Syed Harun Alhabsyi
Singapore
“I thank the Member for his supplementary question as well as his deep concern over individuals who may have difficulty completing the SSG courses. Indeed, even after committing to the course, some individuals do have challenges managing the training load, juggling work or study, health complications as well as unforeseen commitments.”
“In 2025, more than 90% of learners completed their SkillsFuture Singapore (SSG) courses. SSG does not process course fee waiver requests for learners who fail to complete their courses. Such waivers are subject to the contractual agreement between learners and training providers.”
“I beg your indulgence, Mr Speaker. Mr Speaker, I do not have the full number, the extent of the collective amount as asked by Mr Pritam Singh. But I can give him some indication in terms of what are the current numbers that we are looking at for specific agencies.”
“I would like to reiterate again to the Member that the nature of the fees that were charged previously was on account of the service that was rendered by the four agencies. The fees were openly prescribed to the extent to where the services were required by Singaporeans, as well as consumers.”
“Chairman, I move the amendment* to clause 20 standing in the Minister's name, as indicated in the Order Paper Supplement. The reason for the amendment has been explained in my Second Reading speech.”
“Chairman, I move the amendment* to clause 2 standing in the Minister's name, as indicated in the Order Paper Supplement. The reason for the amendment has been explained in my Second Reading speech.”
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“It is a very important step to provide justice and equality to our platform workers. (In English): Mr Speaker, before I end, I have two clarifications for the purposes of this Bill. First, as also mentioned and similar to the points raised by hon Member prior, relating to the wide definition of the meaning of platform service, operator and the worker, I note that the First Schedule only specifies delivery and ride-hail services today. However, based on the meaning of platform service and platform operator, it does cover a broad definition that can be applied today to other types of services that may use similar platforms, but are not yet articulated in the First Schedule. These could include household cleaning services, counselling, psychology and caregiving services, or even possibly overlap with certain professional services, such as home nursing and medical services, some already available through mobile applications. These platform services allow for ready provision of such services, have a platform operator already exercising management control of the particular service and also engage workers or professionals providing that service. Is it envisioned, as technology further evolves, and more of such services can and will be delivered and made accessible through platform-based services, that the workers or professionals providing that specific service be considered as platform workers too under this Bill? This is because such workers or professionals, like their delivery and ride-hailing services counterparts, may opt for a flexible work arrangement, not wish to be tied to a traditional brick-and-mortar employer or institution and may well fall under the remit of a platform worker as we define it in this Bill today.”
“When a platform service relies on an algorithm without any direct human involvement; when there is lesser human interaction, either between the service users, the platform workers or the platform operators; and when a service can be accepted or fulfilled in a contactless way or without human contact; we can easily forget about having compassion for the platform workers behind these services. Sometimes, as consumers, we might pay more attention on getting our orders fulfilled through the platform’s application, without thinking about the circumstances, fatigue and hardship experienced by platform workers who are also challenged by traffic or weather conditions, as well as the time pressure to fulfil the service. This Bill focuses specifically on the basic needs of platform workers. It zooms in on compensation for work injuries in line with WICA standards, enhances their CPF contribution and provides for the establishment of a representative body for platform workers. This is key in enhancing the well-being of the platform workers, especially for the lower income group. It further reinforces the emphasis and responsibility of platform operators so that they show more concern towards the needs of this sector, in terms of the workers’ rights, employment, safety and health issues. This Bill also specifically focuses on addressing concerns and dealing with their long-term insecurities as platform workers, so that it is equal to and aligned with workers in other industries. I hope this the first of many concrete measures for our platform workers to raise awareness on the importance of platform workers in our economy, thus showing our appreciation for the hard work and determination they show every day to earn a living.”
“Because in platform work it is suggested that the more you work the more you earn, it is also tempting to work more and more such that the platform worker, at least, in the moment, may consider disregarding his own safety, health and welfare to make that delivery or service count and bring that additional dollar back home. Add that to the contactless nature of how platform services work, that a delivery that can almost feel automatic and be bereft of any human interaction, the lack of collective bargaining power that platform workers have to put their welfare first in this line of work and an imbalance of power and control between platform companies and workers, it really puts us on the path of potentially dehumanising our platform workers if we leave things be as they are. Mr Speaker, that is why the Platform Workers Bill and future Act is important, to protect the dignity of work and ensure a more fair and equitable support structure for our platform workers. To that end, I thank the MOM for looking into this very important area for platform workers alongside the unions, employers and other tripartite partners. Mr Speaker, in Malay, please. (In Malay): [Please refer to Vernacular Speech.] This Bill gives due weight and attention towards platform workers. Many of them work hard and are often drenched in perspiration just to earn a living, sometimes disregarding the risks to their own health and safety.”
“Thank you, Mr Speaker. I believe, without exception, all of us have been acquainted personally with the ease of a platform service. With the click of a button, we have our food delivered to our doorstep. Another click books our trip to or from home. And yet another click could ensure a timely parcel delivery or a quick retrieval of important documents. The platform service is so efficient, straightforward and with an interface that is easy to use that often, we have come to rely on it as part of our daily lives. The process is seamless and almost automatic. The service platform also allows us to get what we want, when we want it and how we want it. We also felt its special utility during the COVID-19 pandemic, to go "contactless" and that the delivery can be made without human contact or much further instruction. We specify the need, make the order and hey presto, it appears at our doorstep. We decide the destination and agree on the payment and the ride arrives and sends us to the destination with much fuss or kerfuffle. So easy it is to use a platform service that sometimes, we forget the human in the loop, which is why I feel this Bill and the Platform Workers Act is overdue. Platform workers often choose such gig jobs for flexibility of time but this need for flexibility also sometimes arises from a function of their harsh life circumstances and not necessarily by way of their preferred choice. It comes with challenges, including job insecurity, social isolation, irregular work hours and long days. Any injury or illness, a family emergency or unexpected vehicular breakdown can have a very direct impact on our platform workers and without the same sense of safety net and security salaried workers have and are protected for.”
“In the spirit of youthful exuberance, Mr Speaker, where there are opportunities to be had, where the step is pragmatic and where the floor of support is reasonable and reassuring, most youths would leap at half a chance to give it a go. It is my firm belief that, if we do it right, it is possible for our youths to flourish, compete, give of their best and thrive, grazing in the pastures of the world, yet remain rooted here in this little red dot we call home.”
“It should percolate through to how we curate policy, with youths as an enabling consideration and part of the nation's sustainability plan for our future. The firm anchor and starting point of youth development remains in terms of early accessibility to education, not just in terms of academics alone but also for the development of character, values and self-confidence, as well as starting all our children with the correct and equitable footing to begin their lives. However, beyond access to school and education, might we be able to consider other aspects of support and imagine different solutions that contribute to a thriving ecosystem for our youths? For example, when the Ministry of Trade and Industry and the Ministry of Foreign Affairs engage our overseas counterparts diplomatically, could we be more deliberate in expanding areas of collaboration specific for our youth base to thrive and find opportunities, too, especially in emerging markets, such as the Association of Southeast Asian Nations (ASEAN), India, China, the Middle East and perhaps, even in less chartered pathways, in Africa and South America? Could perhaps the Ministry of Manpower's policies be more permissive to support employment efforts for youths to do side steps and nudge employers to consider youth development in other areas and yet find a way that it could also be sustainable for businesses in the longer term? And would, perhaps, MSF and MCCY consider community and social support for our youths who may come from underprivileged families, to afford them some stability, assuage their concerns and lend them confidence to still push ahead, to take that leap for an overseas internship, apprenticeship or work opportunity?”
“In this space, we must make an effort to build greater social connectedness, as well as civic participation and affiliation in our youths that stand the test of time and the allure of opportunities beyond our shores. It is less a question of dollars and cents, and more of how connected they are back to Singapore. We want them to see this red dot as a place to build families, raise children and as a safe and a secure place to live and play; for our youths to feel that this is the place that allows them to flourish and grow, for them to have confidence in our public institutions, and for them to care deeply about Singapore and that Singapore cares deeply for them as well. This can only be had by a strengthening of national identity, collective experiences through school, work, National Service and a social connectedness to family, friends and the way of life here. These are things that are intangible, are less than formulaic, take decades to build and require a combined function of social policy, leadership and pragmatism that cut across all sectors, whether they be public, people or private sectors. This also allows a virtuous cycle of thriving youths who turn into leaders of tomorrow who care for the country and then create opportunity for the society and youths of tomorrow to thrive in turn. In closing, Mr Speaker, my Adjournment Motion speaks to how the Government must create opportunity for youths to thrive in our midst. Today, it is anchored under the Ministry of Culture Community and Youth (MCCY), more specifically with the National Youth Council, and rightly so. However, in terms of actionable steps, the youth agenda could be palpable more widely.”
“More so than having a seat at the table for youths to share their concerns as a member of society invested in our collective future, when youths express their views, it allows them a further exercise of having to know one another, to acknowledge diversity of worldviews, locally and overseas, and then further celebrate that diversity. It is also an exercise for our youths to develop skills for difficult conversations, to develop a readiness to be corrected and to appreciate that we all have our blind spots coming from our respective social, cultural and religious traditions. It is then incumbent on us to create spaces and allow platforms for youths to feel comfortable and confident in the expression of their views, whether they be in agreement and support, or disdain and frustration, over the status quo. As the world becomes more diverse, layered and complex, a youth core skilled in negotiating difficult decisions respectfully, interacting with differences of opinion calmly and achieving common intent pragmatically, will be a distinctive trait to a world becoming more and more polarised. Finally, Mr Speaker, even as I wish for our youths to thrive, to chase their pathways of success and to be confident in themselves, I share my genuine worry that it will all come to naught if we cannot root their hearts here with us to call Singapore home. The world is getting smaller, the search for talent is stiff and our youths, too, are very much sought after and valued. Youths are more mobile than the generations before, and we do want them to seize the opportunities globally and be well-travelled, but yet, still maintain strong ties and roots back home.”
“Our youths can take heart that they start from a position of strength and can rightly have some latitude to feel confident and be positive of their abilities, to not fret the small stuff and that they have it in themselves to be resilient in the face of any uncertainty that the world may bring. Third, on giving opportunity for youths to express their views, we live in a world today that is so interconnected that it is impossible to ignore what happens around us, whether in our neighbourhoods, locally or from a place far away. Our youths are digital natives and their calibration of social proximity, networks and friendships are not the same as the generations before. They devour news online, are open to the influences of the world and care about the happenings around them. They want to make a difference and be a helpful citizen of Singapore and also to the world. Our youths are exposed to global trends and happenings very quickly and sometimes graphically so. They have views, some stronger and more passionate than others, about many things, whether it be about climate change and environmental concerns, wars raging and people needlessly dying around the world, as well as strong views on issues relating to inequality, mental well-being, the construct of family and sexuality, drug habits and intergenerational differences. If we want our youths to thrive, for them to be raised with a global outlook and have a fire in the belly to think critically and creatively about the world around them, then it must come with a willingness for us to lend opportunity for them to express their thoughts and lend their voice as, together, we knit the social fabric that is Singapore.”
“Mr Speaker, while I qualify that these studies are school-based at a younger age group and do not necessarily capture the youth audience in general, it is something that is worth addressing. It is not the case that I am advocating for us to toot our horns or be haughty about our achievements. To be hungry for more and not be blinded by success keeps us on our toes, and a good dose of humility keeps us grounded as a country, for there are other things we are deficient and needful of. However, there is scope for us to develop better confidence and optimism in our youths in their ability and standing in the world today and being raised from an education system that is world-class, by educators who care, and through a work ethic and culture that is resilient and robust. Arguably, the early education indicators suggest that all things being equal, our youths can compete more widely against the world and will do well. If we wish for our youths to thrive, an important part of this narrative must be that they, too, are able to value themselves in alignment with their abilities, that they are encouraged to stand and be counted as youths of potential, and that they are allowed to recognise and be excited about the prospect of success well beyond our shores and the global opportunities at their doorstep. Only then will we be able to realise the full strength and potential of an education system we have invested so much in and restore the confidence, optimism and self-belief for our youths to thrive.”
“Notwithstanding their idealism and passion, they take a pragmatic view of their circumstances in that their passions are not necessarily sacred cows, especially when balanced against the rising costs of living, the responsibility to put food on the table and the need to care for their families, dependants and children. If we can provide assurance that there is value, that there is an amelioration of some risk and a provision of safety to explore beyond the traditional measures of success, it will go some way to pivot our youths to go into paths less travelled. Second, on building confidence for our youths, I was struck by the recent findings of the 2022 Programme for International Student Assessment award by the Organisation for Economic Cooperation and Development (OECD) through the press release of the Ministry of Education on 18 June. Relevant to us specifically, our students have attained pole position in terms of Mathematics, Reading and Science and, this round, we also topped the matrices for Creative Thinking. In another global study comparing global reading literacy levels in Primary 4 students, our students topped the Progress in International Literacy Study last year. What is striking though is that despite our articulated strong ability and high levels of creative thinking, the same press release also noted that there is a dissonance in our students' objective measured abilities versus their belief and confidence in their abilities and own creativity. In essence, even though we topped the class or the cohort internationally, the level of self-confidence we have in ourselves is captured as being less than the OECD average, and not commensurate with the strengths that we have.”
“However, I would caution that at the last mile, it is important to address and reassure the youths, that as they try to follow their heart and curate their own pathway of success, and, if it so happens that they do not find themselves in the proverbial 5C boxes, that the opportunity cost of that side step and experimentation is not insurmountable. The sustainability of this cultural and mindset shift on redefining success will hinge on the lived experience of ordinary youths and whether their families view this with the same enthusiasm or scepticism, especially from families of less privilege; one with no safety net materially or for those who have only one shot at success to uplift those around him or her, where pauses and U-turns, perhaps cost a lot more in relative terms for themselves and their families. For this redefinition to happen, and happen well, the effort to shift must not only be taken in our schools for our students and educators, but it must also permeate through the psyche of our businesses, employers, parents and even our scholarship panels who lend opportunity to youths who wish to pursue creative and less than traditional pathways of success. If we want youthful innovation to thrive, their exuberance and passions to take flight, and also groom their willingness for U-turns, side steps and experimentation, then, as a society, some reassurance needs to be there, that it is okay to bruise once in a while, that it is okay to misstep and tumble, as long as there is safety net such that you are not falling the full flight of stairs and risking too much at a time of yourself and the needs of your family. Emerging into the hallways of adulthood, or "adulting" as the youths say, our youths are restless about their futures, too.”
“How then do we build a youth core that is fiercely competitive, skilled, passionate and spirited when it needs to be, yet at the same time, tampering with traits of compassion, a sense of community and togetherness, mutual respect and dignity for ourselves and one another? Mr Speaker, as part of this Adjournment Motion, I offer four areas that may benefit from the Government's emphasis to lend opportunity for our youths to thrive. First, to redefine what success means for youths. Second, to build confidence in our youths. Third, to give opportunity for youths to express their views. And fourth, to ensure our youths continue to have a strong sense of rootedness to Singapore. Recently, on redefining success for youths, the hon Prime Minister released a video on redefining success in Singapore beyond the proverbial 5Cs. He spoke of having had the benefit of mentors, a need to recognise that people flourish at different times, that there are different pathways to success, and that there should be room for different skills, aptitudes and talents, as well as different aspirations, priorities and hopes. That there should be space for "U-turns, side steps, slowdowns, pauses, experimentation and outliers", and to "respect all forms of work and never be afraid to try". In the Prime Minister's words, "no need to squeeze ourselves into boxes we were never meant to fit". In gist, I agree with the hon Prime Minister's view of redefining success. There is so much more that life has to offer and I have some confidence that the youths resonate with that; where there must be a plethora of pathways to find meaning and purpose in our lives as Singaporeans and our yardstick of success in life must widen beyond material gains. To hear it from the office of the Prime Minister is reassuring.”
“Youths, Mr Speaker, are also society’s bulwark of resilience and recovery from challenges and adversity. How a society develops its youths, the indicators of their growth, their outlook, their worldview and their ability to adapt are forward indicators of how youth as a group can weather storms, crises and turbulent times for themselves and for the country in future. How youths manage stressors today, would be a reasonable indicator of how the country manages a crisis tomorrow. How adaptable and resilient our youths are today, would be a fair measure of how the country and society tolerates uncertainty tomorrow. If we err in developing our youths, the country suffers tomorrow. We must endeavour to get it right and we must give every opportunity for our youth to thrive. It is a national impetus. For our youths to thrive, it must be that they are energetic, enthusiastic and optimistic about future paths of success; that there is scope for them to believe deeply that they can realise their potential to flourish, to grow and to be better versions of themselves. They must be able to find themselves in networks of trust, safety and support, enough for them to feel confident to push boundaries, to move out of their comfort zone and to take on a growth mindset. They must feel ready to express and stand by their views for a better world for the future of their generation, yet still be prepared to stand corrected and be open to opposing ideas. There must also be a willingness to think beyond themselves and consider wider societal mores, be forgiving of setbacks and kind to well-intended failures, yet still maintain the resilience, ruggedness and fervour to go at it again and again and again.”
“Thank you, Mr Speaker. In any society, Youth is a demographic of significance. Various authorities define this group differently but suffice to say that the period of youth generally starts at the cusp of late adolescence, into the years of formal adulthood and transits to the early working life of an adult. It is the energy and gumption, the health and verve, as well as the innovation and pushing of boundaries by youths that are key to propel any society forward to the next bound. Youths are foundation and key to a society’s future survival. Where leaders can dream, where governments can plan and policies implemented, the longer-term sustainability of such an effort will eventually fall squarely on the shoulders of youths of today, for they are the leaders of tomorrow. It must be the case that they remain rightly invested and guided in principles and values, as well as have the right capability and skills in leadership to keep society cohesive and Singapore successful. It is also from the churning belly and energy of youths that economies thrive, productivity is at its firm best and the fire of entrepreneurship lights new opportunities and growth for the country. Youths are both the agents of social change, yet also the conduit of cultural continuity. They sometimes challenge established social norms, question the relevance of certain rules and whether some things remain important or should change. The sustenance of any language, culture, heritage and values anchor on its acceptance and willingness for active participation of youths as their torchbearers into the future, else they will vanish and left only to be admired and talked about in museums rather than lived by.”
“No meaningful medical treatment is possible without first ensuring safety of the patient and rescuer. This parallels our approach to dealing with medical emergencies too, as is the protocol for Basic Cardiac Life Support which I am sure many Members of the House are trained and are familiar with. The acronym is DRSABCD – Assess for Danger, Assess for Responsiveness, Send for Help, Airway, Breathing, CPR and Defibrillation, where in the first instance, danger must be ameliorated as a first and utmost priority and remains several steps ahead before CPR treatment can take place. Similarly, in the face of a psychiatric emergency, where there is an active threat or concern over suicide, a danger to life either imminent or reasonably anticipated, the work of our Police officers and their Civil Defence counterpart remain important. Within reasonable grounds, my view is that they should be empowered to exercise appropriate means to perform such a lifesaving role, before any ensuing treatment can be administered accordingly. Mr Speaker, I rise in support of the Bill.”
“Where the apprehension is done under subsections 26A to 26F of the Police Force Act, the Ministry must then ensure that the individuals are sent for a formal assessment by a medical practitioner or a designated medical practitioner at a psychiatric institution under the sections 9 and 10 of the MHTCA with expedience and without delay. If the premise of the apprehension was due to concerns over a potential suicide attempt and a mental disorder, then it follows that it is treatment that the individual needs and care and assessment must be forthcoming as soon as safety is established. Third, to work more closely with mental health professionals in such crisis work. I think there is scope for the Ministry to study the prospect of closer collaboration between mental health professionals and law enforcement especially when dealing with crisis calls relating to mentally disordered individuals. There could be value in having combined teams of law enforcement and mental health practitioners as collaborative first responders to ensure that, on one hand, there is Police resource for swift apprehension to safety of such individuals where required and if the threshold is not met and care can be safely given, mental health professionals, in turn, could be the ones offering supportive care thereafter. In conclusion, Mr Speaker, I would like to thank our Police officers on the ground for the work that they do in relation to such apprehensions, where there needs to be a delicate balance in their approach of care for the person in distress, alongside a swift desire to bring the person to safety. As a clinician and psychiatrist, my role in addressing psychiatric emergencies is moot without first ensuring that any patient of mine is safe, first and foremost.”
“This Bill, Mr Speaker, gives some latitude for Police officers to act with some urgency and not reactively, before a suicide attempt becomes imminent and before rescue could be more risky, both for the person who is under duress and for those who are trying to make a genuine attempt at rescue. Where suicide risk assessment, even for psychiatrists, is not a perfect science, my view is that it is fair and appropriate for Police officers to exercise reasonable judgement without waiting for a suicide to be imminently clear or after such attempt at lethal harm has been actualised. Mr Speaker, there are ground concerns that stigma could be further perpetuated as a direct result of the proposed changes in the Bill, but I beg to differ, in that this Bill is scoped within a very specific circumstance of a psychiatric emergency and only where there is a patent risk of suicide. Even as I advocate for this Bill today, there are three things I hope the Ministry can look into moving forward, if not already done today, to really reassure concerns on the ground and hon Members of the House today. First, it is to ensure structured training. Structured training for Police officers in the apprehension of attempted suicide cases would be important to guide Police officers fronting such work, and this could be coupled with considered inputs from care professionals and specialists in the field. Such structured training would also be important to ensure that while there is some latitude and range for judgement by Police officers on the ground, the exercise of such powers of apprehension continues to be done with propriety, with confidence and with safety in mind. Second, to ensure access to psychiatric evaluation and assessment without delay after apprehension.”
“However, there are times where family members, who themselves could also be at a loss, reach out for external help from community organisations or call upon law enforcement, especially when they are deeply concerned for the safety of the individual. I can say with some confidence that our Police officers are confronted with this on a daily basis. Almost a daily occurrence, at the IMH Emergency Room, ever so often there would be some Police presence bringing a distressed person to be assessed by a designated medical practitioner, on account of section 7 of the Mental Health (Care and Treatment) Act, or MHCTA. When someone is on the brink of suicide and immense despair, they would have lost all hope, are taxed with a sense of worthlessness and with no longing to continue living. Police officers and their Home Team colleagues remain their last hope for rescue, and such officers often put themselves at risk to honour their duty to protect fellow Singaporeans. For context, often these apprehensions take place in unfamiliar surroundings and home environments, in the presence of sharp objects like blades and knives, with open ungrilled windows or even at corridors of significant height. The tension in the air would be palpable, sometimes with raised voices of frustration and emotions running high. Time is of the essence and where reasonable grounds are sufficiently present to suggest a potential threat to self and others, my view is that apprehension may be necessary to save a life under such circumstances.”
“Thank you, Mr Speaker. My contribution to this debate relates specifically to part 3 of the Bill, the Amendments Relating To Apprehension under the Mental Health (Care and Treatment) Act and the Police Force Act. I wish to declare that I am a psychiatrist in private practice and am the Honorary Secretary of the Singapore Psychiatric Association. I am also a visiting consultant psychiatrist at a restructured hospital. I wish to also add that I have dealt with many a psychiatric emergency in my line of work. I have myself been conflicted and made the harrowing call to law enforcement over grave concerns that an acquaintance was at risk of potential suicide. Firstly, let me qualify categorically that by an overwhelming proportion and majority, most individuals labouring under mental illness would not fulfil the threshold set out within this proposed Bill for apprehension by Police. The large majority of those with mental illness struggle silently, may appear normal to most and are able to navigate life's challenges with some treatment and support from family and loved ones. The individuals for whom this Bill could apply represent but a slither of individuals who are afflicted with mental illness or mental health concerns. When placed under much duress, entrenched and severe mental illness can impair one's mind, to the extent that he or she may consider life not worth living anymore and contemplate suicide. Often, at this juncture, all hope appears lost, reasonableness is absent and negative thoughts have festered well beyond fleeting moments of self-doubt in themselves and their lives. If we are lucky, such individuals – with encouragement from family and loved ones – would agree to present themselves to a psychiatrist much earlier for treatment.”
“I believe we can do better to engage our youths, harness their creativity and innovation, as well as curate ideas through their perspectives and share their willingness to challenge conventional wisdom and current solutions. This is an important aspect of our nation-building exercise and as the Government moves ahead in its plans for Forward SG. In my work through the various initiatives with the National Youth Council, our youths care about what happens in Singapore, are concerned for its future and share a deep resonance in wanting to build a more caring, cohesive and inclusive society. In this light, I urge the Ministry to cast their net wider and more deliberately in engaging youths across different communities and backgrounds and bringing them together through activities that build common ground, unity and a shared identity. Youths in themselves are heterogenous, and if we consider the wide age group defined under the banner of youths from 15 to 35, we must tailor the approach better to cater to the wide range of interests and diverse priorities at different timepoints in the lives of youths. Even as there are opportunities for youth programmes of NYC through the Youth Action Challenge, Young ChangeMakers grants and various youth panels, I urge the Ministry to study its reach further and ensure breadth in participation at all levels of youth, as we seek to invest in the next generation of Singaporeans, empower them to take ownership in collaborative solutions for current and anticipated societal challenges, and build a collective future together for Singapore. Enhanced Support for Our TeamSG Athletes”
“However, the benefit of being able to see a multiplicity of individuals in team sports, where we have a broad representation of athletes from all communities playing together for the national team, is emblematic of the kind of Singapore we hope to build. It resonates at a deeper level for us as a people and it becomes a palpable vision of the society we want for ourselves. Third, I hope for the Ministry to narrate the value of Sports better for the ordinary Singaporean and help make it easy for people to participate in them en masse. The benefit of sports in health and mental well-being cannot be understated and should continue to be emphasised at the level of the individual. Yes. However, the societal benefit of sport can only be realised if everyone participates, enjoys and interacts with one another in play and activity. Even for relatively individual sports, it is possible, with some creativity, to encourage togetherness and cohesion in the activity. For example, even for the solitary activity of running, which some may prefer, there are running clubs where people may build friendships, find commonality and meet others through their collective joy and passion in the specific sport. Such cohesion and strong relationships make for a sustained participation in sports and more opportunity to bring people together. My other area of emphasis in this cut is for the Ministry to continue harnessing the potential of our youths. In fact, we saw quite a relatively young audience earlier on from St Joseph's Institution and we talked about our ageing population often and, indeed, this is an important concern. However, by a similar proportion, it also means that the number of youths are in relative decline and youths are a much valued resource.”
“I urge the Ministry to look closely and more strongly at sports as a means to rally and bring people closer together. Those of us who have engaged in sports and continue to do so will agree that it builds character, values and a certain resilience that cannot be replicated in the classroom. Team sports further engender a spirit of responsibility, trust in others, camaraderie and a sense of team like no other. There are three things that I hope the Ministry will focus on as part of this Budget, as far as sports is concerned. First, we need to continue focusing and investing in sporting excellence as a country and do more for our athletes. Our athletes need our support to do well, for they spend a good portion of their hours, days and weeks, even years on end to achieve the success for the country. In fact, for a good portion of the time where their peers spend building careers and income, the prime of the young lives of these athletes are consumed in honing their sport, optimising their performance and pushing their physical bodies for peak outcomes, for which, sometimes, injuries can occur. Where there is talent in our Singaporeans and they are willing to go far with us in terms of their sporting excellence, I propose we spare no effort for them to give their best for Singapore. Second, I hope for the Ministry to look more deeply and specifically at team sports. While we already have examples of success in individual sportsmen and sportswomen, we need to do better for team sports as well. It does take much more deliberate investment, a sustained care in the planning over years if not decades for the sport, and a wider systemic approach to develop young talent within a team sport.”
“Mr Chairman, I focus my cut on the value that sports and youths can bring to building community, promote inclusivity and strengthen social cohesion. First, on sports. The value of sports is beyond the physical. Its value is multifaceted, encompassing also psychological, social and economic benefits, with its significance observed at all levels of society, too: at the individual, community and globally. Beyond the obvious benefits of health and exercise, sports has the power to strengthen well-being, unity in diversity and organic cultural exchange in communities. Importantly, sports has the power to galvanise and rally. 6.30 pm When Shanti Pereira won the Silver in 100-metre and Gold in 200-metre events at the Asian Games last year, ending Singapore's 49-year wait for a track and field medal, many Singaporeans were glued to their television screens and fixed to their seats. We were in awe of her success and achievements in 2023, and taken to her example in terms of her determination, resilience and ability to overcome adversity. When Joseph Schooling won the Olympic Gold in the 100-metre Butterfly in 2016, the sentiment of national pride was much the same. Few things rally people, community and a nation more than a celebration of a fellow countryman's great success in sports. The barrier to entry to sporting success is relatively low in that it does not matter whether one is a populous country or a country with wide and sizeable geographical areas. For example, if we use the Olympics as a benchmark, Liechtenstein with a population of under 40,000, San Marino under 35,000, Bermuda under 65,000 have won multiple medals at the Olympics. It is, indeed, possible.”
“What are the next steps to further enhance MUIS' competencies and capabilities, in order to produce a robust institution when facing contemporary challenges in Singapore? Can we also increase support for local madrasah education as it is a pipeline for local religious scholars, in order to produce community leaders who can provide solutions to contemporary issues in Singapore in an appropriate, wise, credible and balanced manner? Second, Chairman, I would like to ask about the success rate of M3's initiatives to date. The implementation of M3 programmes has been encouraging, because it combines the resources across the three major community institutions, namely MUIS, MENDAKI and MESRA, in a way that multiplies their respective efforts, and this has benefitted the community. M3 is already in its fifth year. I hope that Minister will be able to share, in particular, the result of all the good work and programmes under M3, and whether there are any early outcome measures to indicate that home ownership, health indices and accessibility to education, especially early childhood and post-secondary education – are improving within the Malay/Muslim community, and also whether there are any early outcome measures that indicate that drug abuse and crime recidivism rates are decreasing further among the communities and families engaged by M3. My view is that M3 should also focus on such outcome measures, and it should give attention to these indicators. Certainly, it should be considered as one of the benchmarks of M3's success to ensure that the community’s progress and improvement are assessed objectively.”
“Thank you, Chairman. In Malay, please. (In Malay): [Please refer to Vernacular Speech.] First, regarding MUIS' role in Muslim affairs, there are various complexities and diversity in today's world, especially with the rapid developments in the use of technology, such as the increasingly widespread use of artificial intelligence (AI), machine learning and so on. From a religious perspective, the community faces a variety of complex issues, such as the latest technologies in medicine and food, as well as in the international financial systems and structure, as presented at the Fatwa Conference organised by MUIS recently. We can see how international issues, such as the events in Israel and Palestine, Russia and Ukraine, as well as in the Middle East, can give rise to strong and considerable tension and emotions in society. There is also an additional dimension in Singapore, where the Muslim community is a minority group within a plural society. However, there is a desire among Muslims to further enhance their contributions, not only to issues that are near and dear to the Malay/Muslim community, but also to contribute to the nation and the wider Singapore society. There is also a desire, as well as expertise and knowledge from asatizah and members of the Muslim community to contribute their expertise and capabilities towards the religious affairs and benefit of the global Muslim community, for both the minority and majority groups. Many turn to MUIS' leadership to provide clarifications and guidance to address challenges that Muslims face. Is MUIS' current structure adequate and can it fully support the needs of the community in the future?”
“Thank you, Chairman. I have two clarifications, mainly towards Minister. The first is regarding MIC@Home. Heartened to see that safety as well as outcomes are comparable as it stands today, but Minister also mentioned that in terms of pricing, it is expected to be the same or less. I am just wondering whether, at least in my mind, should it not be less pricing in absolute terms, given that the care is based now at home and auxiliary services, such as the bed, change in linen, meals, utilities would be much less. I appreciate there are other costs, but I wonder whether the Minister could clarify that. The second is on the planned increase for COMIT as well as CREST. I would like to ask the Ministry whether they would consider increasing the number in greater proportions, given that the emphasis on mental health will be towards the community. I think a greater increase of COMIT and CREST teams would give some confidence to our GPs on the ground, in terms of dealing with mental health issues in the community.”
“Have there been any barriers in this regard and could the Ministry share the forward steps that can be anticipated in this space? Finally, much has been said about the promulgation of the National Mental Health and Well-being Strategy and the anticipated greater awareness of mental illness and mental wellbeing over time. Are there any changes to be made to the Healthier SG implementation plans, especially towards incorporating the four tiers of the tiered care model and to realise the four articulated focus areas as outlined by the strategy?”
“Chairman, I would like ask the Ministry regarding the progress update for Healthier SG implementation thus far. First, whether the manpower, infrastructure and systems implementation plans are keeping pace with the timeline and envisioned capacity of the national healthcare system as it pivots to Healthier SG. I note that the Government announced last month regarding changes to and guidance on the salary of our nurses, but are there similar concerns and plans for the retention of other healthcare professionals including doctors and allied health professionals. I also wonder whether the remaining eight polyclinics slated to be open by 2030 are on track, and whether there have been any challenges to the system integration efforts between private GPs, polyclinics and hospital clusters to realise the full potential of Healthier SG over time. Second, could the Minister also share whether early indicators suggest that Healthier SG plans are achieving its articulated goals and outcomes? Is the approach towards better preventive healthcare being realised? Have both doctors and patients, at the last mile, reported stronger patient-doctor relationships and are patients having better experiences when receiving their care with their primary healthcare provider through Healthier SG? Third, part of the vision of Healthier SG is that there be more rooted partnerships and the integration of health and social ecosystems of care. Have partnerships been strongly established with agencies like AIC, the Health Promotion Board (HPB), People's Association (PA) as well as Sport Singapore to realise the vision of Healthier SG? Could the Ministry share specific examples of how this has been done and expected to evolve over time?”
“Where there is money to be made, scammers are ruthless in baiting and ensnaring individuals in their moment of vulnerability and when they least suspect it. And victims, having been scammed, are often encumbered with guilt and shame, as well as the incredulity and disbelief after. Recent figures released by SPF show a continued rise in scam numbers and that more and more people are falling prey to scammers. It does not reassure us that scammers continue to be guile and creative in their ways and equip themselves with the technology to scale scamming operations remotely to find their next unsuspecting victim and scam to the tune of hundreds of millions of dollars per year. It suggests a knowledge gap in the public and a lack of general vigilance and awareness of the potential of being scammed. We also do not want people to feel so paralysed that they retreat inwards and not avail themselves to the use of technology that could make their lives easier. Can MHA elaborate how the Ministry intends to strengthen its approach to prevent scams at the population level and share the breakdown of scam victims by demographic indicators? Are there specific vulnerable age groups and communities that need more help?”
“Mdm Chair, first on drugs. Singapore is swimming against the tide in its fight against drugs. Where we rightly double down in our fight against drugs, global and regional trends suggest a more permissive attitude towards drug use and drug abusers are starting younger. We need to ask ourselves, how is it that teenagers as young as 14 years old – as reported by the Singapore Drug Situation Report – have access to these drugs? It cannot be that they just suddenly develop the habit and achieve access to these substances. Beyond the quantitative the Central Narcotics Bureau (CNB) statistics released thus far, I urge MHA to have a deeper look at the qualitative aspects of each case to study the social determinants that lead to drug use and target these proximal factors better – as part of a whole-of-Government approach. And to look deeper at community prevention strategies with other ministries, community partners and the National Addictions Management Service to better strategise a broader, wrap-around approach in its drug prevention efforts in Singapore. Preventive drug education and teaching drug harms in schools need a better approach, for we must protect our young robustly from having access to these substances. I also wonder whether the numbers of new psychoactive substances are an underestimation, because they can be harder to detect in standard detection kits. Second, on scams. Scams permeate all aspects of our lives. Where there is money to be made, scammers are ruthless in baiting and ensnaring individuals in their moment of vulnerability and when they least suspect it. And victims – having been scammed – are often encumbered with guilt and shame, as well as the incredulity and disbelief after. 4.45 pm Second, on scams. Scams permeate all aspects of our lives.”
“In light of that, the Overseas Humanitarian Assistance Tax Deduction Scheme (OHAS) is also a welcome reminder of our privilege as a Singaporean society, and the depth of means to which Singaporeans have, relative to others around the world, to provide and support people in crisis to rebuild their lives again. This is an extension of our lived ethos and values as a Singaporean society that everyone deserves a chance at success, that not all lived realities are made equal and that privilege exists in many shapes and forms. It is not wrong to live a life of privilege, to compete fiercely and strategically for our survival, and to want to do well for ourselves, our families and our next generation. However, with the blessings of privilege, we must recognise that our environment, the people around us and chance had a significant role to play. Tempting as it may be to only give ourselves a pat on the back, we cannot discount the role that others have had to play in our success story, be it our accomplishments as individuals and as a nation. The humility keeps us grounded, informs us of a worldview of care and concern for others and further fortifies us as a society of ethical values, compassion and kindness. With that, Mr Speaker, it is my hope that the delivery of this Budget in the coming year continues to further erode inequalities and lends opportunity for social mobility to continue taking root in our midst. I rise in support of the Budget Statement.”
“In theory, the bread pan is ready and we have got all the ingredients for the bread in the mix. The yeast sometimes can be a little tricky and fickle to get going, and it takes patience for the bread to rise. Similarly, in delivering a Budget towards realising social mobility, the constitute ingredients like funding, structure and processes matter, but they do not matter as much as how we approach the issue in a spirit that genuinely cares and is concerned for the most vulnerable in society. Finally, Mr Speaker, social mobility has its lessons for us as a nation, too. We have done well in our 58 years since Independence. We must recognise that in as much as Singapore starts from a strong position today, that we are doing well through our fervent efforts to improve and strengthen Singapore society, and that we are on a reasonable cadence for continued success, we must also have the humility to accept that we arrived here in 2024 with a little luck against the odds stacked against us in history, recognise the privilege of standing on the shoulders and wisdom of leaders before us, and that the starting point for Singapore today in 2024 has arisen from inherited structures and efforts of generations of Singaporeans prior. We, too, are privileged. There are others who may not be as fortunate to be where we are today and we remain a country many others seek to emulate. We must guard this privilege well and be custodians of Singapore’s continued prosperity, but at the same time, we cannot also turn a blind eye to other calamities in this world, such as places of war, conflict, crises and disasters.”
“Her intellect, humility, real-world resilience and results notwithstanding, she had a lack of role models, was oblivious to the plethora of global options at her feet and how, with the right support, in good time, she could pave the way for her family to a better life, potentially lifting not only herself but also her mother and siblings out of their current life circumstances. Because of her background, she genuinely had no access nor sight to see beyond what her lived reality could offer, and her aspirations and ambitions were much constrained and reduced from what she could have easily attained. The truth was neither she nor her family had the social capital to envision a future beyond the horizon of what they could reasonably see. There are gems in the rough arising from many of these families. They are borne from a life of adversity, hardship and challenges, and what some of their children need is really a fair and equitable opportunity. These children often grow up faster than most, their negotiation skills drawn from the uncertain and harsh environment they have grown up in, and they possess an adaptability and resilience that can be hard to replicate and teach in the classroom. Especially when we see deep potential and exceptional qualities in an individual child, if we were to fully affirm our ethos of social mobility, we must be able to give him or her access to the full swathe of options and the full mile to realise their potential. And when we shed light on these options, it must be coupled with a genuine desire that they deserve to be successful, too. Across all Ministries, whether it be in addressing inequalities of access to health, education, housing and social support, I believe, Mr Speaker, we have the structures and unitary components in place.”
“Yeast is one of those delicate ingredients in bread that can be hard to quantify, and its introduction into the recipe is almost an art and takes careful judgement. Social mobility is the same. It is not a mere insertion of quantifiable ingredients and an anticipation that things will rise automatically. The Budget is helpful, the funds are important and so is the structure to enable it. But we must remember that the exercise of social mobility is also just about maintaining dignity and autonomy. It is about knowing that society has your back and are rooting for everyone to succeed. Our social policies can only come to life when, at the last mile, we deliver them with a genuine and determined desire to uplift, with a care and concern deserving of a fellow brethren with a shared Singapore identity and a genuine belief that the vulnerable, having been played a card of less privileged circumstances in life, deserve to succeed, too. In my volunteering capacity, I remember interviewing for a scholarship, a young lady from a single parent household, formerly from a neighbourhood secondary school, having done part-time work to support her family, but yet also scoring a near-perfect grade point average (GPA) for her polytechnic studies. What struck me and my fellow panellists most about our interview with her was how unaware she was, notwithstanding her sterling grades, about her potential options to study, flourish, to be exceptional and to take on the world.”
“The adult in the room will recognise that in the longer term, a diploma would be of natural benefit, but consider also a young person from a family of less privilege, pressed with imminent caregiving responsibilities of his siblings and wider family at an early age and no direct sight of the longer-term implications of such a decision. My view is that through the ITE Progression Award, while relatively modest and encapsulated within the CPF construct, there are practical benefits that could nudge more to consider strongly to move on to diplomas if they qualify. I hope that the Ministry monitors this trend to see how it encourages more ITE graduates to pursue diplomas and, if proven beneficial and well-received, to consider a greater quantum for them in time. I wonder if the Ministry could confirm whether this could be retrospectively introduced to former ITE students already currently in polytechnics or those who have recently graduated this year. This would go a long way in helping them move forward into the next phase of their lives and in giving their best to their current studies. Mr Speaker, other than dollars and cents, really, the challenge of social mobility is about building self-confidence and self-esteem of the vulnerable and less privileged in themselves. This is harder to quantify and we can never emphasise this enough, for it is a delicate process and we need to get it just right. For those of us who have ever tried a hand at making bread, it is the yeast that makes bread rise. We can knead the bread with all our might and effort, add the ingredients like flour, water, salt and sugar, and yet it still does not rise in the bread pan.”
“I wonder if the Ministry could share what the thought process behind this was, in terms of how the $4,000 top-up amount was arrived at and why not more, the choice of 40 years old as the age to introduce this programme and why it is limited to a diploma programme only. I wonder if it were possible to consider introducing this at a younger age, say, 35, and whether degree programmes could be permitted as well. While some individuals may be keen to spread some breadth to their knowledge base by taking a diploma unrelated to their existing expertise, others may be keen to dig deeper into their field of interest and pursue a degree instead. I am also heartened by the ITE Progression Award. It is a welcome nudge for ITE students who qualify to continue on to pursue a diploma and that upon completion of the said diploma, to get a further $10,000 CPF top-up in the Ordinary Account. From time to time, I hear of young talented ITE graduates who do well in their courses but stop short of wanting to continue. Sometimes, the draw of the gig economy or full-time employment in the short term, coupled with the pressing need to contribute to the family’s household income looks like a reasonable option to enter the workforce, rather than be confronted with another three years of education at a pace of learning that is faster than before. When they enter the polytechnic after finishing ITE, it will also be apparent that they are older than their peers who may have come directly from secondary schools.”
“For example, enhancing the Assurance Package lends confidence to each Singaporean household that there is something for everyone and no one is left behind, especially at a time when there continues to be inflationary pressures and rising costs of living. When coupled with the Enterprise Support Package, even as businesses seek to transform and strengthen their workforce, the true yield and benefit also go to the Singaporean workers, for it gives them opportunity to upskill, develop and grow alongside that of the business enterprises they work for. That the Government continues to pay close attention to local enterprise, especially smaller firms, is heartening and we hope that this seeds confidence for our local businesses to grow further and for them to flourish even beyond our shores. I echo the Deputy Prime Minister’s call that we need to deepen this culture of lifelong learning and skills mastery to develop every Singaporean to their fullest potential and for each and every one of us to have the opportunity for productive and meaningful careers. The SkillsFuture Level-Up Programme actually makes me feel young again. What this programme does is that it gives a second wind of opportunity to learn a new skill, especially in a world where things have moved so quickly and technology has outstripped skillsets learnt from what feels like a lifetime ago. It gives support to our workers to take that step towards learning again. And both the $4,000 SkillsFuture Credit Top-up and the opportunity to have a renewed access to subsidised full-time diplomas are very much welcoming news to me.”
“In our dynamic and fast-paced world, trying to achieve social mobility remains a constant moving target and it has not been easy to keep pace and ensure full equitability in opportunities for all. As a society though, we must continue to commit to giving our best to get this right for all Singaporeans. For without social mobility, there is little hope, opportunity, growth and success for the underprivileged and most vulnerable amongst us. There will be entrenchment of privilege and, in fact, distrust and discrimination will only fester and proliferate, gnawing and tearing at the social cohesion we have taken so long to build and strengthen. Everyone, regardless of their life circumstances, deserves a fair and equitable chance at success. Today, Mr Speaker, we are perhaps more coordinated than we were decades ago in wanting to gain traction for social mobility. We have the hon Minister in-charge of Social Services Integration as well as the Rehabilitation and Social Mobility Policy Department, as part of the Policy and Planning Directorates of the Ministry of Social and Family Development (MSF). We recognise that in wanting to empower and uplift the most vulnerable, it requires a whole-of-Government approach. We cannot afford to take on the issue of social mobility and its layered challenges piecemeal. Problems relating to early access to education and health, employment opportunities and steps towards housing ownership must be addressed collectively. We know that ComLink+ attempts this today and the intent is to take a holistic and wrap-around approach to support families. I can see how some of the proposed changes in the Budget will help address social mobility to some extent.”
“In this paradigm, an understanding of the importance and acceptance of social mobility is critical for our society. At the level of the individual, as much as we do not wish it for anyone, we cannot ignore this vulnerability and pretend like it cannot happen to any of us. We must accept with some humility that the success that has befallen us is not necessarily the result of hard work alone but that of our favourable social milieu, the people around us and, some would argue, chance to a significant extent. The reverse also holds true; that for many individuals and households assessed as low in their socioeconomic status through a measure of their income or financial ability, many find themselves stuck, not by virtue of a lack of hard work, effort or intellect. Some have not yet been blessed with the privilege of opportunity and mentorship, they may be encumbered by ill health and disability, or just born into circumstances that snared them early into a cycle of poverty, scarcity and hardship. When we take a deep look at success through the lens of inequalities and social mobility, we then are able to view our own successes with some modesty and romanticise less about the gallantry of our own efforts, and we view the lack of success in others with much concern and interest into their well-being and life circumstances. Many Members have, before me, spoken about social mobility in this House in the past. Truly, social mobility is, indeed, the cornerstone of a fair and just society. It allows for individuals to move up or down the social escalator of life, regardless of their initial background, ethnicity or economic status. Some would describe it as a social ladder, but I contend that things are moving at such a pace that makes an escalator a more apt descriptor.”
“Whether we may have been born into some form of wealth and socioeconomic privilege, whether we had the privilege of good health, a decent upbringing, stability in the household and loving parents, or the privilege of teachers, confidantes, mentors or friends who looked out for us, gave a word of advice or nurtured us to who we have become and where we are today. My humble view is that no story of any success bore out of the efforts of a single individual alone, but it had to be that alongside that valiant individual's effort, the village around him or her made it possible for success to first take root. Second, we know not everyone has this privilege. We hear of children born into dysfunctional families, suffering abuse and afflicted by trauma. We know of families where breadwinners or other members are suddenly saddled with debilitating illness and disability and how that can catastrophically change the outlook of a family within an instant. We hear tales of families so big relative to the size of their physical house that the only true privacy one has from the shared space is only when he or she is in the washroom. We also hear of neighbourhoods of rental flats where children grow up in less than savoury environments, confronted with an early introduction into a life of antisociality, drugs and crime, and where Police presence is not uncommon. Third, that the true distance between the two, having such privilege or otherwise, can actually be quite the fine line. It is a fallacy to think that our station in life is set at birth and that things cannot upend themselves. Sides can change, illness can hit and jobs can be lost. In our fast-paced world, despite our best efforts, sometimes change can be unforgiving, dramatic and merciless.”
“Thank you, Mr Speaker. I would like to, first, thank the hon Deputy Prime Minister and Minister for Finance, as well as the various Ministries in rolling out the proposals for Budget 2024. With the advent of emerging technologies, including artificial intelligence (AI), coupled with a proliferation of social media yet to be fully understood and its impact realised, the world is moving incredibly fast and at a blistering pace. The pace of change in the world today and, indeed, in Singapore, is no longer just a function of linear years, months, weeks or days, but the pace of change globally has profoundly accelerated since the turn of the century. Stasis today no longer means we will be left behind by a mere few steps but inevitably left behind exponentially further and further with the passage of time if gaps are left unaddressed. A deep concern I have is the impact on those left behind as Singapore attempts to surge ahead and maintain its pace in the world today and, in tandem with this concern, is the profound issue of social mobility. My contribution to this Budget debate seeks to raise greater awareness on the topic of social mobility, its importance and value to us as a people and as a country in the context of our Budget in 2024. When we talk about social mobility, a few things come to mind. First, whether some of us care to admit it or not, each and every one of us here have benefited from some form of privilege.”
“This is because under the National Mental Health and Well-being Strategy, this patient would have already exhausted all the initial three tiers of care and there is urgency in the need for specialist assistance by this point. It makes sense that this could be reduced if the expressed strategy were to achieve its full potential. If the proximal three tiers are effective and adequately address mental health needs early, it would follow that at tier 4, there would be less referrals overall to our specialist services in hospitals and this, in turn, lends capacity to manage the care of higher intensity, specialist-led cases. Furthermore, if we set our mind to it and acknowledge that this is the outcome we wish to attain as part of our standard of care at tier 4 and that mental health and well-being are important as a priority for our nation, then we must galvanise the resources necessary to realise this vision. Mr Speaker, I am in full support of the vision that the Government has in articulating the National Mental Health and Well-being Strategy. Beyond the health issue, there is great impetus in the social and economic domains to be realised for Singapore in the medium to longer term. Notwithstanding my comments, I am in support of this Motion.”
“I also urge the Government to consider subsidies of greater quantum and wider coverage for psychotropic medications as well as other treatment modalities, including evidence-based neuro-stimulation treatment, such as repetitive transcranial magnetic stimulation as well as electroconvulsive therapy. The better our subsidy and financial support coverage for treatment options at tier 4, the more focused treatment approaches can be and with good outcomes for our patients. In terms of insurance coverage for accessibility to mental healthcare services, as passionately expressed and outlined by hon Member and fellow medical professional Dr Tan Wu Meng, I urge the Government to maintain sight of this developing space to ensure adequate, fair and equitable insurance coverage for all. In light of this, Mr Speaker, my fourth and final point would be to call for the Government to articulate, as part of its strategic impetus, measurable targets for all four articulated focus areas across the four tiers of its Tiered Care Model for the National Mental Health and Well-being Strategy. For tier 4, at least one cluster of measurable targets I can offer to be met over the next five to seven years would be that the median and 95th percentile of waiting times for access to psychiatrists and psychologists must drop. I believe that we should articulate a clear target on what is a reasonable waiting time for a patient referred from primary care services to specialist-type services and, in my humble view, I think the last patient referred to a psychiatric service, meaning the 100th percentile, should have access to a psychiatrist, at the very latest, within six weeks for a first visit.”
“It remains the case that MOH does have a regulatory framework for other allied health specialties, such as occupational therapists, physiotherapists and speech therapists, and we should allow for no less for clinical psychologists to give assurance to patients that the standards of care are high, commensurate with their needs and they can be assured of quality of care. From a healthcare manpower planning standpoint, accreditation and regulation would allow the Ministry sight of how many clinical psychologists the country and our public hospitals now have and need to ensure timely and accessible care as part of the wider National Mental Health and Well-being Strategy. My third point relates to accessibility of tier 4 and its associated mental healthcare services and speaks to what I shared at the Adjournment Motion in October 2023. The Government can and should do more to ensure tier 4 services continue to be accessible to Singaporeans, even as it seeks to buttress the overarching national strategy over the initial three tiers of care. I note the Government intends to increase psychiatric beds by 2030, but it is also important that for mental healthcare, the capacity for inpatient beds, rehabilitation programmes, psychiatric nursing homes and outpatient clinics keeps in tandem with the anticipation in demand in the coming years. In fact, hon Member Mr Yip Hon Wing's speech earlier spoke to the varied and increasing complex mental healthcare needs in Singapore's ageing society now and in the foreseeable future. It will continue to be a moving target, but we must plan forward as specialist resource and infrastructure take time, even years, to come to fruition.”
“My second point, Mr Speaker, is in relation to clinical services provided by clinical psychologists. As we finesse our mental health strategy towards improving care, the Government should consider the feasibility of a regulatory framework for clinical psychologists. This would be especially important for those working in tier 4 and in clinical settings in the community. Where clinical psychologists are concerned, there must be clarity over the prerequisite training and experience in clinical settings as they interface with patients regularly, patients who are vulnerable and are seeking care for their mental health needs. While psychologists' skillsets may be transferable to areas such as sports, education and organisations, the specific training for clinical psychologists needs to be further deliberated, structured and regulated in clinical settings, such as hospitals and outpatient clinics, and with the availability of adequate supervision. Respectfully, there are many different branches of psychology, such sports psychology, education psychology and organisational psychology, but clinical psychology skillsets required in the delivery of mental healthcare and clinical services are, indeed, distinct and different. To register my point, Mr Speaker, there are 641 psychologists registered under the directory of psychologists maintained by the Singapore Psychological Society (SPS). This list is by no means exhaustive and indicative of the total number of psychologists in Singapore, as not all psychologists maintain this association with SPS. However, when one filters the search to include only clinical psychologists, the number then whittles down to 292 clinical psychologists only.”
“So, we see a leap of that from 27, 29 and then 45 days, as of the response last year. As I emphasised in my Adjournment Motion in October 2023, median times, while helpful for healthcare planning of resources, only reflect 50% of the patient experience, and there is another 50% of patients referred to a psychiatrist that is seen beyond 45 days. Based on another Parliamentary reply in August 2023 to hon Member Ms He Ting Ru on 2022 figures, MOH also responded that 95% of subsidised patients were given an initial psychiatric appointment within three months. So, we have a data point for 95% within three months, which is about 90 days, as of 2022. For sure, Mr Speaker, the numbers of psychiatrists are not everything in the delivery of mental healthcare. However, if we were to be serious about wanting to ensure that we are adequately resourced with expertise in our midst, surely, we need to look hard at these numbers and recognise how much better we can and should be in our delivery of mental healthcare services, especially at the specialist level of care where our patients are most vulnerable. A good critical mass of experts in the field further helps us develop deeper expertise in sub-specialty areas, such as community psychiatry, child and adolescent psychiatry, psychogeriatrics, addictions, forensic psychiatry and psychiatric rehabilitation, and in key emerging treatment modalities, such as neurostimulation services for our patients. The same experts can also inform other aspects of community care and education in the other tiers of the National Mental Health and Well-being Strategy. Today, I posit that this is difficult and hardly possible because the same experts are stretched to meet the bursting demand for inpatient and outpatient care services.”
“I argue that the numbers speak for themselves when taken in relative comparison to the number of psychiatrists per population in other developed countries and the widening waiting times for psychiatric visits in Singapore over the years. The number of psychiatrists in Singapore is estimated to be 4.4 out of 100,000 per population. This was the number given by the Ministry of Health (MOH) in response to a Parliamentary Question (PQ) by former Nominated Member of Parliament (NMP) Assoc Prof Walter Theseira in January 2020, four years ago. However, when compared to other developed countries, according to WHO data from dated numbers between 2015 and 2017, I could not find any data which was a bit more recent. Based on that data, Norway has 48 per 100,000, Switzerland has 43, New Zealand has 28, Australia has 13, Japan has 11 and the US has 10 per 100,000 population. This is in relative comparison to Singapore at 4.4. The second point is also that the waiting time for patients over the years also indicates a widening of waiting times for psychiatric subsidised visits in our public hospitals. In response to a PQ by former NMP Ms Anthea Ong in January 2020, the median waiting time for new subsidised appointments to see a psychiatrist across public hospitals was 27 days in 2018. So, in 2018, it was 27 days. The answer to another PQ in 2021 to a question by Mr Leon Perera on waiting times was that the median waiting time for the IMH was 29 days in 2020. So, 27 days for all public hospitals in 2018 and 29 days for IMH in 2020. Yet, more recently and more alarmingly, in July 2023, to a similar question by the hon Member Mr Yip Hon Weng, the median waiting time for new subsidised psychiatric appointments was 45 days.”
“The scope of my contribution to this debate will consider the professional aspects of clinical delivery of mental health, particularly at tier 4 of the Tiered Care Model articulated in the said strategy paper. Tier 4 services are of high intensity, delivered by psychiatrists, psychologists and other multidisciplinary mental healthcare professionals in hospital settings, both inpatient and outpatient, to support those with high mental health needs. These services comprise specialist-led psychiatric assessments, psychological and medical interventions, including acute and emergency services. As far as the National Mental Health and Well-being Strategy paper goes, tier 4 is the sharp tip of the strategy that deals with the most acute, challenging and complex of psychiatric cases. Mr Speaker, what is palpable is that in tier 4, the forward developmental plans on healthcare manpower and competency are less articulated. I note that the strategy paper states that tier 4 services largely reside in hospitals which have their own competency development plans for clinical staff and would not be covered by the National Mental Health Competency Training Framework. However, it is important to ensure that tier 4 services keep up and remain in tandem with the larger national need and demand for mental health services. I would like to surface four points for consideration at this tier of mental health services as we move to forward this Motion in advancing mental health for Singapore. Firstly, Singapore needs more psychiatrists. I say this, conscious that I am one such psychiatrist, but it is not out of self-absorption of my specialty that I say this.”
“As mentioned by the hon Member of Parliament, Dr Wan Rizal, a recent study conducted by Duke-NUS Medical School and IMH estimated the total economic burden of lost productivity due to anxiety and depression in Singapore to be S$15.7 billion. This was based on survey data from 5,725 adults collected via an online panel between April and June in 2022, with the results made public in April 2023. The Singapore Mental Health Study of 2016 also found that the average annual excess cost associated with mental disorders per person was estimated to be close to $4,000 and at a population level, the incremental costs of mental disorders in Singapore is about $1.7 billion per year. These costs tend to come from absenteeism, reduced productivity and direct medical care, including hospital visits and admissions. There is also increasing awareness of the longer-term costs relating to intermediate and long-term care services, as well as indirect medical costs on family members and caregivers. Similar patterns, Mr Speaker, and cost trends relating to mental health are evident not only in Singapore but the world over, and the costs of ignoring mental health and well-being are staggering. To that end, that the Government has promulgated the National Mental Health and Well-being Strategy paper published in October 2023 is much welcomed. I see this as a great start. It covers good breadth and, importantly, gives a frame and structure towards the national strategy in dealing with mental health and well-being. I imagine many hon Members speaking today will approach the Motion with a wider population-level concern relating to the strategy paper.”