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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“May I ask the Minister of State did he mean per year's cost of $80,000? How much would it add up to in the end?”
“Sir, I was referring not so much to the diagnostic type of capability but more on the teaching part where a teacher is able to pick up abnormal behaviours or characters in the students and to refer them for more assessments.”
“Sir, may I ask the Senior Minister of State whether it is possible to equip the teachers in the classes to be able to pick up psychologically abnormal children as our children spend a large part of their time in schools? This is to be able to refer these kids for further check-ups so as to prevent the unwanted consequences, the extreme of which is suicide.”
“The United States and Singapore have experienced the highest growth rate in healthcare expenditures. Sir, the right approach should be an integration of the private and public sectors in Singapore to maximise our small resource pool. (8) Sir, new medical technology can contribute to efficiency gain in the hospitals, for example, in making it possible for more day surgeries done which otherwise require hospitalisation stay. Technology acquisition is closely linked with manpower considerations. Physicians are a major factor in the demand for and use of technology. More specific training of physicians to use high-tech devices should be encouraged. Limits on medical technology have been envisioned for the private sector in Singapore. Sir, these limits will jeopardise Singapore's role as a healthcare magnet for patients from foreign countries. Technology limitation might alter the inflow of such patients. Sir, I would like to end by reiterating that the development of Singapore into a medical hub of the region and turning Singapore into the "Mayo Clinic of Southeast Asia" is a worthwhile industry to pursue. Having more full-paying foreign patients, apart from giving a spin-off effect for our other services by having more visitors to Singapore, may be a source of subsidy rather than a cause of rising healthcare cost for local patients. There is a need for a mindset change here. Mr Deputy Speaker, Sir, I hope that the above suggestions to address the affordability of healthcare in Singapore can be considered favourably by our Government. 7.15 pm”
“If cures or better still the preventive factors can be found for the common cancers affecting Asians, such as nasopharyngeal cancer, many will be saved from dying from them. It is better to place more emphasis on prevalent diseases and possible future plans in Singapore in the development of these diseases. For example, Hepatitis C has emerged from obscurity to being recognised as the major public health problems world-wide. Sir, because western researchers may lack priority and subject material to work on Asian conditions, priority in use of funds and manpower should therefore be directed at our specific needs and especially at those diseases that affect mostly Asians. We should have more detailed epidemiological studies of disease patterns and based on medical research and life sciences study on them, to better plan and cushion our own long-term healthcare cost. (7) The rise in healthcare expenditure has prompted many nations to develop and implement on armoury of cost-control mechanisms. A study on the experience of six countries, Australia, Canada, Germany, United States, United Kingdom and Singapore, showed that healthcare inflation can be managed and not through the strategy of competition but through centralised control over healthcare resources. Two countries, the United States of America and Singapore, opted for competition in healthcare financing. In the case of Singapore, our Government decided to use market competition by carefully designing competition between the public and private hospitals. The expectation of countries subscribing to this approach is that competition will drive down prices, while providing incentives to improve efficiency and quality. However, evidence suggests the contrary.”
“The Ministry's priority must be to continuously identify prevalent diseases that need greater attention and to continuously monitor and study the trends for prevention and common diseases, as well as the many different aspects of preventive healthcare. Consider these examples. Since colorectal cancer is the second leading cause of cancer in men, there should be a national screening programme started. Since pneumonia is the third leading cause of death, it will be useful to find the causal factors and establish the preventive measures. As the prevalence rate of depression in Singapore is 8.6%, a new emphasis on mental health, which has not received its due attention, is necessary. Mr Deputy Speaker, Sir, since morbidity and mortality from any disease can be dramatically reduced when the diseases are treated in their early stages, preventive healthcare should be especially targeted at the younger age group. I am concerned that the young may assume that they are less vulnerable because of age, and therefore have no need for regular check-ups. We have to make sure that they are not left out in our preventive care efforts, especially in prevention of early and treatable conditions like diabetes, hypertension and high-blood cholesterol. In tackling this problem, there is a need for much creativity, funding and enthusiasm. (6) Appropriate investment in medical research and life sciences directed at our prevalent needs, like finding the cures for the common diseases and cancers that affect most Singaporeans, can address the long-term healthcare affordability. If gene therapy can be found to treat and prevent heart diseases, diabetes and hypertension, the amount of savings will be enormous.”
“It is very much cheaper to maintain a nurse as compared to, let us say, a doctor. Moreover, well-trained nurses can carry out many functions otherwise performed by doctors and this frees the latter for other duties. The present shortage of nurses has to be addressed urgently. We do not have an undergraduate nursing programme for nurses. There is only the diploma course from Nanyang Polytechnic and Certificate in Nursing course from ITE. Sir, it is about time that this option be made available. We need to train more professional nurses, not just as caregivers but also as care managers, coordinators and innovators to keep up with the changing needs. The provision of an undergraduate programme for nursing will also address the shortage of nurses and this will provide another channel for the better qualified students that will otherwise not go to ITE or Nanyang Polytechnic to do nursing. This group may feel that they are wasting their talent by not pursuing a university degree. The undergraduate course will provide the discipline to grow as many nurses can also upgrade themselves after graduation from ITE and Nanyang Polytechnic. Sir, the scope of nursing work must be expanded. Qualified nurses become even more relevant as we pursue the life sciences and excellence in medical healthcare. We can have nurses as trained personnel to assist in scientific and clinical projects as part of a team with doctors and scientists. (5) Preventive healthcare must be the hallmark of all issues concerning healthcare affordability. The adequate allocation of funds today and the success of preventive measures will save us millions in the future. The Ministry of Health must ensure continuity and lasting follow-through of all efforts on preventive healthcare.”
“In tandem with the establishment of homecare, there must be effective support from primary healthcare, community healthcare and social services, as well as modified housing. I feel that for homecare to be really effective, there must be the involvement of the community. There should be more community volunteers and home help for families to care for the dependent elderly in their homes. There should also be more adjunct community supporting services like domiciliary, daycare, rehabilitation and occupational therapy services to complement the homecare. Such facilitation will translate into lower costs and convenience for a happier people. (4) We need more innovative concepts to better plan the present and future manpower needs of our healthcare system because manpower costs demand a rather large portion of our healthcare costs. We must have fresh ideas and a "dare-to-do" attitude in trying out new grounds. For example, in order to cater to the manpower needs in starting homecare services, MOH should re-look at the usage of healthcare workers and consider using not only full-time paid personnel, but also family members, community volunteers, and so on. Such healthcare workers can be trained in a matter of weeks. In England, it takes only three weeks of intensive training to equip them with the necessary skills. They are certified at the end of courses which teach them in assisted feeding, catheter care, prosthesis use, simple dressings and simple grooming as in toenail cutting for non-diabetics using sterile techniques. Sir, another example is the recognition that nurses who are well-trained can do a lot and can contribute not only to better care of patients but also to lower costs in healthcare delivery.”
“For a start, MOH can provide more briefing materials for MPs to familiarise their grassroots workers with what is provided for. With the new Eldershield and Elderfund, MOH must provide even more in public education regarding the various schemes available. (2) To ensure special long-term affordability, "health risk pooling" through insurance, a risk transfer mechanism, may be better than plain dependence on savings alone. Therefore, a bigger proportion of Medisave should be allowed for purchase of medical insurance, such as the Portable Medical Benefit Hospitalisation and Surgical cover. The fear of encouraging the buffet syndrome or of driving up healthcare costs can be contained as long as Medisave accredited insurance companies contain the co-payment and deductible elements in their policies. This will emphasise the principle of individual responsibility or one's own healthcare needs. This will encourage Singaporeans to better plan and save when they are younger, and not to depend just on Medisave alone or, worse still, to depend on Medifund when they fall sick. It is necessary for the people to know that we cannot assume there will always be budget surpluses to build up our Medifund and provide an unlimited safety net in the years ahead. (3) Sir, our homecare services are almost non-existent at present. We need to make this service available quickly in order to lessen the need for high cost stay in the tertiary institutions, especially the acute hospitals. With our ageing population, homecare, where many discharged patients can be looked after in their own homes, will be an increasing demand and an important part of our healthcare structure.”
“If the ratio of Government and private proportion is going to remain, the impact on the people can be great indeed. It is worse still as in this year, when in absolute terms, the allocation to MOH is less because the Government allocation is based on GDP. As the NHE cannot be lessened, the extra burden will be on the people. Today, I would like to beseech the Government to address this concern of many Singaporeans and find ways to ameliorate their worry with some expedient actions and with further and better planning to soften the future burden. Sir, as a people, our main prime resource, the provision of good healthcare to all Singaporeans must be prioritised. This is to ensure a healthy workforce as the main contributors to our survival as a nation. The MOH should have the same importance and bestowed the same weightage as other Ministries, the MOE, for example. The Ministry of Education is cultivating our future resource, but the Ministry of Health is sustaining and nursing the present as well as our future resource. Sir, I would like to suggest the following eight ways relevant to Singapore to address this issue of affordability. (1) There is a need to allay the concerns of many, especially the elderly on the affordability of hospitalisation bills should they fall sick. It is a fact that hospitalisations can cost thousands of dollars and can even be tens of thousands if surgery is involved. This is so even in our public hospitals. We need immediate action towards assuring people that affordability of hospitalisation is ensured with our 3M-scheme (Medisave, Medishield and Medifund). Remarkably, many people still do not understand their usage fully.”
“Mr Deputy Speaker, Sir, my parliamentary colleagues in this Budget debate have spoken on the different financial aspects and the difficulties faced by our people, SMEs and corporate companies. I would like now to dwell on another financial consideration of many, that is, healthcare affordability which has been touched on by my parliamentary colleague Madam Halimah Yacob earlier. After listening to 23 speakers before me and a long day, may I seek the patience of my colleagues here for a while more to hear me out. Sir, healthcare affordability has been a major concern for many Singaporeans. This concern will only get worse with the expected escalating healthcare costs in view of our ageing population and rapid advances in medical technology. In fact, Singapore's national health expenditure, at the current level of healthcare servicing, will rise to 7% of GDP by 2030. The widespread worry, especially among the elderly, on hospitalisation affordability is understandable. I am reminded of a familiar saying "Can die but cannot afford to fall ill" and I hope we do not succumb to such a predicament in the days ahead. Our National Health Expenditure (NHE) increased from $4.4 billion in 1999 to $4.7 billion in 2000. As a percentage of GDP, NHE formed about 3%. Per-capita health expenditure rose about 6% in one year from $1,360 in 1999 to $1,439 in 2000. The NHE proportion is borne two-thirds by the people, or the private share and only one third by the Government. This contrasts significantly with that in England where the private share is only one sixth, in Australia where the private share is only half, and in Hong Kong and Malaysia where the ratio is roughly one to one.”
“Would the Minister not agree with me that many patients with disabilities are as a result of diseases? A good example he mentioned earlier was stroke. Therefore, how can he then refer to such cases as not medical-related cases and not needing Medifund?”
“Sir, may I ask the Minister of State whether it is correct to say that Medifund cannot be used for nursing homes and step-down care. Therefore, may I ask him whether his Ministry has created a group of people with special needs that cannot be met by our present schemes, in other words, have we created a group with no safety net for them? How would the Minister of State assure Singaporeans that nobody would be deprived of medical care as a result of lack of financial means?”
“May I ask the Minister of State whether it is correct to say that many overstayers are old people with no income or from families with low income and many of them with no family members who can look after them. May I ask whether this new ruling will jeopardise this group of people further financially and socially.”
“May I ask the Minister of State whether it is right to put the onus on the doctor to certify the discharge of his patients? Do the doctors have enough time to investigate whether, socially, these patients are ready for discharge? Will he not agree with me that a patient cannot just be assessed physically, but also in totality?”
“May I ask the Minister of State who certifies the discharge of overstaying patients? Dr Balaji Sadasivan: Mr Speaker, Sir, the certification that the patient is medically fit will be done by a doctor. As in the acute hospitals, these patients are in departments that are under the care of consultants. The consultant in charge will be responsible for the patient being certified fit for discharge.”
“May I ask the Minister of State whether it is appropriate to implement the new subsidy for overstayers ruling as there is, at the moment, still a shortage of nursing homes and community hospital beds to discharge these patients? Moreover, the home care services are not adequate presently to have them sent home.”
“Under present circumstances, such schemes should not be undertaken by the public hospitals as this will further tax their resources and may also cause misunderstanding in perceived differential treatment to patients. Promoting its services overseas can be done through and with the Singapore Tourism Board and tour agencies with innovations that combine healthcare services as part of tourism promotion. Having packages in insurance products that can be sold in the region resulting in people coming to Singapore for medical check-ups every year and having their travel, hotel and even shopping needs being looked after as well. The spin-off effect of being a regional medical hub will be big for other services, such as hotel, retail, convention industries and so on. Sir, in this new economy, Singapore must reinvent itself to achieve greater success in the future and the above considerations should be part of this process. 4.30 pm”
“We need to enhance development of clinical education and research. These are but a few aspects that have to be seen to quickly or we may lose the cutting edge we have against our neighbouring countries that have started going in this area. In the past, the case against our becoming a medical hub was the fear that the healthcare costs will rise further for the locals and that the country could see another exodus of top specialists into the private sector. Sir, a mindset change is required here. As a medical hub, we may not face a rise in healthcare costs for local patients. This is because full-paying foreign patients may even be a source of subsidy, apart from giving spin-off effects for our other services by having more visitors to Singapore. Moreover, we can always have mechanisms put in place so as to limit the amount of public sector resources that can be used for foreign patients and to cause all doctors who want part of the foreign pie to contribute some of their time in treating our local subsidised patients. Sir, as long as quality and priority healthcare services are provided for in our public hospitals to Singaporeans, as Mr Lee said earlier, good basic medical care for all, provision of healthcare services to foreigners should be seen as a new strategy for us to move to the next level in the new economy. A visiting Harvard don said that Singapore has a clear edge in the consulting, engineering and healthcare industries in Asia. Sir, he said that there are tremendous needs in the region for healthcare services and the industry can be much bigger than IT. There is a need for increased collaboration between private hospitals and private entities to promote Singapore as a medical hub.”
“Sir, the stress of education is real for students. The Government has recognised that innovative skills and creativity are important. But its push to promote innovative skills and creativity in children may be jeopardised by the amount of maximum curricula in the name of maximising each child's potential. Sir, how do we transit into the new way? Are there existing policies that in fact impede this transition? Concerning my last topic, Mr Speaker, Sir, is the development of Singapore into the Medical Hub of the region and turning Singapore into the Mayo Clinic of Southeast Asia. I am glad that recently, Government leaders have said that Singapore's economy can be revamped by promoting it as a regional hub for services like healthcare, education and tourism. Sir, it is possible to develop Singapore into the Mayo Clinic of Southeast Asia if we put our minds to it. The Mayo Clinic in the United States is one of the top medical centres in the world, giving comprehensive treatment for virtually any disease. I would like to discuss the ways towards this path. Shortage of doctors and medical personnel is a limiting factor and I feel the way to overcome it now is to maximise the pool we have at the moment. Training new ones will take time, but this is not to say we need not start training more new ones right now. Maximisation of our present pool of doctors has to come from the integration of the public and private sectors. We need to treat both sectors as one entity and tap their potential fully so as to become the regional medical hub we aspire. We can call upon the many private specialists to contribute more. They can return to work in the public hospitals and many of them can even go into research work. We must train more medical personnel to cater for the increased demands.”
“Sir, I agree with the President and I would like to add that such inculcation in our young must be started early, when they are still in school, to have greatest impact. Whilst I applaud the Government for redesigning our education system to one where, among other things, creativity is highly encouraged, one cannot help but wonder how this can be achieved if our students are under constant stress. Surely this will have a negative impact on and can potentially stifle the development of creativity and innovation in our students. Although we have an internationally recognised education system, we have unfortunately developed a reputation for having a stressful education system. Children complain that they have little time for play because they are burdened with plenty of homework and studying for assessments and examinations, besides having to participate in extra-curricular activities and going for tuition or enrichment programmes. A study by Dr Stella Quah of the National University of Singapore on the Singapore Family revealed that the greatest worry for about 45% of them came from the problems associated with their children's education. In 1998, 2,358 new cases of children aged below 18 were registered at Government's psychiatric clinics. In almost 95% of the cases, the children were not mad. Sir, they were just stressed out. Half of these cases were children from primary schools, 35% from secondary schools and 15% were pre-schoolers. Parents have been blamed for the stress in children. If this is so, then it is time to also look into the causal factors in parents and address them accordingly. We need to re-look at heavy syllabus with too much homework and stress, ranking of schools, streaming and varsity-entry criteria and so on.”
“The assistance for the lowest strata of the society that are existing from our Government must be re-looked to see if they are adequate to keep up with this present widening income strength. There is a need to review our various schemes on a more regular basis. Especially as Mr Lee just said earlier that there may be a rise in indirect taxes that will have impact on lower income groups. Sir, the PAP won a strong mandate from Singaporeans because the PAP has a tremendous record for being able to deliver on its promises to the people. Today, I would like to ask on behalf of Singaporeans that the PAP Government not only make good the promises it has made in the last GE, but also make it at a speedier pace. This is especially so where there is much sufferance incurred on the needy, the retrenched and on the children of families with difficulties. As DPM Tony Tan has said, "The job of MPs is to attend not just the big picture, but also these personal concerns of their constituents". Sir, whilst all MPs should contribute towards remaking our future, they must also have a hand on forging a new social impact. Therefore, more schemes involving MPs should be put in place in the delivery of help and care to the residents. My second topic, Mr Speaker, Sir, is this. In the past few years, education in Singapore had undergone changes to provide for flexibility and innovations to enhance national economic competitiveness in the global economy. The President has said, and I quote, "We should inculcate in the young a more inquiring and adventurous spirit, and encourage them to think up new ideas and create new opportunities".”
“Mr Speaker, Sir, in his Address, the President has outlined the challenges for Singapore and the steps we need going forward in this era of a globalised economy. I would like to echo his call and to specially mention three areas that are worth our further deliberations. They are: (1) The inevitable outcome of globalisation in widening the income gap, thereby increasing the societal divide; (2) The redesigning of the education system in Singapore; and (3) The revamping of the healthcare scene in the globalised economy. On my first topic, Sir, Singapore families are earning more than a decade ago but the 2000 Census data shows that the divide between the richest and the very poor has widened. During the last year, the top 20% of households had an average income 21 times that for the lowest 20%. This trend is going to stay and the divide is going to broaden further in the next 10 to 20 years. This is inevitable with the change when we are striving towards an entrepreneurial and innovative society in the face of a globalised world. That this is a concern was reflected in what the President said, and I quote, "our income distribution will stretch", and "as we upgrade our economy, we must maintain and strengthen our social cohesion". The fear from this divide is the disruption of the stability and very fabric of our society. The social and political implications will be great. Sir, my concerns are especially for those low income earners who will be further marginalised due to their low education and significant structural unemployment. There is an urgent need for efforts to maintain social cohesion as globalisation pulls the wages of top earners up while pressing those of the least well-off down. What can be done?”
“Sir, may I ask the Minister whether I am correct to say that colonoscopy is actually the most widely and currently advocated screening test for colorectal cancer and is, at the moment, being adopted by America because they have very high incidence of colorectal cancer just like Singapore?”
“May I ask the Minister whether it is better to use Medisave to detect early diseases and save lives rather than safeguarding the Medisave for old age and end-stage diseases by which time, the funds in the Medisave would have been made redundant in the case of cancers for such patients?”
“Sir, may I ask the Minister whether it is correct to say that mammography in the polyclinics is only applicable to women aged 50 years and above on demand, that there is no population screening programme and there is also a co-payment fee of $50 for each screening? But since an average of three women are diagnosed with breast cancer, half of them are below 50 years of age, and that breast cancer is curable if detected early, should not the Minister facilitate more women to go for early screening and save lives?”
“All right. Mr Speaker, Sir, the most important factor is early detection. Therefore, may I ask the Minister for Health whether he will facilitate more people to go for early detection by allowing them to use their Medisave?”
“I will come to it, Sir, because I need to state the facts.”
“Sir, can I seek your patience? I am coming to my question.”
“Mr Speaker, Sir, may I seek your patience and indulgence of the hon. Members of this House? I beg to differ with the Minister for Health on what he has just said. Sir, last year, 4,220 Singaporeans died from cancers, constituting about 27% of all deaths. Colorectal cancer is the commonest cancer among Singapore men and women, and breast cancer is the most frequent killer of Singapore women.”
“Mr Speaker, Sir, may I ask the Minister whether he agrees that the quality of our services sector could be further improved compared to many countries, especially the consumer services? May I also ask the Minister whether now is the opportune time to address this issue and how would his Ministry address this issue?”
“For those whose children are not prepared to join their fathers' shops, then we have got a scheme to help them exit. I believe each is given a grant of $48,000. We cannot avoid this restructuring. Basically, we have too much retail space in Singapore. Recently, in Bedok Reservoir, Sheng Siong opened a new supermarket. They say, "Special sale - eight cucumbers - $0.30". Everyone flocks there. My residents are all very happy. But all the neighbourhood shops are very unhappy. Can we stop it? Is it good to stop it? Even if there is no Sheng Siong, there is Carrefour, there is Walmart. There will be other chains operating, which will be able to sell at lower costs because they have got better supply chain management and they have got stronger purchasing power. Our job is to facilitate adjustment, not to add friction to market adjustment. That is the approach we are taking. For those who want to make the adjustment, we help them in as many ways as we can. For those who want to exit, we try to make it as easy for them to exit as possible.”
“Sir, I would like to pose two questions to the Minister. May I ask whether the HDB rental rebates announced earlier would more than offset the recent HDB rental hikes, or would the Minister consider reversing these HDB rental hikes to give an even better impact on these post-budget measures? Could I also ask the Minister whether he would give more incentives to businesses, factories and manufacturers to turn the downturn time to opportune time by helping them to revamp and upgrade to improve their competitive edge and their productivity? BG George Yong-Boon Yeo: Sir, Dr Lily Neo had an exchange with Minister Mah Bow Tan earlier on this particular issue of rental rebates. There are really two choices. For those who are already below market rental, we could have said, "Look, you do not qualify for the additional rebates because you are already below market rental." Or we say, "Let us separate the two aspects". There is already a long-term policy to bring them up to market rentals so that shops on the same row operate on a level playing field and, on that basis, we give them their rebates. Or have two separate classes of shops. I agree with Minister Mah Bow Tan that the one we have proposed is the fairest. As to whether in specific dollars and cents for particular shops, whether the net result is positive or negative, that question I would have to refer to Minister Mah Bow Tan for response because I am not familiar with the exact details. It probably varies from shop to shop. As to the other question about incentives to help our shops upgrade and become more productive, as you know, we have many programmes under PSB to help them. It is not easy. Very often, it depends on whether their own children are prepared to take over those shops and to have them upgraded.”
“Sir, may I ask the Minister whether our present policy jeopardises struggling HDB retailers who cannot afford higher rentals by forcing them out of business and depriving them of their livelihood? Could the Minister consider readjusting our policy to better cater to the demands and needs of the day?”
“Sir, the Minister did not answer my second question whether the market rates that have been used as a benchmark for the recent rental adjustment reflect the present economic climate.”
“Mr Speaker, Sir, I would like to declare that I am a lessee of an Sir, I would like to pose three questions to the Minister. May I ask the Minister whether the recent efforts to assist HDB shop retailers in their predicaments would be defeated by the adjustments of HDB rentals to the market rates? May I ask whether the market rates that are being used as benchmarks for the present rental adjustments reflect the prevailing economic climate? And also may I ask whether the present method of assessing the market rates, based on recent HDB lettings, is a fair practice? Because it has been known that many novice and enthusiastic new lessees always tender higher prices and be successful at such prices that do not conform to the prevailing rentals.”
“Sir, could I ask the Deputy Prime Minister whether there will be a problem of less financing available for home purchasers as a result of this Bill, and whether there will be unloading of properties by some banks as a result of this Bill, and thus adding to the present property glut? BG Lee Hsien Loong: Sir, as I explained in my main speech, it is not the intention of the changes in this Bill to tighten or loosen bank loans to the property sector. The 35% ratio which we intend to set has been calculated so that nearly all the banks are below this limit. The main banks are all below this limit. There are a few small banks which are above it, but we will give them time to adjust their loans, and I do not think it should have any significant impact. In future, whether we tighten or loosen this limit is a separate matter, which we will address in future when the moment comes. It depends on the circumstances at that time. As of now, we see no reason either to tighten or loosen the state of bank lending to the property sector.”
“If it is yes, I hope the Ministry will be more active and proactive from now on. The other question I would like to ask is whether his Ministry has given attention to public education, especially to those pilgrims involved, on such topics as how virulent the W135 strain can be, the carrier status of those returning pilgrims who may harbour the bacteria in their noses and mouths for up to three days, and why it is advisable for returning pilgrims to avoid contact with their family members on returning.”
“May I correct the Senior Parliamentary Secretary? There were cases in 1999. The other question I want to ask is whether his Ministry could be more alert on prevalent contagious diseases due to our globalised world and be more vigilant and proactive in taking preventive measures before death strikes.”
“Sir, may I ask the Senior Parliamentary Secretary whether the advice on the use of W135 vaccine could have been given earlier, as there were many pilgrims who were infected with significant mortality in Saudi Arabia for more than two years now?”
“However, the Bill does not confer any rights on the employee in the event the employer fails to pay the employee. This should be redressed in the Bill. I hope the Ministry of Community Development and Sports will consider my aforesaid suggestions favourably. Sir, I support the Bill.”
“MCDS can always give guidelines as to the kind and the number of courses for parents that would yield maximum results. Sir, I have said before that 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 care-givers 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. We may like to encourage or even entice such suitable housewives and retirees to "work" as home care-givers by allowing them some income whilst staying at home. Thus, we should allow use of moneys from "baby bonus" to pay for childcare with registered and approved "home care-givers", instead of conventional nursery or childcare centres only. On reimbursement of third child maternity leave paid to employees, I hope MCDS ensures that the procedure for claiming the benefit is made as convenient as possible. It should be a hassle free experience, and there should be minimal tedious form filling. MCDS has spelt out the claim procedure for this third child maternity leave, and one of the criteria is that claims must be submitted within a month after the end of the maternity leave. Late claims will not be accepted by MCDS. On this aspect, I feel that the one-month claim period is too short. Perhaps the Minister would consider having it extended to two or three months, and giving more flexibility for later claims with valid reasons. Sir, clause 11 gives the employer and the Government rights against an employee where payment is made to the employee owing to a mistake of fact or on reliance of false and misleading statement furnished by the employee.”
“May I ask the Minister for Community Development and Sports whether his Ministry will be flexible in those cases where births are premature when the expected dates of delivery should have been on or after 1st April this year? It must be recognised that there are medical, as well as unpreventable conditions that give rise to delivery of babies earlier than the expected dates. Such premature deliveries are due to unforeseen circumstances through no fault of the expectant mothers. Sir, although I agree that there is a need for a cut-off date, I feel that exceptions must be allowed for medically certified premature births. I hope MCDS will consider my stand in this favourably. Families can use the moneys from the "baby bonus" to pay for the development and education of their children. Sir, development of children is indeed important, as not only do we want more children, we must ensure we get the best-developed children. For this, we need to start promoting good parenting skills. Educators and service providers have emphasised on the need for parents to learn parenting skills early to prevent problems further downstream. They have observed that parents of troubled youths typically lack parenting skills and have other problems such as strained marital relations. In light of this, I propose that equipping parents with good parenting skills should be facilitated and encouraged and we should allow some of the "baby bonus" moneys to be used for this purpose. Since clause 3 of the said Bill enables the Minister to make regulations, and clause 3(2)(h) in particular, gives discretion to the Minister to determine the purposes for which the money may be used, I would urge the Minister to consider my proposal.”
“Sir, I stand to speak in support of the Children Development Co-Savings Bill. Singapore's total fertility rate (TFR) currently stands at a dismal 1.59, as mentioned by the Minister earlier, which is very much below the replacement rate of 2.1. In view of the fact that our country is small, and we have a smaller base in population to start with, this figure is indeed worrisome. It is, therefore, timely and welcomed that Prime Minister Goh, in August last year, announced the "baby bonus" and third child maternity leave, as well as the set up of a Ministerial Committee to study our declining birth rate. Government handouts and support have helped ease the burden of raising children in some of the northern European countries. Denmark has a total fertility rate of 1.7, which is relatively higher compared to, say, Italy, with a TFR of 1.2. Sir, the level of childcare facilities and parental benefits seem to make a significant difference. Most countries on the southern rim of Europe, such as Italy and Spain, have some of the lowest TFRs on the continent. The governments there provide much less child-related allowances than the Nordic countries that have some of the highest fertility rates in Europe, despite the fact that the proportion of women in their labour force is also among the highest. In the northern countries, childcare services are widely available and are subsidised by up to 85% in some cases. Financial support is provided in the form of birth and child allowances, up to the time the child reaches adulthood in certain cases. I am confident that Singapore can achieve results, just as good, if not better, with the right incentives. Sir, the "baby bonus" incentives are applicable to babies born from 1st April this year.”
“Poor air quality decreases productivity because of discomfort, absenteeism and sickness. A number of Australian and overseas studies have identified the high costs of poor quality indoor air. Sir, these costs included direct medical costs, loss in productivity and damages to material and equipment. Loss in productivity in the United States of America is estimated to be nearly five times that of direct medical costs. Air quality is influenced by temperature, humidity, air movement and air contaminants. There are legislation and regulations governing indoor air quality in US, Australia and New Zealand. In view of the great implications of indoor air quality, I would urge the Minister for the Environment to have regulations in place here to ensure compliance with air quality and thus ensuring healthier workers, and better productivity. Recently, the US Environmental Protection Agency's draft report concluded for the first time that dioxin was a human carcinogen. May I ask the Minister for the Environment what are the measures taken by his Ministry to control the level of dioxins emitted into the atmosphere, and whether the current levels emitted to our air atmosphere are safe.”
“Sir, bad air in the office buildings here makes one in three office workers feel lethargic and experience dryness of the throat, skin and eyes. A new survey by the National University of Singapore (NUS) researchers found that workers here have it worse than those in 11 European countries when it comes to 10 out of the top dozen health problems linked to "sick-building syndrome". Sir, "sick-building syndrome" refers to an excess of work-related irritation of the skin and mucous membranes and other symptoms, including headache and fatigue, reported by occupants in modern office buildings. The researchers checked 98 locations in five buildings. The buildings generally had lower levels of carbon dioxide and fine dust particles but marginally higher carbon monoxide levels than buildings in Europe. But high levels of contamination were found here in a few isolated locations in the five buildings surveyed. Yeast, mould formaldehyde and carbon dioxide also exceeded the limits in some spots. Sir, one interesting finding of the local survey was that workers were not as dissatisfied with the air quality as those in Europe, although Singapore workers showed more symptoms. Our cultural differences could explain this. It is possible that employees here are less likely to complain to their bosses, even if they suffer "sick-building syndrome", than workers in European work places. Earlier, studies here by ENV found that one in five office workers here have health problems because of poorly ventilated buildings. It is a known fact that indoor air quality is a subject of public health importance as many spend a lot of time working indoors. Studies show that most people here spend 80% of their time indoors.”
“Often times, we need to solve problems at the root and sometimes the parents may have to be advised. Sir, it would also be worthwhile for the Ministry of Education and the schools to put in more effort to alleviate the anxiety and better inform the parents on issues, such as streaming, banding, and so on. A holistic and comprehensive education would be ideal in helping parents with school-going kids balance work and family commitments. We may, perhaps, try matching work hours with school hours. Sir, since we are tending towards single session schools, we can have the children stay back in the school to do "homework" or have "remedials" whilst their parents are still at work. Another way of helping parents, especially those who are working, is to organise the extra curricular pursuits collectively in the schools after classes. This will save parents having to ferry their children to and from different places for these hobbies. I would like again to plead with the Minister for Education on another item. Would he give the directive for our schools to start later so that children do not have to wake up in the wee hours each morning? Sir, I would urge the Minister for Education to look into the above issues favourably. Sir, can I go on to my next cut on stressful education?”
“Sir, the Ministry of Education has been scoring highly in preparing Singaporean children academically and is now endeavouring to further educate and equip them to face the information technology and new economy age. Thus far, MOE has been concentrating more on imparting knowledge to the children. But, for an ideal education, MOE should treat the education of our children in a more holistic way. The well-being of the children, such as their mental state, their social requirements and their physical needs, should be the concern of all the teachers as well. Sir, teachers should not just concentrate on teaching them the academic syllabus. They are very much in contact with our children and are ideally suited to take added interest and be concerned with their students in a more holistic way. They should also teach and help them cope with life. I am not, in any way, suggesting that we diminish the responsibilities of parents. I am suggesting that teachers be equipped with skills and encouraged to identify students with difficulties, be it social, mental or even financial, and refer them for assistance. In 1998, 2,358 new cases of children aged below 18 were registered at the Government psychiatric clinics. As mentioned earlier by Dr Wang Kai Yuen, only recently, a 12-year old student jumped to her death. Sir, could stress, maybe due to the heavy school load or the unrealistic expectations of parents, be the cause? Perhaps, our children should also be taught how to cope with stress from young to attain their maximum potential. The early detection of those children who are vulnerable to stress will save them from poor performance and mental breakdown. To be effective, schools have no choice but to get involved with some parents. This area must be expanded.”
“People want to sell their shops but they are then subject to change of use. And if HDB says no, the sale is off. For shopkeepers who then have to stay in the shops, they want to diversify. They want to put up something else, besides groceries. HDB again says no, you cannot. This is only a grocer's shop. You cannot have a florist next to it. So change of use is important but "D" - Diversification is helpful. "E" - for those who want to exit, I think we should have compensation programmes to allow them to exit with a small little sum, maybe for the rest of their lives. They have been successful in bringing up their children and sent them to universities. Now these children do not want to go back to the shop. So let them have a sum to retire in happiness and enjoy the rest of their lives. "F" - when you diversify, sometimes they may not want to leave, they want to have their shop floors strengthened, because upstairs is no longer a place for them to sleep. They want to store their goods up there, but HDB says, "No, you can't because the floor is too weak." Therefore, if these shopkeepers are willing to strengthen their floors, let them do so. For new shops, I would ask HDB to perhaps build stronger floors so that other uses can be made of these shops. Sir, all these things would then help to give our shopkeepers, for those who are entrepreneurial, a new lease of life and for those who are not entrepreneurial, to exit nicely. The same thing would go for hawkers. If the hawkers want to exit, there should be a nice little sum for them to exit because nobody wants to sell fish anymore, and their children do not want to sell vegetables anymore.”
“I shall be short, Sir. (In Mandarin): Sir, I have moved an adjournment motion in this House to highlight the difficulties our HDB shop retailers face now. I would like to repeat my call for the Ministry of National Development to consider helping them out with the following measures (I would like to declare that I am running my clinic from an HDB tenanted shop): (1) Allowing splitting of the shops into smaller shops to co-exist with other types of businesses; (2) Granting easier "change of use" of their shops; (3) Resettling some retailers to other places that have better need of their kind of trade; (4) Relocating shops in poor locations and poor market conditions to better business areas; (5) Having the option of selling their shops back to the HDB without losing too much; (6) Lowering HDB rentals; (7) Reducing and restructuring HDB shops, not only in terms of new supply but also in consideration of existing ones; and (8) Regrouping HDB shops to form "commercial streets" of distinctive features. Sir, I hope that the Minister for National Development will consider my proposals favourably. Assoc. Prof. Toh See Kiat (Aljunied): Sir, I was going to talk about the ABCs of HDB shop retailers and hawkers. But I have now got to shorten my speech. I cannot go all the way to "Z". I will just stop at "F". "A" is for accolades. I think we have to praise our shopkeepers, retailers and hawkers for keeping the cost of living down. They have helped us, we must help them. "B" is for business mix. I must join in the call to make the business mix more intelligent and acceptable. We cannot have people survive if there are five grocers in a row and three barber shops next to each other. "C" is change of use. HDB can be more flexible in allowing change of use, especially for sales.”