Leon Perera
Singapore
“I thank the Nominated Member, Mr Mark Chay, for his clarification. I did, in my speech, allude to my awareness of the existence of sports scholarships and I mentioned a few, nor in my speech did I claim that there is no Government support for these less well-known sports.”
“Sorry, again. I acknowledge that, of course, no system is perfect. I think we all acknowledge that. My colleague Assoc Prof Jamus Lim presented data on the performance of different countries in sporting excellence, government spending relative to gross domestic product (GDP) per capita.”
“Thank you, Mr Deputy Speaker. I would like to ask one short supplementary question. I am wondering if the Government will consider requiring or mandating private companies to provide an elderly or parent care leave to some extent, or flexible work arrangements that will allow for time for eldercare and parent care duties?”
“Thank you, Mr Deputy Speaker. Just one supplementary question for the Senior Minister of State. He referred to the service quality framework that the Government uses vis-à-vis SingPost because SingPost is a Government licencee.”
“I was suggesting that the determination of consistency of the Ministerial Code of Conduct be done by an independent organisation. It could be the AGO, it could be a judge or retired judge or someone else to put that imprimatur of independence. I was not suggesting either or. You may disagree with that.”
“At the end of the day, healthcare is, and will remain, must remain, a profoundly human endeavour. There is no more important goal in healthcare than attracting, retaining and bringing out the best from our great healthcare workers.”
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“And what support has been given to NPOs to ensure that these extremely vulnerable people can access medical and economic support at this time. Secondly, on those staying in HDB rental flats. Over the past four years has been my privilege to work with our volunteers to deliver assistance of various kinds to those living in rental flats in Serangoon and Bedok. Some of our beneficiary families have done all right. Two of our beneficiary families recently had children who qualified for entry to an Autonomous University. I cannot tell you how gladdened I was and how that cheered our volunteers. Yet, others are not doing so well, and face multiple issues that hinder them and their children in the pursuit of flourishing life. For those on ComCare awarded for a period of a few months, renewals are often an extremely stressful experience. The Government has said that their eligibility for ComCare will be eased during COVID-19. My Parliamentary colleague Mr Faisal Manap has also spoken on this issue and made a few suggestions, with which I agree. I would like to ask will the Government confirm that it will defer HDB rent hikes, allow HDB rent payment deferment and extend the current ComCare arrangements wherever needed, at least for a decent runway amidst this crisis, say six months. Now would be the time to be pragmatic and not ideological about such questions. Next, on our SMEs and micro-businesses. We need to get by until the economy comes back with pent-up demand. During this time, we should do everything practicable to keep viable SMEs and micro-businesses alive. If they are wound up, those entrepreneurs may not return, hurting employment and long-term economic growth potentially which needs entrepreneurship to balance other sources of innovation and investment.”
“It is openness and accountability that will get us to understanding and it is our democratic society enshrined in our pledge that will beget openness and accountability. On social media, there are many chat threads openly saying that authoritarianism has worked, democracy has failed. Look at China versus Italy and the USA. Yet some of the countries that have done well through this crisis thus far, like Taiwan, South Korea and Japan, have open democratic systems. We would do well not to draw the wrong conclusions about democracy as many who lived through the Great Depression of the 1930s did, with disastrous results for the world. Sir, the Resilience Budget is to be welcomed. This is what the reserves principal has been saved to do. The Workers' Party supports the idea of not touching the reserves principal except in times of crisis, as I said in Parliament last month. On that note, I would like to ask the Finance Minister of the $48 billion Supplementary Budget and the $4 billion of enhancements. Firstly, how much was obtained from drawing down past reserves. I believe that was $21 billion, which begs the next question. How much was obtained from drawing on the surplus from this term of government? Thirdly, has the surplus been drawn upon fully with this Supplementary Budget? And fourthly, how much was obtained from other sources and what are those sources? Next, I will speak about a few issues and potential gaps. First, Sir, on the most vulnerable in our society. For those who are homeless I know that wonderful not-for-profit organisations (NPOs) like Homeless Hearts of Singapore, New Home Community Services and many others are stepping efforts to help this vulnerable group. What are the outreach efforts being put in place by MSF and other arms of the Government?”
“Mr Speaker, Sir, in my last speech in this House, I talked about seeing the opportunities in this crisis. What a difference a month makes. I will not talk about opportunities this time. The focus should be on getting through this to the other side – a post-COVID world. Other things should not distract Singaporeans from this mission right now. Before I begin, I declare my interest as a CEO and a shareholder in a company providing research and consulting. Sir, many of us feel fear right now. I would argue that what we should fight is not fear. Rather, we should fight the twin evils of indifference, complacency and unscientific views, on the one hand, and unbridled panic, on the other. A little fear may actually be helpful, keeping us on our toes and mitigating the risk that bad habits will return at the first sign of good news. But it should be a little fear for everyone and not only a little fear for ourselves. That should come from trust in the scientific view that if most people get sick, no one will be safe as individuals and families. As the famous scientist, Neil deGrasse Tyson, recently said, this COVID-19 crisis will put to the test a key question: does society listen to scientists? We all have a role to play in answering that question as a country. All of us react differently to an event like this based on our personalities, medical profiles, socio-economic circumstances and many things besides. It is easier for some of us to work from home than others, for example. Recognising these differences means accepting that there will be questions, there will be discussions, there will be debate, trade-offs and, yes, course correction. It is unity that will ultimately breed success in this effort but it is understanding that will beget unity.”
“Sir, the Government has introduced mandatory front-of-pack nutrition labels for less healthy pre-packaged sugar-sweetened beverages (SSBs), and advertising bans for the least healthy SSBs on local mass media channels. More than 30 countries have introduced such labels. In Chile, the sales of drinks with the unhealthy labels fell by 25% after one-and-a-half years. However, with the daily sugar intake of Singaporeans more than double that of the level recommended by the World Health Organization, could we go farther? Could MOH consider reviewing the results of these moves and if these are not effective consider adopting to some degree and in a tiered and calibrated fashion the measures that have been adopted for tobacco products, such as more graphic warning labels and packaging? A study by researchers at Harvard in 2018 suggested that graphic warning labels on sugary drinks reduced purchases more than text-based labels. Research funded by the UK's Department of Health also suggests that removing products from choice locations within a retail outlet – for example, at the check-out counter where impulse buying is common – can reduce sales. While product placement is negotiated in contractual agreement between the sellers and the retailers, it may be necessary to explore nudging retailers to move in this direction in time though, of course, not without industry consultation and piloting. Industry buy-in for such moves may be facilitated by the fact that many of the firms producing high sugar food and beverage products are gradually seeking to shift revenue share to healthier products over time, as they see the writing on the wall globally.”
“Do all childcare centres require vaccinations certificates before enrollment? Can we do more, for example, working with pre-school centres and private enrichment programme centres to flag out cases of non-vaccinated children? Health Promotion and Preventive Health”
“Mr Chairman, Sir, based on the reply to my Parliamentary Question (PQ) last month, after the launch of the National Adult Immunisation Schedule in 2017, the take-up rate for adult vaccination rose, but is still way below that of some other developed countries. For example, for flu vaccines among seniors, our take-up rate may be around 24% versus 70% in the UK, US and Australia. Can we do more to promote adult vaccination? For example, the Government works with employers to conduct health screenings, can those same platforms, events and working relationships be used to offer on-the-spot vaccinations to workers and companies? Can we also do more to nudge GPs to display material in their clinics that prompts patients to ask for vaccinations. Of course, price is always a consideration, as many would want to conserve their MediSave for other future needs. I would repeat my call made in Parliament for the level of subsidy given for adult vaccines to take into consideration the downstream fiscal cost savings to the state from fewer diseases as a result of vaccines. Finally, our child vaccination coverage for measles, for example, is high at around 95%. But in 2019 there were 152 measles cases, which was the highest number of cases since 1997. MOH figures also showed that there were several hundred cases of mumps every year since 2012. In response to a PQ about measures to prevent measles outbreaks, the Minister for Health opined that passivity could explain most of the cases of children not being vaccinated. However, the growth of anti-vaccination beliefs worldwide should not be under-estimated. I would like to ask for an update on what measures MOH is planning to reduce the numbers of children not receiving these essential vaccinations.”
“Sir, I have argued previously in this House for exploring social impact bonds (SIB) as policy tools to ensure that public spending achieves reasonably successful policy outcomes, reducing the risk of wasted public spending. SIBs, well implemented, enhance results-oriented public spending. By one estimate, as of July 2019, 132 SIBs have been launched in 25 countries raising more than $420 million in investment to address social challenges. A few SIBs have been launched in the UK and one in Columbia to target skills training towards those who are unemployed, vulnerable and not in education, employment or training. With this cut, I would like to suggest exploration of SIBs as a tool that could be used to direct training towards Singaporeans facing employability issues. National Internship Framework”
“" The most central question the TOK addresses is, "How do we know?", while other questions include: "What counts as evidence for X?", "How do we judge which is the best model of Y?", "What does Theory Z mean in the real world?" Some elements of this are covered in the Upper Secondary English curriculum, but not all. This goes beyond language and media literacy, and it is really about the philosophy of knowledge. As most of our students are not in the IB programme, I would like to ask if this is currently being addressed in our Secondary school curriculum and, if so, in what ways? And if MOE is examining modules like the IBs TOK, to explore how we might enhance our teaching approaches in this regard. Improving CCE”
“Sir, aside from teaching our students content and, of course, developing soft skills, character and values, I would argue that nurturing critical thinking skills is of paramount importance. This is particularly so in light of how the world economy is changing and how more basic types of intellectual work are increasingly going to be handled by technology. In fact, as I referred to in my Budget speech, the authors of the World Economic Forum Global Competitiveness Report 2019 commented that Singapore has room for improvement in developing skills like critical thinking among its workforce. Going forward, clarity about the sources of knowledge and higher level thinking are going to be key. 6.30 pm One aspect of critical thinking which I want to focus on for this cut is conscious reflection on thinking, thought processes, the rules of logic and the principles of knowledge – how we know something is true and the various categories of knowledge. It is important that our students are encouraged to think about thinking itself. For example, they should know how to reduce an argument to its basic form to separate the premises from the conclusion to understand what the tautological statement is to understand the difference between causation and correlation and to be familiar with the various forms of reasoning like deductive and inductive. The International Baccalaureate programme includes a Theory of Knowledge (TOK) module. On the IB website, this is described as aiming to make students aware of the interpretative nature of knowledge, including personal ideological biases, "to reflect critically on diverse ways of knowing and on areas of knowledge; to be aware of themselves as thinkers, encouraging them to become more acquainted with the complexity of knowledge.”
“I thank the Senior Minister of State for the answer. Just one supplementary question. Is advertising deployed primarily where there is a need or there is seen to be a need to encourage citizens, target of the advertising, to take certain action or to do something? Is that the main consideration or is it also just general awareness or view or disposition towards the policy or measure that is being advertised?”
“But is the Government studying the risks that such projects by other countries may pose to Singapore? Economic Transition to Decarbonisation”
“Pipeline natural gas has been supplemented by imports of liquified natural gas (LNG) for some years now from diverse source countries. However, Indonesia has announced that it is to stop natural gas exports to Singapore from Sumatra in 2023. It was not too clear if pipeline gas from Natunas would be similarly affected but the statement emanating from Indonesia's Energy and Mineral Resources Ministry on 8 February would seem to suggest so. If this takes place, it will place some pressure on our power-generation sources. Renewable energy sources, mainly solar power, as well as regional power grids, would take time to build up. 6.30 pm Would the Government share its mitigation measures in light of this? Can LNG imports, for example, plug any gap that emerges after 2023? We should also take this opportunity to improve the renewable portion of our power generation mix. I am heartened to hear about the decarbonisation measures spoken about by the Government in Parliament last week. My colleague, Mr Dennis Tan, outlined various perspectives and suggestions from the Workers' Party on environmental policy in his Budget speech last week. In conclusion, I would like to ask if the Government is studying two other energy possibilities. Firstly, there have been media reports about private sector plans to build a solar farm in Australia and export the power to Singapore via a subsea cable. Secondly, I noted Senior Minister Teo's statement on nuclear power at the PMO COS that the potential for nuclear power is still being studied. Russia and China are exploring floating nuclear power plants based on seaborne platforms, with Russia in the process of deploying one. It may or may not be a practical possibility for Singapore to derive power by such means in the foreseeable future.”
“Mr Chairman, Sir, the challenge of navigating Industry 4.0 is all about attracting investments in future-ready categories like AI, drones, IoT and so on. But that in turn can be unpacked into several distinct challenges that need to be met to attract that investment. Firstly, creating a viable eco-system with financing and Government support. Secondly, creating access to a critical mass of workers with the requisite skills and risk appetite and in this we have to balance foreigners with the Singaporean Core. Thirdly, stimulating local demand for these products. While investments in Singapore would be to serve the region and the world, some local demand would help attract the attention of investors. And fourthly, creating network effects where interactions among players and industry, academia, research centres, Government and top leaders can take place, thus catalysing new ideas. To address the fourth challenge, why not catalyse the creation of networking platforms for distinct Industry 4.0 spaces like AI and IoT. One useful model could be the Product Executive Forum in Boston, an exclusive group for senior product leaders in that area. It brings together promising industry executives, academics and top leaders. It functions through breakfast seminars, round-tables and other events. Catalysing such a platform may be helpful. After all, in the Industry 4.0 race, it is not just about having the right people but also about those people interacting and cross-fertilising ideas and work streams. Energy Security Next cut on energy security. Mr Chairman, Sir, natural gas is the main way Singapore generates its electricity today. Indonesia accounts for 85% of imported natural gas in gaseous form with the remainder coming from Malaysia.”
“Sir, I note the Government's announcement that 60% to 70% of the jobs created domestically in Singapore from Foreign Direct Investment (FDI) are PMET jobs. Going forward, it is important to support and develop Singaporean leaders in the private sector. To the extent that there are impediments to this, these should be understood and addressed. A number of programmes have been launched to nurture local PMET and leadership talent, such as the Youth Future Leaders' Programme by EDB and NTUC, the SkillsFuture Leadership Development Initiative as well as the Enterprise Singapore-ASEAN Leadership programme. I would like to ask for an update on the programmes used to support companies in Singapore, including MNCs to develop a pipeline of local talent in PMET and leadership roles. What has been the success associated with such programmes to-date? Start-up”
“Mr Chairman, Sir, Singapore has 23 implemented Free Trade Agreements or FTAs and may conclude other FTAs in future. Every FTA negotiation involves making a determination on how much improved market access to give foreign companies in exchange for market access for Singapore companies in that foreign country. Implemented well, FTAs can introduce a wider range of goods and services in Singapore at lower prices for the end consumer while also giving our local firms greater market access and a more level playing field abroad. I would like to ask before an FTA is concluded, how does the Government obtain feedback from relevant local firms about what problems they face with market access within that country, as well as what enhanced competition from that country's firms might mean for themselves, their industry peers and the domestic economy? Does the Government also review implemented FTAs to assess the net economic impact of the concessions given in respect of market access to foreign firms inter-corporate transferee rights and other concessions as well as whether market access for a Singapore firms has in fact materialised as envisaged under the FTA? Lastly, is there a mechanism for local firms to easily give feedback on FTA related matters and can some feedback channel be indicated on the FDA section of MTI's website? What processes are used to assess the net economic impact of FTAs after they are enacted? Is feedback gathered from local firms as to the analysis of prices of goods and services before and after? Is that kind of analysis done, for example?”
“In a 2019 global survey, it was found that Singaporean gamers spend more time playing electronic games than other Asian counterparts. Loot boxes, a consumable virtual item used to redeem a randomised selection of further virtual items, is increasingly seen in some quarters as a form of gambling. A study by academics at the University of York indicated that micro-transactions are rising as well. In many games, these are to purchase loot boxes. From a separate study by academics in York, there is some evidence linking loot boxes to problem gambling. Based on a Parliamentary Question I asked in January last year, MHA is studying the matter. Belgium has banned loot boxes purchased using real money. The UK National Health Service has also called for the industry to ban loot boxes. Its Mental Health Director Claire Murdoch warned that these were in danger of "setting kids up for addiction". Singapore ought to consider implementing, at the very least, regulations to limit access to micro-transaction-driven loot boxes by youth, so as to prevent habituation to addictive gambling-like behaviour among young gamers. Raising of Retirement Age”
“Singapore Exchange Regulation Chief Executive Tan Boon Gin said, and I quote, "Shareholders, especially minorities deserve to know why company directors and executives are paid the way they are." "The Board and Management therefore owe it to investors to explain the link between performance and remuneration." The same reasoning would apply to our SWFs because the Government is the shareholder, the people of Singapore are, by implication, stakeholders. In the case of the Norwegian SWF, the government questioned the rising operating expenses of the SWF publicly. The compensation of the CEO and CIO of the Norway fund are publicly known. In passing, let me note that I am not holding up the Norway model as one we should emulate in all respects. That is not my point. I am also not calling for Government interference in the commercial operations of the SWFs. That is not my point. I would like to ask how Singaporeans are able to obtain a reasonable degree of accountability and transparency over matters relating to business succession and top executive compensation at our SWFs which manage hundreds of billions of dollars of public funds. Would the Government consider, at the very least, allowing a bi-partisan Parliamentary Committee to interview the key personnel from these SWFs once a year so that there is some degree of accountability to legislators? Ministry's Role in Industry Development”
“Mr Chairman, Sir, in 2017, I asked a Parliamentary Question (PQ) about succession planning in Temasek Holdings. The reply was that these matters are to be dealt with by Temasek's Board and the Government does not interfere because Temasek operates as a commercial entity. In 2019, my Parliamentary colleague, Mr Png Eng Huat asked about whether remuneration bands can be disclosed for senior officers in sovereign wealth funds or SWFs. And again, the reply was similar. The reason this is problematic is that the two entities are not privately-held commercial entities in which case the stance would be understandable, but public ones managing public funds. The public has a legitimate interest in understanding for instance, why CEO succession was deemed to be enough of a priority in 2009 to appoint a CEO designate, and yet, there has not been any concrete movement or succession on the 11 years since then, in spite of what one must assume would be no lack of suitable candidates internally or externally; or whether remuneration given to top executives is consistent with market norms and represents good value. In contrast, the Singapore code of corporate governance calls on listed companies to disclose total remuneration paid to the top five key management personnel. A 2018 study found that close to 70% of Singapore listed companies did so. The SGX and most of the exchanges do not take the view that the disclosure of such information is unnecessary in the public, and shareholders only need to know past financial performance and nothing else, because such disclosure has a bearing on likely future performance and risks among other reasons.”
“Thank you, Sir. Just a small clarification to Minister Chan. If I understood Minister Chan correctly, he said that there are three considerations for determining the functions within the PMO. And I think the third point was that, functions are sometimes incubated and then transferred to a Ministry where there is a more natural fit with the domain of that Ministry after a certain period of time. So, firstly, is that understanding correct? And secondly, where does that leave us, in terms of functions that have been there for a very long time? For example, the NRF. It is under PMO. I think that has been there for quite sometime vis-a-vis MTI.”
“Mr Chairman, Sir, when I first entered this House in 2016, the Estimated Budget for the PMO was $488 million. In the latest Estimates, this has risen to $1.05 billion. The PMO houses functions that cut across Ministries relating to climate and population, for example. But over the years, the PMO has also come to acquire coordinating and leadership roles in a number of areas where there would seem to be a more natural fit with domain Ministries. For example, why is National Research Foundation programme under the PMO rather than MTI since research should be pursued in such a way as to maximise and multiply its benefits to industry and to the economy, which is MTI's purview? A similar point could be made for the National Security and Intelligence Coordination programme vis-a-vis MINDEF which would seem the natural location for the ownership of Total Defence programmes; SNDGO vis-a-vis the Ministry of Communications and Information. In the debate on the GovTech Bill in 2016, I asked why the CSA was at that time located in the PMO rather than within MINDEF, the answer was, "this is to give the CSA the ability to oversee cybersecurity at the national level, and so on". Does this mean that all policymaking fields that function at the national as opposed to sectoral level and cut across Ministries to some degree will eventually come under the PMO? And if so, how do we ensure that the duplication of functions and expertise is minimised vis-a-vis domain Ministries, which generally have more staff with expertise in the domains? How would we also ensure that due weight in policymaking is given to subject matter experts in the domain Ministries? Innovative Public Service”
“I thank the Minister for his answer. Just one supplementary question. Does the Ministry also work with the F&B sector to encourage them to declare peanut content in the food that is served?”
“I thank the Senior Parliamentary Secretary for the answer. Sir, just one last supplementary question, really just to confirm if I understood the Senior Parliamentary Secretary correctly, the thinking of the Government is that AEDs(T&L) are less necessary now and therefore, the numbers are going to be reduced and then, those AEDs(T&L) are going to be transited to other roles and so on. I just want to confirm that understanding.”
“Thank you, Sir. I thank the Senior Parliamentary Secretary for the answer. Just one supplementary question. There is some anecdotal feedback – it may or may not be the correct perception – that AEDs for classroom support are being reduced in number. Is that actually taking place or are there any plans to do that or is that just an incorrect perception?”
“Having a pool of workers with such training could also help attract both foreign and domestic investments in these high-growth sectors. Of course, any such move has to be done in tandem with the growth of investments in these sectors to ensure the jobs and career paths are available to those who join such industries. Lastly, as part of the Singapore Public Sector Outcomes Review (SPOR), can we adopt independent measures that regularly track the capacities of our people versus other countries in terms of attributes, like resilience, entrepreneurship and creativity? Beyond just hard skills and cognitive intelligence, it is these capacities that we need to nurture in the long term. It is these capacities that will be our surest defence against whatever economic and technological evolutions bring; and tracking them in the SPOR report is a nod to the fact that our policies do play some role, not the main role, or the only role to be sure, but some role, in nurturing these capabilities and capacities among our people. Mr Speaker, Sir, in conclusion, the future is always uncertain but there are some epochs in history where it is more uncertain than average and we are probably living through one of these. We are dealing with huge geopolitical shifts, massive economic disruption, changing demographics, the existential threat of climate change and the possibility of Black Swan events like disease pandemics. But uncertainty is never a reason not to make projections and not to make plans. Times of change and crisis are also moments for the agile, the resilient and the creative to find new opportunities, anticipating and adapting to those moments in history like our own that see non-linear change can bring immense benefits not only in economic terms.”
“I know that there are limits to how much we can do under WTO rules and other treaty obligations, but surely there are ways to navigate these obstacles to some degree. And, as I referred to earlier, A*STAR has licensed IP to SMES, but the question I am raising here is how to upscale this to enhance the commercial impact and provide enablers to ambitious local firms to become world-beating. Thirdly, many of our talented youths go into the Civil Service. Twenty-six percent of autonomous university graduates go into the Public Service as their first job, according to a Parliamentary answer given in 2018. Can we create a programme that mentors and coaches civil servants in their 30s, 40s or 50s who wish to leave the service to become entrepreneurs? Such a programme could help them develop skillsets relating to fundraising, employee recruitment and retention, marketing and so on, not so much training but coaching and pointing them in the right direction as well as connecting them with funding sources, including state-backed ones. After all, we do not only want locals to get the $7,000 jobs and the $10,000 jobs. We also want some locals to create such jobs. Fourthly, can we undertake a project to map out the categories of jobs at risk from Industry 4.0 and then initiate a programme to inform workers in these sectors of the imminent risks over the mid and long term and nudge them to engage in reskilling and career switches to high-growth disruptive industries? Perhaps an incentive scheme could be deployed to attract local workers into Industry 4.0 sectors, like renewable energy, drones, AI and deep tech, especially those sectors where the Singaporean Core is weak.”
“This was the philosophy of Korea in the 1960s and 1970s, where the state insured provision of loans to chaebols or large firms, which could consistently grow exports and hard currency earnings and loan support was withdrawn from those that could not consistently deliver those results. While to be sure that not everything Korea did in those decades was correct in hindsight, that policy contributed to the emergence of giant companies like Samsung and LG today. Conversely, support to local firms that do not demonstrate ambition and performance can be disciplined and focused on competitiveness improvement, job safeguarding and business succession planning. Sir, this is a call for strategic results-based spending to develop local entrepreneurs in ways that benefit domestic employment. This is not a call to give away state monies to local firms irrespective of outcomes, and I trust that it will not be referred to as the latter. Secondly, Sir, we know that productivity is partly a function of investment and we cannot depend only on FDI for this investment in the long term. Can we not do more to tap on our fiscal resources to channel substantial R&D investment into creating IP that is then seeded to local companies in a very substantial and systematic way, but with the IP owned by the state and licensed to the firm's so that the state can nudge these firms to grow in ways that benefit the domestic economy and locals? The area's earmarked for R&D investment in this way could be targeted so as to fill gaps in the global IP landscape in future-ready fields like AI so as to ensure maximum "commercialisability", so to speak.”
“If we do use more fiscal resources to do that, we should also recognise that if our efforts are successful, we may be able to save social safety net spending further downstream and we may also raise GDP and, hence, tax revenue which are good fiscal outcomes. My analogy here would be spending more to make vaccines free or close to free, a subject that I have raised a few times in this House, which may have the effect of reducing state spending on hospital subsidies, MediFund and so on further downstream. And this is just an analogy. Mr Speaker, Sir, the three dimensions of national life I mentioned are very much interconnected. However, as formidable as the challenges are, they are not insurmountable if we tackle them earnestly. Therefore, I would like to conclude with just a few directional suggestions on how we might address these future challenges from where we are at this point in time. Firstly, investing more in local enterprises that can deliver. This was how the Japanese built up their world-beating giant firms – the Japanese and Koreans I should say. For those local firms which can consistently deliver financial and economic growth while safeguarding or growing domestic jobs to those firms that significantly enhance our economic vibrancy, more support could be provided beyond the caps and limits associated with current economic schemes. I had an exchange on the subject in this House with the then Minister for Trade and Industry, Mr Iswaran in 2017. I understand his counter argument that we do not want to go too far down the path of picking winners. There is a grain of truth there. But some of our existing efforts like state-backed co-investment, for example, could be seen as picking winners anyway. And why not let the winners pick themselves?”
“An analogy from the business world might be the two extremes of spending too much and running into a cash crunch on the one hand and not investing enough in the company to develop the capabilities of the employees, new business strategies and intellectual property (IP) on the other. Sir, our Reserves have been estimated at over a trillion dollars. Every year, these Reserves grow from half of the NIR as well as from land sales and any unspent surplus from each term of government, among other things. I am not suggesting drawing down on the Reserves at this point. But in the longer term, is there more scope to slow the rate of Reserves growth, so as to release more funds to invest in our people and address the challenges we face in terms of livability, employability, innovation and so on that I spoke about in the first part of my speech? Let us bear in mind that during the worst global economic crisis the world had ever seen since the Great Depression of the 1930s, during the Global Financial Crisis of 2008, we drew down only a tiny fraction of the Reserves. Should our Reserves always go up and up at the same rate? Can we not have reasonable conversations about how to vary the slope of Reserves growth while agreeing that the principal should only be drawn down in an emergency? And how, in doing that, we can invest in our people and companies so as to help them become the most creative, resilient, innovative and entrepreneurial that they can possibly be so that they can deal with any challenges the world can throw at us with confidence?”
“This, in turn, may promote a culture of being more willing to take risks to reskill, start a business and, possibly, even to have children, because one is more confident about the future. Some research suggests that our economic outlook and our sense of economic security does impact these behaviours. And if we fail to address the challenge of livability like parts of the US and England, our people may turn against globalisation which would damage prospects for vibrancy. Let me note in passing, one could respond to this point by saying that this is a call for profligate spending because it requires spending commitments before we know we have the money to fund it. It is not. It is a call for building into policy design mechanisms that self-correct and have built-in adjustment processes rather than leaving it purely to future Executive discretion. The Executive and Parliament can still decide not to go ahead if the money is not there. Next, Mr Speaker, Sir, I want to talk about sustainability. Vibrancy and livability are already difficult challenges in themselves. But we must ensure that policies aimed to address these challenges are sustainable and are responsible. To be sure, it is a good thing that we have large Reserves that yield Net Investment Returns (NIR), the largest state revenue stream today and that can be drawn down in emergencies. Many countries do not have this and have high levels of fiscal debt relative to GDP. But are there not also dangers in going to the other extreme and being too prudent as it were? Could that also lead to a failure to seize opportunities to develop the capacities of our people for the future? Clearly, we have to find the Goldilocks zone between these two extremes.”
“What else can be done to breed confidence that our system will manage livability in the future? Our total fertility rate has been one of the lowest in the world for years. Twenty-nine percent of young Singaporeans in a recent survey said that they would consider migrating in the next five years. I suspect that getting livability right would make a difference on these fronts. The approach to managing the cost of living is a case in point. Why not develop an approach to policymaking that commits the state to adjust for future conditions by building the adjustment mechanism into policy design, rather than leaving it to future acts of Executive discretion, which may or may not happen? Right now, this is done in some cases, like permanent GST Vouchers, but not in others. One example of this would be adjusting Silver Support for inflation from time to time based on policy design rather than leaving it to the Government and Parliament at its discretion. Parliament can still vote against inflation-based increases should fiscal resources be insufficient. So, the mechanism can still contain an element of evaluation. But the fact that the design of the policy has a built-in mechanism to recommend changes and adjust based on inflation at certain defined time intervals creates some assurance that, yes, society will not leave me stranded in the future one day. This is not just a benefit for today leaving me uncertain about tomorrow. This is a very specific example to make the general point that if more well thought through social protections and stabilisers are built into policy design, it may assure Singaporeans that the society has their back. And this may reduce risk adversity and the focus on short-term income rather than long-term income.”
“But we have all come to acknowledge that future FDI inflows may be under threat from anti-globalisation trends that my party Chairman Ms Sylvia Lim spoke about yesterday, in particular, the deliberate efforts some countries may take to pull back supply chains to their domestic economies in light of things like the coronavirus and US-China geopolitical tensions. To insulate against this risk, we face the challenge of raising the game of our local firms. Sixth, with the rise of uniquely disruptive technologies like artificial intelligence (AI), autonomous vehicles, the Internet of Things and drones, whole categories of employment may be wiped out practically overnight. The advent of autonomous vehicles may put at risk the jobs of drivers in the taxi and private car hire industry. Many jobs in backend operations and frontend services are also at risk from AI, robots and chatbots. So, one additional challenge is to ensure that our people can keep their heads above tomorrow's rising waters of employability amidst the sea of economic disruption not seen in generations, not only in respect of skillsets like deep tech and coding but also soft skills like creativity, leadership, entrepreneurial acumen and resilience. In fact, the authors of the WEF report cited room for improvement for Singapore in skills like critical thinking. Sir, how do we meet the challenge of enhancing our vibrancy, which implies stimulating homegrown innovation and entrepreneurship? The next broad point I will speak on is livability. A blind chase for vibrancy of an economy is no full guarantee of the well-being of its citizens. Putting effort into livability, therefore, is one of the most crucial challenges facing Singapore.”
“Firstly, our economy is now heavily dependent on China, which was experiencing a growth slowdown even before the coronavirus. Second, our productivity performance goes up and down, but it is also bifurcated between high productivity, manufacturing and other externally oriented sectors and some less productive sectors, and between a multinational corporation (MNC) sector with higher productivity and an SME sector that employs two-thirds of our workers with less. Thirdly, our SMEs and, particularly micro businesses, will face headwinds, not only from the coronavirus, but also the more general China slowdown. In fact, it is argued in a recent letter in the media from the Chairman of Credit Counselling Singapore, many micro businesses may become ensnared in a cycle of chronic indebtedness as a result of the economic impact from the coronavirus episode, as happened with SARS in 2003. Fourth, while the GDP share of R&D is decent, it is not as high as in some developed countries, and there is some evidence that R&D GDP share is linked to Total Factor Productivity. More importantly, beyond the MNC sector, it is not at all clear if R&D is being taken up and commercialised successfully on a substantial scale by our local companies, notwithstanding some take-up of licences from the Agency for Science, Technology and Research (A*STAR) by local enterprises, for example. Fifth, we continue to be successful in attracting foreign direct investment (FDI).”
“Mr Speaker, Sir, in 2019, we were considered by the World Economic Forum (WEF) to be the country closest to the frontier of competitiveness in the world. However, instead of giving in to the temptation to vaingloriously bask in such rankings, we looked critically at the report on real shortcomings so that we can reflect on them. The WEF report highlighted room for improvement in respect of promoting entrepreneurship and improving the skills base, for example. Sir, I should, therefore, focus my speech on three aspects of national life that pertain to the longer-term outlook that we face – vibrancy, meaning the quality of the economy; liveability and the well-being of the people, and sustainability of our fiscal resources – before concluding with some directional suggestions that attempt to speak to the challenges we face across all these three dimensions. Before I begin, I declare my interest as the CEO of a research consultancy that undertakes work in a variety of business arenas, including industry 4.0 spaces. Firstly, on vibrancy. Mr Speaker, Sir, on the back pages of The Economist magazine, they track economic indicators of various countries. Decades ago, Singapore's GDP growth was consistently among the highest in the region and the world. In recent years, it has been more modest but still better than or the same as other developed countries in this region. In 2019, however, our GDP growth was low against even developed Asian economies like Korea, Taiwan and Australia, let alone the US, and this was before the coronavirus. The Government's forecast for 2020 is roughly the same rate of growth. Sir, while we face the short-term challenges of dealing with COVIC-19, in the mid-term, our economy faces deeper structural challenges.”
“I thank the Minister for his reply. Just to confirm, so, if there is a request made to MFA from the next-of-kin or from a person who is incarcerated, and if it is permitted, if it does not contravene local laws, can we assume that MFA would generally extend some kind of consular assistance to every such request?”
“I thank the Senior Parliamentary Secretary for a very comprehensive answer. I think that information was very useful. Just one supplementary question, which is that, in determining the quantum of subsidies, does the Ministry actually do modelling whereby you look at the cost of MediFund, hospital subsidies and so on and so forth that will be saved if the vaccine take-up is increased, and you sort of use that as a way to calculate how large the subsidy should be, such that it is fiscally neutral or it may even be fiscally positive? Because it would seem to me that there would be savings as the vaccination take-up increases and that should be used as a basis to make these vaccines either highly subsidised or possibly even free in many cases.”
“It is becoming increasingly important to differentiate your products from the pack. The time for uniformity in food and beverage (F&B) is gone and GIs are going to be a big contributor to this." In this context, I have two other questions. Firstly, how many applications have been made for local GIs to date? According to the same media report I cited earlier, and it is confirmed by the Senior Minister of State, 140 GI applications have been made to IPOS since the GI Registry was opened in April last year, but it is unclear how many are for local GIs. Secondly, will the Government consider working with local farming and food processing entrepreneurs to support their efforts to register GIs? Developing Singaporean GIs could be an avenue to boost the economic and job creation potential of the local food industry.”
“My first question would be, as a Singaporean consumer purchasing a product where a GI has been registered in Singapore, how can they obtain some degree of assurance that the product they are purchasing is a genuine GI product, as it were, rather than a product from a different region that has usurped the name protected under the registered GI? No doubt, once the GIs are registered, producers and traders of the GI products will be able to request customs authorities to "detain suspected infringing goods which are imported into or exported from Singapore", as IPOS declared in the media report. But the ability of producers and traders of GI products to enforce their rights may be uneven on the ground. Can IPOS consider working with GI rights holders, industry associations and other stakeholders to create an easy-to-use directory entirely funded by GI rights holders which will list legitimate products bearing the GI by brand, product type and retailer? Industry stakeholders will be strongly incentivised to fund such a directory. Next, GIs represent an opportunity for local farming and food processing entrepreneurs to brand Singaporean products for enhanced competitiveness in export markets while also potentially contributing to the tourist experience for inbound tourists into Singapore who may seek good quality local food. In fact, it is not uncommon for tourist authorities to promote local foodstuffs and where they can be obtained. The Food and Agriculture Organisation (FAO) Asia Office said, as quoted in a media report by Food Navigator Asia, and I quote, "As the industry moves towards globalisation and bringing local products to the world, local or ethnic products are increasingly becoming a target for GIs as these are often the most popularly searched by tourists.”
“Mr Speaker, Sir, the GI (Amendment) Bill seeks to clarify a number of technical points relating to the GI Act of 2014 which came into force in 2019. In particular, it prescribes how the Act should be interpreted in respect of variants of a GI as well as clarifying the legal procedure by which an appellant can seek to qualify or limit the scope of the rights conferred by the registration of the GI. Through bringing about these certifications, the Bill is a significant step in the right direction. I have a few questions and suggestions for the Minister in respect of this Bill. Before I raise these, I would like to declare my interest as the Chief Executive Officer of a research consultancy that undertakes work in the agrifood and processed food and beverage space among other product categories. GIs are terms which are used to inform consumers that a product, mostly food and drinks, comes from a particular place. The GI Act of 2014 established a new system of registration in Singapore to improve the certainty of protection given to GIs with effect from 1 April 2019. This had been part of Singapore's compliance with the EUSFTA where some 100 applications have been protected under the GI Act. Perhaps the most famous example of a GI is champagne. Other examples are Tennessee whiskey, Pinggu peaches, Darjeeling tea and Parmesan cheese. Essentially, GIs must identify goods where the qualities, characteristics or reputation of the product should be essentially due to the place of origin. GIs help consumers gain assurance that the product they are buying embody the geographically grounded characteristics reflected in the product name.”
“I would like to thank the two Ministers for their Statements. Just two supplementary questions, I believe, for Minister Lawrence Wong. The first one is, there is, of course, a Price Control Act (PCA) and there were reports of traders of masks who were profiteering, charging very high prices. I understand that the Price Controller has written to some of them. And, of course, as economists all know, using price controls has its downside and its risks. You can create "black markets" and so on. But for exceptional and crisis situations like this, is deploying the PCA to actually put price controls in place, using this legislation, something that the Government will consider, in future, just for limited periods of time? My second supplementary question is with regard to the method of distribution of masks. I would like to ask the Government to share its considerations behind why the masks were not mailed out rather than collection being made at different collection points. There has been some discussion around this. There could be some advantages to mailing out masks in terms of not encouraging people to cluster together and so on. I believe that there was an exercise in 2014 when some organisations mailed out N95 masks during the haze period. So, there is a precedent there. I just wanted to understand the thinking a bit more and whether mailing out of masks is something that might be done in future, if such cases arise.”
“Sir, just one supplementary question for the Minister. Just to confirm, on an ongoing basis, going forward, does the Government ensure that the potability or drinkability of the water supply in Tekong is same and equal to the standard on the mainland? Is testing regularly done to ensure that?”
“Mr Speaker, Sir, I thank the Minister of State for his reply. Just a few supplementary questions. I believe the Minister of State mentioned that 80% of jobseekers do not perceive any kind of discrimination. Just to clarify, was this a survey of both jobseekers and those already in jobs? Did the survey cover both jobseekers and those who are already in jobs about the perception of discriminatory human resource (HR) practices? Or was it only jobseekers? And if it covered both, was there any difference in the findings between those who are jobseekers and those who are already in jobs about their perception of HR practices in their company? Secondly, of the 20% who did perceive some form of discriminatory practice, can the Minister of State share what was the breakdown by the type of discrimination perceived, be it by gender or nationality or other type for that 20%? Thirdly, what was the sample size of this survey? Fourthly, has it already been made public and, if not, will it also be published in full?”
“A 2006 study of 122 drugs tested by the programme showed that two-thirds of them were stable every time a lot was tested. Each of them had their expiration dates extended on average by more than four years. But the same type of drugs in hospitals or pharmacies get thrown away when they expire. Does our healthcare system destroy significant quantities of drugs due to expiry? If so, could we consider something like that US Shelf Life Extension Program, to use clinical data to extend the life of drugs?”
“In the Mercer Marsh study quoted earlier, it was noted that Singapore's medical inflation is partially driven up by supply-led factors, such as high-cost pharmaceuticals and biologics. I asked a Parliamentary Question on the use of generics in the public healthcare system last year. The reply stated that, and I quote, "In 2017, to better guide institutions and doctors in the use of generic drugs, we introduced a basket of clinically and cost-effective generic drugs, which can replace a more expensive branded equivalents. MOH and the Health Sciences Authority (HSA) monitor new generic drugs that enter the local market and add them to the basket on a regular basis." I have two suggestions. Firstly, can healthcare providers be required to include in bills information about the cost of treatment had a generic been used? Alternatively, a simple app or website could provide information on HSA-approved generics in respect of differential pricing. Secondly, can the proportion of use of ACE-endorsed bioequivalents, lower cost alternative drugs for key conditions and procedures, be these generics or biosimilars, also be made public, broken down by healthcare provider? Fourthly, on waste reduction. One expert at an event in Singapore on healthcare costs said that waste in OECD countries amounts to as much as one-fifth of healthcare expenditure. I would like to discuss one example. The US Food and Drug Administration (FDA) has long known that many drugs remain safe and potent for years longer than their published expiration dates. FDA and the US Department of Defense created the Shelf Life Extension Program (SLEP) to test the stability of drugs in the federal government stockpiles and then extend their expiration dates where justifiable.”
“” Sir, I would like to ask if the Government could consider publishing data on lower cost procedures at major healthcare service providers and perhaps even making tweaks to funding models to incentivise these lower cost approaches where relevant. This can be done initially by focusing on procedures where there is the most volume vis-à-vis potential to impact on cost. The issue of day-surgery or outpatient surgery is a good case in point. It would seem that only medical care is covered by insurance, and patients then have to pay out-of-pocket for transport, home nurse visits, perhaps some tele-monitoring and even meals. Can insurance funding models be changed such that cash is paid to cover these costs pegged to but not equal to what it would have cost to do this on an inpatient basis, so as to incentivise outpatient surgery? Also, ambulatory or outpatient surgery centres need a formal arrangement with the hospital for transfer in case of adverse events. In terms of the regulatory regime, is there a sufficient nudge for hospitals to embrace ambulatory care for surgery? I would also like to ask if the MOH's Agency for Care Effectiveness (ACE) looks into flagging out cases that, for want of a better term, can be termed "unnecessary innovation". For example, an NPR article from 2017 in the United States (US) recounts how one pharmaceutical producer marketed a single pill that combined two over-the-counter (OTC) drugs as an innovation because it was easier to take one pill than two. A month's supply of the two inexpensive drugs cost about $40. The company billed insurance $3,252 for the new pill. Thirdly, Mr Deputy Speaker, Sir, I will turn to the promotion of generics and biosimilars.”
“Having said that, can we do more to monitor and publish trends relevant to curbing unnecessary treatment by focusing on specific kinds of procedures? For example, according to the "Health at a Glance: Europe 2018" report by the Organisation for Economic Cooperation and Development (OECD) and European Commission, Portugal created a national commission to monitor C-section rates and indexed funding to hospitals partly to C-section rates. Italy has similar financial incentives to hospitals with lower C-section rates and publishes information on C-section rates at different hospitals. The same report details how Denmark, Sweden, the United Kingdom and Finland have high day surgery rates for a number of common procedures. Studies have shown that day surgery can reduce the cost of surgical procedures substantially compared to in-patient surgery. The report states: "In Sweden, one of the main factors that has contributed to the expansion of day surgery over the past few decades has been clinical leadership in the adoption of evidence-based guidelines to streamline pre- and post-operative surgical procedures and promote safe and effective use of day surgery. Nationwide collaboration and support from national authorities have helped to set up and disseminate new standards, while leaving sufficient autonomy to enable adaptation to local circumstances. The expansion of day surgery has helped achieve substantial savings...A 2016 review by the National Board of Health and Welfare showed that the costs of the 11 most common types of procedures would have been 14% higher if the share of day surgery had not increased between 2005 and 2013.”
“Doctors need to be reassured the system is fair or everyone will start to turn away or decline to treat complex or poor pre-morbid patients. But it could well be worth the investment and, at the very least, should be studied since what we want is value and this means price or fees as a function of outcomes. Secondly, can MOH consider creating a simple app or website for patients to key in the counselled projected charges broken down by facility, doctor and so on, so that patients can see in simple charts the variation from norms? And can such price comparisons be made a mandatory part of the financial counselling? Under pressure of time or stress, a patient may not shop around when initially choosing a healthcare service provider. But this idea may give them some food for thought for considering their healthcare service provider the next time they have the same complaint. Next, I turn to mechanisms to curb over-treatment and over-testing. There may be a natural tendency to over-prescribe, over-treat or over-test, in lieu of strong controls and pressures from customers and regulators. Earlier, I touched on how patients, as customers, may not always be in the best position, be well-incentivised or sufficiently resourced to exert pressure on healthcare providers to keep prices in check in a skillful way. Insurance coverage may also distort choices by both providers and patients. What can regulators do? MOH's Agency of Care Effectiveness has been issuing care and drug guidance since 2017. However, defining over-treatment is notoriously complex, as some cases require more extensive – and expensive – testing and treatment than others.”
“Data is in some cases published according to the 25th, 50th and 75th percentile. However, it is not clear what causal effect these measures have had to date of this publishing. I would like to ask, since MOH started the publication of this data, does MOH have any evidence or indications as to what the effect has been, to assess the return on that investment? At the level of theory, a few observations can be made. Not all patients would have the skill, time and inclination to study prices and make informed decisions on that basis. This problem gets compounded when that patient is faced with a medical emergency or pressing problem where familiarity with one healthcare provider or physical proximity may weigh on the decision more than any prior study of pricing. Moreover, many patients may be confused as to the link between pricing and quality and may not only be willing to pay more for better quality but may misunderstand higher pricing to mean higher quality. Many patients who are more broadly consumers may use price as a surrogate for quality in the absence of other information. Would MOH consider the following further measures? Firstly, publishing data by hospital, but also with data on the outcomes for those procedures at those hospitals where relevant and where there are sufficient datapoints, by outcome measures, I mean for example, but not necessarily, re-admission rates, safety of care, mortality, patient experience, waiting times and so on and so forth. This will help patients make the link between price and quality. I am aware that this needs an investment in data systems and expertise to capture data well and risk-adjust to take into account the differential complexity of patients. This will take time.”
“A media report from late 2018 quoted the Life Insurance Association of Singapore (LIA), have found that average private hospital bills were increasing by 8% a year compared to less than 3% for public hospital bills, though I note that the 3% figure is still far higher than general inflation. Medical or healthcare inflation is a challenge faced by many countries around the world. It is partly driven by the increasing availability of advanced cutting-edge drugs, treatments and diagnostic techniques which are expensive. How do we control medical inflation and curb any tendency towards over-treatment and over-prescription without shutting the door to research and development and innovation in the medical sphere? So, the rest of my speech will focus on ideas to answer this question. I will speak on several themes related to this question. Firstly, I would like to speak on price transparency, which is one thrust being explored around the world. The movement towards price transparency aims to make market mechanisms work to curb healthcare inflation through market competition. In November 2018, MOH started publishing fee benchmarks for private sector professional fees, which are not mandatory caps, but which place some onus on healthcare service providers to justify their fees. And prior to this, MOH has been providing similar guidance to public hospitals since 2017, I believe. MOH now publishes information on 222 common surgical procedures like hip replacement and colonoscopy, comprising 85% of all procedures. Details include, depending on the type of dataset, the public or private setting, hospital ward type, bill size, operation fee, surgeon fee, anesthetist fee, facility, average length of stay and implant breakdown.”
“Mr Deputy Speaker, Sir, the Healthcare Services Bill seeks to accomplish a number of things. To introduce a services-based licensing regime for providers of healthcare services replacing the old premises-based licensing regime; to strengthen the safeguards for the safety and welfare of patients; to improve the governance requirements for providers of healthcare services; to enhance regulatory powers in relation to providers of healthcare services, including allowing intervention in failing providers in order to stabilise operations and ensure continued patient care. These are all steps in the right direction. Member of Parliament Ms Sylvia Lim, my party Chair, has made a number of points about the Bill with which I agree and which I shall not repeat here. My speech will focus on what else can be done to contain healthcare inflation. Part 57 2(R) of the Bill empowers the Minister to regulate the sector so as to require price transparency towards patients and customers. Mr Deputy Speaker, Sir, according to Mercer Marsh Benefits 2019 Medical Trends Around the World Report, based on surveys of insurers regarding type, cost and frequency of medical conditions that were claimed for by company employees in 2018, Singapore's medical trend rate, which measures medical cost inflation, was 10% in 2018, 10 times the Singapore economy's estimated 2018 inflation rate of 1% at that time. In a Parliamentary reply from 2018, the Government figure for healthcare inflation measuring the growth rate of prices for healthcare-related goods and services paid by patients after Government subsidies was about 1.2% between 2013 and 2016.”
“Will some thought be given to a measure of underemployment in terms of pay and qualifications, so that at least we know how well we are doing on this front, going forward, given that this may be a structural issue that Singapore and other economies face as well? Lastly, the Minister spoke about youth unemployment. What is the Minister's sense of how we are trending in terms of the time taken for our youths who come out of universities, polytechnics, Institutes of Technical Education (ITEs) on the time that they take to find permanent employment, as opposed to contract employment, as opposed to internships? Anecdotally, we do hear that there are some challenges there. For example, one resident I encountered said that his daughter, who graduated from one of our autonomous universities six months ago, is still looking for a job. Of course, that is just one datapoint, but what is the trend that the Minister sees on this front, going forward?”