Fatimah Lateef
Singapore
“Some cases or disputes put up for mediation may span a period of time, maybe even years, and agreement may not have been reached at the first sitting.”
“This is because I feel that this can be a potential area for abuse and also misinterpretation. Take, for example, the beauty and wellness industry. It is not within the scope of this Bill. Neither is Traditional Medicine and Complementary Medicine.”
“In this light, perhaps can MOM work with the Ministry of Health (MOH) on a framework or guideline to assist and advise medical practitioners on some kind of algorithmic process, so that there is actually some kind of a loose framework they can refer to?”
“Therefore, we had to conduct more dialogue sessions and discussions, such as case studies, where we can show our families, especially those from the low-income groups, how to obtain assistance from the good schemes made available by our Ministry.”
“Chairman, I have one clarification for the Minister. It is actually pertaining to single unwed mothers, and I know the principles and values we want to uphold in the society and all that.”
“In terms of innovation and productivity, healthcare, as I said, is labour-intensive and patient-centric. So, we need to review that appropriately as well. Fifth, it is data-driven healthcare which is really a must moving into the future. This will help us formulate guidelines and policies.”
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“Speaker, I would like to ask the Minister for Health pertaining to the guideline on the five-day MC. We understand the reasoning behind the five-day recommendation and also how we will assess in giving this MC. However, there has been many misinterpretation perhaps and spinoffs from these five days and I am asking this question on behalf of frontline healthcare workers. Because people are now coming and demanding, "Why is it just three days and not five days? MOH says it is compulsory for you to give us five days". So, therefore, we make the decision based on clinical judgement and case-by-case basis. Can we just get clarification and reinforcement that it is really not mandatory, but it is a guideline, a recommendation, but it is really up to the doctor and the frontline healthcare personnel as to how many days we want to give? We understand the five days and we understand that if you do have upper respiratory tract symptoms with fever and all that, and even with no travel history, the five days are definitely justifiable. But for others who may not have all the components of the symptoms, but there are other problems, I hope that the Minister can reinforce that it is really up to us on a case-by-case basis to decide on this.”
“Some cases or disputes put up for mediation may span a period of time, maybe even years, and agreement may not have been reached at the first sitting. If an agreement is then eventually reached, how can we prove that it is actually settled through mediation and not due to other platforms, alternatives and various permutations of interventions, during the course of the matter in question? Another query I have on this is: will an agreement arising from mediation now be enforceable with the passing of this Bill? Can the Minister please clarify as well? Finally, will two parties in dispute seeking enforcement apply to the Courts of the state or country whereby the majority of the assets are located or can this be otherwise? Who can decide on this? And what if both parties are at loggerheads pertaining to this? So, these are some of the clarifications I have. Pending these, I support the Bill.”
“I believe there are also some inconsistencies with the fundamentals of commercial mediation in the Western jurisdiction. Perhaps the Senior Minister of State is probably more well-versed with this, and if it is possible, perhaps he can enlighten us on some of the possible reasons for this. Can I also clarify with the Senior Minister of State that as long as a settlement is intended and will result from mediation, then that commercial case will qualify for enforcement under the Convention, regardless of its place of origin or the nation of origin? Sir, mediation is an art, with the science part of it as well. The mediation industry is variable across different countries and jurisdictions. Its recognition is also variable. For example, in the UK, it has a well-known reputation and history of being strong in arbitration. What is important in considering this Bill is the fact that mediation will be driven very much by the local framework, culture and emphasis. Mediator recognition, training and qualifications also vary across the globe. Cultural diversity will exist and we know that "culture can, indeed, trump strategy". In view of all these factors, how do we ensure some degree of consistency and standardisation? Another concern is on the requirement of having "the mediator signing the document". A mediator's document is quite different from a witness' statement in Court, for example. In some places, the mediator may not be comfortable to have his or her name and documents appear and be utilised in a Court of law. Mediators may disagree to sign the Settlement Agreement and, if they are not comfortable with this, to be also subpoenaed as witnesses. How then should these cases be handled?”
“Mr Deputy Speaker, first and foremost, let me declare my role as the advisor to the International Institute of Mediators (IIM). This is a landmark Bill. It represents a significant major step for cross-border resolution of commercial disputes. This is with the hope that businesses will benefit with more certainty and assurance. Sir, it is also about our Singapore branding, our badge as a global arbitration and mediation hub. Singapore had a major role in drafting the document. And what is more is that the Singapore Convention on Mediation was opened for signature on 7 August 2019, our Bicentennial year, and also named after us. It is an honour, indeed. Mediation is now getting more popular and thus more frequently used at both domestic and international platforms. Reading through the Bill, there are some unique pointers unlike other multilateral enforcement regimes, such as that it does not operate based on reciprocity between member states. I have, Sir, several clarifications and queries. Firstly, under section 6, subsection 4, pertaining to the certified translation into English of the settlement agreement if it is in other languages. Can the Senior Minister of State clarify if the service will be provided by a list of approved vendors globally or the parties involved will have to source for this themselves? Next, can the Senior Minister of State please outline if the Courts of signatory countries will handle applications to enforce or clear parties involved? Some major nations have not ratified the Convention. Are there specific reasons or considerations for this? With a Bill as this under the umbrella of the UN, it would be excellent to have as many nations come on board and, if not so, the reasons, perhaps could be addressed adequately.”
“Mr Speaker, I was involved in managing patients during SARS. Seventeen years later, I am still involved in managing patients at the frontline with this coronavirus outbreak. I have to say that we have been working with MOH over the years and I would like to applaud MOH on its communications, coordination and also performance now, 17 years down the line. I have to say that we are performing at top-notch. So, thank you to all the MOH staff and also all the people who are working long hours behind the scenes. One of the things that has been very, very useful for us is the MOH surveillance hotline, which operates 24 hours. I am able to call them 24 hours, anytime, to check on locations as well as quarantine orders and any other information. I hope that MOH can continue with this for as long as we need it, even beyond that. That is the first point. The second point is essentially about publicity and also perhaps education for people who are coming forward. We have got employers who are saying that these two air-con repairmen have gone to the room where there was a suspected case. They are asymptomatic but the employers have asked them to come to the Emergency Department of a tertiary hospital to be assessed. Of course, we will assess and send them away to the GPs because we do not want to overload the hospital. Perhaps we can do more education for people like these. We understand the concerns and the worry that the public may have and people who may have been so-called spinoffs or been associated in some indirect way with people who may have been suspected of having the infection. But perhaps more publicity and education, and perhaps working with the media as well, will help.”
“This is because I feel that this can be a potential area for abuse and also misinterpretation. Take, for example, the beauty and wellness industry. It is not within the scope of this Bill. Neither is Traditional Medicine and Complementary Medicine. But these are exactly some of the services which may potentially co-exist on the same premises as a licensed service. So, therefore, there could be some loopholes there. Notwithstanding these clarifications, Sir, I do support this Bill.”
“At Singapore General Hospital, for example, we provide Maritime Medical Advice or Radio Medical Advice to ships in the waters around Singapore and even as far as the coverage of parts of the Pacific and Indian Oceans. Please advise on the definition and coverage of these services as well. Fourthly, on clause 26, pertaining to the Clinical Ethics Committee (CEC), can we understand a bit more on this and also the component members and how many members will the CEC have? What are their other terms of reference? Also, will there be any difference in the components and also job scope as compared to the Ethics Committee that our institutions already have today? Fifth, how fast can the "step in order" or the "expedited step in order" be approved and obtained in the event that it is required? Sixth, can the Minister also explain with some details of the Quality Assurance Committee? How is it going to work? What are the main objectives and desired goals and how will they function? Seventh, with the move from premises-based to service-based licencing, many are concerned with the rise in the costs they have to pay. What will be the framework or formula for this conversion and can the Minister ensure that the hike will be within reasonable limits? This is especially so with the current economic climate, as we update this Bill to execution. Eighth, pertaining to the process of mapping services at the healthcare premises, how fast can the request for new services be processed? Also, will the spectrum of point of care tests permissible be reviewed from time to time to incorporate the latest and the updated? Finally, the ninth point, on the co-location of licensed and unlicensed services within the same premises, can the guidelines be made clear and succinct?”
“Mr Deputy Speaker, this Bill was first enacted in 1980 and amended in 1999. Thus, it is, indeed, time to review and update to ensure patient safety through licensure, provision of more safeguards and, of course, keeping abreast of the new healthcare landscape and modalities we have today. Moreover, there are a variety of new services since then on offer and things have changed, for example, medical transportation, video conferencing, teleconferencing and even tissue and bone banking. The migration from a premises-based to a service-based model makes sense because we are trying to integrate a lot of our healthcare services. I have a few clarifications. Firstly, for cord blood and stem cells, how will these products be tagged? As it will usually be identified or linked to an individual, will it be under the name of the mother or the baby or the fetus? Secondly, under Part 2, licensing of healthcare services, clause 9, it is stated and I quote, "it is an offence for a licensee to provide a licensable healthcare service at any premises other than licensed premises, or using any conveyance other than a licensed conveyance". Can the Minister comment and elaborate on the offering of House Visits services by GP and Family Practitioner colleagues, for example, as well as home care services by hospice doctors and nurses? In that same context, are there any requirements for locum healthcare services staff who move from premises to premises offering services and taking care of patients with consultations? Thirdly, pertaining to telemedicine, can the Minister also clarify with some details? Does this apply to only within Singapore? How about when our medical staff are consulted on the regional and international platforms?”
“The authorities may need to look at these more wholesomely and this whole interdependent cycle and ring we need to break. In the heartlands, coffee shops are one culprit area for these activities. We have noticed blatant breaches, and overt activities related to vice at these coffee shops seem to be ongoing in broad daylight. This cannot be. What else can one conjecture when dubious characters or so-called pimps sit at the corner table of a coffee shop the whole afternoon, into the night and the early hours of the morning and even after the coffee shop closes? The same person with the same shirt, with the same characters around them. They make negotiation for girls and many other things. And it is very, very blatant and obvious to the lay person. Is it not so obvious to the authorities? These coffee shops have got staircases leading to the upper units and these extremely conducive places for prostitution, or even to be used as an illegal brothel. Transactions can even be done more overtly. Therefore, responses from the authorities, such as "It is a public place and anyone can really sit there", are really not helping the situation. For online vice, it is even more challenging. We are very connected as a society, given the number of devices each person possesses. Vice syndicates leverage technology to expand and flourish their operations, crossing borders even. What is MHA's strategy for tackling this efficiently and effectively? How are we able to work with overseas agencies and countries on this? All in all, Sir, I support the enhanced penalties, and the amendment Bill must execute what it is intended to do to maintain the morality, rights and status of women. I hope to see the enhanced collaborative efforts clean up our heartlands and beyond.”
“Thus, good ground feedback is necessary and useful and can be very powerful, indeed, to ensure that we can execute these policies effectively. My further input on the Bill. Education alone will not get the results we desire. Those involved are too entrenched, the education target may work perhaps for younger people who are considering venturing into this. You may try to stop them using deterrent publicity, heightened awareness and education combined, but it has to be more persistent and more consistent. Otherwise, we will not get the results that we started off to get. On the vice rates, for it to have impact, do more and make it regular, sustainable and consistent, for it to have the effect and the results that it is intended. Otherwise, it will be a cat-and-mouse game, you leave and they will come out and play. Enforcement, as shared in this Bill, too, has to have consistency, or else it will lose the impact that is intended. Now, the review of Housing and Development Board (HDB) and residential premises need even more surveillance, monitoring and proactive measures. You cannot imagine how challenging it is on the ground when feedback is given and it results in a cursory, standardised reply from the agencies or HDB. These gaps need to be addressed and require absolute strengthening. Can something more substantial be worked out with CEA as you are having a dialogue with them – HDB and, indeed, we are looking forward perhaps even to have Members of Parliament being engaged in your focus group discussions because we may have issues that may need to be addressed in some of these reviews? There is a stark link between sex, prostitution, sex drugs, sex enhancing drugs, drug utilisation and sales, love scams, online vice and even cigarette cartel.”
“Now, for fear of her family's safety, she finally decided to come forward. After all, the definition of "vice" by the Merriam-Webster dictionary is really "immoral or evil habit, a sinful or a criminal practice". This mother, with young children, living in a residential area, had genuine concerns. I assisted her to sort out her issues, of course, and it is now settled. But the point I am trying to make, Sir, is this: does it have to be so challenging for one young family and a concerned mom to activate the authorities for issues like this? We want to enhance this Bill. We are doing an amendment. We want to enhance the penalties. We want to enhance the fines. We want to make it a stern point and a deterrence. But can the frontline agencies and officers not be more sympathetic, more understanding, more aligned and more collaborative in their responses in the handling of such issues from the community and the public? That unit in the narrative I shared amounted to being used as a brothel, aligning with all of its definitions in section 2 of this Bill, including the example on "circumstantial evidence". The use of apartment units for vice is very challenging. The authorities alone cannot detect every breach. Thus, I am calling for greater recognition and collaboration with the community partners and residents living in specific areas. They can provide the ears and eyes you so need. This is the best model to have for us to work to deprive the operating spaces in the heartlands and in the residential areas causing all the disamenities. We have the policies, we have the framework, we have the guidelines, but there may be gaps in execution of these.”
“Mr Speaker, I am starting with a narrative. Names and addresses have been anonymised to maintain confidentiality. A lady with a young family living in a condominium came to see me at my Meet-the-People Session. Seven months prior to this, she had noticed suspicious activities going on at a unit across from hers. Both men and women were coming in at regular intervals throughout the afternoon, night and into the early hours of the morning. They were not the same people as you and I would expect if they were members of the same family living in that unit. They were of different ethnicities, different ages and some, as she described to me, would apparently seem to be under the influence of perhaps alcohol or drugs. She tried calling the authorities several times to assess. But each time, she would get responses, such as, and I quote, "The Police have more urgent crime to fight. We will come by later to check. And madam, we cannot arrest people unless you provide us with the hard evidence." And thus, her family installed a CCTV camera to get that hard evidence. Indeed, she got it. The Police asked for photos, evidence and facts, and it was documented with very good timeline annotation. Different people, different ages, different ethnic groups coming into that unit. The pictures were very telling, very hard evidence, even better than the chat logs that were mentioned earlier. Different faces, different people coming in individually or in twos or threes at approximately two to three hourly intervals. She then again approached the authorities. But then it was taking so long and, in view of this, she came to see me. That was some half a year after all these had surfaced. Neither her managing agent nor her Management Corporation Strata Title (MCST) could assist her.”
“In this light, perhaps can MOM work with the Ministry of Health (MOH) on a framework or guideline to assist and advise medical practitioners on some kind of algorithmic process, so that there is actually some kind of a loose framework they can refer to? Also, how frequently does MOM review the claims compensation amount and how is the AMF derived? That would be good for us to understand as well. Finally, on claims processing time, I hope that this can be hastened as well, as on and off, I still see workers requesting for help on follow-up and this is already amounting to probably sometimes two years or more after the initial injury. Therefore, perhaps some expedition in this area will be useful. In all, I support the Bill.”
“For foreign workers especially, they have to actually pay foreign rates and non-subsidised rates. Are these claimable from the employers or MOM? Also, these follow-ups are done before the claims are given out. Therefore, the workers will usually have to fork out their own money for this. These fees may amount to quite a significant value and, at times, the employees have no choice but to follow up. In some cases, we have also seen them defaulting on their follow-up, thus leading to problems medically for them. Can the Minister also share with us on the claims for dental procedures and dental cases that are related to injuries? Are employees only able to attend Government or public dental services or can private dental specialist care also be recognised as well, as dental injuries are probably less common than just medically-related ones? One other area which is still rather nebulous is the area of mental incapacitation resulting from a work-related issue. One of our colleagues Mr Arasu Duraisamy brought this up earlier and I support his call for some considerations in this area. Proving this may be more challenging. Therefore, has there been any examples of such cases, if the Minister can share with us? Also, moving forward, how can we perhaps give these cases some kind of consideration? Next, claims from workers can be reported by the workers, employers or the medical practitioners. SMC takes serious disciplinary action against doctors for non-reporting or even for insufficient medical leave and assessment which is not done appropriately in relation to injuries.”
“Mr Speaker, first, let me make a declaration in my capacity as an Emergency and Trauma Specialist. I manage some of these work-related injuries and deaths at work and I also write their assessment and compensation claims. Pertaining to the technical aspects of the Bill, I have the following queries. Firstly, there are currently some 15,000 to 16,000 claims per year. What is the trend that we are seeing over the last few years? This is a reflection of our workplace safety. Also, how does it compare with other cities with relatively similar industrial and size make-up as Singapore? Secondly, the salary cap for coverage will be increased to $2,100 from April 2020 and then $2,600 from April 2021. Can we not just do this in one step? The sooner the better, I feel. For such an important issue whereby lives and limbs can be at stake, the faster the better. Anyway, the WIC premiums' incremental cost is at 0.015 the annual total labour cost. Can the Minister explain this in a bit more detail and how the decision was reached to do this in two steps rather than just one step? Thirdly, there may be cases where the salary records are missing or unavailable. I note one of the prerequisites is the itemised payslip. How can we reconcile and improve this as it seems a fundamental and basic requirement for employers? Is there a significant number of such cases that MOM faces annually? How can we perhaps implement some kind of enforcement with this because this is really a basic fundamental for our workers? Fourth, for some cases where their medical status needs stabilisation before the final compensation can be decided upon, they will need multiple follow-ups and appointments with the medical specialists. Also, who will pay for these consultation fees?”
“Therefore, we had to conduct more dialogue sessions and discussions, such as case studies, where we can show our families, especially those from the low-income groups, how to obtain assistance from the good schemes made available by our Ministry. CareShield is a scheme that can provide help to families and the amount is not insubstantial because it starts at $600 per month and will increase gradually. Therefore, if we know how to make use of this assistance, we should use the grants and scheme for our needs as well as our families' needs, because the expenditure for long-term healthcare is certainly high. Finally, I would like to ask the Minister, in Budget 2019, it was announced that $5.1 billion will be provided for the Long-Term Care Support Fund. How long is this amount expected to last to meet the needs of Singaporeans? On that note, I support this Bill.”
“Therefore, perhaps there is also a need to review and align this with the Ministry of Social and Family Development and other Ministries and see how we can assist these families as well, because the number of people with psychological disability and severe forms of psychological and psychiatric disabilities are increasing and bound to increase further. There has been some issues raised about the number of ADLs that we can actually include under our consideration for certain schemes, whether it is one, two, three or four. I would like to urge the Ministry to consider, even for people who have less than three, perhaps two ADLs that they cannot fulfil, we can give them a case-by-case consideration because, in considering ADLs, it is a spectrum. It can be from the most minor to the more severe. Therefore, perhaps for those with two disabilities, but they are relatively severe, at the most severe end of the spectrum, we could consider giving them the assistance or enrolling them in the scheme as well. Sir, in Malay. (In Malay): [Please refer to Vernacular Speech.] In 2016, the World Health Organization (WHO) stated that long-term quality care is related to two factors; first, the type of care provided and, second, the lack of integration among different healthcare services. Therefore, I would like to ask the Minister whether we can focus on these aspects in the forward planning for this sector because this sector is a very important one. Until today, although there are many schemes administered by the Government and the Ministry, in terms of long-term care, many people are still unfamiliar or unsure about what these schemes are. So, even more messages, educational information and advertisements are needed.”
“So, that part is something that most elderly people, those with disability and members who have a disabled person in their families are concerned about. One new change is that, with effect from 2020, there is a possibility of withdrawal of $2,400 per year from the MediSave account, subject to having a minimum of $5,000 in the account. The Minister did mention that patients or the disabled person himself as well as the spouse's account can be used. How about parents, siblings and children's accounts? Can these also be tapped on because I think most family members would want to support the disabled member in their family? Can I also ask the Minister on what are our plans moving forward for long-term care at home? We can do so much more in this area, which is an option besides institutionalisation. What kind of further support at home, in terms of training, respite for caregivers at home who need a break from the caregiving process, are we able to assist families with? Also, on the issue of capacity, even in the step-down care area, whether it is at home or in institutions, how are we planning to cope with the supply of manpower? Today alone, we are highly dependent on foreign nursing and caregiving workforce in this area. So, how sustainable is this and what are the supplementation and injections we are planning, moving forward? Finally, with the definition of disability in this Bill, it does not really categorically cover mental and psychological incapacity and disability. We know that for people who have very severe psychological or psychiatric problems, they may not even be able to perform their ADLs.”
“There is because, with ElderShield, we earlier saw that it started at 40. This is a difference of 10 years, and it would be useful for us to understand the difference of 10 years and why we are starting a lot earlier with CareShield Life. From a medical perspective, I can certainly understand that. But maybe from a financial perspective and an administrative perspective, we can get a better understanding of this. Secondly, what happens with a person who is eligible for CareShield Life but lives or works long-term overseas? What type of processes do they have to go through? Can the Minister also outline the steps and requirements for those who are alone and in nursing homes and for those with no next-of-kin support? Pertaining to the disability assessment, on what grounds can the assessment fees be waived? Are there steps or application forms that the applicants will have to pay for such waiver? Please also review the process and make sure that it is simple enough because many of them can be illiterate or they may not be able to understand what is being asked. They may not even have next-of-kin. On the same matter of assessment, some of these people with disability are still in the process of review. That means that disability has not reached a stable stage and they will need regular review in our healthcare institutions to make sure that it is not progressing further. The Minister did mention that we can have data obtained from our healthcare institutions for those people who need regular reviews. But then again, is this sufficient or would they have to pay every time they need to have an assessment done by one of the appointed assessors?”
“Mr Speaker, the Organization for Economic Cooperation and Development (OECD) defines long-term care as "the care for persons needing support in multiple facets of living over a prolonged period of time". Sustainable long-term care requires the following three elements: first, financing; second, delivery and this is where we need the three "Cs" – capacity, capability and coordination; and thirdly, regulation of some form. In many countries today, the distribution of care is shared among the public, private and people sectors. In Singapore, co-sharing is among the Government, the individual and the family, and it is a model that we are quite used to. Essentially, the following four modes of funding are utilised for healthcare: (a) Government subsidies in different forms; (b) MediSave; (c) Basic healthcare insurance, which is our MediShield Life; and (d) MediFund for those who really cannot afford and have no other sources of assistance. For long-term care, ElderShield is the scheme and now, with migration to CareShield. The demands for long-term care will increase significantly with the ageing population, the coming of age of our Baby Boomers and, of course, the population and others who may develop complications of chronic illnesses which we have a lot of. Financing will always put a high demand on governments on various platforms. In this aspect, I have a few queries and clarifications pertaining to the Bill. Firstly, starting off with a fundamental question. The CareShield Life Scheme, which is a migration from ElderShield, is compulsory for all citizens and PRs of Singapore born on or after 1 January 1980 and are at least 30 years of age. Can the Minister explain on the decision and rationale for the cut-off at 30 years?”
“How will MUIS continue to support them as they discharge their roles in Singapore, perhaps the region as well, where they may be consulted and called upon? Development Opportunities for Asatizahs”
“Mr Chairman, in Malay, please. (In Malay): [Please refer to Vernacular Speech.] Singapore is increasingly being recognised as having a religious sector and religiosity that are organised and practical, with evidence-based fatwas and religious policies. Our asatizahs and eminent experts on religion also help to support this reputation. One of the measures implemented recently is the establishment of the SIC and the Singapore Islamic Hub. Many other secular countries with Muslim minorities want to learn about our model. Would the Minister share on its progress? What about the programmes that will be made available, as well as courses that will be held? How will the students’ curriculum be balanced? Where will we acquire the teaching faculty from? Will we accept overseas students? Committee on the Future Asatizahs (In Malay): [Please refer to Vernacular Speech.] With over 4,000 asatizahs now registered under the Asatizah Recognition Scheme, it is hoped that they will bring a more visible positive impact to the community. These asatizahs comprise new graduates as well as those who have spent years in the religious sector and are highly experienced. They can and will have the potential to contribute immensely to the Malay/Muslim community in Singapore and globally. How will MUIS provide support to them in terms of life-long learning, increasing their knowledge and other activities under this masterplan for asatizahs? (In English): We need to enhance our asatizahs' functioning capabilities, breadth and spectrum of knowledge in this ever-disruptive world, especially with newer issues and challenges cropping up every so often, for example, global Islamophobia, terrorism and its unfortunate link to the religion and so on.”
“Sir, advanced care planning is a sensitive area, and more so in our multi-religious and multi-ethnic society. Many lack the genuine understanding of what it is, and it also stems from the fact that it is a taboo subject many choose not to talk about and they feel discomfort in discussing it. It cuts across all ages because talking about death and the end of our lives are really not the easiest things. As a result, many lack the understanding and may be unaware of the important decisions and options they have or have to make whilst they still can. In my work as an Emergency Medicine Specialist, people come in with critical and serious illnesses and presentations, many even stemming from many years of harbouring a chronic illness or diagnosis, and yet, not having an Advance Care Planning (ACP) done at all. We then have to discuss with them or the next of kin at this critical juncture in order to have a decision to be made pertaining to the level and depth of care and resuscitation they wish. Many grapple at this stage as they may not know what their loved ones wish for. They may never have broached the topic and a sense of guilt can prevail. Choosing to know, learn and decide on ACP is really something we may need to do. How is the Ministry sending out more educational messaging and campaigns, perhaps to be executed in a sensitive way and also perhaps working across Ministries, such as MOH, the Ministry of Social and Family Development (MSF) and other partnering organisations, VWOs and non-government organisations, and perhaps also getting our Inter-Religious Organisations and the Inter-Racial and Religious Confidence Circles to talk as well in our society.”
“In terms of innovation and productivity, healthcare, as I said, is labour-intensive and patient-centric. So, we need to review that appropriately as well. Fifth, it is data-driven healthcare which is really a must moving into the future. This will help us formulate guidelines and policies. Key performance indicators must be reviewed regularly as well. With all that in mind, I would like to ask Minister: first, on our healthcare productivity, how are we doing and how are our targets set and how are we moving ahead with this? Secondly, what will be MOH's regulating framework for adopting new models of care for Singapore moving ahead with ageing on top of our minds? Thirdly, can we also have an update on the progress of the regulatory sandbox licensing experimentation and adoption programme (LEAP). MediShield Life for Community Hospitals”
“Sir, we have a strong healthcare system with strong, sound fundamentals. One of the most important characteristics that keep us at the forefront is the ability to robustly adapt and be dynamic. And this is unique in terms of healthcare because it is an area that is rapidly changing and developing. But this journey never ends. It is going to have to continue into the future. I have five areas that we have to focus on moving ahead. Firstly, the balance of quality and affordability. We have been doing this a lot. We have been reviewing our policies, we have been liberalising, we have been doing all kinds of things and tweaking according to the needs of our population as we move into the future. We must continue to do this. We must review at regular intervals and we must make sure that we tweak accordingly and appropriately as well. 1.15 pm The second area is really to embark on new models of care. This must be more in terms of ambulatory, more community-based, more home-based care, more stepdown care and more intermediate care needs as we move forward with an ageing population. There will also be a need to review more preventive services and to have these made more widely available and accessible. Thirdly, manpower. We need an adequate projection of numbers into the future of the pipeline for provision of care of the types of different healthcare personnel that we will need. The demand will be high in an industry which is really labour-intensive. Our graduates from our traditional schools and institutions will continue to churn out numbers. But the numbers will need tweaking as well and this will have to meet our demands. Perhaps, also tapping on the retired personnel who are still healthy will be an option to consider moving into the future.”
“Chairman, I have one clarification for the Minister. It is actually pertaining to single unwed mothers, and I know the principles and values we want to uphold in the society and all that. But many of the issues that they face and grapple with, I agree, can be solved at the constituency level through other networks that we have formed in the constituency and all that. But when it comes to policy like housing, Baby Bonuses and so on, we require intervention at the Minister or Ministry level. Usually, we will appeal and re-appeal, but then it is really a very long circuitous journey for these people. Pertaining to that, taking that a little bit further, I have a couple of cases where we actually have Muslim women who are second wives to Muslim men, and they are also faced with this issue where they do not qualify for Baby Bonuses and other policy issues because they are the second wives of the men. That is another area as well.”
“Sir, the proportion of women in top corporate appointments and board of directors still lags behind their representation amongst professional groups and other leadership roles. Women provide critical contributions and a diversity of views. There is sufficient evidence-based data today to show that positive value that women bring on. Even as we are an Asian Society, meritocratic performance of women must be upheld, acknowledged and celebrated. Having more women on board can help companies entrench a stronger and more well-rounded human resource policy and can help attract potential women leaders boost their development and performance. Diversity in corporate leadership has also been shown to promote better governance and sustained business performance. Can the Ministry provide an update on the work of the Diversity Action Committee and the BoardAgender, and also an update on the code of corporate governance for Singapore Exchange-listed companies to disclose their board diversity policies? Are there local data to support and show the improvements that have been made over the years?”
“Sir, Singapore and the US enjoy a long-standing and deep relationship based on substantive cooperation in many areas, such as economics, trade, education as well as defence and the security sectors. Our Strategic Framework Agreement with the US, for example, formalises bilateral security and defence cooperation. We have both also enjoyed many years of exchanges, including high level ones. In 2017 alone, the US was Singapore's third largest trading partner in goods and also its top trading partner in services. It is also Singapore's largest source of foreign direct investments (FDIs). Conversely, Singapore is the US' second largest Asian investor, after Japan. Besides our regular defence collaboration and exchanges, we are also very active in the US-led Global Coalition to Defeat the Islamic State of Iraq and Syria (ISIS) and we are the only Asian country to have contributed both in terms of military assets and personnel towards this. With the new developments in the US, internally and also in terms of its global status, how will Singapore continue to strengthen and deepen our cooperation and relationship with the US?”
“Sir, now more than ever before, Singapore's security is at risk from a variety of conventional and non-conventional threats and sources, and all the more we need to remain vigilant and defend ourselves and our borders. We will need to continue to boost our capacity and capabilities and build up our defence capabilities, systems, operations, manpower and technology. We need to ensure we maintain our edge at all times. This requires state-of-the art mindset, equipment and systems. The military hardware itself is costly. With that background, what will be the projected medium- to longer-term increments in defence spending? How are we to balance this against the needs in other competing areas? Training also, Sir, requires planning and preparation, more so in terms of teams training, table-top exercises and simulated exercises. These are also not cheap. How will MINDEF be allocating funds into these aspects of development and training as well? Role of NS and Its Importance to Singapore”
“Sir, the military today has a strong emphasis on information technology (IT) and data analytics, including big data. The use of this has become integrated into many aspects of defence. On the other hand, cyberattacks and breaches are also getting more innovative, threatening, complex and widespread. Cyber threats do not fit into traditional security framework. So, therefore, Singapore cannot let down our guard. We are on the radar and the target of many, due to a variety of factors. Recently, the launch of the Cyber Defence School is an excellent move, providing training across the networks and in cyberspace. It will help in training officers in preparedness, thinking several steps ahead of the perpetrator and culprits. How is MINDEF upscaling cyber defence and security and ringfencing, with a view to fortifying our national and defence cybersecurity systems? In alignment with this, can the Ministry also update us on what further efforts are being pursued to continue to develop the area of cyber defence and expertise in the SAF? Can we also have an update on the Cyber NS Scheme and how MINDEF intends to boost our cyber defence expertise in the military? Knowing also that the military response must be part of a concerted national effort, how is MINDEF's approach coordinated with that of other Ministries and agencies in our national cybersecurity ecosystem? Cyber Defence”
“Immigration laws vary from country to country and change according to the needs, factors affecting population as well as growth and development of the nation. There is really no one-rule-fits-all policy. Singapore is challenged even further due to our sheer small size, and more so due to our rapidly ageing populace. Our guidelines and policies must acknowledge our diversity, uphold unity and be realistic and practical. New citizens can have a positive contribution towards nation-building and social integration. The guidelines for recruiting new citizens must be robust and dynamic and at the same time meet our objectives. How are we reviewing our immigration policies? Are we able to implement a more structured community involvement of potential new citizen candidates, perhaps even with the provision of inputs from senior and experienced community leaders? This is with a view to having them immersed and better integrated in the local community and activities. The community leaders can act as assenters and provide valuable inputs in this respect. Challenges Faced by Young Adults”
“Mr Chairman, Singapore has one of the most dynamic and high performance public service sector globally. With a spectrum of younger officers to the very senior and experienced ones, they serve Singaporeans through our Ministries, Civil Service, Statutory Boards and many other organisations. With globalisation and a more connected world, our Public Service must be resourceful, creative and rapid thinking. They must remain nimble and keep abreast of the changes and disruption in the world of today and tomorrow. They must align with the state of the art, be adaptable and flexible in certain aspects of policymaking and governance, but yet uphold the principles that Singapore stands for. The adoption of information technology (IT) and other technology-driven processes, communications as well as surveillance must be top-notch and robust. Yet at the same time, maintenance of safety and security must be upheld. How is the Singapore Public Service assisting the officers in providing adequate training, building of capabilities, acquisition of the necessary software, technology adoption as well as nurturing and managing the mindsets of officers to ensure adaptation, alignment and buy-in? And this is also part of the learn, unlearn and relearn process. Another very important tagline with the Public Service must be coordination. With the amount of disruptions and interventions that we face today, how will the Public Service ensure safe coordination and integration of information, data and details across the service whilst, at the same time, maintaining confidentiality? Citizen-centric Government Services”
“Sir, Budget 2019, follows on as a continuity plan from the last few Budgets. Genuine and deep partnerships will help us as we execute the proposals of Budget 2019. My views are that national Budgets do not just represent the governments handing out to the population unilaterally. It is about the partnership between the people and the Government. It is about how people understand the Budget and tap on the schemes and programmes, and that is where we come in as well where we have to do simplified explanation because there is really a lot of sophistication in simplicity. It is also about how specific groups utilise the resources made available through the Budget. It is thus important to have a proper and deep understanding of why each scheme and each subsidy is proposed and not be swayed by superficial, emotional interpretations of the Budget. Finally, Sir, if everyone is working and moving forward together, we can do so much more and we can succeed together and then success will take place itself and things will all fall in place. I support Budget 2019.”
“In my constituency, under the framework of WeCare@Geylang Serai, with over a hundred partners focused on a variety of areas of help, be it education, support in kind, friendships and befriending collaborations, healthcare and so on, the partnerships are deepened over the years. We see the growth and the nurturing. We see the positive corporate social responsibility (CSR) by many organisations and companies. We also see their help and support evolve and change according to the needs of the times. These are all examples of useful and meaningful partnerships and they are also customised partnerships. They have to stay relevant and they have to be relevant in the world of not just today but also moving forward to tomorrow. Thus, there is also one more partnership that I just want to mention, which is the disruption in partnerships. Partnerships are, indeed, an invitation to engage, and engaged ones are critical in the formation of meaningful networks. With disruption and transformation in our partnerships, the impact is certainly wider, greater and deeper. Disruption is already affecting our local and global relations. Every business and society entity now has greater potential to expand their mission and work. The outreach through disruption and transformation can be tremendous. There are even funds provided by the Government to support this. Digital disruption has coloured our partnerships and relationships. Even our VWOs and non-government organisations (NGOs) are forming partnerships with clients, supporters and sponsors through disruption and disruptive techniques. For example, counselling can even now be done through videoconferencing and through electronic partnership portals. Of course, a word of caution is on the maintenance of confidentiality on such platforms.”
“Thus, my focus on "Partnerships to Prosper", or P to P. Old partnerships, existing partnerships, new partnerships and yet-to-be-formed partnerships. We are all in these together. Only through deepening our partnerships, understanding and collaborations can we have a better grasp of issues, things and phenomena. I always say that partnerships are about "building bridges and managing our egos". It is about respect, honesty and cross-cultural understanding. These include partnerships and collaborations at the global level, with foreign affairs. How we collaborate and befriend other nations is critical, some more than others, but it must all work in a rules-based world order. Our principles must prevail and Singapore's interest must prevail. The same goes for our regional partnerships. For example, at the Association of Southeast Asian Nations (ASEAN) level, Singapore is looked to as a model Asian society and we must strive to demonstrate and model this. Singapore relies also on foreign workforce and new immigrants. These partnerships with them must be two ways: for them to understand us and for us, them. Our own global platform for deepening our learning process is also deepened through our interaction and work with these people. On diplomacy and defence, as mentioned by the Finance Minister, this, too, needs formation of partnerships. Our interaction and relationships with nations and neighbours are just as crucial as building up our Singapore Armed Forces (SAF). Ask any business person and it will be evident that good partnerships and communications are the basic fundamentals of joint ventures, business networks and economic collaborations. At the community level, with ground-up initiatives, partnerships can make the difference as well.”
“This is an unhealthy, worrying and very grim situation. In Singapore, we, the Malay/Muslim community, are fortunate that our rights are protected as a minority group. So, please do not squander the opportunities given to us, which are the same as the other communities. Finally, although we have not reached the same level as the other communities, our Malay/Muslim community has achieved greater excellence. But what about the next stage of our journey? It is up to us whether we can adapt to the modern world, the application of information technology (IT), e-learning and gain new skills in a fast-paced world. I end my speech with a pantun: Values and principles of Singapore, Between the Government and the people Working together, hand-in-hand A community of excellence, a stable nation. (In English): Mr Speaker, they say a stable world order is a rare thing. Governing nations will require skillful statecraft because we will have to wake up to something new every day. Governance must be robust and, at the same time, nimble, subjected to frequent changes and disruptions, which we have to adapt to. The 21st century is a different world we live in. China holds more than $1 trillion in hard currency reserves. India's high-tech sector is growing by leaps and bounds. They have nuclear power and are developing blue water navies. It is a complex, multi-polar era in world politics that we live in with all these tectonic shifts. Singapore is vigilant, well-placed and can adapt, if we keep on this trajectory that we are on. Any instability, any major shifts in the way we work, our little red dot will get left behind. We must surmount the challenges of the day together and retain our core values and principles for a cohesive and stable Singapore.”
“Religion is also an important factor. However, the most essential thing is that our preparations and plans for our golden years begin while we are still young. Most importantly, we must have a roof over our heads, adequate funds for expenses, health insurance, a family that supports and cares for us, peace of mind and the ability to comfortably lead our lives and practise our faith. On to our youths. The number of youths studying up to post-secondary level and those reaching university has risen. The number of workers in the professionals, managers, executives and technicians (PMET) category has also grown. The number of entrepreneurs spreading their wings globally has also increased. For our SME owners, there are many types of assistance and schemes available for business expansion and automation. In this Budget, $100 million has been allocated for business upgrading and enhancement. For our asatizahs, they are getting better qualifications and many are graduating from illustrious Islamic institutions, such Al Azhar. We now have access to global developments and can gain a positive impact from this. We live in a secular nation with religious diversity. We lead our lives freely and we are not oppressed in Singapore. We can pursue our religious activities with ease. In Singapore, we have around 70 grand beautiful mosques with modern facilities. The Islamic Religious Council of Singapore (MUIS) is also always available to issue advisories and rulings for us to follow. If we look at the situation in European countries, for instance, recently, in the 2015 European Islamophobia Report, the number of hate crimes against Muslims has risen. In the US, 10 states have legislated Bills that are anti-Islam and promote Muslim-free businesses.”
“In education, we must continue to inculcate the love for learning at every level, in every individual. This includes lifelong learning. For workers, this kind of learning includes the upgrading of skills, capabilities and qualifications. We must never get tired of seeking knowledge, broadening our minds and improving ourselves. We have now begun to move away from a single-minded focus on academic qualifications and expanded capabilities in other fields. This provides a good platform for our Malay/Muslim community to close the gap and level up with the other communities. This also means that the criteria for educational assistance and the criteria that solely use academic benchmarks should be reviewed and revised. On average, the Government provides a subsidy of almost 90% for every primary and secondary school student. For those from lower-income families, the subsidy will be more than 90%. This demonstrates an emphasis on education, because we know that education is the only factor that enables us to raise the standing and status of our family. As they say, education is the greatest equaliser. In healthcare, during Singapore's early years, we faced the challenges of malnutrition and infectious diseases. At the moment, our Malay/Muslim community is battling chronic diseases, such as diabetes and high blood pressure, and the rates of complications and risks are also high. Now, the issue of ageing has gained prominence. How do we plan ageing successfully and comfortably for ourselves and our families? Certainly, culture and personality have something to do with one’s perception of ageing. A survey in Singapore found that factors seen as important in old age are good health, financial means, healthy lifestyle and strong social support.”
“Mr Speaker, in Malay, please. (In Malay): [Please refer to Vernacular Speech.] Mindset and progress of the Malay community. Mindset determines everything. It is the engine that drives our motivations. Mindset can determine the ebb and flow, the ups and downs in someone's life. Mindset is related to how we shape our lives, our journey and our family with a vision. A mindset change can transform our lives. This year, Singapore commemorates 200 years since Sir Stamford Raffles set foot on this island and 54 years since we achieved Independence. What are the status and performance of our Malay/Muslim community? What is the level of our achievement so far? Over the years, various programmes had been implemented, new policies were crafted, and progressive and competitive schemes had been rolled out by the Government, self-help groups and other organisations. In doing so, with this background, the principles of meritocracy, diligence and cooperation among the different races and religions have always been emphasised. All these are stepping stones and opportunities for us to improve and enhance ourselves and our families. Although we are a minority group, our desire to achieve progress and excellence is strong. The expectations of our younger generation, millennials and our descendants will continue to grow. That is uniquely Singapore. Each generation gets better, more successful, better educated and trained, more successful and more global, and we must not turn back again. In order to determine the thrust of this future, we, and the next generation, must continue to strive, share a common vision, collaborate, possess a broad and progressive mind, and look ahead while exploring a new world order and a new economic landscape with new strategies.”
“With the transfer and merger effected, I assume there will be a review of our national plans. So, will there be any changes to our National Conservation strategy and action plans? Finally, Sir, will there be a single access number or hotline number with the reorganisation? This will help publicise to the public information and also a single point of contact which makes it a lot easier for all forms of feedback as well. With that, I support the Bill.”
“Mr Deputy Speaker, this is an important Bill. It sets the fundamentals based on our principle of “Let's Make Singapore Our Garden” – Our Garden, referring to both flora and fauna – a vision we have set since the 1960s when we commenced our nation-building. It also aligns with Mr Lee Kuan Yew’s vision for us in transforming Singapore into a Garden City. With this Bill, there is a revamp of the Statutory Board and the agencies' organisations. Can I find out how this is going to affect the staffing arrangements and reporting structure? What about the secondment of staff, with the AVA now being subsumed and transferred under NParks as well? The transfer is appropriate, in terms of AVA coming under the same umbrella, as NParks manages our greenery and our parks, which is also the basis of our ecosystem for many animal species and types. Coming together does make sense and helps streamline work processes and flow. The oversight and planning of our ecosystems will also be more wholesome and aligned. Can the Minister advise us also on how the new entity will be working together with other agencies, such as the Health Promotion Board for health-related issues, infectious diseases and also health and medicinal products concerned? How about NEA, especially pertaining to public health issues? Can we also get an update on how much, on average, do we spend on animal management annually? I anticipate this amount is going to increase, with the new developments and changes we have planned for the next several years. The National Biodiversity Centre has been in existence since 2006. With this renewal of the management and plans, are there going to be changes to the focus and thrust of this Centre? Can we get an update on this as well?”
“I see this programme becoming more important in the coming years and, under SFA, we hope there will be more publicity on this programme and also recruitment of people and non-government organisations which are interested in having healthier food choices into the future as we look towards healthier ageing also. With the new agency, how will the relationship with food industries and food businesses be strengthened? They are the important partners who need to be engaged. So, therefore, it is really important that we have focus group discussions and also apprise them of the developments with this new agency. The networks must be established, but we must also bear in mind the ringfencing of the security of our food resources and sources is important. This is because in this age of terrorism, food can serve as a source of targeted widespread terrorist type attacks to impact large numbers of people at one time, and we must ensure vigilance at all times. Thus, even with diversification, we need to maintain surveillance and monitoring and must never let our guard down. Our food safety network and framework must remain up to date and robust. As a very small nation, changes in world food production, trade, food safety and supply will, of course, affect us. But it also tests our resilience, our food innovation capabilities and security. We are on the right track. And with this new Bill, Sir, I definitely think we are going in the right direction. I support the Bill.”
“What newer areas of food supply and research can we expect to see? Will there be a focus on food diagnostics and development, the latter being one area that can address the food challenges a small urban country like Singapore will face? Also, as there are now six institutions offering Food Science and Technology courses, that is, the National University of Singapore (NUS), Nanyang Polytechnic, Tampines Polytechnic, Singapore Polytechnic, the Singapore Hotel Association Training and Education Centre Institution and the AEC College, can you also share with us their programmes and curriculum as I feel that there needs to be a dynamic view of their education in order to stay relevant and even address Singapore's food needs? How can these institutions work with the National Centre for Food Science (NCFS) in terms of supporting attachments, projects, scholarships, new innovative ideas and so on? This is going to be an important area that we will have to look towards the future. One other institution, the WIL @ NUS, which has a lab by Wilmar International, opened in June 2018. This is also another important facility. What is the progress in the work conducted? This would include themes like newer food choices, specific nutrition for the elderly and seniors and healthier versions. So, we hope to be able to hear on some of the developments with these institutions. In line with this, Singapore has a strategic location and position to attract more global and food R&D companies here. Our pro-innovation climate will, of course, be attractive to this as well. One other query I have is for an update by the Minister on the Healthier Ingredient Development programme. What are the outcomes thus far and how is the progress?”
“Mr Speaker, this Bill is all about food, a topic close to all our hearts. It is about (a) availability of food, either from local or global sources; (b) accessibility of food by Singapore consumers through established supply chain networks; (c) affordability of food for consumers and people and (d) safety and nutrition standards of the food available for Singapore consumers. The food manufacturing industry in Singapore contributed $4.3 billion towards our gross domestic product in 2017 alone – not a small sum. In fact, they also employ a large number of employees, and it is an important business, indeed. As such, my first query is on the coordination between the roles and responsibilities of NEA, AVA and HSA, and how this is going to come under the SFA umbrella and perhaps also some simple and consolidated point of contact for consumers and the public as well. Despite various constraints, such as scarcity of land, traditional agriculture and food farms as well as competing economic needs, we must continue to deliver safe, affordable and uninterrupted food supply for our people. And one of the most important fundamental steps for a new agency is to get the basics working right. With a dedicated agency overseeing our food safety and standards now, it is hoped that we can manage the challenges better, handle lapses more efficiently and effectively in a more coordinated fashion. This includes, of course, food-borne disease outbreaks, through tighter controls and checking mechanisms, and engagement of the various stakeholders and the public as well. We hope for better oversight and surveillance in general. Can the Minister also update us on the National Centre for Food Science? What are the main objectives and deliverables?”
“Mr Speaker, can I just ask the Minister, currently, on the website, it is written that the face-to-face interview for people who are asking for ARS accreditation is conducted on an ad hoc and case-by-case basis. Perhaps, this might be a useful thing to be made compulsory. But knowing the numbers are big, there may be some limitations. Perhaps, the best way to assess a candidate is when you are actually able to encounter them face-to-face, interact with them and look at their non-verbal communication skills. Secondly, it is also about the numbers. Has there been any number that can be reported? Since 2017, when the ARS scheme came about, has there been any asatizah who has been reported to be doing something negative or inappropriate?”
“Can I ask if there will be some flexibility given to the TCMPs, especially for the first two years as the running-in period? This request is with the consideration that some of our TCMPs are in the older generation and they are in solo practices and they may need time to adjust to this, to get used to the new guidelines as well. Next, can I get some clarification on the term "TCM practitioner" as used in this Bill? Are the people who run the sinseh shops, prescribing herbal type medications in this category as well? How about those who offer massage and tuina services as practitioners as well as the dispensers in the neighbourhood shops? Are they also incorporated into this Bill under consideration? On the 11 members of the Board, can I suggest also that they represent TCMPs who are generalists and also some who are specialists in certain aspects of the practice? But I also note that we may need to have the relevant and adequate numbers of specialists in the TCM area for now, so, therefore, this is something perhaps to be considered later on. With TCM services, the fees, we note can range from as low as $1 to $2 in the neighbourhood and community clinics to the highly priced ones in advanced centres. What is the Ministry’s view on this? Will we be moving towards some range standardisation, perhaps even into different categories of services which are being offered? Finally, on the issue of MCs by TCMPs and their recognition by employers, this is a long-drawn issue that has been debated very often. Are we planning to come up with some standardisation or guidelines? This has always been a controversial issue. I think it will continue to be because of the range of services as well as the TCMPs that are out there. So, perhaps some comment from the Ministry on this.”
“Thirdly, pertaining to the compulsory CPE, I firmly support this. I also have a few suggestions to make. One, to have the setup of a directory electronically for courses and training being offered for easy access and knowledge of all TCMPs. The usual organisers can come together to discuss and brainstorm this and see how best to execute. But for those who want to offer ad hoc courses and training, there should be a body of persons looking into the suitability of these courses to ensure certain standards are met. There must be a secretariat to also monitor and carry out surveillance to track the number of points and warn practitioners of the shortfall if they risk not getting renewal of their PCs. There were some concerns on the cost to be borne by the practitioners themselves for these courses. In the Medical and Nursing profession, for example, established institutions have got a sponsorship scheme and other forms of support for their practitioners. For large TCM groups, this may be feasible to offer. But for the lone TCMP, there may need to be other considerations given or offer of subsidies or, perhaps, even accreditation scheme. This will be for the Ministry to review and consider. Of course, some courses can be offered online, though e-learning will also take time and money to set up. Some offset can take place by offering some of these courses through SkillsFuture or other upgrading grants. But that is something to be reviewed with caution. In this context, can the Ministry also update us on the use of the TCM Development Grant? What can this Grant be utilised for? Is it just for education or improvement of practice and setup? I note also the number of points for CPE required over two years.”
“Mr Deputy Speaker, I stand in support of this Bill. The TCM industry has boomed of late. This could be due to the increased demand for alternative therapies, an enhanced awareness for such therapies and also the fact that there are now more interest and research into this area. When we speak of TCM, it can conjure different images in different persons, ranging from the neighbourhood sinseh shops with herbal smells, to the very established companies, such as Eu Yang Sang International Ltd. During a recent survey by MOH, it was noted there are about 10,000 Singaporeans who visit and seek TCM treatment every day. Not a small number at all. There are always certain code of conduct, etiquette and practice guidelines which will be ascribed to every body of professionals. The same must apply to TCMPs, who are also involved in caring for the public and patients and thus must be assessed with accountability as well. A few points to bring up. Firstly, the Act, first enacted in 2000, with a view to raising standards and the conduct of practice in the TCM sector is now being reviewed. Since then, have there been any cases which required disciplinary action or suspension? If so, what are the common reasons or root causes? I ask about this with an intent to see if we can address some of these in this latest Bill that we are discussing today. Secondly, I support the formation of the Inquiry Committee when the need arises, versus having a permanent one in place for a certain term because it is more relevant to appoint according to the type of cases, breaches or issues that we are handling at a certain point in time. This way, we can appoint the appropriate type of TCM personnel or even specialists to provide opinion and consultation or serve as an expert witness.”
“After knowing all these factors, are we going ahead with this Bill? My answer would be yes. Why? Because we owe it to those who will be impacted, to those who will benefit, to those who will quit, to those who will not start and to those who are affected by other people smoking around them. Therefore, it may be short-sighted to actually just view this Bill as a single entity. It is something that should be seen in the bigger context of Singapore as a clean and green garden city, in the context of making the presence of smoking restriction framework in our public places common with the fact that we have age restriction limits to purchasing of cigarette and tobacco products and, of course, our ongoing educational efforts and I QUIT programmes that have been implemented over years and generations. All these are also important because we want to make sure that our younger generations stay healthy for years to come. In fact, one of the programmes that is targeting the younger generations will be the smoke-free tobacco generation, that is, for those who are born in the year 2000 and beyond to actually stop smoking. And I think we have been quite active with this programme in our schools and with teenagers as well. So, therefore, when we consider all these put together, hopefully, it will be more positive than negative. So, Sir, I support the Bill.”
“We must unite in our efforts to address this problem together. It is hoped that these messages, and the age limit to buy cigarettes, as well as negative psychological messages, will have an impact on this complex smoking problem. (In English): Is standardised packaging going to work for Singapore? We have had all kinds of efforts put in and I have to commend MOH for all the initiatives that have been undertaken over the years. We have seen the literature from several countries and have seen how this implementation has been rather lukewarm and, in fact, controversial in some countries. So, are we still going ahead with it? In considering this, it brings us to the root cause of, firstly, the association between cigarette smoking and cigarette pack designs, the pack attributes and also people’s choices. Secondly, it is about perceptions about standardised packaging versus the usual packaging. Thirdly, the potential impact of the graphic warnings and advisories. And there have been studies that have been quoted, both pro and also against this. As regulators, they must also ask themselves in planning programmes and enforcements, which include the link between package and design with quality, taste, cost, social appeal, attempt to start and try smoking, and also the ease of quitting and perhaps the perceived harm – amongst the different age groups and different generations. The issue and the problem lie in the fact that these factors affect people differently and unpredictably as well. It is coloured by their upbringing, life experiences, perceptions, inculcation of educational messages into their neural networks and also their psychological resilience and makeup. Those are, indeed, complex elements for us to really control.”