Tan Cheng Bock
Singapore
“As I said, we have not done much. We must not be captured by our old style of managing the old. The new old, as I said before, are better educated and travelled, and are very knowledgeable. So we must quickly explore new ways and methods to meet the expectations of the new old.”
“If we only have such a small pool of talents in Singapore because of our population size, we should spare no effort in seeking every such talent.”
“Thank you. I accepted the Minister's reply on the different pricing in the outpatient polyclinics and the hospitals. My point is that the patient's problem has still not been solved. Whenever a doctor refers a patient from a hospital to an outpatient clinic, he still has to pay more.”
“Six out of the nine items were much more expensive. Sir, I am asking why is there such a difference. Is this a one-off incident or is it going to be a norm? How can doctors in the hospital then refer patients back to the outpatient clinic if the patient is going to pay more?”
“I move this amendment to ask the Minister what is the Ministry's stand on seat belts to be made compulsory for primary and kindergarten buses. I heard over the radio that the Ministry is reviewing the case. There are two issues here, question of cost and question of safety. I think safety has a higher weightage over cost.”
“I also want to commend the NTUC for working with the Government to put this package together. I believe that without the NTUC's representation in putting forward the workers' case, the workers would not be able to benefit so substantially this year from this package.”
The complete record
Every one of 1,095 lines we hold for Tan Cheng Bock, in date order, each linked to its source. Free to read, in full, without an account. Page 13 of 22.
“The rental rebates will benefit more than 83% of the 61,000 HDB tenants. The service and conservancy rebates will benefit 125,000 low income 1-, 2-, 3-room HDB flat dwellers. Dr Ow Chin Hock has even calculated the quantum amount these rebates will help them. Mr Speaker, Sir, Opposition Members have been very critical lately that we do things to benefit the rich. I think we have been fair to all - rich and poor. The rich and better-educated have an advantage over the poor and less educated. They know how to maximise the many schemes and policies and opportunities provided by the Government. As for the poor and less educated, we must continually reach out to them on the many available schemes and opportunities open to them. The best answer is education. We have in place various special programmes, including Edusave, to help them. They cannot start on the same starting line as the others. We must bring them up to the starting level before they can compete. First, there must be hope - hope for a better life and most of the poor bank their hopes on their children. Therefore, we must let them know through schools and at community level that any poor child who can study will be helped. That is why this Government has spread their bursary and scholarship awards to neighbourhood schools distinct from the scholarships that always go to the top schools. We cannot assume that the poor know of the opportunities available. We must bring to their attention by way of the schools, RCs and CCCs that there are social and welfare services like family service centres, custodial care services, financial assistance services, textbook assistance schemes, tuition schemes, at community as well as national level. We have been doing a lot for the less privileged Singaporeans.”
“Private companies are often reluctant to exchange information or co-invest with the GLCs. They fear that business will be stolen from them. This will impede the development of our regional businesses. I hope Commodore Teo's committee will come up with some ideas to overcome this. We should start a new chapter of cooperation between the private sector, GLCs and the MNCs. Forget the past. EDB and the TDB could help out by providing the relevant information of the business risk and leave it to the entrepreneurs to make the final decision. Perhaps EDB may need to expand its role and encourage investments abroad instead of just encouraging investments into Singapore. I do not think we should establish a new body to spearhead this. We have EDB and TDB. Let them expand their scope of activity to emphasise the regional investment as another branch of their work. Too many bodies, too many rules. Our missions abroad must be on the look-out for such opportunities and work with EDB and TDB and report whatever opportunities they have back home. Mr Speaker, Sir, I support the GST and appreciate the Government's concern to ensure that the poor will not be badly affected by the introduction of GST. Such a drastic taxation change is not without its share of problems. The question of the poor and how GST will affect them has been mentioned in many speeches. GST will definitely affect them. To offset this, the Government has come out with a series of rebates for households with incomes below $1,500 a month. These primarily are rental rebates for 1- and 2-room HDB flats and rebates on service and conservancy charges for 1-, 2- and 3-room HDB flats and also upping the public assistance allowance and Singapore Allowance.”
“And the Government's investment in the Brierley group. Not only that, the press would drag up these names at every mention of investment setbacks. "There is no room for failure" has been bandied around for some time. I think it should be replaced by another saying "Failure is the key to success." We must be more understanding and forgiving. Look at the way our press hound the offenders of littering. They seem to relish in the embarrassment. For one cigarette butt offence, you put them through this humiliation. It is out of proportion. Mr Speaker, Sir, I do not condone littering. Culprits should be punished. But to over-punish sometimes has negative effects on the individual and our society at large. Now that the Senior Minister has encouraged Singaporeans to go regional, I hope the relevant Government bodies would not over-react. We should not allow the pendulum to swing to the other end which is quite possible because of the zealousness to overdo things in this country, especially when the idea comes from our Senior Minister. While regional investment opportunities are likely to offer better return than those in North America, the EC countries and Australia, we should not give the wrong signal that these countries are no longer important. We depend on these countries for their technology and export markets. Therefore, while we must look regional, we must be prepared to entertain requests from Singaporean investors in Europe, America, Australia or anywhere in the world. Lastly, going to invest abroad should involve total cooperation between private and public sectors. It is necessary to pool our resources together to compete against many major international players. Presently, there is very little of such cooperation.”
“EDB's role was therefore to encourage investments and it did not encourage our Singaporeans to go and invest abroad. Even when they helped develop Batam, the comment was, "it is again for the MNCs and the local element is again not remarkably significant." But the message is now clearer. Figures on our economy, as revealed by our Senior Minister, showed the unhappy situation we will be in if we do not make the change to build an external economy for Singapore. While many would like to blame the Government for the lack of entrepreneurs, we should also be thankful that the MNCs brought prosperity and enabled Singapore to develop. In fact, it is never too late to encourage the entrepreneurial spirit. After 40 years of dead end Communism, China is brimming over with entrepreneurs. Singapore entrepreneurs have always been around, but they lack recognition. They were at the fringe, at the periphery of the MNCs, ignored by EDB and Government departments. But today, after Senior Minister's speech, they are in the limelight. Creative Technology is cited by everyone as one of our made-in-Singapore entrepreneur. Yes, he deserves it. I heard him at a seminar explaining why he left Singapore, how Singaporeans did not pay much attention to his ideas and how from a small room in the United States he went around selling his ideas and products. Mr Speaker, Sir, risk-taking is part and parcel of doing business. Many have had their fingers burnt, but they accept it as business risk. However, the press and Singaporeans at large are not so forgiving. They are too judgmental and ever ready, to label those who did not do well. The best recent examples are Yeo Hiap Seng's investment setback in the United States. Mr Speaker, Sir, I have no shares in this company.”
“Mr Speaker, Sir, I rise to support the motion standing in the name of the Minister for Finance. A clear message in the Budget speech was the need to develop an "external dimension" for the Singapore economy. Therefore, to encourage local businessmen to venture abroad, he has unveiled a series of tax incentives to go regional. These are unilateral tax credit for dividend income remitted from countries without tax treaties with Singapore; extend double tax deduction scheme to cover exports and services; double tax deduction for approved expenses incurred in developing overseas investment opportunities; and tax exemption for venture capital and regional funds. In addition to making Singapore a more attractive centre for various offshore activities, he has announced a 10% concessionary tax rate to approved art and antique dealers, tax exemption for non-resident beneficiaries of trusts where the trustee is an approved trustee company and extend tax holiday for SIMEX by a further five years. These incentives have been welcomed and appreciated by most businessmen. I personally think that these incentives are timely. However, Mr Speaker, Sir, incentives to go abroad is but one dimension of our drive to go regional. The other is entrepreneurial spirit. Recently, there has been a lot of talk lamenting that Singapore lack entrepreneurs like those in Hong Kong. I think we can trace this to our very early independence days. It is historical. Since independence, we had approached our industrialisation programme differently from Hong Kong. We invited MNCs to help us to industrialise. The EDB enticed them and they came in large numbers, attracted by our political stability and, of course, the incentives offered them.”
“On top of it, the Government is going to add another $100 million annually. I think that is very generous and Singaporeans should appreciate it. EXEMPTED BUSINESS (Motion) Resolved, That the proceedings on the item under discussion and the remaining items on the Order Paper today be exempted at this day's sitting from the provisions of Standing Order No. 1. - [Dr Lee Boon Yang]. MEDICAL ENDOWMENT SCHEME BILL Debate resumed.”
“I thought you support the Bill but now you want clarification from the Minister. Anyway, Mr Speaker, Sir, I rise to support this Bill. As a responsible Government, we should continue to make sure that those who cannot afford medical attention should be adequately provided for. Medifund is one scheme whereby we can ensure that the poorest Singaporeans are provided for, especially our older Singaporeans, those of our forefathers who came to this island and they are old now. They really need a lot of assistance. As a medical practitioner, I have come across many cases of such people having difficulty in paying, and we usually refer them to the social worker. What I want to ask the Minister is that I hope the criteria for getting such funds would not be as strict as those in the Public Assistance Scheme. Many a time when we refer cases for public assistance we find that the criteria are so strict that many of them are really cheesed off because they have to answer so many questions and they are very disturbed by them that some of them give up trying to get assistance. I feel that because Singaporeans have been working so hard we must make sure that at the end of their working life, they must never feel insecure, especially when we come for help. If they feel insecure, then something is wrong. The provision of a scheme like this to ensure that we take care of them when they really are in that difficult position is very good. I notice that 6,000 patients out of 160,000 patients in B2 and C wards applied for waivers. Out of this, 98% were granted, and the sum was $1.7 million. Judging from the initial sum of $200 million for Medifund, that means we will have about $5 million or $6 million every year from investment income. I think that is very, very generous.”
“Mr Speaker, Sir, before I start, can I just ask Mr Low Thia Khiang whether he supports the Bill or he is against this Bill. Listening to him at length, I am not sure whether he supports or he is against it.”
“Mr Speaker, Sir, if this project is still in the proposal stage, why is it that an announcement has been made and this has created so much anxiety among certain Singaporeans? Mr Dhanabalan: Mr Speaker, Sir, perhaps the word "proposal" that I used is not quite the right word. It is an idea that the PUB is looking into. I do not know who made the announcement and how it came out in the press. Certainly no announcement was made by my Ministry or by the Planning Department. But somehow the subject emerged in the media and, of course, nature lovers jumped on it and blew it up into a big matter. But as I mentioned just now, no planning application has been made yet and when it is made, it will be considered in the usual way. HOUSING AND DEVELOPMENT BOARD PURCHASED FLATS (Demand and waiting period) 2. Dr S. Vasoo asked the Minister for National Development whether the demand for bigger Housing and Development Board purchased flats increased significantly in 1990 and 1991 and what further steps are being taken to reduce the waiting period for such flats under the new booking system.”
“It is not that they spoke seven times, or four times. Of the 22 sittings, one spoke in seven sittings and the other in four sittings; and in each sitting, they did cover a number of topics.”
“May I clarify? I did not say that the Nominated Members of Parliament were not so good. I said that the views they expressed were not something so extraordinary that the PAP Backbenchers were not able to express. Mr Choo Wee Khiang( In Mandarin): Mr Deputy Speaker, Sir, if the views and the contents of NMPs' speeches were similar to those of the PAP Members, then it does not mean that their performance was poor. Right? From another angle, we can see that their performance was as good as our colleagues. Mr Deputy Speaker, Sir, I fully support the motion to have Nominated MPs in this Parliament. When we join a political party, it is like taking on a religious faith. It is a kind of belief. Some believers go through their church or religious organisations to serve the people, to serve the society --- I am just making an illustration. Similarly, there are many people in Singapore who do not want to associate themselves with any political party but, nonetheless, they are equally eager to serve the people and the country. So we must create the opportunities for such people to come in. Are we afraid of them performing better than we do? Are we afraid that they may out-shine us? No! We should not fear that they perform better than we do, so long as they have the sincerity in serving the people and the country. Just now, the Members of the Opposition remarked that one day an NMP may be appointed as a Minister. If an NMP has got the quality to become a Minister, why should we oppose it? If we are really sincere in serving the country, then we look at the long term interest of the people. If the Nominated Members of Parliament can really play a positive role in this House, then I would appeal to all of us here not to repulse or reject them.”
“Let them have a longer time to learn how to walk, then they will perform better. So let this system have more time.”
“Sir, may I clarify? I am not the Leader of the Opposition, please! Mr Choo Wee Khiang( In Mandarin): Yes. This is a typical PAP MP. When it is "No", he would say, "No!" When it is "Yes", he would say, "Yes!" Mr Deputy Speaker, Sir, all the 81 Members of Parliament in this House went through the General Elections to win our seats here. After the General Elections the feelings may be different from individual to individual. Of course, some Members may look at the Nominated MP as someone who appears to have taken a short-cut to get into Parliament, and feel short-changed. This is quite inevitable. But I will appeal to the 81 Members, including myself, in this House to search our conscience. Why do we come into Parliament in the first place? We are here not to quarrel with the Opposition Members, we are not here to throw tables and chairs at each other. No! I feel that the Members of the Opposition, Dr Arthur Beng and Dr Tan Cheng Bock are here to serve the country and the people. So they join their respective parties, contest the General Elections to enter this Parliament. We are here to serve the people and the country. Otherwise, we are not fit to be in this House at all. So if we can really attract these non-partisan people in Singapore, accept their patriotism, accept the fact that they also can make contribution in this House, to serve the country and the people, then what is wrong in allowing such people to come into this House? The Nominated MPs were in Parliament for only nine months. Dr Tan Cheng Bock said that their performance was not good. He went by the number of speeches they made. When they spoke less, it did not mean that they were not capable of good performance. They were like children learning how to walk.”
“Sir, I did not support their stand. It is my own personal stand. Mr Choo Wee Khiang (Jalan Besar GRC)( In Mandarin): Mr Deputy Speaker, Sir, just now, Mr Cheo Chai Chen mentioned that Dr Tan Cheng Bock had supported the stand of the Opposition, and shared their views. I feel that they are in the habit of confusing the issue. Why should they want to do so? You can say what you like, and express your views as the Opposition. But Dr Tan is a PAP Member and he spoke in his capacity as a PAP Member, albeit he did not support the motion. This had led my parliamentary colleague, Mr Peh Chin Hua, to say that he could not help feeling that Dr Tan had appeared to be the Leader of the Opposition. That is because our Party Whip has lifted the whip to allow Dr Tan to express his personal views freely. He belongs to the PAP.”
“He respected our views and introduced a clause allowing future Parliaments a say on whether we want Nominated MPs or not. And as he said, he is prepared to lift the Whip. These are very generous concessions. His generosity and personal style make it more painful for me to vote against. But my own feeling on this fundamental democratic principle of having only elected Members of Parliament in this House is too strong to be compromised.”
“They know the ground well and they have presented their arguments adequately here. It is not that these two NMPs are no good. They have presented their arguments reasonably well. But what I am saying is that their presence cannot do more than what the elected PAP Members can do. In other words, Nominated MPs have not made any point not covered by elected Members of Parliament. They have not taken up any significant issue not taken up by the elected Members of Parliament. They left very little impact in this House. In essence, their contribution was minimal. I suspect if we continue with this experiment, we will get more of the same, for by their definition or inclination, they are disinterested in real politics and would rather put all their attention and energies in their career, business, or whatever. Mr Speaker, Sir, in the Third Reading of the Constitution (Amendment) Bill on Nominated MPs, the Prime Minister, then First Deputy Prime Minister, asked this House to "approach this from the higher interest of the nation and not on how the NMPs would affect us personally" and urged us to, I quote him: ' ... give this a try and I believe you will see the merits of the scheme and the contributions of the NMPs when they come into this House. And if you are not convinced after trying out this scheme for the remaining period of this Parliament, in the next Parliament you decide [that means, we decide]. The Whip will be lifted and you can decide how you want the NMP scheme to go in the next Parliament.' [Hansard, Vol. 55, col. 1047]. I hope Members are convinced that they have done a reasonably good job in this House. The Prime Minister has kept his word. He knew that some of us had very fundamental reservations on this.”
“Mr Speaker, Sir, on 22nd November 1990, two Nominated Members of Parliament were sworn in. This was after two heated debates in this House. After some hard bargaining, the Prime Minister, then First Deputy Prime Minister, persuaded this House to accept Nominated MPs and to give it a try or, as he said, we will never know whether Nominated MPs will be useful or not in Parliament. Over a period of eight months, which I consider quite a long time, this House heard and saw the performance of the two Nominated MPs who were both competent and respected men. I do not want to be personal. I have no other way of judging how Nominated MPs perform but through these two people. They put forward their views on a few subjects. And over that period, one Nominated MP spoke only seven times while another Nominated MP spoke four times in this House, and within that period this House sat on 22 occasions. The topics they chose were the same as the PAP MPs. The views they expressed were no different from that of the PAP MPs. On ageing, health, medical technology, cultural and social issues, the depth and breadth of coverage by such elected Members of Parliament like Aline Wong, Dr Vasoo, Loh Meng See, Peh Chin Hua are more than adequate, and they covered most aspects of these subjects. We have also others like Chandra Das, Heng Chiang Meng, Chng Hee Kok, Augustine Tan for their more vocal and in-depth presentations on business and economic problems. These elected PAP Members of Parliament, I am sure, culled their speeches from many expert resources. My question is: has the quality of debate in this House changed because of their presence in this House? My answer is no. Nominated MPs cannot set standards. Elected Members of this House always set very high standards.”
“So I would not repeat. Finally, I would like the Minister to consider an alternative upgrading of the estate. There are, I am sure, old and poorly designed estates, like Teban Gardens, with its long standing intractable problems of leaking toilets, damaged water pipes, spalling concrete and window casements falling apart. Moreover, these flats have no void deck. Sir, I have an album of such defects which I will hand it over to the Minister. I hope that, after viewing it, he would sympathise with me, as the Member of Parliament of that constituency, and also to sympathise with my poor residents. Sir, would it not be more prudent, rather than try to do patch work surgery on such buildings, to construct new flats instead? This, of course, would be on condition that there are vacant lands to, say, build a precinct of five blocks, so that we can move a section of the old estate into this new precinct, tear down the blocks left behind to build another precinct, and then move another sector into this place and so on. I think this is less traumatic, less disruptive, less problems of dust, noise and neater, and the whole estate can be renewed and residents can remain in that neighbourhood. These new flats can be sold to the sitting flat owners at a special price which takes into account the Government's saving on refurbishing cost. The details can be worked out later. Thank you for your patience, Mr Speaker, Sir. I support the Bill.”
“For example, if a balcony costs $5,000 to build and a flat owner thinks that it is not worth the cost of having it because the view is not much to look at, unlike Marine Parade, and the increased space can only have standing room for one plus a few flower pots, can he opt out and save this $5,000? I make this point because we must plan what the flat owner needs and not what we think they need because plans, once drawn and presented, are very reluctantly changed. So I want to be sure that this can be done, ie, of course, after a poll has been taken. I would also like the Government to show clearly the areas in the flat that are upgraded at HDB's cost. I think this is important because there is a need for the residents to know about this. In the upgrading exercise, a conscious effort must be made to have a barrier-free environment. It is well and good to have different layers in the precincts to bring out the aesthetics of the area. But what use is all this if an old or disabled resident cannot have access to it to enjoy all these new developments in the precinct. Or a young couple cannot push the baby pram around because of too many barriers. With all this upgrading of the flat and increased space, two questions invariably must be made known to the residents. One is the question of property tax and the other is the lease period of the newly renovated flat. How much more will he need to pay for his property tax? Some indication should be given and will his present lease be altered, say, back to 99 years. The rest of the amendments refer to procedures of recovery of cost from those who refuse to pay up. It is quite clear and I would not comment on them. The section on procedure and regulation on the sale of shops has been discussed in the Committee of Supply.”
“It has its own upgrading programmes like covered linkways, improvements to lift landings, lift replacement, landscaping and cyclical works like painting, etc. To prevent unnecessary wastage of Town Councils' funds, it is important that HDB gives advance notice to Town Councils or makes known its upgrading plans, including cost, to Town Councils when requested. This will help to dovetail the work of the Town Councils and the HDB's upgrading exercise. With regard to the cost sharing of the specific upgrading of the individual flats, I learn that at present the flat owner pays 10%, either through cash or by way of CPF. I hope this percentage remains at this figure, and I would like to request HDB not to up it. Because the value of upgrading will not be as it is today, which is about $45,000. Maybe it will be about $50,000 in the next five years. Thus, if the cost to flat owners is pegged at 10% of the upgrading cost, he pays only $5,000 in five years time as compared to $4,500 now. To increase this percentage to, say, 20% of the increased upgrading cost of $50,000 will mean $10,000 on the part of the flat owner. I hope capping the flat owner's share at 10% is reasonable. As this is not spelt out in the Bill, I would like to get from the Minister some assurance on this matter. I would like the Ministry to make available to Town Councils and flat owners, a list of the costing for upgrading within the flat, item by item, stating clearly what items are compulsory and what are optional. I am concerned about over-providing, ie, giving more than what is necessary.”
“Mr Speaker, Sir, I rise to support this Bill standing in the name of the Minister for National Development. The Bill, as stated by the Minister, is to allow HDB to implement a major upgrading of our older HDB flats and to improve the common areas and open spaces within HDB estates. It is the correct thing to do, as some of our older flats have deteriorated and with it its value and comfort. It is clearly specified in the Bill that the upgrading will be in precincts, in other words, a cluster of 5-7 blocks will be identified as a precinct and the work will be carried out precinct by precinct. My question is: why upgrade by precincts? Can individual blocks in a well-defined neighbourhood be upgraded without going through this precinct concept? Should the number of blocks to be upgraded be only from five to seven? Can there be more flexibility by not fixing this number and allowing future planners to determine the best mix according to the lay-out of the town? The Bill separates the upgrading works into specific and general upgrading. This is obviously related to costing. One of the biggest concerns in this upgrading exercise is cost. How much will the individual pay, how much will the Government pay, and how much will the Town Councils pay? As stated by the Minister, HDB will bear the cost of such works like installation of dry risers for fire fighting, upgrading of the electrical load and replacement of lift car cage, because these are of public interest and no poll is needed to seek approval. I understand, however, that the cost for general upgrading of the common areas, open spaces, will be shared with the Town Council, while the specific upgrading by the individual flat owners. Mr Speaker, Sir, Town Councils run on a very tight budget.”
“Sir, I thank the Minister for his reply and I beg leave to withdraw the amendment. Amendment, by leave, withdrawn. The sum of $11,578,220 for Head F ordered to stand part of the Main Estimates. The sum of $1,010,900 for Head F ordered to stand part of the Development Estimates. The Chairman: I shall now deal with the remaining heads of expenditure in respect of which no amendment stands on the Order Paper Supplement. In respect of the Main Estimates, they are Heads B, C, D, E, G, H, X and Z. I propose to take these heads of expenditure en bloc. Question, "That the sums stated for those heads of expenditure which appear in the last column of the Schedule of Estimated Expenditure under the Main Estimates on page 47 of Paper Cmd. 9 of 1992 stand part of the Main Estimates." put and agreed to.”
“Sir, I beg to move, That the total sum to be allocated for Head F of the Main Estimates be reduced by $100. Sir, last month, the Leader of the House, in moving the motion to adopt the Report of the Standing Orders Committee, mentioned about the building of a new Chamber. Could the House be given details, if available, of the new Chamber, when will it be ready, and what additional facilities are being envisaged?”
“Sir, can I beg your indulgence to be more lenient on the timing and let the Minister explain on this issue of community hospitals? I think it is very important for Singaporeans.”
“The Minister mentioned that there were some patients who, for some reasons, had been admitted to Class A by the influence of the doctors. What happens if these patients would like to downgrade to Class C? Would they still have to pay the Class A rates, or do they now have to pay the Class C rates? Mr Yeo Cheow Tong: Sir, before I answer, let me also explain that there are certain safeguards. When a patient chooses to go to A or B1 class wards, all our hospitals now have a counselling service where they explain to them the expected bill size. So although the ward charges may be, say, $200, the bill size may actually come up to $400 a day. First of all, before they even bring them to the wards, they will explain to them the expected bill size for their hospitalisation. So when the patient finally goes to, say, A class ward, he knows what is his likely bill size. With that mechanism, very few of the patients now ask to be downgraded. But if they want to go back to Class C, he is allowed to do so.”
“Sir, can I ask the Minister for a clarification?”
“I just want to know whether the Ministry is on the way to recognise these traditional doctors that the Minister has just talked about.”
“Sir, I just want to ask the Minister one question.”
“Sir, he has spent about 10-15 minutes on his Ministerial statement.”
“We should move more into this primary health care area and the proposal that I have made on the primary health care is primarily to see if I could help the Ministry to get a more structured primary health care and, at the end of the day, we would have brought health cost down and Singaporeans will benefit.”
“Mr Speaker, Sir, I would like to respond to some of the comments made by the Minister. I think the Minister has mentioned the health philosophy of our country. I would like to question whether we still subscribe to this philosophy that health is an industry. Because I believe that in health planning, there are actually two facets - financing and health care delivery system. My worry is that we are so concerned about financing that we have actually not paid much attention to the health care delivery system. And I think the two are very closely linked. We can have a very beautiful financing system, but at the end of the day, if your health care delivery system is not efficient, then we are in trouble. 1.30 pm I feel that we might have over-provided some of the facilities at the high cost area and have got ourselves into a spiralling cost. The hospital is a high cost area. So when we advertise the facilities of the hospitals, when we talk about the good equipment that we are putting into all these hospitals, we are creating demand, we are creating high expectations, and therefore all these people will go to this high cost area. So we will again get into this vicious cycle. You have to put more money into this area and, at the end of the day, you will find that more and more of your health budget will have to be put into this high cost area. As a result, you have to increase your Medisave and create Medifund as a safety net for the patients. What I am hoping to do is this. I am asking the Minister to get out of this cycle and change the health philosophy. Health care is a service to the people.”
“However, I observe that there is one issue which has been omitted in this Report, that is, the role of traditional medicine. It is very important for us to determine whether traditional medicine is effective in the prevention and cure of diseases. Traditional medicine such as Chinese medicine has at least two advantages. Firstly, it is cheaper in cost and, secondly, it has taken root in the hearts of the people, and commands the support of the people. Here, I would like to ask a simple question: what plan has the Ministry of Health to assist and support the development of traditional medicine? For example, in the case of Chinese physicians and Chinese medicine, how are we going to appraise the quality of Chinese physicians? Secondly, how do we determine the reliability of traditional Chinese medicine and herbs? How do we complement the studies of Chinese medicine with that of Western medicine? In this respect, can we cooperate with China, Taiwan and Hong Kong because they are quite advanced in this field after years of research and development? The other point that I would like to raise is that, owing to our tight labour market, we also face the problem of shortage of nurses in our medical service. For this reason, we have to resort to employing nurses from other countries. Here I would like to ask the Minister for Health whether the service of these foreign nurses can be extended to three years or longer, after their training period.”
“There is one country that has spent more than 30% of their health budget on primary health care and is showing good results. This country is Finland. Finland has been used by WHO European office as an example where emphasis on primary health care has paid off, but this took 10-15 years. You see, Sir, like us today, they were building hospitals in the 60s and the 70s only to discover that hospital-centred care was simply not the answer. They figured out that more money had to be spent in the community itself where some of the aggravating circumstances of the illnesses were created. In the review of their health system in the 70s, they admitted that the inadequacy of the primary health care was the principal structural defect of the Finnish health care system. It was following that review that they introduced the Primary Health Care Act to bring under one administration and planning authority all the modalities of primary health care. Maybe we should give some thought to this. 4.14 pm [Mr Deputy Speaker in the Chair] Finally, Sir, primary health care is the other facet of the health care delivery system that needs more than the usual attention. I hope that what I have suggested will: (1) improve the present primary health care system to meet the five health programmes by the Health Review Council; (2) make it more effective and more structured, promote wider participation involving the private practitioner doctors; (3) bring primary health care closer to the community; (4) make it more accessible and, finally, I hope, in assisting to bring down health costs. Dr Ow Chin Hock (Leng Kee)( In Mandarin): Sir, many of the recommendations in the Aline Wong's Report are very constructive and of good foresight. I support the recommendations in her Report.”
“It should be a centre where residents can also get information on where to go for their health ills, how to go about it, what to do and when to do. This will keep Singaporeans well informed of the proper utilisation of our health care system. Thus, the health centre will provide two kinds of services, (1) centre-orientated with programmes like health education, promoting healthy lifestyle, healthy nutrition, physiotherapy and simple nursing; (2) home-orientated activities involving the establishment of a home health care team. I made this proposal in past debates on health. It is all in the Hansard. However, to save time, I am giving this article to the Minister for his reading. Another primary health institution we should set up is a specialist referral centre. The referral centre should be part of the community hospital set-up or separate. The idea is to bring certain modalities of hospital treatment out, so that these are managed at such centres at a much reduced cost. Such centres would definitely be supported by general practitioners and polyclinic doctors and they also help to relieve the congestion in our hospitals. I attach a diagram on how this can be done. Could Members please refer to Annex 1? I am sorry I have got no time to explain. I will explain later. With the two new facilities -- community health centres and referral centres -- plus our community hospitals, our primary health care will be effectively strengthened. And together with our polyclinics, outpatient departments and private practitioners and Home Nursing Foundation involvement, we should be able to contain the health ills at the primary level to a very large extent and thus shift the expensive hospital-based health care to a less expensive primary-based health care area.”
“Because of the long working hours and the small HDB clinic set up, it is very difficult for the private practitioner to participate effectively in the quality of care that embodies primary health care. They are unable to provide the supportive and preventive aspects of primary health care and this gap, however, can be filled, I believe, by the establishment of a community health centre at constituency level. Such a centre must coordinate the various programmes laid out in primary health care. It is not curative, not like a general practitioner's clinic or an outpatient set-up. There is no treatment involved here. It is supportive and preventive. It will help to support not only the general practitioners but also the polyclinics, the MCHs, the Health Education and Training Department of the Ministry of Health in further promoting their activities and programmes. Primary health care must reach out to the community level if it is going to be effective. Our programme of centralising the various OPDs into big polyclinics has its advantages and disadvantages. One disadvantage is that it is less accessible and more impersonal because the main hub of their activity is diagnostic and curative. Its role of promoting health care should be shared and some of it devolved to neighbourhood community health centres which will have more accessibility and more personal. This is along the lines of the Neighbourhood Police Post and the main police station. The centre will support the Review Committee's five health programmes, for example, in the management of continuity of care of, say, diabetes. Upon diagnosis of diabetes, a doctor treats and later refers the patient to the centre with a specific programme for the patient and the health care staff can then carry it out.”
“Sir, I beg to declare my interest. I am a general practitioner. Before I begin, I would like the Clerk to distribute some annexes. [Copies of annexes distributed to hon. Members]. Sir, I move this amendment to make a few proposals for the Ministry to consider. The Health Review Committee has prioritised five health programmes for the next decade and recommended channelling additional resources to them. They are: 'Improving the health of the elderly; Strengthening the management of the main killer diseases -- heart disease, stroke, cancer, diabetes mellitus and injuries; Enhancing child health services; Improving mental health care; and Health promotion and disease promotion.' Sir, these are not hospital-based programmes, but primary health care programmes. It is indeed a move in the right direction. At present, only 12% of the health budget is allocated to primary health care as compared to 75% for hospital care. A primary health care centre should be a person's first point of contact with the health system. How you manage him at this level is very important, because it affects hospitalisation later on. In other words, if a person with diabetes is badly managed at this point, he ends up early in hospital with eye, kidney and lung complications and with increased health bill for that person and high subsidy cost for the Government. If we think that private practitioners contribute 75% of primary health care is very adequate, then we are very far from the truth. Percentage wise, I agree 75% is a good figure. But primary health care involves managing a number of health modalities, eg, health education, school health, physiotherapy, etc, in addition to providing medical services like treating coughs and colds and minor illnesses.”
“In view of the shortage of time, I will raise this issue in the form of an Oral Question later on. The Chairman: Thank you. Encik Othman.”
“Sir, I just want to seek a clarification from the Senior Minister of State. I know that there is this policy of not accepting graduates who do not have two teaching subjects as teachers. I am wondering whether the Ministry would like to review this policy, because I am sure there are some graduates who may not have two teaching subjects. For example, a graduate in history and politics, would the Ministry consider accepting such a graduate as a teacher?”
“I thank the Minister of State for his reply and I beg leave to withdraw the amendment. Amendment, by leave, withdrawn. The sum of $348,989,600 for Head U ordered to stand part of the Main Estimates. The sum of $4,068,436,000 for Head U ordered to stand part of the Development Estimates. Head M -”
“Sir, on a point of order. Mr Chiam did not file an amendment. And if you allow him to speak, I presume you are changing the rules of debate.”
“The good thing about this was that that particular person who operated the stall actually employed two others to help him. HDB discovered this and decided rightly, to remove his licence to operate that stall. But I ask myself this: In the process of withdrawing the licence from that particular stallholder, who actually is a sick person, we are actually depriving four families. I think the Minister can consider this very carefully. Politically, when you remove the licence from that poor hawker and his stall supports four families, it would not be very good for us. Please do not give me a straight answer. Please think about it.”
“If the HDB refuses their request for early purchase of their shops, will the HDB consider the rental paid for now to the shops actually sold to them later as part payment of the sale price? The third question is on tenants with multiple tenancies. The HDB announced that for such tenants discount on sale price is given only to one shop. We believe the HDB's intention is to prevent unhealthy speculation on its shop premises. May we request that the HDB consider granting discount to all the shops that are currently under a single tenant if all the shops had been actually occupied by the tenants for more than a certain number of years? The next topic I would like to touch on is this. I would like to request whether we can legalise the subletting of hawker stalls in HDB hawker centres. I know this is something we will have to consider very carefully. Perhaps the Minister need not give me a straight answer now. He can think about it very carefully. I am always worried because, if you ask him a direct question now, he may just say, "No", and you are finished. Sir, it is actually impossible for a hawker to operate his stall from 8.00 o'clock in the morning to about 10.00 at night. Our requirements are that they should be there all the time. If they are not there, the hawker inspector is there to take note of their absence there. They will either be given a fine or they will be given a notice saying, "Look, you have not been operating that stall. If you do not operate that stall again, we are going to withdraw your licence to operate that stall." I will give you an example. In my constituency, there was one hawker stall owner. He was actually a sick man. I think he could have sublet the stall to somebody.”
“Sir, I beg to move, That the sum to be allocated for Head U be reduced by $10 in respect of Code UI 5200 of the Development Estimates. In moving this amendment, I hope to raise a couple of issues: (1) the pricing of HDB flats, (2) the sale of HDB shops and (3) subletting of stalls. I shall touch on the first issue, ie, HDB flat prices. Sir, I raised this during the debate on the Presidential Address and I thought I had better raise this up again because I feel that the price of HDB flats has actually gone up substantially. HDB flat prices have increased significantly over the last four years, with such steep increases. There is a danger that public housing will be priced beyond the reach of the average worker. I would like to ask the Minister how do increases in HDB flat price compare with increases in wages, private property prices and prices of resale HDB flats on the secondary market over the past 10 to 20 years. I have raised this before. The second topic that I want to touch upon is related to the sale of these HDB shops. My colleague, Dr Wong Kwei Cheong, has spoken a little bit on this and I shall not go over his points. But I would just like to pose a few questions to the Minister. What will be the sale price for premises that are scheduled for sale in seven or 10 years time? It appears that the later the premises are scheduled for sales the more the shop tenants will have to bear the disadvantage on the sale price. This is because the sale price of a reasonably good shop is likely to be higher as time passes. The second question is on the rental for shops that are scheduled for sale in seven or 10 years time. For such shops, will the HDB exercise flexibility to allow the existing tenants to purchase the shops now if they wish to do so?”
“Sir, in view of the Minister's fairly adequate answers, I beg leave to withdraw the amendment. Amendment, by leave, withdrawn.”
“Mr Speaker, Sir, I have no intention to trip the Minister when I asked those seemingly innocent questions. I am sure Members of this House have problems trying to figure out the --”
“Mr Speaker, Sir, can I just clarify? I was under the impression that the ratio was something like this -- one Singapore worker to two foreign workers. But that Singapore component comprises a Singaporean, a permanent resident, and a skilled foreign worker.”
“Take my constituency of Hougang, for example. Prior to the General Elections, an application was made by the CCC of Hougang constituency to the CIPC for the construction of a covered link-way. After the elections, I wrote to the CIPC to make enquiry about it. The CIPC replied that the CCC of the Hougang Constituency had withdrawn its application. When I wrote to the Hougang CCC, the reply I received was that they had never applied. Of course, I understand the reason! In this process, my experience is that the matter involves two very important questions. One, what is the role of the CCC? The CCC, according to my understanding which is also the Government's open definition, is a community project consisting of community leaders. Since it is for community work, and improvement to town facilities is also for the good of the community, I fail to understand why they withdrew their application. On the other hand, another matter which warrants our special attention is that the fund to be allocated by the CIPC comes from the taxpayers' money. Should not all the town councils and all the tax-paying Singaporeans residing in the constituency be equally and fairly entitled to apply for such funds? Sir, I hope that the Ministry of National Development will announce to the public the total amount of allocations approved by the CIPC, up till this date, and a breakdown of allocations approved for each individual town council. I would also suggest that the Ministry of National Development set up a Town Facilities Improvement Fund to allocate funds to the town councils for improvements to facilities within the constituency.”
“Thank you, Sir, I will just continue what I have to say. I shall just touch on Housing and Development Programme, which will take only a few minutes. Sir, clearly, the task facing the HDB is likely to be profoundly different from that it has faced in the past. The massive refurbishment programme requires more professional and management attention. Nevertheless, it will be useful to clarify whether these reasons completely explain the 16.3% increase in the administrative cost between FY 90 and FY 91. Lastly, there seems to be a drop in the return on investment indicators for HDB's operations in relation to car parks, hawker centres and markets. Will these functions be eventually privatised? 3.30 pm Mr Low Thia Khiang (Hougang)( In Mandarin): Sir, every HDB housing estate will be aging after some time. The facilities in the estate would need to be improved, for example, the children's playground, etc. If these upgrading and improvement works, particularly in the older housing estates, are solely dependent on the town council without funding from any other sources, then more often than not, it will be inadequate. The Ministry of National Development has a committee known as the Community Improvement Projects Committee (CIPC) which is responsible for handling and approving applications submitted by the town councils for community improvement projects. What surprises me is that the application must be submitted through the Citizens' Consultative Committee (CCC) to the CIPC, and the application must first be approved by the Adviser to the CCC. To the best of my knowledge, the establishment of town council is to represent the town concerned. Why is it that application to the CIPC must be made through the CCC? What is the reason for it?”
“I have another amendment. Can I just continue? So I would not move the other amendment.”
“On indicators for the processing of building control applications, it may be useful to indicate the average time taken for the total number of building control applications processed during the year, as well as the average for the upper tenth percentile and the bottom tenth percentile. Efficiency must be measured not just in terms of processing cost, but also in terms of the degree to which the Building Control Division is responsive to the service of its constituency of individual home owners, architects, engineers and developers. Thus, it might be useful to indicate the length of processing time as a measure of efficiency in the future.”