1 Mr Leon Perera asked the Minister for Home Affairs (a) whether the Government undertakes systematic preventive measures to engage the children of drug offenders in programmes that aim to mitigate the risk of these children becoming drug offenders themselves in future; and (b) if so, what criteria or metrics are used to evaluate the effectiveness of such programmes.
\tThe Minister for Home Affairs (Mr K Shanmugam): Mr Speaker, I thank the Member for the question. First, we need to be clear on what are the primary causes of the drug problem which lead to children being affected.
The Member's question focuses on measures to engage the children of drug-abusing parents, to prevent them from becoming drug offenders themselves. Looking at this narrowly, from that perspective, will not give an accurate picture.
The primary issue is the trafficking and pushing of drugs in society. If we do not deal with those issues upstream, before the harm is caused, then there will be serious consequences to the lives of people and loss of children. So, we have to focus on deterring and disrupting the supply of drugs.
If we do not do that properly, the children will suffer neglect at best from their families and many will face the risk of getting into a life of crime and drugs. Downstream efforts to help the children, will really be like fighting against the tide in such situations. We are very concerned about the children and the other people affected by drugs. That is why we take a tough approach on drugs.
I will ask the Member if he agrees with the tough approach we have taken on drugs, the approach to severely punish the traffickers and suppliers responsible for this problem, if we are concerned about children, then I assume the Member will agree with us.
Let me give an example – a five-year-old boy, I do not want to name him – died after being scalded with hot water in 2016. Every year I can name you a case of such a child. Five years old, four years old, parents affected by drugs. The court heard that his mother, who had thrown the hot water on him, told the IMH psychiatrist that she had abused meth for years and that she was probably suffering from withdrawal symptoms in the days before the boy's death, because she was unable to buy drugs from her usual supplier.
In such cases I asked Members, what could have been done to save the child, which is part of the question the Member is asking. What we have done is to save the lives of thousands of such children with our focus on preventing widespread use of drugs through our very tough drug policies; probably one of the only country, if not, one of the few countries in the world that have dealt with this problem effectively.
That helps prevent such cases from happening in the first place. We could identify the problem accurately if we want to find the right solutions. I have tried to explain how we try and make sure we reduce, minimise the risks of the situation that the Member has been referring to, from even arising in the first place.
But despite all our efforts, and despite our tough laws and stance, there will be persons who will continue to abuse drugs and place their families and children at risk. In those cases, how do we help the children? The Government works closely with the community to help them. Newly admitted offenders are encouraged to participate in the Yellow Ribbon Community Project (YRCP). Under the YRCP, volunteers reach out to the families of inmates through home visits and link them up with various social support and community programmes.
They also identify vulnerable children of inmates who may require support in their education or who may require counselling and refer them to relevant community programmes. There are now more than 1,200 YRCP volunteers, who have reached out to more than 15,000 families. This is real hard work on the ground. Not glamourous, but thousands of people going, spending thousands of hours, helping.
Prisons will also refer inmates and their family members who require assistance to the Family Resource Centres, (FRCs). FRCs operate from the Prison Link Centre in Changi. They render financial assistance, accommodation and social assistance. Where necessary FRCs will refer the families to the Family Service Centres (FSCs) for further casework support within the community.
The FRCs have assisted close to 4,000 inmate families in the last two years. FSC social workers will try and review the family's risks and needs, and coordinate intervention and support across different agencies. For school-going children, FSCs will also link up with the schools to discuss their needs – the types and level of support needed by the children.
Besides FSCs, we also have youth agencies, which provide support services for children and young persons who have behaviours which put them at risk, or who require constructive engagement. These include mentoring programmes, interest-based activities and career coaching.
Then, there is the aspect of parent-child bonding. Prisons get involved in that. It provides inmates with family-centred programmes, like the Social Skills Training Programme and the Family Reintegration Programme, to equip them with communication skills, to engage their children and loved ones more effectively.
In the past five years, Prisons has provided about 21,000 programme places to inmates for this purpose. Prisons also works with various other community partners on programmes and services, aimed at addressing the impact of the parents being in jail. These include counselling, tuition assistance, parenting programmes and family bonding programmes, for example, run by The Salvation Army, Centre For Fathering and the Singapore Children's Society.
Over the last two years, 282 inmates and their families attended these programmes. The Member has also asked about how do we evaluate the effectiveness of these programmes? I think the first question is, when I lay this out, I think Members will agree that this has to be done. I cannot believe that any Member here would say, we should not do any of these or should be cutting back on these.
In terms of quantifying it, this is a very difficult to study, because there are too many factors that are outside of Prisons' control. Let me name some: how a child grows up, how a child averts the risk of a life in crime and drugs depends on family circumstances of the children involved; the social influences on the children; the willingness of the family to be fully involved and engaged in the programmes offered; also, how available the drugs are to that child, for children; the susceptibility of the family members including the children to the attraction of drugs. I can name many such factors.
So, it is not an area you can easily quantify. You have to make an assessment and go ahead and do it; as we have been able to convince thousands of volunteers to do, together with Prison's officers and NGOs which see the benefit of doing these activities.
While no specific quantification has been done, Prisons' professional assessment, based on the interactions, is that the programmes have helped the families which have a positive attitude towards receiving such help.
Prisons generally look at how the effectiveness of its various programs can be assessed. When they next assess, I will ask them to consider again whether there are ways in which some kind of measurement be done, either now or in the future because we are also talking about children growing up to be adults. So, you are talking about 20 years or so.
\t
\tMr Speaker: Mr Perera.
Mr K Shanmugam: I did ask Mr Perera whether he agreed to the approach.
\tMr Speaker: Mr Perera.
\tMr Leon Perera (Aljunied): Thank you, Mr Speaker, Sir. I thank the Minister for his reply. I certainly do agree that penalties have a critical role to play to control the supply and availability of drugs, as the Minister has explained. Rehabilitative approaches and preventive and early intervention programmes, such as what the Minister has explained, also have a critical role to play as well.
\tMr K Shanmugam: I thank the Member for his unqualified support and I assume Workers' Party's position on the drug policies. \t
Mr Speaker: Leader of Opposition.
Mr Pritam Singh (Aljunied): A good way to start the morning, Minister. Sir, I believe some years ago, the hon Member Mr Christopher de Souza filed a Motion on the drug issue, and I made a speech in that debate. It was really about acknowledging that this is a serious issue, the drug problem, especially internationally. And certainly, I would support a tough stance against drugs.
\tMr K Shanmugam: I thank the Leader of Opposition.
","clarificationText":null,"clarificationTitle":null,"clarificationSubTitle":null,"reportType":null,"questionCount":null,"footNotes":null,"footNoteQuestions":null,"questionNo":null},{"startPgNo":0,"endPgNo":0,"title":"Concrete Steps by ASEAN to Facilitate Return to Stability in Myanmar ","subTitle":null,"sectionType":"OA","content":"2 Mr Leon Perera asked the Minister for Foreign Affairs given the escalating developments in Myanmar involving the use of violence by security forces against demonstrators such as the violence seen in Mandalay on 20 February 2021 (a) what concrete steps will ASEAN take to facilitate a return to stability in Myanmar; and (b) what are the immediate and long-term consequences for the region if the situation does not abate.
3 Mr Louis Ng Kok Kwang asked the Minister for Foreign Affairs whether Singapore will consider sending another consignment of humanitarian aid to the Rohingya refugees in Cox's Bazaar, Bangladesh, since the efforts to repatriate the Rohingya refugees back to Myanmar have stalled.
\tThe Minister for Foreign Affairs (Dr Vivian Balakrishnan): Mr Speaker, may I answer Question Nos 2 and 3 together, with your permission?
\tMr Speaker: Yes, please.
\tDr Vivian Balakrishnan: Thank you, Mr Speaker. It has been more than a month since the 1 February 2021 detention of Myanmar's civilian government leaders including President U Win Myint and State Counsellor Daw Aung San Suu Kyi. The situation in Myanmar unfortunately remains fraught with much uncertainty and there remains significant risk of escalation. The United Nations reported that on 3 March alone, 38 people died.
MFA has strongly advised all Singaporeans to defer travel to Myanmar at this time and we have also advised Singaporeans who are currently in Myanmar to consider leaving as soon as they can by commercial means whilst flights are still available.
I have spoken extensively on Singapore's response to these developments in Myanmar, including during my Ministry's Committee of Supply (COS) debate on 1 March. On 2 March, I joined other ASEAN Foreign Ministers via video-conference for an Informal ASEAN Ministerial Meeting (IAMM). At that meeting, the representative of Myanmar's military authorities, Mr Wunna Maung Lwin also briefed us on his account.
Singapore believes that ASEAN should play a constructive role in facilitating a return to normalcy and hopefully, stability in Myanmar, in line with the principles enshrined in the ASEAN Charter. The Chair of ASEAN issued a Statement on 1 February, the very day the NLD government was ousted. The Informal ASEAN Ministerial Meeting (IAMM) I referred to earlier, was convened on 2 March 2021. The meeting reaffirmed the practice for ASEAN to discuss important issues of common concern whenever they arise. This meeting was an opportunity to have frank and open, candid discussions, and to reflect the international community's concerns directly to the representative of the military authorities.
Members would be aware of the media coverage of that meeting. We also provided a full transcript of my intervention during that meeting.
The ASEAN Foreign Ministers urged the Myanmar military authorities to exercise the utmost restraint and to refrain from the use of lethal force against unarmed civilians. I conveyed Singapore's grave concerns over the situation in Myanmar. We are appalled by violence, inflicted by security forces against civilians. It is the height of national shame for the armed forces of any country to turn its arms against its own people.
\t
The use of lethal force against unarmed civilians is inexcusable under any circumstances. The immediate concern is to step back from a rapidly deteriorating situation.
I called on the military authorities to seek a peaceful solution for Myanmar. The alternative is prolonged instability and to quote Prime Minister Lee Hsien Loong, \"an enormous tragic step back\" for Myanmar.
The military is an institution in the body politic of Myanmar. In fact, the military authorities in Myanmar played a role in Myanmar’s political journey towards democracy in the past decade. It has to reach a modus vivendi with the other key stakeholders in Myanmar including Daw Aung San Suu Kyi. There remain prospects for a peaceful resolution as long as all sides can come together, engage in genuine and direct dialogue, and find a way to return to Myanmar’s democratic transition.
We thus hope that the military authorities will release President Win Myint and State Counsellor Daw Aung San Suu Kyi, so that these discussions can commence. We also support a visit by the Special Envoy of the United Nation Secretary General to Myanmar, Ms Christine Burgener, and hope that she will also be given access during her visit to Daw Aung San Suu Kyi and other NLD leaders.
Mr Speaker, if events continue to escalate, it will become even more challenging for all parties in Myanmar to achieve that essential reconciliation. If tensions do not abate, the longer term stability of our region will also be affected, with potential serious consequences for everyone. There will also be further humanitarian impact given the current severe COVID-19 and economic stresses confronting their people, and do not forget the unresolved resettlement of displaced persons from Rakhine State.
Singapore's assistance to the displaced persons from Rakhine State is on-going. Singapore has contributed over S$1 million in bilateral humanitarian aid to both Bangladesh and Myanmar. We also made contributions through the ASEAN Coordinating Centre for Humanitarian Assistance on Disaster Management.
Reflecting the generosity of Singaporeans, our private sector and community organisations have also stepped up, raising funds to provide for the material needs of those in the refugee camps.
Unfortunately, the COVID-19 pandemic last year also compromised the delivery of some of this humanitarian assistance.
It is important to resume efforts to ensure the safe, voluntary and dignified repatriation of refugees back to Rakhine State. We have lent strong support towards ASEAN's efforts to help improve the ground conditions in Rakhine State, such as through the Preliminary Needs Assessment (PNA) and the ASEAN Secretariat's Ad-Hoc Support Teams, which focused on implementing the recommendations of the PNA teams. These recommendations include priority projects, such as the supply of radio receivers to the local community, in order to strengthen the dissemination of accurate information.
We are prepared to send further consignments of aid and stand ready to support future comprehensive needs assessments once repatriation commences, so that we can be more targeted in helping the displaced persons.
But at the end of the day, the solution to both the political and the humanitarian problems lie within Myanmar itself and in the hands of its people. We hope to see an outcome that reflects the interests and the will of the people of Myanmar.
Singapore and ASEAN hope that Myanmar will succeed in its path towards democratic transition and national reconciliation. We will do what we can to support this. But, ultimately, only the people of Myanmar, including Tatmadaw, the NLD, and the diverse ethnic groups, some of whom have armed militias, only they can find a sustainable political solution that is in the best interest of their people.
We can only hope that wisdom will prevail. And despite all the bloodshed so far, I still think it is not too late.
\tMr Speaker: Mr Perera.
\tMr Leon Perera (Aljunied): I thank the Foreign Minister for his comprehensive reply and his clear condemnation of the situation in Myanmar. I think since I filed this question several days ago, the situation seems to to have worsened. I just have one supplementary question for the Foreign Minister, which is that at the ASEAN level, is this being monitored with a view to keeping other options open to nudge the government in Myanmar towards reconciliation, towards political settlement, should the situation worsen even further in the days and weeks ahead?
\tDr Vivian Balakrishnan: The short answer is yes and the foreign ministers are in daily contact with one another.
\tMr Louis Ng Kok Kwang (Nee Soon): I thank the Minister for the reply. I have raised this issue in Parliament quite a number of times. I know the Minister is deeply concerned about the refugees as well.
Like him, I have been to the refugee camps in Cox's Bazaar and it really is suffering at a scale that is unimaginable. I met many of the children there, many of whom have watched both fathers and mothers get killed. So, I really hope and I asked MFA to consider sending another consignment of humanitarian aid this year, and that will really help the refugees that are currently in Cox's Bazaar.
\tDr Vivian Balakrishnan: Mr Speaker, as I said earlier, we would certainly consider additional assistance, but there are many obstacles. In fact, the more fundamental political and violent events occurring within Myanmar itself complicate any attempts to address this humanitarian disaster, but we will continue to look out for opportunities.
\t
\tMr Christopher de Souza (Holland-Bukit Timah): I thank the Minister for Foreign Affairs for his comprehensive answer. My supplementary question refers to two instruments: the ASEAN Charter and the ASEAN Human Rights Declaration.
In the discussions with Minister's counterparts in ASEAN, would reference be made to both those instruments and the general principles elucidated in those instruments, to have some level of forbearance over the actions of the military in Myanmar?
My view is that the actions do go against the whole tenor and principles laid down in the ASEAN Charter and the ASEAN Human Rights Declaration.
\tDr Vivian Balakrishnan: Mr Speaker, in our meetings, discussions, both formal and informal, clear reference has been made to the ASEAN Charter, and, of course, the question of human rights.
But I also want the House to have a realistic assessment of the factors at play. The history of Myanmar over the past 70 years, and I mentioned that earlier this week, is a long and tortured history of a large, wealthy talented country, unable to come together and achieve national unity, unable to reconcile differences between ethnic groups, political ideologies, between the different pillars of the political construct that is Myanmar.
Again, if you look over the past 70 years, the military authorities in Myanmar frankly do not respond to economic sanctions, do not respond to moral opprobrium. And certainly, references to the ASEAN Charter in Human Rights, whilst essential, are not sufficient to change their behaviour. So, we do need to be realistic in what we say or do. I want to emphasise that my key objective – again, perhaps, influenced by my medical background – is, first, do no harm. Do not raise false hopes, do not incite and do not encourage further crystallisation of disputes and violence.
I say all this so that Singaporeans, both within this House and outside this House, will understand that despite all our fervent and earnest hopes of reconciliation, the keys ultimately lie within Myanmar. There is a limit to how far external pressure will be brought to bear. It does not mean we approve of what they have done and how they do it, and we are clear in our expressions of disapproval. But let us also be realistic and let us hope that good sense prevails.
There are also profound lessons for us in Singapore, to count our blessings since Independence, that we have been able to come together as one people, regardless of race, language or religion. We have been able to build a democracy that functions. We have been able to reconcile differences. We really have so much to be thankful for and to count our blessings in Singapore.
Mr Speaker: Order. End of Question Time. Introduction of Government Bill.
[Pursuant to Standing Order No 22(3), Written Answers to Question Nos 4 and 6-7 on the Order Paper are reproduced in the Appendix. Question Nos 5 and 8 have been postponed to the sitting of Parliament on 8 March 2021.]
","clarificationText":null,"clarificationTitle":null,"clarificationSubTitle":null,"reportType":null,"questionCount":null,"footNotes":null,"footNoteQuestions":null,"questionNo":null},{"startPgNo":0,"endPgNo":0,"title":"Postal Services (Amendment) Bill","subTitle":null,"sectionType":"BI","content":"[(proc text) \"to amend the Postal Services Act (Chapter 237A of the 2000 Revised Edition) and to make consequential and related amendments to the Criminal Procedure Code (Chapter 68 of the 2012 Revised Edition)\", (proc text)]
[(proc text) presented by the Senior Minister of State for Communications and Information (Ms Sim Ann) on behalf of the Minister for Communications and Information; read the First time; to be read a Second time on the next available Sitting of Parliament, and to be printed. (proc text)]
","clarificationText":null,"clarificationTitle":null,"clarificationSubTitle":null,"reportType":null,"questionCount":null,"footNotes":null,"footNoteQuestions":null,"questionNo":null},{"startPgNo":0,"endPgNo":0,"title":"Proceedings on Ministerial Statement","subTitle":"Suspension of Standing Orders","sectionType":"OS","content":"The Leader of the House (Ms Indranee Rajah): Mr Speaker, may I seek your consent and the general assent of Members present to move a Motion to allow the Ministerial Statement on Review of Sentencing Framework for Sexual and Hurt Offences be taken now.
Mr Speaker: I give my consent. Does the Leader have the general assent of hon Members present to so move?
[(proc text) Hon Members indicated assent. (proc text)]
Mr Speaker: Leader, please proceed.
Ms Indranee Rajah: Mr Speaker, I beg to move, \"that, notwithstanding Standing Order 91(2), the Ministerial Statement on Review of Sentencing Framework for Sexual and Hurt Offences be taken now.”
The Statement is on a matter of some importance and it would be more expedient and efficient for the disposal of Parliament business for the Ministerial Statement to be taken before the resumption of the debate on the Committee of Supply and it will also to allow sufficient time for Members to seek clarifications from the Minister for Home Affairs.
[(proc text) Question put, and agreed to. (proc text)]
[(proc text) Resolved, that, notwithstanding Standing Order 91(2), the Ministerial Statement on Review of Sentencing Framework for Sexual and Hurt Offences be taken now. (proc text)]
Mr Speaker: Ministerial Statement. Minister for Home Affairs and Law.
","clarificationText":null,"clarificationTitle":null,"clarificationSubTitle":null,"reportType":null,"questionCount":null,"footNotes":null,"footNoteQuestions":null,"questionNo":null},{"startPgNo":0,"endPgNo":0,"title":"Review of Sentencing Framework for Sexual and Hurt Offences","subTitle":null,"sectionType":"OS","content":"The Minister for Law (Mr K Shanmugam): Mr Speaker, Sir, on 8 March, the world will celebrate International Women's Day. Our discussion today on protection of women is timely.
We have had some cases for the past few years relating to sexual and hurt offences which triggered much discussion on whether the sentences imposed were adequate.
In September 2020, last year, we started off an important broad-based conversation on the position of women in Singapore, how we can better deal with the issues they face, not just crimes but the overall position of women. That review goes beyond the law, beyond the narrow context of sexual and hurt offences.
This particular review here, which I am going to speak about, is on the context of sexual and hurt offences. Stiff and effective punishments are necessary, but they are only one part of the picture. The penalties may deter, but they are not going to remove the attitudes behind such conduct.
As a society, we must look deeper. The broad-based review will look into how equality and respect for women can be better ingrained in our society and inculcated as a fundamental value from young; and to change mindsets, tackle underlying attitudes and behavioural patterns.
We have had many discussions with various groups, many more discussions are planned and we are on track to issue the White Paper later this year. Today, for the purposes of my Statement, I will focus specifically on our approach on punishments that sexual and hurt offenders will face.
Let me start by referencing three cases.
First, in September 2019, we have the case of a 22-year-old university student who molested a woman on a MRT train. The Court gave him 21 months of probation. The probation report stated, and I quote, \"good academic performance in school, highlighted his potential to excel in life\". AGC appealed against probation. They did not agree that a sentence of probation was appropriate and the High Court agreed with the AGC and imposed two weeks imprisonment.
The second case was in July 2020, a 22 year-old university student caused hurt to his ex-girlfriend. He had put his hands around her neck, choking her and pressed her eye as well. He was given a 12-day Short Detention Order (SDO), 80 hours of Community Service Order (CSO) and a five-month Day Reporting Order (DRO).
The third case in July 2020, a 23-year-old undergraduate, used a handphone recorded a video clip of a female person in a bathroom. He was sentenced to a 14-day Short Detention Order and a 130-hour Community Service Order. AGC felt that the sentence was too light and they appealed, but the sentence was upheld in Court.
These cases generated public discussion. There were also other cases where male university students took videos of females in bathrooms. There was a public sense that the sentences were not adequate, questions were asked – was there more leniency because of the educational qualifications of some of the offenders?
In this speech, I will set out the Government's approach on sentencing adult offenders for hurt or sexual offences; and second, what should be the relevant factors in sentencing.
When it comes to sentencing, the Government decides on the policy, puts it before Parliament and the philosophy, principles – what we want to see in the laws, what should be the range of sentences, what factors are relevant – those are matters of policy that the Executive works on and puts before Parliament and Parliament decides. The Courts then apply these laws.
Thus, it is for the Government and Parliament to decide whether the punishments are adequate. The Courts look at the laws, the range of sentences and decide each case on its on its facts, because sentencing in the end is fact-specific.
So, when it comes to sentencing, what should our philosophy be? There are four principles that are often referred to.
First, prevention – where an offender poses a threat to public safety, the sentence should prevent the offender from causing further harm.
Two, deterrence – the sentence should deter the offender as well as others from similar behaviour in future.
Three, rehabilitation – the sentence should, where and to the degree appropriate, seek to encourage the reformation of the offender.
Four, proportionate punishment – the sentence should punish the offender according to his blameworthiness and seriousness of crime.
I will now deal specifically with sexual and hurt offences. The Government takes a tough approach on sexual and hurt offences. We have made significant amendments over the years to enhance the protection for victims of sexual and hurt offences. I have set them out in the Annex. With your permission, Mr Speaker, Sir, may I ask the clerk to distribute the Annex. Members may also access these materials through the SG Parl MP mobile app.
Mr Speaker: Yes, please. [Handouts were distributed to hon Members. Please refer to Annex 1.]
Mr K Shanmugam: If I may carry on while that is being distributed.
In 2019, we amended the Penal Code and Protection from Harassment Act, or POHA. Under the amended provisions, those who commit sexual and hurt offences against vulnerable victims, face enhanced penalties. That would include: victims in intimate and close relationships with the offender; children under the age of 14; domestic workers; and physically or mentally disabled victims who are substantially unable to protect themselves from abuse, neglect or self-neglect.
Offenders who commit offences against such vulnerable victims are now liable for up to twice the maximum prescribed punishment.
For example, if you take the unfortunate case for the Myanmarese foreign domestic work Ms Piang – if those facts had taken place after 1 January 2020, then those found guilty could face much higher punishments.
For example, giving another example, there was a case some years ago, husband and wife abused their foreign domestic helper. The husband had slapped, punched and kicked the victim, hit her with canes and bamboo sticks and pushed her against the cabinet. The wife had slapped and punched the victim. They were convicted of numerous offences including voluntarily causing hurt under the Penal Code.
The husband was sentenced to 43 months' imprisonment. The wife was sentenced to two months imprisonment. If those assaults had taken place after 1 January 2020, their sentences are quite likely to have been higher because the penalties have been enhanced.
We also specifically made criminal acts like voyeurism, dissemination of intimate images without consent – these have become more prevalent with technology – the conduct were offences previously, but not specifically identified as voyeurism offence or a dissemination of intimate images offence.
Voyeurism, for example, previously would have been charged under insulting a person's modesty. Dissemination of intimate images, for example, would have been charged under distributing pornography. Maximum penalty for voluntarily causing hurt has been increased from two to three years imprisonment. We have also enhanced penalties under POHA for harassment of persons in an intimate relationship with the offender and for repeated breaches of Protection Orders.
Both the penal code and POHA amendments took effect on 1 January 2020 and the amendments apply to offences committed on or after that date.
In 2018, the CPC and the Evidence Act were amended. The accused and counsel were required to seek the Court's permission before questions could be asked about a victim's physical appearance, sexual behaviour, where these do not relate to the charge. We also prohibited the release of identity of victims before a complaint is made and the default position for trials is closed-door hearings when the victim testifies. We also allowed the use of physical screens to shield victims from seeing the accused when testifying in court.
Earlier in 2012, the Evidence Act was amended to remove provisions based on outmoded assumptions about victims of sexual offences. When it comes to sentencing of adult offenders who commit sexual and hurt offences, our position is that the sentences must reflect that such acts are deeply offensive to our fundamental values.
Outrage of modesty is not merely an offence that a man commits because he is tempted by the way a lady dresses. Voyeurism is not merely a thoughtless act that a young student commits in a moment of folly. These and other similar offences, whether committed against a female or male victim, should be dealt with seriously. These actions must be seen as an affront of fundamental values. There can in general, be no excuses for these offences.
Mitigation pleas based on the offender's educational qualifications or academic potential should not carry much weight. For such offences, principles of proportionate punishment and deterrence should generally take precedence over rehabilitation.
This means, if you touch a woman inappropriately without her consent, if you upload intimate images of an ex-girlfriend or any other woman; if you video record a woman showering, you must face serious consequences in law. And you should not be able to come to Court and say you have a bright future you will go far and so on. You can go far, but first serve the sentence. [Applause.]
If we make examples of some offenders, however bright their potential outlook in life, then the message of deterrence will likely be stronger. I am going to ask MOE to summarise these points and send to all students, boys and girls, so that everyone understands where we stand, and they must realise that a moment of folly can lead to very serious consequences. We will make sure our laws reflect this severity.
That said, there may be exceptional circumstances. Let me give a couple of examples. An offender, for example, may have a very low IQ, that affected his judgement as to right and wrong; or a serious mental illness that had a causal link to the offending conduct.
Relevant offender-specific mitigating factors should generally continue to be taken into account. These factors should be assessed on a case-by-case basis with due consideration given to the harm caused to the victim and the need for deterrence.
With this in mind, I will set out three steps that we are going to take now: one, increase penalties for three specific sexual offences; two, AGC will generally object to rehabilitative sentences for adult offenders who commit certain sexual and hurt offences; and three, a guide on sentencing will be published.
First, increase in penalties for three sexual offences. As Members know, I have been coming repeatedly to amend these laws and you can see that from Annex 1A. So, we have been constantly reviewing. We did a further review of our penalties for sexual and hurt offences in the Penal Code, including voyeurism, distribution of intimate images, outrage of modesty and voluntarily causing hurt.
In our view, the maximum penalties are properly calibrated for most of these offences. We have set them out in Annex 1B. There are, however, three areas where we intend to increase the maximum punishments.
First, outrage of modesty under section 354(1) of the Penal Code. From 2016 to 2020, on average, we had 1,190 cases of outrage of modesty reported each year, which is about 24% higher than the previous period of 2011 to 2015.
We want egregious cases to be dealt with more severely. We will increase the maximum imprisonment term from two years, to three years.
Next, where sexual activity in the presence of a minor takes place, or sexual images are shown to a minor between the ages of 14 and 16 years; and if you compare that with exploitative sexual activity in the presence of a minor or showing a sexual image to a minor who is between the ages of 16 and 18 years. These two offences are similar in nature to offences involving sexual communication with minors.
We will therefore correlate the penalties – increase the maximum sentence from one year to two years’ imprisonment.
Second, unless there are exceptional facts, AGC will, as a general rule, object to rehabilitative sentences for adult offenders who commit certain sexual and hurt offences.
Where adult offenders – I emphasise adult – commit sexual and hurt offences, the need for proportionate punishment and deterrence must take precedence over rehabilitation. This is a matter for the Government to decide. It is a matter of policy.
I have discussed this with AGC and AGC agrees with our view. Therefore, AGC will generally object to rehabilitative sentences, such as probation and community-based sentences, where the offenders are adults who commit certain types of hurt or sexual offences. I should add that that is the general position they have taken anyway, but they are going to be much stricter about it.
We will need to give due consideration to exceptional circumstances, which may justify deviation from this general position. We have to, in Parliament, and the Executive, and of course, AGC in court.
For example, where the facts of the case are such that rehabilitation should be the dominant sentencing consideration. Take a situation, where a first-time adult offender with an intellectual disability touches a woman. It may, in certain circumstances, better serve the public interest to impose a rehabilitative sentence with appropriate conditions, to reduce the likelihood of future re-offending, rather than to impose an imprisonment term.
Take another example, where the offender suffers from a treatable psychiatric condition that contributed to the commission of the offence, a Mandatory Treatment Order may be appropriate.
The third step that we will take is to publish a guide on sentencing in Singapore.
To better educate the public about the sentencing process, MHA and MinLaw have worked with AGC and the Law Society and we have prepared a guide on sentencing in Singapore. This guide explains sentencing process in our courts, addresses important questions of public interest like: (a) what are the objectives of sentencing? (b) what are the common types of sentences imposed by the Courts? (c) what factors does the Court take into account during sentencing? (d) how does the Court decide what sentence to impose? The guide will be published on the MHA, MinLaw and AGC websites.
Therefore, if I may summarise this part, in respect of sexual and hurt offences, based on what I have said, it should be clear that an offender will not receive a lighter sentence simply because he has higher educational qualifications, or has better prospects in life.
There is another important step that we are going to take. MHA and MinLaw have also been considering how we can achieve greater consistency in sentencing and how there can be greater public education about sentencing.
We studied the experience in other jurisdictions: England and Wales, and Scotland. We noted that the formation of a Sentencing Body that promulgates sentencing guidelines can be useful. It can enable proactive publication of guidelines to pre-empt or address areas of concern, and that can facilitate a more consultative process. And it will allow views of more stakeholders to be taken into consideration.
MHA and MinLaw have discussed with various stakeholders, including AGC, the Judiciary. We will set up a Sentencing Advisory Panel. The key function of the Panel will be to issue non-binding sentencing guidelines.
To illustrate, if the Panel decides to issue a sentencing guideline for a hurt-related offence, the Panel can set out the sentencing framework, sentencing bands, based on the twin factors of harm and culpability. The framework can include relevant aggravating and mitigating factors to be considered in sentencing.
The guidelines will be published and be accessible to the public. It will be persuasive, but of course, not binding on the Courts. The Courts decide each case on the facts before them.
We envisage that in working out the guidelines, the Panel will consult other stakeholders, where appropriate. And that will provide greater clarity to the public about the likely sentence and the relevant factors to be considered in sentencing, as compared to the current position where the legislation only sets out the maximum penalties.
It is expected to be an inter-agency Panel. It will comprise stakeholders from the criminal justice system, including Members of the Judiciary, AGC, MHA and SPF. We will give more details on the Panel later.
Let me now, in the context of the points I have made, consider again the cases I mentioned at the start of the Statement.
The first case, the one in April 2020, where the High Court overturned the initial sentence of probation and imposed imprisonment, our view is that that was appropriate and that would be the case now with the amendments.
The second case, the 22-year-old university student who hurt his ex-girlfriend in May 2019. The sentence in the case was decided in accordance with the law at the time and rightly so. Had the acts been committed on or after 1 January 2020, he is likely to have been charged under the new Penal Code provisions, voluntarily causing hurt to a victim with whom he was in an intimate or close relationship. He would have been liable for up to twice the maximum penalty. For voluntarily causing hurt, twice the maximum penalty is up to six years’ jail, $10,000 fine, or both. Because that is the maximum penalty, he would then not be eligible for community-based sentences, which by law, are only generally available for offences punishable with a maximum imprisonment term of not more than three years.
The third case is the 23-year-old university student who committed voyeurism. Before the Penal Code amendments came into force in 2020, such acts were usually prosecuted under the rubric of insulting the modesty of a woman, punishable with up to one year’s imprisonment, or fine or both. Now, with the introduction of a specific offence of voyeurism which carries double the penalty – two years’ jail, or fine – there is now also the possibility of caning.
As I said, AGC will also, in general, object to probation or community-based sentences being imposed in cases involving voyeurism offences. Offenders who commit such offences should not expect to be treated leniently.
Mr Speaker, I have set out our philosophy, a tough stance towards sexual and hurt offences.
Beyond these penalties, the criminal justice system also reflects the values of society. Such acts must be seen as penalising a gross violation of fundamental values in Singapore. The usual mitigating factors will have less force when viewed in this prism. The starting point should be the conduct should never have happened. No excuses. Offenders should expect to face the full force of the law.
Society needs to play its part as well to unequivocally repudiate sexual and hurt offences as violations of fundamental values. Collectively, with right laws and policies, and more importantly, with the right societal mindset in place, we can move towards being a society that fully lives up to our values. [Applause.]
Mr Speaker: Leader of the Opposition.
Mr Pritam Singh (Aljunied): Thank you, Speaker. I thank the Minister for the Statement. My query pertains to hurt offences. I take the Minister back to the debate when the Criminal Law Reform Bill was tabled in Parliament in 2019. There was a discussion amongst Members of how voluntarily causing hurt, being a non-arrestable offence, is dealt with by the Police. Then-Senior Parliamentary Secretary who at the round-up speech confirmed that Police do look at voluntarily causing hurt (VCH) offences in some broad classes – I do not think those were closed classes. These included road rage, secret society members, fighting, racial, religiously-aggravated VCH cases. The Senior Parliamentary Secretary then in the round-up speech mentioned that, I will quote what he said, \"post-amendment we can assess if there is a need to create a more expedited framework for the resolution of other types of VCH cases and if this can be done without compromising due process or compromising the delivery of Police response to other more serious offences\".
I would just like to confirm whether the Ministry has considered looking at VCH offences, the section 321 type of offences, the non-arrestable offences, in a more variated manner so that we can take expedited action in the appropriate cases.
Mr K Shanmugam: Thank you. That question actually highlights one of the more involved discussions that MHA has been having, with me involved. Let me put it this way. Voluntarily causing hurt, as Mr Singh would know, it can cover a broad ambit. Let me give a couple of examples.
You are in a supermarket. Someone goes past you and push you. Let us leave out the sexual part of it – just two men. He pushed you aggressively. That is at one level. You did not feel hurt, nothing, but he should not have pushed you. You go and file a Police report.
On the other end of the scale, could be a more serious assault which does not result in grievous hurt – because then, it would be voluntarily causing grievous hurt – but nevertheless, leaves you in a state of shock.
It is quite clear the second category — I mean, we talk about Singapore being a safe society. My position to the Police has been that those sorts of cases, you want to be able to walk in the streets, feeling safe. You need to know that if there is that kind of conduct, that will end up in court. But if you start taking every assault to court, I do not think we are doing justice as a society either. Because you will get into a detailed involved assessment of intent, cause.
I think the intent of your question then and now, Mr Singh, is that the criminal law is not the best solution for these cases. It should be dealt with through other ways, without undermining the rule of law. We agree. There are some internal frameworks for the Police to try and assess that and deal with it. If the Police try to deal every single case of police report on voluntarily causing hurt, it would be an impossible situation. And I do not think we will be better off as a society either.
So, there is a framework to try and deal with this. Of course, people who are not happy, there are other routes, as the Member knows as well; through a magistrate's route as well.
If you want more details of how we work it, to the extent that it is possible to give it, because we do not want people gaming it either, I am happy to share the details.
Mr Alex Yam (Marsiling-Yew Tee): I thank the Minister for his Statement. I think we certainly welcome the new framework. I have spoken on this on a number of occasions and I welcome the updates. Just one clarification I seek from the Minister. In the last two years, one of the questions that was raised is, quite a number of cases relate to those who have a position of trust with the victim. Just to rattle off some recent cases: teacher molests seven boys, former Secondary school teacher abuses 15-year-old students, Secondary school teacher molests boy in school lab, Primary school teacher molests 12-year-old boy and so on. You also have, recently: male nurse allegedly molests male patient, Statutory Board director outrages modesty of female subordinate, doctor at Mt E accused of molest against a female patient.
Many of these are in a position of trust. Would the Ministry consider further enhancing the sentencing framework and increase the penalties for those who not only cause hurt or sexually abuse the victim, but start out from a position of trust, so that we ensure that such crimes where the victim already feels a sense of comfort in the presence of the person, does not fall prey to such offences.
Mr K Shanmugam: I thank the Member for the question. I mean he reeled off a list of cases where people have abused that position of trust to molest or otherwise hurt someone close to them.
Let me make the general point first. We are a low-crime society. Societal relationships, man's behaviour with man, these things happen everywhere. I do not want people to go away thinking that, in some way, in Singapore, it is more extreme. In fact, it is much lower. It is much lower because, as I have said before – and I think Senior Minister Teo might have, too – in Singapore, a few things are quite certain. When you have done wrong, you are likely to be investigated. Second, the investigations do not usually take very long. Third, if you are guilty, you are likely to be found guilty and you are likely to face the penalties because we start off from that framework. Also, on the whole, we have a highly law-and-order-based society. People obey the laws. I think we have managed to keep the criminal behaviour to a much smaller context than many other countries do. So, we start from a position which would be of some envy to most well-ordered societies.
With that, the specific question that Mr Yam has asked, these factors are already relevant, highly relevant, for sentencing. If you are in a position of trust, if you are a teacher, that is a very serious consideration that is taken into account in sentencing. So, there will be no question in the minds of people, if you are a teacher, if you are a doctor, you are in a position of fiduciary relationship where you have control or you have oversight over the other person and you take advantage, the Courts treat that very seriously, and we have reflected that approach quite clearly.
And that is, of course, without considering, if you are a professional, the professional bodies will have something to say. For doctors, the Medical Council will follow up. So, you will face both professional consequences and criminal consequences. So, I think we ought to be quite clear that being in a position of trust is a very material – in fact, central – consideration in enhancing penalties.
Mr Speaker: Mr Christopher de Souza.
Mr Christopher de Souza (Holland-Bukit Timah): Thank you, Mr Speaker. I agree with the Minister that we are starting from a position of strength. My question is in relation to the handout provided. At section 73, it says that there are enhanced penalties for offences against domestic workers, and that can be twice the maximum penalty.
My question here is really that it is good that we protect our foreign domestic workers because they are in a position of vulnerability. But I think that section 73 should be widened not just to include foreign domestic workers, but people who are in a position of vulnerability because of their employment. And that can expand beyond the FDW matrix. So, if we are, indeed, wanting to protect the vulnerable, then would a reconsideration of section 73 and the widening of it be considered in this review?
Mr K Shanmugam: I thank Mr de Souza. I think the current position, we were quite deliberate that it should cover vulnerable victims. And in my speech now, as well as when I moved the amendments, the way we saw our society, what is happening, you have children who are vulnerable, you have domestic workers who are vulnerable and, in a fast-ageing society, you have senior citizens who are vulnerable, who are not able to take care of themselves, and you have intellectually-challenged people who are vulnerable. So, we have sought to define people in vulnerable categories; and offences against them, the penalties are much more severe. So, we have already gone down that route and the definition is quite comprehensive in terms of starting with what we mean by \"vulnerable\". So, all those categories I have mentioned are considered vulnerable.
We then added on another category that would not, in the usual sense, be considered vulnerable – girlfriends or people in an intimate partner relationship when they are subjected to violence. If you are in a marriage situation, the Women's Charter allows you to go and take an application, a Personal Protection Order (PPO). But if you are an unmarried partner, you cannot go and take a PPO under the Women's Charter because, by definition, it only applies to people who are married, spouses. So, we extended the protection to persons in an intimate partner relationship. So, if you abuse your girlfriend, now these enhanced penalties will apply to you, and your girlfriend can take out the appropriate orders under POHA, for example. So, we have covered vulnerable categories. But I will be happy to ask my Ministry to relook at it. But we were quite focused in the way our society was changing. Particularly, I was concerned about senior citizens who now are at homes, and elder abuse, and I felt that we ought to stiffen the law before it becomes prevalent.
Mr Speaker: Ms Sylvia Lim.
Ms Sylvia Lim (Aljunied): Thank you, Speaker. I have two clarifications for the Minister on what he said earlier regarding the policy that the AG in general will object to a rehabilitative sentence for certain kinds of offences. So, my first clarification on this is: is there going to be a change in the law to specifically provide that rehabilitative sentences will not be available to certain categories of offences?
My second clarification is: I think it is important also for the Minister to confirm that these moves in no way undermine prosecutorial discretion which is provided for under the Constitution. So, I would like him to confirm that, so that there is no misunderstanding on this point.
Mr K Shanmugam: Thank you. On the first question that AG, AGC or prosecution will generally object in general, in fact, as I have said in my speech, for some time now, that has been the position of prosecution in general when it comes to sexual and hurt offences. They object to community-based sentencing or rehab-based sentencing, and they focus on deterrence and sending the message. I am re-emphasising and reaffirming that approach and saying that AGC will be even clearer in that approach hereafter.
On the second question whether this undermined prosecutorial discretion, absolutely not. I mean, as I have mentioned in my Ministerial Statement, you will have cases where individuals – intellectually-challenged, did not know what they were doing was right or wrong or on the margin – these are not matters that we can set out in broad terms here in Parliament, and AGC will have to decide, case by case, and the Courts will have to decide case by case. But what is important is that Parliament understands and affirms, and the Executive, my Ministry, puts before Parliament the Government's policy and this Ministerial Statement sets out the Government's policy for Singaporeans, which we put before Parliament that we will take a no-nonsense approach to sexual and hurt offences. Rehabilitation will not be the primary consideration. The primary considerations will be deterrence and prevention and sending the message clearly, and consistent with what I have articulated, as a fundamental tenet and value. So, it is for the Government to set out that policy. It is for Parliament to put that policy in law where it is not already in law. And I have said we will make amendments in three specific situations, and we set out what we believe should be the approach which is good for society as a whole. And that then has got to be the guidelines for AGC to apply in exercising their prosecutorial discretion. The discretion has got to have a framework to be applied; framework has got to be supplied by Parliament. And for the Courts, with their judicial independence to apply, the Courts also need a framework. So, that is the context to the Statement. Thank you, Sir.
Mr Speaker: Mr Murali Pillai.
Mr Murali Pillai (Bukit Batok): Mr Speaker, Sir, I thank the hon Minister for his Ministerial Statement. I think his unequivocal Statement, in relation to the fact that qualifications of an offender would not matter in relation to sentencing, will go a long way to assuage members of the public that he were concerned about the sentences imposed on offenders that the hon Minister mentioned.
My clarification is on the Sentencing Advisory Council. The hon Minister mentioned that his Ministries will be looking at this. May I ask whether the remit of the Advisory Council would extend to not just offences dealing with hurt or having sexual elements, but really to the entire spectrum of offences, so that members of the public would be able to be apprised as to the sentencing guidelines and this would improve access to justice as well.
The second clarification concerns the Attorney General's role. The hon Minister spoke about the case whereby the 22-year-old undergraduate strangled and I think injured his ex-girlfriend's eye as well. I note that, in that case, actually, there were two offences that he committed. The Attorney General, or rather, the Public Prosecutor applied for the criminal trespass charge to be taken into consideration for purpose of sentencing and I also understand that there was no appeal arising from the sentence. Given that the hon Minister mentioned, in answer to the hon Member Ms Sylvia Lim, that it has been a practice of the AGC to object to rehabilitative and community sentences in relation to such offences, why then was there not an appeal? And in relation to the offence that was taken into consideration, it was criminal trespass but, as I understand, the offence was that he broke into the house of the girlfriend, and the Penal Code has an aggravated form of offence. Housebreaking is an offence for which the offence is punishable by three years' sentence. So, may I understand what is the AGC policy in relation to such matters where there is hurt in the context of a relationship?
Mr K Shanmugam: I thank Mr Murali Pillai for the questions. On the Sentencing Advisory Panel, the remit is being worked out. I think it makes sense for the remit to be covering beyond sexual and hurt offences, and that is the intention. Precisely which offences would be covered, I do not want to prejudge that at this point.
Second, specific to the facts of the 22-year-old undergraduate, under the criminal trespass charge that was taken into consideration, this goes directly into what Ms Sylvia Lim had asked. It is really not for me to second-guess and say, on specific cases, why the Attorney General's Chambers did or did not do something. That is a matter of discretion. But let me recall or put across the facts as I remember them.
I think Mr Murali Pillai will remember. It was a case where, yes, there was a break-in but the ex-girlfriend then spent some time talking to the young man. And, in fact, took him – if I recall correctly – to a part of the house. It may well be, if I were the prosecutor, I would look at it and I will say that that is not going to be an easy case, because, yes, there was initial trespass but was there subsequent consent? So, one has got to look at the facts carefully. There can be a variety of reasons why charges are taken into consideration.
Why was there no appeal? As I said, it was dealt with in accordance with the law at that point in time. Today, we have enhanced the penalty. For example, this would have been treated like an intimate partner violence case, where the penalty would be higher. The Courts imposed a sentence that was in line with the precedents at that point in time and AGC's assessment was that it was not going to be easy to challenge. I cannot be dealing with every specific discretion that AGC exercises.
Ms Nadia Ahmad Samdin (Ang Mo Kio): Mr Speaker, I would really like to thank the Minister and the teams from MHA and MinLaw behind this review and for hearing the voices of many young women as well as the effort to engage and review the framework. I have three clarifications.
The first, from a victim-centric point of view. Other than the intention to amend the maximum penalties for three sexual offences, will the Government consider putting in place programmes and training to better ensure trauma literacy within the criminal justice system to safeguard the interest of victims of hurt and sexual offences?
Second, Sir, the trauma on victims can be irreversible. But I have spoken in this House about going beyond second chances and I have worked with young offenders and families with people incarcerated. I know that some offenders pay for a very long time, beyond their sentence, and society includes them too. I hope the Minister can elaborate more about how the sentencing principles of deterrence and rehabilitation to prevent future incidence of reoffending are balanced in the second proposal as the range of sexual and hurt offences is very wide. What do certain offences where rehabilitation will not be considered include?
My last point. It is very evident from heated discussions online that there is significant public interest in this space. What steps are being taken to educate the public and, in particular, youths about consent and power dynamics in sexual interactions and what role can the media and public more responsibly play to elevate the conversation? I appreciate the sentencing guideline and just hope that it can be made friendly to the layman so that it is easily disseminated, for example, by social media.
Mr K Shanmugam: I thank Ms Nadia Ahman Samdin for those questions. Let me start off with one point that I think we should all be very clear about. We can express our views set out in the Parliament through legislation – tough laws – but let us not walk out of this Chamber with the belief that the laws alone or even the enforcement of them is going to prevent all offences. No society works on that basis.
The one thing I have learned in 30 years in the law, in one way or another, is that the laws are there, the majority of the people do not need laws to keep them straight and a small minority who will be tempted, many of them will not be tempted as long as they know that the laws are tough and there will be enforcement. But there will always be, regardless of what steps you put in to prevent fraud, what steps you put in to prevent criminal action, there will always be a group that breaks the laws.
Having the laws is important for the bulk of society but let us be clear – there will be people who will break them and we will have to deal with it. That is the starting point. Whether it is laws against sexual offences or laws against fraud or laws against speeding; any of which.
With that, how do we take into account victims' interests and protect them? You have victim impact statements. They can be submitted to the Courts so that the Courts are very informed about the impact of the offence on the victim, and the emotional and physical trauma that has been suffered. I have talked about it earlier. In order to protect the identity of the alleged victim, gag orders can be made. I have given you in my Ministerial Statement a framework in such cases on how the victim could be protected from some types of cross examination, from having to face the accused, from having screens to protect them. Of course, in addition, there are Protection Orders available and Expedited Protection Orders available under the Protection from Harassment Act (POHA) and the Women's Charter, as appropriate.
We are also exploring, we are talking to the Courts about the possibility of recording video-recorded interviews of victims and then, using those videos as evidence in court in lieu of examination-in-chief. And we think that that might help reduce the victim's trauma from having to recount again in court the ordeal the person went through. We are trying to reduce the number of times a person has got to talk about the ordeal that he or she went through; usually a \"she\".
But when we speak about all of this, do not forget the presumption of innocence and the accused's right to a fair trial and have the allegations tested in court. So, never forget that.
Second, Ms Nadia Ahman Samdin also asked about the role of media and members of the public. In order to have meaningful discourse, you need a better understanding. To raise the level of understanding, we are, for example, publishing the guide on sentencing that I spoke about in my Statement. We are also talking about the Sentencing Advisory Panel issuing guidelines. But, of course, I think we must be realistic. Not every member is going to check out the MHA website on guidelines and read them. I think a few days ago I recall Mr Pritam Singh saying that he did not realise that I had made nine speeches. I am realistic about how many people read my speeches and visit the MHA website. But we will put it out and we will try and get people to understand. Of course, lawyers will be better informed as well.
The media, I think they play a very important role, in helping the public get a fuller and better understanding of the process and what is the framework. But I think one point to which I do not really have a solution is that individual cases, partially reported, without the full facts, tend to invoke a lot of passion, excite a lot of passion, and then people form views. We have to be careful about the cases being trialed in the court of public opinion. Or there being decisions which are pushed upon by the public with not a full understanding either of the law or the facts. Because not the full facts are out in the media most of the time. We have to allow judges to carry on and do their jobs.
But public opinion is important and for the Parliament to be aware of the public sense of right and wrong is also important because that allows us to calibrate and make sure our laws accurately reflect where the balance ought to lie. Now, we ought to decide that – in the best interests of the public. But public viewpoints and public opinions are relevant in coming to that assessment.
Ms Nadia Ahman Samdin also asked about the balance between deterrence and rehabilitation in sentencing. Most of my speech – quite a lot of my speech – was targeted at dealing with that. Again, it is for the Parliament to decide, depending on the offence, what the balance ought to be.
It should depend on age. That is why in my Ministerial Statement I spoke about adult offenders being treated more severely. You would treat a 15-year-old differently from a 25-year-old or a 23-year-old. So, we need to look those factors. We need to look at the degree of active consideration of what the person was going to do, the culpability, the seriousness of the offence.
For younger offenders, the general approach – the dominant factor – ought to be rehabilitation. Because they do not have the full maturity of adults and they are still in their formative years. The chances of reforming are higher.
But other sentencing principles, like deterrence and proportionate punishment, may take precedence over rehabilitation, even for younger offenders, where the offence is serious, the harm caused is severe, the offender in our assessment is hardened or recalcitrant, or the conditions that make rehabilitation options viable do not exist.
Say, a young offender has committed rape. The Courts may impose imprisonment and caning instead of a rehabilitative sentence like probation or reformative training, because of the nature of the offence, its severity and the likelihood or the possibility that this may happen again and other people need to be protected.
For adult offenders, I have explained, for sexual and hurt offences, rehabilitation would not be the dominant consideration unless there is a strong propensity to reform and specific factors strongly point to rehabilitation. But I have also said, \"I am a person with bright prospects\" or \"I am an undergraduate who is going to do well in life\" – those are not very relevant factors. I have been quite clear about that.
Mr Zhulkarnain Abdul Rahim (Chua Chu Kang): I thank the Minister for Law for that very clear statement. As an advocate to end domestic violence, I really appreciate the statements made. I have two clarifications. One on the guidelines themselves, second on the composition of this advisory panel.
On the guidelines, I understand that the guidelines are non-binding but highly persuasive. In the UK, they amended the Evidence Act to make those guidelines binding upon the courts but the courts can depart from them if it is in the course of justice to do so. But if I may offer another alternative position used in the Victorian courts, where the panel themselves can be invited by the court of appeal to provide some views before the sentencing of a particular case. I say this so that we do not shut out any possibility or flexibility to cater to evolving societal needs and specific individual cases.
On the second part, the composition of the panel, I ask the Ministry to consider a diversity, both in terms of gender and also expertise. In the UK, it is about 60% women but also entirely made up of legal professionals and judiciary. But in Victoria, it is about 50% women but comprising victims, crime support advocacy groups and also criminal justice professionals. Perhaps the Minister can see whether the Ministry can consider such diversity in the panel.
Mr K Shanmugam: On Mr Zhulkarnain Abdul Rahim's two questions, and as to whether the panel can be invited to give views, we will give consideration but the situation in Singapore is slightly different from Australia. Let me explain why.
This is a relatively small place. The panel will also have judges. First off, it would look a little odd that judges appear before judges to give their views.
So, the composition that we are thinking of will have judges, practitioners, lawyers certainly, appointed by the Law Minister. The way we are thinking of, MinLaw might appoint two. Who those two persons will be, we will decide on whether it needs to be from the Bar or from other places. Other stakeholders will be involved.
A sentencing guideline issued by such a body, would be as I said, highly persuasive. It will be widely known across the legal and judicial circles. And I think that it helps us put up a framework beyond the legislation. Whether you need to go further, we can look at things as they evolve, but we also need to be careful how we structure it.
Second, I know, its a buzzword, diversity. I am a believer that you appoint the appropriate persons to the right job. This requires expert viewpoints. The guidelines from the panel must carry weight. It must have gravitas for judges to take it seriously. That does not mean that you cannot take in the viewpoints of a variety of people interested in this matter. NGOs will have interest, others would have an interest, people who want specific laws or specific types of penalties to be changed will have an interest. And you must appoint a panel that is open to hearing all these viewpoints. But the panel must have the expertise to make an assessment based on the law and what makes sense, and put it across. Open-minded, but an open mind is not an empty mind. It must also not absorb whatever nonsense that comes up. It must be able to assess what makes sense, what does not make sense, make an assessment, give guidelines that would carry authority and respect.
Who can provide that? There are many who have viewpoints. They will all be welcome to give their views. By necessity, the panel will not be a very large panel and there will be limits on how many people can be there. There is, in principle, no disability imposed on people, but I do not think we should run after this with diversity as a primary goal. The primary goal must be a sentencing body that would carry respect. In terms of gender diversity, I do not think Mr Zhulkanain or Members need to worry. That is something that my Ministry will keep front and centre, and even if we did not, I think more than half the profession are women anyway. So, you will expect that to be reflected in the panel.
Ms Hazel Poa (Non-Constituency Member): Mr Speaker, we welcome the Government taking a tougher stand on sexual and hurt offences, and we also support the position that the offenders' academic achievements should not be a factor in sentencing.
But I do have a clarification though, on the Sentencing Advisory Panel. While it says that this panel's decisions will not be binding on the Court, it does create a situation, if the Courts were to deviate from the guidelines issued by this panel, it does create a situation that requires an explanation and therefore could create some pressure.
So, my question is, how does the Minister address the concern that this could be viewed as the Executive arm going into an area that has traditionally been under the Judiciary, and could this potentially compromise the independence of the Judiciary in the area of sentencing?
Mr K Shanmugam: I am having difficulty following the question. But perhaps can I ask Ms Poa, in principle, does she support the setting up of a Sentencing Advisory Panel? Then, we may be able to discuss further.
Ms Hazel Poa: I am afraid that I will not be able to answer that question because I need clarifications on how this sentencing panel will influence the Judiciary. My concern is actually about whether it would compromise their independence.
Mr K Shanmugam: I think Ms Poa understands what I am asking, but she does not want to answer.
Why should it compromise the independence of theJudiciary? First of all, I said more than half the members would be from the Judiciary. Second, the purpose is guidelines for the future without referring to any specific case. Just like here, we are discussing what the laws ought to be. Do we compromise the independence of the Judiciary by doing so? Do we compromise the independence of the Judiciary when we set out in the law, what the punishments ought to be? Maximum, minimum, sometimes we say mandatory? Those decisions are made, that is a framework in which the laws are applied.
The guidelines are guidelines which will flesh out a little bit more. And it is for the Courts and the judges in the individual cases to decide whether the guidelines need to be departed from or need to be applied. How do the giving of these guidelines, how do the guidelines that the Courts have internally, how does any of this compromise the independence of the Judiciary? On Ms Poa's reckoning, the judiciaries in Australia and UK are no longer independent. May I have a view, please?
Ms Hazel Poa: The range of sentencing will be actually specified in the law. And within that, the Courts then mete out individual sentences for each case. But so how does this Sentencing Advisory Panel add on to what is in the law? How does it further restrict? I need further clarification on how it will work.
Mr K Shanmugam: I think I have tried to explain this a number of times. Let me make a further attempt. The law sets out maximum penalty – four years, five years – for such an offence. The law cannot, if you look at the legal provisions, go into much more detail than that. Sometimes, you can have illustrations, you can have some examples. And the Second Reading speech tries to flesh it out a bit more.
But a Sentencing Advisory Panel looking at different types of cases can set out, flesh out a little bit more, in non-binding language in cases that fall into this sort of factual matrix involving offenders above a certain age, involving this type of offence. Generally, we think the range of sentences, our view is that it should be between this and this. That is what the Sentencing Advisory Panel can do. And as I indicated, more than half of the Sentencing Advisory Panel will comprise judges anyway. It is bringing together a combined wisdom to set out a framework for how cases can be dealt with and it is aid for the individual judges faced with individual cases and applying the law and the guidelines to the specific facts to see whether the facts come within, should it fall within this range or there are facts which take it out.
As I said, on the reasoning of Ms Poa, a number of judiciaries around the world would not be considered independent.
Mr Patrick Tay Teck Guan (Pioneer): I thank the Minister for his Statement. I fully support the measures and the framework. I just want to make a point on behalf of workers, particularly, in four sectors: healthcare workers, transport workers, private security workers, as well as cleaning sector workers. I am fully aware that section 6 of the Prevention of Harassment Act does extend to Public Service workers and we have enhanced that. Whether Minister can consider in view of the vulnerability or should I say in a sense that they are essential workers, consider covering them within the ambit of this framework.
Mr K Shanmugam: Sorry, what, including them and vulnerable workers? Vulnerable categories?
Mr Patrick Tay Teck Guan: Perhaps consider them as in a position where we need better protection for them and in more deterrent sentences.
Mr K Shanmugam: I think we need to be careful about using the tag of vulnerability. There are two points here. Certain categories of workers that you have mentioned perform essential services, they are front facing, they face people and we need to help them because they are more often abused. That is a fair point. But you got to find the right rubric.
The right rubric is therefore not to extend the categories of vulnerable victims. I think the right rubric is to say these people face bigger risks and can we identify them or people who fall in those categories for some additional protection? For example, public sector workers, essential workers, these are all defined and may help them. And I think upon your advocacy, we have also extended greater protection to other categories of workers. So, it is possible to work the law towards covering different categories, but you must use the right framework.
Mr Speaker: Mr Gerald Giam.
Mr Gerald Giam Yean Song (Aljunied): I thank the Minister for his Statement. However, it did not mention MinLaw's effort to protect victims of workplace sexual harassment, which is also very serious.
An AWARE-Ipsos survey in November found that 40% of workers in Singapore said they had been sexually harassed at the workplace, but only three in 10 of them officially reported it, for reasons that include the fear of not being believed or being blamed for bringing it upon themselves.
So, my question is, has the Government done any victimisation surveys of its own to uncover the extent of workplace sexual harassment in Singapore? And if so, what are the findings?
And secondly, are there plans to table any legislation to oblige employers to prevent and address workplace sexual harassment. I understand that TAFEP has issued a tripartite advisory on managing workplace harassment and that is quite comprehensive. However, it is only an advisory and it is not a statutory requirement. So, employees can choose to ignore them.
I also understand that we have POHA, but that requires the victim to file for a court order which may be too onerous for them. So, would it be better to give the TAFEP advisory more teeth?
Mr K Shanmugam: As I understand Mr Giam's question, for harassment, there is a continuum. There is harassment which does not cross the threshold of criminality and then there is a harassment that does cross that threshold.
Once it crosses the threshold, that is what I have been talking about, amongst other things. The law takes over, criminal sanctions apply. I am not sure Mr Giam was in Parliament then, but when POHA was amended, it specifically allows individuals who feel harassed to take steps and to prevent the harassment, because, as I said, not all harassment amounts to criminal conduct. We drew a line ahead of whatever is criminal and said individuals, you can go and get remedies.
It has been made relatively easy to apply and get such orders.
We amended POHA to make expedited orders possible and make it even easier for orders to be obtained and we also made it criminal if people continuously breached Protection Orders. So, there are these steps that have already been taken.
Whatever the law can do, we have done. One of the remits I have asked MinLaw to look at would be, has been to analyse the number of applications that have been made, the time that has been taken and how effective is the process, and whether there are things that can be done to make it more effective.
So, from the legal perspective, we have empowered the individual, we have tightened up the criminal law. The laws stand there, first, to give aid and succour to individuals; and second, to protect them through the criminal process against the offender.
I think the essence of Mr Giam's question really is, beyond the legal framework, can more things be done from the perspective of employers and workplace safety. And that is a question I would invite him to file with MOM.
Mr Speaker: Ms Carrie Tan.
Ms Carrie Tan (Nee Soon): Mr Speaker, I thank Minister and MinLaw and MHA for the enhanced framework. I think it is really important and I am grateful for the Government in taking a strong stand against the sexual offences and hurt to better protect women and girls.
I have a question and I will take the opportunity to ask. It is not so much related to this particular sentencing framework. But to address the trend whether the norm in society where women are subject to sexual objectification, often in the media. I have come across residents' parents who grapple with their young children being exposed or even exchanging sexual content over the phone and so on with their peers – as young as the Primary school age. So, I think that is a very alarming phenomenon.
I would like to hear from the Minister what are his views in terms of this trend and whether there will be any laws or whether there are currently any laws to look into the media and content to take an upstream approach in protecting women against sexual objectification?
And also, I would like to express my gratitude for the fact that sexual communications are now a category of offences to avoid sexual grooming of persons from a young age. But I think the general societal exposure to sexual content, victimising or objectifying women, might be something that we want to address on a broader scale.
Mr K Shanmugam: I thank Ms Tan for that. On the exposure of young children to sexual images, that is an offence. I talked about it and, in fact, the penalties have been enhanced.
The other question is a much broader one – sexual objectification. How does the media portray women? How do we think of women? That is beyond the remit of Home Affairs and Law because we deal with crime and punishment.
But it is precisely the topic that is front and centre for the women's conversation, which has been kicked off in September of last year. I spoke about it when I started off my Ministerial Statement.
These cases where the boys going to girls' toilets in universities and take a video, and they think of it as a prank or something that is cool to do. How does that mindset come about? And if we approach it simply from a criminal law perspective, yes, we will keep putting these boys into prison.
But while we have to take a tough approach, what is really needed is a new approach and new way, a change of mindset. Which is why last year, when we kicked off this entire process of having conversations on women's development, I spoke about us having to affirm the status of women, the inviolability. It is a fundamental value for society. And every boy and girl has got to grow up learning that respect for women is a non-negotiable point. And, therefore, it is not cool to go and do this. It is not just a prank. It is a serious violation of a fundamental value.
That is the approach we have to instil. So, it has got to bring a multi-agency effort to the table and that is what is being done through the conversations, understanding we have got to do it in the schools, we have got to get people to understand, we have to get them to understand from the time they are young. That has got to pervade across all sectors, including the media.
Against that are very powerful countervailing forces – the power of money and what sells. What makes a film more watchable, what makes a TV show successful? So, these are all factors. In a context where people will do everything possible to push their products, including objectifying women in the process, if they can sell more cars or whatever. But how should we approach it as a society? It is a value system and it is going to require a mindset change, it is going to require education. The answer does not lie with the law alone.
Mr Speaker: End of clarifications.
","clarificationText":null,"clarificationTitle":null,"clarificationSubTitle":null,"reportType":null,"questionCount":null,"footNotes":null,"footNoteQuestions":null,"questionNo":null},{"startPgNo":0,"endPgNo":0,"title":"Commencement Time of Committee of Supply","subTitle":"Announcement by Mr Speaker","sectionType":"OS","content":"Mr Speaker: Order. We have completed the Ministerial Statement. We are now going into the Committee of Supply to debate the Estimates. I have revised the commencement time of the Committee of Supply to start immediately. With the change in commencement time, the revised \"guillotine\" time for Head W, Ministry of Transport is 2.10 pm. Hon Members will be notified of the revised conclusion times for the subsequent Heads of Expenditure.
The Clerk will now read the orders of the day.
","clarificationText":null,"clarificationTitle":null,"clarificationSubTitle":null,"reportType":null,"questionCount":null,"footNotes":null,"footNoteQuestions":null,"questionNo":null},{"startPgNo":0,"endPgNo":0,"title":"Estimates of Expenditure of Singapore for the Financial Year 1 April 2021 to 31 March 2022","subTitle":"Committee of Supply - Paper Cmd 5 of 2021","sectionType":"OS","content":"[(proc text) Order read for consideration in Committee of Supply [6th Allotted Day]. (proc text)]
[Mr Speaker in the Chair]
Mr Saktiandi Supaat (Bishan-Toa Payoh): I beg to move, \"That the total sum to be allocated for Head W of the Estimates be reduced by $100\".
It did not seem so long ago that peak hour congestion on our public transport was a common grouse among commuters and it has actually increased now, the peak hour congestion.
Over the course of a year, COVID-19 pandemic has dealt us a vastly different set challenges as a result reduced ridership and changing travel patterns. Earlier this month, the LTA revealed that the average daily ridership for buses and trains have hit an 11-year low, falling by 34.5%. Whether demand for public transport services will rebound remains to be seen. In Singapore, public transport remains the cleanest way to move large masses of people around. It builds the foundation of our car-lite vision.
According to a recent report by the Institute of Policy Studies, our citizens are increasingly taking an interest in environmental issues and prioritising them among their key concerns, even above economy and jobs. We must capitalise on this opportunity and include greener transport in our 2040 Vision.
We also need a transport system that is affordable all and sustainable to run. Barring environmental benefits, the changing patterns of travel poses a conundrum. As of July 2020, all bus services were already operating in the red. Even before the pandemic struck, just 3% or bus services here were able to generate enough fare revenue to cover operating costs.
The trains are not doing better. In May last year, then transport Minister, Mr Khaw Boon Wan shared that rail operators were already making losses before the pandemic struck. This has given rise to concerns about the economic viability of our public transport industry. I think it is timely for all stakeholders, Singaporeans and MOT, to discuss and address this issue over time, especially so now in this new normal environment.
Over the years, our public transport network has grown increasingly sophisticated and integrated. The fares follow an integrated distance-based structure. Commuters are making more transfers during trips but the trips are shorter. Travel time has also reduced drastically. Now there are many integrated routes to get to your destination. The average fares are lower, especially for bus trips. In previous fare review exercises, the actual fare increase was found to be less than that determined by the current fare adjustment formula. This has had an adverse impact on the financials of the industry, as the additional fare revenue could never fully compensate for cost increases in operations.
Despite the dip in ridership, service capacity and headways must be preserved to ensure safe distancing measures can be practised. The introduction of additional disinfection procedures, protection equipment and safe distancing personnel only lead to increased costs. Of course, we must also factor in maintenance costs as our rail and bus system ages. But as we embrace these changes, are they financially sustainable on the current operational model?
What is worrying is that in most discussions on sustainability now, the emphasis has been on environmental sustainability. The neglect of financial sustainability has been an important omission. Improving the financial sustainability of public transport would help to realise potential environmental and social benefits of public transport since it would make expanded public transport service more affordable, both for the governments who provide it and for the passengers who use it.
Germany and the US offer interesting contrast in the financial sustainability of our public transport. Over the past decades, Germany has improved its public transport services, increase productivity, reduce costs, cut subsidy requirements and attracted more passengers. American public transport systems have improved and expanded services but at a far higher cost, requiring much larger government subsidies and attracting fewer additional riders. In Singapore's case, are we at risk of skewing towards the American trajectory?
Can the Minister explain the viability of our current fare model, subject to our Government Budget constraints going forward?
We need to strike a balance between ensuring financial sustainability for operators while keeping fares affordable in this difficult climate and maintaining the quality of service and ease of access to areas which are far from transport nodes.
Can we also explore ways to maximise even more non-fare revenues from ads and retail business, property rentals and other value capture mechanism such as click and collect at transit stations? Can we also explore other financing options such as private investments?
But we need also to focus on encouraging higher usage of public transport. I have a few suggestions.
First, can we encourage transport operators to explore a new integrated mobility ticket or enhance our existing offerings by providing free access to all transit services, including reduced rates for taxis, car-sharing services and rental cars as well as discounts for other services, such as bicycle maintenance and travel information services?
Second, can we also explore linking e-tickets for large events such as professional soccer games and music concerts, generally also serving as transit tickets to access and leave the venue at no extra charge?
Third, we should ensure existing feeder bus routes are efficiently linked to different MRT rail nodes, especially the new ones.
Fourth, to ensure fares are affordable for financially needy commuters, I would like to suggest we ensure fare concessions extended to also assist adult learner students who may have stopped work or are increasingly going back to night or part-time school to upgrade their skills.
No matter the funding sources employed to cover public transportation costs, it is crucial that the transport authorities find the right balance between efficient and affordable prices and the financial sustainability of the system.
[(proc text) Question proposed. (proc text)]
Mr Ang Wei Neng (West Coast): Chairman, I would like to declare my interest for being part of the ComfortDelGro management team for the rest of my MOT cuts.
Singapore’s public transport system has been ranked the best in the world in 2020 by consulting firm, Oliver Wyman and the University of California, Berkeley. In 2018, McKinsey ranked the Singapore public transport system the second best in the world after Hong Kong. But our transport fare is the most affordable in the world, according to McKinsey.
Many thanks to the public transport workers, MOT and LTA for making this possible. What is the cost of achieving the most affordable public transport in Singapore?
Two billion dollars in operation subsidies a year, not including capital cost expenditure. The Government is spending $60 billion this decade to expand and upgrade the MRT system in Singapore and this is over and above the $2 billion operational subsidies. Is this sustainable?
In evaluating public transport affordability, McKinsey considered the monthly cost of public transport relative to residents' income, that is, the methodology is not looking at the absolute cost of the public transport fare alone but in relation to the income level of each city. Using this objective model, McKinsey concluded that the public transport in Singapore is the most affordable in the world.
However, public transport fare is a sensitive topic. Very few people in Singapore would openly agree that the public transport fare in Singapore is affordable. Most people would want public transport fare to be free. However, there is no free lunch.
For bus operations, the capital cost is relatively low as compared to the train system. Earlier in the Budget debate, I spoke on the need to revamp the bus routes to be sustainable. For train operations, the most profitable train operator in the world is Hong Kong MTR which uses the rail plus property model. Hong Kong government is the majority shareholder of MTR and it gives land and development rights to MTR at the greenfield price, that is, the price of the land before the railway is built. MTR subsequently builds malls, offices and private residential houses around the MRT stations and collects lucrBative rent to subsidise the train operation. In Singapore, revenue from land sales are channelled into the Government's reserve.
No other major train operator in the world is making money. SMRT and Downtown Line Pte Ltd have been losing money for the past few years. But why was SMRT so profitable in the earlier years? There were many reasons. In 2015, the mean kilometres between failures or MKBF for the Singapore rail network was 133,000 train-km. In June 2020, five years later, the MKBF was an amazing 1,638,000 train-km – a 12-time improvement. The dramatic improvements were due to the hard work of public transport workers, MOT and LTA. However, such improvements would not be easy to achieve if not because of the new rail financing framework or NRFF that came into effect since 2016.
Without going into technical details, the NRFF allows the train operators to shift the revenue risk to LTA. This was especially crucial during the COVID-19 pandemic when the ridership plunged, and so did the fare collection. The question is whether LTA is prepared to take on the full revenue risk just like the Bus Contracting Model? This is so that the train operators can concentrate in operational excellence at the lowest possible cost without worrying about fare revenue collection and fluctuation.
If so, will the Government have to subsidise the train operations even more? Or charge a higher fare? If not, could we maintain our excellent MKBF records? I know it is a fine balance, but as a responsible Government, we have to make tough choices and not kick the can down the road for the next generation.
Mr Melvin Yong Yik Chye (Radin Mas): Mr Chairman, during the Budget debate, I spoke about the implications of the work-from-anywhere and work-from-home phenomena. COVID-19 has transformed our travel patterns, due to the changes in the way we live and the way we work.
Has peak-travel public transport commuter load returned to pre-COVID levels, or are we in a new normal situation due to staggered working hours, split-team and telecommuting arrangements? Should we review our public transport provisions, which were developed in the pre-COVID days, to account for these changes?
Sir, we spend about $1 billion annually to subsidise our public bus operations. Before the pandemic, only 11 out of 356 bus services were profitable. However, the drop in ridership due to the safe management measures taken to combat the pandemic has worsened the situation. According to MOT, as of July 2020, all our public bus services were in the red, meaning their fare revenue could not cover their operating expenses.
Rail operations too, are heavily subsidised. Sir, it is important that we find a sustainable financing model as we continue to expand our public transport network in the coming years. We need to also ensure fair renumeration for the more than 20,000 workers who work tirelessly, day and night, to keep our public transport system operating smoothly and safely.
Perhaps, it is time that we review our Bus Contracting Model, which was introduced in 2016. With our expanding MRT network, is the traditional hub-and-spoke model of our public bus operations still relevant? Will we consider affordable on-demand bus services to replace trunk and cross-island bus services that incur high costs, but have low commuter load?
Mr Gan Thiam Poh (Ang Mo Kio): To minimise our carbon emissions from land transport, we need to have more people using the public transport system as their preferred or default mode of travel. MRT and buses are the greenest, cleanest and most efficient people-mover. Does the Ministry have the latest updates on the usage of our MRT and buses? What are our targets for public transport utilisation, as compared to other travel modes, in five and 10 years' time respectively? What measures and incentives will MOT implement to enable Singapore to reach these targets?
The COVID-19 pandemic has accelerated the adoption of flexi-work and work from home. Working arrangements and commuting trends has been affected significantly. How does MOT assess the impact of this new circumstance on our public transport usage in the near future and what are the plans to adapt the operations of our MRT and buses to the new norm?
The Government had announced the expansion plans for our MRT network. In view of the pandemic and change in commuting patterns, will our public transport infrastructure investments still be viable and financially sustainable? What are the projections for other financial outlays, such as maintenance and replacement works, which need to be paid by the Government to keep our public transport system going?
As MOT introduced new MRT lines and bus services, fares had been kept affordable. However, this also meant that fare revenues could not keep pace with cost increases. The Government has been subsidising bus and rail fares and operations heavily. What are the subsidy projections for the next few years?
Government funds are finite and the subsidies cannot keep increasing. We need a system that is both affordable for all to use and is sustainable for us to run. All of us – commuters, operators, Government – have to play our parts for our public transport system to work, and work well. Can we rely on technology to achieve this?
Presently, transport demand is unevenly spread between peak and non-peak periods. We have apps for people to check bus schedules and arrivals. Perhaps some form of pre-booking may be helpful for operators to optimise trips, improve efficiency and cut down wastage. Commuters can be incentivised to pre-inform with discounts on fares, for example. The greater the adoption of such apps' utilisation, the better the match between operators and commuters – a win-win situation and a much more sustainable way to move around.
Finally, I would like to request that we should always have a core network of bus routes, even though there will be some duplication with certain MRT routes to serve as a buffer in the event of any MRT breakdowns. This provision is to deal with the \"just-in-case\" situations which can potentially leave thousands of commuters without transport. The advantages of buses is that they are flexible and their routes can be easily adapted for contingencies and emergencies.
Mr Dennis Tan Lip Fong (Hougang): Mr Chairman, Singapore's Aviation industry has been one of the hardest hit industry in this pandemic, given the sector's complete dependence on international travel. With the resurgence of COVID-19 in many regions of the world, as well as the emergence of new and more contagious COVID-19 strains, the outlook for the aviation sector remains bleak with air travel likely to be stymied well into this year and next.
I recognise the efforts made to support this industry in terms of re-establishing air travel and supporting airport-related companies and employees through the various support packages previously announced, and the newly announced plans in Budget 2021. However, I wish to clarify with Minister on a few matters.
The aviation sector has seen the biggest influx of targeted support of $870 million in this Budget. However, is the Ministry also looking to extend targeted support to other aviation related businesses that are similarly affected by the effective halt of air travel? Specifically, the aerospace sector needs help. It currently employs some 22,000 people of which 80% Singapore residents and contributed some $13 billion in total output to our national economy in 2019. Companies in this sector include those involving maintenance, repair and overhaul (MRO), avionics and aircraft component production and repair.
These businesses are essential segments of our aviation supply chain in Singapore, and face major and sustained downstream impact resulting from airlines deferring aircraft orders and reducing their after-market expenses. Already, we have seen significant retrenchment exercises among a number of key players in the sector. For example, the aircraft engine manufacturer Rolls-Royce retrench about 24% of its workforce in Singapore in July last year. NTUC itself had to intervene in the retrenchment exercise conducted by Eagle Services Asia to protect Singaporean jobs.
With no signs of an immediate recovery for aviation, more of such retrenchments may be expected as companies seek to cut down on their expenses. Even when the air travel does begin to normalise, given that the aviation supply chain is driven by airline demand, aerospace companies could likely be some of the slowest to recover in this hard-hit sector. While they still do have continuing GSS support the sector could use more targeted support if we are to maintain our position as an aviation and aerospace hub. Could the Ministry considered tailored support schemes that could be explored specifically for this group?
Would the Ministry also be able to provide further details of its previously announced plans to develop programmes for aviation workers; at risk of losing their jobs or being unemployed, first mentioned in December last year? What is the coverage and scale these programmes, and when will they come into effect?
This is a especially pertinent as aviation workers are likely to continue to experience a dent in their incomes, not to mention face increased job risk, well into this year and next, even as other parts of our economy slowly start to pick up.
I would also like to ask in terms of retrenchment in the sector, what percentage of the aviation and aerospace sectors has been made redundant and what percentage of this retrench group has benefited from the COVID-19 recovery grants? Can there be consideration of extending the eligible period of support beyond the current three months, given that the aviation sector is likely to remain impacted by the pandemic for a prolonged period of time. And employees in this niche industry may need more time to secure jobs outside this view, given the need for retraining and reskilling.
Lastly, I think there is a need for us to evaluate the upcoming pipeline of talent from our Institutes of Higher Learning into both the aviation and aerospace industries. Fresh graduates from these programmes may find little opportunities there if the global recovery is gradual. I hope the Minister can assuage these concerns.
Ms Poh Li San (Sembawang): Chairman Sir, I declare my interest as an employee of the aviation sector.
The COVID-19 pandemic has literally sent our once vibrant and booming aviation sector into a cliff drop. Since the imposition of border closure in March 2020, passenger traffic has plunged from pre-COVID-19 peak of almost 69 million passengers per year to less than 3% of that. With the COVID-19 pandemic still raging in many parts of the world, non-essential overseas travel will likely still be curtailed for at least another year, until vaccination operations for the majority of our local population are completed.
Changi Airport was the sixth busiest international airport and the Singapore Airlines used to carry more than 36 million passengers per annum pre-COVID-19. Unlike other airports and airlines that are still able to continue to operate domestic flights during this pandemic, Changi Airport and Singapore Airlines group are 100% dependent on international travel.
To the credit of many stakeholders in the aviation sector, tremendous efforts have been made to keep the planes flying, serve passengers and carry cargo, during this extremely difficult period. SIA has reconfigured some passenger aircraft for cargo flights and kept key city links connected even with very low passenger loads.
Chairman, Sir, I have a few queries relating to our strategies to reboot air travel and to revive the Changi airhub.
One, how much longer can SIA and Changi Air hub sustain if travel border remains closed beyond this year?
Two, beyond the extended JSS and support for the aviation sector as announced in Budget 2021, does the Government intend to continue to support the recovery of the aviation sector and, if so, what are some of these additional support measures for companies and workers?
Three, can the Government provide an update on the developments in the aviation sector since the Ministerial Statement in October 2020? What has the progress of our measures been so far?
Four, we have seen an increase in the number of imported cases over the past few weeks. Is this due to our border re-openings? How can we continue to re-open our borders safely?
Five, there have also been a few cases where air crew and other aviation frontline workers who caught COVID-19 earlier this year. What has the Government done to safeguard our borders and frontline aviation workers?
Six, in a post-vaccination world, what are our plans to open up our borders and revive air travel? Will vaccinated individuals be allowed to travel with fewer restrictions?
Seven, how can we rebuild the connectivity at Changi Airport and protect our status as an aviation hub?
Lastly, how can we strengthen our competitive advantage to capture air travel demand as it recovers?
I hope Minister for Transport can inspire hope, confidence and provide guidance through this harsh winter for the aviation industry.
Mr Ang Wei Neng (West Coast): Chairman, I would like to declare my interest as Advisor to the Singapore Port Workers Union.
We understand that the Maritime sector is the least affected transport segment in the COVID-19 pandemic. At the same time, the construction sector was badly affected by the circuit breaker last year, which dramatically slowed down the construction schedule of many infrastructural projects.
Was the construction of the Tuas Mega Port affected by COVID-19 pandemic, and by how much? If so, given the rise of international trade due to the popularity of cross-border online purchases and recovery of the world’s economy from the pandemic over the next few years, are there plans to accelerate the construction of the Tuas Mega Port?
I am also concerned about the accessibility of the Tuas Mega Port for its workers, because unlike the former sites at Tanjong Pagar and Keppel, the Tuas Mega Port is right at the extreme western end of Singapore. For the benefit of those who have to travel to the Tuas Mega Port, which will definitely become an activity hub, could the MRT line be extended to the Tuas Mega Port? If so, when? Are there plans to provide priority housing in Jurong West for port workers who opt to work in Tuas?
Mr Saktiandi Supaat: Mr Chairman, the Maritime sector remains a crucial pillar of support for our economy. In spite of the pandemic, it has remained resilient, thanks to good pandemic safety management along with its global reputation for excellent connectivity and efficiency. As other countries are looking to diversify their supply chains to the Southeast Asia region, we can leverage on the sector to strengthen our position.
During the Committee of Supply debates last year, the Ministry announced that the sustainability remains a key priority. Indeed, while shipping is one of the world's cleanest and energy-efficient modes of cargo transportation, it leaves a significant environmental footprint.
Since 2011, under the Maritime Singapore Green Initiative (MSGI), $100 million was set aside to promote sustainable shipping. This initiative was further extended to December 2024 and enhanced to focus on the carbonisation of shipping.
The Green Energy and Technology Programme, in particular, aims to encourage Singapore-based maritime companies to develop and conduct pilot trials for green technologies. What is our progress? Can we leverage on this to create more jobs for Singaporeans?
Can the Minister share the plans to promote more sustainable practices in the maritime sector? How will this lead to new and exciting career pathways for locals? We should not waste this crisis and ensure that we create new jobs.
Ms Yeo Wan Ling (Pasir Ris-Punggol): Sir, the Labour Movement thanks our tripartite partners – the LTA, our taxi, PHV platforms for working hard with us on providing the much-needed short and medium term reliefs for our driving brothers and sisters. The expedited tax disbursements are certainly well received. Our point-to-point drivers have also raised longer term livelihood concerns due to the prolonged crisis, as well as the evolution of technology in the transport sector.
With long queues at taxi stands, not of passengers, but of taxis themselves, our drivers know that the recovery of the domestic consumer economy will not be the end of their problems. Instead, our drivers anticipate the re-opening of borders and our night life to give their livelihoods a much-needed boost.
These are strange times, as our taxi and PHV drivers trawl our empty streets, night after night, hour after hour, looking for possible passenger. We need to practise empathy and, indeed, sympathy towards the plight of our fellow Singaporeans. Our brothers and sisters are hit with the double whammy of low street hails, having to drive aimlessly around, wasting fuel and time, on having to deal with the petrol tax hikes. Would the Ministry consider allowing for more flexibility for our P2P drivers, to allow them to stop and wait in taxi stand bays outside the designated waiting lots, and even around taxi drop-off points, during the night when there is no longer any traffic or road safety worries about parked taxis along the road. This will greatly ease the burden and stress of our drivers.
As our drivers focus on getting passengers safely and efficiently to their destinations, we must allay their concerns of obsolescence.
Be it electric or driverless vehicles that hallmark our future, transitions will always require adjustments. Having undergone technological change with ride-hailing apps, diversifying into transport services like deliveries, or even just facing the economic realities of COVID-19 crisis, our P2P drivers are a resilient bunch. However, the Government must anticipate, ease and enable our drivers to prepare for these changes. We must not let the P2P transport sector become a byword for creative destruction, just as rickshaws and trishaws are looked upon today, but beckon and support them along the evolution journey of our P2P transport sector.
Take the petrol tax hikes, for example. As far as it may go in pushing the rest of Singapore into a car-lite society, our driver inescapably live in a car-heavy livelihood. If they are given the support and opportunity to go electric to avoid petrol costs, many would gladly do so. However, their hands are tied, and so the environmental boons become their economic bane. While we must prepare our P2P drivers for the future, could we do more to gird their livelihoods in the present as well? Could the Ministry share more and how taxi companies will be supported in shifting to more energy-efficient cars without the burden of this cost being put on our drivers?
Mr Ang Wei Neng: Chairman, I have earlier declared my interest for being part of ComfortDelGro management team.
Would it be possible for LTA to give some insights into the demographics of those who are driving taxis and private-hire cars or PHCs? Taxis and private-hire cars are collectively called Point-to-Point or P2P vehicles. Specifically, how many young tertiary-educated Singaporeans below the age of 40 are driving P2P vehicles?
My sense is that driving a P2P vehicle has become very popular amongst the youth, especially due to the COVID-19 pandemic. It is good that they are finding ways to make a living but I do not think it is wise for so many young Singaporeans to be contented with the P2P career as a driver.
Would MOT consider capping the number of PHCs like what MOT has done to limit the number of taxis? In fact, our founding Prime Minister, Mr Lee Kuan Yew, did not want so many Singaporeans driving taxis. Thus, the growth of taxis was restricted and only Singaporeans above 30 years old could drive the taxis. The rationale is not to hog too many young people in the driving profession. Is this rationale still valid today?
This is also in the context of an explosion of P2P vehicles in Singapore in the last decade. When Uber officially launched its service eight years ago in Singapore, there were 27,000 taxis and very few PHCs. Today, there are 16,000 taxis but there are 50,000 PHCs. In totality, there are 2.5 times P2P vehicles today as compared to eight years ago. Do we really need so many P2P vehicles and drivers in Singapore?
Mr Melvin Yong Yik Chye (Radin Mas): Sir, the COVID-19 pandemic has badly battered our aviation and point-to-point land transport sectors, and I am glad that the Government has provided continued support to the workers in these sectors with the extensions to the Jobs Support Scheme and the COVID-19 Driver Relief Fund.
However, with many governments globally struggling to procure vaccines for their population, the downturn in global air travel is likely to continue. Many of our aviation brothers and sisters, from SIA and SATS, for example, were re-deployed to other sectors for the past year. What will happen to them? Are there still job prospects left in our aviation sector?
Despite the prolonged downturn, certain segments of jobs within our transport industry have remained resilient.
First, the electrification of our land transport system is expected to give rise to new jobs. An electric motor has only about 20 moving parts, compared to nearly 2,000 in an internal combustion engine. How does MOT intend to retrain our existing technicians and create new jobs in tandem with the push for electrical vehicles?
Second, our MRT network is expected to double to 360 km by 2030. How many new jobs will our expanding rail network create for Singaporeans?
Third, the e-commerce boom during the pandemic has shown us that logistics is a vital sector, and more than just the delivery of goods and food. What is MOT’s plan to leverage the fast-evolving urban logistics industry to create new jobs?
Lastly, can the Ministry provide an update on the Tuas Mega Port and whether its first phase opening scheduled for this year is still on track? How many new jobs will the Tuas Mega Port offer?
Mr Saktiandi Supaat: Mr Chairman, land transport SMEs are valuable partners who complement our public transport system. During the pandemic, many were affected as they saw demand for their services fall drastically. Tour bus operators experience a two-fold setback with the tourism sector being badly hit. Even before the pandemic, land transport SMEs have been identified for upskilling opportunities.
Some of these collaborations involving the Singapore Institute of Technology, SMRT and SkillsFuture Singapore, were aimed at improving rail reliability and driving innovation and productivity enhancements across the sector. The curricular could impart skill sets in important areas like data analysis and project management.
With change comes opportunity and new technology that we do not envision before and now as we look to tackle the challenges faced by the transport industry, our SMEs can put their new training into good use.
The transport sector should welcome companies with innovative solutions in a variety of areas. This would include understanding consumer patterns, facilitating enterprise, reducing compliance costs, ensuring the safety of construction projects, for example.
There are also many areas we can explore as we work on adapting the infrastructure for a post-COVID-19 society such as green technology, big data and automation. All of these would contribute to job re-design and create new and exciting careers for Singapore in the transport industry.
Can the Ministry share what are the opportunities for land transport SMEs? Is the LTA already conducting consultations with industry, and if not, will it do so?
Mr Ang Wei Neng: Chairman, again, I would have to declare my interest for being part of ComfortDelGro management team.
The robust transport eco-system in Singapore comprises not just public transport, but also many private transport providers which \"fill in the gaps\". It is critical that these providers are able to flourish and thrive in a business landscape, while ensuring that Singaporeans are able to travel safely and efficiently. But the rules which define this landscape have not been consistent.
A few years back, in the name of facilitating innovation, LTA allowed new rental bicycle companies to flourish. But, this created much social problems and many of these companies fell by the wayside. Similarly, LTA once, was lax in regulating PMDs on pavement, on hindsight, leading to many injuries.
At the other extreme, LTA is occasionally strict in regulating existing businesses and increasing compliance costs, even when times have changed.
It is not healthy for LTA to swing to both extremes. Thus, I would like to ask if LTA has plans to do a comprehensive review of its regulations to ensure that the regulations are up-to-date, without unnecessary red tape, and that it remains consistent in its approach.
Before I end, we heard yesterday that LTA would be taking over the regulations of Electric Vehicles, or EV charging facilities from the Energy Market Authority. I have previously mentioned in this House, industry players have a lot of pains in getting regulatory approval to install EV charging stations. With the change, we know the LTA is willing to set up regulatory sandboxes to facilitate the introduction of new charging solutions. This is a good move in the right direction. We hope to see more of such initiatives.
Ms Poh Li San: Chairman, the Caring SG Commuters Committee was set up in 2017, to transform Singapore's public transport system and commuter culture into one that is more caring, welcoming and inclusive. At times, having to wait a long time for buses, squeeze into crowded trains and brave the elements of inclement weather can be frustrating. I would like to know the progress on how commuting on public land transport can be a more enjoyable experience.
What are the plans to build a more inclusive transport system through hardware improvements, such as more considerate design features and barrier-free accessibility facilities?
The COVID-19 pandemic has reduced the number of commuters and some may even avoid taking public transport for the fear of increased exposure to potential COVID-19 infection. Will the Caring SG Commuters Committee focus on shaping commuters' behaviour with the aim of ensuring public health in times of pandemics or even during the less lethal influenza seasons? Should we work on having all commuters to wear mask even after the COVID-19 pandemic?
On a more challenging front, how do we create the heartware to promote a more caring and inclusive commuter culture for everyone?
Mr Gerald Giam Yean Song (Aljunied): Efficient and convenient public transport is vital to achieving many of our national priorities. It allows HDB to build more flats away from the city. It enables workers to travel to further out workplaces and it helps us to reach our climate change goals.
I sold my car five years ago and now make most of my trips by bus and MRT. I have not regretted this decision and I highly recommend it to others who can afford not to drive.
Improving the commuter experience can convince more people to take public transport, reducing both traffic congestion and carbon emissions. How can we nudge much more people towards going car light? I have a few suggestions.
First, reduce the amount of walking needed during the journey. Singapore's tropical weather is not conducive for walking outdoors for long distances while dressed up for work. Transport planners should keep this in mind when planning the location of bus stops and routes for feeder bus services. For example, some of my HDB and condominium residents living along Bedok Reservoir Road do not have a direct feeder bus to the nearby Bedok North MRT and have a rather long walk to and from the station.
Second, construct more cupboard linkways from from housing estates including private condominiums to transport nodes. Covered linkways can influence the commuters decision whether to brave the elements or to take private transport.
Third, reduce crowding on trains and buses so that commuters can have a more comfortable ride with better safe distancing. I hope MRT operators will also stop removing seats from their train cars because we commuters like sitting during our rides.
Forth, continue to make our roads and public transport more accessible for people with disabilities. I earlier suggested that how we should use tactile signals to enable visually impaired commuters to cross roads late at night. I look forward to that being implemented.
Mr Muhamad Faisal Bin Abdul Manap (Aljunied): Sir, I have observed there are schools in the HDB estate where they are covered pathway that extended from the school gate to the nearby bus-stop. In locations where the nearest bus-stop is located opposite the school, which requires road crossing, the shelter is extended across the pedestrian crossing.
However, there are schools which are not provided with such facilities. The Primary school located in my Kaki Bukit constituency is one of them. I have previously written to LTA requesting to construct shelter for existing pathway and pedestrian crossing but to no avail.
I would like to seek clarification from the Ministry on what are the considerations in determining whether to or not to construct shelter for walkways and pedestrian crossing in school zones.
Apart from this clarification, I would like to touch on one of the LTA initiatives, Silver Zone. My constituency Kaki Bukit is one of the earliest beneficiaries of Silver Zone. Under this initiative, LTA has introduced numerous features to enhance road safety for pedestrians, especially our senior citizens as well as for road users.
Among these features are rest points and roundabouts. The former is to allow road crossing in two stages and the latter is to smoothen traffic flow and traffic conflict points. I would like to ask LTA to consider adding construction of shelter for pathways and pedestrian crossing to the existing list of the Silver Zone features. These feature should be constructed at locations where LTA deem necessary and feasible.
Sir, covered pathways and pedestrian crossing will provide better protection to our seniors against bad weather. This will further enhance safety as well as comfort of our elderly Singaporeans.
Mr Cheng Hsing Yao (Nominated Member): Chairman, the key component of a liveable city is its walkability. I would like to ask about the walkability of the areas of historical significance.
These areas such as the Civic District comprise many interesting buildings streets and public spaces of historical significance. Through a combination of public and private efforts, there has been a lot of capital and resources pumped into these areas to transform the users as well as the older buildings.
What has the Government done to enhance walkability in Singapore in areas of historical significance? What are the Government's upcoming plans for these areas?
Ms Yeo Wan Ling: Sir, I am heartened by our resolve to encourage greener means of commute. Popularised in the 1960s, cycling as a mode of transport is not new to Singapore. It gives life to our city, it is more affordable, healthier and possibly, more convenient. However, active mobility is a buzzword, but what does it take for us to make it a reality?
As things stands, I wonder if those seeking to participate in the active mobility movement feel safe to do so. The speed of motor traffic on the roads leave most of our cyclists contesting for space on the narrow 1.5-metre footpath. This is inconvenient at best and dangerous at worst for our footpath users, calling to attention the safeguards that need to be in place to encourage more to embrace walking and cycling.
Could we have an update from the Ministry on its plans for improving our infrastructure to enhance the safety and travel efficiency for all road and footpath users?
Sir, with this, I turn our attention to the growing community of delivery riders who are arguably the heaviest users of these cycling networks. Needless to say, COVID-19 has reviewed the importance of our delivery riders. They brought our favourite foods to our doorsteps when we could not dine out and allowed us to eat in the safety of our own homes.
Our riders' journeys can often be precarious, especially on rainy days. It is unfortunate that we are still seeing accidents on the footpaths and riders colliding with drivers on the road. Riders we spoke with, feel like they neither belong with the motorists on the road, nor with the pedestrians on the runways. Perhaps, it is time for us to examine, how more deeply we can protect the lives of our delivery riders.
Yong Wei is a leader with us at the National Delivery Champions Association. A delivery rider, he met with an accident recently. We thank good fortunes that he walked away only with a broken wrist because I cannot imagine how it would be otherwise. Yong Wei, however, ended up not being able to work for the next four months and this time we thank prolong medical leave insurance that helped him tide through to these four months of lost income.
We have heard from many other riders on their own near-misses. I believe to address the issue of safety for our riders, besides infrastructure improvement, education and awareness must play a bigger part, so that all road and footpath users build better awareness to coexist. Perhaps is timely for compulsory road safety certification and more community awareness campaigns on active mobility.
Delivery riding is a physically tough occupation. Some riders work more than 10 hours a day and delivering upwards of 30 deliveries a day. We need to better promote the welfare of our riders. Rest areas, accessible parking, charging points at malls and food outlets, more efficient pickups and drop-offs will come a long way to alleviate the mental stresses of our riders.
The union calls for better safety nets for our riders and for the Government to push for greater awareness for road harmony and to build better supporting infrastructures for our riders.
Mr Lim Biow Chuan (Mountbatten): Sir, in 2019, LTA imposed a ban on users of personal mobility devices from all footpaths. This came amid an increasing number of accidents involving such PMDs. One cyclist died after an accident with the PMD. This ban brought some relief to the other users of the foot path. However, due to the push for healthier lifestyle, more and more cyclists are also using the same footpaths.
I support the concept of shared foot paths whereby both cyclists and pedestrians can share the use of footpaths. Unfortunately, I regularly receive feedback about the behaviour of irresponsible cyclists who think that footpaths and park connectors are a race track for them to race at alarming speeds.
Sir, I walk along Gardens by the Bay East because that is within my constituency. Many a time as I walk, I worry when I when I feel the buzz of the bicycles racing by me at a fast speed.
Sir, we need to do more to ensure the safety of pedestrians using the footpaths and park connectors. Sometimes, I see seniors taking a leisurely stroll along the footpaths. Sometimes, there are couples with young toddlers and children who meander all over the paths. If a cyclist comes along riding at high speed and crash into the senior or the young child, that would be disastrous.
In a recent court case, a cyclist was sentenced to one week jail after he crashed into a 53-year-old pedestrian, who subsequently died. So, a crash of a bicycle at high speed can have fatal consequences.
I submit that LTA can do more to educate cyclists who use the footpaths to commute to ride at a reasonable speed. Let me stress that I have got nothing against cyclist riding at the reasonable speed but education must also come with enforcement because we need to deter the small minority of reckless riders from being a danger to other users of the footpath or park connector.
Hence, I urge LTA to step up enforcement along the footpaths and to install more cameras to deter inconsiderate riders. Wherever possible, LTA should consider widening the footpaths or park connectors and demarcate one side for cyclists and one side for pedestrians.
The Chairman: Minister Ong Ye Kung.
The Minister for Transport (Mr Ong Ye Kung): Mr Chairman, MOT looks after three connections of Singapore – sea, land and air. In Chinese, we call it \"海陆空\".
The seaport and airport, as I have described before, are like the lungs of the country. They draw in oxygen from the global eco-system, vitalising the rest of the Singapore economy. Land transport is like the arteries and vessels, providing mobility for each of us as we work, live and play across the island.
Today, my colleagues and I will update the House on key long-term challenges and developments of our three connections.
First, maritime. The fortunes of a port city rise and fall. Singapore suffered over three centuries of oblivion from the start of the 15th century. So, our status as a global transshipment hub today is not a right of birth but an earned and constant struggle for relevance.
Fortunately, our maritime sector has been resilient throughout COVID-19. In 2020, last year, container throughput was only 1% lower than 2019, the previous year. So, we are cautiously optimistic that we will have a good year in 2021. But we had to make difficult decisions to get here. One critical decision was crew change.
Every day, more than 250 ships call at Singapore to deliver and transship cargo, for bunkering and repairs. While they are here, many ships want to change their crew who have been out at sea for several months.
When the pandemic hit, crew change came to a halt because of border restrictions. Seafarers on the vessels cannot disembark and new crew cannot fly in to board the vessels. The shipping community faced a looming humanitarian crisis – hundreds of thousands of seafarers were stuck, stranded on board their work vessels, sometimes for more than a year. That was last year.
So, shipping lines urged Singapore, as a major transshipment port, to do something. But to allow crew change in Singapore will expose ourselves to the risk of COVID-19 infections. If we wanted to be absolutely safe, we would have said \"no\", as many countries had. But that would have turned our backs against the international maritime community. They would have lost faith in us and it would have damaged our standing as a maritime hub.
Therefore, together with the industry and unions, we devised rigorous protocols to do crew change safely – repeated testing, quarantine, bubble wrap travel between the vessel and the hotel and the airport, and vice versa. It worked. Today, more than 100,000 crew changes have taken place. Our practice has been held up as an example at the International Maritime Organization (IMO). Shipping lines saluted Singapore.
It was not without cost. As at end February 2021, we had eight imported cases due to crew change for ocean-going ships – very sorry to the Minister for Health – but none led to community infections.
Was it worth it? I acknowledge that opinions differ. For some, they feel that it is more important to eliminate the virus from Singapore altogether. But I think we did the right thing.
For a city state like Singapore, the fight against COVID-19 is not about eliminating all risks by isolating ourselves. It is about how to keep our connectivity open, supplies flowing, protecting jobs and our economy while keeping Singapore safe. This is the real challenge of COVID-19 – not all-or-nothing, black-or-white, but the ability to navigate safely in a grey zone.
This will not be our last test. The Arctic route, the possibility of a Kra Canal and competition from neighbouring ports will continue to challenge our maritime relevance. Senior Minister of State Chee Hong Tat will speak more about this.
Let me move to land transport, where our long-term challenge is sustainability.
There are two aspects of sustainability. The first is environmental. We spoke a lot about it yesterday. I spoke about Electric Vehicles (EVs) but EVs are, at most, a second-best solution. The cleanest and most sustainable way to move is still by mass public transport – buses and trains. In response to Mr Gan Thiam Poh, we want to raise mass public transport modal share during peak hours, from 64% now to 75% by 2030.
Over the last 10 years, it has increased almost by 10%. Mr Gerald Giam switched transport modes. So, he helped – a little bit. But every commuter counts.
Members have asked about the plans for our public transport system. COVID-19 has delayed our plans. But notwithstanding this, over this decade, we will spend more than $60 billion to expand and renew our rail network and we will open new stations or lines almost every year. Let me do a rundown.
Between now and 2025, we will progressively open the rest of the Thomson-East Coast Line. By 2026, we will \"close the loop\" for the Circle Line between Harbourfront and Marina Bay. By 2029, the Jurong Region Line will be completed. In the 2030s, the Cross-Island Line will open progressively.
With all these projects, the Mass Rapid Transit (MRT) network will grow from about 230 km today to 360 km in the early 2030s. In that process, in response to Mr Melvin Yong, many jobs will be created. By then, our network density will be comparable to London and New York City.
As suggested by Mr Melvin Yong and Mr Gan Thiam Poh, we will use technology wherever we can – big data to optimise routing and scheduling, sensors to carry out preventive maintenance effectively, kaizen projects to improve productivity and apps to help commuters plan for their trips.
As for the men and women on the street, we will bring buses and trains as close as possible to their final destinations and also their origins, with pedestrian pathways and covered linkways wherever it makes sense.
For short trips, you will notice commuters are increasingly either walking or cycling. That is why we are expanding the cycling network and repurposing roads wherever possible. LTA has identified 60 projects to convert suitable roads into footpaths, cycling paths or bus lanes. Each project, we reckon, will have their pluses and minuses. So, for every project, we will work closely with the community and proceed only when we assess that, on balance, it benefits commuters and benefits the community. I do not expect all 60 projects to proceed but we will learn from each experiment. Senior Minister of State Amy Khor and Senior Parliamentary Secretary Baey Yam Keng will elaborate.
The other aspect of sustainability is financial. Several Members have shared their concerns on this and I appreciate Mr Saktiandi for especially highlighting this aspect of sustainability.
Train lines are expensive to build. Take for example, the Thomson-East Coast Line – that costs more than $25 billion to build.
That said, capital expenditure is one-time. What worries us more is whether we can afford the operating costs year after year on a long-term basis. This includes manpower, energy, maintenance and renewal of operating assets like trains and signalling systems.
Train fares so far are not enough to cover these operating costs. So, the Government has been spending about $1 billion a year to subsidise rail operations. The situation is the same for buses – Senior Minister of State Chee Hong Tat gave an update to the House recently. So, operating subsidy amounts to another $1 billion of taxpayers' funds every year.
The Government needs to continue to subsidise the operations of MRT and buses. I think we cannot run away from that. But the bill to taxpayers cannot keep ballooning. If it does, we would leave our future generations a growing financial burden. So, how do we square the circle?
Financing and subsidy policies – they matter. For buses, we have settled on a bus contracting model that leverages competition to enhance the efficiency of operations. For MRT, we fully transited to the New Rail Financing Framework (NRFF) – mentioned by Mr Ang Wei Neng – a few years ago.
Under the first version of NRFF, the Government takes over from the transport operator the ownership and replacement of operating assets – trains and signalling systems. The Government then charges the transport operator a fee for using these assets. So, it is like renting, on the part of the operator. Under NRFF Version One, which was implemented for the Downtown Line (DTL), the operator pays a fixed fee, like a rental.
The public transport operator of the DTL still bears significant commercial risk. If ridership is healthy and fare revenue far exceeds operating cost, they get to enjoy a good part of the profit. But if the reverse is true, they suffer losses. This was not ideal because, as a public utility, public transport should be a more stable business.
So, we adjusted the NRFF to reduce commercial volatility. If the operator enjoys high profits, the Government will cream off. If the operator suffers big losses, the Government cushions it. So, this is NRFF Version Two, implemented in 2016 to the North-South, East-West, Circle and North East Lines.
For the most recent Thomson-East Coast Line (TEL), we took on another approach. That is NRFF Version Three. For the initial period when ridership is still not stable, the Government collects all the fare revenue, bears all revenue risks and grants the operator a fee to run the line. So, it is a bit like a contracting model. After ridership stabilises, we revert to NRFF Version Two.
Recognising that the NRFF has evolved over the years, we will review the arrangement for the Downtown Line, given that it is still on NRFF Version One. This will be done with a view to ensure that the operator will run the line reliably, with high productivity and that the line is sustainable.
There are other things we need to do to keep our public transport system sustainable for the long run.
First, operators must train their workers well and find new ways to be cost-efficient. This includes keeping train services reliable and not trying to penny-pinch on maintenance cost, thinking that this will translate to savings and productivity. It does not. We learnt this lesson the hard way.
Second, like before, we will need to adjust fares from time to time. This is needed as costs do go up, including the wages of public transport workers who look forward to earning more.
The Public Transport Council (PTC) makes a careful decision on fares every year. Whenever there needs to be a fare adjustment, we will help lower income households through Public Transport Vouchers. We also have fare concessions to large groups, such seniors and also young students. To the suggestion that maybe we should also extend this to adults taking courses, I would prefer to be very careful about it because, after all, all of us are going to be lifelong learners.
Third, we need to try to reduce excess capacity. The majority of our bus services are trunk services. Majority. And they provide connection for commuters between towns. So, it has never been a pure hub-and-spoke system, as mentioned by Mr Melvin Yong and Mr Gan Thiam Poh. And this will not change. There will always be a core set of trunk services for buses.
But we should also try our best to reduce excess capacity in the system. This is especially when new train lines come up, and ridership for bus services that run in parallel plunge, and then chalk up tens of millions of operating subsidies per service per year. So, we need to progressively adjust these bus services to better keep subsidies in check.
I used to be a union leader for the transport workers' union, and bus drivers on these services would always lament that 很心痛，载空气, they say in Chinese. In English, it means when there are no passengers, it is a bit of a heartache, because they are just ferrying air.
Fourth, COVID-19 has also opened up an opportunity for us to make the system more efficient, by making the morning and evening peaks less pronounced. Mr Gan Thiam Poh mentioned that. And to achieve this, we will need the co-operation of employers, to stagger working hours, allow working from home even after COVID-19 passes.
Finally, let me talk about aviation. When COVID-19 struck, passenger volume at Changi fell to 0.5% of pre-COVID-19 levels. Almost a year later, the good news is Changi is now carrying five times that. The bad news is, that works out to only 2.5% of pre-COVID 19 volume. So, we are still in crisis mode.
Flight movements look better, it is one quarter of pre-COVID-19 levels. But this is, to a large extent, due to a larger number of cargo flights.
Changi Airport is now connected to 66 cities around the world, compared to 160 cities pre-COVID-19. We expect connections to expand further in the coming months to about 80 cities.
In response to Mr Melvin Yong and Mr Dennis Tan, in a crisis like this, job prospects in the sector are naturally muted and subdued. Based on the Labour Market Survey, up to 3Q 2020, the sector had lost 6,000 jobs. About 500 are retrenchments, and the rest non-renewal of contracts or early retirement. Non-residents shouldered the great majority of the reduction.
Hiring of graduates, asked by Mr Dennis Tan, have slowed, though there is still good demand for technicians coming out of our ITE, coming out of our Polytechnics. I then checked with our Universities, who told me that most aerospace graduates still found jobs this year, but likely in non-aviation sectors. So, fortunately, engineers are a very versatile bunch.
Mr Dennis Tan asked about help for the aerospace sector. There are three areas of help, and this was covered in the Budget Statement. One is the Jobs Support Scheme. The aerospace sector is now in the top tier, 30% for the next three months, and then 10% for the following three months. They also enjoy the Enhanced Training Support Package which provides stronger support when they send their workers for training. Thousands have gone and it has been very helpful for the aerospace sector. And also, EDB put in a lot of effort to temporarily redeploy talents to other sectors while the sector waits for recovery.
Mr Dennis Tan asked what proportion of workers benefited from the COVID-19 related grants? I will say everyone who kept their jobs. That is the impact of the Jobs Support Scheme and the\tEnhanced Training Support Package. It helped all these companies stay above water, and retain core capabilities so that there is still a future for the sector. And that strategic outcome is either there or not there, either you believe it will work or you do not believe it will work, and you decide to do not do. You cannot quite measure or audit it.
Ms Poh Li San asked how MOT plans to revive the aviation hub. Unfortunately, I cannot answer that question with certainty. We may have a plan, but this virus has no plan and it does not observe any rules. It is driven by an instinct to dominate the world. To do so, it is transmitting without symptoms, and it is mutating.
So, in terms of prospects, I can only say this: first, this year I do not think it is realistic to expect a V-shape recovery for the aviation sector. Second, it is also possible that the virus becomes endemic, meaning it is something we have to live with, to cope with and to adapt to in the long term, just like the influenza virus. And third, notwithstanding this, with vaccines, and the realisation of governments around the world that they cannot perpetually close up their borders, I believe there will be some re-opening of borders this year, and some recovery this year.
So, our mission this year is not so much to force a sharp recovery of the aviation sector, but to adapt to a new normal, to re-open safely, to build up confidence, to test workable concepts and to strengthen the belief that Changi Airport will still be an international air hub post-COVID-19.
And we are seeing signs of that happening. When WHO scientists from around the world were planning their study visit to Wuhan, they decided to gather in Singapore before they made their way, and they flew through Changi.
The World Economic Forum has decided to hold its meeting in Singapore, in August.
A few months ago, a group of Vietnamese trainees going to Japan to complete their apprenticeship, decided to come to Singapore first and then up to Japan. It is a longer route, but I think they like to fly SIA.
So, the key question is: what are the steps we can take to re-open safely?
As I explained to the House before, what kills travel is quarantine and Stay-Home Notices (SHN). Very few people will want to travel abroad if they know they have to go through a lengthy isolation. So, to revive aviation, we need to replace quarantine and SHN with other methods that can also substantially mitigate the risk of transmission. Now, I think there are four ways after all these months of experience.
The first is testing, which is key to re-opening borders. Nationally, we can now perform more than 60,000 tests a day. And with tests, we can detect infections early and prevent transmissions.
The second is to \"bubble wrap\" travellers. Ensure that they are kept to a tight itinerary, restricted premises, away from community, do not see anybody in the community. This is how we managed to do maritime crew change and this is how the new Connect@Changi facility works.
The third is to recognise that travellers from certain places are safe, because they have successfully controlled the virus. That is why we unilaterally opened our borders to places such as Australia, New Zealand, Brunei and China. And so far, the scheme has not led to any increase in our local transmission. It works.
If other places reciprocate what we do, we have an Air Travel Bubble (ATB). We have yet to launch an ATB successfully. We were close, but we could not. But we now have an agreed text with Hong Kong and the ATB can be launched when conditions are right. We have not given up the idea. In fact, I think ATBs are going to be important, which I will explain.
And that leads to the fourth way, which is a new critical development – and that is vaccinations. As more scientific data become available, we will be able to ascertain the extent to which vaccination reduces the likelihood of someone carrying the virus and passing it to somebody else. And this will enable us to allow vaccinated individuals to travel with fewer restrictions, perhaps even without SHN. It will require a system of certification, like the yellow booklet, which some of us have, that records our vaccinations against Malaria or Yellow Fever. And these discussions are happening bilaterally and also at the International Civil Aviation Organization (ICAO). And Singapore, we have been active in all these discussions.
Aviation is like the lung of Singapore. So, this lung needs inflating, but our head is under water. But each of these four methods I mentioned earlier are like snorkels, sticking out of the surface of the water. They allow us to take in some oxygen, to keep Changi and to keep SIA going. And each snorkel cannot work in isolation. They must work together.
For example, an ATB is a combination of identifying safe places and imposing test requirements. I see ATBs playing a key role in safe opening this year. Because as vaccinations bring down infections across the world, more countries will be prepared to forge ATBs.
We can also identify places from low to moderate infection rates, and combine vaccination with tests, even \"bubble wrap\" travel, and to open up travel corridors. We will do our best to make all these arrangements bilateral so Singaporeans can travel outwards too.
Mr Chairman, COVID-19 has claimed many casualties: lives, careers, years of hard work wiped out in months.
Amongst them are notable brands – like Dan Ryans, like Robinsons. I think we can get over the loss of these names. Painful, but we can get over. But if we lose SIA or we lose Changi Airport, life in Singapore will never be quite the same. We will be bereft.
The transport community knows this and what is at stake.
On the first day of Chinese New Year, I joined the Prime Minister to send off three SIA flights. A cabin crew member I met told me she was issued quarantine orders three times, each time because she served somebody who later tested positive. Fortunately, the last one was rescinded, so she served two. Even then, it is almost four weeks. But each time she emerged from quarantine, she was just as passionate about flying. That day, she was going to Manila.
When we rolled out vaccination for maritime and aviation frontliners, the workers turned out in force. Today, our frontline workers at the seaport and airport, are substantially vaccinated – 92% have gotten their first dose, 85% with both doses. In the coming days, I think we will cross 90% for both doses as well.
I recently met a resident in my constituency. He greeted me warmly and gave me a fist bump. He told me he is a maritime worker, he said, \"I have gotten vaccinated. I can now protect my family.\"
Crowne Plaza is our airport hotel, housing foreign air crew laying over in Singapore for one, two days. Unfortunately, there were transmissions in the hotel, three workers, local workers, got infected. The whole kitchen staff got quarantined. The General Manager and executives rolled up their sleeves, went to the kitchen, took over the kitchen operations. I hope the food tasted okay that day. They closed the hotel after that for a month, tightened the procedures. Today, it is open again.
Week in week out, I see for myself the fight in our workers at our borders.
Mr Chairman, I have told the tale of our three connections. On the seas, we learn to adapt, find the courage and humanity within us to take reasonable risks and to be of service to the world.
On the roads, we will need to be greener, more sustainable – in both the way we travel, and the way we fund our infrastructure.
In aviation, it is the battle of our lifetime, and a story about our spirit of resilience – to press on with duties despite rounds of quarantine; of fortitude – to answer the call to be vaccinated to protect family and nation; of never-say-die – rolling up our sleeves and doing the hard work when duty calls.
So, on the revival of aviation, I do not have a water-tight and detailed plan to present to the House, one that meets the much-vaunted high standards of our Civil Service. Instead, we can only be guided by an unfailing drive to keep pushing forward, knowing that for every two steps we move forward, we may have to take a step back, sometimes, two steps back, and knowing that if we are too reckless and ambitious and take too big a leap, we may have to be set back by a mile.
With each setback, we and I will be questioned, \"Why do you even bother with such an idea? Why never plan properly? Why so naive?\" Fair questions. But try, we must, Mr Chairman. The worst thing to do now is not even try, because that is giving up the fight. With vaccines, the fight is in our favour.
We have strong lungs and open arteries. Most importantly, we have an unwavering heart. This is what we need most, perhaps as importantly as vaccines, to not just walk, run, ride, cycle, sail – but to fly and to soar into the skies again. [Applause.]
The Chairman: Senior Minister of State Chee Hong Tat.
The Senior Minister of State for Transport (Mr Chee Hong Tat): Mr Chairman, I will speak about growing our maritime sector and LTA's pro-enterprise efforts.
Maritime Singapore did well last year. Our port handled 36.9 million twenty-foot equivalent units (TEUs). Our International Maritime Centre grew in scale and diversity. We attracted 11 new shipping groups to Singapore and worked with eight maritime companies to expand their operations here.
Mr Saktiandi Supaat asked about growing the maritime sector and creating jobs. This is important. We must not be too satisfied with our success to become complacent.
We will build on the momentum and seize new opportunities to create an integrated, innovative and inclusive Maritime Singapore eco-system – what we call the three \"I\"s.
Let me start with the first \"I\", integrated.
Our port is consistently ranked first or second in the world on efficiency, reliability and connectivity.
But future growth is never guaranteed. If we do not stay ahead of the competition, others will steal our lunch. We must continue to differentiate ourselves and bring value to our customers.
We are consolidating all of PSA's operations from Pasir Panjang, Keppel and Brani into one integrated Tuas Port, what the Prime Minister called \"our next bold move\".
Mr Melvin Yong and Mr Ang Wei Neng asked for an update on Tuas Port. We are on track to complete the first phase of land reclamation works by end of this year, creating 400 hectares to support 21 berths and handle 20 million TEUs a year. When Tuas Port is fully operational, it will be as large as two Ang Mo Kios and handle up to 65 million TEUs a year, 50% more than our current capacity.
This additional capacity will allow PSA to serve more ships and further enhance our network connectivity, which is a critical factor for a transshipment hub port.
Tuas Port will offer best-in-class efficiency, productivity, reliability and sustainability. It will be fully automated – from cranes to driverless vehicles. These will more than double our labour productivity at Tuas, compared to our City Terminals, and create many skilled jobs for Singaporeans in the port sector. It will also be a greener port, with a 50% reduction in carbon emissions intensity.
The concept of integration extends beyond the port. To key sectors like advanced manufacturing, cold chain and logistics, which form the Tuas Port eco-system, we can move containers directly from the ships to the factories without additional delays or handling costs. We are also enhancing digital integration to facilitate data exchange, helping companies to enjoy greater convenience, reduce costs and save time.
Mr Ang Wei Neng asked about accessibility and housing for workers. We plan to develop Tuas South region for industrial use over the next two decades. We will continue to explore viable transport options for workers and work with MND to increase public housing options in the West.
We will further grow our International Maritime Centre and encourage maritime companies to expand their operations here, including maritime law and arbitration, ship management and marine insurance. We aim to bring in $20 billion in total business spending commitments from maritime companies from 2020 to 2024, and create more jobs and more opportunities for our people.
Let me move to the second \"I\", an innovative Maritime Singapore.
We will partner and support maritime technology SMEs: to push research and technology boundaries; scale up and team up; and turn challenges into new opportunities for growth.
We will increase the cap of co-funding support for maritime technology SMEs from 50% currently to 70%, and encourage industry players to share expertise and resources to co-develop scalable solutions. Eligible projects by industry consortiums will also receive up to 70% co-funding support.
The Maritime and Port Authority of Singapore (MPA) will top up $15 million to the Maritime Innovation and Technology Fund. In total, we will have $100 million to fund maritime R&D and product development.
We aim to more than triple the number of maritime tech start-ups supported under the PIER71 funding programme from 30 to 100 by 2025. The start-up eco-system is gaining momentum with wider industry support. Recently, SEEDS Capital partnered venture development firms to co-invest up to $50 million into maritime technology start-ups.
Our goal is to be the top maritime start-up hub in the world, the Silicon Valley for maritime technology.
Mr Saktiandi asked about the Green Energy and Technology Programme. A key project is the electrification of harbour craft. Our call for proposals has received interest from 16 industry consortiums. MPA is also drawing up a Maritime Singapore Decarbonisation Blueprint 2050 together with the industry to promote sustainable practices and identify new job opportunities.
I have spoken about the first two \"I\"s, \"integrated\" and \"innovative\". The third \"I\" is inclusive, which reflects our vision of creating a diverse range of jobs for Singaporeans with different backgrounds and skillsets.
We want to attract and train more Singaporeans to take on seafaring and shore-based jobs. As the maritime sector grows and transforms, there will be new opportunities and new pathways in areas such as environmental sustainability, systems engineering, cybersecurity and data analytics.
MPA is partnering the industry and Institutions of Higher Learning to facilitate training, attachment and traineeship opportunities as part of the SGUnited Jobs and Skills Package. The training allowances will increase from 1 April. We are also encouraging maritime companies to tap on the Jobs Growth Incentive to increase local hiring as well as Professional Conversion Programmes for mid-career entrants.
MPA will partner the industry to groom a pipeline of future leaders for Maritime Singapore. We are starting a new Maritime Leadership Programme to train up to 30 local maritime managers for the first two runs to hone their leadership skills, build global perspectives on key maritime issues and strengthen their business networks locally and abroad.
Let me now turn to LTA's pro-enterprise efforts. Mr Saktiandi and Mr Ang Wei Neng asked about this.
LTA's work impacts businesses beyond the land transport sector. The built environment sector is one example as development plans involving transport infrastructure or traffic flows require LTA's approval.
Companies often request LTA to expedite their approvals to reduce processing time and business costs. Companies also introduce new business models and technologies, including green solutions.
So, LTA's rules and regulations need to stay ahead of the curve to support new innovations. At the same time, LTA is responsible for public safety and a pleasant commuting experience for all. A balance must be struck.
In line with the SG Together movement, LTA will partner the industry to make its approval process more pro-business. It will form a Transport Infrastructure Collaboration Panel with representatives from the Real Estate Developers' Association of Singapore, Singapore Institute of Architects and Institution of Engineers Singapore. The panel will find ways to reduce business costs and improve efficiency.
For example, it will simplify and shorten the approval process for development plans, by expanding the lodgement scheme to allow more categories of submissions to receive in-principle approval upon submission. This win-win outcome can only be achieved if the industry is clear about what is required in the submissions, to avoid multiple back-and-forths. LTA will work with the professional bodies to conduct sessions and raise awareness on what is required for the submissions.
LTA is also working with URA and other agencies to better integrate transport and land use planning-related information. This will be uploaded online for public access when ready. It will reduce information gaps and facilitate more public-private collaborations.
Next, the panel will review existing rules and set up regulatory sandboxes to support innovative ideas and new business models.
As regulator, LTA is a gatekeeper. It needs to assess proposals objectively. Some they will support, others, they will have to say no. It is not a free-for-all, but also not nothing at all.
To try new ideas, we must also be prepared to take calculated risks and accept some failure along the way. If we have zero tolerance for failure or if we are too afraid of making mistakes, we will have zero capacity for innovation. This is why I support setting up regulatory sandboxes where necessary to pilot new technologies and business models. If the experiment fails, we limit the downsides, we learn from the experience and we try again. If it succeeds, we can scale up the idea and extend it to other areas across Singapore. This is what former Head of Civil Service, Mr Peter Ho, calls, \"aiming for safe fail, rather than fail safe\".
Mr Chairman, in the Summer Palace in Beijing, there was a stone boat built by Emperor Qianlong. He hoped the Qing Dynasty would be like the stone boat – unshakeable and unsinkable. Unfortunately, it is also un-sailable. And we know what eventually happened to the Qing Dynasty. When we build ships, it is not to anchor them in the harbour or in some lake in the Summer Palace. It is to sail out to the oceans, to the open seas and reach new lands, including going into uncharted waters.
To be an innovative nation, we must have the same pioneering spirit and sense of adventure like our forefathers: willing to leave our comfort zones and take calculated risks, never giving up when we encounter challenges and always looking to pursue new rainbows on the horizon. [Applause.]
The Chairman: Senior Minister of State Dr Amy Khor.
The Senior Minister of State for Transport (Dr Amy Khor Lean Suan): My speech will touch on how the land transport sector is coping with the COVID-19 pandemic. I will share how we are future-proofing our land transport workers. Then, I will explain how we will partner the community to repurpose stretches of roads for footpaths and cycling paths to enhance connectivity.
Let me first touch on COVID-19's impact on the land transport sector. As the COVID-19 situation evolved, we had to implement additional safe management measures while ensuring that our transport operations continued to run smoothly. Our land transport workers made this possible. On behalf of MOT, I applaud them for their courage, dedication and resilience.
We are also grateful for the strong support by the unions, associations and transport operators. A good example is that of the taxi and private hire car (PHC) sector. Right at the start of the pandemic, the Government worked closely with the National Taxi Association (NTA), the National Private Hire Vehicles Association (NPHVA) and the taxi and PHC operators to introduce the Special Relief Fund (SRF), which provided much needed support to our taxi and PHC drivers amidst a significant decline in ridership.
As of February 2021, the Government has disbursed more than $155 million in relief payouts to over 50,000 drivers through the SRF and the COVID-19 Driver Relief Fund (CDRF). Additionally, the Government has disbursed more than $500 million to over 57,000 drivers under the Self-Employed Person Income Relief Scheme (SIRS).
I would like to assure Mr Ang Wei Neng and Ms Yeo Wan Ling that we will continue to support our taxi and PHC drivers. In fact, we have committed $116 million towards CDRF payouts between March and June 2021. In view of the fluid circumstances, we will continue to monitor the situation closely to assess if further support is necessary.
Mr Ang shared his concerns about young drivers in the taxi and PHC sector and asked if the Government will consider capping the number of PHCs. Firstly, Mr Ang may recall that we raised the minimum age for new Private Hire Car Driver’s Vocational Licence (PDVL) applicants to at least 30 years old last year, to align with the Taxi Driver’s Vocational Licence (TDVL).
Secondly, Singaporeans below the age of 40 with tertiary education make up less than 10% of all TDVL and PDVL holders. From this group, those below 30 years old make up about 3% of all TDVL and PDVL holders, and they have been grandfathered.
Finally, we have no plans to cap the number of PHCs, as the sector is already sensitive to market conditions. For example, we observed a 12% drop in the number of registered PHCs since the start of the pandemic. For drivers who exit the taxi and PHC sectors amidst the pandemic, we appreciate the Labour Movement’s assistance in helping them to upskill and look for alternative jobs.
Last but not least, we have also partnered NTA, NPHVA and the taxi and PHC operators to commence vaccinations for taxi and PHC drivers last week. This forms part of our efforts to offer vaccinations to our frontline land transport workers and strengthen the resilience of our essential services. Since last week, MOH has issued SMS notifications to all of the more than 50,000 active taxi and PHC drivers. More than 50% of those invited have booked their vaccination appointments. We will work with the associations and operators to encourage more drivers to get vaccinated.
The strong tripartite partnerships that have helped us weather the COVID-19 pandemic will also be critical to support the transformation of our workforce to meet longer term needs. Before COVID-19, we were already looking into trends such as digitalisation and new vehicular technologies. These present many challenges but also create exciting opportunities.
As Mr Melvin Yong pointed out, the electrification of the land transport system will create many jobs and opportunities for upskilling. New competencies are required to maintain EVs and charging infrastructure. In December 2020, the Government supported the establishment of the Singapore Motor Workshop Association’s training facility to impart EV-related competencies. We will continue to work closely with companies, training providers and unions, to identify ways to support young graduates and existing workers to acquire such competencies.
Ms Yeo also asked how we are helping taxi and PHC drivers cope with longer term technology developments, such as digitalisation.
LTA is engaging the industry on an updated training curriculum for the Taxi Driver’s and the PHC Driver’s Vocational Licences, which will place greater emphasis on key competencies to help drivers cope with digitalisation, such as mapping and navigational tools. The new curriculum will also allow drivers to be kept up-to-date with new vehicular technology, such as electric and autonomous vehicles.
LTA will also support greater use of technology to train taxi and PHC drivers, by facilitating training centres to offer online TDVL refresher courses so that the drivers can attend the courses at their convenience. A new conversion course will also be introduced to allow drivers to convert their PDVLs to TDVLs to expand the driving options for vocational drivers. LTA will announce more details at a later date.
Beyond workforce transformation, we can also emerge stronger by building a more sustainable and inclusive transport system under the Singapore Green Plan 2030.
We will encourage more people to switch from private vehicles to Walk, Cycle and Ride (WCR) modes. Since the start of the COVID-19 pandemic, many Singaporeans have embraced cycling and walking. I would like to assure Ms Yeo that we are harnessing this momentum to enhance the safety and ease of using WCR modes.
First, on active mobility (AM) regulations. Over a year has passed since we banned the use of e-scooters on footpaths.
I am pleased to inform Ms Yeo that footpath safety has improved considerably, with accidents involving motorised PMDs on footpaths falling by 79% between 2019 and 2020 to 30 cases. To further enhance safety, we will be rolling out a new import controls regime for personal mobility devices and power-assisted bicycles in the first half of 2021. This is an important measure to prevent the import of non-compliant devices. Meanwhile, we will continue with regular inspections of AM devices to deter illegal modifications.
Second, on WCR infrastructure. Mr Lim Biow Chuan will be glad to know that we are pressing on with our plans to expand cycling paths from 460 km to 1,300 km by 2030.
This will allow more cycling journeys to be completed entirely on the cycling path network, although cyclists may still have to dismount and push at certain locations, such as overhead bridges, for safety reasons. By the end of this year, we will have added 28 km of cycling paths, in Bukit Panjang, Sembawang, Taman Jurong and Yishun, as well mature estates such as Ang Mo Kio, Bishan, Tampines, Toa Payoh. We will also prioritise construction for towns that do not have cycling paths. Senior Parliamentary Secretary Baey will elaborate on how we will develop a culture of gracious usage on paths to complement these efforts.
We will also have transit priority corridors, to enhance the travel experience by public transport. The North-South Corridor (NSC) is one such example.
When completed, it will shave up to 20 minutes for bus commuters travelling from the North to the CBD with its dedicated and continuous bus lanes. The NSC will also serve as a green thoroughfare from the North into the city centre with its cycling trunk routes and pedestrian paths.
Chairman, going forward, as Ms Yeo and Mr Lim have suggested, we will work closely with the community to develop AM infrastructure.
We will repurpose suitable stretches of road into footpaths, cycling paths or bus lanes, and incorporate features that contribute to place making. LTA has identified some 60 possible projects to be implemented and have commenced engagement for five projects. We will seek views from residents, grassroots volunteers, Town Councils, and local businesses, to identify potential enhancements.
These views will shape key project details, such as the length of the stretch being repurposed, or when permanent infrastructure enhancement works will commence or even if the project should proceed at all.
We will start with projects to enhance walkability, starting with areas such as the Civic District as Mr Cheng Hsing Yao has highlighted to benefit the widest spectrum of users. Over the years, we have worked with arts and civic groups and premise owners to realise their aspirations for greater walkability within the Civic District. We have pedestrianised one side of Anderson Bridge and part of St Andrew’s Road, and restricted vehicle access to stretches of Parliament Place, Old Parliament Lane and Connaught Drive. With this, pedestrians can walk seamlessly from Old Parliament House to Esplanade Park.
More can be done. Many Singaporeans have expressed a desire for more extensive pedestrianisation of the Civic District. Mr Mok Wei Wei, the architect for the upgrading of the Victoria Theatre and Concert Hall, suggested fully pedestrianising Anderson Bridge as a gateway to the District.
This would offer unblocked and panoramic views of the District’s architecture. We will consider his suggestion alongside others from visitors, arts and civic groups and premise owners, as we work towards our vision of a more pedestrian-friendly Civic District.
Looking beyond the Civic District, we will also work with the community to gradually reshape the streetscape in areas such as Sembawang, Bishan,Toa Payoh, Tanjong Pagar and Jalan Besar.
We will start with a stretch of Havelock Road. With your permission, Chairman, may I display some slides on the LCD screens.
The Chairman: Yes, please.
Dr Amy Khor Lean Suan: This is a mature estate, and we have heard residents and grassroots volunteers share their desire to make the road more walkable. Local business proprietors have also said that they would welcome wider footpaths, so that customers can browse more comfortably in front of their shops.
We are studying widening the footpath by paving over some roadside parking lots, thereby creating a more pleasant walking experience for pedestrians. We will implement this with water-filled barriers temporarily for several months and then take in community feedback for further refinements, before permanently widening the footpath.
Aside from walkability, we will also start to convert stretches of roads into cycling paths, beginning in locations such as Ang Mo Kio Street 22, to expand our network of cycling paths.
Chairman, 2020 was a difficult year for the land transport sector. And pardon the pun, the road ahead remains challenging. But we will step up our efforts to transform our land transport system to become more inclusive and sustainable.
We will also partner the community to build a landscape of roads and paths that meets Singaporeans’ aspirations for a liveable and sustainable home. This will enable us to walk, cycle and ride safely and comfortably while we look to soar in the skies again!
The Chairman: Senior Parliamentary Secretary Baey Yam Keng.
The Senior Parliamentary Secretary to the Minister for Transport (Mr Baey Yam Keng): Mr Chairman, I will share our efforts in building a transport system that is safe and inclusive for all, on public paths and public transport. More people are taking up cycling and other active modes, with monthly shared bike use tripling in 2020. It is important that all path users, both pedestrians and riders, remain safe.
Ms Yeo Wan Ling asked about improving path safety. Earlier this year, the Government accepted Active Mobility Advisory Panel's recommendation that all bicycles must have brakes when used on public paths and roads. This will come into effect in September.
We also mandated third-party liability insurance for active mobility riders who ride for work purposes, such as delivery riders. This will go some way towards one, ensuring the accident victims receive compensation and two, protecting commercial riders against excessive claims.
To further enhance path safety, we announced that e-scooter and power-assisted bicycle riders must take a theory test to ride in public. With this, all riders will know the rules and code of conduct. We will release the test handbook in April and begin testing in mid-2021.
Ms Yeo Wan Ling and Mr Lim Biow Chuan asked about our efforts to educate pedestrians and riders. From May we will launch a new \"Move Happy\" Graciousness campaign to raise awareness on safe and gracious path-sharing with three guidelines: one, keep left on paths; second, use the most appropriate path; and third, be alert of our surroundings.
We have also run the Safe Riding Programme (SRP) since 2018. Many participants found this voluntary session a fun and hands-on way to learn about safe riding. I am pleased to announce that we are refreshing the SRP around the second quarter this year to make it even more interactive.
Responsible behaviour is also important in keeping roads safe. Like other road users, cyclists must follow traffic rules. Motorists should look out for more vulnerable users. With the right mindset and a culture of graciousness, we can enjoy active mobility in a safe and harmonious way. Mr Chairman, allow me to say a few words in Mandarin.
(In Mandarin): [Please refer to Vernacular Speech.] A culture of graciousness is critical in making our public transport system safe and inclusive.
\tTaking the trains and buses is a big part of our daily lives. To able-bodied Singaporeans, the public transport system is an easy way to get around quickly and conveniently. But the commute can be a bit challenging for elderly and commuters with special needs. They, too, should be able to use public transport seamlessly and safely. We can be more understanding towards this group of commuters, by putting their needs before ours, and stepping forward to help fellow commuters. These acts of care may be small, but they can really make a difference to those who need help.
\tRecently, Ang Mo Kio MRT station service ambassadors told me that students with autism from the nearby Pathlight School sometimes would look for them to have a chat. To these commuters with special needs, the familiar faces of the service ambassadors can be a source of comfort and encouragement.
\t
\tI have written a short poem to encourage everyone:
\"Pedestrians, cyclists and Personal Mobility Device riders,
A friendly reminder to not rush,
Please slow down when there is someone in front of you.
Never forget to put safety first.
Do look at the road ahead and not at your phone.
Whether on the MRT or the bus,
Do not neglect the culture of being a caring commuter.
Let us aim for a smooth travel without barriers,
Everyone appreciates a gracious commute experience.\"
(In English): Chairman, last year, I announced the setting up of a Caring SG Commuters Committee. Ms Poh Li San asked about our plans. Over the past year, the Committee engaged many commuters. Through focus group discussions and surveys, the Committee found that Singaporeans want to help fellow commuters, but often do not know how. Only about one in four commuters know how to assist commuters with conditions such as hearing and developmental disabilities. I can understand why, because these conditions may not be immediately noticeable.
We will therefore try to help the public better understand other commuters’ needs. One key initiative is the recruitment of Caring Commuter Champions, who will be trained by SG Enable to support commuters with special needs. I hope more people will volunteer as Caring Commuter Champions, to make a change in your fellow commuters’ journeys.
The Public Transport Council also found that only around half of survey respondents were comfortable to ask for help even if they needed it. It is sometimes awkward to ask for help, especially when we do not want to inconvenience others.
We want to make it easier for commuters to ask for help. In October 2019, LTA launched a pilot where commuters who need a seat could alert others with a \"May I have a seat please?” sticker. Go-Ahead Singapore also launched a “Helping Hand” trial, providing commuters with mobility needs a card with instructions for the bus captains. Both initiatives received positive feedback.
Today, I am pleased to announce that the “May I have a seat please?” initiative will be made permanent. From April, commuters with long-term, invisible medical conditions or disabilities can request for a specially designed card and lanyard at Passenger Service Centres and Offices.
The Government will continue to invest in safety and inclusivity-related initiatives. We are improving accessibility for persons with disabilities, as Mr Gerald Giam has suggested. Today, all train stations and bus interchanges are barrier-free. About 1,300 signalised pedestrian crossings have audio-tactile signals to help the visually impaired pedestrians. We will work with MSF to enhance these, such as extending their operating hours.
At stations along the newest Thomson-East Coast Line, we have also taken in feedback from focus group discussions to introduce bigger signages with better contrast, larger font sizes and clearer symbols. These are useful for commuters who may not see as well, or may not understand English. These will be rolled out to all new stations.
However, we need to prioritise our efforts given the high cost of infrastructural improvements. For example, we have already committed over $370 million over the last eight years on covered linkways and we will continue to enhance walkability. So, I seek Mr Gerald Giam’s and Mr Faisal Manap’s understanding that we must be financially prudent and focus on areas near transport nodes first.
Finally, commuters have asked for guidance on how to help fellow commuters. The Caring SG Commuters Committee is studying these ideas and I look forward to their recommendations due in the middle of 2021.
Mr Chairman, our daily commutes are not just about moving a person from one point to another. They are also about sharing and navigating a common space, on public paths and public transport. All of us can make a difference. We will continue to partner the community to achieve our vision of a safe and inclusive transport system for all.
The Chairman: Clarifications? Mr Ang Wei Neng.
Mr Ang Wei Neng: Thank you, Chairman. I thank the Minister, the Senior Ministers of State and the Senior Parliament Secretary for painting a very exciting scene that we would have in the next few years for public transport, and especially for aviation. I have two clarifications: one for Senior Minister of State Amy Khor, and another clarification for Senior Minister of State Mr Chee Hong Tat.
First for the maritime sector, we are very glad to hear that the Tuas Port will just not be a port but a hub. Activities would include a lot of supplementary industries. And we know that it could be the best in class, but I hope that it will be best in class supported by a best in class MRT station as well. I did not hear Senior Minister of State Chee Hong Tat saying anything about having a train connection there, but he mentioned about having a new housing estate. So, we hope that he can clarify, because by 2030, as what Minister said, there will still be no train to the Tuas Port area.
The second clarification is for Senior Minister of State Amy Khor. Did I hear correctly that we will add 28 km of cycling path by the end of the year? If so, it does not seem very exciting. For example, in Nanyang estate, there are a lot of cyclists, but there are zero cycling paths, zero kilometers of cycling path. So, what does it take to double or triple the building of cycling paths this year and next, rather than wait for a longer time?
Mr Chee Hong Tat: Mr Chairman, in my speech earlier, I mentioned for the Tuas Port, that we will continue to explore viable transport options for workers. So, this is something which we will study and Mr Ang is right that if you look at the demand for transport connectivity to that part of Singapore, it will not only depend on the Tuas Port alone but also what are the other developments in the surrounding area using the port as a key hub supporting the growth of different industries. So, this is something which we will assess and we will discuss with the relevant stakeholders and other agencies.
The Chairman: Senior Minister of State Amy Khor.
Dr Amy Khor Lean Suan: The Member is right. I did say that by the end of this year we would have added 28 km of cycling paths. Those are the completed cycling paths that we will be adding on. The target is to have about 1,300 km of cycling path by 2030, about 10 years away. We now have about 460 km. So, if you divide it, that is the pace.
But having said that, even now, we have identified 60 road repurposing projects. Many of these, you can look into not just pedestrianising, adding footpaths, but perhaps widening it for cycling paths. Whether if these can come aboard really depends on the support from the local community. When we do road repurposing projects, we have to work very closely with the local community to see if this is something they would support.
When you do this, there will be some trade-offs. For instance, the benefits may take time to come, but the immediate impact is on motorists. They will probably have to divert the roads if we pedestrianise or we widen the cycling paths. They may have to park somewhere else, for instance, if we include the cycling paths. So, we have to look at how to minimise the inconvenience and at the same time, look at how we can bring benefits to the community and look at how to mitigate some of the trade-offs.
The Chairman: Mr Ang Wei Neng.
Mr Ang Wei Neng: Sir, I would really like to appeal for Senior Minister of State Amy Khor to accelerate the construction of cycling paths, especially for those towns that have zero kilometres of cycling track.
Dr Amy Khor Lean Suan: Actually, I did say in my speech that we will especially focus on those towns where there are no cycling paths. So, if the Member is keen on this, let us look at it.
The Chairman: I am also keen. Mr Saktiandi Supaat.
Mr Saktiandi Supaat: Mr Chairman, fortunately I am not asking for cycling paths for Toa Payoh, as we already have those, and we are thankful to MOT for the cycling paths there.
I have two questions, Mr Chairman, one to Minister and second to Senior Minister of State Chee.
I would like to thank Minister for answering my question about the financial sustainability issues that I raised. My question is with regard to fare concessions. The last fare concession increase, if we look at MOT's website, the last inclusion into the fare concession coverage was in 2019, where PTC extended student concessionary fares to Polytechnics and other diploma students. And I think it benefited more than 80,000. My question is, are there any new concessions in play going forward, in future as fare adjustments come on stream. And the Minister highlighted that fare increases might come in going forward, and what are the plans in terms of concessions? The reason why I highlighted about the adult learners, is to capture some elements of adult learners who are studying in the Polytechnics. Some may not be captured in the move on 2019.
The second question is with regard to Mr Chee's response just now, the seafaring and shore-based jobs, and the green maritime sector jobs. How many jobs will be created in those sectors? And whether more can be done to entice more Singaporeans, young Singaporeans, to explore good jobs there? I think not many of our young or our Singaporeans are aware of some of these jobs there. I think those are good jobs that we need to let them know even more about going forward.
Mr Ong Ye Kung: I want to assure Mr Saktiandi, I really understand what you are saying. I really understand. In 2019, in fact, I was really happy that fare concession was extended to Polytechnic students, because the then Minister for Education lobbied very hard for it. And the then Minister for Transport was kind enough to also support it. So, I fully understand. But I think going beyond that, it becomes less obvious. But let us keep an open mind.
I think the principle is this. I am merely mentioning that over the years, from time to time, there have been fare increases and that same system will continue. And in the second half of the year, PTC will have to convene and have to consider. But whenever there is a fare increase, should there be one, we must always protect the vulnerable groups, like the low-income, the students, the seniors, and fare concession is one way to do so. And I think we keep to that principle and see how we can best ensure that those who find difficulty affording can be protected against fare increases.
The Chairman: Senior Minister of State Chee.
Mr Chee Hong Tat: Mr Chairman, I think Mr Saktiandi asked a very important question about jobs, because when we pursue growth, when we attract investments, what is the end in mind? One very important objective is to create good jobs for our people.
In the maritime sector, our aim is to be able to create an inclusive and diverse range of jobs. If you look at the port sector, this will be the traditional roles that we have, crane operators, drivers, but increasingly, we are also looking at new roles that we need different skills and different groups of individuals to come in to fill these roles. When we pursue environmental sustainability, green growth, de-carbonisation of shipping and port operations, I think this will open up new opportunities and new possibilities.
Similarly, I think for the maritime services which actually go hand-in-hand with the port, because when we grow our port and shipping lines call at Singapore, they register their ships here with our registry, they base their headquarters – their regional and global headquarters – here in Singapore, we can then offer them all the other maritime related services – financing, insurance, legal, brokering and so on and so forth.
All that will create a lot of opportunities for different groups of Singaporeans. Different age groups as well. Young graduates, but also mid-career entrants who want to join the sector. So, they may transit, for example, from engineering, from finance sector, from IT, and they want to now enter this growth sector. We welcome them.
Lastly, I want to say this. It is not just the number of jobs – which is very important and we will try our best and we will try and create as many as we can – but in the end, it is also about whether we are able to raise the quality of jobs. This is something which is very crucial because it requires a strong tripartite partnership to work hand in hand with companies and the Labour Movement to be able to redesign the jobs and to be able to upskill the jobs. I think in the process of doing so, together with growth, we are then able to provide higher pay, better prospects, and I think this will allow us to attract more Singaporeans to enter the sector.
The Chairman: Mr Dennis Tan.
Mr Dennis Tan Lip Fong: Thank you, Mr Chairman. I have three clarifications.
First, I would like to thank the Minister and all the appointment holders for the answers that they have given in the Committee of Supply. I thank the Minister, especially for the answers given in respect to the concerns that I raised on the aerospace sector.
The first question I have is in respect of what Senior Parliamentary Secretary Baey has shared with us regarding safe riding. I agree with Member Ms Yeo Wan Ling's concern regarding safe riding on footpaths. I would like to implore on LTA to continue to improve efforts at public education as well as at consistent enforcement. I think it is a message that I have shared virtually every year in the last couple of years.
Yesterday, I shared during the MND Committee of Supply in a cut on safety of the Park Connector Network (PCN). The reason why I shared during the MND Committee of Supply – but it is related to, I think, a lot on LTA's efforts on this – is that I believe that a busy PCN, especially during peak times, is always a good indicator of the state of our culture of path sharing by different users. I expressed concern that over two years because – I shared a previous cut on this two years ago in the same MND Committee of Supply – I felt that there is not many changes in terms of the culture. Therefore, I would like to implore LTA to continue to work on public education as well as consistent enforcement.
I appreciate Senior Parliamentary Secretary Baey sharing about the efforts. Can I continue to implore LTA to consider public education from the point of view of not just giving information to interested users who will draw information from the Facebook but rather to think about how to disseminate public education on safe and considerate use of footpaths and the PCN, to people who do not consciously look for it. Because these are people who use our footpaths, the aunties and uncles who may get upset with people ringing the bell when cyclists are passing by, keeping left or keeping right, people walking their dogs on the PCN or footpaths, stopping to chat. These are all very everyday moments. That is one.
The second clarification – I am not sure which appointment holder will answer this – but I will like to take an opportunity to ask, when does the Government envisage our public bus fleet going fully electric?
My third clarification is not really a clarification but I would like to take the opportunity to thank the Minister for sharing about crew change. I do not have a clarification because I filed a Parliamentary Question on this recently and I would like to thank the Minister and the Senior Minister of State, perhaps, for a very comprehensive answer on my Parliamentary Question on NewOcean 6, relating to the measures on crew change arising from the infection of crew on visiting ships to the port of Singapore.
I just want to take the opportunity to applaud the hard work and the good efforts of MOT and MPA on coming up with the crew change policies and guidelines, as well as for safe boarding of visiting vessels at the port of Singapore by workmen or third parties. I think it is a lot of hard work and I agree with the Minister, and as a member of the maritime community, I agree that these efforts are very important to continue in this COVID-19 climate. It is very important for our port of Singapore, our businesses and our reputation. So, I would like to thank MPA and MOT officers for their hard work.
The Chairman: The guillotine time is 2.10 pm, so let us try to finish by then.
Mr Ong Ye Kung: In the interest of time, I will answer all three.
First, safe riding. I thank Mr Dennis Tan for his very useful suggestions. We will take them in but as he says, culture change is not easy, it takes time. Step by step, we will move in the right direction.
I do want to make a clarification in my speech just now. I mentioned some retrenchment figures and reduction in labour force figures. That applies to the aviation sector, but I know your cut was actually on the aerospace sector. I do not have the numbers for aerospace but talking to unions, there has been some retrenchment – not huge numbers, some. And again, very much borne by the foreign workforce. MOT, together with EDB, will try our best to continue to work with the aerospace sector.
On public bus fleet, the target is 2040 to be fully clean energy. But we just made a big push towards EVs, so maybe it can be advanced. We never know. Keep an open mind.
Finally, on crew change. Thank you for the strong confidence you have shown in our maritime community. I must place on record our thanks to MOH, who worked side by side with us to make this possible. There are many ministries of health in the world who just want total elimination of viruses. But I think we had a good relationship working with MOH. But the decision was not easy. You take a big deep breath and say, \"Let's make this step\"; put in the safety precautions, work with the industry and all the stakeholders, plus the healthcare professionals and experts. And we managed to make it work. Even so, we always continue to be on guard so that we can maintain Singapore as a safe, as well as an open maritime hub.
The Chairman: Mr Saktiandi, would you like to withdraw your amendment?
Mr Saktiandi Supaat: Mr Chairman, we have been discussing about the lifeblood and lungs of Singapore over the past two hours. The Minister even talked about snorkeling underwater to fill our lungs with much needed oxygen and even spoke about taking a deep breath just now!
But it has been an extremely challenging time for the transport sector, especially with the sharp drop in air travel, commuter volumes and connectivity for the past months. The stakes are high as the pandemic is still fraught with uncertainties. It is also challenging to determine the new travel patterns of the near future. But there are exciting times ahead, from the responses just now, for our land transport sector and efforts are being made to make sure our air and sea hubs will thrive again.
I would like to thank Members for all their cuts and many thanks to Minister Ong Ye Kung, Senior Minister of State Amy Khor, Senior Minister of State Chee Hong Tat and Senior Parliamentary Secretary Baey Yam Keng for their responses and to Permanent Secretary, MOT and his team, our MOT family of agencies – CAAS, MPA, LTA. And most importantly, our transport frontliners, for their hard work, conviction and passion to keep our air and sea hubs, and land transport systems running efficiently, smoothly and safely, day and night, since COVID-19 hit us, and also to be ready for the future. With that, Mr Chairman, I beg leave to withdraw my amendment.
The Chairman: With COVID-19 still around, do be careful how you take your deep breath. Make sure you are masked when you are doing it.
[(proc text) Amendment, by leave, withdrawn. (proc text)]
[(proc text) The sum of $4,051,283,300 for Head W ordered to stand part of the Main Estimates. (proc text)]
[(proc text) The sum of $7,615,454,000 for Head W ordered to stand part of the Development Estimates. (proc text)]
","clarificationText":null,"clarificationTitle":null,"clarificationSubTitle":null,"reportType":null,"questionCount":null,"footNotes":null,"footNoteQuestions":null,"questionNo":null},{"startPgNo":0,"endPgNo":0,"title":"Committee of Supply – Head O (Ministry of Health)","subTitle":"Fostering a resilient and caring society","sectionType":"OS","content":"The Chairman: Head O, Ministry of Health. Dr Tan Wu Meng.
Dr Tan Wu Meng (Jurong): Mr Chairman, I beg to move, \"That the total sum to be allocated for Head O of the Estimates be reduced by $100\". I declare that I am a medical doctor in a public hospital.
Sir, in the Budget debate, I spoke about preparing for the next pandemic. Today, I will speak on delivering healthcare to our fellow Singaporeans and supporting our sisters and brothers working on the healthcare frontline. I will speak on five areas today: (a) seniors' access to care; (b) care coordination; (c) care-givers; (d) IT and design in healthcare; and (e) our healthcare frontliners.
Sir, on seniors' mobility and access to care. In an ageing society, we have more Singaporeans with mobility needs. Some stay in older flats with multiple steps at the doorway, flats where the steps are too high for the usual Enhancement for Active Seniors (EASE) programme organised by HDB.
Has MOH studied whether seniors in such households are more likely to miss medical appointments? Has MOH looked at how to better support such seniors so they can more easily get to the clinic so that chronic diseases can be brought under control better and so that hospital admissions can be reduced by going upstream? Can MOH look into better support for home delivery of medications? Because this too will reduce the need for seniors with limited mobility to make multiple outpatient trips.
Sir, my second point on care coordinators.
On my Clementi home visits, I have met residents who have many, many medical appointments. One old lady told me she has 10 clinic visits in the upcoming, next three months. Each of them will mean her daughter has to take time off from work to accompany her to and from the clinic for the appointment.
With an ageing population and shrinking family sizes, this poses a challenge for many seniors in the community.
In some cases, the son or daughter cannot take leave or has used up all of their annual leave, or the family member may be a low-wage worker, daily-rated, which means time away from work becomes loss of income.
Many patients today are older, with more medical conditions—more complex medical conditions. Sometimes three, four, five – even more – medical teams look after the same patient.
Sir, there is a role for more patient navigators and more care coordinators linking up across different care teams to help coordinate the care better, to help reduce the multiplication of medical appointments, to help make it easier for appointments to be brought onto the same day, where possible. We can look at reimagining our healthcare so as to support this better.
Sir, I am told that IMH has a team of patient care coordinators and, over the years, their experience has been that this reduces the number of patients needing admission. There are lessons we can learn for coordinating care across other medical conditions as well.
Sir, my third point on supporting care-givers.
Some years ago, as a young doctor, I looked after an old lady with advanced cancer. She was very, very sick and not getting better. Her 50-year old son quit his job to look after her. He quit his job to look after his mother. Later, she passed away. Her son's duty was done. But he had a lot of difficulty. He found it so hard getting back into the workforce in his fifties. Yet this man, this filial caring son, had shown dedication and devotion to duty, day and night, looking after his mother who was terminally ill.
Dedication, devotion, duty, but unfortunately, potential employers did not see it that way. They asked, \"What is this gap in your CV? Why were you out of the workforce?\" They did not see the dedication and devotion to duty.
Sir, I call upon MOH to work with MSF and MOM to look at how we can better support care-givers – both during the journey of care-giving, and especially when a care-giver is trying to get back into the workforce. Together, across the Ministries, together with industry, and with our brothers and sisters in the Unions, we can find ways to build awareness among employers and even go the extra mile to recognise inclusive employers, who hire fellow Singaporeans who are returning to the workforce having spent time as care-givers showing that dedication and devotion to duty.
Sir, my fourth point on IT and design in healthcare. Chairman, when we empower our healthcare workers, when we look at what is happening on the ground and empower workers on the ground to do their jobs better, it helps patients as well. It improves the quality of care. It improves the patient experience.
Sir, Information Technology, or IT, has transformed healthcare around the world, but we also must continue looking at how IT is implemented and designed. For example, digital ordering of tests today. Is it faster, easier, than ticking boxes and signing a piece of paper? If it is not, we must ask ourselves why and how can it be improved?
Electronic records today. Do they speed things up, so healthcare workers can spend more time, more quality time with patients? Or is there still room for improvement? And if so, why and how can we make it better?
Computer workstations today, the design of workstations today, computers, do they help doctors and nurses maintain eye contact with the patient? Comfort the patients, especially in a world with COVID-19, where everyone is wearing a mask and that eye contact becomes even more important. Does it help that eye contact happen? Or is it sometimes a different experience? And if so why, and how can we make it better?
So, I ask the Ministry, has MOH done any recent studies on the design of healthcare facilities, healthcare IT and the patient experience? Some designers talk about time-movement studies. How much time it takes to get a task done? How much movement is needed to make something happen? Has there been any recent ergonomic research to see what brings more comfort to patients and better performance for healthcare workers?
Sir, these studies may not be easy to do. But what we do not study, what we no not look at, what we do not search for, we do not know. We must seek truth from facts.
Sir, Steve Jobs was co-founder of Apple, and well known for his sense of design and aesthetics. Every iPhone user everyone who uses a modern multi-touch smartphone, sees the impact of his influence and legacy on industrial design. His younger sister Mona wrote in the New York Times shortly after he passed away. She wrote about how Steve Jobs, from his hospital bed, as a patient battling terminal cancer, wanted to make the hospital better. Sketching devices to hold an iPad in a hospital bed, designing new fluid monitors and X-ray equipment, re-drawing the design of a hospital unit.
Not every one of us can be Steve Jobs, but every patient brings an important perspective to the healthcare journey. And when we see better through the eyes of our patients, when we see better through the eyes of our healthcare workers on the ground, we continually see better and better ways to improve our healthcare system.
We can apply the same care and attention and passion to re-imagining the design of healthcare facilities, re-imagining the user experience so healthcare workers can do the job even better, care for patients even better. Whether it is a hospital computer system, the healthcare workplace, or the patient journey. Seeing through the eyes of our people.
Sir, I want to speak about our healthcare frontliners. In particular, I want to salute our nurses and allied health workers. Every doctor knows this instinctively, even before they become a doctor from their days as a medical student. The impact our nurses have, lifting up the lives of our patients making a difference for every patient.
Every patient, every care-giver understands this too. And I say this both as a doctor and as the son of a patient. We see the impact that our nurses have, that care, that dedication, that heart. Nursing is also deeply skilled work, deeply skilled work and essential work.
Last year during the debate on the President's Address, I called upon MOH to look at paying our nurses and allied health workers more and I am glad the Finance Minister has announced better salaries for our sisters and brothers in nursing.
Some years ago, I attended a healthcare conference. One of the speaker was the President and CEO of the Duke University Hospital in the USA. He is a nurse, trained as an Oncology nurse, rose up through the ranks to lead the hospital, to lead an entire healthcare system in the USA. We should continue looking at ways to further empower our nurses in Singapore to create more opportunities for upskilling and advancement, as we all work together to lift up the lives of our patients.
Sir, I also want to speak on another group of healthcare frontliners who are key to keeping us safe. These are some of our outsourced healthcare frontline workers. Our hospital cleaners, our healthcare attendants are an integral part of the health care workforce. They are integral to the hospital. Facing the COVID-19 risks together, serving on the same front line as medical nursing and allied health staff serving together.
Once upon a time all these brothers and sisters were directly hired by the hospitals and not outsourced. Today, a growing number of cleaners and healthcare attendants have been outsourced. But, Sir, the rationale for outsourcing hospital cleaners and hospital attendants is not compelling. It is not compelling. First of all, the demand for hospital cleaners and hospital attendants is the same throughout the year. There is no seasonal component involved. It does not vary much throughout the year. And in a COVID-19 world, it makes sense for team members to stay based within the same healthcare institution rather than moving from place to place amidst a pandemic.
We are already providing outsourced cleaners with protective gear during COVID-19. It recognises that they are part of the same healthcare frontline. And there is something to be said for treating all our hospital cleaners and healthcare attendants as part of the in-house staff, making them feel more fully like part of the team, supporting resourcing, uplifting these workers together accordingly. Because, Sir, when we are fighting on the COVID-19 frontline, we are all in this together. We should think about hospital cleaners, our hospital attendants as part of the whole healthcare team and not as a service to be outsourced.
Furthermore, Sir, direct hiring also makes it easier for hospitals to create additional jobs and job opportunities to hire directly from the community nearby. In my Meet-the-People Sessions in Clementi, I have met older workers who have been retrenched, who are looking for job placements in healthcare institutions nearby. We should look at ways for hospitals to generate employment for residents living nearby as well. I call upon the Ministry to consider this outsourcing issue as one of the issues which COVID-19 is forcing societies around the world to re-think.
Chairman, healthcare is about \"health\" and \"care\" supporting our patients, supporting our care-givers, supporting our healthcare workers –our sisters and brothers on the healthcare frontline. It is about keeping all of us safe, keeping all of us safe together. And so, may we continue building a healthier Singapore as we fight this COVID-19 pandemic as we emerge from the COVID-19 pandemic together. [Applause.]
[(proc text) Question proposed. (proc text)]
Mr Yip Hon Weng (Yio Chu Kang): Chairman, achieving herd immunity through COVID-19 vaccinations is important to our economy and livelihoods. Since the first vaccination roll-out in December, what are the latest statistics pertaining to the percentage of eligible recipients who are vaccinated? How many eligible seniors have been vaccinated?
Even with the commencement of the vaccination programme for senior citizens, some of my senior residents shared that they are adopting the wait-and-see approach. I cite some of the most common reasons pertaining to their decision. They are worried about immediate side effects. Moreover, the two approved vaccines in Singapore are based on a novel technology, so the long-term effects are unknown. Some are also questioning the need for vaccination as the community infection rates are low. They may not go for the vaccination if there is no need for a vaccination certificate to travel.
Is outreach also extended to younger Singaporeans pertaining to elderly vaccinations? Some elderly said that their children or grandchildren discouraged them from taking it. This is because their children are worried that the vaccinations have dangerous implications on seniors with health complications. How does MOH plan to encourage more seniors in the community to get vaccinated?
Mr Ang Wei Neng (West Coast): The National Centre for Infectious Diseases (NCID) was officially opened in September 2019, just a few months before Singapore detected the first confirmed case of COVID-19. Thereafter, NCID played a crucial role in battling COVID-19.
On the whole, Singapore has done relatively well in controlling the number of community cases as compared to our neighbouring countries, Asia and the rest of the world. Certainly, we are not perfect and can do better with the benefit of hindsight. For example, we could have advised Singaporeans to wear reusable masks earlier. Also, the outbreak of COVID-19 at the foreign worker's dormitories caught us by surprise. We could have moved in earlier to improve their living conditions.
Having said that, COVID-19 will not be our last pandemic. We need to document the main learning points of managing COVID-19 and learn from it. Will MOH work with the multi-ministerial task force to conduct a review and release an interim post-mortem report? This would be similar to what the MOF did by releasing the \"Interim Assessment of the Impact of Key COVID-19 Budget Measures\".
We know that the pandemic is not over yet, but an interim report will be important as what has transpired in the past year is still fresh in our memory. More importantly, we would like to know how MOH and Singapore could be better prepared for the next disease X.
The COVID-19 pandemic has put a strain on healthcare services and facilities. I am concerned with two aspects.
First, COVID-19 has delayed the construction of healthcare facilities in Singapore, but the growth in our ageing population is marching on. What contingency plan does MOH have to deal with the delay in building hospitals, polyclinics and nursing homes?
Second, I am concern about the difficulty in employing domestic helpers to care for the elderly. Many Nanyang residents have approached me to appeal for elder care or nursing home facilities, because of the challenges in bringing in domestic helpers to Singapore. This is probably a nation-wide problem. How can the MOH cope with this sudden surge in demand, especially with the delay in the construction of nursing homes?
Besides the need for nursing homes for elderly that are not able to take care of themselves, there is also a strong interest from the more abled elderly to age in their own homes. Many are interested in Singapore’s first Community Care Apartments in Bukit Batok, which are affordable housing with senior-friendly features. I understand that it is 4.2 times oversubscribed. Since the take-up rate is so strong, will MOH and MND consider offering more of such flats at the next quarter or so?
Mr Leon Perera (Aljunied): Mr Chairman, Sir, from a recent reply to my Parliamentary Question, we now know that residents aged 25 years old with below Secondary education have a life expectancy 5.8 years lower than that with those with post-Secondary education. I thank the Minister for Health for the detailed answer. We also learnt that people with below Secondary education have a greater likelihood of chronic illnesses like diabetes and high cholesterol.
Sir, for many of my lower income constituents, convenient and cheap food options are unhealthy ones, like instant noodles. Research shows poverty often overwhelms one's cognitive ability to make good decisions on health.
I, thus, speak on the urgent need to tackle health inequality. It would seem that the prevalence of conditions like obesity, diabetes, hypertension and high cholesterol has risen over the years. Sir, I would suggest that there is an urgent need to revamp for preventive healthcare efforts, particularly for poorer Singaporeans.
While many efforts have been undertaken, the outcome seems to be moving in the opposite direction. To achieve better outcomes, we need better measurement.
Firstly, could we make public more timely and comprehensive data of chronic diseases by socio-economic groups? Other than the response to my recent Parliamentary Question for what I understand the most recent publicly available data on health risks, behaviours and outcomes by socio-economic class was 2010 National Health Survey. The National Registry of Diseases already collects data on the incidence of cancer and chronic kidney failure. It is an easy next step to include SES indicators like income and education. We must also study the entire life cycle of chronic diseases. Are low-income groups contracting more diseases, more severe diseases or even earlier diseases?
Secondly, can we make more data public and healthcare outcomes for low-income groups? Are they receiving a later diagnosis with poorer outcomes compared to wealthy Singaporeans who can choose top tier private care, for example? I am not suggesting that this is the case but it would be useful to have the data. Some doctors have observed COVID-19-related backlogs and patients transferring from private to public to save money, pressuring the public system and lengthening waiting times for subsidised patients.
Thirdly, could we develop a National Health Equity Index? This could be created by an independent group of academics and include social determinants of health as well as health care accessibility, affordability and outcomes. This will pinpoint areas for targeted action.
Once we have more data, we must act decisively. I note that HPB piloted the Healthy Living Passports Scheme in mid-2020 and aim to reach 15,000 lower income residents over three years. How effective have the incentives been among lower income groups? Other than the number of participants, can we targets in terms of better health outcomes?
The National Health Screening Programme, Screen for Life, heavily subsidies screening for some conditions. What is the take-up rate and outcomes thus far, particularly for those who are less advantaged socio-economically?
Mr Chairman, Sir, we must improve outcomes at the intersection of health inequality and preventive health care. Not only because we have a responsibility to the less fortunate but also because this problem creates spill-over effects that can cause society more if left untreated.
Mr Leong Mun Wai (Non-Constituency Member): Chairman, escalating healthcare cost is a major worry for Singaporeans. Since cost is a result of the prices set by the public healthcare institutions, the pricing principles of the public sector is of great interest to us.
Is public health pricing based on average cost or marginal cost?
What are the various cost components incorporated in those costs?
Is the cost-based price checked against the pricing of other countries?
What are the other considerations in determining the final price?
And how does MOH monitor and change the pricing overtime?
Only with this information can we make an informed judgement whether MOH’s services expenditures of about $11 billion which represents about 2.2% of our GDP, is enough or not.
Lim Wee Kiak (Sembawang): Chairman, it is not uncommon for us to hear senior residents complaining about 可以病，不可以死。可以死，不可以病。Which means that can fall ill but cannot die. Singapore has one of the best healthcare systems in the world but it does not come cheap. This is evident from the effectiveness of our COVID-19 response and is further reinforced by the fact that Singaporeans enjoy one of the highest life expectancies in the world – that is 83.8 years for 2021.
But with rapid medical technological and pharmaceutical advances, costs of healthcare delivery have increased exponentially. In 2018, medical inflation was at 10%,10 times more than the general inflation rate in Singapore. But this appears to be a global situation. The average global medical inflation rate was observed at 9.7% that year. As the population ages, more spending on healthcare will be required and the rate of medical inflation will need to be checked.
How is MOH keeping track of the medical inflation trend and looking into its impact on Singaporeans? The average Singaporean household expenses on healthcare costs in 2017 and 2018 were found to have increased by 4.5 to 5.5 percentage point as from five years ago. The actual increase differs slightly across different income groups, and it is somewhat concerning that the below income group, the lowest 20% bracket saw their healthcare costs forming the largest portion which is 7.8% of their household expenses. How much does the average Singaporean household spend on healthcare? And how does it compare to other developed countries? Are our current MediSave contributions keeping pace with the medical inflation?
Our \"3M\" framework public financing healthcare plays a crucial role to keep quality of health care affordable for all.
The Deputy Prime Minister has announced that there will higher remuneration for our nurses and healthcare support staff, which I fully concur with. So, we must now also examine how to fund the inevitable increases in healthcare expenses.
With our ageing population, our elderly will be saddled with more healthcare costs pertaining to illness. Last year, I voiced my concerns for senior citizens who had to pay upfront cash for age-related medical treatments. I would like to suggest that medical usage limits be tiered according to age to ensure our elderly residents' growing healthcare needs are met.
Naturally, we must ensure MediSave contributions would commensurate with the higher medical expenses. When is our last review of our MediSave contributions? Will the Ministry do a review on our current \"3M\" health financing strategy to ensure all Singaporeans will be adequately covered and keep up with medical inflation?
Ms Hazel Poa (Non-Constituency Member): Mr Chairman, MediSave limits are a major concern for the elderly and it is the issue I have been asked most frequently to raise. Many feel that the annual limits of $200 or $500 are inadequate for their needs, given current healthcare costs.
In November last year, Senior Minister of State said that MediSave limits are being reviewed. Can the Minister provide an update on the status of the review?
At the moment, MediSave can be used mainly for hospitalisation and in-patient treatment with limited outpatient treatments allowed. Limiting MediSave to mainly in-patient treatment skews demand towards hospitalisation. Outpatient treatment is cheaper and can manage disease before they worsen and become more costly to treat. If we can allow MediSave to be used more widely on out-patient treatments, we can shift demand towards the lower cost outpatient treatments and help control healthcare costs.
Can the Minister consider expanding the range of outpatient treatments allowed to use MediSave?
Mr Gerald Giam Yean Song (Aljunied): Many seniors suffer from chronic conditions which require extended care and that can be very expensive. Most outpatient treatment is not covered by MediShield Life and access to MediFund is only available to the very low income. The use of MediSave is subject to annual withdrawal caps. This can have an undesirable effect of discouraging seniors from seeking early treatment.
Can MOH allow MediSave withdrawals for the treatment of all chronic conditions, not just those under the Chronic Disease Management Programme list to ensure that no one is excluded just because they suffer from a less common chronic condition? And can MOH remove annual withdrawal limits on the use of MediSave of patients over 60 years old, who have a balance of at least $5,000 in their MediSave accounts? This can be rolled out at polyclinics, restructured hospitals and CHAS clinics where tight procedures are already in place to ensure that only medically necessary treatment is prescribed.
Ms Ng Ling Ling (Ang Mo Kio): Chairman, the Government has responded decisively in deploying resources to combat the COVID-19 pandemic with healthcare expenditures increased significantly to provide for our public health management measures. However, even without the pandemic, we know that the healthcare expenditure has been rising globally. Globally, we are also seeing similar trends in developed countries due to increasing medical attention, medication, procedures and longer hospital stays from an ageing population.
In Singapore, the Government has been working on making our health care accessible and affordable through investing in medical infrastructure, establishing \"P\" benchmarks, providing various subsidies, as well as working with Singaporeans to encourage a healthy lifestyle. This has worked well for Singaporeans thus far. But we cannot ignore the rising healthcare costs that Singaporeans may face. How can we continue to provide higher value in healthcare in the face of rising healthcare costs and ageing population and advances in medical procedures?
Sir, I hope that the Government can consider value-based healthcare as another lever to help manage overall costs of healthcare for Singaporeans. Value in healthcare is generated by delivering better health outcomes for the same or a lower cost. While our healthcare costs have been rising each year, we currently do not have a very clear grasp if healthcare outcomes of major or common diseases, such as diabetes or asthma have been improving.
Healthcare providers have typically been paid on a fee-for-service model with subvention given mainly by volume. The objective of health, value-based healthcare, is to create financial incentive to encourage providers to improve the health value given to patients.
One example is from Sweden's National Health System where they piloted a bundled payment model for cataract and hip replacement procedure. The bundle sets a single base price that covers the entire care delivery chain from diagnostic surgery to follow-up visits. Providers are paid based on whether they met pre-defined health outcomes to the patient. This has helped in the pilot years for complications to decrease by 18% re-operations to fall by 23%.
I acknowledge that there are no silver bullets to address the rising healthcare costs. Nonetheless. I hope that the Government will consider value-based healthcare incentive approach as an important part of the short and long-term strategy to achieve better healthcare value for Singaporeans.
Mr Gerald Giam Yean Song: Between 2016 and 2019, $7.5 billion in premiums for MediShield Life were collected and $3.5 billion in claims were paid out, while a further $3 billion was set aside for future premium rebates.
Many Singaporeans are concerned about the impending premium hikes of up to 35% to MediShield Life. More transparency on the data and assumptions used will help to better to explain these premium hikes.
Last November, in response to my request for the release of the full MediShield Life actuarial report, Senior Minister of State Koh Poh Koon, said that MOH may engage different consultants to challenge the assumptions and do another calculation and publish some of this data in an academic way. Will the full MediShield Life actuarial report be provided to these consultants and academics for further analysis? And if so, when will this be done?
Lastly, I note that the new MediShield Life premiums have kicked in on 1 of March. Can MOH consider postponing the increased premiums until our economy recovers?
Ms Hazel Poa: Mr Chairman, the issue of portable health insurance was raised by Health Correspondent Salma Khalik in December last year.
Currently, many Singaporeans have integrated plans. As a person gets older, it becomes difficult to move from one insurer to another. This is because people develop medical problems as they grow older. When they tried to switch insurers, they generally face the prospect of these pre-existing conditions being excluded from cover. As a result, beyond a certain age, it becomes practically impossible for people to switch to another insurer even if there is a big difference in premiums paid.
Theoretically, insurers can entice younger people with much lower premiums and later hike the premiums significantly when they are older and unable to switch insurers due to their pre-existing conditions.
Will the Minister consider ensuring that IPs are fully portable by making it a condition for IP providers to allow policy holders to switch providers without imposing additional conditions?
Dr Tan Yia Swam (Nominated Member): Mr Chairman, Sir, I need to first declare conflict of interest as a general surgeon in private practice, with an interest in breast surgery; and my role as the elected President of Singapore Medical Association.
Escalating healthcare costs is a concern for many governments. In Singapore, this has gained much attention recently with questions raised by the public on private insurance agents. In truth, managing healthcare costs is a complex problem.
Learned economists have studied it, and there is no simple answer. I see a need for everyone to be part of the solution. I list five key factors: (a) advances in technology leading to better quality of care; (b) healthcare facilities costs, (c) doctors' fees; (d) patient health-seeking behaviour; and (e) insurers.
As research and experimental trials become validated, the advances will be accepted in mainstream clinical practice. One simple example in my field – 30 years ago, most breast cancer patients had to accept a mastectomy, and the resulting change in appearance was unacceptable to some. Now, patients can opt for nipple-sparing mastectomy and immediate reconstruction which allow the patient to regain a physical appearance which is similar to her normal. This means a better outcome for some patients, but clearly, increase costs.
Who monitors the costs of the private healthcare facilities? As a patient, when I receive the itemised bill, how do I know which of these items are reasonably charged, and which are not? Doctors' fees have often been blamed as the main source of increased costs. How true is this? Historically, SMA had a guideline of fees since 1987, which had to be removed in 2007, as it was deemed anti-competitive. MOH announced in end 2017 that fee benchmarks will be implemented. Since then, the benchmarks serve as a guide on how doctors charge.
Patient health-seeking behaviour also affects costs. When people fall sick, how do they choose their care? Just take a panadol and rest? See a General Practitioner? See a TCM physician? Do they go to a polyclinic, the emergency department or straight to a specialist?
Finally, how are insurers involved? Patients factor in financial costs when they need to see a doctor. Some will go only to their company doctors based on their corporate insurances with no need to pay out of pocket. When they need to have hospital admissions, day surgery or major operations, that is when their Integrated Shield Plans will come in useful.
In my Budget debate speech, I highlighted the importance of shared decision making in healthcare.
We are in the age of patient empowerment. This has been so for quite a few years with an increasingly better educated population. The Judiciary has acknowledged this trend when they introduced the Modified Montgomery Test and the understanding was reinforced by this Government when the Civil Law Act was amended last year.
Patients must be adequately informed before they make a choice on the medical care that they want to receive. I am all for this and medical practitioners here have been making adjustments in the way they practise, in order that patients are better informed and empowered.
Likewise, insurers need to share more information and allow their clients to make informed decisions. From time to time, I get asked by friends and relatives about health insurance, especially Integrated Shield Plans or IPs in short. These questions include – which IP provider is better, and which IP plan provided by the provider is more suited to my needs?
I must admit I am ill-equipped to answer these questions. I myself am insured with an IP, but I must confess that when I bought it many years ago, I did not make a detailed comparison of the various IP providers' offerings, but trusted my financial advisor's recommendation.
Close to 70% of Singapore Residents buy IPs. So, IPs affect the majority of us living here. It is therefore important that Singaporeans are adequately informed upfront by the various IP insurers before they make a decision to buy an IP, or before they make a decision to switch IP providers, since IPs are bought annually.
I ask myself, what would I like to know before I made a decision to buy a certain IP or not. These are the most important questions that will make me choose one IP provider over another. One, what are the premiums for me now and when I get older? Two, what are the benefits and claim limits of each plan offered? Three, what percentage of private sector specialists are empanelled by a certain IP provider? Four, does the IP provider allow me to go to any private hospital in Singapore? Five, are all restructured hospital specialists automatically empanelled? Six, how does the IP provider pay specialists; does it follow MOH fee benchmarks?
I realised that other than the first two questions, information was difficult or impossible to obtain for me to make an informed decision on which IP to purchase. Questions about empanelling are important because ultimately, it is about choice. The IP provider that offers more choices is more attractive to a potential IP customer.
The last question about how IP insurers pay specialists is important in an indirect way. A system that reimburses private sector specialists adequately is more sustainable and better for me as a policyholder, in the long run. More specialists will want to be empanelled with this IP provider and I will have a wider choice. If my IP insurer does not pay the specialist fairly or adequately, how would the doctor feel?
We can use the MOH fee benchmarks as a good guide for this. How does each IP provider pay specialists for procedures? Does a certain IP insurer pay up to the higher limit of the benchmarks, or the lower limit, or up to the mid-point? Or does this IP insurer reimburse at rates that are even lower than the lower limit of MOH fee benchmarks?
It should be a warning sign to policyholders when an IP provider pays doctors below or only at the lower limit of the MOH benchmarks. I think the regulators of IPs, which are MAS and MOH, can obtain the answers to these six questions from IP insurers and present them in a tabulated and easily digestible form that members of the public can refer to when they make their decisions on which IP to buy. This will advance the cause of patient education and empowerment.
A more difficult but important policy question to ask is what proportion of Singapore Residents should buy IP. The combined market share of private hospitals and A class and B1 class beds in Restructured Hospitals is estimated to be in the range of 30% to 35%. Yet the proportion of Singapore Residents buying an IP is nearing 70%.
This is an unusual phenomenon in the running of a health insurance system. In the normal scheme of things, healthy insurance policyholders subsidise policyholders who fall sick and make claims. But in our IP environment, the business of IP is cross-subsidised not just by those who do not fall sick, but by those who fall sick and yet choose to be treated at subsidised B2 and C classes in restructured hospitals when they are entitled to more under their IPs.
At the superficial level, it would appear that there is nothing wrong with this because it is the patient's choice and it is good to be prudent. However, there is an externality cost, when IP holders choose subsidised wards in the restructured hospitals when they fall sick. The consumption of these Government subsidies are indirectly subsidising the insurers' IP businesses and depriving patients-in-need of more subsidies, since MOH's budget is a finite thing.
These Government subsidies would not have been consumed had the patients chose what they were entitled to, to be treated in the private hospitals or in A or B1 class wards. Another important corollary of this unusual phenomenon is that it further lengthens the waiting times for subsidised services in restructured hospitals.
I think it is important that we study this \"voluntary downgrading\" phenomenon so that we can ensure that the IP environment today is functioning faithfully to the original policy intent of IPs. Also, what is the desired proportion of Singapore residents who should buy IPs. Is it the current 65% to 70%? Or below or above this range? I do not know the correct figure, but with a private sector market share of only 30% to 35%, including B1 and A class beds in restructured hospitals, the corresponding figure of 70% of the population having IPs sounds rather high.
Can the private sector support the needs of this 70% if all of them who fell ill chose the unsubsidised services they are entitled to under their IPs? I have a few patients who themselves are insurance agents, and they realise they do not quite know what they are covered for. Are all insurance agents well trained and up-to-date about the products they are selling? Are the medical underwriters also keeping their medical knowledge up to date?
I raise one specific and very common example in my field: a healthy lady in her 20s with no family history is offered a free health screening when she signs up for an IP, including ultrasound of the breasts. This picks up a 3-mm nodule, too small to categorise. This lady is then informed that she will be excluded from breast cancer coverage. Thereafter, there is a cycle of her agent asking her to see a doctor, the doctor telling her it is likely benign and can observe. The agent may then ask for a memo to state that she does not have cancer. I have met patients where they state that the agent has asked them to pay for the surgery themselves to remove the lump, and then appeal to be covered. As a breast surgeon, I do not know how to help this group of affected women. There are no good medical indications for any of these.
In summary, escalating healthcare costs is a complex problem, and the medical professional bodies are ready to be part of the solution through honest, open discussion. I call for increased transparency and accountability of insurance companies and their agents. MOH and the SMC scrutinise doctors. Who is scrutinising the other players in the healthcare costs equation?
Mr Louis Ng Kok Kwang (Nee Soon): Sir, in 2013, the Government started allowing the use of MediSave for IVF, subject to a withdrawal limit per cycle and per patient. Recently, many couples have called for an increase in these limits to better meet IVF costs.
MOH has said, \"Couples who find themselves unable to cope with unexpectedly large bills, for instance, as a result of complications, even after co-funding, may appeal to use MediSave beyond the current limits\" on a case-by-case basis. It has been over seven years since we reviewed these withdrawal limits. I hope we can conduct a review and consider increasing the limits on the use of MediSave for IVF and not just on a case-by-case basis. IVF is a costly procedure. It would be a pity for couples who are unable to afford it but have funds in their MediSave, to be denied the gift of parenthood.
In the dialogues I have organised on IVF, many couples told me that they have achieved better results from supplementing their IVF treatments with TCM. Some doctors recommend TCM treatment for certain patients as it may optimise results. TCM treatments such as acupuncture can act as a supplementary method for patients to increase their chances of success.
My wife also, upon the advice of our doctor, did TCM during our IVF treatments. Some might say that TCM does not work, while others say it does, but we can all agree that it does help provide an ease of mind, that we have tried everything we can do to have a successful IVF cycle.
TCM can be expensive. Couples I have spoken to end up spending around $500 to $1,000 a month, on top of already mounting IVF costs. Can we allow couples to use their MediSave which they are allowed to use for IVF and subject to the current withdrawal limits, for TCM treatments associated with IVF?
Last month, I proposed extending co-funding to the seventh and eighth IVF cycles to support couples who need more cycles to conceive successfully. MOH responded that, \"We also need to balance the need to meaningfully and responsibly allocate public funds on this.\"
In this case, rather than provide additional funding after the sixth cycle, will MOH allow co-funding leftover from the first six subsidised IVF cycles to be rolled over into the seventh and eighth cycle? Can it also allow any co-funding leftover from the three subsidised fresh cycles to be used for the subsidised frozen cycles?
These are funds the Government has already budgeted for. It is win-win solution as it allows couples to complete additional cycles using subsidies that we have already budgeted for without additional allocation needed.
Ms Ng Ling Ling: Chairman, as we dedicate 2021 as the year of celebrating SG women and as a mother myself, I would like to dedicate this cut to bring attention to the health of pregnant women and how it can affect our children. Both overseas and local research have pointed to the impact of maternal health on the health of our children. One of such findings is from a homegrown Growing Up in Singapore Towards healthy Outcomes or GUSTO study conducted by researchers in the National University Health System, KK Women's and Children's Hospital and A*STAR Singapore Institute for Clinical Sciences over the last 10 years.
The study found that one in five mothers-to-be develop gestational diabetes and this heightened the risk of their children developing obesity Type 2 diabetes, heart disease and even neurodevelopmental disorder later in their lives. Another concern pointed out by the study is the mental health of pregnant women. Mental well-being of mothers-to-be will also affect children, who are likely to develop neuro-developmental disorders such as anxiety, depression or disruptive behaviour disorders.
We know that causes for these diseases can be multi-faceted and complex, including the pregnant mothers' own health and her social economic environment. Pregnant mothers and disadvantaged circumstances are at even higher risk.
I would like to ask if the Government will consider a more concerted upstream support at maternal stage for women, including looking after both their social and healthcare needs.
Secondly, would the Government consider piloting more care services for maternal and child health such as the new Temasek Foundation Integrated Maternal and Child Wellness Hub at SingHealth Polyclinic at Punggol, to better understand what kind of intervention can improve the outcomes of maternal and children health.
Lastly, how can the Government enable evidence-based information to be disseminated more effectively to more pregnant women to increase awareness and encourage self-care for the well-being of their children?
The Chairman: Order. I propose to take a break now.
[(proc text) Thereupon Mr Speaker left the Chair of the Committee and took the Chair of the House. (proc text)]
Mr Speaker: Order. I suspend the Sitting and will take the Chair at 3.25 pm.
Sitting accordingly suspended
at 3.01 pm until 3.25 pm.
Sitting resumed at 3.25 pm.
[Mr Speaker in the Chair]
[(proc text) Debate in Committee of Supply resumed. (proc text)]
[Mr Speaker in the Chair]
Head O (cont) –
The Chairman: Minister Gan.
The Minister for Health (Mr Gan Kim Yong): Mr Chairman, I would like to thank Members for their speeches and their remarks. Mr Yip Hon Weng and Mr Ang Wei Neng asked about the COVID-19 situation. Let me provide a brief overview.
Globally, the number of new cases and deaths continue to trend down, although there was a spike in the last week of February. So, we need to watch. Within Singapore, the COVID-19 situation has stabilised, with one or two new community cases on some days. Imported cases are isolated on arrival and the risk of transmission to the community is low. However, the World Health Organization has just warned that we need to stay vigilant as the pandemic is not likely to be over within this year.
I want to thank everyone – Singaporeans, healthcare workers, businessmen, businesses, enterprises, Government agencies – for playing your part this past year. Your sacrifices have helped Singapore weather this storm.
Mr Ang Wei Neng asked about the impact of COVID-19 on our infrastructure projects. As I have informed the House earlier, the pandemic has delayed many of our healthcare infrastructure projects by up to a year or so. Construction works have since been ramping up progressively and we are working on contingency measures to ensure we are able to meet the needs of our people.
We are making steady progress in our vaccination programme. As of 4 March, more than 350,000 Singapore Residents have received their first dose, including some 80% of our healthcare workforce, and 215,000 have received their second doses.
We have started with our seniors, too. I would like to thank our community volunteers from the People’s Association and Silver Generation Ambassadors who have worked hard in reaching out to our seniors and helping them to make their appointments. Over 40,000 seniors aged 70 and above have received their first dose. We will soon begin the vaccination of seniors aged 60 and above. Mr Chairman, allow me to say a few words in Mandarin please.
(In Mandarin): [Please refer to Vernacular Speech.] Seniors are most at risk of severe outcomes if they are infected with COVID-19. Therefore, we have prioritised seniors in our vaccination programme. The vaccines approved for use in Singapore must meet stringent safety and efficacy standards. I urge Singaporeans to get vaccinated.
Some Singaporeans with chronic diseases are worried about being vaccinated. Do not worry, because we will arrange for healthcare professionals on site to assess if you can be vaccinated safely. In fact, most people can be vaccinated safely, including those with diabetes, hypertension, high cholesterol, asthma, chronic lung disease, heart disease and cancer patients in remission. Hence, I encourage Singaporeans with these conditions to register for vaccination as soon as they are invited.
(In English): Let me emphasise that only COVID-19 vaccines that meet strict standards of safety and effectiveness will be used in Singapore for our Singapore Residents.
We will monitor the development of the COVID-19 pandemic and adjust our measures accordingly. We will also continue to strengthen our defences for future health system crises, such as Disease X. Senior Minister of State Janil Puthucheary will share more.
Even as we mobilise the nation to fight COVID-19, we have to remain focused on long-term issues.
Members may recall our Three Beyonds to meet our challenges in the future. Beyond Hospital to Community, to provide better care closer to home; Beyond Quality to Value, to help Singaporeans stretch their dollar; and Beyond Healthcare to Health, to help Singaporeans stay healthy.
We will continue to anchor care in the community by strengthening primary care. We will be building 12 new polyclinics, bringing the total to 32 by 2030. The Community Health Assist Scheme (CHAS) has been expanded recently to allow more Singaporeans to receive subsidised care from private GPs, who are our key partners in primary care.
We are also expanding community care, especially for our seniors. We have expanded the Community Nursing teams to cover 29 regions across Singapore since September 2020, with a total of 185 Community Nursing Posts to make care more accessible to our seniors. We will add new Community Nursing Posts where needed.
Our second thrust is to stretch your health dollar. Dr Lim Wee Kiak and Mr Leong Mun Wai asked about how we manage healthcare costs. We keep care affordable and sustainable through a multi-pronged approach.
First, we leverage risk pooling. Insurance plays a useful role in helping us stretch our resources through pooling, so that those who are ill can tap into the pool to pay for the healthcare services they need. That is why we introduced MediShield Life. But insurance has an inherent risk of over-consumption. This is because of OPM syndrome. What is OPM? Other People's Money. Because through insurance, we are pooling resources and we are tapping on other people’s money in the pool to pay for our healthcare services. So, we need safeguards to encourage prudence when deciding on healthcare services.
Dr Tan Yia Swam asked about Integrated Shield Plans (IPs), and I agree with Dr Tan that we can all benefit from more information-sharing and a better understanding of insurance products. Towards this objective, MOH has facilitated several engagement sessions with insurance providers and professional bodies to foster a better understanding of the parties’ concerns.
Dr Tan herself was present at these sessions and we benefited significantly from her contributions. We have resolved some issues – not all – but discussions are still on-going. An important progress we have achieved is the establishment of a multilateral platform comprising Life Insurance Association, Academy of Medicine, Singapore and the Singapore Medical Association. This platform will allow discussions to resolve issues of common concern.
We are also setting up a claims management mechanism to facilitate resolution of claims-related matters. Our common objective is to ensure patient care is not compromised and allow patients adequate choice, while ensuring that fees and claims remain reasonable. I am confident that with this common understanding, we can find workable solutions that will benefit all parties, insurers, doctors, as well as patients.
Ms Hazel Poa asked about whether IPs can be made fully portable. As IPs are commercial products, their features and pricing are ultimately determined by private insurers. But what is important is that all Singaporeans are covered under MediShield Life, regardless of their medical conditions.
Second, we will continue to improve the healthcare system’s cost effectiveness and efficiency. As Minister Lawrence Wong mentioned, the Agency for Care Effectiveness has enabled us to save $300 million since 2016 and benefited over 375,000 patients. The Agency for Logistics Procurement and Supply, or ALPS for short, has also achieved cost savings of about $180 million in two years by driving economies of scale through group procurement.
Even with our best efforts, we will still be spending more on healthcare over time, given an ageing population and increasing consumption of healthcare services. The Government continues to bear a significant and growing share of the National Health Expenditure, from 40% in 2013 to 46% in 2018.
We want all Singaporeans to be healthy and have access to good and affordable care. We pay particular attention to lower income households, as Mr Leon Perera highlighted, and provide them with additional support to ensure healthcare, including preventive health, remains affordable and accessible to them, and they can improve their health outcomes.
Health outcomes are influenced by multiple factors, including social, biological, cultural preferences and environmental factors, in addition to Social Economic Status, or SES.
Local studies showed that adults with lower SES do have differences in chronic disease prevalence. We have been publishing health data regularly. More data has been collected in the last two years including breakdown by education level as a proxy for SES, and this data will be published later this year. We will continue to refine the data we publish.
From local studies, we also know that adults with lower SES do have good access to care and are able to control their health conditions well. Again, using educational attainment as a proxy for SES, among persons diagnosed with diabetes, hypertension and high blood cholesterol, over 90% of those with below Secondary school education had visited their doctor for their condition at least once in the preceding year. Further, the proportions of those with acceptable control of their medical conditions are close to the national averages. Nonetheless, we must continue to support them to improve health outcomes and we will need to start from young, which I will talk about in a short while.
Through enhancing our healthcare financing system over the years, we have kept healthcare affordable, especially for the lower income patients. In fact, the lowest income quintile’s share of total subsidies was 37% in 2018, the highest across all income quintiles. Our healthcare financing framework is a progressive one, overall. Further, the amount of subsidies received per household for the lowest income quintile has increased by over 70% from 2013 to 2018.
Overall, government spending on healthcare has grown year after year and is likely to continue to increase. But as Dr Tan Yia Swam mentioned, and I quote, \"government subsidy is a finite thing\". That is why we have to be prudent in how we allocate limited resources, to ensure that the support we provide is more targeted to benefit those with greater need.
This is our third effort – to better target subsidies, such that those with less will receive more, healthcare is kept affordable for all, and patients can be cared for at the most appropriate facilities.
We have recently enhanced the subsidies for low-income patients at the public Specialist Outpatient Clinics or SOCs. We will further adjust subsidies at the SOCs by introducing two new tiers of 30% and 40% subsidy for higher income patients. This will enable more subsidies to be channelled to those in greater need.
With more targeted subsidies at the SOCs, we can now allow private patients discharged from our acute hospitals to choose subsidised follow-up care at the SOCs. Currently, they are treated as private patients at the SOCs.
Next, we will align the means-testing basis in the acute hospitals to per capita household income which is more reflective of patients’ means, similar to the basis used for most healthcare schemes, rather than rely on personal income of the patient today.
Lastly, we will also enhance subsidies at community hospitals, to keep them more affordable and facilitate the flow of patients from acute hospitals.
Taken together, these moves will ensure more targeted use of our healthcare resources, stretch our healthcare dollars, and encourage appropriate care. Senior Minister of State Koh Poh Koon will go into greater detail in his speech.
In the longer term, the best way to manage healthcare costs is through our third thrust – staying healthy. We encourage all Singaporeans, young and old, to partner us on this journey: attend your recommended health screenings regularly, go for vaccination, and adopt healthy living habits.
I encourage all to also continue the good fight to win our on-going War on Diabetes and keep chronic conditions at bay. Parliamentary Secretary Rahayu will share more on this, as well as our other health promotion efforts.
Earlier I talked about the three key thrusts, better care, stretching your dollar, and staying healthy. These are not isolated initiatives. All our policy and measures work together to take care of the health of every Singaporean, starting from birth and throughout their life journey, keeping them as healthy as possible, for as long as possible.
The best place to start is right at the beginning. Minister Masagos will share our thinking on improving Child and Maternal Health, how to better support our children and their families, and to bring agencies together to co-deliver services and solutions for better outcomes.
Our care transformation journey will continue. As we plan for our future health system, we will study how we can develop a longitudinal system of care services and programmes, to journey with you and design programmes with a life-course approach, taking care of each Singaporean from birth and throughout their life. The National Healthcare Group has, in fact, developed a River of Life framework to test this approach.
As staying well often involves not just health but also social and other factors, we will also explore how we can pull in resources across agencies and service providers to support your overall well-being. SingHealth, for example, has started trials to prescribe not just drugs but also social programmes, such as diet, exercise and social activities. Dr Tan Wu Meng will be happy to know that they too have care coordinators to help guide their senior patients.
Finally, the built environment also plays a key role in nudging our choices. Therefore, the built environment should be designed to promote healthy living and digital tools can also be used. NUHS, the National University Health System, is working on this with the various agencies. We will share more on these efforts at a later stage.
Anchoring all these transformation efforts are our healthcare staff who will continue to play a central role in our future health system, much like how they have been at the forefront line in our battle against COVID-19. We are blessed with a very dedicated, driven and professional team. They are our most precious resource, and we will continue to provide them with better progression, more training opportunities, and greater recognition of the work and risks they undertake. Senior Minister of State Koh Poh Koon will elaborate on this.
To conclude, as Prime Minister Lee said, it has been a year of uncertainty, anxiety, and fear. Many of us would have emerged slightly different from how we first entered. A little more tired, more stretched, perhaps a little tougher and, I hope, a little wiser.
Partner with us as we journey forward and as we transform our healthcare system to be future-ready. Let us work together and help all Singaporeans to stay healthy, and live well, every day of your life. [Applause.]
The Chairman: Mr Yip Hon Weng.
Mr Yip Hon Weng: Chairman, permission to take my three cuts together.
The Chairman: Yes, please.
Mr Yip Hon Weng: Chairman, active ageing has always been an important part of successful ageing. In the past years, HPB introduced many community programmes to encourage seniors to participate in healthy activities like group exercises and to create an avenue for neighbours to socialise. All these have a positive impact on the resident's well-being.
With the COVID-19, the good work has been disrupted. Seniors are advised to stay home to reduce their exposure to the virus, as they are vulnerable. But this has affected their physical and emotional well-being. Without the in-person group exercises and the opportunity to meet their friends, they have less motivation to exercise. The online programmes are useful. But they are simply not quite the same. Our Action Plans to encourage active ageing must evolve with the pandemic. What is the progress on these? How else can we meet the evolving needs of our future seniors?
Last year, MOH announced various measures to better support seniors to age in place. What is the progress of these measures, especially on the Eldercare Centres? Future generations of seniors will have different lifestyle preferences and aspirations. How are we meeting the evolving needs of our seniors? What are the measures of success and timelines for the plans?
Many seniors have benefited from the Seniors' Mobility and Enabling Fund (SMF). But there is still some room for improvement. Will the Ministry review the policy of the once-in-a-lifetime eligibility?
Some seniors may require a replacement device after their first device has worn out from many years of use. Another problem is that they cannot apply for aids under the same category. So, if one applies for a walking stick now and gets progressively weaker over time, he might need a quad stick or walking frame but he would not be eligible. While there are other schemes like the Assistive Technology Fund under SG Enable, the multiple schemes make things more complex than necessary for the elderly.
The lack of support for the repair of devices is another handicap. Batteries in motorised wheelchairs running out is a common problem and sometimes, these devices are perfectly usable after replacement of parts and repairs. But SMF does not provide such support, so we have to tap on other schemes.
SMF also only covers consumables for applications made through a healthcare service provider like a nursing home. If the senior is cared for at his own home, he is not eligible. This runs contrary to our policies of encouraging ageing in place.
I would also like to suggest that SMF extends its coverage to elderly-friendly safety features in non-HDB estates, such as ramps and grab bars, especially for the lower value private units. I hope that the Ministry can better refine the SMF to help those in need.
COVID-19 presents new challenges for care-givers. The temporary suspension of certain care-giving services as well as the suspension of house visits during the circuit breaker period meant that many care-givers were on their own. Some of them had to cope with heightened feelings of anxiety, loneliness and depression. And with foreign domestic help being more costly and hard to come by in the midst of the pandemic, it is timely to review the Caregiver Support Action Plan that was launched in 2019.
How has the plan benefited care-givers since its launch? How can we better support care-givers, particular those who are looking after individuals with mental health conditions?
Can the Ministry look into availing more flexible homecare services to meet care-givers' needs? There are many instances I can think of whereby care-givers need a break but they are unable to find a care institution to provide short-term care within a short notice.
For example, Mrs Koh, a resident in Yio Chu Kang, is a care-giver to her husband who has advanced dementia. Her domestic helper is going back to her home country and there is a transition period while waiting for the new helper to arrive, given Stay-Home Notice (SHN) rules. As such, there needs to be more respite care options available to help care-givers. We need to give more care to our care-givers.
Ms Yeo Wan Ling (Pasir Ris-Punggol): Mr Chairman, Sir, I declare that I am a director of a social enterprise that provides care-giving services. Care-giving is one of the most noble yet taxing responsibilities a person can take on. In fact, many Singaporeans are called upon to become care-givers at crucial stages of their lives when their careers are developing or at a very abrupt notice when illnesses strike or accidents occur.
Be it senior loved ones, children, the infirmed or fragile, those called on to become care-givers are up to a hefty task, often having to do this on a very long-term basis and often at the expense of their careers, time with their family and, sometimes, their own mental health.
During my Budget speech, I spoke about my frazzled resident who needs 45 minutes a week to restore and refresh her spirits. Many other family care-givers I speak with also tell me that while they have made adjustments to their lives in the long-term care of their loved ones – some have resigned from their jobs, others have taken on full work-from-home arrangements, some have hired foreign domestic workers (FDWs) – the problem comes with the availability and affordability of short-term respite care.
Besides self-care, care-givers need short breaks from care-giving to run errands like going to the post office, picking up groceries, or even going for a much needed haircut. Respite care typically lasts between 45 minutes and about three hours.
To help our family care-givers balance their care-giving duties with the other responsibilities they are carrying in life, support systems like short-term respite care must be made available; and this must be affordable and accessible at very short notice.
The Caregiver Support Action Plan developed by MOH and partner agencies addresses many care-giving related issues. However, I think that there is room to develop more support for respite care options beyond centre-based and nursing home respite care. Could MOH consider expanding their support to care-givers who need home-based short-term respite care through financial support and the availing of local care-giving resources such as creating a repository of local micro-jobbers who have care-giving experience?
Dr Wan Rizal (Jalan Besar): Mr Chairman, I was asked recently, why am I asking for a cut for MOH when they should be getting an increment for their outstanding work in this pandemic, on top of the good work that they have been doing all this while. So, a big thank you to the Minister, his team from MOH and, of course, our healthcare workers.
Unfortunately, we have read reports of healthcare workers being abused physically and mentally while carrying out their duties. Their sacrifice and courage were met by behaviours unacceptable in any circumstances. When the pandemic started to unfold, we hear of healthcare workers being sprayed disinfectant by neighbours, denied boarding private vehicles and many other instances on social media. The number of abuse and harassment cases increased from 1,080 in 2018 to 1,300 last year.
How does MOH plan to further protect our healthcare workers' physical and mental well-being, considering the injustices made against them?
Abuse aside, we are also aware that our healthcare workers work long hours and have overnight schedules. We must provide them with the best work-life balance to maintain healthy, mental well-being. How does the Ministry plan to support our healthcare workers in this aspect?
Ms Mariam Jaafar (Sembawang): Mr Chairman, may I have permission to take both cuts together?
The Chairman: Yes, please.
Ms Mariam Jaafar: As the daughter of a former nurse, I literally applauded at my seat when the Deputy Prime Minister announced the increase in healthcare workers' salaries. It is long overdue.
Besides being a welcomed signal of the increasing recognition of the need to recognise the value of healthcare workers and the work that they do, one hopes that this will go some way to addressing the shortage of nurses and other healthcare workers today as our population ages.
I would like to know if the Government has any expectations or targets for how much we can close the gap in demand with this move to increase compensation and, if a gap yet remains, what more we can do to meet the demand for healthcare workers and where the biggest obstacles are – from the life cycle of recruitment, to advancement, to retention.
On recruitment, I would like to ask about the adequacy of spaces in our nursing programmes in our tertiary institutions as well as any data on leakage of students in nursing programmes who do not go on to become nurses, and why? I would also like to know the success rate at hiring people from other backgrounds into nursing – we heard some of that, I think, earlier in the debate – as well as the success rate of getting back former nurses and other women returning to work after some time off.
On advancement, I would like to know what is being done to enhance the career paths for healthcare workers.
On retention, I would like to know the top reasons why healthcare workers quit and what is being done to address each of these drivers, including a review of shift structures – both working and off-work schedules because a lot of research shows that the impact of shifts is more about off-work schedules and not actually the working schedules – and the support resources available to nurses. My next cut.
The COVID-19 pandemic showed the necessity of a whole system approach in addressing a national crisis. Many doctors and nurses in private practice stepped forward as volunteers and private hospitals took in recovering COVID-19 patients at subsidised rates to free up capacity in public facilities.
Such partnerships between public and private facilities also exist outside of a crisis environment. I have had residents who are public patients telling me they were referred to Raffles Hospital for their x-rays and much to my relief at whether they were making the right decision, I learned that they were going to be offered a subsidised rate. As a result, they were able to get their x-rays done earlier than the queues at the public hospital would otherwise have allowed.
Mr Chairman, the private hospital sector is an important part of the healthcare eco-system. As the pandemic plays out, we may see some shifts in demand, for example, with more private sector patients opting to public care if they lose their jobs and their insurance and, of course, if there are changes to their Integrated Shield Plan (IP).
I would like to ask the Ministry if there is opportunity to optimise the current balance of healthcare in public versus private facilities and better leverage private sector partnerships to provide care for public sector patients, in particular, our subsidised patients, which of course would require the right incentives across the delivery chain.
Similarly, our private general practitioners (GPs), who play a critical role in MOH's thrust to shift healthcare beyond hospital to community as part of the goal to provide accessible, affordable and best care for all, I am heartened that we continue to build primary care capacity and strengthen primary care networks, including for mental health.
But, of course, it is not just about expanding capacity, alignment of interests, incentives and processes is also key. Having GPs and community nurses with special interests and training, giving GPs and nurses direct access to specialist advice and closer teaming and better communication with doctors, which I know some private doctors do really effectively over email and WhatsApp, giving GPs and nurses access to a broader range of diagnostic tests are proven levers to transfer care to the community and, at the same time, reducing overall demand through direct demand management at the GP level and continued education efforts to make informed patients.
The Chairman: Can the Member wrap up, please?
Ms Mariam Jaafar: I would like to ask the Ministry what is being done to enable and empower our GPs and nurses to further deliver care in the community.
The Chairman: Minister Masagos Zulkifli B M M.
The Second Minister for Health (Mr Masagos Zulkifli B M M): Mr Chairman, since Independence, Singapore has charted through several crises, adapted to the changing world while strengthening our social compact to keep our society strong.
Many Members of this House have shared how COVID-19 has accelerated change and uncertainties. As we recover, we must continue to renew our social compact, enabling our people to be resilient in overcoming future challenges.
Our healthcare system is a critical part of our social compact. We will continue to transform it to become a proactive and inclusive care system for all Singaporeans, enabling them to attain good health and live well. We will build resilience in every individual throughout life, designing our care system to address Singaporeans' health needs and risks across their life course.
Today, I will highlight how we are doing this at two ends of the spectrum: first, starting well in life; and second, ageing well.
For our young, we need to help them start well and achieve their fullest potential. International research shows that the early years of life are a critical window for development, with lasting impact on later life outcomes. This extends to even before the child is born, during the antenatal stage. Locally, the Growing Up in Singapore Towards healthy Outcomes, or GUSTO, found evidence that a mother's health can directly influence a child's development, which Ms Ng Ling Ling spoke about. These findings underscore the importance of intervening early in life to prevent disadvantages from snowballing, and that parents play a key role to a child's long-term development.
Mr Leon Perera will be happy to know that it was to this end that the Government launched and is scaling up KidSTART to give children from low-income families a good start in life through upstream support. We equip KidSTART parents with skills and knowledge to support their child's development and physical and socio-emotional well-being.
At our hospitals, the National University Hospital started an intervention programme called Promoting Parental Emotional Health to Enhance Child Learning (ProPEL). It supports mothers and mothers-to-be from low-income families through pregnancy into motherhood to enhance the child's development and learning.
Ms Nurdiana joined the programme during the early stages of her pregnancy. She struggled with anxiety after being diagnosed with an auto-immune disease and had lost her job. The ProPEL team provided psychological interventions – helping her work through her fears and anxiety on health, pregnancy and motherhood. With the support, Ms Nurdiana developed skills to better manage her stress and anxiety. She is now more confident to start her journey as a mother.
The National Healthcare Group is partnering with a few Primary schools on the Living Well@School pilot. It aims to build awareness and motivation in choosing healthier food options for the young. Children are coached on healthier eating choices, while parents and teachers are equipped with resources to scaffold the child’s journey to embrace healthy living.
While we have made good strides in promoting the health and well-being of children and their families upstream, we will continue to invest even more, so that we can have a healthier next generation. We must do so in a coordinated manner, across social, health and education boundaries.
Therefore, I am pleased to announce that MOH will develop a Child and Maternal Health and Well-being Strategy to provide comprehensive support to women and their children. We will drive the Strategy and Action Plan through an inter-agency taskforce, over a five-year period. Its scope will span from pre-conception to adolescents aged 18 years old – many critical developmental milestones occur then. These are part of our larger efforts to improve the population’s health by addressing individual health needs and modifiable risk factors beyond the healthcare domain.
The Taskforce will focus on cross-cutting issues that require multiple agencies to collaborate and address decisively, to achieve a common goal of better health, social and education outcomes for our young. We will review our service delivery processes to integrate our services better, across the domains.
Our plans will be anchored on what matters most to mothers and their children. Since early this year, the Taskforce has already started engaging various groups of parents and stakeholders, to better understand their challenges in fostering a healthy lifestyle in their children and in accessing services. We found their feedback very insightful and will continue to facilitate more conversations throughout the year.
Next, on the second group – our seniors.
While COVID-19 has posed many challenges, it also presents us with new opportunities to further transform our support for them.
In this spirit, we have embarked on a refresh of the Action Plan for Successful Ageing. Since its launch in 2015, we have made significant progress on many fronts. We have raised the retirement age, provided seniors with opportunities to learn and volunteer, and rolled out the Pioneer and Merdeka Generation Packages.
Nevertheless, our plans must continue to evolve to meet the needs and aspirations of current and future generations. Achieving these aspirations is only possible through a whole-of-society, citizen-centric effort that brings together everyone to “turn silver into gold”. In my previous job, I was turning \"waste into wealth\"; this time, I am trying to turn \"silver into gold\".
I am glad to share with Mr Yip Hon Weng that we have started engagement sessions since last October to partner citizens on the Refreshed Action Plan. I encourage everyone to join this meaningful national SGTogether effort!
Having participated in some sessions myself, I am deeply encouraged by the diverse discussions and participants’ aspirations to age well.
Beyond this, Mr Tan Wu Meng and other Members have also asked about our on-going efforts to enhance support for seniors. I would like to share about three areas – first, our care landscape; second, care-giver support; and third, developing the community care sector.
Our care landscape. In our care landscape, we launched the new Community Care Apartments in Bukit Batok last month – a novel public housing-cum-care concept. The flats integrate senior-friendly housing features with care services and community building through social interaction and communal spaces.
When I visited the exhibition at HDB Hub, a senior told me that she had been long awaiting this! Others said they appreciated the communal spirit that it brings, greater assurance to age independently and the range of programmes to keep them active.
The flats were over-subscribed, with more than four seniors applying for each flat. We will continue to work with MND on planning for additional sites.
Last December, we announced a new Eldercare Centre service to serve all seniors nationwide. These centres would be key nodes in our social support and care landscape, and the first batch of centres will start from 1 May 2021. MOH will set aside about $180 million to complete the rollout of over 200 centres by 2024.
Each will provide a common suite of “ABC” services – A for Active ageing programmes, B for Befriending, and C – connecting to Care services. Seniors can participate in wellness activities or have their queries about care services and support schemes answered. Befrienders will reach out to those with little support.
To better reflect the new model, centres that provide the suite of “ABC” services will be named “Active Ageing Centres”. Today, some centres provide care services, such as day care and community rehabilitation. They will be called “Active Ageing Care Hubs” once they come on board to provide the new “ABC” services on top of their existing regular care services.
Next, on care-givers – they play a key role in supporting seniors to age well in the community. To support them better, MOH launched the Caregiver Support Action Plan (CSAP) two years ago. In response to Ms Yeo Wan Ling and Mr Yip Hon Weng, I am pleased to share that MOH, AIC and various community partners have rolled out all the initiatives under the CSAP. I will share a couple of examples.
First, we launched the Home Caregiving Grant two years ago, providing a cash grant to help with care-giving costs. More than 29,000 care-givers have since benefited.
To Mr Yip Hon Weng's query, we are also reviewing the Seniors’ Mobility and Enabling Fund to further defray costs of care-giving.
Second, we set up touchpoints within the community to support seniors and their care-givers. For example, the Silver Generation Office refers frail and homebound seniors to the Medical Escort and Transport service to assist them in getting to their medical appointments.
Third, we also have various care-giver respite services. We introduced the home-based respite care pilot in September 2019 for palliative cancer patients and expanded this in 2021 to all patients receiving home palliative care, regardless of diagnosis.
[Deputy Speaker (Mr Christopher de Souza) in the Chair]
Fourth, we will be launching a new grant, a new grant call this year on the Caregiving Ecosystem, under the National Innovation Challenge on Active and Confident Ageing, to support research on innovative solutions to sustainable care-giving.
Fifth, we have worked with community partners to set up four care-giver community outreach teams to better support care-givers at risk of burn-out or developing mental health needs. We will increase this to six teams by year-end. We have also established seven care-giver support networks in Dementia-Friendly Communities, enabling peer support among care-givers.
In addition, we will pilot a structured support system for care-givers of loved ones first diagnosed with dementia. We will proactively support and equip these persons with dementia and their care-givers with information upon the first diagnosis. I will also share more on the support measures we have for care-givers of Persons with Disabilities in my MSF COS speech.
Finally, developing our community care sector. To better serve seniors’ needs, we have expanded the capacity of community care services. Since 2015, we have added 4,600 day care places, as well as 3,100 home care places for home-bound seniors. We have also added 4,000 nursing home beds to cater to frail seniors with less family support.
We share Mr Ang Wei Neng’s concern about the impact of COVID-19 on the construction of nursing homes. To mitigate this, we are working with providers to open up currently non-operational beds. AIC also helps seniors and care-givers with alternative care arrangements while awaiting nursing home placement, such as the Interim Caregiver Service for short-term home-based custodial care, and the Integrated Home and Day Care programme. Seniors or care-givers who need help can approach AIC for further assistance.
Before I conclude, let me summarise my speech in Malay.
(In Malay): [Please refer to Vernacular Speech.] The healthcare system is critical in building a cohesive social support system.
We will continue to transform it to provide proactive and inclusive healthcare for all Singaporeans.
We will develop a Child and Maternal Health and Well-being Strategy over a five-year period.
This plan will provide comprehensive support to mothers and their young children during the critical phases of life to produce better health, social and education developmental outcomes for future generations.
For seniors, we will work with the agencies and individuals from various backgrounds to co-own and implement new initiatives through the revamped Action Plan for Successful Ageing.
(In English): Chairman, we are in good stead to address the future's challenges by identifying points of intervention upstream and strengthening support in the community. These are part of our continuous efforts to renew our social compact to safeguard our future as a strong, resilient and caring society. [Applause.]
The Chairman: Senior Minister of State Dr Koh Poh Koon.
The Senior Minister of State for Health (Dr Koh Poh Koon): Mr Chairman, even as we continue the fight against COVID-19, MOH’s key priority continues to be a healthcare system that provides good quality, affordable and sustainable healthcare for all Singaporeans. I will speak on how deepening our partnerships with the private sector, strengthening our healthcare financing system, driving greater value in healthcare delivery, and uplifting our healthcare workforce can help us to achieve these aims.
Our strong partnerships with the private sector over the years have allowed us to mount a robust and coordinated national response to the COVID-19 pandemic. For example, we have partnered private hospitals to provide subsidised care to patients, such as Raffles Hospital for non-life-threatening emergency cases, an example referenced by Ms Mariam Jafaar, as well as Parkway Hospital, Mt Alvenia and Farrer Park Hospitals for other conditions, including dengue.
At the peak of COVID-19, up to 400 beds across seven private hospitals were used to manage recovering COVID-19 patients. Private providers also supported our Community Care Facilities, clinics in worker dormitories, roving medical or swabbing teams, and many much more.
Our partnerships with private GPs have also matured over the years. CHAS subsidies have expanded since 2012. Today, over two million Singaporeans can access subsidised primary care at CHAS GP clinics. In FY19 alone, we disbursed more than $180 million in CHAS subsidies. GP clinics in Primary Care Networks (PCNs) anchored care in the community, deriving economies of scale for ancillary services, and serving 130,000 patients with chronic conditions last year. Over 970 private GP clinics serve as Public Health Preparedness Clinics (PHPCs), screening all patients with acute respiratory infections and conducted more than 250,000 swabs for early detection and containment of community COVID-19 cases.
In the long-term care sector, private nursing homes receive funding to provide subsidised services. Both private and not-for-profit organisations also operate many Government-built nursing homes and eldercare centres, under a Build-Own-Lease arrangement. In the pandemic, they actively stepped up safe management measures and supported COVID-19 testing and vaccinations to keep our seniors safe.
To mount a strong pandemic response, MOH also tapped on expertise and resources from private laboratories for PCR testing capacity, vendors and distributors of medical supplies, cleaning companies that disinfected our medical facilities, and security companies, facility managers and transport companies that supported our quarantine and other operations.
There are too many to list comprehensively, but each one helped make our robust national response to COVID-19 possible. On behalf of all Singaporeans, I thank our many private-sector partners for protecting Singaporeans from the scourge of COVID-19.
I, therefore, agree with Ms Mariam Jaafar that the Government should continue to renew and deepen our partnership with private healthcare providers.
First, we will uplift capabilities of our GPs through continuing professional education. For example, the Agency for Care Effectiveness (ACE)’s Clinical Update Service (CUES) assists GPs in navigating areas of uncertainty and challenges specific to their area of practice through personalised, evidence-based discussions. We will also train and equip GPs to care for persons with mental health needs. My colleague, Senior Minister of State Janil Puthucheary, will share more on this later.
Second, strengthening regulatory frameworks, such as the Healthcare Services Act (HCSA) passed in January last year, will help us to better regulate newer, non-premises-based, models of care, such as telemedicine, through a services-based licensing framework.
Fee benchmarks, an area which Dr Tan Yia Swam mentioned earlier, was introduced in 2018. This gave patients seeking care at private sector providers more confidence that charges are fair and reasonable. Early data showed that doctors have been taking reference from the benchmarks, with more than 80% of charges in 2019 within the upper limit of the benchmarks, and this is about 4% higher than in 2018. Therefore, together with the Fee Benchmarks Advisory Committee, we introduced new benchmarks for anaesthetist and inpatient attendance charges in December 2020 and will continue to review and develop new areas of fee benchmarking.
I will now move on to our healthcare financing system which is anchored on Government subsidies and the 3Ms: MediShield Life, MediSave and MediFund.
Today, the Government provides significant subsidies, covering up to 80% of treatment costs. In FY19, Government spending on healthcare subsidies amounted to approximately $5.7 billion, or about 60% of MOH's total operating budget that year. This is projected to grow to S$6.5 billion in FY20, an increase of 13.6%.
As a society, we widely accept the need to be progressive and to target subsidies to those with greater needs. When formulating subsidy levels across the various healthcare settings, we should also encourage right-siting of care. We will, therefore, introduce a set of changes to the subsidy frameworks for inpatient care at the acute hospitals, specialist outpatient clinics (SOCs) and community hospitals. Let me go through each in turn.
First, the acute hospitals. For inpatient admissions to acute hospitals, we currently use individual income as the basis for means-testing. I have seen in my clinical practice and also met people during my Meet-The-People sessions, how a sole breadwinner may earn a high individual income, but shoulders the full responsibility for his or her household needs alone. For such individuals, healthcare costs can become a significant strain, and I have great sympathy for them.
Per Capita Household Income (PCHI), which is already widely used in our healthcare system, is, therefore, a better measure of means, as it also considers the amount of household support available, and the number of household members that this individual supports. MOH will thus align means-testing for inpatient admissions to acute hospitals from individual income to PCHI.
Another observation over the years is that the physical differences between B2 and C wards are no longer so obvious, following infrastructural improvements to raise patient safety and infection control standards. However, we still have a legacy system of using choice of wards as a proxy of financial means to differentiate subsidy levels.
Currently, B2 wards are subsidised at 50% to 65% and C-class wards at 65% to 80%. With better means-testing through PCHI, there is, therefore, less need to rely on ward choice. Therefore, we will unify B2 and C subsidies into a common framework, maintaining the same minimum and maximum range at 50% to 80%. This acute inpatient subsidy framework will also be applied to day surgeries which are currently subsidised at 65%. Effectively, this will increase subsidies for 70% of day surgery bills and encourage day surgeries instead of inpatient admissions when appropriate.
Overall, with MediShield Life and MediSave, we expect that most patients will not see a change in out-of-pocket payments, or OOP payments, with about 30% seeing lower OOP and about 15% seeing higher OOP.
Let me go to the SOC setting. While we raised SOC subsidies for the lower income up to 70% in 2014, higher income patients and median-income patients currently receive the same 50% subsidy support, despite both having quite different financial means.
To bring about greater progressivity and allow resources to be better directed, MOH will introduce two new subsidy tiers in the SOC setting for patients with higher PCHI: (a) 40% for PCHI more than $3,300 and (b) 30% for PCHI more than $6,500. For a family of four, these PCHI levels correspond to household incomes of $13,200 and $26,000 respectively. Nonetheless, these higher income households may continue to tap on MediSave up to the applicable withdrawal limits to help pay for healthcare bills.
With the introduction of the CHAS Green tier in 2019, higher PCHI patients with chronic conditions also have access to subsidised chronic care at CHAS GP clinics as an alternative. Complex chronic patients who are not suitable for management at primary care will also be able to utilise their MediSave through higher limits that are going to be introduced. I will speak more about this later.
Sir, having been in clinical practice for more than 20 years, I have also seen subsidised patients in the surgical SOCs who have, at times, preferred an A or B1 ward for specific procedures. Some preferred air-conditioning and others wanted more privacy in the private wards. But the cost of a potentially long tail of SOC consultations upon discharge worries them. For this reason, some patients have sometimes had to forgo their preference and request for a subsidised ward instead. These particular groups are those that Dr Tan Yia Swam shared earlier.
With better targeted subsidies at the SOCs, we will now allow private patients in the Inpatient setting to opt for either subsidised or private SOC for their discharge follow up. If subsidised SOC is chosen, the patient will no longer be able to pick their specialist, as is the current practice.
Overall, the SOC subsidy changes will affect about 30% of subsidised SOC patients, who are from higher PCHI households. Of these, seven in 10 will see an increase of less than $100 in total co-payment for their cumulative annual bills. This can be further offset by MediSave or MediShield Life, or for those who have private insurance coverage.
For elderly patients, any increase in co-payment will also be partially offset by Pioneer Generation and Merdeka Generation subsidies.
This brings me to community hospitals (CHs). Having worked in an acute surgical ward, I have occasionally encountered patients who have recovered significantly to be well enough for discharge to a community hospital for sub-acute or rehabilitative care, but who were reluctant to do so, due to the differences in the subsidy levels between acute and community hospitals.
We will, therefore, enhance subsidies available in our community hospitals to support patients in utilising appropriate care, and facilitate the smooth flow of patients from acute hospitals to community hospitals. This allows acute hospital resources to be available for patients who require more intensive acute care. We will raise the maximum subsidy of community hospitals to 80%, aligned with that of acute inpatient care, and further increase the minimum subsidy from 20% to 30%.
Together with increased MediShield Life claim limits for community hospitals sub-acute care from 1 March 2021, this should make community hospitals even more affordable, especially when compared to a prolonged acute hospital stay. Almost all, about 95% of all community hospitals patients will see an increase in subsidies.
Mr Chairman, subsidies are the bedrock of our healthcare financing system. Healthcare costs will continue to rise in the years ahead, and Government spending on healthcare subsidies will commensurately increase even after all these changes. The changes outlined will make healthcare subsidies more progressive and help facilitate care at appropriate settings. We expect to implement these changes over the course of 2022.
In addition to these changes, MOH will also review the financing landscape in the Long-Term Care, or LTC, sector. Last year, we launched CareShield Life and Medisave Care, improving affordability. However, as we uplift standards and draw in more Singaporeans to work in the LTC sector, cost pressures may potentially impact affordability. So, in anticipation of these challenges, we will once again review the financing situation for the LTC sector to see if further changes are needed.
Next, I will speak on the enhancements to MediShield Life and MediSave.
First, MediShield Life covers Singaporeans for large hospitalisation bills and selected costly outpatient treatments. Following the recent MediShield Life 2020 review, various benefit changes have been made to ensure that the scheme continues to provide adequate and meaningful protection to Singaporeans. These include raising the policy year claim limit from $100,000 to $150,000. Premiums will also be adjusted to keep the scheme solvent and sustainable.
The Government will provide up to $2.2 billion in premium subsidies and support over the next three years. Net premium increases for all Singapore citizens will be kept to no more than about 10% in the first year. Premium payment will also be deferred till the end 2021 for those who have insufficient MediSave balances and are unable to pay their premiums due to the economic impact from COVID-19.
As noted by Mr Gerald Giam, the benefit changes and premium adjustments will take effect on or after 1 March 2021, which is the Monday that just passed. On premium pricing, I wish to assure Mr Gerald Giam that the pricing assumptions are assessed by independent actuarial experts. We are studying how technically complex actuarial reports can be shared in a meaningful way, and will provide an update when ready.
Second, MediSave helps Singaporeans set aside some income towards their future healthcare needs, such as co-payments for large bills and for health insurance premiums. I would like to assure Dr Lim Wee Kiak that the MediSave contribution rates and Basic Healthcare Sum are reviewed regularly, in conjunction with other key healthcare financing levers, such as Government subsidies and MediShield Life.
Ms Hazel Poa and Mr Gerald Giam asked how MediSave coverage can be expanded in the outpatient setting. We certainly recognise that seniors tend to have higher healthcare expenses, especially if they have chronic conditions.
From the start of this year, we raised annual MediSave limits from $500 to $700 for patients with complex chronic conditions under the Chronic Disease Management Programme, or CDMP. The list of CDMP conditions will be reviewed regularly.
To support elderly patients in seeking outpatient treatment, we also introduced Flexi-MediSave in 2015, and lowered the age eligibility from 65 to 60 in 2018, allowing more patients to benefit. From 1 June 2021, we will further raise the Flexi-MediSave annual limit from $200 to $300. We will continue to review the MediSave withdrawal limits regularly, to ensure that they remain relevant and adequate for Singaporeans.
Beyond healthcare financing, as Dr Lim Wee Kiak has pointed out, we must also control upstream growth in medical costs to ensure affordability in the long run.
First, we should tap on technology to deliver care more effectively while optimising our limited manpower resource. Since the circuit breaker period, polyclinics, SOCs and community nursing teams have used teleconsultation to reach their patients at home, allowing continued consultation and advice for these patients during the circuit breaker period. I understand from feedback that patients are comfortable with teleconsultation.
Further, when ready, the National Central Fill Pharmacy will consolidate medications across multiple providers in a central location, enabling the delivery of medications directly to patient's homes, secured post boxes or other convenient locations. This will improve the access to pharmacy services, including for seniors with mobility needs, as Dr Tan Wu Meng mentioned, and support new care models, such as telemedicine.
We also agree with Dr Tan Wu Meng that patient navigators can improve patient convenience, and our public healthcare institutions have increased the number of staff trained in such roles by 3% annually between 2018 and 2020. But beyond this, we have also improved scheduling services and offer telehealth follow-ups for suitable patients, helping to reduce the need for multiple hospital visits.
Second, innovative care models have been introduced to improve right-siting of care in the community. Examples include the Urgent Care Centre (UCC) pilot concept and the GPFirst Pilot Programme which support patients with non-emergency conditions, helping them avoid unnecessary emergency department visits.
MOH will review the performance of such technology-enabled services and innovative care models, and explore how we can scale up the promising ones. We also strive for greater value and better services in our healthcare system.
The Agency for Care Effectiveness (ACE) helps us to ensure that the prices we pay for subsidised treatments and vaccines are fair and commensurate with the healthcare outcomes they confer. This is done through health technology assessments and value-based pricing (VBP) negotiations. ACE will continue to ensure that subsidised medicines and medical technologies are both clinically and cost-effective.
We also established ALPS in 2018 to aggregate demand and achieve economies of scale in procurement and supply chain management. In 2019, ALPS’s Central Warehouse Distribution (CWD) pilot for polyclinics saved an estimated $1.7 million through advanced warehouse and logistics technology. ALPS will study how this CWD concept can be expanded to the whole of public healthcare boosting efficiency, resilience, and value in our healthcare supply chain.
We also agree with Ms Ng Ling Ling that funding mechanisms can drive greater value through influencing providers’ behaviour. We, in fact, implemented some of the ideas that she has shared.
One financing innovation which MOH has started to adopt is bundled payments, where funding is based on a patient’s entire care episode, even across multiple healthcare settings or attendances. This gives providers the opportunity to optimise care, reduce costs, and pass on savings to patients.
MOH has also implemented a Pay For Performance (P4P) framework which financially incentivises clusters to perform well in key priority areas and the Value-Driven Care (VDC) Programme which tracks clinical performance and cost of care for medical conditions.
We will expand these positive efforts and study other financing solutions and innovations that encourage healthcare providers to optimise care and improve outcomes.
Beyond technology and care models, healthcare is ultimately a high touch and people-centric sector. Healthcare professionals are key in improving patient care and outcomes.
COVID-19 has shown us the importance of maintaining a resilient core of healthcare workers. Following the launch of the SG Healthcare Corps (SHC) in April last year, over 5,000 workers and volunteers have been trained, and provided support in areas such as the care of elderly in nursing homes, swab operations, laboratory testing and vaccination operations.
Going forward, we plan to develop the Corps into a platform for citizen engagement and volunteerism in healthcare during peacetime, and serve as a reserve pool in times of crisis.
COVID-19 has been a trying time for all our healthcare staff and volunteers. I know many staff in our public healthcare institutions suspended their annual leave to meet the surge in manpower demands during the height of the COVID-19 crisis.
Many have played a critical role in the battle against COVID-19 and I would like to express our heartfelt thanks to all of them for their dedication and contributions, and their families for supporting them through this very tough period.
We also recognise and appreciate the contributions of our outsourced workers in the healthcare sector. We agree with Dr Tan Wu Meng that their work is intrinsic to the hospital as many of them, such as cleaners and health attendants, work alongside our healthcare staff in the wards. The intent of outsourcing is to leverage economies of scale and enable our public healthcare institutions to focus on the core mission of delivery of healthcare services. While our public healthcare institutions are not their direct employers, they have also extended support and tokens of appreciation to these outsourced workers. We will continue to work closely with the outsourced companies to improve the work conditions of their staff.
To strengthen our healthcare workforce, I agree with Ms Mariam Jaafar that we need to attract more talent to healthcare and to build a strong local core.
First, we have strengthened our pipeline of fresh graduates. Since 2012, we have increased intakes and retained a strong local core of doctors, dentists, pharmacists and therapists. We have also strengthened the attractiveness of nursing, increasing intakes by about 45%, from about 1,500 in 2014 to about 2,200 in 2020. At steady state, we will be training about 3,300 students annually in our Institutes of Higher Learning to become healthcare professionals.
Second, we have built pathways for progression, and continue to expand mid-career conversion pipelines.
We introduced new pathways for Enrolled Nurses to move from Nitec to Diploma-level qualifications within a shorter time and progress as a Registered Nurse.
In line with the recommendations of the Future Nursing Career Review Committee (FNCRC), we enhanced nursing career tracks and job scopes. Nurses can now perform a wider breadth of care tasks and make clinical decisions.
We are seeing increased interest in our Professional Conversion Programmes (PCPs). Between 2018 and 2020, an average of 160 mid-career locals enrolled each year, about double our average annual PCP intake in the preceding three years. This year, Ngee Ann Polytechnic (NP) will join Nanyang Polytechnic (NYP) in offering the two-year accelerated PCP for diploma-level registered nurses. We will also explore more pathways for mid-career entrants to complete their training in a shorter time. The Singapore Institute of Technology (SIT) is introducing an accelerated PCP in Occupational Therapy for those who have already got a degree in a science-related field. They can complete their training in slightly under three years instead of four years.
Third, we actively partner healthcare employers in re-designing jobs for staff working in healthcare support and operations support roles. For example, the Care Support Associate (CSA) role in SGH, and AIC’s sectoral job redesign project relook processes and blend clinical support, administrative and operations responsibilities into new roles. These initiatives encourage cross-deployment and multi-skilling of staff, create new career pathways, and provide interesting development opportunities for them.
Finally, we are cognisant that salaries play a key role in the attraction and retention of staff. Our healthcare workforce is the lifeblood of our healthcare system and the work that they do is critical in protecting the health and safety of our society. We must maintain the salary competitiveness of healthcare staff against the overall market to attract and retain quality talent.
For doctors and dentists, we recently updated the salaries for junior House Officers, Medical and Dental Officers, Consultant Family Physicians and newly-promoted Associate Consultants within our public healthcare institutions in 2019.
So, I am pleased to announce that nurses in the public healthcare sector can look forward to an increase of 5 to 14% in their monthly base salaries, phased over the next two years. Allied health professionals, pharmacists, and administrative and ancillary staff, including support care staff, in the public healthcare sector can also look forward to an increase of 3% to 7% in their monthly base salaries this year.
We will also increase funding support to publicly-funded community care organisations to ensure that salaries of their staff also remain competitive. The changes to both sectors will be implemented from July this year.
MOH will regularly monitor the salary competitiveness of our public healthcare workforce. Aside from salaries, we will also work with healthcare providers and union partners to make healthcare a progressive and fulfilling career.
Sir, COVID-19 has posed a major challenge to our healthcare system, but we have learned valuable lessons and we will emerge stronger. With deeper partnerships with our private sector providers, innovative, value-based healthcare delivery, a strong healthcare financing framework, and a resilient healthcare workforce, we will be better placed to provide all Singaporeans with good quality, affordable, and accessible healthcare. [Applause.]
The Chairman: Dr Wan Rizal.
Dr Wan Rizal: Chairman, in my recent speeches, I spoke about the importance of mental health and the need to destigmatise mental health issues. Now, its frequency has reached to a point where my students have given me hashtag DWR4MH, which means \"Do what's right for mental health.\" Chairman, we need to change the negative perception and treat mental health issues like any other health conditions. Additionally, it is crucial for those who need assistance are able to get them quickly and properly.
Some time ago, I was approached by a family who has a teenage son who was depressed and suicidal. They did not seek professional help and I quote them, \"malu\" which means \"embarrassing\". \"The incident was indeed embarrassing and brought shame to the family.\" And when they were convinced to seek help finally, they found it daunting to go to the polyclinics, let alone IMH.
The longer we delay the assistance rendered, the shorter the window period to undo this damage. We need a more comprehensive framework to address the issues of stigmatisation and, of course, accessibility.
Last year, the Ministry announced that it would be expanding mental health services under the Community Mental Health Masterplan to enhance the reach and provide support for youths and their families. May the Minister, please, provide an update on this?
The Chairman: Dr Tan, if you like to take both your cuts together, please do.
Dr Tan Yia Swam: Yes, Sir. Mr Chairman, Sir, the COVID-19 Mental Wellness Taskforce convened by the MOH and the IMH in October 2020, with representatives from various Ministries has done great work in promoting mental health literacy. Yet, I hear of anecdotal cases of discrimination against people who have mental illnesses. I will speak on three main groups: one, the general population and working adults; two, the young; three, other vulnerable groups.
For the general public, how do we react when we see someone behaving “oddly” – such as talking to themselves, removing all their clothing in public, becoming violent for no apparent reason, or wailing inconsolably? Do we take a video and post the incident online? Call the Police? Walk away? Or will we step forward to offer some kind of help? I suspect many people want to, but we do not feel able to.
For working adults, I understand when colleagues and bosses see only the underperformance of the affected employee. For example, frequent absenteeism, missing work deadlines, or simply being very unsociable at work. Physical illnesses such as high blood pressure and diabetes, have a measurable scale of normality. Mental illnesses are harder to pick up. Is someone just having a bad day? Is it triggered by something specific and situational which will resolve itself after the event is over? Or could these bad moods be symptoms of a mental illness such as depression, anxiety disorder or even schizophrenia?
We need to have more schemes in place for the general population to recognise early signs of mental illnesses and learn how to assist as a first responder.
Regarding the youth, the world is changing fast. I am only a few years past the official definition of \"youth\", but there are times when I feel very distant from them! Exploring one’s sense of identity as a growing teenager has never been easy. Being in a more connected world now, they are perhaps subject to more pressures.
As a doctor, I have received ground feedback that there is a mental health crisis in our youths – child psychiatrists observe that youth suicide is at its highest rate in the past couple of years. Contributing factors may be increased parental conflicts and divorces, academic stresses, COVID-19, social media and bullying.
How do we recognise and stop bullying of any kind – physical, emotional, verbal? In my Budget speech, I brought up the modern phenomenon of cyberbullying and the amplification effect of social media. A short video clip gets shared, liked and goes viral. Shaming gets weaponised. When I was a child, any once-off silly act gets forgotten, and maybe brought up only at annual family gatherings during Chinese New Year. But now, the Internet never forgets.
Suicide is a painful and difficult subject, as there is a taboo around this. But this is exactly why healthcare has to educate and teach about the mental health issues that contribute to this tragedy.
Let us guide our people to be more caring, and inclusive. How do we approach those who are different? Mental resilience, sleep hygiene, and the safe use of the Internet should be taught in schools, and to adults as well; to be given as much importance as physical exercise! I thank other Members, as well as MOE for addressing this, and welcome the changes to CCE.
However, after we succeed in early detection, are there enough healthcare providers to render help? We will need enough psychiatrists, psychologists, nurses, pharmacists, medical social workers, case managers, family therapists and so on. For many of the patients with mental illnesses, it is a lifelong disease, and some of the triggers may be related to socio-economic stressors.
Young patients with mental health may just be the tip of the iceberg, and further investigation may uncover more members of the family with mental health issues. They will all need to have adequate treatment. Community support has to come in hand in hand with doctors in the hospital to provide integrated care. The network of support is essential to minimise the episodes and severity of relapses. Focus cannot be just on the acute admissions, but in discharge back to the community, gainful employment and meaningful living.
Finally, vulnerable groups such as singles, single families and elderly staying alone may be at higher risk due to social isolation and lack of access to resources. Does the Ministry have plans in place to help these groups?
In summary, the global COVID-19 pandemic has caused increased stress in multiple areas – retrenchment, change in jobs, lifestyles, education. This has a far-reaching impact on interpersonal relationships, physical and mental health. I urge MOH to further develop programmes on mental wellness and building resilience as a routine part of daily life.
Many people are now working from home due to COVID-19. Other speakers have shared on the challenges that parents with young children face working from home. While some adults have managed to incorporate daily exercise into their new routine, many others are struggling to balance work, daily chores and the demands of family care.
For many busy working parents, the daily commute to work and back home might be the only exercise they get. For example, walking 10 minutes to the MRT station and another 10 minutes to the workplace. This makes up a total of 40 minutes' walking time and one may clock 8,000 to 10,000 steps, hopefully. The lack of commute while working from home means a reduction in mobility. Some of us snack more. For those of us who like to chat over coffee or lunch at the office, working from home also results in less social engagement, which may lead to chronic health issues such as obesity, depression and anxiety.
What are the Ministry's plans to support Singaporeans to pursue healthy habits in this new norm?
The Chairman: Dr Lim Wee Kiak, if you would like to take both your cuts together, please do.
Dr Lim Wee Kiak: Mr Chairman, nowadays, we see everyone wearing a healthcare device to monitor our steps, our heartrate, our stress level, oxygen saturation and how well we slept last night. Some of the more advanced ones perform electrocardiogram (ECG) and even measure your blood sugar levels now as well as blood pressure.
On our home front, I am encouraged to read about the Health Promotion Board and Fitbit – headquartered in San Francisco, California – tap on technology to help Singaporeans to live healthier using its devices. I must commend the Ministry for mobilising technology to boost Singaporeans' interest in fitness and healthcare.
Sir, I think Singaporeans are ready to use digital technology to take charge and take responsibility of their own health. Let Singaporeans have accessibility to their own health data when the National Electronic Health Record (NEHR) is ready.
I envisage in the near future, I will have access to my own medical as well as health record, just like the details of my COVID-19 vaccinations on HealthHub app now. In the near future, I will receive a reminder from MOH for my annual health checks, blood tests, annual immunisation, and my once-in-five-years colonoscopy screening. Once completed, there could be an artificial intelligence (AI) system in MOH that will review my health records, and then they will send me an advice to take active steps to improve my health through lifestyle adjustments. They may recalculate and lower my annual MediShield insurance premium, if my health is good.
That will encourage more Singaporeans to come on board and to take responsibility of their own health.
I feel we can go a step further now to get Singaporeans to do more exercises, to manage their stress, maintain mental wellbeing and manage their sleep better. Another area would be to manage good nutritional diet daily and influence them to have good eating habits. Singaporeans already have one of the longest lifespans in the world but we spend the last decade of our lives in poor health.
What we want is not just a long lifespan but a healthier lifespan.
I urge MOH to take advantage of all the advances in digital healthcare devices now to set up a national health management system and to step up the partnership with Singaporeans to achieve good health for life.
Sir, the popular adage goes, \"prevention is better than cure\", and in modern healthcare, immunisation against infectious diseases and potentially fatal diseases is the key factor to a long, healthy lifespan.
One of the things that comes out from this COVID-19 pandemic is the heightened public awareness about the role of immunisation in our healthcare measures. Immunisation is one of the key advances in medicine that has extended the lifespan of humans globally. Apart from the immunisations that we received during our childhood, many Singaporeans do not get regular immunisations unless they need to travel or for work. How many Singaporeans would regularly go for their annual flu vaccinations or pneumococcal vaccinations? Even new vaccines such as the human papillomavirus (HPV) vaccine will reduce the risk of cervical cancer.
Although we have a comprehensive vaccination programme for our children, do we have a more comprehensive programme for adults and the elderly?
We are constantly reminded to take our COVID-19 vaccination to protect our loved ones, especially those immuno-compromised and the elderly around us. Likewise, we should do the same for influenza.
Perhaps not immediately but in the months ahead as we advance in our COVID-19 vaccination, I would urge MOH to take advantage of this opportune time to review and enhance our national immunisation programme, implement measures to promote public awareness and facilitate and improve accessibility and affordability of immunisation for all Singaporeans for their good health.
The Chairman: Senior Minister of State for Health Dr Janil Puthucheary.
The Senior Minister of State for Health (Dr Janil Puthucheary): Mr Chairman, Singapore is fortunate to have a workforce in the healthcare family driven by professionalism and dedication. Our people answered the call of duty, they have carried us far in this fight against COVID-19 and have contributed to keeping Singapore safe during the pandemic.
Our infectious diseases experts and staff at the National Centre for Infectious Diseases (NCID) and other public healthcare institutions have worked to provide clinical guidance to and support for public health operations. Laboratory specialists at the National Public Health Laboratory provided guidance for COVID-19 tests and conducted genomic analysis to support cluster investigations and surveillance for variants. The staff at the public and private healthcare institutions do their duty, putting themselves in harm's way. They undertake healthcare operations in high-risk locations like the foreign workers' dormitories, emergency departments, hospital wards and intensive care units across our healthcare system.
I echo the sentiments of many in the House to express our deep appreciation for colleagues in many, many different roles.
The work continues and Members will know that we started our national vaccination operations at NCID on 30 December 2020.
NCID was one of several initiatives and projects that came out of the lessons we learned from SARS. In the test of that crisis, we identified vulnerabilities and in our response, developed capabilities and institutions that exist to this day, like NCID, helping us with COVID-19.
In this crisis, we are learning new lessons and responding to different vulnerabilities. We need to institutionalise the capabilities that we are developing. We have needed to deal with the pandemic and continue the usual clinical services and, now, stand up a massive national vaccination exercise. Many of these skills, tools, processes and systems we have developed are distributed across our healthcare network and the care providers.
But centrally, at MOH, we have had to also develop and improve our organisational capability to manage the response to this crisis and, hopefully, be better prepared for the next.
At MOH, we have set up a new Crisis Strategy and Operations Group. They have worked hard, in collaboration with other Ministries and other agencies, to coordinate COVID-19-related operations. This is a capability and a team that we will need in order to be better prepared for the next pandemic.
We are heartened by the appreciation demonstrated by the public for our healthcare workers. However, today, there are still cases of harassment and abuse against staff. This has affected their well-being and their safety.
To Dr Wan Rizal's question, we take abuse and harassment against our healthcare workers very seriously and will not hesitate to take appropriate action when necessary.
The enhancements to the Protection from Harassment Act in November 2014 gave additional protection against harassment to Public sector healthcare professionals and support care staff. Public healthcare institutions also have policies in place to handle abuse cases. The institutions conduct training for healthcare staff, including on de-escalation measures during potential conflict and abuse.
In addition, we will work with the clusters and the Healthcare Services Employees' Union (HSEU) on a tripartite effort to strengthen messages against abuse and harassment of public healthcare staff.
During the Budget debate, Mr Darryl David asked about staff benefits. Dr Wan Rizal also asked about this just recently. Our public healthcare institutions do pay close attention to staff leave and make time for sufficient rest. These are planned to ensure sufficient staffing for patient safety. There are also rostered breaks and staff rotations to ensure sufficient rest during and between shifts.
To better support our healthcare staff, a cross-cluster Staff Wellbeing Committee, with representatives from our public healthcare institutions and MOH, has been set up. The committee will share best practices and provide feedback to MOH on possible enhancements to improve staff wellbeing.
Besides healthcare workers, our HealthTech – health technology – engineers have also played an important role. They have rapidly developed systems to support new operational demands, including the on-going vaccination operations.
These are also important capabilities that we need within our system. Thus, to grow our health technology workforce, we work closely with the Integrated Health Information Systems (IHiS) to redesign jobs and actively recruit people into new roles, including software engineers, systems analysts and cybersecurity professionals. To facilitate mid-career switches into HealthTech, IHiS, Infocomm Media Development Authority (IMDA) and SkillsFuture have curated specific training programmes.
One such example of a mid-career switch is a gentleman by the name of Mr Daniel Ong, whom I spoke to recently. He was a copywriter and his formal education was in English Literature. He could not write code before joining IMDA's Tech Immersion and Placement Programme, which is part of our TechSkills Accelerator. In March last year, Daniel began work at IHiS as a front-end developer. He has contributed to two IT projects supporting the fight against COVID-19. Now, he is developing the user-facing components of the system supporting the One-Rehab framework, which I will speak a little bit more about later.
We hope that more people will see opportunities in this HealthTech space and embrace the possibility that with some training, they can join the healthcare family, not necessarily as a clinician but contributing to the success of our public healthcare eco-system.
As Mr Ang Wei Neng pointed out, we can and should learn many things from our fight against COVID-19.
For example, our early, comprehensive and persistent contact tracing and quarantine efforts have played a key role in our COVID-19 response. Besides the vigilance and skill of our healthcare workforce, our digital tools such as SafeEntry and TraceTogether continue to be central to the speed and efficiency of our contact tracing. Coupled with our aggressive testing strategies, these measures have contributed to our success in keeping the number of our community cases under control, for now.
To swiftly identify COVID-19 cases and contain the outbreak, we have built up our testing capacity and our community testing operations. Through targeted operations as well as routine surveillance testing, such as the testing of our hawker centre workers, we have so far been able to detect cases and quickly prevent spread.
As a repository of patient records, the National Electronic Health Records (NEHR) has also been a key enabler in facilitating this provision of care during the pandemic. Healthcare professionals can access NEHR for their patients' COVID-19 test results and their existing medical conditions before the vaccination. The NEHR has also been enhanced this year to meet the requirements for COVID-19 vaccinations, displaying alerts and reporting problems.
As we do this, data security remains a key priority. We have been taking steps to improve the security of our NEHR through technical and process enhancements, in response to the security reviews that we conducted in 2018. We expect to complete most of this within the year and onboard more healthcare institutions to contribute to NEHR more securely.
Beyond COVID-19, we must be ready to respond to future public health crises by having the right systems and capabilities. We will do so in four ways.
First, we will enhance our surveillance and response capabilities through the use of new technologies to enable us to more effectively consolidate, analyse and generate insights from large amounts of data.
Second, we will augment our human capabilities to prepare Singapore against future threats. Skilled clinical teams will always play an important role in detecting and managing new diseases and outbreaks, and we also need other experts such as epidemiologists, data scientists, statisticians and software engineers like Daniel. We need teams to investigate and perform advance analytics, for example, to determine the likelihood of spread and inform our response to an outbreak.
Third, while we remain in DORSCON Orange for now – DORSCON stands for Disease Outbreak Response System Condition – we will look into strengthening our DORSCON framework, incorporating lessons learnt from the pandemic so that we can better communicate public health risk and to help us more effectively respond as a whole society when \"Disease X\" strikes, the next serious pandemic crisis.
Finally, we will develop a national R&D Programme for Research in Epidemic Preparedness And Response – and the acronym is appropriately called PREPARE to strengthen our R&D capabilities to prevent, prepare for and respond to future public health crises.
It will include (a) strengthening infectious disease collaboration networks locally and regionally; (b) strengthening capabilities for the accelerated development of diagnostics, therapeutics and vaccines; and (c) establishing a national infectious disease repository and database for research and data analysis.
To further address Mr Ang’s question, MOH regularly reviews our national response and is conducting an interim review. It will include other Ministries and Agencies. We will share details when completed.
Beyond pandemics, we must ensure that the healthcare needs of our general population are met. The work continues.
Our polyclinics are a vital element in our Public Health primary response. Built in 1980, Clementi Polyclinic is one of our oldest and smaller polyclinics. Its central location has served residents well, with about 850 patients seen per day. We will be redeveloping the polyclinic by 2027 to better serve residents in the region.
Dr Tan Wu Meng asked whether we have considered patient’s comfort and staff’s performance in our design of healthcare facilities. The answer is yes. When designing new healthcare facilities, the design team will engage stakeholders including the care team, patients and carers, and the facilities management team.
The redeveloped Clementi Polyclinic will undergo the same process. It will be more spacious with more elderly-friendly and accessibility features. Residents can also look forward to a comprehensive range of primary care services, including medical treatment for acute conditions, chronic disease management, women’s and children’s health services, as well as radiological, laboratory and pharmacy services.
Another example of the on-going work to improve routine clinical care services despite the pandemic is to ensure our population has timely access to the right level of rehabilitation care. We have developed the National One-Rehab framework. Under this framework, patients will have improved access to community-based rehabilitation and benefit from expanded capacity and capability in the care providers.
Our hospitals, polyclinics and community care providers will embark on a multi-year pilot to validate this new care model. Our hope for patients with stable musculoskeletal conditions such as lower back pain who do not require surgery or complex interventions to receive this rehabilitation care in the community, instead of only at specialist clinics or hospitals.
During last week’s Budget debate, we heard Dr Shahira Abdullah, Ms Carrie Tan, Dr Wan Rizal, Ms Mariam Jaafar and Mr Eric Chua speak about mental health. Since the launch of the Community Mental Health Masterplan in 2012, and its enhancement in 2017, we have increased the capacity of community mental health services. We are on track to meeting our targets by end 2021.
In primary care, we have over 220 GP partners and 14 polyclinics providing mental health and/or dementia services.
We have set up 50 community outreach teams and reached out to over 350,000 persons with mental health or dementia needs. In addition, 21 community intervention teams were established to provide mental health interventions such as psycho-social therapeutic interventions and counselling. We have met our targets of 50 community outreach teams and 18 community intervention teams ahead of our end 2021 timeline.
To Dr Wan Rizal’s question on support for youth and their families, we have piloted the Integrated Youth Service (IYS) within the Agency for Integrated Care (AIC), the Institute of Mental Health (IMH) and Care Corner, which is one of our community partners in the North.
Since April 2020, Care Corner has begun community outreach using online platforms, and has reached out to over 2,600 users. In November 2020, the Care Corner team moved into the new Woods Square Community Space, to provide face-to-face mental health screening and basic emotional support sessions for persons with mental health challenges, and to conduct experiential resilience or mental well-being events.
MOH and AIC have also worked with other community partners to set up youth community outreach teams to reach out to young people in mental distress to provide basic emotional support and resources. The team would also engage the family to understand the stressors and the home environment. Links to social and health services would also be provided.
Through the Youth Mental Well-being Network, we have heard from the youth, mental health and social sector professionals, patients and caregivers, on how we could improve the mental well-being of our young people.
Minister of State Sun Xueling earlier shared on how the Network has initiated ideas for over 30 potential ground-up projects. Parliamentary Secretary Eric Chua will also be sharing about an initiative to provide positive peer support during his MSF speech. The three of us are working together, just as MOE, MSF and MSH are working together on this important area.
To look into the psycho-social impact of the COVID-19 pandemic on the population, we set up the COVID-19 Mental Wellness Taskforce in October 2020. The Taskforce has reviewed and recommended three areas to work on, namely, to develop a national mental health and well-being strategy; secondly, a national mental health resources webpage; and a national mental health competency training framework.
Beyond COVID-19, we will evolve the Taskforce into an inter-agency platform on mental health and well-being, by mid 2021. The platform will oversee mental health and well-being efforts, focusing on cross-cutting issues that require multi- and inter-agency collaborations. We are working out the details of the platform and will share more when ready.
Dr Tan Yia Swam asked about the support for other vulnerable groups such as our seniors and building a more inclusive society. The Government recognises that those who suffer from mental health conditions may face discrimination. We have been working with partners to roll out initiatives to address this issue. It will take a whole-of-society approach to tackle this issue effectively.
The National Council of Social Service launched the “Beyond the Label” movement in 2018 to fight the stigma of mental health conditions and encourage social inclusion, positive attitudes and support towards persons living with mental health conditions. The movement also provides a platform for more conversations about mental health and promotes greater awareness and the acceptance of mental health conditions among the public.
To reach out to persons with or at-risk of mental health conditions or dementia, including seniors, community teams also reach out to residents and their caregivers to provide mental health or dementia information, basic emotional support and links to appropriate services, health or social, as necessary.
For seniors at risk of social isolation, the AACs, Silver Generation Office and local grassroots organisations connect them to befrienders who will reach out to them on a regular basis, providing companionship and encourage them to participate in social activities, keeping active and keeping connected with the local community.
Seniors can also sign up with CareLine, which is a 24/7 social support hotline that provides tele-befriending services as well as emergency response to seniors in distress.
While we do all this to build up the capabilities in our community partners, we will make sure that our main psychiatric sector, IMH, is updated. Since 2018, IMH has been undergoing refurbishment and improvement works to facilitate the care and improve operational efficiency and safety for patients and staff. And these works are expected to be completed by the end of 2022.
Mr Chairman, to fight COVID-19 we have had to rely on the skill, dedication and professionalism of our people. We have had to develop and deploy technology and we have had to scale up clinical services, all the while looking after the many healthcare issues that are unrelated to the pandemic, but essential to our health. We have had to be agile, steadfast and determined.
We are all a bit tired and fatigued, but also hopeful and confident that we can find our way forward. Our ability to get this far was the result of many years of investing in our people, our facilities, systems, research and capabilities. We must learn the lessons from this experience. The preparations for the next crisis, whatever it is, are underway and require that we keep ourselves and our healthcare system in good health. Prevention is best, preparation is also necessary.
The Chairman: Parliament Secretary Ms Rahayu Mahzam.
The Parliamentary Secretary to the Minister for Health (Ms Rahayu Mahzam): Mr Chairman, we remain committed to our long-term priorities even as we focus on containing the pandemic. We continue to transform from Beyond Healthcare to Health, to support Singaporeans to lead healthier lifestyles and stay healthy in the “new normal”.
It is important to take stock of our state of health. I am happy to report that Singapore ranked first globally for life expectancy at birth and healthy life expectancy at birth in the Global Burden of Diseases 2019 study.
However, based on our National Population Health Survey 2020, there are still areas for improvement.
While our smoking prevalence rates decreased to 10.1%, down from 13.9% in 2010, compared to 2017, the proportion of Singaporeans with sufficient total physical activity has dropped. The proportion of Singaporeans that are obese or overweight has increased. In 2019 and 2020, about two out of five are overweight. And the age-standardised prevalence of the three common chronic diseases, high blood pressure and high blood cholesterol have risen and the prevalence of diabetes have not decreased.
There is a need to better understand the current situation among different groups. Additionally, COVID-19 and the various measures and socio-economic challenges have impacted our lifestyles and our health. Dr Tan Yia Swam has also asked about supporting healthy living in this new norm. I will therefore share our plans to innovate health promotion efforts for Singaporeans to remain healthy in the “new normal” and how to better prepare Singaporeans to lead healthy lives for the future.
Indeed, in the past year, Singaporeans faced challenges pursuing healthier habits in ways they were used to. With safe distancing concerns, we were unable to hold our usual health promotion programmes such as mass exercises. As working from home became the norm, we also observed a drop in physical activity time, likely from reduced commuting. This drop is also demonstrated in the daily average step count data from the Health Promotion Board’s (HPB) National Steps Challenge.
We quickly pivoted to delivering our programmes virtually, in line with the safe management measures, or SMMs.
We shifted physical activity programmes online, and produced exercise routines on YouTube and an edutainment series on free-to-air TV channels to help Singaporeans keep active. We understand that some seniors have found it challenging to adapt from physical to virtual modes of exercise. To help seniors navigate around these platforms, we worked with partners such as People’s Association to organise workshops to provide assistance, and equip them with basic IT skills.
I am heartened to hear that our regular participants have benefitted. For example, for the senior-centric virtual Community Physical Activity Programmes, over 5,000 participated across more than 190 sessions from July to December 2020. To benefit as many as possible given the current guidelines, we will be scaling up our virtual programmes progressively this year.
We understand that some still prefer physical interaction for health programmes. To reach out to more Singaporeans, we have gradually resumed physical sessions both in the community, such as our popular Sundays at the Park, and at the workplaces with the appropriate SMMs.
Like physical health, mental wellbeing is also important for one’s health. I echo Senior Minister of State Janil on creating a supportive environment to empower Singaporeans to take care of their mental well-being.
In August last year, we launched the “Brave the New” campaign with MCCY to build psychological resilience of individuals. The campaign provided tips for self-care, and information to support their peers and loved ones. It reached 2.1 million Singaporeans and three-quarters of those surveyed reported being more motivated to self-help or help others in their mental well-being.
To complement this, the “Hi!JustCheckingIn” movement started in January this year to equip targeted segments of the population with the appropriate skills to help them identify and reach out to those who may need support. Building a supportive community is important, to encourage Singaporeans to seek help if they are unable to cope.
Through our community partners, we included seniors in our mental well-being efforts. We understand that many seniors are mentally and physically affected during this pandemic, especially during the circuit breaker. Last year, we trialled the virtual “Balik Kampung” programme to link up 100 seniors over 22 Senior Activity Centres over activities to stay mentally stimulated. With good feedback on how it has helped seniors stay socially connected, we will ramp up these efforts.
We will continue to promote holistic well-being. The HPB’s National Steps Challenge saw over 900,000 participants in its fifth season. The sixth season will start in the third quarter of this year and will augment the traditional Steps Challenge with a different dimension of well-being – sleep, via the first pilot Sleep Challenge.
Having good sleep habits is key to good health and well-being. Through the Healthy365 application and a wearable, there will be nudges to achieve the recommended sleep duration, and tips on good sleep habits. Interested participants can look out for more details on Healthy365 and HealthHub.
We will continue to work on avenues for Singaporeans to keep healthy while staying safe.
We recognise that at different life stages, Singaporeans face different health needs, challenges and risks. Going forward, we will add a person-centric approach to address these across our population segments.
Dr Tan Yia Swam has highlighted health literacy in her Budget debate speech and Dr Lim Wee Kiak has also suggested boosting our efforts with technology. We have embarked on initiatives similar to Dr Lim's vision. I am happy to update that the first digital version of My Health Booklet is ready on HealthHub, developed based on ground insights. This version provides an overview of your health screening records drawn from national health databases and smoking cessation messages for those motivated to quit smoking. We will add more features and health topics such as stress management and the nationally recommended vaccinations starting from July this year.
Another example is LumiHealth, a free, two-year personalised health programme designed by HPB, in partnership with Apple, using the Apple Watch. Under this programme, participants will embark on customised health journeys and earn rewards as they complete health-related challenges. They will also receive personalised reminders, to encourage them to meet their goals. Since its launch in end-October 2020, we have seen more than 100,000 downloads.
We must also not forget our efforts to keep chronic conditions at bay, like our on-going War on Diabetes. MOH developed the Patient Empowerment for Self-Care Framework to empower patients to co-own their care journeys and achieve better care outcomes with support from their healthcare team, family and friends. Under this framework, we developed the first tranche of the National Diabetes Reference Materials that provides fundamental information and hosted it online on HealthHub.
We are now working on the next tranche of materials with more in-depth information to help patients, their family and friends, better understand and manage diabetes. This resource is being co-created by the people for the people – about 700 citizens highlighted additional topics and content that would be useful, and suggested design features for a more user-friendly online experience. These materials will be ready from 2022.
Beyond our broad plans for our Singaporeans, I will elaborate on targeted efforts. Mr Leon Perera has highlighted the lower income groups. Minister Gan has shared how we ensure they have good access to affordable care. While our health promotion efforts remain inclusive to all, there are also efforts targeted to address their health needs, and we work across agencies to provide holistic support.
One example is the Healthy Living Passport programme, which Mr Perera referred to. The programme is designed to improve health literacy and promote healthy lifestyles. It is customised based on the lifestyle needs of lower income families, with tailored messaging and education. This is a multi-agency effort, and will commence after the SMMs are reviewed.
We aim to benefit 15,000 residents over three years. We intend to track changes in our participants' health literacy as well as their behavourial improvements. This would allow us to evaluate the impact of our programmes as we generally do with our efforts.
We see significant disparities in health behaviours and outcomes across ethnicities and will be ramping up efforts in this area. For chronic diseases, in 2020, 14.4% of Malays and 14.2% of Indians have diabetes, compared to 8.2% for Chinese. Thirty-seven point five percent of Malays and 36.1% of Chinese have higher blood pressure, compared to 29.5% for Indians. For cancers, the Chinese consistently have the highest age-standardised cancer incidence rates, but the proportion of Malays among all cases of cancer has gradually increased over the decades.
Looking upstream at other modifiable lifestyle risk factors, the Malays have the highest obesity rates and Indians have the highest prevalence of being overweight. The prevalence of daily smokers are more than twice as high amongst the Malays as compared to the Chinese and Indians.
Research has shown, poor health behaviours can affect life expectancy. Therefore, our community needs to take stronger action, and support one another against poor health habits. Cultural preferences may influence health behaviours and we recognise the importance of engagement and collaboration with the different ethnic minority groups to design culturally relevant programmes. Some of our earlier efforts have seen good progress.
For the Malay community, we have built our partnerships under HPB's Jaga Kesihatan, Jaga Ummah from 23 in 2018 to 32 mosque partners, and 18 other partners such as the Malay Executive Activity Committees (MAEC) and MENDAKI. With their support, we were able to provide a range of healthy living programmes for their congregants.
Our Indian community partners such as Hindu Endowment Board, Sikh Welfare Council, SINDA and places of worship have provided strong support in engagement efforts with their networks. For example, NARPANI Pearavai provides Indian Activity Executive Committees funding to co-create health activities for their residents. Between 2018 and 2020, close to 15,000 Singapore Indian residents have participated in the various health promotion programmes.
We will build on early successes to improve our work, to make healthy living a sustainable achievement. Moving forward, we will expand community partnerships and harness ground-up efforts to multiply our impact and and ensure that our programmes are culturally relevant through customisation.
We will engage key community leaders through significant platforms to garner commitment towards health. For example, at a forum in end-March 2021, leaders from the Hindu Endowment Board, SINDA, NARPANI, Sikh Welfare Council and HPB will discuss the state of health amongst Indians and co-develop culturally relevant efforts to facilitate healthier lifestyles among Singaporean Indians. We look forward to an invigorating discussion and a year of fun, healthier activities for all Singapore Indian residents.
Let me share further for the Malay community. Mr Chairman, allow me to say a few words in Malay, please.
(In Malay): [Please refer to Vernacular Speech.] To bolster health-related efforts for the Malay community, we will form a new working group. I will be chairing this group together with Dr Wan Rizal and Ms Mariam Jaafar, as well as community bodies, such as M3 and the Muslim Healthcare Professionals Association (MPHA).
We will continue to collaborate with the \"Jaga Kesihatan, Jaga Ummah\" (JKJU) network and community leaders to develop and implement health programmes throughout the year to foster good health habits.
We will produce simple tips to remind the Malay community about the important steps to take care of their health. To sustain this effort on health, we will have Health Ambassadors and continue to enlarge this network of volunteers.
Mdm Rahimah is one of our most committed Health Ambassadors since 2012. As a member of the Macpherson MAEC, she plans motivational health lectures for the Malay community. She also spends time teaching our seniors to surf the Internet. Mdm Rahimah’s efforts should be emulated. I would like to encourage all Singaporeans to follow her lead and contribute to the community.
(In English): Beyond ethnic minorities, I echo what Minister Masagos said on the importance of supporting our children and women to lead healthy lives for a healthier next generation. It is key to support couples who wish to start their own families.
Mr Louis Ng asked about supporting couples undergoing IVF. Today, eligible Singaporean couples undergoing Assisted Conception Procedures, or ACP, in public Assisted Reproduction centres can receive co-funding support for the different procedures.
The co-funding applies to each Assisted Reproduction Technology (ART) cycle, and the patient would either receive the co-funding of 75% of the cost or the capped co-funding amount, whichever is lower. As such, there is no remaining balance to be rolled over. However, MOH regularly reviews the clinical evidence around the number of cycles to co-fund. At present, on average, women undergo two ART cycles before achieving pregnancy successfully. Evidence shows that the success rate of ART decreases with maternal age, as each successful cycle progresses. It is not just about Government funding, but the strain of couples to keep trying. Hence, we must continue to encourage couples to marry and start families early, to maximise the chances of conception.
After co-funding, the current MediSave per-cycle limits are generally sufficient to cover the cost of a ACP cycle at public Assisted Reproduction Centres. As not all couples go through multiple cycles, we have allowed a higher MediSave withdrawal limit for the first two cycles so that more of the lifetime limit can be used. MediSave can be used to pay for all standard procedures for each method of treatment, such as the priming of the uterus, egg recovery and fertilisation processes. However, as Traditional Chinese Medicine treatments associated with IVF are not part of mainstream evidence-based treatment, there are no plans to allow MediSave for their use currently.
MOH remains committed towards supporting Singaporean couples in their parenting journeys, and will continue to review the MediSave withdrawal limits to ensure they remain relevant and adequate for Singaporeans, as we balance immediate expenses with retaining sufficient savings for basic healthcare needs in old age.
Apart from supporting couples, we enabled early intervention and enhanced subsidies for vaccinations under the National Childhood Immunisation Schedule, or NCIS, for all Singaporean children at polyclinics, and extended them to CHAS GP clinics across Singapore in November 2020. We have also added vaccines against chicken pox, influenza and pneumococcal disease to the NCIS.
For Singaporean children up to the age of six, we have extended full subsidies for childhood developmental screenings at CHAS GP clinics, to allow for early detection and timely intervention for any developmental delays. There is also support for their families. From last November, subsidies have been extended to vaccinations under the National Adult Immunisation Schedule, or NAIS, at CHAS GP clinics and polyclinics for all eligible Singaporean adults.
Dr Lim Wee Kiak asked about the progress of our national immunisation efforts. Based on the National Population Health Survey 2020, the take-up rate is estimated to be 23% for influenza vaccination, and 14% for pneumococcal vaccination in persons aged 65 to 79 years of age.
I am happy to update that three months after the enhancements, a total of 158,000 and 121,000 doses of the NAIS and NCIS vaccinations respectively have been administered nationally. In particular, for pneumococcal and influenza vaccinations that are recommended for the elderly aged 65 years or older, the uptake has been encouraging with more than 38,000 and 62,000 doses received respectively.
One of the families that benefited is the Chiam family. The three-generational family has been regularly consulting Dr Lim Hong Shen from A Medical Clinic, under the NUHS Primary Care Network. With Dr Lim's strong support, their two children, aged two and four years old, have undergone their childhood developmental screenings and received subsidised vaccinations for influenza, as well as measles, mumps and rubella. The grandfather, aged 69 years old, has also received both the pneumococcal and influenza vaccinations.
We hope that this improved accessibility and affordability will encourage Singaporeans to protect themselves and their families against vaccine-preventable diseases by getting vaccinated as recommended, and support children in starting off well and healthy. MOH is committed to increase the uptake of nationally recommended vaccinations, and will encourage eligible Singaporeans to be vaccinated.
Together, we can encourage one another to take greater ownership of our health and lead healthier lives, for a better future.
The Chairman: We have some time for clarifications. Dr Tan Wu Meng.
Dr Tan Wu Meng: Thank you, Mr Chairman. By way of clarifications, I have one observation and one question. First, regarding the Senior Minister of State, Dr Janil's observation that relooking healthcare needs to be through the lens of longer term issues in a COVID-19 world and looking at the larger social eco-system. I agree with this approach. It is essential in our approach to society and healthcare.
I have a follow-up question for the Senior Minister of State, Dr Koh, regarding the earlier point in my speech on the approach to outsourcing hospital cleaners and hospital attendants. I do not expect an immediate resolution to this question, but I will urge a longer term rethink once the COVID-19 crisis is over.
After all, COVID-19 has raised many questions of countries around the world. If it is supply chains, countries are looking, \"at just in time\" as compared to \"just in case\". And may I suggest that on issues of workforce, we also may want to look at economies of efficiency, but juxtaposing this and considering as well the resilience of solidarity across the entire healthcare team. And I hope MOH will consider this as part of a longer term review for the COVID-19 world, and what comes next.
Dr Koh Poh Koon: Mr Chairman, I thank Dr Tan for his clarification. I would agree with him that as needs evolve over time, and certainly COVID-19 is a very challenging time, for us to also take stock post-COVID-19, what kind of healthcare model will we have, and in that case, to build resilience within maybe certain critical parts of our healthcare system; do we need to review the current structure in which we engage with outsourcing of our staff?
So, I do not think we are ideological here but we will take an open-minded approach to review the needs and maybe talk to our healthcare institutions as well to see during this period, whether they have made useful insights and observations to warrant a change in the current approach.
But I also must caution that in insourcing back certain levels of staff within the system, we need to make sure that there is still a meaningful career progression and prospects for them as well. Because if they are a small number, for which there is little career progression, we need to also bear that in mind to balance out the needs of the organisation versus the aspirations of the person.
The Chairman: Dr Lim Wee Kiak.
Dr Lim Wee Kiak: Thank you, Chairman. I have two clarifications.
First, for the Parliamentary Secretary. Regarding the vaccination programme, I am happy to hear that a huge percentage of our seniors has been vaccinated for flu as well as for pneumococcal. The issue now is, of course, the outreach to the rest. There is currently now no specific outreach programme to reach out to seniors that have not been vaccinated. So, I hope that MOH can review this and then take a look.
When I take a look at the HealthHub apps, there is immunisation charge based on age, but the age stops at 26 years old. Beyond that, there is nothing. So, can MOH take a look at it to see how to expand that further.
My second clarification goes to the Senior Minister of State Janil. I would like to ask the Senior Minister of State on a hypothetical question: if COVID-19 outbreak were to happen in Singapore, in the sense, let us say it happened in November 2019, could our current system or our NCID have picked up the unusual presentation of pneumonia, and could we have the capability to diagnose such a novel virus? Looking back, do we have the ability to do so?
Ms Rahayu Mahzam: I thank the Member for the clarification question. Thank you for highlighting the issue with regard to the HealthHub age cut-off. We are, indeed, still developing the platform and we will be adding more information. So, I will bring this back and then we will develop it further.
In response to the query on the outreach for vaccination, especially the seniors, actually HPB has recently launched a public education campaign to encourage eligible individuals to get vaccinated, and getting them to increase their awareness. The key thing about vaccination is getting them to be aware of it. So, we did try to roll out a public education campaign and this is something that we can build on. The other thing is to work with the General Practitioners (GPs), with the doctors, to get them to routinely advise their patients on vaccination needs, especially every time they come to visit, we would ask them to inform their patients, so that this will also increase awareness and their interest and uptake for vaccination.
The Chairman: Senior Minister of State Janil.
Dr Janil Puthucheary: Thank you, Mr Chairman. If I understand the Member's questions correctly, if an outbreak had occurred now? With the capability we had then or the capability we have now?
Dr Lim Wee Kiak: In October 2019.
Dr Janil Puthucheary: So, with the capability that we had in October 2019, would we have picked up COVID-19 outbreak in October 2019?
The short answer is yes. We pick up outbreaks of disease on a regular basis. Our level of paranoia, anxiety, concern about this increased after SARS, as a result of which clinical teams across the healthcare network have to report any number of either confirmed or suspected infectious diseases. And we have surveillance systems.
So, the real answer is not really whether we would have picked it up, but how quickly would we have picked it up and how quickly would we have responded and put in place many of these strategies that we now see as normal for containing disease outbreak. Whether it is the testing, the tracing, speed of that, the ability to quarantine individuals, the ability to do the sequencing and stand up therapeutics. So, certainly, our capabilities have improved and increased quite significantly since the first outbreak.
So, the short answer to the Member's question is yes but we can do it much better today.
One of the reasons why we can do it much better today is because this is not SARS. We have learned the lessons from SARS, we have learned the lessons from COVID-19, and we have to prepare that Disease X, the next pandemic and the next crisis, will be like neither. And we need that institutional agility and institutional capability to deal with the unknown, which is one of the more difficult things that we have to do. I hope that answers the Member's question.
The Chairman: Mr Leong Mun Wai, please.
Mr Leong Mun Wai: Thank you, Chairman. I have two clarifications.
One is I think the Ministers and the Senior Ministers of State did not answer my query on how the public health services are being priced, whether it is based on marginal cost or average cost. Maybe I add a bit more information on that, specifically about whether it is based on amortisation of assets, land cost, rental cost, all these – I hope to be clarified.
Second question is on MediShield Life insurance scheme. I am actually still very puzzled why our healthcare insurance schemes are left open-ended. Because as one gets older, as Singaporeans get older, they will find it more and more unaffordable.
I have also spoken in my speech that when Singaporeans get older like 80 years old or 90 years old, the premium will become very high. For example, under two scenarios, when you keep the premium —
The Chairman: Mr Leong, can we not have a speech? Just ask your clarifications borne out of the responses of the Political Office Holders (POHs). So, please get to the point of your clarification.
Mr Leong Mun Wai: Okay. I would like to ask for clarifications that the MediShield Life Scheme indeed is unaffordable, as one gets older, and there is a drain on the CPF resources on the Singaporean And that is a very high number, up to $110,000 for a family. So, those are the questions I would like further clarification on. Because these are very important; has to be answered.
Dr Koh Poh Koon: Mr Chairman, I will attempt to explain the MediShield Life premium issue. I have actually done an extensive explanation when I gave an update to this House late last year. I think the answer still applies. Mr Leong should check the Hansard. I think his point that the MediShield Life premium is unaffordable, the older the Singaporean gets, is not correct. Because if he checks my speech in the Hansard, he would have understood the fact that, for the Pioneer Generation, who are the older Singaporeans in Singapore, they get MediSave top-ups to pay for their premiums. In fact, for many of the oldest in the Pioneer Generation, they get virtually free MediShield Life because they virtually pay no premium at all.
So, I do not think he understood what was said in the House last year and I urge him to read my speech all over again in Hansard.
The Chairman: Ms Carrie Tan.
Ms Carrie Tan (Nee Soon): Thank you, Chairman. My question is related to mental health. I thank the Senior Minister of State Dr Janil for sharing with us about the tremendous progress made in the Mental Health Master Plan, and to know that there is so much more infrastructure and community care facilities set up and that we are already ahead of targets.
But my question really is whether MOH has a view or is it currently embarking on any kind of study or upstream prevention campaigns, in the likes of when we identified diabetes to be a big healthcare crisis for Singapore, then we went on a very national campaign and we looked into reducing sugar and salt in our food in the hawker centre and so on. I remember when I was a child in Primary School, I was also in the Trim and Fit (TAF) Club to address obesity.
The Chairman: Ms Tan, if you could kindly ask your clarification.
Ms Carrie Tan: Yes. My question is: does MOH have a view or intention to study how we can embark on a prevention strategy to avoid this continuing trend of high incidence of mental health or mental illness amongst our population in the long run?
Dr Janil Puthucheary: Mr Chairman, the answer is yes. It is not just MOH that is interested in this. This is an area where the academics and the professionals working with people with mental health issues are very interested in looking at. This is not going to be an area that we can have complete prevention. We also have to research into areas about how we can help people cope and mitigate the mental health issues that they come across.
It is not going to be easy to pinpoint a single factor, just like diabetes. While we can concentrate our efforts on sugar or weight loss activity, we will have a variety of things to direct attention and the efforts of the individual in the family. But the reality is it is a wide space with many different causes and many different paths through it, and it will be something that requires effort from a multi-disciplinary team and, indeed, the whole of society. But the short answer is yes, we are very interested in this.
The Chairman: Mr Gerald Giam. Minister, my apologies, I did not see your hand.
Mr Gan Kim Yong: Thank you, Mr Chairman. Let me just add on to what Senior Minister of State Janil has explained. Mental wellness is quite a complex issue. And, very often, is not just a medical issue. Therefore, very often, when we want to address challenges of mental well-being, it will have to go beyond MOH. That is why we are forming a multi-agency platform to allow the various agencies including MSF, and including MOM to look at the workplace mental well-being; and including MOE to start from young.
So, it is a multi-pronged approach and it requires a whole-of-society involvement in this, particularly in preventive mental health. Because it requires a lot of support in the community to work with us, work with various Ministries and agencies, so that, together, we can better address the challenges of mental well-being and help our Singaporeans, particularly, the young, to be better prepared for the challenges that they are going to see, so that we can strengthen their resilience against mental challenges.
The Chairman: Yes, Mr Giam.
Mr Gerald Giam Yean Song: Sir, I have some clarifications for Senior Minister of State Koh.
First, can I confirm the Ministry's definition of PCHI is based on family members living under the same roof?
Second, what is the Ministry's main concern about allowing greater use of MediSave in polyclinics, SOCs and restructured hospitals? I know MOH is worried about premature depletion of the MediSave accounts. However, MediSave can only be used for medically necessary treatments, and the risk of doctors in these public institutions over-treating is minimal. And patients there also have little discretion to demand unnecessary treatment.
On the flip side, patients do retain their discretion to skip treatment to reduce out-of-pocket payments. This will impact the success of their treatment that may cause both the patient and the Government more in the long term.
Can MOH reconsider how prudent it still is to restrict the use of MediSave in these public healthcare institutions?
Dr Koh Poh Koon: Mr Chairman, I thank the Member for asking the clarifications. Yes, indeed, for PCHI, it is based on residents with the same household address, so that we know that they are staying in close proximity and they can mutually support each other.
In terms of MediSave usage for mutual support, in fact, you can designate a next-of-kin, for example, You can have your spouse or even the children, who may not necessarily be staying at the same address, can also add support with their MediSave to contribute to the care of their aged parents, who may not reside in the same address but they can use the MediSave from their children, and vice versa.
In terms of liberalising MediSave usage, we have through the years, allowed more and more uses for MediSave. You will remember that when we first started with the Chronic Disease Management (CDMP), there were only a few conditions that were in it. In the last few years, more and more conditions were added with considerations such as disease prevalence, whether they are effective treatment and whether there is clear treatment protocol, that can translate to a good outcome.
We are open to review the list of diseases that will be added on overtime as the science and the medical understanding develops as well, and in consultation with a panel of medical experts who can advise us on what they feel is useful to include in the CDMP list. We are always opening further opportunity to use MediSave, and as the Member pointed out, they could well be situations in which we could liberalise some more and we will continue to do so.
The Chairman: We have got time for just two more clarifications, so could I invite Members to keep them short? Mr Yip Hon Weng.
Mr Yip Hon Weng: Thank you, Chairman. I am glad to hear from Minister Masagoes that the Ministry is reviewing the Senior Mobility and Enabling Fund. Can the Ministry provide more details about the focus area of review and when will the review be completed?
Mr Masagos Zulkifli B M M: I thank the Member for clarification. We will begin the review this year. Hopefully, by the second half but we do not know yet the scope nor the time that this will complete.
The Chairman: Last clarification, Mr Louis Ng.
Mr Louis Ng Kok Kwang: Thank you, Sir. I thank the Parliamentary Secretary on the reply on the IVF policies. There is quite a fair bit of good suggestions out there on IVF and that is why I filed so many cuts, Parliamentary Questions and Adjournment Motion. Could I ask whether MOH can consider setting up a citizen workgroup to really deep dive into this issue of IVF here in Singapore?
Ms Rahayu Mahzam: I thank Member for the suggestion. I am sure that this is something we can consider and I will follow up with the Member after the Budget and Committee of Supply debates are over.
Mr Leong Mun Wai: Chairman, excuse me, Chairman. My clarification on the pricing of the public health services has not been answered.
The Chairman: I am afraid Mr Leong, it is 5.50 pm, which is the guillotine time for this Head. So, Dr Tan Wu Meng, if would like to withdraw your amendment. Yes, Minister.
Mr Gan Kim Yong: Perhaps I can just give a very quick answer. First, we take into account all the costs that healthcare institutions incurred, because someone has to pay for these costs – whether it is the Government, whether it is the patient, whether it is the institution. So, we have to cost them fully.
Having costed them fully, the Government then provides subvention to cover the bulk of the cost of operation and the cost of investment in the building of the infrastructure. On top of that, we provide subvention for the patients when they go and see the doctors or they receive treatment at these healthcare institutions.
So, yes, we account for the cost of the building and the delivery of services. But at the same time, we provide subvention and subsidies for the patients and for the institutions' operations.
The Chairman: Dr Tan Wu Meng.
Dr Tan Wu Meng: Mr Chairman, I thank all Members for their cuts and I thank our Ministers, Senior Ministers of State, Parliamentary Secretary at MOH for their responses and sharing. The COVID-19 virus does not sleep. It does not rest and so are our healthcare frontliners, our agencies, our MOH officials have also had many sleepless nights because of this COVID-19 pandemic. Presumably, with implications for sleep health as Parliamentary Secretary shared earlier.
So, a big thank you to all who keep us safe, and in doing so, keep Singapore going. I beg leave to withdraw my amendment.
[(proc text) Amendment, by leave, withdrawn. (proc text)]
[(proc text) The sum of $17,355,401,300 for Head O ordered to stand part of the Main Estimates. (proc text)]
[(proc text) The sum of $1,489,629,300 for Head O ordered to stand part of the Development Estimates. (proc text)]
","clarificationText":null,"clarificationTitle":null,"clarificationSubTitle":null,"reportType":null,"questionCount":null,"footNotes":null,"footNoteQuestions":null,"questionNo":null},{"startPgNo":0,"endPgNo":0,"title":"Committee of Supply – Head I (Ministry of Social and Family Development)","subTitle":"Fostering a resilient and caring society","sectionType":"OS","content":"The Chairman: Head I, Ministry of Social and Family Development. Mr Seah Kian Peng.
Mr Seah Kian Peng (Marine Parade): Chairman, I beg to move, \"That the total sum to be allocated for Head I of the Estimates be reduced by $100\".
It is clear from the outpouring of support during COVID-19 that many Singaporeans want to do their part and help each other. This can be done in formal networks – through Government funding, schemes and institutions, but also, and perhaps more powerfully, through collaboration with informal networks – neighbours, friends and communities, including online communities.
Over the years, the formal networks have taken more care, and certainly less bureaucratic, less bloodless approach to help families in a holistic manner. In addition, the old governance philosophy of red tape and jumping through hoops has been replaced by a more respectful calibration, and thicker network of attention and care.
Today, we have one stop centres, we have multiple agencies working together, we have a lens focused on the person, and not a collection of problems. Since 2013, we have 24 Social Service Offices, or SSOs, to coordinate the delivery of services on the ground. I would like to ask the Minister give us an idea of the impact that these 24 SSOs have had over time. Are there plans to expand or scale back the offices?
Second, what has been the main gap that the SSOs have identified? Is there anything else that is missing in our delivery system? Have we asked for feedback from the families and people that we have helped, and see what we can do to improve the services?
Last, but not least, how can we better harness the power of the community to strengthen support for those in need? How can we seed and how can we facilitate such community efforts to maximise the impact and benefits to Singaporeans?
[(proc text) Question proposed. (proc text)]
The Chairman: Mr Seah Kian Peng, if you would like to take your next two cuts together, please do.
Mr Seah Kian Peng: Thank you, Chairman. As social needs grow, it is important for the Government and the community to partner each other to better meet these needs. I had earlier spoken on the power of community in terms of delivery of social services. We can harness the same power in partnership.
During COVID-19, especially during the circuit breaker, many of such partnerships between the Government and community demonstrated their value in meeting increased social needs, such as the PEERS Network and the Charity Food Workgroup.
Even as we take care in terms of fiscal prudence, audits and careful use of public monies, we must also count in the intangibles that such networks bring.
How does the Ministry intend to strengthen such partnerships? What are some of the safeguards and audit measures we can bring into play No one likes an overweening state – and help comes much faster, and in much a friendlier form, when organised and implemented by people we know.
We need strong partners in the community and it is useful to see how much the people and public sector can work together.
Singapore's social safety net was the first and strongest weapon we had against the pandemic. This net – which allowed us some measure of certainty in a very precarious situation, comprised financial assistance, as well as social support such as employment assistance and jobs creation.
It is thanks to this that we dodged many of the bullets that we now see, even in developed countries – the long queues of people at food banks, the homeless on the streets, the disproportionately larger load of poorer people in hospital due to COVID-19.
It may seem here that COVID-19 hurt the poor and the rich equally hard, at least in terms of vulnerability to the virus. However, we must open our eyes to the fact that in any downturn, any downturn, it is the poorest among us who are the most vulnerable.
MSF most recently launched the COVID-19 Recovery Grant (CRG). Can the Minister provide an update on the CRG, as well as how the CRG is designed to help its recipients get back on their feet? Can the Ministry also provide an update on job creation efforts in the social sector?
We need all of us to emerge stronger from the pandemic – not just the strongest, but the weakest among us too. I think we did right in focusing the bulk of our help to help businesses preserve jobs, but I think we must also work at the social end of the stick – take stock of how well the measures worked, what more we need to do, and what we need to change. Let us focus on the outcomes, I would like an update on that.
Mr Melvin Yong Yik Chye (Radin Mas): Chairman, since the onset of the COVID-19 pandemic, this Government has moved quickly and decisively to strengthen our social safety net to support Singaporeans who have lost their livelihoods.
The expansion in our financial assistance schemes, as well as the strengthening of our social support systems, in areas such as employment assistance and jobs creation, have been helpful in assisting the vulnerable segments of our society.
MSF recently launched the new COVID-19 Recovery Grant (CRG) to support lower to middle income employees and self-employed persons whose livelihoods continue to be financially impacted by the pandemic. Can MSF provide an update on the CRG – how many have applied, the average success rates, as well as reasons why applications have been rejected – and share more on how this grant is designed to help the recipients?
Sir, the pandemic has also affected our care-givers, particularly the informal care-givers who perform their duties full-time but without an income. Care-givers are an important pillar of our social safety net, performing their duties invisibly, to prevent vulnerable Singaporeans from falling onto the Government's social safety net.
We need to provide better support to the invisible hands that help us to stich the safety nets above the state's current resources. What are the Ministry's plans to better support care-givers, and to alleviate some of the current burdens that they face?
Lastly, can MSF provide an update on job creation efforts in the social sector? Is there a need to increase the number of jobs in this vital sector, so that we leave no vulnerable Singaporean behind?
Ms Joan Pereira (Tanjong Pagar): Chairman, the COVID-19 pandemic has brought to the fore the important role of our social service delivery. I would like to take this opportunity to put on record my heartfelt appreciation for the staff at our Social Service Office (SSOs) and partner Social Service Agencies (SSAs) and the volunteers and donors who contribute their time and money. I would like to ask a few questions about the Ministry's plans to strengthen the delivery of social services by the SSOs and SSAs.
In order for our social service delivery to reach the needy, we must increase public awareness and boost our detection mechanism. Awareness is the beginning of the delivery process. Awareness of where and how to get help will draw those who need it. On the other hand, there are people who need help but do not or are unable to seek assistance for various reasons.
If the SSOs or the communities are aware of them, we will be able to reach out to them. I would like to ask if the Ministry would share an update on its measures to strengthen its capabilities on these two fronts.
Next, many disadvantaged families and individuals have a range of needs which require intervention by different community agencies. However, not all their needs are always presented to the officers and volunteers. How will the SSOs and SSAs improve on their abilities to detect such issues to ensure that their cases receive holistic help? When encountered with complex cases, how do the various teams of professional staff and volunteers coordinate their work? What procedures are in place to minimize duplications and blind spots?
Another point I wish to make is making it easier for the applicants to access help. Hence, I would like to suggest that we locate mini-SSOs in areas where rental blocks are sited as most of the residents who need help reside in our HDB rental blocks. The mini-SSOs can pull in the necessary resources from the neighbourhood or nearby precincts to help the varied needs of these vulnerable families and provide them with holistic assistance. Help can be more targeted as they cater to these few rental blocks in this particular precinct.
Finally, how is the Ministry leveraging on technology and IT systems to increase efficiency and productivity in social service delivery?
The Chairman: Ms Denise Phua.
Ms Denise Phua Lay Peng (Jalan Besar): Chairman, Sir, during the COVID-19 pandemic in Singapore, we witness many acts of kindness especially the lost, the least and the last in society. I work with some of the best social service professionals from MSF and social service agencies, grassroots and non-grassroots volunteers in my district.
Despite this, there are still gaps in the last mile of social service delivery that need to be addressed. I will touch on three Cs – Coordination, communication and ComLink.
Coordination. A common sight on the ground especially in rental housing estates is an overlap of services such as free distribution of food, masks, groceries, health screening and even home cleaning. During a recent long weekend before the Lunar New Year, I met six groups, some are regular and some are ad hoc, distributing lunch bento boxes to the same group of rental residents. Is there a more effective way of coordination so that there is less overlap, less wastage and better allocation of precious resources?
Next, communication. Sir, it is not uncommon to read from social media anecdotes of vulnerable persons such as the homeless, tissue paper sellers and \"beggars\" sometimes outside places of worship where there are many kind devotees. Yet, from my work with many Social Service partners, including volunteer groups, such as Mummy Yummy, Homeless HEARTS and Keeping Hope Alive, I know that many current help channels do exist. Can the Ministry facilitate a national communication plan at both strategic and tactical level, so that many more know where to get help or to help signpost where help can be obtained? My CDC, of course, would be a willing partner.
Finally, on ComLink or Communication Link. ComLinks are piloted to bring together various service partners to provide holistic solutions to vulnerable families with children. In Central District which I oversee, there are many elderly singles and couples living in rental flats. Can ComLink be scaled to include these households although the elderly, for example, are technically under MOH. Can Government give more resources to MSF so that can comb entire rental housing blocks and not only specific profiles?
The Chairman: Mr Don Wee.
Mr Don Wee (Chua Chu Kang): Chairman, I would like to urge the Government to consider implementing a seamless application process for the disadvantaged children who require financial assistance to attend schools. Social Service Offices’ records about their families can be shared with MOE and schools, so that the children do not need to apply for the Financial Assistance Scheme, school pocket money fund and other related programmes separately.
For the underprivileged families, the adults are already struggling with a multitude of problems. Navigating assistance schemes is not easy for them, much less for their children. As a Smart Nation, we can tap upon information technology to make the process easier for all stakeholders using data integration. The seamless integrated financial assistance application process will need more proactive and closer collaboration amongst the involved Ministries – MSF, MOH’s NEHR MND as well as the approved financial service centre's database on kids studying or staying in the rental HDB units.
The Chairman: Mr Mohd Fahmi bin Aliman.
Mr Mohd Fahmi Aliman (Marine Parade): Chairman, in 2019, MSF announced that it will be setting up four social service hubs, to be named ComLink, at Jalan Kukoh, Marsiling, Kembangan-Chai Chee and Boon Lay over the next two years. These clusters were selected due to the sizeable number of families and children living in rental flats in those areas.
According to MSF, this pilot project announced at Committee Of Supply 2019 provides proactive and integrated support to an estimated 1,000 families living in rental flats to help them achieve sustained stability and social mobility.\" This includes supporting families with the potential for homeownership. Minister Desmond Lee mentioned in Parliament that, \"Most importantly, ComLink will develop a sense of community and mutual help, with neighbours supporting one another in their journeys.\"
Since its inception, has the pilot succeeded in meeting its intended outcomes? Moreover, are there any learning points to be taken away from this pilot project? Also, are there any plans to extend this programme to leverage local community partnerships to support the needs of the families? If so, how will this programme be scalable on a national level in the coming future?
The Chairman: Mr Xie Yao Quan.
Mr Xie Yao Quan (Jurong): Chairman, I just realised it is quite apt that the mask I am wearing today has a 招财猫 on it because my next cut is about money and donations.
Chairman, while donations for specific causes such as supporting those affected by the pandemic have increased, many other organisations have experienced a reduction in donations due to COVID-19. This could hamper the ability to deliver essential social services on the ground and Deputy Prime Minister Heng himself has noted that, and I quote, \"Some charities even had to dip into their reserves to keep operations going. This affects the help that goes to those who need it.\" As such, what are the Ministry's plans to encourage more giving despite this on-going challenging times?
The Chairman: Mr Seah Kian Peng. If you would like to take both your cuts together, please do.
Mr Seah Kian Peng (Marine Parade): Thank you, Chairman. Under the new Change for Charity Grant, a $20 million fund will be set aside to match Community Chest’s donations raised through spontaneous acts daily. It was also mentioned that ComChest will be partnering businesses to provide opportunities for customers to donate to Community Chest through their payment platforms. This could not be more timely as we know many charities, VWOs and social service agencies are currently facing a challenging environment caused by COVID-19. We should certainly encourage individuals to give as part of their daily lives; ComChest should also partner and make it convenient for businesses to provide opportunities for customers to donate through their payment platforms. We all know that Singaporeans, everyone here, has a big heart. So, if we make that facility available, convenient and accessible, I think great things could come out of it.
I would like to ask Minister if he could outline more details on how to ensure the success of this scheme? Now putting on my hat as the group CEO of NTUC Fairprice, I want to assure Minister that we will certainly give this scheme a full consideration and do our part to make lives better for the community.
COVID-19 has caused a significant amount of disruption for the pre-school sector, especially during the circuit breaker. We often think little children spend most of their school time in physical activity and play – which many do – and rightly so. However, the experience of the pandemic has taught us that there will be occasions when pre-school students will have to stay at home for long periods as well.
How will the pre-school sector be supported to emerge stronger from the experience of COVID-19?
Pre-school teachers may benefit from more training, which will enable them to explore innovations in online teaching methods. They could also be supported with grants and new hardware as well as software, so as to allow them to contribute to their students’ development, even when teaching from home.
Second, can we also explore how pre-schools administration can benefit from greater digitalisation, including providing their staff with remote working and learning opportunities. Our pre-school teachers are some of the most imaginative and dedicated in Singapore. We have quite a few of them in our NTUC First Campus. We must help them to succeed in a digital world.
The Chairman: Ms Carrie Tan.
Ms Carrie Tan (Nee Soon): Chairman, although ComCare has helped many low-income persons and challenged families and is a critical social support programme, the number of families helped and the amount spent on ComCare has not reduced, in fact increased, since its inception.
It tells me that ComCare, although it is very helpful as a support, is not getting people out of poverty permanently, and this is not a solution built to last. Without capacity-building of families who are on ComCare, it serves only as a band-aid solution that continues to deplete our financial resources. I am not saying to lower the budget for it, but I am saying we need a clear strategy to supplement ComCare, aimed at empowering families beyond surviving, to facilitate their thriving and reduce their recidivism back to financial support.
And to do this, we need more people who are well-versed in discovering and harnessing the assets and strengths of the community, and to transform the current recipients of aid into active contributors in the community and also pave their way towards higher employability.
I would like to ask if asset-based community development is the intended approach by ComLink, and whether there are plans to dovetail ComLink efforts with the National Jobs Council efforts?
I ask this because I see a ripe opportunity for the transformation of our social services sector. An opportunity to develop empathy and empowerment at scale, to better harness the strengths within our challenged individuals and families.
While I am grateful for the numerous COVID-19 support schemes that have been given out so far, frontline administrators in our SSOs are over-stretched and inundated with very onerous but necessary task of administrative checks and gatekeeping. And we need to help them out, and we can, by augmenting the sector with more personnel, trained professionally in asset-based community development.
With many professionals impacted by lay-offs and a surge in community spirit brought by COVID-19, we now have a pool of highly qualified people, who are seeking more meaningful careers that can be harnessed for the social services sector.
While I feel very encouraged by the announcement of the Community Capability Trust to help SSAs develop capacity, it will be more timely to complement the efforts of the National Jobs Council if MSF can bring this forward to this year instead of commencing only in 2022.
I hope MSF can accelerate its support to the sector and enhance ComLink’s efforts by appointing qualified Social Service Agencies with good track records to train mid-career entrants in community-building and assets discovery work. Trained personnel can then be hired and deployed through SSOs or grassroots organisations. This will help SSOs to enhance its function beyond administrators of support schemes and connectors within the community to become effective community builders.
With that, I would like to convey my high hopes for ComLink, and I look forward to more job creation in the social services sector, to enable the empowerment of our ComCare recipients into a community that thrives.
The Chairman: Mr Shawn Huang.
Mr Shawn Huang Wei Zhong (Jurong): Mr Chairman, may I take my cuts together? Five minutes apart.
The Chairman: Together with your cut at (o), you mean?
Mr Shawn Huang Wei Zhong: Yes.
The Chairman: Alright then.
Mr Shawn Huang Wei Zhong: Thank you. The community, including the social service agencies (SSAs), community groups and corporates, play a critical role alongside the Government in supporting the social needs of Singaporeans. Amidst the disruption caused by COVID-19, we saw many SSAs that rose to the occasion and adapted to the new operating environment to deliver social services to those in need.
However, it was also through this crisis that we have learnt that we will need to have better coordination amongst different SSAs to leverage on one another’s strengthen and expertise to deliver targeted assistance to families to better identify specific needs with the most appropriate solution at the right time. We have also learnt that we need to further strengthen our outreach capabilities and ability to communicate with those in need, especially remotely via teleconferencing. Many SSAs can reap productivity gains if they have had deployed suitable toolkits and platforms within their organisations. However, many lack the resources and the capacity to develop and maintain these capabilities.
To build a better eco-system of social and welfare support, what are the plans to help SSAs further unlock productivity and strengthen resilience?
COVID-19 is one of the first major crisis in the lives of many youths. Due to the disruption in routines and social activities, many youth’s mental health and well-being were affected. However, prevention is always better than cure. Education, awareness and timely persistent community support are important aspects to ensure that our youths develop resilience, understanding and pathways to better manage their own mental well-being. Friends, family, loved ones and those around, must have a keen ability to identify symptoms. In other cases, a better understanding of the youths' environment can help identity risk factors and mitigating measure early.
Can MSF update on how the youth mental well-being network can help support our youths' mental health and well-being through future crisis and COVID-19 and beyond?
Ms Sylvia Lim (Aljunied): In 2019, the Ministry introduced four significant updates to the Children and Young Persons Act.
First, changes were made to enhance the safeguarding of abuse on neglected children; second, the rehabilitation and re-integration of youth offenders was strengthened; third, parents with difficulties managing their children were to apply for family guidance orders replacing the formal BPC or Beyond Parental Control orders; and fourth, community resources to support vulnerable children were increased.
These amendments are very significant.
One of the key changes was to amend the definition of \"child\" to include youths, not exceeding 18 years of age in line with the UN Convention on the Rights of the Child which Singapore has signed. This increase by just two years would require real adjustments by the various agencies involved to cater to the older youths between 16 and 18 years of age.
Another significant change is the new FGO regime which provides for compulsory attendance at family programmes even before parents can file a court application. The amendments were effective in July 2020 and I appreciate that only half a year has passed.
Nevertheless, what is MSF's interim assessment of the impact? For instance, how have the juvenile rehabilitation centres cope with increase and different caseload? Have children been better served under the FGO regime compared to the BPC regime?
Mr Murali Pillai (Bukit Batok): Mr Chairman, Sir, youths continue to feature significantly in the crime trends involving drug abuse, secret societies and criminal activities. Recently, there was also a disturbing report of a youth being self-radicalised to become a terrorist.
How do we help such youths through their families and other partners such as schools, self-help groups and social service agencies to build up their resilience to guard against such negative influences, ensure that each of them will be given opportunities to realise their full potential? What has been the outcome of the measures put in place to assist youths at risk thus far? How effective are they? These are the focus areas of my speech.
In 2016, the Government put in place the Youth-At-Risk Engagement (YARE) Framework to support youth-at-risk (YAR). It was to have lasted three years, with the aim of helping 900 young people through 10 service providers. These agencies would then be trained and use standardised assessment tools to their work with young people.
In 2018, the Government set up the National Committee on Prevention, Rehabilitation and Recividism (NCPR) to oversee national efforts to prevent offending, re-offending and enhance rehabilitation of offenders. The scope of NCPR includes at risk children and youth. I am a member of NCPR.
Working with people whether young or old, requires a human-centred approach, being sensitive to specific home contexts as well as the personality of the youth. Our current programmes include mentorship and sports. Mentorship was a topic that the hon Member of Parliament Miss Rachel Ong touched on during the Budget debate last week when she proposed that youths at risk have long-term mentors. I agree with her. It will be good to understand what has been the outcome of these programmes to date? Do we need others?
Relatedly, do we have enough youth workers, and do they receive enough support? What emerging threats does the Minister see among our young people today that we need to guard against?
Mr Xie Yao Quan (Jurong): Chairman, our youth today are woke about mental health and well-being, not only for themselves but also in terms of how all of us as a society have a role to play to support and journey with those who are coping with mental health challenges.
Our youths are woke about acting on mental health, acting on the reservoir of stigma that still persists today and woke about encouraging and making sure that all those who need help actually come forward to seek help.
How can the Ministry better support our youths in their efforts to advance and champion mental well-being and, specifically, the Ministry has set up a Youth Mental Well-being Network? Can I ask what is the role of this Network, what has been its progress, especially in terms of outcomes and what are the Ministry's future plans for the Network?
Mr Mohd Fahmi Aliman: Chairman, according to MCCY, our youth volunteerism rate has gone up from 23% in 2008 to 40% in 2018 for youths aged between 15 and 24 years old as well as 13% in 2008 to 27% in 2018 for youths aged between 25 and 34 years old. Moreover, youth participation in social groups has generally gone up from ages between 15 and 34 years old from 2010 to 2016. Besides the increase in youth volunteerism and participation rates, our youth have also made remarkable contribution to our community.
In 2018, then Minister for Culture, Community and Youth, Minister Grace Fu, underscored the story of Kenneth and Yin Loong who were among the 15 youth who received Meritorious Youth Award at the People's Association Youth Movement Awards and Central Youth Council Installation ceremonies. Both Yin Loong and Kenneth have been volunteering for more than a decade. Through the Day of Giving series, Yin Loong in Kolam Ayer CCYEC organised food ration contributions and movie screenings for the disadvantaged. In 2017, Day of Giving mobilised 200 student volunteers to make 8,000 cupcakes for old folks' homes island-wide. Therefore, besides the increased rates of youth volunteerism and community involvement, our youth have made deep and everlasting impact on our social fabric.
In light of heartening trend of youth volunteerism and community development, how have we empowered and supported our youth to build a more resilient and inclusive society together?
Mr Chua Kheng Wee Louis (Sengkang): Chairman, I understand that by around 2025, 80% of pre-schoolers can have a place in a Government supported pre-school, up from about 50% in 2019. While the Government has increased the number of infant care and childcare places over the last five years, this is still woefully inadequate in towns such as Sengkang, which has the highest number of young children across Singapore by planning area with 17,000 0 to four-year-olds and about 17,000 five to nine-year-olds as of June 2019.
As such, while there may be vacancies in the system today, this may not be so for particular areas with high concentration of young families. What is the target total number of centres and places that will be offering infant care services and childcare services in 2025 and where will these be located?
Mr Don Wee: Chairman, the efficiency of our nation is powered by many hardworking men and women who work around the clock to support us – the workers who start packing your online orders in the warehouses at midnight, the healthcare staff who tend to our sick and wounded as our city sleeps, the fishmongers who collect our seafood supplies from Jurong Fishery Port, the list goes on.
For shift workers who do not have family support and cannot afford to hire a foreign domestic helper, getting evening and overnight childcare services for their young children is a big challenge. There have been cases where lower Primary school kids are tasked to look after younger siblings or where children are entrusted to incompetent babysitters.
Will the Ministry consider setting up an islandwide network of evening and overnight childcare services for shift workers to ensure the safety and well-being of their vulnerable children?
Ms Joan Pereira: Chairman, as the early years of people’s lives have such a big impact on their lifelong health, cognitive and psychological conditions, great care should be taken to nurture and develop our children. The Government has committed significant amounts of resources to improve the accessibility, affordability and quality of all our pre-schools. However, a child’s development is also heavily dependent on the home environment.
For disadvantaged children, the Government has implemented various initiatives to support their families and enable them to give their children a good start in life. With holistic assistance measures and more conducive home surroundings, these children will stand a better chance in our competitive economic and social environment.
I am heartened that under the KidSTART programme, the development of children from vulnerable families will be monitored and nurtured from the day they were born. The Early Childhood Development Agency (ECDA), which leads this programme, provides support for child development and coordinate the social services for the needy families.
Can MSF share the progress of this programme and its expansion plans? How many more regions will KidSTART expand to and how many more children are expected to be covered? Will the Ministry also provide an update on the status of the \"Growing Together with KidSTART\" initiative? What has been the feedback from the beneficiaries so far?
ECDA partners the Social Service Offices, Family Service Centres and hospitals to support this group of underprivileged children. Will ECDA consider partnerships with suitable community organisations in the proximity of the children’s homes and with the private sector to widen the scope of programmes which can benefit not just the children but also their families?
The Chairman: Ms Ng Ling Ling, if you would like to take both your cuts together, please do.
Ms Ng Ling Ling (Ang Mo Kio): Thank you, Chairman, I will take my both cuts together.
Chairman the importance of early childhood care and education through pre-school cannot be over emphasised in a country like Singapore, where the quality of our human resource has significant impact on our national success. With the increasing Government spending on early childhood care and education of more than $1 billion annually and growing, it is an investment in the right direction. It is still a small fraction of what Singapore normally spends on education system.
Sir, more must be done to ensure a good start for every child in Singapore. I am glad that the shortage of pre-schools in Singapore has been acknowledged and expansion efforts been put in by the Government as early as 2012.
During both the 2017 and 2019 National Day Rallies, Prime Minister Lee also spoke about the initiatives to further develop and boost the pre-school sector. Plans announced so far, including increasing the number of Government-supported pre-schools from about 50% to 80% and enhancing pre-school subsidies for more families to be eligible, are all welcomed but may not be sufficient.
While the Singapore Pre-school Accreditation Framework, or SPARK, is also a good tool to continually enhance and assure quality education in pre-schools, only about 50% of pre-schools are SPARK-certified so far. This may leave parents, whose children are attending the other 50% of pre-schools, wondering about the quality of education that their young children are receiving.
In a few housing estates with high childcare demand, parents are still experiencing waiting times that can range from a few weeks to a few months. For parents needing to return to work and having no alternative help, this can be a daunting wait. In my constituency, where there are new Build-To-Order (BTO) flats, such as in the Buangkok Crescent area, I regularly receive requests from young couples seeking help to ensure that they can secure a pre-school place for their children in order for both parents to return to work. I constantly assure them that a place will be availed to them as soon as possible.
Sir, in Germany, they introduced reforms guaranteeing a place in childcare for every child aged one and above in 2013. Its purpose was to influence peoples' decision to have children in a rapidly ageing society and tackle the nation's long-term demographic change.
Singapore faces the same demographic challenge. To battle Singapore's stubbornly low total fertility rate, we must do more to give assurance to couples that they will not have to worry about having a pre-school place when they give birth to more children. We need to accelerate the pace of the roll-out in regions with a higher proportion of younger families.
Sir, I will like to ask for an update on the progress towards the goals and timeline set to close the demand, supply and quality gap in pre-schools in Singapore. Knowing that a reliable pre-school can be counted upon to look after their children will be paramount for many young couples to have the confidence to have more children.
Every child is precious, notwithstanding what background they come from or what abilities they have. Appropriate early-years intervention and support have proven in many research studies to be critical for children with developmental needs. Children with developmental needs deserve a good start in life, the same as any children in Singapore.
I will always remember fondly of the times that I visited the various Early Intervention Programmes for Infants and Children, or EIPIC, run by the social service agencies during my days in the National Council of Social Service. Despite their different abilities, seeing these children being given the opportunities to learn and acquire new knowledge and skills was heartening.
However, I have always hoped for the day when all our pre-schools will be fully inclusive so that our children, with or without disabilities, can learn and grow together. This will not only assimilate children with disabilities or developmental needs to other children of typical growth earlier in their growing years, it can also develop awareness and empathy in children with normal growth to include their peers with different abilities in play and in activities. Research studies also indicate that typically developing children in inclusive settings perform comparably with or better academically than those in non-inclusive programmes. Sir, I would now like to speak in Chinese.
(In Mandarin): [Please refer to Vernacular Speech.] Every child is precious, notwithstanding what background they come from or what abilities that they have. Appropriate early-years intervention and support have proven in many research studies to be critical for children with developmental needs. Children with developmental needs deserve a good start in life ‒ the same as any children in Singapore.
\tDuring my days in the National Council of Social Service, I participated in various Early Intervention Programmes for Infants and Children run by social service agencies. Despite their different abilities, seeing these children being given equal opportunities to learn and acquire new knowledge and skills was very heartening.
\tI have always hoped that, one day, all our pre-schools will be fully inclusive so that our children, with or without disabilities, can learn and grow together. This will not only assimilate children with disabilities or developmental needs with other children of typical growth earlier in their growing years, it can also develop awareness and empathy in children with normal growth. Research studies also show that typically developing children in inclusive settings perform comparably or even better academically than those in non-inclusive programmes.
(In English): Sir, back in English, please. The move for Early Childhood Development Agency, or ECDA, under MSF to oversee early intervention services and pre-school services from the end of 2020, with the transfer of early intervention functions from the Disability Office in MSF to ECDA is an encouraging move towards inclusive pre-schools.
MSF has also launched an inclusive pre-school workgroup to strengthen the support for children with developmental needs. I will like to ask for an update on the plans and implementation for having more inclusive pre-schools in Singapore.
As the third Enabling Masterplan 2017-2021 will come to an end this year, I would also like to ask MSF how it will engender more creative and impactful ways of nurturing children with disabilities from their early childhood period to better achieve their fullest potential as integral and contributing members of our society.
Mr Don Wee: Mr Chairman, for lower income families, coping with children with special needs is particularly difficult. These families are already struggling financially and with children who require more care, their ability to work and earn income is further reduced. In addition, therapies and intervention cost money and exert more stress on the families. I urge the Government to expedite and increase financial care assistance for them so that they can seek the appropriate therapies for these kids.
For many cases, regular intervention at the earliest opportunity can make a significant difference to their lives because young minds and bodies are pliable and have great potential to receive and retain treatments. With children, we have a \"golden period\" to help them reduce the severity of their conditions, so we should help the families seize the opportunity without hesitation. The funds spent on the therapies will be well-invested, subject to the guidance of the Government, who must draw up a list of qualified practitioners.
In addition, I would like to ask if all applicants for Special Student Care Centres (SSCCs) are able to enroll? Is there any shortage of vacancies and, if so, how many more places will be made available in the upcoming years?
Since July last year, MSF had increased the subsidies and broadened the income criteria so that more families qualify for the Student Care Fee Assistance (SCFA) scheme. Would the Ministry share an update on the impact of these changes and a summary of the profiles of the families and the children it has helped?
Ms Denise Phua Lay Peng (Jalan Besar): Mr Chairman, in the Parliament Adjournment Motion I filed in October 2020, I called for society to change the way it views persons with disabilities, or PWDs. I called for several key gaps to be addressed, for more progress reporting and for more inclusion of the voice of PWDs in policy-making.
I wish to speak on two other topics today.
First, on Enabling Masterplans for the Disabled. The Singapore Government has supported the development of three five-year Enabling Masterplans for the Disabled. These plans list recommendations to enable PWDs to realise their potential and to become integral and contributing members of society. The current plan will be expiring this year and a new one is expected.
I would like to seek the latest update for the current third Enabling Masterplan. Next, I would also like to propose suggestions for the next Enabling Masterplan.
The current Enabling Masterplans take a life-cycle approach and cover general disability issues. But the needs of different disability groups are not homogeneous. I hence propose that the next masterplan also incorporate the inputs of each major disability group. The autism group, for example, where I help and volunteer, has just completed their own enabling masterplan, which I hope will be supported by the Government and the rest of society.
By encouraging each major disability group to take ownership, study the landscape, prioritise their top needs and invite solutions and partners, the national Enabling Masterplan will be all the more relevant and richer in content.
Masterplans that are five years long also should be constantly updated and reported to reflect the latest achievements and challenges. The last published third Enabling Masterplan (EMP3), for instance, was not updated with the most significant change of our time—the COVID-19 pandemic.
Next, on strengthening disability social service agencies, or SSAs. Many of the early intervention, special education and services for PWDs are run by these social service agencies. They provide disability expertise and harness the support of the community assets.
Beyond programme grants, the Government has been supportive through measures such as the Government matching of charity donations through the 250% tax exempt benefit and the latest Change for Charity initiative. I call for the Government to provide more tailored support to its partner SSAs.
Smaller SSAs will need greater support in resources such as shared services in fundraising, human resource, volunteer management and financial reporting and compliance. Larger SSAs too will need support. It is a fallacy that larger charities do not need help nor that they will naturally do well on their own.
Just as Deputy Prime Minister Heng has encouraged the support of large local enterprises (LLEs), so should the same be considered for these larger SSAs.
Some specific ways of support include the following.
Identify their needs and support larger SSAs as they scale or develop deeper capabilities to move into new essential territories. Seed and better support the social enterprises of these SSAs so they can help meet targeted social bottom lines that are important for the community such as jobs in sheltered or supported worksites.
Next, pay or co-fund corporate services such as the CEO and key financial, technology and human resource positions so that these SSAs can focus on and excel in their core services. Most donors do not fund important corporate services, but these are essential for compliance, for growth and for governance.
Help the larger SSAs safely generate better returns from their reserves, which are sometimes large because of the need to save to pay for recurring high-cost services such as day activity centres. Consider setting aside a percentage of Singapore Savings Bonds or infrastructure bonds for the larger SSAs.
Sir, in conclusion, the only way to predict the future is to help create it. The disability sector needs as much help as it can get. The Government cannot do it alone.
Ms Rahayu Mahzam (Jurong): Mr Chairman, I gave birth to my son, Ayden, in 2017 and having him is one of the best things that has happened in my life. Ayden has Down Syndrome and was also recently clinically diagnosed as being on the autism spectrum. There are some challenges for the family but I have so many things to be grateful for and I am glad for the support that I receive to raise my child.
I am grateful for a Government that cares. The Enabling Masterplans and their evolution over the years reflect the efforts of the Government in creating an inclusive environment for persons with disabilities (PWDs). This is an on-going effort and we need to continue building on existing initiatives, but I am grateful for the effort of the team at MSF, who continues to look at various ways to support PWDs and their families.
I am also grateful for activists and advocates who have blazed a trail for many PWDs and their families. Take hon Member, Ms Denise Phua, for example. Her years of advocacy and labour of love opened the doors for discussions and reviews and led to many meaningful initiatives that have made an impact to the sector.
I would also like to mention Dr Lim Hong Huay and the team at Caring SG. I would declare at this juncture that I have been asked to sit as an advisor to this organisation, but I must sincerely say that I am heartened by the efforts and their passion to support care-givers of PWDs and provide them with helpful resources.
I am also truly grateful and indebted to family members and friends who have provided unconditional support and love and have made this journey so much more meaningful. Their kindness and graciousness have let me to believe that there are many out there who are open and willing, and are keen to see a more inclusive society, one that embraces different abilities.
In my own experience and through conversations with parents of PWDs and people in the disability sector, there are still concerns about the level of understanding and inclusiveness in our society. Many parents have shared about unkind remarks people have made to them or the rude stares they receive when their child misbehaves in public. Some parents have shared about challenges they had in finding a suitable child care or pre-school in the vicinity of their neighbourhood. I have heard many instances of PWDs, especially those with intellectual disability, being bullied or taken advantage of in school or at work.
Above all, what families of PWDs hope to see is for their family member to be treated with dignity. They are no lesser human beings and are as entitled to be treated with respect, like any of us here.
At this juncture, I would like to offer some observations and thoughts on creating a kinder and more inclusive society. Firstly, I would ask if the Ministry has been tracking the effectiveness of the various campaigns and effort in encouraging the public to be more inclusive? I am heartened by efforts by various agencies like the \"See The True Me\" campaign and I am always excited to participate in events like the Purple Parade. I believe there is now more awareness and sensitivity, but there is still some way to go before we can say that our community is truly inclusive and embracing of people with different abilities.
Have the different campaigns and efforts to encourage inclusiveness in the community been successful? Do we have indicators in place to help us measure how we are doing as a community and targets which we can work towards? What more can we do to nudge behaviours and encourage people to be more open and compassionate towards PWDs and their care-givers? May be useful to do a review of study so that we could assess a better approach to build on the current efforts.
Secondly, I would like to propose that we take a more holistic approach in looking at opportunities to normalise different abilities within the society, in school, at work, and then the community. PWDs have much to offer society. We should equip PWDs with skills and empower the community so that PWDs may contribute to society in some way.
I had in my speech for MOE's COS debate, shared my thoughts on how this could be done in the school setting. I would encourage a similar approach for the workplace and in the community. For example, I think there is a need to engage extensively and meaningfully with employers to create better understanding of different abilities and provide support for the redesigning of jobs.
I appreciate that there are already efforts on this front and it is a challenging exercise. I feel though, in the long run, there is much value to be gained. Otherwise, we will continue to typecast PWDs, especially those with intellectual disabilities to just do menial tasks and we do not get to tap on their full potential. Another area, I believe we could work on, is to develop various infrastructure within our communities to accommodate different needs. We do see a few inclusive playgrounds, Braille in the lifts, quiet rooms in public places. And that is always very encouraging. However, such awareness and sensitivity to various needs should be more pervasive as we continue to build our common spaces in this country.
Thirdly, I think we need to continue to educate the community on the appropriate norms or social interactions and empower them to embrace people with different abilities. We should create opportunities for PWDs to fully participate, physically and socially, in the community, but I think we also need to learn how to do so meaningfully. I have been to events where PWDs were invited to attend as guests, but they were seated at a separate table or space and there was no interaction with the rest of the participants or guests.
Some families of PWDs would get upset or offended with reactions from the public. I think often people behave the way they do because of ignorance. I believe the Government can play a role in educating and creating understanding, but families of PWDs also need to be open and willing to embrace people who lack understanding, not shun or criticise them. Teach them, tell them kindly about the appropriate vocabulary, the appropriate approach, the appropriate way to interact. I believe that a conscious approach of integration and inclusiveness is necessary at the policy, organisation and individual level. I hope that we will continue to grow as a nation, to be one that truly cares for the vulnerable and embrace differences.
Ms Mariam Jaafar (Sembawang): Chairman, it may be difficult for some people to understand just exactly how it feels for some of us, to look around this gallery and see so many women in Parliament.
In the private sector, organisations like DBS Bank, have led the way with several women in leadership positions. But we are still far away from translating gender equality in our schools to gender equality at the leadership levels, both senior management and Board. And it is not just a matter of time, I have done the research. Around the world, this gap has persisted for a long time, long after we have achieved gender equality in schools.
Even in leading organisations, more can be done to push the envelope, for example ensuring that more women are in leadership positions in revenue functions, in addition to non-revenue, as well as technology functions.
Mr Chairman, it is proven that gender diversity drives performance. Our companies will do better with more women in leadership positions. In addition, women leaders are important because they are role models who inspire the future generation. So, out of the Conversations on Women's development, what are the emerging ideas for what more can be done to really move the needle on getting more women in leadership positions?
The Chairman: Mr Seah Kian Peng, would you like to take your both cuts together?
Mr Seah Kian Peng (Marine Parade): Thank you, Chair. This is the year we have set aside to celebrate women. This may seem, to some of us, to be an artificial effort. Why do we need a year to celebrate women, when they should be celebrated all the time? Or, the word \"celebration\" – is it not condescending to \"celebrate\" women, as if it is something conferred by the power of men or by institutions?
All these could be true, but I feel the effort itself has merit simply because despite all the progress we have made in the last 50 years, many of the traditional inequalities still exist. Added to these are new ones of income and inherited wealth.
Sir, in celebrating women, we make gender salient, we confront biases that otherwise would not have been noticed. Unconscious bias is real, and sometimes, without intending, we do great harm. In these conversations, and to make any sort of progress, it is important to have some moral clarity.
One such issue has to do with apologies. It is important to note that when one apologises for a misstep, not just in relation on such gender biases, but in general, we should not hide behind \"misunderstood\" intentions, neither should we call on the person whom we offended to be gracious and \"forgiving\" about the matter.
It is time we recognise that the lack of malicious intent offers no shield, no defence against the harm that is done. Indeed, it is the very nature of unconscious bias that it is unintentional. So, when we apologise, we should certainly make the intentions behind our acts known, but we should also recognise that this is the start and not the end of the matter.
Women play many important roles in Singapore. They are mothers, care-givers, workers, and members of our society. And I am encouraged that the Conversations on SG Women's Development is focused on addressing the issues that women face at home, in schools, workplaces and the community in real life.
What are some of the issues which have been frequently raised by Singaporeans in the SG Conversation? In this effort, we must ensure that the interests of all women are represented. What is the profile in the Conversations on Singapore Women's Development?
In addition, this conversation takes place within a society, a society of all of us. How many among these are men? What are their views? I recall when I served on the Board of Directors of Centre for Fathering for some 14 years, we had a number of women on our Board – yes on Centre for Fathering. And the views and insights from these women Board members strengthened the Board and made the organisation better. Actually this year, it is Centre for Fathering's 20th anniversary.
Speaking of Boards, wearing my NTUC Enterprise hat, in preparing for this cut, I also asked for some statistics on the women representation on our Board. The hon Member, Ms Mariam Jaafar, you will be pleased to note that across the boards of eight of our social enterprises, 36% are women. This compares favourably with Singapore Institute of Directors's (SID) target of 30% for Public Listed companies by 2030; we are already 36%. But these numbers show that we have made progress but still have some way to go. And again, amongst the leadership team at the NTUC group of Enterprises, 50% are women. But there is still progress to be made.
One last point. What are some of the practical ways to ensure that women enjoy the same financial freedom as men?
Given that family is the first line of care and support for many Singaporeans, we have traditionally supported and encouraged strong families. The implicit, normative bias is this – our old mindset that \"preservation of families\" is inherently good. The MSF handbook for example, states that, \"The guide introduces readers to Intensive Family Preservation in the Singapore context. This guide offers good practices and intervention strategies. Readers will uncover knowledge and skills to preserve families and protect children and young persons\".
The protection of young children is key and unequivocal. But I wonder if we need the moral overtones of \"intensive preservation\". Can we be more neutral between preservation and creation? Between status quo and change? Can we, make a start at least, in according equal respect to the choice between staying in a marriage and leaving it?
In saying this, I do not mean to undermine our commitment to strong families. Rather, I would like to say that strong families can take different forms. Some strong families lie within marriages, others are not. And we ought to make provisions for both. In so doing, I would like to ask, what is MSF doing to help strengthen familial and couple relations?
In cases where it is not possible to save the marriage, how can we mitigate the negative impact of divorce on children? In cases where risk factors for divorce are observed earlier, how can we provide better support earlier?
Last, given what I have said about the need for neutrality in choices, but also respecting the need for strong families, how can we together forge a strong narrative in line with the larger Singapore identity?
Mr Melvin Yong Yik Chye (Radin Mas): Mr Chairman, our children are often the ones who suffer the most disproportionate consequences in cases of divorce, particularly when the divorce is a high-conflict one and the parents involved are unable to co-parent effectively.
According to the MSF Study on the Inter-generational Effects of Divorce on Children in Singapore, children generally tend to suffer divorce penalties in terms of their income and academic qualifications. They were less likely to get married themselves, and among those who did, they were more likely to get divorced.
Sir, we need to do more to break this cycle, by going upstream to help strengthen the resilience of our family relations and keep healthy marriages intact. According to the latest divorce statistics released in 2019, there were about three divorces in every 10 marriages. Can MSF provide an update on the number of divorce cases in 2020? I worry that the added stress and anxiety from the prolonged pandemic might could cause a further deterioration of relations in unstable marriages.
I would like to ask what is MSF doing to help strengthen familial and couple relations, especially for families dealing with multiple challenges due to the pandemic. Can MSF examine ways to help couples identify early signs of marriage distress, especially for the most cited reason of \"unreasonable behaviour\" and help resolve such marital issues earlier, rather than waiting till pre-divorce proceedings have been initiated?
Lastly, in unfortunate cases where it is not possible to save the marriage, what is the Ministry's plans to mitigate the divorce penalties on our children?
Mr Zhulkarnain Abdul Rahim (Chua Chu Kang): Mr Chairman, I am the final speaker, but I am speaking on a different kind of ending – ending domestic violence.
Domestic violence, particularly those committed against young children, the elderly and people with mental and physical disabilities must be eradicated. Economic hardships are a trigger for more abuse in a relationship.
During this pandemic, many survivors of domestic violence feel that they can no longer seek refuge at the home of a friend or relative, for fear they could expose them to the virus. How can we encourage an environment of support whereby neighbours, family members and schools, help to look out for the vulnerable group in our society?
We have also to ensure that our Social Service Agency (SSAs) remain financially strong. They may be under pressure from increased demand and reduced number of volunteers coming forward to help. As we track the secondary effects of this pandemic, we must consider the impact on family violence and prioritise services.
What are the plans and recommendations for engagements with stakeholders following the formation of the taskforce to tackle family violence? Would the taskforce also be looking beyond family violence, but also domestic violence in general which would include intimate partner violence and violence against other vulnerable groups like foreign domestic workers and the elderly?
The Chairman: Leader.
The Leader of the House (Ms Indranee Rajah): Sir, may I seek your consent to move that the Chairman do leave the Chair? This is to enable me to move a Motion to take the proceedings on the business of Supply today beyond 8.00 pm.
The Chairman: I give my consent. Leader.
[(proc text) Resolved, That the Chairman do leave the Chair. – [Ms Indranee Rajah]. (proc text)]
[(proc text) Thereupon Mr Deputy Speaker left the Chair of the Committee and took the Chair of the House. (proc text)]
","clarificationText":null,"clarificationTitle":null,"clarificationSubTitle":null,"reportType":null,"questionCount":null,"footNotes":null,"footNoteQuestions":null,"questionNo":null},{"startPgNo":0,"endPgNo":0,"title":"Exempted Business (Committee of Supply)","subTitle":"Business motion without notice","sectionType":"OS","content":"The Leader of the House (Ms Indranee Rajah): Mr Deputy Speaker, may I seek your consent and the general assent of Members present to move a motion to take this day's proceedings on the Estimates for the Financial Year 2021/2022 beyond 8.00 pm?
Mr Deputy Speaker: I give my consent. Leader.
[(proc text) With the consent of Mr Deputy Speaker and the general assent of Members present, (proc text)]
[(proc text) Question put, and agreed to. (proc text)]
[(proc text) Resolved, That the proceedings on the business of Supply be proceeded with beyond 8.00 pm at this day's sitting. – [Ms Indranee Rajah]. (proc text)]
","clarificationText":null,"clarificationTitle":null,"clarificationSubTitle":null,"reportType":null,"questionCount":null,"footNotes":null,"footNoteQuestions":null,"questionNo":null},{"startPgNo":0,"endPgNo":0,"title":"Committee of Supply – Head I (Ministry of Social and Family Development)","subTitle":"Fostering a resilient and caring society","sectionType":"OS","content":"[(proc text) Debate in Committee of Supply resumed. (proc text)]
[Mr Deputy Speaker in the Chair]
[(proc text) Head I (cont.) − (proc text)]
The Minister for Social and Family Development (Mr Masagos Zulkifli B M M): Chairman, I thank Members for their cuts and also partnering MSF through the years, in building a resilient and caring society together.
COVID-19 has plunged societies around the world into one of the most urgent social crises in modern times. For some time, fissures were already bubbling across many societies – exacerbated by new technologies, demography changes and consequent shifts in central gravities from traditional economic powers to newer ones.
COVID-19 made those fissures even more stark. Demonstrators occupied the streets. Many who already left, felt left behind, lost trust in their social systems. National solidarity was weakened at its core.
In Singapore, we are not immune. We must never allow such divisions to take root in our society, especially amid a crisis. It is tough times like these that will test the strength of societies, and the bonds that bind people together. Around the world, how quickly governments and their people worked together, determined whether they could get a reprieve or were overwhelmed. With your permission, Chairman, may I display a slide on the screens?
The Chairman: Yes, please.
Mr Masagos Zulkifli B M M: There was a time when Singapore faced a similar crisis as a nation. When we became independent in 1965, we had barely $1 billion in reserves and were still negotiating for it to be in our control. We had no natural resources and hinterland. Our GDP was about $3 billion, a small fraction of what it is today. Unemployment was much higher. Few expected us to survive. Let alone prosper.
This did not deter our spirits. We had to find practical solutions to our problems of growth and development in our own context, as Mr Lee Kuan Yew said in 1960, even before our independence. Our pioneers knew that in order for Singapore to succeed, we needed the tightest economic and social discipline.
Our focus was on nation-building. With the scarce resources that we had, our priority was to develop a competitive economy, build up a sizeable defence force, and provide basic education, housing and healthcare to all Singaporeans. Social assistance at the time was very basic. Everyone was very much taking care of each other, taking care of themselves and taking care of each other in the family. That was our social compact. We relied on our strong work ethic and that drove economic growth for Singapore – creating employment for the masses. Leading to improvements in living standards for everyone.
This approach has largely served us well for the first fifty years of our independence. We uplifted an entire population and in one generation rocketed from third world to first.
About nine in 10 Singaporean children would have entered Primary 1 with at least three years in preschool, and 97% of Singaporeans and Permanent Residents' children would go on to post-Secondary education.
Around 90% of Singapore resident household own their homes, with the bottom decile at close to 85%.
We have also kept public healthcare costs affordable, especially for the lower and middle income groups. A quality and comprehensive healthcare has enabled our workforce to be up on their feet much of their lives and enjoy their downtime on holidays and not in hospitals.
Even among the advanced economies, we are one of the few where those at the bottom and in the middle have seen large increases of incomes in the past 20 years, even after accounting for rises in the cost of living. This means that families have more resources today than before.
We achieved these outcomes without having to go down the paths of other advanced countries, which had to heavily tax their populations to finance their burgeoning social systems, with one generation passing on their debts to the next. In Singapore, we keep our taxes low for a substantial majority of our population. We want workers to take home as much of what they earned, while at the same time achieving effective transfers for social equity.
We want to pass down an effective, healthy and debt-free social system, which we have enjoyed and owe this to our children, grand-children and future generations.
Today, our social compact continues to be one where:
One, the Government creates conditions for economic growth. Access to affordable quality education, housing and healthcare services, regardless of our background, becomes opportunities to flourish. Everyone can live with dignity and be self-reliant to do the best for themselves and their families.
Two, families continue to be the core of our society and our first line of support. Strong families in turn support the building of resilient individuals. Because they play a big part in caring and supporting one another through the ups and downs of life.
Three, the community plays an active role in helping those with less because we believe in a caring society.
Together, they form the foundation of our social compact.
Chairman, we will face a very different social landscape over the next 50 years. New challenges, different from what our forefathers faced. Even before COVID-19, we have more than doubled our social spending in the past 10 years. We needed to invest considerable resources into enabling our seniors to age with grace, as our population ages. This will be more challenging to finance, amid a shrinking labour force.
While our socio-economic strategies have uplifted broad segments of our population in the past, our current and future challenge would be to ensure that those at the bottom continue to progress upwards alongside the rest of the society on a moving escalator.
Today, many of these individuals and families face differing and complex needs. The tried and tested solutions of the past need revisiting. There will always be inequality in any society, in one form or another, sometimes even within a family. But we must keep opportunities alive for all Singaporeans to ensure social mobility. It cannot only be for those who have the resources, but for everyone, regardless of where they start in life and where they are today.
We must get this right, no matter how difficult. Because if we fail, Singapore will go down the path of becoming a fractured and disunited nation.
In essence, we want everyone in Singapore to be happy because they succeed in our society of opportunities that the Government continues to create.
At MSF, we will help those faced with transitional difficulties to bounce back and enable those with disabilities to participate, contribute where they can, and benefit from our society of opportunities.
We need those who have succeeded to give back for the betterment of society. Many have done well, not only through their own efforts, but from an enabling system that provided the opportunities.
We must also resist the natural tendencies for society to stratify, and actively encourage social mixing in our housing, National Service and public spaces that we all treasure together, like our hawker centres.
MSF's work contributes to uniting our people, across social classes, backgrounds and groups through their generosity and kindness, to give back, creating a stronger sense of togetherness in our society.
For those permanently unable to care for themselves and without other forms of support, we will help care for them. Enabling, uniting and caring – these are at the core of our mission in MSF.
I would like to sketch out our plans to build a stronger social compact in three areas: First, ensuring greater inclusivity and opportunities for all; Second, helping individuals bounce back from COVID-19; and third, enabling our preschool and social service sectors to emerge stronger.
Minister-in-charge of Social Services Integration Desmond Lee, Minister of State Sun Xueling and Parliamentary Secretary Eric Chua will subsequently elaborate more on our other initiatives – and they all revolve around enabling, uniting and caring for each other.
Chairman, many Singaporeans, including Members of this house, have shared about their wishes for Singapore to be a more inclusive society, which provides opportunities for all. No one should feel that they will be at a disadvantage because of their life circumstances. We share the same vision.
While we have done well in some regards, we must continue to press on. We will strive to give every child a good start in life, regardless of family background. We will make our society more inclusive for Persons with Disabilities, or PwDs, including children with developmental needs.
During my earlier speech at MOH's Committee of Supply, I shared with members about the importance of the early years in building resilience. With this, MOH launched the Child and Maternal Health and Well-being strategy – with a focus on medically sound pathways. But the child's gift to the world can only be realised with a rich environment in which he or she grows up in.
Our pre-schools are an important enabler for this and within our broader strategy to support families with young children. We want to give every child a good start. As we enhance the affordability, accessibility and quality of preschools for all families, we recognise that children from lower income families may require more targeted assistance. Hence, we are scaling up KidSTART to provide this additional upstream support.
Evidence from local research like GUSTO, and our own practice and experience, tells us that intervening properly as early as we can, will in a big way prevent disadvantages from snowballing later in life. In the early years, our KidSTART practitioners focus on equipping parents with relevant knowledge and skills on child development, parent-child interaction, health and nutrition. When the child is older, about age three onwards, we focus our efforts on facilitating their enrolment into our quality preschool system. These will also be progressively implemented alongside the scaling up of ComLink which Minister Desmond Lee will share more on.
As strong and resilient families provide our children with a nurturing environment to row, we have put in place a continuum of family services to meet different needs. We will also continue developing the Families for Life, FFL, movement to help all families build strong relationships upstream and foster a community-based ecosystem of support. Minister of State Sun Xueling will elaborate further on these in her speech.
Chairman, during the Emerging Stronger Conversations, many Singaporeans shared with us about their desire for a more inclusive society for PwDs across life stages. Ms Rahayu Mahzam also asked if existing efforts to encourage inclusiveness have been successful and if more can be done. We have stepped up efforts to raise public awareness of disability issues and inclusion through campaigns, such as “See The True Me”, which reported more positive attitudes towards PwDs amongst viewers.
At the national level, we have three workgroups looking into key aspects of our journey to foster stronger inclusivity in our society under our Third Enabling Masterplan. They look into areas like employment, independent living and making our pre-schools more inclusive, and we will share their recommendations in April. I would like to share more about what we are doing to make our preschools more inclusive, in response to Mr Don Wee and Ms Ng Ling Ling.
Over the years, MSF has worked with the sector to enhance early intervention support for children with developmental needs through our network of pre-schools and early intervention centres. We can do more. Starting by instilling inclusive values and mindsets from as early on in life as possible. This will lay the foundations for a more caring and inclusive society.
This will be beneficial for everyone. Studies show that both children with developmental needs and typically developing children can benefit from greater inclusion in pre-schools in areas like developing positive social attitudes and relationships, without compromising their development. Let me repeat. Without compromising their development. Building on existing efforts, we set up the Inclusive Preschool Workgroup to bring us closer to that vision. They have come up with some recommendations to bring us closer to that vision, which Minister of State Sun Xueling will share more in her speech.
The second key area that we will focus on is helping individuals bounce back from the setbacks of COVID-19, in a manner that builds resilience.
When COVID-19 first hit, the Government mounted a decisive response. We rolled out the Jobs Support Scheme to help businesses retain their workers and launched the SGUnited Jobs and Skills Package to keep our workers economically engaged. To cushion the impact on incomes, we rolled out various financial support schemes. Together, more than $440 million were disbursed under the Temporary Relief Fund and COVID-19 Support Grant which provided a much-needed lifeline to many families.
While the situation in Singapore has stabilised, we recognise that the economic impact of COVID-19 will continue to be felt by many.
Mr Melvin Yong and Mr Seah Kian Peng asked for an update on the COVID-19 Recovery Grant (CRG) and how we are creating more jobs, especially in the social service sector.
We launched CRG in January. It provides temporary financial relief to lower to middle income workers impacted by COVID-19, as they look for new jobs or upskill to prepare for career changes.
One example is Mr Lee whose employment contract ended last year and received support under CRG. Since his job loss, he attended three courses to upskill himself. He shared that CRG helped to cover some of his living expenses, including transport expenses for job interviews and training sessions. He also recently secured a part-time job as a packer to supplement his CRG. He is confident that his training will put him in good stead to transit to full-time work soon.
We want to enable workers just like Mr Lee to bounce back from their setbacks and do well for themselves. Over 7,500 Singaporeans have benefited from CRG to date. This support is complemented by a national drive by the National Jobs Council to create new jobs to help those who are affected.
MSF, too, has supported this job creation initiative. We have worked towards creating around 4,500 jobs and skills opportunities by this year. Singaporeans can look forward to opportunities in the early childhood and social service sectors, as well as within the MSF family.
A key thrust is also the creation of opportunities for PwDs through the existing Open Door Programme and new initiatives including the Place-and-Train, Attach-and-Train, and Skills Development programmes. One example is Ms Kelly Ong, a graduate from APSN Delta Senior school who lost her job during the circuit breaker when her employer stopped operations. As part of SG Enable’s Job Placement Job Support Programme, a job coach helped Kelly with the job search process and prepared her for interviews. Eventually, Kelly found a job as a kitchen crew at a restaurant given her interest in the F&B industry. We will continue to support others like Kelly.
Together, these will put us in a good position to actively build resilience in our people and enable them to bounce back from the crisis even stronger.
Finally, we want to enable our pre-school and social service sectors to emerge stronger and become more resilient to future challenges. In response to Mr Shawn Huang and Mr Seah Kian Peng, I will share more about how we are doing so in three areas. Digital transformation, building organisational excellence and capability, and strengthening partnerships with the community.
Digital transformation. Digitalisation is a core pillar of our transformation journey. To this end, we are developing Industry Digital Plans for both the early childhood and social services sectors. They will provide structured frameworks to help preschools and Social Service Agencies (SSAs) optimise resources and business processes. This will improve efficiency, support professionals in their work and raise the quality of services.
Next, we will strengthen support for SSAs to drive organisational excellence. We rolled out the Transformation Support Scheme to co-fund SSAs to hire manpower in areas of transformation. We are setting up the Community Capability Trust (CCT). It is a new fund of up to $480 million, comprising Government funds and community donations. It will be made available next year to provide longer term support for SSAs’ capability- and capacity-building needs. In response to Ms Carrie Tan, the CCT will build on existing capability building efforts and expand them so that SSAs have continued support to transform themselves.
Mr Seah Kian Peng and Mr Xie Yao Quan also asked what MSF is doing to encourage more giving during these challenging times and to harness the power of the community.
MSF will continue to renew our social compact in a manner that builds a caring society with a strong sense of mutual help and giving back. Corporates and individuals have been giving regularly to Community Chest’s SHARE. To encourage greater giving, we will be extending the SHARE As One programme to provide dollar-for-dollar matching for another two years till FY2023.
As Deputy Prime Minister had earlier announced, Change for Charity is a new initiative to empower giving through everyday consumption habits. From FY2021, Community Chest will work with businesses to enable customers to donate through their transactions on payment platforms. This can be conversion of loyalty points to donations or even direct donations at point of payment. The Government will match 50 cents to every dollar donated through these platforms. We will increase this dollar-for-dollar matching, if businesses also match customers' donations, adding up to three dollars in total.
I was very glad to hear Mr Seah Kian Peng putting up his hand for NTUC Enterprise to be the first to come onboard and hope many other companies will join us. Corporates can receive a one-off grant to support the implementation.
During the Emerging Stronger Conservations, many Singaporeans expressed their desire to be more involved in efforts to care for those in need. We will continue to strengthen our partnerships with the community, in the spirit of SG Together. We agree with Mr Melvin Yong that care-givers play an important role in our social safety net. During my earlier speech at MOH’s Committee of Supply, I spoke about strengthening support for care-givers of seniors. At MSF, we will embark on a similar effort to support care-givers of PwDs. NCSS, SG Enable and community partners will form a Singapore Together Alliance for Action for care-givers of PwDs in the coming months. This will complement the Third Enabling Masterplan, which I spoke about earlier.
Ms Denise Phua also shared about a similar alliance for the Autism Enabling Masterplan. MSF will review the recommendations and is committed to working with friends from the autism community on this.
Chairman, if there is a partnership that we must build, it is between our men and women.\tAll of us know women close to us – our mothers, our wives, our sisters, our daughters. They deserve our respect and to be celebrated. I would like to wish everyone a Happy International Women’s Day in advance.
As a whole, we have done well in many areas – enabling our women to access quality education and healthcare services, and higher labour participation. We have provided them with safe and secure neighbourhoods and streets, where women can be out late at night alone without worrying about safety. A luxury that is uncommon in many other cities and communities. Even among this House, women occupy close to 30% of the seats, which is higher than the Inter-Parliamentary Union’s global average of 25.5%.
The recent spate of sexual offences and violence against women are abhorrent. They somewhat reveal how some of our boys and men view women. We want to correct this. We must not allow such misplaced attitudes to fester because they have no part in our society. And we can do more to protect our women by reviewing the sentencing framework for hurt and sexual offences. And my colleague Minister Shanmugam has made a Ministerial Statement to this end.
But our partnership with our fellow Singapore women cannot stop there. We will also look into other areas that have been frequently brought up. An example is that of enabling the careers of our women – supporting their career development, even while they build their families and increasing the representation of women on Boards through our Council for Board Diversity, in a manner that is not perceived as tokenism.
The on-going Conversations on Singapore Women’s Development aim to explore how we can do better collectively for Singapore women at home, in workplaces, in schools, and in the community on these various issues. Minister of State Sun Xueling will elaborate more in her speech.
Mr Chairman, Sir, in Malay please.
(In Malay): [Please refer to Vernacular Speech.] COVID-19 has brought about many challenges to societies around the world, thus becoming one of the most pressing social crises of this modern age. Those who have been facing challenges continue to be hit by problem after problem, as the Malay proverb goes \"someone falls, and the ladder falls on him, too\". Social divisions are increasingly felt.
At the same time, we will face a very different social landscape in the future, bringing with it various new challenges.
Previously, before COVID-19, we have more than doubled our social spending in the past 10 years.
Our socio-economic strategies have uplifted broad segments of our population. However, the challenge is to ensure that those at the bottom can continue to progress alongside the rest of the society.
We must ensure that opportunities are kept available for all Singaporeans. No matter how difficult, we must ensure that social mobility remains achievable within the established social structure. Because if we fail, Singapore will go down the path of becoming a fractured and disunited nation.
We must also not forget those close to us – our mothers, sisters, wives and daughters. We must ensure that women who need protection are protected, those less fortunate are given help, and those with career aspirations are given the opportunity to achieve it. They deserve our respect and are to be celebrated. I would like to wish all a Happy International Women’s Day which will be celebrated on Monday.
We will continue to partner you, help the less fortunate and support the aspirations of all Singaporeans.
(In English): In my previous Ministry, we did everything we can to save our planet. But leaving good children to take care of our planet is as important as leaving a good planet for our children.
In Singapore, we have progressively strengthened our social compact over the years and took a pragmatic approach, as our society evolved and our resources enabled us. We are now faced with an immediate problem to renew our social compact as we tackle the uncertainties of a future global economy scarred by the pandemic that can either deplete our resources or enable us even more. The long-term impact of climate change will severely tax our resources, too.
Our pioneers set the foundations of Singapore and painted our society with hope amid a crisis. In the background of the uncertainties of separation, we saw hope in building a metropolis together. Similarly, we must ask ourselves: what kind of society do we want to be over the next 50 years? What kind of society do we want to leave our future generations?
How we each decide to act in the face of adversity will shape our values and norms for generations to come. For us at MSF, the crisis presents an opportunity to build more resilient individuals and stronger families, with a more caring and resilient society, characterised by greater inclusivity and opportunities for all.
The Government cannot go about this alone. We need everyone, and a whole-of-society approach and effort to bring us closer to that vision of home. I look forward to our continued partnership with fellow Singaporeans and Members of this House to build a better future for ourselves and our children. Together, I am confident that we can emerge stronger. Thank you. [Applause.]
The Chairman: Minister Desmond Lee.
The Minister-in-charge of Social Services Integration (Mr Desmond Lee): Chairman, Minister Masagos has just set out our social compact and laid out MSF’s key focus areas for the year ahead. Let me now expand on how we intend to integrate social services and transform our social safety nets in Singapore.
COVID-19 has had a profound impact on societies all around the world. But it has also brought out the best in Singaporeans. In the past year, many more Singaporeans stepped forward. Government, community and corporates partnered one another to support our neighbours, our friends and fellow Singaporeans.
At MSF, my colleagues have been working hard to strengthen and transform our social safety nets. This transformation is guided by our 3C principles. First, providing comprehensive support, not only downstream when issues occur, but also going upstream to identify and tackle root issues. Second, ensuring that help is convenient, by putting individuals and families that we serve at the centre and organising support around their needs. Third, coordinating ourselves by building strong partnerships and networks, anchored in local communities.
This foundational work served us well when COVID-19 struck, especially during the Circuit Breaker. One example was the PEERS Network, which stands for “Partners Engaging and Empowering Rough Sleepers”. With your permission, Sir, may I display some slides on the LED screens?
The Chairman: Yes, please. [Some slides were shown to hon Members.]
Mr Desmond Lee: Thank you, Sir. The PEERS Network was officially formed in July 2019, and includes Social Service Agencies (SSAs), community groups and Government agencies. Some are befrienders. Others offer their premises as “Safe Sound Sleeping Places”, or S3Ps for short, and these provide localised interim shelter. Officers from MSF and MND join the partners’ outreach walks to offer assistance. They work closely with PEERS members to support homeless rough sleepers with housing needs.
Early last year, there was an urgency to provide shelter to rough sleepers because of COVID-19. For their safety, we needed to find rough sleepers safe shelter quickly. MSF called for more groups to open their premises as S3Ps. Over 40 organisations answered our call. And this was a six-fold increase from pre-COVID-19 times. We also worked with HDB to provide vacant flats as temporary S3Ps. d.\tThe Network has sheltered about 900 rough sleepers since April 2020.
MSF also set up two new Transitional Shelters in January this year, and about 250 residents from Safe Sound Sleeping Places have moved into new Transitional Shelters. The eventual goal is to help them address their underlying social issues and achieve longer term stable accommodation.
Another example was the outreach effort to households living in rental flats, which commenced last June. We wanted to ensure these households were coping well with the pandemic, as they were much more vulnerable, and to offer support where necessary. We activated the SG Cares Community Networks to support this outreach. The local Networks were started in 2018 to bring together the social, health and community sectors in each town, to strengthen social, health and community integration.
The Networks were quickly mobilised. MSF, PA and MCCY rallied community partners, social service agencies, corporates and some 900 volunteers to reach out to 50,000 rental households. We managed to offer timely support, especially to households who were suffering but had not yet reached out to seek help. We referred 5,000 households in rental flats to various agencies for further healthcare support, counselling, employment and financial assistance and so on.
These examples demonstrate clearly how important networks of trust are during a crisis.
Ms Joan Pereira and Ms Denise Phua asked how we work with social service agencies and community partners to deliver social services in a coordinated manner. Our approach has been to organise our support around each family’s needs and practise what we called the 3Cs earlier.
And to achieve this, MSF has trained nearly 4,300 officers to assess underlying issues and to deliver more comprehensive support. Frontline officers can connect those in need to relevant support, if the families’ issues go beyond their own agency’s remit. This shift, which is a work-in-progress, emphasises a family-centric approach, instead of adopting an agency-centric lens. We will be training community partners and volunteers next, who are important touchpoints to render even more comprehensive support.
Besides building capabilities, we have also integrated processes. One example is the plan that Minister of State Faishal Ibrahim mentioned to strengthen information exchange between Singapore Prison Service and the FSCs – he described this during MHA COS. This enables offenders’ families to receive timely support from FSCs and community partners. Another example is Streamlined Assessment Protocols, or SAPs, that allow ComCare clients to access other forms of help schemes more easily. They now qualify for medical assistance at public healthcare institutions, childcare subsidies and MOE Financial Assistance without having to be repeatedly means-tested. MSF is working with other agencies to set up new protocols, so that clients can seamlessly access assistance via other agencies, beyond the SSOs.
Mr Don Wee had suggested making the help-seeking process more seamless for low-income vulnerable families by sharing data across Ministries and integrating the application processes. This is, indeed, something we are working on with the relevant agencies.
We will make better use of data and technology to improve our clients’ experience and our officers’ productivity. Today, some clients have to repeat their circumstances and submit similar documents repeatedly to apply for different schemes from different departments. Officers often spend time collecting information that is already available with another agency. This time can be better spent building trust and rapport.
The systems enhancements that we mentioned at last year's COS to improve data-sharing between agencies are coming on-stream this year. One platform is what we called One Client View, or OneCV, which was rolled out last month to officers from 12 agencies. In the past, the household who wanted to apply for rental housing, ComCare assistance and childcare subsidies, for example, had to submit income documents three times to these three different agencies. With One Client View, the family can do away with these submissions and simply give consent for agencies to retrieve the information through this platform. One Cilent View has multiple levels of safeguards built in to ensure that such personal data is kept safe.
Another platform, called Case Connect, will be rolled out in phases from June this year. Today, collaboration takes place over different modes – emails, phone calls, messages, handwritten notes. Valuable information can get lost when case workers change, or new partners come onboard, and you can imagine many, many agencies are involved. Case Connect will allow frontline officers and case workers to make referrals, share assessments and updates, and coordinate with other partners on a single platform. To reduce the administrative burden on frontline officers and our social service agency partners, we integrated the systems with single sign-in and will progressively build system linkages. So, not just focusing on our clients, but ensuring that our frontline, both in Government and in the social service sector, they find it meaningful, they find it seamless and they find it integrated for themselves, too.
Case coordination can become challenging with more partners involved. To drive integration, we will take a regional approach to organise key social services because, in reality, if you ask the different agencies, they tend to serve the same families, the same households in the same locality. Our aim is to have a common set of partners serve the same community in the same region. This helps to reduce coordination costs and promote better integration across agencies.
We have been organising many of our programmes with this regional approach in mind. These include KidSTART and Community Link or ComLink, which Minister Masagos had shared about earlier. We will also set up regional Strengthening Families Programme @ FSC to support early-risk and stressed families. Minister of State Sun Xueling will elaborate more later. These programmes will be organised along SSO regional clusters, so that agencies can easily work with the partners in the same region, build relationships among each other to convene case discussions and coordinate support. In turn, this strengthens the SG Cares Community Network in each town.
During the Emerging Stronger Conversations that we have had, many Singaporeans expressed their desire to build a society that cares even more deeply for the vulnerable and less privileged. Mr Seah Kian Peng also asked how we will build stronger partnerships with the community to support those in need. We will strive to achieve this through the SG Cares Community Networks. This is a Singapore Together Alliance for Action, or AfA, which focuses on prototyping new ideas to solve problems. The Networks also provide a platform where local partners in a town, with Government agencies, charities, social service agencies and other community groups get to know one another face to face, collaborate and, over time, build a relationship of trust in the local community. We have seen the collective impact of the Networks earlier. And we believe we are just starting to tap on its potential, and we call on more community partners and volunteers to join our efforts.
Community Link, or ComLink for short, is a flagship initiative that seeks to pull together the elements that we talked about earlier: achieving deeper integration, putting families at the centre of our work, being proactive, building strong local networks, and partnering the community.
Deputy Prime Minister Heng and Minister Masagos had announced the expansion of ComLink earlier. So, now, let me provide some details, which will also address Mr Mohd Fahmi's cut on ComLink's progress and future plans.
In 2019, MSF launched ComLink at four pilot locations: Boon Lay, Jalan Kukoh, Kembangan-Chai Chee and Marsiling. Since its launch, we have supported 1,000 families with children.
Ms Carrie Tan asked if ComLink is taking an asset-based community development, or ABCD, approach. Yes, elements of ABCD are in ComLink but ComLink is more than that.
Under ComLink, instead of waiting for households to seek help, we proactively reached out to families with young children who are living in rental housing to understand their needs, their fears and their aspirations, listen to their voice.
We pulled together data across agencies and used them to identify issues faced by families as well as assets and gaps in the community. Community partners came together to coordinate support for families with complex interlocking issues. We came up with common action plans and journeyed with the families to support them in achieving their goals.
You cannot rush this. It takes time. You have to journey with them. It might take months, it might take years, it might take even a generation. But we journey with them.
We also partnered about 30 corporates, donors and social service agencies, and 240 volunteers to mount some 60 ComLink programmes specifically tailored to meet the families' and the community's needs. So, data driven needs identified by our outreach to the families, hearing and listening to them, and tailoring those support.
Our objective is to systematically uplift families with children living in rental housing and support them towards stability, self-reliance and social mobility.
Let me illustrate with one example. Theresa is a single mother with two children and had difficulty holding down a stable job because of the difficulties she faced. Ever since the Social Service Office (SSO) knocked on her door two years ago as part of ComLink, Theresa gradually opened up to share her challenges and aspirations of becoming a childcare teacher and her hopes of owning her own HDB flat. Her social worker and community partners came together, provided her coordinated support and worked out with her a case plan, a progress plan, a roadmap.
Today, Theresa is a confident parent with stable employment who contributes back to her own local community. Her two children regularly attend ComLink programmes.
We want to empower more families like Theresa's. We will therefore scale ComLink across Singapore over the next two years to cover all families with children living in rental housing. We will do so by expanding from the existing four sites to 21 towns in the next two years to cover 14,000 rental housing families with children across the island.
The SSOs will continue to drive this effort with relevant Government agencies, social service agencies and community organisations through ComLink Alliances.
As we step up efforts to do more for vulnerable Singaporeans, we need to redesign the way we deliver services. This is a natural evolution of the social safety nets that Minister Masagos has set out in his opening frame. And what is this new way of delivering social services?
First, streamline outreach efforts so that families are not overtaxed by various agencies and interventions.
Second, align agencies to a common set of outcomes centred on the families so that families are not pulled in different directions by different agencies and charities.
Third, empower lead agencies such as our SSOs and Family Service Centres (FSCs) to exercise more leadership to stitch together interventions while other agencies support as part of one team.
Fourth, provide better signposting of ground needs to donors, to volunteers, to philanthropists and corporate social responsibility (CSR), so that their giving is not just meaningful but impactful, targeted and productive. Achieve social impact that many volunteers and donors yearn to see.
We are testing out these ideas at selected ComLink communities.
ComLink is an ambitious enterprise premised on the belief that Government, SSAs and the community come together at the national level, supported by resources and the right policies, we can make a much bigger impact in uplifting the low-income and vulnerable.
Social sector practitioners have told us that what we are trying to achieve is critically needed. In fact, we are doing this because of their sound advice and guidance over the years. They tell us this is much needed but not easy to achieve.
We must confess that with no precedent to rely on, we are feeling the stones as we cross the river. But I am confident that we can cross the river to the other side because of our common desire to build a society that cares more deeply for those who have less. We want to roll up our sleeves, make an impact and see the difference.
We need to do this together. So, Minister Masagos, Senior Minister of State Sun Xueling, Parliamentary Secretary Eric Chua and I would like to invite Singaporeans to be a part of this movement on the ground. Those who are keen to join us can approach a Volunteer Centre set up by MCCY in your town or sign up through Volunteer.sg portal. My colleagues and I look forward to working with more of you to build a Singapore where no one is left behind. [Applause.]
The Chairman: Minister of State Ms Sun Xueling.
The Minister of State for Social and Family Development (Ms Sun Xueling): Mr Chairman, Minister Masagos shared MSF's plans to strengthen our social compact, including strong families as our first line of support.
It is on these points that I would like to elaborate today.
First, our families are the foundation of society. We must support them to the best of our ability, across their differing needs.
Second, our women are key members of our families and society. We will support them so they have real choices, so that they do not have to choose between family and their careers, and can achieve their full potential.
Third, our children are our future. We will provide them with a good start in life so that they may grow up to be resilient members of our society and form strong families of their own.
Mr Chairman, to build strong, resilient families, we have in place a continuum of family services to support families with varying needs.
First, for soon-to-wed and married couples, we support them in building strong foundations in marriage and parenthood.
Minister Indranee announced the increase in the co-matching cap in the Child Development Account for the second child. We will also introduce Government-Paid Paternity Benefit and Adoption Benefit Schemes later this year. We will grow the Families for Life movement to strengthen family ties and bonds and we will promote evidence-based programmes for marriage preparation and parenting.
Second, Mr Melvin Yong and Mr Seah Kian Peng will be happy to know that we will help families who show early signs of stress.
In 2019, MSF piloted two Strengthening Families Programme @ Family Service Centres, otherwise known as SFP@FSC, with Care Corner Singapore and Fei Yue Community Services. SFP@FSC will bring together programmes and support services for marriage and divorce.
We will start a family counselling service, including for families with early signs of stress, so we can mend relationship fissures early. Some marriages need more support, such as those who marry before 21 years of age, or transnational couples. Tailored marriage preparation and support programmes will help lay a strong foundation for marriage. We will step up support for families undergoing divorce. Four existing Divorce Support Specialist Agencies, or DSSAs, will be folded into the SFP@FSC. Services will be more accessible as families may approach any of the 10 SFP@FSCs whereas the DSSAs may not be located as conveniently.
The SFP@FSC will adopt an integrated, regional and multi-disciplinary approach to family service provision. Bringing early-risk family services under SFP@FSC allows better oversight of family services and greater integration of support for families with multiple needs.
The SFP@FSC will be organised according to the 10 SSO regions. Upstream preventive measures for all families and downstream interventions for early-risk families and those with complex needs will be accessible in the same location.
To address multi-faceted and complex family issues, the SFP@FSC will bring together a multi-disciplinary team of professionals skilled in family counselling, financial counselling and psychology.
We expect to scale up to five SFP@FSCs, with three more social service agencies working with MSF by the last quarter of this year. The remaining five will be rolled out within the next two years.
On family violence, Mr Zhulkarnain Abdul Rahim asked what can be done to create a community of support. Minister of State Assoc Prof Mohammad Faishal and I co-chair the task force on family violence, which has studied the landscape and possible causes of family violence so that we can intervene effectively. We have conducted focus group discussions and we are currently reviewing feedback from partners and Members of the House.
The task force is developing recommendations to break cycles of abuse and offending under four broad thrusts: (a) increasing awareness and strengthening societal attitudes against violence; (b) making it easier for victims and the community to report violence and to get immediate help; (c) strengthening protection for victims to reduce their risk of being harmed again; and (d) increasing the burden of accountability placed on perpetrators and strengthening their rehabilitation. More details will be shared later.
I will next share how we will continue to support our women. Our women's contributions are integral to the Singapore Story and we must celebrate and support their continued progress. Ahead of Monday, I would like to wish everyone, both men and women, Happy International Women's Day in advance.
Mr Seah Kian Peng asked about the profile of participants and issues raised at the Conversations on Singapore Women's Development.
So far, we have conducted 37 conversations and engaged over 1,800 individuals, including youths, working mothers, homemakers and women leaders. Men make up almost a quarter of our participants, and I know that more will come.
Participants raised concerns ranging from challenges faced by working mothers to violence against women. During my Budget speech last week, I mentioned that participants from our Conversations on Singapore Women's Development raised concerns on the approach for punishment for hurt and sexual offences. I am heartened to hear the Minister for Home Affairs and Law present the Ministerial Statement on the review of the sentencing framework for sexual and hurt offences in Parliament today. It is a strong step to further safeguard the protection and safety of our women and girls.
Participants at the conversations also raised the need for mindset shifts and suggested establishing support networks in workplaces and the community.
Increasing representation of women in corporate leadership was also raised. We agree with Ms Mariam Jaafar that we need more women leaders for diversity in skillsets, experiences and perspectives, which leads to better decisions. The Council for Board Diversity encourages diversity in organisations and identifies and grooms potential board-ready women.
We will continue to gather and study the feedback provided and submit a White Paper to the Parliament in the second half of 2021.
Next, I would like to talk about how we ensure that every child has access to affordable and quality pre-schools.
Chairman, it is paramount that every child is provided with a good start. For families with young children, we have stepped up efforts to enhance the accessibility, affordability and quality of pre-schools. Two key moves were recently made.
Since January 2020, the household income ceiling for means-tested pre-school subsidies has increased to $12,000 a month, from $7,500 for childcare and infant care, and $6,000 for KiFAS. Subsidy amounts also increased across all eligible tiers. Around 78,000 children now benefit from means-tested subsidies, up from around 48,000 in 2019.
We enhanced the Partner Operator (POP) Scheme, from January 2021. In the new term, we lowered fee caps for POP centres from $800 to $760 for full-day childcare per month. We also increased the number of POP centres by 30%.
With the latest subsidies and fee caps, a Singaporean child enrolled in full-day childcare for five years with an Anchor Operator would benefit from about $50,000 in Government funding. Low- and middle-income families can additionally receive up to $28,000 in means-tested subsidies.
Ms Ng Ling Ling and Mr Louis Chua asked about accessibility and quality of pre-school places.
This is an important point that affects young families. I know this all too well. Many Members of Parliament have raised this issue. Back in 2019, together with my colleagues Cheng Li Hui, Rahayu Mahzam and Cheryl Chan, we pushed for more accessible and affordable quality pre-school places, especially in new towns with many young children.
The Government promised in 2019 that 80% of pre-schoolers would have a place in Government-supported pre-schools by around 2025.
We have significantly increased the number of full-day preschool places, from about 120,000 in 2015 to around 190,000 today – an increase of over 50%.
We are thus on track to grow the total number of full-day pre-school places to 200,000 by 2023 and achieve the Government’s promise by around 2025.
We have increased the number of early childhood educators from 18,000 in 2018 to over 22,000 last year. We support the professional development of our educators. One such effort is enhancing the capabilities of educators teaching Mother Tongue Languages.
ECDA partnered the National Institute of Early Childhood Development, or NIEC, in 2019 to introduce Certificate courses for Malay and Tamil language teaching. A course for Chinese language teaching will be introduced later this year.
Ms Joan Pereira asked how we will support lower income families with young children. In 2021, we plan to expand KidSTART, to Choa Chu Kang, Bukit Panjang, and Bukit Batok, on top of the regions already announced.
The community plays an important role. Under the Growing Together with KidSTART initiative, we forged new corporate partnerships with SP Group and The LEGO Group, and deepened existing partnerships with Prudential Singapore and Etonhouse Community Fund. We will tap on individual and corporate volunteers to build stronger, long-lasting relationships with KidSTART families.
Mr Don Wee asked about childcare services for shift workers.
Childcare centres can operate beyond standard operating hours. Currently, over 40 childcare centres operate beyond 7 pm on weekdays. This meets the needs of most parents. Others may arrange for care-givers such as relatives to help out.
As part of the Community Link pilot, we sought feedback from some 650 families and community partners, including on care-giving arrangements. We are studying the possibility of piloting night-time childcare at a ComLink site.
For children with developmental needs, it is paramount to identify needs early and provide the necessary support. Our children are precious and we must create environments where they can thrive, and they can feel included and accepted.
We, therefore, set up the Inclusive Pre-school Workgroup, or IPWG, which Minister Masagos spoke about. Through the IPWG, which I co-chair, the Government has worked with partners across the health, education and social sectors to study how we can better support children with developmental needs.
Ms Ng Ling Ling asked about efforts to strengthen inclusion in pre-schools. The workgroup will release its report in April. Ahead of this, let me broadly share the upcoming initiatives. With your permission, Mr Chairman, may I display a slide on the LED screens?
The Chairman: Please.
Ms Sun Xueling: The workgroup has a tiered support framework, depending on the level of early intervention support required.
In Tier 1, we will work towards every pre-school appointing an \"Inclusion Coordinator\", or ICO, among existing staff, beginning in the second half of 2023. The exact timing will be announced later.
The introduction of ICOs will set a baseline for the sector’s support for children with developmental needs and signal that every pre-school has a role to play in strengthening inclusion.
ICOs will work with early childhood educators to flag children with potential developmental needs for further assessment. They will connect teachers and parents to early intervention support or resources, such as our Development Support-Learning Support programme (DS-LS).
ECDA will work with pre-schools to support appointed staff with appropriate training. ICOs alone are not the silver bullet and we urge all pre-school leaders and educators to partner ICOs in their pre-schools in this inclusion journey.
In Tier 2, we will expand the DS-LS programme and the Development Support Plus (DS-Plus) programme to more pre-schools, to support children requiring low levels of early intervention support.
In 2020, the DS-LS programme covered about 600 pre-schools which enrol over 40% of resident pre-schoolers aged five to six. We plan to expand outreach of the DS-LS programme to more pre-schools covering 60% of pre-schoolers by 2025, and covering 80% at steady-state.
In Tier 3, we will pilot a new Inclusive Support Programme, or I-n-S-P, at a few sites with selected providers to integrate planning and provision of both early childhood and early intervention services at pre-schools for children aged three to six, who require medium levels of early intervention support.
Under the InSP, pre-schools will be resourced with full-time early intervention professionals who will work with early childhood educators.
This will reduce the logistical strain faced by care-givers, of shuttling between pre-schools and early intervention centres, and provide more integrated support.
The IPWG recognises there are children who require higher levels of early intervention support and who remain best served in a separate specialised early intervention setting.
ECDA will follow up on IPWG’s recommendation to study integration opportunities for these children in Tier 4.
ECDA will also strengthen the capabilities of the early childhood and early intervention professionals in our efforts to make pre-schools more inclusive.
Ultimately, strengthening inclusion in our pre-schools will benefit both children with developmental needs, and typically developing children, with enhanced teacher training, and development of stronger social skills from a young age. Chairman, in Chinese, please.
(In Mandarin): [Please refer to Vernacular Speech.] Families are the foundation of our society. Hence, we have in place a continuum of family services to support families with varying needs. In 2019, we piloted two Strengthening Families Programme @ Family Service Centres (SFP@FSC) with two Family Service Centres, which will bring together programmes and support services for marriage and divorce. Based on good feedback from this pilot, we will expand to three more regions by the end of this year, and the remaining five will be rolled out within the next two years.
\tIn support of women, the Government and community organisations have organised 37 conversations as part of the Conversations on Singapore Women's Development, engaging more than 1,800 people from various backgrounds. During the conversations, participants raised various concerns, such as challenges faced by working mothers and violence against women. We will continue to gather feedback and study the suggestions put forward by the participants and submit a White Paper to Parliament in the second half of the year.
\tIn the area of pre-school education, we are stepping up our efforts to provide more accessible, affordable and quality pre-schools. We will increase the number of Government-supported pre-school places, to meet the target set in 2019, of 80% of pre-schoolers having a place in Government-supported pre-schools by around 2025.
\tAt the same time, we will work towards every pre-school appointing an Inclusion Coordinator to provide early intervention support for children with developmental needs. We will also expand the Development Support- Learning Support Programme and pilot a new Inclusive Support Programme to help children who travel daily between pre-school and Early Intervention Programme for Infants & Children centres.
\tWe will also further support low-income families with young children. We will expand KidSTART this year to benefit low-income families living in Choa Chu Kang, Bukit Panjang and Bukit Batok. An important part of the programme is to ensure that young children are adequately nourished. Under KidSTART, practitioners will work directly with parents to guide them on their children's nutritional needs. Our community and corporate partners will also come in to support families with food sponsorships where necessary.
\tChildren are our hope, our future. Regardless of their family background and difficulties they face, we want to create an inclusive and warm school environment for them, so that every child can thrive, overcome the challenges in their lives and education, and develop to their full potential. This requires the concerted effort of all of us. Thank you!
The Chairman: Parliamentary Secretary Eric Chua.
The Parliamentary Secretary to the Minister for Social and Family Development (Mr Eric Chua): Sir, building a strong social compact starts with building resilient and caring individuals. This begins from nurturing our youth to bring out the best in them.
All youths, including our vulnerable and at-risk ones, can be resilient individuals. We must support them well, so they too can realise their full potential. Mr Murali Pillai asked how we can do so.
The National Committee on Prevention, Rehabilitation and Recidivism (NCPR), which I co-chair with Minister of State Faishal of MHA, oversees national efforts to prevent offending, re-offending and to enhance rehabilitation of offenders. Through the Localised Community Network (LCN) pilot, we provide wraparound, coordinated support to children and youth with complex family circumstances or those who exhibit at-risk behaviours.
MSF also works closely with appointed agencies to run programmes aimed at reducing at-risk behaviours, such as \"Youth GO!\".
Over the years, we have made steady progress. The number of youths arrested has fallen by about 40% over the last decade.
Pre-court diversionary programmes have significantly contributed to keeping first-time youth offenders who commit minor offences out of the court system.
We will continue to work with our partners to build a preventive support system for our youths.
We will pilot a mentoring programme targeted at students who leave ITE prematurely. We have two main objectives:
First, to expand the youths’ network of positive relationships. We hope that the young mentees will find lifelong friends and role models in the mentors, pick up useful life skills, and gain access to a trusted adult that they feel comfortable reaching out to.
Second, to empower the youths to achieve their aspirations. We hope to broaden their exposure to opportunities and support them in building on their strengths and talents. We intend to gather mentors from various industries, to guide the youths to explore potential careers in areas they are interested in. Where possible, mentors will pave the way for internships, apprenticeships, or job placements for these mentees.
I am also pleased to update that from February 2021, that is last month, post-care support for our youths discharged from MSF Youth Homes has been extended from two months to one year for all youths discharged from the Homes.
Beyond this, we invest upstream in family and community resources to address risks and disadvantages as early as possible. And we also regularly review our legislation to better safeguard the welfare of our youth and children.
Ms Sylvia Lim asked about the impact of the amendments to the Children and Young Persons Act (CYPA) passed by Parliament in 2019. Most amendments took effect from July last year. Implementation has been smooth so far.
We extended protection to older children who are abused or neglected, by raising the age limit from 16 to 18. From July to December 2020, MSF investigated 25 such cases involving older children.
The shift from “Beyond Parental Control” to “Family Guidance Orders” emphasises the family’s responsibility in guiding their children. Now, parents and children must attend a family programme, before parents can apply to the Court for a Family Guidance Order. The intent really is to equip families with ways to resolve conflict and strengthen family relationships to avoid the need for the Court to intervene. The regime is still new at this point in time, and we need time to monitor its implementation.
We are also enhancing our capacity and capability to rehabilitate youth offenders. It would take resources, time to strengthen safety and security, before MSF Youth Homes are able to take in additional youths.
And on a related note, we are also reviewing the Adoption of Children Act (ACA); to seek public feedback on proposals to better safeguard the welfare of adopted children.
Our efforts would not be possible without close collaboration with the community. As Minister Masagos mentioned, we are strengthening partnerships with the community, and encouraging the spirit of giving and volunteering to uplift our vulnerable communities.
Mr Mohd Fahmi Bin Aliman asked how we are empowering our youths to contribute to building a resilient and inclusive society. Many youths have been leading and igniting change through community initiatives, and we are actively partnering them to channel their energy and ideas for good. And I will be sharing more examples later on in my speech.
Mental well-being is a pertinent issue of our time, brought to the fore by the pandemic. At the start of the circuit breaker, MSF and MOH set up a dedicated National Care Hotline, to provide psychological first aid to Singaporeans. The hotline has since managed over 40,000 calls since it commenced operations in April last year. And in the recent months, with the gradual lifting of COVID-19 measures, total calls managed has decreased and stabilised to 1,500 calls a month, including about 450 per month that needs emotional support. But beyond this, there is more that we must do as a society to promote mental well-being.
Mr Shawn Huang and Mr Xie Yao Quan asked how the Youth Mental Well-Being Network (YMWBN) will help support youths. The Network gives us a platform to brainstorm with the community and try out new ideas to better support our youths’ mental well-being. As Minister of State Xueling shared at MOE’s Committee of Supply, Network members have initiated over 30 potential projects to date. I took part in a brainstorming session in October last year, and was very heartened and inspired by the many good ideas exchanged.
One such initiative is Driving Resilience & Inspiration for The Incredible Next Generation, or DRIFTING in short. Led by Network members Ms Francesca Wah, Mr Caleb Tan, Mr Jerry Seah, Mr Pang Lim and Mr Chan Ming Hui, DRIFTING is an outreach programme that aims to provide positive peer support for at-risk adolescents. Tapping on the experiences of former youths-at-risk and informal community touchpoints such as hairdressers, mama shop owners, DRIFTING seeks to strengthen the social support network and introduce protective factors for at-risk adolescents. The team will soon be ready to recruit volunteers and conduct outreach.
Our youths are also actively involved in causes to help the vulnerable.
Seventeen-year-old Brendson Tan has been involved in ground-up initiative Mummy Yummy since 2013, when his grandmother started the initiative with three other mothers to distribute meals to families in rental flats. As deputy lead of the youth team, Brendson leads over 200 youth volunteers to distribute food door-to-door. And he also leads weekly house visits in Bedok to check on residents’ well-being.
Increasingly, youths also want to have a voice in the policy-making process. We constantly find ways to involve youths in our consultations. For instance, the Youth Advisory Group (YAG) provides their perspectives to the NCPR, which I co-chair with Minister of State Faishal.
In recent years, MSF, community agencies, and religious organisations have also joined hands to form various networks to address social issues.
The PEERS Network, for instance, has 35 partners who run Safe Sound Sleeping Places (S3Ps) and mobilise volunteers to reach out to rough sleepers. I recently joined the Catholic Welfare Services and the Homeless Hearts of Singapore on their night walks. On one walk, we met two uncles who shared their concerns about safety and about losing their belongings when they sleep rough. They were actually initially quite hesitant to move into a shelter, but upon our MSF officers follow up especially on the very next day, they went to engage the uncles again, giving them assurance that the shelter would be suitable and adequate for their needs; they eventually moved into the shelter. And they are now in touch with HDB and MSF SSOs to gradually work out their housing and financial needs.
Other volunteer networks which the public can join include the Vulnerable-in-Community (VIC) Network, which befriends and supports vulnerable individuals, including tissue paper sellers and cardboard collectors; the Charity Food Workgroup for instance, which coordinates charity food support to beneficiaries; and the earlier-mentioned ComLink, which supports families in rental flats.
We hope that more Singaporeans will join us in stepping forward to make a difference. Sir, in Mandarin, please.
(In Mandarin): [Please refer to Vernacular Speech.] Every youth has the potential to become an adaptable and resilient individual. In order to bring out the best in our youth, the Government will continue to work closely with our community partners to build a preventive support system for our vulnerable youth.
We will also pilot a mentoring programme targeted at students who leave ITE prematurely. We hope to guide them to build a network of positive relationships and also help them to find internships or job placements in the areas where they are interested in.
In recent years, we also collaborated with community agencies and religious organisations to set up many platforms to study and address various social issues, such as youth mental well-being, rough sleeping, vulnerable groups in the community, charity food support and so on.
We will continue to work with Singaporeans to build a society centred on resilience, care and inclusivity so that we can continue to thrive in the face of future challenges.
(In English): In closing, let me round back to the questions that Minister Masagos posed earlier: What is our shared vision for the future? What kind of society do we want to be, and what legacy do we want to leave for our future generations?
The future is ours to shape. From conversations with the public to spirited discourse with members of this House, we share a vision to build a society where all Singaporeans have access to opportunities to achieve their dreams and that no one is left behind.
MSF will continue to work with all Singaporeans to build resilient individuals, strong families, and a caring and inclusive society, so that Singapore can thrive no matter what the future brings. [Applause.]
The Chairman: We have some time for clarifications, if any. Mr Louis Chua.
Mr Chua Kheng Wee Louis: Happy International Women's Day in advance. Just a quick one. I think we have the plans to have every household be within 10 minutes walking distance of a park by 2030, so similarly, one of the common feedback that my residents have shared in terms of pre-school is that they are facing difficulties having a pre-school near their place. So, I was just wondering if the Ministry will consider having such a plan whereby every household would be within walking distance of an available pre-school.
The Chairman: Minister of State Sun.
Ms Sun Xueling: I thank the Member Mr Louis Chua for his clarification. Indeed, the point that he mentioned was exactly one of the points that myself and my colleagues, Rahayu Mahzam, Cheryl Chan and Cheng Li Hui, made in our Position Paper in 2019.
And thereafter the Government made a promise that we will look at making pre-schools more accessible, more affordable, and of course, that they are quality pre-schools. For new estates, like Sengkang, like Punggol, if you look at childcare's capacity, it has more than doubled in Sengkang and Punggol in the past five years from about 11,000 in 2015 to over 23,000 places today.
But I take the point that many young families would like to have a childcare as close as possible where it is logically and logistically possible because we also have to look at void deck space and the facilities that are available. But as a matter of principle, the Government knows the needs of young families and where it is possible, as we ramp up the total number of childcare places, we will have them in accessible locations for young families.
The Chairman: Any other clarifications? If not, may I invite Mr Seah to consider withdrawing his amendment?
Mr Seah Kian Peng (Marine Parade): Mr Chair, just on behalf of all the members who filed cuts, just like to take this opportunity to thank Ministers Masagos, Desmond Lee, Minister of State Sun Xueling, Parliament Secretary Eric Chua for your answers to all our cuts.
It is Friday and it is almost half past eight. It may be late. But to all the men and women in this space, the social service space, we know that they work very quietly, but very hard behind the scenes throughout the years. We want to thank them and appreciate their good work and to also assure that all of us in this House will continue to journey with them, so that collectively, we are one step closer to building a more caring, more giving, more compassionate and more inclusive society. With that, Mr Chairman, I beg leave to withdraw my amendment.
[(proc text) Amendment, by leave, withdrawn. (proc text)]
[(proc text) The sum of $4,035,035,800 for Head I ordered to stand part of the Main Estimates. (proc text)]
[(proc text) The sum of $98,938,700 for Head I ordered to stand part of the Development Estimates. (proc text)]
","clarificationText":null,"clarificationTitle":null,"clarificationSubTitle":null,"reportType":null,"questionCount":null,"footNotes":null,"footNoteQuestions":null,"questionNo":null},{"startPgNo":0,"endPgNo":0,"title":"Committee of Supply Reporting Progress","subTitle":null,"sectionType":"OS","content":"The Chairman: Leader.
The Leader of the House (Ms Indranee Rajah): Mr Chairman, may I seek your consent to move that progress be reported now and leave be asked to sit again on Monday, 8 March 2021?
The Chairman: I give my consent.
[(proc text) Resolved, \"That progress be reported now and leave be asked to sit again on Monday, 8 March 2021.\" – [Ms Indranee Rajah]. (proc text)]
[(proc text) Thereupon Mr Deputy Speaker left the Chair of the Committee and took the Chair of the House. (proc text)]
Ms Indranee Rajah: Mr Deputy Speaker, I beg to report that the Committee of Supply has made progress on the Estimates of Expenditure for the financial year 2021/2022, and ask leave to sit again on Monday, 8 March 2021.
Mr Deputy Speaker: So be it.
","clarificationText":null,"clarificationTitle":null,"clarificationSubTitle":null,"reportType":null,"questionCount":null,"footNotes":null,"footNoteQuestions":null,"questionNo":null},{"startPgNo":0,"endPgNo":0,"title":"Adjournment","subTitle":null,"sectionType":"OS","content":"[(proc text) Resolved, \"That Parliament do now adjourn to 10.00 am on Monday, 8 March 2021.\" – [Ms Indranee Rajah]. (proc text)]
Adjourned accordingly at 8.31 pm.
","clarificationText":null,"clarificationTitle":null,"clarificationSubTitle":null,"reportType":null,"questionCount":null,"footNotes":null,"footNoteQuestions":null,"questionNo":null},{"startPgNo":0,"endPgNo":0,"title":"School Fees at Government-funded Special Education Schools","subTitle":null,"sectionType":"WANA","content":"4 Mr Leon Perera asked the Minister for Education (a) for Government-funded Special Education (SPED) schools, what is (i) the range of school fees and (ii) the mean and median school fees for a student; and (b) after the extension of the Compulsory Education framework to include students with moderate to severe special needs with effect from 2019, what has been the change in average SPED school fees.
Mr Lawrence Wong: There are 19 government-funded Special Education (SPED) schools which are run by Social Services Agencies (SSAs).
SPED schools charge different fees to meet the diverse and specialised learning needs of students, as they customise their programmes and services according to the disability profile of their students. Currently, the majority of SPED schools charge monthly fees ranging from $14 to $20 for Singapore Citizens (SCs). Three SPED schools charge around $60 to $70 per month, and six charge higher monthly fees of between $120 and $250. Across all SPED schools, the mean and median monthly fees are around $120 and $70 respectively.
With the extension of the Compulsory Education Act to children with moderate-to-severe special educational needs (SEN) from 2019, and the increase in Government’s funding to SPED schools over the years, SPED schools have been able to achieve stable funding and review their fee positions. In January last year, the SPED schools which charge relatively higher fees reduced their fees by at least 25% for SCs. In the coming years, we will continue to engage schools on reviewing and keeping fees affordable.
Lower income families across all SPED schools requiring financial support with their children’s educational expenses are supported by the SPED Financial Assistance Scheme (FAS). Students on SPED FAS receive full waiver of school fees, free textbooks and school attire, school meals and public transport subsidy. They may also be eligible for other support schemes.
MOE will continue to work with SPED schools to ensure accessible and affordable education for children with SEN.
6 Ms Nadia Ahmad Samdin asked the Minister for Health (a) whether there are efforts for telemedicine and mobile medical services to tackle mental health issues remotely, in particular among the elderly; and (b) whether there has been any evaluation in the last one year on how willing and able are our seniors to use such digital services when it comes to their health.
Mr Gan Kim Yong: Public Healthcare Institutions (PHIs) currently provide video consultation services for the management and follow up of mental health conditions in suitable patients, including seniors. Since 9 October 2020, the Ministry of Health (MOH) has also introduced a time-limited extension of Community Heath Assist Scheme (CHAS) Chronic subsidies and Medisave usage for video consultations carried out for all chronic conditions under the Chronic Disease Management Programme (CDMP), including mental health conditions such as anxiety and major depression.
Seniors with stable mental health conditions and their caregivers can be supported at home by the community intervention teams. These community intervention teams are mobile teams that provide allied-health services such as psychotherapy and counselling. They also provide online counselling and psychotherapy sessions, where needed.
Seniors who face mental distress, for example who feel lonely, anxious or upset by problems, can reach out to The Seniors Helpline, which provides tele-befriending and tele-counselling services to seniors. In addition, CareLine, which is a 24/7 call centre, provides emergency response and social support services for isolated and vulnerable seniors.
As of end October 2020, over 24,000 patients, including seniors, have made use of video consultation conducted by PHIs. CareLine also provided social support to around 10,000 seniors as at December 2020. We have also observed more seniors utilising tele-befriending and tele-counselling services. For example, there were some 8,700 calls made to The Senior’s Helpline in FY2019, up from about 5,600 calls in FY2018. MOH will continue to promote the use of digital and tele- solutions to enable patients to access mental wellness services in a convenient and safe manner.
","clarificationText":null,"clarificationTitle":null,"clarificationSubTitle":null,"reportType":null,"questionCount":null,"footNotes":null,"footNoteQuestions":null,"questionNo":null},{"startPgNo":0,"endPgNo":0,"title":"Policy of Providing HDB Flats to 80% of Singapore’s Resident Population","subTitle":null,"sectionType":"WANA","content":"7 Mr Gan Thiam Poh asked the Minister for National Development (a) whether there will be a change to the policy of HDB continuing to provide flats to 80% of Singapore’s resident population; and (b) whether HDB will review existing policies to further assist Singaporeans in owning HDB flats including giving all Singaporeans a chance to own a BTO flat.
Mr Desmond Lee: Home ownership is the cornerstone of our public housing programme, and the Government is committed to providing Singaporeans with affordable homes.
To ensure affordability, HDB provides generous housing subsidies, especially to first-timer buyers. Eligibility conditions are put in place to ensure that these housing subsidies are targeted at those who need them the most.
One such condition is the income ceiling. The income ceiling had been raised from $10,000 to $12,000 in August 2015 and from $12,000 to $14,000 in September 2019. At the current income ceiling of $14,000, about 8 in 10 citizen households qualify for subsidised public housing. Those who do not meet the eligibility conditions for subsidised public housing have the option of buying a resale flat on the open market without subsidy. Such households may be eligible for the Proximity Housing Grant, which does not have an income ceiling.
HDB will continue to monitor the housing market closely to ensure that housing policies remain relevant and responsive to the needs of the population.
","clarificationText":null,"clarificationTitle":null,"clarificationSubTitle":null,"reportType":null,"questionCount":null,"footNotes":null,"footNoteQuestions":null,"questionNo":null},{"startPgNo":0,"endPgNo":0,"title":"Use of More Sustainable Materials as Alternative to Plastics in Local Mask Manufacturing","subTitle":null,"sectionType":"WA","content":"1 Ms Nadia Ahmad Samdin asked the Minister for Trade and Industry whether the Government has been exploring more ways to encourage innovation in manufacturing methods that use more sustainable materials as an alternative to plastics in local mask manufacturing.
Mr Chan Chun Sing: With usage of disposable masks growing significantly since COVID-19 struck, it has become increasingly important to use more sustainable materials and production processes. The Government has begun to do this by encouraging the use of reusable masks, which significantly reduce the material used and waste produced. We will also consider ways to promote the use of more environmentally-friendly materials.
","clarificationText":null,"clarificationTitle":null,"clarificationSubTitle":null,"reportType":null,"questionCount":null,"footNotes":null,"footNoteQuestions":null,"questionNo":null},{"startPgNo":0,"endPgNo":0,"title":"Review of Regulatory Approach for Pet Industry and Pet Boarding Businesses","subTitle":null,"sectionType":"WA","content":"2 Mr Louis Ng Kok Kwang asked the Minister for National Development (a) whether he can provide an update on the Ministry's review on the regulatory approach for the pet industry and pet boarding businesses; and (b) whether the Ministry will be introducing a licensing requirement for pet boarding businesses in addition to the standards and best practices listed in the Code of Animal Welfare (for Pet Industry).
Mr Desmond Lee: In 2019, NParks embarked on a review of the pet sector to raise animal health and welfare standards, and safeguard public health. Since then, NParks has consulted the public and worked closely with stakeholders, and has made progress in several areas. For example, in 2020, NParks implemented one-time licensing for sterilised dogs and introduced vaccination guidelines to strengthen the animal health system. NParks also worked on increasing dog rehoming rates by allowing more mixed-breed dogs to be rehomed in HDB flats under Project ADORE. To further improve dog rehoming and adoption processes, a multi-stakeholder Rehoming and Adoption Work Group was formed in October last year. We thank the Member for being part of this work group.
As part of the pet sector review, NParks also intends to raise the standards of service providers in the pet sector. For example, NParks plans to license commercial pet boarding facilities based on the scale and nature of their operations. It is also reviewing the licensing conditions for pet boarders and breeders, including the housing and management, healthcare and traceability of the animals. NParks has been working with relevant stakeholders on this revised regulatory framework, and will announce more details when ready.
","clarificationText":null,"clarificationTitle":null,"clarificationSubTitle":null,"reportType":null,"questionCount":null,"footNotes":null,"footNoteQuestions":null,"questionNo":null},{"startPgNo":0,"endPgNo":0,"title":"Update on Investigations into Alleged Animal Welfare-related Offences by Operator of Pet Boarding Facility Platinium Dogs Club","subTitle":null,"sectionType":"WA","content":"3 Mr Louis Ng Kok Kwang asked the Minister for National Development whether he can provide a further update on the Ministry's investigations into alleged animal welfare-related offences by the operator of the pet boarding facility Platinium Dogs Club.
Mr Desmond Lee: NParks has concluded its investigations into the alleged animal welfare-related offences by the operator of the pet boarding facility Platinium Dogs Club. As the case is now before the Court, NParks is unable to comment further on this matter.
","clarificationText":null,"clarificationTitle":null,"clarificationSubTitle":null,"reportType":null,"questionCount":null,"footNotes":null,"footNoteQuestions":null,"questionNo":null}],"writtenAnswersVOList":[],"writtenAnsNAVOList":[],"annexureList":[{"annexureID":1845,"sittingDate":null,"annexureTitle":"Annex 1","filePath":"d:/apps/reports/solr_files/20210305/annex-Annex 1.pdf","fileName":"Annex 1.pdf","sectionType":"OS","file":null}],"vernacularList":[{"vernacularID":4376,"sittingDate":null,"vernacularTitle":"Vernacular Speech by Mr Baey Yam Keng","filePath":"d:/apps/reports/solr_files/20210305/vernacular-Baey Yam Keng MOT 5 Mar 2021 -Chinese.pdf","fileName":"Baey Yam Keng MOT 5 Mar 2021 -Chinese.pdf"},{"vernacularID":4377,"sittingDate":null,"vernacularTitle":"Vernacular Speech by Mr Gan Kim Yong","filePath":"d:/apps/reports/solr_files/20210305/vernacular-Gan Kim Yong MOH 5 Mar 2021 -Chinese (MOH edit).pdf","fileName":"Gan Kim Yong MOH 5 Mar 2021 -Chinese (MOH edit).pdf"},{"vernacularID":4378,"sittingDate":null,"vernacularTitle":"Vernacular Speech by Mr Masagos Zulkifli B M M","filePath":"d:/apps/reports/solr_files/20210305/vernacular-5 Mar 2021 - Minister Masagos - Reply to MOH Cut.pdf","fileName":"5 Mar 2021 - Minister Masagos - Reply to MOH Cut.pdf"},{"vernacularID":4379,"sittingDate":null,"vernacularTitle":"Vernacular Speech by Ms Rahayu Mahzam","filePath":"d:/apps/reports/solr_files/20210305/vernacular-5 Mar 2021 - Parl Sec Rahayu - Reply to MOH Cut(JT)(E).pdf","fileName":"5 Mar 2021 - Parl Sec Rahayu - Reply to MOH Cut(JT)(E).pdf"},{"vernacularID":4380,"sittingDate":null,"vernacularTitle":"Vernacular Speech by Ms Ng Ling Ling","filePath":"d:/apps/reports/solr_files/20210305/vernacular-Ng Ling Ling MSF 5 Mar 2021 -Chinese.pdf","fileName":"Ng Ling Ling MSF 5 Mar 2021 -Chinese.pdf"},{"vernacularID":4381,"sittingDate":null,"vernacularTitle":"Vernacular Speech by Mr Masagos Zulkifli B M M","filePath":"d:/apps/reports/solr_files/20210305/vernacular-5 Mar 2021 - Minister Masagos - Reply to MSF Cut (Cleared by MSF).pdf","fileName":"5 Mar 2021 - Minister Masagos - Reply to MSF Cut (Cleared by MSF).pdf"},{"vernacularID":4382,"sittingDate":null,"vernacularTitle":"Vernacular Speech by Ms Sun Xueling","filePath":"d:/apps/reports/solr_files/20210305/vernacular-Sun Xueling MSF 5 Mar 2021 -Chinese (MSF edit).pdf","fileName":"Sun Xueling MSF 5 Mar 2021 -Chinese (MSF edit).pdf"},{"vernacularID":4383,"sittingDate":null,"vernacularTitle":"Vernacular Speech by Mr Eric Chua","filePath":"d:/apps/reports/solr_files/20210305/vernacular-Eric Chua MSF 5 Mar 2021 -Chinese (MSF edit).pdf","fileName":"Eric Chua MSF 5 Mar 2021 -Chinese (MSF edit).pdf"}],"onlinePDFFileName":""}