Lam Pin Min
Singapore
“Mr Speaker, on behalf of the Minister for Transport, I beg to move, "That the Bill be now read a Second Time". This Bill, together with the Active Mobility (Amendment No.”
“It is timely for us to put in place a regulatory framework to ensure that active mobility devices being brought into and used in Singapore are safe. This is a key step in helping us put in place a safe and sustainable active mobility landscape in Singapore. Mr Speaker, I beg to move. [(proc text) Question proposed. (proc text)] 1.55 pm”
“Clause 6 facilitates the transfer to and vesting in the financial security provider of a seafarer's rights against a shipowner as a result of any liability arising from the shipowner's obligation to repatriate the seafarer. For example, the liability to pay the seafarer's wages and entitlements.”
“Mr Speaker, to ensure a safe and high-quality blood supply for our patients in Singapore, pre-donation interviews are conducted to screen blood donors for risk factors and blood donations are also tested for blood-borne infections. However, infections can only be detected some time after the blood donors have been infected.”
“I thank the Member for that clarification. As far as I know, not all mental conditions will be excluded from blood donation. In fact, we have checked with HSA. There is a wide spectrum of mental illnesses – from very mild mental conditions to very severe conditions.”
“I think we must be cognisant that the reason why they are inmates is because of certain things that have happened, prior to that. That actually pre-disposes them to some high-risk behaviours.”
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“There were underlying causes which would have contributed to the outbreak of violence, be it socio-economic, marginalisation or underlying tensions. Perhaps, it is prescient that Martin Luther King Junior spoke about rioting just a month before his assassination. And I quote him here: "But it is not enough for me to stand before you tonight and condemn riots. It would be morally irresponsible for me to do that without, at the same time, condemning the contingent, intolerable conditions that exist in our society. These conditions are the things that cause individuals to feel that they have no other alternative than to engage in violent rebellions to get attention. And I must say tonight that a riot is the language of the unheard." While it is unfair to compare the situation in Singapore to that of Chicago or Gujarat, the reasons why I recalled the words of Martin Luther King seek to remind all of us that, very often, riots arise because people feel that they are silenced, or that perceived grievances are unheard, or if they feel any social injustice. Page: 54 In our case, foreign workers do have needs that have to be met, be they economic, social or emotional. We need to examine deeply to evaluate the welfare and living conditions of the foreign workers working in Singapore. I am thus glad that Minister Tan Chuan-Jin had on 20 January 2014, acknowledged that foreign workers do have such physical and physiological needs – to catch up with friends, to eat or just to relax. On this note, I would like to ask the Minister on the measures taken to look into the welfare of these foreign workers and the provision of recreational facilities for them, besides their living conditions in their dormitories.”
“" "Some of the men lit beer bottles with fire and threw them at the Police." I can imagine how terrifying it was for Mr Lee Kim Huat, the bus driver, and Mdm Grace Wong Geck Woon, the bus coordinator, to be caught in the epicentre of the anarchy. I wish them well as they recover physically and emotionally from their injuries and also the harrowing experience they have Page: 53 gone through. I am thus glad to hear that a Committee of Inquiry (COI) is convened to ascertain the causes of the riot, assess the handling of the riot and the management of areas where foreign workers congregate. I am sure that the recommendations of the Committee will do Singapore well as we seek to learn from the lessons of the riot. While in Singapore, large scale riots, like the one in Little India, are, to say the least, unheard of since the race riots in 1969, riots have occurred in many other major cities all over the world. Some of the more infamous ones, which I think we will all remember, were the riots in England in August 2011, the Gujarat riots in 2002 where many Hindus and Muslims were killed, and even further back, the Chicago riots in 1968, sparked by the assassination of Martin Luther King Junior. These riots were similar in that they caused either significant damages to properties or loss of lives. The invocation of the memories of these riots here is deliberate. It is perhaps easy to say that the England riots of 2011 were caused by the shooting of Mark Duggan, a local who was shot dead by the Police two days prior to the start of the riots; that the Gujarat riots were because of the Godhra Train Incident and that the killing of Martin Luther King started the Chicago riots. Yet, as any study of the riots will tell you, these were just triggers.”
“Mdm Speaker, thank you for allowing me to speak on the Bill. First and foremost, allow me to express my deepest condolences to Mr Sakthivel Kumaravelu's family for the unfortunate accident that led to his demise on 8 December 2013. I would also like to send my greatest appreciation to the first responders, Civil Defence and Police officers for risking their lives to render assistance to the victim and to keep Singapore safe. The riot in Little India on 8 December 2013 was seen as one of the worst public order disturbances in more than four decades. Least of all, it shocked many Singaporeans, for the scenes on that fateful night were images we did not expect to see here in peaceful Singapore. Even foreign media took notice of this rare incident, which made news not just locally but also all over the world. The message that needs to be conveyed to Singaporeans is important and clear, that we should never take the peace we enjoyed over the last four to five decades for granted. I have not personally lived through nor experienced any riot but have read about the darker days in the 1950s and 1960s when riots such as the Hock Lee Bus riots, Chinese Middle Schools riots and the race riots in the 1960s were not uncommon occurrences. Thus, I am unable to fully comprehend what it will be like to be near or, worse still, caught in the midst of such a mob. Eyewitness accounts of the recent Little India riot, some of whom stay in the HDB block above where the riot took place, shared the following, and I quote: "I felt quite scared during the riot. I've studied rioting incidents in other countries in school but I didn't think it would happen so close to home. It was my first encounter and it's quite traumatising!" "I heard what sounded like bombs going off, three times.”
“I would like to thank the Senior Minister of State for the reply. In addition to hiring more or producing more healthcare professionals, I think the right siting of healthcare givers is also important. I would like to ask the Senior Minister of State what will MOH be doing to encourage healthcare professionals to specialise in areas such as geriatric medicine and other relevant specialties to meet the increasing demand with the ageing population.”
“Mdm Speaker, I thank the Minister for the answer. I would like to ask two supplementary questions. First, how do the schools monitor the progress and suitability of existing students who are in the Integrated Programme? Secondly, how many students in an average cohort end up retaining for additional years, or even drop out of the programme totally?”
“Mdm Speaker, I thank the Senior Minister of State for the answer. I would like to ask the Senior Minister of State if schools with student care facilities can consider allowing students from schools without student care facilities to enrol into their programme. Right now, apparently, the schools do not allow that kind of arrangement. Would MOE be looking into regulating student care services to ensure that our service providers do meet certain minimum service standards?”
“Can I just ask the Minister whether it is possible to bring forward the completion date of the Sengkang General Hospital because, currently, the targeted date is 2018 which is about four years from now? We can actually add in more resources to complete the hospital earlier. Exactly whether how many more General Hospitals does the Minister envisage will be necessary to meet the needs of Singaporeans, let us say, in 2030?”
“I would like to thank the Minister for the very comprehensive answer. I would like to ask the Minister, while the admission rates and the duration of stays for the patients have increased in the current crunch situation, could these be also due to a relative paucity of Page: 36 downstream services, such as the intermediate as well as the long-term care sector, because there may not be a right siting of patients within the medical institution? Some patients may only require some simple kind of monitoring in the long-term healthcare sector but as a result of the paucity, they may actually end up admitting into the acute hospitals causing the current bed crunch. The other question I would like to ask the Minister is: while building more hospitals is necessary, are we just treating the symptoms and not the cause? I would like to ask the Minister to consider taking a more holistic and systematic approach to reviewing the healthcare system and also to provide the right siting – treating the right patient at the right place for the necessary condition – and also streamlining all the work processes to minimise inefficiency and to optimise the resources, such as working with the private sector —”
“I would like to thank the Minister for the comprehensive reply. With regard to the use of N95 masks, we all know that only proper fitting and proper use of N95 masks will provide the necessary protection to the user. So, I would like to ask the Minister if there are plans to work with other relevant agencies, including the People's Association, on the proper use of N95 masks amongst residents, especially in cases where certain residents may not be suitable in the use of N95 masks such as those who are suffering from chronic obstructive lung diseases and heart diseases, the use of N95 masks can be counter-intuitive.”
“I would like to thank the Acting Minister for the reply and also the Ministry for working with my grassroots organisations to help identify potential void deck sites for conversion to childcare centres. Since the past few years, we have converted almost all available spaces but, unfortunately, due to the extremely high demand for childcare facilities, the waiting list still runs into the hundreds. I would like to urge the Ministry to place Sengkang and Punggol in their priority list. I would also ask the Acting Minister what quick short-term measures can MSF provide to address this shortage in the coming months and up to the next one or two years.”
“Mdm Speaker, according to the latest WHO report, the novel coronavirus that has killed at least 18 people in Europe and the Middle East could be transmitted from human to human, albeit after prolonged contact. With this latest information, would the Minister agree that air passengers travelling and confined in an aircraft cabin with an infected person for flight duration of about seven to eight hours typically from the Middle East countries, can pose a significant risk of transmission of the disease? Can the Minister comment on the surveillance measures that are currently available at points of entry and whether these are sufficient to identify these high-risk groups? I would also appreciate it if Minister could explain to the House what sustained human-to-human infection means.”
“I would like to thank the Minister of State for reassuring us that the doctor-to-patient ratio in Singapore is relatively healthy compared to other developed countries. I would like the Ministry to look in detail at the number of specialists in areas, such as geriatrics as well as rehab medicine, since these specialties are more relevant in looking after the elderly population. I would also like to know whether MOH has plans to encourage more doctors to take up specialty training in these areas.”
“Madam, volunteering, as an act, allows people to connect with others who lead different lives. It connects people with the causes they care about and help develop empathy for fellow human beings from a less-privileged background. In Singapore, we do have wide support for youths to pursue and champion the various causes that they believe in. This ranges from monetary support, like the CDC Mayor Imagine Fund and the National Youth Council Grant, to organisational support like NVPC and other VWOs. The availability of such support pales in comparison with the statistics on volunteerism amongst youths today. In particular, volunteerism amongst youths aged between 15 and 24 years rose to 43% 2012, a rise from 24% in 2004. Yet, for many other youths today, volunteering remains something that is done mostly in schools. After fulfilling their CIP hours, many do not continue with the volunteer work. It is also no surprise that in terms of giving aid to strangers and Page: 82 volunteering our time, we rank near the bottom in the 2011 World Giving Index Survey by the Charities Aid Foundation. Madam, youths are our future. Getting them to contribute to society through volunteerism will help them develop empathy and humility. It is an important ingredient to building a more gracious and tight-knit society. In view of this, I would like to ask the Minister to elaborate on his plans to cultivate volunteerism among youths. How can we increase the participation rate of volunteerism among youths, both within and outside the PA network and the schools? How can we encourage youths to continue volunteering even after they have completed their education? Can we create youth volunteers alumni networks where they can continue to share their volunteering experiences with their peers?”
“Are there adequate sports facilities in the suburban areas in Singapore to cater to such needs? Are these facilities priced affordably to ensure that all Singaporeans will be able to enjoy these facilities regardless of Page: 71 income level? Can we look into building more such sports nodes in the community? Super Sports Club”
“Madam, I would like to declare my interest as the President of the Singapore Dragon Boat Association. In our fast-paced society, Singaporeans are caught up with the rat race and devote much of our time to both work and the family. This trend has worsened with the advent of social media and smartphones. Singaporeans are getting more and more connected to each other, albeit online. This has left them with little time to pursue sports. Many graduates also cut down their participation in sports after leaving school due to work and other commitments. Sports is a very powerful tool to bind and connect people and the community. As the report by then MCYS noted, sports has the power to inspire, to bond people, to galvanise them and to develop and build character in them. This is especially true for team sports like dragon boating, soccer, rugby, just to name a few. The People's Association has also done an excellent job in partnering NSAs in organising many sports activities to engage the community. These include the annual PA Paddles Championship and the Singapore Dragon Boat Festival. According to the National Sports Participation Survey of Singapore 2015, we have managed to increase the sports participation rate from about 38% in 2002 to 50% in 2005. However, more needs to be done to encourage Singaporeans to lead healthy and active lives. In this context, I would like to ask the Minister to elaborate on his plans to encourage a sporting lifestyle amongst Singaporeans. At the same time, many sports require substantial build-up in infrastructure to allow Singaporeans to enjoy games. Sports like tennis, squash, netball, handball, basketball and so on require specialised courts to allow players to participate.”
“Mdm Chair, on behalf of the GPC for Health and other health-conscious Members of the House, I would like to thank the Minister, the Minister of State and Parliamentary Secretary for their comprehensive replies and the many early Christmas presents. I believe MOH will continue to work hard to look into all the issues and suggestions raised by Members today and to make healthcare affordable and accessible to all Singaporeans. With that, I beg leave to withdraw the amendment. [(proc text) Amendment, by leave, withdrawn. (proc text)] [(proc text) The sum of $4,929,089,000 for Head O ordered to stand part of the Main Estimates. (proc text)] [(proc text) The sum of $746,558,600 for Head O ordered to stand part of the Development Estimates. (proc text)] Page: 140”
“Thank you, Mdm Chair. I have three clarifications for the Minister. One is on Government spending. We know that it is inevitable that healthcare spending will increase. The current Government share of the national healthcare expenditure is only one-third and I am glad that the Minister has announced that they will be increasing the Government's share of this healthcare spending. Whatever this national healthcare expenditure will be eventually, I would like to ask the Minister what this fair and manageable proportion of the overall healthcare expenditure borne by the Government will be, as this will directly affect and will decrease the financial burden on Singaporeans. Secondly, on polyclinics. I am glad that the Minister has announced that there will be two new polyclinics in Punggol and Pioneer by 2017. However, from now till 2017 is a long four-year wait. What are MOH's plans to alleviate the high demand and long waiting time in Sengkang polyclinic? Thirdly, the Minister did not reply to my call for a transparent professional fee structure. Can the Minister elaborate and explain what this ethical limit, as announced by the Singapore Medical Council is, and whether there can be some form of updated fees publication to better inform patients as well as to guide doctors?”
“Mdm Chair, Singapore's National Childhood Immunisation Programme (NCIP) has been in place for several decades and has been effective in protecting against the targeted diseases. Its schedule has been revised regularly, with the last amendment in 2008. In many ways, vaccination works on the old adage "Prevention is better than cure". By protecting children against certain infectious diseases, vaccination can reduce mortality and morbidity of preventable diseases. Today, NCIP covers over 10 different diseases, but only two, measles and diphtheria, are compulsory. Moreover, some vaccinations are provided free while some, such as Hepatitis, though listed in the national programme, are charged at cost with the option of paying through MediSave. I would like to seek clarification from the Minister on the following: (a) How does MOH determine which diseases are compulsory for vaccination? Should MOH not make more diseases compulsory under the NCIP to offer a better and more comprehensive coverage? (b) Can the Minister consider including more preventable diseases, such as chickenpox, Hemophilus influenza and human papillomavirus (HPV) in the national immunisation programme? With higher air, land and sea connectivity and the large influx of immigrants from countries without comprehensive immunisation programme and coverage, the risk of localised outbreaks of infectious diseases is enhanced. How would the Ministry mitigate this risk and prevent the resurgence of infectious diseases, such as tuberculosis (TB) and poliomyelitis?”
“Page: 69 Affordability, Scope and Capability”
“While the Government has imposed controls on harmful products like cigarettes, it is worrying that the prevalence of smokers amongst the young and the ladies are increasing. The recent extension of the smoking ban is also a step in the right direction. Non-smokers will have more reprieve from second-hand smoke and avoid the harmful effects of second-hand smoke. While we have banned smokers from lighting up in public places, it would not eradicate the harmful habit of smoking. Smoking has been linked to many medical conditions including ischemic heart disease, chronic obstructive lung diseases and cancers. We can do more to eradicate this harmful habit among Singaporeans. One radical suggestion would be to gradually introduce a ban on smoking on certain segments of the population. Would the Ministry consider totally banning the sale of tobacco-related products to cohorts of citizens born after a certain year? While it is often difficult to make smokers change their habits and quit smoking, this would gradually eradicate the habit in the next generation of Singaporeans as they would not be exposed to the bad habit of smoking? While looking after one's health and well-being is an individual choice and responsibility, the Government can facilitate and encourage Singaporeans to do so. Can the Ministry consider working with the insurance industry, or even MediShield to incentivise Singaporeans to lead a healthy lifestyle? This can be in the form of insurance rebates or further premium reduction. Last but not least, will the Minister consider allowing MediSave to be used for medical screenings of some common medical conditions? This would enable diseases to be detected and treated early, enhancing the prognosis and minimising preventable complications.”
“Mdm Chair, according to the Bloomberg Global Health Survey in 2012, Singapore has emerged top as the healthiest nation in the world. This is, in part, due to our highly efficient healthcare system, as well as the major role played by HPB in promoting healthy living among Singaporeans. Yet, let us not rest on our laurels. We need to do more to promote healthy living, with regard to obesity and smoking. Obesity is of particular concern. While our obesity rates are much lower than that of the Organisation for Economic Co-operation and Development (OECD) average of 17%, USA 34% and Australia 25%, our statistics show that Singaporeans are getting fatter. Obesity in Singapore rose from 6.9% in 2004 to close to 11% in 2010. Coupled with a global obesity pandemic, more food choices and affluence in Singaporeans, we face an uphill task. In our fight against obesity, would MOH or HPB consider strengthening food advertising? This would follow international norms where many countries, like the UK and South Korea, have already regulated the food advertising market. Countries like Finland, Denmark and Malaysia have also set out government guidelines on food advertising. Children, in particular, are of concern as, most of the time, they are easily influenced by temptations in persuasive advertisements. Page: 68 The health of the individual is very much affected by the consumption of the type of food. Many of our school children consume meals sold in the canteens. In order to minimise the consumption of unhealthy and junk food, can the Ministry consider mandating that only healthy diet are served in school canteens? To encourage Singaporeans to eat healthily, the Government can consider making healthier choice products sold in supermarkets cheaper and more affordable.”
“However, younger low-income Singaporeans, below the age of 40, are deprived of this subsidy and convenience of seeking treatment from the nearby participating family clinics. Will the Minister consider lifting the age criterion for this scheme so that all low-income Singaporeans can benefit from the scheme? The Chronic Disease Management Programme (CDMP) has also benefited many Singaporeans by minimising the out-of-pocket expenditure when they consult their doctors for the management of their chronic diseases. However, I have received many negative feedback about the administrative fees imposed when using their MediSave for this programme. Can Minister consider waiving this administrative fee, especially for those from the low- and middle-income families so as to allow them to stretch their MediSave dollars further?”
“Mdm Chair, the primary healthcare sector's importance to the overall health landscape in Singapore cannot be overstated. Today, there are some 2,400 private medical clinics and 18 polyclinics in Singapore. Primary care professionals are often the first point of contact with the patients in the community. During last year's COS, Minister mentioned that the Ministry would seek to explore new models of care for this sector. I would like to ask the Minister for an update on MOH's strategy in delivering better primary care services to Singaporeans. With the ageing population, many age-related medical conditions including mental illnesses, will become more prevalent. How will the ministry ensure that our primary care sector, especially our family physicians, stay relevant to cater Page: 66 to the needs of the elderly? The current 18 polyclinics serve about 20% of the primary healthcare market. They provide affordable primary healthcare services to many Singaporeans, especially those from the lower- and middle- income families. What is the number and capacity of polyclinics required to meet our future needs? What role will the polyclinics play in ensuring affordable primary healthcare for Singaporeans? I have received much feedback on the long waiting times and over-crowding in polyclinics, especially the one in Sengkang. Like Dr Teo Ho Pin, I would like to request the Minister to consider introducing some 24-hour polyclinics in certain areas with extremely high demand to help alleviate this problem. CHAS is very helpful in providing affordable and accessible primary healthcare services to lower-income Singaporeans above the age of 40.”
“Physician charges in the private sector can be rather arbitrary, especially after the Singapore Medical Association (SMA)'s schedule of fees was discarded in 2007. The recent introduction of the ethical limits on doctor's charges by the Singapore Medical Council (SMC) has also taken many practitioners by surprise as this will have implications on the way doctors charge. Can MOH elaborate and better define what this ethical limit is to avoid ambiguity in future? I would also like to suggest to MOH to introduce some form of consolidated information on bill sizes and professional fees for all private and public sector hospitals and have them published and updated on a regular basis for the benefit of both doctors and patients. The Minister had announced MOH's Healthcare 2020 masterplan in last year's COS debate. To quote the Minister on the objectives of this masterplan, he said: "Healthcare 2020 will focus on three strategic objectives – enhancing accessibility, quality and affordability of healthcare for our people. This means that Singaporeans will receive healthcare when we need it; our healthcare services will be of good quality and effective and Singaporeans will be able to afford such services." I would like to ask the Minister for an update on the masterplan. Mdm Chair, affordable and accessible healthcare must remain a basic right for all Singaporeans. The Government must ensure that healthcare remains affordable and will not deny any Singaporeans because of their inability to pay.”
“On this note, I would like to thank the Ministry for finally including the MediShield coverage for congenital diseases. Many of my parliamentary colleagues and I have been lobbying for this for many years. While I would be happy if most Singaporeans can stay healthy and not require the use of healthcare services, the reality is that at some point in time, all of us would have to utilise the healthcare system. It would be extremely sad if any Singaporean were to be made bankrupt as a result of seeking medical treatment for themselves or for their loved ones. In view of this, I would urge the Government to conduct a major review of the 3M system, in particular, with the view to enhance MediSave usage, MediShield insurance protection and MediFund assistance to low- and middle-income Singaporeans. MOH should also take a closer look at the high deductibles and co-payment which inevitably result in more out-of-pocket expenses for Singaporeans. With increasing integration of social and medical care under MOH, should we also consider allowing MediSave usage for social care facilities like senior care centres? MOH should also regularly review Means Tested Subsidy Levels, MediShield and ElderShield insurance payouts to ensure that they keep pace with medical inflation. I have also received numerous feedbacks on the affordability of drugs. MOH's classification of standard drugs seems to be too stringent, resulting in many drugs that are commonly used for many common conditions being listed outside the standard list for Government subsidy. One way the Ministry can help lower the out-of-pocket payment for Singaporeans is to subsidise the cost of more essential drugs. Page: 53 Another way to ensure that healthcare stays affordable is to make the fee structure transparent.”
“Should it be measured as a percentage of total income, such as 5%, 10% or even 15%? Or should it be measured as a percentage of the total bill size in the form of out-of-pocket costs for the patient? 1.00 pm While I do not have an answer for that, I would like to highlight some issues and concerns that have contributed to the perception that healthcare in Singapore has become less affordable. Mdm Chair, Singapore's version of healthcare financing hinges on one of the key philosophies of individual responsibility. Coupled with the time-tested 3M framework of MediSave, MediShield and MediFund, the Government has been able to keep our national healthcare expenditure below 4% of GDP, of which only one-third comes from the expenditure from the Government. However, with the rapidly ageing population and the ever escalating medical inflation, the burden of bearing the higher cost of healthcare has begun to fall significantly on Singaporeans. Many Singaporeans have called for the Government's share of healthcare expenditure to be increased. Compared to many OECD countries, the Singapore Page: 52 Government's share of the national healthcare expenditure has remained enviably modest. While the 3M system has served us well, we need to ensure that the 3Ms remain relevant, to commensurate with the socio-economic-political situation and needs of Singaporeans. The restriction imposed on the use of MediSave is a big bugbear amongst Singaporeans. Many lamented: "What is the point of having so much money in the MediSave when they cannot even pay for their current healthcare needs?" Many young parents also shared their concerns of potential financial strain on the family should their newborn be inflicted with congenital illnesses.”
“Mdm Chair, I beg to move, "That the total sum to be allocated for Head O of the Estimates be reduced by $100". I would also like to declare my interest as a medical professional working in a restructured hospital. Healthcare has always been an emotive issue for many Singaporeans, as it affects all of us in one way or another. Everyone seeks healthcare services at one point in our lives, whether we are newborns, children, adults or senior citizens. It is also one of the essential services expected of a responsible Page: 51 government. Singapore's healthcare system has developed and evolved through the years to what it is today, through a mix of pragmatism and eclecticism, learning and adapting from best practices to arrive at a formula that works for us. Our healthcare system is generally cost-effective with a National Healthcare Expenditure (NHE) at 4% of GDP. In comparison, OECD's average is 9.6%. Even then, I am glad to note that Singapore has achieved good health outcomes, in spite of spending less than many other developed countries when measured as a percentage of GDP. However, I have often received feedback from residents and friends on the increasing cost of healthcare. The old adage that "It is better dead than to be sick" seems to resonate with many Singaporeans. Why is this so? MOH has always pledged to provide affordable healthcare for all Singaporeans. As parliamentarians, we have debated for years in this House on affordable healthcare. What then is affordable healthcare? Many academics have tried to define what affordability is. Some measure affordability as the amount of money a household can spend on healthcare costs, while still having enough left to pay for other necessities.”
“Mdm Chair, there has been an increasing trend in international marriages between Singaporeans and non-citizen spouses. From around 31% of all marriages in 2000, the number has risen to close to 40% in recent years. In many cases, the foreign spouses have been naturalised and assimilated into the Singapore society. However, I have encountered many situations where Singaporeans face persistent difficulties in obtaining Long-Term Visit Passes, permanent residency and citizenship for their foreign spouses in spite of their keenness to start a family and develop roots in Singapore. Coincidentally, many of them were from the low income and low educational strata. In view of this, I would like to seek clarification on the criteria for granting such status to foreign spouses so as to give greater certainty for these Singaporeans and also the main reasons for their rejections. 4.00 pm Recent Changes”
“We have seen how Singaporeans have shown their passion on various issues, such as the death penalty, animal rights and Green Corridor, just to name a few. We should, in building a better and more inclusive Singapore, also provide the space to accommodate the views and aspirations of these Singaporeans. In conclusion, I would like to take this moment to recall the lyrics of one of my favourite songs, "Home" by Kit Chan: [(proc text) "This is home truly, (proc text)] [(proc text) where I know I must be, (proc text)] [(proc text) where my dreams wait for me, (proc text)] [(proc text) where the river always flow. (proc text)] [(proc text) This is home truly, as my senses tell me, this is where I won't be alone, (proc text)] [(proc text) for this is where I know its home" (proc text)] "Home", as this familiar song goes, is defined not by the infrastructure, the wages or the jobs, but our senses, our feelings, our emotions. We are Singaporeans because we feel connected. It is truly inspirational in defining what "home" is. As we endeavour to build a better society, let us ensure that while we make the material changes to ensure fairness and inclusiveness, we also need to pay more attention to the intangible, the emotive. After all, it is the experience of being a Singaporean that counts the most. With that, I support the Budget. 1.20 pm Page: 36”
“Madam, besides the under-privileged families, elderly, disabled and their caregivers, I would also like to speak briefly about another group of people in society who are often left in the lurch. This group is the single parent, either male or female. The single parent faces many challenges in life as he or she takes care of the children. For one, the myriad of schemes and subsidies available to married Singaporeans with children are not available to them. Often than not, the single parent is faced with a double whammy of sorts. Apart from the lack of Government support, some are also cut off and "abandoned" by their families. Take, for instance, the Baby Bonus is only eligible, according to MSF guidelines, if the mother is lawfully wedded to the father. The case is the same for maternity leave, childcare leave and income tax relief, where marriage is one of the eligibility criteria. HDB BTO policies are also skewed against those who are single parents. I think we should relook the way we see parents who one way or another have to raise their children on their own. Let us remove our "biasness" and make avail to them all such schemes and subsidies that are available to married couples. We must remember that some of them are single Page: 35 not by choice and we should not further add to the problems they face in raising a child single-handedly. A transiting economy is not the only transition that we need to manage today. Events in the past years have also shown that our society is undergoing significant changes. I think we can agree that there are segments of our society that have become more progressive, more vocal and who are more interested in liberal ideas than others.”
“More importantly, the initiatives taken to enhance the pre-school education scene and provide more support for disadvantaged students in school would ensure that social mobility is maintained. In many ways, this would allow us to maintain the ideals of meritocracy and equal opportunities and build a better Singapore. Yet, when we speak about "meritocracy", which has been one of the cornerstone philosophies of our society, I would like to draw our attention to an article written by Donald Low in the IPS Commons. He argues that meritocracy in the education system in recent years has favoured certain types of people, because of our emphasis on sorting the best from the rest. He also argues that when that happens, people who are better off and well-to-do have a higher propensity to succeed because they have the means to access resources. While I do not agree with all of his argument, I think that there is a certain truth to it. After all, parents who are well-to-do have the means to send their children for such enrichment classes. In fact, popular tuition centres have also started to offer headstart classes, beginning as early at K2 level. Yet most of these are affordable only to parents of the upper middle-income group. The emphasis in the Budget on levelling this playing field is commendable, but I do think we can do more to provide low-income Singaporean children the same access to enrich their children's abilities outside the mainstream education system. Can we not take a leaf from Edusave and to think about the possibility of a means tested central pool which will fund enrichment classes for those less well off?”
“As the transition takes place, I applaud the Budget for helping our SMEs make the painful but necessary change, to become less dependent on foreign labour, and in helping our lower wage, lower skilled workers, through increasing the employer CPF contribution, and Workfare. These schemes will undoubtedly help to ensure that Singapore is more ready to deal with the changes ahead. At the same time, I would like to caution that while we make changes to the economy, let us learn from the lessons of the past. In the late 1970s and early 1990s, we had restructured our economy from a labour intensive, low skilled, to a less labour intensive, higher skilled economy. At each stage, there were Singaporeans, especially the older and less educated ones, who were unable to adapt to the new mind and skill sets needed. As a result, they lost their jobs, and were unable to find new ones, as their skills were no longer relevant. Such structural unemployment is of particular concern. As we make the current changes, let us keep in mind how to minimise such problems and to provide a helping and guiding hand to these Singaporeans to overcome any challenges in the course of this transformation. This year's Budget has also sought to better promote social mobility in Singapore and to ensure better redistribution of wealth to lower- and middle-income Singaporeans. I applaud the Minister for Finance for adopting a more progressive version of taxation. At the same time, I also welcome the revamped assistance scheme, with the increase in the primary cash assistance rate, and introduction of two new tiers of assistance and the enhancement of Workfare to include more low-wage workers. This will help more low-income families Page: 34 cope with the higher costs of living in Singapore.”
“After he was arrested, he wrote a note to the judge saying that he needed to get back into prison for a year, to get an operation. Absurd as it may sound, we must not fall into the same trap in terms of healthcare provision and finances. We must ensure that healthcare will not be denied to certain groups of people because of their inability to pay. Affordable and accessible healthcare must remain a basic right for all Singaporeans. In our review of the healthcare system, we must adhere to certain basic principles that have served us well. Page: 33 Mdm Speaker, while I am still on the topic of elderly and persons with disabilities, it is important that we acknowledge that there is a group of Singaporeans who have devoted much of their time to care for these people. We, as a society, have improved in the past years to meet the needs of informal caregivers. We have a caregiver training grant, respite care options and have gradually begun to change perceptions about caregiving. Yet, can we still seek to do more to assist them? Caregiving is never easy and the stress on the caregivers, financially and emotionally, can be enormous. I have raised this issue many times in the last six years and I would like to raise this again. Can the Government consider providing some form of caregiver allowance to these caregivers, just like what many countries, including Japan and Australia, have done? This could take the form of cash payouts or even MediSave or CPF top-ups. Mdm Speaker, the recent changes to the economy are also a step in the right direction, as we seek to reduce our dependence on foreign labour, increase productivity and transit to a high value, knowledge-based economy.”
“As Deputy Prime Minister Tharman has pointed out, we are a society in transition. This is the time to think about ensuring persons with disabilities get access to equal opportunities and treated fairly in all aspects of life. This should also go hand in hand with the building of infrastructure for the disabled. Mdm Speaker, I am also glad to know that there are plans to review healthcare financing in Singapore, to reduce out-of-pocket costs to Singaporeans, broaden insurance coverage and the use of MediSave and Medifund. As Singaporeans grow older, there is a need to ensure that our healthcare sector remains relevant to the needs of Singaporeans and this is indeed a step in the right direction. I came across an article last week which related how a 41-year-old man in America had to resort to crime and re-incarceration after being released from prison in order to receive the medical treatment he needed for his condition. This man was diagnosed with aneurysms in the artery of his liver while he was in prison, which required life-saving surgery. Fortunately or unfortunately, he was released from prison one week later. When he returned for his pre-operation visit, he was told that since he had been released from prison, he no longer had insurance to cover the surgery. When he asked the doctor what he should do, he was told to figure out how to get insurance instead. But not knowing what else to do, it occurred to him that the easiest way to get the care he needed would be to get back to prison. The week after, he went to a department store and, making sure a security guard saw him, pocketed some moisturising cream. He looked at the guard, smiled and walked out.”
“First of all, more attention can be paid to groom and develop persons with disabilities from a younger age to allow them to develop to their fullest potential. This would mean that society at large also needs to be more understanding of their needs. I do not want to take anything away from the achievements of Laurentia Tan, or belittle the things that our Voluntary Welfare Organisations are doing in Singapore today, but I wonder if she would have been given the same level of support, education and acceptance, as well as accomplish as much, had she remained in Singapore. She had after all, at the age of three, moved to London, remained there, where she received her education and was introduced to horse riding. The mindset in the United Kingdom towards disability is very different from that in Singapore after all. Can we, as a society, work towards acceptance of persons with disabilities, to build better schools, facilities and programmes which will enable them to feel that Singapore is their beloved home, too? Mdm Speaker, the disabled today are gradually finding acceptance in our changing society. I believe most of us here have heard of Esme, the guide dog, and her owner Cassandra. Through their Facebook site, we have seen how they have highlighted aspects of society which have caused concern for them in their everyday lives. I am glad to see how society at large also speaks up for them, notably in the episode regarding a fashion retailer here. With this heightened awareness, more and more retail outlets in Singapore are becoming guide dog Page: 32 friendly. On the contrary, I was aghast to hear of the case of Mr Kua Cheng Hock, whose guide dog was recently denied access on board an airliner.”
“I am glad to note that this year's Budget has announced that the Foreign Domestic Worker Levy Concession will be further reduced from $170 to $120 for families caring for children, elderly and persons with disabilities, in addition to the $120 caregiver grant announced previously. There is also a renewed focus on the disabled with the setting up of a new social agency to look into their needs. Page: 31 I also applaud the Government in leading the way with the two Enabling Masterplans. However, in areas of employment, education and transportation, there remain challenges for persons with disabilities. How can we make society more understanding in the employment of persons with disabilities, in seeing them as equal members of the society, and remunerating them fairly? In transportation, can we also look into providing transport concessions for people with disabilities? What is the progress on the provision of more wheelchair-accessible buses on the roads? Have we done enough in ensuring barrier-free accessibility in our public places? Having said that, I do think we are building a more and more inclusive society. This is exemplified by the fact that just weeks ago, paralympian, Laurentia Tan, who is deaf and has cerebral palsy, won The Straits Times "Athlete of the Year" award for 2012, edging out three other nominees, namely, table tennis player Feng Tianwei, bowler Shayna Ng and footballer Shahril Ishak. It is heart-warming to see how Singapore and persons with disabilities have come so far in the journey to inclusion. Yet, while we build a more inclusive society for all, more can be done to meet the aspirations of the disabled and make Singapore a cosier home for them.”
“Mdm Speaker, thank you for allowing me to join in the debate. It is heartening to know that the Government's direction in this year's Budget has striven to build a better Singapore through quality growth and building an inclusive society. Deputy Prime Minister Tharman has clearly set out the various visions of Singapore that Singaporeans want and I am also glad to see that the Singapore that we are building takes its point of reference from "Our Singapore Conversation" platform. It is only through the active engagement of the various segments of society that we can truly derive a common vision of Singapore for Singaporeans. Mdm Speaker, this is indeed a progressive and inclusive Budget. However, I do believe that there are several areas that we can do better. As Deputy Prime Minister Tharman rightly points out, there are segments of the society that have been disadvantaged and, thus, need more assistance. I would like to turn our attention to these subaltern or marginalised groups in Singapore. The reason is simple. We, in Singapore, have pledged to build a democratic society based on justice and equality. Through our parliamentary and judiciary systems, we have achieved the first two. While we have endeavoured to meet their needs in this year's Budget, I am particularly concerned that inequalities still persist in our society. I will highlight specific groups of people whom I think we, as a society, can do more to help improve their lives. Mdm Speaker, I shall first touch on the needs of persons with disabilities.”
“Mdm Speaker, the fight against dengue has been on-going for decades. So has the research on dengue vaccination. Can I ask the Minister if he has any update on dengue vaccination research?”
“I wish to ask the Minister a supplementary question. What the Minister mentioned that the caregiver grant is only useful when the family is able to afford in hiring a domestic maid. For those families which are from the low-income bracket, the family member may have to give up the job to look after the elderly sick. So, I would like to ask the Minister to consider a caregiver's allowance to help such families.”
“The Boiling Frog story is a widespread anecdote describing a frog slowly being cooked to death. The premise is that if a frog is placed in boiling water, it will instinctively jump out. But if it is placed in cold water that is progressively heated up, the frog will not perceive the danger and will be boiled to death Page: 125 unknowingly. Mr Deputy Speaker, Singapore is at a very important crossroad in our demographic evolution. We do not want to be like the frog in the parable, deceived into thinking that our lives will remain good and cushy, like relaxing in a warm jacuzzi bathtub. It will be extremely irresponsible to think that everything will be fine in the next 10 to 20 years, if we do nothing or little to address the issues facing us. With that, I support the amended Motion. 6.20 pm”
“Mr Deputy Speaker, I wholeheartedly agree with the principles behind the White Paper on population. The numbers are something we must discuss and decide on. We need to build strong families, we need to meet the hopes and aspirations of Singaporeans and we need to make Singapore a quality home for all. In doing so, let us look to fulfil not just prosperity and progress, but also happiness. After all, we pledge to achieve happiness before prosperity and progress in our National Pledge. Let us perhaps look at how Singaporeans can remain linked and connected to Singapore, not just by ensuring that the tangible aspects are available, but also the intangible, emotionally and mentally. The White Paper must move away from just figures and projections, and do more to address the experience of living, the experience of being Singaporean. I hope the Government will ensure a high quality of life for all Singaporeans, leaving no one behind. The ultimate goal must always be creating a Singapore for Singaporeans, giving priorities to Singaporeans in terms of job, education and housing. To build a Singaporean Core, we must not give up in our continuous endeavour in encouraging and incentivising Singaporeans to get married and procreate. We should not simply turn to the easy quick fix solution of immigration alone. Supporting the call from hon Member, Mr Liang Eng Hwa, I urge the Government to quickly address the many hot button issues of infrastructural deficiencies, escalating property prices and the high cost of living. These are issues that Singaporeans are facing in our day-to-day lives. This would give Singaporeans the assurance that the population roadmap laid out in this White Paper is sustainable. In conclusion, I would like to remind Members the parable of the Boiling Frog.”
“Similarly, the covenant between the Government and its people lies simply on that trust. The people or "U" remains the centre of the word "trust" and this trust will only be complete when the Government and the people or "US" remain side by side, in our walk towards nation building. Having heard the statements of Deputy Prime Minister Teo and many other Cabinet Ministers, I am heartened that the White Paper takes as guiding principles − to build a strong Singaporean Core so as to sustain the heart of our nation, that we need to continue to meet Singaporeans' hopes and aspirations and that Singapore must continue to be a home for all Singaporeans. White Papers are tools of participatory democracy, not an unalterable policy commitment. White Papers are used to perform the dual role of presenting firm Government policies while at the same time inviting opinions upon them. It serves to test the climate of public opinion regarding a controversial yet important policy issue and enables the Government to gauge its probable impact. Indeed, what I have just painted are valid concerns from the ground. As we strive to achieve the goals laid down by the White Paper, I hope the Government will be able to provide answers and solutions to mitigate the projected growth Page: 124 of 30% of the population by 2030. I would like to remind all of us here that in our national pledge, we pledge to be, I quote, "One united people, regardless of race, language or religion, to build a democratic society, based on justice and equality, so as to achieve happiness, prosperity and progress for our nation." These ideals reiterated in the pledge have since formed the fundamentals in which we approach nationhood and nation building.”
“Does it mean that we should sweep it under the carpet and leave it to the next generation of leaders to manage? Besides looking at the projected population demographic profile, the White Paper also outlines the Government's policies to maintain a strong Singapore Core, create jobs and opportunities and build a high quality living environment for all Singaporeans. Thus, it is not just about growing the population, but a Page: 123 holistic approach to build infrastructure ahead of what is projected, create the necessary climate for job creation and, ultimately, making Singapore a more liveable place – one we are proud to call Home. To give an analogy from my own personal experience as a doctor, many of my patients are young children and many consult me because they need treatment for their medical conditions. Unfortunately, many of the treatment modalities may not be the most pleasant experience for the young patients. For example, for a child suffering from advanced retinoblastoma, or cancer of the eye, the treatment entails enucleation, or surgical removal of the entire eyeball, followed by chemotherapy. These are difficult and painful decisions for the parents, but absolutely necessary to ensure survivability of the patient. As a doctor, I will have to explain the benefits and potential side effects of the treatment. And as responsible and loving parents, they will have to decide what is good for the child, even though the journey to recovery may be filled with challenges. Of course, whenever possible, the doctor will have to think of ways to mitigate the sufferings and to make the patient more comfortable. What is critical is the trust between the doctor, the parent and the child.”
“This declining old-age support ratio will inevitably result in an increased burden on the productive part of the population to support the economically dependent. There will also be a smaller workforce with a less vibrant and innovative economy, resulting in fewer job opportunities. As the Deputy Prime Minister had alluded earlier, many young people may then decide to leave for faster growing, more vibrant cities, hollowing out our population and workforce. This is already happening in many European countries such as Greece and Spain. To put it simply, the burden of supporting the society will be heavier and this will be borne by our children and grandchildren. To put it bluntly, our children and grandchildren will have to pay higher taxes, unemployment rate will likely increase, and many may even have difficulty looking for a good quality job in Singapore and decide to venture overseas to make a living. Is this what we are ready to accept as a trade-off for a less populated Singapore? This White Paper sets out the long-term roadmap for Singapore's population policies to address our demographic challenge. Let us take a step back and ask ourselves this question: why would the Government put up this White Paper for debate when it could have just succumbed to popular demand by curbing the growth of the population? Would this be the responsible and right thing to do? Would we not be shortchanging our children's and grandchildren's future? Whether the eventual projection be 6.9 million, 6.5 million or 5.9 million, the hard truth is that Singapore needs to grow both economically and in total population to ensure our long-term survivability. Twenty thirty is a long time away.”
“While the immigration office can exercise strict admission criteria, is it ethically or morally right to disallow the parents of our new citizens to relocate to Singapore, especially when the new citizens could be the only children of these elderly parents? The White Paper has emphasised that one of the core pillars would be to make Singaporeans the core of the nation. How are we going to do that when the eventual proportion of Singaporeans in 2030 is only 55%? Will there be a dilution of the Singaporean culture and way of life, thereby losing the Singapore identity? As I ponder more and start to study the details of the White Paper, my head took over from my heart, and I began to rationalise and understand the intent better. What if the Government decides to freeze population and workforce growth altogether? How is Singapore going to tackle the twin challenges of a rapidly ageing population and a low total fertility rate? Rationally, everyone will agree that the status quo of rapid growth will not be possible. On the other hand, what kind of Singapore will it be in the next 10 to 20 years if the Government were to limit our population to the current 5.3 million? Page: 122 As our post-war baby boomers turn 65 years old from 2012 onwards, Singapore will experience an unprecedented age shift. Over 900,000 baby boomers, more than a quarter of the current citizen population, will retire from the workforce and enter their silver years. Come 2030, more than 20% of our population will be above the age of 65. Currently, the total number of working-age citizens to each citizen aged 65 and above is 5.9. If the current TFR remains with no immigration, this will decrease to 2.1.”
“In fact, with the added number of visitors, we would surely experience more strain in our infrastructure and living experience, especially at tourist attractions and recreational facilities. Yet, one of my biggest fears is that we could be oversimplifying the solution to the population and ageing issue, by issuing 15,000 to 25,000 new citizenships Page: 121 to stop our citizen population from shrinking. This, in the short run, allows the working population base to remain constant and to support the ageing population. However, I wish to highlight two major drawbacks with this recommendation. Firstly, there is nothing that will stop immigrants who come to Singapore and swear their allegiance to this tiny nation from moving to another greener pasture. This is especially so if we are unable to remain attractive to these immigrants. Secondly, there is a high possibility that these immigrants who settle down in Singapore will want to have their parents migrate here as well. This is especially true for one-child families from China as with our safe environment, many will want to bring their elderly parents over and care for them in their silver years. I am sure many of us have received similar requests for Long Term Visit Passes, permanent residency or citizenship for these family members at our weekly Meet-the-People Session (MPS). The White Paper says nothing about this trend and this could actually exacerbate our problem with the ageing population. Ridiculous as it may sound, we are now holding a double-edged sword. On the one hand, we need new immigrants to maintain our edge, productivity and economic growth; yet, on the other, they may very well contribute to the woes of an ageing population.”
“In fact, when the news of this projected population was released, I was taken aback too. My heart tells me that this cannot be true. I then asked myself, "Is the Government serious about this projected figure? Is our infrastructure able to accommodate so many people? Will this be cast in stone, with no room for discussion?" With the current population of 5.3 million, Singaporeans are already feeling the strain of over-crowdedness. Many Singaporeans will not be able to fathom the impact of having another 1.6 million people in this small island nation. Many Singaporeans are worried about the day-to-day inconveniences of rushing and squeezing into the MRTs and LRTs, waiting for the next available bus because the previous one was too crowded to admit another one more passenger and having to watch where one is walking when shopping along Orchard Road. Young Singaporeans are also worried about the affordability and availability of homes while older Singaporeans mull over accessibility of healthcare services with the projected increase in the population. It is already a common occurrence of long waiting times at hospital emergency departments and specialist clinics, and near full occupancy of inpatient beds at several restructured hospitals. With the projection of 6.9 million population, would there not be more competition for jobs and school places? Will the transport infrastructure be able to cope with this increase in population? Let us also remember that, at the same time, Singapore attracted 13 million visitors in 2011 and, in 2012, we welcomed more than 1.1 million visitors to Singapore every month. By 2030, this figure may increase even more.”
“Mr Deputy Speaker, thank you for allowing me to join in the debate. Judging from the number of speakers who have indicated their intention to speak on this Motion and the numerous feedback and strong reactions from many Singaporeans, this is undoubtedly a very important and emotive issue, which directly or indirectly impacts the lives of many, if not all, Singaporeans. This year marks the 48th year of our independence. We have come a long way since then. "From Third World to First", by our Minister Mentor, most adequately described our transition from 1965 to today. We have grown our GDP from $1,580 in 1965 to $63,050 per capita. Along the way, our population has grown from 1.9 million to the current 5.3 million. We have, over the last few years, experienced the effects of this growing population. In fact, today, we have come to a crossroad in our national development. To address this conundrum, the Government has released the Population White Paper for discussion. However, the Government's Population White Paper on "A Sustainable Population for A Dynamic Singapore" was released at a very interesting time when many Singaporeans are still adversely affected by the rapid increase in the population over the past decade. Many netizens have mocked at this timing, accusing the Government of being insensitive to the ground sentiments and also being detached from the concerns of common Singaporeans. Page: 120 I have also received numerous feedback and comments from friends, grassroots leaders, colleagues and residents. The majority has expressed apprehension and skepticism about the intent and feasibility of this White Paper. Many are fixated by the figure and have cried foul over the 6.9 million projected population.”
“Thank you, Mdm Speaker. I would like to ask the Acting Minister what plans does MSF have in addressing the severe shortage of childcare centres in new estates, such as in Sengkang? One of the reasons I am asking is because I have received numerous emails from residents requesting assistance, and partly also because of the structure of some of the new BTO flats there that makes conversion of void decks to childcare centres extremely challenging. Will the Ministry consider putting up modular structures to house childcare centres to ease the shortfall, at least in the interim?”
“Mr Speaker, I have two very simple clarifications for the Minister. One is on the visit limits. First and foremost, I must admit that I am not very convinced that the visit limit will be effective. I would like to ask the Minister what is the purpose of imposing visit limits if it is not going to curb the gambling intensity. And why offer this intermediate option if the subject is assessed to be financially vulnerable? Is there any evidence from other jurisdictions that this is going to work? Would it not be better to impose exclusion orders altogether before the subject sinks further into more financial difficulties? The second is to better understand the casino gambling magnitude in Singapore. The Minister has shared with us that about 20% to 25% of patrons to casinos are Singaporeans and PRs. Can the Minister share with us what percentage of the casinos' revenue can be attributed to the expenses of Singaporeans and PRs?”