Lily Neo
Singapore
“Thank you, Mr Speaker. May I ask Minister for Health on MOH's capacity in coping with serious cases of COVID-19 in terms of adequacy in respirators and in our ICU beds. Am I correct to say that already half of NCID's ICUs are taken up? What will happen when it reaches its full capacity?”
“But even so, with the right measures of social and medical assistance in place to assist them with their daily living, they can still age gracefully in the comfort of their own homes.”
“Thank you, Mr Chairman. Yes, I will keep it short. Minister earlier said that MSF will proactively reach out to families in HDB rental homes to assist them, to possibly buy their own HDB flats. Many of these families lamented that they cannot afford it. How does the Minister plan to do it?”
“Thank you, Mr Chairman. May I ask the Minister whether there is a possibility of more widespread community spread of COVID-19? And will MOH be able to cope with this? And whether does our Government have more specific measures in place to cope with this scenario?”
“Thank you, Mr Chairman. Earlier in my speech, I asked whether there are assessments by HDB for applicants of Joint Singles Scheme (JSS) to ensure that they are free from mental illnesses and medical conditions before compelling them to stay together.”
“Many of them have lived in rental housing for more than six years and some more than 10 years. Thus, there are signs of entrenchment. What are the schemes in place and the success rate of such schemes, to assist them in looking for better options in their housing needs and to help them get out of their predicaments?”
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“Clause 39(7) of this Bill states that the biosafety committees are to review their measures, policies, programmes and codes of practice every two years. Is a two-year time frame not too long as pace of progress may be so fast that such implemented measures, policies, programmes and codes of practice might quickly become outdated? A review ought to be carried out every year and it is up to the biosafety committee to decide whether to continue to adopt such measures, policies, programmes and codes of practice or to change them. Sir, the best way to protect against the effects of harmful incidents is to be prepared. This Bill does not provide for contingency plans and emergency procedures to the hazard of agents and toxins being handled by laboratories during disasters. There should be a written contingency plan and a protocol for containment, management and reporting of accidents. May I also ask the Senior Minister of State whether our hospitals are equipped to treat infected individuals or those contaminated with hazardous agents in the event of laboratory mishaps? Should there be a designated higher risk hospital ward set aside to contain infectious diseases in order to prevent the spread to the community? And should there be special medical personnel trained to cope with specific laboratory infectious agents in case of such an eventuality? So I hope the Senior Minister of State will enlighten this House on the issues raised. 4.50 pm”
“Sir, while molecular biology and genetic engineering are medical excellence when applied to fight diseases and advance mankind's needs, they can, in the wrong hands, be a real bane when misused to create bioweapons. Bioterrorism must always be a concern for one and all, and we should emphasise prudence and deterrence in all our approach when dealing with it. While it is our intention to support research and not to encumber it with rules and regulations, we must be able to identify and disrupt criminals and terrorists to safeguard our well-being. May I ask the Senior Minister of State whether there should be more precautionary measures being taken on bioterrorism and national security? For instance, will there be judicious screening of certain foreign nationals for research work in sensitive areas? Should medical researchers working with potentially hazardous agents be registered? This Bill does not provide for this. Should there also be consideration of a system in place to include the life sciences community in our national security threat? How does the Senior Minister of State ensure that laboratory biosecurity threats such as misuse, diversion and unauthorised production of pathogens and toxins are always on the radar screens of surveillance and intelligence networks? Clause 8(4) of this Bill stipulates that the permit for import or transhipment of First Schedule biological agent shall be limited to one consignment. May I ask the Senior Minister of State whether the term 'one consignment' can be rather vague and should not that quantity be specified? If the importer or transhipper wishes to have more in quantity, they ought to apply to the Director for the permit.”
“Mr Deputy Speaker, Sir, I stand to speak in support of the Biological Agents and Toxins Bill. This Bill is important and timely, in view of prevailing circumstances and developments. Yes, the prevailing situation where there is an ever-increasing number of laboratories, 100 or so presently, in Singapore; the opening of more high-safety laboratories dealing with biohazard materials; the emergence of infectious diseases, such as SARS, and, of course, the threats in our fight against bioterrorism. Sir, establishment of laws on biosafety and biosecurity is not new and had been adopted by other developed countries, such as the United States and Britain. This Bill seeks to regulate the safe handling of biological agents and toxins, and to ensure that laboratories are responsible for safety standards and security measures, and to make sure all their staff is adequately trained to prevent mishaps. The safeguarding of the community from accident taking place is especially critical in a densely-populated small country like Singapore. Having well- recognised biosecurity and biosafety standards in place would also boost the confidence of international scientists seeking to do research in Singapore. May I ask the Senior Minister of State whether his Ministry has enough expertise and trained personnel to audit the 100 or so laboratories here in order to certify these laboratories when the Bill is enacted and when annual certification is required after that? How long will his Ministry take to certify all the laboratories? Are recruited safety-officers trained professionally to carry out their duties, and will they be well-protected with all the protection, such as vaccinations?”
“May I ask the Parliamentary Secretary what will the new studio apartments be priced at? Will they be priced at more affordable and attractive prices to the majority of elderly Singaporeans? Will he also consider making the lower floor studio apartments or rooms for rental on a daily basis for those elderly who have big families to accommodate them during weekends? Lastly, will he improve the concept of the independent living and self-reliance concept of studio apartments and ensure that the centres of activities are there for the new studio apartments, to promote healthy living and for the participants of the centres?”
“Mr Speaker, Sir, I would like to ask the Minister whether his utmost task will be on the containment and the prevention of spread of the avian flu virus, especially the virulent human transmittable, should an outbreak occur? How does he plan to do it? Has he got any protocol of actions in place involving the various Ministries, drawing from our past experience of SARS and preventing past mistakes? What will constitute the key point for him to call for immediate action? And lastly, on Tamiflu, is it wise not to switch to other anti-viral agents such as Relenza, because now there is a possibility of mutated avian flu virus that is not effective to be treated with Tamiflu?”
“Sir, since we cannot get rid of dengue altogether and since Singapore emphasises on being the biomedical hub, can more research be done on disease surveillance for early warning on dengue epidemic, the genetic sequencing on dengue virus and on the development of vaccines against dengue? Assoc. Prof. Dr Yaacob Ibrahim: Sir, I would like to assure the Member and Members of the House that that is exactly what we are doing now. We are basically moving upstream, conducting some research projects together within EHI and MOH, to study the various transmission dynamics whether the virus has mutated or not so that we can understand better this particular vector. So I would like to assure her that the research projects that we are conducting now will bear, if we are successful, some fruits that will be useful to us in how we control this vector. But, at the same time, we have to learn from others in terms of their experiences. So, NEA, together with MOH, will remain open to the experiences of other countries so that we can understand best what are the techniques that we have to adopt in our current challenge.”
“Sir, the Minister mentioned the study of fogging. May I ask the Minister, in view of the present dengue epidemic, is it wise to wait for another six months' study on fogging before taking action on it, especially when fogging was already known to have unknown values with mosquito killing rate of less than 4% at best, confirmed by experiments overseas and reconfirmed by the foreign experts invited to Singapore recently? Assoc. Prof. Dr Yaacob Ibrahim: Sir, I cannot argue about the figure because I am not so sure whether that is the correct figure, nor did the expert panel say that we should stop fogging. I think what the expert panel is trying to tell us is that we should not rely on fogging entirely. While the study is being conducted by the technical committee, together with NEA, fogging as a practice is safe and we will continue to do fogging but we have also put in a new standard operating procedure where before any town council or any operator would like to carry out fogging they have to alert us one day in advance so that we can then monitor whether they are doing it correctly.”
“But before that, we will work with the town councils to raise their level of maintenance and vigilance so that they can conduct checks regularly to ensure that we remove all potential breeding habitats within the common areas of the town councils. The expert panel did not say that fogging is not effective. What they said specifically was that fogging is not effective in breaking epidemic transmission. What we have done is that we have started a small technical committee, headed by the professional industry together with NEA, to study the effectiveness of fogging. But, meanwhile, fogging will be one of the tools that we will use in this current challenge. It will complement all other efforts for evidence has shown that fogging can kill adult mosquitoes. So we will continue to study this particular technique in terms of effectiveness but, at the same time, we will continue to use it while trying to improve the professionalism of the industry. On her final point about working with the industry, that has always been the operating procedure for NEA. We work very closely with the pest control operators. We have over the years upgraded the skills of the pest control operators and certainly, in this current instance, I would like to thank the pest control operators because they have come forward to work very closely with NEA to ensure that they can be effective on the ground. I am confident, with the current efforts in place, we will be able to at least put this problem under control. But, as I mentioned in my answer, we know that this is a resurgent problem globally and therefore we have to continue with the efforts we have adopted so far in order to control this particular challenge.”
“— and increasing in order to control the dengue fever and also save costs and efforts on updated techniques. Assoc. Prof. Dr Yaacob Ibrahim: Sir, I agree with the Member that we have to tackle the problem at the source and that is why NEA has always adopted a source-reduction approach. And that approach has been endorsed by the World Health Organisation. Ever since we have been tasked to tackle this problem and ever since NEA was created, our challenge has always been to close the breeding sites and remove all breeding sites as quickly as possible. Every time, there is a case, MOH will alert us and we will deploy our officers down to where the infection has taken place, check thoroughly, both inside and outside, within the surrounding premises, to ensure that there are no breeding sites. One of the things we did in this current challenge is that we have started carpet-combing across all constituencies. By this weekend, we should finish the exercise to explore what other potential breeding sites that may be occurring without our knowledge within the common areas, ie, outside the homes. It has revealed nothing new. We know what are the potential breeding sites. But, more importantly, we have found potential breeding habitats, in other words, there are no larvae found but water has been collecting and therefore we have passed this information back to the town councils so that they can then adopt a maintenance and vigilance approach in order to tackle this problem much quickly. Once the pest control operators are in place with all the town councils they will then be subject to certain audits by NEA.”
“Sir, may I ask the Minister whether NEA should change its tactics and adopt more measures in this fight against dengue epidemic immediately, such as by targeting the mosquito larvae in the prevention of adult mosquitoes. Since the experts have confirmed that fogging is not that effective in Singapore, should that not be switched to focusing on looking for and treating all potential breeding sites? Does the Minister agree that surely killing the mosquito larvae with larvicide is more efficacious because it arrests the source of hundreds of mosquitoes at source? Moreover, larvicide can continue to be effective for more than one month. Lastly, may I urge the Minister to act decisively soonest and issue directives on better effective modes in this fight in view of the fact that the pest control industry is $50 million a year —”
“Are there enough websites on certain types of chemicals? I am not an expert in this matter. I have been told by my EHI officials that most of the repellents in the market are quite good and effective. So I think the information is already available on our website, in terms of the chemical composition that is needed in each repellent. For example, we have been told that citronella is quite good. So now you see soaps being sold with citronella oil that will leave you a layer of citronella that could repel mosquitoes. So I bought a bottle yesterday and used it this morning. I think we have to take the necessary precautions. There are enough of these products in the market. Singaporeans are wise enough and NTUC has helped us to put some of these products up so that Singaporeans can easily access them.”
“May I ask the Minister how effective is the present practice of fogging? Should it be reviewed and changed? What are the insecticides used presently and are they effective in controlling Aedes mosquitoes? May I also ask whether repellent should be given to infected individuals to use in order not to spread dengue fever and whether his Ministry informs and recommends on the safe and effective repellent available? Assoc. Prof. Dr Yaacob Ibrahim: Sir, fogging, according to the WHO, is still the most effective means of killing Aedes mosquitoes. We have standard operating procedures where we have trained our PCOs to carry out fogging judiciously and fogging is only effective, we have been told, in the morning and dusk where the adult mosquitoes go out for a bite and during those times when the weather is a bit cooler, the chemicals will remain longer in the atmosphere so that there is a greater chance of killing the adult mosquitoes. But this is also one of the issues in which we will refer back to the expert panel for them to review as to whether our current practice needs to be enhanced or changed. But meanwhile, where we find a population of adult mosquitoes, we will carry out fogging as we have done over the weekend. We found 16 sites and we did 16 fogging actions. On repellent, Sir, this is available in the market. Basically, there is no reason for us to give it free. It is quite reasonably priced. I bought a couple of it over the weekend. I think this is quite affordable. NTUC has embarked on a campaign to help Singaporeans by giving reasonable discounts. All the repellents where chemicals are used would have to be registered with NEA. We do not check the effectiveness of the repellents. We leave it to Singaporeans to decide.”
“Sir, may I ask the Minister how he intends to enforce this ruling on the change of window rivets? Is he going to have random checks on private apartments and HDB flats? Would he be lenient to those with good reasons for not being able to meet the target deadline? May I also ask the Minister how is he addressing the complaints about some HDB-recommended contractors who over- service beyond requirements, some who overcharge, and some disappear after collecting the deposits? How many of such complaints has his Ministry received?”
“Mr Speaker, Sir, thank you for allowing me to speak, but I shall be very brief. I only want to pose the following eight questions to the Minister for Health. But before I do that, I would like to declare that NKF's patients' welfare is my main concern and I hope that this unfortunate episode will not deprive them the continuum of care. (1) May I ask the Minister whether he should check on the practices of NKF with regard to patients' eligibility for care? (2) How many kidney patients have been rejected over the years? (3) What have been the criteria used to admit dialysis patients? (4) Is NKF too stringent on its minimum health criteria on patients' eligibility for admission? (5) Should NKF take the responsibility on which patients to save? (6) Is it justifiable for NKF to collect about 80% co-payment for its dialysis cost amounting to about $24 million a year from needy dialysis patients to whom the public is donating to help? (7) How many dialysis patients have been turned away for the lack of funds to co-pay due to their co-payment requirement? (8) Is it true that Kidney Dialysis Foundation (KDF) was set up in 1995 to take in rejected NKF dialysis patients?”
“Mr Speaker, may I ask the Parliamentary Secretary whether we should also target our schools, especially secondary schools, in trying to curb the trend of young women smokers?”
“Sir, may I suggest to the Senior Minister of State that, in fact, we do not need to do invasive biopsy as a second line after having prostate PSA, where we can do non-invasive test like ultrasound of the prostate to check whether the patient has really prostate cancer or not? The other thing is: should we always wait for other countries to do the screening rather than do our own? Because we have a smaller population base and we have a better medical system here that we can do things that other countries may not be able to do.”
“Mr Speaker, Sir, can I differ in opinion with the Senior Minister of State because actually, prostate cancer is the fifth most frequent cancer in Singapore presently and its incidence is increasing at 5.6% annually? And we all know that early detection can save lives. Therefore, do we not want to save people and will not the Ministry provide better detection and, at least, increase awareness amongst the public with regard to prevention and deaths from prostate cancer?”
“Could I ask the Senior Minister of State whether PSA is not the best method for early screening of prostate cancer? Therefore, could MOH consider targeted community screening, subsidising PSA test at $5 each in line with the initiative done by the Singapore Prostate Association during the prostate awareness week for men above 50 years of age with symptoms such as frequency of urine, incomplete emptying of bladder and also with a family history of prostate cancer?”
“The Senior Minister of State did not answer about the care in hospital. Could I just also ask for the support schemes available to stroke patients and their family members in terms of medical and social support since stroke disability can be long term and imposes great medical, social and financial burden on the families, especially those who have lost their breadwinners?”
“Mr Speaker, may I ask the Senior Minister of State, in view of the fact that more than 50% of stroke survivors in Singapore end up with moderate or severe disability and the fact that disability can be lessened by early detection and treatment for 70% of ischemic stroke, will the Minister step up awareness in the prevention and disability from stroke with the medical profession and the public as well as offering better and earlier stroke detection and care in our public hospitals?”
“May I ask the Senior Minister of State, in view of the fact that stroke is on the increase, especially with an ageing population and the fact that stroke can be prevented by early detection and better care of hypertension, diabetes and cholesterol, is the Senior Minister of State happy with the present available preventive measures and what else can be done to improve this situation?”
“I welcome the new section 24I which spells out the penalties for the misuse of Town Council funds in order to strengthen the corporate governance of Town Councils to ensure that funds are used only for the purposes spelt out under the Town Councils Act. The penalty is a fine of up to $5,000 if sinking funds are used for other than the purposes specified under the Act. Sir, Town Council's sinking funds are built up from residents' S&C charges over the years. This is for long-term cyclical maintenance of the estates and to provide a good and safe living environment for residents. The Government has the responsibility to ensure that Town Councils use the funds appropriately for the benefit of the majority of their residents over the long term, and that no funds are being misused. As opposed to Dr Amy Khor's and Dr Teo Ho Pin's views, I feel that this section is absolutely necessary. In fact, is not a penalty of $5,000 too lenient as compared to the "penalty" that a resident will face in the case of outstanding S&C charges, which is the sale of his flat by the Town Council? Can the Ministry also elaborate on what are the current checks and regulations that it has in place to prevent misuse of such funds?”
“One might also argue that this empowerment is to allow the Town Council to take action against those flat owners who can afford but refuse to pay up, ie, in Hokkien, the chau kuan residents, and that the existing provisions in the Act already allow Town Councils to sell a resident's flat if he is not able to pay his S&C charges. Sir, this does not mean that because the current provisions in the Act already allow for the sale of a resident's flat for outstanding S&C charges, it is therefore okay for the Town Council to now sell a resident's flat for outstanding upgrading charges. Can the Town Council elaborate on the current measures of identifying who are the genuine residents who cannot afford to pay and who are the chau kuan residents? One might also argue that $3,000 in the HDB LUP scheme and $714 for the Town Council LUP, as quoted in the Today newspaper on 18th July 2005, are not a big sum of money. However, to the low-income earners, especially the bottom 20%, who live from hand to mouth, whose next month's wage is often spent before it even comes, where there is no extra money in their CPF accounts to pay for these upgrading charges due to the increase in MediShield premiums, some might really lose the roofs over their heads due to outstanding payments of these lift upgrading costs. Hence, Sir, I urge the Ministry to reconsider the option of sale of a resident's flat by the Town Council. Should repossession and sale of flat be considered as an option at all in the upgrading cost recovery by the Town Council? Lastly, I would like to touch on the misuse of Town Council funds.”
“Eventually, this household could not afford to pay for their share of the LUP cost and had to be forced to move out of their block of flats. Sir, it is no fault of theirs and it would not be fair to such households to force them to move out of the block. Sir, we also need to look at the role of the Town Councils. Town Councils are separate legal entities formed under the Town Councils Act to manage and maintain the common areas in HDB estates. The functions of the Town Councils are to control, manage, maintain and improve the common property of HDB's residential flats and commercial property within the Town Council. Town Councils are not financial institutions to have the power to seize movable properties in flats or to seize flats for sale. Earlier, we have seen reports in the newspapers of households living in darkness, without water and electricity supplies, because they could not pay their utility bills. Are we going to see families without a roof over their heads because they could not pay the upgrading cost and their flats are being sold by the Town Council? One might argue that this is the ultimate last resort that the Town Council will do for cost recovery in upgrading programmes. Hence, if this is indeed going to be the ultimate last resort, should we not now take a step back and look at the current help measures to analyse why these help measures are not effective in helping residents pay their share of the upgrading cost, if indeed these current help measures are not effective?”
“Sir, the cost-sharing package in this Town Council LUP programme is actually not clear as compared to the cost-sharing package in the HDB's LUP programme. I would like to urge the Ministry to provide more details so that residents can make a more informed decision during the poll for the Town Council's LUP. The next area that I would like to touch on is the help measures. Currently, HDB has several measures and instalment plans to help flat owners who have difficulty in paying their share of the cost for upgrading programme and this includes extending the repayment period for the cost of up to 25 years, allowing the flat owners to defer payment for a certain period of time until they sell their flats to ensure that these flat owners can benefit from the upgrading. However, the new section 24F is contrary to the objective of these help measures that serve to ensure that flat owners would benefit from the lift upgrading. The new section 24 empowers Town Councils to sell a flat where any improvement contribution payable in respect of the flat remains unpaid 90 days after the Town Council has served the owner a written demand for payment. Is it not an irony when a household has voted for lift upgrading in his block only to be forced to sell his unit in that block of flats because of a change in his financial situation, for example, due to retrenchment or even chronic illnesses, such that he is not able to pay his share of the upgrading cost and hence be deprived of it? Consider another scenario of a household who did not vote for the upgrading programme because they knew their financial situation did not allow them to do so, but LUP was implemented in their block of flats because more than 75% had voted for it.”
“Again, an example from the website is that for LUP, for a typical four-room flat in a standard block, the Government would pay about $10,000 while the Town Council and the flat owner would each pay about $900, ie, the Town Council's share and the flat owner's share are equal. Flat owners in a segmented block would pay a higher amount because the lift upgrading would actually benefit less people. However, there is also the cap where the Government would cap the maximum amount per household at $3,000. In the current Bill, the Town Councils are allowed to use their sinking funds for lift upgrading subject to certain guidelines that the Minister for National Development announced in Parliament on 7th March 2005, so that there are enough sinking funds for long-term use. One guideline states that the Town Council would be allowed to select HDB blocks where the Town Council's share of the upgrading cost per benefitting unit does not exceed $5,000. An observation here is that there is no guideline on the selection of HDB blocks with regard to the flat owner's share of the upgrading cost. Would the Ministry consider setting a guideline that Town Council would only be allowed to select HDB blocks where the flat owner's share of the upgrading cost per benefitting unit does not exceed $3,000 or even less, similar to the HDB's LUP programme? A second guideline states that flat owners would co-pay for the works in the same proportion as the HDB LUP. Hence, that means that they would co-pay about 5%-12.5% of the total upgrading cost, depending on the flat type. An observation here again is, by comparing with the HDB LUP co-sharing package, does this mean that in the Town Council LUP, the owner's share would also be raised to $5,000, like in the Town Council's share of $5,000?”
“Should Town Councils take such a draconian action as selling the flat? Would not such demands be too harsh on these residents? The Bill gives Town Councils the power to enter a resident's flat to value the movable properties for the purpose of seizing those movable properties to satisfy the judgment sums or arrears. Sir, Town Councils should only consider seizure of the movable properties in the flat if, in their fair opinion, they have exhausted all enforcement processes and have the view that seizure of the movable properties is the only way to recover such judgment sums or arrears. Moreover, the entering of a resident's flat to value the movable properties is an infringement of privacy. I hope the Minister of State can address all the issues raised on this Bill. Assoc. Prof. Ong Soh Khim: Mr Deputy Speaker, Sir, thank you for allowing me to join in the debate on this Bill. I would like to make a few observations which I would appreciate it if the Ministry could look into them. Just as a recap, when the HDB LUP was first launched in March 2001, the cost of the lift upgrading work was co-shared between the Government, the Town Council and the flat owner. And to ensure that the flat owner's share of the lift upgrading cost is affordable, the Government subsidises 75% to 90% of the cost of the lift upgrading works and the actual proportion would depend on the flat type and the block configuration. From my understanding, based on the information from the HDB's website, Town Councils are already allowed to use their sinking funds to co-pay for the HDB LUP programme.”
“Due to newer technology, according to MND, these HDB flats are now eligible for lift upgrading that will allow the lifts to serve residents on the top floors of such HDB blocks. As these residents had shared the upgrading costs with HDB in the past, they may be reluctant to contribute a second time. Moreover, cost sharing for the upgrading involving and benefiting only the higher floor units may cost too much as there will be lesser units to share the payments. May I ask whether the Minister of State will waive the rules on co-payment and voting for such lift upgrading? Will HDB absorb the residents' share for such upgrading so that Town Councils do not spend beyond their stipulated permissible amount? This Bill does not cater for instalment payment schemes like those offered by HDB. Should there not be a new section inserted to cater for instalment payment schemes instead of demanding full payment within one month from the date of the issuance of the payment advice, as set out in the Bill? Sir, the latest Household Expenditure Survey showed that the monthly incomes of the poorest 20% of households fell by .2% a year between 1998 and 2003 and households grew smaller with fewer working people. Those in this group are the ones that most likely are staying in older flats which are eligible for lift upgrading but have dwindling free disposable income. They are the ones most likely also to have the least spare savings for improvement contributions. How do we assist those who really do not have the means for the improvement contributions? This proposed amendment will empower Town Councils to sell a flat if the improvement contributions are not settled after 90 days of the Town Council serving a written demand on the flat owner (under a new section 24F).”
“Therefore, the allocation of funds from MND for such works will be skewed towards less active Town Councils. This may discourage those active Town Councils in the long run and they may opt to leave lift upgrading to MND instead and save their own funds for cyclical works. The recovery of the costs for the improvement contributions will be undertaken by the Town Council under this Bill. Sir, I feel that this will place Town Councils under a new task that is demanding. HDB will be in a better position to assume this role with existing software and hardware to efficiently manage such recovery of improvement contributions. There is no necessity for duplication of such set-ups by involving the 14 Town Councils. Individual set-up by the 14 Town Councils will cost a great deal and a waste of resources. One large recovery centre in HDB should have better "economy of scale" to deal with such recovery, especially in cases with smaller scale of improvement contributions. The upgrading of lifts in HDB flats involves detailed planning of sites and designs and engagement of architects and engineers as well as the awarding of projects to contractors. This will best be carried out by HDB with the many years of experience rather than leaving them to the 14 Town Councils which have to start from scratch. The lift upgrading requires residents to co-pay and majority "yes" votes will be necessary to proceed with upgrading. Sir, my concern is on those HDB blocks that had undergone previous Main Upgrading Programames but are still lacking lifts going to the top floors of these HDB flats due to technical constraints in the past.”
“Mr Deputy Speaker, Sir, thank you for allowing me to join in the debate on the Town Councils (Amendment) Bill. Sir, I strongly support the lift upgrading programme that enables lift access on every floor in HDB flats to improve the living environment of residents. Such lift upgrading to HDB flats has been done solely by the Ministry of National Development so far. Now, the Town Councils will also be conducting such lift upgrading. My concerns are several on this issue. But before I go into it, may I remind Mr Chiam See Tong that there are 14 Town Councils that are chaired by PAP MPs, myself included. Therefore, rules with regard to criminal offence by Town Council Chairman are also applicable to all the 14 PAP MPs as well and not only to the two Opposition MPs. Therefore, it cannot be politically motivated, as suggested by Mr Chiam See Tong. This Bill will inadvertently raise the expectations of residents towards lift upgrading. It is probable that, henceforth, residents may view lift upgrading obligatory on the part of Town Councils. It is likely therefore residents will compare the "works" of the 14 Town Councils on lift upgrading undertaken and make increased demands on their own Town Councils. The use of sinking fund for upgrading of lifts will mean lesser funds for other cyclical works such as repainting, reproofing and other estate maintenance and improvement works. This is more acute for those town councils with lesser sinking funds and even more critical for Town Councils in older estates that require progressively higher demand on cyclical works due to older HDB flats. Those active Town Councils with the capacity of doing more lift upgrading will have lesser precincts left for MND to offer for LUP.”
“Mr Speaker, Sir, may I ask the Minister, in view of the fact that 200 people, aged 20-30, died of sudden cardiac arrest between 2001-2003, and although many of them had no symptoms and looked perfectly healthy, on autopsy, they were shown to have structural heart abnormalities and problems with heart rhythm. May I ask the Minister whether he will adopt a better screening and implement more stringent check-ups for our NSmen more regularly? Will he ensure that the enlistment check-ups are done by doctors who have undergone training to detect early and possible heart abnormalities? Will he screen our NSmen more regularly and earlier, ie, not from the age of what he mentioned earlier, at 35 for high cholesterol, pre-diabetes and high blood pressure, as these conditions put them at risk for sudden heart attack and stroke? Lastly, will he also offer stress ECG for our NSmen during their enlistment check-up?”
“Mr Speaker, Sir, the Minister did not answer my question earlier on more attractive retraining opportunities, especially with financial assistance. May I also ask the Minister whether he would adopt a more holistic approach in helping the unemployed poor, as they may have other needs besides retraining and job placements, especially those with young families? Will he assign social workers to this group to better cater for their various needs? Does the Minister have any concrete plan of action to address this issue of widening wage gap? My last question is: is there a group of people, due to age or lower education, who are not suited to the presently available retraining schemes? Therefore, will he look into the creation of new job opportunities, for example, healthcare services as homecarers?”
“Mr Speaker, Sir, may I ask the Minister how does he address the concerns of those who have undergone retraining but still cannot find employment or better job opportunities? Will he facilitate better and suitable matching job placement? Will he also make retraining opportunities more attractive in order to encourage more people to go for retraining?”
“Mr Speaker, Sir, may I say that, if a person - I am just talking about ElderShield - is unable to perform the three activities of daily living of washing/dressing, feeding, toileting, and has problems of mobility and transferring even with the aid of special equipment and always requiring the physical assistance of another person throughout the entire activity, it would be unlikely for him to get better with time, and, in fact, he would be likely to get worse. Therefore, is it not inhumane to withdraw the ElderShield payout after five years irrespectively, and is the $300 per month too meagre an amount for survival for such a person?”
“Sir, may I ask the Minister how does he address the issue of the poor elderly who cannot afford the premiums of the ElderShield due to their age group, and yet are the ones who are most in need of ElderShield payout should the need arise? Are there avenues to help this group? Does our present system tilt towards the heavy demand on nursing homes for the dependent elderly should there be a review to ensure better use of resources and avoid unnecessary institutional care?”
“May I ask the Minister whether he would consider a component to encourage people to keep fit and healthy by having incentive premiums for MediShield, eg, annual discounted premiums for those who can maintain their weight or BMI and normal blood lipids and sugar?”
“May I ask the Minister whether in view of the fact that VRE infection is a hospital-acquired disease, affected patients will be given free follow-up treatment and are hospitals covered under insurance for such eventualities? May I also ask the Minister whether he really looks for the causative agent or the factor that caused the VRE outbreak so that other hospitals can learn from the mistake?”
“Mr Chairman, earlier on, the Minister said that he would leave the law on elderly abuse to the Ministry of Law. Can I ask him: surely, this provision must be initiated by his Ministry, rather than just leaving it to the Ministry of Law? Could I ask the Minister whether he would consider setting up a Central Registry since he is streamlining all the different schemes of assistance and employing more social workers to look into this group that is most in need?”
“In order to reduce the incidence of elderly abuse, would MCYS look into the availability of support services to give respite to caregivers and prevent the burnt-out syndrome of these care providers, especially those looking after the elderly, with demanding needs such as dementia or terminal illness? Caregivers”
“Sir, MCYS must recognise the social ill of elderly abuse and implement measures to address it. There were about 100 cases of battered and neglected elders each year in the past five years and these cases were just the tip of the iceberg, as most cases were not reported. Like my parliamentary colleague, Mr Davinder Singh, could I beseech MCYS to look at better laws to protect the abused elders as many of them are helpless for various reasons? Perhaps MCYS should look at having our laws changed to empower social workers, doctors, family members and the homecare givers to protect senior citizens from abuse, in much the same way as they can intervene on behalf of abused children. Presently, the authorities can intervene only if the abused elderly person or a third person has applied for a Protection Order under the Women's Charter. Could MCYS also look into our laws to better protect our elderly from financial abuses? For example, banks should be allowed to intervene when a staff suspects that an older person is being defrauded of financial asset. MCYS should enhance public education on the various kinds of abuses such as infliction of physical pain and injury, debilitating mental anguish, unreasonable confinement, wilful deprivation by caretaker of services necessary to maintain mental and physical health and financial abuses. As elderly abuse is seldom reported, would MCYS raise the awareness, targeting especially the relatives and friends of the victims to let them know that help can, and should, be sought for victims?”
“These centres aim to keep the mobile elderly fit and healthy for as long as possible through the concept of maintaining physical, mental and social well-being of the elderly, especially the less well-off elderly. Will MCYS set up such centres together with MOH at community centres or RC centres involving the grassroots groups and other volunteers from the community? I hope ComCare Fund can be used to fund such centres island-wide.”
“Sir, rendering help to those in their 50s to 80s with no job, no CPF nor anyone to turn to is of utmost urgency. I hope ComCare funds can be channelled to especially help this group. The women folk are especially vulnerable, as over 90% of women aged 60 and above have less than secondary education and, therefore, fewer work opportunities. Many of the poor, especially the elderly, are often ignorant and isolated from the help that they are eligible for. Will MCYS set up a central register for our destitute, chronic poor and disabled, so that effective and thorough assistance can be rendered to them without anyone falling by the wayside? Will MCYS ensure that there are more social workers, working in conjunction with grassroots and voluntary organisations in the community, trained to engage and follow up on those in this register? There is a slew of schemes available to help those in financial hardship that it makes them difficult to follow and to administer. Will MCYS help integrate them and make them more comprehensible? Will MCYS vet through our existing available schemes to remove stifling benchmarks and blanket rules to make sure that fewer fall through the system's cracks and also to factor in the complexities of an individual's needs? For example, we cannot always presume that the aged will always receive care from their families. Sir, everyone accepts that health promotion and disease strategies to enable the elderly to remain fit and active in the community are the most effective ways in getting the best outcome in an ageing population. Could MCYS set up Centres of Activity to achieve this purpose?”
“Sir, with the recent changes in the education system, I would like MOE to give more emphasis to character building of our students to develop values in them that will enrich their lives as individuals, and as members of society. Desirable basic character traits, such as courtesy, honesty, responsibility, fairness, filial piety, consideration for others and obedience to legitimate rules, in other words, knowing the good, desiring the good and doing the good, should be fostered. May I ask MOE what steps are being taken to ensure the character building of our students? It is important that such values be reinforced without being indoctrinated and made interesting through interactive modes instead of being a study subject. Could MOE ensure that such character building education yield effects that students could relate to and apply to themselves? The character traits should permeate the students' environment. How does MOE ensure that students see good examples in all aspects of school life such as through the behaviour of teachers, the administrative staff, the faculty and the policies of the institution?”
“Sir, there is a need for MOE to promote a mindset change in our people with regard to stressful education in Singapore. Stress of education is still being faced by students and parents despite the announcement of MOE for significant cuts in curricula, change of teaching and examination systems, modified ranking and admission procedures. There should be more effort put in to better inform parents and teachers about the recent initiatives of MOE. MOE should step up public education to enhance a positive approach and correct attitudes of parents and teachers alike. Should there not be more emphasis on preparing our young children to be the successful individuals of tomorrow who are innovative, confident, inspired, informed and globally savvy citizens? Parents must be convinced that there are the attributes that their children need for a leg-up in the job market and for success in their careers. Innovative skills and creativity in our children, the attributes which we want to cultivate, will not come from just getting good academic scores. Young children may lose the joy of learning, questioning, exploring if they are overloaded with school work and other extra-curricular activities with no free time of their own. There is a need to promote a mindset change that every child will be given the opportunity to develop his or her best potential, albeit not limited to just the few popular professions. Success must be further defined without stereotyping of certain professions only. MOE must ensure that teachers observe the guideline changes that were announced. It would certainly defeat the purpose of cutting the syllabus of various subjects if the teachers still insist on teaching them.”
“My question was, why not national coverage of MediShield, which the Minister did not answer?”
“Sir, three clarifications for Minister Khaw Boon Wan, please. Earlier on, he mentioned about supply induced demand. Could I ask him whether he has control over such practices in the public sector? Has he identified these practices? And what are the steps taken by his Ministry to stem out such supply driven demand in our public sector? My second clarification is that the Minister earlier talked about Singapore being the regional medical hub, which I concurred with and which I spoke at length in the past in this House. May I ask him that in order to achieve this, we need to maximise our medical resources; therefore, will he endeavour to try to integrate the public and private sectors as much as possible and not just the clusters? And what are his plans on this? Lastly, yesterday, he talked about the exodus from MediShield. Could I ask for an explanation from the Minister why he does not favour a national coverage of MediShield, so that the exodus of MediShield which he talked about would not be an issue?”
“Sir, MOH should aim to provide seamless integrated care services for all discharged elderly patients from public hospitals to placement of patients to stepdown care facilities that look into their medical, social and psycho-social needs. Would MOH ensure coordination and effective implementation of these services and make them user-friendly as well? Home Therapy”
“Sir, would MOH endeavour to improve the quality of life for the elderly? I would like to ask MOH for the policy planning on the medical needs of the elderly in the next 10-25 years when the elderly population will increase from 14% to 20% of the population. Such a policy planning should be prioritised by MOH so that the heavy burden in the future will be cushioned. What progress has MOH achieved to provide for the three-fold increase in the resident population above the age of 65 in 25 years' time? Are there plans to increase the capacity of the various healthcare services such as acute hospital services, nursing homes, day centres, community daycare centres? May I urge MOH to ensure that we do not leave it too late for this provision in the coming years. Sir, I would like to ask if MOH agrees that homecare in Singapore is at its infancy and if MOH considers homecare as an integral part of healthcare in an ageing population? Does MOH see it as a priority presently and, if so, would MOH develop homecare services in professional medical caregivers, domiciliary services, daycare with rehabilitation facilities, occupational therapy services, as well as equipment and adaptations at homes? Would it also look at a variety of inter-related needs such as nutrition, nursing, medication and mobility management and, thus, the services of personnel, transport and domestic support? Should MOH involve the community help and community volunteers to deliver part of the homecare services? Most caregivers in the community are family members and maids. Would MOH help to provide the proper know-how and homecare support?”
“Sir, preventive healthcare aims to have those who are healthy to remain well for as long as possible without getting ill from especially the lifestyle-prone diseases. Life expectancy for Singaporeans is about 79 years, and I would like MOH to start paying more attention to the needs of the elderly and ensure that they keep fit and healthy for as long as possible. I am advocating adding life to years. What are the steps taken by MOH to ensure that the elderly also keep fit and healthy? Will MOH step up health promotion and prevention of diseases for this target group? MOH should partner MCYS in the setting up of centres of activity, especially for those less well-off retirees in the community. There should be at least one centre per constituency to keep the mobile elderly physically, mentally and socially fit. Sir, early preventive measures are preferable and more effective than later interventions at points of crisis. Will MOH promote and reinforce the axiom of "disabilities in old age are often due to disease and early treatment of the disease can prevent disabilities"? Will MOH ensure that those with diagnosed chronic diseases get their regular long-term medications? Chronic diseases, such as hypertension and diabetes, are big problems to the poor, as they have limited resources. By stinging on the required regular long term medication, they end up with diseases, such as stroke, heart diseases and kidney failure that cost them and the society more in the end. Will MOH include chronic diseases care for those eligible poor elderly in the Primary Care Partnership Scheme? Sir, I want to declare that I am a doctor participating in this scheme. Chronic Sick Services to Complement Polyclinics”
“I would like to concur with Mr Chew Heng Ching on the less than satisfactory cleanliness of the road pavements under the charge of NEA, especially in crowded or patronised areas. May I suggest to NEA to identify such areas and employ more cleaners to clean at more frequent intervals? Assoc. Prof. Koo Tsai Kee: If the MP knows of a particular area, we would be very happy to hear it. Certainly, we will follow up on Mr Chew's and Dr Lily Neo's suggestion. There is a problem on the ground and there is a twilight zone, so to speak, and we will try to close the gap there.”