Yeo Cheow Tong
Singapore
“Mdm Ho Geok Choo asked the Minister for Health in light of the recent report on fungal corneal infections (a) whether those who contracted the contact lens related fungal corneal infections will suffer permanent damage to their eyes; and (b) how long will his Ministry take to conclude its investigations into the causes of these contact le…”
“My Ministry performs a regulatory role and what we do is that we try to ensure that we have a conducive regulatory environment for the growth of this industry in Singapore. Let me tell him what we are doing in some areas.”
“Sir, on her two questions, whether we are satisfied that the school buses are collecting fares during the school holidays, as I mentioned just now, the school bus service is a contractual service between the parents and the service provider. It is therefore up to them to work out the terms and to abide by the terms.”
“Sir, on the first question, whether there is any abuse by owners of buses while using the 50% rebate, the answer is no, because LTA monitors very closely.”
“Sir, I have to repeat my answer. We are not responsible for regulating school buses and therefore will not be involved. SCHOOL BUSES (Installation of seat belts) 5. Assoc. Prof.”
“Ong Soh Khim asked the Minister for Community Development, Youth and Sports (a) if his Ministry will increase the cap of $10,000 per disabled person over their lifetime for the Assistive Technology Fund scheme; and (b) if not, whether there will be a flexibility to adjust the funding cap for this scheme based on the applicant's need, as j…”
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“That means we expect to triple the demand because of the aggressive marketing in the last 1-2 years. We expect to further increase that to at least 120,000 cubic metres by the year 2003. That means within a period of about five years, we expect the use of industrial water to quadruple. We are now extending the existing industrial water supply network to the areas where the customers are and we are also expanding the production capacity to keep pace with the demand. Sir, in terms of supplying to domestic households, this has also been tried out in the past. We supplied industrial water to the HDB flats in Pandan and Teban Gardens for toilet flushing. Unfortunately, the experience was not very good. We found that the pipes were getting corroded. The toilet bowls were getting stained. Not only that, there was a lot of unpleasant smell throughout the day. I think the residents could not take it after a while, and we had to discontinue the scheme. The option that we are now exploring is whether it is possible to produce better quality industrial water for toilet flushing. If we can do that, then a lot of these problems that were encountered in the past can be overcome. Sir, we are also looking at recycling grey water from baths and showers for toilet flushing, washing of corridors, bin centres and rubbish chutes. The question that we are coping with is, first, whether this is technically feasible. Can we collect all the waste water from the baths, showers, wash basins for such use? Secondly, whether the system is still going to be cheaper than the cost of desalinating water. Because that is the marginal cost of water for us in the future. If it is feasible, then we should proceed with it.”
“Sir, in line with the need to upgrade their skills, I have asked my Ministry earlier this year, after I visited some of the field officers, to see how we can introduce programmes that can help upgrade the skills level of the DREs. I understand that now we do have some courses, eg, English courses, WISE programme and so on. How do we promote these courses which are available? How do we get more of the DREs to take advantage of the courses that are available? In this respect, we need to work more closely with the union to not only just publicise the schemes, but to encourage the union members to come forward to enrol themselves and to make the time available so as to take advantage of the schemes that are available. We also have to prepare the DREs for the future, because with labour shortage, we must mechanise wherever possible. We will have to train them ahead of the needs and, here again, I would like to request Mr Sinnakaruppan to give union support to this skills upgrading programme that we are looking into. Sir, as he has mentioned, my Ministry and PSD are now negotiating a new collective agreement with the union. There are many points and details to settle, and I would urge the negotiators on both sides to arrive at an outcome that will be satisfactory to all. Sir, Prof. Low Seow Chay talked about recycling water from our sewage plants, ie, making better use of effluent water. We are currently supplying industrial water to factories in Jurong and Tuas, and this has been done since 1966. The current demand is about 30,000 cubic metres, which is far short of what we are capable of producing. My officers have been aggressively marketing industrial water to companies and we expect that the demand will increase to 100,000 cubic metres by the year 1999.”
“Sir, first, let me respond to Mr Sinnakaruppan. He has asked us not to take the work of the DREs for granted, to see how we can help them to level up, and to make sure that they are being paid properly. Let me state that we do recognise that the DREs are doing a very essential job, and that both the Government and the public do appreciate them. I am also very glad that NTUC has designated this year as the Environmental Workers' Year. Sir, most DREs are in low-skilled, low-paying jobs, such as road sweeping, litter picking, but not all. Some of them are in higher-skilled jobs and they are earning over $1,500 a month. The key thing is that the DREs are being paid a salary that is commensurate with the job, and that the salaries are comparable to that paid to similar workers in the private sector. The civil service has a policy of ensuring that its salaries are competitive and in line with what the market is paying. The key to the DREs is, as what has been pointed out by Mr Sinnakaruppan, to help them upgrade their skills, and this really is no different from workers in other sectors of Singapore. Our policy is skills upgrading, whether they are in the industrial sector, retail sector or in the public sector. With higher skills, they can then move on to higher paying jobs and, therefore, earn more. Sir, my Ministry has been introducing mechanisation in the public cleansing operations. For example, now the highways, the major roads, are swept not manually but by lorries specially equipped to do mechanised road sweeping. We will look into how to mechanise more activities. And since Mr Sinnakaruppan has offered his services, I will ask my officers to make sure they make full use of his services.”
“This is mainly because of the habit of littering by our residents. This is a very selfish behaviour. I would like to ask the Minister what are his comments on the cleanliness of Singaporeans and what plan does the Ministry of the Environment have to promote public education on environmental cleanliness. I think we should use the carrot and stick method. Apart from rewarding the people for having the cleanest block, we should also appoint a cleanliness envoy to reward model citizens who are very clean and environmentally conscious. We should also consider how we could go a step further to punish the litter bugs and consider whether our present measures are effective enough. Some people feel that our Corrective Work Order has not achieved its objective. We must think of new measures to punish our litter bugs such as publishing their names in the newspapers over and above the corrective work order so that they would have a sense of guilt in them. Under these circumstances, I think Singapore will be much cleaner and more beautiful.”
“If he wants to buy, then he pays whatever cash he has and he should borrow the remaining sum from a financial institution. Even if he borrows the full sum, the installments are still lower than a stallholder next door who may have tendered for the stall earlier on. If he feels that it is still not worth taking the risk, he can continue to stay on and pay the rentals which will gradually increase over five years. Or if he still does not want to run that risk, he can, of course, request for a subsidised stall at another hawker centre elsewhere. There are many options available for him. If he feels uncomfortable, he is not compelled to rush in to buy the stall. Mr Choo Wee Khiang (Jalan Besar)( In Mandarin): Sir, Singapore wants to become a gracious society, an advanced country and a mature society. To do all this, we must have citizens with a sense of responsibility as in the West. In Switzerland, their citizens do not need fines or corrective work orders to be environmentally conscious. They are very "clean and green". For Singaporeans, to attain a high sense of responsibility like the western countries, it will take quite a long time. But if the Government and the people work together, I think we will be able to reach that standard much sooner. So I feel that the Ministry of the Environment should strongly promote environmental cleanliness to stress the responsibility of the citizens and give them a sense of mission. This public education will ensure that our people will be very conscious about environmental cleanliness and to treat it as a habit and an ethos in our society. But when we look at Singapore during the weekends, especially in the HDB estates, we can see that in the void decks, and the hawker centres, there is a lot of rubbish and litter around.”
“I am sorry. I did not quite catch him. I thought he meant that if a stallholder has $50,000 cash, is he proposing to let them pay $50,000 first?”
“Sir, if the price of the stall is, let us say, $120,000, as stated by Mr Peh, and the stallholder has $50,000 cash, he can still pay the $50,000 cash and get the remaining $70,000 as a loan from a finance company. His instalment every month would still be very low. And when he sells, he can pay back whatever outstanding balance there is from the proceeds of the sale of the stall. Mr Peh Chin Hua( In Mandarin): According to my feedback from the hawkers, some of them are not able to pay $50,000 in cash. It is because they do not have the cash to buy the stall. If they need to pay $50,000, and they borrow the amount from a financial institution, their monthly instalment is only $300-odd dollars. In the event of a resale, they can pay the remaining $70,000 back to the Hawkers Department. However, they do not even have the $50,000 cash upfront, and I know many do not have.”
“As I said, in Singapore, because the majority of us are in highrise buildings, it is not feasible. The link between what you generate and what you pay is not there and the number of people living in landed property is actually a small percentage of the Singapore households. Mr Peh Chin Hua( In Mandarin): Sir, I would like to clarify one point. I understand that in the past, it was easy for hawkers to sell their food stalls in the resale market. But this year the resale of stalls is very difficult. So in the case of the sale of a hawker's stall at, say, $120,000, is it possible for the Minister for the Environment to collect $50,000 first, and allow the hawkers to pay the remaining $70,000 within the next five years or when the stall is resold? This will give them time to make the necessary adjustment.”
“Sir, this is a system that has been introduced in some of the developed countries. But in those countries the domestic residential make-up is quite different from Singapore. Many of the domestic households are in landed properties. You can identify exactly who is generating how much waste. In Singapore, the vast majority of Singaporeans live in highrise flats. It is very difficult to charge according to what each household is generating. But as Mr Chew has pointed out just now, one possibility is to charge by precinct, that means by a whole precinct, a group of flats together. Even then the link between what I generate and what I pay is not there. But once we privatise the system, we will be happy to leave it to the successful tenderers to decide whether they want to charge by precinct or charge on a whole zone basis.”
“There are options open for him. Mr Low Thia Khiang: Sir, may I seek a clarification from the Minister?”
“And to further assist them, we have also arranged for the financial institutions to provide loans up to 100% of the selling price. They are allowed to repay the loans over 15 years. Not only that, for stallholders who have problems, they can include up to three family members as co-owners to facilitate the financing of the stall. As a result of all these efforts, the response to the sale of stalls programme has been very good. As I mentioned just now, over 99% of the cooked food stalls were bought over. I think this shows that the selling prices were reasonable and attractive. 2.15 pm Another factor which confirms this is the resale of stalls. In our monitoring, we found that a third of the cooked food stalls have been resold. Based on the feedback from the hawkers themselves, they have told us that the profits from the resale ranged from $50,000 to $200,000. This shows that the Chief Valuer has been very conservative in his pricing. The other matter is, of course, the stallholders find the scheme attractive because all the restrictions are lifted. As a result, now the instalment payments from the stallholders are still lower than the tendered prices for rental stalls as well as the rental prices set by the food courts and coffeeshops. There is a good comparison there. He asked about those stallholders who do not wish to buy over the stall. There are several options open. One, the hawker can still stay on his present stall if he does not want to buy it. But the rentals would be gradually increased to the market rental over a period of five years. So there is a phasing-in period. He can also give up his stall and receive a cash grant if he qualifies for one. Third, he can request to be given a subsidised stall in another hawker centre that is not due to be sold yet.”
“All that we require the hawker associations to do was to provide two sets of bins - one bin for disposable crockery and another bin for hawkers that are using the non-disposable crockery, because we do not want them to get mixed up. Those hawkers who are using non-disposable crockery were not asked to change. I think many of them are still continuing. We will identify other centres that are feasible and work with the hawker associations to see whether they want to try out this concept too. Let us see whether the concept succeeds in the first two hawker centres, and we have added another two hawker centres to the scheme. If the concept succeeds at these four hawker centres, I am sure other hawker centres will also follow suit. We will leave it to the market. Mr Peh also asked about the sale of stalls. His feedback is that the hawker stalls are too expensive and the hawkers cannot afford to pay the high prices. But yet at the same time, they are afraid that if they do not buy, they also end up in trouble because rentals will go up, or they may have to leave. Sir, let me clarify that the valuation of the hawker stalls is done by the Chief Valuer. In valuing the stalls, the Chief Valuer would take into consideration certain factors, eg, the location of the hawker centre, the popularity of the hawker centre, the location of the actual stall itself and its rental potentials. The Government has been very conscious of the need to keep the selling prices affordable, and that is why we have capped the leases to 20 years, so that the selling prices will be affordable, because longer leases inevitably mean higher selling prices. In addition, we have given the stallholders a generous discount of up to 30%. Again, that has lightened their load.”
“I think it is useful for hawkers to note that they will find it increasingly difficult to employ hawker assistants in the years ahead, because of our tight labour supply. Not only that, even if they can find the hawker assistants, I think they are going to be more expensive as well. Those who are unable to hire assistants will then have to look for other options. And the possibilities would be to operate as self-service hawker stalls where customers come and collect their food themselves, and also to get the customers to clear their own crockery after they have finished eating, exactly like what happens in the fast-food restaurants. I think the challenge is to get Singaporeans to cooperate and to get them to change their mindset, that when they go to a hawker centre, the food gets delivered to them. They eat and run, leaving the table in a mess. We have to convince them that actually it is in their own interest for them to eat and clear. Because if everybody eats and clears his own dishes, then when you go to a hawker centre, you sit down, the table is clean, instead of having to wait for the table to be cleared by others. As a result of this thinking, my Ministry decided to test whether Singaporeans can be encouraged to self-clear the table after eating. We found that at Taman Serasi and Adam Road Centre, many of the hawker stalls were already using disposable crockery. We discussed with the hawker associations there and the hawker associations decided, yes, it is worth their while to give it a try. So we tried out the concept of self-clearing at these two hawker centres.”
“They are also able to sub-let the stall either half the day and operate on their own the other half, or they can even sub-let the whole stall without any problems. This has allowed them to operate the stall more optimally and because of that, it has helped to keep their costs down and enable them to retain their old prices. Sir, on the need to retain some stalls for rental, this is what we are, in fact, going to do, and a significant number of stalls will remain unsold, and these are stalls in centres which are likely to be redeveloped in the coming years. So there will still be competition from a large number of rental hawker stalls to keep our food prices reasonable and affordable. Sir, he has asked about the relocation of Newton Hawker Centre. The Newton Hawker Centre is in a very prime area. Eventually, the piece of land that the hawker centre is sitting on will be redeveloped. The timing has not been fixed yet. We will make the announcement in due course. Mr Peh Chin Hua asked the Ministry not to compel hawker stall operators to use disposable crockery. I would like to clarify that it is not the policy of my Ministry to insist or compel stallholders to use disposable crockery. We believe that this is something which is best left to the market to decide. Hawkers will have to decide whether it is cheaper to use disposable crockery, or whether it is cheaper for them to employ somebody to collect the used dishes and to wash them. We will leave it to them. The economics will work out differently for each hawker. Those with a very high turnover of sales can probably afford to use disposable crockery. Others may not wish to. But we will leave it to them.”
“Yes, my officials have been monitoring both the food prices and the standard of hygiene in the 12 hawker centres that have been sold. In terms of prices, less than 30% of the cooked food stallholders increased their prices. And even then, we found that the increase was quite marginal, and the final price actually was comparable to the prices in centres that were not sold. That means they just adjusted the prices to be level with their other competitors. In terms of hygiene, we have also been monitoring, and I am happy to say that, in fact, the stallholders in the sold stalls, because they now own their stalls, are likely to be also more conscious about the need to maintain their reputation and image. So they have been maintaining the hygiene as well. In terms of food prices, contrary to some fears, the food prices have remained competitive for several reasons, despite the fact that the instalments now are much higher than what they were paying as subsidised rentals before. The main reason is that they are now able to make more efficient use of the stalls. Previously, when they were renting the stalls at subsidised rates, the stallholders were actually subjected to a lot of restrictions. For example, they cannot sub-let the stalls. Not only that, they had to be personally present at the stall during operating hours. This means that most hawkers either operate in the morning and afternoon, and they go home and rest from late evening onwards and they do not open at night. They open for lunch and dinner, but they do not open for breakfast. It is physically not possible for them to be at the stall for 24 hours. As stall owners know, these restrictions no longer apply. They can operate longer hours by employing staff to operate for them when they are at home resting.”
“Yes, I note that he also raised it last year. And that is why in the recent announcement of the new schedule of fee revisions, we only revised the water borne fee, which is volume related, and this ties in with our efforts to promote water conservation. The more you use, the more waste you are going to generate, the more you have to pay also. I agree with him that the sanitary appliance fee should be abolished, because it was introduced a long time ago when it was valid. Today, it no longer ties in with our philosophy. But the difficulty is that the sanitary appliance fee now is a major component of our total waste water fees. Reducing the sanitary appliance fee will require us to adjust the water borne fees very significantly to make up for the loss of this component. By the year 2000, when the recent schedule of fee revisions has been fully implemented, the sanitary appliance fee will then form only about a quarter of the total waste water fees. This will allow my Ministry to gradually reduce the sanitary appliance fee in subsequent revisions after that. After the year 2000, we will definitely be taking steps to reduce the sanitary appliance fee. Mr Kenneth Chen asked about the privatisation scheme or sale of hawker stall scheme and whether we are monitoring on the standard of hygiene and prices, and asked that we should retain some of the rental stalls throughout the island. Since June 1994, we have offered 1,749 stalls in 12 hawker centres for sale to the sitting stallholders. The acceptance rate for the cooked food stalls was very, very good. 99.76% accepted the offer. And for market produce stalls, the acceptance rate was 89.1%. We are selling the fourth batch of stalls soon. Sir, he asked whether we have been monitoring.”
“This is something that we have also been doing, because it is not only good in terms of reducing household waste, but I think it is also good for the companies. When they use less packaging materials, it also results in cost savings for them. So this is something that we can work together with them and we will continue to encourage them to do so. Let me now move on to Mr Chew Heng Ching on the question of introducing competition on the domestic refuse collection scheme. I agree with him that it is the Government's philosophy that we introduce competition wherever possible, because competition tends to promote more innovative thinking, more productive schemes and methods and, therefore, result in lower costs, which eventually will also benefit the consumers. This was indeed the reason why we corporatised the ENV's refuse collection unit last year. The target is to introduce competition into the domestic refuse collection system in April 1999. To meet this deadline, my Ministry will be calling for tenders for the first domestic refuse collection zone in the second quarter of next year. This is to give the successful companies enough lead time to acquire the equipment, because the domestic refuse collection system requires a lot of very expensive equipment, and the zones are going to be quite big. So the successful company will have to invest in quite a fair bit of equipment. We are now working out the details of the tender and it will, of course, contain stipulations that will avoid the possibility of the successful companies defaulting on their contract subsequently. I would encourage companies that are interested, including Mr Chew's, to get ready for the tender, because there are only about 6-9 months more to go. Dr Wang Kai Yuen spoke on the sanitary appliance fee.”
“Sir, Mr Low proposes that the Ministry of the Environment do more to encourage households to recycle or reduce their waste as well as to encourage companies to reduce the amount of materials used in the packaging because, in terms of household waste, this constitutes quite a fair bit. Sir, the household waste, as Mr Low pointed out, actually comprises a wide range of materials, food waste, packaging materials made from different materials and waste paper, the bulk of which is actually old newspapers. This makes recycling of household refuse a little bit difficult. The exception is waste paper and here, we have a very well-established system. As Mr Low has pointed out, this karang guni man goes round from flat to flat to collect old newspapers. In the old days, the farmers also used to collect our food waste to feed the pigs. Unfortunately, we do not have farmers any more. So the food waste is now also thrown together with the other household waste. We have been working with various town councils to implement recycling projects in the public housing estates. Town councils encourage their residents to bring their newspapers and old magazines down to the collection points so that they can be brought for recycling. It is not very successful because few residents could be bothered. What the town councils found was that, quite often, the collection bins also have other things thrown in as well. So we still have to rely on the karang guni man. Nonetheless, my Ministry will continue to explore other recycling options and we will contact the town councils as and when these alternatives are worked out. 2.00 pm The other thing that we are working on, as suggested by Mr Low, is to work with companies to encourage them to use less packaging materials.”
“The concept recognises that manufacturing processes that are environmentally sound benefit not just the environment but also the companies involved. This is because processes that generate a lot of waste end up polluting the environment in the first place and, second, the waste comes from resources that the company has to put in. Therefore, it costs the company money to provide that raw material and to clean up the waste. It is thus beneficial for both companies and the environment to adopt sustainable development systems. The Government recognises that in time ISO 14000 will definitely become an important international standard. Not only that, as pointed out by Mr Heng, environmentally conscious consumers in some developed countries may insist on buying only goods that comply with ISO 14000. Sir, we are now working with the private sector to promote ISO 14000. There is a committee now led by the Singapore Confederation of Industries together with public sector representation that is actively encouraging local companies to adopt these standards. In support of ISO 14000, the Government has already made available several financial assistance schemes. For example, we now have financial grants for local companies to engage consultants to help them attain certification. We also have a special group assistance scheme to help small and medium-sized enterprises obtain ISO 14000 certification at a lower cost. I am sure all these efforts will help to increase the number of companies that are able to comply with ISO 14000 requirements in the years to come. Let me move on to the points brought up by Mr Low Thia Khiang.”
“We also have a standing arrangement with the schools to visit my Ministry to view our exhibits on the environment, watch environmental videos and learn the importance of protecting our environment. We also organise visits for school children to refuse incineration plants, sewerage treatment works and other facilities. Last year, more than 300 such visits were organised. And many schools today also have environmental clubs where students come together to take part in activities like promoting waste recycling, adopting beaches for annual clean ups, etc. Sir, on his suggestion to provide fiscal incentives to promote environmentally friendly practices, this is being done now on a selective basis. For example, tax incentives to promote the use of more water and energy efficient industrial processes. What Mr Heng has suggested is giving incentives to the individuals. We will definitely explore the feasibility of this, including all the suggestions that have been made by Mr Heng this morning. However, while we want to protect the environment, we should also be careful to support the use of technology or equipment which is economically viable. Otherwise, we would be subsidising waste inefficiency, and in fact be counter productive in terms of protecting the environment. Also, if these practices apply to the economic sector, this would then lead to wastage and undermine our long-term competitiveness. Sir, we will continue to find ways to strengthen the public education programme and we look forward to the support of the entire community for our collective efforts to make Singapore truly clean and green. Sir, on the environmental management and production techniques, I agree with Mr Heng that the concept of sustainable development is more than just a passing fad.”
“Sir, we will therefore continue to work at it. With regard to the Science Park analogy, the Science Park is actually open to the entire industrial sector. I think some of the environmental technology companies will find it useful to base their operations in the Science Park because they can then have synergistic tie-ups with other scientifically based companies that are located there. So we will also continue to encourage those that are interested to locate in the Science Park and I think over time the core will grow and the sector will also strengthen. Mr Heng brought up the example of the financial sector. Sir, the Asian dollar market was started in 1968. It took many years for it to be established, as Mr Heng well knows. I am sure, with the support that the Government is giving to the ET industry, that it too, over time, will continue to strengthen and become a significant player in the Singapore industrial field. Sir, on educating the public on environmental awareness and protection, I agree with Mr Heng too that it is important to start the education programme while Singaporeans are young because once you get that concept, the mindset of the need to protect the environment well entrenched in their thinking, as adults, that same habit will carry through. And this is exactly what the Ministry of the Environment has been doing. We have worked with the Ministry of Education and now the environmental topics are included in many topics, for example, in the syllabus of social science, general science, biology and geography, and these topics are taught in both the primary and secondary school levels.”
“We also have a lot of local companies but these are mainly made up of training companies as well as a number of local companies with project management expertise and a few engineering firms. With respect to that, I agree with Mr Heng that we still need to add depth to our environmental technology industry. We need to help strengthen the industry and we need to build up a comprehensive range of core expertise that will enable the companies to actively go into the region, bid for projects and take advantage of the increasing consciousness about the need to protect the environment in the region. Some of the efforts which my Ministry is taking with MTI and its agencies are, firstly, to attract more foreign consultants and environmental engineering companies to base their operations in Singapore and to use Singapore as their regional base. Secondly, to encourage our local companies, especially those with engineering capabilities, to tie up with renowned foreign consulting and engineering companies. Thirdly, to encourage companies to set up pilot plants in Singapore using new environmental technology. Sir, tying up with well-known foreign companies is useful because there are mutual benefits. If the Singapore companies have the regional links and contacts, it will make it easier for foreign companies which are not used to the region to obtain business. My Ministry will also continue to concentrate on the promotion and endorsement of major ET trade exhibitions. In the last two years, we endorsed eight major trade exhibitions and conferences. We will also host regional seminars and workshops as well as run training programmes. In the last three years, my Ministry conducted some 50 training programmes and hosted 10 regional environmental seminars.”
“Sir, I would like to thank all Members who have spoken on the first cut this afternoon. Sir, with regard to Mr Heng Chiang Meng's first cut, I agree with him totally that there is tremendous potential for Singapore to develop into a regional centre for environmental technology. Last year, Dr Tan Cheng Bock had brought up this topic too and, contrary to Mr Heng Chiang Meng's and Dr Tan Cheng Bock's perception, actually the Government has been doing quite a fair bit on this area. Let me explain. First, the EDB, TDB, the Productivity and Standards Board and the National Science and Technology Board (NSTB) have been actively involved in promoting the development of the environmental technology (ET) industry. Some of the major steps that have been taken so far are, first, the NSTB has set up the Environmental Technology Institute (ETI) last year. The ETI costs an initial sum of $30 million and its role is to help enhance R&D capabilities of the ET industry. It also allows the industry to develop a high level of skills and expertise which is important because this is an industry that is highly technical and technology intensive. The Government has also made available fiscal incentives, tax incentives, grants as well as low-cost financing schemes to enable the companies in this industry to either set up in Singapore or to expand as well as to venture into niche ET sectors. They can also use the grants to upgrade their manpower capabilities as well as to embark on R&D activities. Today, there are more than 100 ET companies in Singapore. Several branch offices of very well known international environmental technology and environmental engineering companies have employed very competent and very experienced staff in their Singapore offices for work in the region.”
“Sir, the food retailing business is a highly competitive one. There are some 20,000 stalls in hawker centres and another 12,000 stalls in eating houses and other private establishments. Competition between this large number of stalls has helped to keep food prices reasonable and affordable. Most hawkers are good businessmen and know from experience that overcharging will result in lower demand and loss of goodwill. Hawkers are required to display price tags at their stalls. Consumers can decide for themselves whether or not to patronise a particular stall. This is the best way to ensure that food prices remain reasonable and prevent any unscrupulous hawker from taking unwarranted advantage of the recent increases in water charges and public transport fares. However, we must also be fair to hawkers. As our economy continues to grow at a healthy pace, Singapore workers will continue to enjoy good annual wage increases. Hawkers, too, would like to have their earnings keep pace with that of other Singaporeans. We must therefore not begrudge them their price increases, provided these are kept reasonable. CENTRAL EXPRESSWAY (Easing of traffic congestion on roads in vicinity) 3. Mr Yeo Guat Kwang asked the Minister for Communications what plans are being made to ease the traffic congestion on roads in the vicinity of the Central Expressway which motorists use as alternative ways to their destinations so as to avoid the Electronic Road Pricing System on the main highway.”
“The suggestion by the Member is in fact being practised. Before construction work begins, the contractor is required by the Ministry of the Environment to engage a qualified pest control firm. The list of qualified firms is reviewed regularly and those that have provided unsatisfactory services will be dropped from it. PRIVATE BUSES 2. Dr Teo Ho Pin asked the Minister for Communications whether his Ministry will consider allowing private buses (especially Adult Workers Contract registered buses) to enter bus lanes outside the Central Business District areas between 4.30 pm and 7.00 pm so as to facilitate the alighting of passengers taking private buses.”
“Sir, we need to discourage this tendency of many Singaporeans using the A&E because we have finite A&E resources and A&E clinics are meant to take care of serious conditions. By clogging up A&E clinics with non-emergency cases, those non-emergency patients are actually endangering the lives of the true emergency cases because doctors, being over-worked, may not be able to give enough time and care to those who are genuine emergency cases. I have asked the hospitals to review how A&E services can be more appropriately managed. We need to discourage those patients who can be seen by GPs and polyclinics from making use of our A&E facilities. The review will include reviewing how the existing A&E fees could be revised in such a way as not to unduly penalise the genuine cases. I expect the hospitals to come out with a package within the next two months. On tobacco licensing, Mr Choo Wee Khiang is absolutely correct. The smoking rate among our youths is bad. They have gone up very significantly in the last 10-odd years. We have a ban on smoking and the sale of cigarettes to our youths. But, unfortunately, it is difficult to detect shops that are selling. The Committee on Smoking Control has also recommended that MOH license tobacco retailers and we have decided to do that. We expect to implement this in June 1998 and are now working out the details. I will ask my Senior Minister of State to reply to the other questions.”
“Sir, let me now go quickly to the question of A&E which Mr Choo Wee Khiang also spoke quite extensively on. Sir, I share his sentiments. I too am not very happy with the problems being encountered in A&E. And if you look at the situation, it will explain why. Between 1992 and 1994, A&E attendances went down slightly. This is because, in 1992, we embarked on an intensive education programme on the proper use of A&E. So Singaporeans were more aware. They realised what is the true role of A&E. In 1993, we also did something which I think contributed to the decline. We increased the fees quite significantly and made sure that A&E fees were much higher than the GP fees. So there was a cost of going to A&E instead of going to the GP. During the last two years, 1995-1996, A&E attendances went up very significantly. They went up by over 10% a year and this has led to a tremendous strain on the facilities. The hospitals have added more staff. In fact, the hospitals have, in the last two years, added 22 more doctors, which is equivalent to 25% increase in the doctor staffing and they added 15% more nurses. But, unfortunately, each time, they improved the service, it only led to an increase in demand. A review showed that a significant number of A&E patients actually had relatively minor illness, such as fever, low-grade fever, cough and cold, diarrhoea and superficial cuts. What is also telling is that 60% of all A&E attendances are between the hours of 9.00 am and 9.00 pm when GPs are available and, during the day hours, polyclinics are available too, and many of these cases could actually be seen by GPs and polyclinics.”
“In terms of day surgery procedures, during those eight years, they increased by 145%. The survey of patients' responses showed that 85% of the patients rated the services provided by the hospitals as either good or excellent. This is an improvement from the previous figures. Another area which is very evident is the missing case notes. I think Dr Tan and Dr Michael Lim would be familiar that, in the past, at the Specialist Outpatient Clinics (SOCs), it was not unusual for patients who turned up and found that their case notes were missing. In fact, in 1986, between 3% and 17% of patients ended up with missing case notes. It was a terrible position. Today, the numbers in each of the hospitals total less than 10 cases a month. Compared to the huge patient-load, this works out to about 0.01%. So it shows that the hospitals have managed to get their act together, improve the system and make sure that patients' needs are well looked after. He asked about coordinating the purchase of expensive equipment in public hospitals. At MOH level, we do monitor to make sure that the equipment purchased are not unnecessarily duplicated, leading to wastage. But basically, the decision to purchase a piece of equipment lies with the Board of each hospital and they will make sure that there is a real need for the equipment because it costs money. Secondly, they cannot get a replacement service from any other hospital. I think the situation is very much under control. On the development of sub-specialties, yes, we do coordinate that from the HQ level. Dr Tan spoke for a long time on the listing of hospitals on the stock market. Government has no plans at the moment to do any of that. The restructured hospitals will remain restructured.”
“The benefits will accrue to Singapore patients and of course regional patients can also take advantage of the services there, if they are interested. Dr Michael Lim also asked what is the role of MOH in helping the private sector expand overseas. Sir, MOH focuses mainly on looking after the health care needs of Singaporeans in Singapore. The Economic Development Board is the Government agency that helps to facilitate the regionalisation efforts of our private sector, including the health care sector. This will include investments in regional health care projects. Mr Bernard Chen asked what incentives we are giving to help the private medical sector further develop. Sir, the private sector has grown very very strongly throughout the years without any Govern ment assistance or incentives. I think they have been growing fast enough and we should not over accelerate. Dr Tan Cheng Bock asked for an update on the restructured programme. Sir, he raised so many questions that I lost count. I stopped at 20, and to reply to him, I think I need another hour. I do not have that time. So I would just very quickly summarise our experience. Basically, when we restructured the hospitals, we have four key objectives, ie, to enable them to improve efficiency and standard of service, improve productivity, control hospital costs and allow them to develop and respond quickly to changes in the marketplace and to patient needs. I am happy to say that in all these four areas, the restructured hospitals have done well. They have been able to increase the throughput significantly without having a proportionate increase in their manpower. Let me give you some figures. For specialist outpatient attendances between 1988 and 1996, the workload increased by 65%.”
“But to be a medical centre of high standards and standing, the skills, the expertise of the doctors, nurses, scientists, technologists, therapists, managers must be top-notch. And not only that, they must be able to tie them altogether into an efficient system. This we have. We are also taking steps to position ourselves for the next phase of our medical development. This involves the development of five national medical centres. The National Skin and Eye Centres are ready. We are now in the process of building the National Heart and Cancer Centres, and the Neuroscience Institute. These centres will spearhead the development of clinical service, teaching and research. The concept is that the more complex or rarer cases requiring the expensive equipment or highly specialised expertise or multi-disciplinary treatment will be centralised at these national centres. The national centres will also be open to specialists in other Government hospitals as well as those in the private sector. So there is no need for any of the restructured hospitals to be worried because they will all be part and parcel of this development programme. 4.45 pm Sir, we are also looking into the development of a medical services park in the grounds of the Singapore General Hospital. The aim is to attract entities in a comprehensive range of health care and other supporting activities to co-locate themselves in this park. This way there will be synergy derived from the resultant wide spectrum of medical facilities, expertise and activities. This will, as Mr David Lim has mentioned, definitely help to raise our standards and improve our competitiveness in the health sector.”
“Because of the time element, please let me finish the reply first. If there is more time, he can then take up his points. We recognise the weakness in the system and we are now working with the University, the various medical bodies and the hospitals to encourage this practice to be followed. We are also looking into training more general physicians so that there will be adequate general physicians to look after patients with multiple medical conditions. Sir, the challenge is therefore a real one and we will need the cooperation and understanding of both patients and doctors, and doctors in both the private and public sectors. Let me now move on to the regional medical hub which three Members have spoken on. I will go through very quickly, Sir. Yes, our medical standards in Singapore are very high. And over the years, because of this high standard, we have evolved into a regional medical centre. Doctors in the region feel comfortable referring their patients here and even patients are self-referring themselves to specialists here by consulting specialists whom they hear about through word of mouth from friends and relatives. So the question is: what are we doing to further strengthen our position? Sir, whilst we are today a regional centre, we cannot afford to be complacent, as Mr David Lim has mentioned. Countries in the region are also developing their medical expertise. In the Ministry's view, to maintain our position as a regional medical centre, we have to ensure that our medical software remains a few steps ahead of others. Why software? This is because with adequate finances, anyone can build a model hospital, and the technology and equipment can also be just as easily purchased.”
“I think it is well recognised that a person with a medical condition should first consult a generalist doctor, rather than self-referring to a specialist. Especially if he has multiple medical conditions, the generalist doctor would then be in the best position to decide whether that patient needs to see a specialist and, if so, which specialist. In some developed countries, their health insurance systems and their national health plans require patients to first consult a family practitioner or GP. In Singapore we do not do this, we do not regulate this, and many patients self-refer to specialists. This, of course, then makes it more expensive for him, especially when the GP could have looked after him and solved his medical problems. At the hospital level similarly, the general physician should be in charge of patients with multiple medical conditions. And this would mean that even if the patient had self-referred or had been referred to a specialist or a sub-specialist, and the sub-specialist found that he had multiple problems, the sub-specialist should actually make it a point to refer him to a general physician in the hospital, rather than to send him to a whole series of specialists. Dr Michael Lim Chun Leng rose ---”
“The costs of furniture and equipment (F&E) are part of the hospital's operating cost, just are the salaries of nurses and doctors. In the case of furniture and equipment, they make up 5% of total recurrent cost. But while we account fully for the F&E cost, most patients do not bear the full amount of the cost. This is because patients in B1 get a subsidy of 20%. Those in B2 get 65% subsidy and those in class C get 80% subsidy. That means the Government bears 80% of the costs of the furniture and equipment for the class C patients. So much of what Mr Goh is asking for, I think, is already being provided by the Government. Dr Michael Lim talked about medical specialisation, that increasing specialisation may actually lead to increased cost and he also commented about the practice conventions in SGH. Sir, as medical science and technology continue to develop rapidly, I think it is inevitable for doctors to specialise and sub-specialise even more. I think Dr Michael Lim will fully appreciate that, being a specialist himself. The question is: how do we ensure that patients get the best care possible at the best value? He is correct. Specialist services, if used indiscriminately, will lead to an increase in health care cost. So how do you balance the two? Sir, rather than just focus on SGH, I think the problem is not just SGH's alone, the problem exists in all the hospitals, whether they are private or public. In fact, I have heard many horror stories of patients going to the private sector who were given a go-around and ended up, instead of seeing one specialist, seeing four or five specialists. So the problem is equally prevalent in the private sector. And it is not just restricted to the specialist area. It also applies to the whole medical service.”
“Every year, the Singapore Medical Council receives between 40 and 60 complaints. I think the range is reasonable and the numbers are not too bad, considering that we have about 4,700 doctors in Singapore. In every profession, there will be a few black sheep. Sir, we have been focusing on ensuring that our doctors are competent and capable. However, it is equally important for doctors to maintain and uphold professional conduct to ensure that patients are given the appropriate care and treatment. Consequently, the teaching of medical ethics forms an important part of the medical curriculum. In recent years, the SMC has also introduced a physician's pledge to increase the awareness and commitment of doctors to the vocation. We will also be introducing lay representation in the disciplinary and complaints committees, as mentioned by Mr Chen. He has asked what else can we do. Sir, MOH also carries out medical audits on various procedures and treatments to identify areas which need to be improved or to deter poor medical practice. This is an important element and we are in the process of strengthening our audit capabilities. With all these, I think we should be able to maintain the professionalism in the profession, despite the many competing demands on the time of the doctors. Sir, let me move on to the next cut which is by Mr Goh Choon Kang on the impact of the cost of furniture and equipment on patients. It is prudent and sound to take into account all operating costs of providing a service. This way we will know what the true costs are, which are the areas which are out of line, which are major cost elements and how do we bring about productivity improvements and cost savings.”
“The Nanyang Polytechnic started a course in 1992 and I am happy to report that this has resulted in the increase in the number of applicants. Last year, the Diploma course managed to attract 590 applicants, Singaporeans and non-Singaporeans, compared to about 250 when we had the School of Nursing course. So it has proven to be attractive. We are strengthening our efforts to also recruit foreign nursing students, which is a better approach than trying to recruit trained nurses. Because if the students come here and study in the polytechnic, after three years, I think they will have become more acclimatised to the local demands and practices. But, nonetheless, I think we should not rule out recruitment of trained nurses from abroad. With such a significant shortage, even if they are not fully acquainted with our system, I think they can still contribute. So let us appreciate them for their contributions that they are making. At the same time, my Ministry will be looking into how to make the nursing career even more attractive and challenging. We will be carrying out a comprehensive review of the service in the next few months and we hope that arising from this study, we will be able to once again further improve on the attractiveness of the profession. Sir, let me move on to the next cut which is from Mr Bernard Chen on the professional standard of doctors. He is worried that the recent publicity of complaints to the SMC (the Singapore Medical Council) may indicate that things are not all that well in the medical profession, even though generally the standard of the medical profession in Singapore is very high. I think the point is correct that the standard of the profession in Singapore is high.”
“And the estimated shortage is about 2,200 nurses, ie, a 20% shortfall from what is required. The demand for nurses will definitely increase with an aging population and the expansion of the medical services. We must therefore find more creative and innovative approaches to solve this problem in the next few years. The problem is how to attract young school leavers to go into nursing, especially when there are so many other competing careers that are available, and that is only for the intake level. Secondly, how do we retain the trained nurses in the public sector? I know Mr Bernard Chen mentioned about nurses working in the Middle East. Yes, we know there are some. But in the context of the 9,000 nurses that we have, the proportion of nurses working abroad is actually quite small. It does add to the shortage. In terms of recruitment, we reached a peak of about 751 student nurses in 1989 and we were able to reach that peak because of the recession in the mid-eighties. Suddenly, a lot of school leavers felt that it was worth the while going into nursing. But immediately after the recessionary effects wore off, the following year 1990/1991, the intake dropped by more than half, an average of 330. 751 in one year, next year it was 330. Our target was 900 - a tremendous shortfall. But, fortunately, we have already recognised that it was going to be more difficult attracting students and we had to increasingly make the nursing profession more attractive and competitive. As a result, we were able to persuade the Ministry of Education to start a Nursing Diploma course in one of the polytechnics. Prior to that, nursing was only a certificate course in the School of Nursing. So this represents tremendous enhancement of the professional status.”
“Factoring all these changes, MOH revised the desired doctor population in the year 2010 from 6,400 to 7,100, ie, all these have led to an increase in the projected demand of about 700 doctors. To achieve this figure, we therefore work with NUS to increase the intake this year to 180 and to increase the intake to 200 for next year. 4.30 pm How about the list of recognised medical schools? Our study shows that in 1996, just from 11 medical schools, there are two Australian and nine medical schools under the University of London. These 11 schools alone took in 42 Singapore students, compared to our projected figure of 40 for the entire 28 schools. We understand that a few Singapore students applied for the remaining 17 medical schools in the US, UK and Australia. But this may change in the coming years as the parents in Singapore realise that there are other schools where the intake has been very low that they will get a better chance to be admitted to those schools. I think more Singapore parents would then encourage their children to enrol there. My Ministry will therefore continue to monitor and review the situation over the next few years before deciding on whether or not to increase the list. Sir, I will say that overall, our medical manpower in the public sector is manageable, although tight in some areas. We have steadily increased the staff strength over the years and will continue to do so, especially now that the medical student intake has been increased. What about nursing manpower, which Mr Bernard Chen asked about? Here the situation is more acute. We have a shortage, and the shortage is more significant. There are today about 9,000 nurses in both the public and private sectors.”
“So it is a lesson that we should learn well and adopt. Projecting from the 1980 census, based on the Health Review Committee's recommendation, we would have about 6,400 doctors in the year 2010, compared to about 4,700 this year. That will be an increase of about 1,700 over the next 13 years. In order to meet this projected manpower, the NUS intake was maintained at 150 and the Singapore Medical Council reviewed the list of recognised foreign universities and reduced the list to 28 schools in the expectation that they would take in a total of no more than 40 Singapore students. So 150 Singapore students in NUS plus 40 from abroad would then leave us with more than enough to achieve the desired doctor strength of 6,400 by the year 2010. Earlier this year my Ministry reviewed the doctor projections again, because several factors have changed. Unlike what Dr Michael Lim has said that it was just a short three years ago, those projections were actually done about 7-8 years ago. First, the 1990 census revealed that our population was larger than projected from the 1980 census. That means the base we are using to calculate the doctor population based on that ratio was out by a bit. Secondly, the Government's effort to attract overseas talents will speed up population growth and the revised higher projected population in the year 2010 would mean that the projected number of elderly sick in the future years would also increase. The third factor was regional demand. Because regional economic growth is expected to remain strong in the coming years, we have also revised upwards the projected regional demand for medical services. This is in line with what Mr Bernard Chen, David Lim and the rest have talked about in terms of the regional medical centre and medical hub.”
“Because it takes more than six years to train a specialist, the solution to these periodic shortages in specific areas is really to go abroad and recruit qualified specialists. This is an option that the restructured hospitals are now actively exploring. But we need to improve our internal system too. As Dr Michael Lim has said, we have to look at the conditions of service and make them more attractive. My Ministry is now working with HCS and the hospitals to do this. We are looking at a few things. Dr Michael Lim mentioned about teaching and medical research. Yes, we recognise it. Together with clinical practice, these are the three key pillars of institutional practice. We must recognise the efforts of doctors put into teaching and research, and recognise them in both monetary and non-monetary ways. So overall, we must make the public sector more attractive. But while we recognise that the public sector pay can never match the income in the private sector, our salaries should nonetheless be competitive. What about the long term manpower situation? Mr Lew Syn Pau has asked about that. So have Dr Michael Lim and Mr Bernard Chen. Let me give Members some background information. In 1991, the Health Review Committee on National Health Policies recommended that, first, Singapore should attain a doctor population ratio of 1:650 by the year 2000. As a comparison, the doctor to population ratio of the United Kingdom in 1993 was 1:650. So that places us fairly close to the United Kingdom with a few years' time lag, which is not bad. The Committee also realised that we need to control doctor manpower because the experience of all the developed countries has shown that an excessive supply of doctors only leads to escalation of health care expenditures.”
“Late last year, the Ministry sent a career counselling and recruitment team to Australia and UK and they managed to recruit 46 housemen and medical officers for this year. So this will help boost up our medical officers' strength. What was also encouraging is that the students, after attending the talks, felt encouraged and many of them said that they would definitely be coming back to Singapore to practise after their graduation. For the coming years, we should be able to rectify the situation. What about the second area, the specialists? The perception has been that the resignation rate of specialists, which means Registrars and above, is extremely high from the restructured hospitals. This perception is true for 1995. We had a total of 78 specialists who resigned from the restructured hospitals. This represents about 8% of the total pool of specialists that we have. I asked whether there was any significant factor that led to this resignation. My staff tells me that in 1995 Gleneagles Hospital made available new clinic space and that led to the departure of many of the specialists. In 1994 and 1996, the resignation rates were more manageable, about 5%, compared to the training rate of 7-8% of each cohort. I think there is a balance. For this year up to July, the resignation rate has been 2�%, which is again lower than the comparable period in 1996. Sir, there is a good match between the resignations and the supply in most specialties in the public sector. This is because we have a fairly well-managed and well-planned training pipeline. But shortages do occur from time to time when a particular specialist area experiences more resignations. The areas now that are facing a shortage would be anesthesia, radiology and medical oncology.”
“First, we provided for better and faster career progression. In the past, for the full five years, the medical officers were not eligible for any promotion. They came in on one grade, stayed there for the full five years, and it is no wonder that they complained about lack of career opportunities. We have now introduced two promotional steps into the system. All medical officers would be entitled to one promotion and the better ones would be eligible for a second promotion during these five years . We also increased the allowance for night calls. [Mr Deputy Speaker in the Chair] 4.20 pm In the past, the doctors received $40 per night call for the first four duties and then $100 per night duty after that. We increased the allowance very significantly to between $110-$130 per night call. This is quite a significant increase. As a result, a medical officer today, with five years of service, will be able to earn at least $75,000 a year compared to $60,000 a year previously. This is a 25% increase in salaries. We have also reduced the number of night calls to a maximum of six to seven a month. So the change is for the better, but this also translates into a significant increase in our requirement for medical officers. Overall, the changes have been for the better. The scheme of service is now a lot more attractive and we are optimistic that it should help reduce the resignation rate in the next couple of years. We have also taken an additional approach of going abroad to recruit. As Members know, we have many medical students studying abroad. Our estimate is that over the next five years we will have about 240 students graduating abroad and we would like them to come back.”
“They want to be told what is their medical condition. They require doctors to spend more time explaining to them and communicating with them. That, of course, translates into demand for more doctors. This applies to both medical officers and especially specialists. What are some of the measures that we have taken to relieve the medical officer shortage? The Ministry of Health relied on a survey taken by the Singapore Medical Association (SMA) in 1996 among medical officers who had joined the private sector between May 1995 and May 1996. The SMA's findings were, first, the key reason is that the differential in income from the private sector is significant. The medical officers can get between 40-50% more in the private sector. Secondly, lack of career opportunities. Thirdly, frequent night duties. Medical officers have to work at night. What happens is that they will work the normal day. If they are on night duty, they continue throughout the whole night till the next morning, and they go back to the normal day shift. This means that they actually work about 33 to 36 hours. This practice, I understand, is very common. Dr Tan Cheng Bock, I am sure, went through many of that. The same with Dr Michael Lim. We have adopted this system. In fact, in the past medical officers were required to work anything from eight to more than ten sessions a month. Quite often, I was told by the older doctors, they worked every alternate day, ie, finish the work today, work through the night, do a full-day's work the next day, finish work at 5.00 pm, go home, come back the next day and repeat this cycle. It is very tiring. I feel it is not very fair to the patients as well. Arising from the review in October 1996, the Ministry revised the scheme of service for medical officers.”
“But the shortage is in two very specific areas. The first is in the area of medical officers. The second is in certain specialties. 4.15 pm In terms of medical officers, maybe it is useful for me to explain what medical officers are, because other than the few doctors here, most of the Members are not members of the medical fraternity. All doctors are required to serve a five-year bond with the Government after completing their housemanship and they serve these five years as medical officers. The number of medical officers required in the public sector is determined by the requests submitted by the hospitals, ie, the Ministry relies on hospitals to tell us what they require, then we will recruit and make available the number that they want. We have about 880 medical officers today. Up to 1994, the public sector actually had a surplus of medical officers. In fact, from 1992 to 1994, the hospitals had to offer early release from the bonds to some of the medical officers who were serving then because they had too many. But since 1995, the hospitals have started to encounter shortage and today we have a shortage of about 90 medical officers. With 880 medical officers and a shortage of 90 medical officers it means we have a shortfall of about 10%. Why did the shortage appear and what are we doing to alleviate the shortage? Firstly, the number of resignations has gone up. Secondly, the hospitals have steadily increased their demand for medical officers for two reasons. Firstly, improved working conditions, as what Dr Michael Lim has been asking for. Secondly, expansion of some services. Thirdly, higher expectations of patients. Dr Tan Cheng Bock mentioned that just now. Yes, patients now are more educated and knowledgeable.”
“Sir, I would like to thank the 19 speakers who have spoken so far. I think I have about 50 minutes to reply to them. I will try to be brief. First, on medical manpower. This has been touched upon by three speakers, Mr Bernard Chen, Mr Lew Syn Pau and Dr Michael Lim. They have asked whether we are going to have enough medical manpower to maintain the high standard of medical care in Singapore, and asked what we are doing to alleviate the shortage in manpower that appears to be existing today. Sir, the issue of medical manpower is, of course, of great interest to many Singaporeans, because it impacts significantly on how well we are going to deliver our medical services. In particular, the decision to increase the intake of medical students into NUS, starting from this year, has also enhanced interest in this topic. Let me first explain what is the doctor manpower situation in Singapore. At the national level, 10 years ago, in 1987, we had a total of 2,940 doctors in Singapore. Today, we have 4,660. This is an increase of 59% over 10 years. The public sector has benefited, because the medical manpower in the public sector has increased from 1,420 in 1987 to 2,180 today. This is an increase of 53%. It is significant. The doctor to bed ratio in the public sector has also improved very significantly. We had one doctor to 5.7 beds in 1987. Today, we have 3.7 beds to one doctor. So doctors have more time to look after patients as well. If the numbers have gone up, if the bed to doctor ratio has improved, why then is there a shortage today? Is there a shortage and, if so, where? Let me explain the manpower situation in terms of both the short term and the long term. The short term, ie, today, there is a shortage in the public sector.”
“Sir, the tender process is open to everybody. There are two sectors of stalls available - one is the market produce stalls and the other is the cooked food stalls. We have about 70 market produce stalls and 25 cooked food stalls being tendered out every two months. So far, for the market produce stalls, the take-up rate has been about 70%. I would suggest that the hardship cases, if they are really interested in having a stall, should try to participate in the tender programme for the market produce stalls where the likelihood of their being successful would be pretty good. STAGED ACCIDENTS (Complaints) 3. Mr Chng Hee Kok asked the Minister for Home Affairs whether the Police Force has received complaints of "staged accidents".”
“Sir, vacant hawker stalls are rented out to the public through a tender system. The Ministry has no plans to change the current method of allocating stalls to the public.”
“PORT OF SINGAPORE AUTHORITY (DISSOLUTION) BILL "to provide for the dissolution of the Port of Singapore Authority and for the transfer of its property, rights and liabilities to a successor company and others, to make financial arrangements for that company and for matters connected therewith, to repeal the Port of Singapore Authority Act (Chapter 236 of the 1985 Revised Edition) and to make consequential amendments to other written laws", presented by the Minister for Communications (Mr Mah Bow Tan); read the First time; to be read a Second time on the next available sitting of Parliament, and to be printed. FINAL SUPPLEMENTARY ESTIMATES OF EXPENDITURE FOR THE FINANCIAL YEAR 1ST APRIL, 1996 TO 31ST MARCH, 1997 (Paper Cmd. 1 of 1997) Order read for consideration in Committee of Supply [Allotted Day]. [Mr Speaker in the Chair]”
“Sir, the administration of SGH does not come under my Ministry. If Dr Maurine Tsakok is aggrieved with the decision of the Hospital, I am sure she knows what to do. BILLS INTRODUCED SUPPLY BILL "to provide for the issue from the Consolidated Fund and the Development Fund of the sums necessary to meet the estimated expenditure for the financial year 1st April 1997 to 31st March 1998", recommendation of President signified; presented by the Minister for Finance (Dr Richard Hu Tsu Tau); read the First time; to be read a Second time on the next available sitting of Parliament, and to be printed. FINAL SUPPLY (FY 1996) BILL "for making final provision to meet additional expenditure for the financial year 1st April 1996 to 31st March 1997", recommendation of President signified; presented by Dr Richard Hu Tsu Tau; read the First time; to be read a Second time on the next available sitting of Parliament, and to be printed. STATUTES (MISCELLANEOUS AMENDMENTS) BILL "to amend certain statutes of the Republic of Singapore", presented by the Minister of State for Law (Assoc. Prof. Ho Peng Kee); read the First time; to be read a Second time on the next available sitting of Parliament, and to be printed.”
“Sir, like in any other private company, if they are aggrieved by the decision of the company, they can take legal action against the company.”
“Sir, SGH is a private entity. It is not part of the Civil Service. In fact, all the administrative decisions are taken by the management and the board of directors of SGH.”