Loh Meng See
Singapore
“Sir, on Infocomm 21 plan, this has been implemented for some years now. I would like to ask the Minister to give us an update on the expenditure and the benefits that have been derived from those investments. Recently, the CEO of IDA announced the Government's plan to widen the scope of the network and introduce better technologies.”
“Sir, I am happy that the Government is allocating new funds for the Library 2010 project. I just want to ask what can the public expect from this additional $118 million that has been provided for.”
“Sir, on the HDB shops, my request is for the Ministry to consider granting the exit package to the rental shops, if their business is not viable and there is an over-capacity.”
“We have heard what Dr Lily Neo and Dr Chong mention about the geriatrics and the need for home nursing care. Many do not have CPF accounts to enjoy the Medisave top-ups.”
“We have been down this road before. Let us not falter, but let us persevere and build up ourselves with the right values, virtues and beliefs to galvanise our people forward. We need to remind ourselves that there is no free lunch.”
“Sir, media competition among local newspapers and TV stations is bearing fruits as consumers are getting better quality products and services. I am pleased to also note the progress of Singapore Press Holdings and Lianhe Zaobao in making inroads into China and also Channel NewsAsia gaining greater viewership in regional countries.”
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“Perhaps, the SDP and PKMS do not know how to study the figures and that is why they said that there had been a statistical massage. But I think this confusion arose because some of them, perhaps their colleagues or friends in PKMS, could have advised and helped the SDP to understand the statistics like those people making epok epok or roti prata. I think they are confused. The questions, accusations and claims are not like people making epok epok or roti prata. They are far from it. Because if you read the basic statistics, these accusations should not have arisen at all. It is not just expenditure that has gone up, savings have gone up. In 1988-89, individual savings in POSB were $5,700. But in 1993, which was not touched and put across by the political parties, it went up to $8,300, an increase of 46%. In 1988, individual savings in CPF were $61,300. By 1993, it was $84,800, an increase of 38%. All these figures show we can spend more, enjoy better life because we have earned more income, partly because we have worked hard and our earning power has also increased. I can also give another example of how Singaporeans have used higher income to enjoy better quality goods. The statistics show that more Singaporeans today are keen to purchase bigger houses. From 1988 to 1993, the number of people who lived in 3-room flats went down by 29,100. In the same period, 71,300 more of 4-room and 5-room units were purchased. This shows that monthly payments to the Town Councils, electricity or monthly expenditure for bigger houses had also gone up. And this increase is of our own choice because we want bigger homes. Within the same period, although the cost of electricity has gone down by 7.5%, Singaporeans spent, on average, 15% more on electricity.”
“The SDP used it as an issue again this year and there is no doubt that it is intentional because of the impending elections. The fact that it is raised once again is not an issue but it is raised to create confusion and anxiety. If we look at the Household Expenditure Report 1993, it clearly shows that inflation had actually gone up 14%, but most Singaporeans had spent 76% higher than previous years, ie, between 1983 and 1988. What actually happened was that most families and individuals who are working today have higher incomes and therefore they have bought bigger houses, higher quality imported fruits, and so on. In other words, more Singaporeans, in recent years, have been enjoying their lives. They have higher incomes which they feel could be used for enjoyment and to lead a more comfortable life. Also, because more Singaporeans are now working harder, they want to spend more. But the increase in expenditure can only come about because of higher income and not because of higher cost of living, as has been made out by the SDP and PKMS report. I refer to the statistics issued by the Statistics Department which show that household income in Singapore, on average, was $2,190 a month in 1988 and this has risen by 63% to $3,564. In the same period, family expenditure in Singapore went up from $1,500 to $2,600. And we find, on the whole, income went up $1,374 in the same period while monthly household expenditure went up $1,100. This shows that there was still a surplus of $235 a month after the increase in expenditure by 76%. At the same time, if we compare the 1988 income and expenditure, there was a saving of $700. And in 1993, after they had spent more, there was still a saving of $922.”
“That is to say, when we reward the best students we should reward not only the first three prizes, but also give some consolation prizes so that more people could be recognized. To have better social cohesiveness, we must first of all have political stability. We must have the best people to be in the Government. Otherwise, we would not be here talking about cost of living. If we look at it calmly and compare the situation in other countries with our way of life in Singapore, whether it is clothing, food, accommodation, or transportation, the basics have already been provided. Now people are talking of living in better houses, travelling in air-conditioned buses, bigger cars, etc. It is because of the sound policies of the Government and the solid support of the people for the Government that Singapore has been successful. I urge the people to cooperate with the Government to make Singapore an even better place to live in. I support the motion. 1.25 pm Encik Mohamad Maidin B P M( In Malay): Mr Speaker, I take part in this debate with a bit of disappointment because this issue is coming back for discussion now. The show started from accusations by the Singapore Democratic Party. But, unfortunately they are not represented here today. It was designed by the leaders of the SDP to mislead Singaporeans and that we have to reconvene the Committee to review the matter and satisfy some Singaporeans who had been misled by these accusations. If we look at the Report of the Cost Review Committee we will find that the accusations were not only untrue but were also made with the intention to mislead and create anxiety among Singaporeans. The Report of the Household Expenditure Survey was conducted in 1993.”
“I encourage grassroots leaders and the officers of various Government departments to spend some time in studying this Report. If possible, they should explain the contents of this Report to the ordinary folks so that the people of Singapore would have a better understanding of issues relating to our cost of living, Consumer Price Index, inflation, etc, so that they would not be unduly worried about the rising cost of living. Finally, I would urge the Government to do three things. Firstly, create employment opportunities so that we have a full-employment situation. Only if we have a full employment situation can we talk about raising our income level. With that, we can ask for a better quality of life, bigger houses, etc. Eventually, what we should do is that we must maintain our competitiveness. We must have good job opportunities and full employment for everybody. Secondly, as raised by Mr Loh Meng See just now, enhance our social cohesiveness. We must reward the able but we should also provide training and education to the less-able in order to narrow the gap between the rich and the poor so that everybody would have the opportunity to participate in the progress of our nation. We have now a very transparent system in Singapore. Everybody has a chance to participate. As we know, some of our Cabinet Ministers come from ordinary families. So any Singaporean who is willing to work hard will have the opportunity to become an MP or even a Cabinet Minister if they are successful in their endeavours. Those who have made it should not be too proud or extravagant in their spending. They should try their best to help those who are less successful and the less privileged.”
“It will also cause them much mental strain. This Report has also recommended the formation of cooperatives so that professionals could group together and build houses for themselves, thereby helping to stabilize the property prices. Just now, Mr Loh Meng See mentioned about Medisave and the problem of the aged. Personally, I know that the Ministry and the GPC for Community Development have often discussed the problem of our aging population. I can say that the Government has many schemes to help our senior citizens. One of these is Medisave and MediShield which are the safety nets for our health care. Why is it that our people still do not fully comprehend the concepts of these safety nets? We should have more publicity on these facilities to educate and explain to our people. Often it is not easy to explain and let our people, particularly the older people, understand these benefits available to them. I would suggest to the Government that we should have better education programmes on these medical benefit schemes for our people so that all these efforts by the various Government agencies could be fully understood by the people. Another point that I would like to raise here is that apart from explaining the schemes to the people on the receiving end, we should also provide more training to the civil servants who are responsible for the implementation of these schemes. It is now a consumer's society. Each Ministry should set up a Customer Services Department to provide better services to the people who are its customers and to enlighten them on the types of facilities available to them. We should narrow the gap and alleviate any misunderstanding between the people and the Government.”
“It is a fact that commodity prices have increased, particularly in private housing where the margin of increase is very large. Although only those who buy properties are affected by this, everybody is talking about it. In fact, everybody is affected, directly or indirectly, by this increase. Many people feel that if they do not buy now, they may not be able to afford it later on. This Report gives a very clear explanation that there are always the ups and downs in property prices. For example, in the 80s they had gone up very high and by 1985/86, they tumbled down. In 1993/1994, there was again another big jump in property prices, but we know that the property market has now softened. But some opposition parties are trying to incite the people. They link the rise in property prices with the cost of living and cause unnecessary fear among our people. This Report has asked for an assurance from the Government that our people will be able to afford to buy at least a HDB 3-room or 4-room flat. Recently, an opposition party has taken up the point of the Government acquiring land at the nominal price of $1. Of course, the Government has been acquiring land, but it is offering compensation based on market prices. The Government has given this guarantee that they will value the land according to market prices. So I do not think we need to worry about it. Many people want to live more comfortably and they claim that they are purchasing bigger houses or flats as a form of investment. By so doing, they have to take up bigger loans. Some young people who have just started working are known to have taken up loans amounting to hundreds of thousands of dollars or even as much as a million dollars. As a result, they will have less cash available at their disposal.”
“Our tertiary students have increased from 39,000 to about 85,000 in each cohort. Our children have better opportunities to receive tertiary education. More students are going to polytechnics and universities than 10 years ago. This, of course, will increase the household expenditure of the parents. I suggest that we accept the recommendation of the Report. For those families whose income is between $2,000 and $3,000, although they are not considered to be low income, I think we should also extend the grant of the bursaries or educational loans to them as well, because education is a long term investment and not a consumption item. As for the pre-primary children, the expenditure is also higher because, as I said, the demands are different now. In the past, our children did not go to kindergartens. Nowadays, it has become a necessity for children to go to kindergartens, and even pre-kindergarten nursery classes. In fact, 99% of children in Singapore go to kindergartens and the fee is about $30 to $40. If you have two children, it comes up to $80 a month, not forgetting that their pocket allowances have also increased. We try to give our children more chances of learning, for example, singing classes, art classes, dancing, piano, computer, Internet, etc. Every parent has this aspiration of letting their children learn as much as possible. There is nothing wrong with it. The other day when I was presenting bursary awards to my constituents, I was asked, apart from helping the children to pay for their school fees, whether we are considering subsidising their tuition fee as well. To many parents, tuition has become a necessity now. Another matter that has been worrying us is the commodity prices.”
“But if you eat in a coffeeshop, two eggs will cost you no less than $1. A breakfast in a coffeeshop will cost you at least $2. But if you have your breakfast at home, the same food would cost you not more than $1. But I do understand that now, with both husband and wife working, they may not have the time to cook their own meals. But whenever possible, we should try to do our own cooking and eat at home. This will help to reduce our household expenditure. This Report recommended that the hawkers should form some sort of cooperative to increase their productivity, to improve their manner of operation, and pass the benefits derived therefrom to the working couples. A friend of mine operates a store in the market by selling clothes to housewives and people who frequent the wet market. She told me that nowadays her stocks consist of mostly imported dresses from Hong Kong, Taiwan, and even the United Kingdom and other European countries. Nobody wants to buy locally-made clothes. I wish to stress that this is a market store in a housing estate, not a boutique in downtown Orchard Road. Our people are now very discerning about our clothes. I notice that cosmetics are now a lot more expensive than before. But people are using them liberally. The senior citizens in my constituency are all putting on make-ups when they come to our functions at the community centres. They are spending a lot on cosmetics! The Government has spent a lot in building schools, colleges, polytechnics. and it offers various forms of subsidies, scholarships, merit awards and bursaries. We notice that many other countries are now reducing their expenditure on education because their governments cannot afford it. But in Singapore we are spending more on education.”
“Now, according to NTUC Fairprice Supermarket, more than 90% of our people are buying 100% fragrant rice and not the ordinary white rice. In the past, we used to feed our dogs and cats with leftover food. Nowadays, our dogs and cats are eating special pet food. My hawker friend told me that many people bought pig liver, pork ribs and a host of other good foods to feed their pets at home. At the fruit stall, fruits which are not so fresh or of lower grades will find no takers. Likewise, a fish-seller told me that nowadays people go for only the very fresh and supposedly higher-grade fish and shun the not-so-fresh fish and cheaper species of fish. Our children now go for seedless grapes. They do not want ordinary grapes with seeds. Apart from all these changes in lifestyle, our family structures are also different. Nowadays, when young people get married, they do not want to stay with their parents. They want to live by themselves and because of this, they would have to set up their own homes. They have to do their own cooking. They have to employ a maid to look after their children. These will inevitably increase their household expenditure. When you are living with your parents, you have them to help you with the cooking or the washing. Of course, I am not saying that we should treat our parents as servants but we can surely have someone to share in our household chores. This would make our living more comfortable, and incur less expenditure. Now, many women folks are working. 50% of the married women in Singapore are working. Accordingly, more families are eating out. Take, breakfast, for example. For breakfast, if we eat at home, an egg will cost you about 15 cents. If you eat two eggs, they are only 30 cents.”
“This Committee has collated the views from various quarters on the various elements of daily lives, such as clothing, food, housing and transportation. The conclusion is that our cost of living has indeed risen over the past few years, but the margin is low and it is well under control. What is the reason for the rise in the cost of living? Why is it that people are still worried about it? According to reflections by some of our grassroots leaders, most people do not understand that because of changes in their lifestyles and expectations, and because we want to buy better goods, use better services, receive better medical care, we incur higher expenditures, hence higher cost of living. We want to upgrade our flats, we want to have more rooms! We want to live more comfortably, and this will surely mean paying more for it. Worse, some people are speculating on properties resulting in the escalation of property prices, and people link the soaring property prices to the cost of living. Mr Speaker, Sir, let me give you an example. From 1987/1988 to 1992/1993, within this five-year period, the average household expenditure increased by 76%. This is a fact. Let me round up the figures. The average household expenditure was raised from $1,500 to about $2,600, an increase of $1,100. But in this increase of $1,100, the actual increase in property prices is about $200, ie, about 14% of the CPI. As for the other $900, the rise was because of changes in our lifestyle. So if we go home and write down on a sheet of paper what we were using five years ago and what we are using now, we would be convinced that the rise in cost of living was, to a large extent, due to changes in our lifestyle. In the past, our people were quite contented to consume ordinary white rice.”
“If Singaporeans know how to differentiate between the right from wrong and the good from evil, Singapore will remain successful because we all make it so. Sir, I beg to move. Question proposed. Mrs Yu-Foo Yee Shoon (Yuhua)( In Mandarin): Mr Speaker, Sir, of late, much has been said about the rise in the cost of living. Is it true that our rising cost of living has become a problem to the people of Singapore? How serious is the problem? On the other hand, why is it that the Consumer Price Index (CPI) in Singapore is only rising rather gradually? For example, in 1993, it was only 2.2%. In 1994, it was 3.1%. In 1995, it was 1.7%. At the same time, the Singapore dollar has been very strong. In 1993, the conversion rate was US$1 to S$1.50. Now it is US$1 to just only S$1.40. Because of this, we are in a better position to purchase imported goods. This is a fact well known to people around the world. Yet, many people simply refuse to acknowledge this fact. What is Consumer Price Index? What is cost of living, and what is inflation? Most people do not fully understand these issues. Now, at least, we have a very scientific and systematic paper in the form of the Cost Review Committee Report to explain these issues to the people in a down-to-earth approach. This report very clearly explains what is cost of living, how it has been rising and what are the reasons for the rise in our cost of living. At the same time, this Report has also made some very constructive recommendations. If we can spend some time to read this Report objectively and to share the contents therein with our family members and friends, this would certainly help to alleviate our worries and concern about the rise in cost of living.”
“Those with the right skills and talents will be better off. The challenge for us is to ensure that Singaporeans continue to have good jobs and good salaries. We have to learn to be self-reliant and to live within our means. We have to recognise that life is full of ups and downs. There will be good years and not so good years. We should not envy others who are better off than us. The cost of living issues raised by the opposition parties are out to divide our people. They fan the emotions of our people. They play up the weak nature of people, to be envious of others. This will break down the social fabric of our society. This will work against our national interest and objective in making our people work together, be united and live in peace and harmony. For those Singaporeans who are well off, they should not flaunt their wealth. The wealthy should not be so arrogant as to look down upon the poor, weak and helpless. The rich must help the poor and the strong for the weak. This makes for a compassionate and gracious society. We must keep the trust between our leaders and our citizens. As we move into the new millennium, there are many countries in the region wanting to catch up with Singapore. If we were to let down our guard and go for soft options, we do so at our own peril, then we deserve the bad consequences. Sir, I have faith in the Singaporean. We are a small country but a rich people seeking justice and righteousness, both in spirit and in truth. I have no doubt that together we can overcome the external forces, provided we do not allow the internal enemy to break us and cause our downfall. Otherwise, we do not even stand a chance against the external competition and overcome them.”
“" The HDB should seriously consider how a reverse mortgage scheme could be implemented to help the elderly who are in need without jeopardising the virtues and values of the strong traditional family-support system. The cooperative movement based on the principles of thrift and self-help has worked successfully in Singapore. The cooperative spirit should be extended to areas that can provide tangible benefits to Singaporeans. I support the CRC's call to the Government to facilitate the setting up of housing cooperatives to build private properties at lower cost and pass back the savings to the buyers who are members of the cooperative. In preparing for the aging population, the NTUC has mooted the idea of building retirement villages within HDB housing estates so that the elderly can continue to stay in the community. The retirement village is good for those who choose and can afford to live in these retirement villages. Sir, for the less fortunate elderly, I wish to suggest that the HDB redesign and reconfigure the present 1-room rental flats provided for aged singles. We should make more economical use of the space and reduce the need of building more nursing homes in the future. At certain floors of HDB blocks, common facilities can be provided. We can encourage voluntary welfare organisations to adopt and provide services to the frail and the aged to live independently in these dormitory-type accommodation. It is not only the money that matters but also the physical help and the ability to socialise with others are as much needed by this growing segment of our population. As Singapore continues to progress and grow, more and more Singaporeans will enjoy the fruits of the country's success. Unfortunately, the rewards are not evenly distributed.”
“More publicity should be given to encourage Singaporeans to use the medical facilities at Alexandra Hospital which is relatively cheaper compared to the other restructured hospitals like SGH and NUH. It would appear that the opt-in system for MediShield coverage for dependent children did not work. Generally, healthy people pay little heed to the need to sign up for medical insurance until it is too late. As the response to MediShield protection for dependent children is poor, with only 25% being covered, the Health Ministry should change the opt-in system to an opt-out system for the benefit of our young children and their families. I share the concern of the CRC that a quarter of the elderly Singaporeans over 60 years old have opted out of MediShield coverage when one would have thought that they need the insurance coverage most. This matter needs closer study by the Health Ministry to entice the elderly to cover themselves under MediShield which is actually good for them. The financial burden can be very heavy when stricken with a catastrophic illness. I wonder if this is related to their inability to use CPF savings to pay for MediShield premium when they are retired and no longer contributing to CPF. The suggestion of the CRC to work out a personal MediShield endowment account to keep the MediShield insurance coverage alive is an interesting one. Sir, on 13th January 1994, when moving the motion of thanks to the President for his Speech to Parliament, I had raised the subject of reverse mortgage to help the elderly in their living expenses. The CRC has recommended, "that reverse mortgages be made available to the elderly to benefit from the rise in the property values over the years.”
“As Chairman of GPC for Health, I am naturally interested in the findings and recommendations of the CRC on health care issues. As we discuss the cost issues on health care, it is important for us to recognise and acknowledge that Singapore has one of the best health care systems in the world. Even then, we should not stop in making further improvements. Perhaps, we can now fine-tune our health care delivery system so that individual Singaporeans can be given the best possible care befitting his individual circumstances and medical conditions. The Health Ministry has recently pledged to intensify the efforts on financial counselling to patients on admission to hospitals. The Ministry has also agreed to remove all unnecessary red-tapes that may cause inconvenience to the patients and their families. This firm commitment and action would lead to even better quality service in the public hospitals and Government polyclinics. Sir, there are some patients, because of their chronic conditions, can ill-afford to pay cash of a couple of hundreds of dollars a month for their long-term medications. I join the CRC in urging the Health Ministry to extend the use of Medisave savings for some outpatient medical tests and treatment that are necessary to maintain the health status of patients, particularly elderly patients, and to prevent complications. Recently, I visited the Alexandra Hospital. I am very impressed by the excellent facilities provided at that Government hospital. Alexandra Hospital has very good subsidised B2 and C class wards to look after the elderly patients. They have the Geriatric Centre to cater to the special medical conditions and needs of the elderly patients.”
“Having raised the issues, he is not interested in seeing them through to their logical conclusions. The CRC has been steadfast in its work. It did not set out to work for the sake of the opposition parties. The members used their time and expertise in the interest of Singapore and Singaporeans. For the SDP and PKMS to allege that the cost of living represented by the Consumer Price Index was hidden from the public through a "statistical massage of numbers" was a grave affront to all Members of Parliament. Every year, Parliament debates the Government budget of expenditure. Are they suggesting that we MPs are being misled? And worse still, Parliament is insinuated as perpetuating the misrepresentation of official statistics. I wonder what the Opposition Members of Parliament have got to say of these accusations. I am glad that the CRC in making its independent and objective evaluation has once again re-affirmed the integrity of Singapore's statistical system and the consistency and soundness of the Consumer Price Index. The MP for Hougang, Mr Low Thia Khiang, has chosen to stay away from this year's CRC deliberations. I think Mr Low wanted to avoid having to agree with the findings of the CRC. He would not want to be put in the awkward position as an Opposition MP. Nevertheless, at the Select Committee on Health Care Subsidy of Government Polyclinics and Public Hospitals, Mr Low had praised the work of the Auditor-General. After reading the CRC Report, would Mr Low also commend the work of the Chief Statistician this time? Perhaps Mr Low would like to give his view to this House on the work of the Chief Statistician and the Department of Statistics.”
“Mr Speaker, Sir, I beg to move, *That this House endorses the conclusions of the Cost Review Committee contained in Misc 4 of 1996, and calls on the Government to accept the recommendations to contain rises in the cost of living and to assist the poor and the elderly. Sir, the Cost Review Committee has done very good work. The findings and recommendations contained in the CRC Report are comprehensive, straightforward and down-to-earth. The Committee was represented by academics, businessmen, journalists and trade unionists. They were ably supported by the officials of different Government Ministries. The task of the CRC was not easy. They had the most unpleasant meeting with the Singapore Democratic Party (SDP) and Pertubuhan Kebangsaan Melayu Singapura (PKMS). The meeting was marred by bad manners, hostile attitudes and irresponsible behaviour displayed by the two opposition parties. Fortunately, the CRC meetings with the other organisations, like the Consumers Association of Singapore, Emporium Holdings and NTUC Fairprice were more sober and fruitful. It was obvious that Dr Chee Soon Juan and his group were out to confuse and mislead the public with distortions. Dr Chee has the habit of making wild and unfounded allegations. He would bring up isolated cases and personal anecdotes and treat them as though they are rampant in Singapore. He should know better that one swallow does not make a summer. It is true that prices and costs have risen but the increases were by no means "phenomenal" as exaggerated by SDP and PKMS. The vast majority of Singaporeans are enjoying higher standards of living and better lifestyles than before. Dr Chee is not known to see issues in perspective and in the context of the overall environment.”
“SDP should be asked: how is it that with the four representors each did not know what the other is doing? Mr Ling How Doong and the SDP have mocked the honour and integrity of Parliament. Their intentions have all along been sinister. I join the Minister to express my displeasure for their inexcusable acts in misleading Parliament and the public on the important issue of health care subsidy. We should not allow again precious resources of the state to be used to look into such frivolous and wild allegations. The resources could have been used to help more patients for which the SDP claimed they were championing but obviously they do not.”
“Dr Chee Soon Juan, when asked for the first time on 15th July 1996 the source of his data on Government health expenditure which plunged from 27% in 1989 to 5% in 1990, said he was not sure of the source of his information. Dr Chee subsequently told the Committee on 12th August 1996 that he had the copy of the Asian Survey article with him on 15th July. But later he changed his position to say that he had a copy with him, but it was in his files at home. Having personally observed his actions and listening to what he said, I could not help but to conclude that he was not telling the truth. Mr Wong Hong Toy said he was the one who calculated the figure of 25%. It became clear that it should have been in Dr Chee's book "Dare to Change" published in 1994. I saw quite clearly Mr Wong's reaction when Mr Kwan Yue Keng mentioned about seeing the chart in Dr Chee's book without prompting. Mr Wong's body language suggested that Mr Kwan has let the cat out of the bag. Mr Wong clearly understood English and really did not need an interpreter but used this as an excuse for not correcting the figure in the chart purported to be calculated by him. Mr S. Kunalen calls himself the Head of Research but did no research. It showed to Singaporeans to beware of someone who inflates his status for which he is not. In reply to my query in the Select Committee, Dr Aline Wong, who is a University Professor, said she would give the research paper a "Fail" mark even for the first degree undergraduate paper, let alone a Ph.D thesis. The SDP is made up of a group of disparate people. There is no teamwork. Singaporeans should be forewarned if the SDP ever says they are putting up a team in a GRC for elections.”
“It started with below cost subsidy and not below market subsidy, and finally, subsidy refers only "when it is a first party's money expended on a third party ... the use of taxpayers' money is not subsidy". At the first Select Committee sitting on 8th July 1996, Mr Ling conceded that there were "market rate" subsidies, agreeing that the Government hospital fees were lower than that of the private hospitals. He also agreed that the subsidy was "substantial". On 2nd August 1996, Mr Ling again conceded this time that "cost subsidy" exists, and that the Government hospital and polyclinic fees were charged below cost. Having conceded that there were below market and below cost subsidies, Mr Ling must explain why he chose to come up with the nebulous and extraordinary definition that "when people's money is being used for the benefit of the people, it is not subsidy". It is important that Mr Ling clarify this, as I am sure the constituents of Bukit Gombak will wonder whether the terms he uses in the Bukit Gombak Town Council are any different from those used by the other Town Councils in Nee Soon Central, Potong Pasir, Hougang or the PAP Town Councils. Sir, the other beneficial outcome of the work of the Select Committee was we got to know Dr Chee Soon Juan and the other officials of the SDP in greater depth. We know from experience that there are individuals who are very impressive when we meet them for the first time on short encounters. We only know their character and true colours in subsequent longer meetings. When we engage them in serious discussions and debate, we know whether they are consistent and honourable men of principles. Fortunately for us, the Singaporean public did not learn too late.”
“Mr Speaker, Sir, I rise to support the motion standing in the name of the Minister for Health. Sir, you chaired the Select Committee on the Verification of Health Care Subsidy of Government Polyclinics and Public Hospitals. We had a number of very long sessions. We heard several representors including that from the Singapore Democratic Party. In retrospect, the work of the Select Committee is not without beneficial outcomes. The SDP had wanted to "hold the Government accountable to the people for its claims on the health care subsidies". They accused the Government of "a pattern of overcharging, of overstating its charges". They had cast serious aspersions against the integrity of the civil service. However, Mr Ling and the SDP forgot the dictum that those who live in glass houses do not throw stones. The allegations of Mr Ling and the SDP could not stand. Instead, the Ministry of Health officials have proven once again that they could be relied upon to administer Government policies effectively and judiciously. The Health officials are thoroughly professional in their work, ready and able to withstand public scrutiny any time. I am glad that the Government has lived up to its promise to the people of Singapore that health care will always remain affordable, especially for the lower income groups. The Medisave, MediShield and Medifund Schemes are available to help Singaporeans who are in need of financial assistance for medical treatment. What was noteworthy were the confusing and contradictory views expressed by Mr Ling How Doong at the sittings of the Select Committee. There appears to be one Mr Ling in the Select Committee and a different Mr Ling outside when speaking to the press. Even his understanding and definition of the term "subsidy" was changed over time.”
“Sir, while the Ministry is reviewing the legislation for beauticians, maybe they should also consider those slimming centres if there are any instances whereby they should be looked into.”
“We are discerning enough to appreciate the importance of the involvement of family members prior to making the decision to sign the AMD. We recognise that any serious sickness of a family member affects everyone in the family. Sir, there are two areas which I hope the Ministry will be vigilant and will monitor the situation closely. For the country's psychological defence, our people must be inculcated with a strong will to face any crisis and be prepared to fight to save dear lives for the sake of family and country. There should not be any let-up in maintaining the high threshold of pain of our people to compete and in achieving better quality of life for our citizens. Any attempt to coerce the elderly patient to sign the AMD which is illegal should be acted upon quickly to nip the problem in the bud. I hope that with this AMD, a step forward is taken to forge the doctor-patient relationship and the concept of the family doctor will be an established practice in Singapore. Sir, I support the Bill.”
“Sir, I wish to commend the Minister for Health and his Ministry officials for the painstaking effort in bringing this Advance Medical Directive Bill through the various stages of consultation. For a subject as important as this, the process of consultation and feedback has been worthwhile. The National Medical Ethics Committee did very good work. The views and comments of the various professional bodies and religious organisations were considered and incorporated into the Bill. By committing the AMD Bill to a Select Committee, it allowed for further opportunity to the members of the public to submit their views. The AMD Bill was further amended. It shows that the Government listens to good and constructive suggestions. I am satisfied that we have done all we could in giving legal effect for advance directive to medical practitioners against artificial prolongation of the dying process. The terminally ill patients are allowed to die peacefully and with dignity. I accept the Minister's view that the AMD will in fact make euthanasia less likely as it removes the ambiguity in the medical care of the terminally-ill patients. In the United States, two federal appeal courts recently lifted bans on physician-assisted suicide. This has led to the tormenting question in the minds of the Americans as to whether the right to die has become a duty to die. We are clear that we are not heading this treacherous route. We will not be subjecting our citizens with this tormenting question. Singaporeans, especially the elderly sick, need not feel that they better choose a quick death because they impose financial and emotional burden on their families and society. I am pleased that the assertion of patient autonomy has been moderated.”
“Sir, MediShield coverage has been a boon to Singaporeans. Many have been helped in the payment of hospitalisation bills. Singaporeans' life expectancy will reach closer to 80 years old in the future. The current age limit for MediShield coverage stands at 70 years old. It leaves a number of years uncovered. Statistically, about 80% of medical bills are incurred in the penultimate years of one's life. Is the Minister able to consider extending the MediShield coverage to 75 years old?”
“Sir, more and more Singaporean companies are expanding into the region. Therefore, we can see more and more Singaporeans working overseas. While travelling and working overseas Singaporeans sometimes do fall ill and have to be hospitalised. May I ask the Minister if there is a plan to gradually allow Medisave to be used in emergency cases when Singaporeans have to be hospitalised while overseas? Sir, the Government's White Paper on Affordable Healthcare stated that there will be a balance billing measure for patients using Medisave for payment of private hospital medical bills. May I ask the Minister what progress is being made to implement this measure? Sir, can I move on to my next subject?”
“From my understanding, the response to the setting up of an Acupuncture Research Institute is very good and the waiting list for treatment runs into months. I therefore suggest that the Ministry of Health work hand in hand with the Chinese medical associations in Singapore to set up another Acupuncture and Research Institute in Singapore. I would like to also ask the Ministry to set up another Institute on cancer treatment. I do not know whether this plan has already been implemented, and what is the response. I feel that the scheme to set up this kind of research centre will be good for the development of Chinese traditional medicine in Singapore.”
“Sir, in the area of traditional Chinese medicine (TCM), I am happy that the Acupuncture Research Clinic has been successfully set up. Sir, since the report by the Committee of TCM, October 1995, we have not heard very much of the progress made on the training and regulation of TCM practitioners. I want to know from the Minister whether he feels that the TCM practitioners are able to work together to organise and regulate themselves. Or does he see the necessity of the Ministry offering a guiding hand to lay the ground rules for compliance? In Dr Aline Wong's Report, there was a recommendation to allow the entry of qualified TCM practitioners from reputable overseas centres. I would like to ask the Minister whether there are any actions taken in this regard. Mr Peh Chin Hua( In Mandarin): Sir, I am also going to speak about the practice of Chinese medicine. With the opening up and economic reform in China, traditional Chinese medicine has matured over the past few years. The practice of Chinese medicine has become more scientific and a lot of improvements have been made. Recently, the Ministry of Health published a report on Chinese medicine. I think all the Chinese medical associations and individuals who are interested in Chinese medicine had supported the recommendations of the Report. I feel that the Ministry of Health can start thinking about setting up departments in the major hospitals in Singapore to practise traditional Chinese medicine, including massage, Chinese herbal treatment, and acupuncture, in order to provide better health care to our people. Under the regulation and guidance of the Ministry of Health, Chinese physicians can be invited from overseas to practise here.”
“Sir, on the subject of home nursing, one way to save medical cost, especially for the elderly patients, is to ensure that they do not stay in the hospital longer than necessary. It is better that they could be kept at home in a home environment. But the problem is that many of the children of these elderly patients are working and they have their own children to look after. So they need support from the community. The Home Nursing Foundation has done a good job but the problem is that there will be more and more elderly people requiring such home-help. So may I ask the Minister what measures are taken to strengthen this area of home nursing service and are we ready to encourage more home nursing for the elderly patients?”
“Sir, as our population ages, weak and frail elderly will be a common sight. Many may suffer from stroke and other diseases associated with old age. The Government has built and supported more community hospitals and nursing homes. The polyclinics currently cover a wide geographical area. May I ask the Minister whether it is feasible for the Government to go one step further to build neighbourhood health care centres? It will maximise resources and facilities and manpower. By providing neighbourhood medical facilities, it would make it convenient for the elderly to use the facilities closer to their residence. We may be able to attract grassroots volunteers to help in the rehabilitation work to speed up the recovery of the elderly patients. Sir, I am thinking of this along the lines of the Neighbourhood Police Post where neighbourhood health centres can complement the regional polyclinics. Would the Ministry consider this in the future plans for the healthcare of an ageing population?”
“A year ago the Managed Healthcare Scheme was offered as the longer term solution. By converting from the fee-for-service to the prepaid system, the Managed Healthcare Scheme is a good mechanism to make primary healthcare affordable. The capitation system and the gatekeeping function of the GPs help to cut down unnecessary specialist costs. Can the Minister indicate what will be the Ministry's position on this and whether he would like to give encouragement to more Singaporeans signing up for the NTUC Income Managed Healthcare scheme? Sir, there is public concern arising from the acquisition of Mount Elizabeth and EastShore Hospitals by the Parkway Holdings Group. They are now the largest and dominant player in the private sector healthcare industry. Will the Minister be able to assure Singaporeans that this development will not have adverse cost impact on patients receiving treatment at the restructured and Government hospitals? Regional medical centres are also being set up and promoted in neighbouring countries. These overseas medical centres will pose a threat to Singapore's position as the Regional Medical Centre of Excellence. Moreover, if the comparative cost advantage enjoyed by Singapore is further eroded, we may even see Singaporeans going to these overseas medical centres for treatment. There may be a drain on our medical talent and foreign exchange. What steps are being taken to maintain our leading edge as a Regional Medical Hub? Perhaps the Minister can comment on this. Sir, can I move on to the next cut?”
“Sir, I beg to move, That the total sum to be allocated for Head P of the Main Estimates be reduced by $100. Sir, in the Economic Survey of Singapore 1995, it is reported that Private Consumption Expenditure on Medical Services was $2.5 billion in 1994 and $2.7 billion in 1995, an increase of 8.1%. On the other hand, the Government's operating expenditure on health was $725 million in 1994 and $685 million in 1995, a reduction of $40 million or 5.5%. By adding the private and Government expenditure, the total sum was $3.23 billion in 1994 and $3.4 billion in 1995, an overall increase of 5%. In the analysis of the Consumer Price Index on Healthcare cost, it showed a modest increase of 1.6% in 1995 compared to 3.1% increase in 1994. It is explained that much of the increase was attributable to higher Government medical fees and dental treatment charges. Sir, the question that comes to mind is that, instead of a reduction, if the Government's operating expenditure was kept at the 1994 level, the cost to the public would be lesser. Perhaps the Minister can explain this and give his comment. There is a substantial shortage of manpower in the Government healthcare sector. If we add to the woes of the private sector hospitals and restructured hospitals, the manpower shortage is perhaps worse. With the opening of the new Changi Hospital, NUH Phase III development, the new Kandang Kerbau Hospital, Tan Tock Seng Hospital, more medical and nursing manpower will be required. The manpower shortage will affect quality service delivery. May I ask the Minister what steps are being taken to improve this manpower situation. The Singapore Medical Association recently announced the proposed fee increases for GPs and private specialists.”
“Presumably, there is better recognition for work performance in the specialised area and better promotion prospects in the autonomous agencies. With operating expenditures classified into running costs and transfers, the autonomous agencies will be able to use temporary help and out-sourcing the work if they are found to be cost effective to do so. It helps keep the Government expenditure down to economical level. Sir, my concern is whether the Government will continue to provide subsidies in public services already enjoyed by the public, especially the elderly Singaporeans. I hope the public will not be made to bear the true cost of services provided as income taxes have already been paid for them. Also, in the areas where there is possible direct competition with the private sector, will it cause the prices of such services to go up higher in the future at the expense of the members of the public? Sir, for the rest of the Budget, I have nothing more to add because it has been too generous for me to comment further. ADJOURNMENT OF DEBATE Resolved, That the debate be now adjourned. - [Mr Wong Kan Seng].”
“Sir, the Minister for Finance has explained quite convincingly of the need to price factors of production correctly to avoid wastefulness and over consumption. Therefore, the price of services like electricity has to be adjusted to reflect the true cost of production. I hope the Government will apply the same principles when paying compensation to property owners whose land has been acquired or will be acquired. The Government ought to compensate based on the up-to-date true replacement cost to lighten the burden of property owners who have to bear the cost of relocation to an alternative site. There is a similar risk that when land is acquired cheaply there is not the urgency to utilise the site, as seen in many land and properties left vacant and unused for many months after acquisition. I think the matter will be quite pressing when land is being acquired for the North-East MRT line. Sir, the Government has initiated reforms to the civil service to provide higher quality service at lower cost. This is done by giving civil servants more autonomy and be result-oriented. I support this pro-active attitude of the Government. This means that the whole corporate culture of the civil service will change. The faceless, cold efficiency of the past will be replaced by a more human face, and it will be communicative and responsive to the public needs. The civil servants are likely to project their individual personality in their work. I wish to ask the Minister if there is going to be a change in the tenure of employment of the civil servants in the autonomous agencies. In the nature of operations, civil servants are encouraged to carve a niche in their careers in the autonomous agencies.”
“Mr Deputy Speaker, Sir, Singapore faced the last economic recession in 1985. The recession prior to that was in 1975. If there was a belief of a 10-year economic cycle, there would have been one in 1995. But it did not happen. Instead, our economy grew steadily over the last 10 years with unusually high growth averaging 9.8% in the last three years. We succeeded because we learnt our lessons well from the 1985 recession. The measures taken then allowed us to take full advantage of the strong regional growth in recent years. What makes it all the more impressive is the successful operation of the flexible wage system tied to the economic growth. Inflation was also kept low. Unlike other countries that are having unemployment, we were able to create 105,900 jobs and the year before that, 70,000 jobs. Singaporeans should count their blessings in being able to find work after graduation and on leaving school. Even the Japanese today will envy us in our ability to provide jobs for our school leavers. Sir, the challenge facing Singapore in the next 10 years is not likely to be a recession but from the very intense global competition which we will ever encounter since independence. There is a need to re-visit the Singapore economy, its structure and directions. The technology and trade environment have changed radically, especially over the last few years. I am not sure whether all sectors of our economy have the same understanding and working in unison to ensure our success in this new competitive environment. I would suggest to the Government to revive the Economic Committee. With the participation of the public and private sectors and the trade union movement, we should be able to forge consensus as to where and how our economy should be heading.”
“Do our civil servants embark on an intensive campaign to bring in the numbers? The form and manner of public education programmes should be handled sensitively with the view to prepare our people and facilitating the process in decision-making. We only need to help Singaporeans make up their minds to decide with confidence and be comfortable in the decision that will be best for themselves and their families. Sir, I am happy to support the Bill and for it to be committed to a Select Committee. I support the principle and spirit behind the AMD, but I hope that we would recognise the possible pitfalls and find ways to overcome the negative effects, if any, of AMD. 2.30 pm”
“The other difficulty that I have is that though we have taken the trouble to define terminal illness, we should also try to define what is meant by "mental incompetence". We presume that it is easy to define mental incompetence, but it is important because here the assessment of mental incompetence really triggers the operation of the advance medical directive. So I would suggest that this assessment of mental incompetence be considered carefully because it is only when the two conditions of terminal illness and mental incompetence must come together before the AMD can come into effect. My worry is really the larger question on the long term effect of AMD on our society and whether this will inevitably evolve a new mindset on our people. For example, what would be our attitude towards the elderly in our society, and even what our own elderly will think about themselves? That growing old is being useless and it is better to die than be a burden to the children and grandchildren. If our people lack the will to live on and endure pain and suffering, will it lead us to become a soft people? We know that for us to excel, we often need to overcome the pain threshold to test our limits. I know that we would not allow that to happen, but we must make sure that it will not be allowed to happen. Because without pain and suffering, how are we to know and appreciate the joys and pleasures of the good and healthy lives that we are having? I mean you need the contrast. Without the contrast, it is always difficult to compare. Sir, the other question is, once the Bill is passed, how would the Government measure the success of implementing such a law. Does the Government measure its success by having the majority of adult Singaporeans signing the AMD?”
“Quick decisions have to be made by the doctors who sometimes have no time or opportunity to consult the family members but to attend to the emergency out of necessity. For the patient who has signed the advance medical directive without informing the parents or spouse, one can imagine the shock of the aggrieved parents or spouse who might want to override the AMD already signed. There must be avenues and mechanism available to deal with conflicts of this nature. We know clearly that the law does not allow overriding, but when confronted with a situation of an emergency, it is going to be very difficult for the doctors to handle. I think some mechanism and avenues must be found to anticipate this difficulty in the hospital setting. Though the Minister has explained that revalidation of the AMD is not as good as the provision for revocation, my concern is that we have allowed young adults above the age of 21 years to sign the advance medical directive and they go through different phases of life. They may not remember whether they have signed one or not. I think this question of validity ought to be considered again at the Select Committee and whether a revocation is still a preferred method to revalidation. I am more concerned about the younger adults than anybody else. Sir, the Bill defines quite clearly the nature of terminal illness. But it does not provide the time frame to specify how imminent is imminent. Is it a month, a few days, when? I know it is not easy, but it is difficult for an ordinary person to understand that you are terminally ill but you do not know how long the patient would last and what constitutes terminal illness.”
“I think the remark made by the Minister that a person should not keep it a secret from his family members is a very important point, because on reading the Bill, it actually allows a person to keep mum and not tell anyone. It is the family members who are likely to be affected most when one of its members is afflicted with a critical medical condition and he needs urgent medical attention and treatment. It is important because in Singapore we stress the family to be the building block of our society and nation, and we should not allow the principle of self-determination to be over-exerted. If that is the case, we run the risk of members of the family pulling themselves apart. This would not be healthy because it would upset family cohesion and kinship ties and it may lead to a less united and less strong country. This is something that I hope we will want to emphasise. As much as possible, we should encourage family consultation. Though we are allowed personal autonomy to sign the AMD, family consultation should be encouraged. One thing good that comes out from the AMD legislation would be that it has already created sufficient awareness and our people will be prepared for the eventuality if they have to decide when confronted with a terminally ill condition. It will also help those who may not have made up their minds earlier to decide at the critical stage whether to proceed with extraordinary life-sustaining treatment. Terminal illness not only strikes with a bout of sickness but comes suddenly when met with an unexpected nasty accident. It is tricky for doctors who have to deal with accidents and emergencies.”
“Sir, the main argument for wanting to have legislation on Advance Medical Directive is to remove the uncertainty and to clarify what are permissible and what are not permissible in achieving the high standards of medical practice and to incorporate safeguards against abuse. However, this may introduce rigidity and take away the flexibility and discretion available to doctors in dealing with matters relating to their specialty. As much as the Minister has argued that in fact it has allowed the doctors to handle the situation better, I wish to suggest that there is also the other side because of the very wide spectrum of age group and the diseases and injuries involved. So there is that much you can legislate. There may be other conditions that discretion and flexibility may still be permitted. Sir, the principle of personal autonomy is the basis for advance medical directive. I am afraid that the over-emphasis on this aspect of personal autonomy is something that I am uncomfortable about. It is questioned whether personal autonomy is really a good thing for someone deciding in advance an unknown future medical condition. In the future, there may be the advancement in technology and discovery of new drugs to treat the medical condition which today is deemed to be terminal. I think experience shows that some of the conditions are curable today but 10 to 20 years ago it was not possible. But I am very happy that the Minister has clarified just now that though the personal autonomy allows a person to sign the AMD, he should openly discuss and consult with the family members. This is because on reading the Bill, I have the impression that the person can actually hide the AMD from the next-of-kins and he is not obliged to discuss it with his family members.”
“Mr Speaker, Sir, I wish to commend the Minister and his Health Ministry officials for their painstaking and unhurried approach in introducing the Advance Medical Directive legislation to Singapore. The Minister has just confirmed that this Bill will be sent to a Select Committee. A lot of work on the Advance Medical Directive has been done by the National Medical Ethics Committee. The Committee has put up an excellent report reflecting the views and incorporating the suggestions of various professional bodies and religious organisations. The Advance Medical Directive Bill before Parliament contains provisions that no right thinking Singaporean can reject outright. This is because no Singaporean is compelled to sign the AMD if he does not wish to do so. It is voluntary and not compulsory. It is an enabling Act, when passed, made available to anyone who wishes to take advantage of it. Yet, as the Minister has alluded to earlier, questions are still being asked as to whether we are too hasty in wanting to pass the law on Advance Medical Directive in Singapore. It has been said that there is no conclusive evidence to show that AMD provides real value and benefits to society. We should instead find improved ways to deal with the problems associated with the care and treatment of terminally ill patients without having to resort to passing the Advance Medical Directive law. Some feel that the present arrangement where the doctor, patient and family members make the decision collectively is better and more helpful in dealing with terminally ill patients. Our doctors are competent and altruistic enough to help decide for the good of the patients and their families.”
“I support the step-by-step approach taken by the Ministry of Health to help as many of the existing practitioners as possible to be trained and qualified for continued practice. This is to ensure that there is no sudden reduction in the number of shops supplying the needs of contact lens users, as otherwise the cost of contact lens may shoot up and this is not in the interest of the consuming public. Contact lenses are also fashion items. Some people use them not to correct vision but, as we have read, to enhance the colour of their eyes. I wonder if it is possible from now on for disposable contact lens to be freely available over the counter in pharmacies and optical shops. From now, are contact lens considered controlled items? Are consumers allowed to self-administer, buying the contact lens on their own and fitting them themselves? Is there a difference between disposable and non-disposable contact lens and those contact lens that correctvision and those that do not? Are they all encompassing? May the Senior Minister of State please clarify the practical difficulties in enforcing the provisions?”
“Mr Speaker, Sir, I rise to support the Bill. Contact lens use became a vogue some 10 years ago when prominent Singaporeans started wearing them. Many young people and those who want to look young and presentable wear contact lens. However, it is not for vanity alone that people wear contact lens. The use of contact lens, instead of spectacles, can help slow down the deterioration rate of poor eyesight. The question we ask is: why do we take so long to register and regulate the standard of contact lens practice? The pair of eyes is a vital organ for all of us. The loss of sight of one eye, according to the Schedule of the Workmen's Compensation Act, is 50% loss of earning capacity. The total loss of sight is treated as total permanent disability and equivalent to 100% loss of earning capacity. This Bill highlights the dangers and risks involved in the fitting of contact lens. And utmost care is needed for both the practitioners and users to prevent injuries and disease to the precious eyes. Sir, so far the situation is under control. As our society becomes more sophisticated, we would expect more users of contact lens. I would envisage that the contact lens market will be a lucrative one in the future. Therefore, the Bill is very timely to ensure that from now on, only trained and qualified people are allowed to set up practice in contact lens. I appreciate the effort put in by the Ministry to balance the interest of public safety and the cost of use of contact lens. Many contact lens wearers are students and young adults. They have become necessary items to individuals who need to wear them for doing certain kinds of work and in occupations that make the wearing of spectacles inappropriate.”
“Mr Speaker, Sir, I beg to differ from Assoc. Prof. Walter Woon's position with regard to the provision of legal aid for criminal cases. It is not wise for the Government to provide legal assistance for criminal cases. I support the position of Dr Arthur Beng. I think our resources are very limited. We should give all the resources available to the civil legal aid cases.”
“Sir, I beg leave to withdraw the amendment. Amendment, by leave, withdrawn.”
“Sir, the other day Mr Ling How Doong had asked for more subsidy to be given to the poor and the unfortunate chronically sick patients. Sir, I thought that such people are already given waivers of medical charges. They do not have to pay a cent if they are "C" class patients, and the Medifund provides for such a purpose. So I do not know what Mr Ling is talking about. I wonder if the Ministry has got any cases referred from him for consideration. The Medifund is accumulating surplus from the first year of operation. In the annual report for the year 1993, the Government gave a start-up grant of $8 million, a total of $5.9 million was disbursed and the total amount approved was in the region of about $4.7 million. Because of the surplus available, can the Government be more generous, if not in the number of applicants, but at least in the amount approved for "B2" ward patients, if the medical bills turn out to be beyond their affordability?”
“Sir, the number of Singaporeans at age 65 and above is growing at a very fast rate. We need to take a total integrated approach in dealing with the problems faced by the aged, namely, the employment, financial security, health and recreational needs and in the areas of social services and institutional care. What steps are taken by the Ministry to ensure that we do not presume that all aged Singaporeans are sick and frail in our society? The Government has to be proactive to see that our aged lead healthy and active lives rather than always to be concerned about their sickness.”
“I would like the Minister to inform the House what is the stand of the Ministry regarding TCM and what concrete step the Ministry is taking to assist the development of TCM and to regulate the practices of TCM. Mr Lau Ping Sum (Ang Mo Kio GRC)( In Mandarin): More than 30 years ago, a well-known writer, Dr Han Suyin, wrote an article on acupuncture. After this article was published, a number of western doctors criticised her views which to them lacked a scientific basis. They thought acupuncture was a kind of "quack" practice. But in the United States today, there are many states where acupuncture is recognised officially as a form of treatment. Dr Wan Soon Bee mentioned that there are a large number of people going for traditional Chinese medicine. I would like to ask the Minister whether there is any plan to set up a research institute or treatment centre for traditional Chinese medicine. We know that acupuncture has some positive effect for certain diseases such as rheumatism, rigidity of the limbs and various pains. It has been proven to be effective in helping to get rid of the smoking habit. I hope we can tie up with experts in China on research in this area. In Singapore, the standard of TCM practice varies considerably for various reasons. For many years, there has been controversy over admission standards, examination standards and the regulation of TCM practice. There are many different views on these matters. I would like to ask the Minister whether any steps have been taken to ensure that we have a uniform standard in the training of Chinese physicians, so that adequate safeguards will be given to our people who go to see them for treatment. 1.45 pm”
“I hope that the Ministry of Health will take note of this so-called Chinese practitioners who came from China on a social visit pass. Sometimes they are found providing treatment on the void decks in the HDB estates. I think the Ministry should look into this matter and take appropriate action to stop this malpractice. Dr Wan Soon Bee (Brickworks GRC): Sir, there are more than 850 Chinese physicians, in fact, some statistics show that it is more than 1,000, 350 TCM clinics, 800 Chinese medicine shops and 30 charitable Chinese medical clinics. In spite of the fact that we have excellent medical services in Singapore, about one-third of Singaporeans have sought TCM treatment. Obviously, TCM is here to stay. With such a large number of Singaporeans using the services of TCM, we cannot continue to ignore it. If TCM is not properly regulated, TCM treatment can give rise to undesirable consequences, either by causing delay of diagnosis and treatment by western trained doctors, or by the TCM treatment itself which is incorrect or inappropriate, thereby giving rise to medical complication. The public is exposed to tremendous risks if such practices are not regulated. I believe TCM has a role to pay. It can complement western medicine. But to-date, the Ministry adopts a very detached stance. It encourages the various TCM associations to amalgamate, set standards and self-regulate. One question we have to ask ourselves is whether the development of TCM is beneficial to Singaporeans. If the answer is yes, then the Government should take a more pro-active role. TCM will not progress much without the active participation of the Government.”
“The various organisations of Chinese medical associations in Singapore also support the Government's call to set up a national coordinating committee on traditional Chinese medicine to hold discussions and dialogue sessions with the Ministry of Health. I hope that in future the Ministry of Health could set up an Eastern and Western medical treatment centre so that the practice of traditional Chinese medicine could complement the western medical practices in promoting better health for our people. With the prosperous development of the Asia-Pacific region, especially the rapid economic reform of China, traditional Chinese medicine will play an even more important role. It is not possible to do away with traditional Chinese medicine. I think we should let Chinese medicine complement western medicine. We should look squarely into the matter and find ways and means to resolve the differences rather than to try and avoid the matter. As pointed out by BG George Yeo, in the course of radiotherapy or chemotherapy, many cancer patients are found to be taking Chinese herbs at the same time. They do not reveal this to the physician or oncologist. This is because some western doctors are sceptical of the effect of Chinese medicine. I am glad that the Ministry of Health will set up a cancer centre and strive to make it a regional centre. I hope that the Ministry of Health will consider setting up a centre for the famous acupuncturists and osteopaths in Chinese medicine and together with western doctors and western medicine jointly set up a chronic disease centre for the benefit of our people in the future. Another point that I would like to raise is what Mr Loh Meng See has mentioned just now.”