Warren Lee
Singapore
“Sir, there are 300 clan associations, approximately 200 of them belonging to a single umbrella for Chinese clan associations. They have played a significant role in the development of Singapore, especially for early immigrants, who faced hard times, financial assistance, job placement, building communal facilities, dispute resolution, sch…”
“With the community parent, children who need to work long hours or overseas need not worry endlessly about their elderly parents living alone.”
“Sir, I am really glad to hear of the Minister's vision for the revived waterways. Can I ask whether he might include plans for Sungei Sembawang or Katib Bongsu canal? Assoc. Prof. Dr Yaacob Ibrahim: Certainly, we will include all our waterways. I have been told that we have done something at Sungei Sembawang.”
“Preparedness Against Infectious Diseases Sir, during World War II, losses due to malaria and other preventable diseases among allied forces operating in the China-Burma and India theatre far exceeded the number of casualties inflicted by enemy action.”
“In fact, in the latest issue of Pioneer, which was just circulated by the Minister, on page 8, you will find these brighter, better gymnasiums. There are 12 of them, the latest ones, across the SAF camps. There are also the latest gymnasiums in the SAFRA clubs. Some of the machines emulate what Dr Warren Lee has been saying.”
“Sir, like other Members of this House, we have noted that relations between Australia and Singapore are broad-based and go back many years. Our troops train in Australia, Qantas uses Changi International Airport as a major overseas hub, and our two peoples have strong ties of friendship and family.”
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“Sir, how are our Community Development Councils (CDCs) doing in their task of bonding the people and encouraging a nation of active citizens? For various assistance schemes, how are they performing? What measures of performance can we use to see if they need more help in terms of helping our residents in a timely manner? How do we measure the degree of volunteerism in a community? Given that volunteers have limited time, should CDC council members focus on governance and direction or should they promote direct action and participation? People s Association Sir, I note that many of the staff of the People s Association are really quiet and unsung heroes. Without the secretariat's enabling role, our civil society would be the poorer because many a Singaporean volunteer would have started their volunteer career through experience gained in PA activities. The staff have many tasks. Their officers, among other things, help grassroots organisations (GROs), like the Residents Committees, Community Sports Clubs, IRCCs, CCCs and CCMCs, with secretariat functions. While upgrading courses are available for training volunteer treasurers, perhaps more manpower support could be given to our constituency office staff in their financial reporting functions and they, in turn, could help GROs make the financial reporting less of a chore while still ensuring good governance. Next, how can we make the terms of service of PA officers more attractive so that we can attract more talent? Can we second or allow cross posting for talented young civil servants so that they can gain more ground feel and ground experience and help make better policies for our future?”
“Sir, I would like ask about the nurturing of our young athletes. The Sports School is doing an admirable job but its capacity is limited. We need a larger talent pool. Perhaps, we can recognise that for some children, going to a school well-known for academic excellence is as equally important as getting good coaching for their children's sports. How are we able to promote more models for centres of sporting excellence? Does the Sports Council have easily accessible sports medicine and physiotherapy facilities for the prevention of sporting injuries? Are we sure that our coaches use the latest and most effective coaching methods? Is the injury rate acceptable? Are we losing future champions and future combat-fit soldiers? How can we benchmark ourselves? And are our National Sports Associations able to attract good volunteers? Sir, I have previously spoken in this House about the need to ensure that more children are given exposure to a wider range of sporting activities so that they could eventually choose one that they would really like and excel in. Now, Sir, I would like to ask about the nurturing of our young athletes. While the Sports School is doing an admirable job in opening up opportunities for children of all backgrounds, we can actually do more to get more schools to become centres of excellence by allowing them to have decentralised coaching programmes. I hope that we can benchmark ourselves against some of the methods available in overseas countries. I hope that our NSAs can also get better volunteers and better HR practices. I hope we can minimise politicking and maximise the potential of our athletes.”
“Sir, there are 300 clan associations, approximately 200 of them belonging to a single umbrella for Chinese clan associations. They have played a significant role in the development of Singapore, especially for early immigrants, who faced hard times, financial assistance, job placement, building communal facilities, dispute resolution, scholarships and self-help projects that these early clan associations contributed to their members. I believe now they can still help us to maintain our cultural heritage and our sense of rootedness to Singapore. How can we assure that clan associations renew and reinvent themselves and continue to play a significant role in our nation building? Community Engagement”
“Sir, how are we progressing in the area of helping people with disabilities integrate into normal society? The introduction of kneeling buses, lifts on every floor and the move to make HDB estates barrier free is laudable and will benefit not just the elderly but also those with physical disabilities. However, more targeted help will be welcome. We must also think in terms of life-time benefit versus life-time cost. For example, a $50,000 cochlear implant or artificial ear implanted into a deaf infant will allow the child to grow up with normal hearing and much better employment prospects. Motorised wheelchairs and other assistive technology may help an amputee retain his job or live more independently. Are we able to help these people financially and design inventions that they can afford to use? Are we building enough barrier-free schools for children in wheelchairs and having skeletal deformities? Have we enough facilities for children with dyslexia or autism? Sir, we must find ways to make sure that people with disabilities enter our workforce. In leaving no one behind, I think there is a cost, but there is also a tremendous opportunity to make these people much more productive members of our society. In this regard, I think it is important that we have enough trained manpower. We can start thinking in terms of training middle-aged or other silver-aged workers in the areas of gerontology, occupational therapy, physiotherapy, speech therapy and other therapies which are useful for the treatment of people with autism and dyslexia.”
“With the community parent, children who need to work long hours or overseas need not worry endlessly about their elderly parents living alone. With a paid community parent taking the role of the elderly person's living companion, domestic maid, housewife or unmarried sibling, who gives up family and career to look after the elderly parent, we can free up a lot of young people for the workforce while providing meaningful employment for their young elderly as they themselves transition into this role. Why not give this idea a try?”
“Recognising this reality, we perhaps could do more to allow the elderly to live close to children, but not in each other's pockets, and not outstay their welcome. Elderly couples living alone may not have been our previous paradigm, but may be our present and future reality for some Singaporeans. We must make it a valid and comfortable option for those who need this option. Again, ageing in place may not mean retirement villages or sheltered housing for all. The elderly may be able to live on their own if someone helps with the shopping or the housekeeping or with little problems that can have large consequences, such as leaky taps and stagnant water or even frayed power cords in appliances. In Israel, there are communities whereby a middle-aged or young elderly person is employed as a community parent. This community parent will visit, shop for, and do little handyman jobs around the house for a group of more elderly people living alone. He may also function as substitute next-of-kin. Technology can also help. A wearable personal alarm like a handphone can, once the button is pressed, instantly connect the elderly with the telephone operator who can then despatch an ambulance or the community parent, depending on whether the problem is that the elderly has fallen and broken her leg or has misplaced his or her glasses and cannot see well enough to leave the house. Similarly, a mini-camp located in a strategic location could help the community parent to keep an eye on an elderly person or help the elderly person keep up emotional contacts with the far-flung family members, especially nowadays when Singaporeans are encouraged to work abroad.”
“The Committee on Ageing Issues has issued its comprehensive and well-considered recommendations. I applaud the Prime Minister's move to accept and address all the recommendations therein. I would now also like to draw attention to changes in our family dynamics. Sir, we predicate our policies on the concept of many helping hands and the primacy of the family as the first source of help for the elderly. While it is ideal for Singaporeans to practise filial piety and live in harmonious three-generation families, the realty is sometimes very different. Families are getting smaller and more nuclear. Young couples are not used to the give-and-take and dynamics of large families. Young couples often do not take kindly to advice or interference from the in-laws. Cultural differences abound even in same race marriages, while over time, underlying tensions can be accentuated by differences in spousal expectations, differences in religion, values and child-bearing practices. Many MPs are familiar with the situation whereby elderly couples come looking for separate rental accommodation because they see it as a better alternative to constant quarrelling with their married children. Some elderly do not seem to have a choice in the matter as their children make it plain that they are not welcome. Forcing these families to live together leads to much unhappiness and can be a factor in discouraging couples from marrying and having more children. Children of all ages suffer emotional distress and negative role models and guilt as tempers fray and ugly situations abound. I think we must first of all recognise this realty and factor this into our policy responses. We cannot hide behind platitudes and motherhood statements.”
“Sir, I am really glad to hear of the Minister's vision for the revived waterways. Can I ask whether he might include plans for Sungei Sembawang or Katib Bongsu canal? Assoc. Prof. Dr Yaacob Ibrahim: Certainly, we will include all our waterways. I have been told that we have done something at Sungei Sembawang. Katib Bongsu, if my memories serve me right, would be part of a new reservoir, but that will be later. If we succeed in our pilot project on the ABC Waters Programme at Kallang River, we will explore all the other waterways in Singapore to see how we can enhance it. We will continue to review all the opportunities across our waterways in order to enhance the living environment there.”
“In fact, in the latest issue of Pioneer, which was just circulated by the Minister, on page 8, you will find these brighter, better gymnasiums. There are 12 of them, the latest ones, across the SAF camps. There are also the latest gymnasiums in the SAFRA clubs. Some of the machines emulate what Dr Warren Lee has been saying. There is one machine called the multiple movement machine, which allows the machine to simulate different exercise impact on army equipment. For example, this machine can emulate the movement on a soldier on artillery, so that helps him to build up his muscles that he needs to work on the machine. Certainly, the DSTA and DSO will continuously focus their research on how to further improve this man-machine interface. But we have never forgotten that the fitness of a soldier must be built up from the beginning.”
“Sir, may I seek clarification from the Senior Parliamentary Secretary? I was actually thinking in terms of lifecycle, ie, the maintenance of our soldiers, and whether the SAF would consider focused research. I know MINDEF has got beautiful new gymnasiums and so on as I read the Pioneer magazine. But could we develop short, sharp, simple, focused strengthening exercises which, I believe, are the preferred way of preventing long-term joint injury? We may actually learn a lot from specialised Olympics sports. Assoc. Prof. Koo Tsai Kee: Sir, I have visited the DSO and DSTA. Part of their research is to improve the soldier-equipment interface. All the equipment that we either source off the shelf or we develop in-house are ergonomically designed. This helps to lessen the load on the soldier's muscles. At the same time, we build up the soldier's fitness, in other words, we train him to be fit in order to do the job. So with this man-equipment interface, we find that the impact on a soldier, in terms of injury, is very minimal. Just now, Dr Warren Lee talked about training soldiers on ski machines but we have no ski machines here to minimise impact. Did I hear him correctly? Dr Warren Lee: May I clarify? I was not recommending that we all go skiing. What I am saying is that, if you think more laterally and look at the world of professional sports, we may learn lessons from sporting activities because they have developed ways to strengthen and go for peak performance in their athletes. I believe that is the way that we can look at lifecycle performance for our soldiers. Assoc. Prof. Koo Tsai Kee: Dr Warren Lee talked earlier about the new gymnasiums.”
“Preparedness Against Infectious Diseases Sir, during World War II, losses due to malaria and other preventable diseases among allied forces operating in the China-Burma and India theatre far exceeded the number of casualties inflicted by enemy action. Even in recent times, malaria outbreaks amongst United Kingdom troops in Sierra Leone in 2000 generated attack rates of 10% in certain groups. And attack rates in excess of 40% have been reported in the popular media concerning the deployment of US troops in Liberia as recently as 2003. Sir, the appearance of SARS, bird flu, Nipah virus and virulent dengue epidemics underscores the importance of infectious diseases as it has disruptive influence on modern armies. Even more mundane, food poisoning, chicken pox and flu can cause great disruption to operational readiness. Sir, has the SAF prepared itself for coping with such diseases outbreaks during peacetime and in operations? What are we going to do about this and can we cope?”
“Sir, MINDEF has in place impressive programmes to manage military equipment and real estate on a lifecycle basis. Since our servicemen are our greatest asset, I would like to ask the Minister if we have also in place a programme to prevent degenerative joint problems and allow for rapid diagnosis and treatment of problems as they occur. Has MINDEF looked into this, in terms of primary and secondary prevention? How effective are these programmes? Besides the very welcomed improvement in servicemen's boots, has there been improvement in personal equipment and methods of training? We have a system which produces very fit young men for our military service. But as happens worldwide, as people age, degenerative knee problems such as chondromalacia patellae will start to supervene. Others may tear ligaments and cartilages in training and on the playing field. Debussing from three-tonners by jumping down used to be a significant cause for knee injuries, ankle injuries and back injuries. Has this improved? Sir, early arthroscopic surgery may save the torn meniscus cartilage and prevent later disabilities. But proper rehabilitation means eight weeks of limited mobility and intensive rehabilitative exercises. This represents a loss of valuable manpower and training time. Could we not include simple focused flexibility, agility and strength workouts to strengthen servicemen's knees? Have we looked into, for example, providing knee pads or modify our training regimens to include stretching and strengthening exercises that can prevent injury? Perhaps we can learn from specialised sports, such as skiing, which may not be popular in Singapore. I believe the US Army has tried service research studies looking into these areas and I hope our SAF would do the same.”
“Sir, I was wondering whether all this art buzz would feed into our thrust for creative industrial design as well.”
“Sir, we have a long and fruitful relationship with Israel. But, at the same time, Singapore has good relations with the Palestinian people and the countries of the Middle East. We know we do not take sides but wish for better understanding, peace and a better life for all their peoples. Could the Minister update us on our relationships with Israel and the Palestinian Authority, especially in view of the recent elections in the Palestinian territories and developments in Israel itself? Has our improved relations with the countries of the Middle East impacted on our relations with Israel? Cultural Diplomacy”
“Sir, like other Members of this House, we have noted that relations between Australia and Singapore are broad-based and go back many years. Our troops train in Australia, Qantas uses Changi International Airport as a major overseas hub, and our two peoples have strong ties of friendship and family. Recently, however, many Singaporeans were shocked and saddened by the decision not to allow SIA access to the trans-Pacific route via Australia, coming so soon after our Singapore-Australia FTA. To some Singaporeans, it would appear that the Australian love of justice and fair play has been re-defined by self-interest and fear of competition, while their respect for the rule of law has been brought into question by their reactions to the conviction and treatment of drug traffickers in Singapore and Indonesia. What is the Minister's assessment of our bilateral relations with Australia and how can we move forward from here? ASEAN”
“Sir, the world has seen the rise of China and India. Many world leaders have flocked to visit these countries, and President George W Bush is currently in India. Singapore, however, has had a long history of engagement at a high level with both China and India. More recently, our leaders have been visiting countries in Europe and Russia. President S R Nathan, Minister Mentor Lee Kuan Yew and Senior Minister Goh Chok Tong have all recently visited India, while President Abdul Kalam of India has recently visited Singapore. We have recently concluded the CECA with India, and Minister Mentor Lee recently visited Russia last year. What is the result of these visits? How have our relations with the countries of Europe, Russia and India improved as a result?”
“Sir, allow me to raise just two points. One may be an unintended consequence of the Progress Package in that some businessmen in small and medium enterprises, with workers and subcontractors in the informal sector, have expressed concerns that they may be held liable for inadvertent non-compliance with CPF, Medisave, income tax and workmen's compensation issues if the casual labour and small contractors were to claim an employer and employee relationship in order to claim eligibility for Workfare Bonuses. I hear that, in fact, a few have actively discouraged their workers from signing up for the Progress Package. Perhaps the Government could clarify this line. Lastly, Sir, I think that our Government and our nation have made great progress and I note that many multi-nationals nowadays report their progress in their annual reports in terms of a triple bottomline. Besides reporting on their financial issues, they will also report on the progress, environmental and social issues. I believe, as a nation, we have done well in all these areas but, perhaps, not everyone is aware of the improvements made. Perhaps one day, when we report on the progress of Singapore in Parliament, we would consider this approach as well. With that, Sir, I would like to express my deep support and appreciation for the 2006 Budget and financial policies.”
“We have to acknowledge that the face of the poor in Singapore has changed. It is not uncommon for the new poor, as it were, to possess refrigerators and televisions at home and almost 3.8 million people in Singapore have mobile phone subscriptions. While some have obviously been imprudent in their expenditure, others have merely been caught by the wave of globalisation and outsourcing. Families with middle class incomes also feel the pinch as their salaries stay static or get reduced while transportation, education and utilities go up. The Government's move to help pay for the education of children in this category is to be specially lauded as it signals that it recognises that even though some families are now earning $3,000-$4,000 a month, it can be difficult to provide all the best for our children. In fact, the Opportunity Fund which could be used for computers or school trips abroad is a fantastic idea. It shows how far we have come from the time when the first priority of the PAP Government was the provision of adequate primary and secondary school places for every child in Singapore. When my mother was a teacher in Paya Lebar in the 1970s, she told me she had students who had never been to downtown Singapore. By the time she became a relief teacher in her retirement, she recounted to me that her students in the same school were talking about their overseas holidays whenever school started. In contrast, I had met legislators from developed countries who had never been out of their country. When we talk about being a global city, we need to give our young people the chance to experience first-hand the world around them and also the wide world. I really think that these initiatives are the best things that has happened this year.”
“I realise that there are also other Singaporeans with similar stories, including those who have bought larger flats in better times, to heed the Government's call to let three generations live together. Some of these families are in employment but just getting by and because their elderly parents live with them in larger flats, their elderly parents would get less. In contrast, we all know of well-to-do Singaporeans who drive big flashy new cars like Mercedes Benzes but choose to live in 3-room flats. Now I think there is nothing wrong with that and, perhaps, it is their expression of prudence and humility despite their wealth. But when my residents know that these people will get a lot of SC&C rebates and so on while they will get far less, despite being in more difficult straits, I can sympathise with their feelings of frustrations and being hard done-by. I would also like to highlight, like Ms Indranee, the plight of single parents and the difficulties they face with getting affordable public housing whenever the sale or disposal of the matrimonial home is dragged out or is in limbo, and where they do not have the means to afford open market housing options. Many who were previously considered well-to-do may now face severe hardship. Families in need also include those where ageing grandparents have to provide for dependent children and grandchildren in the case of single mothers, and where one parent is absent, due to abandonment or imprisonment. I wonder if future budgets could also include some provision for this group of the elderly because, perhaps, their needs are even greater than those of the elderly living alone. Sir, as Singapore progresses and enjoys economic success, the living standards of our poor have been correspondingly elevated.”
“Yesterday, Sir, I held a dialogue session in my constituency to seek feedback about this Progress Package and I would like to share with you the sad story of one of my grassroots leaders. When Madam Aini first booked her Executive flat, the price was just over $100,000. At that time, both she and her husband had well-paying jobs with the husband's income alone worth over $3,000 a month. When their family's turn came to choose the flat, the price of an Executive flat in Sembawang had risen to about $300,000, but they gladly accepted the new flat because of their six children. Recently, however, they suffered one setback after another, with both sequentially losing their jobs. For the greater part of last year, only Madam Aini has had a regular job in a call centre earning about $1,500 every month. She thought she was doing well and, in fact, had recruited two other neighbours to join her in employment, when to her shock and dismay, just after Chinese New Year, all 20 of her colleagues were terminated because the company decided to close down the call centre. Another little niche professional living in an Executive flat recounted how he was retrenched a few years ago but found a job in a neighbouring country and now pays foreign provident fund and income tax. He said he just scraps by with a son in an independent school but feels embarrassed each time he is asked to donate to the school but can only afford a small sum. He, too, expressed the hope for more sympathetic treatment with respect to those who have heeded the Government's call to accept jobs overseas and yet still face problems at home.”
“This Government could have used the money for grandeur signature projects or could have just parked the entire sum into subsidies, if the idea was simply to get votes in an election year. But, I think the Government is serious about remaking Singapore and to put our money where our mouths are in order to achieve policy and behaviour changes. Tax policies and Government handouts are instruments to shape the behaviour of individuals and corporations and to encourage so-called better societal choices such as more energy efficient cars, air-conditioners and more investments in key sectors of the economy. The Singapore Growth Dividends signal that help is given, but so is free choice, and that the PAP Government is respecting individual choice and responsibility. The total Progress Package payout for the lower income elderly Singaporeans amounts to a not insubstantial sum, maybe about $2,000-$3,000, if one considers the worth of the rebates included. The individual given the money could blow it all on cigarettes and lotteries, or he or she could actually do the right thing and pay off arrears or set the money aside for their children's education. I think, in that sense, the Government is respecting free choice. But I do have some criticism of the Package as it currently stands. Sir, I understand the difficult line between promulgating a simple but workable policy versus having policies that become unworkable because they seek to address every conceivable loophole. But, nevertheless, I would like to ask the Prime Minister to please consider fine-tuning the criteria for this and, hopefully, future programmes to distribute surpluses back to people.”
“However, I support the ideal that since we have sacrificed together as a nation, we share the fruits together and those who are in greater need would receive more. The rich may have spearheaded or invested in projects leading to the economic growth, but this would not have been possible without the support of our low-wage workers who have their role in propelling our nation forward. Rather than to leave everything to market forces alone, in the Progress Package we have chosen to respect market forces in setting wages. But, at the same time, we have found ways to level out the playing field for the poor. That is what families and friends do - to share and share alike - only this time we are not sharing poverty but prosperity. In this Budget, we see the Government's attempt and commitment to narrowing the wealth divide without disrupting the market for wages. Unlike countries which I have recently visited, where the rich are fabulously rich but the poor suffer at the doorsteps of the rich, our method to redistribute wealth, as it were, tends to lower the Gini coefficient and minimise discontent and envy among the poor. While other countries wax lyrical about human rights and helping the poor, Singapore, in its own quiet way, is walking the talk with affirmation, meritocracy and policies meant to reward talents and effort while not discounting the contribution of each of its nationals. Singapore's poor are, by contrast, very well provided for and may, in fact, be considered quite rich by international standards. Sir, the total amount in the transfers is worth about five Lift Upgrading Programmes annually for the whole island.”
“Mr Deputy Speaker, Sir, thank you for allowing me to speak today. Sir, I want to say that I support the Budget. It seems befitting as a tribute to the late Mr Rajaratnam and others of our founding generations of leaders that the focus of this year's Budget is to achieve progress for and share prosperity with the nation as a collective whole. This Budget speaks volumes. As a result of previous belt-tightening measures, a willingness of workers and industry to undergo painful restructuring exercises, the economy has grown, unemployment has decreased and now, there is a surplus. Now the fruits of our collective efforts are being shared. The tax base has been broadened through GST, so all, rich or poor, contribute to our taxes. But instead of taxing the poor to give tax breaks to the rich as in other countries, we have, in effect, used the money to more than offset the amounts paid in GST by the poor and much more through utilities rebates, town council rebates and assistance schemes for school fees to benefit the poor. I applaud the approach of the Government to investing in our intellectual capital and in our workers, in particular, the manner of redistribution of wealth generated to the lower-income group, while continuing to encourage them to be self-sufficient by advocating and rewarding work through the workfare programme. This business of making sure that only those who have worked continuously for more than six months get workfare is, I think, a key feature of the programme. Because there are far too many people who would rather not work than to receive lower wages than what they would have expected. No doubt, the rich had paid taxes many times more than the amount that they receive in this Progress Package.”
“Sir, would it be possible, even before the person who is charged goes to court, for consideration to be made at the pre-prosecution stage? The Minister mentioned that this happens during investigations. But is there any sort of guideline or reassurance, for example, that a person who is acknowledged by the community to be of low intelligence and who has gone to a special school all his life may not be charged or have the defence of diminished responsibility without having to go through the court process?”
“I hope that the incoming CEO and his team would conduct a thorough examination not just of the accounts but of the practices, and also to speak widely and seek wide feedback about these other questionable practices, some of which I have highlighted. In the final analysis, Sir, whether or not we are talking about charity, business or government, we have to say that the end cannot justify the means.”
“But I think we really need to get to the bottom of the matter and expose any legally or morally wrong practices and change them for the better. What else can we learn from this sorry episode? I hope the NKF would consider setting aside its reserves as a professionally-run endowment fund, with the proceeds to be used for direct patient care. This is a model that has been taken by many Ivy League and overseas universities to manage large endowments. Everything is hands-off,and you make applications to thefunds and funds are made available accordingly. I hope also that we may find a way for the National Council of Social Services (NCSS) and NKF to join forces, and thereby help out a good many VWOs to put them on a firmer financial footing, leaving these volunteers and staff to focus on delivering services to clients. I feel it is also timely for the National Council of Social Services to put forward its case for funding and to examine itself to see which of its funded agencies should continue to get funding from the Community Chest, and then for the Community Chest itself to take some good lessons from the way NKF has been raising money and actually be a bit more commercial about how it is doing things. Turning to the funds actually already raised by the NKF, it appears to me, Sir, that some of these funds may have been raised perhaps, under what might be charitably expressed, as "false pretences". Some of the funds may have been put up by donors based on erroneous and inaccurate figures and, therefore, we should give donors a chance to indicate if they would still place their funds in NKF coffers or, perhaps, reprogramme them to some other charity like the Community Chest.”
“I am also told that this gentleman who was going to be charged more than private rates for dialysis treatment - well, these things are a little bit difficult to prove - and, furthermore, he informed me that there are patients who are in financial difficulties, whose rates of subsidy had not been reviewed for three to four years, that there are patients who dared not complain about the NKF because they were afraid of being blackmarked, of patients who were compelled to participate in public functions because, if they did not turn up, it would go against their record. This is a signed statement, and I am happy to pass this on to the Minister. There are, I am sure, many more stories, both the ones I have heard within this House and also outside, but I think this question of transparency is not only about transparency of the board. Any committee of inquiry or any sort of investigation must really go down to what was happening on the ground, because the man-in-the-street is not so much worried about questions of board governance but what an organisation really does. So, I think, before wecan really talk about restoring confidence in the NKF as an institution, one must not only look at board governance, but alsolook at what has actually been happening, right down to who the service providers are. Coming from a Government hospital, under the able leadership of a Minister, I know that many of these things which I am hearing of would certainly not be allowed. So, I do not see that an NGO, especially one of this nature, should be having any different standards. Sir, individually, many of the stories recounted to me may have been explained away as one of excesses.”
“I have also received signed feedback from another retired lawyer who pointed out to me that the NKF does reject many people. While I, as a doctor, realise that not everybody can be treated, we also do realise that many of the people rejected go on then to be treated by the KDF orprivate dialysis centres at much greater cost. Turning to the point made by my colleague Dr Tan earlier, he said that, actually, one must look at the NKF's reserves in the light of an increasing disease load. This argument only holds if it is true that the NKF actually increases the number of patients that it is going to be treating in relation to the disease load. I think it is very important for us to ask hard questions about who is being rejected, what is the basis for rejection, and where can these people go. If the NKF, with its vaunted high standards, is unable to look after these people, and if they go elsewhere, then something is wrong with those figures as well. And, speaking as a doctor, I know it is very easy to get good healthcare results, if you first choose your patients. If youchoose patients who are less sick and you treat them, they are more likely to get well. So, again, this question of the reputation for good healthcare must, in the light of what we know, be taken perhaps with a pinch of salt, until and unless it can be proven that, yes,we are actually comparing appleswith apples.”
“Public sentiment about Mr Durai's salary and perks may be a proxy or lightning rod for anger and resentment about deeper problems besetting the organisation's policies and practices and the feeling that the Government could have done more to discover and remedy the problems that various members of the public have observed but have notyet spoken out against. The NKF has undoubtedly done good work in raising the standards of treatment of kidney disease, in setting up 21 dialysis centres around the country. Like any other responsible publicly funded healthcare provider, it has had to rationalise the process of care and make tough choices on whom they would treat, whom they would subsidise and whom they would need to reject. Not everyone could have been happy with some of these tough choices. But in the process, the NKF has also indulged in what many regard as questionable practices, both in the area of fund-raising and in the area of application of these funds. Many Members have, before me, spoken of some of these points. I would not repeat them. But let me give you a little bit of feedback from one of my senior grassroots leaders.This man participated in a "free" healthcare screening, a couple of months ago, at Suntec City. After going through the entire health screening procedure, he was informed that if he were to takea battery of tests from a clinic, it would cost him X dollars. And if he wanted to obtain the results of the tests which he had just undertaken, he would need to agree to contribute $6 through GIRO deduction through the NKF. Although this grassroots leader agreed to make the contribution,another of my grassroots felt that the NKF had manipulated people by stating that the screening was free.”
“If mistakes had been made, let us face up to them and move on. Some of these issues may be new to the investigators and toerstwhile supporters, but they areold sores to those who have been watching the situation unfold over the years. The Prime Minister has urged transparency and good governance in all aspects of the society, beginning with MPs and Ministers. We have said that we would not tolerate wrong-doing in Government or commercial sectors. Let us also do the same for the civil society and charity sector. We know that we have branding, even in the area of charities. I, for one, know that one of the organisations I represent, the International Diabetes Federation, chose to have its regional representative office in Singapore, partly because of our reputation for good governance in as much as for the connectivity that Singapore brings. The NKF was viewed by the man-in-the-street as somehow a Government-backed organisation, despite its status as an independent NGO. Statements by leading establishment figures, as the saga unfolded, have only added to this impression. Let us then see to it that we resolve all doubts in the minds of the man-in-the-street and, also, to the many who are watching us from afar. I would like to congratulate the Minister for his choice of interim Board Chairman. I would like to express my full confidence in Mr Gerard Ee and his team. I know that they will do an excellent job of exposing and rooting out any questionable practices and restoring public confidence in what has become a Singapore institution. Nevertheless, there are many people who are unhappy, although their reasons are varied. Sir, those who think that the public anger has been directed solely at the former CEO's pay packet may have missed the point.”
“This episode will also be a catalyst for local VWOs to clean up their acts and to discard outmoded management and fund-raising practices while adopting the best practices of both the corporate and non- profit sectors, even the models of social entrepreneurship,in particular, the concept of a professional run fund-raising arm and the concept of having paid staff to deliver professional standards of day care to their clients with the aid of volunteers coming in at management and, perhaps, even at care giving levels.Far too many VWOs are hampered by having their volunteers divide their time and energy between efforts to raise funds and efforts to provide services, such that theydo not do a good job in either field. I agree wholeheartedly that it is certainly not helpful for us to take out our anger against NKF's staff, many who continue to soldieron as they always have, motivated only by a desire to help those under their care. They and their patients deserve our continued support. However, there is a caveat. Secondly, with regard to Mr Durai, the outgoing Board and their practices, I think let the law take its course and we should not rush in to judge too quickly or to support too quickly before the full facts are known. With regard to the famous $600,000, I agree that a good man should equate to good wage. But as a VWO person and as a doctor, I strongly wonder about how it is that somebody can forgetthe difference between 3,000 patients, 2,000 patients and 1,500 patients. To me, that is simple misrepresentation, especially when somebody has got a reputation for being very obsessive with details. However, I would like to urge a full and thorough investigation with no attempt to cover up or protect any person or organisation.”
“Mr Speaker, Sir, I am pleased that this issue has surfaced and is being discussed at great length in this House. I would like to declare my interest in the field in that I am from the VWO sector. I was the President of the Diabetic Society of Singapore from 1996 to 2002 and has since become the Chairman to the present time. I am also a Board Member of the International Diabetes Federation which is based in Brussels and was previously the Regional Chairman of this same organisation. I am also an Advisor to the Singapore Children Society. I have been following the work of NCSS and NKF for some time. I feel that through this sorry episode, Singaporeans would be able to get a better appreciation of the work of charitable organisations in our country, their various modes of operation and field of service and they will be better able to make informed choices about which charities they choose to support. Singaporeans should remember that there are many other charities, besides the NKF, when it comes to opening their wallets. According to the Minister, there were 1,800 charities in Singapore and, I think, it is over 500 IPCs. I trust that more and more Singaporeans will realise that the continued maturation and progress of our society will depend on our continued support of the many voluntary welfare organisations in our midst and make the necessary commitment to support these VWOs financially and, also, by coming forward to serve as volunteers.”
“Sir, may I ask the Minister whether he is also aware that in the nature reserves, particularly around the MacRitchie Reservoir trails, there are cyclists who are cycling when they are not authorised to cycle, as stated on the big signs out there? Because these trails are very heavily used by walkers and joggers, especially those people who are on their way to and from the Tree-Top Walk, these cyclists pose a danger, as they believe they are only doing trail cycling, and by their nature, sometimes, they go quite fast without due regard for pedestrains. But in the first place, they are not supposed to be there. My understanding is that there are very few NParks staff available. That is why the suggestion to use CCTVs. In that kind of context, Sir, it is a very enclosed area and not a wide open space. Perhaps, we should still give it a thought.”
“Member Mr Chiam See Tong who lamented that, in the past, senior nurses were almost feared by their patients, I think it would be important to make a distinction between fear based on authority to order people around versus respect. I think our nursing profession has moved itself so that its members are now able to command a degree of respect, based on their skills, knowledge and ability to interact with patients, rather than on just their ability to order patients and visitors in and out of the hospital, as was the case in the long past. Certainly, if I may quote examples from my own institution, K K Hospital for Women and Children, the specialised nurses who deal with gestational diabetes, the ones who deal with the National Asthma Shared Care Programme, the nurses who help me in my diabetes clinic, these are all clinical nurses who may currently not be able to be called Advanced Practice Nurses within the bounds of the Act, but who nevertheless are playing a very important role in providing good clinical care for our patients. And I hope that as the Ministry of Health moves on in this direction, it would also consider ways and means to recognise many of these nurses who, because of their entry qualifications into the nursing profession, may have difficulty in eventually reaching a master's degree. I hope we will also find ways and means to recognise them for the important role that they play. Sir, I support the Bill. Mr Chiam See Tong rose ---”
“Because of their role in the continuity of care and their specialised knowledge in certain aspects of medical practice, they would also be able to help busy clinicians to put into fact research protocols which otherwise may be difficult to achieve, given the workload on public-sector doctors. As to the question of whether it is important to have our nurses come in with a degree or diploma, I think other countries have wrestled with this problem. In most countries where nursing has been a profession for many years, not all have had nurses coming in with degrees. In fact, most jurisdictions have had nurses coming in through certificate or diploma training programmes. It is only in the recent few decades that many countries have moved towards having degrees for their nurses. Sir, I have worked now for 20 years in Singapore hospitals and I have seen the transition from certificate and diploma nurses to now degree nurses. It is not the title that is most important. It is the quality of the person, their dedication to their work, the personal attitudes towards continuing nursing education, cooperation with the doctors and administration, and cooperation and working with the patients that count. Senior nurses even without these paper qualifications have an important role in mentoring junior nurses who now have such paper qualifications. I think both have their place in our system. Both have their valuable roles. I would also urge my fellow doctors not to see the development of Advanced Practice Nurses as a threat to their profession but to see their strongly complementary role in moving Singapore towards greater standards of clinical care and its aspiration towards being a medical hub for this part of the world. Finally, to address the problem that was raised by hon.”
“Mr Deputy Speaker, Sir, thank you for allowing me to speak in support of this Bill. Sir, the role of nurses has come a long way in history from the days of Florence Nightingale, where their role was still to care for the patient but seen very much in support, to the current time when, speaking as a doctor of many years, I really think that nurses are an essential part of the healthcare system and of invaluable help to doctors. Nowadays, our nurses are very important in terms of helping us to maintain clinical standards. In the MOH hospitals, doctors come in on a rotating system, spend several months in a posting before moving on to be trained. Advanced Practice Nurses and other nurses who have spent time specialising in the care of certain illnesses are able, because of their specialised knowledge and long experience in treating certain conditions, such as asthma and diabetes, to help the principal physician monitor the patient, improve compliance, and translate very well written clinical algorithms into good clinical practice. They are able to provide a continuity of care which otherwise may be difficult to achieve in a cost-effective way. It is important for good nurses to come into the profession. In order to attract good nurses to come into the profession, one must give them alternative means and routes to rise to the top. In many years past, the only way to rise to the top was through becoming an administrative type of nurse. I am glad that the Ministry of Health has seen fit to amend the legislation to allow and to recognise that nurses may want to really rise to the top in clinical practice. I believe these nurses will help to also improve the standards of medical research in Singapore.”
“Older workers, such as retired executives, technical or supervisory staff entering the healthcare sector in their 40s and 50s could have a 15-20-year career as healthcare assistant professionals and care coordinators and they can help to exercise, transport and accompany the frail elderly to clinics and to assist in social work, physiotherapy and rehabilitative medicine therapy. Instead of needing to employ foreign paramedical staff, Singaporeans could be trained to do these jobs and, in so doing, get employment themselves. In this way, we will be developing the grey sector and reducing our dependence on foreign labour. Training older workers and the well-elderly to take care of the frail elderly will free up valuable labour for wealth generating economic activities while relieving many families of the stark choice of looking after the grandmother versus getting a job. Sir, other MPs may have alluded to also the need for more inter-agency cooperation in terms of ensuring a barrier-free environment for our elderly. But I would like to once again bring up the point that creating an elderly-friendly environment in our HDB heartlands requires the cooperation and commonsense judgement of officers from many agencies. I wish to point out that while there has been much improvement in this area, more can and needs to be done. While each agency, such as HDB, LTA, Town Council and the like has done its part and looked after the buildings, pavements or roads under its purview according to the building-free accessibility and building codes and such other codes, the sum is sometimes less than its parts because it only takes one kerb or step to make it impossible for the elderly or handicapped to get from A to B.”
“Sir, what is the Government doing to ensure quality care for the elderly in the community? Can I suggest a solution that brings together the roles of MCYS, MOH and our private sector family physicians? Sir, GPs are ubiquitous in every HDB community and they are part of the HDB experience that Minister Mah speaks of with such passion. Many would make good and great primary care doctors and case managers for the elderly if they could practise partially-subsidised care. By this I mean that the professional fees will be at private rates but their medication could be at subsidised rates in that the Government could specify a basket of basic drugs for chronic care conditions which GPs could stock at polyclinic prices and which citizens could purchase with their portable healthcare subsidies or with their MCYS benefits, irregardless of whether they see a primary practitioner in the private sector or at the polyclinic. For most people, Sir, it is no more an expensive medication but appropriate use of standard medications that will make the difference. This scheme would make the cost of quality GP care more affordable, allow the sick elderly to grey gracefully in place. In fact, the GP could become the case manager for the elderly without much additional cost and resources. Sir, many of the medical problems of the elderly and sick are common conditions that are amenable to standardised care algorithms and amenable to be cared by trained staff under the care of a fully trained professional.”
“Sir, many initiatives have been announced for families who fulfil the Singaporean ideal of two children and two legally married parents. This has been so in the past. I would like to highlight the plight of the non-standard families in Singapore, the dysfunctional ones, the single parents who were never married, families hit by divorce and death of a spouse, catastrophic illness, and those who have had too many children. I can understand the rationale for the policies and the signal that we must send that we strongly encourage traditional nuclear families who make responsible decisions to bring a child into the world, either to look after the child themselves or put them up for adoption by responsible people. But, Sir, I would like to speak up for the children of such families. They did not ask to be born to such a family. When the family is without proper shelter, food or school fees, it is the children who suffer hunger and malnutrition, obesity and sedentary lifestyle because the parents have no time to take them out. It is the children who suffer physical and emotional abuse when parents divorce or go their separate ways. I believe we must find a way to deal with their problems separately from those of their parents. I believe we must acknowledge, deal with and prevent child abuse that tends to arise in such situations. And I thank Mr Hawazi for his assurance that children who have dropped out of school because of poverty must be able to find a way back into the system. I hope that the Minister will continue to share with us how the new ComCare scheme would be able to meet the needs of our poor and needy.”
“Sir, this Budget has brought much good news for the poor and the underprivileged in Singapore. In particular, I am very heartened to hear about the ComCare Fund that the Prime Minister has announced. Like Mr Sin Boon Ann, I would like to ask how exactly is this fund going to work in its three components of ComCare self-reliance, ComCare grow and ComCare enable. How can we approve the delivery of services to the poor under these new frameworks? How will the role of VWOs be, especially for things like family service centres? Will they be adequately funded in the light of new stresses on the system with more people out of work? How can we address the problems of children of poor families and how can we still continue to encourage self-reliance? Sir, the poor are not the homogeneous group. One might say there are three groups: those who generally cannot get a job because of infirmity or lack of skills; those who will not accept a job because they deem that the jobs on offer are below their skills and experience level and not worth their while in salary; and those who have gotten a job, no matter how menial or poorly paid because they recognise that something is better than nothing. I hope that the Minister will adjust our policy of assistance to the needy to favour those who have already taken on a job, even if it does not pay enough to meet their current needs as they are proven by their actions, that is, taking on a job that they are prepared to help themselves. I also want to say that for this group, we should particularly look after their children to make sure that their children's education is not compromised because the father's or the mother's salary is insufficient.”
“Sir, Singapore seems to have a multitude of agencies and institutes loosely connected with our Armed Forces, such as Singapore Technologies' group of companies, our local defence industries, Defence Science and Technology Agency and Defence Medical Research Institute (DMRI). How do these agencies contribute to our total defence effort? Are they just doing basic research? Could the resources that they consume be better used to buy proven off-the-shelf hardware in the international market? In the case of DMRI, how has the Institute contributed to the effort on combating SARS, bird flu or bio-terrorism? Are we better able to combat dengue and malaria in our population because DMRI exists? Sir, the Asian body frame is smaller than its western counterpart. The diseases and environment we face in Singapore are also different. Can DMRI help make lives easier for our soldiers by helping to design equipment more suited to our people? How can we leverage on the technological advantages that these agencies might be able to provide to overcome our disadvantages as a small densely populated island nation? Are we able, as Mr Ravindran has said, to spin off some of the knowledge from these defence-related research bodies into commercial applications so that our economy can also benefit? I hope the Minister can enlighten us.”
“Sir, I seek the Minister's clarification and assurance that the training, postings, risks and opportunities for the rich and famous are the same as those for everybody else. Thank you for your indulgence, Sir.”
“Yet, perhaps, our citizens would like to be reassured that the SAF of today is serious about training, but also takes good care of its citizen soldiers by modern methods of risk management and risk mitigation, so that training is both realistic and as safe as it can be, given the nature of the tasks at hand. Another topic that somehow refuses to go away is also the doubts that still exist in the minds of some Singaporeans regarding the treatment of soldiers classified as being "White Horse". Sir, Singaporeans are so used to the fact that in Singapore you do your National Service, whether or not you are the son of the rich and powerful, that we often do not realise that our egalitarian system is not that common around the world. In this respect, perhaps we are more akin to maybe the British tradition where the sons of the royal houses have taken great pride in doing their share in the armed services.”
“Sir, the SAF has come up with an excellent booklet called "Defining Moments". In this book, which is a collection of essays from one of the previous year's Chief of Army's essay competitions, servicemen, both NS and regular from the rank-and-file up to General Staff level, related incidents and encounters during their time as citizen soldiers that have shaped their lives and beliefs, and their ideas of what it means to be a leader and what it means to be a Singaporean. It is an excellent book. It actually contains very inspiring accounts by people who had chased robbers, even a PES-E serviceman clerk, commandos and so on. And it underlines what the Minister has just told the House earlier that, at the end of the day, it is the soldier on the ground that makes the difference. This confirms what I have always held dear, that the NS experience is really very, very important in terms of our nation-building. However, I think we also do have another group of memorable moments that some of our soldiers would rather forget, although some actually do wear these moments with pride. This refers to the recent case of deaths during unauthorised training. After those reports came out in the newspapers, some other NSmen recounted to me that they too had either experienced or witnessed instances of unauthorised training methods and punishments. These just never made the news. I was glad that many of these incidents were recounted as being of the distant past, and I was very happy that there were no recent incidents recounted.”
“How could we best deploy our NS cohorts and train them to be able to effectively meet these new challenges while maintaining our competencies in conventional warfare? Have we trained our men to deal with the media war? How do we deal with the NGOs, observers and aid agencies who are often on the ground in the arena of conflict?”
“Sir, the nature of armed conflicts seems to be changing. As we have seen in Iraq, Afghanistan, and more regional conflicts, small numbers of well-armed individuals seem to be able to disrupt vastly better equipped forces in what has often been called asymmetric warfare. Also, the armed forces is sometimes not only called upon to wage war but is also sometimes an instrument of peace and assistance, as many Members have talked about in the recent tsunami disaster. Even as we move into an era of low-intensity conflict and a blurring of distinction between civilians, combatants and terrorists, the conventional armed forces which rely on massing firepower and men on the ground, against fixed defended enemy positions and well-defined targets, may well find itself unable to cope with more fluid situations, where the enemy is not necessarily wearing a different uniform and occupying a different hill. As we have seen, images on a TV screen could be powerful shapers of public opinion, and allegation of ill-treatment of civilians and captured enemies could distort perception of who exactly is the aggressor and who is the aggrieved party. Nevertheless, conventional forces are still needed as the country would still require a visible, credible and well-equipped armed forces to deter conventional aggressors. Would we have enough people and resources to man both our conventional forces and the specialised units needed to deal with these unconventional threats? What is the SAF doing to evolve itself into an armed forces capable of dealing with these threats in a more effective way, in a time of limited resources and limitation on manpower?”
“We also heard how the Singapore International Foundation, SAF, Red Cross and other Singapore-based charities gained valuable goodwill for Singapore during the recent tsunami crisis. Singapore has never stinted in helping others whenever possible, given our limited resources. We have also become much more aware of our neighbours as a result of these efforts. How does MFA plan to build upon this groundswell of popular interest and goodwill to bring about better relations between Singapore and our neighbours?”
“Sir, I thank the Minister for actually having answered many of the questions about ASEAN and the worth of our participation in international organisations which I was going to ask. Certainly, Sir, it was a very proud day for Singapore when our flag was flown at the United Nations for the first time. But it has been many years now and Singapore does spend money and subscriptions to the UN, contributions to the Commonwealth, APEC and many such organisations. While we have heard the exposition of how these organisations help us in this Chamber today, I think many in the community might still find it a little abstruse and wonder just how some of these organisations can help us. Is the Commonwealth, for example, still relevant to us? Does it actually help in our relations with, say, Malaysia, Australia and New Zealand, which are Commonwealth countries in the region? How much of a say do we have, as a small country, in these large fora? Sir, the UN comprises a lot of other organisations within the larger whole, like WHO, UNHCR, UNICEF. The Minister has just spoken about UNESCO and Interpol. How do these organisations fit in and how do they help us maintain our space in this world? I am reminded of the way that, say, Taiwan always wants to go and join these international organisations. Obviously, they think it is very important. How does our membership in these organisations help Singapore? For example, how are we faring in terms of our interests in air traffic control, communications, our place in international law, global warming and air traffic growth? Will these areas benefit from our participation in these international organisations and regional groupings?”
“If we are to have a low direct taxation regime and yet keep up spending on welfare, education, defence and infrastructure, that money has to come from somewhere, either in GST or in the sin taxes. Given the propensity for Singaporeans so inclined to seek out opportunities to gamble, I feel that we need to give the proponents of an integrated resort a fair hearing, at least, before dismissing the idea out of hand. I would, in fact, ask if an upward integrated resort will be able to pull in those who may still feel more comfort in the anonymity and local flavour of existing casinos in neighbouring lands, whether legal or otherwise. In fact, many seem to have the opinion that the Government has already decided on the outcome of the discussions regarding the casino proposals. In fact, I think this consultative exercise allows Singaporeans of all stripes a chance to stand up for their views and allows the Government to engage its citizens in a major policy decision and gauge public opinion. At the end of the day, however, the Government must make a decision based on what is best for the majority. If opinion is divided, 90:10 or 80:20, I believe few governments will not take heed of the clear majority. But what if public opinion is really divided, 20:60:20 or 30:40:30? Should the vocal minority have precedence over the undecided or non-vocal majority? In such an instance, the Government must balance the risk, estimate the true level of popular dissent or support and make the call. What is important is that the Government has raised the issue for public debate. The public has made its viewpoints heard and the democratic process has been preserved. Sir, I support the motion.”
“In this way, we would be better able to direct the money currently spent on utilities rebates towards those who are in greatest need - those who are literally living in the dark and the dirt. Is this method expensive? Perhaps. Does it make commercial sense to spend money on serving customers who already owe you money? Not if you are a purely commercial company, with not a shred of social conscience. But if you are a company with a local board of directors and local roots, then, perhaps, we should look harder to try and find the solution that fulfils a triple bottomline - financial, environmental and social. Please, Power Supply, as a Government-linked company, with a duty not only to its shareholders, as has been said, but its stakeholders - the people of Singapore - do not undermine PM's efforts to create a more caring Singapore with the current method of doing things. Sir, as a country, we took on the challenge of SARS and came up with solutions very quickly. Perhaps we can also address some of these problems equally quickly. We did not present the people of Meulaboh with a price list before we extended our help. Those people were clearly not in the position to pay up. I think there are some Singaporeans who are in the same boat. Finally, Sir, many MPs have been approached regarding the stand on the casino proposal. Much has already been said. I just feel that we cannot have our cake and eat it. The Government derives much money from taxes on horse-racing, alcohol and tobacco. Well, many of our citizens will patronise the numerous casinos in neighbouring lands that offer free food and drinks, transport and accommodation in return for their custom. In fact, some of these are where it was leaked, if gaming revolution comes back to Singapore.”