovered on the 17th of April, 1968, in a 66-year old male Chinese who lives at Lorong 3, Geylang. Hon. Members will remember that the 17th of April, 1968, is only a day after I assumed office as Minister for Health. To the superstitious minded, this may be an omen or an augury perhaps ill or good, depending on the stars, of the things to come during my term of office as Minister for Health. Perhaps the hon. Member for Anson, who is an expert in these matters, can tell us what the stars foretell. Mr Speaker, Sir, for myself and my Ministry, we look at this in the light of cold logic as a challenge that lies ahead of us to wrestle out a successful solution not only of making Singapore clean but also to maintain it as such. Dirt, flies and mosquitoes are all too evident and we do not need hon. Members or members of the public to remind us of this. Mr Speaker, Sir, although to date there are four cases of cholera, I wish to assure hon. Members that there is no cause for alarm. The position is under control. My officials tell me that after studying the pattern of the outbreak, an epidemic spread of the disease is most unlikely. However, to ensure that this does not occur at all, stringent measures have already been taken in and around the places where the four cases have occurred.”