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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“Sir, can I seek clarification on the upgrading of HDB rental flats? The upgrading of HDB rental flats with elderly friendly features in the past has been useful to many residents, especially the elderly residents, and it is a worthwhile project. May I ask the Minister of the progress and whether it can be enhanced further and be stepped up? On another issue, can the Minister give us an update, either public or private, on the retirement village?”
“Sir, there is a need for better planning of the housing needs of Singaporeans in view of the fact that 12% of households today are headed by persons over 65. Should there not be more 3-room and 2-room HDB flats being built in view of more downgraders than upgraders in the recent times? Will MND consider building new HDB flats with "lifetime-designed HDB concept" so that such flats can be adapted as the needs arise to allow people to "age in place"? More studio apartments and retirement homes will be needed to better accommodate the silver generation. Will MND set aside designated lands for this purpose? It may be more feasible to allow 30 or 40-year leases to the private sector to make retirement villages viable. Sir, may I urge MND to be less stringent on the HDB "Joint Singles Scheme"? I am not suggesting that we convert all HDB rental flats to only "Singles Scheme" as many lessees may prefer to rent with spouses or other family members for companionship. Will MND be more flexible to those with no family members or friends to share with as it is very difficult for many singles to live with complete strangers? Like my parliamentary colleague who spoke earlier, may I urge MND to give HDB cash-poor retirees the option of reverse mortgages? This facility will allow the elderly to pay for their daily living and remain in their own homes and there will be less cases of bad management of funds from selling of HDB homes and lesser demand on rental flats. On faster upgrading of HDB lifts, may I suggest that priority be given to those HDB flats with a higher percentage of elderly residents to get earlier upgrading?”
“Mr Chairman, may I ask the Minister whether the deceased SAF servicemen's families will be compensated for the loss of their children during training in SAF?”
“Sir, could the Minister inform this House on the total cost for the whole duration of the deployment of SAF in Indonesia for the recent tsunami effort? Could he also respond to the comment that the SAF has gained a lot of experience and practice from this tsunami relief effort? Has this deployment honed the SAF's capability even further and, if so, in which areas particularly?”
“Mr Chairman, the Minister said earlier that SMRT offers help to the physically challenged residents. May I ask him whether there are any plans to also make our public buses more friendly to the physically challenged residents, in view of our ageing population, to give them independence? Also, are there feasibility studies done so far on the cost to make our public transport more friendly to this group of people?”
“For example, banks should be allowed to intervene when a staff suspects that an older person is being defrauded offinancial assets. Sir, it is timeto recognise this social ill and implement measures to address it. Public education should be stepped up on the various kinds of abuses such as physical neglect, assault, psychological and financial abuses. Sir, I would like to conclude by beseeching our Government to helpdispel the view ofageing with despondency and decrepitude, to assist the elderly live purposeful, useful and healthy lives and to enable them to live their lives with dignity and age gracefully.”
“I am glad of our Government's assurance that no Singaporean will be denied of any medical treatment as aresult of lack of means. It is therefore comforting that the Medifund isa safety net and will be increased to $2 billion. I hopewe would not take too long to reach this amount and seize the good economic years to top up more, as $100 million per year would take us 10 years, not discounting some unfavourable economic years. Iwould also like to urge our Government to approve all the deserving applicants of Medifund and even those who may be in the sandwich group but have exhausted their means. Elderly abuse Lastly, I would like to talkon elderly abuse.There are 100 cases of battered and neglected elderseach year that came to the attention of welfare groups and medical authority in the past five years. Half of these cases of elderly abuse were the victims of their own children. It was reported that these cases were just the tip of the iceberg as most cases were not reported. Sir, why should elderly abuse be treated differently from child abuseand wife-beating in our laws? Presently, the authorities canintervene only if the abused elderly person or a third party has applied fora protection order under the Women's Charter. I would like to beseech our Government to change our laws to empower social workers, doctors, family members and homecare givers to protect senior citizens from abuse, asmuch the same way as they can intervene onbehalf of abused children. Sir, we need better laws to protect the abused elders as many of them arehelpless for various reasons such as shamefulness, total dependency on the abusers who are the sole care-givers or due to sickness or dementia. We also need to review our laws to prevent financial abuse.”
“In view that life expectancy is at an average of 79, it is a worthwhile effort to have programmes assisting our elderly lead healthy lifestyles and providing more preventive care for our elderly. An important message for this target group will be "disabilities in old age are often due to disease, and early treatment of the disease can prevent disabilities". On this premise, it is necessary for MOH to ensure that those with diagnosed chronic diseases can get their regular long-term medications. Chronic diseases are a big problem to the poor, as they have limited resources. By "stinging" on the required regular long-term medications, they end up with more diseases that cost them and the society even more in the end. It is thus necessary to make currently excluded "chronic diseases care" available to those eligible poor elderly in the Primary Care Partnership Scheme. Sir, I wish to declare that I am a doctor participating in this scheme. All in, preventive care, community support services and appropriate rehabilitation not only help prevent unnecessary hospital admissions, but also improve quality of life in the elderly. Sir, I am not advocating adding years to life, but life to years. Medical costs Many Singaporeans are concerned about rising medical costs, and this is especially so for the elderly folk in our midst who have no income but have increasing medical needs. In time to come, this increasing burden will affect even more people due to our fast ageing population. I welcome the newly renewed MediShield scheme, but I would like to urge our Government to ensure better take-up rate, especially by those poor and elderly. More publicity may be needed to get more of them on board.”
“There is a need for better coordination and effective implementation of the various healthcare services. Many caregivers are also not aware of the existing services, or how to access these services. Preventive healthcare Sir, everyone accepts that health promotion and disease-control strategies to enable the elderly to remain fit and active in the community are the most effective ways of getting the best outcome from an ageing population. It is time that we prioritised this area by setting up Centres of Activity, at least one per constituency. These centres aim to keep the mobile elderly fit and healthy for as long as possible. This concept of maintaining the physical, mental, as well as the social well-being of the elderly should be promoted island-wide on a big scale and made available to our elderly whilst they are still well. Such centres can be set up at the community centres or RC centres. By paying a reasonable and affordable fee, the participants sign on at a convenient precinct-located Centre of Activity for the Retired and Elderly (CARE) for their daily exercises, wholesome meals, social activities, learning new hobbies, outings and health education talks. I am convinced that the way to go is to have more such CARE to keep our retired elderly healthy and happy. I hope that such centres can be set up and supported by both MCYS and MOH, and involving the grassroots groups and other volunteers from the community. I hope ComCare funds can be used to fund such centres island-wide. Sir, early preventive measures are preferable and more effective than later interventions at points of crises. This follows the dictum "prevention is better than cure".”
“This area needs urgent priority for the following reasons: (1) Institutional care is costly and causes loss of independence; (2) The family unit, with adequate support, is a principal way to provide care in the home environment rather than institutional care; and (3) Careful pro-active planning and actionare nownecessary, in view of the fast-ageing population, to minimise hospital admissions and dependence on long-term care in institutional settings. Sir, many low-income families will benefit from the Elderfund or ComCare funds that help them cope with loss of income when people give up their jobs to look after the dependent elderly. Most caregivers in the community are family members and maids. They should be given the proper know-how and homecare support. May I also urge our Government to consider doubling the dependant's tax relief for aged persons 75 years and above, to help families meet the greater cost of looking after this group in their homes? Comprising more of the frail elderly, this group is the one most likely to depend on more healthcare and social services.Sir, there is also a need for more Community Care Centres, such as "Day Rehabilitation Centres" and "Respite Care Centres", for the semi-dependent elderly to remain in the community. The Ministry of Health must strive hard for seamless integrated care services for all elderly patients discharged from public hospitals. This is necessary to coordinate and facilitate placement of patients to step-down care facilities that look into the multi-faceted medical, social and psycho-socio needs of the patients. At any one time, there would be some 8% of the elderly that require step-down care of varying levels of intensity. Currently, there are multiple service providers with minimal coordination.”
“Healthcare Sir, better policy planning is needed on the medical needs of the elderly in the next 10 to 25 years when the elderly population will increase from 14% to 20% of the population. The ratio of the elderly to the working-age population (the old dependency ratio) is set to increase dramatically. This shift will likely to have significant consequences onhealthcare demands, especially so when severity of disease and disabilities increase with age. We must cushion the future burdening effects, and that requires pro-active actions especially during the years of budget surpluses from good economic times. At any one time, it is estimated that 2.7% of the elderly will require institutional care, while another 5.3% will require community-based care. On this basis, it is projected that we will have to provide for about 800,000 elderly in 25 years' time. The various healthcare services, such as acute hospitals, nursing homes, day centres, community care centres, will then have to be increased three-fold to cope with such an increase in the future. I urge our Government to ensure that we do not leave it too late for this provision in the coming years. Homecare We need a coordinated plan in place to deal with the ageing problems more effectively, and this is especially so for the non-ambulatory elderly. Presently, there are at least 20,000 semi-ambulant and non-ambulant elderly that require assistance in their care. Homecare should be givenpriority, as homecare in Singapore is at its infancy. Homecare is the care of the semi-dependent elderly to enable them to live in their own homes for as long as possible with appropriate support. Homecare translates into convenience and much lower costs for many and, hence, a happier populace.”
“These elderly-friendly features are essential to enable the elderly to live independently in their own homes for as long as possible. May I also ask our Government to consider building new HDB flats with "Lifetime-designed HDB Homes" concept, so that such flats can be adapted as needs arise to allow people to "age in place"? It is essential to ensure that there is a priority in getting the various Ministries to always have the elderly and handicapped in consideration in all planning, to make our living environment, roads and public transport more elderly-friendly. Sir, for many years, our public transport system has not been user-friendly for our physically challenged residents. We need a revamp here, as our policy will determine the independence of those with mobility difficulty. More studio apartments and retirement homes will be needed to better accommodate the silver generation.I would like to urge our Government to set aside designated lands for this purpose. It may be more feasible to allow 30 or 40-year leases to private-sector enterprises to make retirement villages viable. Sir, may I also urge our Government to be less stringent on the HDB's Joint Singles Scheme? I am not suggesting that we convert all HDB rental flats to only "Singles Schemes". Many lessees may prefer to rent with spouses or other family members for companionship. But let us be flexible to those with no family members or friends to share with. It is very difficult for many singles to comply with this ruling by requiring them to live with complete strangers. I welcome PM Lee's announcement on faster upgrading of HDB lifts. May I suggest that priority be given to those HDB flats with a higher percentage of elderly residents to get earlier upgrading?”
“Like my parliamentary colleague who spoke earlier, Mr Iswaran, may I urge our Government to give HDB cash-poor retirees the option of reverse mortgages? This facility will allow the elderly to pay for their daily living, remain in their own homes, and lead less disruptive lives. There will be fewer cases of bad management of funds from selling their HDB homes. This will also lessen the demand on HDB rental flats. Sir, Singaporeans fare badly in saving for retirement. Could our Government make the Supplementary Retirement Scheme (SRS) more attractive to encourage more to save? Presently, the withdrawal of SRS with tax waivers allowed onlyfor death or being bedriddenis too restrictive. Situations for tax waivers should be broadened to include conditions that cause people to lose the ability to work for their livelihood prior to the minimum withdrawal age. Also, at the point of withdrawal, the capital gains part of SRS should be waived from taxation. Financial planners say that Singaporeans desperately need to know how to invest their money. With many of our people advancing fast in age, it would be prudent to better prepare them for their retirement. Much more should be done to teach financial literacy in the community settings. Housing Sir, better planning of the housing needs of Singaporeans is necessary. About 12% of all households now are headed by persons over 65 years. In 2000, just over 7% of Singaporeans were over 65. By 2009, it will be 10% and, by 2016, 14%. Should there not be more three-room and two-room HDB flats being built in view of the trend in recent times when we see more downgraders than upgraders? There should be more HDB flats being built or improved with elderly-friendly features.”
“Many of the poor, especiallythe elderly,are often ignorant and isolated from the help that they are eligible for. According to a survey by the Social Development Feedback Group, only three in 10 households living in one- and two-room HDB flats are aware of financial assistance schemes. There should be a central register for our destitute, chronic poor and disabled, so that effective and thorough assistance can be given to them without anyone falling by the wayside. We need to have 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. There are too many schemes presently, and this makes them difficult to follow and administer. Sir, we have to consolidate them and make them more comprehensible. We need to vet through the various schemes available to remove stifling benchmarks and blanket rules, and to factor in the complexities of individual needs so that fewer people fall through the system cracks. For example, we cannot always presume that the aged will receive care from their families. Although 86% of older women live with their children, volunteers say that many, especially those in poorer households, put their own needs aside as they do not want to impose further burdens upon their families for various reasons. In 2000, the total CPF funds for women aged above 40 were $19.9 million and $33.1 million for men. As of 2003, only about 40% of active CPF members who turned 55 met the Minimum Sum. Of these, slightly more than half had set aside no more than $40,000 and had to pledge their properties to make up the shortfall.”
“Other job opportunities would be nannies for infants, tourist guides, mentoring roles, certain manufacturing jobs and part-time or flexi-time positions, and so on. (4) A mindset change among employers with regard to older employees must be facilitated. Most studies on mature employees indicate that they are likely to stay with their companies much longer than their younger colleagues. On technology generation gap, studies have shown that mature employees can muster the same information as their younger colleagues and can apply this knowledge equally well. In some cases, mature employees can actually get extra mileage by applying new information more effectively because of their experience. We need to debunk the perception that once people hit a certain age, their bodies and minds go into such decline that the workplace will benefit from their departure. Most people today live well beyond 62 years. Many mature workers are in fact in their prime, in terms of knowledge and creativity. Mature workers represent an available resource to be tapped in order to benefit our nation in this century. Financial needs Sir, rendering help to those in their 50s to 80s with no job, no CPF and nobody to turn to is now crucial. I hope ComCare funds can be channelled to especially help this group of people. Women are especially vulnerable. Over 90% of women, aged 60 or more, have less than secondary education and, therefore, fewer work opportunities. Previous reports have also shown that 54% of elderly women here are widowed, slightly more than three times the proportion of elderly men. According to the Department of Statistics, there were 290,200 women above the age of 60 in 2003.”
“I would like to urge our Government to look at the following areas to facilitate our elderly to gain employment: (1) Allowingfit and willing workers to continue working at their jobs beyond 62. More incentives, such as taxreductions or rebates, could be given to make it more attractive for employers to retain workers beyond the age of 62. It may be more feasible to implement flexible retirement age to get people to retire later. (2) Retraining of older workers has been an emphasis of our Government for years. It remains an important pillar for gainful employment for many and I welcome the new Re-employment Assistance Programme (REAP) to help those with structural unemployment. Over the years, we haveimplemented various retraining schemes and it is now time for us to evaluate the various schemes implemented so far and expand those that have proved effective to make them available to the majority. I would like to urge our Government to make it more attractive, especially in terms of financial assistance, for more people to take up retraining opportunities. Often, the lesser take-up rates were due to lack of suitable matching job placements and inappropriate expectations of both employers and employees. We need to evolve a better synchronised system to ensure higher success. More efforts are also needed to actively promote and encourage all those eligible to ensure that no one is left out due to unawareness of such schemes being available. (3) May I urge our Government to create and incentivise more job opportunities for the older employees? For example, since we need to develop our homecare, the silver generation group is an ideal source for training to fill up the various job opportunities.”
“Mr Speaker, Sir, I rise in support of the motion. Sir, our society has placed heavy emphasis on our youths and allocates much of its resources to the future generation. There has always been this utilitarian approach to life and to people in this society. However, in view of the sharp increase in the numbers of old people in the Singapore population, such marginalisation must make way to ensure all groups of our society are not being left out and are made to feel as part of our system because they matter. I would like, therefore, to urge our Government now to place more emphasis on our silver generation, as highlighted by Mr Iswaran and Mr Ong Ah Heng earlier. Sir, notwithstanding the lifelines to the old, needy and jobless, asannounced by PM Lee during the recent parliamentary debate on the Presidential Address, I would like to highlight areas that are deficient and those that can be further improved on to better the lives of the silver generation. Employment The necessityfor a majority of people here to continue employment beyond the retirement age of 62 is becoming more evident. In fact, it is recommended that fresh stimulation and retraining are what all of us need in "the last years of life" to prevent mental peril. Besides, life expectancy of Singaporeans is at 77 for men and 81 for women and getting increasingly higher. Financial planners estimate that at least 75% ofSingaporeans do not have enoughsavings to maintain their lifestyles after retirement at 62. With declining birth rates, the elderly depending on children for their keep and the declining dependence working ratio affecting the economy of the country will be an issue.”
“Sir, in the recent MediShield revamp, there was no change to the age limit claim for MediShield. Will the Minister consider raising this age limit claim beyond the age of 80, in view of our ageing population?”
“May I ask the Minister when will he raise the retirement age or implement flexible retirement age to enable workers to work beyond the age of 62?”
“May I ask the Minister whether there will be more incentives, such as tax incentive for rebates, to encourage employers to employ older workers? Is it time to review the various retraining schemes to expand the effective ones and to make them available to the majority? Will he make it more attractive, especially in terms of financial needs, to attract more people to take up the retraining opportunity? Lastly, is it correct that the lesser take-up rate of retraining was due to a lack of suitable matching job placements? Therefore, will he put a system in place to get greater success rate?”
“The outpouring of sympathy and helping hands from all walks of life from Singaporeans in unison demonstrate that we are a nation that cares for others in need. This show of benevolence makes me feel very proud to be Singaporean. Such concerted efforts can only bind us even stronger as a nation. Our acts brought relief to many tsunami-afflicted individuals. Our goodwill strengthens the friendship we have with the afflicted countries. I am sure they appreciate our goodwill in their hour of need. We have unveiled our true commendable qualities and the world will judge us accordingly, a global and socially sound nation. Sir, I would like to conclude by complimenting President Nathan on his Address that covered wide-ranging topics charting Singapore's forward path. I concur with him, especially when he said that older Singaporeans helped to build today's Singapore and I am most happy to hear him say, and I quote, "We will support the social, mental and physical needs of the growing numbers of older Singaporeans." Sir, there is much that our Government can look into, in terms of the social, mental and physical needs of our elderly. This is a topic that deserves a hearing of its own and I shall do just that in due course. I conclude on this note in support of the motion.”
“PUB sent out bags of water to affected areas. The Civil Aviation Authority of Singapore has been waiving charges for relief goods. Many organisations are still raising funds for the relief and reconstruction of tsunami-affected areas. To-date, the Singapore Red Cross Society had raised $48 million from individuals, organisations and companies. Singaporeans have raised at least $50 million for the tsunami-affected countries and this figure is still climbing. The total amount collected as a nation, inclusive of those pledged by our Government of $24 million and Temasek Holdings of $16.5 million, will be a staggering amount of about $90.5 million. Singapore is indeed a small country with a big heart. Singapore has also suffered direct casualties. We have confirmed nine dead and 15 missing from the tsunami disaster. My condolences go to their families and friends and I would like to urge our Government to look into stouter support and financial help for their dependants. Let us not forget that they are truly tsunami victims and deserve our sympathy and helping hands too. Perhaps, we should take a leaf from the assistance given to the SARS-affected families from the large funds raised at that time. At the Opening of Parliament, President Nathan said we must secure Singapore's place in the world and nurture our relations with other countries. He said that in an increasingly inter-dependent world, Singapore will fulfill its responsibilities as a global citizen. Mr Deputy Speaker, Sir, our nation's impromptu and concerted efforts for tsunami victims this time demonstrated that Singapore has indeed acted as a global citizen.”
“" PM Lee Hsien Loong initiated a summit of world leaders to coordinate sustained international aid to the affected areas. Held in Jakarta on 7th January 2005, it was attended by 26 delegations from donor countries, organisations and affected countries. Singapore's proposals taken up at the summit included appointing a special representative so that the UN could mobilise relief efforts urgently for tsunami-hit countries and having more aircraft and helicopters coming through Paya Lebar Airbase en route to the stricken areas. One week later, 73% of US$977 million UN appeal launched at this summit was met by donor countries pledged to the United Nations. Indonesia's media acknowledged that this summit was a Singapore initiative and that PM Lee was the first head of state to visit Aceh. Indonesia also praised and carried reports of Singapore's efforts in Banda Aceh and Meulaboh. Singaporeans showed unprecedented compassion and generosity for tsunami victims. Three thousand Singaporeans from all walks of life queued at the Singapore Red Cross Office to donate $2 million in just one day, on 29th December 2004. Instead of celebrating New Year's Day, Singaporeans sweated it out packing relief boxes at SPH News Centre. At DBS Bank, around 12,200 customers donated more than $1.8 million in a mere 3-day period. Everywhere, young people were coming forward, donating money and time. Many companies chipped in by mobilising their staff and assets, and donating to the Singapore Red Cross, quite a handful of them in large amounts too. Temasek Holdings has announced that it will set aside US$10 million for relief, recovery and reconstructive support. Singapore's port authorities waived all charges for handling relief supplies sent through its ports.”
“SAF's massive aid, professionalism, commitment and diligence enabled international relief efforts to show results, with basic services restored in Meulaboh by 12th January 2005, with medical care, rubbish collection and communications restored. Mr Deputy Speaker, Sir, Singapore's quick response, anticipating potential flaws in international relief operations and focusing limited aid in Meulaboh that yielded tremendous results, showed our Government's efficiency, competence and pragmatism at its best. UN relief chief, Mr Jan Egeland, lauded Singapore's timely response, noting how it was one of the first countries to offer military assets to the relief effort: "Singapore's efforts have been exemplary. Very early on, it offered exactly the kind of logistical support and military assets that UN needed the most." TNI Indonesian Major-General Bambang Darmono acknowledged positively the SAF's involvement when he said: "Singapore has helped us a great deal in this crisis. There is this special synergy between TNI and SAF in the field." One week after the disaster, Singapore offered to be the regional coordination centre for international relief operations. The next day, United Nations and International Red Cross accepted Singapore's offer of its air and naval facilities, as well as office space and logistics facilities, to ease the distribution of aid in the region. Our Government activated the biggest ever humanitarian response effort, dispatching 10 helicopters, three SAF navy ships, more than 1,000 military, police, civil defence and medical personnel, mainly to Thailand and Indonesia. UN relief chief, Mr Jan Egeland, praised Singapore for offering assets for immediate use and, as he put it: "Singapore has been generous, putting in all efforts to help in the relief work.”
“About 100,000 people died from the tsunami in Sumatra's western coast. The area around the town of Meulaboh, which lies 150 kilometres from the epicentre of the tsunami earthquake, bore the brunt of the quake. Ten thousand of the 40,000 inhabitants died, and towns and villages were devastated in Meulaboh. On 30th December 2004, SAF Chinook helicopters flew the first large food shipment into Meulaboh. On 3rd January 2005, a lifeline into Meulaboh was finally established by SAF engineers when they achieved a major breakthrough in establishing two landing points at the coastal town which had changed drastically due to the tsunami. This breakthrough brought in the much needed 470 personnel from the SAF, SCDF, volunteer doctors and nurses, 51 trucks, trailers and other equipment transported by the RSS Endurance. It was reported that President Susilo Bambang Yudhoyono was delighted when he received this news. By 6th January, a second ship, RSS Persistence, arrived with another 196 men and relief supplies. On the same day, a SAF portable water-purification plant began producing 3,000 litres of clean drinking water daily. A SAF temporary field hospital was also set up at Meulaboh. The 55-member SAF medical team proved to be a life-saver. Meulaboh lost its two hospitals in the calamity. Only four of its dozens of doctors in the civilian hospital survived. The rest were killed because they were attending an event on the beach on that fateful day. Mr Kofi Annan extended special thanks to SAF for its role in facilitating relief efforts in Aceh.”
“The health hazards, with decaying corpses, no water, no sanitation and no electricity in tsunami-affected areas, were the immediate concern after the aftermath. This spurred our Government to send plane-loads of relief and medical supplies to Medan on the second day of the disaster, and the following day to Sri Lanka, as well as SCDF rescuers to Thailand and Aceh. Sir, the first foreign medical aid to get to Banda Aceh was indeed from Singapore, sent by City Harvest Community Services, arriving on the third day of the disaster. The team conducted 50 operations in three days. As many as 1,500 patients were waiting for treatment on their arrival. The 25-man medical team of the SAF arrived at Banda Aceh on the fourth day to provide the badly needed medical personnel and medicine for the many injured and sick. Just a few days later, they were reinforced by groups of medical volunteers from Parkway Medical Group, Mercy Relief, Ren Ci, and Raffles Medical Group. The Singapore Red Cross Society, hospital and medical personnel from both public and private sectors, Touch Community Services and YMCA also sent teams of volunteers and medics to Sri Lanka. By the end of one week, more than US$5 billion in aid from governments worldwide had been pledged. Unfortunately, the aid delivery to the affected areas was hampered by lack of access. The tsunamis had destroyed roads, jetties and airport. Entering the first week, Indonesia admitted that basic supplies had not reached many affected areas, especially the western coast inaccessible by land. Singapore was one of the first countries to send personnel, vehicles and relief to the beleaguered town of Meulaboh, which lost almost all road links with the rest of Sumatra, making it only accessible by air and sea.”
“Mr Deputy Speaker, Sir, at the Opening of Parliament, President S R Nathan said we opened the Second Session of the 10th Parliament with a heavy heart, as many parts of our region were devastated by tsunamis which brought death and destruction to entire communities. Mr Deputy Speaker, Sir, this tsunami disaster generated an unprecedented outpouring of generosity and assistance from many countries, but the kind of generosity and assistance from our small country is worth a big mention. Yes, Sir, I am proud of our efforts and, today, I would like to commend my fellow Singaporeans and our Government for the overwhelming response and the effective measures we have taken to help in the tsunami-affected areas. Although many of my parliamentary colleagues speaking before me have touched on tsunami-related issues from various perspectives, I would like to give a more detailed account and put on record the unfolding of events that prompted the outpouring of generosity from Singaporeans, voluntary organisations, and Singapore companies that really touched me, and the swift effective actions taken by our Government that really impressed me. Although the tsunami disaster struck on 26th December, ie, last month, it was not until at least three days later that the world realised the scale of the disaster. The enormous scale of the damage to lives, communities and towns shocked the world. As described by PM Lee when he visited Banda Aceh and Meulaboh: "I was overwhelmed by the endless and total devastation." US Secretary of State, Colin Powell, when he visited Aceh, said that the scene was worse than any disaster he had ever seen. Stunned by what he saw in Aceh, UN Secretary-General Kofi Annan said that he must admit that he had never seen such utter destruction, mile after mile.”
“The whole idea of bringing quality family life is such that there will be inclusiveness and, so far in the list, no mention has been made about people with disabilities and how we are going to help them. In fact, with an ageing population, there will also be an increase in the proportion of disabled elderly family members. Perhaps the Minister could just enlighten us on how the Ministry would like to tackle this aspect too.”
“We adopt the life-cycle approach in planning these programmes. For instance, prior to marriage, we have marriage preparation programmes. And then, subsequently, in order to help couples make their transition into parenthood, we have parenting and marriage support programmes which are run as part of the prenatal programmes of the KK Women's and Children's Hospital and Singapore General Hospital. We are also piloting a family education programme at childcare centres next year in order to help young parents. In schools, we have the School Family Education and Step Up programmes, which cover values education and life skills for students, while simultaneously helping parents with parenting skills. For grandparents, we have inter-generational programmes to foster close bonds between grandparents and grandchildren. We also continue to develop programmes to facilitate positive and successful ageing so that our senior citizens will be able to actively contribute to family and community life. Mr Speaker, making Singapore a great place for families is a long-term sustained effort that will require a comprehensive approach, with individuals, families, the community, the private sector and the various Government agencies all working together. The challenges facing our families are dynamic and will continue to change and become even more challenging as society evolves. MCYS will remain vigilant of these evolving challenges, and we will continue to work with our partners to realise the vision of Singapore being a great home for families. Assoc. Prof. Ngiam Tee Liang: Further clarification, Sir.”
“The measures do not just focus on the financial aspects but also seek to give parents an opportunity to spend more time with their children, pursue a range of childcare options, and strike a better balance between work and family life. One clear example is the 5-day work week. My Ministry - I was going to say my family as well - is very encouraged by the positive overall feedback by Singaporeans on these measures. Mr Speaker, our total fertility rate is also affected by higher singlehood rates, which is another issue we face. MCYS and the People's Association are presently reviewing the roles and functions of the Social Development Unit (SDU) and Social Development Service (SDS) to see how we can better achieve the outcome of more marriages. However, even as we want more marriages and more children for our next generation, we also know that families today face many challenges. While our divorce rates are not alarming compared to many other countries, they are nevertheless on an upward trend. Many Members of this House who are parents of teenagers or pre-teens will also know that parenting them has become more challenging. In addition, we have a fast-ageing population. In the context of small families, that also means that more people will be in what we call a "sandwiched" generation, who are facing the simultaneous challenge of both looking after aged parents as well as young children. Therefore, we need, as a society, to ensure that there are adequate support programmes for families like this as they face the future. We will continue to work with community and private sector partners to run programmes and services in order to help families fulfill their responsibilities and to sustain nurturing family relationships.”
“In fact, what we should do, as I said, is to help them find jobs, expand the economy, so that they can move out of these rental flats and own their own homes. FAMILY POLICY 3. Assoc. Prof. Ngiam Tee Liang asked the Acting Minister for Community Development, Youth and Sports (a) what are the outstanding issues his Ministry faces in developing a comprehensive family policy that will realise the vision of quality Singapore family life; and (b) what measures is his Ministry pursuing, or plans to pursue, to resolve these issues. The Acting Minister for Community Development, Youth and Sports (Dr Vivian Balakrishnan): Mr Speaker, my Ministry's policy is to promote family life and family values so that Singapore as a nation will have more strong and stable families. Strong families are the foundation of our society and will continue to remain as the first line of support for us as individuals and as a nation. Our family policies and programmes are therefore intended to create an environment conducive for family formation and the strengthening of family ties. As the family is really part of a much larger system in society, my Ministry works closely with other Ministries, corporate bodies and community groups in order to achieve this desired outcome. There are several issues confronting us in the family arena. A critical issue faced by us right now is low fertility. In 2003, the total fertility rate for the resident population was only 1.25, well below the replacement level of 2.1. The new package of parenthood measures which were announced recently in August 2004 takes a holistic approach to support couples who wish to have more children.”
“Sir, the Minister of State said earlier that it was an ideal. Does that mean that he is going to change this two-sharing rental policy? Am I not correct that those who really apply for HDB rental flats are the ones who cannot afford any other type of housing? May I ask the Minister whether there will be an increasing number of elderly being denied of HDB rental flats, in view of the increasing number of smaller families, an ageing population and the limited number of rental HDB flats? Will he spare more thought for our elderly, especially our needy elderly? Mr Cedric Foo Chee Keng: Sir, when I first joined the Ministry of National Development, the first visit I asked HDB to arrange for me was to visit rental flats, and I have done so. I have visited those flats in Bukit Merah and Redhill Close, and what I saw was a Main Upgrading Programme. The Government is investing a lot of money to make sure that the needs of the elderly are taken care of. If you were to visit these flats, you will see that the lifts are larger to enable wheelchairs to roll in and out. There is no ledge to impede the movement of elderly people. There is even a panic response system inside the flat, should an elderly get into trouble. Here again, I emphasise that, if they live in pairs, that would provide for mutual care and support. So the Government is concerned, aware and is doing lots of things, investing a lot of money to help upgrade the living conditions of the elderly. But to change the pairing policy means to double the number of rental units to Joint Singles that we have today which, as I said earlier, involves a non-trivial sum. More importantly, rental housing is really to provide for the lower strata of our population. It is a safety net. It is not an area which we want to increase.”
“May I ask the Minister of State whether our two-sharing rental policy causes a lot of hardship on the elderly who do not have family members to share their rental flats with? Is it not very difficult for them to share their rental flats with complete strangers, especially at their age? Is it reasonable to insist on them to comply with this policy? Will the Minister of State consider converting some of the two-room HDB flats to one-room HDB rental flats to accommodate more single elderly?”
“Sir, I asked in my question on the number of applicants of HDB rental flats who have failed, but the Minister of State has not replied on that.”
“Mr Speaker, Sir, may I ask the Minister whether he will consider reviewing the signed consent for HIV blood test, especially for antenatal HIV screening, in order to better protect the unborn babies? Is it not correct that those who refuse HIV screening are the ones that doctors are most concerned about but cannot do anything due to the required signed consent? On another question: will the Minister consider helping those afflicted patients who cannot afford HIV drugs because they are very expensive?”
“And I will not blame the parents going this way if it turns out that it is still the "A" that counts at the end of the day. Certainly, our system must ensure that when we tell someone to go on and enjoy studying the second language and when we say a pass will do, it must mean just that - a pass will do, good to have an "A", but is not necessary. Our system must look at our pupils in a more holistic way and with the right approach, parents can be courted and influenced to add value and enhance the implementation of our policy. Sir, the best outcome from our debate today will be to see the next generation of Singaporeans who not only speak and read Chinese but also have the passion for the Chinese Language and Chinese heritage. This can be achieved by having not only the correct policy, but also the sustainable and long-term tenacity on implementation details. Mr Speaker, Sir, I support the motion.”
“Overloading a child may cause not only aversion to learning but also hampering his or her exploratory space and creativity. In 1999, school syllabuses were cut by as much as 30% only to be nullified by some teachers in some schools giving more homework to fill up the time. In the 1999 exercise, whilst the curriculum was trimmed, the examination format did not change; resulting in students and teachers remaining pressurised. Is the Ministry of Education keeping track of the workload of our pupils and ensuring that any anomaly that contributes to the pressure in our teachers and students is addressed? A healthy attitude towards learning as a whole will influence the learning of second language in our schools. Alas, memory work is still essential to master the Chinese Language in a long lasting effect. However, memory work need not be boring when it is motivated and especially when the right teaching techniques are used. Nevertheless, I am glad that the new examination format in Chinese will see a reduction of Chinese character memorisation as this will lighten the workload on pupils. Sir, I always believe the success of any policy will be based on how well the respective Ministry gets its policy understood and supported by fellow Singaporeans. I hope that the Ministry of Education will spare no effort in this regard. The mindset change of teachers, students and parents is key to solving our present dilemma. There is a need for close collaboration and understanding between policy makers, educators, students and parents. Parents may undo what the Ministry of Education is trying to improve by pushing their children for more tuition, more homework and more character memorisation in the hope for higher scores in the public examinations.”
“Without going overboard, we may like to try the following ideas: have more Chinese cartoon programmes on television and more picture books in the shops and libraries; engage students in kindergartens to use Chinese amongst themselves; provide more scope for exposure to Chinese in our day-to-day life with signages in Chinese in the schools, supermarkets and streets. Of course, we may try to encourage usage of Chinese Language at home as what a "mother tongue" should be. This White Paper will introduce a modular approach at primary level with Core, Reinforcement and Enrichment modules. But the students will sit for a common examination after primary level for PSLE. May I ask the Minister whether the aggregate scores on PSLE will remain and be based on the grades of Chinese, English, Mathematics and Science? Candidates of PSLE and parents pay a lot of emphasis on PSLE aggregates as these will determine the choice of schools for the students in the secondary level. Many parents may opt for the enrichment modules for fear of losing out regardless of the capability of their children. Therefore, will this modular system be treated as another form of "streaming"? At the tertiary level, will students be required just to pass Chinese Language for university entry here? I have heard that the medical faculty here requires their applicants to score highest grade in Chinese on top of all other subjects in "A" levels before they are considered for entry. Should there be more flexibility on Chinese Language in the entrance criteria for all our schools, polytechnics and universities? It has been mentioned that the stress level of students here, in terms of overload, has increased since 1990.”
“The devil will be in the implementation details. My concern is on the task of revamping the old methods and encouraging teachers to switch to the new concepts. Only last week, some Chinese teachers interviewed did not agree on the recommended "Recognise first, write later" method. Their argument against it is that if children are not writing, they are less likely to recognise characters. Another said the numerous changes, and I quote, "may come in a bit too fast for teachers in general". Some of our educators have used the traditional methods for years; will they be willing and are they able to change to a new innovative, fun and not regurgitative method? Teachers play an important role in enthusing students to like the language. Some teachers have better and more interesting ideas than others in their teaching methods. Their ideas should be tapped and shared with the rest of the teachers in other schools in order to have better uniformity in the standard of delivery. I hope there will be lots of avenues for the educators to share and support one another in the initial stages of implementation. Will the Ministry monitor the situation closely to ensure no lapses in implementation that may disadvantge any group of students? It is easier and faster to pick up and learn a language at a younger age. We should therefore expose our children to the Chinese Language at as young an age as possible. Having an environment that enhances wide exposure to the language is the key to imbue this culture.”
“Mr Speaker, Sir, thank you for allowing me to participate in this debate on Chinese Language Curriculum and Pedagogy. It is heartening to note that about 87% of students across the spectrum of home language backgrounds are keen to learn the Chinese Language. It is not so, however, to know that a majority of students do not enjoy learning it although they understand fully how important it can be to learn the language. 71% of students from English-speaking homes find learning the Chinese Language difficult. It is like having to take bitter medicine. Though they know the pill is good for them, it is not something easy to swallow. I welcome this White Paper as it is a new prescription for turning this bitter pill to "Smarties" that are not only palatable but also attractive to the students. I strongly believe in the importance of Chinese Language in preserving our cultural roots. It is most awkward when one declares that he or she is Chinese ethnically but cannot even speak Chinese. Maybe here, I just like to share my own experience. Where I grew up was a place where we never had a chance to learn Chinese at all, not in school, and at home, we spoke Hokkien. My parents and I were determined that I should learn Chinese and, therefore, I just took Chinese tuition at home. It came in useful when I went overseas. I could write back to my mother in Chinese and now I can speak and give speeches in Chinese in my constituency. This White Paper aims to engage the interest of students from an early age and hopefully help them develop a love for the language and culture. This will, in turn, help us further strengthen our traditional culture and values. The right concepts need directions to be adhered to by hundreds of educators in our schools to achieve the goals.”
“It is therefore not necessary for HDB to carry out a one-time retrofitting exercise for all the flats fitted with the pipe socket clothes drying system. However, as and when the flats undergo upgrading, the recessed clothes drying system can be provided as long as the flat configuration allows for it. HDB is always looking for more innovative systems to serve residents better. HDB has piloted a new parallel clothes drying rack system in new flats. If successful, HDB will install the system in all its new flats.”
“Sir, earlier on, I asked on the environmental tobacco smoke level measurement. Could the Minister address that question, please? Assoc. Prof. Dr Yaacob Ibrahim: My apologies, Sir. I do not have the answer to that. Let me check whether we have done the test or not. This is something that is done jointly by my Ministry together with the Ministry of Health. I will check and if the information is available, I will pass it on to the Member. Column No : 1247 HOUSING AND DEVELOPMENT BOARD FLATS (Retrofitting exercise for better design clothes drying system) 3. Mr Zainudin Nordin asked the Minister for National Development with the existence of newer and better design clothes drying racks fitted to the new and upgraded HDB flats, will HDB consider carrying out a one-time retrofitting exercise for flats fitted with the older design drying racks. The Minister of State for National Development (Mr Cedric Foo Chee Keng) (for the Minister for National Development): Sir, the pipe socket clothes drying system has been in use in HDB flats since the 1960s. The pipe sockets are used to hold bamboo poles for hanging of clothes outside the kitchen area. With changes in flat design, HDB introduced the recessed clothes drying system in 1995. Under this system, both ends of the bamboo poles are supported by clothes drying racks installed at the service balcony/kitchen on one side, and the concrete ledge outside the bedroom on the other side. As the poles are supported at both ends, they are more stable and make for easier hanging of clothes for residents. Both types of clothes drying systems are safe so long as residents are careful when hanging out their clothes.”
“Sir, may I ask the Minister whether it is correct that studies have shown that smoking in the smoke of others increases the risk of lung cancer by 20-30% and heart diseases by 25-30%? Is it not a fact that environmental tobacco smoke contains approximately 4,000 chemicals that cause health hazard. Has there been measurement done on the environmental tobacco smoke level in our pubs here? Should the Minister endeavour to better protect the health of non-smokers in public places? Should he not highlight to businessmen on the successful experiences of other countries and smoke-free pubs, especially those that have managed to attract more non-smoking customers that loathe the stink of nicotine and health hazards? Assoc. Prof. Dr Yaacob Ibrahim: Sir, I cannot confirm the figures mentioned by the Member but the point that she is making, which is widely accepted by the health community, is that passive smoking does increase the risk of getting diseases such as cancer. On the point as to whether or not we should protect non-smokers, I agree entirely with her that we should protect non-smokers and that is why we are reviewing the places which are not covered under the current smoking ban. But we will also have to bear in mind that we have to consult widely both the public and the businesses. That is why I mentioned in my reply earlier that the businesses will be consulted because they also have to be made to understand that if we move, this should not affect them adversely but, at the same time, we want them to be a responsible partner in the move to encourage people not to smoke and take up healthy lifestyles.”
“Sir, may I ask the Minister, in view of the fact that 75% of Singaporeans do not have enough savings to maintain their lifestyles at retirement age of 62, is it not urgent to address their predicament? When will his Ministry raise the retirement age beyond the age of 62? Will he incentivise measures to make them more employable? What does he plan to do with regard to employers' mindsets on older workers?”
“May I ask the Minister whether there has been an increased number of applications for Medifund over the years? Will this trend be progressively going upwards with time and an aging population? Has the disbursement so far been from money derived from the interest on the capital of Medifund only or it is already involving the principal of Medifund as well? Will this capital be further topped up to cope with the increasing demand?”
“Sir, in conclusion, I am glad that it is the Minister for Health's top priority to expand the insurance schemes and I hope to see good medical insurance schemes in place soon that can solve the healthcare affordability issues well and remove the concerns of Singaporeans on their healthcare needs hereafter.”
“Therefore, it will be good if two chronic diseases such as diabetes and hypertension affecting about 10% and 25% of the adult population, respectively, can be considered by some coverage to ensure good compliance and control so as to reducecomplications such as heart diseases, strokes and renal failure. Our Government is funding about 30% of the total healthcare expenditure mostly through subsidising patients in public hospitals. It should be the Government's priority to fund disease prevention instead of just looking after end stage diseases. Government may consider it necessary to increase the scope of coverage to make it applicable to a wider population by keeping premiums affordable and also to take advantage of a larger risk pool to provide more comprehensive coverage. Sir, in our efforts to help parents to raise families, one worthwhile consideration is on our pro-natalist importance where couples are insured for procreation anomalies such as complicated pregnancies, premature babies and infertility. Lastly, I shall mention another of our present insurance scheme, ie, Eldershield. It was implemented about two years ago and is an insurance plan to help older people who have become disabled. This opt-out scheme will entitle a subscriber to draw $300 a month for up to five years if the subscriber is unable to carry out unaided at least three of the daily activities. Those eligible for claim are usually heavily dependent individuals who find $300 per month inadequate for their care. The time limit of five years is restrictive as many of the severely disabled usually have problems in recovery. Many of the elderly opted out of Eldershield as they cannot afford the high premium for their age group. Therefore, there should be a review on Eldershield.”
“In Singapore, the major providers of healthcare are Government-managed public hospitals. Nevertheless, attention should be paid to the uniform standard and levels of care in any chosen package of healthcare services and mechanisms in place to reduce supplier-induced demand. Block contracts have been introduced in other countries to reduce the incentives to induce supply. Care should also be heeded to prevent the over-consumption incentives in the design of medical insurance. The claimable amount stipulation only with hospital stays will be such an example. Patients should not be encouraged to stay in hospitals due to the design of insurance for claim purposes as many illnesses can nowbe treated as day surgeries without hospitalisation. Some severe illness may not require hospitalisation such as cancer or strokes. In our health insurance expansion planning, some incentives should be incorporated to rally Singaporeans towards keeping fit and healthy. The other issue in the health insurance expansion is to ensure coverage for Singaporeans when they are in dire need, such as when they are without jobs, and between jobs or portable medical benefits. Ideally, medical insurance should also have the component of preventive medicine in order to prevent people getting more illnesses. One good example, Sir, is the control of the metabolic syndrome which has been estimated to be able to reduce national disease burden by 50%, making it the single most important syndrome to work on. The metabolic syndrome is made up of hypertension, diabetes, lipid disorders and obesity.”
“Would not Singaporeans feel more secured to have their life-long medical insurance in the hands of the Government? MediShield also has an age-limit coverage of 80 years which does not serve us well in view of our ageing population and the longer life-span of Singaporeans which is projected to increase further. This is all the more critical when usually it is in the last year of a person's life that the need for medical care is most acute. It is noteworthy that there were about 45,000 people aged 80 years and above last year. Therefore, Sir, the present MediShield with all its deficiencies - the most pressing of which is the coverage for the majority of 90-95% of the basic hospital bills - leaves much to be desired. MediShield will need drastic overhaul if we were to keep it. It will be most unfortunate if we repeat the past mistakes in our experience with MediShield. Time is pressing on, in view of the various factors mentioned earlier, for us to devise a viable insurance scheme that can look after the medical needs of Singaporeans in the public hospitals and their long-term medical needs to give that assurance and peace of mind. Here is our chance to make good this time, and I hope we can be bold, thorough and not leave undesirable gaps from this major review of medical insurance. In a national public insurance scheme, the probability for our Government subsidising the premium, especially for the needy and/or non-working, must be on the cards. Sir, more attention should be paid to the less well-off in our society and, in view of our fast ageing population, it is better to help with a small outlay in terms of insurance premium and through risk-pooling at the outset than for the Government to carry the heavy burden later on.”
“The Minister said that he will keep the MediShield to cover catastrophic illnesses or 5-10% of hospital bills.This will be, effectively, not expanding the risk-pooling advantage of insurance and the majority of the hospital bills will still have to be paid out-of-pocket finance or Medisave.The burden of healthcare will be increasingly difficult to be served by Medisave, especially in ourincreasing ageing population and with the trend of smaller families to share the health burden of each family. Sir, even the non-catastrophic hospital bills can be heavy for many families for one episode, let alone many episodes of illnesses. For example, for B and C class wards, the 50th percentile to 90th percentile of each hospitalisation bill for asthma is about $1,000 and $2,800, and for non-catastrophicday surgery about $4,000 and $5,000, respectively. MediShield's public risk-pool or financial viability is threatened with cream-skimming by private insurers. Several insurers have devised insurance products designed along the lines of MediShield. These insurers offer some differences. For example, the coverage is for longer than the 80 years offered by MediShield and the coverage also offers better claimable amounts. However, their insurance premiums are significantly higher. Private insurers, in maximising their profitability, have cherry-picked their customers - insuring mainly the low-risk group, the young and healthy and leaving the high-risk group, the old and infirm to MediShield. Sir, this begs the question whether, hereafter, is it not better for the Government to assume the bigger role in expanding our healthcare insurance rather than leaving this expansion to private insurers?”