Lina Chiam
Singapore
“But we must take into consideration the effects of real-time information. These days, both passengers and drivers have access to applications that can work out the balance between demand and supply. The most efficient way to match demand and supply in the short term is by allowing prices to surge.”
“The lapses in the management of tenancy contracts, procurement and engagement of external operators by PA form one such example. Moving forward, conducting regular training is something that the Ministry ought to be looking into to ensure procurement officers in public agencies understand procurement best practices.”
“An example would be the case that happened in May 2013. An employer, Lee Yew Nam, had caused public outrage last May after he was shown allegedly slapping his worker in an online video in his office. It was only after another colleague uploaded this video that MOM took notice.”
“One suggestion is to require companies or researchers to post all raw data and results to the Government website, even if the treatment being tested is never approved or if they cannot make it for scientific publishing. This promotes more vigorous scrutiny from MOH should there be any wilful suppression.”
“To what extent will national funds be committed in this multilateral development bank and will Parliament have the powers to check on this creature later on? Mdm Speaker, AIIB may boost our country's stand as a capital banking hub in Asia and, of course, our GDP growth.”
“For the safety of drivers and passengers, I would suggest the recommendation to legislate technology companies operating taxi booking apps to compulsorily provide taxis with a strong, adjustable holder and handphone solely dedicated for use on the apps system only.”
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Every one of 275 lines we hold for Lina Chiam, in date order, each linked to its source. Free to read, in full, without an account. Page 3 of 6.
“If these powers were to be exercised to their fullest extent, such raids and arrests may result in the secondary traumatisation of vulnerable victims of trafficking. What measures are being taken to ensure that this does not happen? As raids are often violent in nature, is this even possible? Why are these provisions on enforcement necessary? Are the current provisions under the Criminal Procedure Code not sufficient? A period which would allow victims the time to "recover and reflect" prior to deciding whether or not to press charges against their trafficker is important for the protection of the human rights of trafficked persons. According to human trafficking experts and the United Nations Office on Drugs and Crime (UNODC), "If a victim is put under pressure to press charges immediately, the risk increases that he or she will withdraw the statement at a later stage." Therefore, designating a recovery and reflection period is in the interest of both the victim and the authorities. Is there a reason why this is not included in the Bill? One of the ways in which traffickers intimidate victims is by threatening their families back home. What provisions are there to ensure that the Singapore Government works with Page: 99 officials and NGOs of sending countries to deal with this issue? Trafficking is a transnational crime which requires regional and international cooperation. What kinds of cooperation will be taken by the Singapore Government to ensure that trafficked victims who return to their countries of origin are successfully reintegrated and do not risk being trafficked again? The importance of a victim-centric approach. Successful prosecution of traffickers will depend significantly on victim cooperation.”
“Threats of penalty are defined as stipulated by the ILO, should be defined but not limited to the following: (a) physical violence against worker, family or close associates; (b) sexual violence; (c) imprisonment or other forms of physical confinement; (d) financial penalties; (e) denunciation to authorities; (f) dismissal from work or exclusion from future employment; (g) exclusion from community and social life; (h) removal of rights or privileges; (i) deprivation of food, shelter or other necessities; and (j) shift to even worse working conditions. It is important to note that Singapore has ratified Forced Labour Convention in June this year and voted in favour of a supplementary protocol to this Convention. In light of this, can the Member of Parliament clarify if the definition of "forced labour" used by the ILO will be the working definition of the Bill? If it is, why is it not defined there? According to this Bill, Police and non-Police enforcement officers are able to arrest and forcibly gain entry into premises without a warrant, and are to be armed with batons and accoutrements "as are necessary". It is important to note that of the 19-page long Bill, six full pages are dedicated to a section on Enforcement while only two pages are dedicated to Victim Protection and Assistance. In percentage terms. the Enforcement section takes up 30% of the Bill, while the Victim Protection and Assistance section takes up only 10% of the Bill. This disparity is something that we should be particularly concerned about. Project X, an NGO that works with sex workers, has witnessed many of such raids and they are often violent and invasive in nature.”
“Several key concepts in this Bill are not defined. For example, there is no definition of forced labour or deception in Part 1 of the Bill, although they are central to a thorough understanding of trafficking in persons. The definition of coercion also does not include a psychological element because psychological coercion in the form of threats and criminal intimidation has been reported by victims of human trafficking. There is also no definition of deception in the law, which is a very common indicator of trafficking in persons. The most common forms of deception encountered by the NGOs are deception of the nature of work and deception of the conditions of work. For example, a domestic worker may be told that she is in Singapore to do household chores but ends up working in a business. A migrant worker may also be promised high salaries and favourable working conditions but ends up working excessive days and hours for no or little pay. Would the new Bill consider such situations as deception? Forced labour is also not defined in the Bill. The International Labour Organization (ILO) defines forced labour as "all work or service that is exacted from any person under the threat of any penalty and for which the person concerned has not offered him or herself Page: 98 voluntarily".”
“For instance, Vietnam is not an approved source country. Would trafficked victims from Vietnam be allowed to work? The current system, as it stands, unfairly discriminates against victims from countries that are not "approved source countries". It also undermines the effectiveness of any anti-trafficking laws, Page: 97 as victims are hesitant to report their cases as an investigation will effectively trap them in Singapore with no livelihood. Victims of trafficking should be entitled to legal aid, in the form of access to legal information and legal representation. In Singapore, victims are not provided with legal aid for the pursuit of civil claims against their traffickers. They are also not provided with protection and advice in order to enable them to participate voluntarily in investigations and prosecutions. According to Anti-Slavery International, in cases where the trafficked person had legal representation and their rights protected, predominantly will lead to a more successful conviction. Lawyers are crucial in ensuring victims of trafficking are given accurate information about Court proceedings, their role as a witness and are recognised as a victim of crime. It is crucial to ensure victims have access to legal redress and compensation within established channels under Singapore law. Victims of trafficking should be offered payment or reparation for injury, loss or harm. Such reparation helps to empower the victim, contributes to their recovery and reduces the risk of re-trafficking. At the same time, it serves as punishment and deterrence for traffickers. Reparation should include restitution from the offender in the criminal Court, aid from state-administered victim compensation funds and damage ordered to be paid in civil or administrative proceedings.”
“Mr Deputy Speaker, under clause 19 of the Bill, Assistance to Trafficked Victims, I note that the right to accommodation and counselling is guaranteed in the new Bill but can the Member clarify if this will apply to all victims and not just those who are victims of sex trafficking? The forms of assistance provided under clause 19(1), too, are inadequate. In some cases, the provisions raise more questions than answers: the clause stipulating the provision of temporary shelter, for instance, is not specific. How long will each shelter be provided for? Will it be safe? There is no mention of whether the trafficked victim placed in a temporary shelter would have freedom of movement. Will the counselling provided be undertaken on a confidential basis? This section of the Bill makes no mention of legal aid, medical treatment, compensation and social support. I would like to propose amendments to include all these under clause 19 of the Bill. It is also important that migrants who have been trafficked not be prosecuted for being an undocumented immigrant, for working illegally or violating work pass regulations. This is because those who are trafficked may have been deceived or coerced into committing such offences. What safeguards are there to ensure that victims will not be unjustifiably punished, especially when these provisions are not guaranteed in law? Employment is also an important issue for victims who are assisting in investigations. Many migrant workers come to Singapore because they want a better life for their families. If they are stuck in Singapore without any opportunity to work, how would they be able to support their families back in their home countries? I note that MOM imposes strict restrictions on nationality for work permit holders.”
“Mr Deputy Speaker, I would like to congratulate the hon Member for Holland-Bukit Timah Mr Christopher de Souza and his team for introducing the Prevention of Human Trafficking Bill in Parliament. This is a long overdue legislation which NGOs and activists have been advocating for many years. The existing legislation, such as the Employment of Foreign Manpower Act, Employment Act, Penal Code and Women's Charter, are inadequate to tackle trafficking in persons. Therefore, it is commendable that it is finally acknowledged that human trafficking is a serious crime Page: 96 which needs to be tackled through a standalone legislation. Mr Deputy Speaker, in my preparation for this speech, I had the opportunity to meet NGO representatives who have expressed reservations about the scope of this Bill. They are concerned particularly that the Bill does not provide adequate protection to victims. NGOs, such as the Humanitarian Organisation for Migration Economics (HOME), which run shelters, help desks and legal aid for trafficked victims are concerned that not enough social support is provided to them. In their experience, they have housed victims who are required to assist in investigations for long periods of time: sometimes for up to two years or more. Some of these victims are not allowed to work, they suffer from mental illnesses, such as depression and anxiety, and have no means of income to support their families back home. The NGOs involved here have made the following demands in a petition which they have submitted to Member of Parliament Mr Christopher de Souza sometime this year.”
“While we do appreciate that the Committee sought specifically to examine applied study for Polytechnics and ITE, we wonder if the Government would consider plans for our Universities – NUS and NTU – to offer deeply specialised degrees in collaboration with multinational corporations so that our graduates can be competitive in job search right after graduation. We thank the ASPIRE Committee for their preparation of the report and we hope that the recommendations in the report can be monitored to ensure effectiveness. 5.43 pm”
“We need to strike a balance between pursuing new activities and keeping the correct industry profile for our citizens. In this regard, we note that Recommendation 4 of the report seeks to strengthen linkages with industry, by establishing Polytechnic and ITE leads for each key industry sector. But we hope that it would not be just enhanced programme offerings, but that it would be a way of reinforcing the correct industry profile for Singaporean workers. Similarly, Recommendation 2 of the report, which seeks to enhance internships at Polytechnics and ITEs, is a good move, but we hope that the kind of internship opportunities created would be focused on the correct industry profiles for Singapore. In short, I believe we do not need duplicate efforts to create more qualifications for Singaporeans. We already have existing projects in SPRING Singapore, EDB, WDA and MOM. Page: 86 We understand that Government agencies fund companies to upgrade employees directly as well. I think the Government should refrain from using resources on similar projects over and over again. Could we not simply direct one of the agencies under MTI to follow up on this? The Government is also good with creating more projects and initiatives, but we may need to have the courage to stop initiatives that are proven not to work. Do we have statistics to justify that WDA schemes have raised salary systematically beyond the rate of income growth before the formation of WDA?”
“Mdm Speaker, the Singapore People's Party supports the Motion and Government's action to enhance executive education programmes, as in Recommendations 7, 8 and 9, the key recommendations in the ASPIRE report to secure better outcomes and opportunities for our Polytechnic and ITE graduates. Recommendation number 5, on expanding online learning opportunities for individuals to learn anywhere and anytime by acquiring new and better forms of knowledge, is a good step towards encouraging lifelong learning. At the moment, we are aware of numerous diploma and graduate programmes subsidised by the Government. We are encouraged that many Singaporeans have chosen the path to upgrade themselves. But we are also aware that the Workforce Development Agency (WDA) has offered many non-degree/diploma programmes for lower skilled Singaporean workers. But these programmes are only as effective as they are recognised by their employers. Often, a worker who enrols in a programme sacrificing time and money may not receive a commensurate increase in wages or level of job scope after the completion of the course. In some cases, over-qualification – in terms of paper chase at least – contributes to underemployment. The pertinent question, rather, is how we can match Singaporeans to the correct level of jobs available in the market. Our mindset should be to create jobs that fit the profile of Singaporeans, not to create jobs that Singaporeans lack the skill for and hope that Singaporeans upgrade themselves to fit the jobs. For example, if we were to grow the Space Industry, we will require a lot of highly skilled technicians in a niche sector. Do we train workers for this new industry or do we focus on industries that our workers can be employed in?”
“I would like to ask the Senior Minister of State a supplementary question. Will the Singapore Government do anything to help the Nigerian girls? This is a global moral obligation. Could we do something to help them, or what can the Government do in this case? Any suggestion?”
“Mdm Speaker, I would like to ask the Minister of State whether there are any volunteer healthcare workers from Singapore working in the Ebola-stricken areas such as Nigeria, Guinea, Liberia, Sierra Leone in West Africa, and if there are Singaporeans working there, what precautions would MOH take when they return to Singapore after their stint as volunteers and caregivers?”
“In the case of those subsidiary proprietors who disagree with the compensation, what is the recourse for them? If the Government intends that goodwill be extended in the event of land acquisition – which MinLaw has implied in this proposed removal of the Betterment Levy – then we Page: 81 believe the powers of the MCST should also be calibrated as they are empowered to receive all monies from a collector as an award of compensation under the LAA for any non-acquisition relating to its strata plan.”
“Perhaps this is also a belated response to complaints over the land acquisition projects of the 1970s and 1980s, when kampong settlers and landowners were forcibly relocated and given a poor compensation deal by the Government. Indeed, they were the ones who should have deserved a better deal from the fruits of Singapore's rapid development. The situation in the present time, however, is dramatically different. If we are to now increase the compensation for landowners, taking into consideration the benefits of the public developments, we will be losing taxpayers' money to enrich the landowners on an "after the fact" basis. This is quite different from a developer who takes a bet on the future master plan of the estate. On non-lot acquisitions in strata title developments, clause 2 firmly establishes that the Management Corporation Strata Title (MCST) is the body that acts on behalf of subsidiary proprietors in a non-lot acquisition in relation to a strata title plan. Of course, this is mainly a clarification of existing laws, such as in section 2(2)(i) and section 40(2) in the original Act, which may potentially disqualify the MCST from acting in such a case. But what measures are there, above and beyond that which is already in the BMSMA that ensures that the MCST is more consultative with its subsidiary proprietors in the event of a land acquisition case? For example, what is the process in order for the MC to obtain consensus from all the subsidiary proprietors to agree to the proposed compensation from the Government and to pass resolutions needed to sell any common property that is comprised in the strata title plan? And what percentage of votes is needed from the subsidiary proprietors to secure the agreement to accept the proposed compensation?”
“Mdm Speaker, the gist of the Land Acquisition Bill is the proposal to compensate landowners better by removing the Betterment Levy through clause 12 of this amendment Bill – a levy which off-sets some of the gain in the value of the remaining land after the acquisition is complete, in section 33 in the original Bill. It is not unusual for the value of land to increase after the Government completes infrastructure projects near to the target acquired land. Such infrastructure may include MRT lines or public parks. We are doubtful about the rationale behind the Government's removal of the levy. First principles would require that landowners understand that the land value increases only because of the development plans that are funded by taxpayers. Should landowners be compensated because of the infrastructure requirements so badly needed by the nation? Yes, but only to the extent of fair value, and fair value should be determined without Page: 80 consideration of the developments. Could this be a form of institutionalising the ex-gratia payments to a landowner that are sometimes made over and above the statutory compensation? The ex-gratia payment scheme was initiated around 1982 to cushion the financial hardship that may be faced by owners of the acquired land. These ex-gratia payments sometimes amount to a substantial proportion of the total compensation offered. While it is, of course, a form of goodwill, the criticism is that it can seem rather arbitrary, as the criteria for deciding on an ex-gratia payment is not made public, to our best knowledge.”
“We state this obviously not to criticise the Government's efforts through this Bill, but to point out the complementary efforts needed to go hand-in-hand with this Bill. It is clear that there are many things beyond the reach of the Singapore Government. We know that the Government is working on these issues. We also hope that the incoming administration of President-elect Joko Widodo of Indonesia will make more headway in tackling the haze problem on the ground. We also note the explanatory statement in this Bill indicates that it will require extra financial expenditure. May I clarify where this expenditure is going towards and what sort of sum are we looking at? A related question is how the Government intends to channel the fines collected from errant companies as a result of the new Bill – I would presume the Government intends to channel them towards further efforts to counter the haze problem? Perhaps the most commonly mooted idea by observers is to channel the Court-imposed fines to the Transboundary Haze Pollution Control Fund, which will help boost the regional Page: 41 leader's receptivity towards the Bill. What we would like to say, on behalf of all Singaporeans who suffer from the haze, is this: Singaporeans will support our Government when it takes brave steps to do the right thing to tackle the haze problem. They have been plagued by the haze problem for far too long. We may not be fully aware of the intricacies of what goes on, such as on the ground in Indonesia. But we want to make sure that Singapore will do the utmost on our part. 3.06 pm”
“The question, going forward, is the implementation of the provisions in this Bill. Clause 4 provides for the extra-territorial application of this Bill. We believe it will be hard to Page: 40 implement this on the ground, such as when collecting evidence from another country for the Courts here in Singapore. There is the real prospect that the firms responsible for burning land in Indonesia may make the local Indonesian farmers the scapegoats for their unsustainable practices. This is not to say that the Indonesian farmers are not culpable, or that they should not be forced to change their ways of farming. Rather, the fear is that the haze problem may persist, while the blame would have merely shifted. That, then, would not be tackling the root of the problem. For this to be ensured, the Haze Monitoring System must be much further improved. Several of the steps to monitor fires and concessions are already being implemented by major players, such as the Indonesian "One Map policy", and non-governmental organisations such as "Global Forest Watch", and even some of the private corporations. However, the problem is that there are information gaps and issues related to the accuracy of maps. There should be greater information-sharing of land ownership and concession boundaries to promote transparency. As we understand it, all ASEAN countries are highly reluctant to be directly involved in the monitoring process and funding. This is perhaps because they do not want to be dragged into spats with Indonesia and transnational firms. Perhaps, they do not want to be held responsible in the event of a mistake or glitch in the monitoring system, as firms would also have the legal recourse to challenge the accusation of governments that they are at fault.”
“Mdm Speaker, I support the Transboundary Haze Pollution Bill which concerns the conduct that causes or contributes to haze pollution in Singapore and provides for related matters. We believe the Government has taken a brave step in increasing the fines under clause 5 of the Bill, after their consultation rounds on the earlier draft Bill circulated this year. Observers we have spoken to shared that they were pleasantly surprised. However, it is unclear if the stiffer fines would be an effective deterrent to the agroforestry companies which make hundreds of millions, if not billions, in profits every year – but a conviction might be a strong enough damper on their business. Any conviction in a Singapore Court will affect their reputation and financial standing which might threaten their access to bank loans and Government tax incentive programmes. This would allow the Bill to have more bite in achieving its intent of curbing the burning of land in Indonesia. It also sends the right signal to the firms involved and to Singaporeans that the Government is serious about tackling the root of the haze problem, by taking one more step ahead. The other point we wish to acknowledge is the Government's decision to go the route of a rules-based, legal regime in tackling the root of the haze problem. For the past 10 years or so, actions have been focused on the ASEAN Transboundary Haze Agreement. But the so-called "ASEAN Way" of addressing the problem by political consensus rather than hard law among ASEAN countries has clearly not solved the haze problem, which peaked last June with a PSI of over 400. It has not been effective in dealing with regional environmental issues. To begin with, Indonesia has not even ratified the agreement yet.”
“I thank the Senior Minister of State for the answer. It was reported in the media that five people who loaded their luggage did not board the ill-fated MH370. I would like to ask a supplementary question in regard to baggage. At the time when they discovered that they did not board the plane, where are the pieces of Page: 30 luggage? Have they been put into the cargo cabin of the plane or are they still waiting outside for clearance?”
“I thank the Minister for his very good answers. I have two supplementary questions. This is pertaining to pilots. Have any pilots or airline personnel made known their reservations to CAAS about flying over the war zone in Ukraine? Secondly, what is the alternative route now for SIA flights to fly to Europe?”
“(In English): Finally, Madam, can MOH consider setting up a Review Committee or some representatives and include a hotline as well to assist in handling queries or clarifications and case-by-case consideration for appeals and matters related to the topic within the next year or so, especially in this initial period leading up to the implementation? There should be representation in the various languages as well. This would be very helpful to assist the public and our citizens in enhancing their level of understanding. Page: 54 Moving forward, there is no perfect healthcare system, nor is there a perfect healthcare funding model worldwide. We have to do what works for us and our citizens, but we must remain flexible and nimble, as appropriate. Health promotion and prevention must still remain the thrust of our healthcare system. Primary care must continue to be strengthened and gaps must continue to be filled. Healthcare is a basic need we must fulfil for society, but our health lies in our own hands. I support MediShield Life and its implementation. 3.48 pm”
“] Madam, the MediShield Life Scheme is very comprehensive and is a good move to help Singaporeans cope with healthcare costs. It is supported by various subsidies, especially for the Pioneer Generation, as well as those in the low and middle income groups. MediShield Life not only helps individuals but can also lessen the burden of their family members because it is their children and grandchildren who usually help out with the premium payments. Our Malay/Muslim community also has a high rate of chronic diseases. This means more risks, complications, treatments, medication as well as admissions to hospitals for treatment and therapy. Thus, MediShield Life, which has removed the annual or lifetime claim limits, will bring major benefits to those who frequently utilise our healthcare system. For example, those who are suffering from end-stage renal failure and require lifetime dialysis treatment, or diabetics with various complications as well as patients with stroke and many long-term complications. These are the groups who will benefit most from this scheme. I also hope our community will take note and try to find out more about this scheme which is very beneficial to them. Come to our dialogue sessions and share it in your constituencies. Ask questions so that you can gain the benefit from this long-term scheme. For those who have Integrated Shield Plan policies, do not rush to make a decision whether to stop or to continue with it. First of all, I would like to ask that they study the details presented and understand it fully. Discuss it with your family members and also get their views about your decision.”
“I hope that we can have some updates and, perhaps, an estimated possible timeframe for consideration as well. One other group of people who have been wondering how it will affect them as well will be the pensioners. Thus far, not much has been shared on this. I wonder if the Minister has any further updates on this. Currently, we have about 32,000 pensioners on various schemes in Singapore. One group of people that we can tap on to serve as our ambassadors for MediShield Life will be the healthcare professionals and healthcare workers. Can we also ensure that we reach out to the institutions to educate them further on MediShield Life and other related policies? Why am I saying that they should be our ambassadors? Well, because the healthcare professionals are the ones ordering the tests and investigations, making the decisions. They have a role in contributing towards our healthcare expenditure and, thus, towards a cost-efficient healthcare system as well. They are also the ones we can count on to help educate their patients. I do hope MOH can work with the various institutions and even primary healthcare providers to empower them and garner their support and help on Page: 53 this matter to communicate and help us explain MediShield Life. This will also be necessary with private healthcare institutions, I feel. Will MediShield Life affect our population's healthcare consumption patterns and profile? Well, we will have to monitor and do surveillance and see what happens. Simultaneously, I feel that education and health promotion are critical for informed choices and decisions which are going to be made for long-term affordability considerations. Madam, in Malay, please. (In Malay): [Please refer to Vernacular Speech.”
“From 2019, for Singaporeans aged between zero and 20 from high-income families, they would pay an annual premium of $130, whilst those over 90 years would have to pay $1,530 annually. This is a whooping 12-13 fold rise. In view of this, should we decide on setting the increments using a ratio or rate-banding? That means if we set the ratio at 4:1 or 5:1, then the older individuals will not have to pay Page: 52 beyond four to five times being paid by the younger person. Something for us to consider. As MOH is reviewing, with insurance companies, on the finalisation of the Integrated Shield Plans, I support the move to have the key features of the standardised plans tagged at the B1 rate, but it is also important for us to educate and make sure that people make the right choice of ward class when they seek healthcare. Also, I hope MOH can take this opportunity to review our private healthcare insurance with the respective companies to make them more progressive and robust, as in some countries. One more query I have is, will those with existing illnesses be managed differently, Madam, from those with no pre-existing illnesses in the revised Integrated Shield Plans which are to be announced? Next, on portable healthcare benefits, it will be a good move for a vibrant economy, such as ours, where workers will go to where their options and opportunities are better. Perhaps, we can consider further dialogues with the tripartite partners and even offer grants and incentives for supporting employers and companies. As I see it, this can help reduce duplication of the coverage between employers' medical benefits and the MediShield Life scheme in the long term. As the Minister mentioned in his speech yesterday, there has been some progress in this area with the dialogues.”
“Madam, our 3M framework offers a strong foundational healthcare financing system which has generated the interest of health economists and many countries over the years. Over the decades, it has been reviewed and liberalised to make it more flexible, robust and adaptable to the changing needs and expectations of the populace. The critical point about this scheme is its long-term sustainability. MediShield Life is a bold and progressive move on the part of the Government and MOH, covering our citizens from birth to the end of life. The move comes at a critical period whereby countries are all grappling with ageing population, rising healthcare costs and, of course, inflation. In general, I support the proposals put forth but I do have several concerns to raise. Firstly, the subsidies for premiums in MediShield Life are tagged to the value of your property and, for the group whose property is more than $21,000, there will be no subsidies offered for the high-income group. I feel this could be a concern because this group may comprise of people who are retirees, who had purchased their homes many years ago at an affordable price or inherited them even, and they may not be cash-rich either. Even if they be eligible for the Pioneer Generation Package now, come 2019, their premiums will be relatively high, without the subsidies. Recently, the Minister for Health announced that they will be eligible for the transitional subsidies on a case-by-case consideration, but my concern is: what happens after these first four years? The rate of appreciation with age can also be a concern. The question is, "Is it too high?" and is age-banding the best way to categorise and do this, if one considers the table that has been put forth?”
“MediShield should also cover pre- and post-hospitalisation care that adds up to significant costs. MediShield premiums should be kept within Medisave contribution levels that are affordable to Singaporeans. In conclusion, there is no perfect healthcare system in the world. A country must have the ability to constantly change and evolve to stay relevant to the needs of the people, the quintessential quality for a good healthcare system. I would like to thank the MediShield Life Committee Review Board for their comprehensive work. 3.38 pm Assoc Prof Fatimah Lateef (Marine Parade): Thank you, Mdm Speaker. Before I proceed with my speech, let me just highlight a few points in response to hon Member Mrs Lina Chiam's comments. First and foremost, I would like to inform her that no one will be left out of the MediShield Life scheme. It is a scheme for every Singaporean and PR in Singapore, from life to death. Secondly, in terms of the subsidies and expenditure, the Government is going to subsidise to the extent of $4 billion in the next five years. So, that is a substantial amount of Page: 51 subsidy. Thirdly, when the Member brought up the point about the type of care that is rendered to people who choose the lower class wards, for example, the subsidised wards of B2 and C class, let me reassure her, speaking from the point of view of a practitioner of medicine for the last 24 years, the type of care that we provide for our patients is the same across the classes. It is just the level of subsidy that differs with the different classes. But the doctors, medications and the type of treatment that we provide are the same.”
“Some patients have even expressed the doubt whether medications provided for patients have the same potency of those in B1 and A wards – like the saying in Chinese: “一分钱，一分货”. You get what you pay for. The Government should allow Medisave to be fully utilised to pay for MediShield Life premiums or Integrated Shield Plans that cover all deductibles and co-insurances for B2 and C class. There should not be a limit imposed. The Government should encourage more companies to have greater portability plans and allow the employers to switch between insurers that ride on MediShield Life without additional underwriting and duplication of their employees' medical benefits. This will lower their premium costs. Page: 50 We hope MOH will also address pensioners' concern about their existing life-long pension benefits and to avoid duplication of their medical benefits with MediShield Life. In this respect, it was noted that pensioners who stay in community rehabilitation hospitals are only allowed $5,000 limit of Medisave usage. Madam, rehabilitation stay in community hospitals usually take months for elderly patients' recovery. I would urge the Minister to extend the Medisave limit as in other restructured hospitals to help pensioners defray the out-of-pocket bills which may amount to thousands of dollars, depending on the ward, even with MediShield plans. Additionally, we advocate for more choices for affordable premiums as long as citizens understand the downside risks of Integrated Shield Plans. I think Singaporeans also provided the same feedback on page 46 of the White Paper. MOH should take this opportunity to do a thorough overhaul to the MediShield and IP schemes and make it truly comprehensive and easy to understand.”
“We are not sure how much more the Government would spend to support the revised healthcare insurance plan when it announced that it will also be providing premium subsidies and Medisave top-ups for the Pioneer Generation for life and premium subsidies for lower to middle income households. Mr Leong Sze Hian, a regular blogger, has asked for the actuarial study to be made public so that Singaporeans can understand if there is a real net cash outflow to maintain the MediShield Life scheme. It was reported that, every year, premiums exceed claims since the inception of the MediShield scheme, to the tune of an estimated more than $1 billion to date. May we also take this chance to highlight the importance of pre-emptive healthcare management? Promoting healthier lifestyles is more important than the best insurance schemes. No claim bonuses could encourage the pursuit of healthy life styles, reduce claims and lower premiums. In this vein, perhaps the Minister could consider a calorie tax on high calorie foods and drinks in Singapore, just as what Mexico has done – the higher calorie the food item, the greater the tax on the item. It is generally a pre-emptive system to increase burden on irresponsible food providers. A recent study by the Robert Wood Johnson Foundation in the United States suggested that applying a tax based on the amount of calories contained in a serving rather than its size would be more effective in reducing obesity. I am glad to note that greater subsidies are provided for patients of B2 and C class wards but would like to ask the Minister whether this will affect the holistic service quality and the range and options of treatment in the lower class wards.”
“Help should be given to them to "deal with bureaucracy" to ease those who need help to cope with their premium increase. The Government should form a committee to look into the impact of rising health costs, caused mainly by the vested interests of pharmaceutical departments and manufacturers of hospital equipment which have pushed up health costs to the rate of inflation. We would also like to ask a hard question. If the Government can make it compulsory for all CPF account holders to subscribe to an annuity scheme, why is it not making all Singaporeans buy MediShield Life? After all, the bigger the pool of insured, the more manageable is the shared risk which will also help in reducing premiums across the board. Universal coverage under the new MediShield Life will imply higher premiums – there is no free lunch. A trade-off has to be made between better benefits and higher premiums. But for those who cannot afford the enhanced package, could the Government provide subsidies after means-testing? And how will the Government plan to help the two-thirds lower income group cope with the premium rises after the transitional period of subsidy is over in 2019, bearing also in mind that there are over 1.65 million or 45% inactive CPF members out of 3.53 million CPF members who may not have sufficient money in their Medisave account to pay their MediShield Life premiums? Or should the unemployed have lesser schemes than the employed? To be a truly inclusive society, no one should be left out of insurance coverage with the Government bearing most of the costs together with Page: 49 Singaporeans.”
“The Government needs to develop a strong system to avoid individual poverty and a collapse of our annuity and medical funding frameworks. We understand that the Government is considering increasing taxes, direct or indirect taxation or income tax and so on in order to meet Singaporeans' request for higher benefits from medical insurances and retirement funds. But we hope that the Government can make their working assumptions transparent so that Singaporeans can better understand the Government's intentions. Page: 48 The Singapore People's Party places a very high premium on the health of all Singaporeans for all illnesses. The provision of healthcare facilities must be accepted as a social responsibility by the Government. Madam, I am in favour of the revised MediShield Life scheme which will give Pioneers better peace of mind for their healthcare bills and ease the burden of caregivers and family members. We believe that the aged will rely heavily on long-term care services. As we age, we will have a significant right-tail distribution of healthcare expenditures. In figure 7.4 of the White Paper, we note that the revised scheme may pay up to 70% of the case study provided as an example – a higher percentage than the previous rate of 43%. However, we hope MOH can come up with simpler ways of explaining the complex policy to Singaporeans, perhaps with a straightforward short video on YouTube in the four official languages, to help the average citizen understand the workings of the proposed MediShield Life scheme. The scheme should be made more equitable for the "asset rich, cash poor" group who may be unfairly penalised because of their annual home values of above $21,000.”
“Mdm Speaker, the introduction of MediShield Life was announced by Prime Minister Lee Hsien Loong in his National Day speech in 2013 as the third key shift which compliments other policy shifts in healthcare financing for all Singaporeans, with lifetime basic protection against large medical cost and for greater peace of mind. The Committee has completed its review and submitted its report on the universal health plan with key principles adopted by the Committee on 23 June 2014. Its recommendations for the proposed MediShield Life national health insurance scheme are: better protection against large medical bills, extending coverage for life until age 92, and insurance for those with pre-existing conditions. Madam, demographics is the most important factor putting economies at risk. Our healthcare financing needs to evolve with changing demographics and healthcare needs. An older population, with smaller families, is many times more expensive to manage than a younger population. Medical insurance and pension schemes do not necessarily take into consideration the huge risks caused by demographic changes. Women can be discriminated against, because they outlive men, and pay less into retirement schemes because of family commitments. A rapidly ageing population has linkages to discount rates, yields, longevity risks, social stability and, finally, economic growth. If we do not ensure that the CPF takes into consideration risks of increasing longevity, we will not be doing our future generations right by transferring the burden to them. Since we have chosen the annuities route, we hope to see a more complex strategy by CPF Board that can effectively hedge inflation risks. The use of the Special Singapore Government Securities (SSGS) is not sufficient as a tool by itself.”
“Has MOE taken steps to mitigate the effects of psychological impact on student athletes if they suffer huge losses to the Sports School athletes during the inter-school games?”
“I thank the Senior Parliamentary Secretary for the answer. I have three questions. First of all, will MOE consider re-allocation of resources for schools that have talent in other sports, other than Singapore Sports School that specialises in niche sports, for them to have a chance to compete in competitions? Second, have any medals been won by school students against the Singapore Sports School? And, third, has MOE taken steps to mitigate the effects of psychological impact on student athletes when they suffer huge losses to the Sports School athletes during the inter-school games?”
“I would like to thank the Minister for his clarifications. I would like to ask a further clarification from the Minister. How does NEA ensure food imported from Japan is free from radiation contamination since the Fukushima explosion a few years ago?”
“I thank the Minister for the response. I have three supplementary questions. Among the PRs who left Singapore permanently by way of withdrawing their CPF, what is the average length of their PR status in Singapore? Secondly, can PRs keep their properties after withdrawing their CPF monies when they leave Singapore for good? Can they be employed again in Singapore?”
“If the Government is sincere about hearing people's voices, we urge them to take an even-handed approach in reviewing the Broadcasting Act in the remaining term of Parliament before the next General Election, as they have slated. If being a constructive opposition means speaking up for the real needs of the people, to build a democratic society based on justice and equality – then yes, we are a constructive opposition. We have no interest at all in destroying the fabric of Singapore. But when we see policies that are detrimental to the well-being of our people and our nation, the Opposition Page: 102 will speak up fearlessly. The Singapore People's Party shall be a loyal Opposition – loyal to the Constitution, loyal to the nation, not to the ruling Party but we will stand together with the Government in times of national difficulties and emergency. But our role in Parliament is to keep the Government in check, ensuring that its promises to the people and its policies are carried out. We will also continue put out our alternative solutions and policy proposals to move Singapore further, both with the Opposition and the ruling Party. As Singapore approaches a new chapter with its 50th anniversary next year, the Opposition's role and responsibility is becoming a more integral part of the governance of our nation. In fact, the whole nation must be responsible for that. We all have a role to play. 6.40 pm”
“We still cling onto the nanny state mentality that disallows a man to fail in life. We say that the ordinary man is incapable of planning his retirement, so we lock up his cash and force him to purchase an annuity. As if it is not bad enough to have a nanny state government that grows at all cost, our Government refuses to install a minimum wage for low-wage workers. Yet, there is in effect a minimum wage for senior civil servants and political leaders – we are referring to the pay benchmarks of our leaders. In the French monarchy period, they were not able to revamp their tax structure. Nobles were not paying taxes and this caused a lot of pain for the government. In Singapore's case today, we treat our businesses like nobles. Instead of increasing the tax and eliminating their access to cheap foreign labour, we decide to tax Singaporeans through systems such as the COE for cars. If the President is serious about unifying Singapore, the path ahead is long. The President shared that we must add substance to voices. After Our Singapore Conversation (OSC), the Singapore People's Party urges the Government to continue launching more nation-wide conversations – regardless of their political inclination. After all, we are all working for a better Singapore. The OSC should be held with ordinary people, of all political inclination, in all places like coffee shops, hawker centres or shopping malls, and also on the Internet – anywhere that is conducive for people to speak their mind freely. We will get better and more accurate feedback at the end of the day. Controlling the discourse online, such as through the new Media Development Authority (MDA) Internet regulations last year, is counter-productive and self-defeating.”
“Theoretically, some of them should be allowed to fail. Restructuring must take place in order to create a competitive environment that can pay good wages. Meritocracy will not happen otherwise. Businesses will push wages down because opportunity cost of not innovating is low. The Singaporean worker will always be too expensive to hire. To help one business survive, we will need limitless low-wage foreign labour. I think this story is quite clear. We are not interested in asking which industries should stay or which should go. But we want to be part of a new governmental apparatus to help formulate policies that favour Singaporeans, not an absolute growth model. The President also talked about a stronger Singaporean Core. At this stage, I also want to stress that capital stuck with the wealthy will always almost transform into rent as it accumulates. The poorer will never be able to catch up unless capital is forced to be more dynamic. On this ground, I question the validity of the current Government's strategy of attracting top billionaires and how overrated the concept of trickle-down economics is in creating jobs. The incentives we throw to attract top businesses could have been better spent allowing students to get their hands wet on entrepreneurship. We disagree with what the Government prescribes in the growth model – only in setting up agencies, creating schemes and buying projects. We prefer that this model be abandoned and that we work directly with tertiary institutions to build businesses. After all, Silicon Valley, Hong Kong and London did Page: 101 not become competitive because of aggressive incentives. Singapore owns a lot of capital but Singaporeans lack easy access to this capital for basic uses, such as retirement and education.”
“While the Government has tried to ensure affordable and quality healthcare, it has recently raised the CPF Minimum Sum to $155,000. This makes retirement tougher. Many Singaporeans are also deeply unhappy about the compulsory annuity CPF Scheme. We need alternative retirement schemes to build an inclusive society. Singapore needs a complex mix of policies, such as alternative investment options to ensure a sufficient pool of funds in CPF. A non-mandatory CPF annuity scheme and private annuity schemes should also be considered. It is important to provide more opportunities for those who fail in school, businesses or in life. We need to think carefully how to embrace failure and provide second chances for Singaporeans. This may include providing a stronger and less complex system of a social Page: 100 safety net for Singaporeans. Tougher questions regarding the localisation of our workforce need to be addressed soon. We understand that 50% of jobs in Singapore are not held by Singaporeans. Economic growth alone is incapable of satisfying the democratic and meritocratic hopes of the people. Specific institutions must be created for that purpose of redistributing the fruits of Singapore's growth, rather than relying on market forces to ensure a meritocratic society. So far, the Government has chosen a purely capitalist system to grow our nation. Our national wealth increased. Companies located in Singapore prospered and business leaders were also able to make profits out of Singaporeans. Many of our local businesses rely on cheap labour to survive. Without them, managers complain that they will fold up. I believe them because they are simply unable to compete technologically anymore, after more than 20 years of cheap quotas. Innovation is no longer in their blood.”
“Mr Deputy Speaker, I rise in support of the Motion in thanking the President for his Address, which was delivered on behalf of the Page: 99 Government in the Opening of the Second Session of this Parliament. We agree with the President that empathy should be one of the core values of Singapore. However, we face an uphill task in achieving this. How do we help youths develop empathy in the face of tougher job competition internationally and in their homeland? This is in the context of a world that is more protectionist. The President addressed the need for more opportunities for Singaporeans to realise their dreams and aspirations. Currently, many Singaporeans feel that they are priced out of their aspirations for cars, houses and higher education. In order to help and enable young Singaporeans to fulfil their potential, and pursue their dreams and aspirations, we must have a happy and healthy environment at home, in school and in the workplace. In order to build a healthy, caring society, there must be mental wellness among Singaporeans. We need to do more for mental wellness of each and every one of our citizens. Only then can we speak meaningfully of higher productivity among our workforce. Lifelong learning for retirees and the elderly should also be encouraged to keep their minds active. We must not forget about the welfare of Singaporeans, even the detainees held under the Internal Security Act – the cases of those who have been detained for more than 10 years must be reviewed. We urge the Government to reprioritise the needs of Singaporeans over and above that of medical tourism, for instance. CPF – there are alternatives to raising Minimum Sum.”
“Would the Minister consider lifting the MediSave cap of $5,000 for patients in rehabilitation at hospitals, as most patients are elderly who need longer hospitalisation and when they come out of hospital, they have to pay thousands of dollars out of their pocket, even though they are under MediShield plan?”
“The Government could then conduct a salary restructure and review of our nurses' salaries in accordance with their skill level, similar to the career structure that was developed, such as for teachers in the education service.”
“Madam, the Government has acknowledged that nurses are not "low skilled" workers, a point brought up by the Deputy Prime Minister during the Population White Paper debate last year. "How important nurses are in the hospital: they are trained, they are critical to the whole system – highly skilled, highly professional," Prime Minister Lee said in a Straits Times report on 13 February 2013. Florence Nightingale defined nursing as "the act of utilising the environment of the patient to assist him in his recovery". A nurse is a healthcare professional who is focused on caring for individuals, families and communities, ensuring that they attain, maintain or recover optimal health and functioning. They are also the important frontline workers in the health industry. When we compare the remuneration of nurses in Singapore with hospital nurses in other countries, they lag behind their counterparts in Europe, Australia and Japan, even though Singapore has one of the highest GDP per capita in the world. It is time that the Government review the career pathways and salaries of our nurses to ensure that they receive a pay commensurate with their skill set and expertise after their in-house competency tests, to provide more advancement opportunities and career pathways and to value-add our healthcare system in Singapore which should be in the form of a nursing, leadership and senior specialist track. More support should be given to healthcare in this regard. I would like to propose that the Government earmark a sum of around $40 million to enhance the competitiveness of our healthcare sector. Under such a framework, the Page: 79 Government can then consider more competitive wages for nurses.”
“This is the time to discuss expansion of the coverage of the 3M system and to have more transparency on the CPF-capped contributions made versus the MediSave expenses. Long-term Care”
“Madam, healthcare insurance is not the answer to all the problems we have at the moment. Some Singaporeans are self-employed and cannot afford it. Yet, others who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover. The problem with our healthcare system goes beyond the uninsured. More Singaporeans are also worried about the premiums, which can only increase with an ageing population. Since insurance cost is lower with a larger pool, we may need to think out of the box. An idea we had was to pool the population among ASEAN countries in order to lower healthcare costs. These are synergies. Healthcare services are lower in our neighbouring countries. The idea is to pool the financial risk from among ASEAN countries. Medical services rendered would, of course, still depend on individual ASEAN countries. The Singapore People's Party received feedback from one of our residents at our Meet-the-People Sessions that she was asked to take multiple tests on the day she was admitted due to heart palpitation. She was frustrated that our 3M system does not cover tests. If we do nothing to slow down these skyrocketing costs, Singaporeans will suffer. Also, there is no national medical database that doctors in private practice can also tap on – the current system is not well integrated. We can mandate employer insurance just like the US, but this may not be the best way for Singaporeans. We understand that CPF contributions are greater than MediSave expenses at the moment. Perhaps, the time is ripe for us to consider expanding the coverage of the 3M system. A politically safe move is to keep the system status quo. But that is not what the situation calls for.”
“Sir, we face the difficult task of equipping students to succeed in a competitive global economy, a knowledge-based society, and a hyper-connected, digital age. Today, our students are worried about job availability. Our PMETs are constantly displaced by cheaper foreign hires, and our older age seniors can no longer withdraw CPF in lump sum. Without the ingenuity to land and compete for jobs, our young people will be subject to unemployment like their PMET seniors – those born after 1965. Already, the Government is finding the task difficult to keep middle-aged PMETs employed. I see this as a warning for our younger generation as well. Work must start now. We need a curriculum with a blend of academic, technical and critical thinking skills. Our students need to learn collaboration and communication, not from textbooks, but from life projects. I urge the Minister for Education to consider international exposure for our students, where up to 20% of our students can be sent for overseas exchange funded by Government. This works both ways as we also receive 20% of international students in our schools. I propose that in the medium term, international schools in Singapore should not merely serve the needs of our expatriates, but to serve as an additional source of supply for education services for Singaporeans, to be subsidised by the Government. The intention is to ensure a portion of our student remains globally connected. If left to market forces, the lower and medium income families will not be able to afford such services. One of the key reasons why our parents are not keen to give birth is the cost of educating a child. We should commit to supporting the full cost of education until the child is 16. Tertiary Student Internship”
“Madam, MOE should consider improving the quality of job scope for teachers in Singapore. We understand that in some schools, teachers report to work before 7.00 am and leave school only after 4.00 pm, after covering co-curricular activities. I understand the need for teachers to set Page: 130 a good example by attending flag-raising, but I question the need for all teachers to be present during every ceremony. It is public knowledge that school has to start earlier than work time – 8.30 am to 9.30 am generally – in order to facilitate parents fetching their children to school. However, it is not entirely logical to regulate teacher's presence the same way as students. As part of resource deployment, I propose a solution to employ retired teachers and professional workers or use the help of volunteers to participate in flag-rising ceremonies in order to keep the school operations running between 6.30 am and 8.30 am. Some teachers can be stationed to be in charge of the ceremony on a rotational basis. Additionally, we may need to increase the salary of teachers to compensate for the lack of relevant skill sets for the private sector, aside from the education sector. Unlike an oil and gas project manager who can easily be employed in another manufacturing company, a middle-aged English teacher may find it difficult to move into most of the private sector industries in Singapore. Given that we require teachers to commit their best years to our students, there is also a corresponding need for us to ensure teachers can be remunerated competitively. Education for the New Singapore”
“Recently, it was reported that funding for top independent schools in Singapore was cut. Sources from alumni estimated that cuts on the Integrated Programme portion were between 4% and 8%. Additionally, according to MOE, Government development expenditure on education decreased by 82%, from $353 million to $83 million. We agree that the immediate action is to narrow the gap between neighbourhood and elite schools. However, this should not be achieved by reducing the competitiveness of our top schools. We should, instead, spend more on neighbourhood schools so that the overall education standards will increase. On the same note, Cedar Girls' Secondary School had their running track taken away. Would it be possible for the Government to construct shared sports facility in different regions that cater only for students? We note that some schools may have their track and other land intensive facilities taken away as we prioritise the use of land in Singapore. Investing in shared sports facility will increase the overall standards of all-rounded education. Secondary School Admission”
“Okay. Please think of the employers for a change because of the levy they pay. It is timely that they should use some of this levy to pay for this psychological test for maids.”
“I thank the Senior Parliamentary Secretary for addressing my request for mandatory psychological test for maids. It was the same answer that he has given me last year and the previous years when my husband also asked for it. So, my husband and I have been advocating for this Page: 109 since then. And it is through feedback and experiences that I need to ask this is because it is going to be an escalating issue. It has been proven that this year, there were two cases: one in January and the latest one about four days ago. So, I think it is timely that his Ministry should consider my proposal and think carefully with an open mindset as we have been told that we always must have an open mindset. We should also think of the employers. Every time, we are always thinking of the employees, how they suffer, how we mistreat them —”
“Mdm Chair, it was reported that there were 30 cases of attacks, manslaughter and murder involving foreign domestic workers. Two new cases were reported this year, one in January 2014 and the other one just three days ago. During the trials, they were said to have been mentally unstable, have low IQ and incapable of rational thought. Many of these cases are preventable, if employers could be given pre-warning and even to the extent of not employing domestic workers with tendencies of abnormal behaviour. Recently, The Straits Times reported that the Indonesian Embassy is in an ongoing discussion with their government to introduce basic psychological tests for new domestic workers coming to Singapore after the recent high-profile murder cases involving Indonesian domestic workers. It is important to have psychology tests for domestic workers as they spend long hours as caregivers of vulnerable members of the family, the young and the elderly, including babies which require them to have extreme patience and rationality. Madam, this issue was addressed in Parliament previously. I would again like to ask whether the Government is willing to make compulsory some form of mandatory psychology tests for new domestic workers as part of the work permit application. This is to ensure the new maid does not have unnecessary violence and homicidal tendencies that may turn out disastrous for the family. The test will also give peace of mind to the family and the maid as a whole. Page: 92 Would the Government also consider subsidising part of this cost of the test from the domestic worker levy collected from employers? Workplace Safety and Health”