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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“Sir, that is the first time I have heard of this, and it is from Mr Chiam.”
“And we are very happy that the Malays and the Indians have reproduced more and that they are now at the replacement level. What we are not happy about is that the biggest group in the population, the Chinese, have not carried their own share and they are still below replacement rate. We are saying that for that problem to be solved, the Chinese must also contribute their full share and I think the facts are there. The problem is there, we focus on the problem.”
“Yes, we are asking all Singaporeans to reproduce.”
“Mr Speaker, Sir, unfortunately, once again, Mr Chiam has not listened.”
“Sir, yes, the Ministry is in fact quite happy with our figure. Because the 1988 figure is only about half the rate of the developed countries. This shows that our facilities are of a high standard. PERSONAL INCOME TAX AND CORPORATE TAXES (Particulars) 7. Dr Lee Siew-Choh asked the Minister for Finance (a) what proportion of the total Singapore budget revenue is represented by amounts collected in personal income tax and amounts collected in corporate taxes for the last 12 years; and (b) whether he will publish such information in the annual reports of the Inland Reveneue Department in future. BG George Yong-Boon Yeo (for the Minister for Finance): Mr Speaker, Sir, I can only provide the information requested for FY 86 and FY 87. In earlier years, tax collection data was only broken down into major tax categories such as income tax, property tax, stamp duty, etc. Further breakdown into sub-categories would require data extraction manually and I do not propose to do so as it is time-consuming and costly, unless Dr Lee has a specific reason for wanting the data. In FY 86, personal income tax and corporate income tax collected were $852 million and $1,321 million respectively, and they accounted for 8% and 13% respectively of total Government revenue in that year. In FY 87, the corresponding figures were $962 million and $1,487 million, or 7% and 12% respectively. The Finance Ministry will arrange for such information to be published in the Annual Report of the Inland Revenue Department in the future. ANNUAL BUDGET STATEMENT Order read for Resumption of Debate on Question [3rd March, 1989] [2nd Allotted Day], 'That Parliament approves the financial policy of the Government for the financial year 1st April, 1989 to 31st March, 1990.'. - [Minister for Finance].”
“Sir, my Ministry recognizes the need for preventive medical care and that is why we have a very comprehensive preventive health education programme which includes encouragement on the use of screening services. However, that does not mean that Singaporeans need to have the use of Medisave before they make use of the screening services. 1.58 pm BETTER RACIAL MIX IN HDB HOUSING ESTATES (Statement by the Minister for National Development)”
“Mr Speaker, Sir, the medical facilities in all hospitals are fairly similar. Some may have older equipment than others. But in terms of the medical expertise we have fairly similar expertise in all the hospitals.”
“Yes. [Mr Deputy Speaker in the Chair] 11.10 am RELEASE OF ISA DETAINEES FOR GENERAL ELECTION 5. Mr Chiam See Tong asked the Minister for Home Affairs whether, like Mr Francis Seow, Miss Teo Soh Lung and the other 8 detainees will be released in time to stand in the coming General Election, if they so wish.”
“Sir, I have already replied to that earlier on. Obviously he was not listening.”
“Sir, the answer is no. With regard to mass screening, I think it is the concept that is important. The concept is that we should try to screen as many people as possible. We will try to find all ways to attain that objective.”
“Sir, I suspect that the listening capacity of the Member for Telok Blangah is better when he is in his clinic than when he is in this House. Sir, I had said that the Member for Kaki Bukit may be correct because it appears that there are conflicts of interest, but I went on to give a very long explanation as to why I think he may not be correct. I talked about family doctors looking after one or two generations of patients and all that. I hope he recalls what I have said, and if he has recalled what I have said, then I hope he will take back his words. Getting back to the rest of the issues that he has touched on. Sir, I believe that whilst preventive health care is very important, however, one must adopt a very balanced approach. I do not think it is necessary to legislate compulsory screening tests. His suggestion about providing free blood pressure test and urine test during election day is a very novel approach to this problem. I dread to think of the logistics involved. Imagine taking urine tests for about a million people on one day, as well as taking blood pressure for that large number of people. I think there are better ways and one of the ways, as he has mentioned, is that whenever a patient comes into a clinic, the doctor gives him a blood pressure test. This we are already doing in our polyclinics. I am sure many of the doctors in the private sector do that too because each time I see my own family doctor, he checks my blood pressure. I think that is a practice that is fairly practised by doctors. Sir, as for degenerative diseases, these are due to harmful lifestyles and diet. These are being catered for very strongly in our health education programmes. So I think we are coping with it.”
“Sir, the review of the salaries is already underway and, as I have informed the House two to three weeks ago, we hope to be able to get a positive reply from the Ministry of Finance soon.”
“Jurong is already well served by NUH and Alexandra Hospital.”
“Sir, I would like to thank the Member for Fengshan for his very encouraging remarks. I am sure my staff will appreciate it. Sir, I cannot see any reason why that booklet cannot be sold to GPs and I will ask my staff to look into it very quickly. With regard to the giving of Hepatitis B vaccination in A & E departments, I am sure there must be good reasons for that. But I will ask my staff to review whether it is appropriate. With regard to the comments by the Member for Ayer Rajah why there is a concentration of hospitals in the eastern part of the island, I am sure the Member for Changi will strongly disagree with him on that. There is a general lack of hospitals in the eastern sector of Singapore. There is only one hospital there at the present moment, and that is, Changi Hospital. Unfortunately, the Member probably did not hear very well my previous reply on Changi Hospital. I did inform the House that Changi Hospital is due for redevelopment in the future. However, we will not be redeveloping it on the existing site. We will be looking for a more appropriate site. Once the new hospital is developed, Changi Hospital will then cease to exist.”
“As I mentioned yesterday, we are continuing the educational programme for Medisave account holders. We are encouraging them to be very careful in the use of their Medisave and to only opt for hospitalization should their medical condition warrant it. With regard to the national health insurance scheme, the Medisave scheme was introduced to avoid a very dangerous pitfall of the general insurance scheme. The experience of the countries with such a scheme has been that it gives the consumer the illusion of free medical services. It has led to the development of a buffet lunch syndrome. The people fel that since they have paid the insurance premiums, they might as well use the medical services indiscriminately. The end-result is that everyone, the whole population, end up paying much much more because of this overuse. My Ministry does not propose to introduce a general medical insurance scheme. But for Singaporeans who prefer to opt for that, such schemes are freely available today and they are provided for by the private insurance companies.”
“It is important to ensure that should a better site site available, we should reserve it so that it will be in a better position to serve the whole eastern part of the island. Sir, we hope to finalize the choice before the end of the year. However, the development of the new hospital is not expected to begin until the early 1990s and its commissioning will not be due until the latter part of the 1990s. In the meantime, patients in the eastern part of Singapore can still continue to make use of Changi Hospital. It may be old physically and operationally; its layout may be inefficient while its A & B class wards may not be as good as those in SGH or NUH. But I can assure Members and Singaporeans living in the eastern part of Singapore that Changi Hospital's medical and para-medical staff are equal to those in our other hospitals. In fact, because of its low occupancy rate, patients are more likely to be given longer consultation time than in other hospitals. The staff are also perfectly capable of handling all A & E cases. Sir, Singapore is a small island. It has excellent expressways and road system. Members can be assured that accident victims can be swiftly taken to the nearest hospital today. The lack of a modern hospital in the eastern part of Singapore has not in any way had any impact on the treatment of accident victims. The Member for Boon Teck talked about the inability of a large number of Medisave account holders to afford medical attention in the future because of the low level of balances. He asked that we consider the setting up of a national health insurance scheme as well as educate Medisave account holders to be more careful in the use of their Medisave funds.”
“Sir, hospitals, unlike community centres and sports complexes, are extremely expensive to build and even more expensive to operate. For example, the National University Hospital costs $230 million to build and when fully commissioned, it will cost about $90 million each year to operate. Much deliberation must be carried out before we decide when to build and where to build our next hospital. Sir, in the planning of hospitals, we have to consider, firstly, the total number of hospital beds that are required in Singapore based on the projected population growth and the projected level of hospitalization. Secondly, the number of hospitals that are required will depend on the optimal operational size of each hospital. Lastly, the location of the hospitals must be decided in relation to the population density and the accessibility. Despite the population growth in the last 15-20 years, the total number of beds in the Government acute hospitals has not changed much. This is due, firstly, to the changing disease patterns and, secondly, the better treatment procedures leading to a shorter number of days being spent in hospital. As such, other than for NUH, there was no need for a new Government hospital to be built in the last 20 years. However, we are planning for one in the eastern part of the island in the future. Sir, as the Member has pointed out, a site in Bedok has been reserved and is still reserved for hospital development. This was done in 1981. However, in view of the development of new expressways, the MRT and the various new HDB estates in the eastern part of Singapore, we have decided to investigate the availability of alternative sites in the eastern part.”
“Today, several new HDB housing estates have already risen from vacant land, swamp land, squatter kampongs and reclaimed land in the eastern part of Singapore, and yet a suitable site for a hospital to cater for the needs of the population has still not been found. The people are surprised that there is no hospital built in conjunction with the HDB's housing development in the eastern sector of the island. Sir, when the HDB plans its estate or new town, many corresponding facilities are also included in this plan. But why is there no provision for a hospital, despite the heavy concentration of population in this part of the island? As the Changi Hospital is poorly located and not designed to equip with modern facilities, many patients have no choice but to make use of the hospitals in the City area. In the event of serious accident either at Punggol or Changi, the victim has to be transported to one of the hospitals located in or near the City area which is very far away. By the time he reaches the hospital, he may have been dead already. Sir, a fully-equipped modern hospital is urgently needed in the eastern sector of Singapore. On behalf of the people living in these housing estates, I urge the Acting Minister for Health to expedite his plan for a hospital.”
“I must apologize to the Member for Kaki Bukit for this oversight. Yes, the private sector does have a role. The Member is correct in stating that unfortunately there may be a conflict of interest there because it may not necessarily be in the economic interest of private sector doctors to ensure that Singaporeans remain healthy. But I personally believe that most doctors are very aware of their responsibility towards their patients. It is not unusual for family doctors to look after one or two generations of patients. So there is a close link built up between family doctors and such patients. And I am sure that these doctors do take their responsibilities very, very seriously and that they do provide health education for such patients. The problem is how do we make sure that this philosophy extends to all the doctors. In that regard, we are working with the various professional bodies to see how that message can be emphasized more strongly and to persuade doctors to devote more time to health education whenever they see their patients. Mr Teo Chong Tee (Changi): Sir, in my question for an oral answer previously, the Acting Minister for Health told me that the Government was looking for a site for a new hospital to serve the eastern part of Singapore. It came as a surprise to me to hear that the Government is still looking for a site. I wonder when will this site be found. Sir, I recall that when the Bedok New Town was first planned more than 10 years ago, a piece of land was said to have been earmarked for a new hospital. What has happened to this plan?”
“During the last financial year, Tan Tock Seng Hospital had an occupancy rate of 91% in its Class B1 wards and an occupancy rate of 78% in Class B2 wards. In terms of hospital management, a 80-85% occupancy rate means that the beds are already well occupied. The reason is that during the weekends, occupancy tends to be low but during the weekdays occupancy tends to be high. So 80-85% occupancy means that during the weekdays they are almost 100% occupied. For the Class C wards, only 66% of the beds are occupied. Many unhappy patients in the Class C wards are clamouring to be allocated Class B1 and B2 wards as soon as they are available. Sir, as we redevelop the older hospitals, this situation will be corrected. However, we will ensure that there will always be adequate Class C wards available for the low income group that genuinely need them. Sir, with regard to the fees for Class B2 and C wards, the Member has asked whether these fees would be increased this year. I wish to inform him that the Ministry has no plans to increase those fees this year.”
“With regard to the points brought up by the Member for Bo Wen, Sir, I have stated many times in this House that the restructuring of the hospitals is meant to give our hospitals greater autonomy, greater flexibility in their management with the objective of being able to control future cost increases. Members may know that our health expenditure has been increasing at the rate of about 15% per year over the last decade. It is a rate that is unsustainable. We must find ways and means of becoming more efficient and of capping these rapid cost increases, and I believe restructuring, is the correct way to do that. If we are able to cap the cost increases, then the future increases in fees will also be lower as well. So it is to the benefit of the patients that we cap cost increases. He has asked specifically whether the Class C beds would be phased out. Sir, the answer to that lies not with the Ministry but with the patients themselves. Singaporeans today are more affluent than 10 or 15 years ago. Together with the availability of Medisave funds, Singaporeans today find that they can afford greater privacy and that they can afford a better level of accommodation. This is reflected in their choice of wards when they are hospitalized. The result has been a tremendous demand for our Class B1 and B2 wards. Because the supply of these better wards is limited in our older hospitals, patients in such older hospitals are being forced to go into C Class wards. As a result, they complain to the hospital administrators that they are being forced to go down to a lower class ward although they are able to afford a higher class ward. The example of Tan Tock Seng Hospital, I think, would be useful.”
“Sir, my Ministry has also received some feedback from foreign patients as well as from local patients and some local doctors too about the high fees that are being charged by some specialists in Singapore as well as the high cost of hospitalization. As Members know, my Ministry does not regulate private sector medical fees. We believe that it is not practical because medical service is very personalized and there is a tremendous variety of factors involved in this treatment. It is best to leave the setting of such fees to market forces. Doctors must be very careful in how they price their services. If they overprice, they will do themselves irreparable harm. They will find that once they lose their patients to other doctors, whether other doctors in Singapore or in other countries, it will almost be impossible for them to attract these patients back. Patients, on the other hand, need to be educated as well. They should not hesitate to ask the doctor as to the likely cost of treatment. And if the estimate given is much too high, the patient would be well advised to go back to his family doctor and ask to be referred to another specialist. I am sure most of the family doctors would be very happy to assist them in that regard. Sir, with regard to the question on incentives for investments in equipment, medical equipment also enjoys the accelerated depreciation that is available in other industries. So doctors who invest in expensive equipment can apply for accelerated depreciation and that, I believe, would give them quite substantial savings in terms of the tax payable.”
“A new service will be introduced soon, and that is, coronary risk screening which should be implemented at the new Toa Payoh Polyclinic and will be extended to other new polyclinics in the future. Sir, we will continue with this programme. We will find ways and means to enhance the programme and make sure that whatever money we put into it is utilized effectively and meaningfully. This way it will ensure that Singaporeans do not just live longer but they will be healthier as they grow old. Sir, the Member for Cairnhill made a very short and brief speech, but in his brief speech he raised so many points that I am not too sure whether I have enough time to cover them. But I will focus on the main questions that he raised. First, what is the projected number of doctors required and whether we have the capability to train them, and will this projected number be able to cater effectively for Singaporeans as well as, hopefully, patients who come from the surrounding regions for treat- ment in Singapore. Sir, my Ministry does carry out regular reviews of our requirements of doctors. The last one was only carried out last year. The projection is that Singapore will need a total of 4,700 doctors by the year 2000 compared with the 2,900 doctors today, ie, an increase of 1,800 doctors between now and the year 2000. I can assure you that NUS is more than able to train the required number of doctors because the intake capacity of NUS is about 180 to 200. In fact, NUS now has more than enough capacity to meet the needs of doctors in Singapore. He has also asked about the high cost of treatment.”
“The press has also been very supportive in carrying almost weekly articles on healthy lifestyles. Our health education programme stresses very much on the individual's own responsibility for his own health and it encourages all Singaporeans to change their lifestyles to a healthy one, eg, a diet of low cholesterol content, and our very, very strong anti-smoking campaign which has been fairly effective in the past few years. We will continue with all these programmes. Health information in the form of pamphlets and booklets is also very readily available. These are available for free from many channels - our poly- clinics, hospitals, private GP clinics - and Members may be interested to know that last year, we distributed 2.8 million booklets and pamphlets directly to Singaporeans. The third approach, which is very important and which has also been pointed out, is that of medical screening. The early detection and treatment of diseases will allow us to prevent complications and recurrences. Catch them at the early stage, chances of a cure are very, very good and the cost of the cure, even more important, is much lower. We are emphasizing on medical screening and our health education programmes play a role as well in this respect because it also encourages Singaporeans to come forward to attend our screening sessions that are available at the hospitals as well as at the polyclinics. For those whose companies provide for it, we encourage them to make use of the services being provided for them. Our screening includes annual blood pressure being taken for all outpatients who regularly attend our polyclinics and hospitals. We have also introduced screening for cancer of the womb and breast for women as well as chest X-ray.”
“Sir, I will take the points from the Members for Kaki Bukit and Boon Teck together. Both Members have expressed their concerns on the prospects of increasing demand for health care, especially as Singaporeans become even more affluent in the future. They have asked that the Ministry focuses more on preventive health care and health education. Sir, I would like to assure Members of the House that my Ministry does strongly emphasize the role of preventive medicine in Singapore. In fact, we have adopted a three-pronged approach to preventive health care. The first approach is that of immunization which began many years back. The immunization against childhood and various other diseases continues to play an important role in our disease-prevention programme. We do continually evaluate the immunization programme and expand the type of immunization available when necessary. For example, we made immunization against measles compulsory in 1985 and last year we started encouraging Singaporeans to be immunized against Hepatitis B because of the close correlation between Hepatitis B and liver cancer. Sir, our immunization coverage for infants is today about 90-95%, and is exceptionally high. In fact, it is a target that many developed countries are still striving vainly for. We will continue to monitor and ensure that this level is maintained. The second approach is health education which the Members have touched briefly upon. There are many diseases, many of them fatal, which cannot be immunized against but which can be avoided. Conditions like heart diseases and cancer are directly or indirectly linked to unhealthy lifestyles. During the past few years, we have been increasingly using the mass media, giving public talks, exhibitions and talks over the radio.”
“Sir, the channels are always open. It is up to those organizations who are aware of such patients to make use of the channels. It is not possible for us to go round, checking every household to see whether there are elderly sick. The emphasis must be to make sure that the availability of the services is publicized so that families with elderly sick who require help, who require home nursing, can easily pick up the phone and call up the HNF. W must also ensure that the community organizations are also aware that HNF does exist and when they come across people living in their vicinity who require help, they can also help these people by calling up the HNF. So the key is to make sure that channels are open, the service is widely known and that HNF will be able to react and help them. With regard to the meal delivery, I do not want to belabour the point but I think the MCD does vet the request carefully to ensure that the requests are justified.”
“I am not too sure whether what he says is correct because the meal delivery is only provided for those who are so sick that they are unable to help themselves in terms of cooking their food requirements. If they are too sick to cook, it is going to be very difficult to force them to cook their own meals. That is why the meal service has been made available. Of course, the emphasis must be to teach our elderly to keep themselves fit, to keep themselves mobile, active and to be able to exercise. So we do try to encourage them not to be confined to the bed and that they should come out to exercise, stretch their legs a little bit, because it is necessary. As to the installation of simple rehabilitative devices at home, I will ask my officials to look into it.”
“And we do get referrals to our Home Nursing Foundation, which is the key organization providing home care for the aged. These referrals are from our hospitals, the outpatient clinics, the private sector doctors and, of course, the Ministry of Community Development. So we do get as much feedback as we can. Also to keep Singaporeans aware of the availability of such a service, last year, we sent out together with the PUB bills, pamphlets on the Home Nursing Foundation to a total of 760,000 households. So we do try to publicize the availability of home nursing by the Foundation. With regard to the number of patients who are being cared for, last year a total of 3,311 patients were home-nursed and the Home Nursing Foundation provided a total of 33,663 home nursing cases. None who approached us were rejected. So the manpower is adequate to cater for their needs. Of course, in line with the ageing population over the next 5, 10, 15 years, should the demand increase, we must make sure that we help the Home Nursing Foundation to adequately staff its nursing ranks. Sir, he asked about transportation for the elderly sick who need to go to the senior citizens' health care centres. The Home Nursing Foundation does have ambulances available and, when requested, they will fetch these patients to the senior citizens' health care centres for their rehabilitation, for the day care. We are also coordinating very closely with the Ministry of Community Development in terms of provision of services to the elderly sick. In fact, my Ministry is also represented on the MCD's Committee for the Aged and there is a lot of cross-sharing of information and data between the two Ministries. Sir, he asked about the meal delivery service being provided for by MCD.”
“The Member for Kaki Bukit has asked about health education. Sir, I would like to seek the Member's concurrence for me to give him the reply later, as another Member has also raised a cut on the same item. Sir, the Member for Telok Blangah asked whether my Ministry takes into consideration the long-term demographic changes to our population when planning our health services for today and the future. Sir, the answer is a definite yes. Long-term planning must take into consideration the relevant changes that are happening to our population. We are very careful because health services are expensive, especially new institutions. This way, money is not spent unnecessarily. The same applies to the redevelopment of Kandang Kerbau Hospital. Sir, although the crude birth rate is declining, the Member would be happy to know that in terms of actual babies the number need not necessarily be decreasing. In fact, our projection is that because of the large cohort of women that were born during the 1950's and 1960's, in the next 10 years the number of births will peak at about 50,000 a year versus today's 40,000 to 43,000 a year. After that, we expect the number of babies born to stabilize at about 45,000, a number which is again slightly higher than today's figure. So I would like to assure the Member for Telok Blangah that the redevelopment of Kandang Kerbau Hospital is very much warranted. Sir, in terms of the elderly sick, the Ministry is looking into the various ways and means of helping the elderly sick at home. He asked whether we are only helping those who approached us or are we helping all who needed the help? We would like to help all who need to be helped. But how do we know that they need to be helped. We must get the feedback somehow.”
“The reason is they were paying rentals which were frozen long before the previous property boom, in fact, over the last 10-15 years, their rentals have not been revised to reflect market conditions, and are a fraction of the market rate today, even allowing for the drop since 1984. It has happened partly because JTC has been too reasonable. In all the years when we needed to revise the rental rates, we refrained from doing so. We have thus accumulated such a vast discrepancy that today many factories which pay one-half, some of them one-third, of the commercial rates. Some of these are plywood factories in Kranji and Sungei Kadut. Despite the revision upwards, even after the revision, many of them are still paying less than half the market rentals. I think that is already a substantial concession which should be called a concession. I have no doubt that the Member for Chua Chu Kang, once this is brought to his attention, will also have no hesitation in calling a rose a rose.”
“That would have put us back to the status quo as it was in 1985. We decided not to do this because we recognize that even today, although the recession is over, rental rates are still generally lower than they were at the peak of the property boom in 1983 and 1984. As a result, we made a special effort to review all the market rents declared by JTC, to make sure that they were realistic and did not reflect a boom which had past. As a result of this revision, the market rentals declared by JTC for its properties were revised downwards by anything from 13% to 25% depending on the location, and the type of factory building. Thus when the discount lapsed, instead of factories just paying 25% more, the increase was much less depending on location. I think that is a reasonable approach. To confirm that, we compared our rates with the private sector. There are private sector industrial properties, although not many. Our rates are marginally higher, which is right, because JTC factories are, generally speaking, better managed, have better facilities and are in much higher demand. In fact, the question was asked on Friday what the occupancy rate of flatted factories is, and it is more than 92%. In other words, it is time for us to build many more now, otherwise we will have a shortage in the foreseeable future. That is what we have done with the factory rates. At the same time we have reviewed our land rental rates. Some land rentals have been reduced in unpopular locations. Indeed some lessees, despite this, have had their rentals revised up.”
“Mr Deputy Speaker, Sir, our blood supply is one of the safest in the world, if not, the safest. We take great care to analyse all blood donations to ensure that the blood that is being transfused is free from contaminants. MAIN AND DEVELOPMENT ESTIMATES OF SINGAPORE FOR THE FINANCIAL YEAR 1ST APRIL, 1988 TO 31ST MARCH, 1989 Order read for consideration in Committee of Supply [9th Allotted Day]. 11.30 am [Mr Deputy Speaker in the Chair] Head V (cont.) - Resumption of Debate on Question [25th March, 1988], "That the sum to be allocated for Head V be reduced by $10 in respect of Code VA 1000 of the Main Estimates." - [Dr S. Vasoo.] Question again proposed. The Minister for Trade and Industry (BG Lee Hsien Loong): Sir, when we adjourned on Friday, the Member for Chua Chu Kang was asking me why I did not call a rose a rose, why we were revising JTC rental rates upwards and, particularly, whether we have taken into consideration the difficulties which are faced by the plywood and woodworking industries the sawmills at Kranji, which were not doing well. Of all people, I would have thought I would have the least reputation for reluctance to call a rose a rose. Let me state the facts as they are. When the recession hit us in 1985, we gave a special 25% discount on JTC rental rates. We recognized that the property market had fallen, rentals of commercial property had gone down, and factories were in difficulty. It was right to make a 25% discount for a limited period of time, initially one year. After one year, because the economy had not fully recovered, we extended the rebate for another year. The rebate ended on 31st December 1987. The question was: what should we do? We could have done nothing and simply let it lapse.”
“Yes. Those with either Hepatitis B or syphilis are informed that their blood is contaminated and they are advised to either go to their family doctor or seek treatment at our Middle Road Clinic.”
“Sir, the percentage of blood collected by the Blood Bank in 1986 and 1987 that was contaminated and could not be used, was 2.3% and 2% respectively. The main causes of the contamination were Hepatitis B virus and syphilis. The level of contamination has been fairly stable, fluctuating around the 2% mark. The contaminated blood is sterilized in an autoclave to destroy all bacteria and viruses and then disposed through the sewer.”
“Sir, the total number of patients whose charges were remitted or waived numbered 5,014 from 1985 to December 1987. The total amount remitted and waived amounted to $1.4 million. This represents 0.8% of the total number of hospital bills raised during the period and it shows that the hospital fees are within the means of the vast majority of Singaporeans. 11.20 am MAIN AND DEVELOPMENT ESTIMATES OF SINGAPORE FOR THE FINANCIAL YEAR 1ST APRIL, 1988 TO 31ST MARCH, 1989 Order read for consideration in Committee of Supply [7th Allotted Day]. [Mr Deputy Speaker in the Chair] Head N (cont.)- Resumption of Debate on Question [23rd March, 1988], "That the total sum to be allocated for Head N of the Main Estimates be reduced by $100." - [Dr Augustine H.H. Tan.] Question again proposed.”
“We have not made a decision on that yet. REMISSION OF HOSPITAL FEES (Figures) 9. Mr Yeo Choo Kok asked the Acting Minister for Health how many patients have successfully applied for remission of hospital fees because of financial difficulty in all the government hospitals from 1985 up to the latest convenient date.”
“Sir, the schools and our School Health Services account for one-third of the referrals. Our Outpatient Services account for 25% of the referrals, Government hospitals for 10%, and the GPs account for 20% of the referrals.”
“Sir, the Ministry has found no evidence of that. What we believe is that the greater attendances are due to a greater level of awareness from, first, the schools, and secondly, parents, to such behavioural problems which are treatable. The high level of attendances also reflects the greater willingness of parents to bring their children in for treatment and not to be worried by the fact that their children may be stigmatized by the attendances.”
“Sir, we have a total of 14 staff that have been allocated to this service. At the present moment they are able to cope quite adequately with the demands. If there is any increase in requirements, we will look into manning the required positions.”
“The answer is no. 11.20 am MAIN AND DEVELOPMENT ESTIMATES OF SINGAPORE FOR THE FINANCIAL YEAR 1ST APRIL, 1988 TO 31ST MARCH, 1989 Order read for consideration in Committee of Supply [6th Allotted Day]. [Mr Deputy Speaker in the Chair] Head M (cont.) - Resumption of Debate on Question [22th March, 1988], "That the sum to be allocated for Head M be reduced by $10 in respect of Code MC 1000 of the Main Estimates." - [Dr Ho Tat Kin.] Question again proposed.”
“Sir, this issue has been brought up almost every year and the answer remains the same, ie, the Ministry will not terminate the legislation to allow legalized abortion.”
“The profile of the abortees are matched very closely with the population profile.”
“Sir, with your permission, I would like to take Questions No. 9 and No. 10 together. Sir, in 1986, 23,035 legalised abortions were performed, 6,314 by Government and 16,721 by private doctors. In 1987, the number of abortions decreased to 21,226. 4,749 were performed by Government and 16,477 by private doctors.”
“Sir, the community hospital, when it is set up in Ang Mo Kio, will offer a wide range of services. The hospital is meant to be a low activity hospital and would cater for patients who are rehabilitating or who are recuperating after a serious operation in the acute hospitals. It will also provide care for the aged sick. It will also provide rehabilitation services. GPs in the area will be able to admit their patients who have illnesses which do not require them to be followed up in the major acute hospitals. UPGRADING OF RECREATIONAL FACILITIES AT WEST COAST PARK 11. Encik Abbas Abu Amin asked the Minister for National Development whether his Ministry has plans to upgrade the recreational facilities at Pasir Panjang Park, Labrador Park and West Coast Park.”
“Sir, the community hospital to be built in Ang Mo Kio is a pilot project to test public acceptance of a new concept of hospital care and management in Singapore. If the pilot project proves successful, my Ministry's plan is to build a second community hospital as a wing of the new regional hospital to be built in the next decade in the eastern part of Singapore.”
“Mr Speaker, Sir, the Ministry believes that some of the doctors in the private sector are carrying out a fair share of the required health education. However, we are not too sure as to what percentage of the doctors are actually doing it. We will be discussing further with the professional bodies to see how we can further improve on the level of health education being carried out. The private sector has also been obtaining from the Ministry quite a large amount of the literature on health education. If that is any indication, it indicates that at least they are taking them and distributing them to their patients. KENT RIDGE PARK (Development Progress) 12. Encik Abbas Abu Amin asked the Minister for National Development what is the progress of Kent Ridge Park; what facilities will be available; and when this Park will be open to the public.”
“Mr Speaker, Sir, my Ministry's expenditure for health education and preventive health care services is as follows: FY 83 $24.86 million FY 84 $28.56 million FY 85 $31.36 million FY 86 $30.61 million FY 87 S30.72 million This includes the expenditure incurred by the Training and Health Education Department, the Maternal and Child Health Service, the School Health Service, the School Dental Service, the Childhood Immunization Programme and the screening and control of tuberculosis and sexually transmitted diseases. The figures do not include the cost of providing the laboratory service to support the programmes and the patient education by doctors and nurses in the hospitals. Such expenditure is difficult to quantify. The cost of preventive health care and health education provided by the Ministry of the Environment and by the Industrial Health Unit of the Ministry of Labour is also not included in the figures that I have just read out.”
“Health education sessions on various relevant health topics are held at the Senior Citizens Health Care Centres, polyclinics, community centres and health fairs, for the elderly and members of their families. Health information is also readily available free of charge in the form of pamphlets and booklets, and they are obtainable from the polyclinics, hospitals, Senior Citizens Health Care Centres, community centres, Senior Citizens Clubs, post offices, major shopping centres, public libraries and at health fairs and public talks for the elderly. We will continue to explore ways to bring such health education messages more effectively to the general public. Despite all efforts at the preventive level, it is inevitable that with an ageing population, the number of elderly falling ill will still increase. A specialized geriatric department, for the assessment and management of elderly sick with multiple problems will be set up this year in Tan Tock Seng Hospital. Since 1984, my Ministry has sent four doctors, three nurses and one medical social worker for specialized training in overseas geriatric medical centres. We are also planning the building of the first Community Hospital. The Community Hospital will provide care for the elderly who are chronically ill and who require more prolonged hospitalization. MAIN AND DEVELOPMENT ESTIMATES OF SINGAPORE FOR THE FINANCIAL YEAR 1ST APRIL, 1988 TO 31ST MARCH, 1989 Order read for consideration in Committee of Supply [3rd Allotted Day]. [Mr Deputy Speaker in the Chair] 11.30 am Head T (cont.) - Resumption of Debate on Question [17th March, 1988], "That the sum to be allocated for Head T be reduced by $10 in respect of Code TH 5200 of the Development Estimates." - [Mr Ng Kah Ting.] Question again proposed.”
“The Ministry does not intend to extend the scheme to traditional medicines. REPORT OF COMMITTEE ON THE PROBLEMS OF THE AGED (Implementation of recommendations) 8. Dr Ang Kok Peng asked the Acting Minister for Health, since the adoption of the Report of the Committee on the Problems of the Aged in July 1984, what measures have been taken by his Ministry to implement those recommendations that lie within the purview of its administrative responsibility. Mr Yeo Cheow Tong: Sir, my Ministry has taken several measures following the adoption of the Report of the Committee on the Problems of the Aged. In 1985, a department of Health Services for the Elderly was set up to specifically promote and maintain the health of the elderly. Its role is to review and implement measures to enable the elderly to be in good health and to live in their own homes as independently and as long as possible. My Ministry also assists the Home Nursing Foundation (HNF) to provide home nursing, day care and rehabilitation for the elderly. Besides providing nursing care, the nurses teach family members simple nursing and rehabilitation procedures, so that members of the families are able to play a bigger role in looking after their aged sick relatives. My Ministry is planning to establish by 1992, 10 Senior Citizens Health Care Centres which will provide day care and free health screening. To date, three such centres have been established. They are in Kuo Chuan, Kampong Ubi and Toa Payoh. In view of our ageing population, it is important to increase the general level of awareness among senior citizens and the general population on how to look after our own health.”
“Sir, we do have a child development monitoring unit that monitors the physical development of children in primary schools. I will instruct my officers to study the data that we have collected from there and see whether there is any correlation between those children who have physical development problems and those who are being looked after by foster parents. MAIN AND DEVELOPMENT ESTIMATES OF SINGAPORE FOR THE FINANCIAL YEAR 1ST APRIL, 1988 TO 31ST MARCH, 1989 Order read for consideration in Committee of Supply [2nd Allotted Day]. [Mr Deputy Speaker in the Chair] 11.13 am Head T (cont.) - Resumption of Debate on Question [16th March, 1988], "That the total sum to be allocated for Head T of the Main Estimates be reduced by $100." - [Mr Ng Kah Ting.] Question again proposed.”