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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“The Minister of State has just mentioned a few universities from the neighbouring countries which were never recognised before. Will this not diminish the standard of our medical healthcare here? Will it not affect the excellent reputation which we have built up over the years? Is it right to take short cuts like this in easing the shortage of doctors in the public hospitals? May I ask the Minister of State whether now is the time to revisit and review the policy implemented in 1993 of not recognising 150 previously recognised foreign universities? Surely, it is better to recruit from such reputable previously recognised universities.”
“Sir, I have asked for the breakdown on the nationality and the university attended. Could the Minister of State be more specific, please?”
“May I ask the Minister of State whether his Ministry will further facilitate by helping people to stop smoking by subsidising a drug, which can help people stop smoking?”
“Sir, can I seek your patience for one more question? Can the Minister assure this House that the scheme to help the lower-income families to own their 3-room HDB flats will not be further disadvantaged? Can he assure this House on that, and that the prices of the 3-room HDB flats are not increasing?”
“Mr Speaker, can I seek your indulgence? My question earlier was related because I was referring to how to address the shortage of 3-room flats. Therefore, I asked about whether HDB would consider allowing singles to buy 4-room flats as well.”
“May I ask the Minister whether he would consider allowing singles to also purchase 4-room HDB flats, instead of just 3-room HDB flats, so as to ease the demand for 3-room flats and, at the same time, giving more choices to singles for purchase of a flat?”
“The Minister just said earlier that there is a demand for 3-room flats. May I ask the Minister whether it was not his assurance, announced during the Budget Statement debate, that his Ministry had made it a policy to make housing more responsive to the needs of people and enable Singaporeans to purchase a flat according to their budget? May I now call on this to be fulfilled?”
“Sir, may I ask the Minister whether it is not the Government's present policy to encourage Singaporeans not to over-invest in property? Therefore, will this demand for smaller flats be increasing? And why is the Minister not promoting and facilitating this policy, and instead choking the supply of these 3-room flats?”
“Sir, am I right to say that 3-room flats are selling at least $20,000 above valuation, and one was even sold at $50,000 above valuation? Does this not indicate that demand outstrips supply? Is this not causing unhealthy and inflated public housing prices? And will this not affect other types of public housing prices in the end? How would the Minister respond to this?”
“The Minister said earlier that HDB stopped building 3-room flats in 1985 as a result of lower demand for smaller flats. Was it not announced then that HDB was ready to build 3-room flats again if demand rose? Is the demand for 3-room flats not escalating as a result of more families downgrading, singles buying 3-room flats and JTC's purchase to house its foreign workers under the SHIFT Scheme? Mr Mah Bow Tan: We do not detect that there is a major increase in the demand for 3-room flats. As I indicated in my reply just now, in fact, we have more than sufficient 3-room flats in the market, both resale, for those who want to buy a resale flat, as well as new, meaning the buy-back flats. HDB buys back and sells at a discounted price something like 150 such flats a month. Not all of them are taken up. So, I do not agree with the Member that there is a very sharp increase in the demand for 3-room flats.”
“I just want to seek a few clarifications. May I ask the Minister whether his Ministry has to set up a new department to look after this new arrangement, and how will his Ministry ensure that there are enough resources and finances to look into this area? Will this also mean that from now on there will be more inspectors going round to check on all the retail shops? May I ask why MND should not take over from the import stage right through to the retail stage?”
“Sir, I did not mention the figures that the Minister of State has just mentioned. I do not know why he is telling me the numbers when I have not mentioned them. Sir, I beg leave to withdraw the amendment. Amendment, by leave, withdrawn. The sum of $598,360,330 for Head I ordered to stand part of the Main Estimates. The sum of $118,332,000 for Head I ordered to stand part of the Development Estimates.”
“I believe that abuse of the elderly will increase in tandem with our fast ageing population. Sir, I would like to urge MCDS to campaign for better awareness, targeting especially the relatives and friends of the victims to let them know that help can and should be sought for victims. There is an urgent need also for us to provide better support services. 4.45 pm”
“Sir, I beg to move, That the sum to be allocated for Head I of the Development Estimates be reduced by $10 in respect of Code IE 5200. Elderly abuse makes up 2.9% of all cases of family violence. The problem of elderly abuse has not received the attention it deserves. Elderly abuse is seldom reported, and this is even more so in our Asian society where filial piety and respect for the elderly is traditional and highly regarded. Sir, it is to be noted that abused elderly are unlikely to report on their own families for fear of embarrassment and fear of losing whatever care and support they may have. The lack of awareness and support services here is a contributory factor to this situation. The survey which was conducted from May 1994 to December 1997 on those who were 65 years or older who presented to the Emergency Department for non-accidental trauma or complaints of other acts of cruelty showed that in 58.8% of cases, the assailants were the daughters-in-law or sons. The average age of the elderly was 74.6 years old and a majority of them were ambulatory but had chronic medical illnesses. Protection from persons causing hurt, continual harassment, threat, wrongful confinement is spelt out in Part VII of the Women's Charter (Chapter 353 of the 1997 Revised Edition). Under this Chapter, the victim can apply for a Protection Order. Elderly abuse is not a problem seen in isolation. It is an integral part of family violence. Successful intervention may indirectly help other victims caught in the same cycle of violence. Elderly abuse can be classified into four types: (1) infliction of pain and injury; (2) debilitating mental anguish; (3) unreasonable confinement; and (4), willful deprivation by caretaker of services necessary to maintain mental and physical health.”
“Sir, due to time constraint, could I be given the permission to skip amendment No. (5) and to go on to amendment No. (6) instead?”
“MCDS should be encouraging and facilitating this type of attitude by increasing the avenues for Singaporeans to remain at work and to do volunteer work. Although we have a higher unemployment rate now because of our recent economic recession, we should have a long-term view and not be deterred. Matching the seniors to further training or to job placements can also be enhanced. People are tending to be healthier and are going to live longer. As we plan, we may need to turn full circle and adopt policies and programmes, provide retraining opportunities, offer flexible work hours and encourage those who want to stay on the job to do so. Sir, we have a large and increasing pool of volunteers to tap from among the older Singaporeans. Training them to be competent in different areas of our needs will give them recognition and worth. The volunteers should be recognised for their work and it would be good if they can get some privileged or subsidised care when, in turn, they themselves need community services. They should also be reimbursed for transportation and minor costs of incidentals. 6.00 pm”
“Sir, as we figure how to best prepare for the demands of our fast ageing population, half the battle would have been won if we could influence Singaporeans with the correct mindset. Positive attitudes towards ageing and the aged should be actively promoted. A mindset change needs time and a lot of effort to nurture, and I would like MCDS to prioritise and enable us to achieve the desired outcome. Older people should be regarded as useful citizens whose wisdom, skill and talent are valuable resources. The society will benefit if we tap these resources for as long as possible. The elderly should not be perceived merely as potential socio-economic problems. Not all old people are senile, moody and weak. We need to have our citizens move away from wrong impressions and treat growing old with dread. We need to show our people that ageing is not always associated with disability, and that disability in old age is often due to disease, which, if treated early, may not give rise to disability. An ageing society can still be active and vibrant. Octogenarians will be common and, in no time at all, many of us in this House will join their ranks. I would not like to think then that all octogenarians are decrepit, depressed or demented. Let us promote "A time to begin a new chapter in life by being active and involved: starting new activities and setting new goals" as our mindset towards ageing and retirement. Sir, older people can indeed approach ageing and retirement in new and exciting ways and MCDS can do much to help them realise that. A new survey of 803 American men and women aged 50 to 75 has found that 40% are working or plan to work after they retire, while an equal percentage do or plan to do volunteer work.”
“Granting subsidy here may encourage suitable housewives and retirees to work and to have income while "staying home". These caregivers can be accredited or monitored and registered under MCDS' supervision. Whilst on the subject of childcare subsidy, will MCDS consider giving full childcare subsidy for special-circumstance lower-income families? The parents in these families need to go out to work but do not earn enough to cover childcare.”
“Sir, the total fertility rate in Singapore is on the decline. Childcare provision constitutes an important influencing factor for many parents to have children. We are still short of childcare centres and I know MCDS' plans to increase childcare centres further. A majority of our young parents are from the more educated group who want professional care for their children. Better childcare centres, with increased numbers of certified professionals and dedicated staff, should, therefore, be planned for our centres. MCDS should provide childcare facilities to both the HDB as well as the private housing estates. There is a need for childcare centres to be located in areas where there is more demand, such as the new densely built areas with many young families. Childcare centres at the workplace are convenient for many parents. This calls for more assistance from the Government to encourage employers to consider providing childcare centres at the workplace. Although there are more childcare centres that cater to children below 18 months of age now, the fees for such centres are very high, with the cheapest one charging $650 after subsidy. Will MCDS please look into the affordability issue and consider providing higher subsidies for such childcare centres? Sir, studies have shown that very young children fare better with family-based childcare. MCDS should, therefore, encourage family-based childcare, especially for infants. The ideal caregivers for infants are, of course, the parents themselves. However, in the context of Singapore, immediate family members, relatives, neighbours and even friends can be reasonably good parent-substitutes. The question is whether MCDS could subsidise such family-based childcare in lieu of care at childcare centres.”
“May I ask the Minister how would his Ministry ensure that donors are not under emotional coercion, and that donors know the long implications of organ transplants, as well as the high medical risks of organ transplants, including death? And whether we should make it compulsory for donors to have psychological assessments or evaluation by psychiatrist, apart from being certified fit by doctors for an organ transplant.”
“Streaming in schools and ranking of schools stress parents. The students, in turn, feel their stress. This has to be addressed accordingly. School starting time should be at 8.30 am instead of 7.00 am presently. Many children have to get up at wee hours of the morning, especially for those who need to travel far from their homes. Classroom learning should be made as interesting as possible, with technical aids whenever possible to facilitate learning for students. This will make learning fun and less stressful.”
“Sir, the emphasis of the Ministry of Education thus far has been primarily on the academic achievement of each student and maximising each child's potential to the fullest. The maximum curricula in the name of maximising each child's potential may jeopardise innovative skills and creativity in our children, which we are trying to promote. Today, I would like to beseech the Ministry of Education to regard our students not just academically but in totality, especially the mental well-being of our children. Last year, psychiatrists at the Institute of Mental Health saw 14,000 children. This could be the tip of the stress iceberg, as psychiatric conditions are still a stigma to many, and many parents do not realise their children need psychiatric help. Suicides accounted for 2.2% of all deaths in 2000. 6% occurred among the 10-19 age group. Although the death rate from suicides has fallen in the past 20 years, suicides for the 10-19 age group have not fallen. Heavy syllabus, too much homework, enrichment programmes, assessments and examinations have been cited as the cause of stress. Some stress can be useful and positive, but this is only up to a certain optimal level, beyond which a person's performance will deteriorate and may even end up with a breakdown. May I ask the Minister for Education whether studies have been done to look into this and what steps his Ministry would take to rectify policies that are causative factors of stress in our students. Teachers who are the surrogate parents during most of the day should try to care for the students in totality. They should be alert to pick up those in psychological anguish and refer them for help if necessary. Early referral to counsellors and doctors will help the students de-stress and cope better.”
“Sir, I beg leave to withdraw my amendment. Amendment, by leave, withdrawn. The sum of $1,483,013,300 for Head O ordered to stand part of the Main Estimates. The sum of $157,824,500 for Head O ordered to stand part of the Development Estimates. Head K -”
“Sir, I beg to move, That the sum to be allocated for Head O of the Main Estimates be reduced by $10 in respect of Code OE 3100. Sir, medical experts believe that cases of Hepatitis C have reached epidemic proportions and predict that the lingering liver disease will kill more people than AIDS over the next two decades. Hepatitis C has emerged from obscurity as a disease familiar to only a few experts to become recognised as a major public-health problem worldwide. Some medical experts believe deaths from Hepatitis C will triple in the next 20 years. Many infected with the blood-borne virus would require liver transplants, and between 1% and 4% of sufferers would develop liver cancer. Hepatitis C is now the major cause of liver disease requiring liver transplantation among adults in most countries. Sir, the development of reliable diagnostic tests has shown how widespread the disease is but, because few victims show symptoms, it is often detected during routine examinations or at blood donations. May I ask the Minister for Health whether any study has been done to ascertain the prevalence of Hepatitis C in Singapore. Will the Ministry of Health embark on preventive measures in tackling Hepatitis C? Sir, there is no vaccine against the Hepatitis C virus, unlike Hepatitis B and Hepatitis A. Will the Ministry of Health prioritise research to find a vaccine for Hepatitis C, much in step with our present emphasis on medical and bio-scientific research? Also, will the Ministry of Health consider screening of Hepatitis C in routine ante-natal check-ups so that gynaecologists can take precautions in minimising the transmission of Hepatitis from mother to child?”
“I beg leave to withdraw my amendment reluctantly. Amendment, by leave, withdrawn.”
“Can I not have further clarifications, Sir?”
“The Minister said earlier that he did not want to review the policy of recognising the 150 previously recognised universities because the doctor shortage is temporary. May I ask him whether his Ministry's projection of doctor shortage is again skewed, especially in view of our long-term emphasis on life sciences? Was it not recommended by a foreign university don that, in fact, Singapore needs another medical school to train more doctors? The Minister earlier also said that the junior doctors from our neighbouring countries are working here under strict supervision. May I then ask the Minister what is the point of having junior doctors working here when they need supervision? Surely, this defeats the purpose and therefore taxing our senior doctors further by having to look after these junior doctors from our neighbouring countries. The Minister also said earlier that competition ---”
“May I seek further clarifications from the Minister as I am not satisfied with the Minister's earlier reply?”
“I know that MOH plans to open more screening centres to cope with the huge demand, and I hope MOH will do this expeditiously to cut the waiting time for women who have registered for screening so that more women can be screened more quickly. The Ministry of Health, Sir, must ensure continuity and lasting follow through of all efforts on preventive healthcare. For example, in those cancers affecting Singaporeans, especially those with hereditary predisposition, there should be a programme in place for immediate family members of affected individuals to be screened for specific cancers. There should be public education targeted at these families to improve understanding that they are more prone to certain cancers. By being target-specific, it will be more cost effective, especially for those cancers that are too expensive for screening as a national programme. Another example concerns mental health, which has not received its due attention. There must be new emphasis on mental health as the present rate of depression in Singapore is 8.6% now. Sir, since morbidity and mortality from any disease can be dramatically reduced when the disease is treated in the early stages, more emphasis should now be given to our people in the younger age group. Heart diseases are a major cause of death presently, and are likely to increase in incidence under present trends. Heart diseases would take root when people are still young, in view of the kind of diet, lifestyle and predisposing medical conditions which they have. We need to target them for increased public education in this respect, and facilitate them in early disease detection and early prevention. Sir, targeting this adult group population needs much creativity, funding and enthusiasm.”
“The importance of preventive healthcare is a foregone conclusion, and I am glad about MOH's visible increased effort in this area presently. I would like to specially mention the success of the Check-Your-Health (CHS) programme in identifying those elderly with undiagnosed diabetes, hypertension and high blood cholesterol. From the launch of CHS in July 2000 to February 2002, 40,230 persons have been screened, and the overall participation rate is 24%. But, more importantly, among those screened, about 60% had not attended any screening before, and 60% of the participants, who had no previous history, were detected with abnormal result at the screening. 70% of those who were referred for further management consulted a doctor within three months of their screening. Therefore, this programme has been useful in helping residents diagnose the three common diseases, and in enabling them to seek early treatment, and in ensuring them to lead a healthier and happier life. I do believe that CHS is a worthwhile programme and should continue to receive funding for screening even more of our elderly. I hope the Minister will consider this. Sir, the National Mammogram Screening/Breast Screening in Singapore, a population-based breast cancer screening programme launched since January 2002, has been so successful that it was overwhelmed by the demand for such screening. Two months after its launch, the Breast Screen Call Centre received about 12,500 calls. About 9,000 women have been given screening mammography appointments, but of these only 5,380 have been screened as there are only four polyclinics offering screening mammography services.”
“Mr Chairman, may I just disagree with the Minister on what he just said?”
“May I seek clarification, Sir? The Minister did not reply to my earlier question regarding recognising the graduates from over 150 previously recognised foreign universities. May I also ask the Minister whether it would not be better to review this policy rather than recruiting junior doctors from neighbouring countries, whose universities we had never recognised before?”
“(5) Having "higher trained" nurses will fulfill the public's expectations of getting better and quality nursing care, much in line with their demands for better healthcare on the whole. (6) As we need to expand the delivery of home care and step-down care, we do not just need more nurses but we also need better qualified nurses that can independently look after patients in their own homes without the hospital-setting supports. (7) Degree-holding nurses may reduce healthcare costs because they will have the extra training that allows them to perform some of the duties that can otherwise be done only by doctors. (8) We definitely need higher trained nurses to perform more diverse duties, as required in scientific and clinical projects, to be part of a team with doctors and scientists.”
“Sir, nurses are important and an integral part of any healthcare system, and I want to beseech the Ministry of Health to look further at making nursing a more attractive career option. Sir, it is better to increase our own pool of local Singaporeans in nursing, as they tend to remain in nursing for good. Many foreign nurses do not have the sense of permanence in Singapore and, in fact, may just use Singapore as a stepping stone to go elsewhere. Furthermore, recruitment of many foreign nurses can pose attendant problems because of language barrier, differences in nursing attitudes as well as other social problems. At the moment, we have only the Diploma Course from Nanyang Polytechnic and the Certificate in Nursing Course from ITE. We do not have an undergraduate nursing programme for nurses. Sir, it is about time this latter option was made available for the following reasons: (1) There is a fast-changing technological advancement in science and healthcare that requires nurses to master complex information. We need to train more professional nurses not merely as nursing care deliverers but also as care managers, coordinators and innovators to keep up with the changing needs. (2) The provision of an undergraduate programme for nursing will also address the shortage of nurses, as this will provide another channel for the students with better examination results, who would not do nursing, by going to ITE or Nanyang Polytechnic. (3) The undergraduate programme will enhance the image of nursing and address the presently "no glamour" perception of many. (4) An undergraduate course will allow the discipline to grow, as nurses can then upgrade themselves after having graduated in the Diploma and Certificate Courses.”
“This is especially significant when the cost to train a doctor in Singapore is so much higher in comparison to medical schools overseas. Yes, it apparently costs at least $500,000 here as compared to $170,000-$250,000 at the universities of Sydney, Oxford and Cambridge.”
“Sir, it is a known fact that there has been a shortage of junior doctors in the public sector for many years. The Ministry of Health's projected need for doctors had been skewed. There should be more accurate projections, and the projections must be reviewed at regular intervals to take into consideration any changing needs and trends. This is an urgent problem that we need to solve, but we should not take any short cut. To me, the Ministry of Health's reflex response to recruit junior doctors from our immediate neighbours is not acceptable. Sir, these doctors are graduates from universities which we never recognised before. Singapore has been known, or at least we want it to be known, as a medical centre of excellence, and this has been built upon the years of excellent training of our own doctors from the best centres. This prestigious status is in danger of being tainted by recruiting junior doctors from our immediate neighbours to work here. I worry. If there should be any mishap caused by these doctors, the confidence our patients from the region have when they seek treatment in Singapore, would slowly but surely erode. I feel that we will lose headway in our effort to be the regional medical hub. Sir, this matter is made worse when the Ministry is continuing to implement the 1993 policy of not recognising the graduates from over 150 previously recognised foreign universities, and is sticking to accepting only graduates of 20 foreign universities. The Ministry should now revise the list of recognised overseas universities. Not only can we get foreign doctors from more reputable overseas universities, we can also get back more of our own Singaporean doctors who have graduated from them.”
“It is really a pity if any national insurance scheme does not address this issue. There is always the argument that higher disbursements and coverage will mean higher premium at the outset. I accept this argument, but I also feel that it is not much good having an insurance plan that cannot adequately serve the purpose it is intended for. I am sure the Ministry of Health has the statistics and resources to better plan and package a really sound scheme. The probability of our Government subsidising the premium, especially for the poor and/or non-working, must be on the cards. Sir, in view of our fast-aging population, it is better to help with a small outlay in terms of insurance premium at the outset than to carry the heavy burdens later. A Government subsidy will also reduce the percentage of those opting out. More attention should be paid to the less well-off in our society. In relation to family income, some sort of cut-off point, below which a subsidy for higher disbursements may be given, would also be a reasonable consideration. I hope the Ministry of Health can reconsider the implementation of ElderShield with the above-mentioned points.”
“Women doctors would be well placed to take up these jobs, as such jobs have more regular working hours. Sir, Singapore prides itself on being a meritocratic society. On this issue, our women are only asking for equal treatment in the competition to enter medical school. Sir, my next cut is on ElderShield. It was announced last year that ElderShield, the national insurance plan to help older people who become disabled, will start in September this year. While I welcome help for the older disabled, I would like to raise some of the inadequacies of this proposed national insurance plan. 3.45 pm 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 following activities: eating, bathing, walking, dressing, getting up and going to the toilet. I would say that application of such criteria means that the subscriber is, in fact, totally dependent on another person daily. Sir, may I ask then how such a person can survive with $300 per month? The situation will be even worse for those who are less well-off and have no other savings. Those who do not look into the details of the plan may, in fact, get a false sense of security and think that their old age woes will be taken care of by this national insurance. The majority of cases of severe disability are the result of diseases, such as stroke and so on. Sir, usually this means that the dependent elderly will also need long-term medications on an outpatient basis. At the moment, patients can only claim from Medisave or MediShield for medical care if they are warded in hospitals. A tendency for patients to opt for institutional care, costing as much as $120 per day, therefore arises.”
“Therefore, the higher number of non-working female doctors may be accounted for in part, by the higher number of retired women doctors. This may also mean that the working life of women doctors is longer and hence total productivity over their lifetime may equal or exceed that of their male colleagues. (4) Both male and female doctors serve their compulsory five-year bond for newly qualified doctors. This should count as partial fulfilment of their responsibilities for their educational subsidy. Even allowing for the greater social responsibilities of doctors whose training is subsidised, it seems illogical that doctors should be singled out and expected to be "serving" in the medical profession for life. No other professional faculty, or Government scholarship programme, has a similar quota on women. Thus, the quota appears to rest on an unreasonable "moral" obligation on all doctors. (5) Studies in other countries have shown that due to better communication skills of female doctors, mothers prefer to take their young children to see women doctors whom they feel may interact and empathise better with children as well as with themselves, as women and mothers. Since women comprise more than 50% of the population in Singapore, they should not be denied access to sufficient women doctors to cater to their needs. (6) Many of the qualified female students who were rejected by NUS have gone abroad to study medicine. Many of them get married and stay on to work there. As a result, we lose highly skilled talent. (7) With the strong push for the life sciences industry, Singapore needs better trained personnel who can bridge the gap between the pure scientist in the industry and the medical practitioner.”
“Sir, I beg to move, That the total sum to be allocated for Head O of the Main Estimates be reduced by $100. Sir, the current quota of 33% on the admission of female students into the Faculty of Medicine, NUS, was introduced in 1979. No other faculty in NUS has such a quota. There is no other highly ranked university in the world that denies entry to qualified people on the basis of gender. The reason for introducing the quota for female medical students was that the attrition rate for female doctors prior to 1979 was 12-15%, and women doctors could not be assigned duties as freely as their male counterparts. However, these reasons are not valid any more. Currently, the attrition rate for male doctors is 2.8% and for female doctors is 4.2%. As for duties for doctors, women doctors have been assigned duties as men have, without distinction. They share night calls equally, attend to the same number of patients and perform the same medical and surgical procedures. Sir, it is time to review the female quota for medical students now for the following reasons: (1) The latest statistics reveal that the attrition rate is not significantly different for male and female doctors. The figures show that 95.8% of female doctors are still working compared to 97.2% of male doctors. (2) The percentage for women part-time doctors is 13.5% and for male doctors is 4.1%. However, part-time practitioners are still contributing to Singapore's healthcare system and the use of part-time is an entirely arbitrary and self-declared status. Women who work four full days each week may well declare themselves as part-timers whereas men who take two or three afternoons off a week will still consider themselves working full-time. (3) Women live longer than men.”
“May I ask the Minister whether there is any watchdog body that scrutinises the efficacy claims by drug distributors on over-the-counter drugs and Chinese medicine?”
“(5) Portable medical hospitalisation and surgical cover will take care of the subscribers in their old age and they need only pay low premiums in their younger working days. This is certainly better than to depend solely on the savings in their Medisave account. (6) There should not be any fear of encouraging the buffet-syndrome, or of driving up healthcare cost, as long as they are accredited insurance companies and carry co-payment and deductible elements in their policies. (7) Lastly, there should not be fear of unrestricted medical and insurance schemes using Medisave as long as there is a mechanism in place that prevents frivolous premiums and coverage by requiring the insured to pay any difference with cash. May I also ask the Minister for Manpower whether more insurance companies can be accredited for usage of Medisave from the present three, so that Singaporeans can have more options.”
“Sir, I would like to request that the Minister for Manpower consider the use of the Medisave part of CPF for the purchase of portable medical insurance (PMI). This is to allow employees to use the Medisave to buy individual portable medical care products to cover illnesses because their employers are not providing for this type of medical coverage, while they are still working, and also when they are in-between jobs. Sir, PMI can help to ensure guaranteed long-term coverage for the employees when they are in-between jobs and in retirement, and to ensure that the accepted coverage will not be cancelled for subsequent ill-health, provided premiums are paid. I would like to augment my request with the following reasons: (1) Medical expenditure, especially for old age, is the concern of many Singaporeans. They are always worried about falling sick and having to end up incurring unmanageable, huge hospital bills. Many fear that the $26,000 savings in their Medisave may not be enough should they need hospitalisation and surgery, when they are no more employed, or become unemployed. Many people also fear running the risk of financial hardship in the end as medical treatment becomes more expensive. (2) Many want the peace of mind by ensuring for better hospitalisation and surgical coverage as MediShield is for the masses, and the benefits are limited. (3) Help risk pooling through insurance, a risk-transfer mechanism, is a better method than just depending on the Medisave alone. (4) The use of Medisave to purchase medical insurance will stress the principle of individual responsibility for one's own healthcare needs. It also encourages Singaporeans to better plan and save when they are younger. This is better than to just depend on Medisave alone.”
“Many young girls end up in a vicious cycle of crime, abuses and flesh trade to sustain their lifestyle. The younger girls are forced into nightclubs and KTVs as hostesses. Does the Ministry of Home Affairs have any figures on such cases of young offenders? If not, will the Ministry of Home Affairs have studies done on this? May I ask the Minister for Home Affairs whether there are any proactive plans taken by his Ministry to curb the rising trend of synthetic drug abusers? May I ask whether there are any local back-street synthetic drug manufacturers, since such drugs are supposed to be easily produced? Are we vigilant in this area? Since many of the synthetic drug users are young people and many starting as early as 14, should there be more public education and drug awareness programmes targeted at our school children? This is important because many of them do not realise the potency and addictive effects of Ketamine and its long-term ill-effects. May I beseech MHA to be current in its knowledge of new synthetic drugs and adapting quickly to the prevailing scene at all times. We need to be on top of the current situation as best as we can. Sir, MHA should collaborate with MOH on a regular basis in using the services of the Centre for Drug Evaluation and Institute of Science and Forensic Medicine to analyse the new synthetic drugs so as to design appropriate urine and blood tests to detect them. Enabling drug detection will help us curb such drug abuse.”
“Sir, the Central Narcotics Bureau caught 3,417 drug abusers last year. This is an increase of 8% over the previous year. Among them were 784 new abusers, representing a 17% increase. Today, I would like to raise a primary concern that the number of people caught with synthetic drugs has gone up. The new "club drugs" Ketamine, Ice and 55 are now more popular with abusers, with "K" or Ketamine, being the most popular currently. Its popularity is due in a large measure to the misinformation that it is not addictive and has no long term ill-effects. Abusers take between two and three swipes of one gramme each time. The first swipe causes hallucination of about an hour and after that the abuser is sober; hence, giving the impression that he is in control. The second and third swipes might cause the abuser to be amnesic and has no recollection of what happened the night before. Because of that, it had been used in gang rapes that went unreported. "K" is most commonly found in nightspots and is peddled by the drug syndicates. Often, the senior syndicate members recruit younger boys and girls to traffic on their behalf. The popularity of "K" to traffickers and abusers alike lies in the difficulty in detecting the drug in the abusers should they be caught. Ketamine offences have risen to 24%, and the number of people caught using, possessing or trafficking the drug increased to 207 last year, up from 167 in 2000. More than half of those arrested (55%) are younger than 25, and one in three of the young abusers is female. There is a high incidence of repeat offenders in synthetic drugs. The age of abusers starts as young as 14, when they are still in school. Almost always upon addiction, the abusers would switch to the most popular and sometimes stronger type of drugs.”
“On that note, could I then ask the Minister of State whether would it not be too much a burden for medical students to bear a huge sum of $400,000 for the medical education? Would it be right to commercialise medical studies in this way? Would it not lead to high medical cost in the future as young doctors aim to clear their huge loans? Would it be right to set a precedent for unsubsidised tertiary education in the future?”
“May I ask the Minister of State whether he concurs with the Minister for Health when he said recently that the five-year medical bond could become a non-issue if medical students pay the full tuition fee?”
“The Minister of State said earlier about getting good money for our medical education. Am I right to say that the medical faculty is the only one that requires its graduates to fulfill a five-year bond? Therefore, are we not already ensuring taxpayers' money is well-spent? Dr Ng Eng Hen: The answer would be yes.”
“May I ask the Minister of State how different is our method of costing compared to other world-leading medical schools?”
“May I ask the Minister of State why is there such a big difference in the fees charged for medical education in Singapore as compared to those in Sydney, Cambridge and Oxford? The total unsubsidised tuition fees for the full course in Sydney, Oxford and Cambridge are between $170,000 and $250,000, as compared to about almost double here.”