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…”
The complete record
Every one of 1,964 lines we hold for Yeo Cheow Tong, in date order, each linked to its source. Free to read, in full, without an account. Page 32 of 40.
“We have just heard Dr Vasoo saying, "Why are we spending so much money on acute care? We should be spending more on preventive and primary health care instead." Therefore, acute care now ends up with less. So at every point down the line, an apportionment must be carried out. The answer is to make sure that the apportionment is done in such a way that every programme can be optimised. 2.30 pm Affordability. Are our health care costs affordable? Are the subsidies adequate? Should we be giving more subsidies? Let us look at the B2 bills. I am going to quote from SGH which has the highest B2 bills. The average cost for a B2 patient is $1,850. We subsidise each patient to the tune of $1,350. The average bill is therefore about $500. So patient pays $500, Government subsidises SGH $1,350. Is that bill affordable? When we look at the 40th percentile family income, we find that you require 6.1 months of Medisave contributions to pay the bill. For the 20th percentile, which is $900 per month, the answer is for that family member going in, they have to use up 9.3 months of their Medisave contributions. We have to look in terms of the frequency of hospitalisation. The average person would expect to be hospitalised about once every eight to 10 years. For a family of five, they are only using up about 45 months of Medisave and they are able to save on the remaining 45 months. The C Class average cost is quite similar to the B2, but the average subsidy is much bigger, and the result is the bill size for the C Class patient at SGH is about $250. This is equivalent to 3.1 months of Medisave contributions for the 40th percentile family income and to 4.6 months' contributions for the 20th percentile. So therefore B2 and C Class remain highly affordable.”
“In fact, one factor will definitely change, and that is our population profile. The elderly will double in 20 years and double again in another 20 years. So that one factor will definitely change, and they will create more demand for health services. We therefore have to find more inexpensive ways for treatment as well as to discourage over-usage and over-treatment. We must therefore use this period to build up our savings at both the national and individual levels. Otherwise, when the elderly increases, there will be no money in the kitty to help look after them. So the challenge is not that we should spend more of our GDP on health care, but how to ensure that the percentage of GDP on health care does not creep up too fast. Sir, the Government does place a very high priority on health care. Dr Hong Hai asked whether in comparison to other Ministries, our share is too low. I think the answer to that is that every Ministry must be gauged by the Finance Ministry in terms of what are the requirements and that the funds are given to ensure that those programmes can be carried out properly. In that respect, I must say that the Finance Ministry has been quite fair to the Ministry of Health and they have been giving us the funds that are needed to ensure that our health services remain good. In terms of affordability and subsidies, which several Members have brought up, Sir, we all know that hospital services are very expensive. I shall not repeat the reasons. Those who want to know can refer to the Hansard. They are well-documented. What we need to realise is the funds available on the part of the Government are never unlimited. Ministries are all competing for funds. So there is a finite amount available for each Ministry. Within the Ministry there are many programmes.”
“Their assessment is that our medical services here are very comprehensive and of a quality that is comparable to that of their home countries. Despite the fact that the percentage of GDP that is being spent on health care by the Ministry has only gone up very little over the years, we have been able to achieve a much higher level of service. Let me give you some other data. It is very important. How much time does the doctor have for the patients? In 1985, just five years ago, in one year we had one doctor to 1,800 patient days. Last year, the ratio had dropped to one doctor to 980 patient days. That means the doctor is able to double his time with every patient. In terms of nurses per in-patient day, in 1985, 450 in-patient days to one nurse; 1990, 410. So in the nursing ratio we have also managed to improve and therefore enable them to give a better service. Another service is the specialist outpatient clinics. In 1985, each doctor saw about 1,900 patients a year. Last year, the ratio went down to one doctor to 1,000 attendances. So again in that area, we have managed to allocate more resources to each patient. This is well reflected in the waiting time. In Singapore, for an elective surgery, the average waiting time is about one to five weeks, average 12 days. In many of the developed countries, the waiting time is two months to as long as two years in the UK. So in terms of value, I do not think anyone can deny the fact that we have a very good health service even though only 3% of the GDP is being spent on it. We can and should be proud of what we have. But we should not celebrate prematurely and start spending more, just because we appear to be able to afford it. The factors influencing the low expenditures may change.”
“In Singapore, our high economic growth rate has meant that although our health care costs have been increasing at about 10%11%, the share of the GDP can be main- tained at between 2 1/2% and 3%. That is something that we must ensure. Keep our high economic growth at the present level to at least 6% in the future. Sir, many Members have asked about the expenditures. Let me give you some figures. For financial year 1980, we spent $260 million, which is 1% of GDP. This year our expenditure is $954 million, including the expenditures of the restructured hospitals, so that we are comparing apples with apples. This is equivalent to 1.4% of our GDP. If you take away the restructured hospitals, Singapore General Hospital, Toa Payoh Hospital, Kandang Kerbau Hospital, our expenditure is $722 million, which is equivalent to 1.1% of our GDP. So in terms of the GDP percentage, although we have tried our best, it is still creeping up - 1.4% today. Sir, whilst the amount of money that is being spent, in absolute terms as well as in terms of percentage of GDP, is important, I think what is even more important is that we must look at how the money has been spent. What kind of values are we actually getting for the money. Dr Hong Hai has quoted some figures, so I would not repeat them. Infant mortality rate and life expectancy - these are two key indicators and we are on par with developed countries. Sir, in terms of the quality of medical services, I have met or have received reports from many prominent visiting specialists, from the US and from the UK, who have been here on short term assignments or passing through while being here on conferences.”
“The Government has focused on this area over the years and has ensured that our costs are as low as possible by ensuring that our hospitals are operated efficiently without frills, avoiding proliferation of expensive equipment, and ensuring that the treatment procedures are appropriate and not excessive. The Government provides 80% of hospital services. The inexpensive Government hospital services therefore also act as a brake against what the private sector can charge. So that has also helped to keep the private sector charges lower than what they could have been otherwise. Sir, when you look at the developed countries, there are several factors there that account for why they spend so much. Firstly, there is a very strong practice of defensive medicine. In the West, litigation is fairly common. So doctors over-investigate. If you go in with a sprained ankle, you are likely to get the whole body scanned in case you fell and damaged other parts of your body. Also, there is an unnecessary hospitalisation for observation as well as a propensity to keep patients in hospitals longer to ensure that they are pretty well before being discharged. There is also a proliferation of medical technologies. The health care cost, the whole world over, is increasing by between 10% and 15% a year. Unfortunately, for the developed countries, their economic growth rates have been averaging 2% to 4%. The inevitable result is that with every passing year the health care costs eat into the budget that is available, and therefore health care costs as a percentage of GDP or GNP in the developed countries have been increasing steadily year by year.”
“We as a nation spend about 3% of our GDP on health care. In UK, about 7%, Germany and Canada, about 9%, and the USA tops the bill at over 12%. So in comparison with USA, our budget is extremely low. The question is: which is the most appropriate level of expenditure? Are we underspending? Or are the others overspending? Sir, there are several reasons as to why we spend less. It is important for us to realise and remember that. Firstly, the figures are not totally comparable. Different countries compile their health expenditures differently. For example, some include expenditures which are really welfare expenditures. Others include environmental and industrial health and other expenditures. So we are not really comparing apples to apples. Secondly, Singapore has a relatively young population. Our median age is only 29 years, and the proportion of the elderly, ie, those people who are over the age of 60, is only 8%. Thirdly, our fee-for-service has helped to curb excessive demand for health care. In Singapore, fortunately, pre-paid medical insurance still plays only a very minor role. Fourthly, it is cultural. I think Singaporeans, by and large, especially elderly Singaporeans, would prefer, if they can, not to be hospitalised. It is only with great reluctance. This is reflected in our admission rate. In Singapore, our admission rate into hospitals is 124 per one thousand population. In the USA, it is 170 per one thousand population. Sir, the last factor, which is a very important one, is that hospital costs comprise the major component of health care expenditures. For example, in my Ministry, they make up almost 80% of our expenditures.”
“Sir, first, I would like to thank Dr Hong Hai, Chairman of the GPC on Health and my other parliamentary colleagues for their comments and suggestions. They have touched on a very wide range of topics. Generally, the comments and the questions show that on many of the fundamentals there is a convergence of views. For example, many feel strongly that we should encourage and help Singaporeans to take full responsibility for their own good health. They want Singaporeans to be provided quality health services. That the Government also agrees. They expect these health services to be cost effective, which we also agree. By being cost effective, we can then keep the health care cost, or we can at least help to restrain the health care cost, from going up too rapidly. They also want the health services to remain affordable to all Singaporeans, which my Ministry also agrees. Sir, my Ministry's policies are directed at helping every Singaporean to take full responsibility for his or her own health. With escalating health care costs the world over, the old saying that prevention is better than cure is never truer. My Ministry is also committed to helping those who fall ill to recover as quickly as possible. This we do at three levels: the primary health level, which is the first line of medical care, the secondary and the tertiary care levels. Dr Tan Cheng Bock has touched on those areas and I will elaborate afterwards. Sir, I will first address the points and questions on expenditures on health care and hospital services, before asking Dr Aline Wong to reply to the other points. Sir, Dr Hong Hai and several other Members have correctly pointed out that our national health expenditures are low and, in certain cases, extremely low, compared to that of the developed countries.”
“Sir, the Singapore Medical Council has already ruled that it is ethical for the medical practitioners to offer discounts. BILLS INTRODUCED NATIONAL PRODUCTIVITY BOARD (AMENDMENT) BILL "to amend the National Productivity Board Act (Chapter 200 of the 1985 Revised Edition)", presented by the Minister of State for Trade and Industry (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. SKILLS DEVELOPMENT LEVY (AMENDMENT) BILL "to amend the Skills Development Levy Act (Chapter 306 of the 1985 Revised Edition)", presented by 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. ANNUAL BUDGET STATEMENT Order read for Resumption of Debate on Question [1st March, 1991], "That Parliament approves the financial policy of the Government for the financial year 1st April, 1991 to 31st March, 1992.". -[Minister for Finance]. Question again proposed.”
“Mr Speaker, Sir, my Ministry has always advised medical practitioners to keep their patients fully informed about their charges so that they are aware beforehand of the financial implications of the recommended treatment. The way this is accomplished, however, has been left to the discretion of the individual practitioner. My Ministry is in favour of requiring all medical practitioners to display their basic rates of charges. This would allow patients to know what they can expect to pay in any consultation or before undergoing any form of investigation or surgery. We are studying how this can be incorporated into the proposed amendments to the Medical Registration Act which are scheduled to be tabled in Parliament later this year. In the meantime, my Ministry has requested the Singapore Medical Council to study the implications of the proposal to require all medical practitioners in private practice to display their rates of charges. Mr Chng Hee Kok (Tiong Bahru GRC): Sir, would the Minister say whether it is proper and ethical for medical practitioners to display their charges and offer discounts against these charges?”
“Sir, I would like to thank the hon. Member for his support of the Bill. Sir, we take note of his suggestion that we should ensure that equipment are being properly maintained and serviced. We will take note of his suggestion and ensure that that is so. In the area of cosmetic lasers, we have found that most of the cosmetic lasers used are of extremely low power and do not pose any hazards. We will continue to ensure that they remain so and that they will not be permitted to use higher powered lasers. For microwave ovens, we will require the importers to advise owners of microwave ovens to send their machines only to approved workshops and that we will require the workshops to have certain checks and to keep a record of all the ovens that they have repaired and what were the faults so that they will be properly documented and followed up. Question put, and agreed to. Bill accordingly read a Second time and committed to a Committee of the whole House. - [Mr Yeo Cheow Tong]. Bill considered in Committee. [Mr Speaker in the Chair] Clause 1 -”
“54 others were seriously exposed and had to be hospitalised for fairly long periods, whilst some 250 other people received significant radiation exposure. Sir, the same radiation machines are available in our hospitals and we cannot afford to have such accidents. The Bill provides that prescribed irradiating apparatus, whether or not in working condition, shall not be disposed of without the written approval from the Director of Radiation Protection. This Bill also contains provisions to ensure proper disposal of radioactive waste and to ensure that they do not accumulate in the premises. They also ensure that radioactive substances are not disposed of into our sewers or into our environment. Penalty The penalty for offences committed is a fine of not more than $5,000. However, in cases of culpable negligence which endangered or were likely to endanger human life, the penalty is a fine of not more than $10,000 or not exceeding 12 months' imprisonment or both. The Bill also allows minor offences to be compounded with fines not exceeding $200. Conclusions Sir, the proposed Bill will allow us to continue ensuring the proper and safe use of radiation equipment and radioactive materials in the medical and industrial applications. It will prevent substandard radiation devices from being brought into Singapore. It will ensure that only properly trained staff are allowed to operate these machines or to use radioactive materials. The Bill will facilitate the safe and effective use of new technologies which emit non-ionising radiation in hospitals and clinics, in industries, public places, as well as in our homes. It is something that is necessary since modern technology and equipment are being introduced and used to their fullest as part of our rapid development.”
“Licensing Requirements Under the provisions of the Bill, licences will be needed for the import and manufacture of prescribed non-ionising radiation devices. The devices to be prescribed will include ultraviolet sunlamps, commercial and domestic microwave ovens, diagnostic, therapeutic and industrial ultrasound machines as well as the higher power Class IIIB and Class IV lasers. In addition, licences will be needed for the use of certain prescribed non-ionising radiation devices, namely, diagnostic, therapeutic and industrial ultrasound machines, Class IIIB and Class IV lasers, and all entertainment lasers. Lasers of Class IIIA and below will not be controlled as they are of low power, for example, of 5 milli-Watt or less and they do not pose significant dangers. Examples of these exempted devices include laser pointers that are widely used, laser printers and the laser compact disc players. Health and safety of workers and the public The Bill seeks to protect the workers handling ionising radiation as well as non-ionising radiation by requiring their employers to provide them with the proper training so that they can competently and safely perform their work. The Bill also requires the employers of such workers to provide and maintain an environment that is free from radiation hazards for both the workers as well as the general public. Disposal Improper disposal of radiation equipment can lead to serious consequences for public safety. An example is the radiation accident in Brazil in 1987 which was caused by the improper disposal of a Caesium machine used for radiotherapy. It resulted in the death of four persons from severe radiation exposure.”
“There is now a proliferation of non-ionising radiation devices in industry, in our hospitals and clinics, in the public areas for entertainment and in our homes. Many of these devices can pose a danger to workers, to patients and to the public in general if they are not used properly. Proposed controls and changes My Ministry has therefore decided that non-ionising radiation devices should also be brought under control, in order to ensure that the safety of the general public is safeguarded. Many developed countries, for example, Australia, Japan, Germany, Sweden have also introduced similar legislation to control non-ionising radiation. We have studied the measures adopted by them and have adapted them to our local needs. My Ministry's control of non-ionising radiation will meet two objectives: firstly, to ensure that users or operators of hazardous non-ionising radiation devices have the necessary qualifications and training; secondly, to ensure that only non-ionising radiation devices that meet accepted international standards are allowed to be imported into our country. In addition to the control of non-ionising radiation, certain aspects of the control of x-rays and other ionising radiations will also be strengthened. Purpose of the Radiation Protection Bill In view of the substantial changes that are proposed, my Ministry, on the advice of the Attorney General, has introduced this new Radiation Protection Bill. This Bill seeks to repeal the Radiation Protection Act (Cap. 262) and to re-enact the Act with amendments. It will bring hazardous non-ionising radiation devices under control and will improve the administration of the existing Act. Sir, I will now deal with the major provisions of the Bill.”
“More radioactive materials are also being used in industry. My Ministry's Radiation Protection Inspectorate has therefore taken steps to ensure the proper control and use of radioactive devices and materials. These include surveys of environmental radiation and regular inspection of premises and facilities using x-ray machines and radioactive materials. We also provide talks and lectures to radiation users and other members of the public, and regular radiological safety training programmes for medical and paramedical staff. These radiation protection programmes have improved radiation safety in Singapore. As an illustration, about 20 persons were accidentally exposed to radioactive materials in industry in 1975. Last year, there were only two cases. None happened in our hospitals. Fortunately, all these were minor accidents and there were no deaths. But we cannot take things for granted. The present Radiation Protection Act has served us well in the control of x-rays and radioactive materials. But it does not cover non-ionising radiations. Recent technological advances have led to the development and use of many devices using non-ionising radiations. Examples of such devices are microwave ovens, ultra-sound machines, lasers and ultraviolet lamps. All these can have harmful effects if not properly manufactured or used. Non-ionising radiations You may ask what are non-ionising radiations. They are radiations which are of a lower energy than x-rays. However, they are nonetheless harmful when used wrongly or applied wrongly. For example, microwaves can lead to burns, cataracts, blindness and even to sterility. Lasers can damage the retina of the eye.”
“Mr Speaker, Sir, I beg to move, "That the Bill be now read a Second time. Radiation and radioactive materials are now widely used in industry and in medicine. In medicine, they are used in x-ray machines for the diagnosis of diseases and for treatment of cancers. They are also used as radioactive isotopes for various laboratory tests. X-rays and radioactive materials have to be used with special care as they are potentially harmful and dangerous to health. Overexposure to radiation can cause serious diseases affecting the blood and bone marrow, such as cancer of the blood or leukaemia. Overexposure can also lead to sterility, cataracts and blindness. Gross overexposure as in radiation accidents can result in serious radiation sicknesses and even death. Those who survive have also an increased risk of developing leukaemia. Present status of radiation protection in Singapore Sir, control of the use of radiation in Singapore was first introduced in 1973. This was when the Radiation Protection Act was enacted to regulate and control radioactive materials and devices emitting ionising radiation. Under this Bill, activities such as the import, manufacture, sale, disposal,transport, possession and use of radioactive materials and devices emitting ionising radiation are subjected to licensing. In addition, all radiation workers are required to be continuously monitored. This is to ensure that the radiation that they receive in the course of their work is within safe limits. Over the years, there has been a rapid increase in the use of radiation in medicine and industry. Many x-ray machines have been installed in hospitals and clinics. The frequency of radioactive isotopes being used for diagnostic purposes in the laboratories has also increased.”
“RADIATION PROTECTION BILL "to control and regulate the importation, manufacture, sale, disposal, transport, storage, possession and use of radioactive materials and irradiating apparatus and for matters connected therewith; and to repeal the Radiation Protection Act (Chapter 262 of the 1985 Revised Edition)", presented by the Acting Minister for Health (Mr Yeo Cheow Tong); read the First time; to be read a Second time on the next available sitting of Parliament, and to be printed. MAINTENANCE OF RELIGIOUS HARMONY BILL (As reported from Select Committee) Order for Third Reading read.”
“BUILDING CONTROL (AMENDMENT) BILL "to amend the Building Control Act (Chapter 29 of the 1990 Revised Edition)", presented by Dr Lee Boon Yang; read the First time; to be read a Second time on the next available sitting of Parliament, and to be printed. LAND SURVEYORS BILL "to establish the Land Surveyors Board, to provide for the registration of land surveyors, to regulate the qualifications and practice of land surveyors, to regulate corporations which engage in title survey work in Singapore and to repeal the Land Surveyors Act (Chapter 156 of the 1985 Revised Edition)", presented by the Minister for Law (Prof. S. Jayakumar); read the First time; to be read a Second time on the next available sitting of Parliament, and to be printed. TRADE MARKS (AMENDMENT) BILL "to amend the Trade Marks Act (Chapter 332 of the 1985 Revised Edition)", presented by Prof. Jayakumar; read the First time; to be read a Second time on the next available sitting of Parliament, and to be printed. CURRENCY (AMENDMENT) BILL "to amend the Currency Act (Chapter 69 of the 1985 Revised Edition)", 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. SINGAPORE TOTALISATOR BOARD (AMENDMENT) BILL "to amend the Singapore Totalisator Board Act (Chapter 305A of the 1988 Revised Edition)", 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.”
“Sir, we do keep track of the patients who are waiting for either heart or liver transplants. At the present moment, there are only seven patients waiting for heart transplants and nine waiting for liver transplants. And in fact in a few cases recently, the relatives of those who have died agreed to donate either the heart or the liver, but they were not usable because of incompatibility or because of other medical contra indications. So we do keep track of the cases where donations are possible and we do try to persuade those relatives to agree to donating the organs. BILLS INTRODUCED 1.09 pm PROFESSIONAL ENGINEERS BILL "to establish the Professional Engineers Board, to provide for the registration of professional engineers, to regulate the qualifications and conduct of professional engineers, to regulate corporations which engage in professional engineering work in Singapore; and to repeal the Professional Engineers Act (Chapter 253 of the 1985 Revised Edition)", presented by the Senior Minister of State for National Development (Dr Lee Boon Yang); read the First time; to be read a Second time on the next available sitting of Parliament, and to be printed. ARCHITECTS BILL "to establish the Board of Architects, to provide for the registration of architects, to regulate the qualifications and practice of architects and the supply of architectural services in Singapore by corporations; and to repeal the Architects Act (Chapter 12 of the 1985 Revised Edition)", presented by Dr Lee Boon Yang; read the First time; to be read a Second time on the next available sitting of Parliament, and to be printed.”
“WORKMEN'S COMPENSATION (AMENDMENT) BILL Order for Second Reading read. 4.30 pm”
“Sir, Dr Lee Siew-Choh does not seem to be able to face realities. Yes, catastrophic illnesses strike a person without warning, just like any other illness, and that is why it is important for all Singaporeans, firstly, to participate in MediShield in case such an eventuality occurs. Secondly, we have been spending a lot of money on health education to tell Singaporeans that they have to keep themselves fit, healthy and try not to fall ill. For those patients who do fall ill and they require help, yes, help is available. Those who can afford it and do not require help, there is no reason why Government should subsidize them. But for patients who require financial help and they go into the B2 and C Class wards, Sir, the help is plentiful. The subsidies for Class C exceed 80%. For those who suffer from a serious illness and who require operation, in the higher tables of operation, there is a cap imposed so that they do not pay more than a certain amount, no matter how serious an operation they require. So the help is available, including complete fee waivers. We do not want to end up as a welfare state. That is fast going out of fashion, but Dr Lee apparently does not seem to appreciate it. Question put, and agreed to. Bill accordingly read a Second time and committed to a Committee of the whole House. The House immediately resolved itself into a Committee on the Bill. - [Mr Yeo Cheow Tong]. Bill considered in Committee. [Mr Deputy Speaker (Mr Lim Boon Heng) in the Chair] Clause 1 - Amendment made: In page 1, line 4, after "shall", to insert "be deemed to have". - [Mr Yeo Cheow Tong]. Clause 1, as amended, ordered to stand part of the Bill. Clauses 2 and 3 ordered to stand part of the Bill. Bill reported with an amendment; read a Third time and passed.”
“But a catastrophic illness is something which occurs suddenly and it disables that man to a great extent and these are the cases where we hope the Government will be able to help. But apparently the Minister does not seem to think that way. It is very important that we must realise that whether it is B2 or C class, Government must help to make sure that those people who are stricken with such illnesses are given every facility to improve and get on. He also said that it is impossible to implement some of the suggestions I made. Sir, it is never impossible. I think we have seen enough of TV advertisements about "Impossible, impossible". But we must realise that it is all a matter of priorities. If the Minister wants to spend money on "Swing Singapore" or on some other things, of course, the money is not there. If he wants to spend all the money on defence and armaments when everybody is cutting down their defence expenditure, of course, the money is not there. But there is plenty of money in our kitty. Why does he not make use of it to help the people instead? He is not doing that. Therefore, the choice is not so much with the patient but with the Government. It is the Government that forces the choice on those people who go to hospital. When they have no money they cannot help but ask for Class C. But when there is no Class C they cannot help but opt for Class B. That is all there is to it. So let us be clear about it.”
“For those in the lower income group who require assistance, they go into the B2 or C class wards. They pay a very small percentage because our subsidies are very, very high. As wages increase, the institutions must meet their expenses in two ways. One is in terms of improving efficiency, and secondly, through recovery of costs. For patients in the B2 and C class wards, that recovery of cost is partly met by increased subsidies from the Government. But the remaining portion must be recovered from the patients through fee increases. By adjusting the fees regularly, we will be able to keep these increases to a much smaller level than the recent one. In terms of medical fees, the choice is up to the patient. If you want better service, we need to employ more people, the right calibre of people, and we must pay them, which means costs must go up. The restructured and Government hospitals will eventually offer different level of service. Their manpower establishment will vary from hospital to hospital. Certain hospitals may be able to get by with lesser people, their service may not be as good but it is likely that their fees would also be lower. At the end of the day, Singaporeans will have a choice of not just the different classes of wards but the different hospitals which may provide different levels of services. Dr Lee Siew-Choh: Sir, I have no quarrel with the charges for A class. I merely use that as an example to show that the claimable amount is very small. But I think the Government must make clear the distinction between a catastrophic illness and a patient who stays in a hospital for some time. He keeps on stressing how long a person stays.”
“He has also asked for existing illnesses to be covered under the scheme. Sir, if we do that, there is no reason for anybody to want to be insured. Insurance means you share the risk well before you are struck by a disease. If everybody can opt in and be covered for a disease or an illness which they already have discovered, then we will only be covering those who are sick and that is no longer an insurance system. So what he is talking about is totally impossible to be implemented because it is just not a very logical suggestion. He has asked for the rates to be lowered. Sir, MediShield is being operated at cost. We will try to maintain the premium as low and for as long as possible. If we find that the premiums for certain age groups have been over-estimated, there are mechanisms for the premiums to be lowered in the future. His next point is about raising the claimable amounts. Sir, the claimable amounts are more than adequate for the B2 rates. He has talked about the ICU rate of $350. Yes, that is for a person who has gone to a B1 or A class ward. But for a B2 patient the $140 a day is more than adequate to cover his stay in the ICU. Sir, he has also managed to jump on to his favourite hobby-horse, which is to tie the issue of medical fees to MediShield and that he will support it if we stop raising medical fees. Sir, that topic has been debated many times before by Dr Lee, but I want to take this opportunity to reply to him again. Sir, Singaporeans generally want a high level of service. Service has to be provided by people. Service does not just appear from thin air. This means we have to pay for our staff. For those who can afford it, the policy is that they pay for what they demand and for what they receive. So A and B1 patients should pay full costs.”
“But based on the surveys carried out by my Ministry and the CPF Board, we have found out that the premiums from MediShield are between half and a third of comparable premiums imposed by the private insurance companies. Of course, they offer a little bit more. But then if we triple our premium, I think we can offer a lot more than what the private insurance companies are offering. The point is we are trying to ensure that we are keeping the premium as low as possible so that the lower income group can afford it. The deductible is equivalent to about 15 days' stay. That means a patient who goes in for, say, 17 days' stay, must cover the first 15 days on his own and MediShield would start from approximately the 16th day onwards. Therefore, for the first hospitalisation which he has quoted from the MediShield pamphlet, of course, the quantum paid by the patient must be high. But as he has also shown, for the subsequent hospitalisations, once it exceeds the deductible amount, he pays only 20% which is the aim of the scheme. This is to alleviate the burden faced by those who require prolonged hospitalisation. He has also quoted the case of a A class patient where for the first period of stay he pays 92% of the bill and for subsequent stays he pays 77%. Sir, that is intentional, because our reimbursements are pegged to the C and B2 classes. So those who pay low premiums and go to the higher classes of wards cannot expect the lower income group to subsidize them for their stay in A class. Therefore, we have also recomputed their bill to the equivalent of B2 bill, and that is why they end up paying a lot more since they have chosen to go to a higher class ward. He has given us some suggestions, one of which I have already covered, and that is the extension of the age limit.”
“With regard to her fourth point that the deductible and co-payment may be too high for certain categories of people and that they may not be able to afford them, for that group of people they can still ask for waivers from the hospitals and they would be reviewed on a case by case basis. For congenital diseases, whilst insurance companies and insurance schemes do not cover congenital diseases, we have been doing our best to assist those cases on a case by case basis and we will continue to do so. With regard to Dr Lee Siew-Choh's point, Dr Lee does not seem to be able to differentiate between a general medical insurance scheme and a scheme that caters for catastrophic illnesses. A general medical insurance scheme would start payment from the first dollar that is incurred but, of course, those schemes are also extremely expensive. The MediShield scheme starts from a dollar a month which is $12 a year for those up to the age of 30. A general medical insurance scheme would probably require a premium of at least $150-$200 for such a person. So we are talking of entirely different scales of premiums. He wants it cheap. He wants it to cover everything. MediShield is run at cost. It has to cater for that particular group of people, ie, the group of people who are suffering from catastrophic illnesses. And because we are catering for those suffering from catastrophic illnesses, it is important to have the deductible so that the scheme is not paying from the first dollar. Because if the scheme is paying from the first dollar, then the premium cannot be kept at the present low level. He has compared the premium with another scheme run by the private sector. I am not too sure where he is quoting from.”
“Mr Deputy Speaker, Sir, I will first address the serious points raised by Dr Aline Wong before I address the distorted interpretations of Dr Lee Siew-Choh. Dr Aline Wong had asked how many years would we wait before extending the age limit. We will monitor the data for the first two years and see whether the usage rate is predictable. And if we can make a decision at that time, we will then do it. Otherwise we may have to wait another year or two. With regard to coverage for dependants, in the information materials given out by the CPF Board on MediShield, the coverage of dependants was highlighted, including a form for the account holder to fill in the dependants' data. I believe most account holders are aware of that avenue but we will still continue to publicise that and hope that more will opt in their dependants. With regard to opting in, in order to keep the scheme low cost and simple, we do not intend to impose a medical examination because the cost of the examination alone may be equivalent to two, three or maybe even four years' worth of premiums. What we would do would be to impose a 2-month grace period before MediShield is activated for that particular individual. MediShield also has the right to inspect the medical records of that patient so that if the administrators find out that actually the treatment is for a disease which was already existing prior to that person opting in, then he will not be covered. We believe in keeping it administratively simple and as low cost to administer as possible.”
“Sir, as I have stated in my answer, we will be working for the eventual restructuring of all Government hospitals. However, we have decided to defer the restructuring of Alexandra Hospital for the time being. PULAU UBIN (Development plan) 13. Mr Teo Chong Tee asked the Minister for National Development what is the development plan for Pulau Ubin.”
“Sir, let me first clarify that the Government has been restructuring the management and operation of Government hospitals and not privatising them. We believe that the autonomous restructured hospitals are able to provide better and more efficient hospital services. This has been borne out by the experience of the National University Hospital, the Singapore General Hospital and the National Skin Centre. Surveys at these institutions reveal a high level of patient satisfaction with their services. The result has been a significant increase in their patient load over the past year. Their share of subsidised patients has also increased. Since the restructured hospitals are better able to serve the needs of patients, we will be working towards the eventual restructuring of all acute Government hospitals. However, we have noted the feedback and concerns of some MPs on the current pace of restructuring. As I had informed this House during the Budget debate in March this year, my Ministry has deferred the restructuring of Alexandra Hospital.”
“Sir, I do not have such details. GOVERNMENT HOSPITALS (Privatization) 12. Dr S. Vasoo asked the Acting Minister for Health why it is necessary to privatize all Government hospitals and whether it will be in the interest of the Government to retain at least one hospital under its management.”
“Sir, I have answered this question several times. So I hope he remembers my answers to all his previous questions as well.”
“I cannot recall what is the number of proposed C class beds in SGH. But I would suggest that the Member refer to the Hansard for my previous answer on the number.”
“Sir, SGH has a very generous system of fee waivers and fee remissions. Those patients who go to SGH and feel that they cannot afford the SGH B2 fees can request for a partial remission of fees. Dr Lee Siew-Choh: What is the number of C class beds that they want to put in SGH?”
“Sir, whilst there are no C class beds in SGH, there are plenty of empty C class beds in Tan Tock Seng, Toa Payoh, Kandang Kerbau and Alexandra Hospitals. And as the Member knows, SGH will be putting in the C class beds by the end of the year.”
“Sir, in the area of fee increases, in terms of whether or not to increase fees, I think it is not possible for the Government to consult the people. However, what we can do is to provide a range of services for the people to choose from. So if patients who feel that the B2 fees are now unaffordable, they can still opt for the C classes which are still very, very cheap.”
“When we enter the new phase, we shall face many new problems which are intan- gible and related to emotions and inner thought. For example, how to build up a cohesive society? How to strengthen the sense of identity with our nation? How to encourage people to participate in decision-making? How to strengthen the ties between the people and the leaders? These are new challenges that we have to take. We cannot have something like a cultural revolution to purify the thoughts of our people. We must also not depend on satay or char kway teow or soup kambing to group our people together. We must be frank and sincere and solve our problems together in a consultative manner. We must share with our people our aspirations and concerns. We must accommodate those who oppose us and instil more confidence in our people in the second generation leaders. We must build up new bridges or new channels between the people and the Government so that we can work together for a better future.”
“Given the thinking of some of our highly educated Singaporeans and the inherent problems of our pluralistic society, the Maintenance of Religious Harmony Bill and the White Paper on Shared Values are of great significance. This is a clear example of our far-sighted political leaders who are leaving no stones unturned to make sure that there is peace and harmony among our races and religions. The Maintenance of Religious Harmony Bill is a preparation for the rainy days in anticipation of any possible mishap and to reduce any inter-religious friction and to prevent people from making use of religion to attain political objectives. The White Paper on Shared Values is an attempt to seek common ground in diversity. It is to list out the values shared by our people from the various ethnic groups so that the cohesiveness of society can be strengthened and that we could develop our own characteristics. The shared values are not merely a formal statement. They serve as a guidance and code of conduct for Singaporeans and for future generations. If we can always put national interest and collective interest before our own individual interest, then it will help our people to reduce their self-contrednes and individualism, or even to reduce the desire to emigrate. If we place great importance on 'family' then we would not have, as what Mr Eugene Yap has described, people who are unfilial to their parents or couples who are hostile to each other. If we can inculcate mutual tolerance and mutual respect, then we should be able to avoid conflicts between races or religions. If we try to deal with problems in a consultative, and not confrontational manner, then we would be able to build consensus and solve many problems in a harmonious way.”
“From the feedback of some constituents and community leaders, I sense that the majority of them were very happy and proud of their cultures when they visited the activities in the different cultural months organized by the various communities. Thirdly, I have brought up this point before and I will repeat it here - we must not mix "cultural identity" with "national consciousness". After 25 years, we have developed a strong sense of national consciousness. We are proud of the success of Singapore, we are proud of not only the SIA, Changi Airport, and our Prime Minister, but also many of our achievements, but this does not mean that we already have our Singapore culture. Let me give an example: Members of Parliament often go in groups to other countries to represent Singapore. The delegation may comprise MPs from various ethnic groups, and the MPs may deliver speeches to defend the interest of Singapore. We behave like Singaporeans. But when we are having our meals, we have to be conscious of the differences of our religions and the customs of different ethnic groups. Finally, it will take a long time for the Singapore culture to develop. Moreover, this must come about naturally and not be pressure cooked. Some observed that the Americans established their own literature only after Mark Twain published his work. So, we should not be too hasty in the development process towards a Singapore culture. Of course, we have the Singapore dress and things which are Singaporean, for example, hawker food, but this does not necessarily represent the Singapore culture.”
“19 pm [Mr Deputy Speaker (Mr Lim Boon Heng) in the Chair] Secondly, I must say that school life is not everything to the students. When SAP school students are at home or when they go to the junior colleges, tertiary institutions or doing national service, they have plenty of opportunities to mix around and interact with students from the other communities. Thirdly, and more importantly, we must remember that SAP schools are not established purely for the teaching of CL1 and EL1. Another main objective is to maintain the excellent tradition of the Chinese schools. If parents from the other races are willing to send their children to the SAP schools and to study in an environment of traditional Chinese schools, I believe the SAP schools are ever willing to accept and welcome them. There is one point that I wish to respond. This is about the cultural months. We have listened to Dr Lau Teik Soon just now and I have also read Dr Tay Eng Soon's suggestion that we should have a Singapore Cultural Month among the ethnic groups. Firstly, we must understand one thing: if we do not have a Singapore culture, how are we going to hold a Singapore culture month? How could we have a drama performance if we have not written the scripts? If we merely put the art performances, handicraft, and food stalls of Chinese, Malay, and Indian, can we call this a Singapore culture? I remember I read an article in a book called "Management of Success". There is a formula: S = C + M + I + O. S represents Singapore, C for Chinese, M for Malay, I for Indians and O for others. Are we prepared to accept this formula, ie., S = C + M + I + O? Secondly, if we are not proud of our own cultural heritage, how could we appreciate and respect other people's cultural heritage?”
“Maybe Members are all tired of listening to me. To speak to those who do not understand Chinese about the Chinese language is like playing the harp to the cow ( ). I do not know whether the cow is stupid or because the player could not play well, but it is sad that the player has to go on. I hope that the policy makers in the Ministry of Education will not feel that learning 3,000 characters within 10 years is too much. Let me give some statistics. The Lianhe Zaobao has been using 3,428 words in Chinese and it has a core vocabulary of 11,622 items. But in the curriculum for Secondary 4 students, there are 3,000 single words and 10,509 vocabulary items. So the number of words is still less than that used by Lianhe Zaobao. If we were to reduce this number, then there will be a bigger difference between the curriculum and the words used by Lianhe Zaobao. This will result in our secondary school students being unable to read the Chinese papers and magazines. Then how are we going to encourage them to learn Chinese, so as to acquire the values, and to cultivate their interest in their own culture? When we were talking about the bilingual policy, some Members mentioned that students in SAP schools lack the opportunity to interact with students of other races. First of all, I would like to say that students in SAP schools have opportunities to interact with students of the other races during their ECA or sports activities. From what I know, we have right now the World Conference of Girl Guides in Singapore. The organisers make sure that students from various schools and of various races work together. I know this because my child is studying in one of the SAP schools. Her partner is a Malay student. They have been working happily together. 4.”
“At the appropriate time, the Chinese organisations or enterprises should cooperate with Mendaki by enriching its financial resources so that more Malays stand to benefit. The Member for Sembawang GRC, Mr Charles Chong, mentioned that those who have difficulty in English normally suffer in silence but those who have difficulty in their mother tongue are more vocal in their protest. The bilingual policy is a right policy. In 1989, the President, in his speech, stated that the promotion of mother tongue was to enhance the teaching of traditional core value. In this Presidential Address, the addendum on the Ministry of Education has reiterated that language acquisition is central to learning. The younger Singaporeans should learn their mother tongue so that they can retain their values. The Ministry of Education has decided to give priority to primary education. We should give credit to the Ministry for this decision. At the primary level, inculcation of moral education and core value and learning of mother tongue will be most effective because primary school students are in an impressionable age. Therefore, I suggest that in the first three years of primary education, more time and emphasis should be given to the learning of mother tongue than English language, and that only in primary four should the emphasis be reversed. In fact, if we look at Japan and some of the Western countries, they are using the sequence method, that is, to learn their mother tongue first before they start learning English. This has not affected the progress of the economy or technology in these countries. Although we have been using the parallel method, we could use the experience of these countries for our reference. On the teaching of Chinese, I have spoken a lot about it.”
“Some of them even use their votes to bargain with the Government, and some choose to emigrate for minor excuses. Sometimes in my discussion with my colleagues we often sigh and ask, "Why is it that during the 60s and 70s when we went overseas to study, we were prepared to give up the opportunity of getting higher pay by staying in the foreign country, and chose to come back to Singapore where our careers were not certain, but now that Singapore is much affluent and offers better opportunities, why are some professionals migrating and pledging to be citizens of other countries?" Another problem is brought about by our multi-cultural and multi-religious society. For example, some people question the bilingual policy, and some dispute the celebrations of cultural months by different ethnic groups; there are conflicts between religions and there was controversy about the tertiary education fee of Malay students. On the last issue, Mendaki has made a very bold decision, that is, Malay students who come from well-to-do families will have to pay part or all the fees in the tertiary institutions. This decision will not only benefit Malays in the lower income group, but, more importantly, Mendaki has given a signal that the Malay community is prepared to march together with other communities on equal footing. As stated in the Presidential Address, "it augurs well for the progress of the Malays and the integration of the different races of Singapore." The Chinese community should make an appropriate response and to encourage our Malay compatriots to march forward in this new direction. Chinese companies should give the Malays equal opportunities of employment and to do away with any misconception of racial discrimination in employment.”
“And for this reason, I am full of confidence for our economic future. In the economic arena, there is one problem that has been troubling the Government, ie, the distribution of social services. On the one hand, we have to satisfy our people's demand in the quality and diversity of our social services. On the other hand, we have to look after the lower income families to make sure that they are adequately taken care of in the areas of education, health care and housing. This is a problem of distribution of wealth in economics. In this area, we cannot depend too much on market forces. We must strike a balance between efficiency and equity. At the commencement of this new phase, we should remind ourselves that the PAP still advocates democratic socialism. We must ensure that the children from the lower income families will have an equal opportunity to be educated in independent schools and tertiary institutions. We have to provide adequate subsidies so that the poor will get good medical care. However, I believe the biggest problem that the second generation leaders will have to face is not in the economic area but in culture and politics. The Commonwealth magazine ( ) has described Singapore as follows, and I quote: "The lack of root in culture, the confusion of values and the impact of westernisation are problems that are gradually surfacing in the horizon." Prolonged prosperity and stability have led to complacency. There is no crisis mentality, and the people have developed an illusion that the stability and prosperity that they have enjoyed up to now will automatically go on forever. They have higher aspirations and they become fussy over things. What they ask is: what can the country do for me and not what I can do for the country?”
“In late May this year, I went with the Deputy Speaker (Mr Lim Boon Heng) and two other colleagues to Brussels and Berlin. We saw the Berlin Wall being knocked down and I picked up a few pieces of stones from the wall as souvenir. I was deeply impressed by the economic dynamism in Europe and the self-confidence of the Germans. We have to strengthen our economic ties with the European Community. In the meantime, we have to cultivate more talented people who speak German and French. The rise of the European economic power does not mean sunset for the Asian-Pacific region. This region is still full of vitality, great potential and has its competitive advantage. Apart from Japan and the four NIEs, we will see Thailand, Malaysia and Indonesia taking off one after another. The First Deputy Prime Minister has just mentioned about the triangular economic growth between Singapore, Johor and Batam. That will give us more confidence in the growth of this region. But I want to point out that the cooperation among these three countries is for economic purpose based on certain complementarity of such factors as land, labour, capital, management and water. At the same time, though China is suffering a setback because of the Tiananmen event last year, perhaps there will be another turmoil with the change of leadership. I believe the open door policy of China will not be changed. No one can afford to ignore a US$300 billion economy. If China can maintain Hong Kong as it is after 1997, and if it can come to some economic agreement with Taiwan, then China will play a very important role in the Asia-Pacific region. Singapore is the hub of the Asia-Pacific economy and it has maintained good relations with the United States and the Western European countries.”
“Those that have done so will continue to be gazetted unless they acknowledge that they were in the wrong and satisfy us that they will not interfere in our domestic politics again. Mr Speaker, we have a bright future ahead of us. We face it with good cheer and confidence. For that, we owe it primarily to one man - our Prime Minister. [Applause]. Dr Ow Chin Hock (Leng Kee)( In Mandarin): Mr Speaker, Sir, the conclusion in the Presidential Address is that we have reason to be full of confidence for our future. In our new phase, we have to seek new challenges to inspire our people to continue in their work for a better life. A good life does not mean just material life. We have to cross into another dimension, including the art, cultural and recreational activities. For those who have visited the Singapore 2000 Global Technopolis exhibition, they would have an insight into the type of comfortable and convenient way of life in the 21st century and be optimistic about the future of Singapore. I believe the people of Singapore will work harder to promote good economic growth because this would benefit everybody. So long as the free and multi-lateral trade system continues to function, so long as productivity continues to increase, and so long as the management efficiency and organizational ability continue to improve all the time, we have reason to believe that our economy will continue to expand. Of course, we have to closely monitor the advance in technology and the changes in the international market so as to seize the opportunities that come with these changes. In 1992, the unified European Community will be established and it will be a force to be reckoned with alongside the North American and Asia-Pacific region.”
“Next, I have to decide on who would be my Deputy Prime Ministers, and whether I have one or two. I have decided on two Deputy Prime Ministers. Third, though we have decided on Mr Lee's role after he steps down as Prime Minister in the Cabinet - Mr Lee will be a Senior Minister - we will also have to prepare for a role reversal. Fourthly, Cabinet changes. There will be no drastic reshuffle. It will be a Cabinet that reflects continuity rather than radical changes. Lastly, even as we work on the programme of this Parliamentary session, we are simultaneously preparing the programme for the new session, for the next President's Address. It will be a fresh programme to bring us a few steps nearer our Vision of 1999 which we formulated in 1984. The society which we want to bring about will be more refined, more compassionate, kinder and gentler, to borrow President Bush's words. But it will not be a welfare society. The Government will not run a budget deficit. It will continue to revise fees periodically, in line with changes in costs and wage increases. The Government will not flinch from taking critical decisions on issues which are for the national good. It will continue to be hard-headed and tough-minded. It will not govern by popular polls. There will be greater freedom for Singaporeans to make their own choices, and to express themselves, but this freedom is not extended to actions which rock the boat. We will not allow anyone to capsize Singapore. We will not brook interference from foreign newspapers in our domestic affairs. Those that do will be gazetted and have their circulation reduced.”
“Political succession cannot be considered successful or completed unless we win the people's support at the next General Elections. How we perform will depend on how we discharge our responsibility to the people, whether we can give a new lift to their lives and whether we have gained their confidence and trust. That is important. We have got to gain their confidence and trust and we have three or four years to prove that we can perform, that we can give them a new meaning to their lives. We have to understand the aspirations of the people. That is important. Unless you understand their aspirations, their hopes and fears, you cannot realise their aspirations for them. Singapore is a middle-class society. So there are new aspirations, middle-class aspirations. These have to be met. At the same time, there are others who are not quite yet middle-class. They too have their aspirations. And in our society, as in any society, there will always be an under-class. They too have their problems and their aspirations and those aspirations too must be met. Talk and rhetoric will not do, not sufficient. You have got to go beyond talk and rhetoric, translate ideas into practical programmes which can benefit the people, and the people must see the benefits of these programmes. The next few months will be busy ones for us. We have a heavy legislative programme - elected President, the Maintenance of Religious Harmony Bill and, also as important, a White Paper on shared values. I also have to make several major decisions. I will consult my colleagues but ultimately I have to decide for myself. I have to take these major decisions myself. First, I have to settle the date of changeover. It will be a November date.”
“Singaporeans are reluctant to work abroad, I think, for very good reasons. One is Singapore is a very attractive place to live in; secondly, education of their children. As good parents they are concerned with the education of their children. So we have got to begin to address the problem and see how we can look after the education of their children, and we will address this problem in due course. Mr Speaker, Sir, this session of Parliament is rather special. It is a changeover session, like a changeover in a relay race. I can sense that there is quiet excitement, although there are no fireworks in this debate, but that is as it should be. It shows that we have dealt with the major problems successfully. MPs do not feel agitated over unsolved major problems. Otherwise they would have raised them over here in this House. Circumstances are as favourable as they can be for the baton to be handed over. But the life of a nation or a society is a never-ending relay race. We may have covered one lap outstandingly. But there is another lap to be covered, and yet another lap and another lap, and by new runners. We are ahead in this lap. Do we have the stamina to stay ahead in the next lap, and the lap after that? There is no guarantee that we will still stay ahead, or that others will not overtake us. How to stay ahead, and give Singaporeans a prosperous, secure life? This is the basic question we must increasingly ask ourselves. The Prime Minister will pass his baton to me later this year. But that does not mean I am running the relay alone. We are all that runner. You are not a spectator or a disinterested outsider. You are on the field, running collectively to keep Singapore ahead. Metaphorically, all Singaporeans are now running that new lap.”
“This point came to me vividly when I had dinner recently with a group of investors who participated in the Global Technopolis Exhibition. There were about 10 of them, and I asked whether they have investments in Johor. I was surprised that all 10 have plants already in Johor. And one of the investors also has a plant in Batam, and a few more are thinking of setting up plants in the new industrial park which EDB is jointly developing with Batam. These investors are excited over the triangle of growth concept and they are assessing whether there will be genuine cooperation between the three countries. If they feel that there is, then they are going to further invest in the region, because it is very convenient for them to do so, taking advantage of the resources and labour available in the other parts of the region and using Singapore's organisational ability, its financial attractiveness and transport and communication infrastructure. When the growth triangle takes off, we can link it with other growth points or other regions. We can begin to invest, and encourage investments, in the northern Malaysian states in Penang, Kedah, Langkawi. Sarawak is interested in developing its tourist potential. We can link with Sarawak, invest in Sarawak. Not just Singapore investments but investments from Johor, and investments from other foreign interests. We can link up with Brunei, Sabah, and other parts of Indonesia. And as this concept grows, and as the plan is being realised, we can go further afield, and from bigger triangles or stronger links with other triangles or other developing regions in other parts of the world. As we go international, we need a new breed of Singaporeans, the expatriate Singaporeans or those who are required to work outside Singapore for long periods.”
“I see droves of these passengers coming to Singapore, and then from Singapore moving outwards to parts of Johor, to Pulau Bintan, to Batam, particularly when the holiday resorts are ready. I see cruise vessels ferrying passengers from Singapore to these areas for those who have time to take a leisurely cruise. For those who are in a hurry to go to their destinations, there will be hydrofoils and hovercraft taking them over quickly to Batam, longer to Bintan, and perhaps a little longer to Desaru. I see this place teeming with tourists because the Japanese will be travelling in a big way; the Germans will be coming too. And as the world develops, other tourists will come to this part, provided we can attract them over here with good facilities. Now, Johor wants to develop Desaru, Pulau Bintan wants to develop its Pasir Panjang. Singapore can help in these developments by having a ferry terminal at Changi Point - a modern ferry terminal which can cater to the ferry boats and the passenger ships. For the next stage of our economic development, Singapore has to go international. We have to think international - beyond Singapore, think of the region and beyond. This is because nowadays manufacturing processes are located in many parts of a region, not necessarily in a country. Investors now do not just evaluate a country by country. They evaluate whole regions, the single European market, for example, Eastern Europe as a region, the Asia-Pacific as a large region, and the triangle of growth as a smaller region. They would have one component manufactured in one country, another component in another country, and another component yet in another country, depending on the comparative advantages these countries offer for particular components.”
“But despite the high costs, we will pay for the development and for the pipe-line from Sumatra to Singapore. We will just write off the expenditure the way we have written off the investments in our MRT tunnels. In other words, treat them as infrastructure, pay for them, and hand them over to the PUB. We welcome Indonesia' offer of water to Singapore from Bintan and Sumatra. We will reciprocate by helping Batam and Bintan to develop. That is the least we should do. In exchange for the water from Sumatra, we have to reciprocate, and economic growth, if we can help them to do so, is the best way of reciprocating. Singapore can also help Johor to develop. I see Johor becoming a newly- industrializing state within Malaysia. It has tremendous potential - land, good beaches at Desaru, and also more labour available in Johor than in Singapore. It has also better infrastructure than Batam and Bintan. But Johor lacks capital and managerial expertise and, of course, entrepreneurship which Singapore has. So Singapore can provide capital, entrepreneurship, managerial and, computer programming expertise to Johor. But how fast Johor will grow depends on what signals they give to foreign investors, in particular to Singapore investors. If it signals that it wants cooperation from Singapore, it welcomes investments from Singapore, and also of course when it signals that there is good cooperation with Singapore, I believe investments will pour in into Johor. Let me give you another example of this potential of the growth triangle. Changi Airport is being developed to handle huge volumes of passengers, some 20 million passengers per year.”