Michael Lim Chun Leng
Singapore
“Mr Speaker, Sir, I would like to ask the Minister, in the light of scientific evidence to show that as many as half of the people who are presented with a heart attack at a hospital do not have any critical stenosis or narrowing in the heart artery, but actually only have a very minor narrowing in the heart artery, and as a result of tear…”
“My question is: in the light of things evolving, whether for specific high-risk individuals, we should actually look at other means of identifying them. On the second point about AED, if we reach the A&E for a sudden cardiac death, of course, your mortality is more than 90% because it takes a long time to reach it.”
“Clinical practice guidelines help doctors to manage patients in the most optimal way. They do not help doctors manage patients in a most cost-effective manner. Ultimately, most Singaporeans want to have the cake and eat it. Let us not raise the expectations too high. Let us keep healthcare bills in the public sector affordable.”
“The Ministry had spent millions of dollars on IT cost, man-hours and employing new staff. Yet, till this day, few believe that it has translated to any real tangible improvements in the healthcare delivered to the man-in-the-street.”
“Mr Speaker, Sir, I am getting a bit confused here. I am trying to understand the process. Can I check with the Minister? Does it mean that an operator can seek approval from PTC and PTC, based on a certain set of criteria, has approved the routes or what they are supposed to do, and then the operator can decide not to follow what PTC has…”
“Sir, I would like to ask the Minister how can there be more predictability if one took an express bus from point A and reach point B on the same express bus vis-a-vis someone who has to take a bus to the MRT station, drop off at another MRT station and then take another bus to his destination. How can there be more time predictability?”
The complete record
Every one of 361 lines we hold for Michael Lim Chun Leng, in date order, each linked to its source. Free to read, in full, without an account. Page 4 of 8.
“We will review this growth rate regularly after that. If congestion eases following the expansion of ERP, the Government will release an additional 10,000 plus COEs. My Ministry will further assess the situation after we have implemented phase 2 of the ERP. 1.45 pm Now I come to methods of COE allocation. The Government agrees with the GPC that the market mechanism is the most efficient means for allocation of COEs. COEs should rightly go to those who value the right to own the car the most. Competitive bidding is the best way to achieve this. It also ensures that the scarcity value of COEs accrues to Government and therefore to society as a whole rather than to each individual if we were to use other allocation methods, whether it is queuing, lucky draws, or whatever. How do we know whether the VQS system is efficient? Is it by allocation of COEs? Is it by COE prices? This is what Mr Iswaran wanted to know. Some other Members have mentioned that there is a view, among some people, that the changes are to maintain Government revenue from COEs by ensuring that freak results such as the $50 COE do not recur. Members have asked that we dispel the perception that these changes are to increase Government revenue. Sir, I have said on a number of occasions that the VQS is an instrument to manage traffic. It is not a tax instrument. Although COE revenue has become a significant part of Government revenue, it is not a tax instrument per se. COEs are a scarce commodity and they are a national resource, like land. Having decided that the best way to allocate this scarce resource is through the market mechanism, we must ensure therefore that the bidding system is an efficient one, which sets a fair price for the COEs.”
“If we did so, ERP charges would be many times higher than what it is today. Therefore, maintaining a balance between ownership and usage management measures through VQS and ERP is the most prudent approach to manage our traffic. But the GPC feels that with the Government's ongoing improvements to the public transport system, expansion of road network, greater reliance on the ERP, the allowable vehicle growth rate, which is currently set at 3% per annum, could be reviewed upwards. This is a recommendation which has created some excitement. Sir, the growth rate of 3% was set at the time when the VQS was first introduced, taking into account our long-term road-building programme, our public transport developments as well as developments in traffic management systems. To the extent that these factors have changed since the growth rate was set nine years ago, the GPC's recommendation to review the rate is accepted. The LTA recently carried out such a study/review using its transportation model, and it simulated the impact of a 3% growth rate on the congestion levels of our roads, taking into account the various improvements in public transport, road network as well as the introduction of ERP last year. The study concluded that if the ERP coverage and rates are maintained at today's levels, the congestion level on our road network will worsen significantly over the next five years. However, if we were to implement a more extensive coverage of ERP and, if necessary, higher ERP charges, we can sustain this 3% growth rate, and manage the congestion at localised bottlenecks. To increase the growth rate further at this stage would be unwise. The Government has therefore decided to maintain the 3% growth rate until the year 2005, because we take a 5-year planning horizon.”
“This is a significant vindication and reaffirmation of the system. As the Lianhe Zaobao editorial a few days ago put it, motorists both love and hate the system. They love the system because it works, and when they travel to other cities which are gridlocked, they really appreciate the quota system. But they are not so keen when it comes to paying for COEs. So this love-hate relationship, I think, is going to be a fact of life. But I am heartened because when we first implemented the quota system, I do not think there was any love in sight at all. If anything, it was a hate-hate relationship. Now, people are beginning to appreciate the benefits of the quota system and see the impact and recognise that it works. I think it shows that we are making progress. It demonstrates that Singaporeans do appreciate the need for Government to take tough but necessary measures from time to time to tackle intractable issues such as traffic congestion. Sir, our land constraint, as many Members have heard me say many times in this House, means that the amount of space that we can devote to roads must be limited. The vehicle population grows at 3% per annum compounded, but our land is not growing at 3% per annum. In fact, between 1995 and 2000, we anticipate that our road network will only grow something like 1/2% per annum, in terms of lane kilometres. Already, 12% of our land is set aside for roads, the same amount of land set aside for roads as for housing, 12%. So there is not much room for us to build more roads. We can reclaim at the margins. We can build interchanges, flyovers, even underground roads, but our road capacity will expand at the most by something like 2%. It is not possible to rely solely on the ERP to manage congestion.”
“Last but not least, I felt that it would be good to have a party other than the Ministry conduct the review, so that they can take a fresh look at the issue. I am glad that the GPC has undertaken their task in earnest. I have been following their deliberations and I know that they have actively sought the views of various interested parties as well as members of the public. I understand that almost 100 written representations were received via fax, mail and the Internet. This is excluding the pile of feedback that the Ministry had earlier collected which we dutifully handed over to the GPC Review Committee. They also conducted three dialogue sessions with interest groups, with academics from NUS and NTU, with the Feedback Unit's transport group and also with the general members of the public. They spent a lot of time and effort in arriving at their recommendations, and I would like to place on record in this House my appreciation and thanks to the GPC, especially to its Chairman, Mr Chay Wai Chuen, and to the resource persons for undertaking this important task. Sir, let me now give the Government's response to the recommendations of the GPC. First of all, on the VQS itself. My Ministry agrees with the GPC that the VQS should remain, as it is one of the key pillars of our traffic management strategy. I note that many other Members who have spoken today, Mr Ong Kian Min, Mr Ang Mong Seng, among others, also share this view. The system has allowed us to effectively manage the growth of the vehicle population at a level that can be sustained by our road infrastructure and given the overall constraints of our limited land. I am gratified that almost all who gave feedback to the GPC agreed that the VQS should be retained, despite the introduction of the ERP.”
“When COEs could not be transferred, people decided that they would take the COE, register a car and then transfer the car. So we had to plug that loophole, and we did. From time to time, there have been many other suggestions made to further modify the system. Pay-as-you-bid is a constant refrain. There have also been calls for the Government to prevent dealers from bidding. With the introduction of the ERP, there have also been renewed calls to abolish the VQS, because with the ERP in place, why do we need the VQS? Although the VQS is working well and although the prices have been relatively stable over the last year or so, as many Members have pointed out, I decided that it was timely, after almost 10 years of operation, to take stock and to do a thorough, comprehensive review of the system. Some of the suggestions that were put to the Ministry earlier, we had kept in view because we did not want to keep on making changes every year. But we decided that after 10 years, after watching the system and seeing what are the merits and demerits of the system, this was a sufficiently long time for us to sit back and take stock. To answer Mr Iswaran, the objectives of the review were two-fold. One is to review whether the VQS is still needed in view of the ERP, and whether it is still effective in meeting our traffic management objectives. Two, if the VQS were to be retained, how can it be further improved in order to make the system fairer and more objective. To undertake the review, my Ministry turned to the GPC for Communications for assistance. The GPC is well qualified to conduct the review because its Members are familiar with the current system. Moreover, they have recourse to a group of resource persons who would be able to provide expert views on the subject.”
“Three years prior to 1990, the net growth was almost 7%. Obviously, we could not carry on like this. We either had to keep on raising taxes and ARF drastically in order to bring the growth down, or we had to fix an acceptable growth rate, and let motorists decide how much they want to pay to own a car. The Government decided to go for the latter option. We settled one key parameter of the transport equation, which was the vehicle population and, at the same time, we provided a more flexible and market driven solution to the perennial question of how much should we tax car ownership. Sir, the VQS is quite unique to Singapore. We were the first to implement such a system and up to today, we are still the only country in the world to do so. Many people come to Singapore and study our system and they say, "Oh, what a wonderful system you have. This solves all our problems." But when they go back, nothing happens. So, we had no other experience to rely on. We had to learn as we went along, as it were. Over the last nine years, there were many changes in the system. These changes took into account the views of the public as well as responded to the changing environment. Earlier on, we were pressed to make COEs non-transferable. From the economic point of view, Mr Iswaran will tell you that this is not the most ideal solution, because COEs as a commodity should, strictly speaking, be transferable, and there should be a market for it. But people felt that non-transferability was making COE prices go up too high. We made COEs non-transferable for cars and motorcycles. Of course, as expected, this brought about other consequential problems. We had to make the cars themselves non-transferable.”
“30 pm Just now one of my colleagues, Mr Goh Chee Wee, has suggested that another way is to have frequent perhaps fortnightly, weekly or monthly COE bids. My only concern is if you do that, each time the category will be quite small, and we would have defeated the purpose of merging our categories, which was to have a greater COE pool. Because, as we discussed, if we have a very small COE pool in each category, then there is increased risk of manipulation. The recommendations have been agreed and thought through carefully. Most of these measures can only be successful if the Ministry of Communications not only adopt the recommendations but devise and set up the necessary administrative safeguards to ensure that these recommendations can be implemented successfully. Ultimately, I believe that if the Ministry of Communications follows the recommendations and adds the necessary safeguards, the VQS will evolve into a fairer and better system for all Singaporeans. The Minister for Communications (Mr Mah Bow Tan): Sir, first, I would like to thank all the speakers who have given very valuable inputs and suggestions on the VQS review. As Members will recall, we implemented the Vehicle Quota System almost nine years ago. That was in May 1990. At that time, the Government was faced with a dilemma of how to control the vehicle population. We had previously relied on vehicle taxes to do this. Before 1990, from 1975 onwards, the vehicle taxes like ARF, registration fees, customs duties and so on kept going up. Every time the vehicle population went up unduly high, you could be sure that in the next budget, the car taxes would go up. But in spite of all this, the vehicle population reached double digit growth of something like 12% per annum in the period 1982-1983.”
“Several possibilities were discussed but the only way we can prevent market manipulation is to have a formula to penalise those who manipulate the market by running up the COE prices. Of course, the Ministry may argue that we must let the market determine the prices of the COE. This, I agree but with caveats. Unfortunately, despite the transparency, the odds are stacked against the ordinary Singaporean and therefore, the outcomes can still be manipulated. My fear is that if uncontrolled, the open bidding system can only lead to a running up of COE prices unnecessarily. The Government must consider some schemes to prevent this from happening. Since the release of the Report, I have also given more thought to this and I have a suggestion. One suggestion which I would like to recommend is that for each quota category, let there be a two-tier scheme with a lowest successful bid for each tier. Hence, for example, the top 10% of the successful bidders will have to pay the price of the lowest successful bid among the top 10%, and the other 90% will pay the lowest successful bid. However, if there was no manipulation, it is likely that the bids will be within a narrow band. To avoid penalising bidders if the band is narrow, the system may incorporate a clause which can state that if the difference between the two lowest successful bids is not more than 10-20% of the lowest successful bid, then the entire category will only pay the lower of the two lowest successful bids. This scheme will penalise those who run up COE prices and yet will not penalise buyers if bidding is done within a narrow band. This will also reduce the likelihood that COE prices will run up. It will also dispel the misconception that the exercise is meant to increase Government revenue. 1.”
“Sir, thank you for allowing me to join in the debate. A land transport policy affects the daily lives of most Singaporeans and hence it is not surprising that changes in land transport policies are watched closely by most Singaporeans. The report of the Vehicle Quota System Review Committee was released recently. I was also a member of the Committee. In view of the concerns that have been expressed on some of the changes, I would like to take this opportunity to further expand on the proposed open bidding system. The Committee recommended an open bidding system but it was after a long debate within the Committee that we finally agreed to try the open bidding system in the Open Category. The reality is that although the open bidding system is more transparent and provides more information to bidders, the playing field is not level as motor dealers have an edge over ordinary Singaporeans. In fact, if there was collusion, they could control the outcome of the bidding, having been given more information. They have the experience, the time to monitor the bids, a large number of COEs to have an effect on pricing and the ability to buffer COE prices with the profit from the sale of the car. For a motor dealer, it is better to have a sale with a lower profit margin than no sale and no profit. The Committee had long debates on the merits and demerits of the open bidding system and there was genuine and real concern that if manipulation can occur to the detriment of the ordinary Singaporean, it would have defeated the aim of the exercise, which is to have a more transparent and level playing field for everyone. Hence, I wish to take this opportunity to stress to the Minister that safeguards against manipulations must be implemented.”
“For example, I have a family in my constituency who has gone without utilities for months, and when they came to my attention and we made several efforts to approach them, and when we said that we would help them get their utilities (water and electricity) connected, the first response was, "No, please don't do that, because I cannot afford that." It has come to a stage where they feel that there is no avenue for assistance. I think we do not want them to reach to that extent. What we want to do is to help them regain their confidence and overcome their difficulties. The Government should consider increasing funding to CDCs so that they will be in a better position to help these families tide over their difficulties. CDCs can become focal points and one-stop assistance centres for families who are faced with a barrage of unpaid bills and arrears from different agencies. As we undertake these measures to improve the competitiveness of our economy, we must let Singaporeans know that while we have to look at the big picture, we have not forgotten the individuals who face hardship. Instead, we will help them overcome their difficulties. Together, we will work towards building a stronger and more resilient Singapore.”
“However, even if you were to cut the pay by 25%, I could not see how it could help to increase the competitiveness of the Singapore economy. I think he has forgotten that the main aim of wage reduction is to increase our competitiveness. The performance of our Government leaders in this economic crisis has been sterling. They have helped Singapore gain an impeccable reputation. I think they deserve better. Yes, Ministers and top civil servants should lead by example. The wage cut that will be advocated for the public sector, I think for Ministers and civil servants, they should be at the top of the range. But it does not serve any purpose if we cut their pay excessively without any good reason. It is also important that the effect of wage cut be cushioned for those from the lower-income group. We have to understand their needs and ensure that they have a safety net, so that their families will not suffer excessively. Yes, we need to focus on the bigger picture to stimulate the economy. However, we must also remember that there are many families out there who will face increasing financial hardship. Government bodies should make downward adjustment costs selectively, for example, decreasing transport cost. Perhaps bus companies may want to consider decreasing the cost of bus stamps for school-going children. These are measures that will help the lower-income families. Perhaps when rebates are given to hawker centres and food courts, there might be a mechanism for these to be passed back to the consumers. We do not want a situation where the families face so much hardship and are unable to get assistance that their spirit gets broken because of these setbacks.”
“Instead of competing with each other, GLCs should link up with some of these local enterprises to compete in the international market. Secondly, on world-class companies, I support the move to make our GLCs into world-class companies. In trying to recruit foreign talents to increase our skilled manpower resources, it is important that we attract foreigners who are truly talented and not people of second or third echelons but top echelon to serve these companies. Some have said that in many countries there is political cronyism. But in Singapore there is no political cronyism but there is public cronyism. GLCs are favoured. I think we must dispel this notion. This is all the more important during the process of making our GLCs into world-class companies. We must be able to show them that it is a level-playing field and dispel that misperception. Thirdly, managing our limited resources. As our manufacturing industry grows and as our economy continues to expand, the use of water will continue to increase. We have already planned for desalination plants and there are occasional campaigns to save water. But it is time that more forceful steps need to be taken. We should inculcate water saving habits in the young children in schools. They must be reminded that water is a scarce resource and perhaps we should teach them to use water as if they were living in a desert community, so that their generation will learn to appreciate the importance of water. Fourthly, reduction of wage cost to increase our competitiveness. Mr Chiam has proposed that Ministers' pay be cut by 25%. Yes, I think Ministers' pay should be cut as an example for others to follow.”
“Mr Speaker, I fully support the recommendations of the Committee on Singapore's Competitiveness, and I would like to add to some of the points that have been discussed in the Report. Firstly, the development of entreprenuers. Many businessmen say that we lack the entrepreneurship spirit seen in Hong Kong. It is timely for Government to create the right environment to enable the development of an entrepreneurial culture. This would have to be instilled early in the life of our young children. We should encourage and nurture them in school by teaching them to be creative and understand that there is more than one way to approach problems. We must teach them not to fear mistakes but to learn from mistakes. More importantly, both the employers of the public and private sectors must change the present working environment and stereotyped mindsets for more open environment where free flow of ideas are expressed and exchanged among all levels of the hierarchy. We must not be too quick to penalise those who make mistakes which are not due to carelessness, negligence or ill-intentions. In the business world, businessmen have commented that the GLCs have moved beyond their core businesses and have diversified into other businesses to the extent they are found in almost every trade. Because of their sheer size or, at times, monopoly, entrepreneurs feel stifled and are sometimes unable to compete not because they do not have a better product or skill but because they do not have the financial muscle to compete with GLCs when GLCs enter into the fray. Instead of stifling competition, GLCs should work with good entrepreneurs and provide the environment for them to succeed on a win-win formula.”
“After all, you want to provide the best environment for our pupils and to build not only good schools but better schools. If we can tap on the value systems, the academic record and alumni spirit of these schools, it will help the Ministry to establish better schools and not just good schools. The Minister has just said in his speech earlier on about the importance of character, motivation and ability. And these very schools which have these records and established traditions are the best schools to establish these areas of character, motivation and ability in our school children. So, therefore, I hope that the Ministry will consider this.”
“Sir, the Ministry continues to build new schools in new estates and sometimes even in the established estates. I am certain that the schools built by the Ministry are good schools. However, there can be no denying the fact that some schools are better than others. Even the Ministry has a ranking system for the schools. Over the years, many schools have developed good standards and have established excellent track records. Many of these schools are either Government-aided schools or SAP schools. Some, like Raffles Institution, are Government schools. Many of these schools have a long tradition and established system and strong alumni which contribute to the development of the school. It is time that the Ministry considered tapping on these schools for their expertise when they build new schools in new estates. There is, of course, the concern that if the SAP schools or Government-aided schools are involved in establishing new schools, the minority races may avoid SAP schools for either language or religious reasons. And this will result in uneven distribution of minority races in neighbourhood schools. I think the solution is not to prevent good schools from establishing their tradition and good system elsewhere but rather to ensure that they open up and encourage people of all races to join the schools. Many of these schools have an established system, a very strong school spirit and a loyal alumni which together make a strong recipe for success. In new estates, like Sengkang and Punggol, where several new schools can be built or accommodated, the Ministry may want to consider allowing some of these well established schools who want to share their success to set up new schools and manage these schools.”
“As announced, the cost of the ERP charges will be levied on a per entry basis. Therefore, vehicles will be charged every time they pass through the ERP gantry. I think we want to alleviate the burden on the motorists. Firstly, we may want to relook at the boundaries carefully, especially the CBD boundaries, so that those who work within the CBD and have to travel from one point to another in the CBD should be able to return back to their office without having to go in and out of the ERP gantry points and incur unnecessary cost. Secondly, the Ministry may want to consider a rebate system or a diminishing charge for a motorist who has to make multiple passes during a single day. I believe that those who have to make multiple passes through the CBD every day have to do so not because they really want to do so, but because they have to do so. I do not see any great attraction in the CBD that would attract people to make multiple trips into the CBD. Some who are in the sales line or the delivery services may have to make multiple trips into the CBD as part of their business. I think the aim is to dissuade people from using the CBD. However, as I said, if they have to make multiple trips, it is usually because of business reasons. For these reasons, the Ministry should have a system where people who make multiple trips, say, three to five trips into the CBD or pass through the gantry several times, they may want to either give them a rebate or reduce the charges during the repeated entries, so as not to add unnecessarily to the cost of business. I hope that the Ministry will reconsider these comments.”
“Sir, the ERP will be implemented soon. The implementation of the ERP has been explained very clearly. And as we all know, the ERP is meant to dissuade excessive usage of the roads in the areas which are very heavily congested with traffic, for example, CBD. In general, I do support the concept of the ERP. There are certain advantages and disadvantages. For myself and others like me, who have to use the CBD or CTE, I would say that it is an advantage. At the present moment, if you want to go there, you have either to choose between a daily or a monthly pass. Therefore you have to make a detour to a post office or somewhere which sells monthly pass and buy the pass. If not, every day, you have to scout around for a booth, stop by the booth and buy the pass. Sometimes, in a hurry, you may forget and then you enter these areas inadvertently and end up with a fine. For these people, who are probably the large majority of those who use these areas, I think things have become more convenient where you do not have to make a detour or you do not have to stop by a booth to buy your passes, but you can just enter these areas as long as you have the Cashcard and the IU. And some of us, like myself who buy a monthly pass, the number of times I actually use the gantry points at the permitted times would be probably less than 10 a month, but I buy a monthly pass because of its convenience. So for those of us who are in this category, we will benefit from these changes. In fact, we will pay less. By and large, I think the Ministry has explained to us that the intention is not to earn revenue. However, there are certain areas in which the Ministry can further improve upon to reassure the majority of us that that is not their intention.”
“If adjustments are being made, can the Minister let the House know what active measures will be taken to meet this demand?”
“Sir, in the last few years, the Ministry has spent significant amounts of money in developing new hospitals and specialist centres. However, in some hospitals, the occupancy rate for paying beds is not high. For example, I have had the opportunity to visit some of my grassroots members who have been hospitalised in the Kent Ridge Wing of NUH and I was surprised that the place was rather quiet. Not too long ago, it was publicised in the newspapers that there were plans for building a hospital wing near NUH where Johns Hopkins Hospital will be involved. I am concerned that we may be building more than is necessary. Residents have given feedback that it is not unusual to wait for long periods for admission to subsidised ward. But it is often not too difficult to get admission to paying wards. Is there a misallocation of resources resulting in insufficient subsidised beds andby an excess of paying beds? Our hospital facilities should be used efficiently and perhaps the redistribution of beds and allocation of resources will help to overcome some of these bottlenecks in our public healthcare system. As these medical institutions are built with public money, it is important that we reassure the public that whether they are subsidised or paying patients, they will not be disadvantaged in getting access into our public medical institutions. Hence, in the development of our health facilities, the Ministry must take into account the demand for subsidised services. In this economic downturn, it will not be unexpected that more Singaporeans will use subsidised healthcare services. If there is an increased demand, will the Ministry be making adjustment in our healthcare facilities to meet this increased demand?”
“Patients who are very ill and require urgent attention should perhaps be classified as "priority one" patients, and these patients must be attended to within a stipulated time-frame. Patients who are ill and require hospital admission but do not require attention so urgently should perhaps be classified as "priority two" patients. Perhaps it is time to have ISO standards for delivery of medical care. Upon admission to the hospital, again, there are other new dilemmas. For example, in Singapore General Hospital where virtually all the departments are very specialised departments and there is no real general medicine department, there is a dilemma for the doctor at the A&E department as to which department to admit the patient to, if he has multiple-problems. And when the patient with multiple problems get admitted to the ward, will the doctors be so focused with their own specialty that they do not pay adequate attention to other specialties? For example, if a patient with breathlessness is admitted to the ward and has a heart problem but gets admitted to the Chest Ward, will it be such that the doctors are so focused on the chest problems that the heart problems are missed totally? I think these and other issues have to be addressed by the Ministry. Yes, it is good to have new hospitals and new machines but I think, most importantly, we must have a high standard of medical care. Only by delivering a good quality of medical care, can Singapore lay its claim to be a Centre of Medical Excellence. Can I continue, Sir?”
“It can then identify areas of weaknesses, for example, if there are insufficient medical staff, and overcome these problems. At the hospital level, patients who are seen at the Accident and Emergency Department may have to wait for long periods before being admitted to the hospitals. My residents have seen me to complain about the long waiting period for transfer to the wards after being seen at the Accident and Emergency Department. Despite the serious illness that their relatives have had, no beds could be found in the subsidised ward and they had to wait for several hours. While waiting at the Emergency Department for a long duration, no definitive care was administered. Unfortunately, for two of my residents, their relatives died shortly after admission to the hospital. I think this is a major weakness in our hospital system which needs to be addressed. There are several potential options which the Ministry may want to consider: First option: to admit subsidised patients who have serious illnesses and require urgent attention to the first available bed, even though it may mean having a subsidised patient lodging at a paying bed and being charged at subsidised rates. This should not only apply after office hours but throughout the day. Second option: to have the ward medical team come to the Emergency Department to review and treat patients while they are waiting for transfer to the hospital ward. Or perhaps a third option: to have a team of doctors at the Emergency Department who are sufficiently well trained and whose primary role is to initiate treatment and do the necessary investigations while the patient is awaiting admission to the ward. There should perhaps also be a classification system for admission.”
“Sir, I wish to declare that I am a doctor in private practice. Over the last few years, the Ministry of Health has spent much effort and resources in building new hospitals and medical centres to its credit. However, what makes the medical centre or a hospital a good one is not just the physical building or what machines it has, but more importantly, these institutions should be judged by the standard and quality of healthcare provided. It is time that the Ministry made an objective assessment of the quality and standard of health that is given to all Singaporeans who use public health institutions. In the front-line we have our polyclinics where very often, doctors and nurses are overloaded with work. It is time for the Ministry to do a clinical audit of the outcome and standards of care provided at our polyclinics. Many of the lower income families, less well-off Singaporeans, and our senior citizens use the heavily subsidised services. It is important that we provide an acceptable quality of care for these patients. How many patients with high blood pressure have normal blood pressure after being treated at the polyclinics? How many diabetic patients have well controlled blood sugar levels after being treated at the polyclinics? Good control of common medical ailments, like high blood pressure and diabetes, will reduce the incidence of more serious diseases, like stroke and heart diseases. The Ministry can only realise its objective of providing a high quality of medical care if the large majority of patients with common ailments are well managed. Hence, it is time for the Ministry to do a clinical audit on the standards of care provided in polyclinics.”
“Sir, as blood product has a limited lifespan and cannot be kept for prolonged periods of time, I would like to ask the Ministry about the suggestion brought up by Dr Lily Neo and whether there is any example of such a so-called autologous blood bank for the general public since it is not possible to keep blood for prolonged periods of time.”
“Sir, I support Dr Tan's point. I think the point that Members must note here is that as a medical student, you have to sign a bond. It is not as if someone gave you an option and say, "Would you like a scholarship? Would you like a bursary? You make a choice." Yes, I take the scholarship. I break the bond. I am penalised. Here, you do not have a choice. You go into medical school. You sign the undertaking and you are subjected to these rules. I think there is a distinction here in that we are not looking just at people who are given an option. They do not have an option, unless you say you do not want to do medicine. I support Dr Tan's point. I think we need to look at this clause very seriously, because it not only can be applied in this situation but it can also be applied in other situations as well.”
“Mr Speaker, Sir, the point I wanted to make was that, in making these changes in this Bill which I personally welcome, if you want to compel members of the profession to vote, it really does not make sense if having undergone such a big exercise by compelling everybody to vote and penalising them if they do not want to vote, then at the end of the day, the members who are elected are the minority, not the majority. As it stands now, voting is optional under the present system and so those who want to vote for the members can vote on who will get in. But if we know that the majority of the members are nominated members and if you want to compel people to vote, it really does not make sense. As I said in the analogy which I gave, if you want to make voting of Members of Parliament compulsory in the elections, then it is really a mockery of the system if there are more Nominated Members than Elected Members. The same analogy will follow too.”
“As the expectations of our population increase, the need to make sure that disciplinary cases are fairly conducted and be seen to be conducted is very important. We have seen in the newspapers in the past years that there have been a lot of disputes but there is always a perception by the public that whenever a case is being referred to a professional body to judge one of their peers, there always seems to be an element of cover-up. To be fair to the doctors concerned, when they judge their peers, it could be difficult. So could the lay person be given at least a bit more say in these committees and could the Ministry provide an avenue for appeals to be heard in the sense that the final decision may not rest with the Medical Council where one of their own members has been judged? This will go a long way to convince our population that in cases of malpractice or neglect, the cases are fairly conducted and at least publicly seen to be so.”
“It also regulates the conduct and ethics of registered medical practitioners. I notice that all the Council members are medical practitioners. There is no lay person in the Council at all. There is always a temptation for a professional group, whether it be doctors or lawyers, to resort to a certain degree of closed-shop practice, and the registration of medical practitioners can be construed to be a closed-shop practice in the sense that they may want to shut out certain people whose qualifications may not meet with the approval of the practitioners. If there is no lay person in the Council, there is no so-called check and balance. It would also appear from the Bill that the Council is the final authority. There is no recourse for appeal. I wonder whether the Minister will consider, in the event that a medical practitioner who is barred by the Council from being registered to be a practitioner, whether he has recourse at least to the Ministry to have a second opinion. Otherwise there is a tendency for the professionals to shut them out. I am not saying that it is happening now but there is a possible danger in that. The second comment I would like to make is on the disciplinary proceedings and Complaints Committees. Again, although there is a lay person in these committees, the lay person is an observer. By definition, an observer is not supposed to say anything. He only observes. How will his views be taken into account in the Committee? Or will his comments, in fact, be accepted or will he have a deciding factor in matters that require a decision? Dr Tan has mentioned quite eloquently that the number of cases of complaints on doctors is increasing and the Minister has also confirmed that.”
“Further, I feel that members should be allowed to represent themselves because members may not represent themselves or submit explanations unless the Complaints Committee in its absolute discretion otherwise allows. This is in clause 40 (21). I think this is not fair. For a doctor, the moment he faces any disciplinary action, even though he is totally innocent, the publicity that is generated is sufficient to cost significant harm to his reputation and his practice of medicine. Lastly, if a doctor is sent to the Disciplinary Committee and eventually the charges are either dismissed by the Disciplinary Committee or they are referred to the High Court and dismissed by the High Court, will the Medical Council pay for the legal costs incurred? I think it is not fair to the medical practitioner if, on top of suffering harm to his reputation and the effect on his practice, he has to incur costs on a case which is found without basis by the Disciplinary Committee or the court eventually. I hope that the Minister will look into these points. EXEMPTED BUSINESS (Motion) Resolved, That the proceedings on the item of business under discussion and the remaining items on the Order Paper for today be exempted at this day's sitting from the provisions of Standing Order No. 1. - [Dr Lee Boon Yang]. Mr Bernard Chen (West Coast): Mr Speaker, Sir, unlike the previous three speakers, I am not a doctor. So I hope I can give a non-medical practitioner's view. I just want to make two comments on the Medical Registration Bill. The first refers to clause 4 where the composition of the Medical Council is spelt out. The Council has quite wide functions in terms of the fact that they are deciding on the issue of practising certificates for medical practitioners, including foreign doctors.”
“Every time you want to attempt to do anything new, you have to clear the Ethics Committee, the Credentials Committee, and the Medical Advisory Board in the hospital before you can even write to the Ministry to ask for approval to do any new procedures. But when I was in the restructured hospital, this was not the usual practice. So I think it is good to instill discipline in all the hospitals, whether they are private or Government hospitals, if we want to become a regional centre of excellence. My next point refers to the Complaints Panel (clause 40(21)). Again, the members are appointed. Are there any ways for the person who has been complained against to write to the Ministry or to the Medical Council if he feels that the member on the Complaints Committee is biased or prejudiced or there is a conflict of interest? As Members know, even within restructured hospitals, there are rivalries between departments and sometimes the rivalries can be fairly bitter. There might be certain instances where a person feels that he may not get a totally impartial hearing. Again, with regard to the appeal to the Minister, if the person is reviewed by the Complaints Committee, how would the Minister be advised? Will there be an independent panel that would look into the facts of the case and advise the Minister or will the Minister just make a decision solely on the report of the Committee? I think the same applies to the Disciplinary Committee as well in clauses 42 to 45. Again, there must be a way in which a member can express concern if he feels that the members on the Disciplinary Committee have certain biases or prejudices.”
“I think it is good that the Ministry should look at this so that appropriate people who are trained should be allowed to do this procedure and those who are not trained should not be allowed to do this procedure. For example, if you do not do this, in a restructured hospital, if you are a very, very senior doctor in the department, and there is a new procedure which your junior doctor who has gone overseas for training has come back and started performing this new procedure, you can say that you are competent to do this procedure because of your years of training, but you may not actually be competent to perform this procedure. An example of this is what the Minister mentioned just now, laparoscopic surgery. Many of these surgeries are performed mostly by the younger doctors. But what is there to stop a very, very senior doctor who is not trained to do it to perform it. There are no safeguards at this point in time. I also welcome the move by the Ministry to bring more discipline to the medical fraternity, but I beg to differ from Dr Tan Cheng Bock in some points where he says that doctors in private hospitals have to perform many procedures to make the owners of the hospital happy. I think this is not true because the specialists there do not own the hospital and the hospital does not own the specialists either. There is no pressure to use more facilities so that you can be accredited. In fact, I would say that having practised in both restructured and private hospitals, I was pleasantly surprised when I went out to private practice that they have accreditation processes not only for specialties but down to the type of procedures that you can do. This is something which is not very apparent in our restructured hospitals.”
“Part V, clauses 34 and 35 deal with the establishment of the Specialists Accreditation Board. I welcome this move by the Ministry to establish a Specialists Accreditation Board. Currently, most specialists are accredited with the Academy of Medicine which maintains the Specialists Rolls. With the establishment of this Board, the function of this Board will supersede the establishment of training requirements and the accreditation process for specialists which are currently being carried out by the Academy of Medicine. Again, the Board members are appointed by the Minister. Perhaps, I think the Minister should explain to us what is the process of choosing suitable people to sit on this Specialists Accreditation Board, as these people have significant powers to affect the appointment of people for the specialists register. Is there a pre-appointment period so that members of the medical profession can write to the Ministry to comment about those whom they deem are unsuitable? Furthermore, for those currently accredited by the Academy and those on the roll of specialists, will the list be transferred or will everybody have to be re-registered again? With increasing advances in medical technology, I think the Ministry has to go beyond just simply accrediting someone, for example, as a general surgeon, a cardiologist, an obstetrician or a gynaecologist. Because medicine has advanced so rapidly, within a certain specialty there may be very high-tech services where only certain specialists are trained and not all specialists within that specialty can perform these procedures.”
“If we take the Singapore Parliament as an analogy and voting in Singapore during elections is compulsory, I think it would make a mockery of the system if there were more nominated Members of Parliament than elected Members of Parliament. Likewise, if voting is to be made compulsory for Medical Council elections, it stands to reason that elected members should outnumber nominated members. I am not certain why the Ministry wants to appoint so many members chosen by them. I am also not sure that the Minister himself is familiar with the members of the medical profession and the process of appointing members is not clear or transparent to members of the medical profession. Those within the fraternity will know the members very well. It does not mean that if a certain member is a head of department or even holding a very senior position in a hospital that this person is suitable to sit as a member of the Medical Council. I think the Minister should clarify this point as to why there is a need to have more nominated members than elected members. The second point pertains to another point which Dr Tan has also raised in clause 33(1)(g). Medical students who are entering medical school - I stand to be corrected - if I am not wrong, are bonded for five years or a certain period of time. And if they break this bond, they have to pay certain liquidated damages. If the student, upon finishing his examinations and practises as a doctor, decides to break the bond and pays the damages, I want to seek clarification whether there will be penalties imposed upon him. It stands to reason that if he pays the liquidated damages, there should not be a need to punish him further. Next, I would like to move on to registration of specialists.”
“Mr Speaker, Sir, thank you for allowing me to join in the debate. I must first declare that I am a practising medical specialist. I welcome this Bill by the Ministry of Health. I think it has made many important changes which keep up with the changes in medicine. The Bill covers three main areas; firstly, matters pertaining to Medical Council; secondly, matters pertaining to accreditation and registration of doctors; and, lastly, disciplinary action on doctors. I would like to take this opportunity to touch on a few points regarding this Bill. Firstly, matters pertaining to the Medical Council. Clause 6(2) states that: `Every registered medical practitioner who is required to vote for the election of members of the Medical Council in accordance with subsection (1) and who fails to do so shall not be entitled to apply for a practising certificate unless he satisfies the Registrar that he had a good and sufficient reason for not voting at the election or unless he pays to the Medical Council a penalty prescribed by the Medical Council.' I think this point was brought up by Dr Tan as well. I support the Ministry in making voting compulsory because it means that the medical fraternity will take a more active interest in the Medical Council which has significant powers over the medical profession. However, I feel that clause 4 does not do justice to the spirit of clause 6 which makes voting compulsory. As pointed out by Dr Tan, out of the 17 members of the Medical Council, only 8 are elected members. The other 9 members are appointed by the Minister.”
“Sir, liberalisation of the telecommunication services has resulted in a better range of services and lower cost for the consumers. In licensing up to two more cellular mobile phone operators, will Singaporeans be expecting newer and better services? Will aggressive marketing of these cellular phone services result in an increased consumption of these services by young teenagers who have yet to earn a salary but feel that it is a status symbol to own a cellular phone? Competition has also resulted in a proliferation of services provided by cellular phone operators. It is difficult for the lay public to sometimes understand whether it is necessary to have some of these extra services. The providers should educate the public so that they only consume the services that are required. Excessive unnecessary consumption of these services may be an unhealthy trend. Furthermore, with increased market penetration of cellular phones, what is being done to prevent cloning of cellular phones? At the end of the day, with more services, what measures are being taken by the Ministry to ensure that the consumers' interest will be looked after?”
“Sir, the Public Transport Council makes important decisions on public transport, including bus routes, new bus services and increase in fares of public transportation. However, many people are not clear as to the way in which the Public Transport Council works. It is not clear what forms the basis for decisions and how the Public Transport Council makes these decisions. Can the Minister explain to Members how the PTC makes decisions so that appeals by MPs for changes in bus services can be more effectively put forward to the PTC for consideration? Dr Tan Cheng Bock: Sir, I am not speaking, as Dr Michael Lim's points are similar to mine.”
“Sir, regionalisation is the latest buzzword. Singapore wants to be a regional medical hub and, at the same time, we want to expand into the region as industrial parks and Singapore companies are set up overseas. There will be a need for Singapore health care facilities to expand overseas. I want to ask the Minister what measures have been taken by the Ministry in conjunction with other Ministries to promote Singapore as a major regional hub and to attract supporting health related industries into Singapore. What is the role of the Ministry or the Health Corporation of Singapore in promoting regional medical expansion? What joint ventures have HCS embarked on? And what support or incentive measures are available to encourage Singapore companies to set up health care facilities overseas?”
“If this similarly applies to all the other restructured hospitals, how does the Ministry maintain its supervisory role either directly or through HCS? If the Government is providing significant development and operating expenditure and subventions to the various restructured hospitals, it would be inconceivable that the Ministry cannot have a significant say in the management of these hospitals. If we want to prevent unnecessary competition between our restructured hospitals, if we want to improve the morale of our medical staff, if we want to pool our medical resources together, if we want to contain costs, if we want to provide a high quality health service, then the Ministry must take a strong leadership role. The Ministry has to look for new solutions for these problems and help our health service meet the needs of the next millennium. 3.45 pm”
“The concern now is whether the current response to increase the medical student intake and to take in more foreign doctors will result in excessive manpower in the near future. The Ministry should explain to Members of the House and give us a better picture of the rationale for such changes in manpower projections. Thirdly, service conditions in hospitals. The terms of service and remuneration in the restructured hospitals keep changing. The remuneration system has been modified numerous times in the last 10 years. I am certain that the Ministry's intentions for these changes are good. But when the system keeps changing very often, it affects the morale of doctors and they leave the service. The severe shortage in medical manpower is felt mainly in the Government and restructured hospitals. Unless service conditions improve, this will continue to be so, no matter how many new doctors and foreign doctors are employed. Service conditions must be improved. It goes beyond financial recognition. Doctors want their work to be recognised, whether it is medical treatment administered or research papers. Junior doctors get demoralised when credits go to others for work they perform. It is not pay alone but also the need to be treated fairly, to be heard and for efforts to be recognised. Then he will feel that his contribution to the health services is appreciated. A happy doctor is also likely to remain in the restructured hospital service. Lastly, leadership role of Ministry of Health. The Minister has said that SGH is a private entity and it is not part of the civil service and in fact all the administrative decisions are taken by the management and board of directors of SGH.”
“Sir, health care services is an important area of concern for all Singaporeans. As demand for health care services increases in the next millennium, the Ministry will have to formulate policies to maximise the potential of our limited resources. I would like to know how the Ministry will meet some of these challenges. Firstly, the national centres. The establishment of national centres for various medical specialties will improve the standards of care within these specialties. Many of these national centres will also have expensive diagnostic and therapeutic equipment. How does the Ministry prevent a Government or restructured hospital from duplicating resources and equipment already available in the national centres or in other hospitals? I am not only referring to MRI machines but also to CT scanners, ultra-sound machines, lasers and other expensive equipment. Is the mechanism an ad hoc informal mechanism? Or is there a structured formal mechanism? The Ministry must define the role of national centres and corresponding disciplines in the hospitals clearly to avoid straining our limited medical resources, especially medical manpower. This brings me to my second point - medical manpower. It was not too long ago that the Ministry had said that the number of medical students would be restricted and the number of overseas universities, with recognisable basic medical degrees, would also be restricted. Within the short space of a few years, the Ministry has now reversed its stand and said that manpower needs are insufficient. Certainly, it is not easy to make manpower projections but the Ministry has a long record of managing the manpower needs and one would expect their projections will not be too far off the mark.”
“There are no simple solutions but one suggestion that I have for the Ministry, which they may wish to consider, is that they may want to have a hospital handbook on "Common Medical Problems in the Hospital" for doctors in the hospitals, which will lay down the investigations and the treatments for common medical problems seen in hospitals. This will minimise the need for unnecessary referrals for simple problems in the restructured hospitals. Such a medical handbook on common medical conditions in the hospital will also allow optimal cost-effective choices in the investigations and treatments. Addressing these concerns will not only contain the costs of health care but it will also increase the efficiency of our health service, both from the provider's and the recipient's viewpoint.”
“When this patient is discharged from the hospital, he will have to see the eye specialist at the National Eye Centre for his eye problem and see the kidney specialist and the chest specialist at SGH. He will also have to go to the National Heart Centre to see the heart specialist. If he is not already on follow-up in the SGH by the neurological department for his nerve problems, he may also have to make a trip to the Neuroscience Centre at Tan Tock Seng Hospital. As a result of these multiple visits, the financial cost and time spent will be substantial. We do not deny that there will be a need to have patients to be seen by medical specialists of different specialties, but some of these problems are simple enough to be managed by a generalist. Also, medical officers and house officers who work in these departments will also have a narrow exposure to the disciplines of medicine and have less grounding in general medicine. This will also give them less working experience and exposure to the wide spectrum of medical problems. It will also increase the tendency to cross-refer as doctors become very focused within their own disciplines even at a very early stage. Excessive referrals also put an increased strain on doctors who already work extremely hard in the hospitals. Precious time is taken out for tending to minor medical problems which can be managed by any other doctor. Costs will also increase because by having more departments, there will be more administrative staff required and there will be more office space required. The Ministry will have to balance the need for specialisation and the need to optimise our resources. The unintended result of increase in health care cost resulting from the differentiation of the specialist departments must be studied.”
“Sir, as Singapore develops, the health services also develop. As a result, there is increasing specialisation within the medical services. Increasing medical specialisation results in an increased availability of treatment choices. This will not only improve the quality of health care services that the average Singaporean can get access to but it will also help Singapore develop into a regional centre of medical excellence. However, increasing medical specialisation, especially within our restructured hospitals, has also resulted in some undesirable trends. In SGH alone, it seems as though there is almost a separate department for every specialty available. One unintended effect of this is the fragmentation of care, as patients often have more than one medical pre-existing condition. For example, if a patient who has diabetes mellitus and has multiple complications of diabetes mellitus and is admitted to SGH for chest infection, he will pose a dilemma because he not only has chest infection but has other complications of diabetes such as disease of the heart arteries, eye problems, kidney damage, nerve complications and poor leg circulation. If the patient is admitted to the department for respiratory diseases, it will not be unlikely that there will be referrals to other doctors to manage his problems. Each referral to another department will result in additional consultation costs. Even though there may be a doctor, who is overall in charge of the patient, more often, because of the differentiation into specialised departments, it is likely that the other areas will be left to other specialists.”
“I hope that the Government will encourage the people to learn their mother tongue well in addition to the English language. In this way, we will be able to build a psyche of self-respect. We must be able to ensure that the students can use English competently in their work and can also understand our own culture and values system through the Chinese language. Students imbued with this language ability will be able to have a balanced development for themselves and to make greater contribution to the society. Sir, I support the motion.”
“But the actual standard of the Chinese language is determined by the interest and the effort of the students themselves. Among my friends, there are some who are strong in Chinese and some who are not so strong in Chinese. Those who were interested in the Chinese language spent a lot of time outside the curriculum to read books, newspapers, magazines and others. Of course, they have a better command of Chinese. Now the students, apart from their regular studies, have to allocate time to many extra-mural activities, computers and television. As a result, they have very little time left for reading Chinese magazines and Chinese literature. Of course, this affects their standard of Chinese. But individual students who have special interest in Chinese can opt for Higher Chinese, they can read Chinese magazines and Chinese newspapers. They can still attain a high standard of the Chinese language. SAP schools have provided a good environment for the learning of Chinese and Chinese traditional culture. Nobody can deny that Mandarin is more frequently spoken in Singapore now than 30 years ago. More Chinese students are speaking in Mandarin in schools and Chinese programmes over Channel 8 are very popular. This shows that it is wrong to say the Government has been suppressing the learning of the Chinese language. We all agree that it is equally important to learn Chinese and English together. English is an international language and also a language for cross-community communication. English is also a very convenient language for business and administration. While we acknowledge the important of English in research, business and inter-communal communication, it is important also for us to know our own mother tongue for the preservation of our culture and our psyche.”
“Some have doubts on the sincerity of the Government's effort in promoting Chinese education and the implementing bilingual education policy. As a Chinese-educated myself, I fully understand their feelings. Before independence, Chinese students took part in student campaigns against the colonial government. Chinese education was under suppression and English education was supreme. At that time English was the language of the ruler, and Chinese was the language of the ruled. The Chinese-educated therefore felt indignant about it. After independence, the Government has been implementing bilingual policy so as to enable our students to master English as well as their mother tongue, and the status of Chinese language has been enhanced. But English remains as the working language of the Government, language.commerce, business, and therefore it is in the leading position. And those educated in Chinese feel that they are less competent in English and hence inadequate, or even feel that they are neglected. So the words of Tang Liang Hong have gained sympathy from these people and they will want the Government to pay attention to their feelings. Is the Chinese language being suppressed, and has it caused its standard to be lowered? I often hear my friends from the Chinese-educated circle saying that the standard of Chinese is low in Singapore. And there are some other friends, especially those who are parents, feel that Chinese language texts are very difficult to understand and the demand on their children is too high. Of course, compared to my days, the contact hours for Chinese teaching have been reduced and it may have affected the standard of the Chinese language.”
“Secondly, on upgrading of HDB flats, I said I believed that it was a matter of time that the Opposition wards would get upgrading, and the timing will be determined in accordance with the order of priority. I am confident that this will be the case. As to when this can be done, it will be decided by the Prime Minister. Let me go back to what I --- Mr Low Thia Khiang( In Mandarin): Dr Ker, does it mean that if we wait long enough, we will get it? Is that what you mean? With regard to the people losing the national soul, I have already clarified my stand. I did not say that all the people had lost their soul, but I believe some have. Dr Ker Sin Tze( In Mandarin): As I said, it is question of time. As for how long the opposition wards will have to wait, that will depend on the performance and the effort of the Member for Hougang and other related factors. Sir, since the election campaign in December last year, the Government has been taking to task the opposition candidate, Tang Liang Hong, for his chauvinistic bias. Chauvinists ignore the sensitivities of other races and they propound radical views. If such words are not stopped, it will cause suspicion and division among the various races to the detriment of our national stability and economic growth. I think it is very important that we should expose the true colours of chauvinists. Tang Liang Hong came out as a champion of Chinese education and in the process he has caused some impact on the Chinese-educated. Some are sympathetic with his specious and confusing views. Some think that the Government has not been treating the Chinese-educated favourably and think that the Government is persecuting him.”
“So I would like to ask the Member for Hougang whether he has agreed with what was quoted by him. If he agrees with the quoted statement, it is an insult to the people of Singapore. It is an insult to the voters of Singapore. Mr Low Thia Khiang( In Mandarin): First of all, let me talk about what Dr Ker has said about insulting the people of Singapore. This is representative of how some people of Singapore feel. What we cannot ignore is that there are in fact some people who have such feelings. My purpose is to show the feelings of some of our people. The election strategy of the PAP has caused not only some Singaporeans but also foreigners to have such a wrong impression of the people of Singapore. This is not a good thing to us. Just now Dr Ker said that he believed that the Government would also upgrade the flats of the opposition ward. I do not know why he said "he believed". Is he really sure that the Government will do that? Secondly, the Prime Minister had also said that if the people voted for the opposition, then the opposition wards will be falling behind and they will be degraded into slums. Dr Ker Sin Tze( In Mandarin): I would like to respond to his statement that he was merely giving a feedback from the ground. But if what he had quoted in this House about the people being unable to withstand the material inducement of the PAP and have lost their soul was just to reflect the voice of the people, then I would ask him whether he agrees or disagrees with this view. If he does not agree, he should at least say that, "I do not entirely agree." Or he should criticise this kind of view. Otherwise, Members of this House would take it that he shares the view of the quoted statement.”
“The policy was introduced by the PAP and they claimed that it was a national policy. Now they are in power. Does this upgrading programme include the oppopsition constituencies? If they say that this is not just an election strategy of the PAP but a national programme, then does this apply to the whole of Singapore or just to part of Singapore? Secondly, just now when I mentioned about the people losing their soul, it was not what I said. I was quoting from a letter written by someone to Mr Bai Shi De. I do not fully agree with what he said. Of course, I can understand that not everyone voted for the PAP just because of the upgrading. Because there may be some ardent supporters of the PAP. But I think we should not ignore such feelings of the people. So I hope Dr Ker will enlighten me. Dr Ker Sin Tze( In Mandarin): Upgrading, as repeatedly pointed out by the Prime Minister, is the policy of the Government to help the people to improve their living environment. It was one of the programmes which the Government would implement if elected. By voting for PAP candidates, the electorate had signified their desire for and acceptance of the programmes including HDB upgrading, they should therefore be accorded with upgrading priority. As to the opposition wards, I do not think the Government will neglect them. As to the timing of implementation, we will have to look at the overall programme for the whole nation in terms of priority to determine when it will be the turn for the Opposition wards. On the second point, the Member for Hougang clarified that what he mentioned about the people of Singapore having lost their soul was not his own statement. However, when he quoted somebody, he should at least indicate whether he has agreed or not with such a statement.”
“The PAP Government presented a programme of upgrading and other measures for the electorate to determine what they wanted and if they supported the upgrading and other measures or policies of the Government, then they should vote for the PAP. But if they were to support the platform of the opposition parties, then they were also equally free to vote for the opposition. From the last general election, we can see that most Singaporeans supported the PAP. Similarly in UK, the Labour Party presented to the electorate their own platform and they won the support of the people and they formed the Government. Of course, among the people we have some who support the opposition, and some for the ruling party. You cannot say that the people are divided as a result of the Government's platform and programme. You cannot use this kind of argument to say our election strategy is to divide the people. That is incorrect. Mr Low Thia Khiang( In Mandarin): Can I make a clarification? Dr Ker Sin Tze( In Mandarin): Let me finish my second point, please. Secondly, the Member for Hougang also said that the people were induced to vote for the PAP by material benefits offered by the Government. So they have lost their soul. I think this is insulting the people of Singapore. They treasured their rights to choose during the election. They assessed the capability of the four parties contesting the election and evaluated what they could do for them, and they finally made the wise decision in choosing the PAP. But the Member for Hougang said that they could not withstand the inducement and the threat by the PAP and they made the wrong choice. I think this is a great insult to the people of Singapore. Mr Low Thia Khiang( In Mandarin): First of all, I hope that Dr Ker would answer my question.”
“Apart from that, the PAP Government says it is going to build Singapore into the best home for ourselves and our children. This is indeed another major challenge we have to face. Apart from facing the external competition, the Government should not neglect the heavy pressure that our people are facing domestically. With the people having to face the problem of prices going up all the time, how are they going to build up the best home for our people and our children? In fact, some of them are even considering migrating to other countries. So the PAP Government should not only believe in the magic of the market economy and neglect the ruthlessness of the market economy and the adverse effect it can have on the cohesiveness of our people and their sense of belonging. This is the time for the PAP Government to mend the rift that has appeared after the general elections and to avoid the people from further drifting apart. Historical experience shows that a strong economy alone does not guarantee the survival and wealth of one nation, the people's cohesiveness, political will and a sense of belonging are more important. Dr Ker Sin Tze (Aljunied)( In Mandarin): Mr Deputy Speaker, I rise in support of the motion moved by the Member for Bukit Timah. I would like to deal with the matter relating to the Chinese education. But before I speak, I would like to direct my remarks to the speech of the Member for Hougang. He said that during the last general election, the People's Action Party used the method of inducing and intimidating to split the people of Singapore. I think he was completely wrong on this, because under the democratic government system, we have to face the people at a certain stage. Every party must have its own party's platform for the people to choose.”