Gerald Giam Yean Song
Singapore
“Thank you, Mr Speaker. The focus of my supplementary question will be on the film classification guidelines, which currently state that, quote, "Chinese films meant for theatrical release should generally be in Mandarin, in line with the Speak Mandarin Campaign.”
“Mr Speaker, we cannot allow physical infrastructure expansion to blind us to the shifting digital geography of global trade nor should we allow frontier technology to reduce the economic agency of our transport workers.”
“Sir, I thank the Minister for his replies. I understand the difficulty in getting the exact numbers. But is there an order of magnitude that the Government can provide as to how many such fees were collected and what is the total quantum? Just an order of magnitude, does not have to be an exact number.”
“Sir, I thank Mr Ng Chee Meng for acknowledging my OJT proposal. I am aware of the work of CTCs, but my proposal goes beyond what the CTCs currently provide. First is the depth of the wage support, and second is the structural design of OJT.”
“I thank the Minister for responding to my question just now. I am glad to hear that there will be more precise matching with the help of SWDA's the integrated intelligence function. But can I ask if this function will be provided to all jobseekers who approach SWDA or its agencies, like e2i, to seek for job assistance?”
“Sir, can the Minister elaborate a bit more about how SWDA will enhance the job search assistance programme? Specifically, will career counsellors move beyond basic resume editing and portal referrals to leverage real time vacancy data for proactive matching and advocate for candidates?”
The complete record
Every one of 984 lines we hold for Gerald Giam Yean Song, in date order, each linked to its source. Free to read, in full, without an account. Page 18 of 20.
“Madam, I was glad to hear the Minister's assurance during his speech that private Shield plans are not allowed to refuse coverage once the policyholders are enrolled. But then his response to Dr Lam just now got me a bit worried. Can I clarify if private Shield plans are allowed to drop coverage of specific illnesses upon renewals – for example, if a patient gets prostate cancer – are the private Shield plans allowed to refuse coverage of that cancer if there is a relapse the next time? If so, is the Minister okay with this? Second clarification: I am happy to hear the introduction of the flexi-MediSave. But I think the Minister did not address my request to expand the CDMP list of approved MediSave conditions to all medically necessary treatment that is of proven value and is cost effective. Last clarification: I think it is good that the Eastern Health Alliance is conducting home visits for patients, or even hospital visits. Are the patients made to pay for these visits? I hope not. And are there plans to use telehealth to monitor activities like medication compliance because this can reduce costs and extend the reach of such interventions?”
“The Singaporean lifestyle is, unfortunately, not the most healthy and positive, and looking at our chronic illness rates, it is indeed telling that we need more focus and emphasis on health promotion and preventive care from an early age. This is also closely linked to being educated and knowledgeable in health-related issues. Certain groups, especially our seniors in low-income households, have very low health literacy rates as well. If we can rectify this, perhaps we can see some reversal in certain negative and worrying trends in healthcare. What else will MOH be rolling out, together with HPB, in this area? Will there be more partnerships that we can see to ensure outreach and spread of information get filtered to those needing it most in the last mile and are falling through the cracks in this important focus? Will there also be more health promotion facilities that we can see? Madam, health promotion strategies must include advocacy, surveys and research. The main thrust must be the demand for good health, rather than just good healthcare. Page: 119”
“Madam, age-appropriate preventive health screenings have been recognised as a cost-effective way to identify health problems before they develop further and end up being more costly to treat. However, many are reluctant to undergo health screenings because of the inconvenience, cost or fear that it will reveal health problems whose treatment may be beyond their ability to pay for. More resources should be invested in promoting regular health screening on a wider scale. High-risk groups should be identified and greater effort made to reach out to them. Page: 118 To encourage greater adoption of health screening, I propose that all Singaporeans who reach age 40 be provided with one set of free health screening tests for common chronic conditions and cancers under HPB's Integrated Screening Programme. This should include the cost of a doctor's consultation. Subsequent health screenings should be provided at subsidised rates and patients should be allowed to use their MediSave to pay for the remaining costs. Having more Singaporeans in high-risk groups undergo regular health screenings could reduce overall health expenditure as diseases are detected earlier, hence, requiring less costly interventions. Preventive Health and Health Literacy Assoc Prof Fatimah Lateef: Madam, lifelong health promotion and care must be planned right from early adulthood. It is too late to think about your low bone density when you are 68 years old and have already sustained an osteoporotic hip fracture from a fall. Awareness, knowledge acquisition and inculcation of healthy habits and lifestyle start early, in preparation for the latter years. Participation in health screening is also critical, as early diagnosis can lead to early intervention and of course, better rates of cure.”
“Madam, I would like to make a few proposals regarding MediShield Life before the scheme is introduced next year. First, I would like to reiterate my call for premium subsidies to be extended to all vulnerable groups of Singaporeans, including elderly persons with low savings but not only members of the Pioneer Generation, people with disabilities, those who have exhausted their MediSave and those who are already qualified for Government financial assistance schemes like MediFund, Public Assistance, ComCare and CHAS. Second, can the $70,000 annual claim limit be removed from the insured's life? On the affected policyholders, it would be financially crippling if their insurance cover were removed when they reach the claim limit since they would already have spent a lot their savings on the co-payments. As fewer than 0.1% of policyholders reach the policy year limits every year, continuing to cover them will not result in significantly higher claims or premium burdens. What it would provide is tremendous peace of mind for them. Third, MOH should ensure that MediShield Life does not follow the practice of some private insurers who sometimes reduce coverage after policyholders are diagnosed with an illness, to prevent them from claiming again when they suffer a relapse. This should apply to the integrated Shield plans that ride on MediShield Life. And, fourth, can we have better coordination of MediShield Life with private and company health insurance to ensure that they do not overlap? This would avoid unnecessary premium payments which benefit no one but the insurers.”
“Madam, restrictions on MediSave withdrawals sometimes result in patients facing financial difficulties even though they have balances in their MediSave accounts. MediSave should be allowed for all medically necessary treatments that are of proven value and are cost-effective. MOH should greatly expand the list of approved outpatient treatments under the chronic disease management programme. While 15 chronic diseases are now on the list, there are many others which are not but which require long-term medication and frequent consultations which can be very costly. The Page: 62 expanded MediSave withdrawal list should be updated regularly by an independent panel consisting of doctors and healthcare researchers. In addition, patients above the age of 75 should be allowed to use their MediSave without being subject to annual limits. This will ensure that they are not deterred from seeking treatments because of high cash payments.”
“Madam, traditionally, we contain healthcare costs by curbing patients' demand for healthcare. We do this by making patients co-pay, so that they think twice before seeing the doctor or requesting for more diagnostic tests. However, most times, it is the doctors who decide on the course of treatment for the patients. Therefore, healthcare providers, not patients, drive the bulk of healthcare spending. If we want to control costs, we need more focus on the providers. Page: 43 Can MOH explore alternatives to the current fee-for-service payment approach? Fee-for-service payment tends to give providers a perverse incentive to boost revenue by increasing patient throughput, rather than keeping patients healthy and out of hospital. Instead, MOH could better incentivise providers to contain the overall growth of healthcare costs across the continuum of care – from primary to acute to step-down care. Doctors and healthcare providers should be given greater financial flexibility to redesign healthcare delivery, so that proven and cost effective services can be reimbursed. For example, we could reward providers for efforts to enhance patients' medication compliance, monitor patients' weight gain or blood sugar levels in their homes, or perform follow-up consultations using web conferencing. Second, different providers should be better integrated and made collectively responsible for providing integrated care for patients. GPs, acute hospital specialists and step-down care professionals should be rewarded for cooperating and sharing information to improve quality and control costs, not simply by the volume or class of patients that they treat. Spending Smart and Aligning Incentives”
“Madam, telehealth is a mode of healthcare delivery that uses technology to enable remote diagnosis, consultation, treatment, education and care management of Page: 40 patients. It includes the use of home monitoring of chronic diseases, remote consultations between patients and providers, and video-conferencing between doctors in different hospitals. Telehealth has the potential to reduce healthcare costs, increase the level of convenience for patients and improve patient outcomes. One key barrier to a greater adoption of telehealth is the absence of an agreed-upon reimbursement model. If doctors cannot get paid for telehealth consultations, they are more likely to ask patients to come to the clinic for a face-to-face consultation. Similarly, if patients cannot use their MediSave or receive subsidies to pay for telehealth consultations, they would be more likely to choose to make the trip down to the clinic. Given the cost savings, improved outcome and improved patient satisfaction that telehealth has the potential to bring, the Ministry should look into ways to increase its adoption in Singapore. These include providing the infrastructure and support to healthcare providers and patients in acquiring telehealth technologies, reforming reimbursement models for telehealth and revising any legislation that unduly inhibits telehealth adoption. Polyclinics”
“I have four clarifications for the Minister regarding the BSEP. First, how much will the additional 450 buses cost? If we extrapolate the cost of the 550 BSEP buses, and it appears that the 1,000 buses would cost the Government about $2 billion. Is that the amount that it would cost? Secondly, are these additional buses meant to enhance the standards further beyond the current QoS (quality of service) standards, or is it just to meet the current QoS standards? Thirdly, while I believe that there should be continued investment in public transport, where will the Government draw the line in subsidising the operational cost of profit-making PTOs? Fourthly, are there any plans to claw back any of the future profits from them?”
“Madam, in January, when the Public Transport Council (PTC) approved hikes in bus and MRT fares, many commuters asked why fares were being raised when they had yet to see satisfactory improvement in service reliability. The PTC Chairman acknowledged that service reliability needs to improve, but said that this issue should be kept separate from fare raises, which are to cover rising costs for operators. This is quite baffling for most commuters, myself included. In most service industries, customers demand good service before they agree to pay. But for public transport in Singapore, we seem to be expected to pay more just to get satisfactory service. Can the Ministry consider revising the fare review formula to incorporate service reliability as one of its components? This will create a direct link between service quality and fare adjustments, and will better align the incentives for transport operators with the interests of commuters. Page: 44 Rapid Transit System between Johor and Singapore”
“Madam, Government leaders have, over the years, frequently told Singaporeans that their HDB flats are an asset which they can monetise during retirement. However, less frequent are the reminders that, as a flat approaches the end of its 99-year lease, its asset value will depreciate to zero. While most Singaporeans know that their flats are on a limited lease, many assume that HDB will not let their assets become worth nothing, or that their flats will eventually go through an "en bloc" before their leases expire. The Minister told me in a reply to my PQ in January that the selection of sites and the pace of the Selective En Bloc Redevelopment Scheme (SERS) will depend on factors, such as their redevelopment potential and the availability of replacement sites for rehousing and other resources. Can the Minister confirm whether all old flats will eventually be replaced through SERS before they reach their end of lease? If not, what proportion will not be replaced? Other than SERS, what are the Government's plans for HDB flats that approach their end-of-lease? For example, will their leases get topped up, and will the topping up cost be borne by HDB or the lessees? There are now over 31,000 flats which are more than 40 years into their lease. I am sure many young couples are still buying these resale flats, which would mean that the leases may end within their lifetimes. If the Government does not have any specific plans for flats when their leases expire, I think it should make this clear to the public, so that buyers can factor this in when choosing a resale flat and they do not pay too high a premium for older flats. Page: 104 Booking System and Income Ceiling”
“In the latest breakdown of economically inactive persons in Labour Force Survey 2013, there were 8,600 discouraged workers. These are persons who are not actively looking for a job because they believe their job search will not yield results. There are others who want to work but cannot because of family responsibilities like childcare, care-giving to family and relatives, and housework. Almost half of the over 300,000 economically inactive women cited these reasons. There were also over 85,000 time-related underemployed residents. These are part-timers who were willing and available to work additional hours but are unable to find better work. Finally, there are underemployed workers who are doing work that they are overqualified for. Many older PMEs are in this group. May I ask the Minister: (a) What is MOM doing to help discouraged workers to find work? (b) How does MOM help the underemployed to increase their working hours or find jobs commensurate with their skills and experience? (c) And how is MOM working with companies and other agencies to remove structural impediments to employment, like lack of childcare, student care, eldercare or flexi-work arrangements? Can MOM publish a new aggregate measure of labour under-utilisation that factors in not only the unemployment rate, but also discouraged workers, the underemployed and economically inactive persons who want to return to the workforce? Tracking this measure will help focus minds on factors that lead to a lower labour force participation rate, which has a direct impact on economic growth Page: 29 and household incomes. Laws against Workplace Discrimination”
“Madam, the Trans-Pacific Partnership (TPP) is an ambitious Free Trade Agreement (FTA) involving 12 Asia-Pacific countries, including the US and Japan. The scope goes beyond removing tariffs to tackling broader environmental, labour and intellectual property rights issues. The IP rights chapter in the TPP has raised much concern among negotiating countries. The US proposals reportedly seek a much more stringent level of IP protection than the WTO standards or even the US-Singapore FTA. They are said to strongly favour American industries and big corporations. There are worries that the TPP may extend the scope of pharmaceutical patents and delay the sale of generic drugs. This could raise prices of pharmaceuticals in TPP member countries, including Singapore. Can I ask the Minister: would the TPP directly or indirectly cause an increase in the price of medical drugs in Singapore? Will our patients have to wait longer to obtain affordable, life-saving generic medicines? And what are the concrete steps our negotiators are taking to protect our national interests in this area? As a major trading nation, it is important for Singapore to be part of the TPP. However, I hope the Minister can assure us that the strategic and macroeconomic benefits of the TPP to businesses will not come at the expense of ordinary Singaporeans. Thank you.”
“For most NSmen, annual in-camp training (ICT) involves long hours away from work and family. There is often a lot of waiting time in between the action, hence, the adage, "hurry up and wait!" Commanders, however, are much busier throughout the ICT because they are often engaged in planning while the men wait. Yet, for the sake of equity, units usually issue call-ups to all involved NSmen for the full duration of the exercise. This incurs a huge cost in terms of the NSmen's time and Make-up Pay – which is based on the NSmen's civilian salary. To better utilise NSmen resources, could non-commanders be recalled for a shorter ICT duration or even fewer ICTs? To address the inequality, key appointment holders and commanders could be rewarded with extra pay or benefits to compensate them for the additional sacrifices they make for our nation. NSmen and their Aspirations”
“Each year, MINDEF takes up the largest share of the Budget among all Ministries. This year, the defence budget is $12.6 billion – more than a fifth of total expenditure. Singapore has the highest defence spending in South East Asia by far. According to the latest data from the Stockholm International Peace Institute, we spend 42% more than the next highest spender in the region, and 80% more than the third highest spender. I fully appreciate the need for us to maintain a strong and credible defence force and to remain ahead of potential adversaries. However, in deciding on its expenditure and choosing cutting edge defence technology, does MINDEF consider that if we leap too far ahead, there is a risk of spurring an arms race, as countries in our region may feel under pressure to keep up with us? This could lead to even greater spending in the future, which may be unsustainable. Outsourcing within SAF”
“A question for the Minister. Firstly, I said in my cut quite clearly that I did not expect Singapore to contribute 0.7% and, certainly, not $2 billion. So, I am aware that every dollar we spend on international development must be one less dollar we spend on domestic needs. I also thank Senior Parliamentary Secretary Sam Tan for explaining MFA's contributions through the SCP. My key question actually in my cut was: "Does the Government see international development as a cost-effective way of furthering our foreign policy goals in terms of building goodwill and support from other countries for Singapore?" For example, after the Asian tsunami, Singapore engaged in several projects in Aceh province as well as in Sri Lanka to build up some of their capacity, not just in terms of technical assistance and training, but actually going to that country and engaging in development projects. Are there plans for Singapore to similarly explore such things, such that we can further our foreign policy goals a bit better? Page: 151”
“Sir, international development is a form of foreign aid that seeks to improve the lives of people in developing countries, while at the same time furthering a country's foreign policy goals. It does not traditionally play a very visible role in our foreign relation strategies, apart from technical assistance programmes that we provide to developing countries. This is unlike most developed countries that have dedicated international development agencies and, sometimes, even a Cabinet Minister-in-charge. In 2013, Singapore contributed $26.7 million in Overseas Development Assistance (ODA), which includes technical assistance programmes, Page: 129 scholarships and tuition grants to foreign students. Can the Minister share what other forms of ODA Singapore contributes to which are not captured in this amount? Many developed countries in the United Nations have committed to a target ODA contribution of 0.7% of gross national income. What is Singapore's ODA as a percentage of GNI? While I do not expect Singapore to target 0.7%, are there plans to increase our ODA in the future? Does the Government see international development as a cost-effective way of furthering our foreign policy goals? Given the multifaceted nature of international relations today, what is the role the Government sees international development playing in the years ahead? Consular Services”
“If the concern is that some SMEs and IT vendors will abuse the grants, then audits could be conducted after project implementation and penalties could be put in place to deter such behaviour, rather than weigh down all SMEs because of the actions of a few black sheep. Mdm Speaker, I have more to say on other aspects of Budget 2014, including defence expenditure, the prudent use of NSmen resources, Page: 95 MediShield Life, healthcare financing, and helping more Singaporeans to enter the workforce. I will elaborate further on these during the Committee of Supply (COS) debate.”
“This is critical because SMEs will be limited to these vendors and solutions – for better or for worse – if they want to tap on the IPG fund. In this respect, would it not be more appropriate to allow SMEs to choose the best vendor and solution that meets their unique business needs, rather than restrict them to a pre-qualified list from the Government? Under the current iSPRINT scheme, SMEs need to wait for several months for grant approval from IDA, and I am told that IDA asks SMEs many questions before approving the grant. I presume this is to ensure that SMEs and vendors do not abuse the grants. There is also a lengthy business proposal that must be submitted to justify the funding. After evaluation, IDA may decide that the "qualifying costs" for the grant will be lower than the actual implementation cost of the system, hence, lowering the overall grant disbursed. As a result, many SMEs may find that it is not worth the time and effort to apply for such funding, and this will result in a lower adoption of productivity-enhancing technology in SMEs. Only 500 SMEs have benefited from funding for sector-specific proven solutions so far under the iSPRINT scheme, out of over 154,000 SMEs in Singapore. This stands in great contrast to the Productivity and Innovation Credit (PIC) Scheme, which does not require such a lengthy and onerous application process to obtain funding. Is it no wonder that the PIC has proven to be much more popular with SMEs? Over 80,400s SMEs tapped on the PIC scheme in the last two years. I hope agencies can adopt a more streamlined approach when evaluating and approving technology grants for productivity enhancements. This will be a key success factor for IDA if it is to reach its target of another 10,000 SMEs over the next three years.”
“The Deputy Prime Minister acknowledged that while productivity has increased by 11% since economic restructuring began four years ago, this was entirely due to the strong cyclical recovery in 2010, with little improvement since. At this rate, is the Government going to be able to meet the targeted 30% cumulative productivity growth by 2020? In the last four years, hundreds of millions of taxpayer dollars have been transferred to businesses through various grants and tax credits for productivity-enhancement schemes. The schemes introduced in this year's Budget are mostly enhancements or extensions of existing schemes. Given the disappointing overall productivity growth for the past three years, I think we need to examine these schemes to see what adjustments need to be made to produce more positive outcomes. Budget 2014 will include a major effort to scale up the use of InfoComm Technologies (ICT) by SMEs. The Deputy Prime Minister said the Government will give a stronger push to the piloting and scaling-up of ICT solutions that can help to transform whole sectors, through the ICT for Productivity and Growth (IPG) Programme. Under one of the initiatives in the IPG programme, IDA will pre-qualify eligible vendors and their solutions. SMEs need not apply to IDA for the subsidy; they can approach the pre-qualified vendors and IDA will reimburse the vendors Page: 94 directly. These apply to only sectoral solutions currently supported under IDA's iSPRINT programme. How will the Government ensure that IDA uses a fair and objective method, and that its officers have sufficient industry experience and competencies to select the right vendors and solutions?”
“I note that Budget 2014 provides an additional one-off GST Voucher in the form of cash for seniors and a U-Save Special Payment. However, these are only for this year, and they still do not fully offset the GST expenses for all lower-income households. Can the GST Voucher scheme be enhanced so that it fully offsets the GST expenses of all lower-income households, and offsets a greater proportion of GST expenses for middle-income households? This will better ensure that the GST Voucher scheme fully corrects the regressive nature of GST and makes it more progressive. Page: 93 Next, on productivity enhancement schemes and their outcomes. Before I continue, I wish to declare that I work in the IT industry and in the SME sector. I agree with the Government's intent to raise productivity in our companies, increase technology adoption and reduce reliance on manpower. In his 2010 Budget Statement, the Finance Minister said that the "key goal" of the Government was to grow productivity by 2% to 3% per year, or 30% cumulatively, over the next 10 years to 2020. He said this will allow Singapore to maintain an economic growth rate of 3% to 5% a year, even with slower growth in our work force. The Deputy Prime Minister reiterated in this year's Budget Statement that raising productivity is "at the centre" of the Government's economic agenda. How have we progressed so far in achieving this key national goal? In 2011, labour productivity growth was 2% over the year before. In 2012, it dropped by 2%. Last year, it was flat – there was no overall growth from the year before.”
“In particular, I am of the view that all those who served in the first few batches – and not just the first batch – of National Service (NS) should qualify for this package because they played an important role at a critical juncture in our nationhood. Page: 92 Madam, it is important to emphasise that the Pioneer Generation Package is not a "senior citizens' package" even though all of our pioneers are now elderly. It should not be viewed as the fulfilment of the Government's obligations to the elderly. There is still much that needs to be done for the elderly and future elderly in Singapore, especially people with disabilities, homemakers and low-income workers who will have insufficient savings when they reach retirement age. Madam, I would now like to touch on a few other aspects of Budget 2014. First, on the Goods and Services Tax (GST). For the past six years, GST has been the second-largest contributor to Government revenue, after corporate income tax. In FY2013, its contribution of $9.52 billion exceeded that of personal income tax by almost $1.9 billion. In FY2014, GST's proportion of revenue is expected to increase to 17%, up from 16.7% last year. It is widely recognised even by this Government that GST is a regressive tax because the poor fork out a higher proportion of their income to pay GST than the rich do. The permanent GST Voucher scheme is meant to correct this regressivity. However, GST Vouchers fully offset the GST expenses for only retiree-led households and the very low income. For other lower-income households, on average, the GST Vouchers offset only about half of the GST they pay each year. Therefore, many lower-income earners are still net contributors to GST.”
“The subsidies for specialist outpatient clinics and polyclinic services, as well as disability assistance, will be rolled out in September 2014, and all pioneers who do not already qualify can join the Community Health Assist Scheme (CHAS) only in January 2015. The MediShield Life subsidies will be applied at the end of 2015. The Government should expedite the roll-out of the Pioneer Generation Package benefits. For example, since CHAS is already in place, can we allow all Pioneer Generation members to immediately benefit? Although MediShield Life will only be rolled out in end-2015, the Government should start applying MediShield premium subsidies for the Pioneer Generation from this year. The elderly above age 65 are already shouldering a heavy premium burden of between $540 and $1,190 per year for just MediShield Basic. Alternatively, the Government could consider doubling the planned additional Medisave Top-ups for Pioneer Generation members until the Pioneer Generation Package is fully rolled out, so that pioneers can start to enjoy the benefits of this package sooner. This would provide 65-year-olds an additional $400 in Medisave Top-ups this year and next year, instead of $200 in each year. The Deputy Prime Minister said that there would be a panel to assess appeals from those who marginally missed out on the precise criteria. Could the Deputy Prime Minister share what are the guidelines the panel will be given to make these assessments? I hope the panel will err on the side of generosity, as many of those who just missed out may have made significant contributions on par with pioneers.”
“Mdm Speaker, the Workers' Party supports the Government's initiatives to honour our Pioneer Generation of Singaporeans. In August 2011, we released a National Day statement entitled, "Honouring our First Generation". In our statement, we said, and I quote: "The Workers' Party wishes to pay a special tribute to the first generation of Singaporeans who struggled to build our nation during the early decades of independence. They are now our parents and grandparents, uncles and aunts; the elderly cleaners; the retired civil servants and teachers; the first National Servicemen." "This generation embodies the true Singapore spirit – the determination to work hard, overcome the odds and carve out a better life for their children. They serve as a shining example for many future generations to follow." "History may only remember the kings and not the soldiers, but let us never forget the contributions of the first generation of Singaporeans. More than anyone else, they deserve to enjoy the fruits of our nation's success." "The men and women in our Pioneer Generation have borne society's burdens…They gave the best years of their lives to our nation. Our nation must now give its best in return to them." Page: 91 I think this aptly describes our respect for and gratitude to the Pioneer Generation of Singaporeans. Madam, it is important that we honour our pioneers before it is too late. Last year, over 13,000 people aged 65 and above departed from us, according to the Singapore Demographic Bulletin. Last week, I met a resident who said that his 80-plus-year-old neighbour was very happy to learn about the Pioneer Generation Package, but sadly, he passed away suddenly the next week before enjoying any of the benefits.”
“The most the regulator can do, under this Bill, is to direct the licensee under section 18A(2) to remove a CEO from his or her position, but it appears that this can only be done if LTA never approved of the appointment of that CEO in the first place. Could the Minister clarify? If LTA had approved of the appointment of a CEO, and that CEO subsequently fails to perform, can the LTA direct the licensee to dismiss him or her? Besides influencing the appointment of the CEO and directors on the board, would the Government consider introducing other regulations to make senior managers of PTOs more personally accountable for the quality and reliability of their MRT services? For example, the LTA could require licensees to name the individual who is assigned crucial responsibilities like rail and train maintenance, so that when regulatory action is taken against the company, the LTA will know which senior people should be held responsible, and, if necessary, censured. I believe this approach could be more effective in keeping the PTOs on their toes than imposing large fines on the company. 6.27 pm”
“0 million penalty imposed by LTA for the December 2011 train service disruptions" as well as other expenditure. During the operators' last application for fare adjustments, they cited higher operating expenses as one of their key justifications for fare increases. Hence, the penalties could be indirectly contributing to fare increases. When the PTC examines the public transport operators' (PTOs') requests for fare increases, which include reason of higher operating expenses, does it factor out the fines that the PTOs have incurred for service lapses? Next, penalties imposed by LTA for service disruptions are donated to the Public Transport Fund, which is used to buy transport vouchers for needy commuters. This means that the fines paid are eventually returned to the operators in the form of fare revenue. Finally, the Bill stresses that financial penalties "still cannot be imposed on a licensee by the LTA if the licensee is likely to fail to provide and maintain an adequate, safe and satisfactory service". This provides yet another safety net for the MRT operators, who may claim that a penalty is too large for it to bear without impacting maintenance and service quality. Will all these circumstances surrounding financial penalties neutralise their deterrent effect and render them a rather ineffective mechanism for ensuring Page: 105 good performance? Furthermore, financial penalties are imposed on the company and do not directly impact the people who are in a position to improve service quality and reliability – that is, the top management of the PTOs. There is nothing in the RTS Act that stipulates that bonuses or salaries must be cut, or heads must roll if senior managers fail to meet their KPIs and major disruptions occur too frequently.”
“This Bill seeks to amend the Rapid Transit Systems (RTS) Act by enhancing the financial penalties that may be imposed for regulatory defaults by licensed MRT operators, also referred to as "licensees". It also enhances the powers of LTA in relation to the appointment and removal of the CEO, chairman of the board of directors and directors of a licensee. Currently, in the event of a regulatory default, a licensee will be liable for a fine of up to $1 million. This Bill seeks to provide LTA with the option of imposing a fine of up to $1 million or up to 10% of the licensee's annual fare revenue, whichever is higher. Page: 104 In the history of the MRT, the maximum fine of $1 million has only been imposed twice. SMRT was issued a $1 million fine for each of the massive service disruptions on the North-South and East-West lines that took place on 15 and 17 December 2011, which affected over 221,000 commuters. The move to peg the maximum penalty at 10% of annual fare revenue raises the financial risks for the two operators. However, despite the maximum penalty being imposed for the December 2011 disruptions, there has been no consistent decline in the number of incidents on the MRT network causing delays since then. In fact, the number of incidents causing greater than five- and 10-minute delays increased from 2011 to 2012 before declining slightly in 2013. This does not give very much reason for hope that increasing the penalties further will improve service levels. The MRT operators include the penalties as part of their operating expenses. In its most recent annual report, SMRT stated that its "other operating expenses saw an increase of 8.8% to $204.5 million, due mainly to higher legal and professional fees and a $2.”
“Just one more clarification, Minister. Will the workers need to get the EC WSQ certificate before they can qualify for that minimum wage that is specified in the Progressive Wage Model, or do they just have to take that one module?”
“Yes, Sir. I have three clarifications for the Minister. One is regarding the requirement for the WSQ programmes to be taken before you can be certified. I understand what the Minister means that you only need to have one WSQ EC module in order to meet the requirements under this law. But the law also requires the companies to adopt the Progressive Wage Model which requires companies to achieve the Certificate in Environmental Cleaning, the higher certificate and advanced certificate, in order for the cleaners to progress up the wage ladder. So, it is not just one module, it is actually more modules at the end of the day for these cleaning companies to send their cleaners for. Secondly, I first acknowledge the Minister's point that the TCC does not consist of only civil servants but the Minister has not responded to my request on whether the TCC can publish the methodologies for arriving at its wage Page: 96 recommendation and explain its reasons for coming to those recommendations. And the third clarification is: the Minister did not answer my question about what the Government's plan is to help the workers who find themselves out of a job because of the consolidation of the cleaning industry as a result of this law.”
“First, to require the TCC to publish a report explaining its methodology of how it derived its wage recommendations; and, second, to require the Commissioner to explain his reasons for differing, if at all, from the TCC's recommendations. Madam, the Government has said that this is not the beginning of a national minimum wage policy, but a targeted sectoral approach to upgrading skills, quality and wages. However, by introducing this Bill which targets the cleaning industry, it has swung from a laissez-faire free market approach of letting companies determine their workers' wages, to one featuring a high degree of micromanagement of cleaning businesses by civil servants. This is, in fact, a more intrusive and interventionist approach than a national minimum wage. A national minimum wage approach leaves it to companies to adapt and respond to the minimum wage levels set by the Government and the methodologies used are transparent, taking into account cost of living, economic conditions and labour market factors. The PWM leaves most of the adaptation and response to Government bureaucrats, most of whom have little industry experience. Page: 84 Are we sure that civil servants can do a better job at improving the productivity of the cleaning industry than the cleaning company bosses? Madam, the Government has announced that it will soon extend the PWM to the security industry. Will it also become a template for some other industries employing low-wage workers? If so, it is important that we embark on the correct approach to raising wages, and not go overboard in introducing bureaucratic micro-management of businesses and industries, which might end up hurting both the businesses and the workers they employ. 5.23 pm”
“Is the Government prepared for the possibility that many of these cleaning companies will have to shut down as a result of these compliance costs? If this happens, many cleaners will lose their jobs and may not be able to easily find jobs in other companies because they do not hold the necessary WSQ certifications. We have to keep in mind that many cleaners are elderly workers who are not able to easily adapt to a new work environment. What is the Government's plan to help these workers, Page: 83 beyond existing social assistance schemes? I would like to seek some clarifications from the Minister regarding how the wage levels under the PWM were derived. The PWM for office and commercial cleaners dictates a wage floor of $1,000 for indoor cleaners, $1,200 for outdoor cleaners, $1,400 for multi-skilled cleaners and $1,600 for supervisors. F&B establishment and conservancy cleaners have slightly different wage levels. How were these wage levels derived? In other countries, minimum wages are set in a much more transparent manner, using factors like age, industry sector, skill level, or cost of living and the wage required to cover the basic needs of workers and their families. Which factors were considered and what was the methodology used by the Tripartite Cluster for Cleaners (TCC) in setting the current PWM wage levels? I note that section 80H(3) of the Bill states that the Commissioner for Labour shall consider the recommendations by the TCC in setting the PWM wage levels. In order to increase the transparency of these wage setting exercises and provide better guidance for other industries, I would like to propose that section 80H(2) and (3) be amended as follows.”
“I believe for most general cleaners, on-the-job training, hands-on experience and a good working attitude will be more effective and productive than 15 working days of classroom training. Furthermore, the methodology for many of these courses includes lectures, AV presentations and written tests. This might present a challenge for the many elderly cleaning "aunties" and "uncles". These courses do not come cheap either. The total course fees for the basic WSQ Certificate in EC are over $2,000 per trainee. Yes, there is Government funding of up to 90% of course fees for Singapore residents, but this funding is still taxpayer money. There are only five approved training providers for this programme, including NTUC Learning Hub and ST Electronics (e-Services). With over 55,000 resident cleaners and many more foreign cleaners to train, I wonder who is benefiting more from this mandatory certification programme: the cleaners or the training providers? Even the Government seems to recognise that training can place a burden on companies and is not always necessary to improve work performance. Because of this, WDA allows an Assessment Only Pathway (AOP) for cleaners to obtain their WSQ certification without having to attend classroom training. To comply with the licensing requirements and the PWM, there will be many more costs for cleaning firms, over and above the higher wage bills. These include the cost of training, the cleaners' absentee hours, the cost of training administration which includes submission of claims, cost of assessments and penalties for any non-compliance. Will cleaning companies, many of whom are already operating on very thin margins, be able to bear all these costs?”
“For the Environmental Cleaning (EC) Workforce Skills Qualifications (WSQ) programmes, does the WDA require training providers to administer pre- and post-course evaluations and assessments to measure training effectiveness? If so, can the Minister share how these assessments prove that the EC training programmes conducted so far have translated into better work performance and improved business outcomes for the cleaning companies and the cleaning industry as a whole? Let us dive a little deeper into what the EC WSQ programme entails. The basic EC WSQ Certificate requires general cleaners to undergo up to 122 hours of classroom training with approved training providers. This is over 15 working days for a full-time cleaner, or 30 working days for a part-time cleaner. It should be noted that many cleaners work part-time. The core and elective units in these courses include: perform basic cleaning of hard floor surfaces – 24 hours; perform basic cleaning of washrooms – 32 hours; perform basic cleaning of carpets – 24 hours; and demonstrate an understanding of the local cleaning industry – 12 hours. And that is just for the first level of certification. The next level, the Higher Certificate in Environmental Cleaning, demands another 16 working days of training, while the Advanced Certificate requires another 21 working days. During this time of a nation-wide manpower crunch, it would be a significant Page: 82 strain on cleaning companies to have to release each of their cleaners for so many days of training. More importantly, do general cleaners really need so many hours of classroom training to perform their work well?”
“Mdm Speaker, this Bill enhances the powers of the Director-General of Public Health to improve the state of cleanliness and public health in Singapore. A prominent feature of this Bill is a new requirement for all cleaning companies to be licensed and adopt the tiered wage system for their cleaners. The Government's intent appears to be to use licensing to compel all cleaning businesses to adopt its Progressive Wage Model (PWM). The PWM consists of a ladder of wage levels which is supposed to provide a pathway for cleaners to progress to higher wages as they become more skilled, more productive and take on higher responsibilities. The PWM was introduced to counter the practice of cheap sourcing which, the Government says, prevents the market from working well, to translate training, standards and productivity Page: 81 gains into improved wages for workers. The Government has taken pains to emphasise that the PWM is not a national minimum wage because it believes that wage increases must be driven by productivity growth. Hence, the PWM does not just set wage floors; it also prescribes requirements for training and certification for cleaners. I welcome any measure that will raise the incomes of low-wage workers on a sustainable basis over the long term, and I am glad to see the wage floors introduced in the PWM. However, the PWM contains several big assumptions which must be questioned. It assumes that training and certification will translate to better work performance, which will improve cleaning standards and lead to productivity gains, which will then justify higher wages. I am not fully convinced of the causal link between training and improved productivity in the cleaning industry. What studies has the Government done to validate this assumption?”
“It is going up from US$40 million to US$672 million, an increase of almost 17 times. Can I ask the Deputy Prime Minister how the Government arrived at this quantum? I understand that voting power at the World Bank is allocated based on the capital stock held by each member. Is the increase in our subscription intended to strengthen our voting power or increase our influence at the Bank? If so, can the Deputy Prime Minister explain what are the tangible benefits that this translates to for Singaporeans? Does it make much of a difference if we raised our vote share from the current 0.05% to 0.25%, and is it worth the full US$672 million? What will be the frequency of the payments of our subscriptions and under what extreme circumstances that the Deputy Prime Minister mentioned will Singapore have to make a full subscription? Will we be obliged to contribute the full subscription whenever the Bank calls for it? Sir, I support Singapore playing a bigger role in international organisations like the World Bank. However, I would like more clarity on why our subscription needs to be increased by such a large amount and how Singaporeans will benefit from this change. Page: 102 6.07 pm”
“Mr Deputy Speaker, the Deputy Prime Minister and Minister for Finance is seeking Parliament's approval to increase Singapore's membership subscription to the International Bank for Reconstruction and Development (IBRD) from the current US$40 million to US$672 million. The IBRD, commonly referred to as the World Bank, is an important international development institution that focuses on uplifting poor and vulnerable communities in the developing world. It aims to promote global collective action on issues like health, trade, agriculture and climate change, Page: 101 strengthening governance and anti-corruption efforts, and prepare for crises. Singapore has been a member of the World Bank since 1966. We had, in the past, benefited from World Bank loans for infrastructure development projects. Between 1963 and 1975, Singapore received 14 loans from the World Bank for port expansion, sewage, power, telecoms, education and environmental management. These included US$15 million for the Port of Singapore Authority and another US$15 million for Pasir Panjang Power Station. Now that we are a developed economy, I think it is right for us to contribute back to the development of other countries by supporting the work of the World Bank. As a responsible member of the international community, we should play our part to help alleviate poverty in this world. Our current subscription limit is US$40 million. This limit has not changed since 1966 when we were much poorer and smaller. Considering our economy has grown a lot since then, our current subscription appears relatively low. We have one of the lowest subscriptions among the 188 member countries in the World Bank. Having said that, the quantum of the proposed increase in our subscription limit is not small.”
“Madam, just a quick question. Would it not be more straightforward to just set high enough standards and then penalise the PTOs for failing to meet those standards? Because this can certainly spur improvements at the backend as well, and the PTOs' reward really is in more satisfied customers and bigger ridership.”
“Madam, I thank the Minister for the reply. Research has shown that the police officers' skill in recording rape complaints is important because it may affect the willingness of victims to cooperate with the authorities, the quality of the crime report that results and the degree of secondary trauma experienced by victims. Can the Minister clarify whether the Police has specific and standardised Page: 23 protocols for recording the rape victims' statements? The Minister mentioned that the police officers have to undergo training. Does this training include subjects like common rape myths, so that they do not inadvertently put the rape victims at risk of re-victimisation? Lastly, the Minister said that the Police will work with counsellors. Is there a standard protocol to refer the victims to counsellors at every instance or is it only on specific instances where the Police makes a judgement?”
“I have two supplementary questions. First, have the hospitals considered converting the A and B1 class wards to C class wards, especially in this period of bed crunch, so as to free up more space for the patients? And, secondly, are the public hospitals still marketing their international patient services to foreigners because these would naturally add to the bed crunch as well?”
“Madam, to follow up on the earlier question, will foreign funding include subscriptions from overseas as well as advertising from overseas? He mentioned that advertising restrictions do not apply for the traditional media because they are subject to other regulations. But would it apply to online media as well for both subscriptions and advertising?”
“The Government has already invested $172 million to develop Phase 1 of the NEHR, and is paying about $20 million each year in maintenance costs. The subsequent phases are expected to cost more. While the Government deems it important to recover the cost of developing and maintaining the NEHR, the goal of cost-recovery must not impose a roadblock to the full adoption of the system by all healthcare providers in Singapore. It is important to ensure that all providers, including GPs and specialist outpatient clinics, enter the necessary clinical data into the system, so that the full benefits of having electronic health records can be realised. Madam, healthcare is an issue that is close to the heart of every Singaporean. While we are all at risk of falling ill, unaffordable medical costs are not inevitable. The Government must reform the way that healthcare is financed in Singapore, so as to ease the healthcare burden on all Singaporeans. This will give our people peace of mind, knowing that they will be able to afford all necessary treatment if they fall ill. 6.32 pm Page: 114”
“They should focus on keeping patients healthy and ensuring they take their medication regularly. This will minimise hospital re-admissions, investigations and treatment, all of which are more expensive. Providers should be paid based on their achievement of measured quality improvements, not simply the volume of patients they see or the level of fees their patients pay. All this could lead to healthier patients and lower costs for both patients and the system. Technology should be used as a "force multiplier" in the face of limited manpower in our healthcare system. While Singapore is no laggard in healthcare technology, its potential is not being fully realised. Often, the Page: 113 problem lies not with the lack of technical expertise, but with a lack of adoption. One example of this is the National Electronic Health Records system (NEHR). The NEHR enables patient health records to be shared across the healthcare system. It can reduce medical errors, and improve productivity and coordination between providers. This will lead to better diagnoses and treatment, and reduced medical costs. The NEHR has been rolled out to all public hospitals, polyclinics and long-term care providers. However, while over 5,000 clinical users have access to the system, what percentage of these users are fully utilising the functionality of the system? Is usage lower than it should be, due to usability issues or some providers still preferring to use handwritten clinical notes? How is MOH ironing out these issues to increase usage of the system? The usage of NEHR in the primary care sector is lagging even further behind. As at March this year, it had been rolled out to only about 50 out of the 2,000 private GP and dental clinics.”
“The providers of all assistance schemes, including MediFund, hospital endowment funds and other charity schemes, should be able to access these records. This will better ensure that patients receive all the financial assistance Page: 112 that they qualify for. Better still, can vulnerable groups of patients be pre-qualified so that they do not even have to submit any applications before receiving financial assistance? Currently, this is already being done for the CHAS cardholders receiving outpatient treatment. MOH should consider extending the same for inpatient financial assistance schemes. As I call for the expansion of the role of the Government in easing the healthcare burden on Singaporeans, I am also aware of the many challenges that our healthcare system faces in containing ever-increasing costs. We need to look into ways to contain healthcare costs while still improving patient outcomes. Many of the current measures to contain healthcare costs focus on curbing consumption by patients. However, most patients do not have sufficient knowledge to decide on the type of treatment they need. These decisions are usually entrusted to healthcare providers, which include doctors and hospitals. Therefore, providers drive the bulk of healthcare spending through their decisions to admit patients to hospital, order medical tests, prescribe drugs and charge fees. Therefore, if we seek to control costs, we need to actively engage providers. To achieve this, all providers – including GPs, hospitals and preventive care providers – must be made collectively responsible for providing a full spectrum of care for patients. These providers should cooperate and share patient information with one another, in order to make more accurate diagnoses and coordinate patient care.”
“A few weeks ago, I met an elderly resident at his home in Bedok, who suffers from COPD, a chronic lung disease. He is unable to work and has no children to support him. When I asked him how he was coping with his medical expenses, he told me that he was using his MediSave but had almost exhausted it. I was disturbed to learn that he often skipped medical appointments and cut back on his medication just to save money. I told him that there was financial assistance available and that he should not compromise on his health. But he told me that he had given up applying for assistance because of all the documents that he had to submit and the interviews he had to attend for the purpose of means-testing. Recently, a colleague sent me a photo of a large banner at the counter of a pharmacy at a Government restructured hospital that read: "Please inform our staff if you do not want to take the full supply and/or if you need to know the total cost of your medication". These two situations illustrate how many Singaporeans find themselves making hard choices between getting the necessary treatment and saving money, and how the onerous process of means-testing may be deterring some needy patients from obtaining financial assistance and, therefore, treatment. I have spoken in this House before about how all means-testing should be done without the need for patients to physically submit income documents. The patients and their families should only need to give their consent for the provider to assess their income records with the relevant Government agencies like CPF Board and IRAS. This facility should be made available at all institutions, whether private or public.”
“However, the experiment also found that co-payments caused patients, especially the poor ones, to reduce the use of medically necessary care. The experiment found that poor patients with hypertension tended to avoid treatment, leading to significantly higher mortality rates. High co-payments have also been shown to have an effect on patients adhering to their prescriptions. In another experiment by researchers from Harvard Medical School, nearly 6,000 patients who had just suffered a heart attack were prescribed drugs that reduced the chance of another attack. Half of them had their co-payments for these drugs waived, while the other half paid the usual fee. The result showed that more patients in the zero co-pay group took their medication regularly. They saw their health improve, with lower incidences of stroke and repeat heart attacks than the patients who had to co-pay. Interestingly, the elimination of co-payments did not increase total spending by patients and insurers, and even reduced spending in some areas. The lesson from these two experiments is that if co-payments are too high, poorer patients may be deterred from seeking medically necessary treatment. Page: 111 Similarly, it is difficult enough to get patients to adhere to their prescriptions and high co-payments could make it even harder. This could have knock-on effects, like higher rates of hospital re-admissions, which will cost both the patient and the system more in the long run. The Government's claim that no one will be denied healthcare because of inability to pay is cold comfort for some Singaporeans who regularly forgo medical appointments or cut back on prescribed medication because of the high costs and the difficulty in obtaining financial assistance.”
“The appropriate level of premium subsidies should be automatically extended to them, without a need for them to apply separately. This could help many more Singaporeans to cope with the rising premiums, while ensuring that the MediShield Fund remains solvent. While MediShield is intended to help cover the costs of large medical bills, policyholders will still have to make co-payments in the form of deductibles and up to 20% in co-insurance. Last year, over 2,400 MediShield policyholders made co-payments of over $10,000 each. Page: 110 These co-payments can be financially crippling on their own. Would MOH explore the introduction of an annual cap on out-of-pocket co-payments made by each patient? Any medical bills above the cap would be borne by the Government. Such schemes are a feature in most developed countries, including Japan, South Korea and New Zealand. It is also one of the key consumer protections in the Affordable Care Act in the US. An annual cap on out-of-pocket payments will limit the financial risk that individual patients are exposed to, and help allay the anxiety of many Singaporeans about uncertain medical expenses. From the Government's perspective, co-payments are necessary to discourage over-consumption. The Government's fear is that "free" healthcare will escalate costs and become fiscally unsustainable. However, people do not consume healthcare like they do other goods and services. Most people visit doctors rather grudgingly – usually when they fall sick and have obvious symptoms. Demand for healthcare is, therefore, not unlimited. A health insurance experiment conducted by the RAND Corporation, involving over 7,000 patients in the US, found that, indeed, higher co-payments reduced the consumption of healthcare.”
“However, I remain concerned about the rising premiums. The Government has already warned that premiums will go up. While I accept that increased Page: 109 coverage will come at a cost, there are two questions we must consider: should all of these cost increases be borne by policyholders? And will some groups of Singaporeans find the premiums unaffordable? MediShield premiums currently rise with age. An 86-year-old pays a premium rate that is more than 23 times that of a 20-year-old. The elderly shoulder a disproportionate premium burden. Policyholders over age 60 contribute about 36% of total premiums, even though they make up just over 12% of policyholders. Most of the elderly are retired with little or no income. It is unfortunate that many of those who are least able to afford the premiums are, in fact, paying the most. Many of our senior citizens have exhausted their Medisave accounts and have difficulty coming up with the money to pay their premiums. Every year, an average of 650 elderly policyholders opt out of MediShield coverage completely. This leaves them vulnerable and without insurance protection, putting them at risk of financial catastrophe if they fall ill. The Government does not directly subsidise MediShield premiums, although it does give ad hoc Medisave top-ups to the elderly and a Medisave grant to newborns. I would like to propose that the Government introduce a MediShield premium subsidy programme for all vulnerable groups of Singaporeans. These would include elderly persons with no income and limited savings; people with disabilities; patients who have exhausted their MediSave; low-income families; and those who already qualify for MediFund, Public Assistance, ComCare and the Community Health Assist Scheme (CHAS).”
“It is a fundamental responsibility of the Government to ensure that all our citizens have access to high quality healthcare based on their medical needs and regardless of their income. The healthcare burden cannot continue to be borne so heavily by individuals and their families. Singapore's population is ageing and healthcare costs are expected to continue rising. The Government must be prepared to shoulder a much larger proportion of healthcare costs than it currently does. We need to shift away from seeing healthcare as primarily an individual responsibility, and emphasise more Government intervention, risk-sharing and fairness in financing. We need to change the way healthcare is financed, so that Singaporeans who fall ill can focus on seeking the most appropriate medical treatment, without worrying about whether they are able to afford it. I would like to make a few proposals on healthcare financing to reduce the financial burden on Singaporeans when they fall ill, to improve the efficiency of the healthcare system and contain medical inflation. First, on MediShield. MediShield is an insurance scheme intended to cover large hospital bills. However, it does not provide full coverage. Patients need to make hefty co-payments, in addition to other claim limits like caps on hospital ward charges, and annual and lifetime claim limits. As a result, MediShield claims covered only 2.1% of total healthcare expenditure in 2011. In August this year, the Government announced plans to provide expanded insurance coverage under a new "MediShield Life" scheme. These changes to cover all Singapore residents, without exclusions for old age or pre-existing conditions, are certainly welcome. They are consistent with what many Singaporeans and the Workers' Party have been calling for.”
“Mdm Speaker, thank you for the opportunity to speak on this Adjournment Motion. Many Singaporeans are worried about falling ill and not being able to afford their medical expenses. A survey conducted last year by Mindshare, a global media and marketing services firm, found that 72% of Singaporeans felt they "cannot afford to get sick due to high medical costs." This echoes the sentiments of many Singaporeans I have spoken to, many of whom are elderly or have sick family members to care for. In particular, the high out-of-pocket payments at the point of treatment are a great source of worry for many. It is not uncommon to hear accounts of older folks ignoring health problems and delaying visits to the doctor because they fear that medical expenses will be a financial burden to themselves and their families. Medical inflation in Singapore was almost 9% in 2011 – much higher than general inflation. Our people should not have to face these increasing medical costs alone. The structure of our healthcare financing system is a critical factor in determining whether healthcare is truly affordable for all Singaporeans. In Singapore, less than one-third of all healthcare costs are paid by the Government. More than 60% of the costs are paid by patients out-of-pocket, Page: 108 which include cash and MediSave. This is much higher than the average of 14% in high-income countries, according to data from the World Health Organization. Is it any wonder then that Singaporeans are feeling the strain of healthcare costs? High out-of-pocket spending can create barriers to healthcare access and use, because people who have difficulties paying medical bills may delay or forgo treatment even though they need it.”
“Madam, I have two clarifications for the Minister. First, regarding the deductions. How does the Ministry monitor employers, especially employers of low-wage workers to ensure that the deductions are not excessive and unreasonable? Second, regarding the prosecution and the fines, if an employer is prosecuted, how will the Ministry ensure that the employer actually ends up not just paying the fine but also pays the worker?”
“The Bill introduces a new section 105, which gives inspecting officers the power to arrest without warrant persons suspected of committing offences under this Act. It includes powers to "use all means necessary to effect the arrest". Section 105D provides for the inspecting officers to be armed. However, in section 103, these inspecting officers have no such powers. They are allowed to examine, search and retain evidence but not to arrest suspects. I would like to ask the Minister: why is there now a need to give inspecting officers powers to arrest and restrain people suspected of violating the Employment Act? With these new powers, will inspecting officers be given the same level of training as police officers to ensure that they do not use excessive force when conducting the arrest or restraining suspects? Lastly, the Bill raises the salary threshold for employees covered under the Employment Act to $2,500 for non-workmen but keeps it at $4,500 for workmen. According to MOM, this will allow the salary threshold of non-workmen to catch up gradually with workmen and in the longer term, will allow the removal of Page: 84 the demarcation between these two groups of workers. May I ask the Minister, how long it will take to remove this demarcation, and what are the existing obstacles to its removal? In summary, Madam, I am glad to note the introduction of some new protections for workers and some PMEs in this Bill. I have mentioned a few concerns about salary deductions, penalties, exemptions from work hour limit protections, compensation for holiday work and the powers of inspecting officers. I hope the Minister will address these concerns in his response. 5.08 pm”