Toh Chin Chye
Singapore
“--- And meet their friends. I do not know. How do we go about it? Supposing we have an impasse. We cannot find anyone who is willing to take on the job of the President. It is a lonely job, yes. I have no ambitions to be called "His Excellency".”
“28 also provides that if the Government is going to change the Constitution in order to modify the powers of the President, he must go and seek a mandate from the people twice (not once, but twice) - first,in a general election and win a two-thirds majority, come back to this House, change the Constitution, and then take the amendment bac…”
“The Minister has not made it quite clear what is tax avoidance, what are the examples of tax avoidance that he would like to close. The Comptroller of Income Tax no doubt has many cases on his hand. If the public, who are paying taxes, are given to know what is legitimate and what is illegitimate, then I think they would be more at ease.”
“It will be invidious for special legislation to be passed for companies that provide essential services so that Government control over them can be maintained.”
“For a whole family to lose their property just because of the act of one is unjust. It is similar to what happened during the days of the Emergency in Malaya when whole villages were resettled because a few were deemed to have collaborated with the Malayan Communist Party. It is exactly the same principle.”
“And, of course, on the HDB side, its accounts will show a deficit because it has to pay high interest, or vast amounts of money in terms of interest, back to the Government. Yesterday the Member for Rochore pointed out to this House the sum of $8.8 billion which was loaned by the Government to the HDB.”
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“To ask the Minister for National Development (a) what is the number of hotels and boarding houses and their number of rooms as of 1st January, 1983; and (b) what is the anticipated flow of new hotels and boarding houses for the years 1983, 1984, 1985, 1986 and 1987.”
“Mr Speaker, Sir, I agree to the necessity that Singapore should have a competent Civil Service. But what puzzles me is this, In 1980 the Consumer Price Index was 8.5% increase over the previous year but expenditure on manpower was 12.6%. In 1981, the Consumer Price Index was 8.2% increase over the previous year but expenditure on manpower was 13.3%. In 1982 the Consumer Price Index fell down to 3.9% but expenditure on manpower increased to 26.7%. 1 am a little puzzled at the inverse relationship between the Consumer Price Index and expenditure on manpower. Can the Minister please clarify?”
“Mr Speaker, Sir, is the Minister aware that in spite of the Skills Development tax and in spite of the efforts of the Productivity Board in organizing courses, the productivity of Singapore labour has fallen down to 2.2%?”
“Mr Speaker, Sir, may I draw the attention of the Minister for Finance that payroll tax has increased by 216% over a period of five years. Contributions to the CPF have increased by 289% in five years. I dread how fast the Skills Development tax will add up to the cost of labour. It is inevitable that in the payment of these levies altogether the cost of labour would be pushed upwards, and this will make exports less competitive. Will the Minister agree that the Skills Development levy does not seem to completely fulfil the original intention and whether he will consider suspending the Skills Development tax until such period when the Singapore economy is on the boom again?”
“Mr Speaker, Sir, the Act provides for equipment subsidies and the Minister answered just now that subsidies were given in order to permit some companies to mechanize. I would like to question why should one company's contribution be used to subsidize the capital assets of another company?”
“We have to use one of the residents to provide information to the members of the Board who are all part-time on the Kongsi, information as to who among the residents require medical treatment, who requires hospitalization, and who are terminally ill so that they can be provided for. This man happens to be in receipt of public assistance. But because the Committee on the advice of the officer of the Social Welfare Department gave him an allowance of $100 for this administrative work for keeping records, to my consternation I learn that his allowance of $60 was withdrawn. Today this man is now living on our hands without public assistance. I would like, Mr Speaker, Sir, the Minister to give his judgment on this case and to reply to the questions that I put.”
“The idea of the Kongsi came from my observation that the amahs in my constituency were very self-sufficient. They never went to the Government for jobs nor did they plead for public assistance. But they pool their resources together and there were 40 of them in one decrepit old house. They manage to get along and survive through cooperative efforts. It was this that gave us the idea for the Kongsi and how those on public assistance can learn to help themselves by pooling their resources. The cost per person per month in my Kongsi works out to round about $140 per month per person. This excludes the cost of voluntary nursing provided for by volunteers from the Singapore Nursing Association and also visits by a general practitioner who is a member on the Board. What I would like to raise is this.”
“' I cannot help feeling that it is reductio ad absurdum. I want to point out to the Minister, lest he has forgotten his 1980 Annual Report, that there are currently 14 non-profit community homes run by the public for the aged, of which I mentioned there are two in Rochore, one organized by the Welfare committee of my Citizens' Consultative Committee and the other by the Christian Brothers. These homes cannot substitute for the Ministry's efforts. They can only be supplementary. What I would like to put to the Minister are these two questions. (1) Is it the Ministry's policy to encourage public-spiritedness in helping in the care for the aged? Will it deal with more sympathy the problems faced by voluntary bodies who are now running these community homes? (2) What is the attitude of the Ministry to public assistance being given to a resident in one of these homes, should such a resident be able to find part-time employment and be given a nominal allowance? Sir, I raise these two questions with considerable passion because it involves a tenant or resident in my Rochore Kongsi for the Aged. The practice in the Kongsi is that they, being recipients of public assistance, should be able to contribute towards their own upkeep. But this is not possible because at $60 a month you expect them to live on two meals a day. It is not possible. 70% of the expenditure of the Kongsi goes to purchases of food. For every $1 that the resident contributes to the operation of the Kongsi, $1.60 has to be found from donations. In practice, we return $15 for every $60 that the resident receives. The $15 is being kept by the resident for his own consumption. So the resident really contributes $45.”
“In 1981 it was $892 per person per year. However, do not be mistaken by figures because this does not reflect the generosity of the Ministry. We have to discount for inflation. If we were to consider that $1 in 1971 was worth 25 cents in 1981, the recipient in 1981 was really receiving only $223 a year. For 1982 the budget for Public Assistance is $4.35 million, of which $793,000 is for staff salaries, allowances and CPF contributions and contributions to the Skills Development Fund, leaving only $3.5 million for Public Assistance. What it adds up to is that it costs $1 to give away $4.40. The Ministry in some respects is to be sympathized, and in some respects I think we need to spur it on to greater efforts. It is commendable that the Ministry's staff has carried out a survey on the aged. As the report is not available to Members of Parliament, we will have to take it at face value from excerpts which have appeared in the newspapers. Reading it, I must confess I find it difficult making sense of the conclusion they have come to, The relevant passages are: 'Only 15.6% of the households had income less than $400 a month while 30.2% had income of $1,000 and more.' I was just wondering how was it that they did not measure the number of families that were earning less than $1,000 a month. They went on to say: 'Most of the non-government homes charge between $100 and $300 a month.' I have a vested interest here, Sir, in admitting that my Rochore Citizens' Consultative Committee runs a Kongsi for the aged. They do not charge $100 a month. Therefore, I think this is a perversion of a fact. Secondly, they say: 'The fact that they can still afford to support the residents shows that financial difficulties are unlikely to be strong reasons for the residents' admission.”
“Sir, I am obliged to you for permitting me to speak in the Committee of Supply. Sir, I speak against the background of proposed salary increases in the Civil Service and increases in pension allowances for those who are drawing under $850 a month. It is unfortunate that I should do so under the heading of the Ministry of Social Affairs. I would like to draw the attention of the House to a relevant fact. In 1981 the cost of administration was budgeted at $2.5 million. In 1982 it is $4.4 million, or an increase of 76%. The budget for Community Services, for which the Ministry is really responsible for, was $14.2 million in 1981 and $15.8 million in 1982, an increase of 11%. If we were to take the cost of administration at headquarters against the value of community services the Ministry is offering, we find that the ratio of Administration cost to Community Services is 1:5.7 in 1981 and 1:3.6 in 1982. I think the meaning of these figures is quite clear - that we are getting less community service for more administrative work. We have been talking so much about productivity. Obviously this is an index which the Ministry of Social Affairs may well have to look into. While I am in a way sympathetic to the Ministry of Social Affairs - to the Minister in particular, because it may not be his fault really that he is not providing more community services - I see there is really a distortion in the budgeting that we are providing more for administration and less for community welfare. Take Public Assistance. In 1971 there were 8,915 persons receiving a disbursement of $2.71 million. In 1981 this has been reduced by more than half to 3,809 persons receiving $3.4 million. It works out that in 1971 the average disbursement was $304 per person per year.”
“Mr Speaker, I am sure the Minister has looked into the problem of keeping alive the service trades. May I ask him whether he will look into the possibility of offering a longer lease of tenure to those who are in the service trades? As of this moment they are all signing a monthly tenancy.”
“The Housing Board, in its long years of history, will by now have a very good idea of rentals in the different districts of Singapore. No sensible person, of course, believes that rentals would be static. Rentals would depend on location of premises as well as on inflation rates. But it is possible for the HDB to have the data to calculate or estimate what are fair rentals in the different locations of Singapore and reserve some of these shops for the service trades. There are two ways to do this. One is balloting among those who are in these service trades. The second way - assuming that there would be a free market and the HDB being the biggest landlord in Singapore - is to allow those in the service trades to tender. For example, doctors can tender for a certain number of shops in a specific area reserved for doctors or general practitioners who wish to practise. Likewise, plumbers, electricians and so on. Because it is not possible for those in the service trades to compete in a tender system against those who are running larger business enterprises. So on the one hand, while we see a very successful HDB system in the Waterloo housing estate where all the motor-car spare parts businesses are located, on the other hand, a follow-up has not been done for the service trades. I would like to speak on their behalf and hope that the Minister for National Development will look into this proposal to make life much easier for all of us and in this way also help to cut down the cost of living.”
“Now it is necessary that, in order to do these little jobs, one either learns how to do these things by one-self or to approach a contractor. And no contractor, to my knowledge, will want to do a job unless there is a minimum sum attached to the job. All this, of course, adds up to the cost of living. In particular, doctors and dentists have regarded that rentals constitute 20% to 30% of their overhead expenses. For a young medical graduate to start private practice - let us assume in HDB premises because private sector premises are just beyond his ability - it will be necessary that the young practitioner should not be loaded with high overheads or his patients will not be able to pay for it. Here, we have a clear example that urban renewal, while successful in the physical aspects of making, Singapore a brighter and cleaner city, has neglected the study of what the side effects are. There is some degree of insecurity and uncertainty about the tenancy agreement which is signed by those who have tendered for Housing and Development Board shops. It is a monthly tenancy and it seems odd to me that those in business should be doing business on a monthly tenancy, without any security of tenure. To be truthful, although the HDB does not wield a heavy hand in stalking out its tenants, nonetheless from a legal aspect, it is possible for the HDB to do so. But more important is this: The monthly tenancy does not also guarantee that the tenant can work into his cost how much of his overheads are due to rentals and how it should be passed to the consumers. Perhaps the Minister for National Development might want to study this proposition which I have put forward once before, namely, that balloting be allowed to those in the service trades.”
“Mr Speaker, Sir, thank you for the opportunity you have given me this afternoon to speak in committee. In my 22 years as Member of Parliament for Rochore, I have witnessed the dramatic change in my constituency and we must give the Ministry of National Development its kudos which they deserve and admit that urban renewal is a great success. Unfortunately, the Ministry is engrossed in the physical planning of Singapore but appears to take very little interest in the side effects which urban renewal has brought about. I would like to speak on one specific point, namely, the disruption of those entrepreneurs who are in the service trades, for example, plumbers, electricians, hairdressers, barbers, carpenters, masons, not excluding doctors, dentists, opticians and so on. Year by year, it is becoming very obvious that all those who are offering these services have been dislocated, partly because they have been relocated to other constituencies but mainly because of their inability to pay increasing rentals for HDB shops. Where alternative premises have been given to those in the service trades, rentals are so high that it is inevitable that the rentals are passed on to the consumers. Where those in these trades have not been given alternative premises, they have been dispensed out of business. The end-sum of it all, (if course, is that there is a rise in prices. It is not simple or easy enough these days to get a carpenter to come to the house to patch up a broken door or a glazer to patch up a broken window, nor is it easy to get an electrician to rewire a house, and so on. I speak on behalf of these little tradesmen who were offering services to consumers in Singapore.”
“Sir, just to follow up, may I ask the Minister of State of Education this question: Can he attribute the number of drop-outs in primary schools to the restructuring of the education policy?”
“The Ministry has no plans to set up a medical clinic at the Airport to service passengers. The Department of Civil Aviation and the airlines themselves are responsible for air passengers. They are the proper authorities who know how many passengers will require occasional medical treatment and to organize medical facilities either for peak periods only or on a 24-hour basis. As Changi Hospital is located close to the new Changi Airport, the facilities of the hospital will be available. If an air disaster should take place, procedures have been drawn up to activate rescue and ambulance services and for patients to be treated in public hospitals. This was the case in the Spyros disaster in 1978. ASSENTS TO BILLS PASSED The following Bills were assented to by the President of the Republic of Singapore on the dates stated:- 2nd December 1980 (i) Income Tax (Amendment No. 2) Bill (ii) Economic Expansion Incentives (Relief from Income Tax) (Amendment) Bill. 3rd December 1980 (i) Professional Engineers (Amendment) Bill (ii) Jurong Town Corporation (Amendment) Bill (iii) Abortion (Amendment) Bill (iv) Employment (Amendment) Bill (v) Workmen's Compensation (Amendment) Bill (vi) State Lands (Amendment) Bill (vii) Accountants (Amendment) Bill (viii) Motor Vehicles (Third-Party Risks and Compensation) (Amendment) Bill (ix) Sale of Commercial Properties (Amendment) Bill.”
“Mr Speaker, Sir, I beg to move, "That the Bill be now read a Third time." The Report of the Select Committee on the Bill has been circulated to Members of the House. The Committee received several representations from professional organizations. The Committee noted the points raised by them and have incorporated virtually all the suggestions that have been made to the Committee by these organizations. Clause 9, in particular, relates to appeals to advisory committees and permits in the case of physicians who are registered under the Medical Registration Act and dentists who are registered under the Dentists Registration Act to appeal to the advisory committee consisting of members of the Singapore Medical Council and the Dental Board. Clause 10 ensures that all books and documents which are inspected in the clinic or in the hospital will be only those related to medical practice. Clause 12 ensures patient confidentiality, and information on patients will be provided only at the request of the patient or at the request of another person acting on the patient's behalf. This is to make certain that the data which we are asking for from private clinics and hospitals will be used only for statistical purposes. Sir, I beg to move. Question put, and agreed to. Bill accordingly read a Third time and passed. CONSTITUTION OF THE REPUBLIC OF SINGAPORE (AMENDMENT) BILL Order for Second Reading read.”
“Mr Speaker, Sir, in 1976 I asked for a survey to be conducted on patients who went to Alexandra Hospital. Most of the patients who went there were in B class and C class. The results of the survey astonished me because those assistants who conducted the survey visited the homes of the patients. They were surprised to find that patients who were in C class had television sets, air-conditioners, telephones and refrigerators in their homes. And asking a patient what is his income, is like putting the fear into him that you are going to spill on him to the income tax man. Mr Tan Cheng San( In Mandarin): Sir, after the explanation given by the Minister, I beg leave to withdraw my amendment. Amendment by leave, withdrawn. The sum of $216,750,460 for Head P ordered to stand part of the Main Estimates. The sum of $67,225,600 for Head P ordered to stand pan of the Development Estimates. Head O -”
“I would like to impress upon the Member for Paya Lebar particularly and the Member for Changi, both of whom represent the trade union movement, that workers need not feel worried that they are going to be squeezed because of this revision of charges. I would only ask them to make a study of what they would have to pay to consult the private practitioners.”
“The ratio of nurses to patients, of course, in the B1 and B2 classes will be higher to reflect greater 8bility to pay for services. We do not say that C class patients are therefore left on their own. But it is necessary now and then to ask oneself: what does the private sector charge, or how do the private hospitals handle the private patients and whether this is equivalent to Government standards, or whether the standard of service in Government hospitals is below that of private hospitals. If it could be proved that this was so, then of course corrections will have to be made. The Member for Paya Lebar has mentioned that we have imposed a surgical fee of $30 for C class patients, when it never existed before. This has been done so as to impress upon the patient that surgery is a very serious affair. The charge does not even cover a mini-fraction of the cost of paying for the anaesthetist, the surgeon and his assistant, the nurses who help in the operation, and the cost of maintaining the operating theatre which has to be kept sterile and washed after every operation. In fact, some of the C class patients who are in the hospitals have been to see traditional physicians, like acupuncturists, before they end up in the hospitals. And I am told from private investigation that acupuncturists charge as much as $25 per session, without anaesthesia. The acupuncturist takes a needle and just pushes the needle into you. You enjoy it without anaesthesia. The surgeon, on the other hand, before he takes up his scalpel, makes sure the patient is properly anaesthetized, and it costs only $30. So there is absolutely no comparison at all.”
“Doctors, like other people, leave the service of the Government or of the University for reasons of their own. As for early discharge from hospitals, I would say that doctors are the best judge as to when a patient can go home. If patients wish to stay longer in a hospital, then they must be prepared to pay for the cost. They cannot lodge indefinitely in the hospital and take up beds which other patients need. I think it is important for all of us to remember that a hospital bed is a valuable commodity. So we do not want parasites to hang on as long as possible, I would say, at very highly subsidised rates. Whether it is in C class or B class, I would like to remind Members of the House that these rates which we are imposing are just a fraction of the actual cost. It is not the intention of the Ministry to make a profit out of health care. But we have gone very far already in calculating how these costs must be shared by patients, and it is fair enough that it should be a percentage of these costs. The B2 class has been created to bridge the gap, as I said earlier, between C class and the B1 class. Because the B1 class was pegged at $30 in the past, it has created a big gap between the $30 ward charge and the $4 ward charge for C class. The end result is that this has encouraged many patients to go into the C class. There are patients who we know can afford to pay and who want to move out of C class. We are, therefore, creating a B2 class for this category of patients. I expect that with increasing affluence, there will be more patients who will want B2 class wards. These wards will give patients greater privacy. For example, in the new Singapore General Hospital building, there will be two bays in the B2 class, each bey containing only five beds.”
“Health treatment is not a commodity that is being consumed regularly, and therefore the charges which are being imposed will be within the means of every C class patient to pay. 5.45 p.m. As far as accouchement fees are concerned, the Member for Paya Lebar complains that I have increased it by $10 for the second child in C class. Here again, I would point out that the $90 fee which is now being paid for a second child in C class had been under-estimated. It has been brought up to-date by an increase of $10. If the Member for Paya Lebar, who seems so concerned with the working class and those earning very low wages, were to make a survey of accouchement fees charged by midwives in the private sector, he will find that the midwife's fee ranges from $150 to $200 per child. We are charging $60 for the first child and $100 for the second child. These charges are well below the charges which are being imposed by midwives in the private sector. May I further add that when a woman delivers in a Government hospital, it is also possible that there may be complications in delivery and there are specialist doctors around who can perform complicated deliveries, whereas the midwife cannot and does not. Therefore, the increase in the charges is again a small sum and really does not reflect the amount of work that goes into obstetric care. The Member for Changi suggests that the service in the hospitals is unsatisfactory because of the resignation of doctors. I am afraid he will have to ask the Member for Kim Seng whether the service has been satisfactory because the Member for Kim Seng has left the service of the University, or has it been unsatisfactory since he left? This is a question that I cannot answer. But I am in no way at all responsible for the resignations.”
“If this were done, and as it will be done and paid for by the A class patients, it is going to come to a considerable sum of money. I would like to remind both Members that they should compare the imposition of 50 cents diagnostic fee for C class patients with the actual fees to be paid for by A class patients. They will find that it will cost A class patients about $10 to $30 for a laboratory test and $5 to $360 per X-ray examination. Moreover, both Members should be aware that the price of silver has gone up which also means that the cost of X-ray films has gone up. Therefore, 50 cents to be charged for diagnostic fees is negligible or insignificant. A patient who enters a hospital will know that the daily ward charge covers his meals and PUB charges for which the Ministry and the hospital will have to pay. As Members are aware, the PUB has increased its charges and the hospitals have to pay these increased charges. The daily ward charge also covers the cost in terms of the attention given to him by nurses and hospital servants. All these incur expenditure. In fact, ward charge is the main cost for staying in a hospital. In addition, he has to pay a treatment fee and laboratory test fee. All these have been weighted against the survey on household incomes made by the Housing and Development Board. These figures have not been arbitrarily thought up, but we have calculated that it is within the means of a patient, even in the C class ward or from among the working class, to be able to pay the fees. Of course, I would like to add that being sick is not an everyday occurrence. One does not go to the hospital every day.”
“Mr Speaker, Sir, both the Member for Paya Lebar and the Member for Changi have dwelt mainly on the changes in the hospital charges for C class wards. I would like to point out that the daily ward charge for Class C has been increased by only $1 over the existing rate of $4. Over a period of five years, $1 has lost much of its value in terms of real purchasing power. From that point of view, I think an increase of $1 is practically negligible. The Member for Changi and the Member for Paya Lebar know very well that five years ago their lunch at a hawker centre cost much less than what it is today. So paying $1 more per day to stay in the hospital where he is provided with three meals, pyjamas, and surrounded by hospital servants and nurses, is actually a very minimal increase. In the case of the imposition of $1.50 for treatment fee, this is to remind the patient that if he were to go to the Outpatient Department he will be charged $3, and he will have to go home. The charge of $1.50 covers the cost of consulting fees due to the doctors and also the cost of medicine. When this sum of money is compared to the existing sum of $3 which he has to pay at the Outpatient Department, I think $1.50 is again a nominal charge. In the case of a 50 cents charge for diagnostic fee, which includes X-ray, I would like to remind both Members that the number of tests per patient has been going up over the years. It is expected that every patient will now have about six tests in bio-chemistry, five tests for blood, and probably one X-ray and one bacteriological test. What we can do, of course, is either to levy an average charge or to charge the actual cost of each test.”
“Mr Speaker, Sir, I beg to move, "That the Bill be now read a Second time." The Poisons Act controls the import and sale of poisons. Last year, the Inspectorate Section of my Ministry dealt with 29 cases of offences under the Act. Nineteen cases were successfully prosecuted in court and the offenders duly fined. Ten cases are still outstanding. However, the Act imposes a limit of $1,000 fine or six months' imprisonment for non-compliance with the provisions of the Act. A parallel Act, the Medicines Act, provides control over medicines and contains a more realistic penalty for offences of similar gravity. The Poisons (Amendment) Bill enhances penalties for offences under the Act and brings them in line with the provisions under the Medicines Act, that is, a fine not exceeding $5,000 or imprisonment for a term not exceeding two years, or both. We hope that this Amendment will deter unscrupulous and illegal trading of poisons. The Amendment Bill will also facilitate licensing and control of poison products. Sir, I beg to move. Question put, and agreed to. Bill accordingly read a Second time and committed to a Committee of the whole House. The House immediately resolved itself into a Committee on the Bill. - [Dr Toh Chin Chye]. Bill considered in Committee; reported without amendment: read a Third time and passed. REGISTRATION OF CRIMINALS (AMENDMENT) BILL Order for Second Reading read. 5.41 p.m.”
“Mr Speaker, Sir, I beg to move, "That the Bill be now read a Second time." To ease the shortage of dentists, the Ministry of Health started a three-year course in dental therapy in 1975. The first batch of dental therapists graduated in May 1978. At present, the requirement is that these therapists must have 10 years of practical experience under the supervision of a qualified dentist before they can be registered to practise independently within the limited field. The Ministry of Health has been monitoring the performance of this first batch of dental therapists. We have found that their competence in carrying out straightforward dental procedures, such as simple extractions, fillings and making of dentures, equal to that of dental officers. The Ministry therefore feels that these dental therapists would be competent to set up their own practice after five years instead of 10 years of practical experience under supervision. This is the main provision in the Dentists Registration (Amendment) Bill, 1980, which is now before the House. Sir, I beg to move. Question put, and agreed to. Bill accordingly read a Second time and committed to a Committee of the whole House. The House immediately resolved itself into a Committee on the Bill. - [Dr Toh Chin Chye]. Bill considered in Committee; reported without amendment; read a Third time and passed. POISONS (AMENDMENT) BILL Order for Second Reading read.”
“Mr Speaker, Sir, I beg to move, "That the Bill be now read a Second time." There are three types of hepatitis. Hepatitis A, or infectious hepatitis, is spread by contaminated food and water. The second type of hepatitis is designated hepatitis B, or serum hepatitis. It can be transmitted through a hypodermic syringe or needle that has been contaminated with the blood of a patient or carrier of hepatitis B. Thirdly, there is a type of hepatitis which is neither A nor B. It is spread to another person by inoculation or contaminated blood, especially in a blood transfusion. Under the Infectious Diseases Act, 1976, only one form of viral hepatitis, i.e. hepatitis A, is a notifiable disease. To prevent its out-break, the Act provides for control of unhygienic practices in food establishments only. The Infectious Diseases (Amendment) Bill will expand the scope of the existing Act to make all forms of hepatitis notifiable diseases and to extend control to cover unhygienic practices in any occupation, trade or business, besides those in food establishments. Sir, I beg to move. Question put, and agreed to. Bill accordingly read a Second time and committed to a Committee of the whole House. The House immediately resolved itself into a Committee on the Bill. - [Dr Toh Chin Chye]. Bill considered in Committee; reported without amendment; read a Third time and passed. DENTISTS REGISTRATION (AMENDMENT) BILL Order for Second Reading read.”
“PROVISIONAL MASS RAPID TRANSIT AUTHORITY BILL "to establish the Provisional Mass Rapid Transit Authority and for purposes connected therewith", recommendation of President signified; presented by the Minister for Communications and Acting Minister for Culture (Mr Ong Teng Cheong); read the First time: to be read a Second time on the next available sitting of Parliament and to be printed. SUPPLY BILL "to provide for the issue from the Consolidated Fund of the sums necessary to meet the estimated expenditure for the public services of Singapore for the financial year 1st April, 1980, to 31st March, 1981", recommendation of President signified; presented by the Minister for Trade and Industry (Mr Goh Chok Tong); read the First time; to be read a Second time on the next available sitting of Parliament, and to be printed. SUPPLEMENTARY SUPPLY BILL "for making Supplementary Provision for the public services for the financial year 1st April, 1979, to 31st March, 1980". recommendation of President signified; presented by Mr Goh Chok Tong; read the First time; to be mad a Second time on the next available sitting of Parliament and to be printed. FIRST SUPPLEMENTARY ESTIMATES OF EXPENDITURE FOR THE FINANCIAL YEAR 1ST APRIL, 1979 TO 31ST MARCH, 1980 (Paper Cmd. 3 of 1980) Order read for consideration in Committee of Supply [Allotted Day]. [Mr Speaker in the Chair] 2.45 p.m.”
“Mr Speaker, Sir, I have circulated to Members of the House a Table (Cols. 637 - 640) setting out a revision of hospital charges. The last time when hospital charges were revised was in 1975. It has been five years since the old rates have been in operation. During this time, the costs of maintaining hospitals have gone up, largely due to increases in salary, NWC awards and also to increases in the prices of goods which the hospitals have to purchase. Table - REVISION OF HOSPITAL CHARGES (Cols. 637 - 640) The Table, in setting out the new hospital charges which we hope to make applicable from 1st April, has been rationalised so that the patient is aware of his contribution to the cost of his stay as an in-patient. The costs that he will have to pay have been divided into ward charge, a medical treatment charge and, thirdly, a diagnostic charge which includes laboratory and X-ray charges. A new B2 intermediate ward has been created in order to bridge the gap which now exists between the existing B class at $30 per day and the C class at $4 a day. The B2 ward will have six to 10 beds depending on the hospital layout, but all of them will provide greater privacy than C class wards. Initially, B2 beds will be available in Toa Payoh Hospital in April, Kandang Kerbau Hospital in May and in the new Singapore General Hospital building when the wards become operational at the end of this year. Mr Speaker, Sir, my Statement is open to questions from Members but as we are awaiting the Budget Statement later on in this sitting, may I suggest that if Members wish to raise any point on this matter, they can do so during the debate in the Committee of Supply under the Head of the Ministry of Health. BILLS INTRODUCED 2.43 p.m.”
“It is the intention, therefore, of this Bill to uphold the patients' right and to protect patients. As I have pointed out earlier on, there are segments of the population who are fastidious over health care and are easily gullible to all advertisements relating to cures, fantastic cures, which may well be unfounded. It is to protect them that we have to extend the Nursing Homes and Maternity Homes Registration Act to cover clinics run by private physicians. This is a gap which has been in existence over the last 20 years. The situation today warrants that expeditious action be taken because, as Singapore hopes to become a medical centre in this region, we can expect that more and more adventurers will make use of this facility in Singapore to advance their own cause.”
“But let us assume that all these things have been covered up, then of course, there would not have been coroner's inquiries, there would have been no newspaper reports, and everybody would have believed that the Government medical staff, surgeons and other hospital staff are as capable and as efficient as their counterparts in the private sector. But the Member for Moulmein could probably do an investigation on the quiet to find out what happens in the private sector. I suspect that he will be entering the twilight zone. For his information, if he is ignorant, I would like to inform him that patients who are high risks are rarely treated by private practitioners. In fact, they are referred to Government hospitals. Patients who have become moribund because of mismanagement by private physicians are also referred to the Government hospitals. So in the end the Government hospitals are the reservoirs or receptacles for very bad risk cases whilst private practitioners take on the low risk cases and gain fame. There is a degree of unfairness in the mass media and, if this is reflected by the reaction of the Member for Moulmein, it will be a great help indeed if the mass media could do their own probes. I for one could vouch that letters of complaint about the performance in the private sector have been written to the mass media for publication in the newspapers but have been covered up. The letters, copied to me, were written to the Straits Times but they chose to publish only letters of complaint against public hospitals, never against private hospitals. I think the mass media in this sense is doing a disservice to the public, the consumers. Patients are consumers of health services and it is their right to know what they are consuming, how they are being treated.”
“Mr Speaker, Sir, I thank the Member for Moulmein and the Member for Khe Bong for their ostentatious support. I must emphasise that the Bill on which we are discussing relates to the licensing of premises and has no relationship with the emoluments of doctors. I am quite sure, nonetheless, that my medical staff will be very pleased if they could have heard the Member for Moulmein speaking on their behalf and acting as their champion. I must add that it was not quite fair for the Member for Moulmein to bring up before the House what was reported in the newspapers on two cases which appeared before the coroner. In the Government hospitals, the Ministry of Health officials, doctors, physicians, dentists and other staff members are publicly accountable and, therefore, there is great scruple over unusual deaths that may occur in a hospital. It is because the peers exercise judgment over themselves that unusual deaths are promptly reported to the coroner and a public inquiry held to ascertain whether the death has been due to negligence or has been due to misadventure. For this reason, we can say that patients who are treated in Government hospitals can be thankful that here we have a system which keeps physicians, surgeons and other hospital staff on their toes, so that standards are maintained and mistakes are not covered up. This is essential to good hospital practice, and it is because of this that we have received adverse publicity.”
“Clause 10 of the Bill permits inspection of premises - (a) in order to ensure that the premises comply with the conditions of the licence which has been given to the practitioner, and (b) for action to be taken against unregistered premises. Clause 12 of the Bill requests data from private hospitals and clinics. This is not an intention to invade the patient's privacy or to be curious about the patient's record. The purpose is to obtain statistical compilation of morbidity data. At present, whatever morbidity statistics we have are available only from the public sector but a large segment of morbidity data available in the private sector is not being collated because of the absence of a machinery for such purpose. Amendment will be made in this clause so that the patient's consent will be required, if it is at all necessary, for any clinic to furnish the particular patient's record. Section II of the Nursing Homes and Maternity Homes Registration Act relates to unauthorised communication made by officers in the execution of the Act. This provision will be transferred to the Private Hospitals and Medical Clinics Act. Clause 14 provides for advisory committees. This will be established to help the drafting of regulations relating to the Act and for such purposes as may be required in its implementation. Sir, I beg to move. Question proposed.”
“Likewise, under the Abortion Act, regulations also exist on certain standards required in premises where abortions are performed. All these clauses relating to minimum standards will be transferred to the existing Private Hospitals and Medical Clinics Bill. There will be two separate registers for these premises as is already the practice for dental premises under the existing system. Dentists who come under Division I have their premises registered separately from the premises of dentists who are registered in Division 11. Likewise, we intend, under this Bill, to keep two separate registers for medical clinics, one for physicians who are registered under the Singapore Medical Registration Act and the other for physicians who are not registered at all. Clause 4 (1) of the Bill does not apply, and is not intended to apply, to houses of patients which are visited by physicians for the treatment of their patients. Clause 5 of the Bill relates to the minimum standards which I have already spelt out. They are already contained in the Nursing Homes and Maternity Homes Registration Act, regulations under the Abortion Act and regulations under the Dentists Registration Act. In clause 9, an amendment will be made to allow appeals against revoking of licences to be heard by sub-committees of the Singapore Medical Council and the Dental Registration Board, insofar as these appeals relate to premises which are used by practitioners who are registered respectively under the Medical Registration Act and the Dental Registration Board. However, the Minister's decision will be final after he has considered recommendations by these subcommittees.”
“Mr Speaker, Sir, I beg to move, "That the Bill be now read a Second time." Singapore is now a free market place and it lends itself open to adventurists and entrepreneurs who will invest in the gullibility of a segment of our population. For example, in the past years, we had the Gemini Chit Fund, pyramid selling and sanatronic clinics. Members of the House will recollect that in May 1977 I brought their attention to the existence of sanatronic clinics which were mushrooming in Singapore and which claimed to be able to cure a wide variety of ailments, ranging from rheumatism, migraine, insomnia, mental fatigue, asthma, indigestion and skin diseases. There is, at present, the Nursing Homes and Maternity Homes Registration Act which was passed in 1959 but this Act is inadequate for today's situation. It is because of this that today I am moving the Second Reading of the Private Hospitals and Medical Clinics Bill. The purpose of this Bill is to license the place of practice of physicians and dentists whether they are or are not registered under the Medical Registration Act and the Dentists Registration Act. This Bill therefore covers premises used by physicians practising traditional medicine and acupuncturists. The Kwong Wai Shiu Hospital is a charitable institution performing an admirable service to the community as a nursing home. There is no intention to curb the activities of this hospital. However, it is necessary that minimum standards must be provided for in private hospitals, nursing homes, maternity homes and in clinics where physicians perform curative services to patients. Some of these standards are already spelt out in the existing Nursing Homes and Maternity Homes Registration Act and also under regulations relating to the Dentists Registration Act.”
“For example, littering of food scraps on the five-foot way causes breeding of flies and rats, and water pollution. In recent years, in order to maintain a high standard of hygiene, the Ministry of the Environment has been taking action to resite street hawkers into markets and food centres. We therefore cannot permit eating houses to extend their businesses on to five-foot ways. Furthermore, serving of food in the open causes obstruction and inconvenience to passers-by.”
“Mr Speaker, Sir, residents in the Upper Changi area requiring maternal/child health and family planning services are now being attended to at the Bedok Polyclinic. This polyclinic was opened in October last year. The Ministry of Health is planning to set up a similar polyclinic for Tampines New Town. This clinic, when opened, will replace the Loyang Maternal and Child Health Clinic. There is no need to expand the medical and surgical facilities in Changi Hospital which has a capacity of 180 beds but of which only 140 beds are activated. The bed occupancy rates of 42.3% for medical beds and 59% for surgical beds are very low compared to the occupancy rates of other acute hospitals. However, my Ministry is planning to convert some of the vacant medical beds in Changi Hospital into paediatric beds. This will enlarge the range of medical services that will be made available to residents in the Changi area. FOOD ESTABLISHMENTS (Extension of business onto pavements) 4. Mr Ho See Beng asked the Minister for the Environment whether the prohibition by his Ministry of a food establishment in a Housing and Development Board estate from extending business on to the five-foot way and the warning given to the proprietor of the risk of being prosecuted if the notice is ignored will apply to all food establishments in Singapore or only to those in HDB estates. The Senior Parliamentary Secretary to the Minister for the Environment (Mr Chor Yeok Eng) (for the Minister for the Environment)( In Mandarin): Mr Speaker, Sir, the prohibition against extending business on to the five-foot way applies to all food establishments in Singapore. Serving food on the five-foot way or other open areas will cause public health problems.”
“Mr Speaker, Sir, at present, there are 26 outpatient dispensaries (OPDs) and 30 maternal and child health (MCH) clinics in Singapore. The OPDs offer general curative services to the public while the MCH clinics provide preventive health care to pregnant women, infants and pre-school children, and at the same time offer family planning services. With the shift of population to Housing and Development Board new towns, the Ministry plans to build a polyclinic where there is a concentration of 100,000 people or more. These polyclinics will provide comprehensive health care which includes curative, preventive, dental and home nursing services. Within this year, three such polyclinics in Bedok, Clementi and Bukit Merah new towns will start operations, and in 1980 a polyclinic in Ang Mo Kio new town is expected to start functioning. The Ministry of Health proposes to establish polyclinics wherever HDB new towns are planned. Because of the population shift, some of the existing OPDs and MCH clinics which are experiencing low attendances have been closed. Where facilities are available, OPDs and MCH clinics which are now functioning in separate buildings will be integrated under one roof for the greater convenience of patients. MINIMUM WAGE LEVEL 2. Mr Ang Nam Piau asked the Minister for Labour whether the Government intends to impose a minimum wage level for Singapore workers.”
“- [Dr Toh Chin Chye]. Bill considered in Committee; reported without amendment; read a Third time and passed. EVIDENCE (CIVIL PROCEEDINGS IN OTHER JURISDICTIONS) BILL Order for Second Reading read. 3.20 p.m.”
“Mr Speaker, Sir, I beg to move, "That the Bill be now read a Second time." The existing Pharmacists Registration Act provides, inter alia, for a Pharmacy Board which has the Director of Medical Services as its President and Registrar. It has been considered that the pharmaceutical profession ought to be self-governing. Hence the Pharmacists Registration (Amendment) Bill seeks to alter the composition of the Pharmacy Board to comprise members of the profession only. The Chief Pharmacist of the Ministry of Health will, therefore, be the President and Registrar of the Board. The existing Act provides that any person who holds any qualifications recognised by the Pharmaceutical Society of Great Britain can be registered as a Pharmacist in Singapore. The Bill seeks to discard this dependency on the Pharmaceutical Society of Great Britain by establishing our own sine qua non for registration. This will enable us to control the type and quality of Pharmacists in Singapore. This Bill re-defines the registration requirements of Pharmacists, so that registration is restricted to persons who have obtained pharmaceutical qualifications from the University of Singapore and persons who possess qualifications approved by the Minister for Health. There are sections in the existing Act which pertain to the Pharmacy trade. These provisions, which control the trade and the safety, quality and efficacy of pharmaceutical products, have been made in the Medicines Act of 1975. This Bill seeks to update the present Act by a deletion of those sections which have been adequately covered by the Medicines Act. Question put, and agreed to. Bill accordingly read a Second time and committed to a Committee of the whole House. The House immediately resolved itself into a Committee on the Bill.”
“Point of clarification. Mr Speaker, I think my colleague, the Minister of Education, has got me wrong. I did not say that I was against bilingual education. I was saying how, in the case of the Japanese, two operating systems in the brain reinforce each other because they were teaching one language, whereas in Singapore we have got two separate languages but they do not reinforce each other. I distinctly added that bilingualism can be practised in Singapore provided certain parameters or weightages applied to one language as against another are clearly spelt out. The other point which I very seriously made is that the fault lies with the Ministry of Education, namely, they have been teaching Chinese for so many years that up-to-date they have not been able to produce the list of 2,000 characters which the pupils ought to know.”
“I think parents cannot really relieve themselves from the responsibility of moral education. Telling stories to the children by the mother or father is probably far more effective than stories told by the teacher. Perhaps moral education should begin with parents and special classes organised for those who are going to be newly-weds and parents. I have no opposition to the resolution which is drafted in so broad terms. However, I fear that the honest intentions and the good reasons in publishing the Report on Education will be forgotten in the course of time and the bureaucracy will return to its old ways of doing things. For these reasons, I beg to move, Mr Speaker, Sir, an amendment to the main resolution by adding after paragraph (3) the following:- "(4) advocates that the Ministry of Education collates the suggestions and criticisms raised during the debate in the House; (5) urges the Ministry to study the implications of policy changes in depth and to give schools and parents adequate lead time to implement such policies." Question proposed.”
“During the first three to four years of a child, the brain is growing and it is during this crucial period that the child should be exposed to environmental stimuli from the parents or siblings. Experiments have shown that if one were to bandage the eyes of a monkey at the age of three weeks the monkey will become blind very soon. The visual cortex has lost its plasticity to learn. So likewise the home environment is important for development of the child's brain. Nations call themselves fatherland or motherland but all of them speak the mother tongue, but no father tongue. The emphasis is on "mother" because it is the mother who breast-feeds the child and in the course of breast-feeding the child - the mother is closest to the child. It is the contact between the infant and the mother that stimulates the child's brain through touch stimuli, visual stimuli and auditory stimuli. These are important in the first few years of the child's growth. If this is absent and if a child is left isolated, the child can grow up deaf and dumb although the ear is perfectly normal. The tongue can move, but if the area of the brain which is responsible for receiving auditory sensation has not developed the speech area will not develop. Teachers need to know what are the physiological mechanisms which go into the learning process. We did hear something about moral education being linked to the mother tongue. Here again, I must say that moral education begins at home, not in the school. Teachers cannot act in loco parentis and at best they can only supplement a child's moral guidance. When I was Vice-Chancellor, students very firmly told me that they would do their own thing and I was to do my own thing.”
“Success in bilingualism, you will share with me, is desirable. Today in this House many of us speak two languages, if not three, and without using the ear-phones. But universal bilingual proficiency in Singapore will have to be seen in the lifetime of future generations, not in our own lifetime. I will tell you why. There was a paper written by two general practitioners, Dr Lee Ho Guan and Dr Leong Vie Ching, published in the Singapore Family Physician, January/March 1975. They made a survey in 1973 of a population of 1,646 patients and they discovered that the main languages spoken at home were Chinese dialects 64.8%, Mandarin 1.3%, English 5.2%, Malay 7.8%, Indian 1.8%. Others 0.7%, Two languages 8.2%, and No Details Given 10.2%, probably because they were dumb. More Chinese in Singapore will no doubt in time to come be fluent in Mandarin but my guess is that dialects will not completely disappear, nor can they by edict be scrubbed out. As I indicated earlier on, Swiss German is not German German or Austrian German. It is not the German that they teach in the schools. It is a dialect. Likewise in China, why is spoken Mandarin not standard in all the provinces? Why do they speak Mandarin with an accent? i suggest that this is because of the continuing use of dialects in the provinces in China. Businessmen in Singapore may still have to conduct business with visiting Chinese businessmen who are conversant in dialects but not necessarily in Mandarin. Last, but not least, I would like to emphasise that we should not lay all our woes on the failures of the children at the doors of the Ministry of Education. The family is the most important educational institution.”
“So Pre-University students who wish to study Medicine will need to apply their minds to Chemistry, Biology, and Mathematics. Moreover, medical students in the first year face a new style of idiomatic English, heavily laced with glossary derived from either Latin or Greek. It is very rare indeed for a Chinese stream student to enter the Medical Faculty because of the lack of command of English. Insistence on this second language at 'A' level also creates a paradox that you deprive a monolingual student, who may be very able in other subjects, from admission to the university. I know of students who failed CL2 at 'O' level but have gone to Britain, have taken their 'A' level without a second language and have been admitted into British universities. It would appear that it would be easier to enter a British university than our universities in Singapore. So do not think too much of President's scholars who go abroad and come back with a First Class. For most students who do not come from wealthy homes this overseas route to university is remote. In the end we inflict on ourselves the penalty of a reduced number of potential and competent professionals whose services our society will need in the future. I am particularly concerned because of the declining number of births and because of this the degree of freedom in streaming students is proportionately reduced. If the Ministry were to follow rigidly the assumptions made in Table 6.1 of the Report, 8% brilliant, 31% above average, 41% average and 20% below average, I am afraid we are going to face shortfalls in manpower requirements for the future. The brilliant students can look after themselves. They are in the minority. It is the main task of the Ministry of Education to look after the majority who are not brilliant.”
“I am disappointed that the Report now recommends that the second language be made compulsory at the 'A' level examinations. I do not support this recommendation. Statistics from the University of Singapore show that there were 3,542 total applicants in the academic year 1977/78 from the English stream. Of these, 843 or 23.8% offered CL2 (Chinese as second language). In the academic year 1978/79 there were 3,817 applications. There were 875 who offered CL2 or 23% of the total number. These are encouraging statistics. As many as a quarter of the applications into the University of Singapore from the English stream are already offering CL2. I would like this to be a natural growth and not to make CL2 as a compulsory subject for admission into the University of Singapore. It will create resistance. But there are also considerations. If a second language is made compulsory at 'A' level, a Pre-University student will have to take an extra subject. At the moment he takes the General Paper and four other subjects at 'A' level. If second language is made compulsory, he will have to take six subjects altogether. The pressure to get into the university is now so keen that you can very well imagine how much more pressure will be imposed on a Pre-University student in future. Furthermore, each faculty has its own specific requirements for studying special courses. Take the case of Medicine. Because rapid advances have been made in molecular biology, it is essential that students at 'A' level should have a firm grounding in Chemistry and Biology. Statistics is taught in the second year in the Medical School so that students will understand the significance of clinical syndromes and the use of statistics in epidemiology.”
“There is an urgency that the Ministry should set out its list of 2,000 fundamental characters or basic characters which the child will have to know at PSLE and 'O' levels. It can be done. In 1976 the Ren Min Ri Bao ( ). the Peking People's Daily, published a study on the frequency of usage of Chinese characters. It examined 7,075 news releases and newspaper articles comprising nearly 7 million characters. The Ren Min Ri Bao discovered that 5,080 characters were in common use, of which only 2,076 accounted for 99% in accumulated usage while the remaining 3,004 for only 1%. Eventually 3,200 characters were compiled for further discussion and study. This would suggest that we do not need as many as 5,000 characters to study. A basic set of 2,000 characters will be quite appropriate in the context of Singapore. This is an important reason why bilingualism has turned out to be a failure. I would like to caution the Ministry of Education not to swing to an extreme position where bilingualism is considered preeminent. So that all officials in the Ministry concentrate on promoting bilingualism, regardless of the fact that students have other aptitudes which can give them saleable skills when they leave school. If Lee Pan Hon's musical talent had not been spotted by chance, it is quite possible that he would be no more than an average student in Kreta Ayer and end up as a fiddler on the SAF Road Show. When I was the Vice-Chancellor of the University of Singapore, I had urged Pre-University students to choose subjects which would give them mobility in their choice of courses at the University. They were not to confine themselves to Mathematics and Science and exclude subjects in the Arts and Social Sciences. They could even include a second language.”
“supposing we are quite content with studying 2,000 Chinese characters, retaining them in our memory and be able to retrieve them and to write them, at primary school level for six years. It means that on the average the child would need to study 330 characters a year. When the child reaches Primary 3, and if the child has forgotten what he has done in Primary 1, then the number of characters that he will learn or acquire at the end of six years will probably be less than 2,000. That is quite a difficult task. Ideograms have to be memorised whereas phonograms only require to be spelt out, and spelling is far easier than memorising ideograms. You can form your own vocabulary. If you are a scientist and you have discovered a new substance or a phenomenon, you can give it a name. It will be published in international scientific journals. If the Japanese discovers anything, they will publish the name in katakana, not in new Chinese ideograms. Language is one of the reasons why science and technology in China have not progressed as fast as science and technology have advanced in the West. The psychologist will tell you that there is such a phenomenon as interference existing in the brain. There is a mental block. So when you have to use both English and Chinese, it may be that one is not only not reinforcing the other, but one may cancel the other out. So it ends up with students who can be only monolingual. It is a fact that even Chinese students in English schools, who come from homes where father speaks Mandarin, mother is teaching Chinese in a Chinese school, describe Chinese as the most unpopular subject. They are falling between the English stool and the Chinese stool. So we need first to rectify this omission by the Ministry of Education.”
“1 of the Report shows, the attrition rates at primary and secondary school levels are zero in Japan, zero and 9% in Taiwan, but 29% and 36% in Singapore. These differences are due mainly to the fact that in Japan and Taiwan one predominant language is taught, whereas in Singapore we are giving equal weightage to two different languages which do not reinforce each other. In promoting our policy of bilingualism in English and Chinese, we must recognise inherent physiological systems for learning languages which may not be equally developed in every child. Bilingualism is possible provided we accept the fact that applying equal weightage in achievement of linguistic proficiency, particularly for English and Chinese, is false. It is an error and it cannot be applied to the majority of the student population. It is true that there are some with exceptional linguistic abilities and these students should be sent to an Institute of Languages, but they are the minority. English, with an alphabet, is easier to study than Chinese which does not have an alphabet. For English stream students, studying Chinese in our schools has been made unnecessarily difficult by the fact that up to-date the Ministry of Education has not listed out which are the first 1,000 active characters and which are the next 1,000 less active characters. The Director of Education told us that all we needed were 2,000 characters at PSLE level. He may believe it, but I am afraid his teachers in Chinese do not believe him at all. Far from it. They have impressed upon me very sternly and consistently that we need 5,000 characters at PSLE level and 10,000 characters at 'O' level. So I did a little mental arithmetic.”
“It is a dialect peculiar to the northern part of Switzerland and cannot be under- stood in the border states of Germany or Austria. What I need to emphasise is that what is taught in the schools need not necessarily be the lingua franca that is being used. English and Chinese have nothing in common. They are entirely two separate languages, one using phonograms and the other ideograms. Japanese is one language which uses Chinese characters or ideograms called kanji and phonograms called katakana and hiragana. Some persons suffer from defects in the nervous system and when they do so, they fail to understand the, meaning of the printed word. They suffer from what is called word blindness. The clinical term is alexia. A study of such neurological patients in Japan showed that surprisingly Japanese patients could read ideograms, i.e. they could read kanji. But, on the other hand, they could not comprehend the meaning of words formed from katakana or hiragana. This has given rise to the postulate that reading ideograms or learning the meaning of ideograms is through association of the visual cortex and the speech areas of the brain while reading words made up of phonograms is through association of the auditory cortex and the speech areas. So there exist two different systems in the brain for learning languages and because Japanese is a single language, these two systems reinforce one another. This is not so in the study of English and Chinese, each of which employs a different system and reinforcement is absent. It may explain why our attempts to push bilingualism in English and Chinese are meeting with so much difficulty and resistance. The Japanese obviously have the advantage. As Table 3.”