Mr Speaker, Sir, I would like, if I may, to focus the attention of this House on one issue which I believe needs to be addressed immediately, and that is, the impact of the National Ideology on the youth of Singapore and on their aims and aspirations. I say this because I believe that it is now time to disabuse the young Singaporean of the misconception that the formulation and implementation of the National Ideology will result in a less open and participatory style of government and in greater censorship in the flow of information. If that wrong perception is not addressed and corrected, the skeptical amongst the young may give less than their wholehearted support to the National Ideology. There is no disputing that the National Ideology is necessary. The object is the creation of a society which is communitarian, hardworking, pragmatic and capable of moving as one, and in the same direction. The ultimate objective is a Nation of Excellence. There are on-going discussions in relation to the content of the National Ideology. A number of values have been identified. Two which stand out are the communitarian concept of putting the interest of society above those of the individual and filial piety which, loosely speaking, is synonymous with respect for authority. It is very likely that because these values are highly regarded by the people who have seen the value of the ideals that they will find their way into the National Ideology, as they should. However, the younger generation is concerned more with what happens next. How, in practical terms, is the Ideology going to work and how will it impact on their aims and their aspirations? We have reached a stage in our development where the younger Singaporean enjoys a range of liberties and it is quite clear in his or her mind that the trend ought to be towards greater liberalization, towards an unrestricted flow of information. One illustration is the recent heated debate in the Forum Page in the Straits Times in connection with the censorship of religious or quasi-religious works. The young also feel that they must be consulted and convinced before policies are implemented; that there must be deliberation; that there must be a visible interplay of contending forces for the best ideas to take root and to grow, and for the best policies to take shape. However, because we are looking for traditional Asian values, the chances are that the elders, and not the youth, will be the major contributors to the National Ideology. By its nature, the National Ideology must draw from our experienced citizens who because of their age and maturity are in a better position to say what should be preserved, what ought to be discarded and how and why such values as are retained will better glue us together. Therefore, the young feel that this is a possible scenario: a National Ideology whose content is not determined by the youth being introduced in a society where the young have strong and fixed views and ideas about their goals, aspirations and aims. If one were to assume that the National Ideology will take 20 to 30 years to take root, one then goes on to the assumption that (and which is necessary) for it to be effective, these values will have to be continuously imparted and practised. Outlooks and attitudes will have to be shaped. The young generations will ask the following questions: (1) In the context of communitarianism and respect for authority, does this mean that exposure to western ideas and influences would be narrowed? (2) For respect for authority to mean anything, does this mean that dissent, debate or disagreement would be frowned upon and unquestioning obedience encouraged? These questions must be addressed or otherwise our detractors will take advantage of any doubts which may exist. I am delighted that these questions are in the process of being addressed and today the Minister for Trade and Industry has further clarified the position and gotten rid of the misconception that the National Ideology is inconsistent with our goal, which is a lively, vibrant nation full of ideas and creativity, a goal which is encapsulated in the Agenda for Action. Simultaneously, with such clarifications, I would urge the Government in its policy declarations to avoid running the risk of misinterpretation for the skeptical amongst the young may read way too much into it. For example, in the Addendum of the Ministry of Communications and Information to the President's Address, it is stated that as far as information and broadcasting is concerned, the aim is to help "understand national issues, Government policies and play a role in nation building." SBC, on its part, will "broadcast more community based news stories and interviews to clarify policies." Without clarification, eyebrows will be raised. If the youth, who will continue to want to have their say and as much access as is possible to unrestricted information, sense a hint of tighter censorship or greater control generally, they are then going to feel that their aspirations cannot be attained in Singapore. They will feel alienated or claim to be disenchanted. They will not give their support to the Ideology. And without their support, it becomes impossible to transmit the values down the generations. And ultimately, the National Ideology would be offered as a reason, valid or otherwise, to migrate, to say that "Singapore is not the place for me." I urge the Government, therefore, to continue to assure the younger Singaporeans that we are sincere in our objective of encouraging participation, of creating more opportunities for Singaporeans to actively participate in shaping their own future; that subject to present limitations only, there will be unrestricted flow of information because that is consistent with what we are trying to achieve. As we build on the superstructure, as we aim to be up there with the best, we have to make sure that our foundations are reinforced so that short of a devastating earthquake, we will still be around when others might have crumbled. Mr Speaker, Sir, I support the motion. The Minister of State for Community Development and Education (Dr Seet Ai Mee): Mr Speaker, Sir, I rise in support of the motion moved by the Member for Siglap in thanking the President for his Address. Mr Speaker, Sir, in two important documents presented by our First Deputy Prime Minister in 1984 and 1988, namely, "The Vision of 1999" and "Agenda for Action", Singapore is depicted as the "Switzerland of Asia" with highly developed manufacturing and service industries, vibrant economy, per capita income of US$15,000 or more, a beautiful and efficient city, where Singaporeans have more leisure and are more mature, better educated, and live in harmony and tolerance. The First Deputy Prime Minister has painted a beautiful picture - one which tugs at the very heart strings, truly a utopian and perfect picture. Referring to perfect pictures, I am reminded of this anecdote: While looking at him painting the ceiling of the Sistine Chapel, Pope Julius II criticized Michelangelo and suggested that the artist put a gilding round where the prophets were depicted or, the Pope added, "they would look poor." "But", Michelangelo replied, "the people I painted were poor". In Singapore, economic growth has enabled our people to improve dramatically our standard of living. Our per capita GNP is now among the highest among the countries of Asia. Higher productivity in the economy has meant that people have been able to purchase more goods and services than ever before. Poverty has decreased by most measures because the economy has been successful in expanding business activity without excessive inflation. However, the prosperity of the last decade is not shared by all. There are some in our community who have missed out. Mr Speaker, Sir, to the question of how many are poor, there is no simple answer. In Singapore, if we define poverty to mean the indigent or starving, there are few. If we define it by mean lower income, it is subject to many vagaries. From a labour force survey in 1988, based on gross household income data, it was estimated that 20,430 very low income families, or 4.8% of total households, with gross minimum household income of less than $400. Can a household really manage on less than $400 a month? This 4.8% are therefore, really, really, poor! In the experience of the hon. Member for Kebun Baru and the Ang Mo Kio Town Council, 4.5% of households were in arrears of service and conservancy charges of six months or more, and in a recent article in December 1988 the hon. Member asked: "Who will help the poor in Town Councils?" Mr Speaker, Sir, I would like to ask a similar question this day: Who will help our poor in medical care? In the last three months, in the Meet-the-People Sessions, I have had to deal with two appeals concerning government hospital bills. One had to do with a protracted stay in hospital, and the second, a surgical operation followed by a long stay. In both cases the families could not pay the hospital bills and had been given warning notices. Arrangements for payment in instalments had to be made for the first and utilization of two daughters' Medisave accounts for the second family. Mr Speaker, Sir, these cases set me thinking and investigating and I wish to share my findings and concerns with the House today. Sir, I wish to address the issues of provision of C-class beds in our hospitals, to cater to the needs of the lower income group, of Medisave and Catastrophic Illness Insurance schemes for the unemployed, needy and the aged. Our medical services had striven for excellence and we have achieved great strides in improvements in primary health care, medical specialities and support services. Naturally, these can only be achieved at increased financial cost. As Singaporeans become more affluent, there are also greater expectations for better health care, resulting in higher cost to the nation and to the care recipient. How can one meet the rising cost of medical care and hospitalization? The introduction of Medisave in 1984 where CPF savings can be used to pay for hospitalization has alleviated the problem to some extent. But Medisave accounts are, after all, limited savings and if hospital costs continue to escalate, these savings will be eroded in no time. Out of a total of 1.764 million Medisave members as at 31st December 1988, 41.8% had less than $1,000 and 29% had from $1,000 to $4,000 in their accounts. These figures show that almost 71% of Medisave members have less than $4,000 in their accounts. And in this age of rising hospital costs, $4,000 certainly will not go far. What about the 41.8% who have less than $1,000? What about those with no or very low Medisave savings because of their low income? What options are available for them - the poor in our society? There are two trends I would like to focus attention on, Mr Speaker, Sir, in relation to hospital beds for the less well off. The first, of course, is the rising costs for C-class and B2 ward charges in acute hospitals since 1980. The second, the decreasing number of C-class beds in our acute hospitals. From 1980 to 1987, the cost of a C-bed rose from $7 to $20, an increase of almost 200% and for B2 beds from $15 to $33 for other hospitals and $43 for the Singapore General Hospital. These are hefty increases, far higher than national wage or inflationary increases. Secondly, the number of C beds in acute hospitals dropped from 4,007 in 1980 to 2,054 in 1988, a reduction of 1,953, while the number of B2 beds rose from 66 to 1,581, a gain of 1,515. In the building of the new SGH and NUH, C-class wards were discontinued and new B2 class wards introduced. While these wards were smaller and more comfortable than the old C-wards, in cost terms to the poor patients, it meant paying in 1988, $43 total B2 ward fees for SGH per day as compared to $10 C class fees in 1983. In the Addendum to the President's message, the Acting Minister for Health informed us that there will be redevelopment of four major hospitals, Tan Tock Seng, Toa Payoh, Kandang Kerbau and Woodbridge Hospitals. When the new SGH and NUH were built, all C-class wards were discontinued and B wards introduced. Are we to take this as a trend which will continue, especially in the new acute hospitals? May I request that the Acting Minister for Health consider continuing the practice of providing of C beds while introducing B2 beds in the new hospitals, taking cognizance of the words of the First Deputy Prime Minister on 10th September 1988, when he cited as one of his priorities for his new Cabinet and I quote, "help for those in the bottom 25% of society, who have missed out on progress and prosperity". It is this 25% who will need the provision of new C ward beds. Much attention has been drawn to our "greying population" in the last few years. Figures show that the number of aged persons of more than 60 years of age will rise from the present 220,900 to 835,000 in the year 2030 and those old-old, greater than 75 years of age, from 31,300 to 242,800 in 2030. As our people age, there will be more medical and health problems. The immune and regenerative systems run down with the ageing process, and the old will succumb to more diseases and illnesses, and will require more health care. Today, although the aged comprise 8% of our population, they account for 20% of all Government outpatient attendees and 18% of all hospital admissions. Furthermore, the average length of stay in acute hospitals of the aged is 14(r) days, almost twice the average length of stay of younger patients. As our population greys, there will be a need for more acute and non-acute hospital beds. Currently, catastrophic medical insurances will cover events only up to the age of 65 and terminate with unemployment or default of premium payments. Furthermore, premiums increase with increasing age and premiums are at a premium once one exceeds the age of 60! Insurance policies are after all not subsidies but a means to spread the risk among contributors. Current hospitalization and catastrophic insurance policies cease provision at the time when it is most required, the years beyond 65. I hope that the Acting Minister for Health, in his introduction of Catastrophic Illness insurance, will not forget to make consideration for the ageing and the unemployed in our population. We are not Gods. We are but men and women. We may be healthy now but we can and do get sick. And major diseases like cancer, stroke and heart attack are no respectors of persons. They afflict rich and poor alike. Unfortunately, we cannot, much as we would like to, claim that it is man's inalienable right to have good health. While this cannot be, what I feel should be is that regardless of station, in our fast developing and progressing society, good hospitalization and medical care should be available to all, old and young, rich and poor. The rich and able who can afford can opt for private medical care and pay for private hospitalization and health care, commensurate with the degree of comfort and personalized service they desire. While those in our community who are poor should still receive good medical care in Government hospitals and wards. The medical, surgical and ancillary charges of these wards, be they C class or B2 class, in the words of the Member for Tiong Bahru GRC, "must be kept affordable", so that our sick who are poor and aged will never be deprived of good medical care. While in Singapore we teach our community to share and to care and to be compassionate, this level of caring and sharing and compassion must also be shown by our Government. While we have wisely not espoused the concept of the welfare state as practised by some western countries, we do have a duty to care for the poor in our society, and provision for subsidized hospitalization and medical services is clearly an area of importance. I plead this cause, lest in the pursuit of excellence, we become a nation which has lost its heart. Mr Speaker, Sir, I support the motion. 4.10 pm