Edwin Tong Chun Fai
Singapore
“These questions have been answered in the reply to Questions Nos 26 to 31 for Oral Answer on today's Order Paper. [Please refer to "Addressing Issues Identified in Legal Profession Sustainability Study", Official Report, 7 July 2026, Vol 96, Issue 32, Written Answers to Questions for Oral Answer not Answered by End of Question Time secti…”
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“We have also developed and published fee benchmarks, as Mr Leon Perera himself noted, for private sector professional fees for common surgical procedures. Finally, the Agency for Care Effectiveness (ACE) also publishes guidances on clinically and cost-effective patient care. Mr Leon Perera no doubt has cited a number of different studies. At various juncture, he mentioned studies from various places, data published from various sources, some experts speaking at a conference, delivering a paper and some results from programmes and studies somewhere. I am not prepared at this stage to agree to the conclusion of these studies because they need to be contextualised. We need to look at the details. We need to look at who studied it and what the assumptions might be. If Mr Leon Perera would be happy to share these studies and the other details that he had mentioned in his speech with us, we can do a more careful study and look at the options open in terms of adopting some of these measures in Singapore. But where we are on common ground between Mr Leon Perera and the Bill, is the need to ensure that we promote price transparency. As Mr Leon Perera mentioned at the outset, indeed, that is specifically provided for in the Regulations.”
“But, of course, that will have to be revisited if they either sell the business or change the ownership in a material way. Next, let me turn to healthcare costs which several Members, including Dr Chia Shi-Lu, Mr Leon Perera, Er Dr Lee Bee Wah and Mr Christopher de Souza, have raised. Concerns regarding the impact of the Bill on healthcare costs and, of course, passing on of these costs to the patients were raised, and I think those were valid concerns. Let me address them. Let me start by saying that no single measure can really tackle the issue of healthcare affordability and I have taken on board Mr Leon Perera's various suggestions. I will address them in a moment. For now, let me just very quickly outline the various initiatives that have been done to keep healthcare costs low and sustainable for all Singaporeans. As I had mentioned, we adopt a multi-tiered approach – multi-tiered, multi-pronged, and I would say also multifaceted approach – to controlling costs, with the basic assurance that no Singaporean would be denied access to basic healthcare due to financial difficulties. That is the assurance that would be given. The multi-tiered approach that we take will include enhancing the 3Ms – which we have done at various stages and which we will continue to do – MediSave, MediShield Life and MediFund; and also extending significant subsidies, including the CHAS scheme. Looking ahead, we are also enhancing the role of insurance in long-term care, such as with the launch of CareShield Life from mid-2020. We have also put in place other measures to curb the increase in healthcare costs. These include requirements under Integrated Shield Plan insurers for new rider plans.”
“Second, clause 31 plays a part by limiting advertising of licensable healthcare services to licensees only and, as I mentioned at the start, to persons acting on the authority of a licensee. Third, clause 37 allows MOH to publish information to ensure patient welfare, or for public interest, and this includes publishing a list of unlicensed providers. That said, ultimately, public education will play an important role to prevent or reduce and, as far as possible, remove all of such misimpressions. MOH has and will be enhancing efforts, as we implement the Bill, for public education. When in doubt, I would advise patients to check on the registers maintained by the professional boards, such as SMC. Mr Melvin Yong raised a query on the regulation of mental health professionals. Professional associations, such as the Singapore Psychological Society and the Singapore Association for Counselling, provide advice on trained professionals in their respective fields. So, the scenario that Mr Melvin Yong is trying to avoid, where there is doubt as to whether someone is a counsellor or not, whether he is a psychologist or not, the associations can provide further avenues for assistance. Ms Joan Pereira and Prof Fatimah Lateef have given useful comments on other Bill requirements, such as naming restrictions and point-of-care tests. We will consider these in implementing the Bill. And I would add to Ms Joan Pereira's point that should an entity today already be using one of these otherwise prohibited names, if the licensee does not change, the ownership does not change, and it is simply carried over into the new Bill, we will be prepared to allow them to continue using the name.”
“As I explained at the opening speech, the prohibition on the co-location is to prevent parties from being misled into consuming the unlicensed services under the impression that it is part and parcel or adjunct to the licensed services. This is no different from the current position under the present PHMCA. However, where the services are complementary to each other between the licensed and the unlicensed services, some examples I mentioned earlier, this concern is mitigated. And in these circumstances, we will be prepared to make an exception for certain healthcare professionals to co-locate with licensees. So, for example, a physiotherapist can co-locate with an orthopaedic clinic, so that more holistic services can be provided, such as in that case. In other circumstances, we will review on a case-by-case basis. The Bill also contains other measures which will assist patients in making informed decisions when selecting healthcare services. So, Ms Irene Quay cited the register of licensees in clause 22 of the Bill. This register will be accessible by the public, making it easy to check, for them to determine if a provider is, in fact, licensed by MOH or not. Er Dr Lee Bee Wah and Mr Melvin Yong asked how we can prevent patients from being misled by unqualified providers into thinking that they are qualified when they are not and then go and seek their services. First of all, the licensee is responsible for ensuring that their personnel, all their personnel, are appropriately qualified and competent. If a licensee permits unqualified personnel to provide healthcare services, MOH could investigate and take the appropriate regulatory actions.”
“Let me, however, take some time to just assure Members and address some of these concerns, nonetheless. First, clause 27 of the Bill requires licensees to implement measures to protect their medical records and ensure that the records are accurate and remain up to date. As MOH encourages more licensees to digitalise their medical records, we will also be working closely with the licensees to study further ways to safeguard the collection, storage, access, use and, of course, sharing of health information. This will no doubt include developing cybersecurity guidelines specific and customised to the various healthcare services and exploring efforts to better support smaller healthcare providers as they take steps to improve their cyber and data security positions. We will be engaging the licensees on this effort and will be releasing more details on this in the first half of 2020. As for NEHR, Dr Chia Shi-Lu asked if this would represent a mortal blow to NEHR. It does not. But, nonetheless, MOH will want to ensure that all necessary safeguards are in place to handle the evolving cybersecurity threats and also ensure that where various cybersecurity reviews for NEHR have been commissioned, the appropriate enhancements would be made to the system. As such, as has been announced previously, the mandatory contribution to NEHR has been deferred until all the enhancements have been completed, and we are satisfied that the system is assessed to be sufficiently robust. MOH will make further announcements on this at the appropriate juncture. Next, let me turn to queries raised by Prof Fatimah Lateef and Ms Irene Quay on the co-location between licensed and unlicensed services.”
“This, in turn, translates into undermining the safety of patients and adversely affecting their welfare. Members would know that under the existing PHMCA, MOH can only take regulatory actions, such as revoking or suspending the licence, which was not feasible, given that this would interrupt continuity of care for the resident patients. Under the Bill, step-in powers will now enable MOH to intervene in the operations instead to address the problems and improve continuity of care for patients. MOH will also "step-out" once the service is stabilised and patient safety is assured. On Mr Melvin Yong and Ms Irene Quay's queries regarding the restriction on employment of certain individuals in long-stay settings, the mandated background checks are to be conducted by licensees on all prospective staff, and existing employees will not be affected. The objective of the check is to prevent individuals who have committed egregious crimes – it might be causing hurt, grievous hurt, or more serious crimes like rape – from being employed and potentially harming vulnerable patients in these settings. For foreigners – and I think some Members asked about the efficacy of this regime for foreigners – the background check really would have to be on a best-efforts basis, as and when information arises and can be determined. Dr Chia Shi-Lu, Mr Louis Ng and Mr Gan Thiam Poh have asked for an update on the measures, including cybersecurity measures, to assist licensees in protecting health information in their electronic medical records. And Ms Irene Quay also asked when MOH would be mandating contribution of patient health information to NEHR. I think one of the Members calls it the "elephant in the room" that is actually not in the Bill. And, indeed, it is not in the Bill.”
“Those are relevant matters that fall within the rubric of both clinical as well as ethical considerations that the CEC would be well-placed to review. Next, let me talk about the step-in mechanisms and employment restrictions which various Members have raised. As I have mentioned at the outset, the rationale for these powers is, ultimately, to protect patients and ensure that they receive not only appropriate but also continual care, notwithstanding the performance of the healthcare service provider. Prof Fatimah Lateef, Mr Christopher de Souza and Mr Louis Ng raised queries as to when the step-in powers could be triggered. They will be triggered when it is in the patients' interests to do so. Ultimately, of course, that is a multifaceted and dynamic assessment of the facts in each case. We would like to, however, assure the House that the step-in powers will be activated sparingly and as a measure of last resort for the specified licensees. Other alternative measures as may be appropriate in the circumstances – like penalties or warnings if the situation is not at a sufficiently grave stage, or the appointment of a new management team to rectify the issues – these are measures which could be considered, and within reason, before a step-in order is made. Licensees will be given an opportunity to make written representations before the step-in order is activated, unless it is an extreme case where an expedited or urgent step-in order is required. These powers can make a real difference in protecting patient safety and ensuring the continuity of care. For example, there may be cases of certain specified service providers with financial difficulties who may find it difficult to afford to continue its services and patient care.”
“I think I heard Ms Sylvia Lim mentioned also the case of Prof Lim that went before the Court of three Judges a few months ago. The QACs' function is in reviewing adverse clinical events and recommending initiatives to improve the quality and the standard of care. That is quite different, and it does not affect the other avenues available to a patient, either through SMC's disciplinary proceedings or, should the need arise, for civil compensation under the civil Courts. Those still exist and nothing in this Bill prejudices that or changes the options available to a patient. Therefore, the oversight of a case or oversight of professional misconduct or conduct of a medical practitioner still falls with the SMC, and the rubric and the regime that are there still exist. The QACs exist separately and, as I have explained, for a different purpose and outcome. The Clinical Ethics Committees (CECs) have a different role to play. They review ethically-challenging cases and ensure that ethical care and treatment are provided in the context of the facts of that case and the treatment, modality or options that have been considered. There will be a list of prescribed medical treatments that require CEC review, where the care management of patients is likely to be complex; where societal values could be either undermined or challenged; and where the values of the medical practitioners might be challenged as well. To give some examples to Members of what we have in mind, for instance, where there is a proposed surgical separation of conjoined twins, that will be something that the CEC should review. Or, for example, in the creation of a saviour sibling to save one sibling, that should also be considered by the CEC.”
“That is the reason really to ensure there is a PO and a CGO that deal with the technical and clinical aspects of the practice. And MOH plans to include such requirements in the Code of Practice, as I have said, under clause 38 of this Bill, which will guide licensees with a bit more specificity on the levels of skill and competencies required. But as I have said, at the same time, not being overly prescriptive so that it becomes something that you just have to tick all the boxes. That is not the intention. Mr Christopher de Souza and Prof Fatimah Lateef have asked for details on specified committees for quality assurance and clinical ethics. I believe Ms Sylvia Lim also raised questions on the quality assurance committees (QACs). Let me deal with those questions. QACs are already an existing requirement under the current PHMCA. They provide a protected environment, as Mr Christopher de Souza said, without prejudice, for healthcare professionals to be open about an adverse event to identify the problems, learn from it, and correct errors without fear of being sued based on the materials that are discussed there or the discussions or candid sharing at those occasions. Through the learning environment that the QACs foster, proper root-cause analysis can be conducted and professionals can come up with solutions that will prevent the recurrence of such errors. That, after all, is the intention. Over the years, QACs have served their functions well in reviewing adverse clinical events. Ms Sylvia Lim asked specifically on the functioning of the QACs – how they are performing, and whether, ultimately, they will provide proper oversight of the way in which procedures are handled or the way in which patients might then raise complaints.”
“Mr Murali Pillai would have seen clause 2(3) of the Bill which sets out the factors that will be considered in deciding whether a person is suitable to be appointed as a key appointment holder, PO or CGO. It provides what I would regard as the no-fly zones, the broader outliers. So, there is financial suitability, there is the question of whether there is a prior conviction, antecedents and so on. But at the same time, we also do not want to be overly prescriptive in the quality of the candidate that comes forward. So, to that extent, there is an interplay between the criteria that are set up here and what the Director of Medical Services might subjectively determine as to their suitability in each case. We also intend to provide clear guidance of instances where persons will be found to be unsuitable, so that licensees will be apprised of the applicable criteria. This can be done through regulations and, as Members know, clause 38 of the Bill also provides for a Code of Practice as regards the relevance of all licensees to these requirements. It can be published in the Code as well. Should a licensee appeal to the Minister against any decision to reject the appointment of his key appointment holders, the PO or CGO, the Minister will consider each case based on its own facts. I think Mr Murali Pilliai raised the point about the appeal and how the Minister will consider it. Clause 48(7) (b) of the Bill, which provides for appeals to the Minister, allows the Minister to vary, substitute the decision of the Director, as the case might be appropriate, upon the appeal. As for Mr Murali Pillai's point on ensuring that key appointment holders are competent in corporate governance and financial management, we agree.”
“At the same time, we recognise that the scale and complexity of licensees and the kind of services that they offer, the scale of their operations and their set-up will differ. The requirements will, therefore, be attenuated to take into account the nature of the licensee's business, so as not to unnecessarily increase regulatory burden on all of them in equal proportions. Let me first address the queries from Mr Melvin Yong and Mr Christopher de Souza, and I think, indeed, also from one or two other Members, about the officeholders stipulated under this Bill. The Bill requires all licensees to appoint a Principal Officer (PO), and certain licensees providing more complex and technical services must also appoint a Clinical Governance Officer (CGO). The PO is akin to the manager appointed by the licensee under the present PHMCA regime and is responsible to assist the licensee in ensuring compliance with the requirements of this Bill. The PO is required to have sufficient organisational authority and management skills to adjust operations and make decisions, while the CGO is intended to oversee the technical and clinical aspects of the service. MOH will be satisfied as long as the PO and CGO are able to discharge their duties appropriately and we will not require specific personnel, such as the CEO, to be the PO or CGO in each case. Similarly, for small GP clinics that likely do not provide any complex specialised services, one individual can fill the role of the licensee and the PO, and a separate CGO will also not be required in those cases. Mr Murali Pillai queried on whether there are objective criteria to determine the suitability of key appointment holders.”
“Further, training schemes have also been introduced and facilitated by MOH to upskill the existing manpower to meet the new requirements for paramedics and also emergency medical technicians. At present, more than 50% of private ambulance operators have come on board the VAS. MOH will continue to work with other operators to prepare their vehicles, as well as skilling up their manpower. As such, ambulance services will be licensed in the second phase, as I mentioned at the opening speech, of implementation, and ambulance operators under VAS will be seamlessly ported over as licensees under the HCS Bill. Dr Chia Shi-Lu and Ms Sylvia Lim asked questions about costs and fees of private ambulance operators. We understand and we share those concerns. MOH will be working with the VAS ambulance operators to develop and publish an appropriate range of fees charged, so that consumers can have more transparency and can better make up their minds and have informed choices of the providers to use. We intend to publish those fees before these ambulance operators are phased in under the second phase. And, in fact, we target to do so in the course of this year. Prof Fatimah Lateef, Mr Christopher de Souza and Mr Melvin Yong have asked how the Bill impacts existing PHMCA licensees and whether its requirements to enhance governance will place an unnecessary burden on licensees. Members will, of course, know that that is not the intention of this Bill. But at the same time, healthcare services, especially those that are newer, will need to be properly regulated. The rationale for introducing the enhanced governance requirements is to ensure that the licensees are well managed, so that they can effectively and safely serve their patients' needs.”
“We will do so, so that we can then introduce these regulations after they have been found to be workable and, most importantly, safe for the patients. Moving on to the private ambulance sector, Dr Chia Shi-Lu, Ms Sylvia Lim and Mr Melvin Yong raised questions about this. As Mr Melvin Yong mentioned, it is an area that was not previously regulated. As such, progressive efforts have been made to ensure that private ambulance operators will be able to ramp up and be regulated under this Bill. The point is, if overnight, everyone is subject to this Bill, you might then find, as I think one of the Members mentioned, some questions as to whether every ambulance operator will be able to deliver the same level of services. So, we take a more gradated and calibrated approach on this. Let me just elaborate on a couple of the measures. In 2017, we issued standards for emergency ambulance and medical transport services so that operators will have clarity on the regulatory requirements that they must meet. This process, where we expect to see ambulance operators come into scope in the second phase, in fact, started some years ago so as to socialise these requirements to them, to acclimatise them to the standards that they would have to meet. MOH recognises that private operators may require support to ramp up their capabilities and to meet these standards. Hence, a year later, in 2018, the Voluntary Accreditation Scheme (VAS), which Ms Sylvia Lim referred to in her speech, was launched to help familiarise private operators with the applicable standards for clinical governance, for personnel, and also for vehicles early, so that steps can be taken to raise the clinical service standards, and they know what the benchmark and the bar would be.”
“Let me clarify that the Bill does not have extraterritorial powers, but if the telemedicine provider provides services, from wherever he might be, where such services are received in Singapore, then those services must be licensed under the Bill, and all foreign doctors working for the provider of those services, must be registered with SMC. There is, of course, this question of how do you enforce and how do you deal with potentially errant providers who exist outside of Singapore. MOH will continue to improve patient engagement and education on the benefits and some of the obvious limitations of telemedicine, including consuming healthcare services provided from abroad where, as I have said, oversight and regulatory enforcement are not as readily available so that patients will know they can make an informed decision as to which healthcare services to use or to consume for their treatment. Mr Melvin Yong raised questions on licensing for new healthcare services, cutting-edge healthcare services, like through the use of AI. MOH is, of course, aware of the increasing role and importance of AI in healthcare. It is nonetheless an evolving area, and we are monitoring this space closely and also engaging the relevant stakeholders – those who develop the AI, those who use the AI – to try to find the best possible guidelines and also to develop them in tandem with the industry to assure patient safety. Mr Melvin Yong made valid suggestions on the prospect of expanding the regulatory sandbox to these cutting-edge areas to explore new frontiers and to test the boundaries, and to see what works and what does not work in the safe context of the sandbox.”
“In addition, the National Telemedicine Guidelines set out specific guidelines relevant to telemedicine that registered doctors and healthcare professionals would have to abide by. I would reiterate that the broad principle is that doctors are expected to provide the same quality and standard of care as in-person medical care. The fact that there is now, or there could be, a more convenient medium by which the care is delivered or the patient has communicated with, should not be a reason in itself to lower that standard. The doctor should clearly indicate the limitations, in an appropriate case, of the telemedicine services at the start of the consultation and might, in fact, need also to refer that patient to a face-to-face consultation if he forms the view that he is unable to take proper history, to assess the patient properly and to form a sufficient judgement in order to discharge his expected standard of care. Moving forward, we will continue to refine the telemedicine regulations, have them tested, looked at and assessed in the context of the industry as well, to make sure that they are as appropriate and as relevant to the ground practice as possible. On this score, MOH has set up the Regulatory Sandbox to work closely with telemedicine providers to co-develop service-specific regulations. This will not only ensure that we remain in tandem with the practice of telemedicine, but that patient safety and welfare would also be adequately safeguarded. Some Members have asked about cross-border healthcare services, including the use of telemedicine.”
“Hence, I should clarify that the scenario that Ms Irene Quay contemplates occurs only when a hospital pharmacy also chooses to serve walk-in customers in addition to serving the hospital's patients. That being the case, the pharmacy would be expected to abide by the retail pharmacy standards set out under HPA. That said, I have taken on board Ms Irene Quay's comments about the rationalisation, and MOH and HSA will continue to streamline our processes to seek to avoid duplicative work by licensees to comply with the requirements of both this Bill as well as HPA, including for tele-pharmacy services, and will no doubt consult with Ms Irene Quay and the Society further on this point. So, to give an example to Ms Irene Quay, the 2019 Singapore Standard for Supply and Delivery of Medication is a common national standard for all healthcare providers and retail pharmacies if they want to supply and deliver medications. Dr Chia Shi-Lu, Mr Melvin Yong and Ms Joan Pereira have asked about services that will be regulated for the first time under the Bill, in other words, not previously or hitherto regulated, but introduced for the first time under this Bill, and these include services like telemedicine and ambulance services, and asked how these services will be regulated prior to the rollout and implementation of this Bill. To Dr Chia Shi-Lu and Ms Joan Pereira's questions on telemedicine, we should view telemedicine as an extension of the practice of medicine, provided through a platform different from the traditional clinic setting. Nonetheless, this is the practice of medicine, and it remains regulated by existing standards, such as ECEG.”
“In the meantime, professional guidelines, such as the SMC's Ethical Code and Ethical Guidelines (ECEG), provide guidance for medical practitioners contracting with TPAs to ensure the objectivity of the medical practitioner's clinical judgement and the provision of the required standard of care. So, for Members who are familiar with ECEG, you will know that advertisements are prohibited, save for certain circumstances set out; and at the end of the day, the judgement of the medical practitioner – how he looks at the patient, how he treats the patient – should be unimpaired and unaffected by any TPAs. Medical practitioners are ultimately responsible for their agents, if any; and if TPAs advertise licensable healthcare services, they would be subject to clause 31 of the Bill and can only advertise on a licensee's authorisation and must comply with all relevant advertising rules. Ms Irene Quay also raised an issue on possible overlaps between the different Acts and cited an example of hospital pharmacies being subject to both the current PHMCA and, in future, this Bill, as well as the Health Products Act (HPA). HPA governs the position when a pharmacy serves walk-in customers or walk-in patients. In such a situation, where the patient is not coming from the hospital where he would have had a prescription and had been seen by doctors, different standards would apply. In fact, we would expect that different standards should apply. If a pharmacy is part of a hospital and only serves in-hospital patients, then its licence will be part of the hospital's, the hospital being the primary licensee. The pharmacy would not need a separate one.”
“SCDF serves highly-critical cases and they hold their services to higher standards. SCDF mandates a six-monthly paramedic skills certification test and quarterly Continual Professional Education sessions to improve and also broaden the knowledge, skills and competence of their emergency medical services crew. In contrast, the draft ambulance Regulations require Emergency Ambulance Service Crew to attend lectures, simulation, practical sessions or clinical discussions at least once every six months and paramedics are required to be recertified every two years. For SAF clinics, all personnel are qualified according to national requirements. Medical officers are trained to national standards, and are also Singapore Medical Council (SMC)-registered with working experience in the restructured hospitals. There are regular refresher courses for staff, as well as regular audits for the clinics. Dr Chia Shi-Lu asked for clarifications on how this new framework might deal with Third Party Administrators (TPAs) and medical concierges. The current scope is limited to regulating providers of direct healthcare services. TPAs and concierge services are principally administrative in nature. They are agents of the principal medical providers and are not engaged in direct patient care. So, they will not be licensed under this framework. However, MOH is monitoring the patient safety risks and studying the landscape of these services further, before deciding on the appropriate framework, if any, to regulate these entities. If the licensing of TPAs and concierge services in some form is found to be needed, an amendment to the scope of this Bill can be made at the appropriate juncture to include them, again, with the appropriate contextualisation.”
“Indeed, the framework for any regulation, even for these services which are yet to be in scope, will be as set out in this Bill. So, they will know the parameters and the landscape and rubric of the Bill, even before it applies to them. Second, as to when these other services will be included, MOH will be adopting a calibrated and risk-based approach to progressively license healthcare services. We do not, at present, have any plans to license these services but will closely monitor the landscape. If significant patient risks, for example, emerge in these services, then we can decide to license these services, but as I said at the outset, the broad framework will already be as set out in this Bill. In addition, before we move to regulate any new services, Members can be assured that MOH will engage and consult with the relevant stakeholders on the proposed standards to ensure that they are contextualised for that particular service. So, we might have the framework set out in this Bill, but for the particular types of services and spectrum of different services, the precise way in which they will come in might have to be contextualised. And we will have a programme to engage and to consult, before they are added into scope. Ms Irene Quay has asked why Government entities like SCDF-owned ambulances and SAF medical centres are excluded from the Bill's scope. As I have mentioned at the outset, these entities serve critical national functions, and they do themselves come under separate internal governance structures and standards. I would add that Government entities providing healthcare services are subject to stringent internal standards and, in some cases, more stringent than what is being proposed by this Bill. Let me give some examples.”
“Mr Deputy Speaker, Sir, I thank Members for speaking in support of the Bill, as well as for their constructive comments and suggestions. I thank, in particular, Mr Leon Perera where he says that the Bill represents steps in the right direction. I will address the various issues raised by Members. There have been several questions on the regulatory scope and the types of services that will be licensed. Let me address these points. The Bill seeks to be clear and transparent in the scope of "healthcare services" that can be regulated. Our primary focus as we implement the Bill is on services that provide clinical care for a condition or a disease. Mr Murali Pillai has asked if community-led initiatives, including those provided by VWOs, will be in scope and be licensed under the Bill. And I think Mr Murali Pillai mentioned senior care centres, for instance. These entities, including Senior Activity Centres, provide services which are predominantly social in nature and they will, to that extent, not be regulated under the Bill. But sometimes, these centres also provide services that are clinical in nature. For example, they might have a doctor located within the senior centre, and if the doctor is engaged to provide clinical services in that centre, then that doctor will require a medical clinic licence or will have to be employed by a clinic licensee. Ms Irene Quay, Prof Fatimah Lateef, Mr Christopher de Souza and Mr Melvin Yong asked for timelines on the licensing of allied health, mental health and traditional medicine services, as well as non-doctor-led home and community-based services, so that the providers would have sufficient time to prepare for regulation. Sir, let me be clear that there will be sufficient time and notice.”
“My Ministry remains committed to ensure that healthcare in Singapore is safe, of good quality, affordable, as well as accessible. As we continue to build on our regulatory transformation journey to enable new healthcare services and care models to support our ageing population, I would like to urge the Members of this House to give your support to the Healthcare Services Bill. Mr Deputy Speaker, I beg to move. [(proc text) Question proposed. (proc text)]”
“MOH intends to take a phased approach on the Bill, targeted to be from early 2021 through to the end of 2022 – a phased, graduated implementation of the regime under this Bill. Regulation of licensable healthcare services will be effected, therefore, in three phases, so that providers will be given sufficient time to understand the regulations and also, in some cases, to ramp up its own resources to meet the relevant regulatory requirements. The first phase will bring PHMCA laboratory licensees under the Bill’s regulatory regime. The second phase will involve medical clinics and other ambulatory care services, as well as ambulance services. In the third and final phase, hospital and long-term care services, as well as other new licensable services, will be regulated by the Bill. MOH will assist all licensees and ensure a seamless transition to the new licensing regime. We will also continue streamlining our regulatory processes to reduce the burden on licensees as far as possible. Sir, let me conclude by making the point that in implementing the regulatory regime under this Bill, MOH will continue to engage licensees in the same manner as it had done in coming up with the rubric under this Bill to ensure that they will have a seamless transition from PHMCA into the regime under this Bill. We strive to enable new and innovative healthcare service models as well as the use of technology to develop within safe and reasonable boundaries. The Healthcare Services Bill will allow my Ministry to evolve its regulatory framework in tandem with the changing needs of healthcare demands and also the changing healthcare landscape. Together, we can achieve the key objectives of protecting patient safety, welfare and also assuring continuity of care.”
“And I would argue that the case for this is perhaps even more compelling in the healthcare setting, given that lives as well as the continued delivery of care to patients, whose welfare and interests are at risk, remain at stake. The Bill will also ensure licensee accountability by broadening our range of regulatory sanctions and strengthening our regulatory toolkit. Clause 39 provides powers to stop the provision of services that are detrimental to patients. While such powers presently exist in PHMCA, they are limited to cases where the service endangers the health, safety and welfare of patients. Under the Bill, we will also be able to stop services that go against the rules of professional conduct and ethics. So, for instance, if a disciplinary tribunal under the Singapore Medical Council has found that a particular treatment should not be provided for specific indications as there is insufficient clinical basis or evidence, MOH can issue stop orders for all licensees to cease any provision of such treatment accordingly. To exercise oversight and control over non-compliant licensees, we will have a wider range of regulatory actions and higher penalties for offences in the Bill. Clause 20, therefore, allows various regulatory actions to be taken against non-compliant licensees, as opposed to PHMCA, where we could only revoke or suspend the licence. So, there is a broader range in the toolkit which allows for more flexible arrangements, given the nature of each particular situation. Penalties for offences have also been updated and aligned with comparable offences under other more recently enacted legislation. Next, let me turn to the proposed implementation of this new regime.”
“Clause 37 will then empower the Ministry to publish information acquired in the course of administering this Act. In this regard, we intend to publish a list of non-compliant licensees and unlicensed providers, and we hope that by making such information available to the public, we can help patients make more informed decisions. Thirdly, we will put in place rules and powers to ensure the safety and continuity of care for patients through the introduction of "step-in" arrangements. Part 4 of the Bill will specifically introduce provisions to achieve this by empowering MOH to directly "step -in" or appoint a "step-in" operator to take over the operations of a licensee who is in serious financial trouble, or is contravening or is not complying with the provisions of the Bill, or is otherwise carrying on its operations in a manner that is detrimental to the interests of patients or customers, but nonetheless wants to or persists in carrying on these operations. The primary purpose is to protect patients’ safety and welfare against a recalcitrant provider endangering patients and also preventing an abrupt discontinuation of residential healthcare services. For this reason, the "step-in" provisions will only apply to a list of designated residential healthcare entities that will be prescribed in the regulations. These will include nursing homes, hospitals and inpatient palliative care centres. "Stepping-in" will also be a temporary arrangement until the service has been stabilised, and the patient's safety and welfare are no longer compromised. I would add that "step-in" powers are not unique to this Bill. Other regulatory frameworks for essential services, such as those in the financial services or transport sector or the like, also provide similar powers.”
“Next, the Bill will also introduce a number of measures to ensure that patients are well-informed and are aware and not misled by errant healthcare providers. Clause 29 will enhance naming restrictions to provide better clarity to patients on the healthcare services provided. Hence, non-licensees will not be able to use names that create a misimpression of providing licensable healthcare services when they either are not or should not be doing so. Likewise, licensees will also be prohibited from using names of services that they are not licensed to provide. Clause 30 will disallow unrelated, unlicensed services to co-locate with or within a licensed service, unless MOH approves. The intent behind this is to prevent or, as far as possible, mitigate public misperception that such unlicensed services, such as wellness and spa services, are either endorsed or licensed, because of their close physical proximity and association with the licensed healthcare services. Clause 31 will strengthen the advertisement controls under the Bill to prevent non-licensees from advertising licensable healthcare services. Therefore, only licensees and authorised persons appointed by a licensee will be allowed to advertise licensable healthcare services and, in doing so, will have to comply with the prescribed requirements to prevent advertisements that are false, misleading or laudatory and lead to a consumption of unwarranted treatments; and also those that cause a mismatch of expectation between the advertisement and what the public sees. Besides having levers to regulate the licensees, the Bill will also enhance existing powers of the Ministry, carried at clause 36, to gather data for patient safety, welfare and public interest purposes.”
“In addition to setting up proper governance structures and imposing standards on key appointment holders, we also need to ensure that the employment of healthcare workers – those who work or who are employed by the licensees and who deal with patients on a day-to-day basis – are also properly managed and there is appropriate oversight. This, I would say, is especially so when catering to the vulnerable patient groups. Such patients may be at risk of abuse, particularly when they require substantially long stays at a healthcare institution. Therefore, this Bill introduces safeguards in this area at clause 28 to impose employment restrictions on certain licensees. Let me explain that. Such licensees will be prohibited from employing any individual convicted of prescribed egregious criminal offences involving violent acts, and must provide the information of all prospective staff to the Ministry for screening with the Criminal Records Office. We understand that we should not treat all past offenders in the same way, or to assume that they are automatically recalcitrant. Employers who wish to employ past offenders of prescribed offences in the appropriate case may apply to seek the approval of the Director, who will consider each such case on its own merits. I would add that this employment restriction is not new. It is similar in nature to the approach taken under the Early Childhood Development Centres Act. Additionally, the employment restrictions will be limited only to settings where patients are at higher risk if they require, for instance, substantially long stays or are mentally and physically vulnerable. This would include long-term residential care services like nursing homes, inpatient palliative care services, and the Institute of Mental Health.”
“While the licensee is ultimately accountable for overall compliance to the Bill, clause 24 requires the licensee to appoint a suitably qualified individual as the licensee's Principal Officer (PO) or the Clinical Governance Officer (CGO), to strengthen accountability as well as clinical oversight at the different layers of its management. However, even as powers and responsibilities are set out under the different layers of governance under the Bill, healthcare professionals will be given autonomy to exercise discretion in the execution of clinical decisions for patient care, to serve the patient's best interests and also in accordance with professional ethics and considerations. We will, therefore, introduce provisions in the regulations for due consideration to be given to the views of practising professionals for clinical care matters. Clause 25 of the new Bill will also require certain licensees providing higher patient risk services, for example, acute hospitals, to set up specific internal committees to monitor the quality as well as the ethics of the services. These specified committees include the Quality Assurance Committees, the Service Review Committees and the Clinical Ethics Committees, each dealing with different aspects of clinical, ethical and quality considerations. Procedural details for these committees will be carried in the Regulations. Stakeholders had raised concerns on whether these governance requirements impose additional burden on smaller licensees, such as the GP clinics. This is a relevant concern, but this will not be the case, as the requirements that are set out are appropriately calibrated to the scale and also to the complexity of the licensee's operations.”
“For example, a provider can decide if he wants to hold a suite of service licences for a nursing home, a clinic, telemedicine and health screening. Secondly, as we move towards regulating new services and care models, we will enhance institutional governance and institute additional safeguards to ensure patient safety and welfare. That, ultimately, is the raison d'etre behind this Bill. The strengthening starts first from our licensing regime and, under clause 11 of the Bill, the Director of Medical Services, who is defined as the "Director", will be required to consider multiple factors in deciding whether to grant or to renew a licence. This includes, but is not limited to, whether the applicant is a suitable person and his ability to provide clinically, as well as ethically, appropriate patient care. Other factors that may also be considered include the applicant's prior conduct when participating in various public schemes, such as the Community Health Assist Scheme (CHAS), MediSave or MediShield Life schemes, as well as the track record of compliance with regulatory requirements under the Bill and also under other laws relevant to the provision of healthcare services in a safe and appropriate manner. Clause 23 also requires the key appointment holders of a licensee, such as its governing board or key management, to be suitable persons. Key appointment holders must possess the appropriate skills and competencies to carry out effective governance functions.”
“If sufficiently serious concerns arise, these services can then be licensed by including them in the First Schedule. In that case, the same regulatory regime as is now set out in the Bill would then apply. Government entities, such as the Singapore Armed Forces (SAF) medical centres and Singapore Civil Defence Forces (SCDF) ambulances, are exempted from this Bill. They are bound by internal Government standards and rules, which are generally equivalent to or more stringent than the current licensing standards. There are also staff disciplinary frameworks to deal with errant personnel in the case of such Government services. The Bill's scope also does not include beauty and wellness services as these services do not diagnose, assess or treat diseases or illnesses and are of minimal patient safety risk. Entities that do not provide direct patient care, such as Third Party Agents referring patients to healthcare services licensees for their care, will also not be regulated as licensees under the Bill. But this would be an area that we will review, and at the appropriate juncture, if necessary, can always include into the Bill through suitable amendments. As we transit into the Healthcare Services Act, we will move away from the current premises-based licensing framework, which, as I have mentioned at the outset, is a lot more rigid and inflexible, confined only to one licence per premises and also limited to those in physical brick-and-mortar premises. Hence, Part 2 of the Bill introduces a services-based licensing framework which is more flexible and also more modular. This approach will better suit the business models of providers, who would just have to take the licences based on the services that they wish to provide.”
“I would like to take the opportunity here to thank all those who contributed actively throughout this process in the consultation exercises, helping with ideas and suggestions to jointly shape and create the new healthcare services regime. Sir, let me now go through the key features of the Healthcare Services Bill and highlight the areas of changes from the existing legislation. First, let me start with the scope. We will clearly define the scope of the regulatory regime and the move towards a services-based licensing framework. The scope of the Healthcare Services Bill extends to the regulation of any service by direct providers of "healthcare services" as defined in clause 3. This includes services that diagnose, assess or treat diseases or illnesses; provide nursing or rehabilitative care; or assess the health of individuals. Services that will require licensing will be set out in the First Schedule. Licensable services are largely similar to the services already provided by the premises-based licensing regime currently under PHMCA. In addition, however, the Bill will introduce licensing requirements for certain non-premises-based services, such as telemedicine, emergency ambulances, and new specialised services, such as cell, tissue and gene therapy and clinical genetic testing. While the scope of the Bill is broad enough to include standalone allied health, nursing, traditional medicine and also complementary and alternative medicine services, we will not, at this stage, be licensing these services for the time being. However, my Ministry will continue to closely assess these services, particularly from the perspective of risks to patient safety and welfare.”
“Taking into consideration the above issues with the changes that are needed in the evolving healthcare landscape that I have mentioned, it is timely that the Ministry is now introducing the Healthcare Services Bill to replace the existing PHMCA, so as to have better levers to regulate the safety and care provided by the existing, and also the evolving and newer, healthcare services providers. This Bill will, therefore, seek to achieve a few objectives. First, to provide greater flexibility and modularity in licensing, to enable the development of new care models that centre around patient needs. Second, to better protect patient safety and welfare by strengthening licensee governance and also introducing additional safeguards. Third, to strengthen continuity of care and ensure more appropriate and robust licensee accountability. In putting up this Bill, the Ministry of Health (MOH) conducted extensive public and stakeholder consultations between 2017 and 2018, and also studied developments in the local landscape, as well as the regulatory regime that exists in several overseas jurisdictions. We received a lot of useful feedback from licensees, patients and the public, and some of these ideas have been incorporated into the new regulatory regime that now finds its way into this Bill. Some examples include the bundling of specific licences for general practitioners (GPs) to accommodate their core work, as well as allowing licensees to co-locate with certain registered healthcare professionals to facilitate the provision of complementary healthcare services.”
“Secondly, patients, especially the aged sick, may want more convenience and cost savings in their clinical care for some minor ailments or follow-ups to their chronic conditions. This may be possible today when hospitals or medical clinics provide telemedicine or mobile medical services, on top of their premises-based care. In other words, they provide premises-based care and, on top of that, also provide telemedicine or other mobile medical services. There is, therefore, a need to move beyond just regulating premises or to be premises-based in the regulation framework, to also be able to look at regulating services delivered beyond the premises, if we want to ensure the safe delivery of such services into the community or done remotely, as I have mentioned, through telemedicine. At the same time, we also need to ensure that the welfare and well-being of vulnerable individuals or patients can be enhanced, and that the elderly and the frail patients are well looked after. This will include the assurance for the continuity of care for patients, and the introduction of additional safeguards to prevent abuse. Finally, there are new scientific and technological advancements leading to the emergence of innovative diagnostic methods and also therapies, such as cell, tissue and gene therapy, clinical genomic testing, and proton beam therapy. There is, therefore, a need to have an enhanced governance structure to more closely monitor and also track the delivery of such newer services, including looking after the appropriateness of care and the information that is being provided to patients.”
“Mr Deputy Speaker, on behalf of the Minister for Health, I beg to move, "That the Bill be now read a Second time." Sir, the objectives of the Healthcare Services Bill are to safeguard the safety, welfare and continuity of care for patients. These are all matters of paramount importance. Today, premises which are used as hospitals, medical clinics, nursing homes and clinical laboratories in Singapore are licensed under the Private Hospitals and Medical Clinics Act (PHMCA). PHMCA was enacted in 1980 and sets minimum standards for licensees' premises, personnel as well as processes to safeguard patient safety and welfare. PHMCA was last amended in 1999, and the regulatory framework needs to be refreshed and updated to address today's rapidly-evolving healthcare landscape. While Singapore has one of the longest life expectancies in the world, there has also been a rise in the number of unhealthy years lived because of ageing-related illnesses and chronic diseases. Hence, to provide more appropriate and accessible healthcare to our ageing population, there needs to be a shift in care models to align ourselves with one of my Ministry's "Three Beyonds" – "Beyond Hospital to Community". There will, therefore, be more vertical and also horizontal integration across traditional healthcare settings. For example, nursing homes may now be able to also provide dementia care and geriatric clinical services within one location. And that is for the better, because it puts the related and complementary services under one umbrella. These integrated models of care are difficult to license under the present premises-based licensing framework of PHMCA and, therefore, the licensing framework will need to be improved to accommodate such new and also evolving models of care.”
“Mr Deputy Speaker, I beg to move that the amendments* standing in the name of the Minister for Law, as indicated in the Order Paper Supplement, on the grounds on which I have outlined earlier in my opening speech. [(proc text) *The amendments read as follows: (proc text)] [(proc text) In page 4, line 17: after "5.", to insert " —(1)". (proc text)] [(proc text) In page 4, after line 18: to insert — (proc text)] [(proc text) "(2) The Penal Code as amended by the Criminal Law Reform Act 2019 (Act 15 of 2019) is amended by inserting, immediately after the word 'intentionally' in section 26D(3), the words 'or with wilful blindness'.". (proc text)] [(proc text) Amendments agreed to. (proc text)] [(proc text) Clause 5, as amended, ordered to stand part of the Bill. (proc text)] [(proc text) Clauses 6 and 7 inclusive ordered to stand part of the Bill. (proc text)] [(proc text) Bill reported with amendments; read a Third time and passed. (proc text)]”
“Mr Chairman, there are two amendments, as I have outlined earlier, to clause 5, as indicated in the Order Paper Supplement. As the amendments are related, may I seek your permission to move them together?”
“This is to allow for further development of the doctrine of "wilful blindness" by the common law. This is important because the Court of Appeal had suggested that the doctrine might apply slightly differently in practice, depending on what specific fact an accused is said to have been wilfully blind towards. Next, let me turn to the Singapore Corporation of Rehabilitative Enterprises Act. Clause 6 of the Bill amends the Singapore Corporation of Rehabilitative Enterprises (SCORE) Act, such that SCORE’s financial year will run from 1 April of each year to 31 March of the following year. This will align SCORE’s financial year with that of the Government and other Ministry of Home Affairs agencies. Finally, as part of SCORE’s rebranding exercise, an amendment will be introduced to the SCORE Act to allow SCORE to perform its functions or carry out its duties under one or more business names specified by the Minister for Home Affairs by notification in the Gazette. SCORE’s new name will be announced once the rebranding exercise is complete. Sir, in conclusion, this Bill amends the six Acts in the manner that I have just described, including the amendment at the Committee stage, for the reasons I have outlined. Sir, I beg to move. [(proc text) Question put, and agreed to. (proc text)] [(proc text) Bill accordingly read a Second time and committed to a Committee of the whole House. (proc text)] [(proc text) The House immediately resolved itself into a Committee on the Bill. – [Mr Edwin Tong Chun Fai.] (proc text)] [(proc text) Bill considered in Committee. (proc text)] [Deputy Speaker (Mr Charles Chong) in the Chair] [(proc text) Clauses 1 to 4 inclusive ordered to stand part of the Bill. (proc text)] [(proc text) Clause 5 – (proc text)]”
“Therefore, if section 26D is brought into force as it was originally drafted, this would abolish the "extended conception of wilful blindness" under this case authority. This outcome would be contrary to the policy intention of section 26D, which is to codify the law, rather than to change or narrow the position under the law. I will, therefore, be proposing an amendment to section 26D to preserve the position under the current law, which includes the "extended conception of wilful blindness". The amendment does not in any way prejudice accused persons, as it does not expand the common law. For completeness, Mr Deputy Speaker, I should point out that the Court of Appeal had explained that there are three elements to the "extended conception of wilful blindness", and these are, namely: one, the accused must have had a clear, grounded and targeted suspicion of the fact to which he is said to have been wilfully blind; two, there must have been reasonable means of inquiry available to the accused person, which, if taken, would have led him to discovery of the truth, at least in the context of the fact of possession; and three, the accused must have deliberately refused to pursue the reasonable means of inquiry so as to avoid having such negative legal consequences as might arise in connection with his knowing that fact. The Court of Appeal limited this "extended conception of wilful blindness" to the context of knowledge for the purpose of proving possession under section 18(1) of the Misuse of Drugs Act in this case and recognised that it may be different with respect to knowledge of the nature of the drug under section 18(2) of the Misuse of Drugs Act. However, Members would note that the proposed amendment to section 26D does not set out all these three elements.”
“This amendment is intended to preserve the status quo under the current Penal Code, so that the right to private defence can be raised as a defence for non-Penal Code offences. I will also be proposing an amendment to the Bill during the Committee stage, to amend section 26D of the Penal Code, which has not yet been brought into force. This amendment will ensure that when section 26D of the Penal Code is brought into force, there will be no change or deviation from the current law on wilful blindness, which was the intention when this House passed the CLRA. Let me explain this to Members. Section 26D of the Penal Code was introduced under CLRA to codify the common law definition of knowledge. Its current form reflects the Penal Code Review Committee’s decision not to provide for the concept of "wilful blindness" as part of section 26D. The Committee had assessed the case law, and especially the Court of Appeal’s decision in 2011 in Nagaenthran a/l K Dharmalingam v Public Prosecutor [2011] 4 SLR 1156, and concluded that "wilful blindness" was simply an evidential tool used to infer that an accused had knowledge. The Committee concluded that there was thus no need to provide for the concept of "wilful blindness" in section 26D. After the passage of CLRA, however, the Court of Appeal delivered its decision in Adili Chibuike Ejike v Public Prosecutor [2019] 2 SLR 254. The Court of Appeal held that "wilful blindness" is properly described as a mental state falling short of knowledge but which is legally deemed to be equivalent to knowledge. The Court described this as an "extended conception of wilful blindness", where "it can almost be said" that the accused persons knew the fact in question. This position represents the law today.”
“Clauses 4 and 7 of the Bill amend each respective Act such that it will no longer be mandatory to appoint a Deputy Chairman for the National Arts Council (NAC) or the Singapore Sports Council (SSC). Instead, the Minister will have the flexibility to appoint a Deputy Chairman in appropriate situations. This flexibility will allow the Ministry of Culture, Community and Youth (MCCY) to better address the needs of these two Statutory Boards. A savings provision has been included to preserve the appointment of existing members and officeholders of the NAC and the SSC. The Singapore Sports Council Act will also be amended to provide that the Chief Executive Officer of the SSC may be appointed as a member of the Council, in an ex officio capacity. Next, let me turn to the amendments to the Penal Code. Clause 5(1) of the Bill rectifies a potential technical drafting gap that could arise once section 8 of the Criminal Law Reform Act (CLRA) 2019 comes into force. The amendment is for the sole purpose of removing this potential technical drafting gap, which I will explain to Members. The existing section 40(2) of the Penal Code allows for the right of private defence to be raised as a defence to non-Penal Code offences. This right of private defence is currently set out in Chapter IV of the Penal Code. CLRA moves the provisions relating to the right of private defence to the new Chapter IVA of the Penal Code. Before this move can take effect, a new reference to "Chapter IVA " must be inserted into the existing section 40(2) of the Penal Code as a consequential amendment, to clarify that the provisions relating to the right of private defence will continue to apply for non-Penal Code offences.”
“Mr Speaker, on behalf of the Minister for Law, I beg to move, "That the Bill be now read a Second time". This Bill contains a number of amendments to several Acts. Most of the amendments are minor and technical in nature. One amendment, which I will seek to introduce at the Committee stage, is for the purpose of amending un-commenced legislation so that common law developments are not abolished once the legislation is brought into force. Let me take Members through the amendments. First, clause 2 of the Bill amends section 55(7)(b) of the Building Maintenance and Strata Management Act (BMSMA) to correct a typographical error. The existing section 55(7)(b) of BMSMA provides that an individual cannot be appointed as a treasurer if he is already the chairperson or secretary; and the re-appointment would result in the individual holding office as a treasurer for three consecutive terms. The two limbs of section 55(7)(b) should be disjunctive, and not conjunctive. Clause 2 of the Bill corrects this typographical error, by substituting the word "and " between the two limbs with the word "or ". Next, let me touch on the amendment to the Control of Plants Act. The existing definition of "prohibited pesticide" in section 2 of the Act refers to the Tenth Schedule to the Food Regulations. However, the Food Regulations have since been revised, and the previous Tenth Schedule is now the Ninth Schedule. Clause 3 of the Bill introduces an amendment to the Control of Plants Act to update the existing reference from the Tenth Schedule to the Ninth Schedule. Third, let me come to the amendments to the National Arts Council Act and the Singapore Sports Council Act.”
“So, is Mr Faisal Manap saying that absolutely nothing at all will be done by AHTC, notwithstanding the grave and serious judgment that has been released by the High Court, which AHTC, and I hear the Workers' Party, recognised and accepted, that nothing will be done in the interim?”
“First of all, Mr Faisal Manap, there is no suggestion that you reverse the mandate that has been given. You heard me very clearly. We are asking for a narrow recusal over financial oversight. Why financial oversight? Because these are the very same issues that the Court in this case has made very serious and egregious pronouncements. Second, in relation to the suggestion that the mandate was given in 2015, but today we are in 2019, and the judgment has been released after having heard all parties, and certain findings have been made. I would like to ask Mr Faisal Manap, does he not recognise that those findings are very serious, egregious, grave findings?”
“You agree it is not sub judice. So, why is it not appropriate? Can we hear from you? We are talking about what is to happen in the interim in the Town Council, over which you are the Chairman, until you get the reversal from the Court of Appeal, if that happens. So, can Mr Faisal Manap explain in the interim why is it not appropriate to be talking about actions that you should take now to safeguard, to ensure that your residents' interests come first? Let me give you an example of what this recusal means. If, for example, a teacher was found to have done something wrong – a teacher who interacts with students every day – then he cannot teach until he clears his name on an appeal. It is similar in this case. The Motion does not require anyone to resign, to step down, not even to refrain from all functions of a town councillor, but only that which relates to financial oversight and control. Can Mr Faisal Manap explain why that is not in the best interest of the Town Council and the residents, why that is not the proper and decent thing to do, so that you have assurance that whatever is the outcome on the appeal, your interest and those of your residents are safeguarded?”
“At the second Town Council meeting in August 2011, the councillors thought that they were going to a meeting to approve a waiver of tender in order to appoint FMSS, not knowing that FMSS had actually already been appointed, or that FMSS themselves had helped to sanitise the very report that made the recommendation about the waiver of tender over their appointment. How is that good governance? In fact, your councillors were given a very misleading picture. But what is even more stark about this episode is that not only did the Workers' Party subvert the entire system of accountability within the Town Council and made use of the councillors to suit their own personal and political agenda, but also that Ms Sylvia Lim kept the truth from her fellow town councillors. That, I find, a lot more egregious. They might well have had their own concerns about the political allegiances of CPG or AIM, but the town councillors are Workers' Party members from their own party or supporters, and they include fellow Members of Parliament in this House. That they felt they had to mislead their own colleagues to get FMSS appointed without tender, I think, speaks volumes. As I said at the start, it is your right to appeal and seek to overturn the findings. But until then, in the interim, common decency and practice requires that they recuse yourselves from having oversight of financial matters. So, we call on the Workers' Party to abide by their own single thread – and Mr Pritam Singh knows this well – of transparency and accountability, and to put residents’ interests first. On the speech that Mr Faisal Manap made, let me ask a few questions. First, the Member said it is not appropriate to consider the Motion at this time. Then, what does this mean? At what stage should we consider it?”
“How can this status quo be allowed to continue? Whatever your views are on the judgment, today, this judgment represents the position in law. Until it is set aside, this judgment is valid. The second point which stood out for me was the way in which the councillors, your councillors, who are supposed to be the check and the approving authority with independent judgment, were instead completely sidelined, misled and effectively made use of. Town Council meetings are very serious affairs. Councillors are charged with the responsibility to make decisions about the town they manage, and often, there are significant financial repercussions. In this case, at crucial Town Council meetings, the Court found – and, again, let me quote – that there had been "a palpable economy of truth in the way things were disclosed" at Town Council meetings. In particular, the decision to delegate authority to Ms Sylvia Lim to undertake matters on behalf of the Town Council was also obtained without proper disclosure of facts. The Court found that there was, and I quote again, "a deliberate and calculated move" to keep CPG and the rest of the Town Council in the dark about the plan to appoint FMSS without a tender being called. To give this House a sense of what happened, two Town Council meetings concerning FMSS at the relevant time were called, one in June and another in August 2011. Councillors were not told at the June 2011 meeting that a letter of intent, there was intent to be signed with FMSS in July 2011, even though, by that time, the Workers' Party had already decided to appoint FMSS.”
“It was calculated, careful, deliberate, an outcome that was obtained by much planning, design and engineering. The elected councillors continue today to be in AHTC, to continue today to run the Town Council and that includes having control and oversight over financial matters. So, on this, two points stand out for me. First, the Court found that, in ensuring that the appointment of FMSS would pass muster, Ms Sylvia Lim asked for Ms How Weng Fan and Mr Danny Loh to "sanitise" the draft report – I mentioned that earlier, let me come back to it. Why? So that, in your own words, Ms Sylvia Lim, it will "pass the auditors' eyes"; your email of 3 August 2011. It is already astonishing enough for an elected official to ask for a report to be sanitised so that it passes the auditors' eyes. We all know what "sanitise" means. We all know what "pass the auditors' eyes" means. If it was a truthful report, and you knew it to be truthful, there should be nothing that needs to be done. But, clearly, this was not the case here. And do not take my word for it, look at what the Judge had found about that report. It said, "It was not truthful and painted a wholly inaccurate picture" and it "sought to cloak the appointment of FMSS with a veneer of propriety”. But to add insult to injury, this sanitising was to be done by the very persons whose appointment without tender the report itself was meant to recommend – How Weng Fan and Danny Loh. This is wrong at so many levels. Even a child knows that you do not ask the fox to guard the chicken coop, or a wolf to watch the sheep. But this little episode provides an insight into the way in which affairs are being conducted at AHTC. And Ms Sylvia Lim continues in a position of having financial oversight over matters today.”
“In addition, at trial, Ms How Weng Fan also disclosed a conversation, where she said it was actually Ms Sylvia Lim, and I quote, who "doesn't want to extend" AIM. So, what we see with the disclosure of documents and when matters had gone to Court are a very different picture from what we have heard, a very different picture from what Ms Sylvia Lim has sought to be put out in the press, in Parliament and, of course, at election rallies. The Judge, having heard from Ms Sylvia Lim in Court on this issue, concluded, and I quote, "AIM's withdrawal in no way precipitated the defendants' course of conduct leading to the waiver of the tender...[and] that [they] had sufficient time to call for a tender notwithstanding AIM's withdrawal". So, Mr Speaker, what we see, looking back over the years at this long and very sorry saga, is the Workers' Party shifting from one untenable excuse to another, in order to justify appointing FMSS without calling a tender. And this itself is set against a backdrop of constantly refusing to disclose to auditors, your own as well as those from AGO and KPMG, fobbing off inquiry at every turn, refusing to do interviews so that the real reason could remain suppressed until, as we see, their own Independent Panel decided to bring this action and it unravelled in Court. So, let me round up by going back on what this Motion calls on the Workers' Party to do. Ms Sylvia Lim and Mr Low Thia Khiang continue today as elected councillors, including having financial oversight over the affairs of the Town Council. Surely, this status quo cannot continue, given what the Court has found. As I said at the start, the conduct in respect of which the Court has found was not caused by a one-off occasional or even careless error.”
“Not surprisingly, the Judge had strong words about the Workers' Party seeking to present FMSS as a contingency, as a reason both to the public as well as in justification for not having a tender and he said, and I quote, "this was nothing more than an attempt to varnish the plan with a veneer of credibility in order to camouflage its true motive". Let me turn now to AIM. Another excuse that has been constantly trotted out by the Workers' Party, in an attempt to justify the waiver of tender, you use the fact that AIM had terminated the TCMS. This House will know, Mr Speaker, that this has been used before, to give off the impression that, this time, it is AIM, a PAP vehicle, which had forced AHTC to hurriedly appoint FMSS without a tender. Ms Sylvia Lim will also recall that in an election rally on 2 September 2015, the blame was put squarely on this termination as being the reason for the Town Council not having called a tender for the appointment. It might well have been a convenient election rhetoric, but as her own evidence in Court has revealed, it was also an entirely false excuse. The truth is that there was no question of the termination having played any part in necessitating a waiver of tender. The Town Council had sufficient time to call a tender; it just did not want to do so. Indeed, Ms Sylvia Lim will recall that when you were shown contemporaneous documents in Court, you accepted to the Court that AIM had, in fact, had been helpful to your Town Council – helpful – that AIM was assisting in circumstances beyond what they were required to do; and that AIM gave more time to AHTC than it was required to do. Ms Sylvia Lim will remember this very clearly.”
“So, far from seeking to protect their resident's interests in the face of sudden unanticipated circumstances – a narrative which the Workers' Party had very painstakingly spun, the Judge found that they had, in fact, painted a misleading picture to the world, leading everyone to believe that they were compelled to appoint FMSS without any tender and masking the fact that they did not act in the best interests of the Town Council and of the residents it serves. The Judge did not mince his words on this sorry episode. He called it, at various occasions, "misleading", "not honest", the picture was "not a truthful one", "camouflaged" and "not the true picture". Take your pick. They all mean the same thing. But he was particularly galled by how such a misleading narrative was conveyed to the public, and specifically to the very constituents which the elected Members of Parliament were elected to serve in the first place. So, a misleading narrative, repeatedly put out over several years, to the public, in Parliament, in Court, by Members of Parliament who knew perfectly well this narrative was not true. How is this being accountable or transparent? Another contrived excuse for the set up of FMSS was that it was only a contingency, just in case. On 13 May 2013, Ms Sylvia Lim told this House, and I quote, "The set-up of FMSS was because of this very real possibility that we will be faced with nobody else to do it for us." This, again, is a wholly untenable position to take. The Workers' Party was clear and deliberate in themselves not wanting CPG to carry on. So, what contingency are we even talking about? The Judge's finding that I have outlined above completely demolishes any notion that FMSS was meant as a contingency. It was, in fact, premeditated and a fait accompli.”
“But such a narrative was entirely false, one that was designed to give cover to the advancement of their own collateral motives, whilst at the same time sacrificing the interests of residents. Ms Sylvia Lim and Mr Low Thia Khiang knew there was no urgency. The Court heard from both of you, Mr Low and Ms Lim, and came to this conclusion, after having heard you. CPG was required in law to continue as the MA. They could not walk away as the MA even if they wanted to. Neither could they not offer you the prevailing rates that they had been using and charging the previous Town Council. They were committed to it but you were not. CPG's position was inconvenient to both Ms Lim and Mr Low, since you wanted FMSS appointed, whatever the case. And to get FMSS in, you had to make it look as if CPG wanted out. And it is very apparent from the evidence you gave in Court. Ms Sylvia Lim's evidence in Court under oath was that she did not even ask to see the CPG’s contract. She did not know what the terms were, did not know the termination mechanisms were, did not know what the contractual rights might have been. The Workers' Party had also already written to Ms How Weng Fan as early as 19 May, that is, barely a week after General Election 2011 – wrote to her to say that her company would be appointed as MA of the Town Council and this is well before the Workers' Party even had any conversation with CPG.”