Ng Ling Ling
Singapore
“My final appeal is to the Government, including the Ministry of Finance, to consider providing more budgets for MSF to gradually convert these social residential homes for the vulnerable to purpose-built Homes, like what the Ministry of Education (MOE) did for special education (SPED) schools over the past decades.”
“— everyone in social services who are working very hard to help our Singaporeans in need. I have two questions for the Minister. The first one is on social service research.”
“Chairman, I just have one clarification for the Minister for Health. I am really glad to hear about increase in healthcare subsidies for Singaporeans because it is always a good thing, but if it is on the back of continually increasing cost, then it begs the question of sustainability and the tax burden on our future generations.”
“For our Indian community, there are what we call Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homoeopathy (AYUSH), which is increasingly known in India. My question is, does MOH sees wisdom in beginning studies and understanding into such traditional medicines of our Malay and Indian communities too?”
“My clarification is that, for important issues, like climate change and also earlier, the ageing population, we have Senior Minister-level and Deputy Prime Minister-level coordination, whether this whole class of issues on PDPA, PSGA, cybersecurity, cybercrimes should coordination be taken at a more senior level, at Deputy Prime Minister…”
“The total age dependency ratio that the World Bank uses is the ratio of young and elderly dependents who are generally economically inactive, compared to the number of people of working age. Despite this good data from the World Bank, with an ageing population and declining TFR, there is still cause for concern.”
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“From working adults striving for career advancement, seniors navigating their golden years, to young families dreaming of a brighter future, our policies must continue to be inclusive, flexible and forward-looking as we prepare for the next decade. Let us continue to work together to uphold the values of inclusivity, resilience and unity, ensuring that every citizen, regardless of age or life stage, can look forward to a thriving future, prepare for the challenges of today and the opportunities of tomorrow. Mr Speaker, I stand in support of Budget 2024.”
“I have encountered many residents coming to seek help at my Meet-the-People Sessions to secure HDB flats to start a family. They are usually young couples who have not been successful yet in their balloting for new flats – be it BTO or Sales of Balance flats – but hope to have a home to start a family soon or have a baby coming on the way. In fact, the request for assistance in balloting for new flats usually forms the majority of my Meet-the-People Session appeals to HDB for my young residents, especially during the BTO launch seasons. Could the Government consider extending the new PPHS (Open Market) Voucher also to couples who have been applying, but have yet to be successful in balloting for a new flat, especially those who are expecting their first baby? Finally, I also believe that more needs to be done to alleviate the fear of having children due to the high cost of living in Singapore. According to a survey done by Channel NewsAsia and YouGov in 2023, 52% of those below 35 years old cited the affordability of raising a child in Singapore as the main reason for not wanting to have one soon. As Budget 2024 looks towards supporting families at each stage of our lives, I hope that the Government can consider placing more importance on implementing comprehensive strategies, such as creating a social support ecosystem for mentoring young couples in financial planning, financial management, so as to reduce their financial anxieties associated with raising children in Singapore. Mr Speaker, as we look towards building a shared future, we must continue to adapt and evolve our support for the diverse needs of our people.”
“During my Meet-the-People Sessions, I have come across cases where the single seniors, who are 55 years old and above, who have finally succeeded in balloting for their own HDB 2-room Flexi flat, and were looking forward to having a home of their own as they reach retirement, but they are unaware that the sums from their Ordinary and Special Accounts, that have been transferred into their Retirement Account when they reached 55 years old, could not be used when their house came, for payment beyond the loan they can get from HDB at that old age. Some of them were disappointed that the extra sums transferred into their Retirement Account could not be reversed when they needed the amount to pay for these BTO flats. Even though they have tried to appeal to the CPF Board for the withdrawal of their Retirement Account for their flat purchases, the recourse for them is limited, as the CPF Board also needs to ensure that the Retirement Account amounts are maintained to support their retirement needs. Although the Enhanced Retirement Scheme is helpful for those seeking higher CPF retirement payouts, I urge the CPF Board to highlight and explain the policies for transfers into Retirement Account clearer and to work with HDB to advise those who have not yet settled their housing needs, to be more mindful of the amounts to be transferred into their Retirement Account. Lastly, I would like to speak about the aspirations of our young couples and families, and how they can be better supported to achieve their dreams of home ownership and starting their own family. I am glad that the Government has introduced the Parenthood Provisional Housing Scheme or PPHS (Open Market) Voucher in this Budget for one year to support eligible families to rent a HDB flat in the open market.”
“During my house visits and grassroots events, many of these young seniors have shared with me that they welcome the move by the Government to introduce the Majulah Package to better assure their retirement needs. One of these is the Earn and Save Bonus of up to $1,000 annually to help young seniors accumulate more retirement savings. A group of them are, however, full-time caregivers to their elderly parents who are in their 80s and 90s and who are frail. They shared with me that the Majulah Package would have been helpful for them too, but family caregiving is not recognised as a formal employment. Will the Government be open to adjusting some of the criteria for the Majulah Package's Earn and Safe bonus, such as by establishing the family members' genuine needs for full-time caregiving, and the duration of caregiving provided, to include this group of young senior caregivers, who are also concerned about their own financial needs, so that they can also benefit from the package? I also welcome the move by the Government to raise the Enhanced Retirement Sum from three times the Basic Retirement Sum, to four times, to allow more members, aged 55 and above, who wish to put more of their accumulated CPF savings to receive higher CPF payouts on retirement. Nevertheless, I would like to raise a concern for some single seniors, aged 55 years old and above whom I have met at my Meet-the-People Sessions, who have yet to settle their housing needs. The latest Population Trend 2023 showed that the proportion of singles rose across all male and female groups aged 25 to 49 years, between 2012 and 2022. This would inevitably mean that we would have more individuals who are approaching the age of 55 years old, who are still single.”
“I understand from some of my residents that despite the generous SkillsFuture Credit, time for attending approved courses is a major factor in them using up the credits. As such, I would like to ask the Government how it can further support employers to enable their employees who are motivated to upgrade, to be given more training leaves and time-off to pursue upskilling courses and more so, to embark on another diploma programme as the new top-up to the scheme will enable. Another consideration is the age of the Singaporean interested to utilise the top-up credit to stay employable. Let me share the story of one of my residents, Mr Lee, who is 64 years old and looking for employment. Mr Lee came to my Meet-the-People Session and shared that he held a diploma in mechanical engineering from Singapore Polytechnic and an advanced diploma in manufacturing technology many years ago. He had also taught modules and given lectures to ITE students previously. Mr Lee is healthy and hopes to continue working but he struggled in his job search due to his age. I worked with Workforce Singapore (WSG) to make referrals and tried to assist him in the journey. His case highlights the need for a more inclusive, flexible approach to career continuation for our older workers besides upskilling. For a case like Mr Lee, how likely would SkillsFuture Level-Up Programme help in his job search if he does invest time to take up another diploma? This is something in the mind of some of my residents in their 60s who are keen to continue to pursue life-long learning and to work well into their 60s and 70s, if they are in good health. Next, let me move to another group of important Singaporeans, our young seniors in their 50s.”
“Mr Speaker, I welcome the comprehensive packages in Budget 2024, with its focus on building our shared future together in the next decade as a nation that aims to remain vibrant and inclusive, fair and thriving, resilient and united. Last year, I rose to speak on three areas in my Budget Debate speech to urge strong efforts by the Government to: one, support working adults; two, care for our seniors; and three, support our young couples and families. For this year’s Budget, I would like to continue focusing my speech on considerations and support for these three groups who made up most of the residents in my Jalan Kayu Constituency. In the Jalan Kayu constituency, the largest segment is aged between 20 and 60 years old. They are mostly working adults who may be embarking on their first job to sustaining employment as far as possible in their senior years, all with the hope of retiring with comfort and confidence. As such, the Budget packages announced that can affect some of their career trajectory and opportunities are of great interest to them. I am delighted to hear that the Government is introducing the new SkillsFuture Level-Up Programme to better support mid-career workers. This includes a $4,000 top-up SkillsFuture credit in May to encourage more mid-career workers to refresh their skills and progress in their careers. However, I am concerned about the low take-up rate of individuals attempting to upskill or consider mid-career switches through the SkillsFuture Scheme so far. As data published from SkillsFuture Singapore (SSG) last year showed, across all ages, seven in 10 Singaporeans have not yet used their SkillsFuture Credit since the scheme started in 2015.”
“As our nation starts incorporating mental health as a key pillar of our healthcare policy, I believe that as a united people, we can work together to build a more resilient, compassionate and mentally healthy Singapore. Notwithstanding my considerations raised, I support the Motion.”
“Because, they are, unfortunately, often chronic in nature. I have heard of stories of inclusive work teams who, out of good intentions, had thought that helping a colleague with mental health condition to discontinue medication is a sign towards recovery, just to be shocked to see their colleague suffer a relapse after a high workload period. To enable more inclusive workplaces, appropriate education for employers and co-workers is, thus, crucial. Hence, I would like to propose for the Government to leverage on the tripartite relationship between employers, the Government and the union to work with the mental health professionals to promulgate more accurate understanding of mental health conditions and some form of Individual Placement and Support (IPS) plans for appropriate accommodation for persons with mental health conditions to integrate and sustain employment for as long as possible? In conclusion, Mdm Deputy Speaker, let me quote from the Constitution of the WHO, which states, "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." Mental health is more than merely an absence of mental disorders or disabilities. Rather, it is a state of well-being in which an individual can realise his or her abilities and potential to work productively and make contributions to the society. Today's Motion and the National Mental Health and Well-Being Strategy are a commitment to the holistic well-being of every Singaporean. It is a pledge to foster a society where mental health is no longer seen as a stigma, but as part of a nation's collective responsibility.”
“To better support persons with mental health conditions, workplace intervention and accommodation is necessary to help those who desire employment, which will allow them to achieve financial independence and security, contributing to their sense of belonging to a community and boosting their self-confidence and positive identity. I am heartened to know that one of the Government's key focuses in the National Mental Health and Well-Being Strategy, is on improving workplace mental health and well-being. This includes enhancing mental well-being in the workplace, tackling workplace discrimination and strengthening employment support for individuals with mental health conditions. I am also encouraged by the moves of various companies in the private sector that has introduced flexible work arrangements and welfare policies to support the mental well-being of employees with differing needs. I believe that helping persons with mental illness seek or stay in employment, is an important part of mental health intervention to be incorporated in their care and treatment plan. Nevertheless, stigma and discrimination inevitably continue to exist within some workplaces. I would like to ask, whether the Government will systematically roll out initiatives to better educate employers and train co-workers to better understand and facilitate work accommodations for colleagues with mental health conditions? For example, many people are not aware that common mental health conditions, such as depression and anxiety, have almost 50% chance of a first relapse and a higher chance of further episodes of relapses thereafter. It should not be a surprise that such common mental health conditions are included in the Chronic Disease Management Programme in Singapore.”
“While I appreciate schemes to make mental health treatment at GP clinics to be more affordable and accessible, such as the CHAS subsidies at CHAS GP clinics under the Chronic Disease Management Programme and MediSave support, I believe that more can be done to enable individuals, who require both medication and counselling therapy in the primary and community setting to get more seamless help. I hope that the Government can elaborate on more plans and protocols to manage the cost and facilitate the referral and provision of both medication and counselling therapy in the primary and community care settings. For example, instead of having the patients navigate a myriad of different professionals for medication and counselling support in different places, would MOH consider adopting approaches, such as Collaborative Care Model in the US, by resourcing private GPs within the MHGPP, to organise their GP-led team to include behavioural therapists and counselling therapists and, focus on providing evidence-based and goal-oriented mental health care for intervention, preferably at designated time or at the convenience of a GP clinic. Lastly, I wish to address the need for employers and co-workers to understand accommodation needed by individuals with mental health conditions. We know that while work is essential for economic and social reasons, it can be challenging for those affected by mental illness to sustain employment. Studies in Europe have shown that, although most persons with severe mental illness are willing to seek competitive employment, they are nevertheless substantially excluded from the workforce.”
“Several of my Jalan Kayu residents shared with me that GP clinics are often more convenient and perceived as less stigmatising for them to approach for mental health challenges concerns, as compared to the mental health section of polyclinics or even psychiatric wards of public hospitals. However, the ease and costs of receiving both medication and counselling intervention in the primary and community settings still have their gaps as they may be delivered by different professionals from different organisations at different locations. Let me illustrate this with an example. For an individual with early onset of mental challenge symptoms like prolonged insomnia and low moods and clinically diagnosed for depression and/or anxiety, he or she may benefit from the counselling therapy as the first line of treatment and some medication from a GP. However, he or she is unlikely to receive both care at the same GP clinic at the same time, especially for the counselling therapy component. If they need a certain type of prescription medication not carried by the GP, this will also pose some difficulties in their access to the needed care. Counselling therapy sessions in the private setting also usually cost more than in polyclinics or public hospitals. Usually, individuals facing mental health challenges are already scared, overwhelmed and in distress when diagnosed. Such fee gradients and wait-time between medication and counselling at their GP private clinics in the neighbourhood versus public polyclinics and hospitals' psychiatric wards may increase patients' psychological burdens and disrupt treatment follow-up.”
“I feel that more can be done for this group of vulnerable caregivers, especially those dealing with chronic and recurring care recipients. I would thus like to propose for the Government to enable more research and to develop strategies to address the unique needs of caregivers dealing with loved ones afflicted with recurring or chronic mental illnesses. For example, will the National Mental Health Competency Training Framework guide mental health practitioners in acquiring the knowledge, skills and competencies required? Can these be also extended and contextualised to family caregivers to strengthen the collaborative relationship between practitioners and caregivers of persons with mental illness? Second, one of the major focuses of the National Mental Health and Well-Being Strategy is the expansion and improvement in access to mental health services in the primary and community settings. I support the shift of mental health treatment in the community closer to home to increase care access. As stated in the strategy report, 17 out of the 24 polyclinics today already provide mental health services. By 2030, this will be extended to more polyclinics, including new ones. This is certainly a step in the right direction. However, in Singapore, a substantial portion of primary care family doctors are operating out of private GP clinics. Although it is encouraging to see that since 2012, more than 400 GPs have been trained under the Mental Health General Practitioner Partnership Programme (MHGPP), this is still less than a quarter of about 1,700 GP clinics in Singapore.”
“In 2020, a survey by the Singapore Management University (SMU) showed that three in four caregivers are tired and exhausted from caring for persons with mental health issues and nine out of 10 of them require the hiring and specialised training of a domestic helper. These caregivers can be parents, spouses or even children, depending on which stage of life that the mental health conditions afflict an individual. Undoubtedly, caregivers of persons with mental health conditions can be bewildered and confused on what is the best course of support, especially at the onset of the mental illness in their loved ones. Even for those who achieve remission, a relapse can also be very hard for their caregivers to accept and to provide support. We can imagine the emotional anxiety and physical exhaustion that they may experience resulting from having to monitor the mental conditions and physical symptoms of their loved ones and looking out for their needs. By prioritising the needs of their loved ones over themselves, many caregivers can themselves fall into depression as they have to struggle with also complex emotions of anger, disappointment, exhaustion and guilt. Although there are resources available for caregivers in general, such as training programmes, support groups and counselling services, as mental illnesses can be more complex and can occur at different life stages, I would like to suggest for more tailored care and support for caregivers for persons with mental illnesses. Social service agencies such as Caregivers Alliance Limited have been making remarkable contributions to these fronts, but more resources may be needed to scale caregivers' support programmes as we see the prevalence rates for mental health conditions increase.”
“Mdm Deputy Speaker, I rise in support of the Motion raised. Madam, MOH launched the National Mental Health and Well-Being Strategy in October 2023, which signals the Government's recognition that mental health is a significant issue that ought to be tackled coherently and comprehensively at the national level. Several Members of this House have mentioned the concerning data from the National Population Health Survey 2022 which shows that the prevalence of poor mental health has increased significantly between 2020 and 2022 from 13.4% to 17%. This is almost one in five Singaporeans prone to mental health suffering. What is of greater concern is the higher proportion of poor mental health among our younger adults aged 18 to 29 at 25.3%, or one in four young adults. I believe that the National Mental Health and Well-Being Strategy and today's Motion are important steps towards creating a mental health inclusive society in which every individual with a mental health challenge can feel safe to be accepted, supported and most importantly, to recover. I would like to focus my speech on three aspects: one, caregiver support for those looking after individuals afflicted by mental illnesses; two, the accessibility and affordability of mental health treatment in primary and community settings; and three, work accommodation for individuals with mental health conditions. Firstly, we need to continue strengthening caregivers' support for those who are caring for loved ones afflicted by mental illnesses, especially at the onset of the conditions and when the conditions are recurring and chronic.”
“As such, the registration of our societies, whether specified under the Schedule of the Societies Act or not, should advance objectives in promoting communal harmony and the interest of all Singaporeans. Notwithstanding my clarifications raised, I support the Bill.”
“Lastly, it is worth noting the susceptibility of registered societies in Singapore to foreign influence interests through covert operations. We are reminded that in today's globalised world, the reach of foreign powers is not limited by borders and this makes the regulations of our societies even more imperative. I hope to understand how MHA intends to combat that in this amendment Bill. While clause 9 of the amendment Bill, which modifies section 11A, clearly empowers the Registrar to mandate rule changes for specified societies as a condition for registration, I am concerned if this is sufficient to manage potential risks. This formal compliance might appease the authorities on paper, but there remains the risk that the society in question could continue to pursue unlawful objectives. Therefore, I seek clarification from MHA on the mechanisms in place to ensure that undue foreign influence does not infiltrate specified societies discussing or promoting issues related to sensitive issues. Additionally, will non-specified societies be directed or asked to modify their constitutions if they are identified as engaging in causes that seem to discuss or promote issues that are not aligned with a specific policy or the national interest of Singapore? In closing, Mr Deputy Speaker, we cannot overlook the delicate balance that must be maintained between allowing societies and interest groups to grow and safeguarding national security. Internal security is of paramount importance to safeguard Singapore against social divisions that destabilise and tear apart any social fabric. As I have raised earlier, we must ensure that our legal frameworks are robust enough to protect our community groups from being exploited for unlawful purposes.”
“With the amendment, non-specified societies that apply via the Automatic Route are subject to inquiries by the Registrar to ascertain if they, indeed, qualify for registration via the Automatic Route. It is essential to strike a balance between enabling the formation of societies and ensuring that these groups do not pose risks to national security or public order. I believe that the proposed amendment aims to serve this very purpose. However, I seek to understand the methodology that the Registrar will employ to make these judgements. How comprehensive will the vetting process be and what measures will be put in place to ensure that societies with potential risks are effectively identified? Additionally, I would like to clarify with MHA on the specific criteria that will be employed to assess whether societies are engaged in unlawful activities that will be prejudicial to public peace, welfare or good order in Singapore. This will offer greater clarity to the public, as well as existing and prospective societies, on the conditions that must be met to ensure compliance. Secondly, clause 4 of the Bill also amends section 4A to provide the right of appeal to the Minister for Home Affairs from the decision of the Registrar not to register or to refuse a non-specified society. This provides a means for groups to be able to seek redress if they feel that they have a strong case for registration. This appeal process ensures opportunity for due process and serves as an important check-and-balance mechanism. On this issue, I would like to ask MHA how many appeals have been reviewed over the years by the Minister for both scheduled and non-specified societies, and on what grounds are the appeals granted by the Minister.”
“Mr Deputy Speaker, social groups play a critical role in fostering social cohesion among Singaporeans. They serve as platforms for the development of strong bonds and community relations, uniting individuals from various social and cultural backgrounds. By forming a society, these groups establish a common identity among members who share a specific objective or purpose. Societies provide a setting for members to engage in discussions or activities related to particular interests or issues in Singapore. I appreciate MHA's effort in simplifying the process for registration of societies in the past. However, despite existing regulations governing the registration of societies, the evolving societal dynamics and complex international environment have made it more challenging to manage the risks and threats associated with social groups. Societies can be vulnerable to, and potentially engage in, unlawful activities or be subject to undue foreign influence. Hence, I support the proposed Societies (Amendment) Bill, aimed at strengthening safeguards against such threats. I would like to focus my speech on three clarifications: one, the Automatic Route's comprehensive vetting process; two, the criteria for special appeals to the Minister for Home Affair; and three, strategies for safeguarding against undue foreign influence on societies that focus on sensitive issues like politics, race and religion. Firstly, in the amendment Bill, clause 4 amends section 4A to empower the Registrar to refuse to register a society that is not specified in a Schedule, or a non‑specified society, if the Registrar is satisfied that the non‑specified society is likely to be used for unlawful purposes or for purposes prejudicial to public peace.”
“I would also like to thank members of the public as well as key stakeholders for raising their feedback and concerns through Focus Group Discussions, surveys and REACH consultation. Madam, reciprocity underpins many relationships. Society must continue to balance between ensuring elderly parents having access to justice and care while protecting abused children from facing distress and having to deal with their traumatic childhood experiences due to neglect from their parents. The MPA amendments aim to achieve such a balance. Mdm Deputy Speaker, I support the Maintenance of Parents (Amendment) Bill.”
“] Deputy Speaker, the Maintenance of Parents (Amendment) Bill tabled by the workgroup aims to formulate measures to protect children from abuse, neglect or abandonment and to prevent parents from abusing the laws and disturbing their children's lives and mind unnecessarily. In my English speech, I mentioned a case whereby a mother with gambling addiction applied for maintenance from an adult child. Although her application was rejected and the Tribunal also recommended that the mother undergo counselling, the mother did not continue after one visit. This will also make future conciliation between the two sides difficult. Many addiction problems are longstanding, causing family tensions and distrust between parents and children. Hence, the amendment Bill will give the Commissioner for the Maintenance of Parents and the Tribunal for the Maintenance of Parents greater powers to compel addicted parents to undergo counselling and to mend their family ties through counselling. The workgroup believes that through counselling, the root of the problem can be addressed. It can help addicted parents get rid of their addiction and repair family ties effectively. In addition, the amendment also enables the Commissioner and the Tribunal to order non-monetary maintenance to allow children to maintain their parents without being exploited. (In English): Mdm Deputy Speaker, as I conclude my speech, I would like to again express my gratitude to the leadership of Mr Seah Kian Peng as well as the teamwork from the workgroup that has done this review of the Maintenance of Parents Act and make the tabling of the amendment Bill today possible.”
“These amendments will allow the Tribunal to have more options to address fundamental family issues to improve approval and compliance of the maintenance orders. Counselling can provide a safe space and facilitate process for both parents and children to express their emotions and concerns. For elderly parents struggling with addictions like gambling, counselling can allow them to discuss their challenges, and the underlying issues that contribute to their behaviour in a neutral setting, a support that they might not have had access to in the past. Uncovering root causes of addictions and bad habits, which are often associated with deeper emotional or psychological issues such as stress, depression, loneliness, or a desire for excitement, is important for a conciliatory approach, to help develop healthier coping mechanisms. Through mandatory counselling, elderly parents can learn effective coping strategies to deal with the triggers that lead to their addictions or bad habits, which strain family relationships, leading to conflicts, trust issues and financial problems. Counselling can rebuild trust, establish healthy boundaries, enable forgiveness and foster a supportive environment for recovery. The intent of this amendment is not for adult children to avoid maintenance payments but to ensure that the root cause of the problem that leads to adult children not maintaining their parents can be addressed holistically. The aim is to benefit both parents and adult children to bring about better outcomes and resolutions. Mdm Deputy Speaker, please allow me to say a few words in Mandarin. (In Mandarin): [Please refer to Vernacular Speech.”
“For cases that involve behavioural issues like problem gambling, alcoholism or drug addiction, adult children are often reluctant to pay maintenance as they are concerned that their parents would waste the money, entrench their problematic behaviours further and result in a worser outcomes than when they did not have the money. The Tribunal also shared that they often encounter families having deep-seeded conflicts and complex family issues that needed more professional intervention such as counselling. Without addressing the underlying factors that cause a deep strain between parents and adult children, even if maintenance support is approved, non-compliance after a period will rise due to loss of trust and further breakdown in the relationships. When addressing such cases, there needs to be non-monetary orders especially professional interventions, beyond just addressing the living expenses through maintenance payments. Professional counsellors or social workers can help the parents and adult children better understand the underlying problems and deal with root causes. Currently, the Tribunal is only empowered to make orders on maintenance payments for the purpose of defraying the costs and expenses of the parent. With the proposed amendment, the Tribunal will have two additional powers. One, the Tribunal have the discretion to give direction for appropriate non-monetary orders according to each family's unique circumstance where necessary; and two, the Tribunal will be allowed to subject the maintenance payment to compliance with the non-monetary order or with other specified conditions, such as attendance or completion of counselling sessions.”
“Mdm Deputy Speaker, in our Asian culture, we are mostly brought up to honour our parents. When our parents fall into needs, most of us would naturally want to help them and fulfil our filial piety duties. When parents take the responsibility of bringing up their children well, most will agree that it is right for their children to take care of them when they are no longer able to support themselves. However, where parents have abused or neglected their children when they were young, and subsequently seek maintenance support when their children become adults, this may lead to significant distress and re-traumatisation of childhood abuse or neglect during the maintenance claim process. I am privileged to be part of the workgroup led by the hon Mr Seah Kian Peng and my Parliamentary colleagues have shared extensively on how distressing emotionally and mentally it can be for adult children to be reminded of the abuse and neglect experienced when they were young and how the amendments will help to protect the abused victims with a fair process. I would like to speak more on cases where parents had sought maintenance support from the adult children, but the money was mostly used to feed addictions or problematic behaviours. In the process of the workgroup review, we were brought to understanding several cases such as one where a mother had problem gambling behaviours and her son opposed the application, citing her gambling habits as the reason. The application was dismissed and the Tribunal encouraged her to attend counselling. As this was not mandatory, the mother only attended one session and the relationship between her and her children remain broken.”
“Deputy Speaker, I thank the Minister for the very positive updates on the number that had already been pre-enrolled. I have two supplementary questions. Some of my Jalan Kayu residents, having heard about Healthier SG, especially the younger ones, who know that chronic disease risk can start from 40 years old and seeing that those with chronic disease can be pre-enrolled, asked if in the course of the year – they understand the phases and the need to prioritise our seniors – should they happen to be in a GP clinic and the GP clinic has the capacity to enrol them, can they be more proactive and be allowed to enrol? So, the question is: if they happen to be in a GP clinic for the next one year before their phase comes, and the GP clinic has the capacity to enrol them, can they be considered? The second supplementary question is that some of my more senior residents who have been seeing polyclinic doctors for their chronic disease management are quite convinced that GP clinics may be closer to their home and, as they age, mobility issues come in, and being enrolled will be good. So, they are asking whether their out-of-pocket expenditure, when they go to the GP clinic for their regular follow-up visits, will the consultation fee and medication fee be also managed and be close to what they are paying for at the polyclinics?”
“Yes, Sir. I thank the Senior Minister of State for a very assuring reply on appeals are allowed for MOH. I just wanted to ask two supplementary questions. One, the scenario I asked in my Parliamentary Question, if a patient which is at stage 4 or which is terminal, is the insurance company that is providing Integrated Plans (IPs) for cancer coverage, obliged to appeal to MOH for grandfathering, if the patient is supported by an oncologist's clinical recommendation that the patient should continue on this cancer treatment or drug, even though it is outside of the drug list? My second supplementary question is that for very rare cancer such as that of appendicitis, they are dropped into a general cancer category in CDL with the lowest subsidy caps. Can MOH consider to separate rare cancers out, for a clinical panel to evaluate them on a case by case basis for the cap?”
“Thank you, Deputy Speaker. I just have two supplementary questions for the Senior Minister of State. Thank you for the explanation on how capitation grant will be implemented. My first question is that, if capitation is a method of encouraging less wastage and more preventive and primary care, how is MOH monitoring that clusters even with operational flexibility given, is actually channelling more of their resources towards primary and preventive care. The second question is, towards the health outcomes that the clusters are asked to work towards for the funding, can the Senior Minister of State give an example of how a cluster will be incentivised to shift the capitation funding towards where we are directionally moving, preventive and primary care, rather than what they are doing today, it could be just for volume.”
“If we succeed in facilitating for Singaporeans to enrol and build relationship with a trusted family doctor of their choice for long-term health management, surely this family doctor can be a most comforting main point of contact for medical advice relating to one's end-of-life care, if the family doctors are well-supported by home palliative care service providers, with integrated workflows from hospitals to homes. I read with comfort The Straits Times article published recently on 1 May, titled "Leaving ICU to die at home, surrounded by family and familiar comforts". I applaud the medical teams at Ng Teng Fong General Hospital for piloting "IAMGoingHome" since October last year, smoothening the workflows from both the intensive care unit (ICU) and Supportive Care and Palliative Medicine at the hospital to safely transfer patients, who no longer seek aggressive treatments and desire to die at home, to reach home smoothly for their last wish to be fulfilled. My wish, Mdm Deputy Speaker, for the near future, is for the Government to centrally support the piloting of such possibilities at every public and even private hospitals and hospices, and not just in one pro-active hospital like Ng Teng Fong General Hospital, integrating the workflows at some point with family doctors participating in Healthier SG. So that, in the end, most Singaporeans can have the choice to end our walk on this world with dignity, peace and in the comfort of our home.”
“However, as I mentioned, the adoption level of ACP is currently still low. A study of the ACP database in 2019 showed that only 1.44% of chronically ill patients took up ACP. WHO estimates that each year, about 56.8 million people, including 25.7 million in their last year of life, need palliative care. However, worldwide, only about 14% of people who need palliative care currently receive it. The global need for palliative care will continue to grow because of the ageing of populations and the rising burden of noncommunicable and some communicable diseases. These are demographic trends and disease burden challenging Singapore as well. Early delivery of palliative care can reduce unnecessary hospital admissions and the use of health services, thus managing healthcare costs increases. We need to step up awareness and access to palliative care options in the coming years. Next, on the health, social and community players involved in palliative care support. Whether carried out in a hospital, hospice or home, the support today can involve several different teams and several different care providers. The identification of "being cared for by a trustworthy doctor" in the study on good end-of-life components which I mentioned earlier, is an important one to note. In this regard, can family doctors be gradually enabled to become a central player in providing home palliative care for Singaporeans who prefer that. The idea is in line with the spirit and principle of Healthier SG, the major multi-years initiative led by MOH to better manage the health of our ageing population and manage healthcare costs.”
“A small local study in 2012 with about 60 Singaporeans aged 50 years and above identified, I quote, "Having physical comforts at the end-of-life, avoiding an unnecessarily prolonged dying process, maintaining sensitivity towards religious and spiritual beliefs, avoiding burden on family, avoiding expensive care, being cared for by a trustworthy doctor, maintaining control over decisions and achieving a sense of completion." This brings me to the topic of palliative care. The World Health Organization (WHO) defines palliative care as improving the quality of life of patients and that of their families who are facing challenges associated with life threatening illnesses. WHO further explains that palliative care involves a range of services developed by a range of professionals that all have equally important roles to play, including doctors, nurses, support workers, paramedics. pharmacists, physiotherapists and volunteers in support of the patient and their family. According to the Singapore Hospice Council, there are currently nine community organisations that provide home palliative care. I would like to raise a few issues regarding the palliative care support in Singapore: (a) a lack of awareness of palliative care; (b) health, social and community players in palliative care; (c) caregiver support in palliative care; and (d) cost and subsidy issues related to palliative care. I would elaborate on the first two issues while Mr Yip Hon Weng will cover the last two issues in his speech. A study in 2018 showed that only half of the patients with advanced cancer were aware of palliative care support options. The other half were not. A key indication or expression of preference for palliative home care is done through ACP, which I mentioned earlier.”
“I explained to the group of active volunteers why I started annual health screening from the age of 40. Because I learned that risks of chronic diseases start from that age. And why I signed my AMD and LPA in the last two years when I entered my 50s. Because of COVID-19 pandemic showed me the unforeseen fragility of health and life. However, most important of all, I shared that I only have one son and the last thing I want is to be a burden on him. The volunteers understood and agreed to the need to sign these instruments for planning. Lucky for us, the lawyers among the group offered free certification to help the rest through the application process. I would like to suggest for the different Ministries and statutory agencies, namely, the Ministry of Health (MOH) for AMD, the Ministry for Social and Family Development (MSF) for LPA and the Agency for Integrated Care (AIC) for ACP to come together for a more concerted in enabling conversations and getting deeper understanding around these three useful planning tools and more instead of community groups sporadically conducting such training separately and whenever we have a generous enough lawyer who volunteers to do it free. I hope that MOH, MSF and AIC can provide integrated training resources to the network of over 100 Active Ageing Centres (AACs) around Singapore which will be increased to about 220 island-wide by 2025 to conduct such conversations periodically to help more Singaporeans talk about and simplify their planning on end-of-life choices. Next, increasing primary and community care options for end-of-life support. What constitutes a good end-of-life?”
“My fellow colleague on the Government Parliamentary Committee for Health, Mr Yip Hon Weng, will speak on caregiver support and the need for more possibility and flexibility in the subsidies for palliative care. Firstly, destigmatising the conversations of end-of-life and simplifying the planning. Many Singaporeans may not appreciate the range of decisions that one needs to make regarding healthcare, legal and financial matters for one who is dying until a loved one confronts death. Efforts have been made by the Government to introduce the Advanced Medical Directive (AMD) since 1997, the Lasting Power of Attorney (LPA) through the Mental Capacity Act since 2008 and Advanced Care Planning (ACP) since 2011. When I surveyed a group of about 40 active volunteers in my Jalan Kayu Constituency serving in the grassroots or at my Meet-the-People Session averaging at about 55 years old and above about a month ago in preparation for this speech, I found that the majority have not done any of these three instruments, with less than a handful with the LPA. When I further inquired on their reasons, most said that they felt that there was no need at their age until much later or did not associate this as inter-related instruments for their self-determination on maintaining the preferred quality of life and dignity when we lose our mental or functioning abilities, especially in the end-of-life stage. Nationally, the adoption levels of these instruments reflect responses of the small group I surveyed – with only about 24,682 Singaporeans having registered for AMD as of 2015, 43,000 having submitted their LPA as of March 2018, although the numbers are growing and only 4,500 instances of ACP were completed in 2018.”
“Mdm Deputy Speaker, a bright and white hall adorned with beautiful flowers, maybe some warm fairy lights, certainly my favourite hymns, including "Amazing Grace" playing in the background, and my family and friends around. This is my dream funeral wake which I regularly remind my husband to ensure that I will have if he is around to see it through. Yes, this is not a typical conversation between wives and husbands, less so for parents and children, maybe even be taboo, if brought up among some elders in our midst. In a recently launched book titled "Singapore Ageing: Issues and Challenges", co-edited by our former Member of Parliament, Dr Sushilan Vasoo. The final chapter dealt aptly with end-of-life issues as its title – "Every Ending Requires Planning" – by co-authors Lee Geok Ling and Chee Wai Yee. I cannot agree more. A 2014 survey by the Lien Foundation found that 77% of Singaporeans wanted to die at home. However, as of 2017, only about 30% did so, with the other 70% dying in hospitals, nursing homes, hospices and other settings. Whilst the percentage who passed away at home improved to 39% in 2022, it is still some distance away from the desire of most Singaporeans. Without destigmatising the conversations on end-of-life and normalising the understanding, decision-making and support for Singaporeans to die with the dignity of their choice, most of us would not be able to fulfil our final wish of the most definite event of our life. With a fast-ageing population, this can increasingly be an issue. I will speak on two aspects of enhancing choices and dignity in end-of-life, namely, one, destigmatising the conversation and simplifying the planning; and two, increasing primary and community care options for supporting wishes of dying at home as far as one prefers.”
“Lest it becomes a motherhood statement, where we talk about but see people around us constantly losing their health with a heart attack or a sudden stroke, complications for chronic diseases as our population continues to age, let us have all hands on deck, in a clinically informed, administratively efficient and coordinated way, to ensure that this phrase is truth for most Singaporeans in the many years to come. Mdm Deputy Speaker, I support the Motion.”
“I would like to make a specific suggestion to exploit faster the telehealth capabilities of not just video consultations, but end-to-end full-loop remote vital sign monitoring systems for management of common chronic diseases like hypertension, diabetes and hyperlipidemia. Government funded clinical trials must speed up and extend to private GP space. Chronic diseases are silent diseases, and complications in the form of heart attacks and strokes are too late for Singaporeans to know that their health is not in a good shape. Many of the remote vital sign monitoring technology has been clinically proven to have better health outcomes for specific segments of chronic disease patients, but I see two constraints slowing its proliferation in Singapore. One, operational trials to smoothen end-to-end data transmission between patients and primary healthcare teams, and care team workflows for responses to anomalies in the vital signs; and two, consent procedures for individuals to decide on the extent of releasing their personal vital signs data to their trusted doctors, public or private, and supporting teams, including community organisations like Active Ageing Centres. Both constraints require the trust and protocols or even legislation to be established by the Government, with the trust and facilitation from the private and public healthcare providers, including GP clinics as well as the not-for-profit charities providing community healthcare services, to empower more Singaporeans to receive the right knowledge of their health and take charge in managing our own health in an informed way with our care teams. Mdm Deputy Speaker, in conclusion, I have quoted the phrase "Health is Wealth" several times in my speeches in this House.”
“More handshakes across agencies under different Ministries for a less onerous and time-consuming workflow must be made with a whole-of-Government mindset if we want to see GPs embracing Healthier SG to help this multinational strategy succeed. Secondly, looking after our frontline healthcare workers, especially those in the emergency wards. Last week, some of us were informed of a message that some community groups in a western part of Singapore have received from a good public hospital. It was a cry for help. The message shared that the hospital had been facing a very high emergency load, with 100% occupancy in the past two weeks. ED doctors were operating as fast as they could with admission waiting time increasing and about 100 patients waiting for beds. Their plea is for grassroots volunteers to help spread the message of not going to emergency wards unless necessary and to consult the GP clinics first if their conditions are stable. I thank the Government for the various interim strategies announced in this House to provide a valve to the high demands of beds faced by our hospitals and the long-term strategies through Healthier SG to build capabilities and capacities among our GP clinics. In the meantime, it will be important to step up bolder HR actions to support the frontline healthcare workers. I repeat my suggestion for consideration of employing above establishment with the appropriate HR mechanism in public hospitals to allow buffer for surges and more importantly, essential rest for the physical and psychosocial wellness of our doctors, nurses and frontline healthcare workers. Lastly, my point on not only the need for whole-of-Government commitment, but also whole-of-society actions for maintaining health in our ageing population.”
“He has a GP clinic situated at the basement of a HDB block, a bomb shelter built by HDB and leased out to this clinic for many years. During the COVID-19 pandemic, as a Public Health Preparedness Clinic, he was given a temporary booth at the vacant void deck as his clinic stepped up to help in the administering of COVID-19 tests and vaccinations. It was proven then that senior residents could access this clinic more readily with the void deck space, instead of the basement bomb shelter space which can only be accessed through a stairway. The Singapore Civil Defence Force (SCDF) could not approve the clinic to install a wheelchair lifter down the flight of stairs. Extending a lift to this basement clinic will need to wait for HDB's Lift Upgrading Programme, with no definite plan or timeline in sight. With the GP, I appealed to HDB to provide the vacant void deck space permanently to this GP Clinic. While the in-principal approval came, we were told the process from concept drawing to Temporary Occupation Permit will take another six to 12 months. This GP is struggling with the capital renovation quotes of about $200,000 he has just received from potential contractors and he is thinking of giving up. Even if he manages to raise the amount, we were informed that the approval is further subject to agreement by the URA, Building and Construction Authority and SCDF. Help doctors to help patients more and to do administration less. This example I cited is just one of several that I have experienced while rallying GP clinics in my constituency to support Healthier SG, so that our residents can start their preventive health journey early with a trusted family doctor as exhorted by the Government.”
“Mdm Deputy Speaker, I stand support of the Motion raised by the three Nominated Members. In fact, I have no doubts that the Government is committed to supporting healthcare beyond the COVID-19 pandemic. Looking at the 2023 national Budget that this House supported recently at the COS Sitting, health, with a projected total expenditure of S$12.59 billion is only second to defence, with a total projected expenditure of S$13.41 billion. Where I think the Government needs to continue to be vigilant is how this Budget is being spent and, more importantly, if it is translating to better health outcomes for our ageing population. In addition, I cannot agree more with the NMPs that health for Singaporeans must be a whole-of-Government effort. I will push further to say that it must be a whole-of-society effort. Let me elaborate through three points: one, supporting our family doctors through the Healthier SG implementation; two, looking after our frontline workers, especially those in the emergency wards; and three, empowering Singaporeans with more knowledge and support to manage our own health better. Firstly, on supporting our family doctors in GP clinics. I am a firm proponent of the Healthier SG initiative, having visited various parts of Netherlands, the United Kingdom and the United States a few years back on their healthcare systems to manage increasing chronic disease burdens in ageing populations of advanced countries like ours. GPs in Singapore, who are in the heart of the Healthier SG movement have, however, not been the centre of gravity in how our Government ensures delivery of good healthcare until recent years. I cite an example of a very hardworking GP in my Jalan Kayu constituency.”
“I also hope that MinLaw and MSF can authorise social workers to apply to the Court for alimony on behalf of the divorcee when necessary, such as when the welfare of the children is seriously affected. Second, I would like to relate the story of my resident, Mdm Goh. In the process of claiming maintenance, the Court issued a warrant of arrest but Mdm Goh's ex-husband was not contactable, hence, the alimony could not be claimed. Mdm Goh had to raise three children on her own and struggled financially because she could not get any maintenance. Her story illustrated the importance of therapeutic justice. I hope that MinLaw and MSF will provide more social assistance in cases, such as Mdm Goh's, and to help them claim maintenance. (In English): Mr Deputy Speaker, given that most divorces are likely to occur between five and nine years of marriage, the psychological impact towards separation and divorce can be substantial and long-lasting. This is even more so if the couples have young children. Hence, let me conclude my speech by affirming the efforts of MinLaw and MSF in their determination to reform and strengthen Therapeutic Justice elements in the family justice system. Additionally, I also hope that this Bill will help vulnerable individuals, especially those that may have been through an abusive marriage, to regain themselves swiftly and rebuild their lives. Notwithstanding the considerations that I have raised, Mr Deputy Speaker, I support the Bill.”
“Given her unresolved maintenance payments from her former husband, which may never be paid, she may be a genuine single parent who will require ComCare assistance to be maintained at a level for a few more years until her two younger children also enter primary school and when she can hopefully find a full-time job with her ITE qualification. Mdm Goh's case shows the necessity to emphasise Therapeutic Justice and assistance for vulnerable divorcees, with both MSF and MinLaw coordinating the processes to render needful assistance so that the divorcees and their children do not fall into hardship due to unintended policy gaps. Mr Deputy Speaker, please allow me to say some words in Mandarin. (In Mandarin): [Please refer to Vernacular Speech.] Mr Deputy Speaker, in recent years, our divorce rate has been on the rise. Therefore, it is extremely important to simplify and strengthen our family justice process. I strongly support the Family Justice Reform Bill jointly drafted by MinLaw and MSF. This will allow marriages to end in a harmonious manner and safeguard the welfare of the children through a therapeutic justice system. I have two suggestions on the Bill which I hope MinLaw and MSF will consider. First, the family justice process set out in the Bill requires divorcees to apply for maintenance online. I am worried that online applications will deter divorcees who are not tech-savvy and will indirectly affect them and their children's welfare. I hope MinLaw and MSF will work together to identify vulnerable groups who need help, such as low-income divorcees who are single parents, and provide more social assistance to help them claim maintenance effectively.”
“I would like to cite the example of my resident, Mdm Goh, as one such single mother who needs more help from MSF and MinLaw for enforcing the maintenance from her divorced husband. Mdm Goh came to my Meet-the-People Session some weeks back to seek help on financial assistance. She is a single mother in her early 30s with three young children, aged three to seven. Following her divorce a couple of years ago, while the Court has ordered her former husband to pay about $1,200 monthly maintenance to her and their three children, he has not done so. Mdm Goh started applying for enforcement but has been stuck for a while as the Court informed her that her former husband has an outstanding warrant of arrest, which renders the enforcement of maintenance not possible until his arrest. He has not been contactable. Meanwhile, Mdm Goh has been relying on ComCare support, which was reduced recently. While she understands that ComCare assistance is provided only for short to mid-term and she needs to get a job, she has only been able to convince employers to let her work on daily hour-rated jobs because of her need to rush home to care for her young children before and after school or childcare hours, alone. She also has to wrestle with her bankruptcy status due to her former husband using her name against her will for a loan on which he defaulted. Her own parents struggle with mental health challenges and are deemed unsuitable for caregiving of her young children by social workers assisting her. Mdm Goh has been anxious and desperate. Thankful to SSO's help to my appeal, she is given some ComCare extension while I assist her in finding jobs nearer to her home.”
“I wonder if MSF and MinLaw could work together to identify vulnerable individuals, such as low-income single parents, or divorcees with special needs or disabilities, including those due to stroke, that would require more support in their application and enforcement for maintenance. A suggestion is for MinLaw and MSF to consider empowering Social Service Office (SSO) or social workers with the role to act on behalf of such applicants, in their navigation of the online application and appropriate referral to the Family Justice Court if they are found to require additional attention to expedite enforcement of their maintenance, especially where the welfare of young children is at stake. Secondly, I would like to raise another consideration with the enforcement of maintenance. In the Bill, amendments are proposed to the Women's Charter in section 71 to empower the Court to make attachment of earning order for maintenance to secure payment of any maintenance from the respondent. Additionally, the Bill added a new section 81 to the Women's Charter to provide directions to the Court on the orders that it may or must make on a maintenance enforcement application, which included a Show-Payment Order and, when breached, the respondent is liable for imprisonment. Despite these safeguards, there may be instances where respondents continue to act irresponsibly and are defiant to these orders, failing to pay maintenance, especially after one year from the hearing. In such instances, I would like to ask what powers and directions the Courts are vested with to ensure that the maintenance order would be fully enforced within a reasonable stipulated time, for the respondents to be brought to task expediently to reduce hardship on the applicants needing the maintenance.”
“Mr Deputy Speaker, data published in 2021 by the Department of Statistics Singapore showed that the general trend of divorce rates is increasing in Singapore, with 7.2 male divorcees for every 1,000 married men, up from 6.3 in 2020; and 6.9 female divorcees up from 6.1 in 2020. Although Singapore, as a society, is primarily anchored on family-centric values, with the Government and the community at large encouraging marriages and supportive of couples through their marriages, we acknowledge that some marriages may inevitably break down, due to multifaceted factors. We do need to help couples deal with the fall-out from the break-up of their marriage and help both parties move on with their lives, especially if there are children involved. Therefore, I am very supportive of the introduction of the Family Justice Reform Bill. However, I would like to raise two considerations. One, with regard to the new Maintenance Enforcement Process (MEP) and two, on the non-payment of maintenance and how the process could be enhanced to support more applicants, especially the vulnerable ones. Firstly, the enhanced MEP starts with applicants applying online for enforcement. Like my concerns shared in my previous speech on the Mental Capacity (Amendment) Bill relating to the process of applying for Lasting Power of Attorney, the process for the enforcement of maintenance assumes that all applicants are tech-savvy and will not have any difficulties applying online. Nevertheless, we know that there will be cases where applicants are not tech-savvy and may be discouraged to submit an online enforcement application because they are unable to do so readily, even if they are facing financial hardship.”
“Most family doctors would have received some basic training, but as common mental health conditions, like depression and anxiety, are harder to treat than coughs and colds, many family doctors need continuous education and training, as well as peer-consultations opportunities from their peers and specialists, and collaboration with counsellors. Consultations will also take a longer time and they will need higher subsidies for consultation with patients struggling with mental health. I hope that the Government can provide more subsidies and training to GPs with regards to the treatment of mental illnesses, so that they can play a greater role. Secondly, youths today still have high aspirations. According to an IPS survey on "Future of Work Singaporeans Want" in October 2022, young Singaporeans prioritise personal growth, learning opportunities and career progression over job security. I believe that companies and business leaders can play a greater role in mentoring young Singaporeans and further promote a mentoring culture. Lastly, on the issue of encouraging our young people to marry and young couples to have children, besides the financial incentives that are important, I hope the Government can press on in the tripartite approach in providing greater support and more flexible work arrangements for more employees. (In English): Mr Speaker, I would like to end with a message of unity. As Singaporeans, we possess the spirit of kindness, drive, and hope. As we start the second session of this Parliament, may we stay united, combining our national will and grit with good stewardship of the hard-earned resources availed to us, to create a better future for ourselves and for our future generations to come. With that, Mr Speaker, I support the Motion.”
“As such, besides financial incentives, I hope that the Government will continue to press in on the tripartite approach, to implement more physio-social support and flexible work arrangements for more employees in Singapore. Even in positions like frontline service staff and intense workplaces like in the healthcare, legal and financial sectors, where flexible working arrangements seem difficult today, I think bolder human resource policies, including employing slightly above establishments to cater for peaks and surges must be trialed to manage work stress, especially for our younger couples. Mr Speaker, please allow me to say some words in Mandarin. (In Mandarin): [Please refer to Vernacular Speech.] Mr Speaker, I would like to thank the President for the speech which she delivered on behalf of the Government. I hope to raise three suggestions here to contribute to a better Singapore. First, in view of our high-stress society and an aging population, I hope the Government can speed up the delivery options for treatment and support of mental illnesses. Currently, psychiatric illnesses are primarily treated by psychiatrists or psychologists in hospital psychiatric wards. However, I believe that mobilising neighbourhood GPs as the first line of care defence for mental health is a good strategy. For most of the children, youths and adults facing mental health issues at the early stage, it would be less stressful for them to walk into a GP clinic than to go to a psychiatric ward.”
“During my Budget speech earlier this year, I recommended for more upstream and local resources to enable social interactions among our young people. I was involved in a REACH-Friendzone Conversations @Me event in my constituency recently. While it is certainly not a dating platform, the interactions and sharing were most authentic among the participants, majority of whom are 26 to 30 years old. They shared many similar struggles and hopes. Many said they could come after a long day work, because the get-together was near their homes. I am a firm believer that an authentic friendship is the foundation of any enduring relationships, sometimes leading to marriage like for me. This event would have been a one-off if not for a kind sponsorship I personally obtained to plan more sessions in the months ahead. I hope that the Government would consider empowering MPs with more funding support to regularise such thoughtful local social interactions opportunities for our young people in our constituencies. Our total fertility rate has hit record low last year. The Government has done a lot in increasing financial incentives like raising the Baby Bonus, the subsidies for assistive reproduction procedures, infant care and childcare. These are all important measures but according to the 2021 Marriage and Parenthood Survey, besides financial costs, stress and difficulties in managing work and family demands remain the other top reasons why Singaporeans are not prepared to have more children. For sandwiched dual-income families, caregiving of both elderly parents and young children can add to further burden.”
“We have our collective memory, formed in our fight for independence and national hood, shaped by threats and opportunities of larger countries and regional powers around us, often outnumbered in size, but not in the will to survive and thrive. Singapore business sector can proliferate a stronger culture of mentoring. Personally, I enjoy mentoring and will be formally or informally mentoring several younger people between five and 25 years younger than me in a year. In my constituency, I have partnered the National Trades Union Congress (NTUC) Women and Family Division to widen the pool of mentors through the Women-Supporting-Women Mentoring Scheme. I learned about the Australian Business and Community Network or ABCN for short recently at the inaugural Singapore Volunteer Management Conference. ABCN is a purpose-led, not-for-profit platform established by a group of like-minded CEOs who collaborate to maximise their impact, especially in making a difference to kids facing poverty, violence or drugs. The CEOs know that education is crucial for lifting young Australians out of disadvantage and partner almost 200 schools to empower students through a structured mentoring by volunteers at all levels from companies in the network. I hope to see such collaborative mentoring model replicated and scaled by the business community in Singapore too. Lastly, on the tough but rewarding role that I most value, being a mother. I have never regarded having children as a duty but a joy. Whether by natural delivery or by adoption, parenting teaches us many things in life beyond self. However, there remains a gap in Singapore for young people who aspire to be married to do so, and for young couples desiring children to have them.”
“I agree with Mdm President that Singapore must not allow advantages and privileges to become entrenched and persist over generations in a small group. To broaden and make more open the idea of meritocracy, it will require conscious efforts from the whole of society, not just the Government. Young people today continue to have high aspirations and expectations. According to IPS’ “Future of Work Singaporeans Want” survey conducted in October 2022, young people are more likely to value growth, learning and career advancement to job security. In another survey published by TODAY Online in 2022, it was found that although fresh graduates are landing in full-time jobs with higher median salaries and better-than-expected starting pay, those between 21 and 34 expressed lower upward mobility compared to older respondents. This is intertwined with the global macro-economic challenges and competitive realities that our young Singaporeans face. I believe that corporate and business leaders can do more in mentoring our young people. I visited Israel in 2017. Among the many lessons I learned, one that stood out for me was how their older people were willing to mentor all younger ones. I was told that this has been their survival instinct through the generations, so that as many of their people can continue to succeed as possible despite the Jewish Diaspora and traumatic persecutions their people experienced through history, like the Holocaust in World War II. Singapore has several traits like Israel. We are a small nation where our people are our most precious asset.”
“One, by providing more training and subsidies to family doctors in GP clinics, to make them the first line of care for mental health. Walking into a GP clinic is way less intimidating than walking into a psychiatric section of a hospital for most parents, children, youths, young adults and seniors. Most GPs have the basic training but as common mental illnesses, such as depression and anxiety, are more complex to treat than coughs and cold, many GPs need refresher training, specialists’ peer consultation, teaming with counsellors and higher subsidies for the longer consultations usually needed. Two, by enabling simple-to-use, clinical evidence-based and privacy preserving technology to augment prescription of medicines by GPs and specialists. Innovations like Cognitive Behavioural Therapy Based AI chatbots, to provide lower cost counselling, has been progressing worldwide. More can be done to insert these tools to the medical-social team for integrated care of medicine and counselling at a lower cost for patients. And three, by empowering more in the community, including parents, students and grassroots volunteers, with mental health first-aid skills. I will be piloting “Be a Samaritan (BAS) Programme” by SOS in my constituency soon. This is a two-part programme with a one-hour e-learning and a two-hour physical role-playing workshop, which will teach participants the basic skills to be first responders to those facing mental crisis, suicide ideation, or affected by suicide. I hope that more support can be provided to proliferate such skills in the community, like the way we have been training grassroots leaders in Cardiopulmonary Resuscitation (CPR) or Automated External Defibrillator (AED). Let me move on to my next "M", Mentoring.”
“According to the data from the Samaritans of Singapore, a non-religious and not-for-profit charity focusing on crisis intervention and suicide prevention, 378 people here took their own lives in 2021, with the largest group aged 10 to 29 years old. Slightly more than one life a day and one too many lives lost. We need to equip more parents with the basic mental health knowledge and skills to help their children and youths when they are going through mental distress beyond normal levels. In super-ageing societies, such as Japan and South Korea, increasing age is associated with increasing depressive symptoms, largely due to poor physical health status and lack of extended family networks. With our fast-ageing population and increase in seniors living alone or only with another senior, we too must be alert to these issues. While early efforts like the National Mental Health Blueprint in 2006, the Community Mental Health Masterplan in 2012 and most recently, the Interagency Taskforce on Mental Health and Well-being in 2021, have all worked towards expanding psychiatric programs and shifting towards more community-based care to increase accessibility to mental health support, the most recent spike in mental health concerns during the COVID-19 pandemic indicated further transformation required in the delivery of mental health services and support, especially for our young and old at the early risk or onset stages of mental health struggles. In this regard, I would like to urge the Government to speed up augmenting mental health treatments and support, currently mostly delivered through hospital psychiatric wards by specialists like psychiatrists or psychologists, in three ways.”
“Mr Speaker, I rise in support of the Motion of thanks. In my maiden parliamentary speech, I spoke about engendering and ensuring the collective and holistic well-being and happiness of our people. This remains a key thrust of my efforts as a Member of Parliament (MP). I thus resonate with the important points made by Mdm President in the Opening of Parliament for the second half of this Government term. As we continue to transit from the COVID-19 pandemic, with a purposeful and comprehensive legislative agenda ahead, I would like to speak on three "M"s that are close to my heart. Not the usual three "M"s debated in this House, but important three "M"s that I will champion to further contribute to building a better Singapore for all. They are: Mental Health, Mentoring and Motherhood. Firstly, my residents in Jalan Kayu know that I strongly advocate and promote healthy living. Through the new Jalan Kayu Community Health Club opened in February, our grassroots leaders partner our regional Central Health system, anchored by Tan Tock Seng Hospital, and the general practitioner (GP) clinics in the neighbourhood to increase health screening awareness and disease management knowledge among our residents. Through the corporate social responsibility (CSR) sponsorship of smart watches, we empower our residents to know and monitor their health better. Two months into operations, more than 600 residents above 40 years old have signed up. While we are starting with physical health and common chronic conditions like high blood pressure, high cholesterol and high blood sugar in line with the national Healthier SG roll-out in the next few months, we will also be looking out for the mental health and wellness of our residents.”