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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“Mr Chairman, Sir, I have two clarifications. The first one is on leave but it is not maternity or paternity leave. Seeing that we are encouraging Singapore to become the philanthropic hub and also the volunteer capital of Asia, and companies are now being judged on the triple bottomline of their economic performance, environmental contributions as well as social contributions, is the Ministry considering formalising to a certain extent volunteer leave, and to support the proposal? My second clarification is on industrial accidents. We are seeing more industrial accidents at the hospital. I do not think the numbers have increased but probably more serious ones perhaps, and often these are traumatic in nature. Most of them happen at construction sites, as you probably would gather. Are there plans to enhance the initial management of these casualties on site, ie, before the arrival of the ambulances, because a lot of damage or deterioration can actually happen before the ambulance arrives and these examples could be related to spinal and limb injuries? So are there any plans to empower or train some of these site supervisors to help out before the arrival of the ambulances?”
“Mdm Chairman, health promotion has been given a new prominence. The increasing focus on health outcomes reconfirms the priority placed on investment in the determinance of health through health promotion. Continually asking ourselves the question, where and how is health created will link us to two major reform debates, firstly, the formulation of new public health strategies and, secondly, the need to reorient and refine health services. Health promotion is the science and art of helping people change their lifestyle to move forward to a state of optimal health. Optimal health is the balance between physical, emotional, spiritual and social health. Lifestyle changes are facilitated through efforts to enhance awareness, change of behaviour and promotion of environment that supports good health. The Ottawa Charter of Health Promotion from WHO Geneva 1986 emphasises the prerequisite for health promotion. It touches on advocacy for health, enabling all people to achieve their full health potential and mediating between the different interests in society in the pursuit of health. The Jakarta Declaration on Leading Health Promotion into the 21st century is also relevant as well in this context and stresses on the importance of participation through sustained efforts. For the sum of $86 million expenditure on health promotion programmes every year, like the healthy lifestyle programme and the school health services programme, are we seeing the results that we expect? Is Health Promotion Board tracking some of the KPIs on these? And are we meeting the targets that we have set, for example, the identification of early psychosis results from the Trim and Fit programme in our schools or even the numbers coming forward for cancer screening? Preventive Healthcare”
“Madam, as we formalise SingaporeMedicine, the numbers of health-related visits will certainly increase. It is projected that by 2012, the number is going to hit a million. With regard to this, what are the plans and programmes by our healthcare institutions to cope with the increasing numbers and complexity of medical problems? It is anticipated that we will require more inpatient beds, outpatient clinic slots, high-tech and state-of-the-art equipment and an increase in certain types of manpower, such as allied health personnel, nurses, pharmacists and specialists. There will certainly be competition from our rapidly ageing populace and also the increment from a larger population of foreigners and foreign talents that we are trying to attract to Singapore. We would also have to improve our service standards significantly, enhance communication skills, and this includes perhaps also some officers who are trained in foreign languages and also to strategise our plans to face the increasing medical tourism competition from countries in the region, such as Malaysia, India and Thailand.”
“Madam, we are on the brink of a dementia epidemic in the Asia Pacific region. The disease burden will increase significantly in the coming years with tremendous economic and social impact. How this translates into cost in public health will vary according to the country and the mix of care provided. Currently, there are 22,000 elderly diagnosed with dementia in Singapore - this is about 6.8% of our population. By 2020 and 2050, the numbers will be 54,000 or 15.7% and 188,000, that is about 56.7% patients with dementia and related illnesses respectively. Direct cost will include quantifiable cost from hospitalisation, treatment, drug, nursing care, etc. There will also be indirect cost incurred to the family, the healthcare system and society as a whole. Will MOH be conducting some analysis on this projected cost to Singapore to fine-tune our public healthcare system, our 3Ms, ElderShield, and so on? The Kyoto Declaration which provides a framework for determining the actions required may be used as a reference document. Indeed, we just heard earlier that the Minister has mentioned some reform to the ElderShield as well as the Medifund Silver. Certainly, these are steps in the right direction. 5.00 pm We may also have to consider some different imputation algorithms based on international statistical data to reach an appropriate estimate for Singapore in Singapore dollars, as we may not have local current statistics. Electronic Medical Records Exchange and Telemedicine”
“We should also, on the other hand, train every medical student, every medical officer and every trainee with some basic knowledge of geriatrics. This is because not every old person needs a geriatrician, but every physician needs to have some training in geriatrics.”
“Sir, with the current doctor to patient ratios, many studies have shown that it is going to be a big challenge for the elderly in many ageing nations to receive the optimal holistic care they require. Unless we can make managing healthcare issues of the elderly top priority, the supply of trained healthcare personnel will be insufficient to meet our elderly explosion. Currently, there are only a handful of geriatricians in Singapore. The British Geriatrics Society recommends one consultant geriatrician for 4,000 population over 75 years, or one consultant per 50,000 general population, and this refers to a full-time consultant. A significant proportion of the healthcare budget is allocated towards manpower training and upgrading. Can the Minister please share with us the numbers of doctors and nurses who have received specialised training in disciplines, such as geriatrics, psychological medicine and psycho-geriatrics? And also, will the Ministry of Health be opening up the number of slots available for basic and advanced training in these disciplines over the next five to 10 years? We need to attract more young and interested doctors and nurses into these areas and we are still short of role models and mentors for them locally. Finally, Sir, I also have a suggestion to add. Geriatricians must be utilised more efficiently. They should not become adjunct primary healthcare providers, but instead be allowed to focus on age-related syndromes that fall through the cracks. We cannot overload the limited number of geriatricians we are going to have. Rather than being a vertical discipline which focuses on one area or one organ system, geriatricians will manage diseases in a horizontal fashion, cutting across organs and systems.”
“I know we like all the developments in the arts. But I would like to get some assurance from the Minister that we will always integrate the elderly, the disabled, as well as the sick, because arts can also be used as a form of therapy.”
“Sir, I would like to find out if there are any plans to actually coordinate activities, basically cultural and heritage activities, organised by the many clan associations that we have in Singapore to come under some kind of umbrella so that they can contribute towards the future that we look forward to in the area of arts and culture.”
“But we are targeted, we have sorted out our strategies and we have identified our partners. So I would advise Members of the House to just watch this space. This is a place in which I think a lot is going to happen and we will give you a further update next year. Values and Norms in the e-Arena”
“In fact, the market potential for games probably exceeds the potential for Hollywood blockbuster films. This is a big area. The second way we are doing this is to develop online platforms. We call it i.JAM for short in which people from both research and industry sectors can come together, exchange breakthrough ideas and suggestions and look for opportunities to collaborate to bring these ideas to reality. This is, in a sense, what the Member was suggesting just now that there is a need for constructive and useful engagement and dialogue to occur between the experts, on one hand, the venture capitalist, on the other, Government, on the third hand, and potential users on the fourth hand. We are creating these platforms for dialogue and collaboration. The third way we are doing this is to position Singapore as the preferred testbed for innovative and commercially-viable IDM R&D applications. We may be a small market, but we are a reference market. And if an application works in Singapore, it has got applicability in other areas in Asia and in the Middle East and, ultimately, at the global level. The fourth initiative is to encourage further investments by key industry players in the development of new open access platforms. This, we believe, will stimulate the development of applications, products and services on these open access platforms. These initiatives have received tremendous support so far. We have had 30 IDM stakeholders who have come on board. Our educational institutions have ramped up their R&D efforts. Local institutes have offered a slew of their breakthrough technologies or their IP for further development. But it has only been six months, so I can assure that we have not spent $500 million yet.”
“Let me quickly move on to the two questions on the interactive and digital media (IDM) scene. The Member has quite correctly pointed out that the National Research Foundation has set aside $500 million to invest into this sector. We aim to use this money to increase Singapore's R&D capacity in the IDM space and more than that. It is not just research for research's sake, but so that we can help develop breakthrough products and services which can make Singapore and Singapore businesses more competitive. We intend to increase the value-added contributions of the interactive digital media space to $10 billion. That will be up from the $3.8 billion in 2003 and to create 10,000 new jobs. At the end of the day, everything which we do here is still about jobs and money, livelihood. I am also acutely aware that there is a need to focus, because Singapore is very small. So at this point, we have decided to focus on four areas. (1) Animation, games and special effects; (2) Media intermediary services; (3) Mobile services; and (4) Educational services and the use of IDM to further educational opportunities. So these are four areas which we have decided to focus on. 2.00 pm How will we make progress in these four areas? First, we have decided that we need to form a global network of research institutions, both local and overseas, in order for them to focus on these four areas and to see how Singapore can be a useful site to develop ideas and research potential in these areas. Last October, the MDA and Massachusetts Institute of Technology announced the Singapore-MIT International Game Lab which will further global research and develop world-class academic programmes in games technology. We all know that this is a huge growth area.”
“We have made global headlines. In the last few months, we have seen a string of CEOs from many MNCs coming here, people like John Thompson, Michael Dell, John Chambers from CISCO, just to name a few. They have come here to look for opportunities, because they know that whatever Singapore says it will do, it is serious about it. Non-IT companies, such as Credit Suisse from banking and DaimlerChrysler, have moved their IT nerve centres to Singapore because they understand that with First World infrastructure, a stable government, a stable regulatory regime and with IP protection, this is the place to be to develop and have their disaster recovery sites, back-up sites, business contingency and continuity sites going. So there is buzz in the sector and there will be many, many opportunities. It has also benefited the man-in-the-street. For example, Members must be aware by now that broadband prices are falling. In fact, broadband prices have fallen by as much as 37%, just in 2006 alone. Speeds have also been increasing. Some households already have access of 100 Mbps. But the significant drop in broadband prices has fuelled further adoption of services. And 3G subscriptions, which Mr Zaqy enquired about, has increased from 174,000 in December 2005 to close to 884,000 in December 2006. It now comprises about 19% of our subscriber base. Three out of four households have access to at least one computer at home, and it is the norm for our youths to use the Internet and this connectivity as their primary means of communication, gaming, entertainment, gathering information and interaction. So I remain optimistic that these investments that we are putting in place will be used and we will be able to exploit the fruits of these investments.”
“So it is better that the IT professionals themselves take charge of their own professional upgrading. We therefore helped to establish a National Infocomm Competency Framework (NICF) and a National Infocomm Competency Academy (NICA) will basically build a consortia, consisting of the Institutes of Higher Learning (IHLs) and industry experts, to make sure that there are industrially relevant courses and upgrading opportunities. So we will work on this. We will also continue to invest in our youth. Last year, MICA unveiled a $120 million Infocomm Manpower Development Roadmap with a particular emphasis on Student Outreach, to help develop infocomm appreciation in the first instance but to encourage innovation and capability amongst young people who ultimately can become infocomm professionals. For example, we have 110 Infocomm Clubs established in both primary and secondary schools, with more than 5,000 students currently enrolled as members. We have also expanded the National Infocomm Scholarship. It is now supported by 20 leading employers who offer these scholars global industrial attachment opportunities as well as taking them on as employees subsequent to their training. Singapore’s Institutes of Higher Learning (IHLs) must continue to attract their fair share of the brightest and the best into this industry, and we will continue to encourage them to do so and to also have, for example, integrated Masters programmes which will feature tie-ups between local universities and reputable foreign universities, such as Carnegie Mellon University and Georgia Institute of Technology. We currently have ongoing joint programmes with our local institutions. Sir, let me sum up by saying that we have had encouraging results so far, as far as iN2015 is concerned.”
“For instance, Friartuck, a local company, partnered with Fujitsu to successfully out-compete international players to snag a very significant deal recently with the National University Hospital. Since 2002, infocomm Local Industry Upgrading Programme (iLIUP) has helped to develop 400 products or solutions and train more than 1,000 IT professionals. I also want to spend a little bit of time talking about IT professionals. The Member is quite right. If our IT professionals stay still, ie, just on the basis of their qualifications which they obtained five or 10 years ago, they are in very great danger of being crushed by the forces of globalisation, eg, the PMETs, which many Members have spoken of over the past few days. So we need to make sure that our IT professionals are able to upgrade themselves. And this is a significant number because, today, we have 111,400 IT professionals in Singapore. In fact, our target is to expand this number by a further 80,000 people. We need to make sure that these almost 200,000 people will continue to be globally competitive and be able to get good jobs and have a good livelihood in the decades to come. How will we do this? IDA has set up the Critical Infocomm Technology Resource Programme (CITREP). This is basically a way in which local professionals will be able to obtain financial assistance in order to upgrade themselves, and we have committed $53 million since 1996 to fund some 35,000 training places. And I will give this House the assurance that we will continue to fund this programme to ensure that upgrading opportunities will exist for our IT professionals. But it is not just for the Government to do so because, as the Member has also quite rightly said, this is a fast-moving field. The developments occur in the industry itself.”
“Since 1st July 2004, the Government has also taken the position - and this is significant - that all Intellectual Property (IP) developed by our outsourced agencies and by SMEs, when they are participating in any Government ICT contract, this IP will belong to that company, unless there are very clear strategic reasons for Government to retain ownership of that IP. Why do we do this? Because, having given you an opportunity to participate in this, you have developed an application, an idea, we now want you to be able to take this idea, service and product to the local market and, better still, the global market beyond. Again, we are putting our money where our mouth is, and we are saying, take this IP, which you have worked with us, to develop, and exploit it fully. IDA and the Singapore Infocomm Technology Federation (SiTF) are still engaged in further discussions on how we can make other improvements to our contract terms and conditions for SMEs and the other companies participating in Government ICT contracts. But the Member has also quite rightly said that we do want our SMEs to grow globally. The Singapore market, on its own, is too small. We have several schemes to support our SMEs, eg, the infocomm Enterprise Programme (iEP) which enables smaller companies to develop reference sites and to build their IP. We also have the Overseas Development Programme, the infocomm Local Industry Upgrading Programme (iLIUP). All these, as Mr Zaqy has said, help to promote and facilitate partnerships between MNCs and our local infocomm enterprises and help them to acquire technology, gain access to markets and also gain track record.”
“So we launched the programme in November last year to provide subsidised broadband access to some 10,000 needy households, focusing especially on those with school-going children, because we believe that, in these specific instances, this is not a luxury or entertainment but essential for education. By 2015, our goal is to see that 100% of households with school children will have both computers and broadband access. For those who are perhaps older or, for whatever reason, less comfortable with computers, we have launched a series of CitizenConnect Centres. Some of you may have seen that in your own Community Clubs. This is basically a sort of a kiosk in which an elderly person or a person who does not have a computer or connectivity at home can use. If he needs help, someone will hold his hand, show him or her how to use it to transact with the Government. But the larger objective is educational, that they will use the computer and that they will know that it makes a difference to their daily lives. Let me now focus a little bit more on the SME point. I want to assure this House that we give equal opportunities for all suppliers who are bidding for Singapore Government contracts. And local SMEs have a fair shot at winning Government contracts in open competition. Let me cite some statistics. In FY2005, 116 out of 196 contracts were awarded to local SMEs for Government ICT tenders of value less half a million dollars. So there is no need to create artificial insulation or protection. Our SMEs are well capable of competing and winning contracts. Have a little bit more faith in their ability.”
“By 2008, we expect that there will be 300 mobile Government services. This will include whether you want to discover where is the next big event, pay taxes or fines, and hopefully other more pleasant interactions with the Government. The Government has to use this, again not to gain headlines but because we believe that, when the Government takes a lead in this, we can set standards, develop platforms and help private-sector companies, to whom we outsourced these applications, to develop IP. This then becomes available to benefit the individuals who transact these services and the businesses which will use these services. So I agree entirely with the suggestions by Mr Zaqy Mohamad that the Government outsources. This is another source of business for our SMEs. Having said all this, it is also important to remember that, as a Government, we must ensure that we build an inclusive digital society, which means nobody gets left behind in the digital space too. Whether you are rich or poor, young or old, able or disabled, we must make sure that you have the hardware, connectivity, education and options to tap the many, many opportunities that this sector will generate in the future. I will give you some examples. IDA has the New PC scheme which is basically a subsidised computer ownership programme. Between April and December last year, close to 1,900 households benefited through this scheme by getting the subsidised computer. But, today, we realise it is not just about a computer. You need broadband access.”
“Complementing the wireless component, of course, is now the next enhancement of the wired component of broadband infrastructure. We envisage that the next generation broadband infrastructure will provide symmetrical 1 Gbps access for all businesses and homes that subscribe to it. We also intend to ensure that this will be an open access architecture, so that we will have the same competitiveness which you currently see in the mobile telephone market in order to keep prices as low and as affordable as possible. Because, as many of you have already observed, it is pricing which also determines uptake. This, we believe, will lead to the development of diverse new services for both businesses and individuals. We conducted a Request-For-Concept exercise last year and 33 big and small companies responded. Later today, IDA will announce the shortlist of pre-qualified applicants who will participate in our upcoming Competitive Dialogue in order to take this project on to its next phase. 1.45 pm But I agree entirely with Members that pipes, broadband and hardware are just one part of the equation. Ultimately, we need to fill those pipes with applications, services and to develop platforms for the people, private and public sectors to interact and transact on a day-to-day basis, because that is where value gets created. Let me cite some examples. The Government has taken the lead on this. We know that mobile telephony has a penetration rate of 103% in Singapore, ie, many people have more than one handphone account. What we have done is to transfer as many e-Government applications as possible onto these mobile platforms and today we have counted that we have about 150 Government services available for mobile transactions.”
“But I will be blunt with all of you and say that this is a dynamic moving situation and other cities have not stood still. We are all aware of the developments in Seoul, Tokyo, Hong Kong, Shanghai and Hangzhou, which have already started to implement their own ambitious ultra high-speed broadband networks. Therefore, we cannot afford to sit still. In this day and age, broadband infrastructure is not a luxury. In fact, it is probably in the same order of magnitude as the pipes and the sewers that run under our ground in order to support our economy and our lives. Against this backdrop of keen competition, we therefore have to plan for the future but, because the Ministry of Finance always overlooks and oversees us, we have to promise to do so, and, in fact, all of you promise to do so, in a cost-effective and efficient way. We have already started on this. Let me give you some examples. In December last year, you may be aware that we launched the first component of our Next Generation National Infocomm Infrastructure, and this first component is what we call Wireless@SG. With this infrastructure, we provide free access to some 1,300 hotspots across Singapore today, and the number of hotspots will increase to 5,000 by September this year. But Wireless@SG is not just to gain headlines. It has to benefit both the individuals who use it and, perhaps, just as importantly, to businesses and SMEs that Mr Zaqy spoke about. Many of you will recall the Straits Times' article just before the New Year in which even a bak kua seller in Chinatown is making use of Wireless@SG to run his wireless point-of-sale terminals so that he can conduct sales literally on the five-foot way, on the pavement, or even outside the shop.”
“Sir, as the question that I was about to ask is relatively similar to what the previous speaker has just said, I will just go ahead to my question. In the area of interactive digital media, could the Ministry please share with us the progress and disbursement of the fund that has been mentioned earlier thus far? What has the take-up rate been and which are the areas of focus? And, also, finally, how many IPs that have been created are online for this? The Second Minister for Information, Communications and the Arts (Dr Vivian Balakrishnan): Sir, let me first thank hon. Members for their very pointed queries which give us a chance to set the record straight or to take their ideas on board. First, let us talk about the the Intelligent Nation 2015. This is our infocomm masterplan. This was announced by IDA in June last year. We intend to invest $4 billion into this sector, not a small sum. Over the next 10 years, we believe this investment will transform the way we live, the way we work, the way we play, the way we make a living. Miss Penny Low has asked quite rightly about the state of our infrastructure relative to other countries. Today, we have a pervasive, good broadband infrastructure in Singapore. For instance, if you look at home broadband penetration rate, today, it stands at 63%. We expect that this would go up to 75% by the end of the year. And we target that, by 2015, 90% of homes would have broadband access. This did not come about by accident, but because of foresight and plans which were laid more than a decade ago. But this investment puts Singapore, as far as our infrastructure is concerned, in the forefront of the development of a knowledge economy, which we reap today.”
“Sir, the proposed Arts School will be a place where we nurture our pre-tertiary students to achieve and develop their creative and artistic potential. It hopes to diversify our educational landscape just as the Sports School and the NUS School for Science and Mathematics have done. Indeed, the arts scene in Singapore is expanding and getting more vibrant, but running a whole new school dedicated entirely to the arts at the pre-tertiary level will be a relatively new venture for Singapore. There will be challenges but we can learn from the experts from collaborations and visitations to world-renowned arts schools. I believe a committee has already been set up to do this and I applaud that. I would like to ask the Ministry what would be the cost to Singapore in terms of capital as well as operating cost. Which discipline of arts will be available, namely, the visual, the performing as well as the design arts? And, also, will there be an emphasis given to the ethnic arts? Will foreign students be enrolled as well? Will it be able to sustain attendances after the initial novelty period wears off, bearing in mind that currently, we also already have the arts and music education programme offered in several schools? 'Cool' Singapore”
“Mr Chairman, Sir, the emergency ambulance service must provide rapid transport, accurate initial evaluation as well as the initiation of life-saving measures. Some of the gold standards that are adhered to would include the chain of survival as well as the golden hour concepts. Our emergency ambulance service is essentially a single-tier system which operates from 14 different fire stations and also 24 fire posts throughout the island. In the day, we have 35 ambulances on the run and, at night, there are only 28 covering the whole island. We also have fast-response paramedics on motorcycles operating from 7.00 am to 10.00 pm daily. Our ambulance to population ratio is currently 1:105,000. The recommendation by the National Association of Emergency Medical Services Physicians is for one ambulance per 40,000 population, and this is to be doubled at peak operating hours. Therefore, my questions are: (1) Are there plans for expansion and enhancement to the service to meet the demands of higher public expectations and improving the waiting times? These waiting times are directly linked to survival outcomes. For example, our out-of-hospital cardiac arrest survival rate currently is at 2.5%, compared to 20%-30% in more advanced EMS systems. (2) Will there be plans to also increase the number of fast-response paramedics as well as their scope of coverage? (3) Are there also plans to regulate the private ambulance service in Singapore? Crime Rate”
“It will strengthen the sense of belonging - the Singapore heartbeat. The moral test of any society is how we treat our weakest, our elderly, our underprivileged or disabled, our needy and our sick. This Budget represents the heartware for us to do all these. But we, the people, need to provide the software. Our national volunteerism rate is at 15.2% at the last NVPC survey of 2004. More companies and corporations will need to recognise and participate in volunteer and philanthropic activities. Corporate volunteerism must expand. Corporations' performance is now being judged to the triple bottom line of economic, environmental and also the social contribution. Companies promoting volunteerism and also philanthropy must be given some kind of recognition. The recognition and allocation of volunteer leave need to be formalised as well and taken more seriously. Recognition and using of role models must be stepped up. We must become a more gracious society and continue to build on our heartware. Only in this way can we achieve our civil society with active citizenship through volunteerism and philanthropy, and I am sure our happiness index will improve as well and route towards becoming a top level first-world nation. Mdm Deputy Speaker, with all these, we will grow the Singapore pie. Mr Lim Swee Say has confirmed that the pie is not going to grow too large. Well, we will not be able to sub-divide it into too many minute sub-segments, as it would not satisfy our appetite. Perhaps the day will come when we can actually twin the pie and even triplicate the pie, and perhaps we can have different flavoured filling as well to choose from. 6.48 pm”
“In research and development, the research community is delighted with the projected increment of the R&D budget up to 3% of the GDP annually by 2010. This also comes with another $500 million for the National Research Fund. This is seen as an investment for Singapore's future, planning for growth in this area which comes along with job creation, technology enhancement and also intellectual property development. I hope to see some of these monies channelled into research related to the elderly, dementia, psychogeriatrics and also psychological health. These are often called the softer sciences and they have not been given too much emphasis so far, but we would like to see that change. Philanthropy refers to the desire to help mankind while volunteerism is the offering of services based on one's own free will. The call by the Second Minister for Finance in his Budget speech for Singapore to become a Philanthropy Hub is indeed a very fresh perspective, very different from the usual call to become a financial hub, a medical hub or a trading hub. We can be whatever we set our minds towards and strive for. His call is on target as Singapore has great potential to become the volunteer capital of Asia. Our position is conducive. We are at the crossroads of Asia, Southeast Asia. Our reputation is well-known in Singapore, it is synonymous with trustworthiness, action and accountability. The new 80:20 rule which we are doing away with is indeed very attractive as well, and that Asia is a disaster-prone zone may be an impetus for this. Philanthropy on a smaller scale must be promoted through the enhancement of the spirit of volunteerism amongst our people. Volunteerism promotes community bonding as well in the development of a gentle and gracious society.”
“Here, we have middle-aged as well as the older generation being enrolled in courses as though they are going to universities which are useful in their day-to-day living. Several batches have now graduated and they have only positive things to say about the programme. Perhaps, more funding can be channelled into this meaningful programme from MCYS and also NCSS. Mdm Deputy Speaker, in the United States, President George Bush has recently trimmed his healthcare expenditure to seek a more balanced budget. There is going to be a US$70 million cut from Medicare and Medicaid over the next five years. The democratic law-makers are calling this, and I quote, "Pulling the lifeline on the poor". We must never get to that stage. In Singapore, our healthcare financing model ensures fiscal sustainability and affordability by all, while some may need a little bit more help than others, with shared responsibility between individual and society. With the formalisation of SingaporeMedicine, more foreigners will be seeking medical care here. The numbers are projected to rise to one million by the year 2012. We must prepare by planning now with expansion of services, increase manpower of the various appropriate disciplines in the right proportions, increase bed capacity and outpatient specialist clinic slots. We are going to have to meet the increased demands of healthcare of these foreign medical tourist patients or our own patients of the increasing number of elderly with multiple problems that we are going to face and also the increased number of patients to be generated from our call to foreign talent to come and settle in Singapore. The time to start preparing is indeed now and I certainly see changes announced in this Budget, gearing us slowly but surely in this direction.”
“If an average 60-year-old does not have enough money in his or her Medisave and healthcare insurance, what will be the options? In this context, I am glad to hear of the $200 million top-up of the Medifund and the upcoming enhancement to the Eldershield scheme. The new scheme with CPF and Medisave opportunities for the informal workers and the contract workers is indeed a plus point in this year's Budget as well. But what will be the implications to our 3M system? What will be the cost to the elderly patients and to Singapore for each additional life year? We need to take into account that medical technology will add cost for additional life year. The Ministry of Health may also want to consider doing some quality of life measurements with a focus on its future trends, looking at health priorities within an integrated framework for elderly care. We will be needing more hospitals, nursing homes and step-down care beds in the coming years. In the United Kingdom, guidelines for service according to the Royal College of Physicians and also the Royal College of Psychiatrists states that for an elderly population of 30,000, there must be 45 acute beds, 75 day hospital places and 75 continuing care beds, which is the equivalent of our step-down care beds. It is time for us to project our local numbers for the coming years. Singaporeans must plan for their golden years from now, from our diets to lifestyle and the decisions that we make. Education on self-management and empowerment for the elderly can start from mid-life. A good prototype I would like to share is the Young at Heart Community College or the YAH Community College which is pioneered by the Marine Parade Family Service Centre.”
“Members of Parliament, grassroots leaders and even the media too can play a role by creating and enhancing awareness. I move on now to healthcare. With Singapore having the lowest infant mortality rate in the world and as we rank third in the world in terms of life expectancy, which is now 81.7 years, people are living longer. The bulk of our healthcare expenditure will be attributed to the elderly as they are high consumers of healthcare anywhere in the world. To tackle this problem, we must, either, firstly, free market regulation systems by using drug-related groups (DRGs) and resource-based relative value scales, or secondly, evaluate the needs and demands of our population and structure our healthcare system and financing accordingly. We already are doing both, but we need more to plan for the elderly explosion we are going to face. The population over 60 years of age is going to increase from 6.8% currently to 15.7% in 2020 and 56.7% by 2050. With ageing comes along dementia-related illnesses. This year alone, there are about 23,000 elderly who are diagnosed with dementia. By 2020, the number will rise to 54,000 and by 2050, we are going to hit 188,000 people with dementia. A report commissioned by the Alzheimer's Disease International suggests dementia-related illnesses may soon overtake heart disease and cancer as the biggest health threat in the Asia Pacific region. We need to cope with these projected numbers. We need to conduct local studies and analysis on the direct and indirect cost of managing the elderly with dementia, Alzheimer's diseases, and so on. And we need to fine-tune the ways to finance and organise care over the coming years.”
“To adapt, he has to change his mindset, be more outward-looking and get a wider perspective, change some of his traditional and conventional views, even if he does not have to travel out of Singapore. Parents and the elderly will need to realise the importance of investment in the next generation because their children are the ones who are going to be immersed in this new world order. For example, investing in their sound educational grounding now will prepare them just for this. For indeed, education is the key to handling and adapting to globalisation changes all over the world. They must be encouraged to grab the opportunities. I therefore applaud the Post-Secondary Education Assistance fund. One example I would like to highlight is the Malay/Muslim community efforts to standardise the madrasah education. From next year, the madrasah primary schools will be taking the same national PSLE examinations as every other Primary Six child. The lower-income, the unskilled and the elderly workers must become more proactive and vigilant. The Workfare Income Supplement scheme is a major policy change to help them. The introduction of Workfare as a permanent fourth pillar is a plus point for them. But they must identify and realise why they need training and retraining, skills acquisition and lifelong learning, or they stand the chance of becoming redundant especially in the age of high technology and mechanisation. Job security and empowerment will help them move towards being able to fend for themselves. Therefore, we must all play a role in helping them in the spirit of brotherhood. Employers and the unions must continue to bridge the knowledge of the Skills Development Fund or the Lifelong Learning Endowment Fund to them because they can now apply directly.”
“Mdm Deputy Speaker, I support the motion. In response to the comment by the NCMP Ms Sylvia Lim about the timing and decision of the GST increase, we have seen the foresight and the action of the Government over the last 42 years. And as Mr Lim Swee Say has just mentioned, we did not come to where we are by chance and we have to be fast and certainly, the decisions which have been made had helped us to sprint ahead of many competitive economies. The Government has to make decisions and sometimes, they are difficult decisions in response to whatever challenges we face, especially in the face of rapid globalisation. And also in response to her 60-year-old man's comment about "Love people and do not love things", let me share with her that nowhere else in the world can you get a Budget which exudes love and compassion in abundance as this one. Globalisation is here to stay and we will embrace it as a nation hand-in-hand and adapt to the new reality. But it comes with some challenges. Whereas it is easy for some of us to identify with globalisation and its opportunities, how about the average man-in-the-street, the lower 20% of society and those who live from day-to-day and the elderly? Their question would be: what is in it for us? What does globalisation mean to them? They have to understand the effects of globalisation. It will affect their employability and, of course, their job security. In their current jobs, it is not just comparing themselves to the guy who sits at the next counter. It now boils down to comparing himself to the average worker in China, India or Russia. He has to realise the competition is now that great.”
“Sir, can I ask the Minister of State for the renewal rate for rental flats? Can a group of residents who are in the income bracket of $801 to $1,500 per household income per month be considered on a case-by-case basis because these are people who are in a very tight financial situation?”
“Singapore will also study and share the experiences of these countries. With that, I support this Bill. * Cols. 1339-1340.”
“] Many developments have been taking place in the medical world which is becoming more advanced. Every year, various medicines and new devices are being introduced. Therefore, it is very important to have this Health Products Bill which incorporates various types of medicine and medical devices so that the safety of consumers is ensured. For example, among the Malay community, the usage of jamu or herbal medicine and traditional medicine is still going on actively. Every year, this industry develops by 25% to 30%. This makes the regulation process very complex. Therefore, from what aspect can control be put in place? Certainly, from the advertising point of view. As consumers, we have to be conscious especially with information which is not so correct or wrongly featured in advertisements as well as promotions. Not everything that they say or promise is true. That is why I strongly support the Bill, especially clause 23, where HSA, which handles issues on health products, may order the person who has advertised unsuitably to withdraw all the information which is not true, wrong and inaccurate. This is known as corrective advertisement. It is also hoped that it will make the industry more responsible. I am also very relieved to note that under this Bill, there will be a register of health products. This can be referred to by anyone to ensure that the medicine or device can be used and also be informed of the ingredients. Cooperation between Singapore and members of the Asian Harmonisation Working Party can be further enhanced through participation in courses in this industry and also the regulation sector. Singapore’s specialists who attend these courses can gain benefits and study the available systems in countries like America and Europe.”
“The point I am trying to make here is that post-market surveillance of already marketed devices is a very vital complement to the pre-market review. This is because no system of pre-market review, no matter how thorough, can prevent all potential safety problems once a device is in widespread use. A post-marketing reporting system is essential to monitor adverse events, interactions, falsifications, malfunction, operational and technical defects. In some countries, consultants or safety officers for medical devices are appointed and, thus, I fully support the stipulations in clauses 23 to 28 and the essential principles of safety and performance of medical devices under the Second Schedule. The penalty provisions in this Bill have also been updated and this is certainly necessary. For example, the maximum court fine for the offence of providing false information in the process of applying for a licence under the Medicines Act is only $5,000. The maximum fine for a corresponding offence in the proposed Health Products Act has been adjusted to $20,000. This will serve to act as a deterrent and will certainly stress the seriousness with which such penalties are being viewed. The prohibitions against dealing with adulterated or counterfeit products in clauses 12(5), 13(5) and 16(1) will help to act as a checking mechanism and to reduce chances of another Slim 10 incident. Finally, the modular application of different controls to the different types of health products, which is a new feature, will assist with the customisation of the regulatory regime with the appropriate levels of control. Let me now just say a few words in Malay. (In Malay): [For vernacular speech, please refer to Appendix A*.”
“However, one area which I would like to see regulation would be over the claims and advertisements of health supplements. One other consideration would be whether the Ministry of Health, HSA and the Ministry of National Development, in particular the Agri-Food Veterinary Authority, have any plans to regulate food with therapeutic claims, for example, ginseng drinks with claims of lowering blood pressure, under this Health Products Bill. Medical technology has indeed expanded by leaps and bounds in the last decade and major open surgery is now being overtaken by less invasive laparoscopic procedures with highly sophisticated equipment. With all these developments, we have to remain vigilant. Let me illustrate with an example. Several years ago, a well-known medical device company was redesigning its 60-degree heart valve to open to 70 degrees. This was with the aim of reducing the chance of clog formation and therefore the risk of strokes. The FDA reviewers did not approve the application because it lacked the engineering metal stress analysis and also clinical data. The valve was however approved for marketing and use in Europe. After use in several thousand patients, it was found to break six times as often as the old valve. Another example - a company designed a new stent that was smaller and more flexible than existing ones so that it could be used in convoluted as well as narrow heart arteries. The device was approved for marketing in Europe. When the FDA reviewed the device, engineers discovered a design feature which caused metal fatigue and breakage, and the company had to redesign the stent before the clinical trials could start.”
“Mdm Deputy Speaker, I rise in support of the Health Products Bill. I will speak in English first, followed by Malay. This Bill will create an omnibus to regulate all health products eventually. The common legislative provision is indeed a welcome move to make it easier for understanding and practice. Starting off with only the medical devices listed in the First Schedule, this legislative Act will eventually become the vehicle regulating all types of health products for human use and consumption. The review of the Medicines Act is going to be carried out for future incorporation into this Bill. I would like to put forth the following two recommendations: firstly, the provision of bio-equivalent data to be provided by generic manufacturers. This is also already a requirement by the US Food and Drug Administration (FDA) and it is time for Singapore to follow suit. Secondly, with respect to identification of medicines, it would be safe as well as useful to have the drug name, composition, batch number or expiry date printed on every segment of the blister package of medication. Currently, this information is shared by several segments at a time, and when patients, especially the elderly, cut these segments into individual pieces, which they very often do, the crucial information is missing and lost. Pertaining to the regulation of health supplements, I agree with the Health Minister that we should not be rushing into this. A detailed assessment by the Health Services Authority will be required. Currently, health supplements are not regulated, even in the United States. And if we do decide to regulate, it would indeed be a very bold and complex step indeed.”
“Sir, I have three supplementary questions. Firstly, I would like to ask the Minister with regard to the intellectual debate that is on-going now on the future directions of research. What would be the future on biomedical research as this would really have a bearing for the research fraternity as well as the influx of foreign talent and research into Singapore? Secondly, can he please elaborate on the fund allocation for research, say, in the next five to 10 years? Thirdly, I would like to know whether there would be plans for a ratio or a quota of foreign versus local researchers or research grants and projects.”
“I just want to ask a supplementary question. Lately, there have been some cases which have been highlighted where some of these foreign nurses have not had their permits renewed. Is there a kind of a plan or trend where we are trying to decrease the number of foreign nurses by decreasing the number of permits?”
“They can convey or create a mood, an attitude, an atmosphere or even an awakening. Mr Speaker, Sir, I support the motion.”
“When we speak at our election rallies, we used a combination of languages. And it is timely indeed for this practice to be extended to this House. Singapore is small in size but big on languages. This was reported as early as 1991 in the Business Times of 15th November and our parliamentary Chamber will now be more of a linguistic stage with diversity in languages co-existing in a very dynamic way, reflecting our national integration. It will also emphasise the conservation of our mother tongue and indeed a very positive step in fostering further rootedness among Singaporeans. There are already many other nations that have adopted the dual or multilingualism policy, and these would include Scotland, Malta, Wales, Canada and Hungary, just to name a few. Many of these nations have agreed that members have the right to use their mother tongue when addressing Parliament and in their public service. When we have visitors to our Parliamentary debates, it would be excellent to showcase our multi-lingualism, which is unique and inspiring indeed. Moreover, with more foreign talents coming to reside within our borders, this practice will raise the profile of our languages as it will be seen not only as being spoken at home, the markets and in the coffeeshops but in Parliament, where important issues are discussed and critical decisions are being made. The importance of the usage of our mother tongue will also have far-reaching benefits in the region and, in particular, countries such as Malaysia, Indonesia, China and certainly India as well. Therefore, our bilingual capabilities are highly valuable and must be utilised as widely as possible. After all, when a real leader speaks in any language, people listen. Words in the appropriate language can do so much more.”
“Mr Speaker, Sir, I rise in support of the motion raised by the Deputy Leader of the House. The Singapore language policy has always included a promotion of bilingualism, mastering English as a language for commerce, education and also administration, and certainly using Mandarin as a unifying language for the Chinese community. Passing this motion would be in line with the promotion of our cultural and lingual diversity in a multi-racial, multi-cultural and multi-lingual society. We, Members of the House, leaders in our community, must set the example and spearhead the efforts in Parliament. We shape our language and certainly our language shapes us as well. Using our mother tongues in our speeches will enable a greater connection with members of our community, especially those who do not understand and speak English. According to the General Household Survey of 2005, for example, about 24% of Chinese households do not use English at all and we have a relatively similar number for Malay households as well. These are exactly the segment we will be reaching out to with this new policy. They will now be able to connect better with their Members in Parliament and follow and support their speeches closely. With a language familiar to them, they will be more at home, and we certainly cannot deny that certain issues when discussed and spoken of in a certain language can create and generate more emotions, greater passion and also impact than when stated in English. This is a known phenomenon and may be related to the way our brains encode messages and information in the limbic system. It is also human nature to click and connect with those with similarities to you and particularly those who speak and understand the same language.”
“Sir, can I just find out the utilisation rate for the Subutex voluntary rehabilitation programme and the take-up rate since it has been implemented and, also, if the Minister has the data for the ratio breakdown? Assoc. Prof. Ho Peng Kee: About 3,000 persons signed up for the Subutex programme. Of these, about 2,500 turned up for the first consultation, and about 1,600 completed the medical detoxification phase. So not all have signed up. But I think what is heartening is that of the number of Subutex abusers who were arrested, not more than 170 were people who had gone for the SVRP programme. In other words, a large majority who went and completed it were not arrested subsequently for Subutex abuse. So that is heartening.”