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
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“A point of clarification. I have listened to David's comment. Unfortunately, Chng Hee Kok is not here. Can I take it from him that he is saying that Chng Hee Kok did not tell the complete truth? This is important. He is a Member of Parliament, and I would expect him to tell the truth.”
“He then has the audacity to ask Mr Chng Hee Kok to resign as an elected MP and, as I said, on what issue? A minor issue, a different approach to management of bond breakers. Mr Chng Hee Kok's electorate, those who voted him in, will be wondering why they have to lose their MP. Maybe the EDB chief should go to Mr Chng's constituency and explain to the constituents why their MP should go. He talked of a lack of leaders with creativity in his interview with Pioneer IT. I think Members must read this. It is a very important paper and I will ask the Clerk of Parliament to circulate this later on. And I quote him: `They are preoccupied with auditing, counting, making sure that every chair and table is there. They are so preoccupied with the material part, they forget that the most important is the creative part, the people.' Mr Speaker, Sir, all that is well said, but you ask yourself: how to be creative when the leader of a company has no room for differing views? All this talk of creativity in that interview is just lip service. Sir, this is a serious matter, because I see his action as an affront to the office of the elected Members of this House, by a member of the Administrative Service. May I ask the Minister what he intends to do? Sir, I support the budget. I am very impressed by the Nominated Member's discussion on the budget. She did a very good job. And I am sure we support our Finance Minister's budget.”
“Mr Speaker, Sir, when I discussed this with my Members of Parliament, I was shown a copy of a newsletter called Pioneers of Computing where he was featured as IT champion. In this interview, he had expressed views contrary to Government policy. For example, he questions Government upgrading of our HDB flats. He is quoted as saying, and I quote him: "We spend millions of dollars renovating HDB apartments for people. What for?" In other words, he disagreed with this major Government policy. No one asked him to resign. Yet, he wants Chng Hee Kok to resign and other MPs to also resign. On what matter, on a minor issue - a departmental issue on bond-breaking. He obviously has his own views as to who should lead Singapore. I quote: `When we were a young country in the 1960s, we were creators, Lee Kuan Yew, Howe Yoon Chong [referring to all in the frontbench]. Now, we have the era of the CFOs. [I will explain what "CFO" stands for.] This is where Singapore is right now. Now we have to see if we go up or down. You must get rid of these people. These people should never be allowed to be No. 1, because they are not creators.' Mr Speaker, Sir, you judge for yourself. Is this not a reference to the present leadership, as no more than uncreative CFOs, which stands for chief financial officers? Earlier, in his interview, he equates CFOs as bean counters. Are our Ministers bean counters? Is the naming of bond breakers a Government policy? No, it cannot be. It is a departmental policy. As Members in this House must have read in the papers that even PSC, the body that awards prestigious scholarships, is not naming the scholars. Therefore, he is not being fair to Mr Chng Hee Kok, and was hiding behind the Government to push his own view and belief.”
“After he asked Chng Hee Kok to resign, he stormed out of the meeting. Should a man of his standing do such a thing to an elected representative who refused to agree with his views? I do not think our Prime Minister has ever done that. It is not a gentleman's behaviour. We want to build a more civil society and we must behave like one. To add insult to injury, he wants Chng Hee Kok to let him know the names of those MPs who share Chng Hee Kok's views and he does this by way of a letter, signed not by him but by his Head of Human Resource Division, a Mr Timothy Sebastian, asking these MPs to meet and discuss with him. Since he has already concluded that those who disagree should resign, there would have been no civilised discussion. And I presume the MPs will be told off, similarly, the way he told Chng Hee Kok, and the demand for their resignation will be asked. Let me read the letter that was faxed to me by Chng Hee Kok: `Dear Mr Chng, Your meeting on the 19th January 1998 with our Chairman Mr Philip Yeo refers. During the meeting, the issue of scholars terminating their scholarships was discussed. It was also mentioned that there are other MPs who have differing views from our Chairman on this issue. Our Chairman would like to meet with these MPs to hear their views and further discuss the issue with them. In this connection, we would appreciate if you could let us have the names and contact details of the relevant MPs so that a meeting can be arranged.' Mr Speaker, Sir, has he the right to summon MPs for a meeting to answer to him why they disagree? Is he getting too big for his shoes? And this is not the first time he has displayed such an attitude towards elected leaders.”
“Thank you, Mr Speaker, Sir. I think this subject is important because we are allocating funds to the various Ministries and organisations, and of course, Singaporeans would like to know the funds we allocate to these organisations. They must also be accountable to this House whether in terms of their financial performance or the way they handle matters, and I still strongly believe that I have a right to speak on this matter. Mr Speaker, Sir, as I said, as an elected Member of this House, I cannot be a bystander when my Parliamentary colleague is insulted in this manner. I cannot allow the episode to pass by without expressing my concern. I suppose my Parliamentary colleagues would have done likewise. We are the representatives of the people. We are here in this House to air the views and concerns of the people. Many of us in this House have spoken strongly against the Government policies. We were reprimanded by the Ministers and we were taken to task even by the Prime Minister, but we are still not embarrassed because we have spoken out honestly and frankly what we believe in and also to let the Government know how the people at the ground feel. Despite our differences in views, we were never asked by the Prime Minister to resign. In this instance, my Parliamentary colleague was offering a view that was different from the EDB Chief and because of this, he was asked to resign. His reasons are: (1) he is a Government MP; and (2) naming bond-breakers is a Government policy. Let me state my stand on bond-breaking. I think it is not gentlemanly and should be discouraged, but not by naming them in public. Mr Speaker, Sir, I have to continue because I have to paint the picture to this House why this subject is important.”
“Mr Speaker, Sir, I am not being personal. I just want this House to be clear on why I think this exchange should be made known to Members of this House as this involves a top administrator and elected Members of this House and it touches on areas of creativity, leadership and alternative views. Mr Speaker, Sir, I listened to Chng Hee Kok's encounter with the Chairman of EDB with shock and disbelief. As an elected Member of this House, I cannot be a bystander.”
“Mr Speaker, Sir, I rise to support the Budget. The Budget emphasises on education and our educational system is moving towards creative thinking and creativity. Yet there can be no creativity if discussions are not done in a gentlemanly manner with opportunities to speak up and alternative viewpoints sought. It is in this context that I want to seek clarification from my Parliamentary colleague, Mr Chng Hee Kok. Mr Speaker, Sir, I would like to ask Mr Chng Hee Kok whether he would like to confirm what he told me outside this House sometime ago that the Chairman of EDB asked him on these points: (1) that he should resign because as a Government MP, he should not disagree with this Government policy of naming bond-breakers; (2) that other MPs who disagree should also resign; and (3) that the EDB Chairman stormed out of the meeting. Can I ask Mr Chng Hee Kok to clarify? Mr Chng Hee Kok: Mr Speaker, Sir, essentially I agree and confirm what my colleague, Dr Tan, has mentioned. Actually, on top of that, he (EDB Chairman) mentioned two other points. Since this subject has cropped up, I should mention that when he showed me the statement, he threatened that my name would be put into the statement because I supported those three named scholars by speaking publicly against the issue. My name was supposed to be included in the statement. He also suggested that I should send my speech (the speech which I made on 12th October 1997) to him for vetting. I want to assure Members of this House that in all my years as a Member of Parliament, no Minister or office-holder has ever asked me for my speech before I speak on any subject. I told him that I have never offered my speech to any Minister of this House for vetting, Sir.”
“It is in public. There is no question that it is private. Mr Speaker: Order, order. Dr Tan, can you resume your seat? Dr Tan Cheng Bock resumed his seat.”
“No. I want to ask the Member through the Minister.”
“Mr Speaker, Sir, can I direct the question to the person who asked the Question? Can I ask the Member to have a close look at our frontbench? Is he aware that they were all elected?”
“Sir, the Minister mentioned about the various types of pollutants. I would like to ask the Minister which particular component is very high. He mentioned about oxide of nitrogen. I know that oxide of nitrogen is one of the main pollutants of wood burning. Is it very high? I want to know how high is it. Because it has an effect on the health of Singaporeans. Mr Yeo Cheow Tong: Sir, our studies have shown that other than dust particulates, the other pollutants have not changed very much.”
“Sir, the Minister has asked his Ministry's boys to be compassionate. At least, he is now a little bit more compassionate!”
“Sir, maybe we could allow a conditional registration in those cases. Give the young doctor a chance.”
“Mr Speaker, Sir, I take it that the Minister agrees that this Bill does allow you to deregister a doctor based on the reasons he has given. Sir, I do not want to go on discussing this. Perhaps we could get the Minister for Law to study this carefully because it is very important. For a young doctor, just imagine he is deregistered because he dislikes the working conditions of the hospital and he cannot pay up. His clarification may be good enough for them not to remove the doctor now. But I hope that for legislation in this House, it is better we get all the things properly done. I hope the Minister for Law (he is not here) could have helped us out. Mr Speaker: Mr Yeo, could you allow Dr Toh to clarify?”
“Mr Speaker, Sir, I know that a doctor can be deregistered for many other reasons. I am sure all the medical doctors here will know. What I am saying is that, in this particular case, the reason for his deregistration is a breach of contract. It is not for professional misconduct or negligence. It is because he does not like the working condition, he left. And what happens if he has got no money and cannot pay the liquidated damages? He will be deregistered. So I am saying that this particular section could be in the Act already and maybe the Ministry officials overlooked this and passed it over to this new Bill. The Minister thought it is correct. So everybody says it is correct. But we are perpetuating a wrong.”
“First, I thank the Minister for his clarification. But I am still not clear because I am not a lawyer. However, if we were to read this clause very carefully it does give people the impression. For the benefit of all in the House, I will read it: "Power of Medical Council to remove names from registers Notwithstanding the provisions of this Act, the Medical Council may, upon such evidence as it may require, order the removal from the appropriate register the name of a registered medical practitioner under any of the following circumstances: (g) if he has failed to serve the Government or such other body or organisation as directed by the Government for such period as may be specified in any undertaking given by him to the Government." As I said earlier, when you register somebody, you register him based on his professional competence. That is the criterion and that is the key for registration of doctors. He must be competently qualified. He must come from the National University of Singapore or any of the medical schools recognised by the Government. In this case, the medical student has broken his bond. That is a breach of contract. It has nothing to do with the very reason he was registered. And the Minister said that if he can pay his liquidated damages, he would not be deregistered. I still think that it is wrong. That means you are actually removing him from the register for a different reason, and not for the original reason. I am not a lawyer. I am sure this needs clarification because this was carried over from the previous Act and we cannot perpetuate a wrong if it is a wrong.”
“Mr Speaker, Sir, can I seek a clarification?”
“You will see that there are many things happening and I am sure the Minister may be aware too. Mr Speaker, Sir, as I said, the Bill, on the whole, is a very good Bill and I support this Bill.”
“Mr Speaker, Sir, many of our private hospitals are now in the hands of a foreign-owned public listed company. They are now run by non-medical personnel who are not interested or aware of the ethics of medical practice. Their main concern, of course, again is bottom line. Doctors in such establishment would be under severe pressure to perform to meet the bottom line, or probably they would be removed. Doctors not in their payroll would have to meet certain requirements or lose out on the use of the facilities that these hospitals are providing. Therefore, there are going to be more cases of professional misconduct and unethical practices. Thus, at this point, I would suggest there must be in place, and I hope that they are already in place, medical audits, tissue audits and hospital audits. I think we need to have all these in place because we need to audit how the hospital is functioning. We need tissue audits. Maybe this House is not aware what is tissue audit. Tissue audit is very simple. Every time a surgeon removes a tissue from the body, you must subject this tissue to an audit. In other words, the tissue must be examined by a pathologist to ensure that normal tissues are not being removed. We can remove things from the body. But to the non-medical people, they all think opening up an abdomen is such a great thing. But to the surgeons, it is the easiest. So when you remove something from the abdomen, we must make sure the tissues removed are not normal. This is a good check for unnecessary surgery. So this tissue audit is only one aspect. Medical audits are important. I do not want to go through the details. For hospital audits, you have got to make sure that the hospitals are being audited very carefully because there are so many procedures.”
“And some of these clinics are now banding together and forming companies to get listed in the Stock Exchange. The implication is very simple. Doctoring is now a business and the bottom line is very important for such companies. As I said before, I dislike calling the medical profession a business. As such, medical practice, medical culture, doctor's behaviour will all change with all this listing of clinics. Various kinds of treatment and equipment, not available in the past, are now available. Doctors, for example, have to turn to skin peeling. It is a treatment for skin problems. GPs are using ultrasounds, X-ray machines, ECG, doing colonic washouts and sigmoidoscopy procedures. There must be more control on the use of these equipment. While we should not discourage doctors from offering more choices of treatments, there must be some degree of caution. The use of ultrasound, for example, should always be accompanied by a report. Not only ultrasound, but the use of any other medical equipment. This report is very important because it reveals the competency of the doctor when he makes such a report. He must be competent enough to put it down in writing that this is what he sees on an ultrasound picture, or this is what he sees on an X-ray picture. But many a time, as a practising doctor, I come across patients presenting me with an ultrasound picture or an X-ray. I tell them honestly that I am not competent enough to read because I am not well-trained in that field. So Mr Speaker, Sir, may I ask the Minister to consider my request to make it compulsory for anyone who wants to make use of these sophisticated machines to at least give us a report. You can put this as a condition for the renewal of his certificate.”
“But a few will send the poor patient on a merry-go-round, passing from one specialist to another, and the patient is very much the poorer. It is bad for the specialist's practice because he now depends on the family doctors for referral. But, on balance, a proper referral system is good because medical practice in Singapore will be better organised and will help Singapore develop into an efficient medical regional centre to benefit locals as well as foreigners. Finally, Mr Speaker, Sir, Part VII deals with disciplinary proceedings and the Health Committee. A great deal of this Act is spent detailing the disciplinary proceedings and as it is fairly well done, I will not dwell into it because it will be just repeating what is in the Bill. However, the inclusion of lay persons into the Committee is a good move. For too long the medical profession has been accused of protecting its own interest. I am sure the lay people in the Committee will provide another dimension into the discussion of disciplinary actions on doctors. It makes it more transparent. The setting up of a Health Committee is something new. It is again a right step. It provides a check on doctors who may be, as the Minister said, physically and mentally not well enough to practise. It also places on practising doctors to report such doctors to the Health Committee. And as pointed out by the Minister, at present there is no law to disallow such doctors to practise. This present Bill clearly states that the Health Committee can recommend to the Medical Council to deregister a doctor if the Health Committee finds him unfit to practise on medical grounds. Mr Speaker, Sir, as I said in one of my speeches, most of our primary healthcare is in the care of the private clinics.”
“I want this clarified because it has serious implication for young practising doctors. Mr Speaker, Sir, Part V deals with Specialists Accreditation Board. I support this establishment. We need a proper list not only for doctors but also for patients. However, there is one question that I want to ask the Minister. Having established this Board and having doctors accredited along the line of specialisation, does it mean that such accredited specialists can see only patients within their area of expertise? In other words, a heart specialist can also see and treat a patient with an abdominal problem, or a breast cancer, or the common cough and cold? Must he only see referred patients by family doctors for his expert opinion and perhaps management? Or can he also see patients off the street like any other general practitioner or family practitioner? I am not sure whether the Ministry is moving towards a proper referral system as practised, for example, in Australia and Britain. If not, what is the other reason for setting up this Accreditation Board? There are implications should we move into a referral system. It has good and bad points. Good for patients for it means a better maximisation of our health care delivery system. There will be less wastage. Because in such a system, patients wanting to seek specialist care can go through their family doctors who then refer the patients to the proper specialists. But when specialists see patients off the streets, there is a chance the specialist might be seeing a patient not within his field of practice. This is very possible in Singapore because Singapore patients are very gullible. They usually listen to friends. Many good specialists in Singapore normally refer such patients to the GPs for assessment and proper referral.”
“But there is one particular circumstance, clause 33(1)(g), that caught my attention, and that is this: "if he has failed to serve the Government or such other body or organisation as directed by the Government for such period as may be specified in any undertaking given by him to the Government." This would mean that he can get deregistered. Let me explain further, Mr Speaker, Sir. Our medical students are bonded to serve the Government. Upon graduation, he gets a provisional registration to practise as a house officer. Once he has completed his housemanship, he gets full registration and can practise as a doctor. This clause, which I have just quoted to you, and unless my interpretation of this clause is wrong, allows the Medical Council to remove his name if he breaks his bond. Can I ask the Minister if this young doctor who for whatever reason decides to leave the Government service and go into private practice, let us say, after serving only three years of his eight-year bond, will he be deregistered? Under this present clause, he can be deregistered. I think this is a very serious matter as a young doctor cannot practise medicine unless he is fully registered. The issue here needs clarification. I see the conflict because his registration as a doctor was based on his professional competence and the fact that he holds a degree from the National University of Singapore or any of the recognised medical schools, as stipulated in page 10, clause 20(1) and (2). And throughout the Part, the key for registration was professional competence. In this clause, his deregistration was based on a breach of contract for failing to serve his bond. We deregister doctors for professional incompetence, negligence but, I am sure, not for a breach of contract.”
“And I am sure many of you must have heard that there are so-called foreign doctors who practise out of homes of Singaporeans or even from hotels. We must therefore discourage these practices. Moreover, practices of medicine like skin peeling and use of sophisticated medical machine, for example, ultrasound, to impress gullible Singaporeans should not be in the hands of non-medical personnel. These practices must be under supervision of the doctors, and I am glad the Minister mentioned that. There are also, if the Minister is not aware, roadside laboratories being set up where they do laboratory tests for your cholesterol, triglycerides, sugar, and these gullible Singaporeans will subject themselves to these tests and the practitioner would then advise them to seek treatment from him or persuade these Singaporeans to go and seek treatment from their own quack doctors. So I am glad this Bill takes into account this factor. Let me refer to Part IV which deals with registration of medical practitioners. In general, I have no quarrel with this Part. However, can I refer you, Mr Speaker, Sir, to pages 17 and 18, clause 33(1) and 33(1)(g). This refers to the power of the Medical Council to remove names from registers. Clause 33(1) states: "Notwithstanding the provisions of this Act, the Medical Council may, upon such evidence as it may require, order the removal from the appropriate register the name of a registered medical practitioner under any of the following circumstances:" There are many circumstances listed out.”
“Is it because the Ministry has less confidence in the medical professional group? Unlike the Law Society, this Bill allows only doctors with at least 10 years' experience in the practice of medicine to stand for election. If you want a better representation of the Council, allowing them to vote their representatives with their own band age of practice would be better. Here we have to take the example of the Law Society where those with less than seven years' practice can have their representation. Similarly, those practising between seven and 12 years will do the same, and those more than 12 years have their own representation. I do not know whether there is any particular reason why voting along the respective band years of practice is not being considered for the medical profession. We could have two bands - one for those with less than 10 years of practice and another band for those with more than 10 years of practice. On the question of compulsory voting, the Minister just mentioned that only 15% voted in each exercise for election into the Medical Council, in the present format. I think this is because voting is quite cumbersome. Each time a medical doctor wants to vote, he has to get two signatures from two other doctors before he can vote. So I hope we can change this pattern of voting for doctors into the Medical Council. Mr Speaker, Sir, I would refer to Part III of the Bill which is on pages 8 and 9. I support this upping of fines and imprisonment for those who purport to be medically trained doctors. In the past, as the Minister has mentioned, the fines were too low and therefore many non-medical Singaporeans dared to take a chance.”
“Mr Speaker, Sir, I would like to declare my interest. I am a family medical practitioner. Mr Speaker, Sir, there are 63 clauses in this Bill, excluding the Schedule. Of these 63 clauses, only 12 are similar to the old Act. The rest are either amendments or new provisions. I have gone through this Bill and I support this Bill. In fact, it is long overdue as medical practice in Singapore has changed tremendously and this Bill will bring it up to date with the many developments in medical practice. However, there are a few clarifications I would like to seek and suggestions which I would like the Minister to consider. As this is a long Act, I will approach this in sections or parts, as laid out in the Bill. Mr Speaker, Sir, Part II deals with Medical Council. It relates to the Constitution of the Medical Council and it makes voting for election of Medical Council members by registered medical practitioners compulsory. I will take the two clauses (4 and 6) of this Part II. Mr Speaker, Sir, there are 17 members on the Singapore Medical Council (SMC) Board. Of these, nine are nominated and eight elected. If you introduce compulsory voting, I would have thought that we would follow the example of the Law Society where there are only three nominated members out of a board of 19. Is there any particular reason for a majority of nominated members over the elected ones for the medical profession? I support the compulsory voting system to be introduced because it would allow the members to send in the representatives of their choice for the wider medical body. But it does appear odd if compulsory voting only permits the elected doctors to have a minority representation on the Board, like I said, eight out of a majority of 17.”
“I would just like to ask the Minister. He has not answered the question: what are the criteria of selecting a particular functional group over another? That is one question. The other point he did mention was that there is a possibility that in your selection process you could allow somebody with very strong racial views to come in. You are saying that you are prepared to allow this and let him come into this House for two years, and let him speak and air his views here. By then it would be too late.”
“Mr Speaker, Sir, I think it is an issue of conscience. Mr Speaker: Mr Wong, are you giving way?”
“If you remember, I did mention my fear about non-partisan Singaporeans coming into this House. I did mention very clearly that we must be very careful not to allow groupings to come into this House. So it was not a new thing. It was something which I have mentioned from the very beginning.”
“You put me in a difficult position, for I have to vote along Party lines. However, my conscience is not clear if I vote along Party lines. To me, it is wrong. Mr Speaker, Sir, I have no choice. I very reluctantly choose to abstain.”
“But if you have seen and had to treat riot victims, like I had to do in hospital, you will want to make sure that this does not happen again. That is why I supported the Maintenance of Religious Harmony Act and the GRC concept to ensure that multi-racialism and religious harmony in Singapore must always be the key pillars of our strength. So we must clean out all possibilities of allowing racial, communal and religious politics in this House. This NMP Scheme, by way of institutionalising functional group representation, could one day be the back-door entry for religious, racial and communal politics. My young friend who just spoke said this is not possible. Well, he has not gone through the political life. He has not seen what riots are. Maybe he is too casual about this. But to me it is a very serious thing. In the last two debates, the Whip was lifted, and I voted against it. My stand has not changed. Today, the Party Whip is not lifted. Is it correct?”
“If you kill a cat you can go to jail. Then the Association of Muslim Professionals, Mendaki, Sinda, CDAC, will also want a voice because they want to speak for the poorer community of the Malays, the Chinese, the Indians and I think they are an important functional group, and they should be given a voice, instead of only the professional and business groups. Of course, there are the consumers. I am sure CASE also wants a representative. So is the Singapore Motors Sports Club. The Automobile Association of Singapore will also want to seek representation because there is a large motoring population. As functional groups get wise to the scheme, they will come in bigger numbers. Your clan association, the Singapore Hokkien Huay Kuan, I am a Hokkien speaker, and my Hokkien Association would want a voice here. What about the Hakkas, the Teochews, the Cantonese? They also want a voice here. Can you accommodate all of them? Thus, we may be opening a big Pandora's box for religious and communal groups and vested interest groups to come in. If you consistently pick representatives from selected functional groups, there will be cries of favouritism and unfairness from these vested and pressure groups. Soon, your nine NMPs will have to increase to 12 or more, if you want to accommodate the different functional groups. If you adopt an exclusion policy, like I have said, you will be harassed more by the many pressure groups. Selecting two Nominated MPs is manageable. But when you start to expand the numbers, to select nine, 12, 15, there is an increasing possibility of lowering one's guard in the selection process and you get one wrong man into this House and we are all in trouble. Many in this House may think that I am exaggerating the situation.”
“To fine-tune the selection by inviting the leaders of certain key functional groups, as mentioned by the Leader of the House, to nominate their members for consideration, as proposed again by the Leader of the House, is to court trouble. Sir, we are going to beg more questions than answers. What are the criteria of selecting one functional group over another? Is it because a particular functional group is inadequately represented in this House? In this case, I really cannot reconcile how we need another trade unionist in the House when there are already nine elected trade union Members in this House. Are you saying that these nine Members cannot give vent to views of the unions? It is now inconsistent with the original objective of having a non-partisan voice in Parliament. For if an NMP must belong to a functional group, there is a likelihood that he will be lobbying for their sectional interest instead of articulating on national issues. Under your present fine-tuning selection, an NMP is non-partisan only in name but partisan in heart and spirit. Mr Speaker, Sir, I am sure you will agree with me on that. It could lead to a fractious Parliament. Sir, there will be many functional groups wanting to seek representation when they see themselves left out. If the Singapore Medical Association has a representative, why not the Law Society or the Singapore Institute of Architects? Or for that matter, the taxi drivers' association or the hawkers' association. They are also functional groups. This list can go on and on. How then are we going to put a stop to the growing expectation and demand? We will create more dissatisfied groups, because we cannot satisfy all the requests. Soon SPCA wants a voice to speak for animal rights. Are we going to turn them down?”
“From six to nine. That is even more. We are formalising the introduction of functional groups in the scheme. In other words, these functional groups are going to be institutionalised. In the last debate on this issue, the Leader of the House told us that he would move an amendment to the Constitution to increase the number of NMPs from six to nine for two reasons: (1) to give vent to views which may not be canvassed by the PAP or Opposition Members; and (2) to fill the void left by the loss of two elected Opposition Members. Sir, the last general election should have settled the issue of repressentation in this House. If Singaporeans only choose to elect two Opposition Members, so be it. There is no need to replace the loss of two Opposition Members with three Nominated Members of Parliament. It is the people's choice, not ours. And if elected Members in this House are not able to vent their views, they have to face the electorate in the next general elections. We started with two Nominated MPs in the House with a clear objective of providing non-partisan views in the House on many matters ranging from politics to education, business, trade, social and cultural issues, Later, in the last Parliament, we had a total of 10 NMPs altogether. Two of them served two terms. These NMPs were elected on their own individual merits, ie, they have distinguished themselves in the fields of arts and letters, culture, the sciences, business, industry, profession, social, community service or the labour movement. Although they were people who came from the key functional groups, their presence in this House was because they were individuals, and not as representatives of any of the functional groups. Now we are going to institutionalise functional groups.”
“(Ayer Rajah): Sir, I do not want to go through again all the arguments backing my fundamental position against the Nominated MP Scheme. These are already on record in the Singapore Parliament Reports. Today, I want to concentrate on the amendments to the Nominated MP Scheme. There are two basic shifts in the scheme. One, we are increasing the number from six to eight. Some hon. Members: Nine.”
“Sir, the Minister has already given the answer. This is all that I wanted to ask.”
“Mr Deputy Speaker, Sir, I shall trim my speech to the barest minimum. Sir, young couples are always worried whether they can afford to buy HDB flats. So, as usual, every year, I will ask the Minister the same question to make sure that he gives the young Singaporeans assurances that they can afford to buy these HDB flats. But, today, because of time constraint, I shall make it so brief and make it very easy for him. Suppose a young couple wants to buy a 4-room HDB flat. We know the cost is about $180,000. He pays the required 20%, or a cash deposit of $36,000. So the balance is $144,000. Their total family income may be $4,000. This is what I gather from yesterday's Lianhe Zaobao. Their income is $4,000 and the balance they have to pay is $144,000. The CPF regulations allow them to use up to 30% of their total income for the repayment loan. I hope I got this point correct. My question is: with this sort of income and CPF regulations, can the couple afford to buy a 4-room HDB flat?”
“As a Government, we must not abdicate our role of providing health care to our people We must not abdicate our role to the private companies or even to our own GLCs. It is a responsibility we should shoulder honourably. Thus, we must continue to pay more attention to the remaining Government hospitals like Alexandra Hospital and Woodbridge Hospital. We must provide more funds to these hospitals to help such hospitals upgrade, to meet the needs of a sophisticated population. We must prevent these hospitals from restructuring. And I would go further and say that any new hospital built should remain purely Government controlled and, in this way, we would give our people more choices of hospital care.”
“The major shareholders of these public listed companies are Malaysians. This monopoly of control of our private hospitals is not good for Singapore. This means that they set the pricing of our medical services for hospital care in the private sector, as the monopoly rules out practically all competition. Sir, we must remember that 80% of our primary health care is in the hands of the private sector. If listed public companies run these set-ups, what will happen to the health care delivery system? A listed company has to answer to the shareholders first, and it is rubbish to say that patients do come first in such hospitals and clinics. A listed company is not a charitable institution. Medicine, like others, is not a commercial enterprise. At the core of the practice of medicine is humanity. It should never be viewed in the strictest commercial sense. I am therefore pre-empting any possible move by the Government to allow any restructured hospital to seek a listing. Sir, this is not a far-fetched idea. When you and I first came to this House, we could not imagine that sacred cows like PUB, Telecom, MRT and PSA could one day be privatised and eventually get listed, or already listed like Telecom. As the Ministry of Health gives more and more autonomy to such hospitals, as highlighted again by Dr Michael Lim, they could eventually decide to let such hospitals become privatised and become part of the Government's stable of Government-linked companies. This then would pave the way for seeking listing on the stock exchange, if not direct, indirectly by way of being part of Government GLCs like Keppel, DBS Land, Sembawang and the ST group of companies. Or the present GLC companies could buy up the privatised restructured hospitals.”
“Are our restructured hospitals willing therefore to train our medical students? If so, do they have a structured programme with NUH for such training? Or are they doing it as required by the Ministry of Health, as they are receiving subvention grants? What is the future of the restructured hospitals? There are now centres for treatment like cardiac centre for treating heart patients, paediatric centre at the Kandang Kerbau Hospital, skin centres, urology centres, etc. When such centres are established, the restructured hospitals must feel a little bit uneasy or even threatened, as these centres would draw patients away from those restructured hospitals with less than adequate facilities for the particular modality of treatment. But then restructured hospitals have to meet the bottom line. They must find ways and means to break even or even make a profit. This being so, there is a likely possibility that these hospitals may set up subsidiary companies to start special facilities like the gamma knife project, and charge patients accordingly, as a subsidiary company may not be obliged to follow the fee structure of the hospitals concerned. This would mean that subsidised patients, C and B2 patients, may need to pay the full fare for a service of this kind. And pensioners may not be allowed access to such facilities because it is not part of the hospital entitlement scheme. Finally, as medical health care has become a lucrative industry - a word which I really hate, we are not an industry - is the Ministry watching very carefully that such hospitals may want to raise funds by way of listing on our stock exchange? Precedent has been set with the listing of a group clinic and the control of practically all the private hospitals by a public listed company.”
“Sir, I am a medical doctor. It has been quite some time since the restructuring programme of our Government hospitals. Perhaps, it is timely that this House be given an update of the hospitals. Dr Michael Lim just now highlighted some problems faced by patients with multi-disease illness. Have services improved in terms of waiting time for patients to see doctors for consultation and treatment modalities? Have adequate C Class beds been set aside for those Singaporeans in the lower income bracket? Is affordability to stay in such restructured hospitals a serious issue? And how does the establishment of these hospitals affect the Medisave accounts of Singaporeans as medical costs have gone up? Do they have to contribute more to Medisave in future? What control has the Ministry of Health over such hospitals? Again, Dr Michael Lim has highlighted some of these issues in this particular field. Is there a careful monitoring of the type of services being provided so that there is no wastage of manpower and no duplication of equipment? Is there evidence that hospitals are over-servicing patients to justify the purchase of expensive equipment by encouraging patients to use the equipment when the indications are not so obvious, like having a CT scan for any complaint of headache? There must be some performance indicators to monitor these hospitals. What are these and how have these hospitals measured up to these indicators? 4.00 pm Sir, the teaching of medical students is not a money making proposition. In fact, it could be a chore for these hospitals. In the past, where bottom line is not the important consideration, all Government hospitals took to teaching very readily and eagerly, but now things have changed, as the hospital culture has changed.”
“I hope it is not used as an excuse for not speaking up. Our multi-racial Asian society makes it even more so for the individual to be very careful in expressing his views, especially if he refers to race or religion. Many of us who are old enough to experience the racial riots and also read about the Maria Hertogh riots will definitely want to make sure that such events will never happen again. I remember that as a medical student I had to take care of riot victims in hospital. I was really shocked and was very determined that it should not happen again. Maybe this is one of the reasons why I was drawn into politics, because we must not allow it to happen. But when Singaporeans are given this signal about creative thinking we should expect a lot more than what we are doing now as they might want to do more. But this is a challenge that we have to face. How we address it will be very difficult, but I think we must challenge it. Of course, as Asians, this question of face-saving is very important. Can our society therefore evolve to a stage where the right of the individual to speak and to express his views transcends all these things? That is the question I would like to ask our Singaporeans.”
“There will be students who can solve, for example, mathematical problems in different and non-standard ways, and they should not be penalised for not following the teachers. Then there will be projects that need to be assessed by civil servants and because they are again non-standard, they are not given due consideration. Or perhaps our present rules and regulations do not allow such changes. I remember there was one young man who came to me with a beautiful project and I passed this project to the URA. It was to deck the canal which is opposite Centrepoint. It was a beautiful project. I brought it to URA because I thought he had creative ideas. Unfortunately, it was turned down because our rules and regulations do not allow this particular project to be carried on in this manner. It must be tendered out. I am wondering when we start to have this trend, we are actually creating a lot of expectations in our population. They might come up with beautiful ideas but when they come to you, you say, "Sorry, you have to tender out." I have no answers for this, Mr Speaker, Sir, but I guess we have to start thinking and find ways to accommodate all these changes that will result from our new approach to teaching. Of course, finally, change must also come from the individual, ourselves, because a thinking individual is actually a responsible individual. If one is a victim of an offensive remark and because one is a thinking individual, one should have the maturity to brush it aside if it is not worthwhile rebutting. Or we could argue back in an objective, non-prejudiced manner without resorting to violence. Responsibility for one's action is important if our society wants to mature. It is always easy to put the blame on the Government for fear of not speaking up.”
“But real breakthroughs often start from research for its own sake. These are the breakthroughs which dictate what the future markets will be which separate the leaders and the followers. I hope this $700 million R&D fund will at least help some of these companies who want to embark on R&D programmes. Although there were no announcements for a reduction in personal income tax, it was softened by a 10% tax rebate for the Year of Assessment 1997. I think Singaporeans should be satisfied with this, as in addition to the 10% rebate, there is also benefit on increases in certain of his personal allowances. As for those who do not pay taxes, the rebates and grants for citizen households staying in rental and owner occupied HDB flats are welcomed. With the increase in water rates, lower income families living in 1-, 2-, 3- and 4-room HDB flats will be granted a rebate on utility bills in 1997/1998. This, I am sure, will help these Singaporeans to offset the increases. Mr Speaker, Sir, there has been a lot of talk recently on creative thinking and I notice that the Ministry of Education will be given $19.4 million worth of money. I am sure a lot of this will be spent in this particular direction in our education. What do all these really mean? The term "creative thinking" necessarily implies that from time to time, old standards and old ideas will be challenged by new ones. And if we are committed to such a mood of thought, we must allow this challenge. This requires a change in the mindset of teachers who are teaching students and, of course, of civil servants who are running our many institutions and Ministries.”
“They complain that the cost of doing business in Singapore is very high, and some of them move abroad and set up companies overseas. But many got their fingers burnt in the recent devaluation of the Thai baht, the Philippine peso and now probably the Indonesian rupiah and the Malaysian ringgit, which also took a down turn. These companies are hoping for the Minister to announce measures to bring down the cost of doing business. Of course, they are always concerned about the corporate tax, but we have already announced in the last budget that the corporate tax will be reduced for this year's tax concessions. I think they are now turning to the Committee on the Long Term Competitiveness of Singapore Report early next year. I think they expect a lot of goodies, and I do hope by then they will get something. I am in favour of more publicicity to be given to the more than $700 million to be spent on R&D, the Cluster Development Fund of $300 million and the Economic Development Assistance Schemes administered by the EDB and other Government agencies for Singapore companies. Singapore is only adapting to change. We are not leaders. We have no products we can say that we developed them from our own R&D. The West is still leading. They are the creators and inventors. We are just followers and adaptors. Holland, for example, is a small country by comparison to many other big western countries, and the population is not very big. But they have very good multi-national companies and they have very good original products and companies like Philips that are world renowned. Well, we hope that we can do something like that. But here in Singapore, I am afraid that the present thinking on R&D is that our R&D is based on bottom line.”
“Mr Speaker, Sir, I rise to support the Budget. This year's Budget is obviously very focused on the financial sector. In fact, it has been called the "Shenton Way Budget". There are incentives for fund management, institutions involved in Asian Currency Unit operations, banks and merchant banks managing initial public offers in foreign currency shares, financial institutions that issue offshore debt issues and credit rating agencies. I see these incentives as ways to further strengthen Singapore's position as a regional financial centre. There are, however, a few questions that many in the financial world are asking. For example, there are about half a dozen fund managers in Asia that manage about $10 billion dollars worth of funds and our minimum amount required to qualify for this Budget's tax exemption scheme. Also, there are not many banks that earn more than $50 million from ACU activities. Obviously, you have to be a very big player before you can benefit from these incentives. Why is this so? There are many people asking this question and perhaps the Minister can answer this. Similarly, smaller and medium-sized companies in Singapore would not be able to benefit from the tax incentives from satellite operations and the building allowance for logistics operators. I wonder how many companies in Singapore have plans to launch satellites, or provide integrated logistics services which cover warehousing, distribution, information management and other high value added operators. It looks as if only huge companies can do that and benefit from the incentives. Sir, manufacturers, retailers and property developers feel very let down by this Budget.”
“Finally, Sir, I would just like to make a little comment on Mr Sin Boon Ann's speech. I think he spoke like a typical academic arguing his case. I just would like to hear from him five years later when he becomes a more polished politician. Question put, and agreed to. Resolved, "That this Parliament, in accordance with section 1(1) of the Fourth Schedule to the Constitution of the Republic of Singapore, resolves that there shall be nominated Members during the term of this Parliament."”
“That means you have some thoughts about this. There is a possibility that you could include all these people.”
“Are you saying that there is a possibility you could include clan associations and the religious bodies into your functional groups?”
“Mr Deputy Speaker, Sir, I just want to seek a point of clarification. The Leader of the House mentioned about these functional groups. Can he please explain what sort of grouping he is referring to? I know that apart from business people, the unions and so on, would he include the clan associations and religious bodies? Mr Wong Kan Seng: Sir, the idea of improving the NCMP scheme is really something that we have been thinking about. I might say that even the Workers Party thought along the same lines many years ago when they were looking critically at the Bill and poking at the principle and so on. They also said, "Why did the Bill not require nominations from organisations and bodies that are involved in promoting the economy or the social rights of Singaporeans, for example, the Chambers of Singapore and the professional bodies?" So we will continue to make improvements and the suggestion of Dr Tan will be taken into account. But just to elaborate on this ---”