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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“The Government must continuously monitor, enforce and review the casino regulatory regime, and also work with various stakeholders in ensuring that the two IRs continue to value-add to the economy and remain as attractive destinations for tourists. There is also an urgent need to look into measures to control the proliferation of other forms of gambling, including online gambling, which can similarly bring about detrimental effects to the family and the society. With that, I support the Bill. 4.22 pm”
“With the amendments to the Casino Control Act, is it time to also send a more consistent message to these jackpot clubs which are part of the ecosystem of gambling? Should they not be subjected to the same regulations or rules as the casinos? Similarly, online gambling has been recognised as a growing and popular form of gambling for those who are more IT-savvy. While the amendments introduced in this Bill are noteworthy, more attention should be paid to the dangers posed to the family as a result of addiction to online gambling. A report by the law firm Rajah and Tann also notes that the Betting Act is silent on the controls and measures to be taken with regard to online gambling. While enforcement on the Internet remains difficult, I think much more can be learnt from the US and Europe, where gradual measures are undertaken to control online gaming. In the US, for instance, the US Congress passed the Unlawful Internet Gambling Enforcement Act in 2006, which makes it illegal for its financial institutions to transfer money to offshore gambling websites or to online payment websites used by such websites. In Europe, the European Commission has also set out an action plan for online gambling, proposing a comprehensive set of actions and common principles on protection, aimed at clarifying the regulation of online gambling and encouraging cooperation between Member States. In comparison, in Singapore, we have not really looked seriously into the issue of online gambling and how such online gamblers can be helped. In conclusion, Sir, this amendment Bill is necessary to ensure that casino gaming is conducted honestly and the vulnerable persons and society at large are protected from the potential adverse effects of casino gambling.”
“This is a very strong signal to operators about the Government's resolve in responsible gaming activities in Singapore and would also encourage the casino operators to constantly review and improve on processes to ensure that they are always compliant with the rules and regulations. The strategy to ensure the Integrated Resorts bring sustained economic benefits to Singapore in the areas of job creation and promoting tourism must be maintained, if not enhanced. There is no doubt that the two IRs, since their opening, have value-added to our economy and created many job opportunities for Singaporeans. However, the IRs need to keep up the development and promotion of non-gaming attractions to remain as a compelling tourist destination. The formation of an Evaluation Panel (EP) to advise CRA on the IRs' performance on the non-gaming aspects is thus timely and essential. This will help ensure the sustainability and attractiveness of the IRs to the tourists from all over the world. We need to look long term into the future and not just take a myopic view of just using the casino gaming to attract tourists. While the changes to the Act show our seriousness in preventing problem gambling in the casinos, there are other forms of gambling in Singapore which can similarly wreck families and ruin lives. Page: 1392 Sir, I recently met one resident whose mother was a gambler. He had tried to stop his mother from gambling, but because of the prevalence of jackpot rooms in clubs, she still frequents such legal joints, without having to pay entrance levies. These legal joints – some of which are available in the heartlands – provide gaming activities to the masses, without the usual safeguards seen in the casinos.”
“A plausible solution to complement the visit limit system would be to impose an additional loss or bets limits on these vulnerable patrons. Alternatively, the Government should also consider a hardline approach of excluding these individuals altogether, once they have been identified as financially vulnerable, rather than offering such an intermediate option. Page: 1391 In addition, under section 170B, the Bill has been amended to make the casino operator accountable for a responsible gambling programme at all times. While it is useful for the operator to be accountable for such responsible gaming measures, I am especially concerned as there is an inherent conflict of interest. The casino operator would be more concerned with profit, and the prevention of persons from engaging in more gambling might be a tough call. One consideration is to institute a neutral third party in the arena to identify and counsel potential problem gamblers. This neutral third party can be funded by the casino. The National Council on Problem Gambling (NCPG) is already doing much with regard to the promotion of responsible gambling. Can it not be granted the powers and funds to do immediate policing on the ground? Maybe we can have NCPG officials police the casino grounds to ensure responsible gaming and identify high-risk individuals. Sir, I also support the amendment to increase the maximum penalty for disciplinary action against casino operators from the current $1 million to 10% of a casino's annual gross gaming revenue.”
“Thus, while more jobs are created and our economy becomes more vibrant, we need the CRA to have stronger powers to rein in on the possible adverse effects the casino might have on Singapore society. Let us remember that in history, both in Singapore and elsewhere, that excessive gambling has always been viewed negatively and our pioneers have fought strongly for it to be curbed. Interestingly, within a short span of two years, the casinos in Singapore combined ranked second after Macau, in terms of revenue, outperforming Las Vegas. There are a total of 42 casinos in Las Vegas strip and 33 in Macau. Yet, with merely two casinos, Singapore is able to catapult to such profitability in such an amazingly short period of time. The Government has always reassured Singaporeans that the gambling situation in Singapore is under control. I would like to ask the Minister what percentage of patrons to the two casinos are Singaporeans and Singapore Permanent Residents (PRs) and how much of the revenue is contributed by the expenses of Singaporeans and PRs. In this regard, is the $100 levy imposed on Singaporeans and Singapore PRs sufficient and effective in discouraging Singaporeans and PRs from trying their hands in challenging Lady Luck? While I support the imposition of a limit on the visitations to casinos, I am, at the same time, apprehensive about its effectiveness in curbing gambling activities on vulnerable patrons. Having a visit limit system will not address the concerns of increased gambling losses from increased quantum of bets. In fact, some sceptics believe that the imposition of a visit limit may, in fact, increase gambling intensity.”
“Mr Speaker, Sir, thank you for allowing me to join in the debate. Page: 1390 Gambling has always been a part of Singaporean way of life. From the very beginning, our first resident Major General William Farquhar legalised gambling and issued licences to the operators of gambling dens. Over the years, gambling has grown and we have seen the formation of the Singapore Turf Club in 1842 and, of course, Singapore Pools in 1968. The more popular forms of gambling today include the 4Ds and Toto, which have become an integral part of Singapore betting culture, judging from the long queues whenever there is a big draw on-going. We have also heard many stories of how families came to ruin and stories of loan shark harassment just because of a gambler in the family. I recall there was a run of a TV series called Show Hand "注定" on Channel U last year. Although it was a television series and the stories were fictional, the show accurately portrayed the issues and the challenges that people living with gamblers had to go through. The addiction to gambling can be so strong that the characters constantly turn back to gambling, despite being given many chances to turn over a new leaf. Sir, in this regard, I rise to speak in support of the Casino Control (Amendment) Bill. The higher financial penalties and the stronger and better measures are essential safeguards to ensure that Singaporeans do not fall prey to gambling and international junkets or immerse themselves further into the culture of gambling. These changes are necessary just as the casino and Integrated Resort have become an important and essential part of our economy.”
“Mr Speaker, I have two supplementary questions for the Minister. With MOH's intention to extend the maximum age of MediShield coverage from 85 to 90, there will be a corresponding rise in the premium for those above 85. Will MOH consider raising the upper limit in Medisave quantum for paying the premium for this group of elderly such that there is no need for out-of-pocket cash payment? Secondly, I would like to ask the Minister for an update on the public consultation on MediShield for congenital diseases.”
“Mr Speaker, I would like to check with the Minister the reasons that certain GPs are not participating in CHAS.”
“While I agree that it is indeed useful to allow more institutions to carry out such process, may I know the process by which the checks to ensure that such procedures are carried out in accordance to the statutes spelt out in the Act? I understand that the amendment in section 6 gives public officers, authorised by the Minister for the purpose, to have the power to inspect the health institutions and examine records of such sterilization. How then is the public officer able to audit all such health institutions, clinics, hospitals and so on, to ensure that there is no deviance from the original intent of the VSA? Sir, laws forbidding sterilization of the mentally incompetent may be nearly as dehumanising as the forced sterilization laws they replaced. The Voluntary Sterilization (Amendment) Bill needs to be carefully calibrated to protect the vulnerable, yet not be excessively restrictive. Weighing the complex medical and ethical issues involved and determining patients' best interest require one to be cautious and thoughtful, with individual case reviews with strict procedural safeguards. With that, I support the Bill. 3.37 pm”
“A number of countries either have a minimum age where persons are considered capable of consenting to sterilization, or require a court order before a minor can be sterilized. This is not the case in our current or amended Bill. Page: 985 Sterilization undertaken solely to control fertility of and reproduction by mentally incompetent persons can be both contentious and potentially subject to abuse. When sterilization is contemplated, it should clearly be demonstrated that it is for the benefit of the individual and not solely for the benefit of the caregiver or a third party. The rights of the individual must always be protected. Section 3(2)(d) and (2)(e) dictate that for a person who lacks mental capacity within the meaning of section 4 of the Mental Capacity Act to consent to such treatment, if on application of the spouse, parent or guardian of the person, the High Court makes an order declaring that such treatment is necessary in the best interests of that person. I would like to clarify with the Minister if this process of applying to the High Court would be tedious and costly and what assistance can be rendered to families who lack the knowledge and financial means to proceed with such an application. In the rare event that the spouse, parent or guardian of a previously High Court approved sterilized mentally incompetent person decides to opt for a reversal of the tubal ligation or vasectomies, will an application to the court to reverse the procedure be required? Sir, it is also useful that under the new amendment, the list of institutions carrying out sterilization will be expanded to all health institutions, as long as the doctor carrying out the procedure has the proper means, capability and qualifications to do so.”
“In Tunisia, an individual must have four children before obtaining sterilization for contraception purposes; while in Panama, a woman must have five children. Several countries, however, combine parity and age requirements. For example, Finland has a minimum age of 30 or a requirement that a person has had three children, if younger than 30, before sterilization is allowed. Another issue of major concern in the context of voluntary sterilization is that of informed consent, that is, whether the sterilization is truly voluntary. As a legal matter, informed consent generally requires that the person seeking a medical procedure be provided information on the risks, benefits, alternatives and characteristics of the procedure. In the case of sterilization, required information would include that temporary methods are available, that the procedure involves surgery, that the surgical procedure involves risk and benefits, that the procedure is permanent and also worth mentioning is that the procedure does not provide any protection against sexually transmitted infections, including HIV. Thorough counselling is, therefore, important and I hope MOH can consider making pre-sterilization counselling a pre-requisite. There is also concern that the amendment Bill provides insufficient protection to minors. Section 3(2)(c) dictates that persons under 21 can consent to sterilization for non-medical reasons, provided a parent or guardian also gives consent to such treatment. However, there is a deep concern as to what extent minors, especially those who are much younger, are able to comprehend the concept of sexual sterilization. Potential controversy may occur in cases where the other parent of the child objects to the procedure, for whatever reasons.”
“The social rationale would be to prevent harm to the child if the mother is mentally unable to provide appropriate care for the child. As surgical sterilization is an invasive procedure and it involves an element of risk, it is imperative for the doctor and the guardian to consider other alternatives of pregnancy prevention before proceeding with the application for court order for surgical sterilization. There should be strict guidelines for such proxy consent sterilization. It must be established that the person's mental capacity must be permanently incompetent and in accordance to the provisions of the Mental Capacity Act. It cannot be over-emphasised that sterilization is performed in the best interest of the patient and is also the most practical and least restrictive contraception available. The motivation for requesting sterilization must also be examined very carefully and whether they are in conflict with the patient's interest. Page: 984 Sir, while I agree and support the amendments, I do have some clarifications for the Minister on certain provisions in the amendment Bill. Singapore, having one of the lowest total fertility rates in the world, has a rather liberal legislation on voluntary sterilization. While I strongly support the need for more protection for persons with mental incapacitation, the law seems quiet on certain restrictions on sterilization seen in many countries, such as minimum age and parity requirements. A number of countries have specific age and parity requirements for sterilization. The most common minimum age is 25, and can be found in some Nordic countries. Some countries impose parity requirements only, which are based on a person's number of children.”
“The amendments to the Voluntary Sterilization Act (VSA) are necessary to keep pace with societal changes and the expectations of Singaporeans. It needs to stay relevant in the modern day context. Sir, as Chairman of the GPC for Health and as a doctor, I fully support the decision to align the VSA with the Mental Capacity Act 2010. The amendments, as we know, make clear the conditions in which the process can be carried out, especially in the cases of persons who lack mental capacity. The formalisation of the process, will allow the doctor performing the procedure to know clearly the limits to which the process can be carried out. As I went through the Bill, I noticed that one of the key elements is to align the Act with the United Nations Convention on the Rights of Persons with Disabilities (CRPD) and to impose a requirement for court order in cases involving treatment for sexual sterilization for persons who lack mental capacity to consent to such treatment. Such persons are unable to give informed consent, and thus cannot be considered voluntary in the true sense of the word. Paradoxical as it may seem, the title of the Bill is "Voluntary Sterilization Act". A more appropriate name will be "Voluntary and Proxy Consent Sterilization Act". Majority of patients undergo voluntary sterilization for medical and contraceptive reasons. Sterilization to prevent pregnancy of a woman, who is mentally incapable of giving informed consent, must be performed after due considerations and in the best interests of the person. So, what are the possible reasons or justification for this procedure to be carried out on the mentally incompetent? The obvious medical rationale would be to prevent harm, if pregnancy or delivery would endanger the life or health of the mother.”
“It cannot be over-emphasised that the best interest of the patient remains centre-stage in all these debates on the amendment Bill. Questions have been raised as to whether a parent or a guardian should be allowed to consent to the sterilization of an incompetent person without an independent third party approval. The major concern is that a request for sterilization may be made to satisfy the needs or convenience of the person requesting the sterilization, and may not necessarily be in the best interests of the incompetent person. I am glad that the amendment mandates that sterilization of such persons may only be carried out if the Court declares that the sterilization is necessary in the best interests of the person. Page: 983 In addition, I strongly support the removal of the phrase in the current VS Act that "the doctor must certify that treatment is necessary in society's interest." Unfortunately, such a phrase may be misinterpreted to mean that sterilization may be carried out for eugenic reasons. Doctors or policy makers should not play God to decide who or who should not inhabit this world. Eugenic sterilization infringes on basic human rights. The perception that disability is inherently bad and people with disabilities lead blighted, tragic lives ignores and invalidates our actual lives and experiences. We must constantly remind ourselves that it is not the disability so much which restricts equality and full participation in society, but the combination of social stigma, systemic barriers and prejudices. How gracious and magnanimous a society is, can be reflected in how we treat and embrace the least fortunate amongst us. (In English): Mr Speaker, please allow me to continue in English.”
“Mr Speaker, Sir, in Mandarin, please. (In Mandarin): [Please refer to Vernacular Speech on Pg 1026.] Voluntary sterilization has been practised in many countries for various reasons, as a form of birth control, for medical and social reasons as well as eugenics-based practices for the control of certain hereditary diseases. Because voluntary sterilization is surgical and carries with it certain risks and is intended to be permanent, it demands more robust measures to protect the individual against discrimination and potential abuse. The amendments to the Voluntary Sterilization Act (VSA) are necessary to keep pace with the changes in society and to ensure that it remains relevant in the modern day context. The current provisions in the VSA are potentially discriminatory against those with disabilities, such as mental illness, mental deficiency and epilepsy, as it does not take into account the different severity of these conditions and many with such conditions may still be capable of giving informed consent. Besides meeting the requirements of the United Nations Convention on the Rights of Persons with Disabilities and aligning with the Mental Capacity Act which came into force in March 2010, it also takes away the ambiguity and uncertainty of the legitimacy of the consent that the doctors have to obtain before performing the procedure on such persons who lack mental capacity. For persons who lack mental capacity, the current provisions allow parent/guardian, if unmarried, or spouse, if married, to make the decision and give the consent for sexual sterilization procedure. While there have not been cases reported of wrongful intentions, this can be a potential problem without the necessary safeguards to protect such persons.”
“Vernacular Speeches Page: 527 Vernacular Speech by Ms Tin Pei Ling Page: 528 Vernacular Speech by Mr Low Thia Khiang Page: 530 Vernacular Speech by Mr Heng Swee Keat Page: 531 Vernacular Speech by Mr Low Thia Khiang Page: 532 Vernacular Speech by Ms Sim Ann Page: 533 Vernacular Speech by Dr Intan Azura Mokhtar Page: 534 Vernacular Speech by Mr Lim Swee Say Page: 536 Vernacular Speech by Mr Low Thia Khiang Page: 537 Vernacular Speech by Mr Lim Swee Say Page: 538 Vernacular Speech by Mr Masagos Zulkifli B M M Page: 541 Vernacular Speech by Mr Hawazi Daipi”
“MG [NS] Chan Chun Sing : Since the opening of the casinos, the Government has put in place a comprehensive package of social safeguards to minimise the ills of casino gambling. These include the casino entry levies, entry ban for minors below 21 years old, credit restrictions for local casino patrons, casino exclusions and strict regulations on casino advertising and promotions to the domestic market. Page: 526 The casinos have previously informed the media that tourists and other foreigners make up two thirds of casino visitors. They do not track foreign workers visitorship separately from tourists. To minimise the ills of casino gambling on foreign workers, the National Council on Problem Gambling (NCPG) has in place employer facilitated self-exclusion which allows employers to facilitate the applications for foreign workers wanting to voluntarily exclude themselves from the local casinos. Employers of foreign workers can do so via the NCPG website or in hardcopy by hand or by registered mail. Foreign workers may also apply for exclusion in person at the NCPG office or the Migrant Workers Centre, or complete the application form from the website and mail it to the NCPG office. As at 30 September 2011, 22,700 self-exclusions by foreigners are in force. My Ministry will continue to monitor the efficacy of existing social safeguards. We are prepared to strengthen them if necessary.”
“To help these needy Singaporeans, the Ministry of Education has in place a Financial Assistance Scheme (FAS) to help pay their school and standard miscellaneous fees, subsidise examination fees, and pay for basic schooling items such as textbooks and school attire. The scheme currently benefits 42,430 Singaporeans. To supplement the FAS, school-based assistance is available to students who require additional financial assistance for expenses which may not be covered by the FAS, such as transport, or for those who do not meet the income criteria of the FAS. In the period from 2009 to 2011, each school was given between $20,000 and $40,000 towards this end. In addition, the Opportunity Fund was set up in 2006 to help students from low-income families purchase their own personal computers and to subsidise enrichment programmes so that all students can participate in developmental opportunities offered by the school. As with all schemes, the FAS is reviewed periodically. The scheme was last reviewed in 2009. Another review of the FAS is currently ongoing and the eligibility criteria of the Scheme will be looked at as part of this review. I would like to take this opportunity to assure the House that no Singaporean child will be denied a quality education as a result of his or her family financial circumstances. Page: 525 Safeguards on Gambling at Casinos 13 Mr David Ong asked the Acting Minister for Community Development, Youth and Sports (a) whether the present safeguards on gambling at casinos are adequate for Singaporeans; (b) what is the number of foreign workers (including domestic helpers) gambling in casinos to date; and (c) whether there are any measures for employers to exercise exclusion orders for their foreign employees working in Singapore.”
“Mr Heng Swee Keat : Currently, the only private universities in Singapore, ie, institutions with the rights to award degrees in Singapore, are SIM University (UniSIM), and the Foreign University Branch Campuses (eg, INSEAD) brought in under EDB's Global Schoolhouse Initiative. Besides these, many other private education institutions (PEIs) offer external undergraduate degree programmes in collaboration with their overseas university partners. Currently, about 41,000 Singaporean Citizens and Permanent Residents pursue undergraduate degrees at the private universities and PEIs. About two-thirds of these individuals are enrolled in part-time programmes, such as those at UniSIM. This suggests that many of the students are working adults who are upgrading their knowledge and skills. MOE does not collect data on the number of Singaporeans enrolled in undergraduate courses overseas. Page: 525 Review of Income Limit for Financial Assistance Scheme 12 Mr Patrick Tay Teck Guan asked the Minister for Education whether the Ministry is reviewing and raising the current gross household income limit of $1,500 for a household with one or two children to qualify for the Financial Assistance Scheme given to needy pupils in Government or Government-Aided schools. Mr Heng Swee Keat : General education for Singaporeans is highly subsidised. The fees for Singaporeans in Government and Government-aided schools are $11, $21 and $28 per month for students at primary schools, secondary schools and junior colleges/centralised institutes respectively. Even so, we recognise that there will be Singaporean families who require financial assistance for their children's general education.”
“Page: 524 Night Calls in Public Healthcare System 10 Mr Christopher de Souza asked the Minister for Health (a) what is the average number of night calls per month for a junior doctor in the public healthcare system; and (b) what are the long-term measures implemented by the public healthcare sector to ensure that doctors have adequate rest after receiving such calls. Mr Gan Kim Yong : On average, a house officer is allocated about five night calls per month. With the implementation of the residency system of specialist training in July 2010, residents' duty hours are now subjected to a limit of 80 hours per week, averaged over a four-week period. In 2010, 91% of residents kept to this limit. To ensure that junior doctors have adequate time for rest and personal activities, a minimum of 10 hours of rest between all duty periods, including after a night call, is also enforced. Senior doctors of restructured hospitals have been alerted to recognise the signs of fatigue and sleep deprivation in staff under their supervision. This is to prevent and mitigate the potential negative effects of inadequate rest on learning as well as patient care. MOH is committed to promoting the well-being of junior doctors as well as the safety of patients; and will continue to work with the restructured hospitals to achieve this. Page: 524 Singaporeans in Undergraduate Courses in Private Universities and Overseas 11 Mr Yee Jenn Jong asked the Minister for Education (a) how many Singaporeans are currently pursuing undergraduate courses in private universities in Singapore; and (b) how many Singaporeans are enrolled in undergraduate courses overseas.”
“JTC will continue to track industrial rents as part of its overall responsibility. Page: 523 National Service Deferment for Enlistees Pursuing Qualifications in Medicine 9 Mr Pritam Singh asked the Minister for Defence (a) what is the Ministry's current policy on National Service deferment for enlistees pursuing qualifications in medicine in local and overseas institutions across the educational spectrum from undergraduate to post-graduate and specialisation courses or training; (b) whether there have there been any changes to this policy since its inception; and (c) if exceptions have been made, under what circumstances have they been made. Dr Ng Eng Hen : In response to a separate Parliamentary Question on 20 October 2011, the Minister for Defence has provided details to MINDEF's policy of disruption for medical studies which address the queries in this question. Please refer to that reply. To summarise, since 1973, MINDEF has allowed full-time National Servicemen (NSFs) to disrupt for medical studies as we need military doctors to serve in the SAF. From 1981 to 1992, disruption was extended to NSFs to obtain overseas medical degrees that were recognised by the Singapore Medical Council, as the number of local medical graduates was insufficient. From 1992, disruption for overseas medical studies was no longer allowed, as there were enough local medical graduates to meet the SAF's needs. Page: 524 The length of disruption varied, based on the time required to obtain the medical degree. It took longer for those completing medical degrees in the United States, where medicine is a graduate program and required a pre-medical degree for entry. All those disrupted for medical studies met eligibility criteria that were explicitly stated.”
“Under the divestment terms, the rent escalation for existing tenants was capped at 5% per annum over JTC's July 2007 posted rents for a period of three years. Hence, one year after the divestment, the maximum rents these existing tenants paid should be no more than 5% above JTC's July 2007 posted rents. The actual adjustment in rent would vary among individual tenants, depending on the level of their base rent. JTC is not privy to the actual adjustments, as the tenancy agreements had become private commercial transactions with the divestment. The second phase of the divestment was completed in August 2011. One of the conditions of the tender was for the bidder to provide a business continuity plan for tenants. One tranche was sold to Soilbuild Group Holdings Ltd, which committed to cap renewal rates for a three-year tenancy for existing tenants at not more than 10% above JTC's July 2011 posted rents, for a period of two years. Another tranche was sold to Mapletree Industrial Trust (MIT), where the renewal rates would be pegged to JTC's July 2011 posted rents with a cap of 5% per annum for three years, upon the completion of the trade sale. In addition, for tenants who have more than 10 years of continuous tenancy, MIT has offered an additional 2% discount off JTC's July 2011 posted rates in the first year. The renewal rates for this group of tenants would be subject to a lower rent escalation cap of 3% per annum of JTC's July 2011 posted rates for the subsequent two years. One year after the second phase of divestment (which would be August 2012), JTC would similarly not be privy to the actual adjustments of rent. However, the new owners will have to keep to the rent caps when negotiating tenancy renewals with the tenants.”
“5 Source: Comprehensive Labour Force Survey of Singapore, MOM Page: 521 Breakdown of PMETs in Singapore Industries 7 Mr Patrick Tay Teck Guan asked the Deputy Prime Minister and Minister for Manpower what is the breakdown of Singaporean, permanent resident and foreign Professionals, Managers and Executives in Singapore from 2006 to 2010 according to the various industries/sectors. Page: 522 Mr Tharman Shanmugaratnam : The breakdown of Singaporean, permanent resident and foreign Professionals, Managers and Executives in Singapore from 2006 to 2010 according to the various industries/sectors are provided in Table 1 below. Page: 522 Divestments of JTC's Properties 8 Mr Yee Jenn Jong asked the Minister for Trade and Industry (a) how many properties of JTC Corporation and how much total floor area have been transferred to Real Estate Investment Trusts or sold through trade sales since 2006; and (b) what is the average percentage change in rent of these properties one year after having transferred out from JTC. Mr Lim Hng Kiang : JTC Corporation undertook two phases of divestment in 2008 and 2011 respectively for its ready-built high-rise industrial properties. A total of about 2 million square metres (sqm) of Gross Floor Area (GFA) of space in 83 properties was divested. This corresponds to less than 5% of the overall industrial space market. Most of these properties were flatted factories. The remaining properties were amenity centres and other types of industrial buildings. Separately, JTC divested three dormitories in 2007 with an estimated GFA of 110,000 sqm. Page: 523 The first phase of divestment was completed in mid-2008 with a sale to Mapletree Investments Pte Ltd.”
“STEP scholarships range from diplomas and post-graduate diplomas to Masters degree programmes. Page: 521 As the more substantial programmes under STEP require a longer time to complete, their effect on employment outcomes would not be immediately apparent. Nevertheless, we are tracking the outcome of STEP and strongly urge individuals to continue to upgrade themselves in order to ensure that their skills remain relevant. Moving forward, WDA will also be embarking on a series of public consultation exercises with PMETs to better understand their needs in CET, as well as the challenges they face in seeking upgrading and employment opportunities. 1 STEP scholarships are only open to Singapore Citizens. Page: 521 Unemployment Rates of PMETs Occupations 6 Mr Patrick Tay Teck Guan asked the Deputy Prime Minister and Minister for Manpower if he will provide the unemployment rate of Singaporeans and Singaporean permanent residents who are Professionals, Managers and Executives by age and gender from 2006 to 2010. Mr Tharman Shanmugaratnam : The unemployment rates of residents in Professional, Managerial & Executive (PME) occupations by age and gender are provided in Table 1. Table 1: Unemployment Rate of Residents in Professional, Managerial & Executive Occupations by Age and Gender 2006 2007 2008 2009 2010 Total 2.4 2.3 2.2 3.5 2.4 15 - 29 2.1 2.7 3.3 3.7 3.5 30 - 39 2.3 1.9 1.9 3.8 2.3 40 - 49 2.1 2.1 1.9 3.0 1.9 50 & over 3.4 2.8 2.4 3.5 2.5 Males 2.4 2.1 2.0 3.4 2.3 Females 2.4 2.5 2.7 3.7 2.”
“MTI estimates that the IRs will add $2.7 billion (or approximately 0.8%) to Singapore's annual GDP and generate between 50,000 and 60,000 direct and indirect jobs throughout the economy by 2015. Government agencies including MOM, MTI, WDA and STB will continue to provide strong support to their recruitment and training of Singaporeans for jobs within the IRs. Page: 520 Skills Training for Excellence Programme 5 Mr Patrick Tay Teck Guan asked the Deputy Prime Minister and Minister for Manpower how many Professionals, Managers and Executives have upgraded their professional skills since the inception of the Skills Training for Excellence Programme (STEP) and how many have had better prospects and salary increases after completion of the training programme. Mr Tharman Shanmugaratnam : As part of our national productivity and continuous education and training (CET) efforts, the Skills Training for Excellence Programme (STEP) was introduced in March 2011 to help our Professionals, Managers, Executives and Technicians (PMETs) update their skills, knowledge and expertise. STEP brings together a suite of programmes ranging from modular workshops and courses, full qualification programmes, to master-classes and scholarships, catering to the diverse needs of PMETs and employers. More than 400 courses are currently available and over 40,000 PMETs have undergone the various programmes under STEP so far. In addition, 340 STEP scholarships 1 for Singaporeans valued at approximately $12 million have been set aside for nine sectors, including Aerospace, Construction, Healthcare, Retail, Tourism and Built-Environment. Other upcoming STEP scholarships will cover areas such as Manufacturing and Marine Engineering.”
“Earlier this month, the general manager and a site manager of a company were charged in Court for declaring false addresses for their foreign workers to facilitate their company's Work Permit applications. Since 2009, MOM has relocated over 33,000 foreign workers from unacceptable accommodation. Enforcement actions were also taken against the employers concerned. Employers may be fined up to $5,000 or jailed up to six months or both, for each worker found to be housed in unacceptable accommodation. We press for stiffer penalties against employers who repeatedly fail to provide acceptable accommodation for their foreign workers, or house their workers in egregious conditions. For instance, in 2010, one employer was fined $60,000 for housing workers in unacceptable conditions. In addition, errant employers are also barred from hiring foreign workers for a period of time. Page: 520 The Government will continue active enforcement to ensure that workers are housed in acceptable accommodation. We will also be reviewing our administrative requirements and penalties to ensure that they are adequate for this purpose. Page: 520 Employment at Casinos 4 Mr Pritam Singh asked the Deputy Prime Minister and Minister for Manpower what are the latest available employment figures for our two casinos and what is the percentage breakdown in terms of foreigners, permanent residents and Singaporeans employed. Mr Tharman Shanmugaratnam : The Government is unable to provide the firm-level statistics which the Member has asked for as such statistics are protected under the Statistics Act. Nonetheless, there is some publicly available information from the two Integrated Resorts (IRs). They have recently stated that they directly employ more than 22,000 workers, of which about 70% are locals.”
“Page: 519 Mr Teo Chee Hean : The Singapore Prison Service publishes the number of judicial executions in its Prisons Annual Report. This is publicly available on its website. From 2004 to 2010, there were a total of 26 Singaporeans and 12 foreigners who were executed in Singapore. There were no Permanent Residents executed during this period. The breakdown is provided in the table below. Year Total Singaporeans Foreigners 2004 8 6 2 2005 8 7 1 2006 8 6 2 2007 3 1 2 2008 6 3 3 2009 5 3 2 2010 0 0 0 Page: 519 Accommodation for Foreign Workers 3 Mr Christopher de Souza asked the Deputy Prime Minister and Minister for Manpower (a) if he will consider requiring employers of foreign workers to show proof of accommodation that will be provided to the workers; (b) what is the number of foreign workers who have been found to be housed in inappropriate accommodation in the last two years; and (c) whether the Ministry will consider heavier penalties to deter errant employers from providing inappropriate housing to their foreign workers. Mr Tharman Shanmugaratnam : Employers are already required to register their foreign workers' accommodation address with the Ministry of Manpower (MOM) before they can collect their Work Permit cards. The address registration system will reject the registration if the address is unapproved and the worker cannot collect his Work Permit card. Falsely declaring an address is an offence under the Employment of Foreign Manpower Act. Employers are also required to report any change in their foreign workers' residential address within five days. The penalty for not doing so is a fine of up to $5,000, or a jail sentence of up to six months, or both.”
“A taskforce, co-chaired by MOE and Economic Development Board (EDB), and involving key social and economic agencies is looking into this and will announce its recommendations in the first half of next year. Written Answers to Questions Page: 518 Applications for Permanent Residence 1 Mr Pritam Singh asked the Prime Minister (a) how many applications for permanent residence have been rejected on a yearly basis from 2000 to 2010; and (b) what are the specific criteria for approval of such applications. Mr Teo Chee Hean (for the Prime Minister) : The number of permanent residence (PR) applications which were rejected on a yearly basis from 2000 to 2010 is appended below. Year PR applications rejected 2000 33,698 2001 32,236 2002 31,673 2003 24,664 2004 17,452 2005 13,213 2006 17,508 2007 18,385 2008 22,472 2009 58,923 2010 68,143 Source: ICA Each PR application is evaluated holistically on a set of criteria which includes factors such as the individual's economic contributions, qualifications, age and family profile to assess applicants' ability to contribute and integrate well into society and commitment to sinking roots. It would not be appropriate to reveal the specific criteria for approval of PR applications as this could encourage individuals to attempt to circumvent or abuse the system. For this reason, most countries do not publicly disclose their detailed selection criteria for residency or citizenship. Page: 518 Judicial Executions in Singapore 2 Mr Pritam Singh asked the Deputy Prime Minister and Minister for Home Affairs from 2004 to 2010, how many criminals have been hanged in Singapore and what is the breakdown in terms of foreigners, permanent residents and Singaporeans for each of these years.”
“The proportion of IS varies by faculty, ranging from around 1% in Medicine and Law, courses highly popular with Singaporeans, to 27% in Science and Engineering. These courses produce much-needed manpower for key industries but are less popular with talented Singaporeans. IS provide important manpower support to key economic sectors after graduation, as well as hone our local students' cross-cultural competencies in the university. As announced by the Prime Minister in his National Day Rally speech, we will cap the IS undergraduate intake at the present levels; this will gradually bring the proportion of foreign students down even as we expand university places for Singaporeans. This will also facilitate better integration between Singaporeans and IS. A small proportion of IS pay full university fees, that is, they do not enjoy any subsidies. The rest are on the Tuition Grant scheme, which helps to defray their fees. IS who receive the Tuition Grant pay fees that are about 70% higher than the fees paid by Singaporeans. In addition they are required to work in Singapore for three years. Some IS are also on various scholarships which cover their tuition fees, but they have to serve a longer bond period of six years. The universities, various community organisations and Government agencies award scholarships and bursaries to locals for studies in our local universities. In AY2010, a total of around 30,300 Singapore Citizens received a scholarship or some form of financial assistance which helped fund their undergraduate education. The Government intends to offer more scholarships to locals, to nurture a strong core of Singaporean talent with the requisite skills to anchor our key current and emerging economic sectors, and secure our future.”
“14 pm The Leader of the House (Dr Ng Eng Hen) : Mr Speaker, Sir, I beg to move, That this Parliament, in accordance with paragraph (1) of Standing Order No 100, appoints the following as members of the Committee of Selection: Mr Chen Show Mao Mr Gan Kim Yong Mr Hri Kumar Nair Dr Mohamad Maliki Osman Dr Ng Eng Hen Mrs Josephine Teo Mr Lawrence Wong Sir, the appointment of this Committee will enable the Committee to begin its work of nominating Members to the six Standing Select Committees to the House and the Special Select Committee on Nominations for Appointments as Nominated Members of Parliament. Resolved, Page: 516 That this Parliament, in accordance with paragraph (1) of Standing Order No 100, appoints the following as members of the Committee of Selection: Mr Chen Show Mao Mr Gan Kim Yong Mr Hri Kumar Nair Dr Mohamad Maliki Osman Dr Ng Eng Hen Mrs Josephine Teo Mr Lawrence Wong Page: 516 Adjournment Resolved, "That Parliament do now adjourn to a date to be fixed." − [Dr Ng Eng Hen]. Adjourned accordingly at 7.17 pm to a date to be fixed. Written Answer to Question for Oral Answer Not Answered by 3.00 pm Page: 517 Foreign Students Enrolled in Local Universities 12 Mr Ang Wei Neng asked the Minister for Education for the 2010 and 2011 academic years (a) what is the number and proportion of foreign students enrolled in local universities by faculty; (b) of these foreign students, how many are not paying full university tuition fees; and (c) what is the number of Singaporean students receiving bursaries and scholarships in local universities. Mr Heng Swee Keat : International students (IS) made up 18% of the total undergraduate intake in Academic Year (AY) 2011.”
“My father, who had only primary school education, supported all four of us through university locally by sheer hard work and thrift. All of us have decent jobs now, make a decent living, own our own homes and are now parents ourselves. Page: 515 The PAP Government, like the tree, has done well in providing and caring for its people over the last 46 years. We should give credit when credit is due. We should never throw the baby out with the bath water, as my hon. colleague, Mr Christopher de Souza, aptly puts it. However we should also not rest on our laurels but must continue to do more to improve the lives of Singaporeans. I said this with my hand on my heart. Allow me to sum up the closing address with this quote from Helen Keller, a deaf-blind activist and it revisits the concept of happiness. She said, "Many persons have the wrong idea of what constitutes true happiness. It is not attained through self-gratification but through fidelity to a worthy purpose." On that note, I would like to thank all Members for supporting the motion and Mr Speaker, Sir, for your patience over the past five days. [Applause.] Question put, and agreed to. Resolved, 'That the following Address in reply to the Speech of the President be agreed to: "We, the Parliament of the Republic of Singapore, express our thanks to the President for the Speech which he delivered on behalf of the Government at the Opening of the First Session of this Parliament.".' Page: 515 Committee of Selection (Appointment of Members) 7.”
“But soon the boy grew older and one day he came and asked, 'Can you give me some money to buy things and have fun?' 'I have no money,' said the tree, €˜Just apples, twigs and leaves.' 'But you can take my apples, boy, and sell them in the city.' So he did. And the tree was happy. But soon again the boy came back and he said to the tree, 'I'm now a man and I want a house to keep me warm.' 'I can't give you a house', the tree said, 'The forest is my house.' 'But you may cut my branches off and build yourself a home.' So he did. And the tree was happy. And time went by and the boy came back with sadness in his eyes. 'I want a boat that will take me far away. Can you give me a boat?' 'Cut down my trunk and make a boat,' said the tree, 'Then you can sail away and be happy.' So he did. And the tree was happy. And after many years the boy came back, both of them were old. 'I really cannot help you if you ask me for another gift.' 'I'm nothing but an old stump €¦ and sorry I've nothing more to give.' 'I do not need very much now, just a quiet place to rest,' The boy whispered, with a weary smile. 'Well', said the tree, 'An old stump is still good for that.' 'Come, boy', she said, 'Sit down, sit down and rest.' So he did. And the tree was happy." Sir, metaphorically, I see the tree as our country, Singapore; and the little boy, its people – like you and me. Like many Singaporeans, my siblings and I have benefited from the meritocracy and the social mobility Singapore has offered. My siblings and I, four of us, grew up in a 3-room HDB flat in Tanglin Halt Road. Although there were two bedrooms, all of us squeezed into one. My parents slept on a bed, while the four of us slept on mattresses on the floor. We were contented. We were happy.”
“But as we seek to do all these, to make Singapore the best home for all Singaporeans, we must, as some Members in the House have warned, remember our history and how we have transformed Singapore from a Third World to a First World country. Our journey together over the last 46 years had not been built on welfarism, nor had it been built on populist policies. As Ministers of State Amy Khor and Lee Yi Shyan have reminded us, while we pursue ways to make growth inclusive for all, we should not forget that we still need to balance fiscal sustainability, fiscal prudence and fiscal management for future generations. Rome was not built in a day. Neither was Singapore. Let us remember that our modernity, our success, our growth, was not an overnight phenomenon but rather a result of years and years of toil, hard work and determination by Singaporeans, yesterday, today and tomorrow. Mr Speaker, Sir, before I end, allow me to indulge in a short story. This is a story which I used to read to my children when they were much younger. It is entitled The Giving Tree. I am sure most of you must have read it before. It was published in 1964 by Harper and Row. It is a children's book written and illustrated by Shel Silverstein. This book has become one of Silverstein's best known titles and has been translated into more than 30 languages. It reads: "Once there was a tree and she loved a little boy. And everyday the boy would come. And he would gather leaves And make them into crowns and play king of the forest. Page: 514 He would climb up her trunk And swing from her branches and eat apples. And when he was tired, he would sleep in her shade. And the boy loved the tree And the tree was happy.”
“Page: 513 With a changing world and an evolving political landscape, we, as parliamentarians, as representatives of the people, must set forth to forge a new social compact with the people. This is done in the midst of an increasing influence of the social media and the Internet as a new platform for citizen engagement, which many Members in the House have already spoken passionately about. I am extremely glad that the Government would take a "more open approach" to governing the country, which would include sharing more information with the public and engaging the citizens more. Let us be political leaders, like what Minister Lim Swee Say had alluded to, who work with our citizens for the betterment of all Singaporeans. Mr Speaker, Sir, my fellow hon. colleagues in the House, PAP or otherwise have stated clearly the passionate causes which they will be championing during their term. Let us all leave this session of Parliament remembering that building a better life for all Singaporeans means not only waxing lyrical about policies and legislations but turning words into actions that can benefit Singaporeans of all segments of society, including the marginalised. I am thrilled by Minister Yaacob's speech where he highlighted how technology will be harnessed to close the gaps for people with special needs – with their causes championed, we will build a more inclusive society. I am also delighted to acknowledge Acting Minister Chan's promise to do more to strengthen our social safety net and to ensure that no one will fall through the gaps.”
“In particular, Members have asked if doing so was at the expense of Singaporeans for they had to bear with the inadequacy of the infrastructure due to immigration and the inconveniences and discomfort of overcrowding. In order to achieve inclusive growth, Members had given many great ideas to help PMEs, women, low-wage workers and other vulnerable groups. In reviewing what we had achieved over the past decade, I am quick to agree with Ministers of State Lawrence Wong and Tan Chuan-Jin that the Government had seized windows of opportunities that arose. In fact, it was the result of grabbing such opportunities that had resulted in growths of median income for Singaporeans. It was a trade-off and not a matter of poor scenario planning by the Government, as some Members had alleged. Such trade-offs do not benefit the Government alone but the majority of Singaporeans while adversely affecting some. After all, as an ophthalmologist, I am perhaps one of the best persons, in addition to Dr Lim, to tell you that hindsight is always 20/20 or best vision of all. Similarly, as the Prime Minister has mentioned, it is impossible to have 100% foresight for we can never be certain of the volatile future and must be prepared for any surprises that come our way. What we can do is to grab the opportunities as they arise and be responsive to the needs of all Singaporeans. We must also remember that only with growth can we have the ability and means to support strong investments in education, healthcare, housing and social assistance programmes for all Singaporeans. We should see economic growth as a means to an end.”
“I am sure we can all agree that HDB's job today is much different from 30 to 40 years ago. Today, it has to cater to various segments of the population with different housing needs. I am reassured by Minister Khaw's declaration that his Ministry will build more homes and also address the specific needs of various segments of society, in particular the newlyweds and the low-income families, over the next couple of years. Members have also spoken passionately about the need to reform and review our education system to ensure that it stays relevant to Singaporeans, including those with special needs. I am particularly impressed by Minister Heng's promise of making "every school a good school" and the emphasis on character development. As we look to meet the challenges in the future, let us, as the Prime Minister had noted in his speech, ensure that our education system stays nimble and flexible towards the new challenges that we will face. Our transport system has for decades been a model of emulation for many other countries. But as we move towards a new future, perhaps it is time to revisit some of our fundamentals in public transport. There is room for improvement. Members had spoken about making the public transport more efficient and less crowded. And I certainly look forward to a cheaper, better, faster and, hopefully, reliable transport network. Several of my fellow colleagues have raised a pertinent point about transport concessions for polytechnic students and I believe this is something we can consider sooner than later. The pursuit of economic growth has also been a topic of contention.”
“We were also brought on a teleport journey, from the era of patriotic courtiers of Tang Dynasty in feudalistic ancient China, to the perceived Utopia on Earth – Bhutan; and from doom and gloom Europe, back to vibrant and inclusive Singapore. While this House spoke on a wide array of issues, it is clear that all of us can agree on one fundamental tenet – that we as parliamentarians will strive to make Singapore a better home for all Singaporeans. Over the last few days, many issues were raised by my fellow colleagues. One hot issue that was debated fervently was how to make Singapore a better place by improving the quality, accessibility and affordability of healthcare. With the impending silver tsunami, many Members have highlighted how healthcare policies need to be changed to ensure that the needs of the ageing population can be met. I also echo the sentiment that we should look into ways to help all Singaporeans cope with the rising healthcare costs. Page: 512 Besides healthcare, the rapidly ageing population entails other challenges. Members suggested ways to help the elderly population stay employed, active and healthy. I am sure the Ministerial Committee on Ageing, chaired by Minister Gan, will look into the issues that an ageing population will face in the future and I am confident that ageing as an upcoming challenge will be addressed holistically and adequately. Another recurring theme that arose during the debate was public housing. Members had spoken about the need to make public housing relevant to the needs of Singaporeans today. At the same time, we must remember that HDB flats should stay affordable so as to maintain its objective of housing and rooting Singaporeans to the nation.”
“Mr Speaker, Sir, there has been so much discussion about the pursuit of Happiness in this House over the past five days. Happiness is indeed an abstract philosophy with so many differing opinions. What exactly is happiness? As strange as it can be, there would not be happiness without sadness or misery. Human beings cannot stay in a positive state forever. This would become his normal state and would not feel happy anymore. The debate on Happiness has, paradoxically, generated much heated exchanges, disagreement and sporadically some unhappiness. In fact, life is full of paradoxes. Take for example, we have bigger houses but smaller families; more medicine but less wellness; teach less, learn more; and on few occasions during the debate, we became long on quantity, but short on quality. Sir, happiness, to me, is simply the blessing of waking up in the morning and knowing that I can still live another day to serve my fellow countrymen and spend time with my family and friends. Having said all these, I will do my best to sum up the debate in a concise manner so that I can contribute to the GCH or Gross Chamber Happiness in the House. Over the last five days, I have had the privilege of listening to the many eloquent speeches of my parliamentary colleagues. During my opening speech, I had said that I would be looking forward to a candid discussion in this House. Having heard some 70 speakers, every single one of them, including the Prime Minister and several Ministers, I am sure we will all agree that the quality of this debate in this House has been nothing short of being robust, constructive and, on some occasions, heart and mind-lifting.”
“Madam, I would like to take this opportunity to thank the Minister and the Senior Parliamentary Secretary for the comprehensive and engaging debate in this House. As always, it is so refreshing and reassuring to hear the Minister share his Ministry's strategy and also his own personal philosophy to live well, live long and with peace of mind. On that note, I seek leave to withdraw the amendment. Amendment, by leave, withdrawn. The sum of $3,580,115,300 for Head O ordered to stand part of the Main Estimates. The sum of $496,845,000 for Head O ordered to stand part of the Development Estimates. COMMITTEE OF SUPPLY REPORTING PROGRESS”
“Madam, I would like to thank the Minister for right-siting the new Sengkang General Hospital (SKGH). I am sure the residents in Sengkang and Punggol, including Pasir Ris and Hougang, will be very happy with this news. I would like to seek a clarification from the Minister – what will be the bed capacity of SKGH, and whether we can bring forward the completion date, instead of the 2020 that was announced by the Minister. Secondly, I am also quite delighted about the setting up of the Seniors Mobility Fund. I would like to ask the Minister how can this Fund be utilised and what it covers. Can the Ministry also consider setting up an Assistive Technology Centre that can research and produce equipment to assist the elderly and the disabled to cope with their activities of daily living?”
“Take Down Syndrome for example, the commonest chromosomal abnormality which causes a multitude of congenital defects. These people can live to a very ripe old age and managing all their potential complications can indeed be hard on the families. Thus, it could be beneficial if MOH can consider allowing their Medisave or MediShield to be used for payments for the management of congenital diseases. For selective cases where familial screenings are to be carried out, can we also consider using it in a graduated fashion with specific guidelines?”
“Madam, the flow of medical tourism is not a one-way traffic into Singapore. Increasingly, more and more Singaporeans are travelling overseas to seek medical treatments. These could range from complicated operations, such as organ transplant to corneal refractive procedure, such as lasik. The scheme to allow Singaporeans to pay for medical treatments at selected overseas medical institutions was introduced last year. Singaporeans choose this option for several reasons, the commonest being the cheaper medical cost overseas. Can the Minister update the House on the utilisation rate so far, and how has this scheme benefited Singaporeans? Insurance for congential diseases Madam, having a newborn child with congenital illness can be devastating news to the parents. Besides the emotional upheaval, parents whose children are inflicted with congenital diseases also face tremendous physical and financial stresses. In light of our Government's promise of an inclusive society, would the Health Minister consider extending MediShield, which is our national health insurance to cover congential diseases for children? Medisave Assoc. Prof. Fatimah Lateef: Madam, our infant fertility rate in Singapore is one of the best in the world today. Congenital birth defects, on the other hand, have now become a major cause of perinatal and infant mobility and mortality here. We do have the national birth defects register set up by MOH in January 1993. Those affected will require regular and frequent medical follow-ups, investigations, interventions and hospitalisation. These can incur very high costs. The parents are often left with not much of a choice as these conditions are rare and they require rather aggressive interventions.”
“We need to project the expected numbers of elderly – elderly elderly and elderly sick, who will be requiring these facilities in the next five, 10 or 20 years. Can we also plan to have more of these nursing homes located conveniently in close proximity to our heartlands? This would facilitate family members visiting the seniors regularly and maintaining inter-generational family ties and bonds. Currently, about half of our nursing homes are already located near heartlands. We always prefer our elderly to be close to our homes or in our homes or in the community but nursing homes may be an inevitable reality in today's world where families face conflicting responsibilities. We must give thought to what makes our seniors truly happy in the nursing homes. More amount of modern amenities and parties organised by staff cannot replace the true joy that they see when they have their family members and friends visit. On the issues of funding, currently MOH is doing a lot through Medifund contributions. With the recently announced Community Silver Trust in this year's Budget which confers one-to-one matching for donations to VWOs involved in long-term care, this will lighten the load and burden a little more and stimulate more money into this important area. When it comes to manpower and staffing of nursing homes, we must also inject more zest so that people will tend to choose this career. I would like to ask what is MOH's plan on this important development of a model that we are aiming towards which is a world-class long-term care model. Long-term care capabilities”
“In order for the elderly to age and recuperate properly and happily in their homes, the Ministry would need to look into building up the necessary resources and expertise in growing the homecare sector. I would therefore like to ask the Minister the following: (i) What is the current state of homecare and intermediate and long-term care in Singapore and how does the Ministry plan to develop these sectors in the coming years? (ii) Can the Minister consider setting up a one-stop caregiver resource centre to provide a range of supportive services, including dedicated homecare medical teams to conduct medical review of stable patients at their homes so as to minimise the hassle of frequent travels to the hospitals or clinics for reviews? (iii) Can the Minister also consider the provision of monetary allowance for caregivers to compensate family caregivers for their hardwork and sacrifices in looking after the elderly, rather than taking the easy way out of dumping their old folks in nursing homes? This would also help to free up the limited resources and vacancies in nursing homes for those families who really need them most. Nursing homes Assoc. Prof. Fatimah Lateef (Marine Parade): Mr Chairman, nursing home refers to a premise used for the provision of nursing for persons suffering from illnesses or convalescing from injury and infirmity. As we prepare to ride the silver tsunami, we must be prepared from now our mindsets, infrastructure, facilities and services to support this. With the existing numbers of nursing homes now, it is not uncommon to hear families and spouses lamenting that long waits to get family members into one are quite long really. Moreover, many of us are unable to afford the fees of private nursing homes. What are our future plans to meet this need?”
“Our battles with SARS and H1N1 have taught us the importance of close collaboration between various Government agencies and multi-disciplines in dealing with epidemics and pandemics. A breakdown in communication could result in dire consequences. I would like to ask the Minister for an update on the infectious diseases and flu pandemic preparations. Are there scenario planning exercises to ensure the readiness of the various relevant agencies? Homecare and intermediate and long-term care Sir, my fourth cut. Singapore is one of the fastest ageing populations in the world. Coupled with our low fertility rate, more than 20% of our population will be above the age of 65 by the year 2030. In addition, Singaporeans are also living longer and a significant number of years of our lives will be spent in sickness. As such, the demand for intermediate and long-term care for the patient, especially the elderly, will increase. This forms a very important component in the holistic care of a patient, from acute to rehabilitation to eventually recuperating in a nursing home or homecare. More resources must be put into developing the intermediate and long-term care sector, as this is currently under-developed, judging from the long waiting list that these institutions are experiencing. However, being an Asian society, the family has traditionally been the main source of support for our elderly. Many elderly sick patients would definitely prefer to stay in the comfort of their homes than be placed in nursing institutions. Homecare will not be possible without the dedicated participation of the caregiver, who is a family member most of the time.”
“However, the speed of healthcare infrastructural development did not keep pace with the population increase, resulting in the long waiting times and the shortage of hospital beds in our clinics and hospitals respectively. The opening of Khoo Teck Puat Hospital (KTPH) has relieved the high workload in Tan Tock Seng Hospital (TTSH), and several months into its opening, KTPH is already experiencing high occupancy of its inpatient beds. In addition, with the rapidly ageing population, there is an urgent need to look into infrastructural requirements to meet the increased demand. I had also received feedback that the increasing population in new towns like Sengkang and Punggol has resulted in long waiting times at the polyclinics such as Sengkang Polyclinic. I would like to ask the Minister for an update on the healthcare infrastructural development, especially the Ministry's strategies in tackling the rapidly greying population. I would also want to ask the Minister for his plans in promoting community rehabilitation of patients with mental illnesses. Infectious diseases and flu pandemics Sir, my third cut. Singapore is a globalised and connected world with a very busy seaport and airport. Our tourist arrival reached 11.6 million last year. As the economy picks up, more and more Singaporeans are going for holidays abroad, judging from the sell-outs at recent travel fairs. The excellent air, sea and land connectivity has resulted in our borders being highly porous and highly susceptible to all kinds of infectious diseases. An infectious strain in one corner of the world can spread to Singapore overnight.”
“Diabetes is one disease, if not well-controlled, can lead to many medical complications, such as kidney failure, heart disease, blindness and disability from leg amputations. Can I ask the Minister for an update on the prevalence of obesity in Singapore and what is MOH's strategy in tackling the issue of obesity in Singapore? In 2003, the World Health Assembly adopted the global strategy on diet, physical activity and health which targets lifestyle modifications that can combat the increase in non-communicable diseases. The WHO issued objectives for developing countries regarding school meals and healthy living. Can I ask the Minister if his Ministry has studied this strategy and whether this is relevant in our local context? Staying healthy is actually one's responsibility. You cannot force a person to stay healthy if the person is not motivated to do so. Smoking, alcohol consumption, drug abuse and living a sedentary lifestyle are important risk factors for a future plagued by illness, pain and sufferings. In spite of the challenges faced by the Ministry and the Health Promotion Board in promoting a healthy lifestyle amongst Singaporeans, I would like to ask the Minister for his strategy in helping Singaporeans lead healthier and happier lives. Has the Ministry considered ways to incentivise Singaporeans to stay healthy, such as lowering premium or rebates for health insurances? I hope the Minister can share with us his words of wisdom in building a wellness-centric healthcare for Singaporeans. Healthcare infrastructural development Sir, my next cut. The population of Singapore has increased significantly over the past five years and the current resident population in Singapore stands close to five million.”
“To achieve this KPI, it is crucial to maintain a healthy lifestyle, exercise and go for regular health screening. Although the grassroots organisations and many VWOs have taken the right step in organising mass health screening for the residents, following up on cases that need medical attention is even more important so that early intervention can be instituted. Over the years, Medisave has been liberalised progressively for payment of medical-related insurances, outpatient treatment and investigations. An example will be the Chronic Diseases Management Programme (CDMP) where Medisave is allowed to be used for the cost of outpatient treatment, up to a cap of $300 per Medisave Account per year. However, we know that early detection and subsequent prompt treatment of diseases can improve the prognosis and outcome. I would like to urge the Minister to consider allowing the use of Medisave for health screening but still subject to similar restrictions of capping the maximum withdrawal limit to $300 per account per year and strict guidelines on the types of screening allowable. This would prevent premature depletion and potential abuse of the Medisave savings. One of the challenges facing affluent societies, including Singapore, is obesity. Obesity is one of the most important factors causing an upsurge in the twin diseases of hypertension and diabetes. These two diseases are the major contributing cause for the 18 million cardiovascular deaths in the world. Hypertension and diabetes can be prevented with regular exercise and by leading a healthy lifestyle. Obesity is linked to many other diseases and one of the most well-known is diabetes.”
“' I found myself immediately pondering how fleeting life is, how everything can change in a split second. After hearing this, I decided to quit smoking myself. Sometimes, it takes a wake-up call to truly appreciate things – you do not realise how good and important it is to have a healthy body until you lose it!" 3.45 pm Sir, this testimonial of an ex-smoker illustrates very well the importance of good health. Good health does not come naturally and will not last forever. It is a goal that can be achieved easily through healthy living, healthy eating and regular exercise. Falling sick and going to the hospital is never a happy occasion, with the exception of giving birth to one's newborn child. Notwithstanding the good reputation of our medical institutions, going to one can be a stressful experience. Patients can wait up to one hour, sometimes even two hours, to see the doctor for consultation that lasts only a few minutes. Then spending another hour just to collect the medication at the pharmacy. Thus, I believe that it is the wish of all Singaporeans to avoid going to hospitals as much as possible. Once stricken with a disease, the qualitative added life years of a person can be severely limited, even with treatment. For example, a transplanted renal patient will be on immune-suppressant drugs for the rest of his life and this can often lead to all kinds of other diseases due to the side effects of the immuno-suppressive therapy. Our healthcare system must therefore strive to keep patients away from the hospitals as much as possible. Even better, manage their health such that a person's entire lifetime visits to the hospital is kept to the minimum. This must be the key performance indicator (KPI) we should strive more in a wellness-centric healthcare model.”
“Mr Chairman, Sir, I beg to move, That the total sum to be allocated for Head O of the Estimates be reduced by $100. Sir, allow me to relate this account written by a relative of a patient dying of end stage respiratory failure. He wrote: "Last night I was at the emergency department with my uncle who was dying. He was 62 years old with end stage respiratory failure, and had a background of chronic emphysema. Emphysema is a form of chronic obstructive lung disease where the air sacs of the lungs known as alveoli are progressively damaged. My aunt was with him and was visibly shaken at the state of his condition, even though he had struggled with his breathing for more than two decades of his life. I was touched by the little acts and the conversation that transpired between my uncle and my aunt. She was trying to make him as comfortable as possible, giving him extra pillows and asking him if he was okay. He was either unaware of the seriousness of this hospital admission or he had chosen to ignore it. Most of his limited conversation was about completely trivial things – the weather, the upcoming weekend. At one point, he whispered to my aunt, but she could not hear him because he was wearing a large full-face mask, hooked up to an oxygen machine. She leaned closer, 'What's that dear?' I was also up close, and could barely make out what he was saying. What last words would he whisper, I thought to myself. I pictured myself in his position – maybe I would tell my wife how much I loved her or enjoyed us being together. My uncle leaned closer to my aunt and mumbled in his feeble voice, 'I am sorry I have not listened to you all these years. I love my cigarettes but I love you even more. Please forgive me.”