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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“This triangle comprises Johor, the Riau Islands of Batam and Bintan, and Singapore. I expect Singapore to grow by about 5% or 6% per annum over the next few years. But Johor and the Riau Islands can grow by a much faster rate. This is because both Johor and the Riau Islands are start- ing from a lower base. They also have abundant resources, untapped resources, long stretches of beaches under-used, and also more labour than Singapore. More importantly, Johor and the Riau Islands will be getting a cheap supply of energy. In the case of Johor, gas from Trengganu. In the case of Batam and Bintan, gas from the Natunas. They can supply food to Singapore - pigs, poultry, fruits and vegetables. They can industrialize. In tourism, this area can be the Caribbean of the East. Let me give you an example of how cooperation can make this triangle of growth concept work. Batam and Bintan do not have sufficient water over the longer term to support a bigger population. And Indonesia wants both islands to prosper and grow so that they can support a much bigger population than now. Singapore also needs water. And water is available in Sumatra, but from Sumatra to Singapore the distance is over 250 km, and much further than 250 km to Batam and Bintan. It will not be economical or feasible for both these islands to tap water supply from Sumatra or even to pump water from Pulau Bintan to Batam. But if Singapore comes into the picture and we provide the base for water supply from Sumatra, then Batam and Bintan can tap water off the pipe-line from Singapore from Sumatra. That makes it economical for Batam and Bintan to have water from long distance. Of course, the pipe-line and the costs of development will be astronomical, even for Singapore.”
“I understand that Kuala Lumpur is still working on the draft. As far as I can see, there are no major obstacles. At any rate, it will not affect the time-table of leadership change in Singapore. Prime Minister will continue to see the Water Agreement through, whether he is Prime Minister or not. I have asked him to settle old accounts as I prefer to open a new era unfettered by old thinking. Once the Water Agreement is signed, it should open up a new chapter of cooperative relationship with Malaysia. At least that is what I hope, and that is what I will work for, not just with Malaysia, but also with Indonesia and our other neighbours - a new era of cooperative relationship with them. We are living in a new world, a world that is turning its back on past unhappy experiences. The Berlin Wall is now a historic relic. The two Germanies are being united. The Warsaw Pact is being dismantled. Gorbachev has met Roh Tae Woo. The Japanese Emperor and Prime Minister have apologised to South Korea for Japan's past misdeeds during the Second World War. The world is marching relentlessly towards peace, greater cooperation and openness. Everywhere, there is movement forward. It is a world that is breaking loose from its past shackles of animosity. In such a world, we too need new attitudes and a new relationship with our neighbours. We must not be handcuffed by history. We have to break free, and play and work together, for a more prosperous ASEAN and a more peaceful world. As I look into the future, I see a prosperous ASEAN, including perhaps the Philippines, provided the Philippines can put its own house in order. Within ASEAN, there will be a smaller region, a growth triangle, a special region that will grow faster than the rest of ASEAN.”
“I will look into that. The First Deputy Prime Minister and Minister for Defence (Mr Goh Chok Tong): Mr Speaker, Sir, I am encouraged by MPs' support for my consultative and participative style of Government and Government's programme and direction in the coming years. They have raised many useful points. These would be addressed in due course. What I want to do this afternoon is to share with you my priorities over the next few months. Two years ago the Prime Minister indicated that he was ready to step down. I asked him to carry on for two more years. I wanted him to complete his negotiation with Malaysia over water and gas supply to Singapore. The supply of water to Singapore is a very sensitive and complex issue because of its wider political implications. Under the 1962 Water Agreement we are entitled to draw up to 250 million gallons per day, but unfortunately we cannot draw that quantum unless we build dams over certain parts of the Johor River. These dams have to be built but their construction requires the approval of Malaysia. PM is seized with this problem and has dealt with this for two and a half decades. We agreed that it was better for him to settle this with Dr Mahathir than for me to do so. Since then, we have made good progress over our negotiations over water with Malaysia. The Prime Minister and Dr Mahathir signed a Memorandum of Understnding on 28th June 1988. That paved the way for the Mentri Besar of Johor, Tan Sri Muhyiddin, and I to sign an agreement over the compensation to be paid when we build Linggiu Dam and also over the price formula for the treated water which we will be buying from Johor in excess of the 250 million gallons per day. But the formal Agreement has yet to be signed. It should have been signed by 20th April this year.”
“Sir, we will look into their needs and we will help them where necessary and where possible.”
“Sir, Dr Lee stresses that hospice care givers will have to provide social, moral and spiritual support. I agree, and that is why this sort of support is best given by volunteers. It is also best given by members of their immediate families as well as friends. Sir, we will help the voluntary organisations in terms of training, but they must reach out to encourage more volunteers to come forward, volunteers who are fully committed to this role. The Ministry will provide the support to help them to carry out this job once they have identified those volunteers. Sir, in terms of health screening programmes, we already have a health screening programme for the elderly. As I have mentioned just now, these are carried out in the senior citizens' health care centres and these are provided free of charge for the elderly. If Mr Yeo is referring to the health screening programme for the general adults, it is also available from several polyclinics and our intention is that we would extend these health screening programmes for adults to other polyclinics as and when we are able to get staff.”
“Then when they are well enough to go to the senior citizens' health care centres, they are then brought to these centres where the rehabilitation equipment is available. We also provide respite care for families with elderly sick so that they can bring the patient to the hospitals for a period of time in order to allow the family some respite from their work. Sir, we also provide training for independent living for the elderly as well as training for members of the family to be able to assist the elderly who are living at home. All these programmes will make it easier for the families to cope with their elderly relatives and therefore allow the elderly to be looked after in their own homes.”
“Sir, we already have a mobile X-ray team that routinely visits the senior citizens' health care centres as well as the senior citizens' clubs at the various community centres. They also visit the homes for the aged. All elderly persons are encouraged through the grassroots organisations to make use of such mobile services whenever they are in the area. These services have been provided free to the elderly. We also provide free check-ups at the senior citizens' health care centres and this will continue. We also encourage doctors in the locality to participate in providing free health care screening for members of the senior citizens' clubs in the various community centres and I think this programme is available in many of the clubs in the community centres. In terms of geriatric care for elderly in the hospitals, we have already started a programme in Tan Tock Seng Hospital. They will develop another department in Toa Payoh Hospital when it is rebuilt with 80 beds. To prepare for the growing number of elderly, we have already embarked on a programme to train doctors, nurses, therapists and social workers in geriatric medicine. We have also invited foreign experts to come to Singapore to help train our local staff. Mr Yeo asked about the level of home support for families at home. Dr Lee Siew-Choh has also asked just now about what we are doing for stroke patients. Sir, we already have a home stroke rehabilitation programme for stroke cases discharged from our hospitals. The programme ensures that the rehabilitation is done early and is carried out in two stages. The first stage is at the home of the discharged patients provided through our Home Nursing Foundation.”
“I think it will lead to a situation not unlike the former death houses in Sago Lane. This would be a retrogressive step if that were to happen. As pointed out by the NCMP, 10-15% of the patients are admitted into the hospitals and they are admitted in their last illness. This is unavoidable and my Ministry will cope with them. The development of the community hospital will in a way help to alleviate the problem. The community hospital will provide facilities for the terminally ill to be admitted in the last few days of their life. This would ensure that they are made comfortable and free from pain. The provision of hospice services requires dedicated volunteers, ie, people who are fully committed to the role that they have undertaken. It is a function which is best left to volunteers, because I do not think paid staff would be able to do the job very well. My Ministry is therefore prepared to provide support to such voluntary organisations. For a start, we have already made available office space in the primary health offices in Dunearn Road to the Hospice Care Association. We are also helping the Home Nursing Foundation to provide nursing care to the terminally ill in their homes. We will also run special training courses for our doctors and nurses to deal with the medical problems of the terminally ill. In this way, we will also be able to train members of the voluntary organisations as well. Mr Yeo Toon Chia has asked what the Ministry is doing in improving the care for the elderly. Sir, he has asked that easy access be made available for the elderly in terms of routine check-ups and in terms of X-rays and what are the charges for such programmes.”
“Sir, Dr Aline Wong has suggested that the Ministry extends the senior citizens health care centres to all polyclinics and that we assign more MOs and more paramedical staff, nurses and therapists. The plan is for the senior citizens health care centres to be set up in all the 10 new polyclinics. These will be open by the end of 1994 when the last one is completed. We will definitely look into her suggestion that we look into how to expand the facilities to all polyclinics as well. I think the problem is that the existing six polyclinics, which are of the older generation ones, already suffer from shortage of space. And the senior citizens health care centres are quite space intensive. So we have to see how we can get around that problem. On the grant for more funds, the Ministry will ensure that adequate funds are given to ensure that the programme can operate well. On the question of whether the day care centre programme can be stated separately in the budget presentation, we will look into that. Dr Lee Siew-Choh has talked about hospice care and he has asked that the Government gives support to this programme. Sir, we believe that a person's last days should be made as comfortable and as free from pain as possible, as pointed out by Dr Lee. We feel that there should be dignity in dying and that this should be in the environment of the home among the immediate family and the loved ones. As such, we encourage the concept of hospice care at home. This means that the terminally ill will be nursed at home by the family with the support of voluntary organisations and existing services from the Home Nursing Foundation. Sir, hospices, if not run properly, are likely to deteriorate into places where families dump their elderly sick.”
“Sir, Mr Choo Wee Khiang is trying to show that he is very compassionate. I appreciate that. But unfortunately the hospitals have to recover what it costs them to operate the car parks. Therefore, visitors who use the car park pay for it; those who do not use the car park, ie, they go there by bus or by taxi, are not required to pay for the car parks.”
“Sir, as I have mentioned, NSC imposes a small mark-up to cover the overheads. If he could give me the bill size of the item, I will find out why it is more expensive. I am sure that the NSC would be shown to be not over-charging.”
“Sir, unfortunately, his message did not come through clearly. If that was his intention, I fully appreciate his intention and I hope that this message will go down to all Singaporeans. He has also raised a point which I overlooked, and that is, the bill size for the National Skin Centre, the medication being more expensive than what was available from the private sector. Sir, I am not familiar with the item. In fact, he did not even mention the item. But I can say generally that the guideline adopted in the National Skin Centre is that they will have a small mark-up on the actual cost of the medication to cover the overheads. It is a small mark-up and I think it is fully justifiable. Patients have a choice of going to the Centre's pharmacy to buy the medicine or they can buy the medicine elsewhere. The case mentioned by Mr Choo again is also a non-subsidised patient. For subsidised patients, those who are treated at the National Skin Centre, are charged only $1 per item used.”
“So we do audit the private sector claims more often. What was found? Sir, the audit reviewed that the errors were mainly minor. First, there were few errors and those few errors that were found were mainly minor errors, and there was no deliberate attempt to take advantage of the Medisave system. There was no over-treating of patients and there were no overstays that were found. On the methodology, Sir, I do not have the information. But from memory, the auditors will sample Medisave claims and they will then ask the respective hospitals and doctors for the medical records of the case. They will then audit through the diagnosis of the patient's conditions, what were the complaints and what was the treatment that was carried out. So they do look into the medical details and also to ensure that the treatment was in accordance with the patient's medical conditions. He has also asked whether we have any intention to enlarge the audit. At the present moment, we are quite satisfied with the results of the audit and therefore there is no intention to expand it further. However, if the trend proves to be disturbing, then we will definitely increase the number of audits to deter any wrongdoing. He has also asked whether there is an intention to implement preventive audit. I am not too sure what he means. But what we intend to do in the future is to make the Medisave claims into a computerised format. In this way the doctors, who make a claim on behalf of their patients, will then be able to vet whether the claim is correct, whether the operation carried out is correct, and therefore avoid any of those minor errors that had been found. So we hope that in this way we will also avoid those minor errors that we are finding.”
“We will look into how we can make it compulsory even for all patients who are to be admitted into hospital to receive this multi-lingual brochure so that they can be informed patients before they gain admission. Incidentally, the brochure will also advise the patient on what information to look for or to ask from their doctors. For example, likely length of stay, likely complications, costs. All these pointers are there to help the patients. Sir, I think the patients who do read through those brochures will be fairly well informed. He has asked for a report on the Medisave audit. Sir, the Medisave audit scrutinizes both the financial as well as the medical professional aspects of Medisave claims. The financial part is carried out by the CPF Board auditors and they review regularly whether the Medisave withdrawals are made in accordance with the Medisave regulations and guidelines. They also verify, for example, the relationship between the owner of the account and the patient for whom the account is being used. This is to make sure that the Medisave account holders are not using the Medisave funds for people other than their immediate family. So this is to safeguard against abuse. The medical professional audit is conducted by my Ministry and we check for any irregularity in diagnosis and medical procedures carried out by the doctors. We also look into whether there is any gross investigation, any gross over-medication and whether patients are over-staying. It also ensures that the claims for surgery and other charges are in accordance with the Medisave schedules. Sir, he has asked for the number of cases that were audited. In 1989 a total of 2,716 claims, making 1% of the total claims, were audited. For the private sector Medisave claims, this represents 3%.”
“Otherwise they will have to top up over and above what they can claim through Medisave. Medisave has a safeguard of $300 a day. Anything that is above that has to be topped up in cash. So the patients who go there must know that they must have enough cash available to top up. Otherwise they should choose the B2 or the C class for which there are plenty of vacancies. He has also made some remarks about car parks. He said that the moment the hospitals were restructured paid parking came in. I think Members speaking in the House also owe it to themselves to verify what they say. I do not think Members should come to the House and make statements that are not true. Sir, the Government hospitals have been having paid car parking all along. In the Government hospitals, the car parks were operated by the URA on the coupon parking system. When the hospitals were restructured, and being a private hospital or owned by a private company, the URA was not prepared to continue with its coupon parking system. Therefore, the restructured hospitals have no choice but to offer the management of the car parks to a company which actually provides a better level of service, because now you do not have to worry about coupons. You just go in, take your parking ticket, and stay as long as you like, or as short as you like. When you want to go back then you pay. So it is an even higher level of service to the visitors. Therefore, it is not true that the restructured hospitals took the opportunity to introduce paid parking the moment they were restructured. Sir, he has asked that we educate patients on avoiding overuse. That is a good point. As I have mentioned earlier, we will be doing that. The brochure on this will be ready very soon.”
“Oh, it is a copy of the bill. Sir, I have spent quite some time explaining about hospital cost and what patients should be expected to pay in the respective classes of wards. Sir, the Government's policy has always been that the low income group who uses B2 and C will be heavily subsidized and therefore the bills in those wards would be highly affordable. The Member has come quoting figures without telling the House what class of wards they were in. I think the impression gained has been that those are patients who were admitted into the lower class wards, maybe unintentionally. I think it is important for us to realise and for us to give the right message to Singaporeans that, depending on your income level, you should be using the class of ward that is most appropriate to your level of affordability. B2 and class C will always be affordable. Adequate subventions will be given to them. But I do not think the Member is suggesting that for patients who are admitted to B1 and A, who choose to go to those wards for a higher level of privacy, for a higher level of air-conditioned comfort, I am sure he is not suggesting that we also subsidize them in order to make it possible for them to go there. Sir, the cost of hospital care is very, very high. Those who choose to go to the A and B1 must expect to pay the full cost of those services. At the present moment, they are still not paying the full cost because they are still receiving a subsidy. So the $27,000 and the $10,000 that the Member has spoken about are still too low because by right they should not have received any subsidy. So Singaporeans must take note that if they choose to go to the A and B1, they must be able to afford those wards.”
“Sir, he also read from a certain part of a letter. Could he tell us from the letter which class ward was the patient in?”
“Sir, before I reply to Mr Choo I would like him to clarify a few points. Firstly, the two cases that he quoted, the patient with a bill size of over $10,000 and the patient in NUH whose bill size was over $27,000. What class wards were they in?”
“Sir, we will look into this with the Ministry of Finance, since the budget documents are published by the Ministry of Finance, as to what can be done. But this is the established practice for all Government companies that whatever subventions they are receiving are shown just as subventions rather than the details of the companies' activities. However, as I have stated, Members, in the meantime, are free to ask for information. With regard to Dr Arthur Beng's points, we will ensure that they have a good neo-natology service.”
“Mr Speaker, Sir, if Mr Chiam would like to help us recruit, we will of course be very grateful for his assistance. Are you going to, Mr Chiam? Let me get on to the last Member, Mr Choo Wee Khiang. He mentioned "many". I think "many" are still not doing justice to the medical profession.”
“Because there are so many other attractive employment opportunities for school leavers. That is why we have to pay them more and that is why health cost must go up. That is why fees must continue to rise. Otherwise, we will not have any nurses in the future.”
“We will recruit locally the bulk of what we need and we will try to recruit what we can from overseas, the numbers of which I think will always be small.”
“I will, first, mention the surgical patients, because I think that is the more significant one. This is where Dr Tan mentioned that they can earn more if they operate on them in the private ward. Own choice - 55%; family and friend - 20%; employer or insurer - 11%; doctor - 8%; nurse - 2%; others - 4%. For the medical cases, own choice - 55% (same as for surgical); family and friend - 29%; employer or insurer - 6%; doctor - 9% (surprising, because medical doctors do not earn significantly from private patients; it makes no difference to them, whether it is A, B1 or C); nurse - 0%; others - 1%. Perhaps I will ask them to do another study. In the case of doctor, what did the doctor influence them? Did the doctor explain that for A and B1 wards, you have privacy, air-conditioned? Or did the doctor influence them by saying, "Look, if you don't go into A or B1, I won't operate on you." But whatever it is, it is 8%. We will look further into that to ensure that the doctors are not abusing the system. Mr Chiam asked about nurses. What are we going to do to solve the shortage? Sir, I thought I have been explaining that all along just now. Do you want me to repeat the answer? [Interruptions]. We will ensure that we are competitive, and we will try to recruit more, as we have done. I thought I saw Mr Choo writing down the figures just now. Do you have the figures? Maybe he can tell Mr Chiam afterwards.”
“We realise it is an expensive service, and that is why we have ensured that those people who want to use the service pay the cost for it. We also know that the success rates are low world-wide. In Singapore, our success rate for the IVF programme, if I recall correctly, is about 14% for pregnancy rate, which I think is fairly high, in comparison with centres around the world. It shows that doctors are careful in selecting the patients for admission to the IVF programme. We have also informed the private sector IVF centres that we will monitor their pregnancy rates very closely too. And if their pregnancy rates are low, it means that they have not been strictly vetting their cases, we would withhold permission for them to continue operating. I think the IVF centres are fairly new. Let us give them time to operate, to build up their experience and to ensure that the service that they are giving is of a high level. He has also talked about patients who are being encouraged to use B1 and A, otherwise the doctors will not operate on them. I have some data here that show the results of a survey carried out in February this year among patients in A and B1 wards at SGH and NUH. A total of 176 patients in these wards who had undergone surgincal operations were reviewed and a total of 113 patients were asked and these were in the medical wards.Again, these are forms given to them and they are anonymous. They filled up the forms and they just popped them into the boxes. We asked them: Who influenced you in the choice of wards? And we listed: own choice, family friend, employer/insurer (because some employers do offer certain benefits as well as insurance schemes that they purchase), doctor, nurse, others.”
“I think I will be fair to him. I will not load him with an old hospital. To be fair, if he is prepared to, we will give him a new hospital to run. Sir, Dr Arthur Beng asked whether the lifting of the consultation fee scheme limit will also result in more trainees opting for surgical disciplines. First, I want to bring Members back to the point that even before the lifting, the surgeons were already earning more than the non-surgeons. Those who are interested in the salary would have left for the private sector and will earn even more. So I do not think lifting that cap would in any way influence the trainees to opt more for surgical disciplines. But in any case, the number of surgical traineeship posts is always limited, and they have always been filled. So if more opt for them, it only means that the departments will have a bigger choice of trainees to choose from. Sir, Dr Tan Cheng Bock gave a long speech about the specialists performing operations under Tables 5 to 7. That was the point which I was trying to make - that no matter which ward you are in, if you require a specialist of that order to operate on you, you will be entitled to one, and you are not going to be given to a trainee or a Medical Officer to practise upon, which is what I think many Singaporeans fear. So my aim, if he had been listening properly yesterday, was to inform the House and Singaporeans that, don't you fear, if you have a serious condition, no one else but the consultant or the Senior Registrar will be looking after you. So I was in no way deceiving the House with data. It was meant with that in mind. So it was not an attempt at deception. Sir, he also talked about IVF and whether we know that for IVF we need high level staff and that it is a very expensive service.”
“I will ask my officers to get in touch with him to work out the details. An hon. Member: Alexandra Hospital.”
“If there is any private sector group that is prepared to take over one of our hospitals and operate it with the subventions that are available, and still provide subsidised care of a comparable level to the other hospitals, with comparable charges for those in the lower income group that use the B2 and class C wards, there is no reason why we should not. I hope Dr Arthur Beng and maybe even Dr Tan Cheng Bock himself may want to have a try at running it. [Interruptions]. If he is interested, he can also come forward and make us an offer, and we will review that.”
“But again I do not think that is in the interest of patients. What plans do we have for upgrading Alexandra Hospital? Sir, we are looking into it on what we can do with AH, in terms of improvement of facilities, and to ensure that the equipment that it has is at least adequate. Dr Aline Wong suggested that we disallow walk-in referrals. I think that is a good suggestion. I will ask my officers to look into that. She also mentioned about specialists working overtime and that the staff are not benefiting. Sir, I would imagine that if the staff are asked to work overtime they should be paid overtime rates. Let me look into that again. Otherwise, I do not think they will be working there voluntarily. But I will definitely ask my staff to look into it. Dr Arthur Beng has asked about the role of MOH after the restructuring. Sir, the role of MOH would be, firstly, the primary health care. Then, we have preventive health care and promotion of health, which are very crucial activities. We will still be monitoring and coordinating the activities of the restructured hospitals. Let us not forget that even though they are restructured and autonomous, they are still Government-owned. We must still ensure that the subventions that they are getting, which are tax money, are being used properly, and that those in the lower income group who seek treatment there are being given a good level of care. And with the restructured hospitals, I think that would in fact take up even more time than with the hospitals operating as a MOH hospital. He has asked whether we would be prepared to let a new hospital be operated by private sector people. Sir, I think that is a good idea.”
“I think that would be very retrogressive, much as Dr Lee would like us to do. Sir, he talked about the US system being inferior. I did not say that the US system was better. I said that, if he had been awake and listening, the Soviet Union, with its free system, has 15 more times usage of medical care than the US. And the US is really bad enough, because US has one of the highest usage rates. And I think Singapore would be well advised and well served if our people do not follow what is happening either in the US or, worse, in USSR and China. Sir, he said that if we had not lifted the cap on earnings, there would have been no grievances about salaries. Surely he knows that every year the Government service loses large numbers of specialists to the private sector because, firstly, they can earn a lot more; and secondly, they have a much higher degree of freedom and autonomy by being their own boss. The least we can do is to ensure that the gap in salaries is closed a little bit. They cannot be their own boss, but we try to allow them as much autonomy as possible in carrying out their practice in the Government service. This way, we will then best serve the lower income group that MPs and the NCMP profess to be very concerned about. Dr Aline Wong talked about the subventions for SGH and that the increase between 1988 and 1989 did not appear to be real, because they reflect hidden subsidies. Sir, yes, they reflect hidden subsidies. But, as I have shown earlier, the hospital has also been able to recruit staff to provide a better level of service. That cost must be recovered, otherwise SGH will be forced to allow attrition to bring that down to where it was before. If patients want that, it is very easy for us to force SGH to do it.”
“Sir, Dr Lee Siew-Choh asked whether we know that teaching time has been reduced and that the impact on teaching has been adverse. Sir, a study was carried out earlier this year and a questionnaire was sent to trainees (to be returned anonymously) asking for their feedback on the quality of training. I am happy to say, although I do not have the information here, that the bulk of the trainees replied that they felt that the quality of training has not declined in any way. I think the figure for that was in excess of 85%. If the NCMP likes, he can file a question on that and I will provide him with full information on the survey. He stated that patients would rather opt for SGH rather than Alexandra or any of the other Government hospitals. I think that is only commonsense, is it not? It is their choice. All the hospitals are available. If there is a hospital next to them, Tan Tock Seng or Toa Payoh Hospitals, there are all the facilities. And as Dr Lee Siew-Choh pointed out, they also equally have good doctors. If patients choose to go to SGH rather than go next door, it is their choice. This is Singapore. This is not China, please. He has also said that if C class was better, then people would opt for C class. They again have a choice. They want a better mode of accommodation, they want a little bit more privacy, there is B2 available for them. If they prefer something even better, there is B1. If they prefer to be isolated in a A class ward, single room, are prepared to pay for it, sure, the choice is there. They choose based on what they can afford. They choose based on what level of comfort they want. And we respect their choice. This is the free system that we have here. Sir, we should not be forcing everyone to go to C class if they do not want to.”
“Mr Speaker, Sir, I beg to report that the Committee of Supply has made further progress on the Main and Development Estimates for the financial year 1990/91, and ask leave to sit again tomorrow.”
“I remember in the past when the TV broadcasting section organised singing competitions, there was the classification of art songs and popular songs; whereas now, there is only one category of popular songs. This has deprived singers of cultural songs the opportunity to perform and the form of art songs has declined. As far as I could remember, singers of cultural songs have never appeared in the variety concerts of the TV section ever since. If this trend were to go on, then young people of Singapore will not ever know what is the form of cultural songs, not to talk of fostering their taste in cultural songs or ability in their appreciation. I hope SBC will pay attention to this aspect and check this trend of unbalanced development.”
“So from here we can see that certain mean characters with decadent thought and music would endanger the country by polluting and contaminating the cultural atmosphere of the country. This shows how great the influence of art and culture is over the people. Most of the pop song programmes produced by SBC are not lacking in enticing and bewitching sound and a great part of which are of the decadent type which will easily give a bad influence to our young people by numbing their senses and drowning their feelings. Other than radio, TV is just the same. Earlier, I was talking about the radio broadcast but now I want to talk about TV broadcast. In recent years, SBC has been striving to improve its TV programmes, with quite good results. Almost every night, there is a variety musical entertainment programme, the contents of which are mainly concentrated on pop culture and popular singers. Of course, this has something to do with the taste of our people. It has also something to do with SBC's abetment in organising such programmes. However, I would like to ask the SBC whether they should be influenced by the taste of audience and try to meet their requirements all the time which will only help to promote pop culture and popularising particularly Hong Kong and Taiwan popular foreign culture. The higher and deeper culture because of the neglect by the very important mass media, has not been promoted or has not been able to grow and develop well. For example, the artistic songs, cultural and folk songs which were regarded with equal importance in the past, have now declined and disappeared. On the other hand, popular songs have emerged and acquired the mainstream status.”
“But in respect of contents, it seems to give people the impression that there is some sort of compartmentation of programmes in that Chinese programmes mainly concentrate on the Chinese background and Chinese viewers, the Malay with only Malay background viewers and Tamil with purely Tamil in mind. They seem to have no relationship to one another in the multi-racial context of Singapore. Last Sunday, I happened to see a Malay TV drama. It was about young people taking to drugs. This would give people the wrong impression that the problem of drug taking is a Malay social problem and not a problem or concern of the whole of Singapore. So I hope that SBC would pay more attention in future to see that there could be more TV serial programmes reflecting our multi-racial backgrounds as a whole, not in separate compartments, according to ethnic backgrounds separately. Now, I would like to touch on the topic of popular songs. Last year, in order to meet with the competition from Batam, SBC set up one new radio channel producing only English programmes. This year SBC has produced another one called the 93.3 channel purely on Chinese programmes. So, there are plenty of pop songs on the air. Some people say that now our air is filled with all the pop songs with decadent or bewitching music. In the past, a student of Confucius, by the name of Yen Yan, asked Confucius how to rule a country. Confucius replied that it should be "fang jeng sen, yuen ling ren; jeng sen yin, ling ren dai." "Ling ren" means a mean person and "jen sen" represents decadent music. It means banishing decadent music and keeping away from mean persons. So one who rules a country should have an upright mind and should do away with the influence of mean people.”
“As a result, they would feel bitter and complain that SBC is not being fair to them. I hope that the above five points will be adopted to improve the development of our TV industry as well as to attract and retain more artistes for SBC. Sir, I would also express my concern over what Mr Teo Chong Tee had suggested in Parliament yesterday and today about SBC actors blending the use of the English word "Sir" for Mandarin Jan-Guan and "MC King" instead of bin jia da wan, as such use does not quite reflect the reality of our daily life. We should not use all sorts of dialects and slang that are available to pollute the proper Mandarin that is used in the programme. A few years ago, when I led a delegation to China I asked one of the team members how was his brother getting on. When he replied, he used a mixture of dialect, colloquial Malay, English and Mandarin. It sounded simple enough to us, but it was incomprehensible to the Chinese around. This is a very serious pollution of the proper Mandarin language. Should this kind of polluted language appear in the TV shows, then I fear it will lead to more serious consequences. I hope SBC should ponder carefully such use as suggested by the Member and avoid polluting and distorting our language in their shows. Mr Goh Choon Kang (Braddell Heights)( In Mandarin): Sir, I agree very much with the Member for Changi about the shows produced by SBC. The shows should reflect more of our local situation and realities. In the past few years SBC has achieved quite good results in these serial programmes they have broadcast.”
“SBC could replace the Artistes Liaison Unit with an Artistes Personnel Section. (I know SBC has a personnel section but it does not deal with the artistes' affairs). This section can deal with all matters relating to the artistes, for example, their performance, behaviour, welfare and safety as well as their discipline, awards and punishments. At the same time, this section can also collect feedback or complaints from the artistes so as to strengthen the industrial relationship between the artistes and the management of SBC. 2. To renew the artiste's contract six months before the expiry date. SBC should avoid renewing the contract at the last minute. In this way, the artiste will feel confident and secure. This can eliminate the wrong impression that SBC does not care for the artistes' employment. 3. To allow the artistes to have an equal opportunity to perform. Systematic planning and careful coordination of allocation of performance schedule would avoid misunderstanding between the artistes and SBC and also avoid the dignity of the artistes being hurt. 4. To allow the artistes to perform outside SBC's assignments, like in commercial advertisements, stage shows, opening ceremonies, etc. to make extra money to supplement their income and enhance their popularity, on condition that such activities would not affect SBC and their reputation and performance with SBC. SBC should not require them to work overtime without giving them extra payment. 5. To set up a code of conduct for part-time artistes. In case any part-time artiste makes a mistake, he or she should be admonished and warned. To quietly stop the part-time artistes from appearing on TV shows as a punishment will not achieve any desired effect as they would not know what wrong they have done.”
“I am just thinking that if we could selectively blend some of these simple conversational expressions used by our people in real life into the dialogues of our Chinese TV serials, then I am sure it would not have any adverse effect on the standard of these serials. On the contrary, it would enhance their local flavour and make these TV serials more convincing and interesting so as to strike a sympathetic chord with our people. At the same time, it would help to promote better mutual understanding and unity among compatriots of our various races and lend to a more harmonious and cohesive society. Sir, there is one other point I wish to raise. Since we have promoted various mass education campaigns, such as the Keep Singapore Clean campaign, Courtesy campaign and so on. I hope that SBC could also include the concepts of these mass education campaigns in the plots of these TV serials so that these education campaigns would perpetually exert an imperceptible influence on our people. I hope that the Singapore Broadcasting Corporation will consider and study my suggestions. Mr Peh Chin Hua (Jalan Besar GRC)( In Mandarin): Sir, we can be proud of the development and achievements of the Singapore Broadcasting Corporation over the years. This is attributable to the able management of SBC and the efforts by the artistes as well as the cooperation of all the staff and workers in SBC. However, recently, we have seen many resignations of SBC artistes and staff. This has caused us to worry about the future of the now lively TV performance of SBC, and has incited a lot of comments by the fans. From what I gather about the cause of resignations, I would like to suggest the following points to the Minister and SBC in order to strengthen the relationship between the artistes and SBC. 1.”
“As Tan Tock Seng Hospital has yet to be restructured and depending on the number of nurses who will be opting to join the restructured Tan Tock Seng Hospital we are not too sure, as to whether we will have the total number of vacancies that will be available to absorb those who opt not to join the restructured hospitals. MAIN AND DEVELOPMENT ESTIMATES OF SINGAPORE FOR THE FINANCIAL YEAR 1ST APRIL, 1990 TO 31ST MARCH, 1991 Order read for consideration in Committee of Supply [5th Allotted Day]. [Mr Speaker in the Chair] Head I (cont.) - Resumption of Debate on Question [19th March, 1990], "That the sum to be allocated for Head I be reduced by $10 in respect of Code IJ 3100 of the Main Estimates." - [Mr S. Chandra Das]. Question again proposed. Mr Teo Chong Tee (Changi)( In Mandarin): Sir, yesterday afternoon when Parliament had its moment of interruption, I was talking about the TV programmes produced by SBC. I will continue with my speech today. Sir, I am suggesting that when the SBC scriptwriters write their scripts they blend in the characteristics of the different lifestyles of our multi-racial society into the dramas. Let me elaborate - in our daily lives we are in contact with people of different races almost every day - in public places or in our offices when we meet our Indian or Malay friends, we would spontaneously greet each other in English or Malay, for example with words such as, how are you, selamat pagi, or apa khabar. And when we patronise the shops of our Indian or Malay friends, we would also use some simple practical words to communicate with them. Sir, I am not suggesting that we should make a mess of the dialogues in our Chinese TV serials and lower the standard of the Chinese language.”
“Sir, the restructured hospitals have offered subsidised medical care and benefits after retirement to officers and nurses who satisfy the following conditions. Firstly, the nurses must have had 10 years of pensionable service with the Government before joining the restructured hospitals; secondly, they have opted on the ex gratia award scheme; and thirdly, they will continue working in the hospital until the age of 60 years.”
“I have already explained that we will try to retrain and redeploy them.”
“Sir, SGH is looking into it. Let us give them time. 12.50 pm LAND TRANSPORT POLICY (Statement by the Minister for Communications and Information)”
“Sir, for the purposes of Medisave reimbursements, Medisave itself has a schedule of fees that can be used for deductions or for reimbursements from Medisave accounts.”
“Sir, SGH is a Government-owned hospital.”
“Sir, the original plan was to introduce class C wards into SGH together with the re-building of the other older hospitals. However, in view of the many requests from colleagues in this House and from members of the public, I have asked SGH to consider whether this can be done earlier. Dr Wang Kai Yuen (Bukit Timah): Sir, may I ask the Minister whether he would consider SGH as a Government hospital or not a Government hospital.”
“The proportions of hospital bills settled by multiple Medisave accounts at the Singapore General Hospital (SGH) and the National University Hospital (NUH) for B1 and B2 patients in FY88 and 89 are as follows: ____________________________________________________ FY 88 FY 89 Inst ________________________________________ B1 B2 B1 B2 ____________________________________________________ SGH 3.1% 2.8% 2.9% 2.1% NUH 4.6% 4.2% 5.3% 4.3% ____________________________________________________”
“Wong asked the Acting Minister for Health what were the proportions of hospital bills settled by multiple Medisave accounts at the Singapore General Hospital and National University Hospital for B1 and B2 beds in FY 88 and FY 89 (up to the latest convenient date).”
“The information for inpatients who received remissions at SGH and government hospitals is as follows: _______________________________________________________________________ FY 87 FY 88 FY 89 (Apr-Dec 89) ______________________________________________________ Govt SGH Govt SGH Govt SGH Hosps Hosps Hosps _______________________________________________________________________ No. of inpatient bills remitted 616 142 532 157 32 142 *No. of free cases - - - - 6786 269 % of inpatient bills remitted 0.4 0.2 0.4 0.2 6.7 0.7 _______________________________________________________________________ *Free cases are those on public assistance scheme or those issued with medical fee exemption cards. Similar figures for FY 87 and FY 88 are not available. The figures (exclude those on public assistance scheme or those issued with medical fee exemption cards where they are provided free treatment) for outpatient bills remitted at SGH and government hospitals are as follows: _______________________________________________________________________ FY 87 FY 88 FY 89 (Apr-Sep 89) ______________________________________________________ Govt SGH Govt SGH Govt SGH Hosps Hosps Hosps _______________________________________________________________________ No. of inpatient bills remitted 343 37 378 61 167 64 % of outpatient bills remitted 0.03 0.01 0.04 0.01 0.04 0.02 _______________________________________________________________________ NATIONAL UNIVERSITY AND SINGAPORE GENERAL HOSPITALS (Settlement of Bills by Multiple Medisave Accounts) 2. Dr Aline K.”
“Sir, the senior citizens are distributed not just in the city but also in the older housing estates. We will make sure that they all have easy access to such centres. VACANT LAND ADJACENT TO SIMEI MRT STATION (Development plan) 14. Mr Teo Chong Tee asked the Minister for National Development what is the development plan for the piece of unturfed vacant land adjacent to the Simei MRT Station.”
“Sir, the training of physiotherapists and occupational therapists need not be carried out locally because there are very well-established centres in other parts of the world to which we are already sending our local trainees. The Ministry will continue to ensure that the PSC continues to offer scholarships for physiotherapy and for occupational therapy and we will also actively encourage the restructured hospitals to send their own trainees abroad for training.”
“Sir, my Ministry has started to establish senior citizens health care centres at some of the polyclinics. The plan is to establish one in each of the new generation polyclinics that will be opened in the future. This will eventually result in about 16 of these polyclinics having these senior citizens health care centres which provide a wide range of services for the elderly, including rehabilitation, day care and free health screening for senior citizens.”