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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“In Malay, please. (In Malay): [Please refer to Vernacular Speech.] Mr Speaker, it is hoped that standardised packaging for cigarettes will, firstly, make it less attractive to smokers, especially the younger generation and those who want to try smoking and have just started smoking; second, reduce the impact of advertisements and promotions; third, further strengthen messages about the negative impact and dangers of smoking; fourth, create clearer graphics on the risks and warnings about smoking on its packaging. These measures will, hopefully, further reduce the number of smokers and also stop those who intend to start smoking. It is also in line with the WHO Convention to further reduce the number of smokers globally. But will these measures have an impact, especially on our Malay community? They have the highest number of smokers at the national level. A study by the Institute of Mental Health (IMH) in 2010 showed that 4.5% of Singaporeans are addicted to smoking and 20% of them are Malays, which represents a higher proportion compared to our population figures as a minority group. What can we do to manage this situation? Programmes like the I QUIT Programme/Challenge to Quit Smoking during the Fasting Month of Ramadan, advertisements and others, as well as various measures by the Government, seem to have lost their effect. Health statistics show that the number of our community members who are unhealthy, in terms of having chronic diseases and a smoking habit as one of the risks, are worrying. Our Malay male smokers, for instance, start smoking at a young age, during their teens and even while in school. This is unhealthy! Parents who smoke introduce the risk of second-hand smoke to their children and family members, and this will further increase their risk.”
“Mr Speaker, I listened to the Minister's explanation with great interest. Also, being a Director of Quality, Clinical Service and Patient Safety in Emergency Medicine and Trauma, so, that really has got a synergy between the two. The fact that the Minister mentioned that the incorporation of safety culture practices into the whole organisation is welcomed. But more than that, looking at the examples given by the Minister and the whole description, it is actually about human factors – human factors and human errors. So, there are people who study human factors, human factor science, human factor analysis and perhaps, this is one area of focus, not just after an incident happens but also perhaps as a preventive measure to get human factor specialists to actually study some of the more high-risk activities. Probably, you will not be able to study all the activities that go on in the SAF, just as we cannot do it in medicine. But perhaps the more high-risk activities that people are going to be involved in, and especially, compared to medicine, you are involved with more heavy machinery and equipment. So, how do we use human factor specialists to help us with this?”
“Can I ask the Senior Minister of State, with the changeover to the Modified Montgomery Test and also taking the Hii Chii Kok case as an example – which, of course, has its pros and cons as well – moving forward, because we practise in a restructured hospital where there are lots and lots of junior doctors and personnel in training who are performing procedures almost every day and taking consent, so, perhaps, will MOH be able to come up with some kind of standardised guidelines for doctors in practice as well as for specialists? And also, perhaps to do some focus group discussions not only with the senior representatives but also with the junior level doctors, because they are the ones for whom we need to allay their anxieties, and they are the ones running the clinics, whether through direct supervision or indirect supervision by seniors and consultants; they are the ones who are running our clinics and the hospitals in the restructured hospital setting these days.”
“Thus, disclosures and consent become compulsory and are given significant weightage. In this day and age of the PDPA and handling information and particulars with utmost confidentiality, we will definitely have to strike a balance between this and upholding public health policies and principles. Therefore, would MOH be embarking on more public awareness and education programmes to help the frontline medical personnel when we are having issues with outbreaks and handling infectious diseases, including antibiotic resistance as well? I notice that HPB has already started an educational campaign on that matter. Fifth, what about persons on flights enroute to Singapore who are suspected or are diagnosed with certain infectious diseases? What is our framework with CAAS and also other airlines? How fast can contact tracing and ringfencing be done? And this is critical because our borders are really very open these days. With these clarifications, Sir, I support the Bill.”
“Sir, let me, first, declare my interest as a frontline medical specialist who is involved in decision-making and also management of patients with infectious diseases. The Infectious Diseases Bill was first enacted in 1977 and last amended in 2008. Thus, indeed, it is timely to have it updated and reviewed, looking also at the current state of affairs of the world with the spectrum of new, emerging and re-emerging infectious diseases. In doing this, Singapore must continue to stand guided by global bodies, such as WHO and the Communicable Diseases Centre (CDC). I have a few clarifications for the Minister. One, in light of an infectious disease outbreak or suspected outbreak in Singapore, what is the chain of command that we practise? At the institution level, all our restructured hospitals have got an action plan and also a response plan. Do we also wait for MOH, WHO and CDC advisories? What is the coordination like on a bigger scale at the global or even regional levels? Is there a direct chain of communications and correspondence for Singapore that has been established? Second, in the event of cross-border outbreak or spread, how and what will be our model of working and communications with our closest neighbours, for example, Malaysia? Do the environmental and health organisations of both countries have a modus operandi in place? Third, temperature scanners these days are not commonly seen at our borders as compared to the period during the SARS outbreak. Does this mean that we rely entirely on people and travellers declaring that they are ill at our points of entry? Can the Minister please just comment on this as well? Fourth, in dealing with infectious diseases and notification, there is a need to report particulars and details.”
“They would probably have to go through some niche area themed training as they will be given the power to even seize the items and weapons that are involved. I hope to have some clarifications on these issues and hope to support the Bill with the clarifications.”
“Mr Speaker, this is an important Bill and, indeed, as we get more advanced and industrialised, our demand and acquisition for such chemicals will inevitably increase as well. Today, more and more industries are using some of these elements, which have the potential to become weaponised, in the wrong hands. I have a few clarifications for the Minister. Firstly, are there certain criteria and screening processes involved for persons joining and working in certain industries, such as the criteria that are available on who will be using and handling these chemicals, for people and employees, for example, using chemicals that have the potential to become weaponised? Are these criteria clearly set out and are the employees familiar with these criteria and how often are they renewed and updated? Is there some kind of accreditation for these employees? Secondly, for the transportation process itself, are there requirements for the vehicles used to transport these items to be clearly marked and labelled? Are there special signages, logos or emblems used for these purposes as well? Thirdly, transport of these items can take place in various ways. It could be from specific locations to another location within Singapore. How about the transfer of chemical weapons or related chemicals within the same campus or institution but, probably, from one building to the next or within the same building but to another premises? What about the regulations and requirements for such transfers? Are these also subjected to some kind of framework? Fourthly, what are the trainings for these "authorised persons and national inspectors” that are mentioned in the Bill?”
“I thank the Minister for his response. I note that the Ministry will be reviewing the adoption framework on a more generic basis, but with specifics to the case itself, can I just find out whether the Ministry will be involved at all in monitoring or surveillance of this child during his growing-up years? For example, will school counsellors be alerted? What about management of expectations of the child and also their psychological and mental well-being? Will there be any involvement of the Ministry on these grounds?”
“(In English): There is a need for us to develop a culture of risk sensitivity through better risk assessment. All stakeholders across all industries must work hand-in-hand to uphold our reputation and combat the potential undesirable effects of a possibility that is waiting to happen. All stakeholders and the industry's regulators, enforcement agencies and everyone must do our part and uphold our reputation of being a clean and trusted business and financial centre with strong anti-money laundering and counter-terrorism financing controls. I support the Bill.”
“Thirdly, also pertaining to FATF, there is a recommendation on preventing abuse of non-profit organisations and the non-government organisation (NGO) sector. Globally, this sector seems to be at a higher risk for money laundering and terrorist funding activities. Can the Minister share on how we have ringfenced and conducted surveillance on these as necessary? Fourthly, on matters pertaining to money laundering and counter-terrorism funding, it requires a national and concerted effort. Whilst the financial sector may be more well prepared and vigilant as it is often a target sector, how about our other non-financial sectors and stakeholders? What about accountants and lawyers, for example? Fifth, in line with this Bill, we may also need to strengthen and have more prudent risk assessment when dealing with foreign businesses and investments. How are we educating and aligning our business personnel, trade sectors and also how is the Ministry working perhaps with our chambers of commerce. Mr Deputy Speaker, in Malay, please. (In Malay): [Please refer to Vernacular Speech.] I have two questions for the Minister in relation to this Bill. First, regarding this Bill, can the Minister provide clarification on the sharing of cross-border information through the officers who are tasked with the issue of terrorism funding? Secondly, aside from the financial and audit sectors, other sectors can also be affected and become victims in this matter. How does the Islamic Religious Council of Singapore (MUIS) provide guidance and heighten awareness amongst our Mosque Management Boards so that they have a better understanding and become more vigilant about their financial account matters?”
“Mr Deputy Speaker, Singapore is a financial hub. We have trusted reputation as a financial, business and economic centre. Our regulatory framework is current and relatively robust but there may be loopholes. Moreover, money laundering and terrorism funding these days are getting more sophisticated and it may go undetected for some time. Being linked to different aspects of terrorism today seems to be sexy and fashionable, especially for certain segments of people and perhaps also our young who may view it as an exciting adventure. They are more information technology (IT)-savvy, and its use and execution can be very smooth and fabulous but still a form of exploitation. I support the enhanced framework and the higher maximum penalties proposed in the Bill. This Bill is moving in the right direction to ensure law enforcement and intelligence agencies have the powers to keep Singapore safer. I have a few clarifications for the Minister. Firstly, can the Minister explain the role and job description of a suspicious transaction reporting officer? How is it different from the usual enforcement officers? As their jobs entail getting and procuring information with foreign countries as well, how are these officers identified and trained? How are they different from the usual CAD? Secondly, Singapore is a member of FATF. How do we stand in the implementation of the recommended regulations and guidelines thus far? Under this FATF, it helps us to identify our own national level vulnerabilities. What are these so far and how have we worked to ensure they are addressed appropriately and adequately and are reviewed at regular intervals?”
“It is essential for them to safeguard their rights and concerns. Fifth, lifelong learning is of utmost importance. Here, I feel that our community is still lagging behind and must be more proactive. The number of participants in upgrading courses is still low in, for instance, SkillsFuture courses and others. Let us all make a commitment, open our minds and aim to continue learning, with full of determination. Before I end my speech, Mr Speaker, I would like to reply to Mr Faisal Manap's question about us doing self-reflection and also whether our measures are bold enough. I would like to reply to his question with a poem: To be bold, one must have substance Be bold in the right context Don’t change just for the sake of changing Change for the right reasons. Sir, I support the Motion.”
“Some think that this happens due to changing times, immigration and the spread of beliefs and ideologies. Here, our Malay/Muslim families can play a critical role by teaching the correct beliefs to their children, ensuring that religious education comes from proper sources and religious teachers who are certified and accredited by the Islamic Religious Council of Singapore (MUIS). This is crucial. The correct understanding is also important because if the wrong and deviant teachings become widespread, the harmony and social cohesion that we have built over the years will be compromised. Radicalism and extremism are thorns in our society’s side. Second, technological and digital transformation. This wave is upon us and we must open our minds to keep pace with the times. Students, our new and Pioneer workers, teachers, religious teachers and Malay/Muslim organisations must ride the Smart Nation wave as well as its accompanying initiatives. Do not allow ourselves to be left behind. Grab all the available opportunities. Third, increase involvement in the areas of research, experimentation, mathematics and all the sciences. While there are those who have embarked in these fields, but the numbers are still very low. Improvement in these areas can further strengthen our Malay/Muslim community’s strategic position in the nation. Fourth, a deeper understanding on legal matters, legal rights and the law. Many have made the wrong move or took the wrong path due to ignorance of this area. Hence, moving forward, we must enhance education efforts and community dialogue sessions on these topics. With Singapore as an International Arbitration Centre, our community members need to upgrade themselves in this aspect in order to deepen their understanding on this topic.”
“It will require care teams with credibility and the required training; reputable and strong institutional backing and support, such as from our academic medical centres, which are already in existence; a strong sense of ties inter-professionally; and efficient implementation, responsiveness and, of course, always, always a degree of flexibility. Scenario 2 must be made up of interdependent individuals and groups united by a shared goal, with practical vertical as well as horizontal integration. This is a critical consideration for all of us, both healthcare providers and healthcare consumers, in Singapore. It is a decision we must make and accept together. Mr Speaker, in Malay. (In Malay): [Please refer to Vernacular Speech.]: Singapore's Malay/Muslim community continues to move forward, is more progressive now, with many more professionals, more students at the university and postgraduate levels. There are more success stories and excellent achievements amongst our youths, entrepreneurs as well as our workers. All these take place within our unique society, in a multiracial and multi-religious Singapore, where the different races interact and integrate and which also requires us to have open minds and be big-hearted. These values are inculcated in our children from young when they are taught about meritocracy. They want to stand shoulder to shoulder with the other races and communities and compete on the same issues. Moving forward, there are several distinct challenges that I would like to share. Firstly, increased religiosity. This happens not only in relation to the Islamic State of Iraq and Syria (ISIS), but also in other aspects of Islam. This also happens in other religions and has been a global trend.”
“Scenario 2 is a more community-based model which is patient-centric, in alignment with the notion that the patient should always be at the heart of all that we do and in our care delivery. Are we ready to challenge the status quo and ensure healthcare affordability for our population in the longer term? Which model will be able to meet our needs and the expectations of our population? Importantly, we have to review which model is economically sustainable in the medium to long term, especially with our rapidly ageing population. In my view, the considerations that need to be taken into account in coming to that decision include: the disease prevalence and burden in Singapore or in a certain country; the existing healthcare model and system that we have; the ratio of healthcare providers to healthcare consumers or the population; the cost of healthcare and healthcare funding; the current and projected healthcare demands as well as needs; and our perceptions of our healthcare providers, such as family physicians, primary care physicians versus our specialists in tertiary hospitals. Now, Sir, in our community-based care model, it must be evidence-based. It must have platforms for efficient knowledge sharing, maintaining confidentiality, of course, and our National Electronic Health Record (NEHR) is a good basic start to this. It must also have a means of educating and influencing mindsets of our population so that we can change their behaviour about healthcare choices. Only with these can we have the connectivity and decentralisation of a community-based model of care, as in Scenario 2.”
“A nurse in the ward, while giving instructions, noted that her responses was slow and she kept forgetting. So, she highlighted this to the medical officer who then felt a psychiatric consult was necessary. The psychiatrist came to see her and then he said that a geriatrician consultation will be appropriate because she had signs of dementia. And after many, many consultations and a week in hospital, she was still there and yet there was still no outcome as to when she would be going home. Her family was concerned about the medical costs and the bills and they were told to approach the Business Office to discuss this. Now, let us move on to Scenario 2: a 78-year-old lady sustained a fall at home and landed on her back. Her neighbours heard her and they called the neighbourhood family physician who came and visited her at home and discovered the tenderness in her hip. She was prescribed analgesia and the family physician called her daughter who was at work to update her on her condition. He explained that he would be taking her down to the Family Medicine Centre (FMC) across the road from her block to have her X-rays done and, in the meantime, he had also activated the physiotherapist and care coordinator from the FMC to visit her at home and help with some exercises. The neighbours activated their community befrienders' network and several ladies came down to help out with her meals, her household chores and administration of her prescribed medication. They kept her daughter informed and updated her as she could not leave work. Now, what will it take for us to move from a model of care in Scenario 1 to that of Scenario 2? Scenario 1 is a hospital-based, hospital-centric, multidisciplinary model. It is also traditionally a very physician-centric model.”
“Men or women, they must be of the right mindset to contribute and be a part of it all – part of nation-building and a part of Singapore. This is also because each person, each woman, has her own issues, considerations, priorities, work-life balance, family commitments, expectations, concerns about publicity, public scrutiny and other interests. Mr Speaker, I am all for greater women representation. As the fairer sex, let us also ask ourselves "are we hungry enough?" Or are we just pushing for the sake of pushing? In pushing for gender equality, clarity, practicality and awareness of all the factors and confounding issues must be seriously considered for a balanced approach, with appropriateness. Now, on our healthcare model. Consider Scenario 1: an elderly lady, aged 78, had a fall at home. The family called the emergency ambulance services, she was sent to the nearest acute care hospital and she sustained fractures in her hip region. She experienced a lot of pain and, therefore, movement was not possible, neither was ambulation. She was hospitalised and an orthopaedic surgeon became her primary doctor. In the ward, she was referred to the physiotherapist for rehabilitation and exercises. She was also referred to the pain specialist for pain control, as oral medications were not sufficient and an endocrinologist was called in to help with her diabetes mellitus management, as her sugars were always high. The medical officer also asked the dietitian to review her and talk to her family about her food intake and regulation to help with her sugar control. At admission, a blood test was done and it showed that she had renal impairment, so a renal physician was also called in to help.”
“Gender mainstreaming entails bringing the perceptions, experiences, knowledge and interest of women as well as men to bear on policies, policymaking, planning and decision-making. It must not be an "add-on" just to please, or a "by the way" kind of thing. How gender perspectives can be identified remains at the core. Now, it is not uncommon for us to hear women, women groups and even men sometimes pushing for gender equality. But let us consider the following points. Firstly, our focus must be on our people, both men and women. It is a critical prerequisite, I feel. When the focus is primarily technical or technological, people – both men and women – will not be adequately considered and it is challenging to include a gender perspective. Secondly, consider this. Even if we reach a 50:50 mark for gender representation between men and women, are we women – and men – going to be happier, more comfortable, well-adjusted in our jobs and our lives, and feel the fulfillment that we so desire? Will our work be done when we reach this ratio? Will our journey end? Will it stop there? Will our fight be completed? Indeed, success to women, and men, have different definitions and connotations. So, let us be realistic and practical when handling the topic of gender equality. Also, are enough women pushing the envelope and coming forth? Where are the women at times when we call for them? And sometimes, it can be challenging to get the numbers, especially in some areas, some disciplines, and you will have to agree with me on that. Perhaps we need a new innovative way to engage and bring women forward. Perhaps mainstreaming techniques need a review with fresh eyes.”
“Mr Speaker, "We must tackle inequality vigorously" are the words from the President's speech. Let me share my views on gender equality. In Singapore today, women and men are a little more equal than in some other countries and more than we used to be. In the latest Human Development Report by the United Nations, we ranked 11th out of 159 in 2016. Our Gender Inequality Index (GII) in 2016 was 0.068, the smaller the number, the more equal we are. That puts us as the top Asian nation for gender equality. Our Global Gender Gap Report showed that we need some nudging along in two areas. In particular, firstly, political empowerment; and secondly, representation at professional and managerial levels. I would say, we are inching along gradually. Firstly, women representation only exceeded 10% of companies and board directorship, according to a study by The Diversity Action Committee on the top 100 largest primary listed companies in Singapore. Secondly, there continues to be a persistent gender wage gap, though this may be closing up very gradually as well. And thirdly, female company directors of Singapore Exchange listed companies earn 43% to 45% less than their male counterparts, according to one National University of Singapore (NUS) Business School Study. If gender equality is the goal, then I say, gender mainstreaming is the strategy for us. Closing up the gender gap is really a journey that is happening and must continue to happen with the development and transformation of Singapore itself. It is also linked to our continued growth. Gender mainstreaming is the push for meaningful inclusiveness of women in all areas – in every area, every sector, every arena. Formal structures must be in place.”
“Sir, the pawnbroking industry started in 1875 mainly in the small businesses sectors giving out loans to walk-in pawners who presented valuables as collaterals. Currently, there is an estimated 150 such businesses here. During periods of economic crisis and downturn as well as festive periods, there is often increased activity in this area. Recently, there have been several pawnbroking chain outlets set up nationwide. How are the licences for these outlets granted compared to the conventional pawnbroking shops we have? In line with the recent Bill passed on the regulation of moneylending industry, will the Ministry be considering some form of regulation in the pawnbroking industry, with a certain degree of flexibility, of course? Should we review and relook at the Registry of Pawnbrokers and their workings and guidelines?”
“Sir, persons younger than 18 years of age who wish to get married must first apply for a special marriage licence from MCYS and the Syariah Court. Since the minimum age for Muslim marriages has been increased from 16 to 18 years in 2008, how many applications and approvals have there been for such special marriage licences? Also, how are these applicants counselled and assessed? Can MCYS update us on the number of teenage marriages in the Malay/Muslim community over the last three years? Joint madrasah system”
“Mr Chairman, the issue of dysfunctional families in the Malay-Muslim community seems to be an evergreen topic. Despite efforts by multiple Malay-Muslim Organisations (MMOs), VWOs and community groups, the issue appears unending and complex. Many are noted to have dropped out along the way – somehow, somewhere, sometime. Is this due to lack of coordination and integration by the sectors involved? MENDAKI is currently expanding programmes under the family development network umbrella, using some of the funds to be received under the Mosque Building and MENDAKI Fund (MBMF). These new programmes will specifically target families affected by divorces, remarriages, low-income and other social issues. How will these programmes be coordinated and how will it work with different organisations to cover the existing gaps? Dysfunctional families and single mothers”
“Mr Chairman, teachers nurture the young minds of the future and most certainly their role is a crucial one. NIE has launched the teacher education model for the 21st century (TE21) in 2009. This has been implemented to enhance and ensure our educators stay relevant and responsive in the new evolving educational landscape. What and how much of this programme has been implemented? What are the changes to the pedagogy and how are these tailored to fit teachers in the different levels, for example, primary, secondary, tertiary and also the college level. What has been the response from educators from of this 21st century pedagogy; has there been any teething problems? Radical activities and behaviour of youth Recently, the world was shocked by another act of terrorist attempt involving a young Nigerian man who tried to blow up a plane. Interestingly, his dad and teachers had been said to have reported of his radical beliefs to the authorities and the school. Are our educators in schools equipped with the knowledge and skills to detect early signs of radicalism amongst students? This incident can also be an example for parents. Are there appropriate channels for parents to voice concerns and work with teachers to get advice on the appropriate approach to such youths and how to handle these issues?”
“Health promotion, as defined by the World Health Organization 2005 Bangkok Charter for Health Promotion in a Globalised World, refers to the process of enabling people to increase control over their health and its determinants, thereby improving their health. The Health Promotion Board has been spearheading health promotion in Singapore. 1.45 pm Looking at our statistics of chronic and lifestyle diseases, we need a more concerted effort. Thus, increase awareness and education, more proactive health screening, reinforcement at workplaces; where most of our working adults are, and even in institutions of higher learning and schools. Besides the physical, psychological wellness must also be given a greater thrust. Will there be more funds allocated towards this? Are we increasingly investing in innovation towards enhancing health promotion and will we see more proactive collaborations between MOH and Health Promotion Board with relevant agencies such as MOM for workers' health, MOE for students' health, as we strive towards the goal of more healthy nation? Workplace health promotion”
“With developments and research in the medical field, there is now an increased battery of tests available for health screening for a variety of conditions. Some Singaporeans have not been very proactive in coming forward for health screening. Perhaps, they are complacent or, rather, they are confused how to choose and proceed. Can MOH invest more in educating the public pertaining to health screening? Can MOH also consider allowing Medisave to be used to fend off some cost of health screening? Liberalising too much will open a whole new Pandora's box and we risk having unnecessary tests added to the list. Will MOH be able to come up with a list of approved testing for screening for various groups with some degree of flexibility, of course, and consider allowing a small portion of Medisave to be utilised for this with a fixed cap or ceiling on an annual basis? This would be very much along the lines we have allowed Medisave to be used for part payment for chronic diseases. Affordable long-term care”
“Mr Chairman, the area of mental health and illness has long been de-emphasised, due to the many stigma and complexities associated with it. Thanks to the Ministry of Health, there has been much more focus on these issues of late. Increase fundings towards this area, including almost double research funding in mental health. The cost of institutionalising these patients are many and varied. Once suitable for ambulatory community care, doctors will discharge them. Can MOH work and coordinate with more VWOs, NGOs, volunteers and community leaders to strategise and coordinate community support groups who can lend a hand and an ear to these people; tasks they can take part, including befriending, advising, social outings, ensuring and supervising taking of medications, giving appropriate feedback to medical personnel and IMH on observed behaviours, etc? This group can be given some simple training to acquire these necessary skills and can include independent and well elderly or retired nurses who can contribute to society. 12.15 pm Sir, the cost of medication for psychiatric and mental illnesses can be high and many patients have been known to default treatment due to inability to cope with payments. Since Medisave has been liberalised to be used to fund two chronic mental illnesses, which is schizophrenia and also depression last year, how many people have taken this up and how much costs did this amount to? Will there also be plans to include other chronic mental illness to the list? Care of mental health patients”
“We have a first-world healthcare infrastructure and we also need to meet first-world manpower standard. Eventually, they will have effect on efficiency and affordability. What are our plans in terms of meeting our manpower needs for the future? Policy matter”
“Sir, first, on the future of healthcare. Healthcare systems are subject to powerful forces that can override rational priority setting and policy formation, sometimes pulling them away from the intended direction. Three issues of concern in healthcare today are, first, disproportionate focus on specialists and hospital centrism; second, fragmentation and lack of coordination to make a seamless system; and, thirdly, rising healthcare cost. These can cause the system to be viewed as sources of inefficiency and inequality. For the future, the healthcare system must be able to respond faster and better to challenges of a changing world. This calls for, firstly, the need to strengthen and enhance our primary healthcare with greater empowerment of family practitioners. This will involve more training, skills upgrading, change of mindset and a more collaborative partnership of family practitioners in the regional healthcare cluster that we are forming. Secondly, ensuring sustainable and suitable healthcare insurance for every family based on needs, income, etc. MOH will have to assist with monitoring, recommendations and public education as well. Thirdly, keeping healthcare at affordable cost through surveillance and regulation of commercialisation as well as the factors that interplay both public and private. What steps will MOH embark on to meet these expectations and demand for healthcare of our future? Healthcare manpower My second cut is on healthcare manpower. Trained and skilled manpower is a precious commodity to a country like Singapore. With increasing workload in the public sector, staff continue to be lost to the private sector, overseas institutions and other non-healthcare related areas.”
“Sir, the United Nations Climate Change Conference in December 2009 was one with some controversies. The Copenhagen Accord, which was drafted by countries such as China, the United States, India, South Africa and Brazil, and deemed to be a meaningful agreement by the US government, was noted but not adopted or passed unanimously. While countries at different levels of development may have personal agendas pertaining to the issue of climate change, Singapore, as a responsible nation in a global world, has pledged our effort to lower carbon emissions by 16% before business as usual level by 2020. Will this stretch us to the limits in terms of our mitigation measures, as 2020 is only 10 years away? The Copenhagen Accord does not meet all the elements we would have liked to, have been added. What exactly is Singapore's position on this matter? Should we have negotiated for a more generalised global treaty instead? International recognition of Singapore”
“Sir, as we make the move towards becoming a more green nation, there will eventually be lower usage of electric power generated from fossil fuels, thus, less greenhouse gases and acid rain emissions. One of the options of the alternative sources of energy is that of solar energy and this seems appropriate with our climate and our position close the Equator. What steps is the Ministry taking to encourage the development of infrastructure to harness solar energy and its usage? Can the Ministry come up with a listing of appropriate companies, contractors and gadgets in the market for easier consumer identification and choice? Starting with a small list, I feel this can be expanded and also publicised. Other plans to work or collaborate with other agencies to encourage the use of solar, which I feel is certainly less controversial than that of nuclear energy.”
“Sir, in the 2008 COS with the vision of the oncoming silver tsunami, I had brought up this. This year, yet again, a call for reconsideration for a retirement village concept tailored to the needs of Singapore combining elderly capable of independent living, those with assisted living and residential as well as nursing homes, all housed in an area equipped with facilities. Appropriate and relevant staffing will, of course, be required. The well elderly can provide manpower for employment in the retirement village, helping their weaker and immobile counterparts. This integrated concept of dwelling units, nursing homes, stalls, restaurants, etc, which are elderly-friendly and even partly manned by the elderly can certainly cater to their various needs – an extremely wholesome concept for living for our rapidly ageing population. What is MND's take on this retirement village concept this year, this time?”
“Mr Chairman, the G20 was established in 1999 as a response to the financial crisis then. The grouping brings together both advance and emerging economies to discuss measures to promote financial stability and of course sustainable economic growth. Following the last crisis from which we are just emerging, G20 has been striving to strengthen international cooperation and assisting in implementing sound expansionary macro-economic policies. The networking, goodwill, camaraderie and thought sharing is certainly a benefit with such groupings. How has Singapore benefited from G20 and will there be any future developments? Are there plans to implement any changes to the way the group works and implement guidelines that assist nations following the latest global financial crisis which we just experienced?”
“Sir, the Middle East represents a non-traditional area for Singaporeans to set up companies and have business collaborations. This has, however, been on the rise, especially in the last several years. Of late, there have also been more high profile visits by our leaders and business sector representatives to the Middle East and we, too, have hosted many of them coming here. How big is the Middle East as our trading partner and what are the future directions and targets for Singapore-Middle East cooperation? Are we planning any further FTAs with them? Also, taking into account the region's unique cultural and religious sensitivities, how well are our businessmen and companies prepared for this venture? 3.45 pm United Nations”
“Sir, SAF recently announced a series of changes to the BMT and one of these being the change for the recruits for training will become prolong, from 15 weeks to 19 weeks. It is estimated that about 10% of the recruits will fall into this category. Also, the other group that will be affected will be those with medical conditions which is estimated to be about 6%. For the latter group, the training will now be increased to nine weeks. We all know that it is being said that BMT makes men out of boys. Can the Minister please elaborate on the rationale for these new changes and how they tie in with the broader philosophy of training for our men, so that parents can understand them better? Individual physical proficiency test (IPPT)”
“Sir, the SAF continues to evolve itself, adapting to the latest in technology and also intelligence. All these are in line with moving into the 3rd Generation SAF. The minds of criminals too continue to be more complex with all the web of intricacies such as those seen in the movies. With more and more recent incidents related to safety and security and terrorism such as the escape of Mas Selamat, and of course, airport and border security, what steps are being executed to ensure SAF personnel are well integrated to work and co-ordinate with our other forces and groups from the Home Team? This is in particular regards to homeland security. 3rd Generation SAF”
“I would like to suggest a review of the current guide using the ability to perform six sets of activities of daily living certified by a practitioner. Perhaps both MCYS and MOH can collaborate to refine the definition and conduct more publicity and public education related to this to enhance understanding. Mr Speaker, we have come a long way for a small, young nation. From nowhere, we are now somewhere, I have to say. From the days when letters to Singapore were sent to China, our brand name is now not uncommonly on the lips of people globally. This did not come easy and it will continue to be challenging as well. Our work ethics, our mindset, growth, productivity and everything else need to be strengthened continuously. We cannot look back. We cannot procrastinate. In the end, it is all about attitude. No limits, no excuses, no ifs and no buts. It is just our attitude. If we have been afraid and we have had butterflies in our stomach, then now is the time to make that change – align and make all those butterflies fly in formation. The world is indeed as large as the lens through which we view it. With that, Mr Speaker, as the 50th MP to speak on the Budget, I support it. *Cols. 3015-3016. 1.29 pm”
“Perhaps with the bed crunch situation we face ever so often in our restructured hospitals, remote care through teleconferencing provided at an area and facility outside the hospital may become common practice in time to come. With all the focus on productivity and bottomlines, please do not forget the human factors, and I agree with Ms Audrey Wong on this because, eventually, it boils down to us dealing with people. Let me give Members an example: HSR, Realtors with a Heart, is a company that towers over its competitors. It has received more than 20 awards and recognition recently and it is also rated No. 1 in a productivity campaign under the HSR property group. It is the fastest growing real estate company in Singapore. My encounter with the company was slightly different, because I was there to receive a donation on behalf of Mercy Relief, raised by the HSR staff in response to the Sumatran earthquake. The moment I stepped into the organisation, there was positive energy – a very strong positive energy. A warm and caring atmosphere exuded as I moved from place to place in their facility. The "Attractor Factor" was very powerful. Their staff, multi-racial with foreign workers as well, were genuinely happy, and they were just looking and feeling great. This was consistent with all the employees I met that evening. Indeed, we can certainly combine hardware and software to come up with the best results in Singapore companies. In this Budget, Sir, there is more relief for the handicapped. This is indeed great news. However, the definition of the word "handicapped" is still rather nebulous. Does it comprise seniors in the various stages of Alzheimers' disease, dementia and also the mentally infirm?”
“Two, enlarging and strengthening our Singapore brand name on the global stage. Three, exposure of students to emersion in culture, understanding and building bonds, in other words, international relations, an example for all companies to try to emulate. Developing an inquiring mind and inculcating the research culture, which is a basis, is also crucial in our next phase of development and growth. If we always do what we have always done, we will always get what we have always got. "You must do things you think you cannot do", so said Eleanor Roosevelt. I can say that many innovative instincts may have been killed because of lack of funds, lack of expertise to write up and package the proposals, uncertainty about where to get advice and assistance on the research projects. Perhaps out of every 10 applications, eight may end up being rejected. Can Singapore consider setting up an inventor-friendly and approachable Innovation and Invention Advisory Committee, accessible to anyone who needs advice on their research projects. Sure, we have the BMRC, NMRC, NRF, etc , but these may be beyond many of the applicants with simpler and smaller projects, and these may well be the projects which eventually make it big. In mental health, for example, we often face the challenge of monitoring whether these patients take their drugs diligently in order to control their symptoms, especially when they are out in the community. I learnt recently that there is a technology using a chip which can be used to monitor from afar if the patient really swallowed his tablets for that day. Is that not wonderful because we can also cut down on manpower, on volunteers, on ambulatory care nurses and counsellors doing the monitoring!”
“" I would strongly urge him to review that comment in view of the Jobs Credit scheme, the WIS and now Enhanced WIS (Work Income Supplement), the WTS (Work Training Supplement), which can subsidise 90% to 95% of absentee payroll and course fee for training, the Post Secondary Education Account and many others which may be specific to the company and the profession. Are these not incentives for training and upskilling? I would say then, the only thing lacking would be their internal drive and motivation of the workers and the employers. To complement investments in productivity, there is also a move to increase foreign worker levies, which we have just heard. I would like to urge that this again be done very very gradually as foreign workers make up over one-third of our workforce and, of course, they represent an essential component in our growth. Certainly, the suggested tiered system in certain industries may work but I have concerns that it may have some backfire effects in certain other industries and may even lead to higher labour cost. Therefore, I am assured by the Minister's speech earlier where he said that MOM will be monitoring this very closely. Let me now share a very positive example. The Management Development Institute of Singapore (MDIS) has campuses here and also one in Tashkent, in Uzbekistan, which I visited – a wonderful and state-of-the-art campus. The Minister for Higher Education there has stated that students in all undergraduate and graduate courses in Management must go through MDIS in Uzbekistan. MDIS is also expanding to be the management institute in the Central Asian market and later they are planning to extend to Malaysia and India as well. What is in this for MDIS and for Singapore? One, revenue for MDIS.”
“If you do not meet the minimum requirement for the year, the practising certificate will not be renewed and therefore you will not be allowed to practise. There is a reason why this is essential – new developments, new ideas, evidence-based practices and changes are happening daily. With the characteristics of the doctor in me, when I came to Geylang Serai, my constituency, grassroots professionalisation and continuous learning and upgrading became part and parcel of their lives. Now, I am proud to say that they are a very motivated lot and nearly 70% have been for at least two or more self-improvement courses in the last two years. However, this is not good enough. We have to go further. So we have set a target – 100% trained by the end of 2010. Now, my grassroots leaders practise what they have learned and apply the knowledge and skills in events organisation and residents' outreach. Our workers too need to move up and move forward because in today’s globalised but small world, when you apply for a job, you are not just competing with foreign workers and local applicants. You are competing with the same level workers in Russia, India, Malaysia, China, etc. That is why the Government will allocate $5.5 billion over the next five years to help enterprises and workers enhance productivity. Mr Low Thia Khiang, Member for Hougang, claimed in his speech that "low-wage workers do not have enough incentives to go for training.”
“Finally, Mr Speaker – skills, positive energy, productivity, motivation and lifelong learning – these are the buzzwords that will be on Singaporeans’ lips from now on. (In English ): Sir, in our early years, with the vision, strategies and mindset of our leaders, Singapore grew rapidly. Growth of 8% to 10% was not uncommon. We have moved on – from third world to first world status. When we have achieved so much, further growth may not be as fast and the growth curve, not as steep. There are new challenges, what with our open economy. Thus, to adapt to these rapidly changing domestic and global situation, it calls for a transformation in the way we think, the way we work, and the way we act. No more stereotyping. Our tagline would have to include words like ideas, innovation, invention, inspiration and information technology. Things do not change. We have to change. We have to be the agents of change. A country’s budget reflects the vision and the performance of the government. Over the years, notice how it is customised and tailored to meet our evolving needs and challenges, whether local or global. This year’s Budget is yet another creative one. I would personally call it the people’s Budget, and how appropriate,because people are our major resource in this land scarce tiny little red dot. Thus, the focus on manpower, skills, training, talent capital and development. Talent retention is a necessary shift for organisations not already having plans on doing this. Continuous upgrading, learning, unlearning and relearning is crucial. In medicine, we have compulsory continuing education for doctors.”
“[For vernacular speech, please refer to Appendix A*.] Mr Speaker, the changing economy and competing market demands need workers possessing the latest skills that are relevant and can add value at work. Hence, workers must take steps to upgrade their skills in order to get better income. If they do not do so, they will be left behind. In the current situation, workers must not just be contented doing low-skilled jobs or odd jobs, because it only provides low wages that are also irregular at times, while the cost of living keeps rising, times change and technology is getting more advanced. The time has come for us to also further understand the concept of productivity and innovation, and try to practise it. However, as we learn something new, we must avoid falling into problems like spending beyond our means, being in debt and so on. I would like to suggest that the Government explain clearly the concept of productivity and how it can be implemented under our strategic transformation of our economy in various sectors, especially in industries with many low-wage workers. This is because there might be misconceptions and a lack of understanding on what productivity means. Some might think that it means working for longer hours; some might think that it brings higher income for the same amount of work, and some might also assume that it is a process where automation will do all the work so that workers do not have to work as hard. I would also like to call on the Malay bodies and grassroots organisations like the Malay Activity Executive Committee (MAEC) to engage the Malay community to explain the correct concept of productivity.”
“I hope that the programme will also include features like core leadership competencies and life-long learning. This scheme will also bring about a positive effect to the public in terms of their perception towards our military men and women, as they enhance their own confidence and resilience. They will become men and women who are able to think of solutions with proper judgment, by inculcating innovation, interpersonal tact and knowledge of their domain. This domain expertise encompasses tactical and technical skills as well as cultural and geo-political awareness. With this, the SAF will become a strong institution that we can be proud of. But let us ponder for a moment. We did not achieve all these by chance. It was achieved through visionary strategic planning and a political will to build a military that is integrated, relevant and can adapt itself to any situation or challenges. Mr Speaker, I support this SAF (Amendment) Bill. *Cols. 1821-1822.”
“With greater definition and delineation of posts and professionalisation, would come a need for greater training budget, remuneration and promotion packages, attachments, overseas postings and the like. There will be changes in job descriptions and responsibilities as well. Can the Minister please update us how on target we are with this and in implementing all the suggested changes? Also, one of the concerns I have is that, with the increasing of the retirement age of SAF personnel, once they exit from the Military, will they have an exit plan management for them? Perhaps, we can consider some collaboration or partnership with relevant companies to help these people in starting up their second career because as we know, with increasing age, certainly there will be challenges in looking for second jobs. Finally, I support this Amendment Bill, in line with our practice of retaining talented, good and committed people, who are the only resource for our little red dot. The Military Domain Experts Scheme is a step in the right direction to nurture our men and women into military leaders: leaders with character, presence and intellectual capacity. (In Malay): [For vernacular speech, please refer to Appendix A *.] The Singapore Armed Forces (SAF) serves Singapore, protects our national interests and carries the responsibility of defending Singapore. The introduction of the Military Domain Experts Scheme will help the SAF to continue working hard to pursue excellence, build its capacity and increase its professionalism. With the available choices provided, our young people will be given the opportunity to gain higher and deeper knowledge, in addition to enhancing their skills.”
“The Singapore Armed Forces is one of the largest public institutions, which started from scratch and developed into the state-of-the-art military we have today. Over the years it has evolved to adapt to changing needs, times and capabilities, expanding its roles to include civil military co-operation, humanitarian assistance as well as collaboration to support social operations. The changing global face of threats and terrorist activities, in a completely new security environment, calls for further strategic developments and enhancements. All these are in alignment with the introduction of the Military Domain Experts Scheme. With the transformation to the Third Generation (3G) SAF, there comes a greater need for professionalism and for professionals to possess deeper expertise in key areas or professional domains, as we call them. These Military Experts will be uniformed personnel trained in specialised areas such as engineering, nursing, technical military operations and even intelligence. I feel this is in alignment with the increasing expectations of our younger generation, who crave for more, who often ask, "What's in it for me?", who are considering to make the armed forces their preferred career choice. It is about developing excellence through professionalisation with the increasing level of education and qualifications we are seeing in our young of today. The proposed changes to the terminology to be used (eg, Senior Military Experts), falls in place nicely as they certainly do give a more professional ring to the positions and the posts in alignment with the greater depths that will come with the revision and also enhancement in job descriptions.”
“Parents and families play a crucial role in this. The principle is easy, that is, if there are dysfunctional family units in a country, this will affect that country’s stability. We must develop these characteristics, as it will help us overcome the challenges in the coming years. Firstly, achieve better social cohesion. This is especially with the increase of new citizens and foreign workers. Secondly, increase the number of people who come forward as volunteers and philanthropists. Thirdly, make Singapore a first class country to live in. And, fourthly, enhance and strengthen Singapore’s brand name in all international arenas. All these will certainly take time. But what is important is that we do not delay and begin now, open our minds, be far-sighted and continue working hard to take the appropriate steps. "Where there’s a will, there’s a way." *Cols. 405-406.”
“The Singapore soul is that strong emotional attachment that gives us the close affinity to the ideals of national cultural identity and nation building. It is about our heritage and conservation. It has to be the ethos of our being as we strive to become grateful people in a gracious society. In the new world order, Singapore will have to ask how we balance, firstly, a continued drive and a less stressful lifestyle. Secondly, the needs of the elderly versus the aspirations of the young. Thirdly, looking after Singaporeans versus the balance of regionalisation and internationalism. And, finally, consultation and consensus versus quick decisiveness. We need to use our soul to reach out to the needy, the low income, the disabled, the elderly with their sets of issues in Singapore. As we start to face the beginnings of the silver tsunami, we need heartware. We need to bring back the heartware in our society. It has been said that how a nation takes care of its elderly is a reflection of its soul. The time for reflection is indeed now. And let me end off by having a quotation from Helen Keller, she said that "No pessimist ever discovered the secrets of the stars, sailed to uncharted lands, or opened up a heaven new to the human spirit". So that is for us to consider. Mr Speaker, Sir, in Malay. (In Malay): [For vernacular speech, please refer to Appendix A*.] Courteous, hospitable, highly ethical, morally strong, big hearted and generous. These are the Asian characteristics and culture that we must enhance in ourselves. In addition, there are the spirit of cooperation, working together, loyalty to friends and neighbours, and the culture of collaboration. The basis is simple – instil a positive, proper and resolute behaviour in our children from their teenage years.”
“We need them in our economy, they need us. Instead of complaining, we need to come up with innovative ways to have a win-win solution for both sides. On enterprise, Singapore must continue to be a vibrant converging point for enterprises and businesses from diverse geographies looking for stable and conducive environment to bring new ideas and innovation as well as new markets. The spirit of enterprise must prevail. It is all about finding and creating opportunities, taking and managing risks, feeling comfortable even if we do not have all the answers but discovering them along the way, one at a time. Last year, I was approached by a person who had invented a novel, first of its kind, quick-to-set-up portable sanitation system. This was the kind that could rapidly be deployed in crisis situations, in disasters, third-world countries and even rural areas. He had even participated in the WTO Conference demonstrating his product. It was not the World Trade Organization Conference, it was the World Toilet Organization Conference. It attracted an overwhelming number of interest from businesses, companies, countries and even the United Nations. He had applied to the relevant departments and agencies in Singapore for endorsement of the product as one that was made in and originated in Singapore. However, there was no response from the appropriate parties despite emails and correspondence. Will experience like this cripple our spirit of innovation and enterprise? It is for us to answer. We are now living amongst Generation Y. Their culture is more towards I, me, myself, a more individualistic approach rather than the kampong spirit that our previous generations were used to.”
“DPM Teo Chee Hean himself supported this in the article in the Straits Times titled "Empathy, the buzzword", Friday, 22nd May. Another example of innovative teamwork was seen in 2003 during the SARS outbreak. The Ministry of Health had to work with other Ministries, such as the Ministry of Home Affairs, Ministry of Law, Singapore Tourism Board, and WHO. This required a different mindset altogether. It meant working with people from different organisations with different sets of rules, regulations and codes of practices, and even people from other countries with different mindsets. We are quoted in the literature for the novel way we handled the SARS outbreak. We applied cutting-edge technology and knowledge in vaccine search, case handling, rapid infrastructure turnover, and even developing the SARS ambulance, the first in the world. But even with all this experience behind us, we must never let down our guard because we must continue to remain vigilant in the changing world. How we came up with our 3M and 3E policies in healthcare have indeed helped us evolve them, changing healthcare needs over the years, is yet another very innovative approach. Another dimension for MOH to consider in the long run would be how Singapore can tap into the latest techniques and development in science to provide excellent and affordable healthcare for us. MOH would, for example, in this case, have to work closely with the Agency for Science, Technology and Research or the Biomedical Research Council. This collaboration would require a different mindset of collaborative culture. Building a cooperative relationship is the first step towards engaging a collaborative culture. Also, how we move forward with the foreign workers issue, which is very hot indeed, is entirely up to us.”
“They will attract foreign talent, as well as tourists and the spin-offs are indeed tremendous. Innovation and creativity: You cannot have one without the other. Thus, the concept must be inculcated from young, starting from our schools, where our young start to develop their intricate network of values. We must continue to be innovative in our strive to survive. "We are what we are today, out of necessity", that is what Foreign Minister George Yeo said, and I agree with him. Therefore, we must continue to do so, for example, continue to be innovative and proactive in our approach to handle emerging infectious diseases, such as the current H1N1 flu outbreak. When we talk of team work, we talk of collaborative culture. When we really work together, we will then begin to change beliefs, practices, tensions and disagreements. The "no wrong door" policy is one such example. All of us are familiar with the multiple re-appeals we have to do for some of our residents who come to see us at our Meet-the-People sessions (MPS). Often, they will narrate to us how they had communicated with the frontline staff of different agencies, informing them that they will be seeing the MP to ask for help and appeal. The response from the staff, according to some of the residents we have seen, had been, "You can see the MP if you wish, but there is no point because we will not change our decision". Where is the empathy we want to see? Where is the hope we want to give? And where is the case-by-case consideration we promise our residents? In life, if you can give someone hope, you practically can give them the will to live and persevere. Thus, I am heartened to hear that the PS21 initiative in the civil service will be re-energised and finetuned to develop greater sensitivity.”