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?”
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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 8 of 8.
“As we unfurl our sails of democracy and freedom, ride the winds of an ever-changing world, we must encourage those who are capable to help those who are less able, we must strive to help Singaporeans own their own roof over their heads, we must widen the doors of education, we must ensure that affordable basic health care is provided to all Singaporeans, we must fasten our finances with ropes of prudence and we must have a united multi-racial crew who will rally to the cause of Singapore. With this robust ship, the Government will be able to use the hands of compassion and empathy to steer with wisdom and lead the nation across the seas of uncertainty into the promised land of the Next Lap. Mr Speaker, Sir, I support the motion. VISIT OF THE HON. SENATOR DATO' CHAN CHOON TAK AND MEMBERS OF THE DEWAN NEGARA MALAYSIA (Presence in Gallery)”
“Just as we need people to contribute money to help the less fortunate, we also need people to contribute time to help the less fortunate. We should start developing this altruistic approach in the schools, polytechnics and even universities. The Government should consider setting aside a designated time during each school term for them to perform community services. This will help to create an awareness of the less fortunate in the community in our young and to inculcate a more caring spirit. If we want Singapore to be a caring society, we must do our best to kindle the fire of altruism in our youths. I support the setting up of Family Service Centres. The provision of more Family Service Centres will encourage the more able in the community to help the less able in the community. The Family Service Centre will also be in a position to tap the strengths and resources of the grassroots and community organisations in the provision of social services to families in the community. Compassion and empathy must temper the iron-clad rules of bureaucracy. The revestment of a HDB flat, the cutting off of basic utilities, the inability to pay for educational expenses in a family in dire financial straits put on them an immense amount of psychological strain. We must soften the blow, preserve the vestiges of their human dignity and marshall the resources of the Government and the community to help them keep their heads high again. The cold hand of bureaucracy must wear a glove of compassion. The Government is compassionate but it is equally important that the bureaucracy, that is the face of the Government to the ordinary citizen, is perceived likewise too. Hence, the Government must imbue the bureaucracy with compassion and empathy. Finally, I must now end.”
“Many of the patients in secondary and tertiary care hospitals stay after the acute period because of the need to convalesce. They do not need the so-phistication and the high cost of tertiary care hospitals during the convalescing period. What they need is low cost community hospitals. Building more community hospitals will reduce the pressure of beds in secondary care and tertiary care hospitals and ultimately reduce the need to build more high cost hospitals. Today's appetizer on health care will suffice and the main dish and the dessert will be served on another occasion. The Hon. Minister for Health will then have an opportunity to chew on the healthy diet of affordable health care and restraining escalating health cost. I hope that today's appetizer will whet his appetite. Ultimately, we must have a slim and trim health care service that will provide affordable quality health care to all Singaporeans without putting undue strain on the nation's finances. Lower socio-economic group Last but not least, my heart compels me to speak on behalf of the less well off in our society as I have a soft spot for them. I support the aims of the Ministry of Community Development in working with the community and encouraging the community to participate maximally so that together they will build a cohesive, compassionate and robust society. With increasing affluence, materialism becomes a point of focus for many Singaporeans. It is important that we become affluent not only in material needs but also in altruism. We do not doubt the generosity of Singaporeans when called upon to contribute to charities. However, we also note that the number of volunteers is decreasing.”
“This body should comprise a multi-disciplinary team of specialist doctors, economists, biomedical engineers, medical researchers and other relevant specialists. Thorough evaluation of all new medical technology or medicines will safeguard against the uncontrolled proliferation of new and expensive medical advances which have not been proven to be of value. Only then can we continue to provide a high level of quality health care without burdening the State finances excessively. As the Government builds new hospitals, we must also weigh the cost of building a tertiary care hospital as compared to a secondary care hospital. In the tertiary care hospital, there is a wide range of specialists and sub-specialists, there is a high specialist to patient ratio, there is an impressive array of high technology therapeutic and diagnostic equipment and operating expenditure is high. A secondary hospital has the major disciplines of medicine, a lower specialist to patient ratio, the essential diagnostic and therapeutic equipment, and it is less expensive to operate. I am of the opinion that we should build hospitals which provide a good quality of basic medical care without the frills of modern technology such as Magnetic Resonance Imaging, transplantation programmes which are extremely expensive and will only benefit a minority. We already have tertiary care hospitals which can provide these services. My fear is that if we were to build more tertiary care hospitals with expensive technology, more patients will be put through such tests to justify the cost of these modern medical advances. This will result in unnecessary escalation of cost both for the Government and the patients. I strongly support the concept of community hospitals.”
“The state health care system in New Zealand, United Kingdom, Canada, France and Sweden are beset with overwhelming financial problems. In 1991, the USA spent 12.4% of the GNP on health, yet 40 million Americans are kept out of the health care system. The experiences of these countries remind us that we should not let history repeat itself. We must continue with the philosophy that those who can afford should pay but those who cannot afford will not be denied of health care. The phasing out of subsidies for A and B1 class wards and the continued provision of subsidies for B2 and C class wards is a step in the right direction. Restructured and Government hospitals should reflect the true cost of health care in their A and B1 class wards. Singapore is a regional centre of medical excellence. The rapidly changing pace of medical advances dictates that to remain as a regional centre of medical excellence, we must continue to acquire new medical technology and medicines of proven value. If we do not do so, the average citizen will not have access to these modern diagnostic and therapeutic techniques but the rich can easily seek such treatment overseas. However, the Government must not be shackled by the prohibitive cost of modern medical treatment. If the Government was to provide subsidies for all these new medical advances, the state coffers will be in dire financial straits. Hence, the financial burden in such a situation cannot be borne solely by the State. We must be discerning and prudent. We must differentiate between medical advances of proven value versus glamorous high technology medicine whose efficacy is uncertain. What we need is a medical evaluation body similar to SISIR.”
“Before I leave the subject of education, I am again reminded of the remarks made by the Member for Potong Pasir who quoted Dr Vivian Balakrishnan and surmised that the university administrators, lecturers and students were on a leash. This morning, I had spoken to Dr Balakrishnan who practises in the same hospital as I do. His remarks were made in the context of raising funds for the University Endowment Fund and he had suggested that the alumni be given more say in the university administration so that there will be a sense of belonging to the University, and certainly not because there was no freedom and democracy in the university environment. The Member for Potong Pasir had further quoted out of context by saying that no great people will come from such universities in which the alumni was not actively involved. The speakers at the forum had meant that because NUS had such a short history, there was no great personality that had arisen to whom the students could look up to. However, if we were to include the years of the Singapore University and the University of Malaya, there would have been great personalities whom the students can be proud of and that would help to forge a sense of belonging and identity. Health Health is dear to the hearts of all Singaporeans, and I see it as my bounden duty, to use my intimate knowledge of the health care system, to achieve the twin goals of continued provision of affordable quality health care and to temper the escalating cost of health care without compromising on standards. From the outset, let me say that the standard of health care in Singapore is comparable to the best in the world. To continue providing a high quality of health care, it is inevitable that health care cost will escalate.”
“The Ministry of Education has always stated that admission to independent schools is solely based upon academic criteria. Scholarships and bursaries are made available to those from the lower socio-economic groups. One of my concerns about the independent schools was the affordability of the enrichment programmes and activities in these schools. It is reassuring that the Edusave programme will help to fund the enrichment programmes. It is important to ensure that having gained admission to the independent schools, students from lower socio-economic families will not be socially alienated because of their inability to afford the enrichment programmes. The independent schools have a moral responsibility to ensure that this situation will not arise. When commenting on education, we are often so absorbed by the needs of those who are being educated that we sometimes neglect those who educate. The pressure by principals for their schools to perform well, the pressure from the school inspectors to teach the perfect lesson, the pressure of being unable to discipline an errant student without courting a complaint letter from parents - all these connive to erode the dedication and loyalty of teachers who have answered to the calling of education. We must study the plight of teachers with the same energy and vigour as we do when we seek to improve the quality of education. Therefore, I urge the Minister for Education to harness the wisdom of his Ministry to ensure that the heights of education will be equally supported by the pillars of dedicated educators, an adaptable educational system and conscientious students.”
“Mr Speaker, Sir, on education, I see education as a cornerstone of success not only to the individual but also to the country. It is also the ladder by which one can climb out fromthe poverty trap into better socio-economic rungs. In a meritocratic society like Singapore where educational achievement is placed on the highest pedestal, the relentless pursuit of academic excellence is an absorbing priority. The Government has done much to ensure that each Singaporean has the opportunity to realise his maximal educational potential. I am certain that if the Member for Hougang were familiar with the educational scheme, he will know that the Government does not deny any child of reaching his maximal educational potential because of his intellect. The limitation is not on the part of the Government but on the part of the individual. We must not rest on our laurels and we must continually adapt our educational system. At the primary level, the new Primary 4 streaming system gives the parents an opportunity to determine which stream the child goes to even if it differs from the streaming recommended by the school. In some instances, the expectations and hopes of the parents may far exceed the ability of the child to obtain the necessary grades. The Ministry of Education should undertake a survey to monitor the performance of the students who are in the streams that their parents have opted for although their school has recommended otherwise. In this way, the Ministry of Education will be able to advise parents of the consequences of choosing a stream other than what has been advised by the school. This will allow parents to make informed choices and it will also allow the Ministry of Education to fine-tune the streaming system.”
“However, in this present age, I believe that we must also win their hearts though without compromising the need to preserve the interests of society. The Government will have to continue to use the channels of communication to foster a closer relationship with the ordinary citizens. The Government must be seen to be able to empathise. The Government will have to ensure that policies are implemented sensitively on the ground. The Government will have to adapt and make adjustments whenever necessary. Few in Singapore will disagree with me when I say that most, if not all, Singaporeans prefer the practice of freedom and democracy in Singapore as compared to that practised in the context of Western culture. I will find it hard to believe if the Member for Potong Pasir says that he disagrees with the majority. I think that the correct thing to say about freedom and democracy in Singapore is that the Government, having carefully balanced the scales of personal freedom and civic freedom, should continue to be guarantors of the freedom of the individual and the society. Education I see education as a cornerstone of success ---”
“The West being perceived as the epitome of freedom and democracy, it is not unlikely that the Member for Potong Pasir clamoured for more freedom and democracy in the Western context. Harvard sociologist, Orlando Patterson, the author of the book Freedom which won the 1991 National Book Award for non-fiction, described "freedom" as the heart of Western culture, the germ of its genius and all its grandeur, but freedom was also the root of Western greed, alienation and social injustice. Patterson warned that, in USA, the darker side of freedom looms large over the social fabric and it was this dark side that the East was most likely to follow. In the USA, individual freedom is paramount to the extent of infringing on the freedom of others. The American concept of freedom is so skewed that civic freedom, which gives society freedom by participation in government, is a poor cousin to personal freedom. If every person had the freedom to do anything he wanted, he will infringe on the freedom of others and there will be no freedom but rather anarchy. Hence, to have the maximum amount of freedom for society as a whole, the unbridled reins of personal freedom will have to be restrained whenever the practices threaten or encroach on the freedom of society at large. Simply put, civic freedom for the society must prevail. The elected government must then be the sentinel of society's freedom and interests. In most situations, the individual perceives it as also being good for him. Unfortunately, the perception is not always so. The government will then do its best to explain the principles behind the policies. The Government may win the minds but not the hearts of many when unpopular policies are instituted. Few doubt that the Government will be able to defend its policies.”
“Mr Speaker, Sir, I rise in support of the motion standing in the name of Dr John Chen. Singapore has come a long way from the uncertainties of yesteryears to become a modern, affluent and bustling city. Our success is due to the farsighted and visionary Government whose primary aim was to make Singapore a success. For the immediate future, the plans laid out in the Presidential Address and the attached addenda will improve the quality of life in Singapore. The Government has also looked beyond the horizon and has laid out our plans for the future in the Next Lap. The myriad of topics assaults my mental faculties, but constrained by time, I will restrain myself to four main areas: freedom and democracy, education, health and the lower socio-economic group. Freedom and democracy The open, consultative style of Government has encouraged Singaporeans to be more vocal. This is healthy for politics. It allows people to voice their support or dissent for policies. It gives the Government an opportunity to understand their misgivings, explain the principles behind the policies and even modify policies. At the end of the day, it is not simply a matter of who is right or who is wrong, neither is it who has won the debate. Often, the crux of the matter is a tussle between individual liberty versus the interests of society. The Member for Potong Pasir bandies the popular phrase "freedom and democracy" and uses it as a rallying call, but I am certain that no crusade will follow, for in Singapore we have both freedom and democracy. The Member for Potong Pasir did not indicate which model of freedom and democracy he meant and neither did he give any constructive comments on this matter.”