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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“I would also like to suggest to the Ministry to identify and publish the list of recognised foreign institutions for the pharmacy degree so that Singaporeans who choose to study abroad and have the intention to return to Singapore upon graduation can be better informed when deciding on their varsity of choice. Pharmacist specialist register In order to support Singapore's vision of being a medical and biomedical science hub, pharmacists with specialised expertise are increasingly required. Examples of specialisation include geriatrics, oncology and cardiology. I would like to suggest the formation of a Specialist Training Committee (STC) to determine the relevant specialisation required to cater to the special needs of Singapore, taking into consideration the rapidly ageing trend and the increased prevalence of certain chronic illnesses. The STC will also establish and maintain structured training programmes for both undergraduate and post-graduate training in the future. The recognition of pharmacy specialist is also welcomed as it provides a further route of advancement for pharmacists in Singapore. Continuing professional education The introduction of continuing professional education is important in maintaining the standard of pharmacy practice in Singapore. This is in line with other healthcare professional groups such as the continuing medical education for doctors and the continuing nursing education for nurses. Participation in continuing professional education will ensure that practising pharmacists keep current and well informed of the latest development in their areas of practice and specialty.”
“As one of the key strategic manufacturing sites of the biomedical sciences industry, Singapore currently holds six of the world's top 10 pharmaceutical manufacturing facilities. With the rapid growth in the fields of healthcare, pharmaceuticals, life sciences and research in Singapore, there is indeed an increasing demand for pharmacists. Interestingly, there are currently just 0.3 practising pharmacists per 1,000 population here in Singapore, probably one of the lowest among developed countries, compared to 1.2 in France and Japan, and to 0.4 per 1,000 population in Denmark. Although the output of locally trained pharmacists in the National University of Singapore (NUS) has increased from 41 in 1996 to 115 last year, as what the Minister has mentioned just now, this is assessed to be insufficient. According to the Ministry of Health's projection, ideally, 200 new pharmacy graduates should be needed every year. To meet current and future demands, there is an urgent need to recruit from overseas. In order to cater to this arrangement, one of the amendments to the Act is therefore to allow differentiation of the pharmacist register into full, conditional and temporary registrations, the latter being relevant to foreign trained pharmacists. Whilst there is a requirement to augment the number of pharmacists in Singapore, there is also a need to be stringent in the selection and recruitment processes as a lowered standard of practice in the pharmacy profession may result in undesirable or sentinel events, which can affect the well-being and safety of patients.”
“Mdm Deputy Speaker, pharmacists are health professionals who practise the art and science of pharmacy. They typically receive a request for medications from a prescribing healthcare worker in the form of a medical prescription and dispense the medication to the patient and counsel them on the proper use and possible side effects of the drugs. In this traditional role, pharmacists ensure the safe and effective use of medications. Nowadays, pharmacists also participate in the management of diseases, where they optimise and monitor drug therapy, often in close collaboration with physicians and/or other health professionals. In many Western countries, specialties also exist within the pharmacy profession. Some examples would include oncology, cardiology, psychiatry and nutrition support pharmacists, just to name a few. Pharmacists are therefore very skilled and professional individuals with specific knowledge that makes them a vital part of our healthcare team. The proposed changes to the 22-year-old Pharmacists Registration Act is a major milestone and is necessary to ensure that the pharmacy profession remains current, relevant and competent, and to bring it to the next higher level of professionalism. The major changes introduced in this Bill are: 1) Differentiation of pharmacist registration into full, temporary and conditional registration; 2) Introduction of the pharmacist specialist register; 3) Introduction of compulsory continuing professional education; and 4) Establishment of the Singapore Pharmacy Council. Manpower requirements/registration of pharmacists Given Singapore's focus on the biomedical sciences and healthcare services, the pharmaceutical industry is enjoying an important role in our economic prowess.”
“I would like to ask the Minister, with the introduction of voluntary HIV screening for healthcare workers, what would the possible implications be if the healthcare worker is found to be infected with the virus in terms of his work, and whether we consider it a work-related infection and he be compensated accordingly.”
“Although it has been revealed that the long-term benefits to members will be enhanced with the expected gains to be more than the current 4%, it is also a fact that it can vary undesirably in times of poor economic performance. Can the Government instead guarantee a minimum 4% interest range, which is what Singaporeans are already enjoying regardless of the market performance? This would give CPF members, especially the low-income and middle-income Singaporeans, peace of mind and that they do not lose out excessively. Having mentioned some of the concerns of CPF members, what about those Singaporeans who do not contribute to CPF, namely the homemakers, self-employed and contract workers? How then can their needs be looked after in this often-neglected group? The Government's effort to ensure Singaporeans' retirement adequacy is laudable. Not many governments in the world would make such a long-term, bold strategic planning and policy change to ensure that their citizens are self-sufficient in their old age. However, the initiative to raise the minimum draw-down age from 62 to 65 must be coupled with a robust system of ensuring re-employment of older workers. Legislating re-employment of older workers through the Re-employment Act is a necessary and correct step forward. However, employers' buy-in is absolutely critical for a win-win solution in the preparation for an ageing workforce in the future. Sir, on that note, I support the motion. 5.29 pm”
“This would sufficiently cover a majority of CPF members till they are 90 or 95 years of age respectively. The argument for such a proposal is that by setting aside a certain amount from the Minimum Sum for the annuity plan when members turn 55, the draw-down amount would be reduced and the longevity payout after age 85 would be a mere $200 to $300. Would not stretching out the draw-down period serve almost the same objective? In addition, can CPF members who have already purchased similar private insurance plan be exempted from this new proposed annuity plan? What about those members with multiple medical illnesses who are often deemed by insurers to be at a higher risk of earlier death? To make them subscribe to the compulsory annuity would tantamount to selective underwriting which would be deemed unfair to them. If possible, the annuity plan should be made as flexible as possible with the basic plan being affordable to all. Any additional supplementary requirements can be made optional to cater to the diverse and peculiar needs of individual Singaporeans. The 1% CPF interest rate hike is a much welcome move by many Singaporeans. However, this increase is limited to $20,000 in the Ordinary Account, and a ceiling of $60,000 taking all accounts together. What is the rationale for pegging the ceiling at $60,000? Does it not make more sense to peg it to the prevailing Minimum Sum since this is the amount assessed to be the bare minimum needed for the retirement needs of an average Singaporean? It has also been announced that the interest rate for the Special, Medisave and Retirement accounts will be pegged to the long-term bond yield.”
“On a similar note, Singapore is also facing a tsunami of a different kind, threatening to engulf us if we do not put in place necessary policy changes to respond to it. The Singapore society is beset with several foreboding trends - the falling fertility rate, smaller family size, longer life expectancy and, consequently, a rapidly greying population. To put things in perspective, as what the Minister has alluded to in his statement today, the number of working adults supporting those not working, ie, the support ratio is about 8:1: all things being equal, the support ratio will decrease to 4:1 by year 2030. The face of our society is set to change with the increasing proportion of elderly in the very near future. A conscientious and proactive look at the predictors of an ageing population over the next 20-25 years has motivated the Government to seriously rework its policies on retirement and CPF changes. The changes to the CPF announced by the Prime Minister during the National Day Rally has generated mixed reactions from the public. The proposal to make the buying of an annuity compulsory has stirred emotions among many Singaporeans. Because of its compulsory nature, many Singaporeans have put up a mental resistance to an otherwise sane and rational policy. Many argued the rationale for making it compulsory when it is their own money and such a move further restricts their freedom to use their retirement funds as they see fit. Can the annuity plan be made an opt-out system, just like the ElderShield scheme? Alternatively, instead of a national longevity insurance scheme to take care of one's longevity needs, can we stretch out the draw-down period from the current 20 years to, say, 25 or even 30 years?”
“Mr Deputy Speaker, Sir, having spoken to many of my grassroots leaders, constituents and friends after the National Day Rally, some of the responses and feedback I gathered can be summarised as follows: "Why cannot the Government give us back our hard-earned money earlier?" "The first thing I want to do is to pamper myself and go on a well-deserved long awaited holiday." "Why worry about it? I don't foresee myself living till 80." "As long as I am healthy and able to continue working, it doesn't matter." Many people must be wondering if we could predict who will reach a ripe old age. The short answer is an obvious "No"! However, statistics have shown that the average life expectancy has jumped from 61 years five decades ago to about 80 years today. Life is a bit of a lottery and there is a certain whimsical element which forbids us from predicting the future. Nevertheless, there are a number of things we, both the responsible Government and the receptive citizens, can do to swing the odds in favour of a long, fulfilling and independent life. On Boxing Day of 2004 in Phuket, when the sea water suddenly receded far from the usual water marks, leaving many fishes exposed on the beaches, many villagers and tourists had naively run out to catch the rare wonderful sight and to reap the unexpected catch. Many were ignorant and oblivious that this was a sign of impending disaster and were caught off-guard when the gigantic deadly tidal waves swept in shore killing thousands. Had we known then and made the appropriate preparations, many innocent lives would have been saved. Reacting now to the dangers of tsunami after an earthquake, many nations have put in place early warning systems to caution the possibility of an impending tsunami affecting their coastal regions.”
“I urge the Ministry to closely monitor the situation with the implementation of this Bill and to reassure the public that the Bill would not lead to spiralling of costs in the primary eyecare. Sir, on that note, I support the Bill.”
“However, there is ambiguity in Part II of the Schedule on whether the use of pharmaceutical eyedrops is permitted in the practice of optometry. Proper refraction of very young children requires the use of cycloplegic eyedrops such as mydriacyl, cyclopentolate and atropine. Such pharmaceutical eyedrops can give rise to local as well as systemic side effects or adverse reactions, and therefore must only be used with proper medical supervision and guidance. Sir, while the Bill has many positive elements and is worth supporting, it is indeed like a duck floating in a pond. While we see the duck floating gracefully, we need to also be conscious of the duck's struggle below the water. The introduction of the Bill to regulate the industry would also cause disruption to the existing primary eyecare practitioners. The Ministry should strive to be as fair and as reasonable as possible in managing the current group of primary eyecare practitioners. It is estimated that, amongst these existing practitioners, about 40% are without any formal training. Requiring them to go for formal training, passing the test and then be registered with the new Board seems to be the right and logical thing to do. However, there are quite a sizeable number of them with decent on-the-job training and many years of experience, but may lack the linguistic capability to pass the necessary qualifying examinations for registration. They may therefore unwittingly be forced out of the industry altogether and lose their only livelihood. This would be unfair and very unfortunate. Lastly, one of the perennial concerns of regulating any industry is the added cost as a result of compliance.”
“It will definitely raise the standard of primary eyecare providers through the requirement of formal training for the optometrists and opticians. This is an important step in the right direction. The registration of optometrists and opticians would bring the industry practice in line with other healthcare professionals. Mandating continued professional education as a prerequisite for subsequent renewal of the practising certificates is important as such a requirement will ensure that these primary eyecare providers keep up to date with new developments in their fields and also to maintain a high level of competency so as to provide quality and safe primary eyecare to the public. Sir, I strongly support Part II of the Bill which calls for the establishment of the Optometrists and Opticians Board. With the setting up of the Optometrists and Opticians Board, under the new statutory regulatory framework, professional guidelines, including the training requirements for admission to the register, accreditation of courses and disciplinary actions against errant practitioners will be set. This would go towards raising the optometrists and opticians' professional standards and also instill a higher level of patients' confidence. In addition, in order to protect the interest of Singaporeans, I would like to suggest the imposition of provisional registration for foreigners or locals with overseas training should they want to practise in Singapore. This would allow the Board to assess the competency level of these practitioners before they receive their full registration. This practice is similar to those of other professional healthcare providers, like doctors and dentists. The Schedule sets out the acts or activities contributing to the practices of opticianry and optometry.”
“Unlike most developed countries, Singapore currently does not regulate its optometrists and opticians, other than those involved in the practice of contact lens fitting and dispensing. In most developed countries, like Australia, Canada, Hong Kong, United Kingdom and the United States, the practice of optometry and opticianry is tightly regulated. In these countries, only those with the appropriate qualifications can register and practise as optometrists and opticians. In general, optometrists function as primary eyecare providers, performing refraction, eye screening and basic eyecare while opticians dispense optical aids. Errant practitioners can be disciplined by the respective regulatory agencies. However, this is not so in Singapore currently. Traditionally, practitioners learn their role through apprenticeships and only a small number was trained overseas. The situation has started to change in the 1990s when Singapore Polytechnic started conducting courses in optometry. It is prudent to maintain high standards in the optometry and opticianry profession as many people turn to them whenever they have visual problems, commonly blurring of vision. Improper optometry and opticianry practices can pose a health risk to the public. Hence, although the intent and purpose of this Bill has been mooted for sometime now, it is timely and necessary. Up until now, the optometry and opticianry industry is a low entry barrier industry. It requires little or no formal training for one to set up a practice in the private sector. Few or almost nobody demand to see the qualification of the optometrists and opticians that they visit. The Bill provides for the setting of a proper footing for the primary eyecare industry.”
“Mr Speaker, I rise in support of the Optometrists and Opticians Bill. Vision is arguably one of the most important and valued of our human faculties. It is important for learning, working, moving about and enjoying human endeavours. In Singapore, many patients turn to optometrists and opticians whenever they experience visual problems. Optometrists and opticians can therefore play an important role as primary eyecare providers. Myopia is one of the most common eye conditions in Singapore and is also one of the most common causes of poor vision. Poor vision from myopia affects about 30% of our primary one students and about 65% of our primary six students. Interestingly, Singapore has the dubious honour of having one of the highest myopia incidences in the world. In fact, we are also known as the myopia capital of the world. The problem of myopia is also affecting Singaporeans at a much younger age. This "myopia epidemic" has caused much concern and attention nationally as sub-optimally managed myopia and severe myopia can result in amblyopia or lazy eyes and potentially blinding complications respectively. With the decreasing total fertility rate and the rapidly ageing population in Singapore, one in five Singaporeans will be aged 65 and above by the year 2030. The prevalence of chronic systemic diseases, such as diabetes mellitus and hypertension and eye conditions such as glaucoma, aged-related macular degeneration and cataracts, will see a significant rise with the increasing ageing population. It is envisaged that the role of primary eye care providers is even more important as early detection and management of these eye conditions will result in better visual prognosis.”
“Sir, I would like to ask the Senior Minister of State whether ICA would consider publishing the eligibility criteria or come out with some points system, so that potential applicants are able to assess their eligibility when they wish to apply for permanent residence or Singapore citizenship. Assoc. Prof. Ho Peng Kee: Sir, this has been done, because there has been the call all these years for greater transparency on two fronts. The first front is with regard to the specific application. When we reply to them, we will let them know whether their income is not sufficient or their residential stay is not enough. So they will know the reason for their failure. Secondly, on a wider plane, in fact, we have disclosed the general areas where applications will be considered. DPM Wong Kan Seng, for example, in 2004, gave a press interview when he stated that the general criteria included educational qualifications, their immediate economic contributions, ability to integrate into society, duration of stay in Singapore and so forth. To facilitate, in fact, not just foreign spouses but foreigners applying for either permanent residence, Singapore citizenship or other passes, we have also started a portal. I think the Member knows about this. It is the e-service Naturalisation Eligibility Tool launched earlier this year, so that those in Singapore who want to assess their eligibility can go into that portal. We will do what we can, because imparting information so that they know where they stand is important.”
“I would like to thank the MOS for the comprehensive answer. I think besides mortality, pneumococcal infection can also result in permanent morbidities, such as brain damage and permanent deafness. I was just wondering whether the cost of immunisation outweighs the cost to the society in cases where they develop brain damage and deafness in the long term.”
“I would like to ask the Parliamentary Secretary whether there are plans for MND to mandate the use of environmentally-friendly green building technologies in future Government buildings and, secondly, whether he could provide an update on the $50 million research fund set up in 2005 for the construction and real estate sector to promote green building technologies.”
“Mr Speaker, I would like to ask the Minister of State two supplementary questions: firstly, are there plans to rejuvenate the ferry service to Sentosa or even consider a new ferry service from the mainland to the doorstep of the new Sentosa IR which may, hopefully, ease the land traffic demands? And, secondly, has the Ministry ever considered introducing other alternative transport modalities such as heli-transportation to Sentosa?”
“Sir, I am aware that children below a certain age and height enjoy free rides in MRT. With increased affluence and better nutrition among Singaporeans, children tend to be taller nowadays. In fact, I have received feedback from my residents that some of their two-year-old or three-year-old grandchildren are above one metre and they had to pay the fare to ride on the MRT. My question is: would the Minister consider raising the upper height limit for children to be entitled to free rides?”
“Mr Chairman, Singapore ranks among the top international maritime centres of the world. Singapore's standing rests on its status as a hub port. It is the world's busiest in terms of shipping tonnage, with 1.3 billion gross tonnes handled in 2006, and containerised traffic with 24.8 million, 20 foot equivalent units handled in 2006. In terms of cargo tonnage, Singapore is ranked second behind Shanghai with 449 million tonnes handled. Excellent connectivity is also one of the strengths of the Singapore port. However, Singapore continues to embrace challenges such as stiff competition from the region, especially China, limited land for future berth development and perennial threat of pirate attacks in the Straits of Malacca. I would like to ask the Minister how would the above challenges affect Singapore's bid to maintain its hub-port status and what are the long-term strategies in enhancing the port performance and venturing into new business areas to stay ahead. Beyond the hub-port, Singapore has also been promoting itself as a centre for shipping and maritime services. I would also like to ask the Minister for an update on this area. With a thriving maritime industry set to grow in the range of 6% to 9% over the median term, is there a maritime manpower development and recruitment plan to meet the projected manpower needs of the industry? Did the 21-episode MediaCorp Mandarin serial entitled "The Peak" or "Zui Gao Dian ", with a star-studded cast including Christopher Lee, Jeanette Aw, Elvin Ng and Qi Yuwu, achieve this objective of attracting young Singaporeans to take up the glamorous, challenging and rewarding careers in this industry?”
“Mr Chairman, in the last land transport review, one of the main thrusts was to make public transport a mode of choice for travelling in Singapore. With a target population set at about 5.5 million, coupled with an expected tourist arrival doubling to about 18 to 19 million by 2020, public transportation is expected to play a more important role to ease massive traffic congestions in Singapore. Would the Minister consider looking into providing up-to-date travel information such as arrival times, waiting times, travel times to public transport commuters, especially the public buses, and capitalising on advanced technological means to provide real-time traffic condition information to private transportation users in order to make their rides on the roads smoother?”
“Sir, I would like to thank the Minister for his response yesterday. I am indeed disappointed that the Ministry will not consider providing caregiver's allowance. I believe that many low-income and lower middle-income families who belong to the typical family that I have alluded to during my cut yesterday will be disappointed as well. I also beg to disagree with the Minister that the caregiver's allowance is necessarily what we call deadweight funding, and that it will dilute the amount of assistance that we can provide to the beneficiaries. The caregiver's allowance, just like the WIS, can be devised such that families who need more help will get more help and vice versa. In addition, the many available initiatives that the Minister had alluded to, such as tax relief, the maid levy concessions, etc, do not really benefit families from the lower middle-income families. Many of these families actually fall into the group where they either do not qualify for financial assistance or Workfare scheme available currently. Therefore, I urge the Ministry not to dismiss this totally but to consider studying how other countries are doing this, so that we can modify the scheme to best suit our needs and to reach out to those who actually need them most. 2.00 pm”
“It offers some financial support to care-givers who may find themselves without immediate and long-term financial security. Without financial support, the sustainability of the care-giving relationship may be threatened or strained. Many countries have already embarked on providing care-givers with monetary allowances designed to compensate family care-givers for their unpaid effort and stress. Take, for example, in the United Kingdom, the care-giver would receive a weekly allowance of about 47 pounds, or just $140, when he spends over 35 hours a week to take care of a person with disabilities. In Osaka city, Japan, care-givers are paid an allowance of 100,000 yen a year for providing nursing care to the elderly family members. Other countries that provide allowances for care-givers include Australia, New Zealand, Norway, Sweden and Estonia. I know it may be potentially difficult to administer, but I believe this hurdle can be overcome by studying how the other countries do it. I would, therefore, like to urge the Minister to consider providing an allowance to care-givers in Singapore or even extending the Workfare scheme to them so that their sacrifices and hard work will not be left unrecognised. Elderly Care”
“Mr Chairman, Sir, Jane, a 45-year-old mother of an eight-year-old boy was doing well as a secretary in an American MNC nine years ago. But at age 36, she left to become a full-time homemaker and care-giver of her 82-year-old mother who is bed-bound after suffering from a major stroke six years ago. Her husband is the sole breadwinner making $2,500 per month, barely enough to make ends meet. Jane is torn between the desire to return to the workforce to supplement the family's income and her love for her mother and duty as a daughter. Money is a constant worry for Jane and her family. Jane's story is typical of many care-givers in Singapore. The care-givers are mostly female, aged 30 and above, with secondary education, married, unemployed and looking after a sick aged parent. They also belong to what is known as the sandwich generation. With the high standards and cost of living in Singapore, most of us need a regular paying job to support our families and ourselves. However, there are many families amongst us with elderly sick or disabled family members who require special attention and care. The care of a disabled family member and the elderly can be emotionally and physically challenging. Often times, care-givers have to quit their jobs to care for their dependent loved ones at home. Home-based care not only provides the ideal cost-effective long term care of the elderly frail and disabled in the family, it also helps free up limited vacancies in rehabilitation centres, day-care centres and old folks homes for families who genuinely require such services. Other arguments supporting payment of care-givers' allowance include recognition of work provided and promotion of autonomy of people living with disabilities.”
“Mr Chairman, I would like to raise a point of clarification on the learning of Chinese dialects in Singapore. Recently, I watched a local play entitled: "Ti Tou Dao ". More than 50% of the conversation was actually spoken in Hokkien or Teochew - I cannot really tell the difference. But the essence of the play is best portrayed through the use of the dialect and much of it will be lost through the translation. I would like to ask the Minister if the learning and the use of Chinese dialect are still pertinent in modern day Singapore and whether with time, it will lose a very rich part of our Chinese culture. I believe my generation still can understand a little bit of dialect but my children's generation probably will not understand it at all. Can we revive the learning of Chinese dialects, maybe just the conversational language, like what the Ministry has allowed the learning of other Indian languages such as Bengali or Gujerati.”
“Madam, an influenza pandemic is a large scale epidemic of the influenza virus, such as the 1918 Spanish Flu, 1952 Asian Flu and the 1968 Hong Kong Flu. The WHO warns that there is a substantial risk of an influenza pandemic within the next few years. The strongest contender will be the H5N1A Avian Flu virus which is rapidly mutating and could mutate into a variant that transmits easily between humans. The influenza pandemic of 1918 killed about 50 to 100 million worldwide in just 18 months, dwarfing the bloodshed due to the First World War. Interestingly and ironically, in those dark times, children would skip rope to the rhyme, "I had a little bird. It's name was Enza. I opened the window and in flew Enza." The origin of this influenza variant was not precisely known till evidence from a recent reconstruction of the virus suggested that it jumped directly from birds to humans. With advanced medical knowledge and surveillance, we do not want similar catastrophic event to happen again, at least, not at that magnitude. While we have succeeded in coping with SARS in 2003, the threat of an influenza pandemic continues to loom worldwide, making our national surveillance system and preparation for disease outbreaks even more crucial and important. I would, therefore like to ask the Minister for an update on its influenza pandemic plan which was drawn up in 2005 and ask him how prepared are the public and private medical sectors in coping with the impending outbreak. In addition, as part of the preparation, the Ministry has stockpiled huge supplies of anti-virals and vaccines. Would the Ministry update us on its stockpiling policy and the disposition of soon-to-expire and expired anti-virals and vaccines?”
“Madam, an electronic medical record is a medical record in digital format. Its use facilitates access of patient data by clinical staff at any given location - sharing of patient information and clinical notes with other healthcare providers, enhancing safety by building automated checks for drug interactions and allergy, scheduling and easier archiving and storage of records. Electronic medical records exchange (EMRX) established in 2004 is an initiative by the MOH and the two public healthcare clusters to share electronic medical records across all public hospitals and polyclinics in Singapore. The initiative also helps reduce cost as doctors from different institutions can now view the results of any recent blood test, X-rays and investigations online, thereby reducing the need to repeat the tests. In addition, teleradiology was also implemented in December 2005 at certain polyclinics where digitised X-ray images were diagnosed by a foreign country outsourcing partner. With the Ministry's mission to ensure healthcare remains affordable, I would like to ask the Minister the following questions: (i) to provide an update on the usage rate and the benefits of EMRX and teleradiology in Singapore since their implementation; (ii) to consider extending the EMRX to all private healthcare institutions and practitioners, as the sharing of the medical information would minimise unnecessary and duplicate medical investigations being performed when patients cross between public and private sectors; and (iii) to consider broadening the scope of tele-medicine to achieve cost and time savings for patients without compromising on quality and safety of healthcare delivery in Singapore. Managed Healthcare”
“A point of clarification to the Senior Parliamentary Secretary. Although the size of a mosquito is small, the impact on our lives as well as the economic cost is quite significant, I believe, although we do not have any statistics to substantiate that. In addition to vector control, I would like to urge the Ministry to also look into research and development of the dengue vaccine, because with the vaccine, we can solve most of the dengue woes that we are facing right now.”
“Sir, modern technological advances have pushed car innovations to cater to the changing needs of Singaporeans. Previously, cars were gas-powered, and now car manufacturers have created hybrid cars. A hybrid car actually uses a combination of petrol as well as electricity, and hybrids are known to be environmentally friendlier compared to the conventional gas-powered cars. It consumes less energy, quieter to drive and emits significantly less pollutants to the environment. I would like to ask the Minister what is the population of hybrid vehicles in Singapore since the implementation of the green vehicle rebate in year 2001, and whether there are any further plans and added incentives to encourage more Singaporeans to drive such hybrid cars or other alternative green vehicles. Environmental Responsibility”
“Sir, the global burden of dengue has increased dramatically in recent decades and is currently classified as a re-emerging infectious disease by the WHO. Dengue is known to be endemic in approximately 100 countries with more than 2.5 billion people at risk. The major disease burden is found in South East Asia and the Western Pacific with increasing reporting of the dengue infection in the Americas. Annually, it is estimated that about 50 to 100 million dengue infections occur world wide. The number of cases reported in Singapore has recorded an all time high in 2005. It was to be the worst dengue epidemic ever experienced in Singapore's history that eventually claimed 19 lives and resulted in over 12,000 cases by the time it tapered off in October 2005. The number of mortality and the prolonged down time from the illness may pose significant strain on the healthcare system, as evidenced by the postponement of many elective surgeries due to shortages of hospital beds during its peak in 2005. Thus, it appears reasonable and paramount that dengue vaccine research and development should be a national as well as a global health priority. I would like to ask the Minister for the potential economic cost of this disease annually, as well as an update on his effort in tackling dengue infection in Singapore, and whether there are any plans to develop a dengue vaccine and to eradicate this disease from Singapore totally, just like we had eradicated malaria and poliomyelitis. Smoking Ban”
“Sir, my point of clarification is with regard to training safety. I am aware that in the RSAF, there are reporting systems for both flying-related as well as ground-related accidents or incidents where the analyses and the lessons learnt are disseminated to servicemen. This initiative is commendable as it encourages open reporting and, hopefully, prevent similar recurrences. I would like to ask the Minister if similar open anonymous reporting systems are available in the Navy and the Army and, if it is so, whether such systems have been effective in preventing recurrences of accidents or incidents during training.”
“Mr Chairman, Singapore has been a responsible member of the international community by contributing to many United Nations peacekeeping and related activities as well as numerous humanitarian and disaster relief operations in recent years such as the Taiwan earthquake in 1999, tsunami relief in Aceh and Thailand in 2004, just to name a few. Similarly, many VWOs and NGOs also take part in search, humanitarian and disaster relief missions; often times, duplicating the efforts provided by the military. Humanitarian and disaster relief often requires collective, multi-agency response. Depending on the scale of the catastrophe, collective national or even international responses may be required. The Armed Forces can play an important role in a coordinated response to humanitarian and disaster relief contingencies, especially in large scale and acute disasters as they are disciplined, operationally ready and can contribute valuable assets. I would like to ask the Minister if it is feasible for the Ministry to set up a central coordinating body within MINDEF to coordinate and amalgamate the many ad hoc contributions from the NGOs and VWOs with those of the military so as to optimise the efforts and limited resources available. 3G SAF”
“Madam, this cut on the foreign workers' accommodation is the last on the list as well as for the day. But I certainly hope that it will not receive the least attention and priority in the Ministry's agenda. The successful award of the two Integrated Resorts development will see an expected growth in the construction industry with corresponding increase in demand for foreign workers. There have been reports in the media on the poor welfare of foreign workers and the living conditions of their dormitories in Singapore. Recently, I came across a particular blog site entitled "Foreign workers in Singapore", showing pictures of the pathetic living conditions of Bangladeshi workers. The pictures depicted 20-30 workers living in a crammed and dark dormitory room, some even cooking and dining in a small corner next to the double-deck beds. Do we want to portray this appalling image of the plight of foreign workers in first world Singapore to the rest of the world? It is only logical and obligatory for employers to provide safe, hygienic and proper accommodation for their foreign workers as a comfortable and decent place of residence will allow proper rest and in turn increase productivity of these workers. I would, therefore, like to ask the Minister for an update on the inter-agency review of the provision of accommodation for non-domestic foreign workers, if there are any guidelines for contractors or employers of the minimum standards required for a worker dormitory and whether there are measures put in place to ensure that Singaporeans will not be adversely affected or inconvenienced by the suggested housing plans for these workers.”
“While most post-treatment rehabilitation and follow-up is one main concern to medical tourists, countries like Costa Rica offer residential and recuperative facilities dedicated solely to medical tourists at affordable rates. For example, according to its website, Villa Plenitude is a dedicated post-operative recuperation facility comprising 10 luxury rooms, all equipped with private bathrooms, cable television, telephone, a spa with Turkish baths, massage, aroma and physiotherapy spa, facials and beauty treatments, pool and Jacuzzi. Imagine, all these at the rate of US$100 for a standard package and US$150 for a deluxe package, which also includes dedicated professional post-operative care by trained nurses. How are we compared to our competitors in the area of hospitality services? In order to compete regionally and globally, we need to constantly improve our services. Often-times, this requires thinking out of the box to give the oomph factor. As mentioned by Minister Tharman in his Budget Statement, the world is coming to Singapore. We are not just attracting more large investments and MNCs to Singapore. Our world-class healthcare services are also attracting many foreigners here to seek medical treatment. Globalisation is indeed working to our advantage and we must seize this opportunity to market ourselves and compete with the players from the region. And I hope to believe that our original objective of attracting one million medical tourists by 2012 is a conservative estimate. Sir, on that note, I support the motion. 4.15 pm”
“In addition, these centres should continue to engage in R&D, leveraging on the growing biomedical research in Singapore to develop new state-of-the-art medical treatments. We should continue to engage in clinical research with the many pharmaceutical, biotechnology and medical technology companies, so that Singapore can remain cutting-edge in its healthcare services delivery. With world-class research capabilities in genomics, molecular biology, bio-engineering, nanotechnology and bio-informatics in place, we are in a good state to embark on translational research, thereby extending our capabilities from basic research to clinical trials and, eventually, valuable outcomes at the clinical level. This would be one way of keeping Singapore's competitive edge and to enable our healthcare professionals to provide the latest innovative treatments and therapies, enhancing Singapore's reputation as the leading hub for healthcare in Asia. As the term illustrates itself, medical tourists naturally need medical tour guides or ambassadors. Extending our services beyond medical care will naturally attract more foreign patients to Singapore. Besides quality medical services and relatively low cost compared to their home countries, foreign patients from the Middle East and other non-English speaking countries will expect to understand and be understood when they visit Singapore for both medical and vacation purposes. Although there are currently international patient service centres set up by many healthcare establishments exclusively to serve the needs of international patients, we will need to strengthen on personalised services, such as going the extra mile to learn their languages, cultures and behaviours.”
“However, with an additional one million medical tourists expected in the next five years, more resources, such as medical manpower and additional infrastructure, should be built in order to cater to the increased demand anticipated. Sir, in order to promote Singapore as a leading destination for medical tourists, we need to assure our world-wide medical travellers that we are able to counter such limitations as well as provide quality medical care and services over and above what our competing countries, such as India and Thailand, can provide. While India and Thailand boast about their low-cost medical care and services to attract medical tourists, we need to relook at our cost competitiveness in order to lure medical tourists to our shores. It may not be feasible to compete dollar for dollar. Rather, we should position ourselves as being able to provide sophisticated and safe medical care, which is value for money. We must capitalise on our excellent pool of medical expertise and continue to attract the growing numbers of international professionals to Singapore for training, learning, sharing and networking. Investments in this area would help to ensure that our medical professionals stay at the forefront of the healthcare developments. There is also a need to carve out special niche areas to better compete with our regional competitors. Our centres of excellence, such as the Singapore National Eye Centre, the National Neuroscience Institute, the National Heart Centre and the National Cancer Centre, offer complex quarternary care in the fields of ophthalmology, neurology, cardiology and oncology respectively. Aggressive marketing strategies should be undertaken to promote the availability of these very specialised medical capabilities in our centres of excellence.”
“Unlike India, Thailand has modern infrastructure with clean and safe streets. Regardless of its growing popularity, medical tourism has its limitations. In places like the United States where most have insurance and access to quality healthcare, modern tourism is viewed as risky. In some parts of the world, wider political issues can influence where medical tourists will choose to seek out healthcare. For example, in late 2006, some patients from the Middle East were choosing to travel to Singapore or Hong Kong for healthcare rather than to the United States. A stable and secure Singapore will therefore serve as an additional plus point where patients want peace of mind and have to decide between our competitors and us. The common limitations to medical tourism include the following. Government and basic medical insurance and sometimes extended medical insurance often does not pay for medical procedures overseas - meaning the patient has to pay cash upfront. There is usually little follow-up care. The patient is usually in the hospital for only a few days and then goes on a vacation portion of the trip or returns home. Complications, side effects and post-operative care become the responsibility of the medical care system in a patient's home country. There are growing accusations that profitable private sector medical tourism is drawing medical resources and personnel away from the local population. However, some analysts argue that the biggest beneficiaries would be the domestic patients, as the cutting-edge medical technology needed to lure medical tourists and the international accreditors do prescribe detailed parameters and quality standards, benchmark and compliance norms, ensuring good standard quality for all patients.”
“For example, in April, Madras Medical Mission, a Chennai-based hospital, successfully conducted a complex heart operation on an 87-year old American patient at a reported cost of just a mere US$8,000, including the cost of his airfare and a month's stay in a hospital. The patient claimed that a less complex operation in America had earlier cost him US$40,000. Following closely behind Singapore, India has six hospitals in the JCI accreditation list. However, the biggest obstacle preventing the rapid growth of India as a healthcare destination is its relatively poorer infrastructure and the lack of quality hotels. Medical tourism is also a rapidly growing segment of Thailand's tourism and healthcare industry. Lower labour costs translate into significant cost savings on procedures, compared to hospitals in the United States and other western countries. In 2005, one Bangkok hospital took in 150,000 treatment seekers from abroad. In 2006, medical tourism was projected to earn the country 36.4 billion Bahts. There is no better exemplar of the trend than Bangkok's Brumrungrad International, which looks more like a high-end hotel than a state-of-the-art hospital. In addition to having a Starbucks, a McDonalds and on-site valet parking, Brumrungrad also provides a visa extension centre, a team of well-trained interpreters to help with language problems, and 123 hotel-like rooms and suites where patients can recuperate after medical treatment. Today, many Thai physicians hold US professional certification. A number of Thai hospitals have relationships with facilities in the United States. The US consular information gives the Thai healthcare system high marks for quality, particularly facilities in Bangkok.”
“According to a recent report by Singapore-based travel, supplier and ticketing firm, Abacus International, the growth potential for medical tourism is somewhere between 20% and 30% over the next few years, and Asia's medical tourism industry is expected to generate more than US$4.4 billion by 2012. In Singapore alone, 374,000 visitors came here solely to seek medical treatment in 2005. The estimated average expenditure of a medical tourist is about US$362 a day, which is more than double an average tourist spending of US$144. Singapore aims to attract one million medical tourists by 2012, making it a US$1.6 billion market annually. With patients travelling with families, not only for the medical industry, the economic spin-offs for the overall tourism industry are set to grow as well. Besides Singapore, many Asian countries, such as India and Thailand, have risen to become popular destinations for medical tourists. India is a relatively newcomer to medical tourism but it is quickly catching up with Thailand. Recent estimates indicate that the number of foreign patients there is growing by 30% each year. India has top-notch centres for open heart surgery, paediatric heart surgery, hip and knee replacement and areas of advanced medicine in which India is generally considered a global leader. Estimates of the value of medical tourism in India will reach as high as US$2 billion a year by 2012. India's medical industry's main appeal is the low-cost treatment. Most estimates claim that treatment cost in India starts at around a tenth of the price of a comparable treatment in America or in Britain.”
“Being a part of the medical fraternity, I am proud and honoured to note that Singapore had made international news for many complex surgeries in specialities such as ophthalmology, neurology, oncology and organ transplants procedures. Our healthcare services, coupled with advanced research and development, are built on a heritage of excellent quality, safety and trustworthiness. Currently, Singapore boasts the largest number of US Joint Commission International (JCI)-accredited hospitals in the region. Quality of medical care is ensured through accreditation from the JCI, the global arm of the institution that accredits most United States' hospitals. In time, we may look towards other European or Asian-based systems of hospital accreditation in an attempt to broaden our credibility and appeal. With the emerging popularity of medical tourism worldwide, I think it is important that we recognise the impact that this industry has on our economy. Most of the travelling patients come from the regional countries such as Indonesia, Malaysia, Vietnam and Brunei. In addition, we are also witnessing healthy growth in patient numbers from South Asia and the Middle East. On top of that, patients from developed countries, such as the United States, also choose Singapore as their medical travel destination for relatively affordable quality healthcare services in a safe and clean cosmopolitan city for peace of mind. In Asia alone, it is estimated that there are 1.3 million medical tourists a year compared to 160 million international journeys. This means medical tourism makes up less than 1% of the Asian travel market.”
“A combination of many factors has led to this recent increase in the popularity of medical travel - the high cost of healthcare in many industrialised nations, the ease and affordability of international travel, and the improvement of technology and standards of care in many countries in the world. A great enticement to medical travel is also the convenience of obtaining prompt medical attention in comparison to that of the home countries. For example, the time spent waiting for a procedure, such as a hip replacement, can be a year or more in Britain and Canada. However, in Singapore, Bangkok or India, a patient could possibly have an operation the day after his arrival. Sir, currently, together with countries in the region like India, Thailand, Hong Kong and Israel, Singapore is one of the most popular world-wide destinations for medical travel. Similarly, countries such as Argentina, Bolivia, Brazil, Costa Rica, Mexico and Turkey are well patronised for their cosmetic surgical care. As a leading healthcare services hub in the region, Singapore has positioned herself as a medical hub where healthcare services, medicine, biomedical research and pharmaceutical manufacturing converge. The successful separation of the 10-month-old Nepalese conjoined twins in 2001 had elevated our medical expertise on to the world's headlines, and we have since accomplished many more milestones both in Asia and in the world arena. Our recent hosting of the first Medical Travel Conference from 12th to 15th December 2006 also attracted participants and media from 21 countries, setting the pace and platform for the development of the budding medical travel industry.”
“Mr Speaker, Sir, like many of the hon. Members of this Chamber, I would like to applaud the Second Finance Minister for the very comprehensive and all-encompassing Budget - one that looks after Singaporeans from all strata and walks of life, but not forgetting to ensure Singapore's economic growth and prosperity by investing in the future. I am delighted to note that the Government is placing a lot of emphasis in preparing for the future healthcare needs of Singaporeans. This is in anticipation of the rising healthcare expenditure as a result of the ageing population, medical advances and the changing disease patterns from infectious diseases in the 1960s to chronic diseases, such as stroke, diabetes and hypertension, which require long-term medical care. The healthcare services in Singapore have a reputation of being world-class, reliable and efficient. The combination of excellent healthcare infrastructure, availability of skilled medical professionals and the latest medical technology has made Singapore the convincing healthcare services hub in the region. Singapore's goal is to become Asia's premier healthcare hub through the attraction of foreign patients, ie, medical tourism. The term "medical tourism" I believe, is no longer unfamiliar to most. The term has risen from the rapid growth of an industry where people from all around the world are travelling to other countries to obtain medical, dental and surgical care while, at the same time, their family members or the patients themselves may engage in sightseeing, vacationing and fully experiencing the attractions of the countries that they are visiting. Medical tourism has, in recent years especially, risen to become a new revolution to the economies of many countries.”
“Sir, bankruptcy under the law of Singapore is not an offence and, if there is a Yellow Ribbon Project to help reintegrate ex-convicts into society, I believe there is a need for a similar initiative to give undischarged bankrupts a helping hand to move on in life. May I ask the Senior Parliamentary Secretary if there are any undischarged bankrupts who are employed in the civil service and, if so, how many are there and what are their areas of work? Mr Hawazi Daipi: Sir, I do not have the information. Indeed, undischarged bankrupts who are unemployed, just like any other unemployed, can reskill themselves in other areas which they may want to learn, to further improve their re-employment capabilities. Sir, I do not have with me the information on the employment or re-employment of undischarged bankrupts in the civil service.”
“A medical device classification system is needed in order to channel medical devices into the appropriate degree of regulation and control. Health products can also be classified into the following in decreasing order of regulation and control: (a) pharmaceutical drugs, requiring the most stringent regulation for obvious reasons; (b) biologicals, such as stem cells and vaccines; (c) nutriceuticals or functional foods and other active ingredients known to result in possible but uncommon adverse effects when consumed inappropriately; and (d) dietary supplements, with good track records and have no reported adverse effects reported in the literature. In conclusion, I wish to reiterate that the Health Products Bill is a proper framework that embodies the critical regulations, control measures and proceedings required to ensure safe and effective entrance and availability of health products in Singapore. With fine-tuning over time and as the Act expands to include other health products in future gazettes, I am confident that we will be able to strike a good balance between the expeditions of wide availability and access of health products, including new medical device technologies and the assurance of high quality, safety and efficacy of such health products in Singapore. On that note, I support the Bill.”
“A graduated system of control is more appropriate. In such a system, the level of control is commensurate with the level of potential hazard inherent in the type of medical device concerned. A medical device classification system is therefore needed in order to channel medical devices into the appropriate degree of regulation and control. It is also important to note that should the regulation on health products, such as health supplements, be made too stringent in the future, it may require a very high level of scientific substantiation, including human clinical trials to license their use. The imposition of such an inappropriate pharmaceutical model for low-risk natural health products would inevitably raise the cost of natural health products and reduce consumer choice. Interestingly, while many countries are pushing for some form of regulation of natural health products, the Canadians are moving in the opposite direction. They have debated on the Bill C-420 - one which attempts to move natural health products from under a repressive 'drug style' directorate to a 'food style' directorate for natural health products with a long history of safe use in Canada. Even FDA allows certain health claims for food high in nutrients proven to support health, eg, FDA allows food high in potassium to claim that 'diets containing foods that are good sources of potassium and low in sodium may reduce the risk of high blood pressure and stroke'. Such permission is given based on sufficient medical evidence and strong authoritative recommendation. I would, therefore, like to propose to the Ministry that the principle based on the concept of risk management endorsed by the Global Harmonisation Task Force for the regulation of medical devices be applied to other health products as well.”
“As we can see, these areas are critical and significant components of the Health Products Bill and such MOIs with our regional or distant neighbours would certainly help to reinforce the effectiveness of the new Health Products Bill. To increase the efficiency and competencies in medical science technologies of our nation, I suggest that we could look into the possibility of establishing similar MOIs with countries like Japan and the United States where medical science technologies are advancing rapidly. Besides collaboration with agencies from the technologically advancing nations, we may also like to consider working with countries that are facing increasing cases of counterfeit or adulterated health products. Cooperation and exchange of information with regulatory agencies from countries, where most of such products originate, could help to increase the quality, safety and efficacy of their health products, which would in turn reduce the possible entrance of counterfeit products into Singapore. Mdm Deputy Speaker, I would like to caution that the new Health Products Bill be introduced gradually and judiciously. A 'one-size-fits-all' regulatory regime will not be in the best interest of consumers and it should allow for modular application of the different controls to different types of health products. This will help to minimise over-regulation as well as under-regulation of certain types of health products. For example, there are currently many different types of medical devices in the market, ranging from the simplest to the most complex; the non-invasive to the invasive. It is not feasible economically nor justifiable in practice to subject all medical devices to the most rigorous conformity assessment procedures available.”
“Post-market surveillance is a critical form of control measure to ensure that manufacturers, importers, suppliers and other health professionals continue to adhere to the regulations of the Act even after registering or attaining the licence to the health products. An example of an agency that places relatively high regard to post-market surveillance on medical devices is Australia's Therapeutic Goods and Administration (TGA). To place some flavours on the post-market activities implemented by TGA, its three major components include: (i) the manufacturer's post-market surveillance system; (ii) post-market monitoring of market compliance by TGA; and (iii) vigilance programmes. In future reviews of the Act, the Authority may consider advocating greater emphasis on such post-market surveillance of the health products. With the implementation of the new Health Products Bill, it could be a good time to also relook into some of the current auxiliary plans that help to maintain the high quality, safety and efficacy of the medical products and devices in Singapore. A good example of such a plan is the Memorandum of Intention of Cooperation (MOI) signed between our HSA and its Australian counterpart, TGA, in May 2002. The MOI was signed to jointly collaborate and cooperate in the regulatory framework for pharmaceuticals, medical devices and complementary health products of the two bodies. The scope of the MOI covers the exchange of information relating to the authenticity, quality, safety and efficacy of complementary medicines, medical devices, human and tissue products, the development of professional competencies and other scientific collaborations.”
“The new Bill also covers products which do not fit the sole description of either medicine or device, such as the drug-eluting stent. With the present climate of increasing globalisation, where goods and services are expected to move freely with minimal barriers between markets, it is important that we maintain the appropriate levels of regulation, control measures, and vigilance in order to prevent the entrance of unsafe medical devices and other health products into our Singapore market. In addition, the Health Products Bill also proposes to bring the four existing legislation on medicines, namely, the Medicines Act, the Poisons Act, the Sale of Drugs Act and the Medicines (Advertisement & Sale) Act under one framework, as the general feedback of having the current regulatory controls fragmented and spread out in the different Acts makes them rather confusing and difficult to understand. The new Health Products Bill provides a detailed list of pre-market administration control measures that entails a series of control measures of manufacturing, importing, supplying and advertising health products in Singapore. It also illustrates the registration, licensing, enforcements and offences related to the dealings of health products. While the Bill already covers a relatively broad area of control measures, I believe it can be fine-tuned further to greater enhance the regulatory system of the health products in Singapore. Apart from the pre-market administration of the health products and the devices in Singapore, we need also to recognise the importance of the post-market surveillance.”
“Mdm Deputy Speaker, I rise to speak in support of the Health Products Bill that was first read on 22nd January this year. I applaud the system of regulatory control implemented by the Ministry and the Health Sciences Authority (HSA) to ensure that health products, particularly, the medical devices, available in Singapore are of high quality, safety and efficacy. Many health products are currently unregulated and are left to the consumers' discretion in deciding what is safe and what is best for his or her own health and well-being. Many seemingly "harmless" health products and food supplements can have serious adverse effects on the individual's health if taken inappropriately. It is well-known that certain vitamin supplements when taken in excessive amounts can be toxic to the human body. Garlic, another naturally occurring food product, for example, has blood thinning properties that can result in bleeding problems during surgery. The Health Products Bill serves to protect public safety and is essential to weed out "snake oil merchants" making outrageous health claims about their products. The proposed new Health Products Bill, in its first initial stage, applies to medical devices only, as depicted in the First Schedule. There are currently no regulations to ensure that such medical devices are reliable, safe and perform to their claims. Regulation is therefore necessary because an increasing number of medical devices are being implanted into the human body and left there for a long time. It is also imperative to note that minor flaws in these intricate devices can have disastrous consequences, resulting in severe morbidity or even mortality.”
“Sir, I would like to ask the Minister what is the retention rate of these foreign nurses and if these foreign nurses are using Singapore as a stepping stone to greener pastures elsewhere and, if so, whether this volatile influx and efflux of nurses would affect the standard of nursing care in Singapore.”
“Mr Speaker, Sir, I would like to thank the Minister for such an inspiring speech. I felt as though I have just come back from Japan. With the anticipated ageing of the population, I would like to request that the Ministry actually look into enhancing the manpower requirements to handle the increased demand in the areas of geriatric medicine as well as rehabilitation medicine. Because I understand that there is a shortage of geriatricians as well as geriatric nurses and other allied health professionals. Moreover, it takes at least 12 years to train a medical specialist in those areas.”