Koh Poh Koon
Singapore
“In 2025, for walk-in patients, the median and 95th percentile doctor consultation waiting times were eight minutes and 72 minutes respectively. However, the Ministry of Health (MOH) does not track waiting times by peak versus off-peak hours, but it is likely that 95th percentile waiting times happened during peak hours.”
“The offences and penalties for importing, supplying or abusing SPS products are similar to those in the MDA, to ensure similar level of deterrence. Mr Speaker, with your permission, may I ask the Clerks to distribute a handout that summarises the changes in legislative penalties for key offences.”
“So, if you are a Singaporean student, you will expect that there will be some subsidies to the fees. The third question on how can the public, who may want to seek psychological care, know who is legitimate.”
“Sir, I thank the Member for his question on audiologists. In general, a qualified audiologist in Singapore needs a higher level of certification because a diploma level may not be quite enough to perform the task. So, we will look and see whether there is a way to actually find an in-between.”
“We are starting with registration to give formal recognition to those who are practising in higher risk sub-sectors in psychology and making sure that the quality, the standards and the support is given to them to deliver the care that the clients and the patients need.”
“It takes a bit of, not just system change in the providers, in the doctors and the care teams, but also, a gradual shift in the mindset of our population as well. So, it is something that we have to continue to do. There is no magic bullet to this and it is not something we can achieve overnight. 12.15 pm”
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“Thank you, Sir. I would appreciate the Member coming back to us with details subsequently. I will be happy to also work on the MOH side and see if there are other areas in which these residents may need help through some of the resources that MOH may have.”
“Thank you, Mr Speaker, for the opportunity to seek a clarification from Member Ms He Ting Ru. She made a speech in this House during the debate on the Budget Statement on 28 February 2022. Unfortunately, she left shortly after her speech and was unable to return to the Chamber for the rest of the Committee of Supply (COS), as I understand she was down with COVID-19. But in her speech, she made this statement and I quote, "After all, what does it say about us as a society that our senior residents come to us and tell us as a matter of course that they have requested for their medication dosages to be cut down because they cannot afford to pay for the full dosages that doctors have prescribed to them to treat their medical aliments". Further down, in the next paragraph of her speech, she also said, and I quote, "These are real-life scenarios that all of us have seen our residents tackle". Sir, I made my speech in last year's COS in this House, announcing that we have revised the annual MediSave limits from $500 to $700 for patients with complex, chronic conditions under the Chronic Disease Management Programme. So, I would like to seek a clarification from the hon Member. As a Member of Parliament (MP) whom the residents have approached for help, may I seek clarifications from Ms He Ting Ru, what is the outcome of these residents whom she has encountered and provided assistance to?”
“(proc text)] [(proc text) The House immediately resolved itself into a Committee on the Bill. – [Dr Koh Poh Koon)]. (proc text)] [(proc text) Bill considered in Committee; reported without amendment; read a Third time and passed. (proc text)]”
“So, we were able to ride through the wave of Delta infection without resorting to a circuit breaker again and, therefore, we have calibrated some of the measures in dealing with this virus as our own situation evolves. When this current Omicron wave hit us, our population had achieved a high vaccination and booster rate, allowing us to then continue on with our progressive reopening and our move towards endemicity, without further tightening of restrictions. Such a move would have been unthinkable one-and-a-half years ago and our healthcare system at that time could well have been overwhelmed if the same numbers of daily infections were to be seen at that point. So, this clearly attests to the effectiveness of the mRNA vaccines and the trust and unity of our people in responding to the call to get vaccinated and boosted. Our adjustments to Protocols 123 and the maintenance of some SMMs have allowed us to ride through this wave currently without causing our healthcare system to collapse. Like Members, I, too, hope that we can eventually dispense with the restrictions. In a best-case scenario when COVID-19 ceases to be a threat before the end of 12 months, regulations that are no longer relevant can be repealed and Part 7 can be allowed to lapse. In the opposite scenario, if a variant that can cause more severe illness takes hold, the regulations under Part 7 will continue to be important for the protection of public health. Sir, a one-year extension will provide the flexibility for us to adjust and calibrate COVID-19 measures accordingly and I thank Members for their support of this amendment. Mr Speaker, I beg to move. [(proc text) Question put, and agreed to. (proc text)] [(proc text) Bill accordingly read a Second time and committed to a Committee of the whole House.”
“I note Mr Yip Hon Weng has actually filed a Parliamentary Question on the restrictions at coffee shops and canteens. So, I seek the Member's understanding that my colleagues at MSE will look into this and address it at a subsequent Sitting. Mr Yip Hon Weng asked if we might consider a shorter period of extension of Part 7 and base the extension on specific indicators. Ms Sylvia Lim also mentioned that the control measures should be constantly reviewed and make sure that they are fit for purpose. I agree with her. In fact, we monitor the weekly infection growth rate, the R number, as an indication of virus transmissibility as well as other matrices, like mortality rate, hospital occupancy and our healthcare manpower. But each variant, as we have seen in the past two years, has somewhat different characteristics and slightly different behaviour, compared to each other and, therefore, no single set of parameters can be solely relied upon and we have to remain nimble and take all factors into account in designing any of these restrictions. As mentioned in my opening speech, we take a calibrated approach in the control measures and have made progressive adjustments to the SMMs as the COVID-19 situation evolves. Members will certainly recall, when the pandemic first started, we actually went into a circuit breaker and, subsequently, a series of Heightened Alert phases, as we cautiously, gradually, tried to reopen social and economic activities to manage the infection risk in our largely unvaccinated population at that time. With good progress in our national vaccination efforts towards the end of 2021, our collective resilience and immunity and defence against the virus were strengthened.”
“But I must explain that they are meant to mitigate the risk of progression to severe illnesses from COVID-19 infection. Whereas vaccination serves as a more preventive role, that goes further upstream to prevent COVID-19 infection and not allow severe illnesses to take place in the first place. Therapeutics are, therefore, complementary and not substitutes for vaccination. Let me share some data, which are actually quite compelling. Non fully-vaccinated adults infected with Omicron variant, which supposedly is already milder than Delta, are up to 18 times more likely to end up in ICU and 38 times more likely to die from COVID-19 infection, compared to vaccinated and boosted adults. In fact, we see that the unvaccinated children between zero to 11 years old are at risk of Multi-System Inflammatory Syndrome for Children (MISC), that some Members may have read about in the newspapers as well. The incidence in an unvaccinated child can be as high as 470 cases per million infections. Even for the adult population of all age groups, an unvaccinated person is at risk of a one-in-10 chance of getting long COVID-19 after a COVID-19 infection and it has been proven time and again that vaccination can reduce this risk significantly. So, vaccination is still key to us remaining safe, both on a personal level and at the system level. Mr Yip Hon Weng also sought clarification on the rationalisation of SMMs that the MTF recently announced and whether they can be further simplified. In fact, as explained, this rationalisation is, itself, a way to simplify the SMMs into just five key parameters. It makes it easier for the public to understand and, in the coming weeks, as we see the cases continue to show a sustained decline, we can then further ease measures along these key parameters.”
“Mr Speaker, I thank both Members who spoke for their support of the Bill and I totally agree with some of the sentiments they have about challenges we face, how far we have gone and some of the things that we should look forward to in the year coming. Members of the House, however, have also sought clarifications on some issues and allow me to take the House through some of them. Mr Yip Hon Weng asked how we can do more to encourage persons who are sceptical of the mRNA vaccines to take up vaccination to protect themselves. As previously highlighted in Parliament, the Novavax Nuvaxovid vaccine has been authorised by the Health Sciences Authority (HSA) and recommended by the expert committee on COVID-19 vaccination for use under our National Vaccination Programme, as an alternative to the mRNA vaccines. The first batch of Nuvaxovid vaccine is expected to arrive sometime in the months ahead, barring any shipment delays. This will provide those who may have hesitancy receiving the mRNA vaccine an alternative and I hope they do take this seriously and consider getting themselves vaccinated. Even though Omicron causes less severe disease than the Delta strain, during this recent Omicron wave, the 3% of adults who were partially or unvaccinated contributed to 20% of our ICU cases, occupied two-thirds of our ICU beds and caused about 30% or so of the mortality that we see. So, they do pose a significant load on our healthcare resources and, therefore, VDS is still necessary to protect the unvaccinated and prevent our healthcare system from being overwhelmed. Once the Omicron wave has subsided, we will be in a better position to ease our measures further. COVID-19 therapeutics were mentioned by Ms Sylvia Lim and, indeed, they have been authorised by HSA.”
“The Multi-Ministry Taskforce (MTF) had previously announced plans to simplify and rationalise our COVID-19 SMMs to focus on the five most important and effective measures: mask-wearing; group sizes; capacity limits; safe distancing and workplace arrangements. Group size and safe distancing, for instance, limit the number of interactions persons would have at any point in time, especially in higher risk settings. This reduces the overall number of interactions a day and therefore limits disease spread. Capacity limits are important to prevent overcrowding which can lead to superspreading events. In time to come, as case numbers display a sustained and consistent falling trend and the COVID-19 situation abates, we will ease measures along these five key SMMs by adjusting the relevant regulations. Sir, a one-year extension of Part 7 of the CTMA will allow us to remain nimble and adaptable to the evolving pandemic situation and face any possible new variants. If COVID-19 ceases to be a threat before the end of this one year, the regulations can be repealed and Part 7 can be allowed to lapse. However, if more variants and infection waves take hold, the regulations under Part 7 will continue to be important for the protection of public health. Mr Speaker, Sir, I beg to move. [(proc text) Question proposed. (proc text)]”
“New variants and new waves remain a possibility – it is quite a natural thing that viruses continue to evolve and mutate over time, as we have seen with previous variants. When such cases and events happen and whether they affect disease transmission and severity, cannot be predicted ahead of time. New variants can break through borders and we have seen this even in countries with strict zero COVID-19 strategies, resulting in forceful measures having to be implemented, painful ones, like lockdowns. If Singapore’s re-opening is not carefully managed, infections may rise uncontrollably and potentially overstrain or even cause the collapse of our entire healthcare system. Even now, our healthcare workers have been labouring, since the pandemic started, for the past two years. SMMs are still needed for now and we will take a gradual and calibrated approach even as we move towards a greater degree of normalcy in our communities, businesses, workplaces and travels. While we have moved away from lockdowns, which are harmful to the well-being of our people and the economy, we must keep a position where we are nimble and ready to take appropriate measures should the situation worsen or change. Part 7 of the CTMA ("Part 7"), which allows the Minister for Health to make regulations for the purpose of prevention and control of COVID-19 incidence or transmission, therefore remains relevant. As the key legal lever behind various SMMs, Part 7 has served us well by allowing for a multi-faceted public health response to COVID-19. It allowed us to weather the Delta and Omicron waves by slowing transmission.”
“Mr Speaker, on behalf of the Minister for Health, I beg to move that "The Bill be now read a Second time." This Bill proposes a single amendment, to extend the validity of Part 7 of the COVID-19 (Temporary Measures) Act 2020 (CTMA) for an additional year. There will be no other changes to Part 7 of the CTMA, which will continue to enable targeted public health measures to be implemented and adjusted for the purpose of controlling the incidence and transmission of COVID-19, based on the evolving COVID-19 situation. In the past few months, we have taken a three-pronged approach in our response to the COVID-19 pandemic. First, we have put in place the National Vaccination Programme to ensure that the population is well protected from disease through vaccination. Second, we enhanced our healthcare capacity to handle the surges in cases and adjusted our healthcare protocols to right-site care. For example, lower-risk individuals with mild symptoms can be managed by their primary care doctors, while those at higher risk are assessed for management or monitoring at a care facility or hospital. Third, we have continued to implement safe management measures (SMMs), such as limits on group and event sizes, safe distancing and work-from-home arrangements, to ensure community cases do not rise out of control and overwhelm our healthcare capacity. In recent days, we have seen the number of COVID-19 cases peaking. There are indications that the wave is starting to subside and we are optimistic that with everyone's cooperation in adhering to public health measures, our healthcare system will continue to be able to tend to persons needing care. However, we must bear in mind that the pandemic is not over yet.”
“In setting salaries of most occupations, the salient consideration is the conditions of the local market, while taking into consideration the international market, if relevant. In this regard, MOH regularly reviews the salaries of nurses and other healthcare staff to ensure market competitiveness. Nurses' salaries take into account both local and global references. As I mentioned yesterday in my Committee of Supply speech, in 2021, we enhanced nursing salaries in the public healthcare sector by 5% to 14%, to be implemented over two years, including one tranche that will be given out this year. We had also increased funding support to the community care sector to ensure that nurses' salaries in the community care sector remain competitive as well. Beyond base salaries, nurses also receive the Nurse Special Payment (NSP) in December every year. The NSP quantum is reviewed annually to ensure that nursing pay remains attractive. Through competitive salaries and non-monetary means, we will ensure that nursing remains a viable career prospect for Singaporeans.”
“Sir, I thank Dr Tan for her question. As I said in my reply, we will continue to watch this, but we will be happy to also engage with the Singapore Medical Association (SMA) to see if they have insights on areas that we need to focus a bit more attention on. Let me also say that a lot of these arrangements are private contracts between the GP and a third-party provider. Which is why our emphasis always has been that the GP entering into a contract with a service provider ought to be clear that the boundaries of ethics and ethical behaviour ought to be observed. Otherwise, it is very hard for us to police every single private contract between the GP and a third-party provider. I think that the principle must be observed. But if there are unsavoury practices that GPs have engaged in and if SMA is aware, we will probably take some investigative action and advise the relevant parties to not undertake such actions to the detriment of patients. As we evolve the primary healthcare landscape based on Healthier SG, some of these arrangements between GPs and third-party service providers, like TPAs, may also need to be relooked at as well to see how they should reshape themselves in the larger landscape of primary care changes.”
“Thank you, Mr Chairman. I will just add a couple of points about the possibility of increasing medical school intake. In fact, over the last five years, the number of doctors has increased by about 30%. We are talking about registered doctors with the Singapore Medical Council – from about 13,400 to 15,400. We will continue to monitor the manpower pipeline needed to support our healthcare needs. And, as I have said earlier in my speech, we are looking at care model changes and how care delivery in hospitals ought to be changed. So, it is not just going to be a single-track increase in numbers to meet needs but, actually, evolving a model so that we can do more with less. And also the manpower projections will change based on the kind of care model that we are going to put in place in the hospitals.”
“We seek your patience as we work with the healthcare clusters to engage you on improving the situation on the ground. Let us uphold the values of the healthcare profession to provide the best care we can for our patients. Indeed, patients must be at the heart of all we do. But every healthcare worker also matters. Let us all, Singaporeans, help them to take better care of us. [Applause.]”
“On Dr Tan Wu Meng's concerns on Integrated Panels, we had earlier announced that Integrated Shield Plan (IP) insurers had accepted the Multilateral Healthcare Insurance Committee's (MHIC) recommendation to expand their panels. Today, most IP insurers have at least 500 private specialists, with each insurer's panel covering 80% to 90% of their private medical institution claims. To enable even greater patient choice and better continuity of care, the MHIC is considering if doctors who are already with an IP panel can be recognised by other IP insurers to some extent, as Dr Tan Wu Meng has suggested. We will announce more details in the coming months. Regarding access to treatments, our Free Trade Agreements and Intellectual Property obligations provide due recognition to investments that patent proprietors make in developing pharmaceutical products. This is not only fair, but also ensures that Singapore remains an attractive location for drug manufacturing, research and innovation. Having said that, we are working with relevant Government agencies to ensure that generic drugs are not unduly delayed or obstructed from entering the Singapore market. MOH will also continue to strengthen our position as a biomedical hub and anchor our domestic capabilities in new technologies, such as cell-based therapy, and strengthen the resilience of our healthcare system. Mr Chairman, in today's speech, I spoke extensively about our healthcare workers. To our healthcare fraternity, I know many of you may have felt exhausted and demoralised, especially in the last two years. Take heart – Singaporeans are appreciative of your steadfast commitment and dedication. MOH is undertaking reviews to introduce structural changes in our healthcare system and manpower.”
“Our healthcare workers should feel safe to be able and to call out abuse to allow them to focus their energies with the right frame of mind on doing their best for their patients. 3.45 pm Sir, let me address some other issues raised by Members. On healthcare affordability, Dr Tan Wu Meng will be happy to know that from 1 July this year, we will expand the number of chronic conditions in the Chronic Disease Management Programme from 20 to 23. The three new conditions included allergic rhinitis, gout and chronic hepatitis B. More than 134,000 individuals will benefit as they can now use their MediSave and CHAS subsidies for these conditions. We will strengthen our private sector partnerships to meet our growing healthcare needs. Dr Tan Yia Swam raised the need to have stronger oversight over business practices and medical middlemen. Today, Third Party Administrators (TPAs) and concierge services are not regulated under the Private Hospitals and Medical Clinics Act (PHMCA) or the Healthcare Services Act (HCSA), which focuses on regulating direct service provision. Nevertheless, the Singapore Medical Council's Ethical Code and Ethical Guidelines (SMC ECEG) guide that medical practitioners contracting with TPAs should ensure they remain objective in their clinical judgement, provide the required standard of care and reflect their fees fairly and transparently to the patients. MOH will continue to monitor patient safety risks and study the evolving landscape of these TPA companies. We will examine how the TPA market will need to be reshaped as we make bigger shifts in preventive healthcare beyond healthcare to health.”
“The actual number may be higher, as many healthcare workers exercise empathy and, therefore, do not always take a legalistic approach, and report and escalate every altercation. However, their compassion should not be misconstrued as an acceptance to abuse or harassment. We need to make sure that our healthcare workers feel safe in their work environment. I agree with Dr Tan Yia Swam that we need to recognise such abuse and institute safe reporting systems and clear penalties on offending parties. Let me unequivocally state that verbal or physical abuse of any healthcare workers will not be tolerated and offenders will be taken to task. MOH and our public healthcare institutions adopt a zero-tolerance approach towards abuse and harassment of our healthcare workers. Under the Protection from Harassment Act (POHA), public healthcare workers are accorded enhanced protections under section 6 if abused or harassed while carrying out duties. Aside from legislation, we should look at other ways to deter abuse and harassment and move more upstream. Healthcare workers should have the assurance that their employer and the healthcare system have their back, while providing them with the training to handle situations where compassion and empathy are tested to the limits. MOH will, therefore, be establishing the Tripartite Workgroup for the Prevention of Abuse and Harassment of Healthcare Workers. With representatives from MOH, the Healthcare Services Employees’ Union, public healthcare clusters, community care partners and private healthcare providers, the workgroup aims to spearhead a coordinated national effort to prevent abuse and harassment of healthcare workers in the public, private and community care sectors.”
“A third area of focus for this Committee will be on working with key stakeholders to promote a more inclusive culture where junior doctors can feel safe in speaking out on matters related to their safety and wellness, and importantly, to co-create policies and solutions at both the institutional and national level. The issues are complex and seeks to change years of established practice. We aim to put forth preliminary recommendations by the middle of this year so that some immediate measures can be implemented, with a view to completing their final recommendations by early 2023. We recognise that our healthcare workers have always gone above and beyond, especially during these trying times. Mr Abdul Samad and Dr Tan Wu Meng would also be pleased to know that MOH has extended the COVID-19 Healthcare Award not just to healthcare staff in public institutions, but also to outsourced staff. This includes cleaners and security officers, who were directly contracted by the public health institutions and publicly funded Community Care Organisations (CCOs). Paramedics under SCDF would be recognised in their own way. But the biggest encouragement for our healthcare workers must come from the support and appreciation from Singaporeans-at-large whom they serve. We read about spontaneous ground-up actions from Singaporeans to encourage and thank our healthcare workers; examples which were cited by Mr Abdul Samad. Unfortunately, COVID-19 has also brought out some bad behaviour. We have read about the cases of abuse and harassment towards our healthcare workers. The perpetuators have been taken to task and convicted by the Courts. Sadly, the number of cases has been on the rise. At end 2021, there were about 1,500 such cases, up from 1,080 cases in 2018.”
“Therefore, as a first step, MOH has formed the National Wellness Committee for Junior Doctors. Co-led by senior doctors from all three healthcare clusters and MOH, we aim to review and recommend changes to existing healthcare practices and guidelines to improve and ensure the well-being of junior doctors, in three main areas. First, a review of junior doctor workflow models and work hour norms. Other than the considerations I shared earlier, the review will also have to be done carefully as it will have an impact on the workflow of other healthcare workers who work alongside our junior doctors. Another area will be to look at the fundamental balance between training and service workload, and transforming our manpower model. It would not be sustainable for us to just simply increase the "flow" of trainees going through the system to meet service demands, as this will eventually lead to a large "stock" of doctors and cause an oversupply later on. Instead, we need to raise the importance and attractiveness of work roles that are core to the service workload. The second area of focus is career development and training of our junior doctors. Traditional specialist-focused residency programmes are not the only desirable career pathways and there is a need for stronger broad-based generalist paths such as family medicine and hospital clinicians, which if successfully implemented may also address the issue of care-fragmentation across multi-specialty teams. One such pathway is the Hospital Clinician track we launched in 2020, which we hope to expand significantly in the years to come.”
“As we look at the issue of work hours, let us not lose sight of these important considerations which are inherent in the nature of our work as doctors. With shorter working hours in a week, a junior doctor may have to undergo a longer apprenticeship to acquire the necessary competencies. But we also recognise that the workload and the nature of clinical work today is different from yester-years, a point which Dr Tan Wu Meng has made, with an ageing population and higher chronic disease incidence, and expectations of more collaborative and consultative care from patients and their families, the nature of clinic work has changed for our junior doctors. The stresses faced by junior doctors today are symptomatic of a wider need for transformation in the current care delivery arrangements. Whether it is 24-hour or 30-hour shifts, what is clear is that we should not stretch our junior doctors beyond what is physiologically possible and what would risk compromising patient safety, a point also highlighted by Dr Tan Wu Meng. But I want to caution that a simplistic framing of the issue as just work hours is not diagnosing the root cause of the problem. Recently, I met with junior doctors from the Singapore Medical Association’s (SMA) Doctors-in-Training Committee and other groups of junior doctors from all three healthcare clusters. They were proactive in sharing best practices on the ground. We had a candid discussion on the challenges they faced, particularly in this COVID-19 period, as well as the trade-offs of possible junior doctor workflow changes. I am heartened that many of them recognised the complexity and inter-linked nature of the issues pertaining to junior doctors’ working hours.”
“We also agree with Ms Mariam Jaafar's feedback that clusters ought to continue to induct a diverse range of talents and skillsets in their talent development and leadership pipeline. As highlighted by Dr Tan Wu Meng, one specific group of concern are the junior doctors who had to do long shifts on night calls. Singapore Medical Council guidelines stipulate that junior doctors may work up to 80 hours a week, including overnight duties of not more than 24 hours, with up to six hours after that for handover or training. This is benchmarked against the USA’s Accreditation Council for Graduate Medical Education’s (ACGME) guidelines. Surveys showed that 20% of all junior doctors exceeded the stipulated 80-hour work week. This could be due to the nature of clinical work in certain departments or exigencies of service. Some have proposed night float systems. This entails doctors taking turns to work night shifts for a few days at stretch without covering the daytime work, whilst others work the day shifts. Doctors may feel more refreshed when they start their night shifts with a full day’s rest, although there are possible trade-offs in requiring more manpower to do a shift system, more hand-off between team members, which carries some risk of omission in tasks, and possibly reduced learning experience as they may not follow-through in the entire care process to see how their patients progress over time. It would be useful in disciplines where doctors on night duties have fewer opportunities to rest, such as Internal Medicine or General Surgery. The system has been tried in two large departments. Plans to trial this in smaller departments, unfortunately, were curtailed due to COVID-19. When the situation allows, we intend to restart the trials.”
“But there will never be enough manpower if we do not empower ourselves to improve our own health. Hence, through preventive health, population health, Healthier SG, as Minister Ong will address later, we will also reduce the load on our overall healthcare system. To Ms Mariam Jaafar's point about organisational enablers, we agree that this is important and thus, as part of population health, we will be aligning incentives and KPIs with public healthcare clusters in how we design our programme. All these measures are in progress and will take some time to bear fruit. But there are also immediate pressures that we need to resolve and support our healthcare workers straining under the burden. The COVID-19 restrictions on healthcare workers intermingling to bond and destress has led to a sense of isolation among healthcare workers. So, I want to assure Dr Shahira, Mr Leon Perera, Mr Abdul Samad and Dr Wan Rizal that staff well-being and morale is an important priority for us. MOH had set up a cross-cluster Staff Well-being Committee in 2019 to improve the well-being of staff and to minimise burnout. All three public healthcare clusters also provide their staff with counselling services, helplines and peer support networks. MOH is working with the clusters to review and improve staff feedback channels, staff well-being and mental health tracking and monitoring processes. There are also plans to appoint a Wellness Officer or its equivalent in every cluster to oversee and develop the system changes that are needed. We are also reviewing our staffing norms in the public healthcare system to strengthen our resilience to future shocks and better cope with fluctuations in workload.”
“But with a tightening workforce situation here in Singapore, we will have to accept that there will continue to be a need to hire foreign healthcare manpower to complement our local workforce and meet the needs of our ageing population. So, I thank the Leader of the Opposition Mr Pritam Singh for supporting the need for us to hire more foreign manpower to support our healthcare needs. We are also looking on retaining foreign nurses, including keeping their remuneration competitive. We have also worked with other agencies on factors that are important for their retention. We also need to look beyond manpower to ensure our resources are optimised. This includes further leveraging technology to extend the capabilities of our healthcare workers and innovating the way we deliver care and services and redesign healthcare jobs along with training and development opportunities so that each category of staff can perform at the top of their licence. This includes training for digitalisation for healthcare professionals to be prepared for the future. For example, NUS has a Nursing Informatics course to equip nurses with the knowledge on the development, analysis and evaluation of information systems augmented by technologies that support, enhance and manage patient care. We will also continue with our job redesign efforts in introducing new role and new breeds of staff such as Care Support Associates (CSAs) that blend clinical support, administrative and operations responsibilities. We will also change our care models to ensure efficient and effective delivery of appropriate care at all care settings. This includes making sure we right-site patients to ensure that our resources are optimised.”
“Given our low birth rate and shrinking local workforce, there are just not enough Singaporeans to meet all our healthcare manpower needs. 3.30 pm As many Members, including Ms Mariam Jaafar, have pointed out, we will need a combination of approaches to ensure an adequate and strong healthcare workforce. First, we must ensure adequate local training pipelines and continue to attract and enable more mid-career locals to enter the healthcare sector. Our intakes for healthcare programmes at the Institutes of Higher Learning have increased over the past five years. Between 2016 and 2021, intakes for medicine and nursing each increased by about 15%, while the combined intake for allied health programmes increased by about 65%. The healthcare Career Conversion Programmes (CCPs) enables mid-career locals to acquire relevant training to join the healthcare sector as nurses and Allied Health Professionals (AHPs). An average of around 180 mid-career locals per year entered training between 2019 and 2021 amid COVID-19, higher than the average of 110 per year between 2016 and 2018. We will regularly review remuneration, to ensure that we continue to attract and retain staff and maintain market competitiveness. We last enhanced the salaries of selected groups of doctors and dentists in 2019. Dr Tan Wu Meng asked that we do a deep review of salaries for nurses and allied health professionals. In fact, we enhanced the salaries of nurses, allied health professionals, pharmacists and allied admin staff in 2021. And there is a second tranche of increases for nurses this year, 2022. We will continue to monitor and review salary benchmarks in a timely manner.”
“Many have gone beyond their call of duty and we owe them a debt of gratitude. In spite of COVID-19, we have persisted with actively recruiting for our healthcare workforce from both local and international sources. As of end 2021, the public healthcare workforce stood at about 62,500 staff, an increase of about 1,800 compared to end 2020. To address Mr Pritam Singh and Dr Shahira Abdullah’s concerns about attrition, MOH had previously shared that the average attrition rate of doctors and nurses from public acute hospitals in 2020 and 2021 combined together was comparable with that in 2019. Specifically, the attrition in our public healthcare workforce was 9.6% in 2019 and it dipped to 6.8% in 2020 at the height of the pandemic. This then accumulated, resulting in a rise in 2021 with a 9.8% overall attrition. But this is rather similar to our 9.6% in 2019. Specifically, for the acute public hospitals, the average attrition in the period 2020 to 2021 was about 7% to 9% for nurses and about 3% to 5% for doctors. So, the two-year average was quite similar to 2019 levels. However, the 2021 attrition among foreign nurses was 14.8%, much higher than the 7.4% among local nurses. Understandably, some left due to family and personal reasons as the COVID-19 travel restrictions had stopped them from being able to visit and be with their loved ones. But our healthcare workers have stood their post. They have not abandoned their fight against COVID-19 and we thank them for the commitment and the steadfast efforts. Having said that, this does not mean that we dismiss the concerns of attrition. We will still need to do more to tackle our growing manpower needs.”
“Mr Chairman, today, I will address the challenges faced by our healthcare workers, especially during the pandemic and outline MOH’s longer term efforts to take care of our healthcare workers’ well-being and professional development. Even before the pandemic, an ageing population and increased burden of chronic diseases have placed an increased demand for more healthcare manpower. We factored these needs into our manpower plans and recruitment initiatives. But COVID-19 has stretched us further. We had to adjust our manpower deployment during the pandemic to meet evolving needs such as the migrant worker dormitory outbreak, as well as swab and vaccination operations. To Mr Pritam Singh’s query about preparations for ICU surges, I want to reassure him that we have sufficient equipment and consumables to step up ICU beds significantly. And as of January 2022, more than 800 non-ICU nurses have been trained as a reserve to augment ICU nursing manpower by up to 57%. This would enable us to stretch our ICUs temporarily if needed. Thankfully, our ICU capacity is able to cope with the current surge and patients requiring ICU care are a fraction of what we had during the Delta wave. Nonetheless we will continue make the necessary contingency plans given how unpredictable the pandemic has been. But the pandemic had caused a sudden surge in workload and severely stretched our healthcare workforce. We reprioritised workload and reduced non-essential elective treatments. Absenteeism rates have stayed low, below 10% so far. Not only have we stretched the public healthcare sector, but those in the private sector stepped forward to help in so many ways, including support from nursing and other healthcare students, as well as SAF.”
“Sir, I assure the Member that we are continuing to engage the different operators of the different types of dormitories, including our NGO partners as well. We will, definitely, make sure there is sufficient time for this implementation and to develop a transition plan for the different dormitories to meet the new requirements. We will share more details in the latter half of this year.”
“Sir, last year, we announced the review of the Foreign Employee Dormitories Act (FEDA) to expand its coverage to include migrant worker dormitories with fewer than 1,000 beds. This will strengthen our regulatory levers to raise and enforce new standards quickly during pandemics and introduce a consistent regulatory framework for dormitories of different sizes and types. There are, currently, more than 1,000 of such smaller dormitories, including factory converted dormitories (FCDs), construction temporary quarters (CTQs), temporary occupation licence quarters (TOLQs) and non-government organisation (NGO) shelters. The significant number of dormitory beds across this diverse range of dormitory housing types and the broad landscape of operators necessitate more time to engage these groups to better understand the infrastructure constraints and the impact of the licensing requirements, especially on our smaller dormitories. We intend to implement the expansion of FEDA by the end of the year and will share more details on the expansion in the coming months.”
“Sir, in response to Mr Liang Eng Hwa's question, as of end December 2021, the SGUnited Jobs and Skills Centre assisted more than 24,000 jobseekers. Let me explain that these 24 centres are an extension of the five main centres that are distributed around the island, run by WSG and NTUC's e2i. They are actually forward-deployed nodes, to be more embedded in the heartlands to allow easier access by many of our heartlanders who are jobseekers as well. In that sense, the main career centres curate all the jobs that are available, including those on the MyCareersFuture portal but, at the same time, as the main centre looks at the jobs that are put onto the market, they do curate them according to the vicinity of each of the forward-deployed centres and push out these job lists to the centres as well. For jobseekers who are probably within one of the nearer centres when they look for jobs, the centres can also recommend jobs that are closer to where the jobseeker stays so that it helps to facilitate some of these part-time work, or for people who may have mobility issues who want to work closer to home. So, I want to assure Mr Liang Eng Hwa that this is already being done today.”
“Sir, I will take the first clarification from Member Louis Chua about the equivalent of minimum wage for gig workers in the platform economy. The whole definition of a gig worker is that they have the flexibility to work as many hours as they want, whenever they want and with whichever platform they want. So, it is very hard for us to then decide what would be the minimum wage that they can earn if they do not clock certain minimum number of hours. That is the flexibility that is inherent in the nature of the work. We must recognise that it is difficult for us to set that. The market, of course, can decide at some point but in our work looking at the platform workers, we are specifically working at three areas, which are the housing and retirement adequacy, basic workplace protection against injuries, and some of these payment-related algorithms or wage-related outcomes could well be left to the third part of the work, which is on representation by either a body of platform workers; or the unions as a voice for the workers to seek better compensation and remuneration.”
“Thank you, Mr Chairman. I would like to make a correction on my speech made last Friday at the COS and I quote: "As mentioned in my response to the Adjournment Motion put forth by Mr Louis Ng last month and in response to Mr Leon Perera's question on easing of restrictions on migrant workers, let me say that migrant workers can visit recreation centres, or RCs, daily since September 2021." It should be December 2021. [Please refer to "Committee of Supply – Head S (Ministry of Manpower)" debate, Official Reports, 4 March 2022, Vol 95, Issue No 54, Budget section.]”
“I thank the Member for his concern on the workload of our healthcare workers. As I have said, this is a crisis of a generation and it is the truth that many of our healthcare workers are going above and beyond their call of duty, extended hours, also in the primary care sector, our GPs as well. But this is their commitment to respond to the crisis and pulling their weight to make sure they become a strong last line of defence for our safety and our health. In MOH's Committee of Supply (COS) in the next few days, we will be giving a fuller response on some of the strategies that MOH will look at to support our healthcare staff and also to look at boosting our manpower resources over the coming decade. So, I hope the Member will give us time and we will share more and details in the coming COS.”
“Sir, rest day provisions and work hour limits for public healthcare workers are governed by the Employment Act. For those healthcare workers that are not covered by the Employment Act, their rest day provisions and work hour limits are set out in public healthcare clusters’ employment contracts. COVID-19 has stretched our healthcare resources and placed a heavy burden on healthcare staff. All our public healthcare workers have been working doubly hard in this time of crisis. Whenever there is essential and urgent need that requires overtime work, employers will accord overtime pay as required by section 38 of the Act. We urge cooperation and understanding from everyone as the hospitals reduce non-urgent and non-life-threatening care treatments to manage workload, decant those who need less intensive care to Community Treatment Facilities and curtailed visitations to hospitals. Public healthcare clusters have allowed staff to rest and recharge by taking days off, including taking annual leave, whenever possible. MOH is supporting them by doing whatever we can and stepping up on vaccination. We hope to turn the corner soon from this current wave of COVID-19 infections.”
“So, I think there are robust processes in place to make sure that the MediFund Committees perform their roles well and the outcomes, in terms of the numbers that have been assisted, also validate this observation.”
“Sir, the Member is correct that the MediFund Committees do have discretion and MOH provides guidelines regarding means testing criteria, the amount of assistance as a benchmark so that they can have those as a reference. The full discretion is given to these committees to actually deviate from these suggested guidelines. In terms of the outcomes, I think that is the fundamental and most important thing. Despite all the guidelines, are we able to assist most of these people and patients who are in need. In fiscal year 2020, 98.3% of the total number of MediFund and MediFund Silver applications that were received were approved and 87.6% of the approved applications received the full assistance. So, I think the outcome speak for itself that regardless of the guidelines, most of these applications actually receive the assistance they require and most of them in full, as well. Let me also add that MediFund assistance is also automatically extended to needy patients under MSF's social assistance schemes, for example, the ComCare Long-Term Assistance recipients, who fulfil the MediFund eligibility criteria without requiring them to go through the application process. So, those who are already on our radar, who are in need, will receive the necessary support, without further application. In terms of auditing some of these outcomes and making sure that the spirit of MediFund is complied with, the MediFund accounts and administration for each preceding financial year are audited annually, either by Auditor-General's Office (AGO) or an external auditor appointed by MOH in consultation with AGO.”
“To apply for MediFund, applicants must be Singapore Citizens who are subsidised patients and are receiving treatment from a MediFund-approved institution. As long as patients meet these eligibility criteria, the MediFund Committees (MFCs) have flexibility and discretion over the assessment, approval and assistance quantum of MediFund applications. They work with the medical social workers (MSWs) to assess applications holistically, taking into account patients’ socio-economic and health circumstances, as well as bill sizes. MOH provides operational guidelines to MediFund-approved institutions to facilitate their management of MediFund and to provide some consistency for decision making, although MFCs retain full discretion over assessment of applications.”
“Thank you, Sir. Sir, as mentioned earlier, migrant workers have been visiting the community. Today, the visit slots are not fully utilised, but we are prepared to adjust the quota to allow more migrant workers to visit the community as the COVID-19 situation improves. Mr Chairman, to help sustain the resilience of our workforce, we have put in place measures to drive workforce transformation, to uplift our vulnerable workers as well as transform the migrant worker ecosystem by improving existing healthcare, housing and recreational needs. As we continue our work for these groups of workers, there is still much work to be done for others, such as our platform workers. Strengthening our workforce will always be a priority to ensure that we remain resilient in future storms.”
“I want to thank employers, industry associations and non-governmental organisations (NGOs) which have expressed their support for the enhanced medical insurance scheme during our engagements with them. The third area we want to do for our migrant workers is to enhance their social well-being and recreational needs. Our partnerships with NGOs and other whole-of-society partners have been crucial in helping us to support our migrant workers. We have been working hand-in-hand with our migrant worker community, too, as they would better understand the needs of their fellow workers. Mr Rajarathinam Sankaralingam has been a dormitory supervisor since 2012 and assigned to oversee activities in two dormitories. On top of his regular activities and duties, such as conducting briefings to fellow migrant workers on the latest Government advisories and guidelines, Mr Lingam often goes above and beyond by accompanying residents who require medical treatment at hospitals even when these incidents take place at night. We are thankful for their partnership. We are working with NGO partners to make our eight Recreation Centres livelier by bringing in more programmes and activities that our migrant workers enjoy, such as retail bazaars as well as sports and cooking competitions. A ninth Recreation Centre will be ready later this year in Sembawang. Workers are able to visit the Recreation Centres for essential services like topping up and purchasing telephone cards, going to the barber, buying groceries as well as for other recreational activities, such as movie screenings, live performances and meeting their friends.”
“This will provide greater clarity to employers on the coverage that they are entitled to. For example, insurers may exclude procedures that are not medically necessary, treatments arising from workers' criminal acts or repeat occurrences of undesirable acts by workers such as self-inflicted injuries as well as venereal diseases. Insurers may also exclude treatments for pre-existing illnesses that occur within the first 12 months of the worker's employment with the same employer. The third enhancement is that insurers will have to offer age-differentiated premiums for workers aged 50 and below and those who are above the age of 50. This will help to keep premiums affordable for the vast majority of employers, given that 95% of our migrant workers and migrant domestic workers are below 50 years old. The fourth enhancement will require insurers to reimburse the claims for inpatient and day surgery bills directly to the hospitals instead of making employers pay for their workers' medical treatment upfront and then claim it from the insurers later. This will help employers who are cash-strapped and free up cash flow for businesses and help families who have migrant domestic workers in this process. Employers with existing Work Permit and S Pass workers will also progressively transition onto the new medical insurance policy when they renew their work passes. The enhanced coverage for medical insurance will be effected for all new work pass applications by the end of 2022. The enhancements have been carefully calibrated to provide better support for businesses and migrant domestic worker employers in managing large medical bills while keeping premiums affordable.”
“To help employers better manage the medical bills of their migrant workers, employers are required to purchase medical insurance with at least $15,000 coverage for their Work Permit and S Pass holders. As medical costs are expected to increase over the years, more employers may end up incurring larger out-of-pocket expenses on their workers' medical bills. To provide employers greater peace of mind in financing their workers' inpatient and day surgery bills, the coverage of the mandatory medical insurance will be enhanced with the following features. First, we will maintain the first dollar cover of at least $15,000. This ensures that the bulk of employers whose workers' medical bills fall under $15,000 continue to be fully protected under the enhanced model. On average, there are over 1,000 employers per year who face bills that are larger than $15,000. A co-payment component will be introduced for them, up to an annual claim limit of at least $60,000. This ensures that healthcare costs remain affordable and sustainable. Let me illustrate this with an example. Under today's existing requirement, if a migrant worker or a migrant domestic worker incurs a $70,000 bill, the insurer will cover the first $15,000 and the employer will be left to bear the remaining $55,000. With the enhanced medical insurance, the insurer will continue to cover the first $15,000 in full, as per today. For the remaining $55,000, the insurer will co-pay 75% while the employer will pay the remaining bill. This means that the employer pays $13,750, which is significantly lower than the $55,000 he would otherwise need to fork out today. The second enhancement is that we will standardise a list of baseline allowable exclusions across insurers.”
“This integrated primary healthcare system builds on the medical support plan we set up amidst the COVID-19 pandemic. Migrant workers can expect to access a range of primary healthcare services, including acute and chronic care, 24/7 telemedicine services as well as mobile clinical teams, to ensure rapid responses to public health emergencies and concerns in dormitories. The appointed medical service providers will minimise language and cultural barriers in care provision through hiring healthcare workers who can speak the native languages of our migrant workers. Employers can purchase the PCP at a fixed fee of between $108 and $138 for each worker per year, or about $9 to $12 per worker a month. This gives employers cost clarity and will meet most of the primary care needs of their workers. To mitigate the moral hazard of overconsumption and instil personal responsibility, migrant workers will also be required to co-pay a small fee, ranging from $2 for a telemedicine session to $5 for each visit to the medical centre. This PCP will be made mandatory for all workers living in the dormitories or working in the construction, marine shipyard and process sectors, as part of work pass requirements. On the inpatient front, MOM will enhance the coverage of the mandatory medical insurance to better protect employers against large medical bills for their Work Permit and S Pass holders, including those of migrant domestic workers (MDWs). Today, employers are responsible for the medical expenses of their Work Permit and S Pass holders that are incurred in Singapore. Unlike that of locals, the medical bills of migrant workers and migrant domestic workers, or MDWs, are not subsidised. They are also not covered under the national schemes, such as MediShield Life and MediFund.”
“These function as a one-stop centre for newly-arrived migrant workers, bringing together various entry requirements into an integrated and seamless end-to-end process. Workers can serve their Stay-Home Notice (SHN) as required, complete a medical examination, and undergo a residential Settling-in Programme (SIP), all under one roof. To date, more than 55,000 workers have gone through the Onboard Centres. Going forward, MOM will continue to improve the well-being of our migrant workers by fortifying housing standards, improving medical support and increasing recreation options. First, fortifying housing standards is an ongoing process and is necessary to create a safer and more comfortable living environment for our migrant workers. As announced last year, the Government will build two new purpose-built dormitories (PBDs) at Kranji and Jalan Tukang. These dormitories will be built to improved standards to minimise future outbreaks of diseases. We will also work with dormitory operators and other partners to test new and innovative ideas for dormitory living and management. MOM is also reviewing the Foreign Employee Dormitories Act (FEDA) to expand its coverage to smaller dormitories with fewer than 1,000 beds. Second, we will support employers in managing healthcare costs while improving medical support for our migrant workers. I will talk about this in the outpatient setting and the inpatient setting. On the outpatient front, as announced on 19 February 2022, employers will be required to purchase a Primary Care Plan, or PCP, for migrant workers with effect from 1 April this year. MOM has appointed four medical service providers to deliver primary healthcare services over six geographical sectors.”
“To date, close to 600 frontline officers have been trained in basic psychological first aid and more than 200 migrant worker peer leaders have undergone self-care and peer support training. They help to detect signs of distress amongst migrant workers more quickly and link them up with counselling services and support helplines in their native languages. As mentioned in my response to the Adjournment Motion put forth by Mr Louis Ng last month and in response to Mr Leon Perera's question on easing of restrictions on migrant workers, let me say that migrant workers can visit any Recreation Centre, or RC, daily since September 2021. [Please refer to "Committee of Supply – Head S (Ministry of Manpower)" debate for clarification to the month stated, Official Report, 7 March 2022, Vol 95, Issue No 55, Budget section.] Vaccinated migrant workers are allowed on community visits and, as of mid-February 2022, more than 95,000 migrant workers have visited the community. The current community visit quotas are not fully used up and we will be easing in steps the quota and restrictions and as the COVID-19 situation improves. From 18 February, we have also stepped down the requirement for migrant workers to undergo the Rostered Routine Testing, or RRT. This would provide a return to normalcy for these workers. We are also prioritising the granting of entry approvals for migrant workers to return to Singapore after they go on their home leave. This will facilitate them to go on home leave for visits. 7.15 pm As we restore economic activities, we will need to continue bringing workers into Singapore safely and help newly-arrived migrant workers settle in. Therefore, in March last year, we started the Migrant Worker Onboarding Centres, which have now been renamed Onboard Centres.”
“We do regularly review our legislation, including the Employment Act, in consultation with Tripartite Partners to ensure that they are relevant. Several major policy reviews are still ongoing, such as in relation to the work of the Advisory Committee for Platform Workers. It is too early to say how the recommendations would be implemented or what legislative changes are needed. We will consider the recommendations holistically and see how to ensure that our legislative frameworks can support the policies. The eventual recommendations will contribute towards a more sustainable equilibrium – one where the costs of labour protections are more equitably distributed and shared across the stakeholders in the platform ecosystem. Sir, I will now talk about our migrant worker community. The COVID-19 pandemic has been a challenging time for everyone, not least for our migrant workers. They have shown remarkable resilience during the COVID-19 pandemic. Their health and well-being have been a priority over the past year. As of 20 February 2022, 99.4% of migrant workers residing in dormitories are fully vaccinated. During the last COVID-19 wave in September, migrant workers who tested COVID-19 positive were given timely access to medical support, through regional medical centres, mobile clinical teams and telemedicine consults. Most experienced mild or no symptoms and were able to recover safely in recovery facilities, with fewer than 0.1% requiring hospitalisation. Beyond physical health, we co-created a mental health support ecosystem for migrant workers with our partners, including the Migrant Workers' Centre (MWC) and HealthServe.”
“Secondly, allowing withdrawals on demand will also go against the objective of improving their long-term retirement adequacy by setting aside savings for old age and allowing for the compounding of interest to take place over time. So, I would say that the PSP's suggestion is populist but impractical. On financial protection in the event of work injury, platform workers said that they were concerned that injuries would affect their livelihoods, and that the insurance coverage provided was not consistent across different platform companies. We are heartened by the general consensus among platform companies that they should provide some coverage against work injuries. The Committee is exploring how the overall Work Injury Compensation Act (WICA) framework can be applied in this setting, but the Committee also recognises that any solution will need to take into account the nature of platform work, including flexibility in working time and the ability to work for more than one platform simultaneously. On the issue of representation, some platform workers said that they lack avenues to voice concerns and expressed the hope that the unions could represent and assist them if there were disputes. Others wanted a say in contract terms that impact their well-being. We are encouraged that, in response, platforms have indicated their willingness to support good industrial relations and improve the working conditions of platform workers. Suggestions from the platforms include the establishment of industry-wide norms through tripartite discussions or with an independent body. The Advisory Committee will be studying these possible solutions, including the idea for unions to represent the platform workers. Mr Patrick Tay asked if the Ministry will be reviewing the Employment Act.”
“Like many young Singaporeans, she hopes to use her CPF savings to finance the flat and would like more support to help riders like herself better save up for their long-term needs. Clearly, this concern warrants intervention. Failure to do so will result in unmet needs in the future and impose costs on other parts of society. Today, platform workers already contribute up to 10.5% of their earnings to their MediSave accounts. The Committee is considering the idea of requiring platform companies to make CPF contributions to support the retirement and housing needs of platform workers. Platform companies have raised concerns that such a move will result in a sudden increase in business cost, something which I can understand. So, an option being considered is a phased approach which will allow time for the platform ecosystem to adjust. To Ms Hazel Poa's suggestion to allow a special scheme that allows platform workers to contribute and withdraw CPF on demand, I do not wish to pre-judge the deliberation of the Committee, but I would like to make a few clarifications. Firstly, there are already private savings products which are available in the market for everyone, including platform workers. It is common for returns to be commensurate with the length of holding the funds in the account, such as a fixed deposit account. It is impractical to have our cake and eat it by allowing platform workers to withdraw and deposit like a savings account, while still enjoying interest rates higher than what is being offered by a fixed deposit account, for example, in the banks.”
“Even as we support them in their job search through career matching services and programmes under the SGUnited Jobs and Skills Package, they may still face challenges, such as lacking the time to job hunt or having the requisite skills to take on new jobs. This is a complex issue but, clearly, more needs to be done to close the gap in the protections provided for platform workers to ensure a fairer relationship between the platforms and the platform workers. Hence, we convened an Advisory Committee in September last year that includes representatives from Tripartite Partners to review this carefully. Since then, the Committee has been consulting widely through a public consultation exercise. I would like to take this opportunity to share some of our preliminary observations from the exercise. On retirement and housing adequacy, most platform workers expressed concern over their ability to meet both current and future needs. More than half of platform workers who responded to our public consultation exercise felt that mandatory CPF contributions to their Special or Ordinary Accounts would be important for their retirement and housing needs. And on this issue, the IPS survey found that 84% were worried about whether they have enough savings for retirement. Take the example of Ms Peh Xin Xuan, a 28-year-old who has been working as a food delivery rider for many years. For a period, it also served as her main income; it was her full-time job at that point in time. But over time, she found that the irregular earnings, without CPF contributions and the sheer physical demands of platform work took a toll on her financially, physically and mentally. Furthermore, Ms Peh recently applied for a BTO flat with her fiancé.”
“One group of SEPs that we are paying closer attention to are those that work with online matching platforms which provide transport and delivery services. Known as platform workers, they work as private hire car and taxi drivers, or deliver food and goods to our consumers. The Government shares the concerns that Mr Louis Chua, Ms Yeo Wan Ling, Dr Shahira Abullah, Mr Sharael Taha and Ms Hazel Poa have raised about the welfare and job opportunities for platform workers. Mr Don Wee also highlighted this issue at the Budget debate. With the emergence of digital platforms, it is now easier for people to source for work on online platforms. The profile of platform workers is diverse. We find that the majority of those who depend on platform work as their main job are older residents aged 50 and above, with non-tertiary qualifications, although delivery workers tend to be younger than other groups. Platform workers have consistently cited flexibility as a reason for taking up platform work. Some do it to supplement their main source of income, while others rely on it as their main source of income. Earlier this week, the Institute of Policy Studies (IPS) published a study on platform work, involving a survey of more than 900 private-hire car drivers and in-depth interviews with both the drivers as well as delivery riders. The study found that the flexibility offered by platform work comes with caveats. For instance, platform workers often have to follow working arrangements and pricing policies set by the platforms, which can change without their consent. Some have indicated that they view platform work as a temporary arrangement and would like to transit to regular employment.”
“Now, let me focus on senior workers. By 2030, our citizen population aged 65 and above will nearly double to 900,000. With an ageing population, it is important to tap on the accumulative human capital of our seniors to keep our economy growing. To allow more senior workers to work longer if they wish to, from July this year we will raise the statutory retirement age from 62 to 63 and the reemployment age from 67 to 68. In addition, employees who are hired at age 55 and above can qualify for reemployment, as long as they have worked for their employer for two years. According to the 2019 recommendations by the Tripartite Workgroup of Senior Workers, the Government will start to raise the CPF contribution rate for senior workers from this year and will continue to do so in 2023 to support the retirement adequacy of our seniors. By 2030, a 55-year-old member currently earning median income can expect his monthly retirement payouts to be boosted by 10%. (In English): Sir, I will now go on to talk about how we will support self-employed persons. For our self-employed persons (SEPs), the Government has progressively strengthened support for this segment of the workforce over the years. As announced at Budget 2022, eligible lower-income SEPs can receive enhanced Workfare payouts of up to $2,800 from 2023. The Government has worked with insurers to introduce prolonged medical leave insurance, which covers many self-employed drivers and riders. The Tripartite Alliance for Dispute Management provides mediation services to SEPs to address disputes with their service buyers and SEPs can have their rights enforced at the Small Claims Tribunal.”
“As shared by Brother Chee Hong Tat, since April 2019, NTUC has mobilised more than 800 companies to form CTCs and supported companies to develop and implement their transformation plans, including re-skilling of workers. This has enabled unions and companies to work together to respond with agility during COVID-19, to pivot operations to survive and, at the same time, to help workers sustain livelihoods. The efforts of the unions via the CTCs have achieved positive outcomes and MOM wants to accelerate these efforts to benefit more companies and workers. Mr Sharael Taha has asked for the resources to support NTUC to scale up the CTCs. The Minister for Finance has shared in the Budget speech that we will support NTUC's efforts to scale up to 2,500 CTCs by 2025. This will double the coverage from 250,000 workers today to 500,000 workers in 2025. About $100 million will be set aside to support NTUC. We will invest $28 million to support NTUC to drive this transformation and another $70 million grant to enable companies to operationalise the transformation plans through the CTCs. Next, I will talk about our efforts to uplift the different workforce segments, starting with senior workers. As announced during the Budget, the Government will continue to support the retirement adequacy of our seniors by raising the CPF contribution rates. By the time we are done with the full increase around 2030, a 55-year-old member currently earning median income can expect his monthly retirement payouts to be boosted by about 10%. Sir, I would like to say a few words in Mandarin. (In Mandarin): [Please refer to Vernacular Speech.] The Government spares no effort to improve the quality and skills of the workforce so that every worker can enjoy better employment prospects.”