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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Every one of 1,226 lines we hold for Leon Perera, in date order, each linked to its source. Free to read, in full, without an account. Page 7 of 25.
“Thank you, Mr Chairman. I just have two clarifications. The first one to Minister Ong. As the Minister observed, preventive healthcare has been a long journey. HPB was founded in 2001 and we have been spending, I think, about $300 million a year for quite some time. But over the last 10 years, I think the outcomes for chronic conditions seem to have not done very well and perhaps, even gone in the opposite direction. I noted in my Adjournment Motion speech on preventive healthcare that the proportion of older adults with three or more chronic conditions almost doubled between 2009 and 2017. I think the Minister and others have also elaborated on some data points. So, my question is, will the Ministry reflect deeply and, perhaps, audit all the efforts that have gone into preventive healthcare in the last 10, 20 years to find out why there has been this disconnect between the investment and the efforts and the kind of outcomes that we have seen in the last 10 years of chronic conditions. Will that be factored into the preventive healthcare plan going forward? My second clarification is to Senior Minister of State Dr Koh. It is a narrower one. I just wanted to confirm what he said on the COVID-19 Healthcare Award for cleaners. I actually filed a Parliamentary Question on 14 February about whether cleaners were eligible for the COVID-19 Healthcare Award. The answer seemed to be no. It did not exactly say no, but it did not say yes and it said that there are other schemes for cleaners. So, I just wanted to confirm if I heard the Senior Minister of State correctly that now the position is that cleaners in healthcare institutions are eligible for this $4,000 COVID-19 Healthcare Award.”
“Mr Chairman, from FY2016 to FY2018, our public and total healthcare expenditure remained constant at 2.1% and 4.1% of our GDP respectively, approximately, but has since increased. For comparison, Japan spends 9.3%, Germany spends 10.7% and the OECD average is about 8.8%. However, these two years have shown that we need a much more anti-fragile system. Healthcare workers, including nurses, ambulance staff, junior doctors, are overworked the moment colleagues begin falling ill or are told to stay at home. This is not sustainable. I believe the Government understands that it needs to spend more. We see this in plans for upcoming infrastructure, like new polyclinics. I would suggest that public mental health and dental care also needs to expand a lot faster than the headline rate. For mental health, I was told in a Parliamentary Question reply, that the number of psychologists here is only increasing by 4% annually. It is also not easy to qualify as a psychologist. From conversations with my constituents in the Serangoon ward of Aljunied GRC, the waiting time to see a public sector mental health professional or dentist can be long. For such conditions, intervening early is important to limit further health or social consequences. I would like to urge greater urgency in the expansion of our public dental healthcare capacity as well as our public mental healthcare capacity, especially at the tertiary level. A Sustainable Renal Treatment Strategy”
“Mr Chairman, I recently filed Parliamentary Questions on junior doctors' working conditions. I would like to call for a review of the current 80 working hours per week guidelines, with a view to reducing it marginally, say, to 70 hours. Some overseas studies do show that work hour reforms are not necessarily tied to adverse patient outcomes and that 80 hours is more than what is necessary. We can study this locally before making changes. While it is understandable that hours are frontloaded in a junior doctor's career, so they are exposed to a variety of cases and have experience of disease progression and so on, recent reports of burnout are very concerning. Burnout harming doctors' well-being can impact patient care. Sleep deprivation research shows it can impair psycho-motor abilities to a degree comparable to intoxication. Lack of work-life balance may also push well-trained healthcare workers to work in other countries or industries. Secondly, let us move towards 100% compliance with the current 10-hour intervals between duty periods and after in-house calls, up from 90% now. We must also ensure that there is no under-reporting. I understand from my past Parliamentary Question that MOH has indicators showing that there is no systemic under-reporting, but anecdotal feedback suggests that this still happens to some extent. In cases where under-reporting or lack of compliance is found, let us move fast to study lapses and ensure manpower is sufficient. Lastly, I would like to suggest that MOH mandates concrete steps to shorten the time spent handing over and peripheral duties. A 24-plus-hour duty is taxing and reducing administrative time will allow junior doctors to obtain sufficient rest before their next shift. Healthcare Workers' Mental Well-being”
“Such an aid agency could support targeted cash transfers to indigenous and rural communities to manage and protect forests abroad. NGOs, like Cool Earth, already do this and one UN Food and Agriculture Organization (FAO) report studying Latin America found this to be a cost-effective way to preserve forests. In Indonesia, there are already community-managed forests. Sir, we should come in to support such efforts as good neighbours on the same pale blue dot.”
“Mr Chairman, Sir, nature-based climate solutions are powerful methods of carbon capture. They also have the added benefit of protecting ecosystems. As we move to set up our carbon trading hub and companies consider buying carbon credits from overseas entities to offset emission, there is a pressing need to ensure projects are socially sustainable. Lack of local buy-in, poor oversight and poor management can result in projects with less carbon capture than what companies pay for. Indonesia's Katingan Mentaya project has reportedly been one such case. A Nikkei investigation found that more carbon credits were issued than it could likely make good on. Poor quality credits diminish accountability and reduce the emissions captured. Crucially, they could impact the Singapore brand. Renewable projects funded by Government-linked companies (GLCs) should also be accountable for Environmental, Social, Governance (ESG) impacts. Reports mentioned that the Laos hydro projects could be negatively impacting food production, ecosystems and indigenous communities. With Keppel recently signing its hydroelectricity import deal, I hope that our GLCs pay attention to such externalities. Impacts can be minimised with the adoption of free prior and informed consent policies. I would like to suggest that the Government step in to recommend consistent, baseline, transparency and traceability, and due diligence process guidelines for such renewable projects. This is important from the standpoint not only of promoting green outcomes, but for our national brand as well, Lastly, my Parliamentary colleague, Assoc Prof Jamus Lim, previously expanded on the potential soft power benefits of having a foreign aid agency.”
“And even after the release into the community, SPS still continues to engage the ex-inmates and their families. So, we will look at all the different requests and we do our best to provide them the opportunities to be rehabilitated and reintegrated into the community.”
“I thank the Minister of State for that helpful reply. Just two supplementary questions. One is that, if an inmate, for whatever reason – be it lack of capacity or any other reason – would like to attend educational, rehabilitative or religious programmes, but they find that they do not have access to those programmes, can they make a request to attend such programmes and will that be taken into consideration in giving them access to such programmes, if for any reason they do not have that? That is my first supplementary question. Second supplementary question: it is my understanding, based on published, publicly available information, that SPS adopts a classification system for inmates based on what is seen as their propensity to be rehabilitated. So, I am wondering whether those who are classified in that way as being less likely to be rehabilitated, can also demonstrate, through acts of good faith, through requests, that they are open to attending these rehabilitative programmes and get access to them, if they demonstrate that. Assoc Prof Dr Muhammad Faishal Ibrahim: Sir, as I have shared earlier, we use the risk, need and responsivity model approach, as well as the length of the stay in the prison or institution, to look at how that kind of programmes may be useful for the inmates. We have received requests from inmates. And I would like to share with the House that every request that we see, we will assess it, consider it and we will also propose to the inmates what will be useful for them. Rehabilitation is not only about giving them programmes. In fact, we adopt a throughcare approach where the process of rehabilitation begins when the inmates start their prison term, all the way, with the community, at the end of it.”
“For shift workers, it can be really hot sleeping during the day. This reduces sleep quality and quantity, which have an impact on workplace safety. Studies show that driving on low-quality sleep can be as dangerous as drink-driving. With migrant workers, many have spoken about why they choose to sleep on the floor or on hard boards without bedding. The heat can be unbearable because, very often, you have 16 workers in a room and many dormitories have metal roofing and walls. NEA recently released a Good Environmental Health Practices statement. However, there are no legally binding measures regarding heat management. With the MOM employers' guide for domestic workers, there is no definition for "adequate ventilation". In 2017, one of our non-governmental organisations (NGOs) even reported that a domestic worker was made to sleep on the balcony. Of course, most employers put in effort to ensure workers have decent living conditions but let us work towards stricter binding guidelines so that no worker is left behind.”
“Mr Chairman, Sir, heat inequality is an issue I spoke on in last year's climate Motion in Parliament. The number of very hot days where the real feel temperature, considering humidity, exceeds 40 degrees has increased by about eight times since the 1950s to over 80 days each year now. The situation is serious. The Government mentioned one year ago that it is working on an urban heat impact mitigation action plan. I would like to ask the Minister for an update and propose that the action plan consider lower-income groups and blue collar workers, including migrant workers. Firstly, on prioritising low-income groups. The cheapest air conditioners cost about 60 cents per hour for electricity. So, many less well-off residents head to air conditioned spaces like malls and libraries, which are important for the hottest days in the year. There is not always space at the library though. From what I understand, the Green Towns Programme does not prioritise vulnerable neighbourhoods. Can we quickly provide good stopgap measures for such vulnerable areas? We already know where the warmest areas in Singapore are through Landsat thermal images and these places often have high concentrations of HDB rental blocks. We could focus our OneMillionTrees project on areas where vulnerable people live. We also have a programme providing vouchers for households to buy high-efficiency appliances like fridges but can we extend this to include fans and include more households? Moreover, can we look into including living space temperature requirements under the building control regulations? I would also like to ask what are the Government's targets to retrofit all estates to deal with the urban heat island effect? Next, on blue collar workers. Blue collar workers face the short end of the stick.”
“Thank you, Mr Chairman. Just one point of clarification to the Minister Dr Maliki who addressed my cut and it is in relation to my cut where I asked if the Government can publish data by SES, background, for admissions into the different categories of schools: Government, Government-aided and Independent. I think that having some transparency about that would be helpful to help us to monitor our progress to ensure that the more popular and well-resourced schools do not become closed communities. And that is the goal I think we all share. I would hope that the Government would consider just making that data public.”
“Mr Chairman, I filed a Parliamentary Question last November, asking for data on the socio-economic backgrounds of students admitted into different categories of Secondary schools, such as Government, Government-aided and Independent categories. I wanted to find out the extent to which students from well-off families were concentrated in the more popular and well resourced group of schools. While the Government gave a response describing the school admissions process, it did not release the data I asked for. I unsuccessfully attempted to file a follow-up question this January asking if MOE possesses this data. The question was not allowed on grounds of repetition. In 2018, Prime Minister Lee acknowledged the fears of popular schools becoming closed circles. Sir, I repeat my call for the data to be released as a measure of how we are faring on diversity and inclusivity if we are serious about recognising and tackling school-based socio-economic status (SES) trends which may have profound consequences for social mobility. Note that I am asking for data on SES by category of schools and not by each individual school.”
“I thank the Senior Minister of State for his answer. Just one supplementary question, which is to confirm the understanding that MOH provides guidelines as to the quantum, the way in which you do the means testing for MediFund, but those guidelines, if I understand it correctly, are not binding on the different MediFund Committees, so they have the discretion to deviate from those guidelines, depending on their case-by-case assessment. The second supplementary question is, if that is the case, then what process is in place to ensure that there is a basic degree of consistency? Because otherwise, you could get some MediFund Committees being more generous than others, depending on the hospital or the healthcare provider.”
“In addition, if their existing employer cancels their work permit through no fault of the worker, the worker should be allowed to stay in Singapore for 30 days to enable him to find a new employer, regardless of whether his employer consents. The worker will be responsible for his own food and lodging during this time. He can elect between joining the Retention Scheme, if eligible, or relying on this window. An article by non-governmental organisation TWC2 states that many workers had their Work Permits cancelled and were repatriated because their employers had no work but did not allow them to transfer jobs, even though other companies needed workers, worsening the manpower shortage. The 30-day transfer window addresses this. This proposal will not encourage turnover of workers because it only applies if the employer unilaterally decides to cancel a Work Permit. Second, to grow productivity and incentivise work pass holders to stay with employers, I propose allowing employers to bond them for up to two years in exchange for sponsoring formal training. The length of the bond period can depend on the number of training hours, provided that the duration of training and fees meet certain requirements. ITE could partner BCA, which already runs training courses, to develop appropriate courses to increase our migrant worker productivity. Sir, upskilling is important in reducing the number of semi-skilled foreign workers needed and, hence, our dependence on foreign labour.”
“Yes, Chairman. First cut on easing movement restrictions on migrant workers in dormitories. Sir, migrant workers have experienced movement restrictions for almost two years. While the December update allows up to 3,000 workers out daily, workers are often not able to go out on workdays. What is the Ministry's roadmap to ease restrictions? Can the Government explain specific criteria needed for the next round of easing, be it caseload, ICU usage and so on? The vaccination rate among dorm residents is 98% and that ought to be a consideration in easing movement restrictions. Sir, the restrictions are taking their toll on the mental health of migrant workers and pose social risks. Experienced workers might prefer to go home, worsening the manpower shortage and making our economy haemorrhage experienced, more productive workers. We are suffering reputational damage in international news. Al Jazeera quoted one worker as saying: "I feel very sad about the difference in the lives between me and the rest of the people." Chairman, there are practical reasons to ease restrictions, but it is also the decent thing to do. Migrant Worker Retention and Productivity Mr Chairman, Sir, there are economic benefits to retaining migrant workers in our economy who are familiar with Singapore and to increase their productivity, which would mean we need to employ fewer. Currently, a Work Permit holder (WPH) can only transfer to a new job with employers' consent. An exception is the Retention Scheme, which gives eligible workers 30 days to match with a new employer. I support the thrust of this scheme, which is similar to what Workers' Party Members have called for. But it does not go far enough, as it does not apply to all WPHs. I call for it to be extended to all WPHs.”
“I thank the Senior Minister of State for his answer. Just a few supplementary questions. I believe the Senior Minister of State said 6% of the wrongful dismissal claims that go into TADM had lapsed because they do not meet the time bar and 12% are referred to ECT. So, that still leaves 82%. Of the remaining 82%, I am just wondering how many are actually dropped due to lack of evidence and how many are actually successful, whereby TADM upholds that there had been wrongful dismissals? Just wondering if I could have that statistic. My second question is to ask the Senior Minister of State if he could characterise what the lack of evidence issue really is in most cases. Is it a lack of, for example, written email or audio-graphic or video-graphic evidence? Is that usually the reason why the cases cannot be moved forward?”
“Okay. I will just wrap up in the next one minute. Because I would not know what sort of cases would be referred to that, how those cases will be dealt with. What I can say is that in terms of the perception of legitimacy, I think there is a benefit there. The Minister mentioned various practical issues that could come about, for example, do we want to duplicate resources. I mean, there are practical solutions to that. You could design an office ombudsman to address that. For example, investigations could be directed by the office but they could seek resources from other agencies. But I think for the sake of length, I will leave it at that. 5.30 pm”
“An ombudsman would report to Parliament in the manner that I outlined in that earlier speech and that means that it sits fundamentally in a different place organisationally. So, when it investigates alleged abuses, it is seen to be an investigation coming from a different part of the Government. I think being seen to be that, to do that, has advantages in terms of vertical accountability, that is felt by the society and that has advantages in terms of the strength and solidarity of our polity. I would say that there are tangible advantages to be gained from that. It is difficult to speak of practical benefits that would come from instituting this proposal because it is hypothetical, of course. We have never had —”
“Thank you, Mr Chairman, Sir, and I thank the Law and Home Affairs Minister Mr Shanmugam for his lengthy comments on my two minute cut speech. I would like to just respond to some of his points and pose some clarifications. He mentioned that he was not surprised at my suggestion of a judicial check on the administration of punishments in prison. I am equally unsurprised at his disagreement with that. He referred to New Zealand and he pointed out many problems that New Zealand has recently been grappling with. There is no doubt in my mind that if I had cited another country, he would point out problems with that country as well. My question would be that if instituting an independent organisation with investigative powers against the executive government, such as an ombudsman, is such a bad idea, why are so many countries doing that? I made a long speech, which I do not intend to and I cannot anyway repeat, in September 2020 when I gave detailed arguments for an ombudsman, I addressed the objections to the idea, one by one. I talked about the countries that have that. Many countries do incorporate this institution. And if you were to go to opinion leaders, and if you were to conduct public opinion polls in those countries, I am not at all sure that the majority of people would say that, "Well, this is a bad thing, let us remove this institution and then things will get better". So that is the first point I wanted to put across. I think, fundamentally, the main argument for this ombudsman comes down to the fact that, currently, law enforcement institutions sit on the organisation chart within the executive Government, they are within that command and control hierarchy at the end of the day.”
“Mdm Chairperson, I recently filed a Parliamentary Question (PQ) on the use of extra-judicial caning to punish aggravated or major prison offences. While I accept that there is a need for in-prison disincentives against dangerous behaviours, in my opinion, there is too little independent oversight in this process. The Institutional Discipline Advisory Committee reviews the recommended strokes. The Commissioner also reviews the findings and has the authority to vary punishments. However, the process starts and ends within the Singapore Prison Service, which investigates, presses charges and recommends punishment. Can reform with a judicial element be studied, so we have a greater oversight mechanism? This is important in respect of caning, which is a harsh punishment. On caning, lastly, according to one published account, there is a practice that sometimes happens of requiring inmates to "thank" the prison staff after being caned. I am not alleging that this is the case. But I would like to ask the Government if this is a current practice and, if so, would the Government consider stopping it, as it is unnecessary and seems of questionable rehabilitative value, to put it mildly. Reforming Offenders, Lowering Recidivism”
“Thank you, Mdm Chairperson. My first cut, on foreign interference. Chairman, in some of our laws, the Government has sweeping powers over many activities. In the Home Affairs Minister’s FICA round-up speech, he said if the CPIB hypothetically “wants to investigate the Prime Minister, there is a higher authority they report to." I would like to return to one question I raised during that debate, which is, who checks the checkers, and specifically in relation to foreign interference. The world is changing and geopolitical tensions are ratcheting up to levels that have not been seen in recent memory. Ministers, including the Home Affairs Minister and Prime Minister himself, would be extremely high-value targets for foreign interference, particularly given what some might say is Singapore’s significant role in ASEAN. I would like to ask MHA what is the nature of the institutional check on senior Ministers in respect of foreign interference. Does it reside with the CPIB, which is what the Home Affairs Minister’s reply suggested? If so, does the CPIB proactively assess risks of foreign interference against Ministers or does it act only reactively, if complaints are lodged? Are there officers in the CPIB with the necessary skills and expertise to investigate possible foreign interference? I would like to reiterate calls for an Ombudsman to provide independent oversight, similar to that in countries like New Zealand. The office of an Ombudsman would create investigative resources behind a legitimate institutional check that would be seen to be legitimate. In the current climate, there is more of a need for this. Extra-judicial Caning Second cut on extra-judicial caning in prisons.”
“Thank you, Mr Speaker, Sir. I thank the Minister for his comprehensive reply. I have just one supplementary question. So, it does appear that some retailers are providing ex-gratia compensation upon appeal, and when people write in and request a compensation. Going forward, will the Government consider "template-tising" that and setting a standard for what sort of compensation should be paid so that people who write appeals do not get the benefits that other people who do not write appeals get?”
“I thank the Senior Minister of State for his answer. Just one supplementary question. Given that the compliance burden for TraceTogether and SafeEntry is not insignificant – it impacts time, productivity and so on – what would be the criterion or criteria that the Ministry would use to make the decision to phase it out? At what point will that actually happen?”
“Alright. Let me move to my first clarification, which is: I had an exchange with the hon Minister Lawrence Wong in this House in 2018. I asked the Minister at that time what would be a reasonable time interval when we review these rules governing the reserves. They were amended in 2008, they were amended again in 2015. So, what is reasonable time? Are we saying that it is set in stone and we will never amend it? And the hon Minister's reply to me at that time was, "you never say never" and these things do have to be reviewed at a certain point. So, my question is, what does the Minister think is a reasonable point in time when we review these rules, as we have suggested? The second clarification is on the concept of an optimal level of reserves. I would invite the Minister to agree with me that as the absolute level of reserves increases in dollar terms as a proportion of GDP, we must accept that it is legitimate to bring into place policies that slow the growth of that reserve without depleting it. On that note, would it be the case that the Minister rejects altogether any notion that there is an optimal level of reserves and we keep adding to the reserves, ad infinitum, without any regard to the absolute level and its relation to GDP? The last clarification is, the Minister alluded to the fact that when we make suggestions about the reserves, land sales, NIRC, there is a certain cavalier mindset involved in doing so. I would like to ask him, the PAP Government in this House did exactly that, in 2008 and they did it again in 2015. Was that cavalier? And if that was not cavalier, why is it cavalier when the Workers' Party now suggests doing that?”
“Thank you, Mr Speaker, Sir. I thank the Finance Minister for his wrap-up speech. There are three clarifications. Before that, just a very short sort of response or preamble. I think the Minister talked about how much the personal income tax and property tax would have to rise to fill the hole if GST was not hiked. I want to clarify that when my colleague Assoc Prof Jamus Lim outlined different proposals for revenue generation, there was never the intent that the entire burden of plugging that hole falls onto personal income tax or property tax. So, with respect, Sir, I think the view that we are putting forth proposals that soak the rich is a mischaracterisation. In fact, it is a caricaturisation of what we have put forward. The bulk of revenue generation in those proposals actually fell on the changes to the land sales, the changes to NIRC and also the net effect on corporate tax's take from compliance with the BEPS regime. Not a discretionary increase in corporate tax, but how that would impact the overall corporate tax taken. I think our point there is that —”
“If the help is provided in a results-oriented, holistic way, with sufficient dollars, there is every reason to believe that that spending will diminish over time and yield broader social and economic and even sociopolitical benefits, as more people improve themselves in terms of health, life skills, employability and – that most precious commodity of all – self-belief and confidence in themselves. We must not judge our success solely on how much GDP growth we have achieved each year, but also by how much poverty we have eliminated. In recent years, it is unclear if we are making success on this front, with no real downtrend in demand for ComCare, rental flats and other assistance schemes. We must break this cycle and make a substantial dent on poverty. Then, and only then, can we truly claim to be living in a First World Country. Only then can we say that we live in a society that has everyone’s back.”
“Sir, in waging war on poverty, there are many other policy tools we need in our arsenal that I will not have time to expand on and hope the conversation will continue. For example, my colleagues, Members of Parliament Gerald Giam and Assoc Prof Jamus Lim, have tirelessly spoken about minimum wages in this House. Member of Parliament Louis Chua moved an Adjournment Motion about expanding the supply of rental housing, while Member of Parliament Faisal Manap did the same on motorcycle COEs. Workers' Party chair Ms Sylvia Lim has spoken passionately on social mobility. In this Budget debate, the Leader of the Opposition, Member of Parliament Ms He Ting Ru and other Workers' Party Members of Parliament have argued for other policies that will help the poor and the vulnerable, including why the Government's 28% GST hike is unhelpful and unnecessary, which is why the Workers' Party cannot support the Budget. A 28% hike refers to the increase in GST rate from 7% to 9% – that is, a 28% increase. In conclusion, Mr Speaker, Sir, I would like to wrap up by asking a simple question. Is spending more and investing more effort in fighting poverty and breaking the poverty cycle really worth it? I understand that changing our mindset and paying to tackle poverty costs money. But we have done this before. In Year One of COVID-19, almost 200,000 self-employed people were given $1,000 a month. There will be returns from investing in a war on poverty and breaking the poverty cycle.”
“In short, social workers can help people thrive. The last subject I would like to address in my speech is to call for the release of better data to tackle the issues of poverty and social mobility. Better data helps public debate and helps us figure out what works and what does not. And in tackling a problem that is as complex and resistant to simple solutions as poverty is, such data is critical for performance management for the goals we have set. We need to invest in a rigorous measurement of intergenerational social mobility at least once every decade, a call I have made before. And a nationally recognised poverty line should be established, which could aid social workers in making decisions, a call made in this House by my colleague, then Non-Constituency Nominated Member Mr Yee Jenn Jong, in 2013. We should also keep data on child poverty, which is key to intergenerational poverty and which many other countries do publish. I propose that we track the intergenerational rate of reliance on ComCare Financial Assistance and rental housing. One head of an FSC who had been in the field for over 20 years told me that he was receiving cases of young families that were the children of cases he had handled as a young social worker. This is a poverty cycle we must break. Thirdly, I would like to call for in-depth studies to be done, directed, especially, at younger poor Singaporeans, to do deep root cause analysis of the reasons for poverty. Lastly, we should aim to release more data by socioeconomic status, including on health outcomes, educational attainment, new business formation and so on. Any relevant public survey of studies that relate to this should, by default, be published.”
“Many poor Singaporeans I know are willing to work hard and may have a passion or talent for something that could become a source of stable income, pride and self-esteem. Micro-entrepreneurship, particularly among women, whom research has shown are more likely to share financial gains with their children, unfortunately, is a pathway to poverty alleviation that attracts a great deal of multilateral funding in other countries. I would like to briefly repeat a call made by my colleague, Member of Parliament Mr Faisal Manap, to reintroduce the hardship scheme for hawker centre stalls. This could provide opportunities for the low-income and ex-offenders to pursue their aspiration to set up a hawker stall with subsidised rents. Next, Sir, I would like to touch on the social work profession. Social workers are at the core phase of dealing with poverty. Many I have spoken to feel that many of our social workers feel overworked. And this was my sense, too, when I was an FSC volunteer in the 1990s. This is a subject that has been discussed in this House a number of times. We need to invest in more manpower and we need to ensure that compensation is well matched to the rigours of the job, which can be intellectually, socially and emotionally draining. We can do more to set benchmarks for caseloads and increase headcount when these benchmarks are breached. Social workers will find it hard to help others if they are looking for help themselves. Social workers with sufficient capacity are the best people to provide advice and support on more complex issues and not just disburse money. They could be like venture capitalists, investing in people and also providing them with critical advice and coaching to help realise a return on that investment.”
“In citing this, I want to be absolutely clear that our social workers and SSOs, generally, do their very best and do good work, but they operate within the policy parameters prescribed for them. Sir, I cited research earlier showing that income levels of $1,400 and $6,400 per month have been suggested to provide a very basic standard of living for a single elder person aged 65 and above and a family of four respectively. For those aged between 55 and 64, that figure increases to $1,700 per month. Sir, I would suggest that there is scope to revisit and significantly increase the quantum, duration and conditions of welfare assistance we provide to better protect the vulnerable, particularly the children and unemployable elderly. We should address the issue of poverty in a results-oriented fashion and in way that takes into consideration new research when it becomes available. To be sure, I am not suggesting that welfare assistance should be unlimited and unconditional in all cases, or that the levels should be so high as to make it unattractive to work. But as we apply progressive wage laddering, the quantum that makes work unattractive will rise and this should be reflected in our welfare schemes. Sir, another suggestion I have is to enable poorer individuals to contribute back to society in a manner that might most befit their abilities by empowering them to become micro-entrepreneurs. A state-backed facility should be set up to provide micro-loans to poorer individuals to set up microbusinesses, such as home-based catering businesses, for example. The financial services industry is, currently, not set up to do this.”
“Secondly, commitment to taking action on the employability front with training, job seeking and so on and, here, the FSC and WSG account managers can coordinate. Thirdly, commitment to healthy behaviour, such as going for health screening and adult vaccination. Fourthly, commitment to attend personal life skills courses, for example, related to financial literacy. In fact, some of the increased Financial Assistance can come in the form of digital currency that can only be spent on healthier food. At the Committee of Supply (COS), I shall elaborate on this and on child early intervention programmes to break the poverty cycle. Sir, my final topic on the administration of poverty relief would be the quantum of relief. More can be given, with part of it being conditional, as I have argued. Long-term ComCare gives individuals about $600 monthly, short- to medium-term ComCare gives a mean of $600 per household per month in FY2020, which works out to just under $270 per person per month. There are other schemes like the Workfare Income Supplement and Silver Support, but these also number in the hundreds of dollars per month. And not every person who is vulnerable accesses multiple schemes. I am sure other Members of this House have had the same experience as I often have, where persons approach me to plead for Financial Assistance and the case is referred to the SSO. A letter from the SSO sometimes follows, which states that, in their conversation, the residents agreed that they were receiving certain state benefits already and, hence, they have agreed to withdraw their application for Financial Assistance. However, the fact that they initially came to the Member of Parliament underlines that there is a difference of perspective on how much is enough.”
“There should be a certain runway where the Financial Assistance continues after such events to enable the beneficiary to settle debts, to adapt to the new income structure and so on. Next, on the Financial Assistance application process. Applicants are sometimes asked to produce various documents that they may no longer have. Some are asked to hold physical meetings at the SSO office, which can be very hard for them if they are taking care of young children or working. Can social workers visit beneficiaries more frequently at their homes, which would help them to better assess their living conditions? And this is a topic that I have raised before. Can we convince more beneficiaries also to grant the agency direct access to past records residing with banks or Government agencies so that the absence of documents does not become the impediment it often is? Thirdly, let me address how we can increase the quantum of Financial Assistance available based on the beneficiary committing to positive actions that would help them and their family. More financial assistance can be provided beyond the current scheme caps, but tied to various conditions about which the welfare account manager is best placed to decide. These may include, firstly, commitment to ensure attendance of children at early intervention programmes, such as KidSTART, or attendance at school for families where absenteeism is an issue. This follows the Bolsa Família principle of conditional cash transfers to poor families, which has had some success globally. And I note that in a Parliamentary Question reply that just came in, 2% of Secondary school students are tied up with absenteeism.”
“But they should also proactively work with their beneficiaries to assess different opportunities and find the right one, like a consultant and coach would do. I have spoken in this House previously on how some state employability counsellors in some other countries take a results-driven approach. An employability account manager for the disadvantaged would also be in a position to nudge their beneficiaries to upskill or reskill to move out of "at-risk" jobs before they are made obsolete. This recommendation is linked to my earlier call to expand the supply of such training and conversion places. The second issue involves the current process of applying for financial assistance being too complex and exhausting. For example, the interviewing of family members by agencies, in some cases, is unnecessary. Some applicants are deterred from pursuing their Financial Assistance applications because of the humiliation that they would feel if agencies call their relatives. I repeat my call for Financial Assistance to be provided based on declarations as to whether family support is being obtained, without the need for interviewing family members, and with strong disincentives associated with making false statements. Next, when seeking Financial Assistance, ComCare Short- to Medium-Term Assistance currently gives assistance for an average of only six months. To avoid the uncertainty and stress that comes with having to renew the support every few months, a longer-term grant can be given, albeit tied to conditions which I will touch on in a minute. This addresses the disruption of some beneficiaries having their Financial Assistance suddenly cut off when they find a job or increase their pay beyond a certain threshold.”
“Poor families would benefit from having one window for state support and also to have that support scaled up and follow more of a results-driven, account management approach. Sir, let me now expand on my recommendations for poverty alleviation and employability support. Firstly, we should increase the accessibility of state schemes. I will suggest four ways to do this. The first involves us currently having too many financial assistance schemes that confuse and overwhelm their applicants. These include CDC vouchers of various kinds, ComCare and the Pioneer Disability Fund, for example. We should aim instead to minimise the number of scheme distributors and not have applicants being referred from one organisation to the next. What I propose is that all state schemes be funnelled through a central account manager, with one such manager paired to each poor family. Social workers at Family Service Centres (FSCs) seem to me to be best placed to play this role. These account managers should be empowered to channel and administer all state schemes. They should also have visibility on schemes that are automatically administered, like Silver Support and Workfare, so that they can also address issues or errors there and so that they can take a more holistic view of the family's situation. To mirror the one account manager for social welfare support, each poor family and low-income worker should have one account manager in charge of employability at WSG. That manager should be empowered and mandated to coach the worker to access the large array of work and training schemes. Their mandate should not merely be process-driven, meaning they should not be limited to training them on CV-writing techniques or asking them to sign up to passive job alerts.”
“My colleague, Sengkang Member of Parliament Mr Louis Chua has spoken about wealth inequality and cited quite a few data points which I would not repeat here. But we also need to look beyond statistics to the lived experiences of Singaporeans to fully understand why this matters. A 2018 CNA survey found that it was class and not race or religion that was the most divisive factor in Singapore. It also found that those identified as upper class were more likely to feel a greater sense of belonging and national pride than those identified as lower class. In a 2018 poll by Blackbox Research, seven in 10 Singaporeans felt that income inequality in Singapore had worsened over the past five years, with youths and young working adults more likely to feel anxious about the unequal distribution of income. Sir, let me now move to specific policy calls. Before I begin, to set some context, the assistance that is provided to the poor is not always channelled through a one-stop shop. Assistance schemes and ad hoc help are available from different agencies and the process of navigating this ecosystem can be stressful and daunting. In fact, the Government's "kueh lapis" approach of multiple lines of assistance may, in fact, levy an unnecessary bandwidth tax on the poor when they seek help. "Bandwidth tax" refers to the additional cognitive burden they face. To get support from multiple schemes, they personally have to fill up paperwork, produce documents, attend meetings and meet deadlines. And because they struggle, their cognitive functioning is impacted and they may make what many others see as "poor" decisions. As a result, they become entangled even more deeply in the poverty cycle. One study found that the bandwidth tax due to poverty can be the equivalent of 13 to 14 IQ points.”
“From another Parliamentary Question reply, I learnt that we have about 4,000 children living in 1-room rental flats and about 18,000 in 2-room rental flats. I estimate that this means that the average living space per child in such flats is just 10 square metres, 60% less than the average living space per person in Singapore. Research by academics led by Prof Ng Kok Hoe and Prof Teo You Yenn concluded that a single elderly person realistically needs a minimum of around $1,400 per month for basic necessities and $6,400 per month for a family of four. Yet, 100,000 people in our local workforce earn a gross income of less than $1,300 per month. I do not have a figure for the families of four or more earning less than $6,400 per month but it must be significant. The last Household Expenditure survey shows that, on average, households in the bottom 20% spent more than they earned. On social mobility, the available data shows a worrying trend. A 2019 MOF study of intergenerational income mobility found a high degree of mobility for those aged 44 to 53 today. However, this generation came of age at a time of rapid expansion of the economy. Younger Singaporeans today face a completely different set of challenges, such as high housing prices and high income and wealth inequality. One study by Prof Irene Ng, based on a 2002 survey dataset, concluded that 58% of the income advantage of Singapore parents was being handed down to their children, a level similar to the USA at that time. In 2015, the Principal of Raffles Institution said that the school enrolment was exhibiting a class skew that it did not have in the past. Some baby boomers made a windfall from property and this shows in our parallel problem of wealth inequality.”
“Our pledge to build a society based on "justice and equality" calls on us to act. But beyond that, investing in additional anti-poverty and early intervention action for poor children may reduce the incidence of persons needing social welfare support in future. Such investments may unlock talent for our economy, which would raise GDP and the tax base. The World Economic Forum's inaugural Global Social Mobility Report 2020 estimates that if Singapore is able to increase its performance by 10 points on the index, the resulting growth would add S$3.2 billion to our economic output every year. In this sense, investing in anti-poverty action is like making adult vaccines free – it may more than pay for itself in the longer term. Last and most importantly of all, a war on poverty would strengthen the foundations of social solidarity in our nation and help realise the promise that we truly have everyone's back. One response to what I have said thus far would be – well, we are already waging a war on poverty, we are already doing it. We have programmes like ComCare, KidSTART, Workfare, Silver Support, the work of bodies like MENDAKI, CDAC, SINDA and so on and so forth. But let us take a look at some of the objective evidence. In Food Bank Singapore's 2020 Hunger Report, 10% of Singaporean households experienced food insecurity at least once in the last year. Two in five experienced it at least once a month. I do meet some Singaporeans who experience food insecurity when we engage constituents, as, I am sure, do other Members of this House. In a Parliamentary Question reply, I was told that even as Safe and Sound Sleeping Places run by community partners were scaled up in 2021, their utilisation rate was 93%. This is a rate our hotels would be envious of.”
“Mr Speaker, Sir, I would like to start by referencing a memoir written by Ms Liyana Dhamirah called "Homeless". Ms Liyana's memoir traces her journey as a young mother sleeping rough in "crazy rich" Singapore. She, eventually, got back on track with the tenacity to fight stigma, with support from social workers and a spot of luck with generous friends. There are many people in Singapore like Liyana who have pulled themselves up to thrive. But, Sir, my Budget speech this year is not about individual actions. It is about ensuring our policies are designed to substantially reduce poverty and decisively break the poverty cycle for all children born into poor families. Sir, Budget 2022 does provide some benefits to lower-income groups. However, I will argue that we need to substantially improve access to support in three ways. First, access to support for the well-being and dignity of the poor. Second, access to programmes that give a leg-up to children in poor homes. And third, access to employability support for those at risk of being stuck in low-income jobs or long-term unemployment. Such support should be provided in a holistic, results-oriented way. NGOs, volunteers and ground-up charitable initiatives all have a role to play. But they should not be doing the heavy lifting when it comes to funding action against the root causes of poverty. They should be providing the "heartware" to help those who need it, while we maintain a strong baseline of state support, on top of which, NGOs and the community can layer personalised effort, expertise and passion. As a country, we have stood up to national challenges like the threat to our water supply and the COVID-19 pandemic. A major effort to wage war on poverty is not just something we can afford – it is something we must do.”
“I thank the Minister of State for his answer. Just two supplementary questions. The first is on the timeframe. Currently, the investigations can take a year or more. I think, recently, the regime for handling disciplinary issues for doctors for human beings was also revamped and overhauled, partly with the view to reducing the time that issue is hanging over the head of the veterinarian. So, is the Ministry considering ways to reduce that time taken for the investigation? Secondly, in terms of what the Minister of State said on reviewing the structure of regulation and considering a professional or elected body, that is good news. Is there a timeframe when this review is targeted to be completed, roughly?”
“Thank you, Speaker. I thank the Minister of State for her reply. Just one supplementary question, further to what my colleague Mr Gerald Giam was talking about. I heard one report that a PCR test was actually substantially cheaper in a neighbouring country, compared to Singapore. I am not sure how accurate that is or whether it is still the case. But my supplementary question is, looking at the countries in the region which have large populations, has the Government explored doing bulk purchase agreements, working together with other ASEAN countries, to negotiate with the manufacturers of these test kits, whether PCR or ART, as a way of lowering the price?”
“Thank you, Mdm Deputy Speaker. Just a very quick clarification. I thank Mr Xie Yao Quan for his speech. I just wanted to ask a clarification on one point. Mr Xie said that we seek to leave behind something for the next generation and he spoke about the NIR ceiling, and he made a few very interesting points. I just wanted to ask him if he would acknowledge that if we have a 50% cap on the NIR contribution, that is, a cap of 50% that can be taken into the Budget every year, would the hon Member acknowledge that if we increase that cap from 50% to 60%, for example, there is still 40% that goes into the reserves and that gets compounded so that, therefore, you are not actually decreasing the reserves. You are just increasing the reserves at a slower rate and you still will leave behind something more to the next generation, because that amount gets compounded and compounded as the years go by. So, in other words, I am just asking is there anything magical, is there some special methodology that leads us to say that 50% is the Goldilocks zone, that it is exactly right, but 60% is irresponsible or 65% is irresponsible and so on. That is my clarification. Thank you.”
“Thank you. Just one question to follow up. I think the Minister of State mentioned that penalties are being reviewed. I think there is feedback from animal rights, animal rescue groups, that some of the sentences for offences that are being seen are below the maximum and may not be so effective as a deterrent. Is there a timeframe for this review of the penalties for pet abandonment?”
“I just have one clarification for the Minister for Foreign Affairs. Will the Government be exploring the initiation of a common position on this very grave issue with the other ASEAN member states? Is that something that is being considered? Is that something that will be looked at, in spite of the challenges in doing so, which obviously do exist and that is very clear?”
“I thank the Minister of State for her answer. Just one supplementary question which is in relation to creating incentives to retrofit, for those that are not covered by the mandatory rule where there is a new tender or new construction, for existing facilities where there is no mandatory rule. I think in some cases, there is an issue where the landlord is not incentivised to really do a solar deployment, which may be able to benefit the tenant. I am wondering whether this is something that the Government can look at in terms of specifying guidelines whereby the benefits can be shared by the landlord and the tenant and there may be electricity generated that goes beyond what is needed for common areas. Such guidelines may be able to incentivise both the landlord and the tenant to do a solar deployment in cases where it is not mandatory. So, is that something that we can look at?”
“I thank the Minister of State for his answer. Just one supplementary question. If such technology is deployed – and this is just an assumption – is it subject to any kind of judicial oversight? Does a warrant need to be obtained, for example, before such technologies are deployed?”
“I thank the Minister for a very comprehensive answer. I just have two supplementary questions. One is, the Minister alluded to the fact that the long-term unemployment rate does fluctuate across industries and he highlighted the top few industries for long-term unemployment. I am just wondering whether the Ministry has given any thought to identifying those industries that may be most at-risk from long-term unemployment, based on technological changes and economic changes that we can foresee, and whether efforts are underway to proactively push out communications, maybe get ahead of the curve, to employers and employees to get them to reskill or upskill so that they will not be so much at risk of long-term unemployment from these technological changes. The second question is, the Minister alluded to programme such as CCP and I think Professional Conversion Programme is maybe another subset of that. One bit of feedback that I do come across sometimes is that these reskilling programmes, the number of places is limited and people have to compete to get into these programmes. I am wondering if the Government is considering expanding the supply of such programmes to keep up with the demand.”
“I would also suggest that the Government invest more in workforce automation of sorts for doctors, such that the IT system prompts them towards possible conditions the patient may have or alternative theories based on data analytics and AI. The US NPO Kaiser Permanente, again, is widely recognised as having pioneered some world-class IT systems that help doctors do just that, suggesting to doctors that patients may have a certain condition in some cases, in the same way that Amazon prompts buyers by saying those who bought this book also liked this other book. Mr Deputy Speaker, in conclusion, we are not faring well on many chronic disease indicators and this could portend worse to come. That would mean more human suffering and more pressure on our fiscal resources. When the costs of failing are socialised, as it is in this preventive health war, stronger action is justified. The challenges we face in preventive healthcare are large, complex and defy any one magic bullet, but there are good ideas for change on the table, ideas that have been researched and put to the test academically and in the experience of other countries. The rewards for early, bold, decisive action can be tremendous. Our children and grandchildren will thank us for taking those actions today. So, let us do this today.”
“Lastly, Sir, I would argue that we should make health data available more quickly and in more granular detail regarding chronic conditions. Much of the data on disease incidence is not published so frequently and after a significant time lag from data collection. COVID-19 has shown that we can publish data on healthcare metrics practically in real time when the political will is there. It would help us to have public data on diabetes, say, quarterly, to ensure not only better public debate on healthcare policy, but also better alignment of outcomes and incentives to providers. And on this note, I would like to ask if all Members of Parliament can be given data on chronic disease patterns and also other relevant indicators at the precinct level in their wards. It will help Members to know where there are concentrations of particular health issues, with a purpose of raising relevant talking points when we meet constituents and perhaps organising relevant ground events such as talks. Can we conclusively move towards a system where a comprehensive data on a patient is easily and always available to healthcare providers, assuming permissions are given, of course? In fact, can we nudge patients to provide permission for data-sharing across healthcare providers? This would enable medical professionals to reduce duplication of tests and get a more holistic picture of every patient's health situation at any time. Right now, data is available from the National Electronic Health Record (NEHR), but feedback is that the process of accessing it is not easy and not streamlined.”
“Can we think of alternative models where there is a degree of incentivisation based on the success of the healthcare provider in nudging patients towards better health outcomes? In other words, instead of paying providers just for treating the sick, can we pay them in part, at least, for encouraging their patients not to get sick in the first place? The notion is not as utopian as it seems. A few healthcare systems in the world are inching towards that. For example, Kaiser Permanente in California is well-regarded as a provider of high-quality, efficient and affordable integrated care. It is three separate entities: a health plan that bears insurance risk, medical groups of physicians and the hospital system. The financial incentive there is to provide a high-quality continuum of care and maximise population health, rather than profiting from a high volume of compensable services. Can we thus remodel our system of healthcare providers to incorporate incentives for effective preventive health work with patients, rather than just rely on compensation to the healthcare provider being linked only to the performance of treatments and tests? One other specific example would be to empower healthcare providers with inter-operable IT systems that can flag out if a patient has not got a mammogram or a blood screening recently and direct the patient to get that done while they are visiting for something else entirely. This would be the medical equivalent of a no-wrong-door approach. Moving towards such an alternative system of compensation for healthcare providers is, indeed, a very big, some would say, radical idea. As always, piloting randomised controlled trials are all advisable. But the time to act is now.”
“In the past, we have tried vouchers and other similar programmes, but if we could have a regular provision of frictionless aid, this would act as a much stronger nudge to eat healthily at home. Sir, I also want to make a more philosophical point about helping the poor on health. Our preventive health programmes tend to place personal responsibility on individuals to take charge of their health and lead healthy lifestyles. However, we have a collective responsibility to ensure the less privileged among us also have access to healthy lifestyle habits and are supported in that direction. Health is a critical dimension in improving lives and livelihoods for poorer Singaporeans. In reply to my earlier Parliamentary Question in 2020, MOH revealed that the life expectancy gap between those with post-Secondary and above education versus those with below Secondary education was 5.8 years, basically, six years. This is a shocking figure. Though it should be said that similar statistics can be found in other developed countries, at the 2021 Committee of Supply, then Health Minister Gan Kim Yong, remarked that MOH paid special attention to lower-income households, including their preventive health needs. This is a welcome assurance. How effective, though, are the existing preventive health care programmes targeted at low-income groups such as Healthy Living Passport, KidSTART and Propel? Can we release more data on chronic disease prevalence and other health outcomes by gender, by socio-economic status? With more data, we can devise better programmes to nudge those on lower-incomes towards better health outcomes. Next, I would like to talk about incentives for healthcare providers.”
“Some insurers, like NTUC Income, reward policyholders who have good health screening results with shopping vouchers. Sir, many studies prove that it is far cheaper to screen and to catch a disease early and slow down its progression. In Singapore, one in three diabetics, one in four people with hypertension and almost half of those with high cholesterol levels do not know that they have these conditions. Those who do not know that they have these diseases will push up costs for everyone. I have called in a past Parliamentary Question for inclusion of waist circumference measurement in national health screenings. This metric is important in defining obesity risk, rather than over-relying on the Body Mass Index (BMI). I am glad that MOH is moving to implement this and I look forward to seeing more evidence-based inclusions in health screening. Next, in nudging individuals towards healthier choices, I think it is important to place special attention on especially vulnerable groups, like the lower-income. Many lower-income Singaporeans lack the means to purchase and cook healthier foods. When I say this, of course, I do not mean that all healthy foods are costly, but many healthy food decisions are more expensive, complicated or time-consuming. In providing aid to lower-income families, can some of our aid be provided in the form of highly frictionless digital currency earmarked for the purchase of healthier food products with, for example, less saturated fat and sugar? It could also focus on unprocessed foods like raw meat. A digital currency would be easily programmable and could be updated monthly to reflect inflation. With RFID technology in supermarkets and grocery chains, this should not be too difficult to do.”