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\r\nPARLIAMENTARY DEBATES
\r\nSINGAPORE
\r\nOFFICIAL REPORT
\r\n\r\nELEVENTH PARLIAMENT\r\n
\r\n| PART\r\nII\r\nOF\r\n\r\n SECOND SESSION | \r\n\r\n VOLUME\r\n87 | \r\n
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The House met at\r\n12.00 noon
PRESENT:
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Mr Goh Chok Tong (Marine Parade), Senior Minister, Prime Minister's Office.Column: 3619
\r\n\r\nDr Lam Pin Min (Ang Mo Kio).Column: 3620
\r\n\r\n\r\nDr Mohamad Maliki Bin Osman (Sembawang), Senior Parliamentary Secretary to the Minister for National Development.Column: 3621
\r\n\r\nMr Teo Ser Luck (Pasir Ris-Punggol), Senior Parliamentary Secretary to the Minister for Community Development, Youth and Sports and Minister for Transport.Column: 3622
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[Mr Speaker in the Chair]
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ESTIMATES OF EXPENDITURE
\r\nFOR THE FINANCIAL YEAR
\r\n1ST APRIL, 2011 TO 31ST MARCH, 2012
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(Paper Cmd. 1 of 2011)
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Order read for consideration in Committee of Supply [3rd Allotted Day].
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Head V – Ministry of Trade and Industry
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Resumption of Debate on Question [3rd March, 2011],
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\"That the total sum to be allocated for Head V of the Estimates be reduced by $100.\" – [Ms Jessica Tan Soon Neo].
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Question again proposed.
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Singapore company on Fortune 500 list
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Mdm Ho Geok Choo (West Coast):
Mr Chairman, Minister Mentor Lee mentioned recently that Singapore is too tiny and its talent pool too small to produce a world-class manufacturing giant of the Fortune 500 class. However, Mr Lawrence Leow, President of the Association of Small and Medium Enterprises, feels that Singapore can work towards producing companies for the global stage outside manufacturing.
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\r\nMr Chairman, we need to look at ways to transfer the successful experiences of such companies to SMEs in Singapore. SMEs in Singapore are constantly looking at growing their business beyond this island. They need export credit insurance and loan guarantee support. In this regard, what is the progress to date on setting up an export-import bank in Singapore to help local SMES grow overseas?
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In addition, I would like to know how well aware SMEs are of BrandPact, which is a joint initiative by SPRING and IE Singapore to help companies in their branding strategy so that they can improve margins and break into new markets. How do we measure BrandPact's effectiveness?
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Productivity – ramping up progress
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The Minister of State, Prime Minister's Office (Mr Heng Chee How): Sir, I would like to withdraw my cut as the subject matter on Productivity has been explained by Deputy Prime Minister Teo during the debate on the Budget Statement.\r\n
The Chairman: Mr Zaqy Mohamad is not here. Assoc. Prof. Dr Muhammad Faishal.\r\n
Role in national productivity drive
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Assoc. Prof. Dr Muhammad Faishal Ibrahim (Marine Parade): Sir, by allocating a sizeable portion of the Budget to raise productivity, Government has shown that it meant business to raise income for Singaporeans through productivity growth and help companies to leverage on innovation and technology to raise efficiency and productivity. In fact, productivity has become the buzzword among Singaporeans as it represents one of our strategies in the way forward for Singapore. \r\n\r\n
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\r\nEarlier this week, Deputy Prime Minister Teo Chee Hean, who chairs the National Productivity and Continuing Education Council has updated the House on the progress of his Council. I am heartened to note that the Council has endorsed the productivity roadmaps of seven of the 12 sectors and that we will have the roadmaps of all the sectors by the end of this year. Deputy Prime Minister Teo mentioned that productivity is not just about automation or cutting manpower. I totally agree with him that companies must take a holistic, comprehensive and fundamental re-look at their businesses. Identified by the 12 sectors, I can foresee that the current state of productivity at the different sectors would vary as they have their own unique operational characteristics and would need different strategies to enhance their efficiency.
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Sir, I would like to ask the Minister to elaborate on the economic development strategies of the Ministry in its focus on the productivity drive. What are the salient productivity-related characteristics of the 12 sectors? Among others, I am referring to the drivers and inhibitors of productivity for the various sectors. Finally, what are some of the plans that the Ministry has to enhance the productivity of sectors such as construction, retail and F&B in the next five years?
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Productivity measures and other schemes
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Mr Teo Siong Seng (Nominated Member) (In Mandarin): [For vernacular speech, please refer to Appendix A*.] Mr Chairman, Sir, fellow Members of Parliament, first, I would like to declare that I am the President of Singapore Chinese Chamber of Commerce and Industry (SCCCI). This year is the Year of the Rabbit, so I shall use rabbits as a simile for our businessmen. I will use the example of rabbits eating carrots to describe the difficulties faced by SMEs in\r\n
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\r\n\r\napplying for the National Productivity Fund (NPF) and Productivity and Innovation Credit (PIC).\r\n\r\n
\r\n In the new Budget, the Government is topping up the NPF to $2 billion. It also enhanced the PIC, giving the businesses more incentives to improve their productivity.
\r\n In other words, the Government has prepared a full basket of carrots for the rabbits – SMEs – to eat. This is exciting news indeed! However, I have asked many people and they have raised this concern: the carrots are strung up too high, so how can the rabbits reach them?
\r\n In fact, the Government has been supporting the SMEs unswervingly all along. However, due to the somewhat complicated application procedures and a rather long approval process, many companies have been held back. SMEs that have benefited are few.
\r\n Take SCCCI as an example. We set up our first overseas office in Shanghai as a response to the Economic Strategies Committee's (ESC) call. Last July, we applied for the Local Enterprise and Association Development (LEAD) scheme. Although we could not ascertain if the application would be approved, we still resolved to set up the Shanghai office in October last year.
\r\n We made the right decision. So far, we have signed MOUs with five local trade associations and the Chongqing Liangjiang New Area. Our Shanghai office will facilitate mutual visits and business matching. Meanwhile, we are also in discussion with other ethnic associations on collaboration.
\r\n On 25th February this year, the grant was finally approved. We were relieved. Here, I would like to thank MTI and IE Singapore for their trust and support.
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\r\n\r\n Now the NPF has increased to $2 billion. This is a huge sum which promises a lot of carrots for the rabbits. However, what we are concerned about is how SMEs can meet the requirements of the Government agencies to enjoy the grant. SCCCI waited seven months for the approval; this was not long, but do other SMEs have the resources to wait this long?\r\n\r\n
\r\n Hence, I suggest we streamline the application process and shorten the time needed to apply and get funds. This will make the first step easy for SMEs and the rabbits would have the chance to eat the carrots.
\r\n This year's Budget has greatly enhanced the PIC scheme. Companies, however, can only reap benefits in the next financial year. Water afar cannot slake the thirst now. Many SMEs are short of capital. Purchase of new equipment, training of staff, innovation and development all need large upfront capital. When the rabbit is hungry, you present it with a carrot; it may not be a whole carrot, it can be half or one-third. With that, the rabbit can develop some strength first and then will have energy to grab more carrots to improve productivity.
\r\n I suggest that we change the way PIC is applied. We can let the companies enjoy the incentives earlier. This may increase the workload of Government agencies, but the most meaningful thing is for the rabbit to be able to eat the carrots.
\r\n Both NPF and PIC are designed to help companies improve productivity. The next thing we are concerned about is how to implement them effectively.
\r\n This week, Deputy Prime Minister Teo Chee Hean announced that the National Productivity and Continuing Education Council has identified 12 sectors that \r\n\r\n
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\r\n\r\nhave greater room to improve productivity. Among the 12 sectors, seven have already formulated their roadmap. SCCCI has 137 trade association members; we are more than willing to help the Government implement the roadmap according to industry characteristics.\r\n\r\n
\r\n For a smooth implementation, I suggest that trade associations be invited to join the review and implementation process. Being insiders with most knowledge about their own trades and industries, they can provide effective suggestions which can lead to \"double the results with half the effort\".
\r\n With the tantalising carrot in front of him, the little rabbit will try its utmost to eat it. As long as the carrot is not placed too high, it will be within reach of the rabbit. We need to encourage the rabbits to build up team spirit and work together to find good ways to improve productivity.
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The Minister for Trade and Industry (Mr Lim Hng Kiang): Mr Chairman, let me thank Members for their comments. First, let me make some general remarks then I will deal with the issues raised. \r\n\r\n
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2010 was indeed an exceptional year. Our economy grew by 14.5%. We had a strong recovery because we responded effectively to the 2008/2009 financial crisis. Our good performance also validated our economic strategies in the last decade. Let me highlight three lessons learnt.
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First, it validated our strategy of diversifying trade partners and growth clusters. This minimises concentration in any single market or industry, and smoothens economic volatility. Going forward, we can expect global economic volatility to remain a feature so \r\n\r\n
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\r\n\r\ndiversification in our economy is of critical importance.\r\n\r\n\r\n\r\n
Second, it reinforces our policy of welcoming talent who can contribute to our economy. This has helped us to anchor higher value-added activities that created good jobs for Singaporeans. Many of our sectors thrive because Singaporeans and foreign talent work together. Can you imagine our financial services sector or our manufacturing sector, our offshore trading sector, competing without the participation of foreign talent? This would be like competing with one hand tied behind our back.
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Third, our support for the internationalisation of Singapore companies. Due to our small domestic market, our companies have no choice but to expand overseas relatively early in their growth cycle. This is our karma. We are not a huge continental economy like the US, India, Europe or China. Our domestic market is limited and our companies have to go overseas.
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Later on, I will deal with the economic strategies specific to the next few years but I thought I should reinforce these three key fundamentals. We should not lose track of these fundamentals.
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If we take a longer-term view, we have done fairly well. Over the last five years, our GDP grew by 6.4% per year. Median resident household income grew by 2.6% per annum in real terms. For our residents, the average unemployment rate in each year over the last five years stayed within the range of 3% to 4.3%.
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This year, as we have forecasted, we expect the economy to grow by 4% to 6%. Over the medium term, our growth prospects remain positive. Emerging Asia will become a key growth engine and we can take advantage of the growth opportunities arising from that.
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\r\nMs Jessica Tan, Mr Wee Siew Kim and Mdm Ho Geok Choo have asked how the Government is helping Singapore-based companies seize growth opportunities, become competitive and expand into Asia.
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Let me outline three key strategies to achieve this. They are: (i) to make a Singapore a global Asia business hub; (ii) re -position existing clusters and grow emerging ones; and (iii) p ursue productivity-led growth.
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12.15 pm
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Our first strategy is to develop Singapore as a global Asia hub. The companies of today operate globally. Many site their activities across Asia and coordinate them from control towers. Control tower functions will include things like innovation, commercialisation, supply chain and talent management, amongst others. Our political stability, connectivity, access to talent and our educated workforce make Singapore a compelling destination for global and regional control towers. We, in fact, target three groups of companies: multinational corporations, global mid-sized companies as well as Asian champions. We can be a base for MNCs and global mid-sized companies to penetrate the Asian market. At the same time, Asian champions wanting to expand from their domestic base to other parts of the world will also find Singapore very useful.
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Our global Asia hub strategy is working. Take, for example, Applied Materials, a leading global semi-conductor equipment supplier. Last year it set up its first Asian semi-conductor equipment manufacturing plant in Singapore. Applied Materials expects 50% of its global semi-conductor equipment supplies to be manufactured here. The company also manages its regional supply chain out of Singapore.
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Hoya Surgical Optics is another example. It is world-leading manufacturer \r\n\r\n
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\r\n\r\nof intraocular lenses which are implanted in cataract patients. Hoya's presence in Singapore dates back to 2003 when it first set up a plant to manufacture intraocular lenses for global markets. Earlier this week, Hoya announced the relocation of its global headquarters to Singapore. The integration of its headquarters and manufacturing activities in Singapore will improve its overall operational efficiency and bring the company closer to the emerging Asian markets. \r\n\r\n\r\n\r\n
To be a global Asia hub, our value is not just location. Our companies must also understand the business environment in Asia, they must know the business regulations, the demand conditions, have insights to consumer as well as HR best practices in various Asian markets. To support this, we are growing niche capabilities in our professional services cluster. PricewaterhouseCoopers, the fifth largest HR consulting player in the world by revenue, set up the Asia-Saratoga Centre here last year. The centre will develop a database of HR performance matrix pertaining to companies in Asia. Examples of such matrix include recruiting costs and workplace productivity. Using this database, the centre will be able to analyse how well its Asian-based clients are doing in HR management compared to their peers in the region. The database will also allow it to advise its clients on how their HR operations can be optimised.
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We are also helping companies access Asia-ready talent. Many companies have fed back to us that they lack managers who are ready for Asia; managers who understand the Asian business environment and are comfortable operating in Asia. So, last year, we launched the Human Capital Leadership Institute (HCLI) to develop business leadership capabilities in Asia. Come May, HCLI will roll out the Singapore business leaders' programme which will help prepare senior executives for regional leadership positions.
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\r\nOur second strategy is about strengthening Singapore's export base and diversifying our industrial portfolio. Let me share with you examples from some of our key clusters.
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In electronics, we have remained competitive by scaling the value chain. In the 1990s, we engaged in four-inch, six-inch and eight-inch wafer fabrication, now we have 12-inch wafer fab plants. As a result, our share of global semi-conductor output has risen from 6% to 11% over the past decade. The renewal process continues. We are developing deep capabilities in integrated circuits. These are vital components of portable devices such as laptops and handphones. Last year, we launched an Integrated Circuit Design Centre of Excellence in NTU called VIRTUS. VIRTUS specialises in developing technologies required for applications in medical technology, clean technology and consumer electronics. It also helps train talent in emerging electronic sectors such as power management and energy harvesting.
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In logistics, we are similarly undergoing a renewal process. To be closer to their main markets, companies are relocating their logistic centres to Asia. This creates opportunities for us, too. Hitachi Data Systems, for example, found it too slow to ship products from the US to its growing customer base in Asia, so last year it opened a regional distribution centre in Singapore to aim for faster delivery.
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Mr Chairman, a competitive logistic cluster serves as an enabler for all our other clusters. So, to cement our position as a logistics hub, we are developing competency in new niches. For example, SATS recently launched Coolport, a facility that can store perishable foodstuff as well as heat-sensitive pharmaceutical products in a temperature-controlled\r\n\r\n
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\r\n\r\nenvironment. This will help us anchor new investments in biomedical sciences as well as other clusters. \r\n\r\n\r\n\r\n
Our efforts in nurturing new clusters are also progressing well. For example, we foresee good prospects for clean technology which encompasses solar power, wind energy and others. Leading players like Vestas, Siemens and Bosch already engage in high-value innovation and manufacturing in Singapore. To strengthen our base, we have also set up public R&D centres specialising in clean technology. This includes the Solar Energy Research Institute of Singapore (SERIS) in NUS and the Energy Research Institute at NTU. All in all, clean technology is on track to add S$3.4 billion to our GDP. This is slightly over 1%, and generate an additional 18,000 jobs by 2015.
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Let me know turn to our third strategy which is to pursue productivity-lead growth. From the comments on productivity from Ms Jessica Tan, Assoc. Prof. Dr Muhammad Faishal and Mr Teo Siong Seng, it is clear that Members share the view that productivity will be crucial to our ability to achieve sustained economic growth in the future. To achieve our productivity growth target of 2% to 3% per year, we have to achieve sustained productivity improvements at all four levels. At the economy level, we must move towards higher value-added sectors. This is part of the ongoing restructuring of our economy, shifting from low value-added activities to higher value-added sectors and growing new clusters. What I highlighted just now about the developments in our key clusters as well as the new clusters that are nurturing reflect this effort.
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Second, at the sectoral level, we must move up the value chain within existing industries. Efforts at this level recognise that each sector faces its own challenges and requires different solutions to improve\r\n\r\n
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\r\n\r\nproductivity. This is something that Assoc. Prof. Dr Muhammad Faishal also highlighted. We will work with companies that have made headway in their productivity efforts. These companies will serve as productivity champions and help demonstrate the value of productivity improvements to the rest of the sector.\r\n\r\n\r\n\r\n
The trade associations and chambers (TACs) have a key role to play as champions of productivity. We will engage the TACs through our Local Enterprise and Association Development (LEAD) programme which offers sectoral-based customised assistance that target unique industry needs. Mr Teo Siong Seng also highlighted the importance of engaging with the TACs and we intend to do so.
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At the third level – at the firm level – this is where much of the heavy lifting will be done and therefore the Government has enhanced the Productivity and Innovation Credit (PIC) to further encourage companies to invest in activities that foster productivity and innovation. The PIC will allow the individual firm to respond to the productivity call, so, in this way, we can reach out to a very broad base.
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Finally, at the individual worker level, it is also very important that workers continue to upgrade themselves and take advantage of the many avenues in our Continuing Education and Training (CET) system to do so.
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Assoc. Prof. Dr Muhammad Faishal asked about our plans for the various sectors such as construction, retail and F&B. I think in the MND debate yesterday we highlighted the roadmap for the construction sector, Deputy Prime Minister Teo has also provided updates and some examples from the retail and F&B sectors, so let me share with you two others sectoral examples: precision \r\n\r\n
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\r\n\r\nengineering and hotels. In precision engineering (PE), the level of productivity in the sector is only about 50% of that in developed countries such as the US, Germany and Japan. To catch up, our PE players have to move up the value chain. The industry needs to be transformed beyond one that supplies standard parts for local customers to one that designs and makes its own sophisticated final products for the export market. Meiban Group is a local PE player that has successfully made such a transition. They started off as a contract manufacturer of plastic products. It then began to pursue industrial design a few years ago. This has paid off. Meiban is now able to design and patent tools that have doubled the output of current equipment.\r\n\r\n\r\n\r\n
We also need to anchor global players to improve the dynamism of our PE sector. This is not restricted to manufacturing but extends to the entire value chain. This is something that Ms Jessica Tan also raised – the need to have the entire ecosystem and the supply chain. An example is Kulicke & Soffa. This is a market leader in the manufacture of semi-conductor wire bonders. The company started operations here with a modest sales team in 1993, it has since moved on to include manufacturing and product management, and recently also made Singapore its global corporate headquarters.
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In the hotel industry, we face a different set of challenges. Based on the Singapore Tourism Board's (STB) study, our hotel industry's productivity level is comparable to that of Hong Kong. Here, our main challenge lies in attracting manpower for rank-and-file jobs in an already tight labour market. To raise productivity, more hotels have to improve their operational efficiency. They need to review systems and leverage technology to optimise manpower resources. An example of a hotel that has done so is Grand Park Orchard. It purchased passport \r\n\r\n
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\r\n\r\nscanning devices to facilitate guest check-ins, dispensing with the need for manual entries. In this way, their guest services officers are now able to check in a guest in two-and-a-half minutes compared to four minutes previously. To complement the move to improve operational efficiency, rank-and-file jobs in hotels need to be upgraded and redesigned to become higher-skilled ones with better remuneration. More Singaporeans will then be attracted to these jobs. \r\n\r\n\r\n\r\n
For the hotel industry, high service standards are also critical. I agree with Ms Jessica Tan that we need a quantum step improvement in service excellence – visitors must go away with a happy experience. Productivity is not just about reducing the denominator, it is also about increasing the numerator – the value-add. And raising the service standards, in fact, allows us to also raise the value-add.
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Mr Chairman, let me conclude. Singapore is, in fact, in a very good position to tap the opportunities in a rising Asia. Our medium-term growth prospects are promising. However, constraints in labour supply compel us to raise productivity and make the best use of our resources. We therefore need to persevere in our restructuring efforts. We will then have an economy that will create a better quality of life for all Singaporeans. There are some cuts which overlapped with what we are going to talk about in SMEs, so I will leave to Minister of State Lee Yi Shyan to deal with this later.
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Innovation for growth
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Assoc. Prof. Dr Muhammad Faishal Ibrahim: Sir, the Prime Minister announced a $16.1 billion plan to boost research, innovation and enterprise over the next five years in September last year. The move to generate economic growth via innovation is certainly the right way to go \r\n\r\n
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\r\n\r\nfor Singapore as a knowledge-based and innovation-driven economy. \r\n\r\n\r\n\r\n
As a Member of Parliament, from time to time, I have met Singaporeans who would like to better understand how our investments in research, innovation and enterprise translate to benefits for Singapore and the man in the street.
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I would like to ask the Minister to elaborate on the key strategies under the $16.1 billion plan. What programmes have been rolled out under this plan? Can the Minister elaborate on how existing efforts have been enhanced and how do companies, researchers and entrepreneurs stand to benefit from this plan? Prior to this plan, how successful have we been in reaping growth from investment in innovation? Can the Minister share a few success stories from this effort?
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12.30 pm
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Innovation as key enabler
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Miss Penny Low (Pasir Ris-Punggol): Sir, more than $16 billion has been set aside over five years to fund innovation as a key enabler of economic growth, and the way to increase productivity and real income. Bravo! But, Sir, The Economist magazine defines \"innovation\" as \"new products, business processes, or organic changes that create wealth or social welfare\", or simply put, \"the fresh thinking that creates value.\" To achieve quantum leap growth, fresh thinking and organic changes – or systemic innovation – is the way to go.\r\n\r\n
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Systemic innovation involves changing the mind's eyes to see and think in new ways – from economic assumptions to social arrangements, impacting the demand and supply of basic needs. Often, they are catalysed by crisis, disruptive technology, social needs or cumulative physical and cultural changes.
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\r\nBut the mother of innovation usually arises out of needs, and the most compelling needs are those that relate to improving human condition, and not just financial value. Some examples are the spread of education, green and infotech revolution – all of which points not to profit maximisation but to making life better. Perhaps what we need is a systemic paradigm shift from private innovation to social innovation, to yield both economic and social dividends. Sir, what are the schemes that prompt systemic innovation?
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To this end, I advocate refocusing innovation on the following:
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(i) A paradigm shift and changing the language from product and service innovation to social innovation, tackling human needs and making life better for Singaporeans. An example can be found in Singapore Polytechnic that adopted humanitarian values as their ethos, changed the curriculum to give meaning to studies. For example, the engineering and design students team up with VWOs and allow them to empathise firsthand with the disabled's daily struggles, and create meaningful solutions to improve the quality of life for real people. Some of the solutions are so good that commercial interests are found.
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(ii) Demand-side innovation. Our incentives are heavily supply-side bias. But with the advent of new media, demand-side innovations like crowd sourcing, consumer and social needs-driven collaborative innovation offer unprecedented opportunities to harness global creativity and value-add to our products and services. From Google to Facebook, companies that adopt open and user needs-driven processes to their products and business development have become an integral part of our lives. What are some of the schemes that incentivise our demand-side innovations?
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\r\n(iii) Information innovation. We have an excellent data collection system that unveils latent assets and maps future trends and challenges. Why not make our national challenges known in digestible form in a checklist and then invite innovators to tackle them? Doing so would also allow the frontliners to better understand the issues and users to share visions.
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(iv) Collaborative innovation. Cross pollination of ideas combining many elements in new ways has been the most transformative. For example, mobile phones combine micro-processors, transmitters, network of masts and applications that create new businesses that satisfy lifestyle needs.
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To encourage collaborative innovation, the Government can help build trust-creating devices like eBay's peer rating systems or provide public database. Government should also support existing platforms that focus on peer-to-peer, 3Ps and intra-industry collaboration, including that in the social sector. One such platform – and I declare my interest here since I also help to create this platform – is the Global Social Innovators Forum, which is a locally created, internationally recognised annual event that brings together change leaders from the 3Ps and academic circle to build a more inclusive, sustainable and better world.
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Perhaps, the Government can also think about developing a social Silicon Valley where the 3Ps can come together to solve Singapore's most pressing concerns. One such park also called the Social Innovation Park is found in Spain. They visited Singapore's SIP, took our ideas and found great government support, and is now abuzz with many cross-sector collaborations and host more than 50 international companies and associations. Can we do the same?
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\r\n\r\nFifth, innovation in distribution. Just as central planning has become less efficient, distributed periphery network gains weight. Local smart grids, step-down care, telemedicine are some examples. Can we also incentivise the creation of new infrastructure, or adapt old ones to expand into a more efficient distribution centre?
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All of these would also need a new legislative vehicle, a regulatory architecture and investment flow to unlock these systemic changes.
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Sir, in conclusion, where innovation in the private sector is designed to reserve benefits for financial gains and those who can pay for it, social innovation is structured to favour the rapid diffusion of an innovation rather than keeping it private. In so doing, open sourcing solutions and mass distribution lower costs, increase efficiency and create a value system that is different and KPIs that will truly transform our society.
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Sir, higher economic profits and social dividends –
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The Chairman: Ms Indranee Rajah.
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Integrated Resorts
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Ms Indranee Rajah (Tanjong Pagar): Mr Chairman, it has been a year since the Integrated Resorts (IRs) have opened, and there have been reports on the strong performance of the IRs since their opening. I would like to ask the Minister for an update on their performance, in particular, how does that performance so far compare with the earlier projections, and what does the Government expect to be the IRs' economic contribution in the long term.\r\n
Dr Lam Pin Min (Ang Mo Kio): Sir, the two Integrated Resorts – the Marina Bay \r\n\r\n
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\r\n\r\nSands and Resorts World Sentosa – are both in operation albeit not at their maximum capacity. Notwithstanding this, the opening of these two IRs has brought significant economic benefits to Singapore with increased tourist arrivals and betting taxes amounting to $2.3 billion. In addition to the casinos, Singaporeans and tourists alike can enjoy other entertainment amenities, including the delightful culinary skills of Michelin-starred chefs, theme parks, conference and exhibition facilities. I would like to ask the Minister what would be the expected benefits in terms of tourism receipts and GDP contribution when the two IRs are operating at their maximum capacity. Will Singapore be looking at the possibility of building more IRs in the future?\r\n
Tourism
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Mr Chan Soo Sen (Joo Chiat): Mr Chairman, Sir, the tourism sector had a very good year last year. I wonder how much of this is due to the impact of the Integrated Resorts. I would also like to ask what would be the steps that we want to take in order to sustain this growth for the long term. \r\n\r\n
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I remember in the early 1970s when we started our tourism industry, we marketed Singapore as an \"Instant Asia\". What will be the emphasis on the Asian part of the heritage that we are going to put in our strategy to promote Singapore as a tourism destination? For example, heritage towns like Joo Chiat, which is my constituency, what would be the plans that the Singapore Tourism Board have in promoting us to wholesome tourists, not the kind of tourists that my constituents are worried about?
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How about eco-tourism? We may only have a small plot of primary forest, but the advantage is that it is very diversified in terms of ecology. Furthermore, the size is also quite manageable. We do not have to go to the Amazon and get lost. In Bukit \r\n\r\n
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\r\n\r\nTimah, we usually would not get lost and we see a lot of things. What are the steps that we can do in order to promote these as Singapore's instant eco-tourism? How about making Singapore into a \"cooler\" place where the tourists coming here can find this place enjoyable, relaxing and really fun, not the kiasu kind of an image that they have of Singapore? How do we encourage tourists coming here to slow down their pace a little, enjoy our eco-system, enjoy our heritage and enjoy our nice and cool place? I understand that the average tourist stays about four days. If they extend their stay by one day, we have 25% more money to make.\r\n
Dr Lam Pin Min: Sir, tourist arrivals in Singapore rose by 16% in December 2010, as compared to the same month in 2009. In the whole of 2010, tourist arrivals grew by a massive 22%, with a total of about 11.6 million tourists. Tourism is an important sector to us. It is the lifeline of the retail industry as well as the hospitality industry. \r\n\r\n
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I would like to ask the Minister the following: how many tourists are we expecting this year? What are our tourism targets for the next five years? With stiff competition from our neighbours, what additional attractions are we developing to help achieve these targets?
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Energy
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Ms Jessica Tan Soon Neo (East Coast): Mr Chairman, with the recent crisis in the Middle East and Northern Africa, what are the implications for Singapore's energy supply? We would expect that with the disruption in supply, oil prices will be pushed up and add to the inflationary pressures that Singapore is already experiencing. Singapore is highly reliant on energy imports, and any disruption of energy supply and prices will affect our industries and households. We have a developed market with high energy intensity and consumption. Our lifestyles \r\n\r\n
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\r\n\r\nand industries are extremely energy intensive – from our communication devices to entertainment, transportation industry. All aspects of our lives require energy. In fact, if we had a disruption for just a few hours in Singapore, I think you just cannot imagine what that would be.\r\n\r\n\r\n\r\n
Can the Minister share our strategy to ensure Singapore's energy supply resilience and security? What innovations are we investing in for alternate energy sources and sustainability? Both in the short term and longer term, what measures are we taking to address these challenges and implications for Singapore and companies that operate in Singapore?
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Mr Michael Palmer (Pasir Ris-Punggol): Mr Chairman, Ms Jessica Tan seems to have taken the words out of my mouth, and said inflation is on the rise in Singapore and various other parts of the world, particularly so with the cost of crude oil going up per barrel to over US$100. I think in Singapore we should be looking at different sources of energy and alternative sources of renewable energy as well as sustainable energy. Could I ask the Minister to share with us – with the Middle East in turmoil – what effect has the sharp increase in the price of oil had on Singapore, and our cost of energy and cost of goods in general? Do we have other sources of oil and alternative energy sources, such as LNG, which will help soften the effects of the rising oil prices? What steps are we taking to move towards a more sustainable source of energy, such as nuclear energy?\r\n
Mr Liang Eng Hwa (Holland-Bukit Timah): Sir, we have seen unrest in the oil rich Middle East region in the last few weeks. The situation is still unfolding, remains uncertain and with no end in sight. The unstable geopolitical risk has pushed oil price to hit a two-year high of almost US$120 per barrel last week. Some analysts like Nomura even predicted that the oil price could even hit above \r\n\r\n
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\r\n\r\nUS$200 per barrel if the unrest spreads and expands further into the region.\r\n\r\n\r\n\r\n
Should the events in the Middle East turn for the worst, how would Singapore be impacted? Would an oil shock change the outlook of our economic growth? And how prepared are we for a scenario of sustained high oil price?
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Ms Indranee Rajah : Mr Chairman, like my three parliamentary colleagues who have preceded me, I am concerned about the current developments in the Middle East and, in particular, how it will impact Singapore's economy. I would therefore like to ask the Minister what is Singapore's strategy for alternative energy and, in particular, if he could provide an update on the status of the pilot project for electric cars, and whether electric cars can be a viable alternative mode of transport in Singapore. If yes, then how long would it take before electric cars can become a mainstream means of transport?\r\n
The Senior Minister of State for Trade and Industry (Mr S Iswaran): Mr Chairman, I want to thank Members for their interventions and I will address their specific questions on three broad areas – research and development, tourism and energy.\r\n\r\n
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12.45 pm
Assoc. Prof. Dr Muhammad Faishal asked how we plan to harness innovation for growth, and what benefits would accrue to researchers, industries and entrepreneurs. Our investment in R&D is really part of our long-term capabilities to underpin our future economic growth. It has strengthened our economy by promoting innovation and catalysing new area of growth. For example, A*STAR's Bioprocessing Technology Institute has helped to seed the capabilities and the \r\n\r\n
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\r\n\r\nexpertise that has supported, subsequently, the emergence of the biologics industry in Singapore. Today, that industry has attracted $2 billion in investments and it will create more than 1,000 jobs.\r\n\r\n\r\n\r\n
Our SMEs have also gained from our R&D initiatives. Under A*STAR's GET-Up, Growing Enterprises through Technology Upgrading programme, researchers have been attached to some 200 SMEs to help develop new products and services by using technology. One example is Tru-Marine Pte Ltd which developed a new process to repair rather than replace worn engine rotors. This allowed the company to offer a new niche service and, consequently, it has grown its annual revenues from $20 million to $50 million.
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Our commitment to research and innovation remains unstinting. Last year, the Prime Minister announced the Research, Innovation and Enterprise (RIE) 2015 plan which would render enhanced support to our researchers, industries and entrepreneurs. As many Members have already noted the Government will invest $16.1 billion in R&D for the next five years. That is an increase of 20% over the previous five-year plan. At a time when many countries are cutting back on R&D due to fiscal constraints, Singapore stands out for continuing to build its research and innovation eco-system. This investment will yield three main benefits: scientific excellence and talent; greater economic outcomes; and, solutions for challenges that Singapore faces.
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RIE 2015, first of all, will continue to support scientific excellence and nurture talent. We will invest in the creation of new knowledge and ideas, which are the basis of future innovations. The pool of competitive research funding will be enlarged to ensure that the best ideas are supported. Multi-disciplinary and collaborative efforts will be encouraged, as it is often at the intersection of these \r\n\r\n
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\r\n\r\ndifferent branches of knowledge that new ideas and discoveries are made.\r\n\r\n\r\n\r\n
Second, we will leverage on our scientific capabilities to encourage and generate greater economic outcomes. Under EDB's Research Incentive Scheme, $2.5 billion will be set aside to co-fund the establishment of corporate centres of R&D excellence in Singapore. We have also introduced a new $1.35 billion Industry Alignment Fund for collaboration between public and industry researchers in order to align Government-funded research more closely with the needs of the industry.
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Over the next five years, the allocation to innovation and enterprise will be doubled to $1 billion to enable researchers and entrepreneurs to take more ideas from research to commercialisation. One example, the Singapore Institute of Manufacturing Technology received a grant to further existing nanotechnology research and develop a new process for producing self-cleaning paint. This technology was licensed to Haruna Singapore Pte Ltd, a local paint company, for commercial production. This budget will then help match the commercial needs of companies like Haruna with the intellectual property developed in our research centres. It will support entrepreneurs in proto-typing and test-bedding new products and services, and provide seed funding for growing technology enterprises.
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Third, R&D will help to address some of Singapore’s pressing challenges. Miss Penny Low has suggested that the Government adopt a broader definition of innovation that delivers not only economic outcomes but also solutions that address social concerns. I am assuming the Member does not think that the pursuit of economic outcome is inherently wrong in its own terms. But this is more about the remit that MTI and its agencies have, which is primarily to focus on economic \r\n\r\n
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\r\n\r\noutcomes. But the dichotomy between social and economic, in some ways, is a false one because most of the commercially viable ideas start by seeking to address a need in the market which is a social need usually. So, that is the Government’s approach. We want to encourage research which is geared towards meeting needs that are pressing or that are long term in nature, in the marketplace, in the society.\r\n\r\n\r\n\r\n
We established the $1 billion National Innovation Challenge programme to encourage, as Miss Penny Low put it, \"systemic innovation\" to develop solutions to Singapore’s national challenges. It will not only help solve our problems but also serve to build a better life for Singaporeans and spawn new industries and business opportunities in the process. The first challenge, \"Energy Resilience for Sustainable Growth\", aims to develop cost-competitive energy solutions for deployment within 20 years to help Singapore improve energy efficiency, reduce carbon emissions, and increase energy options. The Government has also applied the collaborative innovation approach to address longer-term public sector needs. The $450 million Co-Innovation Partnership Programme will help private enterprises to collaborate with the public sector to develop innovative solutions for specific needs in the public sector. Each collaboration can receive up to $1.75 million under the programme. There is a good pipeline, for example, the Ministry of Health is exploring ways to use remote technology to monitor diabetic patients. JTC is looking at how we can transform excavated soft materials into alternative reclamation fill.
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In general, we agree with Mr Wee Siew Kim that innovation should be encouraged in as many sectors as possible. We have established grant schemes for test-bedding ventures in areas such as urban solutions, health and \r\n\r\n
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\r\n\r\nwellness, lifestyle and media amongst others. We will continue to encourage this diversity and vibrancy in our R&D landscape.\r\n\r\n\r\n\r\n
Turning now to tourism. As with R&D, we are breaking new ground in tourism. Last year, riding on the Asia’s recovery and the opening of the two Integrated Resorts (IRs), we welcomed 11.6 million visitors and registered $18.8 billion in tourism receipts, an increase of 20% in visitor arrivals from the year before and 49% for tourism receipts.
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Dr Lam Pin Min and Ms Indranee Rajah have asked about the long-term economic impact of the IRs. MTI recently announced that based on initial numbers, we are on track to realise the previously projected $2.7 billion in value-add per year per IR, and 50,000 to 60,000 economy-wide job creation in the steady state.
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Mr Chan Soo Sen asked how much of last year’s growth is due to the IRs. It is not possible to give the Member a definitive breakdown but clearly there are many factors at play, we were starting from the low base in 2009; there is also the growth in Asia in general, and there was therefore much greater tourist traffic and then, of course, the IRs which brought a significant addition to our tourism landscape.
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But we must recognise that it is still early days yet, with the IRs in their first year of operation. We must expect that the novelty will diminish even as the IRs continue to roll out new attractions. We must also anticipate increasing regional competition for the tourism dollar. It is really too early to draw a definitive conclusion about their long-term economic impact or, indeed, to form a view as to whether we should have more IRs in the future.
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\r\n\r\nDr Lam Pin Min and Mr Chan Soo Sen have asked about the outlook for the tourism industry. For 2011, STB’s forecast is for 12 million to 13 million visitor arrivals and $22 to $24 billion in tourism receipts. That is an increase in visitor arrivals that range between 3% to 12% and 17% to 28% in tourism receipts. These are significant increases and, if they are achieved, will take us another step closer towards achieving STB’s target of 17 million tourist arrivals and $30 billion in tourism receipts in 2015.
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The reason we have been able to come this far in tourism is partly because of our investments in a strong portfolio of attractions and that has helped us to tap the growth in Asia. We have heard these attractions – the International Cruise Terminal, Gardens by the Bay and the National Art Gallery – these are some of those that are coming in the pipeline that will add to the momentum. Eco-tourism is not really the strongest suit of most cities including Singapore, but tourists who are so inclined can clearly immerse themselves in the verdant environment of the Bukit Timah and Central Catchment Nature Reserves, as well as the Sungei Buloh Wetland Park. It is not really the central prong on which the STB markets Singapore as a tourist destination. But clearly, Singapore can be a launch pad from which to explore those options in the region.
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Mr Chan Soo Sen asked about the cultural tourism and STB is working on curating a diverse calendar of events ranging from lifestyle events, like the F1 and the Asian Fashion Exchange, to cultural experiences such as the Chingay Parade, Thaipusam and Hari Raya celebrations.
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Taking a longer-term view of tourism, we must acknowledge the constraints on our resources especially land and labour. We cannot keep increasing indefinitely the \r\n\r\n
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\r\n\r\nnumber of visitor arrivals, which Dr Lam described as massive, or the number of workers in our tourism industry. So, we need to place greater emphasis on increasing the value-add we derived from each visitor and raising productivity. To raise the yield per visitor, we need to offer a greater experience and value. For example, STB has made a deliberate effort to create a series of lifestyle events around the F1. Consequently, average F1 visitor spending in 2010 was close to four times that of the regular visitors – more on F&B, more on entertainment and accommodation. Another way to add value, and Minister has elaborated on this already, is to meet the rising expectations of visitors by enhancing service quality. Our GEMS Up (Go the Extra Mile for Services) effort is part of a broader national effort to ensure that we are able to raise service standards.\r\n\r\n\r\n\r\n
Productivity push is key. We have had a lot of discussion on it. I just want to make the point that we need to explore ways to enhance efficiency and job redesign. Swissôtel has a programme where selected room attendants are given the additional responsibility of preparing the rooms according to specified individual preferences to enhance guest experience. They are also
\r\nentrusted to do their own quality control checks to ensure that cleanliness and all the other expectations are met. By empowering room attendants and imbuing them with this greater sense of pride and ownership in their work, and increasing job value and wages, this programme should help to increase job satisfaction and improve staff retention. We also encourage businesses to identify more areas where such improvements can be made.
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\r\n We now turn to energy. Even as we pursue growth, we are mindful of the resource challenges that we face. Ms Jessica Tan, Mr Michael Palmer, Mr Liang Eng Hwa and Ms Indranee Rajah have all raised questions over the impact of the \r\n\r\n
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\r\n\r\npolitical turmoil in the Middle East and North Africa on our energy prices and security. It is important that we first recognise that rising energy prices are part of a long-term trend which reflects fundamental demand and supply drivers in the global energy market. Barring major shifts in the global energy supply, energy will become a relatively scarce resource as demand grows, particularly because of a resurgent Asia. If there is a global initiative to price the cost of carbon emissions to the environment, this will exert further upward pressure on energy prices. As a small economy that is almost wholly reliant on imported energy, we cannot be insulated from these global trends.\r\n\r\n\r\n\r\n
Against that backdrop of that long-term trend, we must also be prepared for greater volatility in energy markets. In 2008/2009 because of the global financial crisis, there was demand uncertainty and that depressed energy prices. Today, the turmoil in the Middle East and North Africa has created supply uncertainty. It does not affect us directly as an energy source because most of our sources are primarily in the region. But oil futures have risen by about 21% since the protests in Egypt began. Not all of these will translate into increases in our electricity prices: the strength of the Singapore dollar, our use of natural gas as our primary fuel and Combine Cycle Gas Turbine (CCGT) plants, which are very efficient for power generation, and a competitive electricity market will cushion us to some extent. But we cannot be fully shielded from the impact of these increases if they persist.
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Diversification is key to ensuring that Singapore continues to have secure and competitively-priced energy supplies. The Government will, therefore, continue to explore the development of viable alternative fuel sources. We now import gas from Malaysia and Indonesia through pipelines. We are building the LNG \r\n\r\n
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\r\n\r\nterminal which will provide access to a global gas market and the terminal will come on stream in 2013.\r\n\r\n
Other options include coal and electricity imports. Coal is relatively abundant, and new technologies can help to reduce its environmental impact, so this is something which we should be keeping a close watch on. The Economic Strategies Committee recommended electricity imports as another possibility. A competitive proposal might allow us to access energy sources in our region while freeing up valuable land and other resources in Singapore. We are reviewing our regulatory framework to consider this option for the medium term.
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MTI is also leading a multi-agency pre-feasibility study on nuclear energy. The study is looking at key factors such as technological developments, safety and security issues as well as the economics of nuclear energy. The aim is to inform the Government’s understanding of the risks and possibilities arising from nuclear energy, given the global and regional developments in this space. We cannot rely extensively on alternative energy sources such as wind, geothermal or solar to meet our baseload energy requirements due to our natural disadvantages in these areas. But we will augment our fuel mix with these options where it is technically feasible and economically viable. For example, the Government has invested $31 million in pilot programmes to install solar panels on the rooftops of some HDB buildings by 2015 in order to assess their efficacy.
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While we are somewhat constrained on the supply side, we can help ourselves significantly by using energy more efficiently. We can do more with less energy. The private sector has shown this. For example, 3M has made a concerted effort to imbue an energy-\r\n\r\n
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\r\n\r\nefficiency culture in its manpower team and, as a result, they have achieved a 35% improvement in energy efficiency, with a cumulative cost saving of US$1.4 billion. We can aspire to do the same – as households, as companies and as a nation as a whole.\r\n
1.00 pm
The key aspect in managing such demand is pricing energy right. Consumers will adjust their behaviour when they appreciate the full cost of energy as reflected in its price. Conversely, subsidising energy will only lead to inefficient use of a scarce and precious resource.
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Some households may face difficulties in coping with rising and volatile energy prices. Our approach is to provide targeted assistance to those who need it. In Budget 2011, the Finance Minister has announced $200 million in utilities rebates which will help Singaporeans cope with high energy prices. I can put it in more specific terms. This year, a 1-room household will receive enough in rebates to cover most of its annual electricity bill, while a 3-room household will receive about five months' worth of electricity bills in rebates. These are signficant rebates which are provided in a targeted manner to those who will need them the most. Since 2007, the Government has provided close to $800 million of such rebates, benefiting about 800,000 households.
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Clearly, beyond households, we want to encourage energy efficiency amongst all industry players, across sectors, and the Energy Efficiency Programme (E2PO) coordinates these programmes.
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Ms Indranee Rajah asked about the electric vehicle (EV) pilot project. This is another R&D initiative. The project will test if EVs can become a viable mode of transport in Singapore. We are currently \r\n\r\n
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\r\n\r\ndeveloping the charging infrastructure for the pilot. The first charging stations are due to be completed by mid-2011. The first EVs should arrive in Singapore around that time. We will run the pilot for about two years, and use the data to evaluate the costs and benefits of EVs.\r\n\r\n\r\n\r\n
Mr Chairman, if I may conclude, as the Minister had emphasised earlier, growing the economy requires efforts at various levels. First, we must grow capabilities. R&D is one of the ways we can try which MTI does this. Second, we must seize opportunities arising in Asia. MTI's efforts in tourism seek to do this. Third, we must address our resource constraints. Our multi-pronged approach to addressing our energy challenge will help put the economy on the path of more sustainable growth.
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Inflation
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Assoc. Prof. Dr Muhammad Faishal Ibrahim: Sir, recently, there have been many reports regarding inflation led by the increase in prices of various consumer products. In addition, much has also been debated in this House in our recent Budget debate. While there are views that the increase in prices is led by car and housing, others feel that prices of most goods and services have gone up and will continue to go up. As a result, while there is a fear of this inflationary phenomenon, I have received feedback that Singaporeans are also unclear and confused with regard to the details of the inflation we are facing and how it affects the different segments of our society. Many organisations in Singapore, including the Government, have reviewed their programmes and schemes to help Singaporeans cope with this inflationary phenomenon.\r\n\r\n
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With a sizeable proportion of low-income residents living in my ward, Kaki Bukit Division, I am very concerned if they are affected by the rise in prices. In \r\n\r\n
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\r\n\r\nparticular, I am concerned that many of the middle- and the lower-income Singaporeans are finding it difficult to cope with these increases, especially in terms of food and transportation. From the statistical point of view, I would like to ask the Minister to explain how the current inflation is affecting the various income groups according to the major items that they consume. In particular, which segment of the society have been the hardest hit by the recent inflationary phenomenon?\r\n
Monitoring retail prices
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Mr Liang Eng Hwa (In Mandarin): [For vernacular speech, please refer to Appendix A*.] Recently, I went to the People's Association to attend an event. Since it was still early, I went to a nearby coffeeshop and ordered a cup of coffee with less sugar. The coffee shop assistant brought me the coffee and I was about to take out 90 cents. Before I even handed it to him, he said, \"yi yuan wei ding\". I was puzzled – I did not know what he meant by \"yi yuan wei ding \". He immediately explained that one cup of coffee is $1; it is a set price and cannot be bargained. I understood and appreciated his humour. This little episode gave me a good first-hand experience of the inflation.\r\n\r\n
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I heard that even zhuchao stalls raised their prices. A plate of hor fun now costs $3.50; the price of a can of Coke Light rose from $1.10 to $1.30.
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\r\n I would like to ask the Minister how the Government is going to monitor the retail prices and if there are any anti-competition practices. We want to keep the price at a level that people can accept. Do we have enough resources to monitor effectively?
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The Chairman: Mdm Ho Geok Choo, take both your cuts together, please.
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Red tape and productivity schemes
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Mdm Ho Geok Choo: Mr Chairman, Deputy Prime Minister Teo Chee Hean said on Tuesday that Singapore would stress a culture of continuous improvement and learning in the productivity drive. One missing element here is empowering our people to think of alternative means of reaching the same results.\r\n\r\n
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I know of a HR professional with more than 20 years of experience abroad as a consultant at a well-known bank whose application for certification as a consultant was stalled by the secretariat staff just because he could not show that he had chalked up 1,000 hours of consulting work in Singapore prior to the application. His application was automatically rejected.
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An appeal was made. This HR professional was one of the pioneers of the Management Services Division (MSD) of PSD. He was asked to show evidence of his consulting work with MSD and Ministry of Finance some 30 years ago. Obviously, MOF was unable to help as they do not have the records. It was only through intervention that this HR professional was asked to appear before interviewers who, upon seeing him, were very apologetic and immediately sorted out his application.
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Mr Chairman, I think there is a gap between what the administrators understand of their role and the expectations of the policymaking body. The more important point really is that it would appear that the administrators are not empowered to think from the inside out. They are satisfied to just go by the rules and that is how rigidity sets in.
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I hope the Government will launch a campaign on thinking from the inside out, so as to encourage, firstly, service providers to go the extra mile to resolve \r\n\r\n
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\r\nproblems and, secondly, employers to empower service providers to accommodate alternative but equally effective ways of doing things.\r\n\r\n\r\n\r\n
SMEs and productivity
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Mr Chairman, in helping SMEs, it is good to see five trade bodies here set up the Enterprise Development Centres (EDCs) to train their members to innovate and be more productive. Sir, have these efforts reached their target group, especially the smaller SMEs? How effective have the EDCs been in helping SMEs step up their productivity drive?
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The SMEs, which are trade body members, are more likely to be able to leverage on the network advantages mentioned by Deputy Prime Minister Teo Chee Hean. Which brings one to question how many SMEs do not belong to a trade body and thus are not as plugged-in to the economy and Government initiatives as those who are. For those outside the network, what impact do they have on productivity in Singapore as a whole?
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I acknowledge that the Government has been tireless over the past year in launching productivity initiatives. Some SMEs, though, feel that the Government should not introduce too many new productivity programmes but should instead make it easier for them to adopt existing schemes and to allow them time to show results. Apart from the Productivity and Innovation Credit scheme introduced last year, SMEs are also offered a battery of other schemes, some with similar sounding names. The range is bewildering to individual businessmen. What can be done to tidy up this web?
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Orchids
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Mr Chiam See Tong (Potong Pasir): Sir, the national flower of Singapore is the orchid. Singapore has expertise to grow orchids on a commercial basis. Singapore \r\n\r\n
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\r\n\r\nalso has the expertise to collect and distribute orchids all over the world. Singapore should develop itself to be the world distribution centre for orchids, just like Amsterdam has done so for tulips and other flowers. In this way, 100,000 or more jobs could easily be created for our own people.\r\n
Consumer protection
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Mr Yeo Guat Kwang (Aljunied): Mr Chairman, Sir, as the President of Consumers Association of Singapore (CASE), I would once again urge the Ministry of Trade and Industry to extend the five-day cooling-off period to the beauty industry. CaseTrust-accredited spas are already giving their customers a cooling-off period to reconsider their purchase of all beauty packages. In view of the recent Subtle Senses case, the CaseTrust Council is exploring to introduce the escrow account and insurance for fees collected as a requirement of CaseTrust accreditation scheme for the spa industry, just like what we did for the private schools previously to protect the advance payments made by all consumers.\r\n\r\n
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I hope the Government will require all beauty salons and spas to give their customers a cooling-off period. As consumers, usually the ladies, feel vulnerable when therapists start to sell packages to them during the treatments.
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Next, I understand that MTI has concluded the public consultations for the lemon law. I would like to ask when the changes to the Consumer Protection (Fair Trading) Act (CPFTA) and the Hire Purchase Act on the provisions of the lemon law so that we can better protect all consumers from the purchase of defective products.
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Sir, the Consumer Protection (Trade Descriptions and Safety Requirements) \r\n\r\n
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\r\n\r\nAct was passed in 1975, which was a long time ago. The Act prohibits false trade descriptions and stipulates that breaches of the Act attract a fine or imprisonment or both. While the Act has been set out to protect the rights of consumers and assure them that they are getting what they are paying for, the Act has not always achieved this goal.\r\n\r\n\r\n\r\n
The Act currently lists only 45 products as controlled goods. These are mainly home appliances and components of or related to some of the other petroleum and gas system. I would like the Ministry of Trade and Industry to look into setting safety standards for all goods. This would then mean that all the basic consumer products will be set with acceptable limits of chemicals, for example, and safety standards so that the health of the consumers will be better protected.
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The Ministry should also require importers and manufacturers to state the age group of consumers that the goods are intended or suitable for, and also make sure that all the contents of health warnings or hazards are stated clearly for consumers to make an informed choice.
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The Minister of State for Trade and Industry and Manpower (Mr Lee Yi Shyan): Mr Chairman, let me first address the concerns on inflation, especially Assoc. Prof. Dr Muhammad Faishal's query on how inflation has affected the various income groups. \r\n\r\n
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Singapore's headline inflation rose to 2.8% in 2010, from 0.6% in 2009. The lowest 20% income group experienced the lowest inflation rate of 2.4% compared to 2.7% and 3.1% for the middle and the highest 20% income groups respectively. Last year's inflation affected the higher-income group more than the rest. This year, the Monetary Authority of Singapore is expecting \r\n\r\n
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\r\n\r\nheadline inflation to be between 3% and 4%. The four key drivers on inflation are: higher car prices, rising accommodation cost, higher wages and rentals and higher food prices and utilities. While some of these price increases, for example, the higher cost of food, utilities and service-related items, affect a broad segment of Singaporeans, the spike in car prices would only affect every three in four households which purchased new cars last year. Likewise, for accommodation cost, 87% of households already live in housing that they own. The increase in imputed rental in the CPI will not affect their cash outlay at all.\r\n\r\n\r\n\r\n
1.15 pm
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Mr Chairman, now I will speak in Mandarin.
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(In Mandarin): [For vernacular speech, please refer to Appendix A*.] Mr Liang Eng Hwa has asked how MTI monitors prices and monopolistic practices in the market and whether Government has enough resources to monitor the situation effectively.
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\r\n Mr Chairman, recently MTI set up the Retail Price Watch Group to monitor the prices of necessities and food to prevent monopolistic practices and promote money-saving tips. The Watch Group have focused on four areas.
\r\n First, keep track of price fluctuations. The tracking of prices is mainly done by the Department of Statistics. Currently, the Department of Statistics regularly monitors the sale of necessities, tracking the price of items such as rice, fish, meat, eggs, vegetables island-wide, and even prices of chicken rice and fish ball noodles commonly sold at food centres. From this month, the Department of Statistics will also monitor food prices at food centres, to see which stalls have raised prices. I \r\n\r\n
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\r\n\r\nthink the coffee stall patronised by Mr Liang can also be included in the list. The Retail Price Watch Group also welcomes more people to provide more tip-offs and take part in the tracking of prices.\r\n\r\n
\r\n In fact, the Watch Group suggests that Mr Liang visit Bao Hua Drinks Stall and Ah Di Drinks Stall at Block 527, in Ang Mo Kio Cheng San Constituency, to enjoy coffee at just 50 cents. According to a report in the New Paper dated 15th February, there is another stall in Cheng San Constituency called \"Lao Li Coffee\". I have nothing to do with this stall. [Laughter. ] It also sells freshly brewed coffee at 60 cents. MP Mr Liang Eng Hwa said that $1 is a fixed price, but I say this is not fixed as the market is very competitive and people are trying all means to fight for business. Thus, not all can fix the price at $1.
\r\n Second, ensure that the market operates highly effectively. For the market to operate effectively, getting the support of big retailers is the key. Big retail chain stores are all over the island. If big retail shops do not raise prices, it will have a positive effect on stabilising prices. Currently, NTUC FairPrice has promised that for the next six months, prices of its 500 housebrand items will remain the same. Apart from NTUC FairPrice, Cold Storage, Giant and Shop N Save have also made similar commitments. I hope that the other retailers will also follow their example and offer low-cost options.
\r\n Third, take tough actions against monopolistic and profiteering practices. The newly established Retail Price Watch Group includes representatives from Competition Commission of Singapore and Consumers Association of Singapore (CASE) and their role is to monitor and take action against businesses involved in profiteering, engaging in anti-competition or unfair practices, as well as those who fail to deliver what they promise. In the event that the Watch Group finds any \r\n
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\r\n\r\nshops or stalls involved in inappropriate business practices, the Competition Commission and CASE will take action and investigate.\r\n\r\n
\r\n Fourth, educate the consumer to understand how the market works. For almost all daily necessities and food, there are relatively low-cost alternatives or brands available. The Watch Group will improve communication with consumers through various ways. Our education efforts will focus on letting the consumers know that they have many choices, and be aware of various money-saving tips. The Watch Group launched a new hotline 64611880 and website, www.pricewatch.gov.sg today. This will make it more convenient for our consumers to give feedback and suggestions. I hope that members of the public will generously share tips on getting value-for-money deals. Of course, they can also report businesses that raise prices unreasonably, so that the Watch Group can understand the reasons and source of price increases.
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(In English): Sir, I would like to move on to address concerns of raising costs for SMEs. As pointed out by some Members, some SMEs may also face rising costs, especially for wages and rentals. Many of the measures that the Minister for Finance announced in his Budget Speech to help companies, such as the one-off SME cash grant of 5% of the company's revenue capped at $5,000, corporate income tax rebate up to $10,000, and the Productivity and Innovation Credit will help SMEs cope with rising costs. But even as they address the challenges of rising costs, SMEs should not lose sight of the more important task of raising productivity by embracing innovation, automation and workers' training.
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To address short-term cost pressures, we need to reinvent our businesses for our long-term competitiveness. Consider, \r\n\r\n
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\r\n\r\nfor instance, Q&M Dental Clinic which has a chain of 40 clinics and two dental centres across the island. Q&M faced the problem of increasing material cost eating into their profits. It was difficult to reduce cost from their manual pen-and-paper procurement system. The system was not only prone to human error but also resulted in wastage and many unhappy staff would have to spend time doing very tedious paperwork. These problems are not uncommon among SMEs. Q&M decided to tap on SPRING Singapore's Technology Innovation Programme to develop a computerised procurement system with a database of nearly 4,000 products. This new system allows each clinic to easily place orders, track its monthly expenditure against budget, and reduce wastage through timely reminders on expiry dates of their materials. It saved them many hours of manual submissions and queries. It led to higher staff morale and teamwork. With its new system in place, Q&M sees scope to eventually lower material cost to around 5% of its revenue from the current 8%. By freeing up their staff from administrative chores, Q&M can now commit more time to human resource training as the next phase of their productivity efforts. Q&M has recently embarked on their customer-centric initiative and are sending their staff for customer service training to improve customer service. What we see here is one good step leading to another, along the journey of productivity improvement.\r\n\r\n\r\n\r\n
Let me give Members another example of productivity improvement in one of our well-known seafood restaurants, Jumbo Seafood. There was a time when they used to receive frequent customers' feedback on inconsistency of taste across their outlets, specifically for the chilli crabs. There are customers who prefer certain outlets and shun others. The reason was simple. Everyday, each individual kitchen had to marinate and prepare their own sauces and food items. \r\n\r\n
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\r\n\r\nThis was done before work, in between the afternoon and night shifts. The difference in taste and quality across outlets was affecting customers' satisfaction, brand recognition and market positioning. Jumbo Seafood then decided to set up a central kitchen to prepare their sauces and fast-selling items. This allowed them to maintain consistency and freshness in the food quality across their outlets and to cut down the repetitive work carried out at every outlet. Without having to prepare food each day before work and after the afternoon shift, overall working hours were shortened and their outlet staff had more time to rest and get ready for the intense night shifts. This had led to higher workers' productivity. The central kitchen also reduced the need for large kitchen areas at each outlet, thus creating more space for tables to increase revenue which also means land productivity versus worker productivity. After setting up the central kitchen, Jumbo Seafood experienced a surge in sales with more repeat customers and an improved market position. In fact, F&B chains equipped with central kitchens are in a very good position to offer additional value proposition, such as off-site catering service and takeaway sales. These new services will actually raise the sales per worker and make better use of the equipment and machinery which means assets productivity. This is one way to expand sales beyond the limitation of physical shop fronts.\r\n\r\n\r\n\r\n
To help more companies to do what Q&M and Jumbo Seafood have done, the Government will be injecting substantial resources in the next five years, including the $850 million Enterprise Development Fund announced by the Minister for Finance. This will be managed by both IE Singapore and SPRING Singapore. The fund will support broad-based efforts to help all SMEs upgrade our industry clusters and help our high-growth companies build up \r\n\r\n
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\r\n\r\nfurther capabilities and spur entrepreneurship. It will also help our companies expand overseas. The additional $1 billion injected into the National Productivity Fund will give us more resources to support our industries and companies moving towards higher productivity. The Government will continue to ensure SMEs are aware of the various schemes.\r\n\r\n\r\n\r\n
Mdm Ho Geok Choo asked if our Enterprise Development Centres are effective in reaching out to SMEs to improve productivity, and whether our system schemes could be simplified. The Enterprise Development Centres (EDCs) – five of them now – play a key role, both in reaching out to SMEs, regardless of their membership with Trade Associations and Chambers, to improve productivity. They help SMEs understand and navigate the grant application process. The EDCs proactively engage the SMEs to educate them on relevant Government schemes and provide advice in areas such as finance, operations and management. Some EDCs have helped SMEs to diagnose their productivity's performance and develop appropriate plans to move ahead. I am pleased to note that in 2010 alone, the five EDCs have provided assistance and business advisory services to about 10,000 SMEs, out of which, 900 also embarked on the productivity management programme under the SME productivity roadmap. In our grant application process, the Government continues to simplify our schemes by having enough customisations to best meet the wide diversity of SMEs' needs. Broad-based schemes are designed to be as simple as possible for SMEs to use. For instance, consider the iSPRINT scheme.
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SMEs looking for packaged solutions pre-qualified by IDA to support basic business functions, such as accounting and payroll, do not need to submit any business proposals under the Increase SME Productivity with Infocomm \r\n\r\n
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\r\n\r\nAdoption and Transformation (iSPRINT) or grant application form. They can proceed with the purchase of the solution, implement it and make that claim through IDA, all in about eight weeks. Since its launch, more than 750 SMEs have benefited from iSPRINT programme, generating a projected $400 million in value-added over the next three years.\r\n\r\n\r\n\r\n
For people capability development, involving larger sums of money, more customisation is needed to better understand the SMEs' needs so as to provide the right time of assistance. For example, SMEs looking to build capabilities, such as branding, had to go through a diagnostic process to identify the key areas which need to be addressed and most appropriate scheme for them. Behind the scenes, of course, we have further integrated the collaboration among agencies, such as SPRING and IE Singapore to better serve the common clients more effectively.
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Although the Government will do what it can to make the schemes easier to understand and access, I must also emphasise that SMEs themselves must be proactive in wanting to improve before the right assistance can be rendered.
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Over the years, IE Singapore has rolled out a number of programmes to take SMEs overseas. They include market studies, meeting potential partners and connecting with Singaporeans' firms already in overseas markets. IE also runs programmes that help companies build specific strengths in branding, franchising, intellectual property protection and access to finance. For first-timers, IE also runs SME Market Access Programme. So far, 87 SMEs have gained from this programme.
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One of them is Bee Cheng Hiang, a very well-known Singapore-based barbecue meat retailer with more than 130 overseas outlets. Recently, it made its \r\n\r\n
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\r\n\r\nfirst foray into Seoul. To prepare for this, the company applied for intellectual property rights for its brand in Korea and tapped on the programme to reduce the associated costs.\r\n\r\n\r\n\r\n
As the opportunities in Asia grow, MTI and our economic agencies will step up efforts to open doors. We will also facilitate projects for SMEs through the many bilateral G-to-G platform and business councils we have established with many countries. SMEs should also tap on our wide network of 18 FTAs, including those with key Asian markets, such as China and India, to enhance their market access. We will keep improving our outreach to SMEs on how to take advantage of the FTAs.
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Mr Teo Siong Seng asked about the role of Trade Associations and Chambers (TACs) in helping SMEs make use of productivity-related schemes and to expand overseas. Indeed, TACs are our important and natural partners. As representatives of the various industries, the TACs understand the needs and aspirations of their members and the challenges facing different sectors in improving productivity or expanding overseas. It also have many SMEs in their membership. TACs are thus well-placed to advise SMEs on using the various Government's programmes for productivity improvement and internalisation.
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1.30 pm
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We have a long history of working with TACs. We continue to explore new ways in helping TACs. For instance, we are now exploring with TACs to improve the needs and interests of their members when applying to use programmes under the National Productivity Fund. This may be one way to ease the administration burden on smaller companies. The TACs have been playing an active role in leading business missions and trade fairs. Last year, the various \r\nChambers led a total of \r\n\r\n
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\r\n\r\n150 trade fairs and over 50 missions to overseas markets, benefiting some 3,300 companies.\r\n\r\n\r\n\r\n
Before I conclude, Mr Chairman, let me address Mr Chiam's question on orchids. MTI works closely with agencies like the Agri-Food and Veterinary Authority of Singapore and IE Singapore to facilitate the growth of Singapore's orchid export sector. Our efforts have seen our global market share of orchid exports grow from 7.3% in 2007 to 11% in 2009. Today, Singapore is the third largest exporter of fresh orchids. We promote orchid exports by negotiating free trade agreements that remove or reduce tariffs and non-tariff barriers imposed by our major markets. For instance, in Australia, one of our major export markets, we managed to secure exemption from mandatory fumigation for Singapore's orchid exporters. We will continue with such efforts.
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Mr Chairman, let me conclude, our SMEs are the backbone of our economy, making up 99% of the enterprises in Singapore. Six out of every 10 workers in Singapore are hired by SMEs. Investing in our SMEs is investing in our future.
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The Senior Parliamentary Secretary to the Minister for Trade and Industry (Mr Sam Tan Chin Siong): Mr Chairman, Sir, let me, firstly, thank Mr Yeo Guat Kwang for his feedback and keen interest in championing consumer protection.\r\n\r\n
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Singapore has a multi-tiered consumer protection framework with caveat emptor, or \"buyers beware\", as its cornerstone. Given the diverse and evolving range of consumer products and services, consumer education and awareness to enable them to discern the best deals for themselves, and also to reject unrealistic promises is the most sustainable approach. This has been the principle \r\n\r\n
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\r\n\r\nwhich CASE has been promoting all these years. CASE’s active role in consumer education is thus key to our overall consumer protection framework.\r\n\r\n\r\n\r\n
Our consumer protection legislation provides the next level of defence. Our legislation needs to carefully balance risks against costs, as sweeping and prescriptive legislation will lead to higher business costs that may be passed on to the consumers. So, we regularly review and update our legislation to be in line with the international best practices.
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Mr Yeo Guat Kwang enquired on the progress of the consumer product safety framework. Sir, I am pleased to report that MTI has completed a review of the consumer product safety framework. Beyond the 45 categories of controlled goods mentioned by Mr Yeo, we will be also enhancing our consumer products safety regime to cover general consumer goods to align them with the latest international standards. MTI will be issuing the Consumer Goods Safety Requirements Regulations (CGSR) to give SPRING Singapore the power to stop the supply of consumer goods that do not meet international safety standards. Under these regulations SPRING will also have the power to direct suppliers to inform their customers of the potential dangers of such goods. Suppliers who do not comply can face a maximum penalty of up to $10,000 fine or imprisonment of up to two years, or both. The CGSR, drafted with feedback from the stakeholders, such as CASE, consumers and retailers, will take effect from 1st April 2011.
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Mr Yeo Guat Kwang mentioned the need to provide safety information such as age group, health and hazard warnings on products. With the implementation of the CGSR, all consumer products are required to meet the applicable international standards. This will actually protect the consumers more effectively as \r\n\r\n
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\r\n\r\ncompared to merely asking them to supply the product information.\r\n\r\n\r\n\r\n
In addition to this, currently many manufacturers are already stating information such as suitable age groups and health warnings on their products. Consumers who find such information useful will likely to purchase these products, which will encourage importers to bring in more products with safety information clearly stated. Nonetheless, we will consider a regulatory approach if the market mechanisms are unable to provide consumers with information critical to the safe use of the products.
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Mr Yeo Guat Kwang also asked for an update on the lemon law. At the last Committee of Supply debate, I mentioned that MTI was studying the necessary legislative changes to introduce a lemon law in Singapore. Most of the key features of lemon laws, as implemented in other developed economies, are already present in Singapore’s legislation. For example, under the existing law, a consumer may reject goods purchased within a reasonable period and obtain a refund if the purchased goods are not of satisfactory quality. However, the lack of express legal provisions for the repair and replacement of defective products in the current legislation make it less easy for consumers to seek these remedies. By providing greater clarity, the new provisions will address the problems of some suppliers refusing to replace a defective product after repeated failed attempts at repair. I am pleased to announce that we have completed the public consultations on the proposed legislative changes. The feedback from the public has generally been very positive. We intend to move the legislation on the lemon law in Parliament later this year.
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Our approach is to limit the legislating of specific consumer practices to targeted industries, where the proliferation of \r\n\r\n
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\r\n\r\nerrant businesses makes it difficult for the industry to self-correct through consumer education and accreditation alone.\r\n\r\n\r\n\r\n
Mr Yeo also asked whether the five-day cooling-off period can be extended to the beauty industry. Sir, the cooling-off period has already been part of the CaseTrust accreditation programme, launched with MTI’s support. It recognises and encourages good practices such as giving consumers a cooling-off period and not selling to customers during treatment. The accreditation programme enables consumers to make better choices without going down the route of imposing prescriptive regulations on the entire industry, which will result in higher business costs that will
\r\n ultimately be borne by the consumers. As the accreditation programme has just been launched last year and it is currently being enhanced, we believe it will be best for now to monitor the effectiveness together with CASE and we will tighten the regulations in the industry if necessary.
The Chairman: We have time for clarifications. Ms Jessica Tan.
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Ms Jessica Tan Soon Neo: Mr Chairman, I would like a clarification with regard to the commercialisation of R&D. Could the Senior Minister of State share more about the IP framework in terms of how we will support and encourage development of IP in Singapore? He talked about commercialisation of IP, but could he share a little more about the IP framework to encourage companies to develop and base their IP in Singapore?\r\n
Mr Iswaran: May I just clarify, are you referring to the framework as in how IP is shared between institutes and companies?\r\n
Ms Jessica Tan Soon Neo: That is right.\r\n
Mr Iswaran: Mr Chairman, to answer the Member's question: basically, our \r\n\r\n
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\r\n\r\nresearch institutes adopt quite flexible models and you will find that there is a range of arrangements in how IP is shared with the private sector. That can start from a wholesale sale of the IP in which case the private enterprise takes it over after a period of co-development. There are instances where they jointly own the IP and there are other instances like the one I highlighted in my speech where they are licensed. The approach is a fairly flexible one. The key objective is really this: first, we want to ensure that the research that is undertaken in our institutes has productive application which means collaboration with the private sector is quite essential. But at the same time, we want to ensure that our institutes and the researchers get a fair deal. Within those broad parameters, they are fairly flexible in their pursuit of a range of options.\r\n
Mr Yeo Guat Kwang: Just a point of clarification, Sir. The Senior Parliamentary Secretary mentioned that the lemon law could be passed later this year. Could he be more specific? Could it possibly be the next available sitting?\r\n
Mr Sam Tan Chin Siong: Sir, MTI and the other agencies working on this project are aiming to move the Bill in the later part of this year. It probably will not be at the next sitting but it will be at the next few sittings from today.\r\n
Mr Liang Eng Hwa: Sir, I would like to ask the Minister the strong Singapore dollar has been the key macro weapon to combat imported inflation. However, we are increasingly dependent on the external sector like tourism, exports to grow our economy. I would like to ask the Minister how would the strong Sing dollar, which has been hitting new highs, impact industries like our tourism and export sectors. Also, how would that impact the companies that we are encouraging to \r\n\r\n
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\r\n\r\ninternationalise? I must declare my interest: I do work in a financial institution that deals with the markets.\r\n
Mr Lim Hng Kiang: Sir, as the Member correctly pointed out, there is a very strong trade-off involved. Our monetary policy is hinged on the value of the Singapore dollar, the exchange rate policy. At the same time, we do have other factors to consider – our export market, manufacturing as well as tourism and other sectors. But taking all these into consideration, so far, the Monetary Authority of Singapore (MAS) has a dual role unlike other central banks. Some central banks only have inflation as the key role but the MAS' role is to nurture stable economic growth, which means competitiveness as well as keeping the economy on a stable front, meaning also an inflation role. This is the balancing act that we will have to continue to meet.\r\n
Ms Jessica Tan Soon Neo: Sir, I would like to ask the Senior Minister of State with regard to the strategies for the efficient use of energy. I know he talked a lot about pricing and pricing it right to ensure that we drive the right behaviours. Beyond pricing, have we looked at other strategies in terms of use of technology, innovation, timely information-sharing to both industry and households to enable and develop more efficient energy consumption behaviour?\r\n
Mr Iswaran: Mr Chairman, I thank the Member for the question. The point about pricing: to be very clear that that is the fundamental requirement because if the price is not right, then we cannot expect behaviour to adjust which is the desired outcome.\r\n\r\n
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Having said that, we are not just relying on price mechanism. There is a slew of efforts underway in a range of sectors. If the Member looks at the building sector, for example, we have the patent marks, and so on, which are really \r\n\r\n
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\r\n\r\ndesigned to encourage developers to adopt energy-efficient building designs and we have already seen that coming on-stream.\r\n\r\n\r\n\r\n
If the Member looks at the industries, we have the Efficient Energy Programmes Office (E2PO) which focuses on various programmes which are targeted at and helping industries develop energy-efficient solutions. Because the industries are so diverse, you need fairly customised solutions and so there is a whole new industry around this, of energy consultants.
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If you look at households, we got the ticks that MEWI does and this is part of the process of encouraging our consumers to be more prudent in the way they select their appliances. We are also testing out smart meters. There is a trial run that is taking place in Singapore. The real purpose of these smart meters is to give households and residents a real-time sense of how the consumption of electricity on their part is affecting their bill so that they can correct it. Normally there is a bit of a disjoint because we consume, then the bill comes later. So, this is to give them a bit more of a real-time feel and they can track it and make adjustments.
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There is a range of measures and I think those, together with our core approach on pricing and targeted subsidies, are really designed to create a more energy-efficient system.
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Miss Penny Low: Sir, the Senior Minister of State said that all innovations, whether academic or social, will ultimately benefit the user. I fully agree. As such, can the Minister also clarify why do we then continue to use language and focus on products or supply or services-centric and specific innovations rather than cause-specific? As we hear on Radio FM93.8, \r\n\r\n
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\r\n\r\n\"change your perspective and change your life\". Otherwise, outcome may be just incremental improvements rather than real innovations. \r\n\r\n\r\n\r\n
The second clarification is on collaborative innovation and funding schemes. The Senior Minister of State repeatedly mentioned public and private sector collaborations. I cheer that but the end-user, the people sector, is conspicuously missing from his entire speech. This serves the point I made earlier on in my speech that the $16 billion fund is very much supply-side-centric but most transformational innovations today are driven by demand-side innovations. I wonder if the Senior Minister of State can clarify if there would be more schemes to look into demand-side innovations and push it to the limit and transform some of the thinking and paradigms that we have today and heavily include people and the people sector in the entire innovation drive.
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Mr Iswaran: Mr Chairman, I regret that the Member takes exception to the vocabulary we used in describing innovation. But this is a reflection of the DNA of what MTI and its agencies are about. Because, at the end of day, MTI and its agencies, have been charged with economic outcomes. Clearly, we have got to keep focused on that. That does not mean you jettison all social and other considerations. Indeed, as I have explained, for example, when you talk about meeting a healthcare need – that is actually quite social in its outcome but it has also got an economic dimension. If you want something to be sustainable in the marketplace, then you need a certain economic viability test to be applied to it.\r\n\r\n
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I think the Member also made a point about the people sector and involvement. Sir, we have a range of programmes available. I do not wish to enumerate them in detail but it would suffice to say \r\n\r\n
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\r\n\r\nthat there have been instances where social enterprises and the people sector have taken advantage of some of them. Perhaps not to the extent where the Member would desire.\r\n\r\n\r\n\r\n
I would also draw the Member's attention to the fact that the Ministry of Community Development, Youth and Sports, through its ComCare and other broad programmes, also seeds a great deal of these kinds of people-sector ventures. Sir, I think we need to look at it in totality and not just from the context of what MTI and its agencies are doing, although even within that context we have got considerable allowances made for these kinds of efforts. I think those were the main points the Member made.
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Mdm Ho Geok Choo: Mr Chairman, I would like to seek a clarification with Minister of State Lee Yi Shyan. The Minister of State has shared how paper processing and procedures have been streamlined for more effectiveness in the agencies. I would like to ask what special programmes have actually been implemented in agencies to empower service providers in agencies to be more flexible and to take initiatives beyond and to go beyond provided guidelines.\r\n
Mr Lee Yi Shyan: Mr Chairman, under the Ministry of Trade and Industry we oversee an important portal called the \"Enterprise One\". In the \"Enterprise One\" portal, there are many business-related applications that have been put online so that users, large and small companies, can go to it and download applications very efficiently. Obviously, whether it is a Ministry, statutory board, or even a private-sector company, simplifying user interface is so critical because of the ongoing changes in contents, in products and services offered and also in meeting the changing needs of customers.\r\n\r\n
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\r\n\r\nPSD responsible for the civil service-wide improvement of efficiency, for example, cutting red tape, has very aggressive programmes. I participated in some of them and I am aware that, for instance, they look at Six Sigma, they look at training black-belters in their organisations. These are people that are trained and put into different departments to relook at processes in a very fundamental way with a hope that they can greatly simplify the efficiency and the user experience.
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Mr Zaqy Mohamad (Hong Kah): Sir, I think the MTI's position on productivity is quite clear. I think most companies probably understand. We want to drive productivity – while there are foreign worker levies on one side, on the other hand, we give rebates and incentives to companies. The issue is for many smaller companies, for example, they are never going to transform overnight. I think the easiest way for them is to transfer the cost of increased levies into cost to the consumers. To some extent for the Ministry, it is a little difficult to balance. I would like to hear from the Ministry how it plans to balance productivity on the one side and potential inflation on the other. \r\n\r\n
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The second issue with SMEs is the issue of cashflow. Now that we have increased levies, they get hit on a monthly basis. But cashflow for SMEs – if you understand their business – many of them have very poor collection terms, they tend to face collection issues. At the same time as well, they can only collect items like GST claims once every quarter and sometimes even later, depends on when they get revenue.
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These are the two areas for my clarification. I do have to commend MTI for sharing a lot of examples of small companies making it good. It is important that we have small companies to be the champions because the SMEs like to say that a lot of examples MTI gives tend to \r\n\r\n
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\r\n\r\nbe of big companies with scale. I think it is the right direction to highlight SME examples.\r\n
Mr Lim Hng Kiang: Sir, I do not want to underestimate the complexity and the difficulties we face. Our approach is to take it at various levels: at the overall economy level, at the sectoral level, at the firms' level, at the workers' level.\r\n\r\n
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As the Deputy Prime Minister Teo Chee Hean explained, we take some issues which cut across different areas, so if it concerns the low-income group, we have another group to address it. Some issues can also be horizontal issues, like IT applications, so we have another scheme for it.
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As Minister of State Lee Yi Shyan explained, we have a very elaborate outreach programme to the SMEs through either the trade associations, which then gives us a very sectoral approach, or through the EDC which is a very broad-based approach. Ultimately, of course, the heavy lifting comes from the firms themselves. They must want to improve. There are a lot of schemes and we are open to suggestions how we can make the schemes more easily available to them. But I do not doubt the heavy lifting will, in the end, be borne by the firms and we hope that the firms will rise to the occasion. The impetus to all these is really competition. The companies must realise that this is the way forward. We are providing all these schemes, we are providing all the mechanisms and the help. If they do not restructure and change and others do, then the competition will come from the other companies who will do much better than them. In the end, that would be the main impetus.
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Ms Jessica Tan Soon Neo: Sir, first of all, let me thank the Minister, Senior Minister of State, Minister of State and Senior Parliamentary Secretary for \r\n\r\n
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\r\n\r\nproviding us with the insights on the policies and sharing with the various strategies. We have covered from productivity, innovation for companies all the way to energy and even orchids. We looked at the needs of industries, SMEs, MNCs as well as the consumers.\r\n\r\n\r\n\r\n
Thank you for that insight. It was heartening to hear from the Minister that apart from the policy approach, there clearly is a lot of thinking around the enabling aspects and it is at all levels: the economy, the sector, the firm and worker.
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With that, I beg leave to withdraw my amendment.
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Amendment, by leave, withdrawn.
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The sum of $655,126,100 for Head V stand part of the Main Estimates.
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The sum of $7,432,227,600 for Head V stand part of the Development Estimates.
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Head L – Ministry of the Environment and Water Resources
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Sustainable development
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Mr Cedric Foo Chee Keng (West Coast): Sir, I beg to move,\r\n\r\n
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That the total sum to be allocated for Head L of the Estimates be reduced by $100.
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Sir, sustainable development is about growing the economy while preserving the environment so that today’s success and development are not achieved at the expense of tomorrow’s and we meet the needs not only of the current generation, but also the needs of generations to come. It means economic development with fewer resources and waste, without polluting the environment, while preserving the nature we now enjoy. I am glad that the Government has made environmental sustainability a priority, and a key milestone was the release of the \r\n\r\n
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\r\n\r\nSustainable Singapore Blueprint in 2009. Could the Minister tell us about the progress Singapore has made in developing sustainably over the last few years? Could the Minister also illustrate our achievements for each of the various sectors like households, transport and industry?\r\n\r\n\r\n\r\n
I note that some business owners are less inclined to devote resources towards developing and implementing environmentally-friendly initiatives as they see environmental degradation as something which is borne by the public at large, that is, a negative externality. Hence, there is a market failure. But the quality of our environment should be maintained because the environment is fundamental to every part of our daily lives and well-being. A clean environment is the basis for our health. The environment and the economy are also closely linked. Clean healthy communities are more prosperous and vibrant. They attract people looking for a place to live or set up business. Resource-efficient businesses are more competitive and resilient. The Government, therefore, should do all it can to help households and businesses to become more environmentally friendly. Can the Minister give an update to the House on what more the Government will do to help ensure we continue developing at a sustainable pace for the years ahead?
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Water resources
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Dr Lim Wee Kiak (Sembawang): Mr Chairman, Sir, Singapore has two water agreements with Malaysia. The first agreement will expire on 31st August this year and the second in 2061. We have, over the years, developed and improved our own water catchment and collection and also developed other sources of water such as NEWater and water from desalination. Currently, what proportions \r\n\r\n
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\r\n\r\nof the water we ultilise come from these two agreements and what proportions are from the different sources such as our reservoirs, NEWater as well as desalination? Will the expiry of this agreement result in water shortage for Singaporeans?\r\n\r\n\r\n\r\n
The cost of water from different sources will differ. What is the relative cost of water from each source? What are the implications, if any, to the public from the expiring of the first water agreement with Malaysia? Will Singaporeans see higher water bills after the expiry of the agreement?
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I also understand that we do sell processed water to Malaysia at low price. After the expiry of this agreement, will we continue to sell cheap processed water to Malaysia? What will happen to all our reservoir assets in Malaysia?
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Water supply
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Mdm Ho Geok Choo: Mr Chairman, Singapore's 1961 Water Agreement with Malaysia expires on 31st August. As the date fast approaches, can the Minister update on Singapore's water situation and plans for self sufficiency?\r\n\r\n
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Mr Chairman, I would also like to find out what other plans does the Ministry have to strengthen the habit of saving water. In this regard, with more cars and condominiums in Singapore in recent years, how is the Ministry emphasising water conservation among car owners, car washers and managers of condominium swimming pools and the public at large?
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Last year, I had raised the issue of cleaning homes the waterless way using wet wipes. The Minister had said that MEWR will look into it. Can I have an update on this as well?
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2.00 pm
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Eco-homes
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Dr Teo Ho Pin (Bukit Panjang): Mr Chairman, Sir, the Government has mandated the energy-efficient labelling of household appliances like air-conditioning and refrigerators, and the labelling of water-efficient appliances like taps, dual-flush low capacity flushing cisterns and urinals. The main purpose of the labelling is to provide information for consumers to make informed decisions when purchasing home appliances. Sir, despite the mandatory labelling, not many consumers are purchasing energy- and water-efficient appliances for their homes. The take-up rate for energy- and water-efficient home appliances is low and slow. This means that many homes in Singapore are not using electricity and water efficiently, thus wasting money, energy and water resources.\r\n\r\n
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Sir, consumer education to encourage households to purchase eco-friendly home appliances is an ongoing concern. But not many people in Singapore are living in eco-homes and adopting an eco-friendly lifestyle. Changing living habits and value system of people is always an uphill task. To be effective, I would propose a two-pronged approach to make households eco-friendly.
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First, we must share more eco-friendly home appliances information, and eco-friendly lifestyle tips with homemakers and household decision makers. I would propose that the Ministry consider providing an eco-friendly education kit for every household, and monitor the take-up rate of eco-friendly home appliances and eco-friendly lifestyle closely. To further incentivise consumers to purchase four ticks energy-efficient and water-efficient home appliances, the Ministry should consider providing cash rebates or tax incentives. Second, we must adopt an experiential learning approach to teach children to adopt eco-friendly lifestyle. \r\n\r\n
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\r\n\r\nChildren must be taught and be inspired from young to do their part to protect the environment. We need to instil green values in our children so that they will live eco-friendly lifestyles.\r\n\r\n\r\n\r\n
Sir, I wish to ask the Minister the following questions:
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(i) What measures or programmes are in place to encourage Singaporeans to adopt eco-friendly lifestyles?
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\r\n (ii) Can the Ministry consider providing incentives to encourage households to purchase energy- and water-efficient home appliances?
\r\n (iii) Can the Ministry consider accrediting developers, consultants, contractors and suppliers which promote eco-homes?
Energy efficiency
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Mr Cedric Foo Chee Keng: Sir, Singapore imports almost all our resource needs especially energy, and we heard that during the MTI debate just now. With prices of energy likely to remain volatile and, in fact, many expecting it to go up, we should have a comprehensive strategy for energy efficiency. This is to manage the demand side, targeted not just at individuals but also at our industries and businesses as well. This is especially important as the efficient use of energy will enhance our cost competitiveness and allow us to develop more sustainably.\r\n\r\n
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I am glad that the Government has implemented measures to encourage energy efficiency for consumers and businesses such as energy labelling of appliances, as referred to by Dr Teo Ho Pin, co-funding the training of energy managers for companies and tax rebates for green cars. Can the Minister update the House on what is our overall progress on energy efficiency to date and the measures that I have discussed earlier, \r\n\r\n
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\r\n\r\nand what are Government's plans going forward?\r\n\r\n\r\n\r\n
Since energy efficiency ultimately results in reduced electricity bills, how do we encourage our citizens to save more money? Discouraging the purchase of inefficient appliances which may be cheaper to purchase but end up costing more to the household in the long run due to higher electricity consumption may be one way. Labelling, as Dr Teo Ho Pin talked about, will enable consumers to make informed choices. But I would like to suggest that we move a step further and to make mandatory minimum energy efficiency level for all major appliances before these can be sold in Singapore. In other words, maybe take away those that do not have a tick or just one tick. What about our industries? Is there any more we can do to spur our companies to be more energy efficient? Do we need an Energy and Emission Bill now so that our companies can start in earnest to prepare to meet carbon emission regulations coming out of future international regimes on climate change?
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Lastly, on cars, would the Minister update us on the review for the Green Car Rebate and would something be done for environmentally-friendly diesel cars?
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Green vehicles
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Dr Lim Wee Kiak: Mr Chairman, green vehicles are more fuel-efficient and emit less air pollutants than their conventional petrol or diesel equivalent but they are generally much more costly. To promote the use of green vehicles, I understand that LTA and NEA have jointly introduced the Green Vehicle Rebate (GVR). This GVR aims to bring about a change in consumer behaviour to support clean emerging technologies, by narrowing the cost differential between a green vehicle and the conventional equivalent model. \r\n\r\n
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\r\n\r\nThe rebate is calculated based on 40% of the open market value (OMV) at registration, for passenger vehicles, and 10% of the vehicle's OMV for electric motorcycles.\r\n\r\n
\r\n But there are certainly fewer green motorcycles than green cars on the road. Can the Government consider increasing the rebate for electric motorcycles to encourage the take up of electric motorcycles?
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Another obstacle to green vehicles is the lack of support facilities such as refuelling as well as recharging stations and infrastructures.
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What is the current status of green vehicles utilisation and what progress have we achieved so far in this area? What are the challenges going forward and what is the Government doing to increase the public take-up of green vehicles?
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I have suggested in previous year's COS to set aside a certain percentage of our COEs for green vehicles and create a green car COE category. In this way, our proportion of green cars can be increased progressively over the years. We should also progressively improve the supporting infrastructures and increase the number of CNG and recharging stations supporting these green cars.
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What is the Government's long-term target of green vehicles take-up? Will the Government continue to support the public take-up of green vehicles as this Green Vehicle Rebate is only temporary?
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Sustainable waste management and recycling
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Mr Liang Eng Hwa: Sir, during a recent visit to Taiwan, I can sense that the concept of recycling is well immersed in the Taiwanese way of life. It is becoming second nature in them that they will \r\n\r\n
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\r\n\r\ncarefully separate the recyclables for their wastes and put them in different bins. In fact, many of them have two different bins for recycling purposes. When I visited the 7-Eleven there, the cashier will ask if you need a plastic bag and, if yes, each plastic bag will be charged.\r\n\r\n\r\n\r\n
In Japan, there are strict laws on separating recyclables which go beyond separating glass, plastic and paper. It even pushes for the separation of a special plastic called polyethylene terephthalate (PET), from which it is used to produce the bottles, from the other plastic containers and paper products from cardboard boxes.
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I would like to ask the Minister to update us on the Ministry's plans and policies to promote a sustainable waste management system in Singapore. What further measures would the Ministry and NEA take to increase the recycling rate in Singapore?
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Recycling
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Dr Lim Wee Kiak: Mr Chairman, Sir, being a small and compact urban city-state, Singapore can be a model city nation to the world in the best practices in recycling and waste minimisation. We generate more than 170,000 tons of rubbish per day. With the increase in tourist arrivals and economical activities recovering to pre-crisis level, we can only expect our rubbish load to continue to increase. With limited land for incineration and landfill, we have no choice but to recycle more and reduce our waste. What is the recycling rate in 2010? Are we achieving our target of 60% recycling rate by 2012? What is the Ministry doing now to encourage greater recycling rate by households?\r\n\r\n
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I would like to thank the Ministry for the pilot project that was held in Canberra Division of Sembawang GRC to have one recycling bin for every single block. I would like to know from the Minister \r\n\r\n
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\r\n\r\nwhen will every block of HDB flats in Singapore have their own dedicated recycling bin? \r\n
Haze and air quality
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The Senior Parliamentary Secretary to the Minister for National Development (Dr Mohamad Maliki Bin Osman): Mr Chairman, Sir, we know that living in a very densely populated island like Singapore, protection of the environment is critical. The effect of air pollution on human health is serious. With increasing car population size, one wonders of the impact of this on our air quality, in particular the PM 2.5 (or particulate matters smaller than 2.5 microns in size) is linked to respiratory illnesses, such as asthma and bronchitis especially in the vulnerable young and old. A major source of the PM 2.5 emissions is motor vehicles. Could the Minister share with the House the long-term target of the PM 2.5 level and plans to curb domestic emissions from vehicles? Will the Minister also share his assessment on the impact of rising car population on our air quality?\r\n\r\n
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The perennial transboundary haze pollution problem also continues to be a key concern for Singaporeans. Despite the region experiencing higher rainfall last year arising from the El Nino phenomenon, Singapore's air quality still fell into the moderate range for several days in October last year due to the forest fires from our neighbours. Sir, every year, we still struggle to manage the impact of forest fires on our air quality. There is, thus, a need for Singapore to continue its engagement with countries in the region and ensure that adequate measures are in place to minimise and prevent occurrences of forest fires. These may be plans but may not be executable.
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In this regard, could the Minister share more about the Government's plans to manage and prevent transboundary haze pollution from affecting the air quality in Singapore? Besides monitoring the haze \r\n\r\n
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\r\n\r\ncondition, there is much discourse about the effect of climate change and local climatic patterns. May I ask how the Government intends to enhance our capabilities in climate science?\r\n
The Minister for the Environment and Water Resources (Assoc. Prof. Dr Yaacob Ibrahim): Mr Chairman, Sir, I wish to thank Mr Cedric Foo, our GPC Chairman, and Members for their questions and suggestions. My colleague, Dr Amy Khor and I will do our best to answer the queries.\r\n\r\n
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Mr Foo asked whether Singapore has been developing sustainably. Sir, over the last decade, we have made good progress in enhancing Singapore's environment through the combined efforts of the Government, businesses and Singaporeans. We are making better use of resources. Water and energy efficiency have improved, so are our recycling rates.
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The quality of our living environment has also gone up with the upgrading of our hawker centres, sustaining good air quality and keeping down the incidence of vector-borne diseases like dengue. However, as noted by Members, we cannot afford to be complacent. From time to time, we are reminded of the need to continue to adapt to new challenges. Despite a low incidence of food poisoning in the past five years, at an average of about four incidents per 1,000 retail food establishments, the 2009 food poisoning incident linked to a stall at Geylang Serai's temporary market was a timely reminder for more stringent regulations. NEA increased the frequency of inspecting food establishments, stiffened penalties for food hygiene offences and re-emphasised education for food handlers.
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Likewise, all the flood-prone areas have been reduced by 98%, from 3,200 hectares in the 1970s to 56 hectares \r\n\r\n
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\r\n\r\ntoday. Last year's flooding incidents led us to review the existing drainage infrastructure. The PUB has begun work on several key locations including Orchard Road. Sir, given the uncertainties in weather patterns, PUB will design new drains to cope with more intense rain within the constraints of cost-effectiveness and competing land use. For more extensive monitoring of water levels in the key canals and drains, we have expanded our network of water level sensors from 32 to 90 since December 2010, and will increase it further to 150 this year. An SMS alert system to provide early warning of potential floods will be rolled out to the public later this year. We will also continue to invest in infrastructure and work with building owners and managing agents, businesses and residents to ensure adequate flood protection of their properties. \r\n\r\n\r\n\r\n
It takes more than technology and infrastructure to meet environmental challenges. It requires all of us to do our part. This is why, over time, we have broadened our focus to sustainable solutions which encourage, enable and empower people. Beyond its role as a regulator, the Government will take the lead in sustainable practices and facilitate businesses and households towards being more environmentally responsible.
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Sir, our businesses have responded well to our incentive schemes, coming up with innovative ideas that reduced the environmental footprint. Let me just cite one example. Siemens was awarded a $4 million grant from the Environment and Water Industry Programme Office (EWI) to develop an electrochemical-based desalination process that aims to cut energy consumption by half. A small-scale pilot plant has been in operation since February this year.
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Our communities have also played their part in the progress that we have made over the years. A Public Perception \r\n\r\n
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\r\n\r\nSurvey conducted last year shows that Singaporeans are taking greater ownership of the environment. Eighty per cent of respondents said that they would buy energy-efficient household appliances, even without incentives, while 84% acknowledged that they had a personal role to play in water conservation. Eighty per cent of respondents checked their home every week to guard against mosquito breeding. My colleagues and I are encouraged by these findings.\r\n\r\n\r\n\r\n
These survey findings are borne out in our interactions with the community. I commend the ground-up initiatives by organisations such as the Waterways Watch Society, as well as individuals such as the 2010 Bayer Youth Environmental Envoy, Mr Chua Ang Hong, and the 2010 EcoFriend Award winner, Mrs Dhillon Awtar Singh, a school principal, who actively show the way in preserving, protecting and promoting our environment and water resources.
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Safeguarding the environment for present and future generations amidst new challenges will require our continued commitment and collaboration.
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2.15 pm
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Sir, the Sustainable Singapore Blueprint released in 2009 provides the framework for responding effectively to these challenges. The Bueprint identified key goals for 2030 across various aspects of the environment. This will guide us towards our vision of a liveable and lively Singapore that Singaporeans are proud to call home. In the coming year, my Ministry will focus on the key thrusts of the Sustainable Singapore Blueprint, namely, boosting our resource efficiency, protecting and enhancing our environment, building capabilities and fostering community action.
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Sir, let me first cover our efforts to improve resource efficiency, given our constraints in water, energy and land. \r\n\r\n
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\r\n\r\nBoth Dr Lim Wee Kiak and Mdm Ho Geok Choo asked about the implications of the 1961 Water Agreement expiring later this year.\r\n\r\n\r\n\r\n
Sir, we know Singapore imports water from Malaysia under two agreements – the 1961 and 1962 Water Agreements. Our first Water Agreement with Malaysia will expire on 31st August 2011, while the second Water Agreement will expire in 2061. Through the years, as part of our Four National Taps strategy, Singapore has been building up our local sources by developing new reservoir schemes as well as desalination and NEWater. With the completion of the Punggol and Serangoon Reservoirs by the end of 2011, and the Marina Reservoir which was completed in November 2010, our water catchment will increase to two-thirds of Singapore's land area. The second desalination plant in Tuas, which will be ready in 2013, will add another 70 million gallons of water a day to our water supply. We will continue to introduce NEWater into our reservoirs, especially during dry spells such as the one we experienced in February last year. Together, NEWater and desalination can now meet 40% of our total water demand, the rest can be met by both imported water and water from our local catchments.
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Sir, by 2060, we plan to increase our desalination and NEWater capabilities to be able to meet up to 30% and 50% of our water needs respectively. These local sources are sufficient to replace the water imported under the 1961 Water Agreement. Therefore, the expiry of the 1961 Water Agreement will have no impact on our water supply and water tariffs.
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Dr Lim Wee Kiak has two specific questions: First, upon the expiry of 1961 Water Agreement, Singapore will hand all of the assets under this agreement back to Malaysia and we will continue to sell \r\n\r\n
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\r\n\r\ntreated water to Malaysia, as provided for under the 1962 Water Agreement.\r\n\r\n\r\n\r\n
Sir, for water sustainability, however, having a robust water supply is only half the story. We must continue our efforts in water conservation. Last year, we introduced the Water Efficiency Management Plan, a voluntary initiative under PUB's 10% Challenge to help non-domestic customers. These plans include the analysis of current water use, identification of potential water-saving measures and an implementation roadmap. Non-domestic customers who meet the funding criteria will also be able to tap our existing Water Efficiency Fund to implement these measures.
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Sir, the Government is setting an example. Close to 70% of all public sector buildings have achieved the Water Efficiency Building certification as part of their efforts to reduce water consumption. The private sector is also demonstrating commitment to improve water efficiency. To date, 86 premises have submitted their Water Efficiency Management plans, with overall water-saving targets of up to 10%. As an example, SATS Catering tested and installed a new custom-made dishwasher which cuts diswashing water use by 40%.
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Dr Teo Ho Pin asked about our measures to encourage an eco-friendly lifestyle. Sir, our long-term target is to bring down our daily per capita domestic water consumption to 147 litres by 2020 and 140 litres by 2030. Today, we are at 154 litres, down from 165 litres in 2003. Using water-efficient products can further reduce our water usage. The Mandatory Water Efficiency Labelling Scheme (MWELS) was introduced in 2009 for taps, flushing cisterns and urinals. Currently, more than 5,000 models with water efficiency rating of one tick and above are registered under this scheme. \r\n\r\n
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\r\n\r\nMWELS has allowed consumers to make more informed choices when making purchases. The labelling scheme will be extended to clothes washing machines this October.\r\n\r\n\r\n\r\n
Sir, I thank Mdm Ho for her suggestion on water-saving practices. We will continue to work with the community but, as part of its ongoing efforts to get people to use water wisely, PUB launched the Water Conservation Awareness Programme on 27th February, aimed at various segments of the population, including households. These initiatives include teaching students how to conduct water audits at home with their family and working with maid employment agencies to include water conservation as part of the training given to domestic helpers. Sir, the public has responded well since the launch, with more than 1,800 requests for water-saving kits. I hope Members would have caught some of the TV commercials used by the PUB for this campaign. Indeed, Sir, everyone can play a part by adopting simple water-saving habits in our daily lives. So, whether they want to use wet wipes or they want to use water, if they use it wisely, we leave it to the households to decide.
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Going forward, PUB will continue to explore innovative technologies to ensure water sustainability, such as a smart water grid to optimise our operational of effectiveness and resource efficiency.
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Striving for effective water management has turned a strategic vulnerabililty into a competitive advantage for Singapore. In the last four years, the local water cluster has grown from 50 to more than 70 companies. The new investments secured will add more than $550 million to our economy and more than 2,200 jobs will be created when all the projects are fully ramped up. The annual Singapore International Water Week, which was co-located with the World Cities Summit last year, drew over 14,000 participants from \r\n\r\n
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\r\n\r\n112 different countries and regions, and has positioned Singapore as a global hydro hub for the sharing of ideas and technologies at the forefront of water research and innovation.\r\n\r\n\r\n\r\n
Sir, like water, energy, as mentioned by Members, is a critical resource of Singapore. We have limited access to alternative energy sources such as geothermal and wind energy. Our small physical size also constrains how much we can rely on solar energy. Mr Cedric Foo asked about our energy efficiency in Singapore. So, we all know that greater energy efficiency benefits the consumer, companies, economy and the environment. For families, this translates into lower utility bills. For companies, this reduces business costs and raises productivity. For the economy, energy efficiency enhances our energy security.
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Improving energy efficiency is a primary strategy in our whole-of-Government efforts to reduce carbon emissions. Our energy intensity has improved by about 8% from 2005 to 2009, and we will need to continue our efforts to meet our target, under the Sustainable Singapore Blueprint, to reduce Singapore's energy intensity by 35%, from 2005 levels by 2030. We can meet this target, Sir, through the joint efforts of Government, businesses and the community. All infocommunications technology equipment purchased by our public agencies today meet the latest Energy Star standards. We are encouraging public agencies to install or retrofit their buildings with more efficient chiller systems as these account for the largest part of the building's energy use.
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Sir, as announced in last year's Committee of Supply, energy management practices will be made mandatory for companies that consume more than 15GWh of energy yearly from 2013, to ensure the efficient use of energy. This will be legislated through an Energy Conservation Act. This Bill will be \r\n\r\n
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\r\n\r\npublished later this year to gather public feedback. Sir, in April last year, NEA, EMA and EDB jointly launched the Energy Efficiency National Partnership (EENP) to help our companies build up the energy management capabilities required to comply with the Energy Conservation Act. Companies have benefited from sharing energy efficiency best practices at the EENP events. For instance, a waste heat recovery workshop prompted 3M to actively look for opportunities to manage energy through heat recovery systems within their plants.\r\n\r\n\r\n\r\n
The Singapore Certified Energy Manager (SCEM) programme has also equipped energy managers from companies with skills to manage energy use in their organisations more effectively. To defray part of the training cost, NEA administers a SCEM Training Grant to co-fund about 80% of the SCEM professional-level course fees. As at December 2010, 475 applications have been approved. We target to train 1,000 energy managers by 2013. Sir, in addition, NEA administers incentive schemes to encourage industry players to adopt energy-efficient measures.
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Sir, to further address Dr Teo's query and how the Government will encourage households to go green, let me add that much has been done to encourage the adoption of more energy-efficient practices. NEA's 10% Energy Challenge was launched in 2008 to encourage households to save 10% or more of their household electricity use. We have enjoyed strong community support. As an example, in 2010, the South West CDC and NEA launched the South West Carbon Buster Roadmap, which spells out actions that businesses, community organisations, schools and residents in the district can adopt to reduce carbon emissions.
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One simple step that the public can take is to opt for more energy-efficient appliances. Sir, I announced in 2009 that \r\n\r\n
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\r\n\r\nMinimum Energy Performance Standards (MEPS) will be implemented for air-conditioners and refrigerators, which are the two highest energy users of a typical household. From September 2011, all of the most inefficient 0-tick appliances and some of the 1-tick and 2-tick appliances will no longer be available. There will nonetheless still be a wide range of energy-efficient brands and models. We will be exploring the possibility of extending MEPS to other appliances, such as lighting, in the future.\r\n\r\n\r\n\r\n
Sir, as an illustration of the kind of savings a typical household in a 4-room flat can expect to enjoy, if they choose a 4-tick refrigerator, switch to energy-efficient light bulbs, turn off standby power, they can save about 15% of their monthly electricity bill. In addition, Sir, if they opt for a 4-tick air-conditioner when they replace their old one, keep the themostat at about 25 degrees Celsius, they can achieve up to 30% savings. Sir, this is very significant, and is over and above the U-save rebate of $320 that a 4-room flat household will receive.
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Sir, Dr Lim Wee Kiak asked about the status of the green vehicles take-up rate. Indeed, making energy-efficient choices also extends to our mode of travel and the vehicles that we use. We are encouraged by the healthy response to the Green Vehicle Rebate (GVR) scheme. As of December 2010, there were 8,700 green vehicles, up from 7,200 in 2009. Sir, the Green Vehicle Rebate was introduced in 2001 to minimise the cost differential between green vehicles and their conventional equivalents. To continue supporting vehicle owners in making greener purchases, the existing scheme will be extended until the end of next year for electric and petrol-electric hybrid vehicles. As mentioned by the Finance Minister, the Government will be undertaking a comprehensive review on \r\n\r\n
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\r\n\r\nthe measures to promote the adoption of green vehicles as part of our overall efforts to promote sustainable development. We have to wait until the review is over to know what will happen to the scheme and what are the measures that we need in place for other types of vehicles.\r\n\r\n\r\n\r\n
Dr Lim has a specific request on motorcycles. At the moment, as he rightly noted, they already enjoy 10% rebate on their ARF and they are only paying 5%. We think that is sufficient at this point in time. He also asked about the infrastructure to support green vehicles. As mentioned earlier by MTI, the Government is embarking on an electric vehicle pilot project and we are currently developing the electric vehicle charging infrastructure. The first charging stations are due to be completed in mid-2011 and the first electric vehicle should arrive in Singapore at that time. So, these are the efforts done by the Government to enlarge infrastructure. But as we roll out, we have to test both for their efficiency and cost effectiveness.
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Sir, let us now turn to our waste management system. Singapore's land constraints necessitate effective waste management. Currently, an average Singaporean, you and me, disposes of 860 gm of waste a day, which is about a third more than places like Germany or Taiwan. While individually, this might not seem much, it adds up to about 300 kg per person in a year. Just to understand what this translates, taking the whole population of Singapore, in one year, just for domestic waste alone, we collectively dispose enough to cover an eighth of Singapore's surface area. Waste minimisation and recycling are therefore important strategies for us to reduce the land needed for waste disposal.
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Mr Liang Eng Hwa asked what we are doing to ensure a sustainable waste management system. Our approach to \r\n\r\n
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\r\n\r\nwaste minimisation is encapsulated in the 3Rs – Reduce, Reuse and Recycle - reduce our use of materials where possible, re-use the items in working condition, instead of throwing them away, and recycle what we cannot use to recover its value.\r\n\r\n\r\n\r\n
Sir, we have made good progress so far towards our target of a 70% recycling rate by 2030, with our recycling rate increasing from 40% in 2000 to 58% in 2010. Recyling rates for scrap metals is at 94% while construction waste is at 99%. So for some of the waste streams, we have achieved very good numbers; others, we need to work even harder.
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By reducing the amount of waste generated and implementing more recycling initiatives, companies can reap cost savings in waste disposal fees. Commercial premises such as Intercontinental Singapore and 313@Somerset have already implemented programmes to recycle paper, plastic, glass and metal waste, and we hope that more will follow the example.
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2.30 pm
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To reduce waste at source, NEA signed a voluntary agreement with industries to encourage them to reduce packaging waste. So it is encouraging that over 120 organisations have already joined the Singapore Packaging Agreement and we encourage more companies to do the same. To date, 4,500 tonnes of waste have been avoided through improvements made to processes and packaging, resulting in a savings of over $8 million. Sir, we will continue to encourage waste management efforts by the public sector. NEA's $8 million 3R Fund was launched in 2009 to fund new projects that minimise and recycle waste. To date, 15 projects have been awarded and are projected to reduce around 50,000 tonnes of waste. One such project by Shangri-la Hotel involves \r\n\r\n
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\r\n\r\nsetting up recycling stations, upgrading its existing bin centre and raising staff awareness. \r\n\r\n\r\n\r\n
Sir, for domestic recycling, I wish to reassure Dr Lim Wee Kiak that all households in Singapore have access to recycling services. And this includes collection services provided to all HDB and landed estates under the National Recycling Programme (NRP), with 1,600 recycling bins placed in the common areas of HDB estates. Condominiums and private apartments are also required to have recycling receptacles for residents.
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Sir, the NRP for households will be enhanced in the new public waste collection contracts awarded from 2011 to 2014. We will make it easier for households to recycle. Households can now look forward to more recycling bins and more frequent collection services. There will be one recycling bin for every HDB block with daily collection instead of one bin for five HDB blocks with weekly collection. Landed households will be provided a recycling bin each and their recyclables will be collected weekly instead of fortnightly. And garden waste will be collected for recycling once a week. Sir, waste collectors will also provide incentives to encourage household recycling. These measures will make it easier for the public to practise recycling as a part of their daily lives.
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Sir, we can and must all do our part to reduce the amount of waste we each generate and dispose of through simple everyday habits like recycling bottles and reducing food waste. Collectively, we all can make a difference.
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Sir, let me now turn on to the second thrust which is to protect and enhance our environment. Our economy, society and environment are closely linked. Fresh air, clean streets, liveable spaces are desired features in prosperous and vibrant communities, as noted by Mr Cedric Foo.
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\r\n\r\nDr Maliki asked about our efforts to ensure high air quality standards. Sir, on balance, Singapore maintained relatively high standards in 2010, achieving a Pollutant Standard Index (PSI) rating of \"Good\" for 93% of the year. However, as noted, we experienced a few days of moderate air quality last year due to the haze from forest fires in the region. We are continuing our close collaboration with our regional partners on transboundary haze. Singapore is chair of the Sub-regional Ministerial Steering Committee on Transboundary Haze Pollution from 2010 to 2012. During our term, we will strengthen the bilateral programmes conducted by Malaysia and Singapore in Riau and Jambi respectively. New regional initiatives will also be undertaken, such as the establishment of a Regional Haze Training Network for the sharing of expertise and training in haze management and enhancing the capabilities of the ASEAN Specialised Meteorological Centre hosted by NEA that tracks the hot spots in the region.
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Sir, in addition to monitoring the haze situation, as noted by Dr Maliki, our capabilities in climate science and modelling will be built up to better understand regional and local climatic patterns and predict future climate changes. We are partnering the Hadley Centre of the United Kingdom, a leader in climate science, to undertake climate change studies, to co-develop regional climate models and, more importantly, build up our expertise in climate science.
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Dr Maliki also asked about our efforts to curb domestic emissions. NEA plans to progressively lower the Fine Particulate Matter or PM2.5 levels, which can cause and aggravate respiratory ailments. Sir, we aim to reduce the PM2.5 levels to 12µg/m3 by 2020. And to do so, we will need to keep vehicular emissions in check.
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\r\n\r\nDiesel vehicles have been on the Euro IV standard since 2006. We will adopt the Euro V standards for new diesel vehicles by 2014. Besides reducing PM2.5 levels, this will also reduce other pollutants such as nitrogen dioxide and ozone. Off-road diesel engines such as cranes, excavators and generator sets are another source of PM2.5, and we will be implementing tighter emission standards for such engines from July 2012.
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Sir, I believe I have addressed the concerns of Members.
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Dengue fever
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Mr Low Thia Khiang (Hougang): Mr Chairman, Sir, the World Health Organization (WHO) reported that the incidents of dengue has grown dramatically around the world in recent decades. WHO estimates that it may be 15 million dengue cases worldwide every year. In Singapore, there were 5,103 cases reported last year. Although this is an increase of 13.5% from 2009, the NEA has stated that it has dengue infection under control. Over the years, dengue has become part and parcel of our environmental health risk. As of today, there are still pockets of active clusters of dengue fever in Singapore. A lot of manpower is needed to deal with an outbreak of dengue fever. Such an outbreak can cause anxiety amongst the population as witnessed in the past. Although NEA has the problem under control, it should not rest on its laurels because no one knows when and where the next cycle of outbreak would happen.\r\n\r\n
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Recently, it was reported that Thai scientists have successfully developed the world's first dengue fever vaccine. It was also reported that British scientists have created genetically sterile mosquitoes that use sex to get rid of their own species. The British had even carried out a small trial in the Cayman Islands, in the Caribbean, with promising results. In \r\n\r\n
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\r\n\r\nSingapore, the Environmental Health Institute (EHI) is the national authority on mosquitoes. It conducts vector surveillance and control operations to prevent the transmission of vector-borne diseases to humans. I would like to find out if EHI is doing any research to counter the spread of dengue fever in Singapore. Is it working on any ground-breaking method to contain this infectious disease and what is the progress made so far? Will the Government bring in the dengue fever vaccine from Thailand, if it is proven to be safe and effective?\r\n
Littering and mosquitoes
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Mr Lim Biow Chuan (Marine Parade): Sir, NEA has been organising its Clean and Green campaign for the past years to instil in Singaporeans a sense of pride and ownership in the environment.\r\n\r\n
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In November last year, Marine Parade Town Council also organised a \"Let's Clean Our Town\" campaign for the entire town. For two hours, grassroots leaders and the MPs, myself included, picked up tissue papers, cigarette boxes, cigarette butts, plastic bottles, advertisement flyers, etc. It was back breaking and I could imagine the hard work by our Town Councils' cleaners in having to do this everyday. It appears to me that despite all our efforts over the years, the littering problem is unresolved. May I ask NEA for an update on the progress of the anti-littering campaign? How successful is the campaign today? Has the amount of litter decreased over the years? How many summonses and CWOs have been issued for littering?
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Sir, on my visits to the landed properties in my private estates, I received many complaints that the drains and roads are not swept regularly. Residents tell me that they spot plastic bottles, drink cans, tissue papers in the drains which have not been cleared for weeks. Could the Minister share with this House how \r\n\r\n
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\r\n\r\nare cleaning contracts in private estates awarded? Are there any standards set for the frequency of cleaning to be carried out? Does NEA check whether the cleaning companies have performed their contracts? Can the cleaning contractors provide a cleaning schedule to the residents? What about leaves and litter in the drains? Who is responsible for clearing these litter or leaves? Would the Minister also agree that some of these litter, like plastic cups and bottle caps, if not cleared in a timely manner, may become possible dengue sites and mosquito breeding grounds? Are there any plans by NEA to reduce such incidences of littering which provide breeding grounds for the mosquitoes? Could the Minister also provide an update on the dengue situation in Singapore? Is it better or worse than the past years?\r\n\r\n\r\n
Littering
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Mr Ang Mong Seng (Hong Kah) (In Mandarin): [For vernacular speech, please refer to Appendix A*.] In the eyes of a foreigner, Singapore is a clean and beautiful garden city. However, in a 2010 study by Yale and Columbia Universities on Global Environment Index, Singapore is ranked 28 out of 163 countries. It did not even get into the top 10. It surprised many Singaporeans. Among the criteria are environment hygiene, air quality and water quality. Environment hygiene is the most important measurement.\r\n\r\n
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More than 83% Singaporeans live in high rise buildings. High-rise littering makes HDB estates dirty and that might have affected our ranking.
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HDB residents can see the hard efforts the Town Councils have put in to keep the estates clean. However, some residents have this bad habit of high-rise littering. Residents ask the Town Council to bring these people to justice. We have installed cameras to try to solve this \r\n
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\r\n\r\nproblem. People are caught throwing egg shells, old newspapers and leftovers out of the window, dirtying other people's laundry and the whole estate. According to MEWR's regulation, only people who are caught on camera can be brought to Court. Unfortunately, it is still not easy to do. High-rise littering continues, affecting the cleanliness of the estates. I would like to ask the Minister whether MEWR has good tactics to stop high-rise littering, so we can be ranked among the top 10 in the Global Environment Index in the near future.\r\n\r\n\r\n\r\n
I would also like know if MEWR has any new measures and plans to work with the private sector and the community to improve our environment and the hygiene level.
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Food hygiene
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Mr Liang Eng Hwa: The Singapore Sports School was plagued with food poisoning cases last year with over 100 students taken for medication. In April last year, there was also another mass food poisoning at a community event which affected 48 people. I would like to ask the Minister if the number of food poisoning cases has been on the rise.\r\n\r\n
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Food catering is now a bustling business. I suppose Singaporeans today are eating more catered food than before due to our more active and vibrant lifestyle. Catered food, if not prepared in a proper and hygienic manner, can pose a significant health risk to the public. What does the Ministry intend to strengthen food hygiene for external catering and what regulations are they looking at?
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The Minister of State, Ministry of the Environment and Water Resources (Dr Amy \r\n\r\n
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\r\n\r\nKhor Lean Suan): Sir, we are continuing with efforts to protect our community from the risk of vector-borne diseases through research, surveillance, outreach and enforcement.\r\n\r\n\r\n\r\n
Mr Low Thia Khiang asked about the dengue situation and so did Mr Lim Biow Chuan. Historically, there has been a rising trend for dengue since the early 1990s, but we have managed to buck this trend after 2005 as shown in the slide*. Despite an overall deterioration in the global dengue situation in 2010, we had about 5,000 dengue cases in Singapore, as Mr Low rightly highlighted, which although higher than 2009, was significantly lower than the 7,000 to 8,000 cases in 2007 and 2008.
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There is currently no approved vaccine for dengue available on the market, though research is ongoing. As a dengue vaccine is unlikely to be available in the immediate future, we need to take other innovative and practical measures against dengue. Over the past five years, we have been investing in research at NEA’s Environmental Health Institute (EHI) and developed rapid testing methods to shorten the time needed to diagnose dengue cases and provide early warning of outbreaks. In fact, the researches behind the Thai research that Mr Low referred to has said that they would only be able to come out with the dengue vaccine for market use in about 10 years, ie, within a decade.
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I am pleased to inform the House that the World Health Organization has recently designated the EHI to be a Collaborating Centre in the research of Arbovirus and their associated vectors, such as the dengue virus. EHI will work with the World Health Organization to strengthen disease surveillance and outbreak response capability in the region. These will eventually help to reduce the \r\n
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\r\n\r\ndisease burden in the region, including Singapore.\r\n\r\n\r\n\r\n
On a note of precaution, this year, we are closely monitoring and preparing for the possibility of an increase in dengue cases in the event of a switch in the predominant dengue virus serotype. Historically, such switches can occur every two to three years and result in a significant increase in dengue cases because of the lack of immunity in the population. Dengue-2 has been the predominant serotype circulating over the past four years, so there is a possibility of a serotype switch soon. I, therefore, urge everyone to continue to be vigilant in preventing mosquito breeding so that our dengue incidence can be kept under control. NEA will continue with its pre-emptive surveillance and conduct Intensive Source Reduction Exercises.
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2.45 pm
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Sustaining high standards of public cleanliness can also help reduce potential mosquito breeding sites, as rightly pointed out by Mr Lim Biow Chuan, and ensure a clean and liveable environment for the public to enjoy. Mr Lim asked how NEA ensures high standards of public cleansing. Similar to Town Councils' cleansing frequency of HDB housing estates, NEA has in place a regime to clean our roads and private estates at least two to three times a week. In fact, the contractors are also required to give their phone numbers and contact to the residents so that they can give their feedback.
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NEA also works with PUB to ensure drains are cleaned regularly. Contractors are required to perform additional cleaning for areas with higher human traffic or litter-prone areas. Much of the cleaning work is currently outsourced and NEA deploys officers to carry out daily audits on the contractors' performance, penalising errant contractors, if lapses are found.
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\r\n\r\nAs Mr Ang Mong Seng has highlighted, the persistence of littering in housing estates especially high-rise littering remains an ongoing challenge. My Ministry is continuing to study possible solutions such as exploring greater use of surveillance technology to facilitate enforcements against perpetrators but this is not always practical, as highlighted by Mr Ang. Encouraging greater community ownership and civic responsibility, thus remain the dominant approach in curbing the irresponsible and dangerous behaviour of high-rise littering.
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The new anti-littering campaign which was launched in June last year, was geared towards promoting personal ownership for public cleanliness and good social behaviour. It integrates increased visibility of enforcement as a deterrence with improved location and frequency of emptying litter bins as well as more targeted public outreach and education efforts.
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The new Litter Free Ambassador programme was introduced to empower members of the community to reduce the incidents of littering. Over 2,000 grassroots youth and students have been recruited as Ambassadors to conduct educational outreach efforts, petrol community spaces and act as positive role models to discourage littering in the neighbourhoods and we appreciate the efforts and leadership.
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The Public Hygiene Council was formed in November 2010 to encourage greater partnership in support of public hygiene. The Council, comprising representatives from the people, private and public sectors, aims to role out its initiatives progressively later this year, focusing on issues such as anti-littering, clean public toilets and good personal hygiene. There was a close to 50% drop in the number of littering offenders caught in the six months immediately after the \r\n\r\n
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\r\n\r\ncampaign was launched, when comapred with the same period in 2009.\r\n\r\n\r\n\r\n
The number of Corrective Work Orders imposed has also fallen by 13%. However, more work still needs to be done to shape our anti-littering behaviour and attitude. Mr Ang Mong Seng mentioned Singapore's ranking on the Yale Environmental Performance Index. I would like to clarify that the Index does not include cleanliness as a component. An inaugural litter count survey was conducted last year, covering some 1,900 sites in different categories of public places across Singapore. It was found that on average, 33 pieces of litter were accumulated over a 12-hour period in an area of just a 100 square metres; the size of a typical 4-room flat as shown in the slide which aims to give Members a better visual feel of what this implies. The study points to the need to continue its stronger engagement efforts in schools and communities to improve shared ownership in the cleanliness of public spaces that we want to enjoy.
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Mr Liang Eng Hwa raised an issue on food hygiene. This is a concern given the increasing number and diversity of retail food outlets. We have continued to strengthen the regulation of our food hygiene standards focusing on food handlers as they are an important link in the food safety chain.
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Since October last year, NEA has progressively rolled out the requirement for food handlers to undergo refresher training every three years. Stiffer penalties were also introduced in April last year for food hygiene-related offences. Catered food is an area of emphasis. As caterers typically serve meals to large numbers of people, any lapses in their food handling processes could potentially result in mass food poisoning. We will focus on \r\n\r\n
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\r\n\r\neducating both food caterers and consumers on good practices for preparing and consuming catered food. \r\n\r\n\r\n\r\n
From the end of this year, food caterers will be required to time-stamp their packet meals and put up advisory notices at buffet meals to inform consumers when food should be consumed by as shown in this slide. Studies have shown that food may not be safe for consumption beyond four hours from the time it has been cooked, if not properly stored or held at an appropriate temperature. Consumers therefore need to be careful with food that has exceeded the consume-by time stipulated by the caterer.
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Dengue control, public cleanliness and food hygiene are all areas which require the support of the community. We can all do our part to continue ensuring that the areas in and around our homes do not become potential mosquito breeding grounds, and also help maintain a high standard of public cleanliness in all our common areas. As consumers, we can set the expectation for food handlers to be more hygiene conscious.
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Mr Chairman:Order. I propose to take the break now.
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\r\n Thereupon Mr Speaker left the Chair of the Committee and took the Chair of the House.
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Mr Speaker: Order. I suspend the Sitting and will take the Chair again at 3.10 pm. \r\n\r\n
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Sitting accordingly suspended at
\r\n2.51 pm until 3.10 pm.
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Sitting resumed at 3.10 pm
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[Mr Speaker in the Chair]
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Debate in Committee of Supply resumed.
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[Mr Speaker in the Chair]
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\r\nHead L (cont.) –
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Rental of hawker stalls
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Mr Lim Biow Chuan: Rising costs of living are a concern for Singaporeans. One area where many of the lower-income citizens are affected is the rising cost of food and drink prices in hawker or food centres. It has been reported that cooked food at some foodcourts at ION Orchard, Nex and Marina Bay Sands are sold at more than $10 a plate. It has also been reported that prices of coffee, tea and soft drinks have also increased in many other hawker centres. Recently, NTUC FairPrice announced its \"Stretch Your Dollar Programme\" to help consumers cope with inflation. This is most commendable because this programme places a certain downward pressure on the market for the cost of certain groceries to be contained. \r\n\r\n
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In this regard, I would like to call on NEA to reconsider its policy not to build anymore markets and hawker centres. I also urge NEA to reconsider its policy of tendering cooked food and wet market produce stalls at market prices. If such stalls are allocated at subsidised prices to the less educated or lower-income Singaporeans, NEA can impose price caps on the food sold by these stalls. I understand that this is what some schools ask of their stall operators in their schools or what some commercial companies do – impose price caps on the food sold in their staff canteen as a form of service to their workers in the factory.
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Sir, there are currently several stalls which have been given up by stallholders during the Hawkers Upgrading Programme (HUP). There is scope for these stalls to be set aside and allocated for Singaporeans who are lower income or less educated. NEA can work with the CDCs to see how they can allocate hawker stalls at subsidised prices to \r\n\r\n
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\r\n\r\nlower-income or poorer Singaporeans. The CDC can then work with these residents to assist them to learn to operate a cooked food or market-produce stall. NEA can also impose strict conditions like not allowing subletting and any interested stall operator must agree to the price cap and submit the prices of their food to NEA for approval. In this way, we can help the lower-income or poorer in our society to learn to make a living; at the same time provide alternative to residents and also help place some pressures on other food or market stalls to keep food prices affordable, similar to what NTUC FairPrice is doing for groceries.\r\n\r\n\r\n\r\n
Sir, I recognise that there are many issues to be resolved and, in a certain sense, we are interfering with the free market. But why not try the scheme on a limited basis for stalls given up under the HUP and see how this works out?
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3.15 pm
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Enforcement laws
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Mr Chiam See Tong: Handicapped persons in Singapore find it rather hard to eke out a living on their own, especially if they are doing illegal hawking with no permit. They are fined heavily many times, ranging from $200 to $750 or more if caught. The sale of tissue paper packs by these handicapped persons are not even enough to pay for those fines. I would urge the Ministry to show compassion to those handicaps caught for illegal hawking or fine-tune their enforcement law to allow the handicaps to sell, as it is an arduous task to apply for permit, especially for those in wheelchairs.\r\n
Noise levels
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Mr Liang Eng Hwa: Sir, during my regular house visits, it is not uncommon for residents to complain about noise nuisances, whether it is from the speeding \r\n\r\n
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\r\n\r\nmotorbikes, cars with noisy exhaust pipes or even the sharp drilling noise from construction and piling works, and so on.\r\n\r\n\r\n\r\n
A recent overseas study reported by the Straits Times indicated that constant noise level of more than 80 decibels has been associated with increased risk of permanent hearing loss, 65 decibels with hypertension and heart disease, 55 decibels with significantly disrupted sleep, and so on. Traffic noise can reach something like 80 to 85 decibels, according to the study.
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Singaporeans really hope that the Government can do more to reduce noise nuisances, whether it is by regulations, enforcement or education. I would like to ask the Minister for an update on NEA's efforts to curb noise pollution.
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Dr Mohamad Maliki Bin Osman: Sir, the majority of Singaporeans live in close proximity to each other by virtual of the way our housing estates are structured and built up. Our efficient use of space opportunities can create great opportunities for neighbours to get along with each other and strengthen bonds. But such close proximity can also be a bane to many home owners.\r\n\r\n
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As MPs, we often receive feedback about how neighbours are facing conflicts with each other over noise coming from particular units. From shouting and speaking loudly to children running around to marbles dropping on the floor or even having washing machines running in the middle of the night.
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Many of these feedback about noise levels come from neighbours and our response has always been to advise the party to reduce the noise level and help to mediate. But one question I would like to pose is whether the noise levels generated by these neighbours are within the acceptable limits of the high-density living \r\n\r\n
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\r\n\r\nenvironment in Singapore. If so, who sets the limits and under what circumstances, can action be taken against such recalcitrant individuals? This also applies to other possible sources of noise such as community activities, aircon compressors from nearby buildings and, at times, RSAF helicopters flying above housing estates. Can the Minister enlighten the House on the newest guidelines for acceptable noise levels and how can Singaporeans be better educated to understand what they need to do within the constraints of our built environment?\r\n
Singapore – Venice of Southeast Asia
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Mr Heng Chee How: Sir, Singapore is renowned as a Garden City. We are remaking it into a City within a Garden as well. As an island, we should make full use of the water element to enhance our quality of life. The MEWR's ABC Waterways programme is a key programme that can take us forward in this regard. The efforts so far, I believe, have yielded very encouraging results. The look and feel of our rivers and waterways are progressively being restored to appear ever more natural and less canal-like.\r\n\r\n
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The options of activities in the water and along the banks have thus also increased. Waterside living is also becoming progressively more available to our broad population as opposed to being available only to the wealthy.
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For the HDB, that vision of sustaining and enhancing the value of properties and quality of living has led it to introduce many programmes over the years.
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I, therefore, look at the upgrading programmes of HDB, in terms of the hardware and the living quarters, and within our waterways for the MEWR's ABC Waterways programme as providing a complementary upgrading programme to enhance the overall value.
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\r\n\r\nIn the case of my constituency in Whampoa, there is a stretch of river – the Sungei Whampoa – that lies within its boundaries. Part of this river is currently shared between two divisions of the Jalan Besar GRC – one side is Whampoa and the other side is Kolam Ayer. Recently, a project under the ABC Waterways programme is completed. Beautiful surroundings and I could actually see the delight and joy of the residents as they witnessed the completion of the project. Certainly, in terms of what they can enjoy, it goes far beyond just having a park connectors that run along a canal.
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Therefore, I know from this specific experience that the ABC Waterways programme can and will make a big difference to the look, feel and usefulness of our river and canal systems. I hope that MEWR can give us an update on the overall progress of this important programme, as well as what other projects are being planned under this programme going forward and, in particular, how could the rest of the Sungei Whampoa fare within this project?
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Carbon-neutral national events
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Mr Seah Kian Peng (Marine Parade): Sir, I have spoken previously on the need to ensure that national events become more green. I have also asked Government bodies, including Parliament, to make public their current carbon footprint and to declare their targets and timelines to meet these objectives.\r\n\r\n
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So far, other priorities must have eclipsed these suggestions because I have not seen any Government agency taking this up. I may be wrong. But, yes, I do recognise there have been at least progress on one front arising from my earlier calls. At this year’s New Year Countdown event at Marina Bay, the 20,000 plastic wishing spheres floating on the Bay had a new lease of life as bags or banners. A positive development as \r\n\r\n
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\r\n\r\nthese 20,000 plastic balls yield some two to three tonnes of materials.\r\n\r\n\r\n\r\n
In the meantime, bottled water, plastic bags, goodie bags and other disposable waste continue to be given out at most national events and appear to be the order of the day.
\r\n\r\n\r\n\r\n
Sir, what is the Government’s position on climate change? Do we think that man-made activities are also contributing to the severe and extreme weather conditions we see today? Whether the answer is yes or not, I think that frugality and reduction of waste are intrinsic values. Sir, I propose that for this year’s National Day Parade, let us have a pure celebration without the gimmicks of clappers and other plastic items. Let us encourage people to bring their own bags and snacks. Let us forget about bags and memorabilia. If we must have collectibles, then make sure that it goes only to collectors who perhaps can go to MICA to collect them, rather than give out thousands of widgets that eventually end up in trash cans.
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Sir, I ask the Government to consider increasing the number of carbon-neutral events, to publish data that makes itself accountable in terms of green targets and to reduce the number of goodies bags at major national events.
\r\n
Assoc. Prof. Dr Yaacob Ibrahim: Sir, Mr Lim Biow Chuan asked about the Government's hawker stalls policy. Sir, we recognise that over time our hawker centres have evolved to become not just a source of affordable food but also an important shared community space.\r\n\r\n
\r\n\r\n
About 42% of the nearly 15,000 cooked food and market stalls that NEA manages are paying subsidised rentals. This has helped to keep food prices affordable, although there may be other several factors that affect food prices. Sir, there are no immediate plans to build \r\n\r\n
Column: 3715
\r\n\r\nnew hawker centres but we will continue to ensure that hawker centres provide patrons with a comfortable dining environment through our Hawker Centre Upgrading Programme. Since 2001, over 80% of our 110 hawker centres have been upgraded with improvements made in ventilation, utilities and layout.\r\n\r\n\r\n\r\n
Mr Lim also asked about allocating stalls at subsidised rent to low-income individuals, while Mr Chiam See Tong asked about NEA's approach to illegal hawking by disabled people. There are currently various schemes to support families in hardships and persons with disabilities. Low-income families who need assistance with basic living can approach the Community Development Councils for help. Persons with disabilities can be referred to the various job placement or support services for employment opportunities.
\r\n\r\n\r\n\r\n
Mr Liang Eng Hwa asked what the Government is doing to minimise noise nuisance. As I shared at last year's COS, construction sites near residential and noise-sensitive areas that started work from 1st September 2010 have not been allowed to carry out construction activities from 10.00 pm on the night before Sunday or public holiday till 10.00 am the day itself. This prohibition will be extended to cover the rest of the day for construction sites that commence work from September 2011. Going forward, we will also consider tighter noise limits for construction equipment and methods.
\r\n\r\n\r\n\r\n
NEA is also taking steps to reduce traffic noise. Noise standards for new vehicles were tightened in October last year, and standards for existing vehicles will be tightened in April this year. NEA is also working with the LTA to look into the feasibility of measures to further manage traffic noise.
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\r\n\r\nSir, I share Dr Maliki's concern that community noise is a growing challenge. However, stepping up on legislation and enforcement is not necessarily the most practical approach in such instances. While NEA has established and enforced noise limits for noise sources such as construction sites, factories and motor vehicles which could pose a risk to public health, community noise cannot be addressed as easily. This is because of its transient and subjective nature.
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As we work, live and play in a compact city, greater civic mindedness is very important. This is especially so given our high population and urban density which amplify the impact of noise. Even as we review noise mitigation measures through improved infrastructure design and more effective enforcement, for a better quality of life for all, everyone in the society needs to continue exercising consideration and tolerance for one another.
\r\n\r\n\r\n\r\n
Sir, the challenge of realising our vision of a sustainable Singapore is as much one of partnership and personal responsibility, as it is of public policy. To build a future that we desire and that our children deserve, we need to embrace the idea that taking care of the environment is everyone's shared responsibility, and not just the Government's. In doing so, we will also play our part as a responsible global citizen to tackle climate change, as suggested by Mr Seah Kian Peng.
\r\n\r\n\r\n\r\n
Mr Seah also asked if we can make it mandatory for major national events to be carbon-neutral going forward. On his suggestion for NDP, I will refer the suggestion to Deputy Prime Minister Teo Chee Hean for MINDEF to consider. Given their high visibility, major national events provide a good opportunity for us to promote environmental protection and ownership. In fact, NEA has been engaging the organisers and stakeholders of major events, including the NDP \r\n\r\n
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\r\n\r\norganisers, to make their events environmental-friendly.\r\n\r\n\r\n\r\n
These include introducing measures to cut down on packaging and litter, providing adequate recycling bins, using energy-efficient lighting and encouraging participants to use public transport. These all will help reduce the carbon footprint of such large scale events. For example, NEA has worked with organisers of the Youth Olympic Games, National Day Parade, the River Hongbao and Chingay to encourage participants and visitors to keep the venues litter-free through the provision of adequate refuse bins, display of educational materials and public announcements at event sites.
\r\n\r\n\r\n\r\n
Beyond using national events as platforms to build up a stronger sense of community ownership and responsibility, our officers at the five regional offices islandwide have engaged the grassroots through CCC meetings and grassroots events to better understand and address the community's concerns. A $1.5 million 3P Partnership Fund is also available to support 3Ps efforts by grassroots, schools, NGOs and companies. My Ministry will continue to grow our network of teachers, youth, grassroots and corporate partners to champion the environment in their respective communities and organisations. Such community partnership has been a centre-piece of our water sustainability efforts. The Active, Beautiful and Clean (ABC) Waters programme was launched by our Prime Minister in 2006 to encourage the public to get closer to water so that they can better value and enjoy this precious resource.
\r\n\r\n\r\n\r\n
To address Mr Heng Chee How's query on the status of the ABC Waters programme, I am pleased to share that 15 projects have been completed and these have been well-received by the community. 2011 promises an equally exciting array of projects for the \r\n\r\n
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\r\n\r\ncommunity. The flagship project this year is the Kallang River-Bishan Park project where the river will become the focus of the park following its transformation into a natural meandering waterway. The project also features innovative bio-engineering techniques and natural cleansing systems using plants. At MacRitchie Reservoir, amongst other improvements, visitors can expect a new submerged boardwalk that will allow people to work through shallow waters and appreciate water from a totally different perspective. These projects are part of more than 100 identified islandwide under the ABC Waters Masterplan, including Sungei Whampoa in Mr Heng's ward, which will be implemented in phases over the next 20 years.\r\n
3.30 pm
\r\n\r\n\r\n\r\n
PUB is also working closely with other public and private agencies to encourage the adoption of ABC Waters design features within their developments. ABC Waters design features have been introduced in public housing projects such as the Punggol Waterway and private developments like the Tree House Condominium by CDL.
\r\n\r\n\r\n\r\n
Sir, water we can drink from the tap, reservoirs we can canoe in, vibrant hawker centres, clean streets, fresh air – these are for us to use, but not to be taken for granted. We have to nurture a clean and liveable home for everyone through the combined efforts of all. Our efforts are recognised internationally today, with Singapore ranked first out of the 151 countries in Gallup's 2010 Air and Water Survey and maintaining its top placing among Asian cities in Mercer's Quality of Living Survey for the past three years.
\r\n\r\n\r\n\r\n
Sir, in conclusion, doing our part in safeguarding the environment does not have to be an extraordinary event or \r\n\r\n
Column: 3719
\r\n\r\nactivity. Simple everyday actions can protect the environment. Adopting energy and water efficient devices at home can help extend the lifespan of our resources. Everything we buy or throw away has some impact on the environment because it requires energy, water and resources to produce or dispose. Reducing our food waste, avoiding excess packaging and recycling are all easy ways that take us one step closer to our vision of a sustainable and liveable Singapore.\r\n\r\n\r\n\r\n
We can create an even better environment through positive changes in the way we think and act. Together, Sir, we can safeguard our environment for the present and for future generations to come.
\r\n
The Chairman: We have time for clarification. Yes, Mr Liang.
\r\n
Mr Liang Eng Hwa: Sir, I am glad to hear from the Minister of State on the new mandatory time-stamping requirement for catered food. However, the Minister of State did not elaborate on the penalty as well as the liability and responsibility on the part of the caterer and consumer. Can I ask the Minister of State to shed some light on that?\r\n
Dr Amy Khor Lean Suan: Time-stamping is an added step to reinforcing our food safety regime in addition to requiring our caterers to have at least one food hygiene officer send their food handlers for basic food hygiene course, and so on. For consumers, time-stamping is to give them additional information, to advise them that they ought not to be consuming food beyond the four hours of the food having been cooked because there is a risk of food poisoning.\r\n\r\n
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With regard to the caterers, in the event of a food poisoning incident, NEA will investigate the caterer's premises for \r\n\r\n
Column: 3720
\r\ncorrect time-stamping, food hygiene and personal hygiene practices, and so on. Enforcement actions and demerit points will be enforced for such hygiene lapses. So, we will not just look at the time- stamping by itself. It is just an added step to reinforce the food safety regime.\r\n
Mr Low Thia Khiang: Sir, in an attempt to deal with the dengue fever problem, it was reported that Malaysia tried to do a follow-up trial on the British scientists' study to try to release genetically modified mosquitoes into the environment. I would like to know from the Minister of State whether we are concerned with Malaysia releasing transgenic mosquitoes into the environment, given that Malaysia is so close to us.\r\n
Dr Amy Khor Lean Suan: The transgenic mosquito trial programme by the Malaysians that Mr Low referred to, as well as the ones released in the Cayman Islands by British scientists, is a research programme by Oxitec which is a commercial spin-off from the University of Oxford.\r\n\r\n
\r\n\r\n
In the case of Malaysia, it is undertaken by the Institute for Medical Research (IMR) in collaboration with Oxitec. The transgenic mosquito here involves the use of what we call RIDL or Release Insects with a Dominant Lethal Technology. I suppose they are harakiri mosquitoes. The RIDL Technology first introduces a killer gene into the genome of male Aedes mosquitoes. These transgenic mosquitoes are subsequently released into the nature where they will mate with the wild type female mosquitoes and the killer gene is passed down to the progenes which will die at the late larva or pupil stage. So, in this case, for mosquitoes like that, the TFR is zero, and I suppose this is a case where we welcome TFR being zero. The mosquito population is therefore decimated over time.
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\r\nIn the case of Malaysia, in late January, the IMR confirmed that it has successfully concluded a field release of 6,000 RIDL males at an uninhabited forested area in Bentong, Pahang to study their longevity and flight range. The release took place despite protests from environmentalists. The trial site was fogged to kill all mosquitoes and the site will be monitored for several more months and we understand that there is no plan to release more mosquitoes until the results of this trial are analysed. So given the small scale of the Malaysian trial and the long distance between Singapore and the trial site, NEA assessed that it is unlikely to be of significant concern to Singapore. Should larger trials be carried out in the future or should the trial sites be located nearer to Singapore, NEA has the necessary surveillance capability to detect the entry of any transgenic mosquitoes in Singapore. So you do not need passports!
\r\n
Mdm Ho Geok Choo: Mr Chairman, I have three clarifications for the Minister of State. First, I would like to check how the litter count survey will be used to mitigate the littering problem in Singapore. Second, is there a more robust grading scheme for food stalls than what is currently being used since many people feel that food stalls should either be graded a pass or a fail? And, third, what is the implication of the mandatory time-stamping on the food caterer and the consumer?\r\n
Dr Amy Khor Lean Suan: I think for the third question, I have actually replied in response to Mr Liang Eng Hwa, that if a food poisoning incident does happen, we will investigate as per normal. But, first of all, time-stamping is to give the consumer more information so that he will be asked to avoid taking food beyond the time stipulated.\r\n\r\n
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Regarding the litter count survey, the survey that was done last year is the \r\n\r\n
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\r\n\r\nmost comprehensive assessment of the state of cleanliness of public areas we have done to date. A total of 1,954 sites were actually surveyed. The results of the inaugural survey actually found, as I have shown earlier in the slide, that, on average, 33 pieces of litter were accumulated over a 12-hour period in every 100 square metres of public space, which is the equivalent of a standard 4-room flat and this shows that more needs to be done to sustain public cleanliness and, of course, the public has a role to play to keep the public areas clean by being responsible and clearing their litter after them.\r\n\r\n\r\n\r\n
NEA will continue its stronger engagement efforts in schools and communities to improve shared ownership in the cleanliness of the public spaces that we want to continue to enjoy. In fact, in addition to our Litter-Free Ambassador Programme that we have launched as well as the Students Embrace Litter-Free (SELF) Programme, we also intend to launch a Litter-Free Ambassador Programme for preschoolers in June this year, so that children will be aware of how they can contribute to a clean environment and develop a good habit of always throwing litter in a bin from an early age. We are going to also have \"litter monitors\" appointed to remind their classmates to keep the preschool centres clean and to conduct simple checks within the premises. So the litter count survey really acts as a baseline and we will carry out another litter count survey in 2012 to assess the situation again. This will help us to see the effectiveness of the initiatives that we have already implemented or are implementing between now and the next survey in 2012.
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Mr Cedric Foo Chee Keng: I would like to ask the Minister about electric cars in Singapore. Does he have a sense of how much they will cost and how successful they will be?\r\n
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Assoc. Prof. Dr Yaacob Ibrahim: As I have mentioned in my reply, MTI has replied earlier that they are trying this out. We really do not have a feel for it at this point in time but the pilot is being tested together with EMA. NEA is supporting this process. I think when the time is right, we will make public whether or not this programme is successful.\r\n
Mr Seah Kian Peng: I just want to state that perhaps the NDP was not a good example. I would now like to ask the Minister whether we could consider the National Clean and Green Week as one event to aim for to be the first carbon-neutral national event.\r\n
Assoc. Prof. Dr Yaacob Ibrahim: Certainly, we will consider all opportunities available. The Clean and Green Singapore (CGS), as he rightly pointed out, is a good example. But let me just add one further example which just came to my mind. If you ever visit the Marina Barrage, you will realise that there are no bins, and the reason is very simple. When we started providing bins, they overflowed, and the situation was terrible. What the PUB did, after consultation with NEA, was to give people plastic bags. Only on the way out of the Marina Barrage will they throw away the plastic bags in the bins. As a consequence, the place has been kept clean. So he is right, we should take some of these available opportunities where there is higher human traffic to bring about such changes in behaviour, but it may cause some difficulties in the early days. When we removed the bins at the Marina Barrage and only had a few at the exits, it required some adjustments. So the PUB deployed some officers on the ground. But, today, it is working quite well.\r\n
Dr Lim Wee Kiak: Sir, I would like to ask the Minister: out of the 8,000-plus green vehicles, how many of them are green motorcycles and what is the reason electric motorcycles are not gaining \r\n\r\n
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\r\n\r\npopularity. Are we doing anything about that and what is the reason for not doing anything?\r\n
Assoc. Prof. Dr Yaacob Ibrahim: I do not have the figures here to share with Members. I am not sure why it is not being taken up but, I suspect, if I were to check with MOT, that there are more cars than motorcycles, to begin with. The figure itself is small relative to each other. There may be other reasons, but I will endeavour to find an answer for him.\r\n
The Chairman: Are there any more clarifications? If none, Mr Foo.
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Mr Cedric Foo Chee Keng: I want to thank Minister Yaacob and Minister of State Dr Amy Khor for their replies. They have covered a broad canvas from air to water, to waste management, to pollution, to public health, to mosquitoes – the male ones, the female ones, the Cayman Island, Malaysia – and so forth, and in many of these areas they have done well. We want to commend the Ministry for their achievements but, at the same time, we urge the Ministry to set even bolder targets. And why? So that we can bequeath to future generations a more beautiful and a more pristine Singapore.\r\n\r\n
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With that, I beg leave to withdraw my amendment.
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Amendment, by leave, withdrawn.
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The sum of $727,030,500 for Head L ordered to stand part of the Main Estimates.
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The sum of $410,964,400 for Head L ordered to stand part of the Development Estimates.
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\t\t\t\t\t\r\n\r\n
Head O – Ministry of Health
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Dr Lam Pin Min: Mr Chairman, can I have your permission to take all four cuts together?\r\n
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The Chairman: Yes, please.
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Wellness-centric healthcare model
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Dr Lam Pin Min: Mr Chairman, Sir, I beg to move,\r\n\r\n
\r\n\r\n
That the total sum to be allocated for Head O of the Estimates be reduced by $100.
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Sir, allow me to relate this account written by a relative of a patient dying of end stage respiratory failure. He wrote:
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\"Last night I was at the emergency department with my uncle who was dying. He was 62 years old with end stage respiratory failure, and had a background of chronic emphysema. Emphysema is a form of chronic obstructive lung disease where the air sacs of the lungs known as alveoli are progressively damaged. My aunt was with him and was visibly shaken at the state of his condition, even though he had struggled with his breathing for more than two decades of his life.
\r\n\r\n\r\n\r\n
I was touched by the little acts and the conversation that transpired between my uncle and my aunt. She was trying to make him as comfortable as possible, giving him extra pillows and asking him if he was okay. He was either unaware of the seriousness of this hospital admission or he had chosen to ignore it. Most of his limited conversation was about completely trivial things – the weather, the upcoming weekend.
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At one point, he whispered to my aunt, but she could not hear him because he was wearing a large full-face mask, hooked up to an oxygen machine. She leaned closer, 'What's that dear?' I was also up close, and could barely make out what he was saying. What last words would he whisper, I thought to myself. I pictured myself in his position – maybe I would tell my wife how much I loved her or enjoyed us being together. My uncle leaned closer to my aunt and mumbled in his feeble voice, 'I am sorry I have not listened to you all these years. I love my cigarettes but I love you even more. Please forgive me.'
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Column: 3726
\r\n\r\nI found myself immediately pondering how fleeting life is, how everything can change in a split second. After hearing this, I decided to quit smoking myself. Sometimes, it takes a wake-up call to truly appreciate things – you do not realise how good and important it is to have a healthy body until you lose it!\"
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3.45 pm
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Sir, this testimonial of an ex-smoker illustrates very well the importance of good health. Good health does not come naturally and will not last forever. It is a goal that can be achieved easily through healthy living, healthy eating and regular exercise.
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Falling sick and going to the hospital is never a happy occasion, with the exception of giving birth to one's newborn child. Notwithstanding the good reputation of our medical institutions, going to one can be a stressful experience. Patients can wait up to one hour, sometimes even two hours, to see the doctor for consultation that lasts only a few minutes. Then spending another hour just to collect the medication at the pharmacy. Thus, I believe that it is the wish of all Singaporeans to avoid going to hospitals as much as possible.
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Once stricken with a disease, the qualitative added life years of a person can be severely limited, even with treatment. For example, a transplanted renal patient will be on immune-suppressant drugs for the rest of his life and this can often lead to all kinds of other diseases due to the side effects of the immuno-suppressive therapy.
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Our healthcare system must therefore strive to keep patients away from the hospitals as much as possible. Even better, manage their health such that a person's entire lifetime visits to the hospital is kept to the minimum. This must be the key performance indicator\r\n\r\n
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\r\n\r\n(KPI) we should strive more in a wellness-centric healthcare model.\r\n\r\n\r\n\r\n
To achieve this KPI, it is crucial to maintain a healthy lifestyle, exercise and go for regular health screening. Although the grassroots organisations and many VWOs have taken the right step in organising mass health screening for the residents, following up on cases that need medical attention is even more important so that early intervention can be instituted.
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Over the years, Medisave has been liberalised progressively for payment of medical-related insurances, outpatient treatment and investigations. An example will be the Chronic Diseases Management Programme (CDMP) where Medisave is allowed to be used for the cost of outpatient treatment, up to a cap of $300 per Medisave Account per year.
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However, we know that early detection and subsequent prompt treatment of diseases can improve the prognosis and outcome. I would like to urge the Minister to consider allowing the use of Medisave for health screening but still subject to similar restrictions of capping the maximum withdrawal limit to $300 per account per year and strict guidelines on the types of screening allowable. This would prevent premature depletion and potential abuse of the Medisave savings.
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One of the challenges facing affluent societies, including Singapore, is obesity. Obesity is one of the most important factors causing an upsurge in the twin diseases of hypertension and diabetes. These two diseases are the major contributing cause for the 18 million cardiovascular deaths in the world. Hypertension and diabetes can be prevented with regular exercise and by leading a healthy lifestyle.
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\r\n\r\nObesity is linked to many other diseases and one of the most well-known is diabetes. Diabetes is one disease, if not well-controlled, can lead to many medical complications, such as kidney failure, heart disease, blindness and disability from leg amputations.
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Can I ask the Minister for an update on the prevalence of obesity in Singapore and what is MOH's strategy in tackling the issue of obesity in Singapore?
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In 2003, the World Health Assembly adopted the global strategy on diet, physical activity and health which targets lifestyle modifications that can combat the increase in non-communicable diseases. The WHO issued objectives for developing countries regarding school meals and healthy living. Can I ask the Minister if his Ministry has studied this strategy and whether this is relevant in our local context?
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Staying healthy is actually one's responsibility. You cannot force a person to stay healthy if the person is not motivated to do so. Smoking, alcohol consumption, drug abuse and living a sedentary lifestyle are important risk factors for a future plagued by illness, pain and sufferings.
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In spite of the challenges faced by the Ministry and the Health Promotion Board in promoting a healthy lifestyle amongst Singaporeans, I would like to ask the Minister for his strategy in helping Singaporeans lead healthier and happier lives. Has the Ministry considered ways to incentivise Singaporeans to stay healthy, such as lowering premium or rebates for health insurances?
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I hope the Minister can share with us his words of wisdom in building a wellness-centric healthcare for Singaporeans.
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Column: 3729
\r\n\r\nHealthcare infrastructural development
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Sir, my next cut. The population of Singapore has increased significantly over the past five years and the current resident population in Singapore stands close to five million. However, the speed of healthcare infrastructural development did not keep pace with the population increase, resulting in the long waiting times and the shortage of hospital beds in our clinics and hospitals respectively.
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The opening of Khoo Teck Puat Hospital (KTPH) has relieved the high workload in Tan Tock Seng Hospital (TTSH), and several months into its opening, KTPH is already experiencing high occupancy of its inpatient beds.
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In addition, with the rapidly ageing population, there is an urgent need to look into infrastructural requirements to meet the increased demand. I had also received feedback that the increasing population in new towns like Sengkang and Punggol has resulted in long waiting times at the polyclinics such as Sengkang Polyclinic.
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I would like to ask the Minister for an update on the healthcare infrastructural development, especially the Ministry's strategies in tackling the rapidly greying population. I would also want to ask the Minister for his plans in promoting community rehabilitation of patients with mental illnesses.
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Infectious diseases and flu pandemics
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Sir, my third cut. Singapore is a globalised and connected world with a very busy seaport and airport. Our tourist arrival reached 11.6 million last year. As the economy picks up, more and more Singaporeans are going for holidays abroad, judging from the sell-outs at recent travel fairs.
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The excellent air, sea and land connectivity has resulted in our borders \r\n\r\n
Column: 3730
\r\n\r\nbeing highly porous and highly susceptible to all kinds of infectious diseases. An infectious strain in one corner of the world can spread to Singapore overnight.\r\n\r\n\r\n\r\n
Our battles with SARS and H1N1 have taught us the importance of close collaboration between various Government agencies and multi-disciplines in dealing with epidemics and pandemics. A breakdown in communication could result in dire consequences.
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I would like to ask the Minister for an update on the infectious diseases and flu pandemic preparations. Are there scenario planning exercises to ensure the readiness of the various relevant agencies?
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Homecare and intermediate and long-term care
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Sir, my fourth cut. Singapore is one of the fastest ageing populations in the world. Coupled with our low fertility rate, more than 20% of our population will be above the age of 65 by the year 2030. In addition, Singaporeans are also living longer and a significant number of years of our lives will be spent in sickness.
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As such, the demand for intermediate and long-term care for the patient, especially the elderly, will increase. This forms a very important component in the holistic care of a patient, from acute to rehabilitation to eventually recuperating in a nursing home or homecare.
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More resources must be put into developing the intermediate and long-term care sector, as this is currently under-developed, judging from the long waiting list that these institutions are experiencing.
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However, being an Asian society, the family has traditionally been the main source of support for our elderly. Many elderly sick patients would definitely\r\n\r\n
Column: 3731
\r\n\r\nprefer to stay in the comfort of their homes than be placed in nursing institutions.\r\n\r\n\r\n\r\n
Homecare will not be possible without the dedicated participation of the caregiver, who is a family member most of the time. In order for the elderly to age and recuperate properly and happily in their homes, the Ministry would need to look into building up the necessary resources and expertise in growing the homecare sector.
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I would therefore like to ask the Minister the following:
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(i) What is the current state of homecare and intermediate and long-term care in Singapore and how does the Ministry plan to develop these sectors in the coming years?
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(ii) Can the Minister consider setting up a one-stop caregiver resource centre to provide a range of supportive services, including dedicated homecare medical teams to conduct medical review of stable patients at their homes so as to minimise the hassle of frequent travels to the hospitals or clinics for reviews?
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(iii) Can the Minister also consider the provision of monetary allowance for caregivers to compensate family caregivers for their hardwork and sacrifices in looking after the elderly, rather than taking the easy way out of dumping their old folks in nursing homes? This would also help to free up the limited resources and vacancies in nursing homes for those families who really need them most.
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Nursing homes
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Assoc. Prof. Fatimah Lateef (Marine Parade): Mr Chairman, nursing home refers to a premise used for the provision of nursing for persons suffering from \r\n\r\n
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\r\n\r\nillnesses or convalescing from injury and infirmity.\r\n\r\n\r\n\r\n
As we prepare to ride the silver tsunami, we must be prepared from now our mindsets, infrastructure, facilities and services to support this. With the existing numbers of nursing homes now, it is not uncommon to hear families and spouses lamenting that long waits to get family members into one are quite long really. Moreover, many of us are unable to afford the fees of private nursing homes.
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What are our future plans to meet this need? We need to project the expected numbers of elderly – elderly elderly and elderly sick, who will be requiring these facilities in the next five, 10 or 20 years. Can we also plan to have more of these nursing homes located conveniently in close proximity to our heartlands? This would facilitate family members visiting the seniors regularly and maintaining inter-generational family ties and bonds. Currently, about half of our nursing homes are already located near heartlands. We always prefer our elderly to be close to our homes or in our homes or in the community but nursing homes may be an inevitable reality in today's world where families face conflicting responsibilities. We must give thought to what makes our seniors truly happy in the nursing homes. More amount of modern amenities and parties organised by staff cannot replace the true joy that they see when they have their family members and friends visit.
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On the issues of funding, currently MOH is doing a lot through Medifund contributions. With the recently announced Community Silver Trust in this year's Budget which confers one-to-one matching for donations to VWOs involved in long-term care, this will lighten the load and burden a little more and stimulate more money into this important area. When it comes to manpower and staffing of nursing homes, we must also inject \r\n\r\n
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\r\n\r\nmore zest so that people will tend to choose this career.\r\n\r\n\r\n\r\n
I would like to ask what is MOH's plan on this important development of a model that we are aiming towards which is a world-class long-term care model.
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Long-term care capabilities
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Mr Sin Boon Ann (Tampines): Sir, the silver tsunami is almost upon us and we must be prepared for the transformation of our social landscape. One in every five residents will be above the age of 65 by 2030. Many Singaporeans can expect to live another 20 years more but the quality of life can vary greatly. A significant number will be affected by diseases related to ageing. \r\n\r\n
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I would like to ask the Minister if our acute care institutions and community rehabilitation centres will be gearing up their capacity and expertise to deal with these cases. Do we have enough long-term care institutions and facilities? If so, do we foresee that funding may be an issue due to the sheer number of elderly patients and the long-term nature of their care?
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Nursing homes have also voiced concerns about the lack of healthcare workers and funding for new equipment. Would the Minister share with us his analysis and assessment of this situation?
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Long-term care for the elderly
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Mdm Halimah Yacob (Jurong): Sir, this year's Budget talks about providing the best care for our seniors. I would like to ask the Minister how his Ministry intends to achieve this.\r\n\r\n
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Long-term care should be provided seamlessly, from acute hospital care to community hospital, nursing homes and home-based care. There are many gaps in the services that are currently available to \r\n\r\n
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\r\n\r\nour elderly. There should be greater focus on home-based care instead of hospital or nursing care alone.\r\n\r\n\r\n\r\n
Sir, I have four suggestions to make. First, there is a need to provide an integrated home and community programme comprising medical, nursing and social services to the frail elderly who need intensive long-term care so that they can remain at home instead of being placed in a nursing home. The current day rehabilitation centres are inadequate as they provide only therapy and day-care services. Integrated care will include a wider scope of services with an addition of a multi-disciplinary team comprising nurses, therapists, case managers and healthcare workers.
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The team will work closely with the patient's doctors be they General Practitioners (GPs), polyclinic doctors or specialists in hospitals. Such an integrated home and community care programme would also help provide support to caregivers who can continue to work and get respite from caring for the elderly during the daytime.
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4.00 pm
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Second, Sir, I urge for more support for caregivers who suffer from burnout, emotional stress and, worst of all, in many cases, loss of income and their own independence. This burden usually falls on the women who are often unmarried and unappreciated. I would like to ask the Minister to provide stronger support to caregivers by providing them respite from caregiving responsibilities, training as well as some financial support so that they are not left out and left behind.
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Third, Sir, I urge the Minister to ensure that healthcare is affordable to our elderly, as many suffer from chronic illnesses requiring long-term treatment and medication. With rising cost of healthcare, many are concerned that they will not be able to pay for their bills and, in this regard, I am glad to hear that the $10 \r\n\r\n
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\r\n\r\nmillion that has been set aside to help the elderly in mobility. Could the Minister provide more details on this? \r\n\r\n\r\n\r\n
Finally, Sir, manpower is a big challenge in the healthcare sector. We are short of not only doctors but nurses, therapists and other healthcare workers as well. Could the Minister enlighten this House and what is being done to address this?
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Home care
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Ms Ellen Lee (Sembawang): Sir, with the hospital bed crunch problem at our restructured hospitals and community hospitals, there is a greater need to re-look at how we handle our care for the sickly. There is an urgency in view of our fast ageing population and the increasing need for geriatric care. Despite the opening of the new Khoo Teck Puat Hospital, the problem is not fully resolved. The construction of the new Jurong General Hospital will take some years to be fully ready. Meanwhile, primary and step-down care alone may not be the dynamic panacea. \r\n\r\n
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When a person is very sick, his family members will naturally think of the hospital as the most appropriate place for the sick person because they want the sick person to be better taken care of by doctors and nurses. Singaporeans seem to have lost the ability to take care of sick members of our family, or have no time to do so due to work demands or because the family has shrunk due to fewer and fewer or no children or siblings. In fact, for some ailments and chronic illnesses, I believe the home environment may well be the most conducive and curative environment. There are at present some groups such as the NTUC Eldercare and our hospitals which provide some form of training assistance to family members and domestic helpers to care for the elderly\r\n\r\n
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\r\n\r\nand the sick. I believe to a certain extent home care when it is properly taught and supported by a good back up team at the hospital that can be easily reached in times of need, may well be the most economical option in view of the rising healthcare costs. I therefore ask the Minister if he would consider vigorously promoting such home care as being the right care for patients and what support and programmes can be put in place to support this drive.\r\n
Home and community care
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Mdm Cynthia Phua (Aljunied): Mr Chairman, Sir, geriatric illnesses span over a large variety of ailments of varying intensities. As such, I believe that we should offer more options to cater to the healthcare needs of senior citizens. There is a need to have more Government-subsidised home support services available for senior citizens living alone or with their family members. Mobility issues and physical weakness are common reasons for senior citizens to avoid seeking medical help. For some senior citizens, their limbs are so weak that just stepping out of their house is an onerous task that inflicts great amount of pain on them.\r\n\r\n
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The Government must encourage the availability of more doctors and medical personnel to do home visits to treat and care for these senior citizens. We should provide support for these families to encourage them. Hence, education and relief-care support for caregivers need to be building up over time. If we are able to have a pool of relief caregivers, this would allow the caregivers to be able to walk away for a while and come back with renewed energy.
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This brings us to the day-care centres and nursing homes in the community. The concerns of the community are that do we have enough day care-centres and nursing homes. If there is a shortage, how \r\n\r\n
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\r\n\r\nbad are we? Recently, we have a boost in the number of child-care centres and they were created within a short period of time. We know the numbers of elderly coming over the next 10 years. What are the planning parameters and the Ministry's estimation and its strategies on day-care and nursing homes in the community.\r\n\r\n\r\n\r\n
With the elderly, do we need a geriatric care unit in the community, for example, at each of the polyclinic? This should be a separate queue as the immune systems of senior citizens are significantly weaker than that of the young and the standard medication and treatment does not apply across the board.
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Lastly, can we look into the subsidy for the elderly for day-care services and nursing homes for families since we have allowed levy subsidy of maid for such home care?
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In view of the increasing elderly, we need to have more people knowing how to care for our elderly from the doctors, qualified nurses to step-down care nursing assistants and basic health care personnel. What are the plans of the Ministry to increase this pool of expertise? In addition, at the community level, some regular checks like monitoring tests, for example, the high blood pressure test and the sugar level test, can be done by certified medical personnel who are trained to do this work. In such cases, the residents do not need to travel far and this can be done near their homes.
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Alternatively, if we have a good medical IT system, long-distance consultation could also be done since all our flats are going to be wired by a new fibre network. The data transmission is very fast. This will allow our limited number of medical officers to reach out to more patients in the community.
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Elderly care
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Mr Ang Mong Seng (In Mandarin): [For vernacular speech, please refer to Appendix A*.] Our population is ageing rapidly. Currently, 10% of Singaporeans are aged 65 and above. By 2030, 20% of Singaporeans will be over 65 years old. Our total population by then will be 5 million while seniors aged 65 and above will be 1 million. We must prepare early, especially in the areas of healthcare and nursing homes. We cannot wait until 10 or 20 years later. We must start right now. The Minister has announced the building of more nursing homes in HDB estates. It is welcomed by the elderly.\r\n\r\n
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I would like to ask the Minister how many nursing homes we are going to build in the next five years. As many people do not understand the difference between a nursing home and an old folks' home, I hope the Minister can explain the difference so that the seniors will understand. It is best that if he could say it in Chinese.
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Secondly, the elderly's medical needs are different from that of young people. They mostly suffer from chronic ailments and need long-term medication and care. We need to train a group of doctors and nurses that understand the elderly so as to provide them good services. I suggest we set up clinics for the elderly at the same time as we build the nursing homes to provide medical services to the seniors.
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End-of-life care
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Mr Low Thia Khiang: Mr Chairman, Sir, the Economic Intelligent Unit's Report – the quality of death commissioned by the Lien Foundation ranks an end-of-life care services across the world. Apart from palliative care, end-of-life care in the report also includes broader social, legal and spiritual elements of care relevant to quality of death. Singapore was ranked 18 \r\n
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\r\nout of the 40 countries in the quality of death index.\r\n\r\n\r\n\r\n
Countries that ranked higher than us include the United Kingdom, Australia, New Zealand and Taiwan. Singapore's economic transformation from third world to first world was borne out of the hard work put in by past generation of Singaporeans. Now that these aged Singaporeans are pushing the end of their lives on earth, it is a shame that the quality of end-of-life care given to them is not of first-world standard.
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Even countries such as Belgium and Ireland are able to achieve better scores than Singapore in the four areas covered by the quality of death report. These are basic end-of-life healthcare environment, availability of end-of-life care, costs and quality of end-of-life care. Why is Singapore falling behind so many countries in these areas?
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Sir, I would like to ask the Minister for Health on MOH's initiatives towards end-of-life services. I noted the Minister seems to encourage Singaporeans to die at home to avoid consuming scarce hospital resources. The Government has shown itself capable of giving up $1.5 billion in Growth Dividends to all citizens including the richest amongst us. Could it not consider re-allocating such public money towards support and subsidies for end-of-life care in the areas of palliative care, hospice and home care for the elderly and the poor amongst us?
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Polyclinics
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Ms Ellen Lee: Mr Chairman, Sir, I would like to ask the Minister when will polyclinics be operated on a 24-hour basis? Although our polyclinics run by SingHealth and National Health Group (NHG) cater mainly to patients in the heartlands, they are increasingly being sought after by those living in the private \r\n\r\n
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\r\n\r\nestates as well. The usage of polyclinic services appears to be extremely high as we see many of our polyclinics having long queues with daily patient load that could well exceed 1,000 patients. This could be due to the fact that their operating hours are from 8.00 am to 5.00 pm and that their costs for consultation and medicine are generally lower compared to the privately-run clinics, especially those that remain open after 9.00 pm or 10.00 pm at night. I believe that there is a surcharge or a premium that is being paid for staying opened when all others are closed.\r\n\r\n\r\n\r\n
Moreover, these polyclinics remain open for only six days a week and they are closed on Sundays which means that the crowds on Mondays are usually higher. That there is a growing demand for healthcare services at our local polyclinics is never in doubt. I wish to ask the Minister, in view of our increased population and greater demand for healthcare services and the high healthcare costs, if our polyclinics can remain open for 24 hours.
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Singaporeans' lifestyle has changed tremendously and many do not keep strictly to the nine to five regime, especially those who are working. School-going children who attend the afternoon sessions are reaching homes after 7.00 pm and their working parents are returning home much later than that. When someone falls sick in the night, even the private clinics near their homes may have closed for the night. The few clinics that run 24 hours are charging much higher fees. It is at this time that if the polyclinics are open 24 hours, they will be serving a huge void. Further, minor ailments need not be rushed into the Accident and Emergency units of the hospitals.
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Polyclinics and medical IT
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Mdm Cynthia Phua: Mr Chairman, Sir, presently polyclinics are an essential \r\n\r\n
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\r\n\r\nservice in the community especially for the elderly, a daily service that is visited by many residents. In view of this essential service, the polyclinics are always very busy and crowded and see the whole spectrum of citizens, from infants to the common flu to the follow-up of chronic diseases of the elderly. We know we need more polyclinics simply by the virtue of the increasing population and our increasing elderly population.\r\n\r\n\r\n\r\n
It is time for the Ministry to review the roles and responsibilities of the polyclinics in the community. What are its KPIs – baby care, geriatric care, step-down care of the hospitals or walk-in care for the public? The needs are many and varied. Who are the target customers of the polyclinics? What income levels are polyclinics serving which population segments? How about our foreign workers? They do need care too. Is it part of the polyclinics' role to serve this community as well? In view of the range of needs and the target customers, it will be a challenge for the Health Ministry to ensure that the community or the target customers the polyclinics set to serve are being served well and at affordable rates for the medical care.
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I am not sure of the Health Ministry's planning parameters for the number of polyclinics in the community in relation to population. Could the Minister let us know the Ministry's direction on the roles and responsibilities of polyclinics? Who are the target customers of the polyclinics and its plan on the expansion of the polyclinics in the community?
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Next, just to highlight the concern on the grounds. The long queues and the waiting time: what are the measures the polyclinics are taking to cut down the waiting time? I would also like to highlight that this essential service needs to be accessible to the community and near to transport hubs as our people are getting older. The other concern on the ground is \r\n\r\n
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\r\n\r\nthe opening hours. Many of the rehabilitative and follow-up cases would not be able to go to the polyclinics during office hours and, in general, they would prefer the Saturdays. However polyclinics operate for half a day on Saturdays and the ground is asking for longer hours on the weekends.\r\n\r\n\r\n\r\n
On medical IT, there are two areas of interest: one is the data collection and sharing and the other are the use of medical IT for distant consultation and diagnosis. With the integrated medical information system, this would enable the polyclinics to extend its services to the heartland.
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For example, to tap on Minister Mr Lim Boon Heng's strategy of the Wellness Programme for the elderly, we could get retired nurses to take blood pressure and do basic sugar level tests at the Residents' Committee Centres. Records could be keyed into this integrated medical information system. This would reduce the need to visit the polyclinics.
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Finally, with the fibre network coming into the community, the transmission of data will be at super speed. The use of medical IT for distant consultation and diagnosis is very possible and can be done easily.
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4.15 pm
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Promote pro-health behaviour
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Assoc. Prof. Paulin Tay Straughan (Nominated Member): Sir, as life expectancy improves, it is critical that we promote healthy lifestyles so that we can prolong the periods of good health in our golden years. A key component to sustained good health is the embrace of regular health screening for early detection of ailments. Early detection can arrest the development of many chronic ailments, and will save lives in the case of critical diseases like cancer.\r\n\r\n
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\r\n\r\nCurrently, the take-up rates for many early detection procedures, like the mammogram, is below optimum level. To encourage Singaporeans to step forward and take proactive action to promote long-term well-being, may I suggest that the MOH starts a health credit scheme. Each time, a Singaporean takes part in a health screening exercise at the polyclinics or other locations specified by the Health Promotion Board (HPB) or MOH, he get credits that are entered into his record. The cumulated credits can be used to offset healthcare costs invoked when he sees a doctor, makes purchases at the pharmacy, or even for hospitalisation. I hope that this incentive will encourage Singaporeans to make health screening a norm and part of their annual rituals.
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Manpower in healthcare
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Assoc. Prof. Fatimah Lateef: Mr Chairman, the demands in our healthcare sector is growing annually. With the increasing patient load, rapidly ageing population and increasing expectations of our populace, we have no choice but to increase the number of staff in all healthcare sectors and disciplines. Graduating only 250 doctors a year, we need to employ double this number of foreign doctors. We are also in need of more nurses, and especially allied health personnel. Our doctor to patient ratio is not optimal as in some other developed countries.\r\n\r\n
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With the good NUS doctors, and now the third medical school, the numbers that are going to be added will be very small initially. The numbers will have an impact on quality of care, waiting times, satisfaction rates and other measurable KPIs. What is MOH's plan to enhance healthcare manpower? What has been the outcome pertaining to our ongoing efforts to bring back our Singaporean medical students and some of the young \r\n\r\n
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\r\n\r\ndoctors working overseas? What are the Minister's views on the newly introduced scholarship for medical students studying overseas? Will this create a significant increase in the number of doctors that we can bring back in the next five, 10, 20 years? Also on one other area of concern is the distribution of manpower. Of course, staff will tend to join more glamorous and popular specialties. Are we doing more to attract healthcare staff to the disciplines which are less popular, such as rehabilitation, pathology and renal medicine, and so on. Healthcare manpower projections and planning are crucial and we have to start planning from now.\r\n
Primary care partnership scheme
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Mr Low Thia Khiang: Mr Chairman, Sir, the primary care partnership scheme by MOH has helped needy elderly and disabled Singaporeans receive subsidised treatment at general practitioners (GPs) and dental clinics near their homes. The scheme is convenient, saves travel time and expenses, and eases the pressure on polyclinics to expand their services and facilities to cope with the increase patient load. \r\n\r\n
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I understand that there is good support for this scheme from the GPs located in the heartlands or neighbourhoods. Could the Minister provide the statistics for the current patients' participation rate and share with the House on the experience gained by MOH on the administering of the scheme? Could the Minister also provide information on whether the annual subsidies of up to $240-$360 for the treatment of chronic conditions are enough?
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The current criteria for patients to be qualified for this scheme for subsidised treatment are quite stringent: the qualifying age is 65 and above and the per capita monthly household income of the applicant must be $800 or below. If \r\n\r\n
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\r\n\r\nnot, the patient has to be a disabled or earn the same income level on the Public Assistance scheme. Could the Ministry of Health consider reviewing the criteria to enable more needy patients to benefit from this scheme? For example, the qualifying age could be revised to lower than 65 years old, the qualifying per capita monthly household income of $800 could be revised upwards, and the requirement for the patients to be unable to do any of the six activities of daily living could be reviewed. MOH could also consider a tiered system of subsidies where polyclinic patients can choose to be included in this scheme but will be given lower subsidies, if they were to go to the polyclinic.\r\n
The Chairman: Ms Sylvia Lim. You have three cuts. Take them together, please.
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Standard drugs list
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Ms Sylvia Lim (Non-Constituency Member): Sir, first, standard drugs list. The Government maintains a standard drugs list (SDL) of subsidised drugs. However, there are some issues of transparency concerning the list and decision-making processes. First, is the SDL public information? It is not easy to find the SDL and even doctors I have spoke to were uncertain. In comparison, it is easy to locate the central drugs list maintained by the World Health Organization and several other countries online.\r\n\r\n
\r\n\r\n Secondly, there is little information about how our Drug Advisory Committee raise various factors before deciding if a drug should be on the list or not. The Committee reportedly takes into account factors, including the cost effectiveness on each drug, but what exactly does that mean? For instance, how are the findings on pharmaceutical economic research used in this decision-making process? \r\n\r\n
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\r\n\r\n[Mdm Deputy Speaker (Ms Indranee Rajah) in the Chair]
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4.21 pm
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I understand that there is, within the Health Sciences Authority (HSA), a unit called the Pharmaceutical Economic and Drug Utilisation (PEDU) Unit. This unit assists the Drug Advisory Committee to assess the cost effectiveness of such drugs and the financial impact to the Government's drug budget.
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In 2008, there was an analytical study entitled \"Healthcare Systems and Pharmaceutical Economic Research in the Asia Pacific Region\" published in the journal, Value in Health. The authors of the book opined that the Singapore system involves \"A simplified cost effectiveness evaluation\", which was in fact a trade-off considering the available staff at our Pharmaceutical Economic and Drug Utilisation Unit, and how far the Drug Advisory Committee understood and accepted pharmaceutical economic concepts. Can the Singapore decision process be made more transparent? Australia and Canada both devote entire websites to inform the public of the process of decision-making and the rationale for decisions. The information includes reasons why a drug is not included, with clinical data to back up their conclusions. As we are talking about the danger of life-saving drugs, more transparency will go a long way towards building public trust.
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Osteoporosis
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Next, osteoporosis is a major public health problem worldwide and a particularly significance to Singapore's ageing society. The Government is aware of this as seen in the issue of the MOH's clinical practice guidelines circa 2008 on osteoporosis. Osteoporosis suffers on increased risk in fractures which may\r\n\r\n
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\r\n\r\nrequire hospitalisation and cause their health to deteriorate due to prolonged immobilisation. Many patients who sustain fracture do not return to their previous functional status and may require long-term institutional care. Figures from Singapore show that the incidence of hip fractures has gone up significantly since the 1960s, five times more in women and 1.5 times more in men. One year post-hip fracture, between 20% and 25% die, 30% of survivors are semi- or fully dependent. The costs to the individual, family and society are thus significant. Adequate treatment of osteoporosis is best essential to reduce these effects. What efforts have been made towards increasing public awareness and prevention so that this disease is not undertreated?\r\n\r\n\r\n\r\n
Long-term care
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Finally, long-term care. The Eldercare Fund was set up in the year 2000 to grow income and provide funding for nursing homes and other long-term care providers. The Government has stated that the Eldercare Fund would not replace community support in this sector, and that community donations are vital in financing step-down care for those of low and low-middle income. According to the MOH website's write-up on eldercare, \"voluntary welfare organisations should continue to raise funds from the community and do their part in helping the needy and indigent patients to foot their share of the charges using the donations raised.\"
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In this Budget, the Government has set up the Community Silver Trust to provide donations for long-term care providers. While community-giving must be encouraged and incentivised, my question is what role the Government is playing to monitor and moderate the cost of long-term care to the patient or user?
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Overseas Medisave use
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Dr Lam Pin Min: Madam, the flow of medical tourism is not a one-way traffic into Singapore. Increasingly, more and more Singaporeans are travelling overseas to seek medical treatments. These could range from complicated operations, such as organ transplant to corneal refractive procedure, such as lasik.\r\n\r\n
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The scheme to allow Singaporeans to pay for medical treatments at selected overseas medical institutions was introduced last year. Singaporeans choose this option for several reasons, the commonest being the cheaper medical cost overseas. Can the Minister update the House on the utilisation rate so far, and how has this scheme benefited Singaporeans?
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Insurance for congential diseases
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Madam, having a newborn child with congenital illness can be devastating news to the parents. Besides the emotional upheaval, parents whose children are inflicted with congenital diseases also face tremendous physical and financial stresses. In light of our Government's promise of an inclusive society, would the Health Minister consider extending MediShield, which is our national health insurance to cover congential diseases for children?
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Medisave
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Assoc. Prof. Fatimah Lateef: Madam, our infant fertility rate in Singapore is one of the best in the world today. Congenital birth defects, on the other hand, have now become a major cause of perinatal and infant mobility and mortality here. We do have the national birth defects register set up by MOH in January 1993. Those affected will require regular and frequent medical follow-ups, investigations, interventions and hospitalisation. These can incur very high costs. The parents are \r\n\r\n
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\r\n\r\noften left with not much of a choice as these conditions are rare and they require rather aggressive interventions. Take Down Syndrome for example, the commonest chromosomal abnormality which causes a multitude of congenital defects. These people can live to a very ripe old age and managing all their potential complications can indeed be hard on the families. Thus, it could be beneficial if MOH can consider allowing their Medisave or MediShield to be used for payments for the management of congenital diseases. For selective cases where familial screenings are to be carried out, can we also consider using it in a graduated fashion with specific guidelines?\r\n
Mdm Halimah Yacob: The recent flexibility allowed in the use of Medisave for outpatient treatment was well received by many. However, many have given me the feedback that the limit of $300 is far too low. Some shared with me that the consultation and medication for three months for chronic illnesses alone could cost them more than $200 and this includes treatment at the polyclinics. After that, they would have to use cash, which they do not have. As a result, some may skip visiting the doctor.\r\n\r\n
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I have three points to raise. Firstly, I would like to ask the Minister whether he would allow Medisave to be used for health screening. Secondly, I would like to ask the Minister whether he could consider raising their Medisave withdrawal limit for outpatient treatment to a more realistic level, so that patients could have uninterrupted treatment. Thirdly, with rising healthcare costs, I would like to ask the Minister whether there is a need to increase the minimum required amount (MRA) which was set a few years ago, as our current MRA may not be adequate to meet our long-term needs.
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The Minister for Health (Mr Khaw Boon Wan): Madam, last month, I tossed \r\n\r\n
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\r\n\r\nvegetarian lo-hei with Prof. William Haseltine. He is an outstanding academic, inventor and entrepreneur, a very rare talent. At Harvard University, he became a founding father in an evolving branch of research which sequenced DNA, and then used the human genome to identify and treat diseases. He holds many patents and founded several bio-tech companies. His current interest is to seek out healthcare innovations and apply them globally to bring about cheaper and better health.\r\n\r\n\r\n\r\n
I first met him last year at an NUS Healthcare Forum. He was intrigued by our healthcare system, delivering first world standards at only 4% of our GDP. Many OECD countries spend more than 10%. He was in town to find out more with the intention of writing about it.
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Prof. Haseltine's assessment corroborates with several commentaries about Singapore's healthcare system that appeared during Obama's health reform debates. For example, a Wall Street Journal article in November 2009 described Singapore as having \"world-class quality care at world competitive prices\". The article added that \"Singapore's example might have something to teach them about the kind of reform Americans really need.\"
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The Austrian Health Minister was also in town last month. After spending some time at the Khoo Teck Puat Hospital (KTPH), he remarked to me that many of the policies that he was planning to introduce in Austria were routinely done here. I took that as a compliment from a well-informed peer.
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We do not claim our system to be perfect. But we achieve a better outcome for our people because we have more readily acknowledged the hard truths of healthcare and forged our system based on such insights. What are the hard truths?
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There is no free healthcare; someone has to pay the bill. While most people are honest, some patients and some providers do abuse the system at the expense of the vast majority of honest people. More healthcare does not always deliver better health. Beyond some point, there are limits to medical science. Many healthcare problems are self-inflicted. Dr Lam gave the example of the patient with Chronic Obstructive Pulmonary Disease (COPD). No medicine, for example, can help a patient with COPD unless he or she stops smoking.
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Incentives can work in healthcare but poorly-designed though well-intentioned health policies can end up distorting behaviour. Lastly, and most importantly, we are all mortals and eventually we all have to die.
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Many other healthcare systems choose to ignore these hard truths and are, for instance, based on wishful thinking that people can live forever, that more treatment is better, and there is a cure for every disease, \"a pill for every ill\". For the terminally ill, they will strive to prolong life at all costs, never mind the quality of life nor the futility of such efforts. The US spent 18% of its GDP on healthcare and they know that much of that is unnecessary.
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My recent heart bypass has sharpened my sense of my own mortality. I have regained my fitness level. In fact, today is exactly 10 months after my bypass and I have become even more diligent in my regular exercises. Before coming here, I did four and a half kilometres on the treadmill. But I know the score of having to live with heart disease. I am 59 and I do my best to keep my body in good condition, live a full life, and hope to grow old with dignity. But I am under no \r\n\r\n
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\r\n\r\ndelusion and I know that someday I, too, will leave. The question is how? Like others, I have my share of worries. Will I suffer a stroke that condemns me to severe disability? Will I develop dementia and lose my mind?\r\n\r\n\r\n\r\n
At every Chinese New Year, I wish my residents \"健康长寿\" or good health and longevity. They said \"yes\" to the first part, good health. But on longevity, many said: \"not too long please\" and I know what they mean. We all strive for a long, meaningful life, but the two words \"long\" and \"meaningful\" have to come together in order to make a happy person. A long life of pain and suffering is a miserable life.
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I am reading Susan Jacoby’s latest book “Never Say Die”. This is my bedside reading at the moment. She was most critical of the American approach to end-of-life care. In it, she related her last conversation with her grandmother in a nursing home when she was nearly 100 years old. This was what she recalled: \"A small boy tossed a beach ball in our direction. Gran tried to rise from her chair and throw the ball back but she was too frail to stand without help. Collapsing backward, she said in a soft voice devoid of either self-pity or anger, 'the worst thing about having lived too long is you know you are of absolutely no use to anyone.' It was agonising for me to hear my grandmother said this, because she defined herself by her usefulness.\"
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I often visit nursing homes with my grassroots leaders. Some patients welcome our visit as it breaks their daily routine and we do bring cheer to them. But many with severe dementia live in their own lost world, oblivious to what is going on around them. Many others are clearly suffering. Often, I just looked at my grassroots leaders and by our body language, without a word being spoken, we say to one another: \"Let’s hope we do \r\n\r\n
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\r\nnot end our life this way.\" I would silently offer a prayer for the patients.\r\n\r\n\r\n\r\n
In my Ministry, we have crafted a phrase \"with peace of mind\" into our vision to help Singaporeans \"live well, live long and with peace of mind\". We meant this seriously. I took this mission diligently. My personal mission in life is to help serve the young and the old so that they have peace of mind. In Chinese we call it \"老者安之，少者怀之\". This came from Confucius. That was his personal mission in life when asked by one of his students.
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We cannot eliminate death and suffering. But we can avoid inflicting unnecessary pain and suffering to the natural process of dying by being wise in our healthcare policies and in how we structure our healthcare system. In her book, Susan Jacoby also wrote about an American woman who, just a month before her 100th birthday, underwent surgery to install a special defibrillator and pacemaker in her failing heart. When it happened, it was front page news on New York Times. That is a great achievement in medical science. The surgery postponed her death and extended her life for a while. But it was a life full of suffering, requiring the full-time services of a home healthcare aide, paid for by taxpayers and being confined to a wheelchair with both failing vision and failing hearing. This may be an extreme example, but in the US healthcare system, such cases of aggressive medical intervention during one’s last few months or weeks are not uncommon.
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We have a good and relatively inexpensive healthcare system because we have sensible and wise doctors. We must not port in mindlessly foreign practices based on fallacies and unrealistic expectations. That will only bring misery to the patients and their families at great cost to society. Singaporeans are living longer and, with it, there will be greater demand for healthcare services. They also\r\n\r\n
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\r\n\r\nwant to age in place, at home and in the community, except for the occasional emergencies to the acute hospitals. Much of the healthcare services for the elderly can be competently delivered in the community, away from costly hospitals. That is why Budget 2011 places so much emphasis on long-term care. Even as we improve our hospitals, we will do even more to transform our long-term care sector and many MPs spoke about this.\r\n\r\n\r\n\r\n
We have already started this journey and we are on track. The new Khoo Teck Puat Hospital (KTPH) illustrates how we are making progress. Most MPs have visited it. You have seen how we have raised services, especially for patients in Class B2 and Class C, to a higher level, delivering a \"hassle-free\" hospital experience. You have also heard how KTPH is reaching out to the community outside of the hospital and supporting them to look after the discharged patients. In other words, all the hospitals’ CEOs know that their responsibility now extends beyond the hospital walls. It is not just within the hospital walls. And this transformation is not just in KTPH. There is also a quiet revolution in Changi General Hospital (CGH), Tan Tock Seng Hospital (TTSH), National University Hospital and polyclinics. We have made progress in mental health, chronic disease management, integrated care between hospitals and the community.
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But the work is not finished yet. I still have a substantive agenda of things to accomplish. If we stay the course, over the next five to 10 years, we can further transform our healthcare, to be among the best in the world. Let me sketch out our plan in seven areas.
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First, we will realise our vision of a general hospital in every region. In the north, KTPH has added 550 beds to our bed capacity. In the west, the Jurong General Hospital (JGH) is on track to open in 2014 with 700 beds.
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\r\n\r\nDr Lam will be pleased to know that a new general hospital will come up in his constituency to serve the residents living in the north-east. The new Sengkang General Hospital will be located next to the Cheng Lim LRT Station. It will also be within walking distance to the Sengkang MRT Station which is in Mr Charles Chong’s constituency. It will open by 2020. Given a lead time of six or seven years to design and build, it is not too soon nor too late to start planning. I have asked the SingHealth Cluster to assemble a young outstanding team to take charge of this project. I will challenge them to build a hospital, even better than KTPH and JGH, measured from the patients’ point of view.
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All the three general hospitals will have community hospitals adjoining them, and this will significantly expand our community hospital capacity. These are multi-billion-dollar investments but they are worthy investments. Together with TTSH serving the central region and CGH serving the east, they will realise our vision of bringing healthcare close to the residents living in each region of Singapore. Good healthcare will be within 30 minutes of every patient.
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Second, we have achieved very good mortality indicators, including life expectancy, child mortality and other disease-specific death rates. We will now measure how specific diseases impact the overall well-being of Singaporeans. To do so, we will track morbidity indicators and strive for further improvement. My vision is to get our morbidity indicators to match the top tier of OECD countries in the key disease areas which matter to us, like heart disease, diabetes, mental disorders and cancer. We are currently about average, among the OECD countries. Let us move up to a higher tier.
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This means knowing how to better treat these common diseases, whether in \r\n\r\n
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\r\n\r\nterms of prevention, early detection, treatment, rehabilitation or continuing care. For example, Assoc. Prof. Straughan mentioned just now our mammogram screening rate. We are below OECD average and we have to make progress there. This will require us to raise the capabilities and outcomes of our national specialist centres to match the best elsewhere. Where appropriate, we will invest in building new capability peaks in areas such as organ transplant, geriatrics and rehabilitation.\r\n\r\n\r\n\r\n
Third, we have been redeveloping our polyclinics to meet the challenges of an ageing population. Over \r\n\r\n\r\n\r\nthe past five years, we have upgraded eight polyclinics, including Woodlands, Bukit Batok, Pasir Ris and Hougang Polyclinics. As Assoc. Prof. Fatimah Lateef put it, strengthening primary care is important. Several MPs toured the upgraded Pasir Ris Polyclinic recently. The upgraded polyclinics are now paperless, fully computerised. They are film-less with tele-radiology services. X-rays are being read in India by US Board-certified radiologists and returned within half an hour. They are scriptless, that is no more paper prescription, with e-prescription (electronic prescription) capability. They are also piloting tele-ophthalmology to cut down unnecessary referrals to the hospital ophthalmologist. The use of technology – a point that Mdm Cynthia Phua mentioned just now – all those are happening in our upgraded polyclinics.
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They are also multi-disciplinary, no longer just doctors, nurses and patients, but with advanced practice nurses, clinical pharmacists, podiatrists and clinical psychologists providing consultations, side by side with family physicians. Patients with chronic diseases are given clinic appointments for their regular follow-ups. It is no longer just simply walk-in. This has cut down their waiting time for those with appointments.
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In other words, our polyclinics are no longer like in \r\n\r\n
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\r\n\r\nthe past and that is why I have arranged some MPs to visit them so that they do not live with the image of the polyclinics of the past.\r\n\r\n\r\n\r\n
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One patient emailed me last month, pleasantly surprised by the transformation. I quote him: \"I visited the Marine Parade Polyclinic. The service was fast, friendly and efficient. The time from registration to payment was less than half an hour, a far cry from the days when a visit to the polyclinic was a two-hour affair\". I know that waiting remains a problem in polyclinics for walk-in patients without any appointments. But for those with appointments, waiting is now manageable. We will continue to upgrade the other polyclinics. Over the next five years, Ang Mo Kio, Bedok, Geylang, Tampines and Yishun Polyclinics will benefit from this polyclinic redevelopment programme. This will cost us $50 million. For the rapidly expanding population in Punggol, we are also planning a new polyclinic in that town. This will help relieve Sengkang Polyclinic.
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Fourth, we will transform long-term care like community care hospitals, nursing homes, day rehabilitation and home health care, which many MPs spoke about. Done well, this will particularly benefit the elderly with chronic diseases. The objective is to help them manage the disease well, so that they can have a good quality of life. Transforming long-term care is our top priority in the next decade. We will sharpen our focus on geriatric care. We will equip all our doctors, nurses and allied health professionals with knowledge of geriatric medicine as a core competency. Of course, the healthcare professionals must also acquire the soft skills to understand the needs and concerns of the elderly patients in order to deliver better care, as Mr Ang Mong Seng pointed out just now.
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\r\n\r\nWe have begun preparations to set up a Geriatric Education and Research Institute this year to develop, coordinate and implement various initiatives to strengthen geriatric education and research. We will develop integrated care pathways starting with five groups of patients with hip fractures, stroke, heart failure, COPD and diabetes. By standardising critical elements of care and defined clinical indicators, these integrated care pathways will enable patients to transit smoothly from one healthcare provider to another across the care continuum. This is what I meant by a \"hassle-free healthcare system\". This is also the sort of preferred outcome that Mdm Halimah spoke about just now. Truly integrated care.
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Our AIC – the Agency for Integrated Care is just one year old, but it is already making impact in the long-term care sector. They are doing what Dr Lam described as supportive services to facilitate care in the community. To give an example, AIC stations teams of what we call Aged Care TransitION (ACTION) care coordinators in hospitals to help patients with complex needs transit smoothly from the hospital back into their homes and communities. Their services include helping the patients to arrange relevant community services for the patient and their caregivers. They have already touched the lives of over 10,000 patients. \"Hassle-free\", \"integrated care\", \"clinical pathways\" are abstract technical terms. But when translated into actual actions on the ground, they make a world of difference for the patients and their families.
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Just ask Mdm Samsiah Saifi. Her husband suffered a stroke, became paralysed and bedridden. Overnight, she became both sole breadwinner and sole caregiver. She was at her wits' end. Her ACTION care coordinator from NUH slowly coached her on the appropriate \r\n\r\n
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\r\n\r\nhomecare services that her husband will need and followed up by visiting her husband to check on his condition and medication. Mdm Saifi has her handphone number to consult round the clock. This has given her confidence and peace of mind. AIC has brought cheer back to her life and that of her family. With AIC, there are now many such success stories. We are scaling up AIC operations nationwide to benefit even more patients.\r\n\r\n\r\n\r\n
One primary objective is to help Singaporeans avoid unnecessary hospitalisation. For example, old folks falling resulting in emergency hospital admission are common stories. You avoid falls, you avoid hospitalisation. Tan Tock Seng Hospital (TTSH) works closely with the elderly in the community to assess or measure what is your risk of falling and then pick up the high-risk group, coach them to help them improve their balance because it is a skill that can be coached. As a result, admissions to hospitals by this group of elderly come down.
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Every day, some seniors in some nursing homes will develop some complications. Without resident geriatricians, the only recourse is to call for an ambulance to send them to A&E. Khoo Teck Puat Hospital (KTPH) works with St Joseph’s Home on tele-consultation, so that the nursing home can consult the Khoo Teck Puat Hospital's geriatrician, over the Internet, before they call the ambulance. Not all admissions are necessary and timely advice from the hospital geriatrician is often what is needed. Patients, doctors, nursing homes and hospitals’ A&Es save time as a result. Everyone benefits.
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For our healthy elderly who are living at home, we want to help them stay active within the community. Some eventually may suffer from age-related functional decline. In particular, mobility\r\n\r\n
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\r\n\r\ncan become a problem. It raises the risk of falls and the need for greater caregiver support. A simple mobility device like a walking frame or a wheelchair can make a difference. But VWOs have told us that some of their clients cannot afford such devices. They cannot pay, so they make do with umbrellas. But umbrellas are lousy substitutes, so they still fall. The VWOs raise funds to help them pay for those walking frames and wheelchairs. What they can do is limited by how much they can collect from public donations. That is why we are setting up the Senior’s Mobility Fund and we will put in $10 million for a start. The objective is to help the VWOs reach out to more such low-income elderly and provide them with basic mobility devices. There will, of course, be some means-testing, needs-assessment and some co-payment. All these will be done by the VWOs. This way, we allow greater flexibility and responsiveness in adapting the scheme to local needs. For example, there may also be cases where some sort of transport assistance to help seniors go for their regular rehabilitation exercises may be greatly beneficial. The desired outcome is to enable the elderly achieve independence so that they can move around with greater ease to perform necessary tasks like getting to their day rehabilitation exercises or simply just going downstairs to the void deck or to the coffee shop.\r\n\r\n\r\n\r\n
Transforming our long-term care includes transforming our nursing homes. One significant step is our Nursing Home Development Programme to build new nursing homes in HDB towns. I have discussed this before, including on how to raise their rehabilitative capabilities to help their patients get well and go home. In other words, as Mr Ang Mong Seng put it, to regain their ability in a nursing home and not an old folks’ home. I will, in due course, try to explain in Mandarin the difference between the two.
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\r\n\r\nSuch improved outcomes also require us to transform our home healthcare sector. Ms Ellen Lee, Dr Lam and several MPs stressed this point. This means putting in place supportive structures and services in the community. We are ramping up the Home Nursing Foundation (HNF). They now have nurses in TTSH to connect up with patients about to be discharged to ensure a smooth handover for patients who are likely to require home healthcare. Once the patient is home, HNF coordinates with other providers to meet the patient’s care needs in the community. There are now over 300 patients under their care. We will expand this programme to the other regions so that more Singaporeans can benefit from home care. But it is not just HNF, we will similarly support other VWOs like Touch Community Services and other providers such as NTUC ElderCare to expand home care.
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For home and community care to work, I agree with Members on the central role of the caregivers. They are the unsung heroes and heroines, making huge personal sacrifices, whether out of love, filial piety or simply plain human decency. My Ministry will do all we can to support them with skills training, counselling, psychological support, and sometimes just a shoulder to cry on.
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Dr Lam asked about caregiver allowance. Obviously, this goes beyond my Ministry’s purview. Minister Lim Boon Heng has addressed this point a few days ago. Let me give you my personal take on this issue. I believe paying caregivers to provide care-giving is an insult. It cheapens the sacrifice that they are making. If you believe in this cause, the whole society ought to be supportive. We have our fair share of and we have met some of these dedicated caregivers. When we see them and to help them, me and my grassroots leaders, we simply take money out of our own pockets, or to periodically top up the Welfare Fund. Or, \r\n\r\n
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\r\n\r\nit may be within our clan, our own extended family. In my own extended family, I have a handful of those very dedicated caregivers who sacrificed their lives, sometimes staying single in order to look after somebody that they love. Chinese New Year, we distribute ang pows, I give extra big ang pows for those people. Not to say, \"this is your allowance or your bonus\", but to say, \"thank you for being a kind person and sorry that I cannot be with you shoulder to shoulder to help look after this relative\". I think that is how we should address this whole issue of supporting caregivers as a society.\r\n\r\n\r\n\r\n
Fifth, we will step up efforts to help Singaporeans stay healthy. As stressed by Dr Lam, this is ultimately the most basic strategy: Singaporeans must take ownership of their own health, and embrace a healthy lifestyle. We have increased the budget for the Health Promotion Board to $120 million. They will find creative ways to promote the healthy lifestyle message and to involve the community extensively. Taking Senior Minister Goh’s advice, we will shift the National Healthy Lifestyle Campaign from being top-down to a more ground-up initiative. Soon we will be coming to the MPs to seek your support and active involvement to help us achieve this breakthrough.
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A healthy lifestyle includes a habit to go for regular health checks. Last month, the Academy of Medicine published very useful guidelines on what to screen. My Ministry has accepted the guidelines in full. It will help Singaporeans, in consultation with their General Practitioners (GPs) to choose the appropriate health screening tests that they should undergo given their age and individual risk profile.
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Among the guidelines, there are two relatively costly items: colonoscopy and \r\n\r\n
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\r\n\r\nmammogram. I agree with Dr Lam that we should make these tests affordable through Medisave. Dr Lily Neo and Mdm Halimah made a similar call for mammograms before. I agree with them. We will extend Medisave, within withdrawal limits, to cover mammograms for breast cancer screening in women aged 50 and above, and colonoscopies for colorectal cancer screening for persons aged 50 and above. We will get this implemented as soon as we can make the necessary changes to the computer programmes.\r\n\r\n\r\n\r\n
Sixth, we will strongly involve the community on healthcare issues. There are several aspects to it. Keeping Singaporeans healthy requires the community to collectively keep the environment clean. Peer support helps to sustain a healthy lifestyle among all Singaporeans. Fighting viruses requires a united community response.
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Our society is built on meritocracy and equal opportunities for all. But some will do much better than others. The more successful, in turn, help the less fortunate. That is how philanthropy underpins social bonding and unites people as one. Hence, the Chinese saying \"滴水之恩，当涌泉相报\" (di shui zhi en, dang yong quan xiang bao), to exhort people to pay it forward in society when able to do so.
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Our migrant forefathers walked such talk. For example, in healthcare, the late Mr Tan Tock Seng and Mr Lee Kong Chian left behind their philanthropist legacies in the Tan Tock Seng Hospital and the Lee Kong Chian Medical School. They were the eminent philanthropists of the last century.
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In the US, Bill Gates and Warren Buffet are spearheading a modern version of philanthropy by pledging at least half of\r\n\r\n
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\r\n\r\ntheir fortune to charity. At least 40 billionaires have joined their cause. Their efforts are softening the \"winners take all\" capitalist model. The American system has always had philanthropists who supported their top universities and their top hospitals. What is different this time is that they are parting with their fortune while they are still alive. As Mr Michael Bloomberg, one of the 40 billionaires, put it, I quote: \"You don't have to wait to die to give it away. It never made a lot of sense to me why you'd want to change the world for the better and not be around to see it.\"\r\n\r\n\r\n\r\n
Several years ago, the family of the late Tan Sri Khoo Teck Puat indicated that they would like to donate to the healthcare sector. I suggested that they consider supporting the new hospital which we were then building in Yishun. They readily responded with a generous donation of $125 million. Tan Sri Khoo was an eminent philanthropist of this century and deserved the recognition when we named the new hospital at Yishun after him. There are other eminent philanthropists. I am happy to inform this House that the family of the late Mr Ng Teng Fong has decided to donate $125 million towards the new hospital in Jurong. That is a big boost to our efforts to provide high quality healthcare for Singaporeans living in the west. And in recognition of the significant donation, we will name it Ng Teng Fong Hospital. Both are Government hospitals fully funded by the Government. But the private donations provide additional assistance to needy patients, besides funding other worthy services.
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In similar spirit, through the $1 billion Community Silver Trust, we hope to inspire successful Singaporeans to come forward to co-develop our long-term care sector. This sector has always been served by the VWOs with passion and compassion. But for the next stage of development, we need to inject more \r\n\r\n
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\r\n\r\nfunds, more skills, more resources, more diversity to help raise capabilities and make them world-class. By matching donations, we preserve the legacy of the long-term care sector being driven largely by VWOs and the community. I think it will be wrong if we move in in a big way and displace the VWOs. By matching public donations, we hope to attract larger donations into this relatively less glamorous sector.\r\n\r\n\r\n\r\n
Community support does not merely come in the form of financial donations. Many Singaporeans have been volunteering their services in the hospitals. For example, a team of volunteers has been nursing the roof-top garden at Khoo Teck Puat Hospital, contributing their labour and expertise every day. I go there quite often, different time of the day, sometimes at noon. I see them sweating away like farmers. And when I spoke to them, they said, wo men zuo de hen kai xin (我们做得很开心) or we are so happy doing it. Why? Because they know that the harvests go to benefit the patients in the wards. We will continue to encourage and support such community spirit.
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Finally, our commitment to continue ensuring that healthcare remains affordable for all Singaporeans is firm. Our 3Ms framework – Medisave, MediShield and Medifund – is time-tested. It is an important supplement to the Government subsidy framework which is the main financier of inpatient care. This year's Budget will put nearly $7 billion into healthcare – $4 billion in MOH budget and $3 billion in the various top-ups to help Singaporeans pay their medical bills. This has enabled us to help more needy Singaporeans and we will also continue to enhance our 3Ms. In the new financial year:
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(i) We will increase Medifund budget allocation to $85 million, from $80 million to help more subsidised patients;
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\r\n (ii) We will double the Medication Assistance Fund (MAF) to $20 million, to help needy patients pay for expensive drugs. MAF will be extended to cover six more drugs – I cannot even pronounce their names – they are drugs to treat heart diseases, breast cancer and non-Hodgkin's lymphoma;
\r\n (iii) We will double the subsidy cap for surgical implants to $1,000. I remember Mdm Halimah made this request last month. This will now cover up to 90% of all implants used in our public hospitals;
\r\n (iv) We will expand Medisave to cover outpatient treatment for two more diseases – dementia and bi-polar disorder - in addition to eight existing chronic diseases, making it a total of 10. And this should have covered practically all the major chronic diseases;
\r\n (v) We will expand the Primary Care Partnership Scheme (PCPS) that Mr Low mentioned just now, to cover all the 10 major chronic diseases. This will, as he put it, make it convenient for the elderly to receive subsidised care from the many participating GPs in their neighbourhood; and
\r\n (vi) We will also extend PCPS to cover two specialist dental procedures – root canal treatment and crowning.
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Before I conclude, let me briefly address some specific comments made by Members.
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Ms Ellen Lee asked whether we could run polyclinics 24 hours. I am not keen. The reason is there are only so few polyclinics but there are thousands of GPs outside. I think we should try to leverage on the network of the GPs through PCPS. I think that is a much more cost-effective solution.
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Dr Lam and Assoc. Prof. Straughan suggested that we incentivise healthy\r\n\r\n
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\r\n\r\nbehaviour, like health screening, giving credit for citizens who participate in health screening. We do subsidise such screening for the seniors. But I am not persuaded that we need to bribe them to do what is good for them.\r\n\r\n\r\n\r\n
Dr Lam had a question on utilisation of Medisave overseas. So far, only 58, less than 60, have withdrawn about $125,000 from their Medisave for the treatment in Malaysia. What is the benefit of the scheme when I introduced it? It is to widen choices, and I still believe in it. It widens choices but the low utilisation re-affirms the confidence that Singaporeans have in Singapore healthcare. And I think we should be proud of that.
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Dr Lam also asked about our preparedness for pandemics. We have now experienced two: SARS and H1N1. We did very well in both. But I agree with Dr Lam that we must never become complacent or arrogant. We must always be prepared for surprises. Our preparedness plans are multi-sectoral and they are regularly tested, reviewed, enhanced. The plan includes stockpiling pre-pandemic vaccines as soon as they become commercially available. For example, we have – I forgot the quantity – a lot of pre-pandemic H5N1. Remember bird flu? It is still around in the birds and, therefore, one day it may just jump species and there is a vaccine available. We spent quite a lot of money stockpiling it. Hopefully, we never have to use it. We have also secured new funds to support research in infectious diseases.
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Ms Sylvia Lim talked about Standard Drug List (SDL) and also osteoporosis. She asked a question before in the House which I had answered. The SDL is a list prepared by experts and chaired by the Director of Medical Services, and the professionals have various criteria. I outlined them previously in this House to \r\n\r\n
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\r\n\r\ndecide which drugs go in and which drugs should stay out. She talked about the SDL list, or what is called the Essential Drug List in Australia and some other countries. I want to clarify that the two are different. In many countries, with national health insurance system, the Essential Drug List is the list of drugs available. In other words, if a drug is on the list, only then will the insurers pay. If a drug is not on the list, you cannot even get the drug. Whereas our SDL is for the purpose of deciding on the degree of subsidy in public hospitals. So if a drug is not on the list, it does not mean the drug is not available. It is available, you can buy it from Guardian or even from our hospital pharmacies except that they have got to pay for it, without subsidy, that is all. So that is the reason why we did not think it necessary to make it a public document but there is nothing secretive about the list. If you ask any Government doctor, he will know what the list is. She mentioned that some doctors are ignorant about it. If it is private doctors, I suppose they ought to be ignorant because they do not work in public hospitals. Osteoporosis is something which I am not too familiar. I am not old enough yet, I suppose. But her concern is a real one, which is that with ageing, the incidents will grow and that women seem to be affected by osteoporosis more than men and, therefore, it is something that we should not take it lightly, and we do not. The Health Promotion Board is, in fact, in the midst of including the screening for osteoporosis in their integrated screening programme. They have piloted the screening programme, found it useful and they will now include it in this national integrated screening programme.\r\n\r\n\r\n\r\n
Assoc. Prof. Fatimah Lateef asked about our medical intake. The third Medical School is on track to take the first batch of students in 2013. Together with the other medical schools, they will train at a steady state of about 500 doctors annually. That is not a small number. \r\n\r\n
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\r\n\r\nSupplemented by some foreign graduates, that should be adequate for our needs. Current efforts have already improved our doctor to population ratio of 1:580, which is quite good. But I agree with her that ill distribution among specialties is a bigger challenge and we must address that. Meanwhile, the public hospitals' Pre-Employment Grant for Singaporean medical students overseas in their final years of study has been very well received. From the UK, more than 30 Singaporean students studying there have committed to come back under this scheme. I expect even a bigger number from those studying in Australia and their applications are being processed.\r\n\r\n\r\n\r\n
5.15 pm
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Mr Low Thia Khiang talked about PCPS and found it a useful scheme. I think he commended on it that it is convenient for the patients, etc. But he asked whether we could review the criteria to make it less stringent. We designed this scheme for the seniors and that is why we pegged it at 65 and above. Should we reduce the age? Offhand, I say \"no\" because we are living longer, beyond age 65, and we are promoting re-employment all the way to 65.
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But at the margin, we can allow for discretionary power when we assess the applicants, whether to put them onto the PCPS scheme. He has an interesting suggestion, which is, why can we not have subsidy which is tiered, instead of a common subsidy. I am not keen because the current subsidy is already quite heavy, so I do not know how much more tiering can we do.
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On end-of-life care, he mentioned the Economist Intelligence Unit (EIU) – Quality of Death Report. I thought I discussed this in this House before and explained the ranking. It was quite a good ranking – 18 out of a whole list of many countries. But if you look at the list of countries which are ranked, I myself consider the \r\n\r\n
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\r\n\r\nassessment fair because of the efforts we have put in the last few years. If we were to be rated five years ago, I think our ranking would be poorer. But at No.18, we are No. 2 in Asia. And the reason for the lower ranking vis-a-vis, say, some European countries like Belgium has nothing to do with being first-world or third-world, but it has to do with the degree of ageing of the society. We are still a very young society as compared to Europe. Relatively, Europe is rather old and because it is older, their facilities for providing and looking after end of life care would be much better developed. But our ageing is coming on strongly, definitely in 10 years' time, so we have started the planning exercises five to 10 years ago. I am quite sure, in five years' time, if EIU were to do a similar assessment, our ranking will further improve. I am confident about that one.\r\n\r\n\r\n\r\n
But I take his point that end-of-life care is a very important topic in healthcare. I spend time thinking about it all the time because this is the last stage of one's life. You really want everyone to part not just with peace of mind, but gracefully, with dignity. And I think, as a society, we should do our best to do so. And do not just look to the Government to be the provider because that will always be a sub-optimal solution.
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I was just reading an interview given by Harvard Professor Clayton Christensen to Forbes Magazine and he was talking about how he looked after his dying father. He just dropped everything he was doing and spent time with him. And he told the Forbes interviewer \"that was the best period of my life\". Reading it reminded myself of my mother. She died of ovarian cancer many years ago when I was the Permanent Secretary in the Ministry of Trade and Industry. After doing all the necessary surgery, chemotherapy, etc, my eldest brother who lives in Canada – he has been living in Canada for many years – did what \r\n\r\n
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\r\n\r\nProfessor Clayton did. He just dropped everything, came home to Penang and looked after my mother. I often look back and think, how I wish I could have done the same thing too. That is what end-of-life care is all about. As a Ministry, we will do all we can to support end-of-life care as much as we can. The important thing is, as I have said earlier, do not, without wisdom, mindlessly port in all the American practices, wrong practices of aggressive treatment and putting the terminally-ill in costly acute hospitals, subjecting them to all sorts of pain and sufferings, with zero improvement in quality of care, if anything, just introducing harm and sufferings.\r\n\r\n\r\n\r\n
Assoc. Prof. Fatimah Lateef and Dr Lam Pin Min asked if Medisave or MediShield can be extended to cover congenital diseases. I am sympathetic to this request, but I am not ready yet to reform MediShield. When we do, I intend to extend it to cover congenital illnesses and also mental illness. The key is how to do it in a way to make sure that the premiums remain affordable. And that is the challenge. I think we will find creative solutions to that.
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Mdm Halimah asked about Medisave 300, whether we can raise this cap of 300 to a higher level. Of course, the cap is not cast in stone and we will review it periodically. An immediate adjustment is not necessary because the vast majority of patients do not have difficulty with the cap. Do not forget this is the cap per account. So, if a patient has several children, it is 300 times whichever number of Medisave Accounts. She asked about the adequacy of the Medisave minimum required amount. That is a figure that we adjust periodically to take into account medical inflation. The recent increase in Medisave contribution rate of 0.5%, I am quite sure, will help many \r\n\r\n
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\r\n\r\nmore members to achieve higher savings later on.\r\n\r\n\r\n\r\n
I think I have addressed all the cuts submitted by Members. There were a few cuts on obesity, and so on, which we will tackle in the later part of the day.
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Madam, in the last five years, we have made a lot of progress – it was making our healthcare system better. In independent surveys, our patients rated our public hospitals and polyclinics as either \"good\" or \"very good\". Three in four rated them as \"excellent value for money\". Many foreign experts have studied and praised our healthcare system. But we must press on with reforms, underpinned by wisdom and realism, and a generous dose of humanity. If we stay the course, in another five years, Singapore healthcare will be even better than today. I thank Members for their continuous support for my Ministry.
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Mental health
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Mdm Cynthia Phua: Madam, mental healthcare has always been costly and medical treatment has to be given on a long-term basis. Low and mid-range income groups who are caring for mentally-ill family members would need financial assistance to cope with the long-term medical care, especially when the family members are not working. Many a time, within the family, there are many mental patients as well.\r\n\r\n
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Last October, we raised this issue in Parliament. I wish to take this opportunity to request for more funds to be allocated to management of their welfare. We need to address the needs of the patients who are recovering from mental illness or whose illness is under control. We really need more day care and rehabilitative facilities at the community and the number and sufficiency would entail the Ministry to do an in-depth study for these mental patients. Alternatively, could the \r\n\r\n
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\r\n\r\nMinister set aside funding to support VWOs who provide such services and to help them set up such centres? Funding will need to go into training volunteers and subsidising these facilities for needy families. I look forward to the Minister’s support for more of these day care centres.\r\n\r\n
\r\n The real issue on the ground and the community is that many do not know the condition of mental illness. More education and engagement of the families and the community need to be done. Just recently, there is an article by the Straits Times on the good work done by a psychiatrist from Australia. He mentioned that if the mental patient can be detected early and given the right treatment, they would be able to recover. However in our society, mental illness is still being stigmatised and many people may know but refuse to do treatment early. The Ministry needs to work with the schools and universities for early detection.
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In the community, we came across many new cases where family could not manage to persuade the patient to have early treatment, resulting in nuisances being caused to the neighbourhood and the patient himself who suffers the mental illness. The present law does not allow the Ministry to do direct intervention of bringing new mental patient for treatment. As a result, the community suffers. Recently, it took me a while to persuade the Police to help the Residents’ Committee members, with the support of the family, to bring a resident who had been causing stress to his fellow block of residents to IMH for treatment. Basically, he switched on the radio at full blast 24 hours of the day.
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The hotline mobile team of IMH will only respond if the person is a known patient of IMH. I would like to urge the Ministry to look into the need to amend the necessary law and allow the Ministry personnel for direct intervention to bring \r\n\r\n
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\r\n\r\nnew mental patients for treatment; if not, the community would be even more disturbed and stressed. \r\n
Mr Sin Boon Ann: Madam, mental health problems still hold some stigma in the society and will prevent patients from seeking help and professional advice early and impede their re-integration into the workforce and community after treatment.\r\n\r\n
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I would like to ask the Minister about the progress we have made with our present framework to educate, identify and treat Singaporeans with mental health problems, including milder ones, such as depression and mood swings. Would the Minister also share with us the programmes to prepare and re-integrate patients into mainstream society?
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Another area of concern in a rapidly ageing population, as data from other countries has indicated is that longevity does not guarantee good health or mental health. We must be prepared for cases of elderly dementia and other mental health problems which afflict the elderly. Do we have enough professionals and facilities to cope with this unexpected trend?
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Healthy Singaporeans
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Ms Ellen Lee: Madam, I want to talk on the topic of Healthy Singaporeans – what programmes are available to help Singaporeans cope with close relatives or neighbours who suffer from psychiatric morbidity?\r\n\r\n
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Madam, I have spoken on this topic before, on the rising number of Singaporeans (both young and old) affected by some form of mental illness. The problem does not seem to have reduced in spite of greater awareness being generated. The increasingly hectic and fast paced life in Singapore has been impacting Singaporeans in many ways, notably emotionally, physically and mentally. Even people who look sane and \r\n\r\n
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\r\n\r\n\r\nsound reasonable may be undergoing some stress, but they are not revealing or seeking help as nobody wants to see a shrink or be seen with one.\r\n\r\n\r\n\r\n
Many people in Singapore suffering from psychiatric problems are still severely disadvantaged in the quantity and quality of care available to them. There is not much understanding and regard given to their rights and needs. And these are, often times, due to family members not wanting to admit that one of their members may need psychiatric help or treatment. The problem extends to their caregivers, close relatives including neighbours, as they are affected directly or indirectly by those who suffer from psychiatric morbidity within their close physical proximity. The stresses and pains of these caregivers and neighbours, especially those living in the heartlands and high-rise buildings, often go unrecognised and are, therefore, untreated or unmanaged. As a result, families have broken up and neighbours' disputes are on the increase.
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Appropriate referrals to psychological services, professional help and timely intervention are imperative to ensure those requiring help are identified and addressed. Would the Ministry consider enhancing and provide higher funding for current programmes? Would it be possible to rally institutions such as the HDB, NEA (in relation to noise pollution), Town Councils, grassroots organisations, professional medical help and counsellors to assist such vulnerable groups of people? If the general public, caregivers and community groups are sufficiently aware of households struggling with a member of the family, relative or neighbour who suffers from psychiatric problems, they could be advised on constructive ways to manage the person’s condition in a constructive manner and be linked to support services at the same time. \r\n\r\n
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\r\n\r\nMadam, given that there is an increasing trend, we should act quickly.\r\n
Mental health providers
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Mr Chiam See Tong: Children and adults with special needs deserve better protection. It will reduce the anxiety of both caregivers and patients with special needs, like the mentally-ill and autistic children. I urge the Government to issue special I-cards to these patients.\r\n
It can be an electronic chip that stores confidential information about the patient's illness, special needs, contact and details of primary caregivers and the organisation that issues the card. Such a special identity card should also reduce the workload of the Police, the court and other parties that are involved in any offences that are committed. Making an arrest especially is a challenge.
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5.30 pm
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Parents with special needs children
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Mr Laurence Wee Yoke Thong (Nominated Member): Madam, I thank the Minister for informing the House of the new improvements to our already excellent healthcare system. \r\n\r\n
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Madam, it is natural for parents to be very anxious and concerned when their young are not developing normally. Their fears, most times, are unfounded, hopefully, but sometimes they become a reality. One example, a mother whose child, now 22 months old, was later diagnosed with a Global Developmentally Delayed (GDD) syndrome. When she first brought her son for medical attention, the paediatrician, after examination, reassured her then that her son's condition is temporary and the child will soon outgrow the system. However, as the days went by, her instincts and suspicions became stronger since, as a reference point, she based her son's behaviour vis-a-vis the older brother – a typical child. Remember \r\n\r\n
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\r\n\r\nthe saying \"parents are the children's first teachers\". After seeking proper assessment and diagnosis by the psychologist, her fears were confirmed. \r\n\r\n\r\n\r\n
Point number one: may I suggest to the Minister that medical personnel in contact with parents should pay careful attention to what the clientele are saying. Though they may be laypersons, the service should be friendly-centric as far as possible. I think this is more of an enforcement issue rather than policy as I see it.
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Point number two: to help parents make informed decisions, frontline medical personnel should be more aware of the different types of services available so as to provide timely, appropriate advice to parents. Otherwise, they have to do their own homework, going around asking for information or going to the Internet to search, especially now with the current situation of intake of more foreign doctors in our healthcare service system. In this way, we are, first, enabling our parents; and, two, empowering them to be their own advocate for their children's well-being at the end of the day.
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In conclusion, however, may I place on record the good work and progress of our national healthcare system in addressing the numerous issues and challenges as it strives to make Singapore a hub of excellence for a world-class healthcare system.
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Traditional Chinese Medicine
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Ms Ellen Lee: Madam, I would like to touch on the topic of Traditional Chinese Medicine (TCM) and about extending TCM to all polyclinics. There is now even greater awareness of the usefulness of Traditional Chinese Medicine and its unabated use is evident in Singapore. With more robust legislation and greater professionalism of TCM practitioners, I am glad to see TCM clinics across our \r\n\r\n
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\r\n\r\nrestructured hospitals and polyclinics such as in Yishun. \r\n\r\n\r\n\r\n
I am asking the Minister if he would consider extending TCM clinics across all polyclinics. Many heartlanders, no longer just the elderly but younger people including non-Chinese, are embracing TCM and related services and acupuncture for their ailments. TCM services can be housed within our polyclinics so that strict codes of practice are adhered to, thus ensuring that there is quality service. It could also lower the costs for needy people in addition to providing accessibility. By the same token, perhaps selective use of Medisave monies for chronic illnesses management, such as rheumatism and arthritis, can also be extended to TCM.
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Mr Chan Soo Sen (In Mandarin): [For vernacular speech, please refer to Appendix A*.] This year marks the 10th year since we started the registration of Traditional Chinese Medicine (TCM) practitioners. Singapore is the only country other than China that legislates the registration of TCM practitioners. With the registration, there has been a significant improvement of professional standard and image of TCM practitioners. As a result, as my colleague Ms Ellen Lee mentioned, TCM has increased its popularity, with more and more Singaporeans seeking TCM treatment.\r\n\r\n
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Does the Ministry of Health have plans to further raise the standard of TCM practitioners and the quality of TCM practice in Singapore in the future? Are there plans to encourage our local universities and institutions to do more in terms of research and development of TCM?
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Recently, some TCM practitioners told me that due to the restrictions of the current legislations, TCM organisations could no longer offer Degree courses in TCM with overseas, mainly mainland \r\n
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\r\n\r\nChinese TCM universities. If this is the case, would there not be negative impact on our efforts to raise the standard of TCM practitioners in Singapore, as some TCM practitioners who intend to upgrade their professional standards will not be able to obtain a Bachelor Degree locally.\r\n\r\n\r\n\r\n\r\n\r\n
Another area of concern amongst the TCM circle in Singapore is whether the Government has any plans, at some point of time, to recognise the medical certificates issued by TCM practitioners, or to allow medical benefit claims to be extended to TCM treatment. As my colleague Ms Ellen Lee pointed out, are we going to recognise the medical care provided by TCM practitioners?
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To date, the Government's stand is that it depends on the policy of the respective employer. As the public sector is a major employer in Singapore, may I ask whether the public sector as an employer is willing to recognise the medical certificates issued by TCM practitioners and allow medical benefit claims for TCM treatment? If not now, then how about some time in the future when professional standards of TCM further improve?
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Mr Khaw Boon Wan: Madam, we launched the National Mental Health Blueprint in 2007. The Minister for Finance gave us very strong support, with $178 million invested so far. The key thrust is to strengthen and develop mental health services in the community. The two key words are: de-institutionalisation and de-stigmatisation. We are half way through the implementation, but some impact is already being felt on the ground. Recently, I met a group of psychiatrists. I asked them point blank how do they compare, how do they rate the current state of mental health as compared with, say, five years ago. They told me that the progress was significant as a result of the \r\n\r\n
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\r\n\r\nBlueprint but they added that we still have much to do. The situation, as described by Ms Ellen Lee and the others, confirms the psychiatrists' assessment that the cup is half-full. We will press on to top up the cup.\r\n\r\n\r\n\r\n
Mdm Cynthia Phua, Ms Ellen Lee, Mr Sin Boon Ann asked for more help, more services, more support for this programme and for the patients, and I agree with them. We will do more, we are doing more, a lot more will continue to happen over the next few years. The key is we need to detect patients early so that there is timely intervention. But to do so, we need to reduce the stigma surrounding mental illness so that the patients can be confident to come forward to be treated and, after receiving treatment, to integrate back into the community.
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Under the Blueprint, we have set up a series of multi-disciplinary community mental health teams to bring about early detection and to initiate treatment. They are organised under four different programmes, separately targeting children, youths, adults and the elderly. Each programme caters to a specific age group. The programmes are at different stages of implementation. By that I mean we have tried it out in small areas of Singapore and now, in the final stage, we want to bring it up nationwide. But the initial results are promising, improving quality of life for the patients and their families and, importantly, reduce their re-admissions to hospitals – usually IMH. We are scaling up the programmes nationwide.
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We certainly need to involve the community much more intimately. First, we are building up a community network to support the patients through neighbourhood social services, general practitioners (GPs), polyclinics and other care centres. Today, we have a GP Partnership network where stable patients are put on a shared-care programme with GP partners managing and providing \r\n\r\n
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\r\n\r\nfollow-up in the community. This way, patients do not have to go back to IMH and it is also much more convenient for them. There are nearly 50 GPs and more than 600 patients on the programme. We are also putting multi-disciplinary mental health intervention teams in the community. They will support the GPs to manage simpler cases as well as provide basic psychotherapy, counselling or case management. This is an area where we will always be short of physiatrists and the more we can train up and make use of allied health professionals to support the doctors the better it will be.\r\n\r\n\r\n\r\n
Second, we are strengthening the capabilities amongst the community organisations and social service providers to better manage the patients in the community. Training is being rolled out to equip staff with the right skill sets. So far, we have trained over 2,000 grassroots leaders and frontline staff in eldercare agencies. We have also put in place community support mechanisms such as helplines to link up patients with the appropriate services or resources they need. Mdm Cynthia Phua talked about the hotline in IMH currently serving essentially their discharged patients. The intent, certainly, is for such a national helpline to look after all patients, not necessary just ex-IMH patients.
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Third, we will help our patients pick up skills needed to return to the workforce so that they can achieve independence in the community. This is key. To avoid relapse, the better we are able to get them properly reintegrated back, the best chances of recovery for those patients. But to do so, I need the support of many more enlightened employers to provide job opportunities for these ex-patients. The Institute of Mental Health (IMH) has a \"Job Club\" which helps to support patients' reintegration to the workforce. Since its launch in 2009 – so that is less than two years – more than 550 patients have been successfully placed within the \r\n\r\n
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\r\n\r\nJob Club scheme. We certainly need more employers to come forward to help us. \r\n\r\n\r\n\r\n
For us, we will continue to provide the service providers with adequate funding. Recently, the Tote Board Community Healthcare Fund has pumped in an additional $15 million for us to push this programme. It is a very important boost to our efforts and I will always try my best to seek more funds to support this cause. My sense is this: that actually money is not the real bottleneck, but enlightened people, whether it is employers or family members or neighbours who are prepared to keep their minds open and to accept that this somebody – fellow Singaporeans, fellow human beings – let us give them a hand. If IMH decided that they can be returned to the community, it is safe. There is a wide spectrum of mental illness, not everyone and it is only a small number who may cause danger to themselves or to others, and those patients are all in IMH. Those that we released back to the community, they have stabilised. The key is we support them and, from the doctors' side, make sure that they take their medications.
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Mr Laurence Wee and Mr Chiam See Tong spoke up about a different subject of helping the parents of children with special needs. Children with development difficulties are prone to displaying difficult behaviour; aggression, disobedience or even engaging in dangerous activities, and it is a major, major source of stress for the parents and can even impact their mental health. All these can take a toll on family relationships and, often, parents are just at a loss of what to do. KKH and NUH have been conducting Parents' Forums for a long time for such parents. More recently, we have a new initiative which we are very proud of – KKH is partnering an Australian Parenting Research Centre to launch a training programme to equip parents to understand their child's difficult behaviour \r\n\r\n
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\r\n\r\nand develop their own ways to manage them effectively and prevent the further development of behavioural concerns. \r\n
This is a parenting support course, delivered through a network of qualified facilitators. The original programme in the state of Victoria, Australia, has been around for several years and has been very successful. We are bringing to Singapore, adapting it to local conditions. We hope we can achieve the same results as it did in Victoria. Here again, money was not an issue. We get the support of Temasek Care which is a foundation of Temasek Holdings. They pumped in money so that the course is heavily subsidised and parents will find the fees affordable.
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5.45 pm
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Ms Ellen Lee and Mr Chan Soo Sen spoke on TCM. As pointed out by Mr Chan, we have now 10 years of TCM regulation and we have made some progress in raising the standard of practice and training. Of course, there is scope to do much more. To me, the key question is this. Going forward, do we simply just copy what China is doing and then adapt it here? Or do we try to forge a niche role for ourselves in Singapore, given our different history and greater exposure to western medicine?
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I believe either approaches are sensible. The second approach is, of course, much more challenging but it also opens up new opportunities. Let me give some illustrations. For example, for western drugs, it is standard practice to report adverse events. Some patients may take the drugs and had some problems, and adverse events have to be reported to the Health Sciences Authority (HSA) routinely so that we collect those information, get them analysed and we can give proper advisory to the consuming public. But this is not done for Chinese herbs. \r\n\r\n
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\r\n\r\nLikewise, there could be adverse events as a result of taking Chinese herbs and western drugs. Are there adverse events as a result of the interaction between the two? If so, I think somebody, somewhere, need to know. There are really no such good resource centres, not even in China. \r\n\r\n\r\n\r\n
I have been discussing with HSA because of their expertise in western drugs and I have also discussed with the leadership of TCM recently. Can we not do something like this? We can develop a resource centre. It will not only be good for Singapore but it may become a very good resource centre for the region, or even for China. I think that is a possible niche role for us in TCM.
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Likewise, some of our western-trained doctors are very interested in TCM and I know they have started doing joint studies and clinical trials with TCM physicians. I know of a small group in SGH which has been doing similar studies for several months now, looking at diabetes because the Chinese have their own way of treating diabetes too. Of course, there are western ways of treating diabetes. We want to see, through such joint efforts, if TCM improves the effectiveness or outcomes. If we can subject those TCM practices to scientific scrutiny and then publish them in western medical journals, that would be of benefit to the world. Perhaps, this could be another niche area for Singapore.
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Over the next few years, I certainly hope the TCM leadership can think through these questions, and there could be other possibilities to help us determine the way going forward. If the TCM legislation needs to be amended to facilitate the next stage of TCM development, I would be happy to do so.
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But we must acknowledge the vast difference between TCM and western medicine, both in philosophy and in approach. They are two different things,\r\n\r\n
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\r\n\r\nalmost like two different religions. The different regulatory regimes reflect these differences. The global healthcare system is based on western medicine. TCM is considered as a complementary medicine, regulated to different benchmarks. A TCM physician is not regulated to the same extent as a western-trained doctor. A Chinese herb is not regulated to the same degree as a western drug. That is the reason why Medisave does not cover TCM and that is also the reason why many employers do not accept medical certificates (MCs) issued by TCM physicians. Whether this will change in the future will depend on how TCM intends to reform its practice and approach. In fact, it is also not obvious if TCM needs to or even if it wishes to, can reform and emulate the western medicine approach. China, for many years, has tried to integrate TCM and western medicine and has not found it easy. One professor in Nanjing TCM University, when I visited them, told me they tried and the result was liang bai ju shang (两败俱伤), that means both sides suffered when they tried to integrate east and west. Zuo bu lai ( 做不来), that is, they cannot do it. If you look at the outcome, there are many times more western-trained doctors in China than TCM-trained physicians.\r\n\r\n\r\n\r\n
Meanwhile, we will continue to raise their level of professional standards within the traditional TCM framework. TCM practitioners wishing to upgrade themselves with a degree have several options. The two local TCM colleges have partnered PRC TCM universities. Their Diploma graduates can go on to acquire a recognised PRC degree. The NTU also runs a double degree programme in Biomedical Science and Chinese Medicine course. I heard Mr Chan Soo Sen's comments just now. He might be mistaken. It is not as if the Diploma graduates of the local TCM school cannot continue to train and get a China university TCM. They can. It is no \r\n\r\n
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\r\n\r\ndifferent than say a nurse in Nanyang Polytechnic and with a twinning degree programme that we are now trying to set up through MOE, will finally get a degree from, say, the University of Manchester, or whatever. Likewise, it is the same thing here. What MOE does is to regulate which institution in Singapore can issue a Singapore Degree but for Diploma, that is a different story. They do facilitate the Diploma graduates from continuing on to get a foreign degree. That approach will continue.\r\n\r\n\r\n\r\n
Ms Ellen Lee noted the setting up of TCM clinics in many hospitals and asked if we should allow them to be set up in polyclinics. There are more than 1,000 TCM clinics in Singapore, mostly in HDB towns. I believe access to TCM clinics is not a major issue.
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Wellness-centric community health model
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Assoc. Prof. Fatimah Lateef: Madam, the incidence of lifestyle diseases continues to increase. Singaporeans must take ownership of their health. We need to do more to facilitate this, encourage more proactive health promotion and people coming forward for voluntary screening. Our infrastructure too has to support this. These are some of the ways and essential ingredients I would like to mention. First, a more proactive health promotion programme that increases awareness of health risk associated with certain personal behaviours. Two, patient-centric health management goals. Three, encouragement to have a single provider relationship where they can receive on-going education, primary care and advice on specialty care. Four, continued surveillance of health indicator factors.\r\n\r\n
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The most important step in all these is actually strengthening our primary care set-up with more seamless community care centres, integration across GPs and also family practitioners as well as polyclinics and more ambulatory care set-\r\n\r\n
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\r\n\r\nup in the community in the various areas. Can I know MOH's plan pertaining to this?\r\n
Rising obesity in Singapore
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Mr Sin Boon Ann: Madam, with growing affluence, rising obesity has also become a national problem. Other than the health risk for the individuals, there are other related problems such as healthcare expenses, loss in productivity and so on. Unfortunately, despite common knowledge about the impact of diet and lifestyle, the number of obese Singaporeans continues to increase. I would like to ask the Minister for an update on the Ministry's effort in dealing with rising obesity in Singapore and an account of its effectiveness in dealing with this issue in recent years. In terms of infrastructure, are we providing enough easy access to physical activities, spaces and safe walking trails? As more Singaporeans work longer hours, is there sufficient access to healthy cooked food in our many coffeeshops, hawker centres and food courts? Should we influence the eating habits and preferences of Singaporeans by limiting the number of advertisements in the media by fast-food chains?\r\n
Healthy lifestyle
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Mr Ong Ah Heng (Nee Soon Central) (In Mandarin): [For vernacular speech, please refer to Appendix A*.] Madam, we have now about 300,000 senior citizens aged 65 and above but by the year 2030, the number is expected to increase to 900,000. We need to ensure that our senior citizens stay active and healthy, and continue to contribute to our society. If they fail to reach this goal, we might see our senior citizens, say, 20% of them, ill and bedridden and it will require a lot of resources to take care of them. \r\n\r\n
\r\n There is a common belief that as we age, we should get less active and enjoy \r\n \r\n
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\r\n\r\n life. In reality, we cannot enjoy life as we age by becoming less active. I have known many cases of senior citizens such that when they retire from work, they also retire from life. I know this friend of mine who retired from work at the age of 55. All he did thereafter was to lie on the sofa and he even used the remote control to switch the channels. Now he is 72 years old and has suffered from dementia for almost 10 years!\r\n\r\n
\r\n Madam, our senior citizens must stay active, healthy, continue to contribute to society, and enjoy life. I would like to ask the Health Minister if there is a masterplan to help our senior citizens live longer and stay active.
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Workplace health
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Assoc. Prof. Fatimah Lateef: Madam, working adults spend a large portion of their time daily at their workplaces. It becomes an important area where healthy lifestyle and practices can be inculcated. Staff well-being is important as an organisation's loss of manpower hours, medical leave and inability to function optimally due to illnesses can have a negative impact on companies. The workplace has been established as one of the priority settings for health promotion in the 21st century according to the World Health Organization (WHO). Workplace directly influences physical, psychological, economic and social well-being of workers which, in turn, affects the health of their families, community and eventually society. A health promoting workplace can now become a pre-requisite for sustainable social and economic development. MOH has started a workplace health promotion grant. How many companies have taken this up? What is MOH's plan to enhance health at the workplace?\r\n
Mr Ong Ah Heng (In Mandarin): [For vernacular speech, please refer to \r\n
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\r\nAppendix A*.] Madam, the working adults spend more than half their waking hours at the workplace. The workplace is also where most people identify as the source of their stress.\r\n\r\n
\r\n A healthy staff is an asset to any organisation. This is a fact well-recognised by all companies. Bigger companies, which have more resources, would find it easier to implement workplace health programmes, sometimes together with our Health Promotion Board. However, I notice that this is not the case with the small and medium sized enterprises (SMEs). SMEs may not have the resources like the big companies to implement workplace health programmes for their workers.
\r\n The Health Promotion Board's website has listed a series of programmes designed to promote healthy living. Many of these can easily be adopted at the workplace.
\r\n A large proportion of our total workforce in Singapore is employed by SMEs. I would like to ask the Health Promotion Board whether there is any action plan to engage and incentivise SMEs to implement workplace health programmes.
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Mr Heng Chee How: Our population is ageing because of low fertility and rising longevity. With Singaporeans living longer, resources must be found to fund their additional years so that individuals can sustain their standard of living and quality of life.\r\n\r\n
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To enable Singaporeans to enjoy their added years and to minimise the delay of medical expenses, efforts in the community to help them age healthily have been stepped up. These efforts included, amongst others, the national Wellness Programme, the mass exercise platforms promoted under the Senior for Physical Activity (SPA) Committee and\r\n\r\n
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\r\n\r\nnumerous initiatives by the Ministry of Health and the Health Promotion Board.\r\n
6.00 pm
Madam, besides active ageing, a key part of sustaining a standard of living is to enable Singaporeans to work for more years. Here, I would like to make two observations about the growing importance of workplace health.
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First, many people are spending a significant amount of their waking hours at work. Second, many people are working more years. These two factors together mean that workplace health is a necessary and important second engine to complement and supplement community health efforts. There is a third factor to render workplace health even more important going forward. With the passing of re-employment legislation that will take effect from January 2012, companies will be legally obliged to re-employ workers beyond age 62 up to age 65. At the same time, we have an ongoing national drive towards higher productivity to enable real wages to rise sustainably in the coming decade. Employers will therefore be looking closely at the value add of every worker in this process. All these considerations mean that workers at large and older workers, in particular, must be better enabled to upgrade their employability and value at work.
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Employability is not only about skills, it is also about health and fitness to do the job. Hence, we need to further enhance our workplace health efforts to go upstream and beyond payment arrangements like portable medical benefits which are schemes that help answer the question of who pays when workers fall ill. We have to move upstream from those to encourage the regular systematic and sustainable adoption of workplace health. Put simply, we should be looking at introducing a \r\n
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\r\n\r\nwellness programme at the workplace as well to complement the one in the community. This is easier said than done and calls for much more resources and attention than just urging companies to come out and do a couple of activities and then to reward them on that basis.\r\n\r\n\r\n\r\n
If we were to take a leaf out of the Wellness Programme in the community, I would imagine that for the Wellness at Work programme, I would similarly need to build on certain key features such as, first, a systematic way to more intensively engage companies and educate them on the research benefits of effective workplace health, to incentivise companies to commit themselves to such programmes, to enable companies to make proper assessments of their workforce health needs while not jeopardising the workers' employment, so that they do not pick on particular workers in order to get rid of them for poor health.
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Madam, if I may just conclude quickly. I hope that MOH will take more measures in this area and make strategic use of workplace health as a productivity tool to be both pro-business and pro-worker.
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The Senior Parliamentary Secretary to the Minister for Health (Mr Hawazi Daipi): Madam, let me first thank Members for their contributions to this debate. Dr Lam Pin Min, Assoc. Prof. Fatimah Lateef, Assoc. Prof. Paulin Straughan and Mr Ong Ah Heng have all given useful suggestions on how to make our healthcare system more wellness centric and pro-health. Indeed, this shift to prevention has been one of the biggest health trends in the past decade. People are more empowered than ever before to take personal ownership over their health. Information on how to eat and live healthily is readily available. Just whip out a smart phone, or log onto the Internet and you will find \r\n\r\n
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\r\n\r\ndozens of applications to help you count your calories, track your exercise regime and even help you quit smoking.\r\n\r\n\r\n\r\n
Healthcare systems around the world are responding to these challenges. In Singapore, we are too. In Minister Khaw's speech, he has outlined wellness as one of the main priorities of MOH over the next few years. What this means is that our healthcare system should not only focus on taking care of the 10% of Singaporeans who fall sick but also ensuring that the 90% of Singaporeans who are well can continue to stay healthy.
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This is a significant shift. It will require fundamental changes in the way our healthcare institutions work. It will involve community partners coming together to champion health. Make no mistake about it. It will be a very difficult and uphill journey, but we should strive to succeed because if we do, it will mean that people will lead longer, fuller and healthier lives. In the final analysis, this is really what the Ministry of Health should aim to achieve for Singaporeans.
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This is why I was quite intrigued to learn about \"blue zones\". Blue zones are communities of people tucked away in different parts of the world who are living out the mantra \"live long, live well\". People there commonly lead active lives past the age of 100 years, with high levels of well being. One of the \"blue zones\" is Okinawa in Japan, which Dr Lily Neo has spoken about, and which Minister Khaw has visited. Another \"blue zone\" is Sardinia in Italy, which has one of the highest rates of centenarians in the world.
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Researchers have gone to study these \"blue zones\" and have come back with a list of common lifestyle characteristics from these areas. If you allow me to paraphrase, they include simple things like: keep moving, eat till you are 80% \r\n\r\n
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\r\n\r\nfull, put more vegetables in your diet, manage stress, surround yourself with supportive friends and belong in your community.\r\n\r\n\r\n\r\n
If these \"secrets\" sound familiar to all of us, they are in fact quite similar to some of the simple prevention messages that the Health Promotion Board (HPB) has been advocating: stay active, eat wisely and strive for positive mental well-being. However, the difference is that the people in the \"blue zones\" have made it a way of life.
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In Singapore, we know this is the hardest part. Many of us eat out and work late. I think some Members have alluded to this that we are working longer and we want to put more years into our working life. By the time we get home from work, we are too tired to exercise. This has led to more sedentary lifestyle and rising obesity as Dr Lam Pin Min and Mr Sin Boon Ann have pointed out.
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This was why we launched the National Healthy Lifestyle campaign in 1992. We introduced programmes to help Singaporeans make prevention a way of life. We are reaching the 20th year anniversary of the campaign now, and it is timely to do a stock take. The campaign has led to a greater awareness of healthy lifestyle among Singaporeans, but as Assoc. Prof. Fatimah Lateef has said, we need to do more to encourage proactive health promotion. The prevalence of obesity has increased to double digits, that is, 11% last year. If we do not do anything to arrest the increase, we will soon be plagued with an obesity epidemic and the associated chronic conditions, which would be a huge drain on our healthcare system, let alone at the personal, family level.
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The approach towards promoting healthy lifestyles amongst Singaporeans has been largely top-down thus far. To successfully move towards a wellness \r\n\r\n
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\r\n\r\ncentric healthcare system, we will need a more ground-up approach as articulated by Minister Khaw.\r\n\r\n\r\n\r\n
This is what they do in the \"blue zones\": rely on social capital to live long and live well. They surround themselves with supportive friends and community. In Okinawa, they have what they call \"moais\" – groups of five friends committed to each other for life. Many of these social circles support healthy behaviour which can be equally, if not more, \"contagious\" than obesity and smoking.
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The other thing about the \"blue zones\" is that communities work out what makes best sense to them. The communities have different diets, different ways of managing stress. The Sardinians, for example, manage stress by gathering in the streets to laugh with each other. The Okinawans like to do gardening. They recognise that different things work for different people.
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In a similar way, we need to find out what works for us. Members have raised some suggestions. Assoc. Prof. Fatimah Lateef has urged more health promotion programmes to increase awareness of health risks associated with certain personal behaviour. Mr Ong Ah Heng has asked if more can be done to engage our well developed and well connected grassroots organisations and networks to nudge us toward better health behaviour. I agree with these suggestions. We should find ways to better empower the individuals to take ownership of health, and leverage on the power of social capital in our communities, or what we call our \"kampung spirit \". We need to inspire Singaporeans to health. From there a movement will emerge with a natural momentum. We are hopeful.
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The National Healthy Lifestyle Campaign will be remade to support this. Together, we will build a new health \r\n\r\n
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\r\n\r\npromotion model, with a ground-up approach supported by all Singaporeans. In reply to Dr Lam Pin Min and Mr Sin Boon Ann, we will also make obesity the focus of the campaign. MOH and HPB will work with grassroots leaders to co-create a model of health that works for each community and which targets obesity. We will provide the expertise, tools and training to develop a team of Health Champions in each constituency, who will then act as agents of change to champion healthy living. The analogy I would use is that we are handing Singaporeans the keys to health and together, we will open the door.\r\n\r\n\r\n\r\n
I know of one of these Health Champions, Mohamad Hashim Mohamad Shah, the Chairman of Marsiling Malay Activity Executive Committee, who has started his own journey. Before becoming a Health Champion, he weighed 91 kg. However, after a year of exercising and adopting a healthier diet, he now weighs 83 kg! Seeing the benefits of his efforts, together with seven other Health Champions in the constituency, they have formed a health interest group with about 80 residents in Marsiling. Having learned about elements of chronic illnesses and how to be effective health advocates from the HPB, they each reach out to 10 residents. That is why they are called \"Ketua Sepuluh \" (Leaders of 10) because each one of them reached out to a group of 10 residents. The health interest group meets every month to share tips on healthy cooking and weight management. Many of them go for brisk walks every weekend, while others take up aerobics, cycling or swimming. Some ladies who did not learn swimming at an earlier age are now learning to swim which is encouraging. The Champions are not stopping there. They intend to grow the interest group to 200 people. In fact, there is also a pipeline of residents being trained to become Health Champions. \r\n\r\n
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\r\n\r\nHPB provides the expert guidance and North West Community Development Council helps to coordinate the Health Champions Network in Sembawang GRC and Nee Soon Central and Nee Soon East SMC. I applaud the Health Champions for the efforts to start their own \"blue zones\" and hope others can also share their enthusiasm and keep the momentum going.\r\n\r\n\r\n\r\n
From Health Champions, we move to activities. Activities tailored to the needs of the local community will be developed, and include Healthy Cooking Demonstrations and physical activity programmes like community aerobics and qigong. Non-traditional stakeholders will also be roped in. For example, childcare centres and schools will be engaged to roll out programmes like \"Walk-to-school with Kids\". Shopping malls will also be encouraged to implement health promoting initiatives for shoppers. One of these initiatives is \"Mall Walks\" where Singaporeans can do brisk walking and other exercises in a safe and weather-proof setting. Well, we did that when we launched the last National Healthy Lifestyle Campaign led by Senior Minister Goh and we thought that walking together in a shopping mall was quite fun.
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A prototype of this new \"ground-up\" National Healthy Lifestyle model has already started in the Southwest CDC District. Here, the Health Promotion Board and National Environment Agency (NEA) are partnering with Yuhua Hawkers Association to engage hawkers on using healthier ingredients like whole-grain noodles, brown rice and healthier oil. Other prototypes in Northwest CDC and Sembawang GRC are in the works; they will develop their own unique arrangements. I believe when Nee Soon GRC is formed after the GE, they will also be included in the programme. Where best practices emerge, we will see if we can work for the rest of Singapore. We hope to gain a natural momentum that will lead\r\n\r\n
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\r\n\r\nto other such initiatives being rolled out across the island.\r\n\r\n\r\n\r\n
Let me now talk about workplace health. This movement towards health has another important setting – the workplace. As Assoc. Prof. Fatimah Lateef, Mr Ong Ah Heng and Mr Heng Chee How have pointed out, the workplace is an ideal place to promote wellness and good health practices, since working Singaporeans spend a significant portion of their time at the workplace. But it is not just about being pro-health, it is also about being pro-business and pro-worker.
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I agree with Assoc. Prof. Fatimah Lateef and Mr Heng that workplace health is intricately tied to productivity. Better health means better effectiveness on the job, more alert employees, lower absenteeism and overall improvements in workforce morale and engagement. For employers who want to promote workplace health, it must make business sense, and it does.
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6.15 pm
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Many organisations have effectively created health-oriented work cultures. In the US, Kaiser Permanente, a leading healthcare group, eliminated trans-fats from its patient menus, employee cafeterias, and vending machines in 2008 to protect its patients and employees from the risk of coronary heart diseases. In Singapore, some of our hospitals have also made healthier foods cheaper. The Austrian Health Minister, whom Mr Khaw talked about earlier, recently visited the Khoo Teck Puat Hospital and was impressed by how health promotion was built into the design and workings of the hospital. They were pleasantly surprised when fruit grown on the hospital ground was served to them as snacks.
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For smaller employers – a matter which Mr Ong Ah Heng spoke about – there are understandably more challenges, but it is not impossible. Some SMEs have\r\n\r\n
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\r\n\r\nshown the way. Asia Polyurethane Manufacturing, for example, is a small outfit of just 29 employees. Yet, they have launched initiatives like health screening, aerobics classes and talks on nutrition for their employees. To their CEO Mr Erman Tan, the business case for workplace health is strong. It enhances employee morale and teamwork, and has a huge impact on productivity.\r\n\r\n\r\n\r\n
SMEs will be our focus over the next few years to spark this health movement. Collectively, they are Singapore’s largest employers. In reply to Assoc. Prof. Fatimah and Mr Heng on what our plans are to enhance health at the workplace, we will do three things to persuade business leaders. First, we will make it simple for SMEs to implement workplace health programmes. We will offer customisable off-the-shelf workplace health packages to SMEs. They will simply have to choose the package they want. This frees them from the administrative hassle of sourcing and coordinating health activities for their employees. Second, we will continue our funding support for SMEs through the Workplace Health Grant which offers 90% funding to implement programmes, up to a cap of $10,000 per application. Assoc. Prof. Fatimah may be pleased to learn that since the scheme was extended to SMEs in 2009, 90 SMEs, including Asia Polyurethane Manufacturing, have benefited. For larger companies, a further 200 firms benefited each year from the Workplace Health Grant. Third, we will strengthen and form new partnerships with trade associations so that health activities can be offered to their member companies. The Singapore Manufacturers' Federation (SMa) is the first to partner HPB – 100 of its member companies have pledged to implement comprehensive workplace health promotion for their employees.
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The National Tripartite Committee (TriCom) on Workplace Health, which I\r\n\r\n
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\r\n\r\nspoke about last year, has been key in driving these ideas. They have just reported their recommendations in November last year. Under the TriCom, Workplace Health Promotion elements have been integrated into national frameworks, like SPRING’s Business Excellence Framework and the Guidelines for the Re-employment of Older Employees. HPB is now collaborating closely with the Ministry of Manpower to further tie Workplace Health with Workplace Safety, as Mr Heng Chee How suggested. MOH has set up a group to oversee and monitor the implementation of the TriCom’s recommendations.\r\n\r\n\r\n\r\n
Let me now move to children's health. Children and their parents are a key link in the health movement. We see many parents attending parenting seminars to find out from experts how to bring up their children to be healthy, confident individuals. Here, we have many opportunities to create healthy habits in the way our children eat and keep fit. We know that what we learn when young stays with us.
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Again, we are approaching this from many angles. The National Healthy Lifestyle Campaign this year will focus on the family. Parents will find accessible resources right at the community level throughout Singapore, such as organised walks, classes and support groups.
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Schools are also an important setting of influence. Jamie Oliver, the British celebrity chef, is leading the school food revolution in Britain. He said that \"eating a healthy school meal is a great foundation for a kid’s education and future health.\" We share the same vision. HPB has thus worked hard to change children’s eating habits and attitudes.
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Dr Lam Pin Min spoke about school meals. In Singapore, HPB has partnered\r\n\r\n
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\r\n\r\nwith schools to incorporate guidelines on healthy eating and to limit student’s exposure to foods that are high in fat, salt and sugar – all those things that make food tastes nicer. We are encouraged by the efforts schools have undertaken to translate this vision into reality. About 90% of our schools have adhered to HPB’s guidelines and achieved Healthy Eating Awards.\r\n\r\n\r\n\r\n
HPB has also partnered infant and child care centres and pre-schools to provide supportive environments. Through the Healthy Eating in Child Care Centres Programme, centres are provided with guidelines on offering healthy food and drinks to children. This is now included as one of the items in the licensing of childcare centres.
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On the supply side, culinary training workshops have been introduced for tuckshop vendors to raise their awareness of nutritional guidelines and healthy meal preparations. We are also working with the food suppliers to modify and introduce healthier food items in school tuckshops. Members may know now that schools are not allowed to sell certain types of aerated drinks, which are too gassy and too sweet, and they are not allowed to sell fried food more than once a week.
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Aside from diet, we know that exercise is also important. Research has shown that exercise helps children to be more attentive and think better. I am happy that MOE has reviewed its physical education curriculum and increased physical activity time across the various educational levels.
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Apart from targeting school-going children, there is evidence that suggests that conditions in the womb and during early childhood can influence health later in life, including risk of obesity and chronic diseases. This is why HPB has expanded its target audience to include parents-to-be as well as parents of young\r\n\r\n
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\r\n\r\nchildren through the Healthy Origins and Firm Foundations programme. Here, HPB, in partnership with maternity and children’s hospitals, is developing resource packages for new mothers-to-be to provide them with tips on how to maintain healthy pregnancies and raise healthy children. \r\n\r\n\r\n\r\n
Madam, we have spoken about changes that will be taking place across many physical sites in our communities. There is one development, however, that will place active health management right at the fingertips of Singaporeans, so that health promotion can be 24/7, anywhere and everywhere. Members already know about MOH’s development of the National Electronic Health Records (NEHR). While most of the NEHR will transform the way that hospitals work, one part of that will directly impact you and I. This is the development of a personal health management platform. While this will take a couple of years to develop, we have already taken steps towards better personal health management, like the HPB Diet Tracker iPhone app. What we can look forward to are mobile applications built upon the platform that will support healthy behaviour and personal responsibility for health. In fact, this is the way that many countries around the world are moving toward – telehealth and mobile apps for personal health management.
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Getting healthy is a process, a journey of small steps. And if we go back to the \"blue zones\", it is the simple things that make a difference – what we eat, whether we exercise, how much we sleep. We can all take small manageable steps in our everyday life. These small changes will lead to big improvements in our health. When these changes become a natural part of our routines, we would have formed our own personal blue zones. If we can expand this in the community, get volunteers and advocates amongst community leaders to sell the ideas to our\r\n\r\n
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\r\n\r\nresidents, then we will be able to develop blue zones in our community. Let us journey together to live long and live well.\r\n
The Chairman: Time for clarifications. Dr Lam Pin Min.
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Dr Lam Pin Min: Madam, I would like to thank the Minister for right-siting the new Sengkang General Hospital (SKGH). I am sure the residents in Sengkang and Punggol, including Pasir Ris and Hougang, will be very happy with this news. I would like to seek a clarification from the Minister – what will be the bed capacity of SKGH, and whether we can bring forward the completion date, instead of the 2020 that was announced by the Minister.\r\n\r\n
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Secondly, I am also quite delighted about the setting up of the Seniors Mobility Fund. I would like to ask the Minister how can this Fund be utilised and what it covers. Can the Ministry also consider setting up an Assistive Technology Centre that can research and produce equipment to assist the elderly and the disabled to cope with their activities of daily living?
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Mr Khaw Boon Wan: Madam, the size of the Sengkang General Hospital is one of the subjects that we are studying now. It is part of the planning. But Members can assume that it will be similar to Khoo Teck Puat Hospital. It should have a capacity of 500-600 beds. It depends on the catchment population size. That is some of the data that we are looking at. But it will definitely be a full-fledged general hospital, meaning that it covers all the major disciplines.\r\n\r\n
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The idea of a regional general hospital concept is that in each region of sufficient population, the general hospitals plus its partners – community hospital, nursing home and so on – should be able to look after maybe 85% to 90% of the healthcare needs of the region. It is only \r\n\r\n
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\r\n\r\nthe occasional patient with cancer or severe transplant requirements, who need to go to SGH or NUH. In this way, it brings convenience for the people but, of course, it does not mean that if you are a resident in Sengkang, you must go to Sengkang General Hospital. You are free to choose to go to Changi General Hospital or Khoo Teck Puat Hospital. That contestability must always be there, and that will bring about better service level.\r\n\r\n\r\n\r\n
On the Seniors Mobility Fund: the key word is \"mobility\". We are quite prepared to define it widely and loosely. Anything that will help the seniors move around. We look at it from the outcome point of view. Right now, you are stuck and you need a wheelchair or you need a walking frame so that you can move around, and move out of your apartment. I think talking to our patients, one clear conclusion is always this for the elderly. The moment they lock themselves up in an apartment, almost certainly their health condition just goes downhill. It does not get better. Therefore, the more we are able to get them socially engaged, that is most crucial. That is why Minister Lim Boon Heng's Committee is so busy, working with all Members on the Wellness Programme in the community. Let us support him and his Committee – get our residents out of their apartments. But for some who have difficulty because they are not able to move about, this Fund of $10 million will come in handy.
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The approach we are taking is not a macro bureaucratic way, whereby the Ministry of Health is the one who invites applications and then assess them. That is a wrong way of doing it. But we will give money to the local VWOs. Our job is to sniff around and see which are the good VWOs doing good work on the ground, helping these residents to move around, and then we will support them with the \r\n\r\n
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\r\n\r\nmoney. It is not restricted to just devices. That is why I talked about services. It could be a transport service, if necessary, to bring the seniors to a day rehabilitation centre, which we know is a major gap on the ground currently. We will work through the VWOs.\r\n\r\n\r\n\r\n
If we should set up a technology centre of a higher caliber research type, then $10 million is not enough.
\r\n
But we will have facilities where we help senior citizens who have stroke or whatever to shop around for devices that will help them move around. We do have those centres. We set it up in Khoo Teck Puat Hospital and, I think, in due course, there will be similar facilities in some HDB towns. As for the completion date, I mentioned 2020 to be safe, but I will work very hard to try to bring it forward, if we can.
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6.30 pm
Mdm Cynthia Phua: Madam, I would like to clarify with the Minister on two points. The first one is on the polyclinics. Is he going to extend, in terms of medical IT, to allow for distant consultation? I just met a resident who is diabetic, has high blood pressure and eye problem. She is also a recovered cancer patient. So, she has to go to three different places: Singapore General Hospital, the Cancer Centre as well as the polyclinic for the follow-up consultations. But these are just follow-up checks. Could she go to the polyclinic and maybe have a distant consultation with the relevant specialised doctors?\r\n\r\n
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The second issue is the mental patients again. Currently, in the community, we are really finding it very difficult to bring the patients to IMH to seek treatment and they are not known patients to IMH. So, when can the hotline or the mobile squad be ready to take such patients?
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Mr Khaw Boon Wan: On the greater use of technology, this is something we strongly believe in. We have tried various things: tele-radiology, tele-opthalmology, tele-stroke, because tele-medicine certainly has a great scope for further exploitation, and we will push along this line. But for the specific example that Mdm Cynthia Phua mentioned about tele-consultation, we do that to a certain degree. Tele-opthalmology belongs to that category, but you must have enough volumes, because it is not just a technology, you must have a specialist at the end of the line who is there to do the consultation, even though not in front of the patient. So, that has to be organised. For opthalmology, I think there are sufficient cases to do so. For the specific example that she mentioned, I am not so sure whether there are enough cases. But, in terms of priorities, this is the priority which we will always push.\r\n\r\n
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For the mentally-ill hotline, I do not know yet, but it is something that I am pushing.
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Assoc. Prof. Paulin Tay Straughan: I just like to follow up on the Minister's response to my health credit proposal. I think we should not see it as a bribe to get people to take proactive actions towards prolonging their health. The concern I have is that one of the reasons the low-income individuals do not go for health screening is because they are so afraid that they will find something and that they cannot afford the treatment subsequently. So, they take a very fatalistic approach to life, and they would rather not know because knowing causes them problems. A health credit scheme like this would give them a lifeline: come for health screening, let us detect your illness early, especially cancer. The health credit will help us subsidise or help them pay for early treatment which will be a win-win situation for the individual as well as the family and the State.\r\n
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Mr Khaw Boon Wan: My answer will be this: have confidence in 3Ms. Really, I mean it sincerely. 3Ms will ensure that no Singaporean would be denied any kind of medical treatment. So, if you are screened and you have cancer or whatever, and if you are poor, you will be looked after. Do not worry about that.\r\n\r\n
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I was reading the Straits Times which has a section on \"Mind Your Body\", the latest issue of which is two or three days ago. There was an article by a consultant oncologist in the National Cancer Centre. He made a similar point. He has been a cancer consultant for 10 years now, and he has never seen a patient who has difficulty despite 3Ms. 3Ms is the way to go. So long as you understand it and you navigate it through, there is never an issue of not being able to afford any kind of treatment. So, I do not really think that this health credit is necessary. Neither do I think it will be effective for the example that the Member gave. For example, let us say, if a person found that he actually needed cancer treatment, that may be tens of thousand of dollars. How much credit are you going to give? $5, $15, $20 for a screening. So, how much credits can you accumulate in order to handle a major heart bypass, for example?
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So, have confidence in 3Ms. As Health Minister, I do receive appeals from patients who get into trouble once in a while. But almost all the time when I look into the details, who are the ones who got into trouble? They are outside of 3Ms. They never buy MediShield, they never save in Medisave because they are self-employed, like taxi drivers or hawkers, that is when they get into trouble. I think our answer to Singaporeans must be, please, 3Ms is fantastic, stay in it. Please make sure you are in 3Ms. So, all workers have no problem because they are compelled to save, but they must subscribe to MediShield.
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\r\n\r\nJust two days ago, I was reading Shin Min and Tan Kin Lian was quoted by Shin Min as saying that in Singapore, for the bulk of people who go to B2 and C wards, if they have MediShield, for those who stay after retirement for another 25 years, even if they are very unlucky to be sick for 10 years, his calculation was that $30,000 is enough. Or if you want to be very safe, try $40,000. And that is more or less the Medisave Minimum Sum that we have computed. A majority of Singaporeans with Medisave are now able to achieve that saving level. And more will be able to save that too.
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Mdm Halimah Yacob: I think the Minister did not respond to my point about the importance of upgrading the day rehabilitation centres. The Minister did mention that he considers the day rehabilitation centres as part of the seamless process of providing long-term care for the elderly, and also for ensuring that we can site the long-term care in the community and at home. But if you look at the current day rehabilitation centres, they are really inadequate because they only provide social services and a little bit of therapy. The day rehabilitation centres need to be upgraded to cover other services, for instance, nursing, medical care, or even if you need a manager to manage and help the family when they move from the hospital to the home. It also provides some respite and relief to the caregiver so that the caregiver can put those who are ill at the day rehabilitation centre and go to work, and not depriving themselves of a source of income. We do not need this problem. We do not have this issue being raised many times in Parliament about the need for caregiver allowance. I hope the Minister would consider that because the current centres are really inadequate.\r\n
Mr Khaw Boon Wan: The answer is \"yes\", and I agree with Mdm \r\nHalimah. \r\n\r\n
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\r\n\r\nThat is one of the motivation behind this $1 billion Community Trust Fund. The objective is really to upgrade long-term care. We are happy with current level of long-term care as provided by the VWOs all these years. I think we are grateful to them for delivering this level of service, but what we are hoping in the next decade is to raise it to a much higher level of capabilities, especially in rehabilitation. They would need money, they would need skills, they would need training and they would need resources. That is what this $1 billion injection of fund is meant to achieve, and we would do it in a way without displacing the VWOs. \r\n\r\n\r\n\r\n
As I said just now, if we come in a big way, and then get them out of business, push them out and become a public service, I think we would be poorer for it. The ideal situation is how we can combine funding both from the Government as well as from society, but, more importantly, professional skills of the Ministry of Health with the community VWOs' passion and compassion. If we can combine the two and fuse it well, I think we will get a world-class long-term care. This, I am optimistic and I am confident. We cannot achieve it in one year. I think we probably need a decade to achieve this transformation. But if we do it well, in five years we should be able to see significant difference.
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Ms Sylvia Lim: Madam, I would like to make one clarification and seek a few more from the Minister. \r\n\r\n
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First, it relates to the Standard Drug List (SDL). I think when the Minister first started his response to me, he suggested that I was making him rehash things which he had answered before in Parliament but really the crux of my cut is about transparency, and I do not believe that there was any Parliamentary Question (PQ) filed previously about transparency concerning the SDL. The first clarification for the Minister is this. \r\n\r\n
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\r\n\r\nThe lists which are readily available online, which I mentioned, include the WHO's essential drug lists which the Minister had previously mentioned that our SDL was based upon with local adaptation. That is published online and the Minister was saying that it is really not a secret. So, if the SDL is not a secret, then why not consider publishing it?\r\n\r\n\r\n\r\n
My second point: the Minister mentioned that he did not see why it was necessary to publish it, but I would like his comments on these possible benefits which have been pointed out to me as well. First of all, private doctors have commented that they would find it useful to look at the lists because they could refer their private patients to get the subsidised drugs from polyclinics. Secondly, they will also be in a better position to price their own drugs. And, thirdly, for sick people or families with sick people, they would find publication of the lists useful in their own research about treatment options.
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The third clarification from the Minister is concerning transparency of the decision-making process which I do not think the Minister really touched on. He has mentioned in the past about factors taken into account by the Drug Advisory Committee but exactly how they weigh the factors, and so on, is not very clear. As I mentioned in my speech, there have been pharmaco-economists who have said that our process appears to be a trade-off because it is a simplified evaluation. So, would it not be in the public interest to give more information in order to let the public have confidence in this assessment process?
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Last of all, just now, the Minister mentioned the 3Ms again. From what I know, from data in year 2000, the 3Ms only accounted for 10% of our total health expenditure. Recently, I filed a Parliamentary Question to ask whether the Minister could update on this but he\r\n\r\n
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\r\n\r\nonly gave the inpatient coverage but not the general. So I wonder whether the Minister could update on how much the 3Ms cover the national health expenditure.\r\n
Mr Khaw Boon Wan: First, on the question of transparency, I have no issue with greater transparency. My colleagues know me well that in the Ministry of Health, I have a statement, which is \"there is no secret in the Ministry of Health\". There are only two secrets in the Ministry of Health. One is personnel records of staff; two is patients' records. That is privacy. Everything else is to be open because health policies ought to be argued on logic. If I formulate a particular policy, those are the assumptions and reasons. If you have a better way of doing it, I would like to know too so that we can change the policy. I now hear Ms Sylvia Lim talking about possible benefits of making this list public. I really have no problem. If need be, we just put it on the website, except that it will be a long string of chemicals. My initial reaction was what value does it give, other than satisfying some curiosities. But if it is so important, for me, putting up the list is not an issue at all. What we do not want is intense lobbying by pharmaceutical companies for self-interest and they have subject me to lobbying very often. \r\n
Every time a top CEO comes to see me, we usually do not talk about other things. He would say, \"Please put my new drug onto your list.\" This is self-serving, not so much to improve the health of the people in a way which is sustainable and affordable, because some of these are very expensive drugs, when cheaper options are available. One of the reasons why we spend 4% and America 18% is this – we use lower cost alternatives, because they are equally effective. Why should we over-spend and spend additional money? But we will take a look and see if it is really so important to many people to put this list on the website. I personally have no problem at all.
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\r\n6.45 pm
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What is the contribution for the 3Ms? I cannot recall the answer in 2000 that Ms Sylvia Lim mentioned. But the recent reply I gave about the 3Ms was because I wanted to give a meaningful answer. National health spending is a big basket of things. It perhaps includes buying and selling of herbs like ginseng, or cordyceps. All these, we all know, are personal expenditures. Over-the-counter drugs, like supplements, aesthetic treatments, and they too are in the national health spending. Whereas 3Ms is very specific, largely for inpatient care in public hospitals. In fact, it is also for private hospitals, because we also open it to private hospitals, largely for inpatient care. In recent years, we have opened it up to some outpatient care, but it remains small.
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Therefore, I have said that if we want to look at contribution, then we should compare apple with apple, ie, we should look at 3Ms spending versus total spending on inpatient care. Then it is a more meaningful figure. Whereas if we look at 3Ms spending versus total health spending, which includes aesthetic medicine, etc, and worse in the case of Singapore, because we have a significant medical tourism sector, even foreigners' spending also comes into our national health spending. So what meaning does it give? If I give her a figure, what does that mean to her? That is why I compute it to say, 3Ms versus inpatient care which includes public and private hospitals. And I thought the figure says a lot about our funding system in Singapore. If she reads the answer carefully, half of inpatient care was borne by Government. This is not just inpatient care in public hospitals but also inpatient care in private hospitals, which includes foreigners' spending, and so on. Despite all those things, it is half. So, if we look at public hospital inpatient \r\n\r\n
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\r\n\r\ncare, the Government subsidy is much more than half. I do not know – maybe 70%, or 80%. Then half of the remainder is 3Ms – Medisave, MediShield and insurance. And the rest is employers and out-of-pocket. When I gave that figure and I dived deeper into the breakdown, it gave me a lot of comfort. I think with many years of careful planning in our 3Ms healthcare financing sector, we have got a system which is not bad. Let us do not do silly things to destroy it.\r\n
Mr Ang Mong Seng: Could the Minister brief the House, if possible in Mandarin, on the differences between a nursing home and a home for the aged? \r\n
Mr Khaw Boon Wan: Madam, since it is rather late in the day, let me continue in English. In layman's terms, the simplest is to look at the length of stay. I look at nursing homes as a facility, not unlike a hospital. When a patient goes to a hospital, he expects to get well and then he goes home. Likewise, if a person goes to a nursing home, because he has some disability, he hopes to improve so that he can also go home. But because rehabilitation takes a longer time, it may take several weeks or, often, several months. Whereas an old folks' home is one where somebody may not be severely disabled, but because he has no home to go back to – he has been forsaken, and therefore he is in a sheltered home. That is an old folks' home.\r\n\r\n
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Unfortunately, over the years, our nursing homes are behaving almost like old folks' home, because the patients go there and hardly come out, except when they die. So I am putting this challenge to the nursing homes – let us improve on our ability to rehabilitate the patients. If a patient goes in and, say, he is unable to do three activities of daily living (ADL), we hope, after a while, we can reduce it to two activities, and then reduce it to one, and then the patient can go home. That, I think, is success. In some\r\n\r\n
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\r\n\r\ncountries, they have been able to do it. But to do that, we need many more physiotherapists, occupational therapists, rehabilitation specialists, etc. We need money which we will inject. Again, coming back to the $1 billion Community Trust Fund, that is what I want to tap on, to work together so that we can upgrade the nursing homes. \r\n\r\n\r\n\r\n
But because of this historical baggage of nursing homes, which are almost like sheltered old folks' homes, Senior Minister Goh has a suggestion for me. He says, \"you have to re-brand it – stop calling it a nursing home.\" For this new generation of nursing homes that I hope to create, he said, we should call it \"convalescent homes\". A patient goes there for convalescence with a view of going home. In fact, the Chinese translation of nursing home is quite a good one, liao yang yuan (疗养院) (nursing home), and that is different from lao ren yuan (老人院 ) (old folks' home).
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(In Mandarin): [For vernacular speech, please refer to Appendix A*.] When you go to an old folks' home, you go there because you have no home and no children who look after you. So it becomes a home for old folks. Whereas the nursing home is like a hospital, except that there are no specialist doctors because they are not necessary.
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The Chairman: Mr Low, a quick clarification.
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Mr Low Thia Khiang: Madam, the Minister earlier said his brother dropped everything in Canada to return home to take care of his aged mother. But I am sure he would agree that not everyone can do that. Many need to work to feed their family and they are unable to leave their jobs just to take care of a terminally-ill family member. In that respect, I would like to ask the Minister what is his perspective of end-of-life care, for people who are terminally ill. What support\r\n\r\n
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\r\n\r\nservices is MOH providing to help people who need the services? My understanding is, currently, hospice is pretty expensive and home care support is limited.\r\n
The Chairman: Minister Khaw, just before you reply, I am going to extend the time so that it will allow you the comfort to give your reply properly.
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The Chairman: Order. Pursuant to Standing Order No. 2(5)(d), I propose to extend the time of this day's Committee sitting for a period of up to 30 minutes. It would allow the Minister to finish his reply and wrap up the clarifications.
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Debate in Committee of Supply resumed.
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Head O (cont.) –
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Mr Khaw Boon Wan: Madam, Mr Low is correct that home care and home hospice are important. Those are all part and parcel of long-term care. We use the term \"long-term care\" because it is easy to use, easy to say and we define it loosely. I use it to mean any healthcare outside the hospitals. So it includes a wide range – community hospital, nursing home, hospices, home healthcare – and, increasingly, home care will be a significant segment of that. We must develop and expand all those. I see this whole journey as trying to improve quantity, that means scale it up; quality, that means, for example, the nursing home's rehabilitative activities must be able to be scaled up, ie, upskilled, and also have diversity. Because, in terms of different kinds of services, the needs may vary, different families have different needs and different patients may have different needs. So all those efforts will be what we are embarking upon over the next few years. We definitely would have \r\n
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\r\n\r\nto pump in more money and resources into all these. \r\n\r\n\r\n\r\n
But back to the Member's point about home hospice and home care, the VWO home hospices are all funded by the Ministry of Health. While they raise donations and get supported by the public, they also receive subventions from the Ministry of Health. But as we scale up, of course, more subventions will have to flow down by the sheer increase in clientele and services that they are providing. But I took comfort that when I last looked at cancer patients – because cancer is more predictable, in the sense that we know there is a prognosis, and if the patient is at an advanced stage, the doctor cannot be precise about how many weeks or months but, at least, if it is end stage, they can plan for their end of life – the majority are able to die at home supported by us, whether it is HNF, hospice movement, home care or whatever. And we will see many more such cases, going forward.
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The Chairman: Dr Lam, having listened to the responses, would you like to withdraw your amendment?
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Dr Lam Pin Min: Madam, I would like to take this opportunity to thank the Minister and the Senior Parliamentary Secretary for the comprehensive and engaging debate in this House. As always, it is so refreshing and reassuring to hear the Minister share his Ministry's strategy and also his own personal philosophy to live well, live long and with peace of mind.\r\n\r\n
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On that note, I seek leave to withdraw the amendment.
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Amendment, by leave, withdrawn.
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The sum of $3,580,115,300 for Head O ordered to stand part of the Main Estimates.
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The sum of $496,845,000 for Head O ordered to stand part of the Development Estimates.
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Mr Khaw Boon Wan: Madam, may I seek your consent to move that progress be reported now and leave be asked to sit again on Monday, 7th March 2011?\r\n
The Chairman: I give my consent.
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Resolved,
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That progress be reported now and leave be asked to sit again on Monday, 7th March 2011. – [Mr Khaw Boon Wan].
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Thereupon Mdm Deputy Speaker left the Chair of the Committee and took the Chair of the House.
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Mr Khaw Boon Wan: Mdm Deputy Speaker, I beg to report that Committee of Supply has made further progress on the Estimates of Expenditure for the financial year 2011/2012, and ask leave to sit again on Monday, 7th March 2011.\r\n
Mdm Deputy Speaker: So be it.\r\n
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Resolved,
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\"That Parliament do now adjourn.\" – [Mr Lim Swee Say].
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Adjourned accordingly at
\r\n\r\nTwo Minutes to Seven o'clock pm.
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