Rahayu Mahzam
Singapore
“We engage the insurance providers quite regularly, but we are very mindful about where we intervene, especially because they need to be competitive and there is a commercial dimension to it, which we feel that we should respect. So, how we intervene is via the conditions that are put in place vis-a-vis the consumers.”
“So, that is not something they can worry about. There is already the S+3M framework that is already in place, so we know that MediShield Life is one, they have their MediSave and if all else fails, there is MediFund.”
“Should there be disputes over specific claims, policyholders can take it to the Financial Industry Disputes Resolution Centre (FIDReC), an independent and impartial institution that assists with insurance-related disputes.”
“It is just a symptom, so the underlying cost pressures still need to be addressed. The description that we had put earlier in the past is that it is a knot that we need to untangle; and that is something we are doing with a multi-pronged, with engagements with different parties and stakeholders.”
“I appreciate the Member's feedback. As I said earlier, this is something that we will continue to consider. But we do also have to appreciate that the information that we get is live, in terms of waiting times and all that.”
“But I do take the point and we are actually reviewing to see what is a meaningful way to put out this information so that the public can understand, so that we can all track properly whether the good health outcomes are a result of the efforts that we are making. I will take the feedback back and we will continue to review this.”
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“I thank the Member for the clarification. Typically, the applicants or those who are asking for this will usually just write in to appeal to the Ministry of Health and we would provide them the answer and tell them what the necessary requirements are. But we can look into the suggestion and see how this information can be made more accessible, and perhaps, a form that is simplified for the purposes of this application.”
“Happy International Women's Day to all! During the pandemic, MOH received appeals from some couples to import their pre-implantation genetically screened embryos stored overseas. In reviewing each appeal, the Ministry considered whether processes and standards employed by overseas assisted reproduction (AR) centres are aligned to Singapore’s regulatory requirements under the Licensing Terms and Conditions for AR Services (AR LTCs). The Ministry may on an exceptional basis allow importation of the embryos, subject to conditions. These conditions include: (a) declaration by the overseas AR centre that the relevant requirements under the AR LTCs, including the handling, processing and storage of the embryos, are adhered to; (b) that no other findings besides the presence or absence of chromosomal aberrations are reported, and (c) proper documentation of the screening test results that were provided to the patient and attending physician in our local AR centres. Local AR centres which receive the tested embryos must also continue to ensure compliance with the AR LTCs.”
“However, such awareness and sensitivity to various needs should be more pervasive as we continue to build our common spaces in this country. Thirdly, I think we need to continue to educate the community on the appropriate norms or social interactions and empower them to embrace people with different abilities. We should create opportunities for PWDs to fully participate, physically and socially, in the community, but I think we also need to learn how to do so meaningfully. I have been to events where PWDs were invited to attend as guests, but they were seated at a separate table or space and there was no interaction with the rest of the participants or guests. Some families of PWDs would get upset or offended with reactions from the public. I think often people behave the way they do because of ignorance. I believe the Government can play a role in educating and creating understanding, but families of PWDs also need to be open and willing to embrace people who lack understanding, not shun or criticise them. Teach them, tell them kindly about the appropriate vocabulary, the appropriate approach, the appropriate way to interact. I believe that a conscious approach of integration and inclusiveness is necessary at the policy, organisation and individual level. I hope that we will continue to grow as a nation, to be one that truly cares for the vulnerable and embrace differences. Women in Leadership”
“Do we have indicators in place to help us measure how we are doing as a community and targets which we can work towards? What more can we do to nudge behaviours and encourage people to be more open and compassionate towards PWDs and their care-givers? May be useful to do a review of study so that we could assess a better approach to build on the current efforts. Secondly, I would like to propose that we take a more holistic approach in looking at opportunities to normalise different abilities within the society, in school, at work, and then the community. PWDs have much to offer society. We should equip PWDs with skills and empower the community so that PWDs may contribute to society in some way. I had in my speech for MOE's COS debate, shared my thoughts on how this could be done in the school setting. I would encourage a similar approach for the workplace and in the community. For example, I think there is a need to engage extensively and meaningfully with employers to create better understanding of different abilities and provide support for the redesigning of jobs. I appreciate that there are already efforts on this front and it is a challenging exercise. I feel though, in the long run, there is much value to be gained. Otherwise, we will continue to typecast PWDs, especially those with intellectual disabilities to just do menial tasks and we do not get to tap on their full potential. Another area, I believe we could work on, is to develop various infrastructure within our communities to accommodate different needs. We do see a few inclusive playgrounds, Braille in the lifts, quiet rooms in public places. And that is always very encouraging.”
“Their kindness and graciousness have let me to believe that there are many out there who are open and willing, and are keen to see a more inclusive society, one that embraces different abilities. In my own experience and through conversations with parents of PWDs and people in the disability sector, there are still concerns about the level of understanding and inclusiveness in our society. Many parents have shared about unkind remarks people have made to them or the rude stares they receive when their child misbehaves in public. Some parents have shared about challenges they had in finding a suitable child care or pre-school in the vicinity of their neighbourhood. I have heard many instances of PWDs, especially those with intellectual disability, being bullied or taken advantage of in school or at work. Above all, what families of PWDs hope to see is for their family member to be treated with dignity. They are no lesser human beings and are as entitled to be treated with respect, like any of us here. 6.45 pm At this juncture, I would like to offer some observations and thoughts on creating a kinder and more inclusive society. Firstly, I would ask if the Ministry has been tracking the effectiveness of the various campaigns and effort in encouraging the public to be more inclusive? I am heartened by efforts by various agencies like the "See The True Me" campaign and I am always excited to participate in events like the Purple Parade. I believe there is now more awareness and sensitivity, but there is still some way to go before we can say that our community is truly inclusive and embracing of people with different abilities. Have the different campaigns and efforts to encourage inclusiveness in the community been successful?”
“Mr Chairman, I gave birth to my son, Ayden, in 2017 and having him is one of the best things that has happened in my life. Ayden has Down Syndrome and was also recently clinically diagnosed as being on the autism spectrum. There are some challenges for the family but I have so many things to be grateful for and I am glad for the support that I receive to raise my child. I am grateful for a Government that cares. The Enabling Masterplans and their evolution over the years reflect the efforts of the Government in creating an inclusive environment for persons with disabilities (PWDs). This is an on-going effort and we need to continue building on existing initiatives, but I am grateful for the effort of the team at MSF, who continues to look at various ways to support PWDs and their families. I am also grateful for activists and advocates who have blazed a trail for many PWDs and their families. Take hon Member, Ms Denise Phua, for example. Her years of advocacy and labour of love opened the doors for discussions and reviews and led to many meaningful initiatives that have made an impact to the sector. I would also like to mention Dr Lim Hong Huay and the team at Caring SG. I would declare at this juncture that I have been asked to sit as an advisor to this organisation, but I must sincerely say that I am heartened by the efforts and their passion to support care-givers of PWDs and provide them with helpful resources. I am also truly grateful and indebted to family members and friends who have provided unconditional support and love and have made this journey so much more meaningful.”
“I thank Member for the suggestion. I am sure that this is something we can consider and I will follow up with the Member after the Budget and Committee of Supply debates are over.”
“I thank the Member for the clarification question. Thank you for highlighting the issue with regard to the HealthHub age cut-off. We are, indeed, still developing the platform and we will be adding more information. So, I will bring this back and then we will develop it further. In response to the query on the outreach for vaccination, especially the seniors, actually HPB has recently launched a public education campaign to encourage eligible individuals to get vaccinated, and getting them to increase their awareness. The key thing about vaccination is getting them to be aware of it. So, we did try to roll out a public education campaign and this is something that we can build on. The other thing is to work with the General Practitioners (GPs), with the doctors, to get them to routinely advise their patients on vaccination needs, especially every time they come to visit, we would ask them to inform their patients, so that this will also increase awareness and their interest and uptake for vaccination.”
“We hope that this improved accessibility and affordability will encourage Singaporeans to protect themselves and their families against vaccine-preventable diseases by getting vaccinated as recommended, and support children in starting off well and healthy. MOH is committed to increase the uptake of nationally recommended vaccinations, and will encourage eligible Singaporeans to be vaccinated. Together, we can encourage one another to take greater ownership of our health and lead healthier lives, for a better future.”
“For Singaporean children up to the age of six, we have extended full subsidies for childhood developmental screenings at CHAS GP clinics, to allow for early detection and timely intervention for any developmental delays. There is also support for their families. From last November, subsidies have been extended to vaccinations under the National Adult Immunisation Schedule, or NAIS, at CHAS GP clinics and polyclinics for all eligible Singaporean adults. Dr Lim Wee Kiak asked about the progress of our national immunisation efforts. Based on the National Population Health Survey 2020, the take-up rate is estimated to be 23% for influenza vaccination, and 14% for pneumococcal vaccination in persons aged 65 to 79 years of age. I am happy to update that three months after the enhancements, a total of 158,000 and 121,000 doses of the NAIS and NCIS vaccinations respectively have been administered nationally. In particular, for pneumococcal and influenza vaccinations that are recommended for the elderly aged 65 years or older, the uptake has been encouraging with more than 38,000 and 62,000 doses received respectively. One of the families that benefited is the Chiam family. The three-generational family has been regularly consulting Dr Lim Hong Shen from A Medical Clinic, under the NUHS Primary Care Network. With Dr Lim's strong support, their two children, aged two and four years old, have undergone their childhood developmental screenings and received subsidised vaccinations for influenza, as well as measles, mumps and rubella. The grandfather, aged 69 years old, has also received both the pneumococcal and influenza vaccinations.”
“Evidence shows that the success rate of ART decreases with maternal age, as each successful cycle progresses. It is not just about Government funding, but the strain of couples to keep trying. Hence, we must continue to encourage couples to marry and start families early, to maximise the chances of conception. After co-funding, the current MediSave per-cycle limits are generally sufficient to cover the cost of a ACP cycle at public Assisted Reproduction Centres. As not all couples go through multiple cycles, we have allowed a higher MediSave withdrawal limit for the first two cycles so that more of the lifetime limit can be used. MediSave can be used to pay for all standard procedures for each method of treatment, such as the priming of the uterus, egg recovery and fertilisation processes. However, as Traditional Chinese Medicine treatments associated with IVF are not part of mainstream evidence-based treatment, there are no plans to allow MediSave for their use currently. MOH remains committed towards supporting Singaporean couples in their parenting journeys, and will continue to review the MediSave withdrawal limits to ensure they remain relevant and adequate for Singaporeans, as we balance immediate expenses with retaining sufficient savings for basic healthcare needs in old age. Apart from supporting couples, we enabled early intervention and enhanced subsidies for vaccinations under the National Childhood Immunisation Schedule, or NCIS, for all Singaporean children at polyclinics, and extended them to CHAS GP clinics across Singapore in November 2020. We have also added vaccines against chicken pox, influenza and pneumococcal disease to the NCIS.”
“We will continue to collaborate with the "Jaga Kesihatan, Jaga Ummah" (JKJU) network and community leaders to develop and implement health programmes throughout the year to foster good health habits. We will produce simple tips to remind the Malay community about the important steps to take care of their health. To sustain this effort on health, we will have Health Ambassadors and continue to enlarge this network of volunteers. Mdm Rahimah is one of our most committed Health Ambassadors since 2012. As a member of the Macpherson MAEC, she plans motivational health lectures for the Malay community. She also spends time teaching our seniors to surf the Internet. Mdm Rahimah’s efforts should be emulated. I would like to encourage all Singaporeans to follow her lead and contribute to the community. (In English): Beyond ethnic minorities, I echo what Minister Masagos said on the importance of supporting our children and women to lead healthy lives for a healthier next generation. It is key to support couples who wish to start their own families. Mr Louis Ng asked about supporting couples undergoing IVF. Today, eligible Singaporean couples undergoing Assisted Conception Procedures, or ACP, in public Assisted Reproduction centres can receive co-funding support for the different procedures. The co-funding applies to each Assisted Reproduction Technology (ART) cycle, and the patient would either receive the co-funding of 75% of the cost or the capped co-funding amount, whichever is lower. As such, there is no remaining balance to be rolled over. However, MOH regularly reviews the clinical evidence around the number of cycles to co-fund. At present, on average, women undergo two ART cycles before achieving pregnancy successfully.”
“Our Indian community partners such as Hindu Endowment Board, Sikh Welfare Council, SINDA and places of worship have provided strong support in engagement efforts with their networks. For example, NARPANI Pearavai provides Indian Activity Executive Committees funding to co-create health activities for their residents. Between 2018 and 2020, close to 15,000 Singapore Indian residents have participated in the various health promotion programmes. We will build on early successes to improve our work, to make healthy living a sustainable achievement. Moving forward, we will expand community partnerships and harness ground-up efforts to multiply our impact and and ensure that our programmes are culturally relevant through customisation. We will engage key community leaders through significant platforms to garner commitment towards health. For example, at a forum in end-March 2021, leaders from the Hindu Endowment Board, SINDA, NARPANI, Sikh Welfare Council and HPB will discuss the state of health amongst Indians and co-develop culturally relevant efforts to facilitate healthier lifestyles among Singaporean Indians. We look forward to an invigorating discussion and a year of fun, healthier activities for all Singapore Indian residents. Let me share further for the Malay community. Mr Chairman, allow me to say a few words in Malay, please. (In Malay): [Please refer to Vernacular Speech.] To bolster health-related efforts for the Malay community, we will form a new working group. I will be chairing this group together with Dr Wan Rizal and Ms Mariam Jaafar, as well as community bodies, such as M3 and the Muslim Healthcare Professionals Association (MPHA).”
“This would allow us to evaluate the impact of our programmes as we generally do with our efforts. We see significant disparities in health behaviours and outcomes across ethnicities and will be ramping up efforts in this area. For chronic diseases, in 2020, 14.4% of Malays and 14.2% of Indians have diabetes, compared to 8.2% for Chinese. Thirty-seven point five percent of Malays and 36.1% of Chinese have higher blood pressure, compared to 29.5% for Indians. For cancers, the Chinese consistently have the highest age-standardised cancer incidence rates, but the proportion of Malays among all cases of cancer has gradually increased over the decades. Looking upstream at other modifiable lifestyle risk factors, the Malays have the highest obesity rates and Indians have the highest prevalence of being overweight. The prevalence of daily smokers are more than twice as high amongst the Malays as compared to the Chinese and Indians. Research has shown, poor health behaviours can affect life expectancy. Therefore, our community needs to take stronger action, and support one another against poor health habits. Cultural preferences may influence health behaviours and we recognise the importance of engagement and collaboration with the different ethnic minority groups to design culturally relevant programmes. Some of our earlier efforts have seen good progress. For the Malay community, we have built our partnerships under HPB's Jaga Kesihatan, Jaga Ummah from 23 in 2018 to 32 mosque partners, and 18 other partners such as the Malay Executive Activity Committees (MAEC) and MENDAKI. With their support, we were able to provide a range of healthy living programmes for their congregants.”
“MOH developed the Patient Empowerment for Self-Care Framework to empower patients to co-own their care journeys and achieve better care outcomes with support from their healthcare team, family and friends. Under this framework, we developed the first tranche of the National Diabetes Reference Materials that provides fundamental information and hosted it online on HealthHub. We are now working on the next tranche of materials with more in-depth information to help patients, their family and friends, better understand and manage diabetes. This resource is being co-created by the people for the people – about 700 citizens highlighted additional topics and content that would be useful, and suggested design features for a more user-friendly online experience. These materials will be ready from 2022. Beyond our broad plans for our Singaporeans, I will elaborate on targeted efforts. Mr Leon Perera has highlighted the lower income groups. Minister Gan has shared how we ensure they have good access to affordable care. While our health promotion efforts remain inclusive to all, there are also efforts targeted to address their health needs, and we work across agencies to provide holistic support. One example is the Healthy Living Passport programme, which Mr Perera referred to. The programme is designed to improve health literacy and promote healthy lifestyles. It is customised based on the lifestyle needs of lower income families, with tailored messaging and education. This is a multi-agency effort, and will commence after the SMMs are reviewed. We aim to benefit 15,000 residents over three years. We intend to track changes in our participants' health literacy as well as their behavourial improvements.”
“Interested participants can look out for more details on Healthy365 and HealthHub. We will continue to work on avenues for Singaporeans to keep healthy while staying safe. 5.15 pm We recognise that at different life stages, Singaporeans face different health needs, challenges and risks. Going forward, we will add a person-centric approach to address these across our population segments. Dr Tan Yia Swam has highlighted health literacy in her Budget debate speech and Dr Lim Wee Kiak has also suggested boosting our efforts with technology. We have embarked on initiatives similar to Dr Lim's vision. I am happy to update that the first digital version of My Health Booklet is ready on HealthHub, developed based on ground insights. This version provides an overview of your health screening records drawn from national health databases and smoking cessation messages for those motivated to quit smoking. We will add more features and health topics such as stress management and the nationally recommended vaccinations starting from July this year. Another example is LumiHealth, a free, two-year personalised health programme designed by HPB, in partnership with Apple, using the Apple Watch. Under this programme, participants will embark on customised health journeys and earn rewards as they complete health-related challenges. They will also receive personalised reminders, to encourage them to meet their goals. Since its launch in end-October 2020, we have seen more than 100,000 downloads. We must also not forget our efforts to keep chronic conditions at bay, like our on-going War on Diabetes.”
“In August last year, we launched the “Brave the New” campaign with MCCY to build psychological resilience of individuals. The campaign provided tips for self-care, and information to support their peers and loved ones. It reached 2.1 million Singaporeans and three-quarters of those surveyed reported being more motivated to self-help or help others in their mental well-being. To complement this, the “Hi!JustCheckingIn” movement started in January this year to equip targeted segments of the population with the appropriate skills to help them identify and reach out to those who may need support. Building a supportive community is important, to encourage Singaporeans to seek help if they are unable to cope. Through our community partners, we included seniors in our mental well-being efforts. We understand that many seniors are mentally and physically affected during this pandemic, especially during the circuit breaker. Last year, we trialled the virtual “Balik Kampung” programme to link up 100 seniors over 22 Senior Activity Centres over activities to stay mentally stimulated. With good feedback on how it has helped seniors stay socially connected, we will ramp up these efforts. We will continue to promote holistic well-being. The HPB’s National Steps Challenge saw over 900,000 participants in its fifth season. The sixth season will start in the third quarter of this year and will augment the traditional Steps Challenge with a different dimension of well-being – sleep, via the first pilot Sleep Challenge. Having good sleep habits is key to good health and well-being. Through the Healthy365 application and a wearable, there will be nudges to achieve the recommended sleep duration, and tips on good sleep habits.”
“As working from home became the norm, we also observed a drop in physical activity time, likely from reduced commuting. This drop is also demonstrated in the daily average step count data from the Health Promotion Board’s (HPB) National Steps Challenge. We quickly pivoted to delivering our programmes virtually, in line with the safe management measures, or SMMs. We shifted physical activity programmes online, and produced exercise routines on YouTube and an edutainment series on free-to-air TV channels to help Singaporeans keep active. We understand that some seniors have found it challenging to adapt from physical to virtual modes of exercise. To help seniors navigate around these platforms, we worked with partners such as People’s Association to organise workshops to provide assistance, and equip them with basic IT skills. I am heartened to hear that our regular participants have benefitted. For example, for the senior-centric virtual Community Physical Activity Programmes, over 5,000 participated across more than 190 sessions from July to December 2020. To benefit as many as possible given the current guidelines, we will be scaling up our virtual programmes progressively this year. We understand that some still prefer physical interaction for health programmes. To reach out to more Singaporeans, we have gradually resumed physical sessions both in the community, such as our popular Sundays at the Park, and at the workplaces with the appropriate SMMs. Like physical health, mental wellbeing is also important for one’s health. I echo Senior Minister of State Janil on creating a supportive environment to empower Singaporeans to take care of their mental well-being.”
“Mr Chairman, we remain committed to our long-term priorities even as we focus on containing the pandemic. We continue to transform from Beyond Healthcare to Health, to support Singaporeans to lead healthier lifestyles and stay healthy in the “new normal”. It is important to take stock of our state of health. I am happy to report that Singapore ranked first globally for life expectancy at birth and healthy life expectancy at birth in the Global Burden of Diseases 2019 study. However, based on our National Population Health Survey 2020, there are still areas for improvement. While our smoking prevalence rates decreased to 10.1%, down from 13.9% in 2010, compared to 2017, the proportion of Singaporeans with sufficient total physical activity has dropped. The proportion of Singaporeans that are obese or overweight has increased. In 2019 and 2020, about two out of five are overweight. And the age-standardised prevalence of the three common chronic diseases, high blood pressure and high blood cholesterol have risen and the prevalence of diabetes have not decreased. There is a need to better understand the current situation among different groups. Additionally, COVID-19 and the various measures and socio-economic challenges have impacted our lifestyles and our health. Dr Tan Yia Swam has also asked about supporting healthy living in this new norm. I will therefore share our plans to innovate health promotion efforts for Singaporeans to remain healthy in the “new normal” and how to better prepare Singaporeans to lead healthy lives for the future. Indeed, in the past year, Singaporeans faced challenges pursuing healthier habits in ways they were used to. With safe distancing concerns, we were unable to hold our usual health promotion programmes such as mass exercises.”
“Thirdly, could schools look at intentionally creating platforms by adapting programmes, redesigning school spaces and setting aside time for cross-interaction during learning and play? We should look at how to regularise such interactions and teach students to respect each other and embrace differences. Schools are best placed to create opportunities to normalise acceptance of people with different abilities and celebrate different strengths. I laud all the efforts taken by the Ministry thus far and sincerely hope that the Ministry would continue to build on existing programmes and initiatives. Special Education Needs”
“In Israel, there have been efforts to train those who are in the autism spectrum for cybersecurity jobs and an artificial intelligence (AI) start-up has found that autistic people are highly suited to their business involving data annotation. These developments may still be at the nascent stage, but if we choose to view children with special needs as assets to the community, I am sure we will find a way to maximise their potential. I would also argue that beyond benefiting the students with special needs, students who are typically developing also stand to gain a wealth of skills, values and knowledge that are crucial for the diverse workplace of the future. Learning in school should not be just about learning hard skills and knowledge like Mathematics and Science but also about the softer skills and values. I believe it is in our interest to nurture a culture of inclusion, respect and understanding, and these values need to be inculcated from an early age. I acknowledge that much has been done by schools but I believe we can enhance the existing efforts. To this end, I ask that the Ministry look at a few areas. Firstly, could a review or some studies be done to look at developing fields where the skills and inclinations of the special needs students could be developed? A revised curriculum could then be curated to enhance the student's education experience and better maximise the child's potential. Secondly, could the Ministry and schools also look at how to better equip and support educators to manage diverse student profiles? Beyond just sending them for training, could we look at understanding the challenges and providing sufficient resources to guide educators in this journey?”
“Every child is different and deserves to be given the opportunity to thrive and discover their true potential. Some may even have special needs and may need more support and guidance. However, this should not just translate into giving them special attention and help. What would be more meaningful is to empower and equip them with as many skills as possible so that they can be as independent as possible and could even contribute towards the economy and society in the future. Further, it is also important to provide opportunities for them to integrate into the community. We could start by creating opportunities for them to learn and play alongside typically developing students in school. I am sure many would not disagree with the vision of supporting our children with special needs and creating an inclusive and integrated learning environment for them. But the challenge comes in the implementation. Firstly, there is a spectrum of needs and it may not be easy to truly customise and curate the curriculum and integrate students with varying needs. Secondly, a lot of resources are needed and educators need to be sufficiently knowledgeable and mentally prepared to manage the different students. Thirdly, there may be concerns about shortchanging the typically developing children if teachers need to accommodate those with special needs. I understand the challenges but I believe there is great value in investing upstream to provide our students with special needs with the skills and preparing them for life. The cost of having to care for them in later years may be greater and this may result in a social burden to families and the community. More importantly, this group presents a potential resource which may not have been fully tapped.”
“I thank the Member for the question. The high attrition rate of about 71.7% of enroled subjects before reaching the stage of embryo biopsy and PGS testing, indeed, remains a challenge. Prior to the start of the pilot, the evaluation team had determined that the target of 300 patients with PGS testing would be needed to achieve statistical significance. As of 30 September 2020, as mentioned earlier, 367 patients were enroled but only 104 had enrolled biopsies performed. Almost half of the patients changed their minds after the ovarian stimulation and fertilisation stage, and proceeded with embryo transfer directly without performing PGS or decided to freeze their embryos instead. Other patients did not proceed with a biopsy due to medical reasons, such as poor quality of the blastocyst or embryo arrest. And of these 69 patients with euploid embryos, 60 underwent embryo transfers. This led to 31 pregnancies with 15 livebirths, eight miscarriages and eight on-going pregnancies. As the Member rightly pointed out, we do need a bit more data to fully study this to understand its clinical effectiveness. MOH is doing its best to try and assist and support as many patients as possible to go through this process and this remains something that we will continue to review. And as far as the cost is concerned, this is something that we understand is a challenge. For the patients who really need support for this, we will look into this matter. But as it is at the moment, there is limited and inconclusive evidence on the clinical effectiveness. We do need to proceed carefully with this process because there is also an impact on the embryo. There is a low risk, but there is still risk to the embryo and we do need to make sure that the right people proceed for this procedure.”
“MOH will continue to assess the clinical effectiveness of PGS, including looking at overseas data and collecting more data from cases here in Singapore. MOH will also explore options for co-sharing of costs of PGS for patients who are keen to be part of the study, but have affordability concerns. If PGS is included as a mainstream healthcare service, it will then be assessed for means-tested subsidies.”
“Under the Ministry of Health's (MOH's) pilot for Pre-implantation Genetic Screening (PGS), the intended objective is to improve in-vitro fertilisation (IVF) success rates leading to live births for specific groups of women who have an increased risk for embryos with chromosomal abnormalities. Any woman who fulfills one of the following clinical criteria is eligible for PGS: (a) 35 years and above, regardless of prognosis; (b) suffered two or more recurrent implantation failures; or (c) experienced two or more pregnancy losses. These eligibility criteria are not set arbitrarily but developed with reference to available international evidence and aligned with clinical practices in overseas assisted reproduction centres. PGS is a technically complex procedure which carries potential risks, including damage to the embryos during the biopsy, with impact on their subsequent development, and should be reserved for women who fulfil the eligibility criteria to undergo the procedure. MOH provides substantial funding for the PGS pilot programme. It has extended $1.7 million in funding to support the manpower and operations of the PGS laboratory, and half of the PGS consumables costs. As a result, participating patients are charged only the remaining costs of the PGS consumables which average about $1,100 per test, as well as the cost of the embryo biopsy to remove cells for PGS testing which ranges from $2,500 to $4,500. PGS is performed together with in vitro fertilisation (IVF). For IVF, patients can receive Government support through the Assisted Reproduction Technology co-funding scheme as well as tap on their MediSave. A total of 367 patients were recruited for the PGS study, more than the targeted 300 patients.”
“Mr Speaker, may I take Question Nos 5 and 6 together?”
“However, these sessions may not be sufficient to develop specialised skills. It may be helpful if the lawyers could be supported with a training and development programme that could help them pivot and succeed in a new and growing field. Future-proofing the Legal Sector”
“One, the support for adoption of technology and two, training and development programmes that could empower lawyers from these films by building substantive knowledge on different fields where there is potential growth. At the opening of legal year 2021, the president of the Law Society of Singapore, Senior Counsel Mr Gregory Vijayendran, made reference to the dialogue with the Ministry of Law on a technology platform in a pipeline and a promising initiative of effectively Plug and Play Technology Solutions. May I ask for an update of this discussion? Could we enhance our support for technology adoption? Some of the adoption may require customization to suit the needs of the firm. It may take the lawyers some time to learn the platforms or standard solutions and some more time to build a customised solution for their set-up. Lawyers from small- and medium-sized firms may not have IT staff or teams to support them with this. Would it be possible to create an entity with such firms could avail themselves to technology consultancy services to help develop the IT infrastructure? In addition, would there be sustainable funding or grants to support these firms with the developments? On the second area, could we enhance the platforms available to the lawyers from the small- and medium-sized firms to give them more exposure to new and developing fields of work? Aside from exposure, could there also be opportunities for lawyers from these firms to develop specialisation and deep knowledge for a particular field so that they could potentially develop a boutique practice in a specific area of growth? Currently, lawyers are required to accumulate continuing professional development points and attend various training sessions.”
“Twenty-twenty was a challenging year for many and the legal sector was not spared the effects of the pandemic. In particular, when the circuit breaker was implemented, lawyers had to quickly adjust and adapt to work from home, make alternative arrangements to meet and communicate with clients, and then to have court sessions online. The sector had to quickly adapt and accelerate the adoption of technology. The development of technology in legal practice has been in the horizons for some time now, but the pandemic obviously gave a hard nudge to the sector and hastened the progress. This did not just mean that lawyers had to learn new skills to manage their practice with new technology. It also meant that they had to contend with potential competition, with the advent of artificial intelligence and the development of online platforms for lay persons, which inevitably meant less dependence on lawyers. To be clear, I am not suggesting that we should not allow for these developments just so as to preserve the lawyers' relevance in society. I believe these advancements are important and necessary and we should always look at platforms and opportunities to make the law accessible to the public. However, lawyers from small- and medium-sized firms may face more challenges than others in pivoting and developing their practice into one that is relevant to the times and to seize opportunities in areas of growth. My question is therefore, how can the Ministry help lawyers from small- and medium-sized firms stay relevant and continue to thrive in the changing legal landscape? I believe there are two areas which the Ministry could look into.”
“In fact, despite her busy schedule, she also managed to sew and distribute 600 face masks to frontline officers as a token of appreciation for their sacrifices. Ms Fatimah also rolled up her sleeves to help small businesses during the physical Ramadan Bazaar last year. She invited them to place their products in her shop. Her never-say-die attitude, willingness to innovate and concern about the plight of other business owners are traits that we should emulate and admire. Indeed, women have much potential to help Singapore emerge stronger from this pandemic. I urge the whole community to have an open mind and provide unfettered opportunities for women. Do not underestimate the roles, responsibilities and contributions of women. As the saying goes, “the hand that rocks the cradle rules the world”. (In English): Mr Speaker, the pandemic is far from over. Its impact will be felt for years to come and there is a lot more to be done. We also need to remain committed to our long-term priorities and amongst other things, continue to look at areas where we can address gender bias and disparity between men and women. We are not done building this nation and will have to carry on our efforts to build a fair and just society for all. And I have no doubt, the women in Singapore will stand tall alongside the men, doing their part for this country. It is apt that we are also Celebrating SG Women this year. There is indeed much to celebrate as we are celebrating the great leaders, the pillars of strength within the families, the everyday heroes, who inspire us to emerge stronger together. Mr Speaker, I stand in support of this Budget. [Applause.]”
“These enable our women to progress at a better level than women in other countries. However, we need to continue to increase support to help develop the potential of women. Women in Singapore have made many sacrifices and contributions to their families, society and nation. In some of my interactions with women comprising professionals, business owners, home-based business women and housewives, I have been very impressed with their resilience. Although the COVID-19 pandemic has affected their lives, they remain positive. They also continue to play an important role in strengthening family institutions, becoming valuable assets in their organisations, improving the country's economy and becoming a role model for other countries to celebrate the achievements, progress and potential of women. Recently, Berita Harian highlighted the story of Ms Shirin Hamid, an outstanding corporate woman, holding the post of Director General and Chief Information Officer of the Asian Development Bank (ADB), based in Manila, the Philippines. She led the IT department of the bank that has 45 global offices. Prior to that, she played a role as Chief Technology Officer at the United Nations Development Programme or UNDP in New York for 10 years. This is the highest non-political appointment at the UN. Her achievements in the field of technology, which currently does not have many women from the minority groups, is something to be proud of. Many of us may also know Ms Fatimah Mohsin, designer and founder of Fatimah Mohsin The Wedding Gallery. Due to the spread of the COVID-19 virus, many functions and events had to be cancelled or postponed. This has affected her business, but she has not given up hope. Ms. Fatimah has modified her company's strategy and has opened a new restaurant.”
“Ms Yeo Wan Ling spoke yesterday about challenges faced by female cabbies and also raised the possibility of introducing respite care to alleviate the burden on women workers. Ms Tin Pei Ling spoke earlier about digital empowerment of women. Ms Jessica Tan and Ms Nadia Samdin will be talking about jobs, encouraging more women into certain sectors in the workforce and providing support for women to pursue their aspirations. Miss Cheryl Chan, Ms Joan Pereira, Ms Carrie Tan, Ms Hany Soh and Ms Ng Ling Ling will be covering various aspects of the women’s care-giving roles. Miss Cheng Li Hui will speak on assisted conception. Minister of State, Ms Sun Xueling, will address how Budget 2021 builds on continuing efforts in supporting women in care-giving, supporting vulnerable women, and supporting women in their career aspirations. Their insights will show the broadness and depth of all the issues that matter to our women; reflecting how a Budget debate will always take into account the concerns of all women as our interests and development are intertwined with the development of this nation. Mr Speaker, in Malay, please. (In Malay): [Please refer to Vernacular Speech.] COVID-19 has brought many challenges to our community. It is important for this year’s Budget to ensure that there is steady support for the public and robust plans to improve our economy. Women, just like the men, are impacted by COVID-19 and are very concerned about economic recovery and social issues that emerge in our community. We seldom discuss Budgets through the lens of women, but if we think about it, there are many aspects of this Budget that benefits women. In Singapore, year after year, we see a lot of opportunities and support being given to women.”
“About 65% of the recipients are women who had low earnings throughout their lives and now have less in retirement. In 2019, we saw the Government announcing the Bicentennial Bonus CPF Top-Up. Six in 10 of the citizens who benefited from the top-up are women in their 50s and 60s. From 2021 to 2025, the Government will also provide a dollar-for-dollar matching grant of up to $600 annually under the Matched Retirement Savings Scheme (MRSS) to older members with lower CPF balances and cash top-ups to their Retirement Account. One-third of those eligible for MRSS are inactive CPF contributors, including full-time care-givers, with about 2.5 times as many women as men among them. There has been increasing awareness about women who have spent a large part of their lives not in formal employment but toiling to care for their families. Over time, there has also been conversations around the uneven distribution of the care-giving load and equal opportunities for women. Indeed, there are gaps that we need to work on. Gender bias and stereotypes and the disparity between men and women continue to exist. That is one of the reasons why the Conversations on Women’s Development was started – to encourage a whole-of-society discussion on this to nudge behaviours and call for changes that benefit not just women, but the whole community. The efforts are still on-going and there is still much to be done to meaningfully change mindsets and systems so that our boys and girls in the future have equal opportunities to pursue their full potential. My colleagues, in their speeches, will address some of the issues that continue to be of concern to women in Singapore and share their views on how we can build on our existing efforts to support and empower women.”
“Financial support is necessary to help families tide over this challenging period. Another major area of concern is care-giving. Both men and women can be care-givers, and the Government’s support for care-givers is not specific to any gender. Nevertheless, it is clear that, in many circumstances, women tend to take a disproportionate load of the care-giving role. MOH launched the Caregiver Support Action Plan (CSAP) in 2019 which focused on providing better support to care-givers of seniors and their families. The CSAP included enhancements to: (a) care navigation, (b) financial support, (c) respite care, (d) workplace support, and (e) care-giver empowerment and training. Various initiatives were rolled out under the CSAP, such as respite care pilots and the Home Caregiving Grant in 2019, to alleviate the community cost of care-giving. MOH also worked with community partners to set up care-giver community outreach teams. These teams support care-givers in self-care through health and wellness activities and also provide counselling services where needed. The Government remains committed to supporting care-givers and more plans will be shared at MOH's COS Debate. There are many other aspects of this Budget that would have a great impact on women. Women care about the environment, too, and certainly look forward to further details of the Singapore Green Plan. Women care about their jobs and the economy and would be keen to see the roll-out of the SGUnited Jobs and Skills Package and the Jobs Growth Incentive. Thirdly, the Budget builds on earlier Government policies and the work is not done. We have seen how policies and schemes have evolved over the years. In 2016, the Silver Support Scheme was introduced.”
“To quote Deputy Prime Minister Heng, our healthcare workers have, over the years, been working hard to provide us with the highest quality of care. The announcement that the Government will enhance the salaries of our nurses and other healthcare workers, such as support care staff, is, therefore, welcomed. At this juncture, I feel that we should also recognise women who have been at the leading edge of infectious diseases and public health, guiding our efforts in fighting COVID-19, such as Assoc Prof Lim Poh Lian, Director, High Level Isolation Unit, National Centre for Infectious Diseases and also Head, Travellers’ Health and Vaccination Clinic, TTSH. Assoc Prof Lim is also a member of the Expert Committee on COVID-19 Vaccination. We also have Prof Leo Yee-Sin who is the Executive Director of the National Centre for Infectious Diseases. She had led Singapore through multiple outbreaks, including SARS in 2003, pandemic influenza in 2009 and Zika in 2016. In 2020, she was the fourth Singaporean to be recognised by the BBC in their annual 100 Women list. I should also mention Assoc Prof Ong Biauw Chi, Chairperson of the SKGH Chief Medical Board, who worked tirelessly on the frontlines, managing the dormitories outbreak. We, indeed, have a lot to be proud of, having our women at the forefront of this battle against the pandemic. Secondly, the Budget addresses some of the women’s immediate concerns and their concerns about their families. The Household Support Package and the COVID-19 Recovery Grant, for example, matter to women and their families. Women are often contributing to the family finances or managing their families’ financial commitments. In some families, the economic situation has led to some loss of income.”
“Our women, like their male counterparts, are very much involved and vested in our economic recovery and social development. While we may not typically see the Budget presented in a gender-centric fashion, the reality is that, there are many aspects of this year’s Budget measures that benefit women. In fact, all the Budgets announced in the past years have had measures that impact women. This year’s Budget is building on past efforts to transform the economy and support Singaporeans through various changes. In this regard, I would like to share my thoughts on the top three things about this Budget that matter to women. Firstly, many of the Budget measures this year impact sectors where there is a high representation of women. There are many women working in hard-hit sectors, like tourism and hospitality. In many countries, proportionately more women have dropped out of the workforce. However, in Singapore, the workforce participation of women was not just maintained but, in fact, showed modest growth even in 2020. At the height of the pandemic, the employment rate for females remained at about 73.2%. The extension of the Jobs Support Scheme and Jobs Growth Incentive, therefore, have had a significant impact on keeping many women employed. If these women were forced out of the workforce, like what we see happening in other countries, there would have been severe repercussions to their income, careers and even their retirement. Many of our healthcare workers are also women. They have made sacrifices working in high-risk environments during the COVID-19 pandemic while balancing their other roles as mothers, wives and daughters. They have been working hard even before the pandemic, but showed true commitment in our battle against the virus.”
“She would like to see society become more inclusive and embracing of people with different abilities. She, therefore, welcomes the announcement made by Deputy Prime Minister Heng on the Inclusive Support Programme that will integrate the provision of early intervention and early childhood services to help children with special needs. She also looks forward to the new Singapore Together Alliance for Action to support care-givers of persons with disabilities and hopes that, through this, more enhanced support can be considered for families with children with special needs. The third individual I want to tell you about is Mdm Rajoo Meenachiammal, one of my volunteers. Meena is a dedicated volunteer who enjoys serving the community. She lives with her 73-year-old mother and is the primary care-giver. She works in the security industry and does the night shift so that she can spend time in the day to take care for her mother and bring her for her medical appointments. Meena is grateful for the financial support she will be receiving like the S&CC and U-save rebates, and the CDC Food Vouchers as these help her alleviate her monthly expenses. Joey, Faraliza and Meena are strong and resilient women who are passionate about what they do and care for the people around them. There are many women out there like them and I want to take the opportunity in this debate to share and talk about the Budget from a woman’s perspective. COVID-19 cast a gloomy shadow over many women who struggle to overcome their challenging situations, but it also provided opportunities for them to show strength and become everyday heroes. It is imperative for the Budget to help navigate the people through these difficult times.”
“Mr Speaker, the true measure of a good Budget is how it impacts people. I would, therefore, like to start by sharing the story of people, in particular, three women. The first person I want to talk about is Mdm Joey Lee. Joey is one of the directors and owners of Bread Garden, a family-run bakery business which has an outlet at my constituency, Bukit Batok East. Like many other businesses, Joey’s business took a hit as a result of COVID-19 and the circuit breaker. Events which were planned had to be cancelled. She had several Malaysian employees who could not come back to Singapore. Sales and revenue dropped and Joey and her team had to quickly pivot and learn ways to enhance their online business. All these happened amidst their plans to open another outlet. The Jobs Support Scheme and the Rental Relief Framework were thus very crucial in helping Joey sustain her business. Joey employs many Singaporean workers. Because of the support she received, she was able to continue running her business and open up a new outlet as planned. She managed to retain all her workers and has not had to retrench anyone yet. The pandemic is not over and the challenges with regard to manpower and sustaining the business are still present. Joey is, therefore, keenly interested in the extension of support to small and medium sized businesses like hers, as well as the plans on economic recovery. The second story is that of Mdm Faraliza Zainal, a founder of MIJ Special Education Hub. Fara has a son with special needs and she left her high-flying job at Dow Jones to set up the education centre with the hope of providing support to those in situations similar to hers. She is deeply committed to ensure that early and meaningful intervention is given to children with needs.”
“Thank you, Deputy Speaker. Mr Ng, the review is still ongoing. We do not have the information that can be released at this juncture. We will update, as and when an outcome arises from review. In respect to the number of cycles, as I explained, the basis on which the number of cycles for which subsidies and co-funding are given is pegged to clinical evidence. At this juncture, there is no new clinical evidence. If something comes up and it is something that we can review, we will consider the proposals that you have made. [(proc text) Question put, and agreed to. (proc text)] [(proc text) Resolved, "That Parliament do now adjourn." (proc text)] Adjourned accordingly at 7.54 pm.”
“This could include allowing employees time-off or allowing husbands to work from home to be by their wife's side as she recuperates. In conclusion, I would like to thank Mr Ng for his candour in sharing his personal story. Parenthood indeed brings immeasurable joy, as the experiences Mr Ng shared about his "castle" show us. However, some unfortunately face difficulties in achieving the hopes of becoming parents. We understand how emotional and challenging the journey can be. I would like to reiterate the Government's commitment towards supporting Singaporean couples in their pursuit for parenthood. The suite of measures that have been rolled out over the years bears testament to how policies are continually reviewed to keep pace with new clinical evidence and achieve more effective outcomes. While we may not be able to meet the demands of each and every couple, we will continue to do our part in providing the best support we can and adopt a balanced, evidence-based approach to serve our citizens better. Once again, I thank Mr Ng for his suggestions and hope that we can continue to work together on this front.”
“Similarly, a patient who has utilised one frozen cycle and three fresh cycles can utilise their co-funding for an additional fresh cycle since there are two unutilised frozen cycles remaining. The co-funding would also be capped based on the limit for frozen cycles and the patient would then have one remaining unutilised frozen cycle. Basically, this means that co-funding can be extended to a maximum of six cycles, with a maximum of three cycles co-funded up to the cap for fresh cycles. Mr Ng has proposed gender-neutral fertility leave for the couple undergoing assisted conception procedures based on the issuance of a Medical Certificate. Today, women who are undergoing ACPs are entitled to hospitalisation leave, given their medically-invasive nature. This allows them to take time off work to attend the treatments and get proper rest after. Some doctors also provide husbands who accompany their wives for oocyte retrieval or embryo transfer with memos, which certain employers recognise by extending a day off. We encourage employers to be sensitive to the needs of couples who may need to make use of these existing provisions. I am sympathetic to calls for more gender-neutral leave but I also recognise that any enhancement to leave provisions for fertility must strike a balance between meeting the needs of employees and employers' operational constraints. In extending or introducing leave schemes, we should avoid inadvertently affecting the employability of individuals who use it. What is clear though is that all parties can benefit from greater flexibility at the workplace. I encourage employers to be understanding and supportive of their employees, both women as well as their husbands, who are undergoing ART.”
“Co-funding had, in the past, been limited to three fresh cycles only as previous assessments showed that fresh cycles had significantly higher success rates than frozen cycles. However, we understand that, from a clinical perspective, going for more fresh cycles can potentially increase the risks of ovarian hyper stimulation, which is a known complication of fresh cycles. As the success rates for frozen ART cycles improved over the years and were close to that of fresh cycles in 2009 and 2010, the decision was hence made to extend co-funding to three frozen cycles instead of introducing more fresh cycles to encourage couples to use their frozen embryos left over from previous fresh cycles so that they will not need to go through fresh cycles again just to be eligible for co-funding. Co-funding a permutation of three fresh and three frozen cycles is expected to be more cost-effective than six fresh cycles as the charges for a frozen cycle is lower than that of a fresh cycle and the success rates of both options are expected to be comparable. Nevertheless, I agree with Mr Ng that some couples might have different preferences and needs and may, for instance, wish to utilise more frozen cycles instead of fresh cycles. MOH recognises this and is able to cater to such situations. Couples may approach MOH to request to tap on their unutilised co-funding for fresh or frozen cycles. For example, a patient who has utilised one fresh cycle and three frozen cycles can request for co-funding for an additional frozen cycle since there are two unutilised fresh cycles remaining. The co-funding would be capped based on the limit for frozen cycles and the patient would then have one remaining fresh cycle.”
“We will monitor the clinical evidence and review the criteria if new data suggests improved outcomes. Mr Ng also suggested to provide co-funding for preimplantation genetic diagnosis, or PGD, of up to 75% within the six ART cycles. PGD is currently offered to patients at risk of transmitting serious inheritable diseases that are due to single gene mutations or chromosomal structural rearrangements at around $10,000 to $19,000 per cycle. A pilot study on PGD conducted by NUH has found some evidence that PGD is able to lower the risk of serious disease in the child as well as increase the likelihood of carrying the child to term. PGD, indeed, appears to have benefits which could lead to better outcomes. However, the cost of the procedure is high. We note Mr Ng's argument that subsidising PGD may mean lower costs for the Government as fewer IVF cycles may be needed before a successful pregnancy. MOH is working to mainstream PGD as a clinical service for couples who need it and is studying whether it is cost-effective to be eligible for subsidies. We will also look at the proposal to allow PGD to be paid using MediSave. We will release more details on this review when ready. Meanwhile, patients continue to be supported by co-funding of other associated costs, such as for AR treatments. One other suggestion raised by Mr Ng was to provide flexibility for couples to choose between fresh and frozen cycles for the six co-funded ART cycles. Co-funding for three fresh and three frozen cycles is a considered approach that allows couples to freeze and store excess embryos produced from fresh cycles and to follow up with a frozen treatment cycle subsequently.”
“Clinical evidence has shown that the success rate for ART carried out beyond age 40 decreases significantly, with the probability of pregnancy complications also increasing with maternal age. Success rates are 26.6% for women below 30, 24.6% for women from 30 to 34, 17.1% for women from 35 to 39, and 6.7% for women 40 and above. While the success rate is low in women aged 40 years and above, we acknowledge that there are still successful cases. It is not just a matter of Government funding but the strain of couples to keep trying. Hence, we must continue to encourage couples to marry and start families early in order to maximise the chances of conception. For those who have challenges, we will continue to build a support eco-system for them, but co-funding needs to be feasible and take into account clinical efficacy. Mr Ng has requested to introduce co-funding for more ART cycles beyond the existing limit of six cycles. Currently, the number of co-funded ART cycles is set at three fresh and three frozen cycles based on clinical evidence, which shows that the success rate of ART decreases with age as each successive cycle progresses. I appreciate Mr Ng's suggestion and understand where he is coming from. At the same time, we should continue to stay grounded by the clinical evidence regarding the efficacy of ART for successive cycles to ensure that Government funding is used in a cost-effective way. It may be useful to note that amongst the women who successfully achieve pregnancy, these women undergo an average of two AR cycles before doing so. I accept though that this is an emotional process and couples may want to keep trying. Couples can, nevertheless, continue to tap on their MediSave up to the $15,000 lifetime limit.”
“With effect from 1 January 2020, we further enhanced Government co-funding to allow up to two of the six existing co-funded ART cycles to occur after the women turned 40 as long as they have attempted assisted reproduction or intra-uterine insemination, or IUI, procedures before age 40. Patients can also use MediSave to help offset the out-of-pocket payment at both public and private AR centres. Patients can withdraw up to a lifetime limit of $15,000 from their own or their husband's MediSave Account to pay for assisted conception procedures, or ACPs, which include ART and IUI. There is no cap on the number of cycles and patients may use up to $6,000 for the first cycle, $5,000 for the second cycle and $4,000 for the third and subsequent cycles. These withdrawal limits are designed to strike a balance between supporting couples with their costs of treatment today and helping them conserve funds for their healthcare needs in retirement. After co-funding and MediSave usage for the first cycle, eight in 10 eligible SC couples would incur no out-of-pocket expense while nine in 10 eligible SC couples could expect to pay no more than $500. Couples who find themselves unable to cope with unexpectedly large bills – for instance, as a result of complications – even after co-funding, may appeal to use MediSave beyond the current limits to pay for treatment. Such appeals will be considered on a case-by-case basis. I trust Mr Ng would appreciate that as much as we would like to help as many couples with their parenthood aspirations, we also need to balance the need to meaningfully and responsibly allocate public funds on this. As we work on improving the affordability of ART, we must continue our evidence-based approach to guide our co-funding eligibility criteria.”
“Mr Deputy Speaker, Sir, I would like to thank Mr Louis Ng for his passionate speech and for raising the proposals on how greater support can be provided to couples who undergo IVF. We share his concern on the importance of supporting couples with parenthood aspirations. This has always been a whole-of-Government priority for us and we will continue to work towards providing better support for couples in this journey. First, let me share some of the efforts made over the years to ensure greater affordability of assisted reproduction technology, or ART, for Singaporeans. The ART co-funding scheme, which was first introduced in 2008, aims to provide co-funding for ART treatments performed at public assisted reproduction, or AR centres – namely SGH, NUH or KKH – for couples where at least one spouse is a Singapore Citizen, or SC. Since then, enhancements have been made progressively to better support couples with parenthood aspirations. In 2013, the co-funding quantum for SC-SC couples at our public AR centres was raised from 50% for up to three fresh cycles with a cap of $3,000 per cycle to 75% with a cap of $6,300 per cycle to help defray further costs. At that time, co-funding of 75% for up to three frozen cycles, capped at $1,200 per cycle, was also introduced. Couples were hence able to benefit from co-funding of three fresh and three frozen cycles, or a total of six cycles. In April 2018, the co-funding cap per fresh cycle was further increased from $6,300 to $7,700 while the cap per frozen cycle was increased from $1,200 to $2,200.”
“" The perception that the justice system favours a certain individual or group has the ability to chip away the legitimacy of our judicial system. This is true for all systems and institutions in this country. If a negative perception spreads, even though it is not based on facts, we will erode the trust of the people towards our systems and institutions. We see many things happening in other countries where the trust in the key institutions of the country has disappeared. We cannot let this happen here. We have to ensure that our systems are always clean and transparent, but at the same time, we cannot just wantonly make baseless assumptions and damage people’s trust. Therefore, although I agree with the call to continue improving any existing shortcoming, I feel that there needs to be a realisation and acknowledgment of the strength of our justice system, the existing continuous effort to increase its standards and the sincerity of the many officers who work in our institutions like the police and prosecutors who carry the responsibility to ensure the efficacy of our system. I hope we can continue to uphold our existing systems and continue to protect it; and ensure that justice and equality continue to be the key foundations of our country. A house is standing because of the joints Which is cared for perfectly and well A nation is strong with a promise That our we guard our values with our hearts (In English): Thank you. 8.43 pm”
“We will feel angry if we see discrimination happen at the work place. We will voice our unhappiness if we see a group in difficulty that is not being helped. We do not want to see anyone in Singapore left behind. Like I said earlier, there are certain values which are entrenched in our society and these values shape our way of life in Singapore. Because of this, many systems in our country exist based on our values. If there is an issue of discrimination at the workplace, for example, there is a channel to make a complaint and ask for justice. If we see someone needing help, there is a help channel, for example through the Social Service Office (SSO) that we can refer to. Indeed, there are many efforts and programmes created to ensure that the needy groups are supported to have a better life. The open discussion today also reflects the efficacy of our systems. The debate in this Chamber shows the maturity of our society and the existence of space to voice opinions. If our systems are broken and fairness and independence do not exist, today’s discussion could not have happened. Our systems are surely not perfect and there is much that we need to keep doing. While we try to find the shortcomings and improve our justice system, it is important to preserve our society’s and the world’s confidence in the transparency and integrity of our system. If we are not careful, we may be planting seeds of doubt dan in time, the trust in our systems will be eroded. I would like to quote the words of Chief Justice in the Terence Siow case He said: "..there are few things more corrosive of the legitimacy of the judiciary, upon which the justice system is founded, than the perception that it is stacked in favour of any individual or class.”
“It was sad to watch her situation but fortunately, the case was resolved. Winning or losing does not depend on someone’s life status and a decision is made based on the truth, what took place and the prevailing laws. The justice system is indeed blind; it does not look at whether a person is rich or poor, man or woman, and it does not look at your race or religion. However, it cannot be denied that there is a worry that if someone cannot afford it, he cannot get the advice and legal representation and this would affect his ability to present the best case to the judge. He may also be hampered by legal processes which are complicated and which he does not understand. This what is talked about when we discuss access to justice. I was on the panel of the Legal Aid Bureau for a while and managed to help with a few divorce cases for those who could not afford legal costs. Many lawyers are actually volunteers and there are many schemes to help those who have legal problems. Aside from that, the Court processes are often updated and simplified so as to reduce legal costs. For example, uncontested divorces can be processed more easily at the Family Justice Courts. Are all the assistance schemes adequate? Of course, we should continue to improve the existing help channels. In particular, there is room to increase assistance given to those who may not meet the criteria for existing schemes. I had highlighted this issue in my past speeches in Parliament. I believe that this is a work in progress. But I feel that it is important for us to acknowledge that there are processes and channels for help in our current system. One more matter that I would like to highlight is the hope and desire of our society to see justice and fairness in all aspects of our lives, not just in Court.”
“In 2019, there were 35,209 criminal cases recorded. In the same year, the prosecutors dealt with more than 500 trial cases and 6,189 cases where the accused pleaded guilty. The cases that are shown by the media usually have elements that are sensationalized, but when you look at it deeper, there are good explanations that are given, like the Parti Liyani case that we discussed earlier. If we follow the explanation that is given whenever a controversy is raised, we can see the reasons why a certain decision is made. In general, we can say that the cases do not raise any issues or show pervasive unfairness in our system. Secondly, I also wish to mention how this principle of fairness is something we see broadly in our judicial system including in the civil courts. I was a lawyer specialising in civil and divorce cases. I worked at a medium-sized law firm. The clients that come to see me for help come from different backgrounds. Many had modest incomes. Sometimes my client has to face a big company represented by a big firm. However, in my experience, the judge does not look at someone’s financial ability or skin colour and is always fair. Each party is given the opportunity to present facts and evidence. I still remember, a few years ago, our client was a lady who had lost her husband. Her husband, a motorcyclist, was hit by a bus and later passed away. We made a claim against the bus driver and the bus company which were represented by a bigger firm. However, that was not a barrier to getting a fair trial. I was affected by that case because as we were going through the Court process, at one time, the woman became emotional and stated that she did not want any compensation but she wanted the other side to return her husband.”