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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“The waiting time at the Specialist Outpatient Clinics (SOC) in government and restructured hospitals has improved from a median of 32 minutes in 1990 to 28 minutes in 1992. The proportion of patients who waited less than 60 minutes has improved from 78% in 1990 to 84% in 1992. These improvements in waiting time were achieved despite a 22% increase in the total number of SOC attendances, from 1.35 million in 1990 to 1.65 million in 1992. All the hospitals have upgraded their appointment scheduling systems by computerising them. However, they still face problems with about 20% to 30% of patients who fail to keep their appointments. The hospitals have been regularly advising patients to inform the hospital if they cannot keep their appointments. To overcome the high defaulter rate, a certain amount of overbooking of appointments is done. As it is not possible to predict the exact number of defaulters for a particular session, sometimes patients will have to wait longer if the number of patients turning up is more than anticipated. The hospitals are monitoring the situation closely and fine-tuning the appointment system. The hospitals also face the problem of patients turning up at the SOC without appointments. Patients who do so, but who cannot be turned away for medical reasons, are attended to at the end of the clinic session. They therefore experience longer waiting times. Another factor that contributes to longer waiting times is that certain specialists like Cardiologists and Obstetricians, by the nature of their work, are more likely to be called away to attend to emergencies. The hospitals normally arrange for alternative doctors when this happens. However, the hospitals find that patients often prefer to wait for their own personal doctor.”
“Sir, the waiting time at the Specialist Outpatient Clinics (SOC) in Government and restructured hospitals has improved from a median of 32 minutes in 1990 to 28 minutes in 1992. The proportion of patients who waited less than 60 minutes has improved from 78% in 1990 to 84% in 1992. These improvements in waiting time were achieved despite a 22% increase in the total number of SOC attendances, from 1.35 million in 1990 to 1.65 million in 1992. All the hospitals have upgraded their appointment scheduling systems by computerising them. However, they still face problems with about 20% to 30% of patients who fail to keep their appointments. The hospitals have been regularly advising patients to inform the hospital if they cannot keep their appointments. To overcome the high defaulter rate, a certain amount of overbooking of appointments is done. As it is not possible to predict the exact number of defaulters for a particular session, sometimes patients will have to wait longer if the number of patients turning up is more than anticipated. The hospitals are monitoring the situation closely and are fine-tuning the appointment system. The hospitals also face the problem of patients turning up at the SOC without appointments. Patients who do so, but who cannot be turned away for medical reasons, are attended to at the end of the clinical session. They therefore wait longer. Another factor that contributes to longer waiting times is that certain specialists like cardiologists and obstetricians, by the nature of their work, are more likely to be called away to attend to emergencies. The hospitals normally arrange for alternative doctors when this happens. However, the hospitals find that the patients often --- 1.30 pm”
“The Co-operative Societies Act was last amended in 1990. It has adequate provisions for the control of co-operative societies and the safeguarding of the interest of their members. The accounts of every co-operative society are required to be audited annually by an auditor authorised by the Registrar of Co-operative Societies. The auditor is required to report any irregularity disclosed by his audit. In addition the Act provides for the Registrar to inspect the books of co-operative societies whenever necessary. Where malpractices are detected, the Registrar is empowered, among other things, to suspend the society's activities, freeze its funds, remove its management committee and take appropriate action against its officials. To ensure accountability for utilisation of funds, the Act requires members of management committees to exercise due prudence and diligence in their decisions. Failure to do so renders members of the management committee jointly and severally liable for any loss sustained. Since 1980, the Registrar has had no occasion to take action involving mismanagement or misappropriation of the funds of co-operative societies. There is no need at present to amend the Act for better control and accountability of funds. However, my Ministry will continue to monitor the affairs of co-operative societies and review the legislation should the need arise.”
“Sir, the Bukit Merah Polyclinic is conveniently located on the fourth floor of a HDB shopping complex in Bukit Merah Town Centre. It provides outpatient medical care for all age groups, maternal and child health care, home nursing and various types of screening services, including a free health screening service for the elderly. About 25% of the attendances are by patients over the age of 60 years. The Polyclinic regularly upgrades its facilities and services, and they are currently adequate to serve the needs of the population in the area. The Ministry has planned new services to cater for the aging of the population in Bukit Merah. In addition to polyclinic services, we have recently started, in conjunction with the Presbyterian Welfare Services, a subsidised pilot home help and meal service for the elderly in the area. The Ministry will also be establishing a Geriatric Centre in Alexandra Hospital at the end of this year. This Centre, which is close to Bukit Merah, will provide a comprehensive health care service for the elderly. PEDESTRIAN OVERHEAD BRIDGE IN FRONT OF CHANGKAT PRIMARY SCHOOL (Construction) 14. Mr Teo Chong Tee asked the Minister for National Development whether a pedestrian overhead bridge will be constructed in front of Changkat Primary School at Simei Street 3.”
“Sir, full-time housewives have no regular income and therefore they do not need to contribute to Medisave. In fact, none of them is contributing regularly to Medisave. PLAYGROUNDS AND PARKS IN PRIVATE RESIDENTIAL ESTATES (Plans for upgrading) The following Question stood in the name of Mr Leong Horn Kee - 7. To ask the Minister for National Development whether his Ministry has any plans to upgrade the playgrounds and parks in private residential estates.”
“Sir, as I said before, they will be treated as a family unit, not as individuals, because we consider the family income as the income supporting the family and, therefore, the husband is the key person supporting the family.”
“Sir, the Medisave scheme is meant to be a family-oriented scheme whereby the breadwinner contributes to Medisave and thereby uses Medisave to help pay for the family's overall hospital expenses. So if one housewife's husband is contributing to Medisave as well as being covered by Medishield, then that family could be eligible for greater support than another family where the husband has not contributed to Medisave or has opted out of Medishield.”
“Sir, Medifund is meant to support Singaporeans who are unable to meet their medical expenses, even though they have made their best efforts to look after their own needs by contributing to Medisave and participating in Medishield. It is not meant to relieve Singaporeans of the need to save for their medical expenses. If a person has not consistently contributed to Medisave while working, or has consciously opted out of Medishield, then when he runs into difficulties with his medical expenses, he will receive less support from Medifund. Full-time housewives do not contribute to Medisave as they have no employment income. The help they will receive from Medifund will depend on whether their husbands have participated in Medisave and Medishield. Medifund will naturally consider the case of a housewife more sympathetically if she is covered by Medishield. But Medifund cannot treat identically two housewives, both with Medishield, if one husband has contributed to Medisave while the other husband has not. The exact amount of help will depend on the circumstances of each case, and will be determined by the Medifund Committee of the hospital according to these guidelines.”
“Sir, Singaporeans who have been trained abroad will continue to be eligible for registration. They will be given conditional registration, depending on their background. MEDIFUND (Provision to full-time housewives) 6. Mr Low Thia Khiang asked the Minister for Health whether Medifund will provide the same level of support to full-time housewives who are covered by Medishield but who do not contribute to Medisave, as to those who contribute regularly to Medisave.”
“Sir, there has been a marked increase in the number of Singaporeans taking up medical studies in overseas universities and medical schools in recent years. There has also been an increase in the number of applications by non-Singaporean doctors for registration with the Singapore Medical Council to work or train in Singapore. This trend, if unchecked, will result in Singapore having an excessive number of doctors after the year 2000. This will lead to emigration, especially of specialists. Experience in the developed countries has also shown that an excess of doctors will lead to a higher health care expenditure. There are currently 176 foreign universities and medical schools whose medical degrees are recognised for registration in Singapore. My Ministry is now reviewing the Schedule in order to reduce the number to a more appropriate and manageable level. With regard to Dr Toh's second question, foreign doctors in possession of degrees in the Schedule are eligible to apply for registration with the Singapore Medical Council. However, as to whether they are granted registration will depend upon a number of factors such as whether they possess any special skills or expertise and where they intend to seek employment.”
“Sir, the Singapore Sports Council has reserved two sites in Jurong East. The first site is a three-hectare site at Jurong East Street 31 in Yuhua Constituency for a swimming pool complex and an indoor sports hall. The second site is a three-hectare site at Penjuru Road for an outdoor sports stadium. Planning for the two projects is currently under way and the facilities are scheduled for completion in 1997. PASIR RIS NEW TOWN (Primary and secondary schools) 13. Mr Charles Chong asked the Minister for Education if there are any plans to increase the number of primary and secondary schools in Pasir Ris New Town.”
“Sir, we are in the process of finalising the costings and I expect the charges to be lower than the equivalent class of wards in the acute hospitals. SINGAPORE'S RESERVES (Long-term target) 11. Mr Chia Shi Teck asked the Minister for Finance if he has a long-term target for Singapore's reserves, expressed in absolute dollar terms or in terms of the number of months of imports.”
“Sir, the hospital will remain a community hospital. It is just that it will be run as a restructured hospital, ie, it will be run as an autonomous hospital.”
“Sir, since the community hospital is a low activity hospital, the operating cost must necessarily be much lower than the acute hospitals. For the organisations which responded, the subsidies that they had requested for were, in fact, higher than the overall operating costs of the wards in the acute hospitals.”
“Sir, the building of the new Ang Mo Kio Community Hospital was completed in January this year. My Ministry is currently in the process of installing the furniture and equipment and finalising the new operational systems. We are targeting to open the hospital at the end of June 1993. Our original plan was to invite private organisations as well as Voluntary Welfare Organisations (VWOs) to help manage the hospital. However, no VWO responded, and the subsidy requested by the private organisations which responded was more than what the Government is providing to acute restructured hospitals. My Ministry has therefore decided to manage the Ang Mo Kio Community Hospital as a restructured hospital.”
“Sir, obviously, he was not listening to the figures that I quoted. We have appealed and we have got more funds. This is why the fund given out by the Singapore Sports Council to the NSAs actually quadrupled between 1987 and 1992. I think very few organisations have managed to quadruple the amount of support within a period of six years. So if his association requires more funds, I would suggest that he goes out to persuade more people to support the sport and the association financially as well.”
“The sports associations should try their best to reach out to as many supporters as possible. They should reach out to promote sports more actively and thereby get more supporters for sports.”
“There is really very little commonality between sports and the arts. The key thing to remember is that the Singapore Sports Council is a statutory board which is wholly charged with the promotion of sports in Singapore. As a statutory board, it performs very autonomously on its own and it has all the experts there who help to promote sports in Singapore. I think we also have to remember that when it comes to sports, the key factors are talent, talent, and talent. That means while the Singapore Sports Council can promote the funding, the facilities and so on, at the end of the day, whether we achieve sports excellence would depend on how much sports talent we have in Singapore. With a small population, the chances of us having world class champions are actually quite slim. Nonetheless, we will try hard and we will try to identify whatever talent we have, and see how do we build them up to be at least regional champions, if not world class champions. Mr Choo Wee Khiang has asked for more financial help for the NSAs. In the first place, donations to the national sports associations are already tax exempt. So it would be easier for the NSAs to approach sponsors for donations. In terms of actual grants being given, actually the Singapore Sports Council has already been giving quite a fair bit of support to our NSAs. For example, in 1981, the Singapore Sports Council gave out $300,000. This increased to $670,000, almost double, in 1987. For the first eleven months of last year, we gave out a total of $2.6 million, that is, we quadrupled the amount between 1987 and 1992. Sir, we will continue to see how we can make more funds available, but at the end of the day, we must always accept that it will be a limited pool of funds that are available.”
“Mr Heng Chiang Meng has asked whether the Government will consider extending more tax incentives for the staging of large scale world class events in Singapore. Sir, firstly, the promoters of large scale sports events, if they are using the facilities of the Sports Council, are already given certain concessions, in the sense that we do give them discounts on the fees charged for rental of these facilities. For the non-resident sportsmen who come here, we also do give them a concessionary tax rate of 15% in contrast to the non-residential tax rate of 27% which is imposed on professionals such as lawyers, accountants, architects and engineers, who come here on short-term assignments. So, there is already a concessionary tax rate of 15%. As to whether the Government will consider a concessionary tax rate for the sports promoters, we will have to take it up with the Ministry of Finance and I will ask my officials to see what are the incentives being given by other countries. Mr Sinnakaruppan has asked for more support for constituency sports. Sir, the SSC has been allocated nine full-time officers to support the constituency sports club (CSCs). We are now looking into how they can make better use of these nine persons. We have a pilot programme now at the Delta Sports Club where we make available the officers, plus the secretariat staff, to support seven constituency groups, that means to support the CSCs and residents living in the neighbouring seven constituencies. If this project proves successful, we will also extend it to the other constituencies and, therefore, be able to provide them with better support. With regard to sports being in the same mould as arts and culture, sports is treated differently in every country.”
“Sir, Mrs Yu-Foo has asked my Ministry to consider how to improve the working conditions and the terms of service for the Community Development Officers (CDOs). Yes, we recognise that the grassroots organisations are very important, not just the RCs and CCCs but also those that are associated with the People's Association. We have been looking into how to improve the terms of service of the CDOs. I am glad to inform the Member that we are now looking into amalgamating the CDO scheme with the People's Association. There are certain benefits in this in the sense that, firstly, if we can amalgamate them, then it will allow the CDOs to operate from the PA's community centres. As we all know, the community centres have got very good facilities. And this will also ensure that the CDOs will be able to provide assistance and support to members of the RCs and CCCs who are living within their ward or constituency, ie, close to each of the CC. It will also allow them to optimise on the use of equipment and the CDOs could also tap the staff that are available in the CC. These are good advantages and we are now looking into how to amalgamate them.”
“Sir, the Feedback Unit was set up by the Prime Minister as an additional channel of communication between the Government and the people. The Unit was never intended to have an executive or supervisory role over the work of Ministries and Government departments. Whatever feedback obtained by the Unit is channelled to the highest level of Government and brought to the notice of the Ministries and the Ministers involved. So the feedback is treated very seriously and, where necessary, Ministries will move and amend the policies. This has been reflected in many cases. Sir, the policies propounded by each Ministry are policies which are reviewed at the highest level also by the Cabinet and by the Prime Minister. It is not just officials alone who formulate policies. Therefore, I can assure the Member that every policy is considered carefully before being announced and, of course, some fine-tuning may be necessary. But this role is not a role which is meant for the Feedback Unit. The Feedback Unit has a very important function and it should continue performing this function, which is really to explain the policies and to get feedback from the public on how the policy or its implementation can by further improved, so that the Ministries can proceed to take the necessary action.”
“Yes, Sir. Unfortunately, there are quite a few questions which I have to answer. We will try to ensure that in the new estates, there are new childcare centres for them. She has also asked for the low income households to be provided with help. Again, the childcare needs of the low income group should be seen in the context of the whole family but, at the same time, there are already certain programmes available for the low income families. For example, NTUC does provide some assistance for those from low income families who require some subsidy and certain of the VWOs, who are running these childcare centres, do also provide some subsidy. So, perhaps, these organisations can do a little bit more, if necessary. Sir, with regard to workplace childcare centres, despite all our persuasion, there has only been an increase of one per year, and the reason is very simple. Most companies are not in the business of running childcare centres and since there are enough childcare centres being opened up each year, most companies would prefer to leave it to the commercial operations. With regard to tendering out void decks for commercial operations, Sir, that is what we have been doing. We now have 44 centres in the void decks and we are in the process of tendering out more. We have released 44, of which 41 are in operation, ie, three are still in the process and we will be tendering out more each time. I must inform the Member that these centres, although tendered out, have been charging very reasonable fees, from as low as $250. Sir, on full-day schooling, I will leave it to the Ministry of Education. But as I said, the holistic manner to look at the needs of child rearing should be looked at from the family context and not just from the point of view of the childcare centres.”
“And I am glad to say that most of our families have their children being looked after within their family contacts, rather than being sent out to childcare centres. And as such, the places in childcare centres that we have are fairly adequate. Yes, in certain places there are complaints but it is a problem of facing it in the sense that we are still in the process of building new childcare centres, especially in the new estates.”
“This will enable them to live independently which is quite important to many of these people -live independently and yet be in a position to help each other. So although the children have moved out, they have other companions and other people who can help them. There are now 17 community homes existing. We are working with the National Council of Social Service to see how we can help these 17 homes to upgrade and expand to take in more residents. Sir, with all these programmes, we should be able to gradually have a fairly comprehensive scheme which should help us cope with the growing numbers of elderly in the years to come. Mrs Yu-Foo has asked about the increase in the childcare subsidy. Sir, I am very happy to inform her that my Ministry has finalised the study and will be increasing the childcare subsidy scheme from $100 to $130 for children on the full-day care system, and from $50 to $65 for those who are getting half-day care. Sir, the subsidy will also be extended to children of the fourth order birth because, at the present moment, the childcare subsidy can be enjoyed only up to the third child in each family. The new subsidy scheme will be implemented from 1st of April this year, ie, next month. And this increase would increase the Government's expenditure by about $6 1/2 million per year. Dr Soin has asked quite a large number of questions. I will try to answer them. Sir, she has stressed that there is a need to provide childcare facilities for children up to the age of 12. Sir, we have to look at the childcare challenge, not from the context of only external care provided by childcare facilities, but in the context of our Asian society. The responsibility for looking after children really falls upon the family as a whole, especially the extended family.”
“They are fit, they are active, they do not require any help or assistance at all. The challenge to us is how do we make sure that in the coming years, we will be able to motivate this big group of fit persons to look after the elderly who require some physical assistance, and not rely on the economically active to look after these aged sick. So one possible programme that we are now experimenting with is the mutual help scheme. Under this scheme, the members of the Senior Citizens' Clubs form themselves into separate groups and by getting together often for activities, they build up a very close rapport with each other and then when one member of the group falls ill, the other members of the group will then go and provide assistance. For example, helping him with his medication, preparing meals for him or bringing meals from their own home to give to him and also to help him with the household chores. So this way, although his family members may be working when he falls ill, he does not have to rely on either the hospital or the community hospital for help. He can rely on the whole community network for help. Sir, this pilot programme will be closely monitored by us and, if successful, we will expand it to other areas. Another programme that we have been working on is the Community Homes Programme. This is to cater for the large number of elderly who, because their children have grown up, married and moved out, are left to live on their own. We would like to encourage more of them, instead of living on their own, to move in to sheltered housing. The concept of the sheltered housing is that this would perhaps be in the HDB flats where we would ensure that the facilities are there to help them.”
“Sir, Mr Abdullah Tarmugi has asked what is Government doing to facilitate the provision of more community-based facilities for the aged. My Ministry's community-based programme aims to keep the well-aged, those who are not sick, physically fit and socially active. The Ministry of Health also provides community-based services for the frail aged and the sick elderly. These programmes together between the two Ministries encourage the aged to grow old gracefully within the community and not in a residential institution. Sir, over the years, with the assistance and cooperation of the National Council of Social Services, we have managed to build up a wide range of community services, for example, Senior Citizens' Clubs. We also provide pre-retirement seminars, sports for the aged, sheltered housing, Befriender Services for the lonely senior citizens. On the part of MOH, we have day care centres, respite care centres and so on. All these make up our community-based programmes. The approach has been fairly successful as seen in the large numbers of members in our Senior Citizens' Clubs. For example, the number of clubs has more than doubled from 130 to 284 between 1986 and 1992. More significantly, the membership has quadrupled from 30,000 in 1986 to 110,000 in 1992. This shows that more of our senior citizens are taking an active interest in keeping socially and physically fit and they are joining all these clubs in order to avail themselves to the fellowship and companionship of the neighbours who are also members and to be able to take part in organised activities. Sir, as Mr Abdullah Tarmugi has mentioned, one in four of the elderly will be aged 60 and above by the year 2030. What is important for us to note is that over 90% of the elderly are actually well elderly.”
“Sir, for the single families, there are actually at the moment already family counselling services and support services and helplines are available. I think the question is how do we publicise these support programmes so that those who require help can more easily make use of them. We will look into ways and if Mrs Yu-Foo has got any suggestion, we will be very happy to get them from her. Sir, she has also asked how do we give recognition to the man. Specifically, she has asked about the Father of the Year award. Again, if NTUC is prepared to organise such programme, MCD would also be prepared to give her our assistance.”
“Sir, I agree with Mrs Yu-Foo that we need to strengthen and safeguard our families. Sir, our Asian values encompass values such as a strong family unit, filial piety, respect for the elderly, parental responsibility and family obligations. These are very important values and we should not allow such values to be undermined by negative influences. Sir, whilst the Government can help to propound these values and to remind Singaporeans about their importance, I think it is equally important that parents and grandparents must continue to teach such values to their children and grandchildren. Fortunately, our societal values are still very strong. The divorce rates, while getting higher, are still low compared to the West, but we should not be complacent. The Government will encourage the provision of family life and parent education programmes to support these values and to ensure that as a society, we will continue to remain strong. Sir, these broad-based programmes are now available at the Family Service Centres and they are also organised by various Volunteer Welfare Organisations (VWOs) and religious groups on a regular basis. On my Ministry's part, we have launched the parenting handbook last year and the marriage preparation handbook in January this year. We are now working on a package of resource materials, including videos, which VWOs can make use of in mounting parent education and family life education programmes. Sir, we will also look into taking more steps to promote marriage preparation and to encourage more employers to support family life education programmes at the workplace. In this regard, I hope Mrs Yu-Foo, through her role in NTUC, will also give us her assistance. All these would then supplement the efforts of our schools and the mass media.”
“Yes, Sir. Having a Sports Ministry, instead of having the SSC as a statutory board, will in no way make the situation any better. Sir, Mr Low Thia Khiang has accused the grassroots organisations of being part of the PAP network and not using the money which has been voted by Parliament for community work. Rather, they have used it for political work. Sir, I wish to categorically deny that. Mr Low is very wrong. The CCCs and the RCs are set up as part of the Government network of grassroots organisations. They are part of the Government and their job is two-fold. Firstly, to act as a bridge between the people and the Government. The CCCs and the RCs do that by reaching out to the people, explaining to them Government policies and getting their support for such Government policies. They also in turn give the feedback that they receive from the residents to the Government and persuade the Government to amend those policies where necessary. Secondly, their job is to organise activities which promote social cohesion and racial harmony. Sir, I think these are very important objectives and the RCs and CCCs do a very good job in meeting these objectives. In fact, as Mr Chandra Das has mentioned, last year 1.7 million Singaporeans participated in activities organised by our grassroots organisations. If they were not actively involved in working for the community, where would they get the 1.7 million participants from? Sir, he also quoted Dr Ho Yew Ming. I am not too sure whether Dr Ho was misquoted in the newspaper. But if Dr Ho did say that the grassroots organisations are in a way part of the PAP, Dr Ho is very, very wrong, because they are not part of the PAP. Mr Abdullah Tarmugi: Sir, I beg leave to withdraw my amendment. Amendment, by leave, withdrawn.”
“It is therefore not possible to find a single sports supremo who would be able to reach out to all the 55 associations. Fandi Ahmad's case, as mentioned by Mr Ho, shows very well the need to have someone who is interested in and who is concerned about a particular sport. I think the NSAs know that too, which is why, on their own, 10 of the NSAs have already invited Ministers or Members of Parliament, in their personal capacity, as advisers, patrons or presidents. So we have Mr Lee Yock Suan as the President for Badminton, Mr Ho Kah Leong for Basketball and Mr Mah Bow Tan, of course, who has done a great job in FAS, is promoting soccer in his own personal capacity. So we should let as many champions as possible come out so that each of the sports can then proceed on and do better.”
“However, we must also remember that many of these large scale events, like the Johnnie Walker Classic, are actually put up not by our sports associations, but by commercial organisations. The criteria they use are quite different. If it is an event that is really catering more for the local audience, hoping to get income from the Singapore audience and the regional audience, we have to recognise the fact that our audience base here is actually quite small, except for a few sports with mass appeal, for example, football. Therefore, whether or not such events will continue to be staged here would depend on whether the entrepreneurs and the companies concerned feel that they can turn this into a money making proposition, and whether they can fit this into their world-wide advertising programme, like the Johnnie Walker Classic. If they can, of course, they will stage it here. For such events, we have very little influence over them. With regard to betting pools, I understand that the FAS is looking into it. We will leave them to decide. Mr Ho Peng Kee has asked that a Ministry be set up to look after sports and that there should be a Minister as a sports supremo. Sir, the Member has touched the right chord when he says that sports permeate the national life. Sir, that is precisely because sports is not a sectoral concern. It would better benefit from the many-helping-hands approach that is being adopted by my Ministry. In the world of sports, many champions are better than one. The field of sports is so vast and diversified that we have 55 National Sports Associations (NSAs), each one very independent, each one very conscious of its own priorities and each one wanting minimum interference from others.”
“Yes, Sir. I will look into his suggestion about training overseas. As to a similar organisation like ACCORD, there is already a committee looking into the welfare of the grassroots leaders. It is in the National Community Organisations Council (NCOC). I will ask them to take up the suggestion put up by Mr Das. Sir, on the policy for the aged, Dr Vasoo has asked whether we have plans to encourage more community groups to help support the aged sick. Sir, the aged sick now comes under the Ministry of Health and I think there were quite a few questions raised under my other Ministry's budget on the aged sick. I suggest that the Member look up the Hansard for the answers given by the Minister of State for Health. Mr Chia Shi Teck has asked about making Singapore into a sports hub and allowing gaming/betting pools and so on. Sir, first, we must understand that the many sports facilities put up by the Singapore Sports Council are mainly meant for community use, with the exception of the National Stadium and the Singapore Indoor Stadium which have first class facilities. Therefore, the bulk of our facilities are not really designed for world class events. However, despite that, there have been a number of world class events being staged in Singapore. This includes the Dragon Boat Race, the World Formula One Power Boat Grand Prix and, of course, the recent Johnnie Walker Classic. Sir, many of the international events require quite a fair bit of expertise and manpower resources. As our National Sports Associations get more experience, I think more of them will go out and bid actively for many of these international events.”
“Sir, apart from the traditional forms of recognition, the Government also publicly recognises the status of our grassroots leaders by closely involving them in the decision making process. We do that by bringing our grassroots leaders in for briefings and discussions and their feedback and suggestions are then taken in by the Ministers and Ministries and the policies are fine tuned arising from their feedback. Two good examples are the time-based telephone charging system and the COE system, which were amended arising from such feedback. Sir, to meet the social and recreational needs of grassroots leaders, MCD has also now set up a Grassroots Recreation Club. The club was just opened a week ago. This is a temporary clubhouse in an old community centre. We are now looking into securing land where we can put up a permanent clubhouse, which would be very much welcome by our grassroots leaders. The Chairman: Mr Yeo, we are running out of time on this amendment.”
“In addition, the HDB now allows such people to extend their repayment period up to a maximum of 25 years, plus, for the first five years, the HDB will allow them to pay only 75% of the normal instalment payments. So it is not just one year's deferment, but after that a re-scheduling of their mortgage payments. HDB also allows the flat owners of 3-room flats and above to very freely rent out rooms in their flat. I think that is a very valuable source of income for such people. So for the flat owners there are a lot of alternatives available for them and, therefore, we should not allow them to come in and squeeze out those who really require such help from that small sum that we have in the Rent and Utilities Assistance Scheme. Dr Michael Lim has asked whether GST is adequate. I have answered that already. Mr Chandra Das has asked for greater recognition for grassroots leaders. Sir, first, I would like to thank the Member for having highlighted the tremendous amount of contributions put in by our many grassroots leaders. They have really done a wonderful job and we should recognise them and be grateful to them. At the moment, these deserving grassroots leaders are already given various forms of recognition. For example, National Day Awards. Many of the National Day Awards that are given out each year are received by our grassroots leaders. They get Long Service Awards as well as Meritorious Awards. My Ministry is now also looking into Group Awards to the CCCs. We are now finalising the framework and we would get back to the advisors and our grassroots leaders to get their suggestions on how to make this scheme more attractive.”
“This rebate, as announced by the Minister for Finance, actually amounts to between 5% and 18% of the PA allowances being received by them. So in actual fact, because of the GST, the recipients would get increases of between 8% and 23%, whilst costs should increase no more than 3%. Actually, the PA recipients are going to be far better off under the GST. 3.15 pm Mr Chay Wai Chuen asked for the Rent and Utilities Assistance (RUA) Scheme to be extended to flat owners. At the moment, the RUA Scheme only applies to people who rent HDB flats. It does not apply to flat owners. The reason is very simple. For those who are renting the flats, there is nowhere else for them to go. If they are in arrears, HDB cannot just ask them to leave, because where else do they go to? So we need to give them additional support to tide them over their temporary predicament. The Rent and Utilities Assistance Scheme provides counselling help to those who are in arrears - counselling on how to manage their income and how to improve themselves and get a better job - and with educational assistance for those with children. Sir, for the HDB flat owners, HDB already has a present scheme to help flat owners who are in temporary financial difficulties. How does HDB help? Firstly, the HDB would defer instalment payments for six months. If the financial difficulties are still there, HDB would extend it by another six months. So at the moment, HDB already allows flat owners to defer payments for one full year. That should, in many cases, be more than adequate for those who are in temporary problems, perhaps through an accident or something else, which prevents them from working for a few months.”
“For example, the PA recipients also receive free medical benefits at polyclinics and in the hospitals. So they are shielded from all health care costs. For the school children of PA families, they do not pay any school fees at all. All fees are waived. In addition, they get free textbooks and free uniforms. The schools also provide them with pocket allowances. And for those who need to take transport, the schools also provide them with transport subsidies. So in addition to the PA allowance, the children do receive additional assistance. I think what is also important is that the schools monitor the progress of these children very closely. And those who require assistance are then referred to VWOs who then provide them with free tuition. So the children are again a key focus. For those who, for various reasons, require more help, we also have six supplementary charities which provide additional funding to the PA recipients. Sir, for the elderly who live alone, we also have a Befrienders' Service where we link the elderly who are living alone, with a befriender, who then visits that person a couple of times a week. The Befrienders' Service would also make arrangements for these single elderly to receive, for example, free meals and free rations. Again, the support is very good. Sir, with regard to the GST, as announced by the Minister for Finance, the PA rates will be increased by 3-5% early next year. This increase would then offset the less than 3% increase in costs arising from the GST. But that is not all, Sir, because two-thirds of all the PA recipients live in HDB flats. The majority of these people live in 1- and 2-room rental flats. So all the PA recipients who live in HDB flats will be receiving a rebate.”
“Again, the philosophy is a very simple one. Their children are their hopes for the future. Let us focus on them. Let us help them be the engine for uplifting the family out of their poverty trap. He has also suggested that we monitor the effects of GST on the low-income group. Sir, we will definitely do that. Mr Chandra Das has asked about the public assistance programme. What improvements have we introduced and how do we ensure that the public assistance scheme is providing adequate support to the indigent and to those who are on the scheme? And how do we ensure that with the introduction of GST, the PA allowances will be adequate? Sir, as Mr Das has mentioned, the PA is a very stringent scheme and I am glad he supports the need for us to keep it stringent. In 1989, MCD brought in a firm of private consultants to review the PA allowances. In previous years, the allowances were really, in many ways, formulated by the Ministry itself. But to ensure that all the factors have been taken into consideration, the Government brought in a firm of private consultants to study the expenditure requirements of the low-income groups, what is their spending profile, what are their requirements. Based on their very exhaustive study, MCD accepted the recommendations they put forward for the PA allowances. And these new allowances were introduced in March 1991. We now review the allowances once every two years. The last review was carried out in 1992 and as a result of that review, new allowances were introduced on 1st January this year. So the allowances are regularly reviewed and we make sure they are adequate. Sir, over and above the PA allowances, there is actually a whole spectrum of programmes that we have to help the indigent.”
“And if you are in, whether or not you should be in, you qualify for everything that is within the programme. If it is a VWO that is helping, I think the help tends to be very personalised. They analyze, they make sure that there are good reasons for you to qualify. And if you do not qualify, they advise you what to do to get yourself out of that problem. They tailor programmes to meet the specific needs of each applicant who qualifies. It is very much more personalised and the help they give is then very appropriate, very relevant, and also very cost effective. Sir, because of that, the Government's policy is to encourage the existing VWOs to go into new areas of service, new areas where they have more expertise, they have more capabilities and therefore they can be in a better position to help extend assistance to those who require help. Some examples of what we are looking at are family service centres. These are one-stop social service agencies. We have pilot programmes but, in recent years, the VWOs themselves have also been starting their own family service centres. These will be accessible to all residents and they provide a broad range of programmes, like counselling, tuition, as well as financial support programmes. Secondly, we have the Rent and Utilities Assistance Scheme which Mr Chay brought up just now. This is a scheme to help the low-income earners who are living in rental flats to tide over temporary financial problems. Of course, we have our public assistance (PA) scheme which I will talk about a little bit more. Lastly, we have a very good programme of helping those who are receiving assistance from the Government, ie, those who are on the PA scheme and those who are on the Rent and Utilities Assistance Scheme.”
“And if we can help their children to succeed, then we have permanently helped them to level up. We also have provided them with very heavily subsidised housing programmes as well as health programmes. Sir, in many of the programmes, the Government has adopted the many-helping-hands approach. And through this approach, we have in the last few decades built up a society of compassion, a society where the more successful are very much prepared to come forward and help those who are less successful. This is in contrast to the attempts of certain political parties to sow discord, to raise passions of envy and emotions of hate. Sir, the fact that we are a compassionate society is well reflected in the large numbers of ordinary Singaporeans who are today making voluntary contributions every month to the Community Chest. The last figure we had, 210,000 Singaporeans opted in. They voluntarily put their names on paper to contribute every month to those who are less fortunate. It is not just financial contribution. We have large numbers of Singaporeans who have come forward, again voluntarily, to devote time and effort to the over 200 voluntary welfare organisations (VWOs) that we have in Singapore. These organisations are doing very good work in helping to reach out to those Singaporeans who require help. Sir, VWOs are very very important. In fact, reports have come out recently, especially in the United Kingdom, which regret the growing role of government over the last 3-4 decades in providing help to the less fortunate. And the reason why there is much regret is that when government is involved in providing help, they do it, firstly, in a very impersonal way by using guidelines. You are either in or out.”
“Sir, first, I would like to thank the many Members who have spoken on my Ministry's budget and for raising so many points on my Ministry's work. Sir, Mr Abdullah Tarmugi has touched at length on the Government's approach to welfare programmes and he has asked how we can better help those at the lower level of society to help them level up, as the Prime Minister has said. He has mentioned that we can do more and would like me to explain what else we are doing to better help them. Singapore has been able to achieve rapid economic growth over the last three decades because our policies emphasise meritocracy, hard work and national cohesiveness. Through these policies, we have benefited the vast majority of Singaporeans. We have helped them to do better. We have enabled them to improve their standard of living. The Government can continue to help our people, especially those in the lower-income groups, by continuing to make the economic pie grow bigger in the years to come. We do that by having the right social and economic policies to ensure that businesses can prosper so that good well-paying jobs remain plentiful. This way, all Singaporeans will benefit. Sir, in any society, there will always be those that will be relatively less well-off. In Singapore, where we have a very good record of helping such people, it is not just the small group of indigent, but really the much larger group who falls into the low-income earners, the lower 20% of wage-earners. Our programmes for helping this group include the heavily subsidised educational programmes which ensure that their children will have an equal chance to make a success of themselves. Their children are their hopes for their future.”
“Sir, any Class B2 or C inpatient or subsidised outpatient who is unable to pay his hospital charges can apply for full or partial remission of the charges. In evaluating an application, the medical social workers take into consideration the choice of ward class, the size of the hospital bill and the home and financial background of the patient and his family. Details of the applications for waiver received by the hospitals from 1990 to 1992 are as follows: 1990 1991 1992 No of No of No of Hospital Applns No Approved Applns No Approved Applns No Approved Kandang 39 38 36 34 52 51 Kerbau (97%) (94%) (98%) Hospital National 428 428 371 371 603 603 University (100%) (100%) (100%) Hospital Singapore 2545 2401 1347 1346 1983 1974 General (94%) (99%) (99%) Hospital Toa Payoh 50 50 62 60 132 132 Hospital (100%) (97%) (100%) Total 3062 2917 1816 1811 2770 2760 (Rate of (95%) (99%) (99%) Approval) ESTIMATES OF EXPENDITURE FOR THE FINANCIAL YEAR 1ST APRIL, 1993 TO 31ST MARCH, 1994 Order read for consideration in Committee of Supply [6th Allotted Day]. [Mr Speaker in the Chair] Head R (cont.) - Resumption of Debate on Question [16th March, 1993], "That the total sum to be allocated for Head R of the Main Estimates be reduced by $100." - [Mr Peter Sung]. Question again proposed.”
“Sir, the revision in the Consultation Fee Scheme will in no way affect the operating cost. This is because the Consultancy Fee Scheme comes out from more or less a fixed pool of money. The revision only affects how that sum of money is to be distributed amongst the doctors. MEDICAL AND HOSPITAL CHARGES (Conditions for waiver) 2. Mr Yeo Toon Chia asked the Minister for Health if he will state (i) the conditions under which a patient can apply for a waiver of medical and hospital charges and (ii) the number of such applications in each restructured hospital and the number of successful applicants for the years 1990 to 1992.”
“Sir, the manpower cost of the hospitals appeared to be higher before they were restructured. In fact, the manpower cost amounted to slightly over 70%. This is because a fair bit of the operating cost was actually hidden subsidies provided by the Government. By restructuring, we were able to recognise these hidden subsidies and therefore the manpower cost, as a percentage of the total operating cost, went down to 65%.”
“However, for subsidised patients, because of Government subsidies, much of these cost increases will be borne by the Government. The Government will pay for as much as 80% of the cost increases for Class C patients and 65% of the cost increases for B2 patients.”
“Mr Speaker, Sir, the total operational cost of running the Singapore General Hospital, Kandang Kerbau Hospital, Toa Payoh Hospital and the National University Hospital for 1990, 1991 and 1992 are as follows: Operating Operating Government Net Year Cost Surplus/(Deficit) Subsidy Surplus/(Deficit) 1990 $486m ($201m) $181m ($20m) 1991 $534m ($195m) $187m ($8m) 1992 $547m ($182m) $208m $26m $1567m ($578m) $576m ($2m) ------ ------- ----- ------ The net surplus of $26 million in 1992 was mainly due to an increase in the subsidy received by NUH. This was because NUH's subsidy in earlier years was under-computed by about $10 million and this shortfall was paid to the hospital in 1992. Sir, manpower costs account for 65% of the operating costs of hospitals. As long as Singaporeans enjoy good pay increases, medical cost must rise accordingly. This is because hospitals also have to pay competitive wage increases in order to be able to recruit and retain their staff. It is therefore better that hospitals increase their fees by small amounts every year to cover their cost increases, rather than to defer such revisions and have large increases every few years. The hospitals will, however, continue to improve and streamline their operating systems and procedures, and optimise on the use of manpower. Other measures which the hospitals are taking to control costs include: a) Restricting the purchase and regulating the use of expensive medical equipment; b) Controlling the use of expensive drugs; c) Automating labour intensive procedures; and d) Avoid duplication of services amongst hospitals. Since hospital operating costs will continue to increase, it is inevitable that part of the cost increases be absorbed by the patients.”
“Sir, with regard to blood supply, we already have very high standards of control on the donation of blood. The blood that is collected are subjected to all the tests that are available to ensure that, first, the blood does not have any HIV anti-bodies; second, it does not have hepatitis B viruses; and, third, it does not have other sexually transmitted diseases. So our blood supply is safe and there is no need for Singaporeans to worry about that.”
“Sir, I think Mr Loh has got his statement wrong. It will help if Members keep their speeches short and ask the questions directly. Sir, he has asked three questions in his very short speech. First, how do we protect Singaporeans; secondly, how do we protect the blood supply; and, thirdly, how do we educate Singaporeans. I think his last question is the most appropriate one: how do we educate Singaporeans? This is because AIDS is not a disease that we catch like flu or other infectious diseases, which you can catch by just walking around and mixing with other people. AIDS is a disease which you catch only if you commit a deliberate act. There are a few alternatives. First, through the sharing of needles with infected people; second, through sexual contact; and, third, through blood transfusions where the supply of blood is not safeguarded. Since AIDS is something which you only catch through a deliberate act, the only way to protect Singaporeans is to educate them and to ensure that they are aware of the dangers of AIDS and that they take all necessary safeguards. We have had a very intensive AIDS education programme since 1985 when our first HIV positive Singaporean was found. We will continue this intensive education to make Singaporeans aware of the prevalence of AIDS in the region. Mr Loh has mentioned some World Health Organisation's figures. In fact, the newspapers have been very very helpful in highlighting that there are problems in the region. And we would like to take this opportunity to remind Singaporeans that when they travel, and even when they are in Singapore, they should not take undue risks. They should adopt a healthy lifestyle. They should avoid casual sex, especially casual sex with prostitutes.”
“Sir, in the first place, it is not true that most families have only one Medisave account. In fact, we have altogether in the region of 1.5 million Medisave accounts. In most families where there are working adults, every working adult is likely to have a Medisave account. Because as long as they are employed, the employers must pay CPF, in which case they will each have a Medisave account. Secondly, in computing the Medisave contribution rate, the assumption has been that there is only one breadwinner in each family. When we have more than one person working in each family, actually we have a much bigger safety margin and I think we should preserve that. But the minimum base has been on the assumption that there is only one person working.”
“In fact, with the availability of Medisave now, the elderly's health care needs are even better safeguarded, because now their family members would have more than enough funds in their Medisave to help look after them. Even if the family members do not have enough Medisave, our Government system of B2 and C Class wards together with the waiver system ensures that no one is ever deprived of health care. Regarding the need to have cost sharing, I agree with Dr Soin. Cost sharing is a very important feature in any programme to ensure that health care utilisation is kept under control. In fact, the experience in other countries has been that those people who pay for their own health care consume a lot less medical services. In fact, there was a report in the Asian Wall Street Journal just last Friday which showed that quite clearly. In Singapore, our experience has been the same too. At the present moment, the Class A patients in the Government hospitals already pay about 30% co-payment. That means Medisave would only pay about 70% of the bill. For the private hospitals, Medisave will cover less than 60% in most cases. So the co-sharing element is already there and we would ensure that this feature is retained.”
“Mr Speaker, Sir, I agree with Dr Soin that as many people as possible should have Medisave accounts and that is why Medisave has been extended to the self-employed. Regarding her suggestion that we should allow and encourage families to start Medisave accounts for those aged 12 and above, there is really no need to. The reason is very simple. Those aged between 12 and 21 are very unlikely to require hospitalisation. Many housewives, especially those who have only stopped work in recent years, are likely to have their own Medisave accounts as well. Of course, the elderly, especially those who stopped work about 10 years ago, are unlikely to have any Medisave accounts, but then there are safeguards there. The fact is that there is really no need for every member in each family to have a Medisave account. This is because family members can use their Medisave to help each other. Parents look after their children and when they get old, the children and their grandchildren help to look after them. If they have insufficient Medisave, their grandchildren and children should be able to use their Medisave to help bear part of the burden. Sir, in this way, Medisave actually reinforces the importance of the family unit, which is a key institution in any civic society. And we must continue to strengthen and preserve the family unit if we are to remain strong and stable. Dr Soin has also quoted a psychiatrist who said that perhaps if every elderly has a Medisave account, then the suicide rate amongst the elderly will reduce. If that contention is true, then the suicide rate amongst the elderly before we had Medisave must have been very high. I do not think there is much correlation between an elderly having Medisave and the suicide rate.”