Hansard, 1993-11-10

Under the provisions of clause 2(d) of Article 46 of the Constitution of the Republic of Singapore, the following Members have been granted permission to be or to remain absent from sittings of Parliament (or any Committee of Parliament to which they have been appointed) for the periods stated:- Dr Tony Tan Keng Yam - from 21st to 30th October, 1993. Mr Charles Chong - from 24th to 31st October and from 7th to 11th November, 1993. Encik Mohamad Maidin B P M - from 25th to 30th October, 1993. Mr Heng Chiang Meng - from 25th to 26th October and from 21st November to 1st December, 1993. Mr Chia Shi Teck - from 26th to 30th October, 1993 Mr Lee Yiok Seng - from 27th October to 3rd November and from 9th to 12th November, 1993. Mr Chay Wai Chuen - from 27th October to 4th November, 1993. Mr Davinder Singh - from 27th to 28th October, 1993. Dr Ong Chit Chung - from 1st to 6th November, 1993. Dr Lau Teik Soon - from 1st to 12th November, 1993. Mr Koo Tsai Kee - on 2nd November, from 6th to 8th November and from 21st to 30th November, 1993. Encik Yatiman Yusof - from 3rd to 9th November, 1993. Encik Othman bin Haron Eusofe - from 6th to 8th November and from 18th to 24th November, 1993. Mr Zulkifli bin Mohammed - from 6th to 8th November, 1993. Dr John Chen Seow Phun - from 6th to 7th November, 1993. Mr Chng Hee Kok - from 7th to 11th November, 1993. Mrs Yu-Foo Yee Shoon - from 8th to 10th November, 1993. Mr Peter Sung - on 8th November, from 22nd to 26th November and from 29th November to 4th December, 1993. Mr Goh Chee Wee - from 8th to 10th November, 1993. Mr Goh Chok Tong - from 8th to 10th November, 1993. Dr Wong Kwei Cheong - from 8th to 9th November and from 15th to 19th November, 1993. Cdre (Res) Teo Chee Hean - from 8th to 10th November and on 22nd December, 1993. Mr Chew Heng Ching - from 8th to 16th November, 1993. Encik Sidek bin Saniff - from 9th to 12th November, 1993. Mr S. Chandra Das - from 9th to 12th November, 1993. Dr Yeo Ning Hong - from 9th to 10th November, 1993. Mr Ling How Doong - from 10th to 30th November, 1993. Mr K. Shanmugam - from 10th to 12th November, 1993. Mr Chua Teck Chew, Robert - from 11th to 14th November, 1993. Dr Ho Tat Kin - from 12th to 24th November, 1993. Mr S. Dhanabalan - from 15th to 23rd November, 1993. Mr Goh Choon Kang - from 15th to 23rd November, 1993. Assoc. Prof. Ho Peng Kee - from 15th to 20th November, 1993. Mr Wong Kan Seng - from 16th to 30th November, 1993. Mr Bernard Chen - from 17th to 27th November, 1993. Dr Tan Cheng Bock - from 21st November to 1st December, from 16th to 19th December and from 29th December 1993 to 5th January, 1994 Mr Eugene Yap Giau Cheng - from 3rd to 9th December, 1993 Dr Hu Tsu Tau, Richard - from 17th December 1993 to 5th January, 1994. TAN SOO KHOON Speaker Parliament of Singapore

The following Bills were assented to by the President of the Republic of Singapore on the dates stated: 20th October, 1993 Goods and Services Tax Bill 1993. 28th October, 1993 (i) Insurance (Amendment) Bill 1993; (ii) Road Traffic (Amendment No. 2) Bill 1993; (iii)Parking Places (Amendment) Bill 1993; and (iv) Application of English Law Bill 1993. TAN SOO KHOON Speaker Parliament of Singapore

asked the Minister for Trade and Industry what are the Government's plans to increase the number of scientists and technologists from our local universities and abroad so as to meet the manpower needs of the public and private sectors' research and development programmes.

Mr Speaker, Sir, for research and development to bear fruit, the critical success factor is undoubtedly the human factor. It is thus essential that we have sufficient trained and expert manpower. Under our National Technology Plan, we aim to have a ratio of 40 research scientists and engineers (RSEs) per 10,000 labour force by the year 1995. From the 1992 R&D Survey, we now have 37 RSEs per 10,000 labour force. The National Science and Technology Board is continuing its efforts to strengthen and develop our R&D talent pool. It does this through programmes to increase public awareness of R&D, the funding of postgraduate study grants, research training and exchange programmes and facilitating the recruitment of foreign R&D talent. Whilst our local universities are our main sources of RSE manpower, we need to encourage more of our graduates to enter into research as a career. During the Technology Month held last September, the National Science and Technology Board published newspaper feature articles on our R&D achievements, and conducted seminars, workshops and exhibitions on R&D, together with our universities, polytechnics and research centres and institutes. Many of these events were for students, aimed at stimulating their interest in R&D as a career. In addition, the National Science and Technology Board jointly funds, with private companies, study grants for postgraduate courses in R&D work and technology management, and research training and exchange programmes. These schemes are meant to help companies upgrade their existing R&D workforce, and to encourage companies to train new staff for R&D work. Our local universities cannot fully meet demand for researchers by the private and public sectors. Therefore, to supplement our local pool of RSE manpower, particularly in areas where there are insufficient researchers with the required expertise, the National Science and Technology Board works together with EDB to assist companies to recruit from overseas. These well-qualified, experienced researchers bring with them knowledge and skills that we would take years to develop on our own.

Sir, would the Minister consider keeping in view that there is a fair representation of local women in science and technology?

Sir, as in all areas, we recruit purely on merit. If there are any women who have been rejected because they are women, though they have their merits, I will be very pleased to hear and take action. But I think the Member would agree that we should not lower the standards in order to recruit women into R&D manpower.

I agree with the Minister. But I am wondering whether there are any measures to get women more interested in science and technology because that would be using our manpower and womanpower wisely for the next century.

Sir, all our measures to try and persuade our manpower to go into areas which are useful to our economy are aimed at both the men and women and I want to assure the Member that, having been to the National Science and Technology Board, there is a very high representation of women involved in research.

asked the Minister for Home Affairs (a) whether the Traffic Police investigate cases of minor accidents not involving any injury where there were no independent eye witnesses and Police were not at the scene; and (b) whether the Police can determine which party is at fault, based solely on the reports later made by those involved in the accident.

Mr Speaker, Sir, many motorists are still under the mistaken impression that even for minor accidents where there are no injuries or serious damage, they are required to lodge Police reports. This is not so. (For such minor accidents, the law does not require a police report unless the parties fail to exchange particulars.) As a result, Traffic Police are inundated with tens of thousands of reports of such minor accidents. In 1992 alone, there were 52,471 of such reports. Motorists making these reports expect the Traffic Police to make judgments and allocate blameworthiness and issue summons based purely on these reports. But in most of these cases it is almost impossible for Traffic Police to draw conclusions which will be fair. The reports are made after the parties and vehicles have left the scene and there are no independent witnesses. Almost always, each side making the report categorically asserts that the other is to blame. Because of this, Traffic Police has scaled down investigation of such minor accidents and the insurance industry is aware of it. What is important is that in such accidents, the parties should exchange particulars and then report the accident to their respective insurance companies to pursue their insurance claims. This is the position in many other countries, including Australia. The Traffic Police will, however, still investigate accidents where there is clear evidence of breaches of the law, incidents of criminal behaviour, such as road bullying, drunken driving, and reckless driving.

asked the Minister for Finance whether banks are legally permitted and sufficiently equipped to undertake the role and responsibility of stockbrokers for the Singapore Telecom shares and, if so, whether the precedent is set for banks to deal in more ``selected privatised'' shares in the future.

Mr Speaker, Sir, the recent public offering of Singapore Telecom (ST) shares is by far the largest flotation in Singapore's corporate history. It attracted the largest number of Singaporean investors with more than 1.4 million Singaporeans subscribing for and being allotted ST's "A" and "B" shares. Before the flotation, there were only about 400,000 investors with CDP securities accounts. In anticipation of the large number of people wanting to sell their ST shares during its initial period of trading, special SES trading terminals were set up at 107 branches of local banks located around the island. This is to provide members of the public with easy access to information about ST's share price, and to enable shareholders to sell their shares easily without having to go through a stock broking firm. Besides avoiding over-crowding at the stock broking firms, having the terminals located at various housing estates also reduces inconvenience to the investors, especially the senior citizens. They need not travel personally to the central business district just to sell a couple of hundred shares. About 14,750 investors sold their "A" and/or "B" shares on the first day of listing of Singapore Telecom through these special terminals. The existing SES stockbroking firms would not have the capacity to handle such a large number of individual sellers in addition to the usual daily transactions in the other counters. These special trading centres are set up specifically to only allow the investor to sell his ST "A" or "B" shares. Staff of the bank manning the terminals are not required to provide advice to investors on their share investments. Their job is just to key in the sell orders into the trading terminals to match the current best bid in the market. If an investor is unsure whether to sell his Telecom shares, he would be asked to consider the matter carefully before rejoining the queue to sell his shares. Singapore adopts the universal banking concept whereby our banks provide a wide range of services to their customers. Banks are exempt dealers under the Securities Industry Act. Accordingly, they are permitted to deal in securities on behalf of third parties. All the local banks have their own subsidiaries which are members of the Stock Exchange. Hence, the branches where the special terminals are located are merely acting as agents of their subsidiaries in carrying out the share transactions.

Sir, if it is simply to facilitate the sale of shares, could there be other better methods, like using the telephone lines, instead of setting up the terminals?

That may be difficult because you need to confirm a sale transaction and a verbal request may not be sufficient.

The second question is whether the banks will play this role for future Government privatisation exercise.

It will depend on the Stock Exchange and the size of future offerings.

asked the Minister for Finance, as a result of the successful sales of Singapore Telecom Vendor Shares by Temasek Holdings Pte Ltd to the public, (a) how much was received by Temasek Holdings; (b) how much of the funds received was derived from Central Provident Fund members' accounts; and (c) how does Temasek Holdings intend to invest such funds and what is the expected range of returns on such investments.

Sir, before I ask Question No. 4, I would like to declare that I am a director of ECICS Holdings and IFS which are subsidiaries of Temasek Holdings. Question No. 4, Sir.

Mr Speaker, Sir, the net proceeds from Singapore Telecom's initial public offer was about $4 billion. The amount withdrawn from CPF members' accounts to purchase Singapore Telecom shares was about $2.18 billion. The funds will be reinvested. How this will be done will depend, among other things, on what investment opportunities are available. The expected returns will depend on the nature of the investment, as well as the economic and market conditions prevailing at that time.

asked the Minister for Communications if he will state (i) the number of eligible Singaporeans who did not apply for the Singapore Telecom Group A shares and (ii) the reason(s) for their non-application.

Mr Speaker, Sir, out of a total of 1,694 million offer letters for Group A shares which were sent out to all eligible Singaporeans, 1.45 million returned their application forms to apply for Singapore Telecom Group A shares. In other words, about 244,000 Singaporeans or 14.4% of those eligible decided not to apply. We can only guess as to why this group of Singaporeans decided not to apply for the Group A shares. Some may have had other priorities in the use of their CPF funds. Others may have been averse to the risks of share investment. But whatever the case, the Government has left it to the individual to consider and decide, after making available all the relevant information. The fact that more than 85% of eligible Singaporeans did apply is a measure of the success of this exercise to enhance the assets of Singaporeans and make them members of a share-owning society.

Sir, could it be that these people have no money to apply and they have missed out on the wealth, especially when the prices of ST shares rise? Or could the Government not give them the shares, as it gave them the $200 under the CPF Top-up Scheme? Out of 800,000, I think something like 600,000 did not even top up with $500. They could be the people who are poor and who do not have the money to top up. You need to have money to apply for the shares.

Sir, first of all, it is not true that people who did not apply for the shares were the ones who did not have money in their CPF. A further breakdown of the numbers would indicate that not all the people who were active CPF account holders applied for the Group A shares. There were actually 10% of active CPF account holders, ie, people who are contributing regularly to their CPF accounts, who did not apply for the Group A shares. As I said, we can only guess as to why these people did not apply for the Group A shares. But the more important point really is that it is a conscious decision on the part of individuals to participate in this exercise. The Government gave $200 under the CPF Top-up Scheme and made the scheme as convenient as possible and it also made the Group A share application as simple as possible. But in spite of all this, 10% of active CPF account holders did not apply.

Sir, first of all, I would like to declare my pecuniary interest. Would Singaporeans who are away overseas, and their relatives have been asked to apply on their behalf for the Group A shares, be allocated such shares?

Yes, there were special arrangements made for eligible Singaporeans who were overseas. These arrangements were made well in advance. Proxy forms were made available to those who were about to go overseas. These forms were also available to their friends and relatives here in Singapore so that they could be sent or faxed to them. The administrators of the scheme also accepted responses by fax. So it was made as convenient as possible and all those who responded accordingly were allocated the shares.

Sir, as regards the CPF Top-up Scheme, can the Minister tell the House how many new accounts were opened?

Mr Speaker, Sir, I am afraid I do not have that number available. But if the Member wishes to address the question to the Minister for Labour, I am sure he will get the answer.

asked the Minister for Communications whether a less disruptive method will be adopted for future allocation of shares in the initial public offers of statutory boards, including a step-by-step education on electronic share application on television and video demonstrations in community centres.

Mr Speaker, Sir, the Government adopted various measures to facilitate a smooth initial public offering (IPO) of Singapore Telecom shares. Firstly, there was an extensive publicity campaign which began five months before the IPO. The Stock Exchange of Singapore (SES) and the banks organised a series of share investment seminars to educate the public on the mechanics of share investment. This was reinforced by the "Invest Singapore" publicity campaign, which included mobile exhibitions to 15 community centres all over the island to educate the public on the risks and benefits, as well as the procedures of share investment. The banks and the Stock Exchange of Singapore were also present at these exhibitions to facilitate the opening of CPF investment accounts and CDP accounts. Secondly, the Government simplified the application and selling procedures for Group A shares. An offer letter was sent to all eligible Singaporeans who merely had to sign and return the form in order to apply for Group A shares. The fact that 1.45 million Singaporeans, or more than 85% of all eligible Singaporeans, applied for Group A shares with minimum hassle indicates that the simplified application procedures for Group A shares were effective Unlike Group A shares, Group B shares were fixed-price shares with no discount or loyalty shares, similar to those offered in the fixed-price tranche of other IPOs. There are established application procedures for such shares. These shares were meant to cater for those Singaporeans who wanted some more Singapore Telecom shares. The anticipated target group was the existing share investors, who already have trading accounts with their brokers and CDP accounts, as well as new investors who are serious enough to learn and follow the established procedures. Response to Group B shares was unexpectedly overwhelming. Furthermore, many Singaporeans waited till the last moment to open the necessary accounts, despite the early publicity for the listing. The result was long queues at the CDP and the CPF agent banks. SES then simplified application procedures so that those using cash need not open CDP accounts, and those using CPF funds need not explicitly transfer funds from the CPF Ordinary Accounts to their investment accounts. Unfortunately, before we could implement these changes, some minor incidents of unruly crowd behaviour occurred at the CDP and CPF agent banks. Once the changes were implemented, the queues disappeared. We also anticipated a rush of people wanting to sell ST shares when trading began. We therefore made arrangements for Singaporeans to sell Group A and B shares at designated bank branches as well as at stockbroking offices and simplified the procedures for doing so. As matters turned out, these arrangements were more than adequate. There were no queues or delays, and everything went on smoothly. Sir, ST was the largest IPO ever on the SES. Its listing was not only a financial exercise, but also a political one to distribute share ownership among as many citizens as possible. Overnight, the number of shareholders in Singapore has increased more than three-fold, from about 400,000 to over 1.4 million. Despite this, overall, the operation proceeded extremely smoothly. Credit for this is due to the banks, SES, the CPF Board, ST itself, as well as the many Government departments which helped to coordinate and execute the operation. Their staff worked long hours to make everything ready and to service the public. The Government thanks them for all their invaluable contributions, without which the exercise would not have been possible. The Government will study the lessons learnt from this first IPO of a privatised statutory board, including Dr Toh's suggestion of a more comprehensive education on electronic share application procedures. Nevertheless, the fact that so many Singaporeans have been involved in this exercise will, to a large extent, ensure a smoother implementation the next time round.

Sir, may I ask the Minister whether the Government would consider an opt-out system or scheme for future IPOs? If the answer is affirmative, may I further ask the Minister how the Government would tackle (1) the legal issues relating to such a scheme and (2) the political odium of such a system should the share price upon listing be lower than the issued price since the scheme works on the basis of a passive acceptance.

Sir, an opt-out scheme was one of the options considered in the Singapore Telecom IPO. But the Government decided on an opt-in scheme instead. The decision to invest should be one made by the individual, not by Government. Government can explain the benefits of long-term share ownership. Government can make the procedures as simple and as convenient as possible, but it is up to the individual to decide whether he wants to invest in Singapore Telecom shares or not. An opt-in scheme requires the individual to make such a conscious and deliberate decision. An opt-out scheme does not. We are prepared to consider an opt-out scheme for future privatisations if the experience of the Singapore Telecom exercise had shown that the opt-in scheme that we adopted was too cumbersome, or discouraged too many Singaporeans from taking up the Singapore Telecom Group A shares. However, this did not happen. Of the over 1.6 million forms that we sent out, 1.45 million Singaporeans applied for and were allocated Group A shares, as I mentioned earlier. As a result of the simplified and convenient procedures for application, the whole exercise proceeded smoothly. So the Government will continue to use the opt-in scheme for future privatisation exercises.

Sir, is the Minister aware that there were complaints by some successful applicants for the Group C tranche that there was a delay in the confirmation of these shares which caused them to lose the opportunity of being able to trade in the shares on the first trading day?

Mr Speaker, Sir, I believe there were some complaints of this nature. But again, as I said, this was a massive exercise. It was a very large exercise. There were many people involved and I think the processing of all the various tranches of shares was done as quickly as possible. Staff involved in the banks, CPF and SES worked through the night to try and get the results out as quickly as possible. Under the circumstances, I am sure that there were some people who might have been left out or were informed late about their allocation of shares. But I believe that these matters were being handled by the agent banks as expeditiously as possible.

asked the Minister for National Development under what circumstances can a purchaser of a Housing and Development Board flat sell the flat upon taking possession without the need to wait for five years.

Under the HDB's Home Ownership Scheme, a purchaser of a HDB flat has to complete a requisite occupation period before he can sell the flat in the open market. The requisite occupation period is five years if the flat is bought directly from HDB and 30 months if it is bought in the open market. However, the following categories of flat owners are allowed to sell their flats in the open market without completing the requisite occupation period. The first category are owners of 1-room and 2-room flats. The second category are owners of 3-, 4-, 5- and Executive flats who qualify to sell their flats under the Third Child Priority (TCP) Scheme, and the third category are owners of HUDC flats.

Sir, I want to clarify with the Minister whether, under these three categories, a purchaser can immediately upon taking possession sell the flat in the open market? Or must he sell it back to the HDB?

I thought my answer states specifically that owners of these categories are allowed to sell their flats in the open market.

And are they required to pay a levy on the sale price? If so, how much?

The levy on the sale price is a policy by HDB, ie, 10% for a 3-room flat, 15% for a 4-room flat, and 20% for a 5-room flat.

Is there a bar on these sellers of flats that they do not have to wait for five years to purchase another HDB flat?

Whether the seller is eligible to buy a second flat from HDB depends on whether the flat he is selling is the first or second flat. In essence, the Government policy on subsidy gives the Singapore citizen two chances to buy from HDB. So if the flat he sells is his first flat, he can sell it, pay a levy, and apply for a second flat. But if the flat he is selling is the second flat, then he cannot come back to HDB.

Since it is upon the sale of the first flat and purchase of the second flat, can he immediately also sell the second flat?

It depends on the second flat that he buys. If the second flat falls in this category, he can sell the second flat, as allowed under these three categories.

Then he can carry on ad infinitum and enjoy the profits?

Under these three categories, if a person is buying a 1- or 2-room flat, he can buy and sell. We do not restrict him because we consider the 1- and 2-room flat as transitionary housing. Most Singaporeans will only buy the 1- or 2-room flat as the first step before buying a 3-room or bigger flat. So it is not likely that there are persons who want to buy and sell 1- and 2-room flats. He will not buy and sell and make a profit. There is very little profit in buying and selling 1- and 2-room flats. So the reason why we have waived the occupation period for the 1- and 2-room flats is that we want to give the poorer segment of Singaporeans a chance to upgrade quickly. So they buy a 1- or 2-room flat and after one or two years, they find that their wages have gone up, they can afford a 3-room flat, they can sell their 1- or 2-room flat in the open market and move on to a 3-room flat without waiting for the five-year requisite occupation period. So that policy is intended to help the lower segment of the population. And I doubt if there are many Singaporeans who will continue to buy and sell 1- and 2-room flats. Similarly for HUDC flats. They can buy and sell HUDC flats because, essentially, HUDC flats are very close to the private sector. There is no control on the occupation period of private sector flats. So an HUDC flat is a transition between a HDB flat and a private sector flat and the rules of occupation period have been liberalised so that they are more or less like private sector flats. For the third child category, he cannot buy and sell freely. Under the third child policy, you are only allowed to sell your first flat provided you have applied under the third child policy and under that policy, you are allowed to sell your first flat with a waiver of the occupation period. The second flat you get you have to stay in it for five years. So again, under the category of the third child policy, it is not possible for a person to keep on buying and selling the flat and claim the benefits.

Under the first and third categories, it is not a question of whether he can or cannot move out. The question is whether, under the HDB scheme, he can freely continue to sell the flat upon taking possession. It is not a question of whether he wants or does not want or whether he can or cannot. The issue is whether he can.

The answer is yes. For the first and third categories, the answer is yes.

So he can do it.

He can do it.

asked the Minister for National Development (a) what is the extent of the upgrading programme undertaken by the Housing and Development Board; (b) how many blocks of flats will be entitled to (i) major upgrading and (ii) interim upgrading; and (c) when will the upgrading programme be completed.

Sir, the Main Upgrading Programme will eventually cover most of the existing stock of old flats. With the successful launch of the demonstration phase and the first batch of the main phase, the programme has been geared up to upgrade 10 precincts next year. If there is sufficient capacity in the construction industry, HDB plans to increase this to 20 precincts each year. The Main Upgrading Programme is expected to last 10 to 15 years. The older flats will be upgraded first, but we will also ensure a geographical spread of the precincts to be upgraded. All things being equal, priority will also be given where there is strong support for this programme. The Interim Upgrading Programme (IUP) is intended to complement the Main Upgrading Programme. Without the IUP, some precincts may have to wait for more than eight years before they can be upgraded. With the IUP, improvement works at the precinct and block level can be implemented first, so that more residents can enjoy the benefits of the Upgrading Programme earlier. The first batch of 26 precincts in the IUP was announced recently. HDB plans to upgrade some 20,000 flats each year under the IUP together with the Town Councils. In this way, the benefits of upgrading will spread to as many Singaporeans as possible.

Sir, will the Minister consider building new flats in place of old flats instead of upgrading?

Mr Speaker, Sir, I think the Member is probably referring to Dr Tan Cheng Bock's suggestion, as reported in the press, that the Government should consider building new flats instead of upgrading. According to the newspaper report, Dr Tan Cheng Bock said that upgrading a flat costs as much as building a new one. I think the report stated that it costs the Government about $67,000 to upgrade a flat whereas it is now possible to buy a new budget 4-room flat, the cheapest of which is $70,000. So the cost seems to be the same. Whether we upgrade or build depends on the cost effectiveness of both solutions. In this case, I think Dr Tan Cheng Bock is partly right and partly wrong in making his suggestion, although I would say he is more wrong than right. He is right because the Government did explain that upgrading is very costly, especially if you want to add a utility room. When we announced the new cost sharing package of the upgrading programme, we explained that adding a utility room is very costly, because you have to divert services, lay new foundations and it costs three to four times more per square metre than if we were to build new flats. Dr Tan is right in that sense. It is not cost effective to add new utility rooms to old flats. At the same time, he should not compare construction cost of upgrading with the selling price of budget 4-room flats, because the selling price of budget 4-room flats is very heavily subsidised to allow the poorer segments of Singaporeans to own a 4-room flat. If we were to take a precinct on its own and we have to decide whether we want to upgrade or build, these are the cost considerations. If we upgrade with a utility room, which is not very cost effective, it will cost us about $67,000, of which the resident will have to pay $13,400 and the Government will have to give him a subsidy of $54,000. But if we were to build a brand new flat, a 4-room flat will cost about $90,000. If the Government were to give the same subsidy of $54,000, then the resident has to pay $36,000. So the comparison to the resident is whether he pays $13,000 for upgrading with a utility room or $36,000 if he wants a 4-room flat in the same area. But that means when we rebuild, we are not charging the resident for the land cost, because we are just talking about construction cost. So he has to pay $36,000 extra cost. The second reason why it is not cost effective is that if we were to build bigger units, we will end up with less units than the present number of units on site. Because the more bigger units we try to pack into the same area, the less units we will get. So it will not be possible to guarantee everybody that he will get a bigger unit in the same area because we will not be able to generate the same number of units when we build bigger flats. The third reason why it is not such a great idea is that even in our Main Upgrading Programme, more than 50% of the residents did not subscribe to the utility room. For many of these older residents in the old estates, they are quite happy with the standard upgrading where they pay less than $4,000 and they get a very nice environment and an upgraded flat. They are not interested in paying $13,400 for a utility room. If we were to knock down the flats and ask them to buy a brand new 3-room flat in the same vicinity, it will cost the Government $80,000 to build a 3-room flat. If the Government were to again subsidise $54,000, a resident, who does not really want a bigger flat still ends up with a 3-room flat, will have to pay $26,000 as compared to less than $4,000 under the Main Upgrading Scheme. We have considered both alternatives of upgrading and rebuilding and it is the Government's contention that upgrading is still a better solution for our older estates for these three reasons: (1) Many of the older folks do not want a bigger flat and cannot afford a bigger flat. (2) We may generate less units if we build bigger flats. (3) Even if we build bigger flats, it is not cost effective to do so.

Sir, I accept some of the reasons given by the Minister of State. I would just like to let him know that building new flats in place of old ones is also a form of upgrading. Actually, I am not against upgrading. I just want to make that clear.

Mr Speaker, Sir, I agree with Dr Tan Cheng Bock that rebuilding, instead of renovating, is also an upgrading process for the residents. But we must always look at the cost benefit of each exercise. Where it is cost effective for the Government, the state and the residents, indeed we will consider his suggestion. But in the mainstream of the upgrading programme, as I have explained, it is not cost effective and we will continue to pursue the Main Upgrading Programme.

Sir, from what the Minister of State has explained about these subsidies, can I take it that it is possible for the owners of existing 3-room flats to exchange their old flats, with the payment of an additional $36,000, for an economy 4-room flat in the same location?

I said that that is possible purely on the construction basis if (1) we can convince the other 50% of the residents who do not want a bigger flat that they are also buying into the programme; (2) we will not be able to generate so many big units to replace one for one in exchange for all the small units.

Sir, will the Minister of State consider that the new flats with a 99-year tenure are better than old flats with 20 years of the lease having expired?

Mr Speaker, Sir, the Member is not comparing like with like. That means when we rebuild, we are giving them 99 years and they are extending the land use. If we want to compare whether it is cost effective to renovate or rebuild, then we should use the same land lease terms.

Sir, would the Minister of State identify certain precincts within old housing estates where the land is big enough to accommodate the same number of new 4-room flats as the existing 3-room flats? Also, HDB could conduct a survey, or by ballot, to find out whether the residents residing in a precinct would all agree to exchange for a 4-room economy flat. Will the Minister of State for National Development consider rebuilding and selling a 4-room flat at $36,000?

Mr Speaker, Sir, I have already explained that in the bulk of the older estates, first, there is very little land for us to carry out a major rebuilding programme in such a way that we can guarantee everybody a one for one exchange. Because when we rebuild the older precincts, we will end up with less units. Second, as we have explained, in the Main Upgrading Programme, we really do not encourage Singaporeans to opt for a utility room. We explained in the press conference that it is not cost effective for us to add a utility room to an old flat. The objective of our Main Upgrading Programme is to upgrade the environment, improve the facilities and improve the environment of the flat. It is not to add space. If a resident really wants space, I think the best alternative for him is to apply for a new flat in the new towns. At the same time, we provide the option of a Standard-plus package in case there are people who feel very strongly that they want a utility room. In that situation, they must pay a higher share of the cost because it is not cost effective to put a utility room. In short, the answer to Mr Low is that where it is possible for us to rebuild, instead of upgrade, the Government will consider to do so. But in the main, for the reasons I have explained earlier, the upgrading programme is still the better way to proceed.

Sir, the Minister of State has explained very clearly why it is better to upgrade than to build new blocks of flats. If that is so, in the earlier years, why were so many blocks of flats demolished instead of being upgraded?

Sir, those blocks which were demolished in the earlier years, and which we continue to demolish today, were the 1- and 2-room rental flats. Singaporeans, in case Mr Chiam does not know, have grown richer. They are not staying in 1- and 2-room rental flats any more. Many of our 1- and 2-room blocks of flats have very high vacancy rates. We do not demolish rental flats haphazardly. We have a rule which says that rental flats in an area will be demolished if the vacancy reaches above a certain percentage. So we are just adjusting to the demand pattern of Singaporeans. As they grow richer, they want to buy bigger flats. The rental flats fall vacant. So we relocate them and we knock down the old rental flats. When we knock down the old rental flats, we create some land available. So we rebuild so that Singaporeans can enjoy some new flats in the older estates. But that is not to say that we can start a programme and guarantee every Singaporean that he can exchange his old flat for a new flat in the estate that he is staying. That is just physically and fiscally not possible.

asked the Minister for Education (a) what measures are being taken to test the soundness of health schemes, eg, walking on stones, that are introduced in our schools; and (b) who bears the cost of such unproven ``health'' equipment or measures.

Sir, several health schemes have been introduced in our schools by the Ministries of Health and Education. Among them are the Annual School Health Screening, Vision Care Programme, Anti-Smoking Programme, the School Dental Service and the Trim and Fit Programme. Officials from both Ministries monitor the progress and evaluate the effectiveness of the programmes regularly. One primary school has recently introduced the "walking on stones" exercise to its pupils in the belief that the exercise could improve their physical well-being. The School Advisory Committee paid for the stone slabs used for the exercise. The Ministry has advised the school to be careful about introducing such unproven "health" practices.

Sir, would the Minister of State assure the House that any physical exercise programme introduced in schools in future will be under the supervision of trained PE teachers?

We will certainly ask the PE teachers to pay attention to whatever exercise that will be carried out. I believe that in that primary school it involves the PE teacher there.

Recently, there was a report that the physical fitness exercises were not what they should be, ie, they were not good. For example, the sit-up exercise is bad for the spinal chord. Why were the physical fitness exercises allowed for umpteen years until they recently found that those exercises were bad for health?

I do not know which incident the Member is referring to. I will have to check with the Ministry to find out which incident the Member is referring to.

The incident was reported in the SBC News.

I will have to look into the details of the incident.

Sir, may I ask the Minister of State what is wrong with walking on stones to harden the soles?

Like all exercises, "walking on stones" is one exercise that is meant to produce some effect in improving the health condition. So there is nothing wrong if there is no proof that it is harmful or ineffective.

But what about the opportunity cost lost? Because while the students are doing an ineffective exercise, they could be doing something that is effective.

We are not sure that that is not an ineffective exercise.

asked the Minister for Community Development if he will state the progress on the implementation of the Small Families Improvement Scheme.

Sir, since the announcement of the Small Families Improvement Scheme by the Prime Minister at the National Day Rally on 15th August this year, my Ministry has been working with various relevant Government and statutory bodies to work out the operational details. My Ministry has also held briefing and discussion sessions with various community groups likely to come into contact with families eligible for the Scheme to enlist their help in reaching out to them. We are also developing information pamphlets for distribution through the voluntary welfare organisations, grassroots organisations, unions and self-help groups, as well as family-planning clinics and other relevant agencies. The Scheme will be implemented in January 1994. More details on the Scheme will be released in December this year.

How many families are projected to benefit from the Scheme?

Sir, we estimate that about 4,000 families could benefit from the Scheme.

Would the Minister tell the House how the predecessor Cash Grant Scheme and the Small Families Improvement Scheme differ in their policy objectives?

Sir, the Cash Grant Scheme required the women to come forward to be sterilised. That is the main difference. They are aimed at helping families to keep their family size small. In terms of the broader objectives, they are the same. It is just that the mechanism is different.

Is the Cash Grant Scheme still in practice or has it been abolished?

Sir, this Small Families Improvement Scheme will replace the Cash Grant Scheme because this Scheme is much more attractive than the Cash Grant Scheme.

In the Cash Grant Scheme, it was $1,500 as the cut-off point. In view of the rising cost of living and the fact that the Cash Grant Scheme was introduced many years ago, would the Minister consider increasing the threshold of the cut-off point?

Sir, we do not believe in indexing the various thresholds or cut-off points to inflation. This Scheme is more attractive and those who really require help should come forward to seek assistance under this new Scheme.

asked the Minister for Information and the Arts, in view of Rupert Murdoch's purchase of STAR TV and plans for the distribution of satellite programming across the Asian continent, whether Singapore has any plans of its own to embark on satellite broadcasting.

Rupert Murdoch's entry into Asian satellite television broadcasting means keener competition. Intense competition for viewership invariably leads to a lowering of programming standards. This has been the experience all over the world. Our policy of disallowing satellite dishes for private households will not be viable once dishes become too small to be easily detected. We can delay, but we cannot prevent, the proliferation of TV channels in Singapore. Neither do we want to. By the time rural villages in China and India have ready access to 10, 20 channels, we really have no choice but to follow suit. Our response to increased competition in TV broadcasting is in three parts. First, by forcing SBC to become more competitive. SBC will be corporatised at the end of next year into a number of companies. We will privatise the companies gradually over a number of years. Second, by making cable TV widely available in Singapore. We are now working on a plan to provide every household in Singapore a cable capacity, with data compression, of over 100 channels. Not all channels will be for television. Many will be used for multi-media services like education and marketing. Work will begin next year and all households in Singapore should be wired up by the end of the decade. This will reduce the desire for satellite dishes and enable us to cut out channels which are pornographic or incendiary. In an emergency, the Government will still be able to reach out to everybody, whatever channel he may be watching. But more importantly, a comprehensive cable network will make us one of the most advanced cities in the world in information technology infrastructure. Third, we will go into regional broadcasting and the international multi-media business ourselves. The competition is tough. We will have to find niches to get into. Last year, the Singapore International Foundation (SIF) expressed interest in setting up a satellite broadcast service for Singaporeans and friends of Singapore living in the region. The Singapore Government has agreed to fund this service. From 1st January next year, SIF's Singapore International Television will be launched on Indonesia's Palapa satellite. It will broadcast one hour of news, documentaries and entertainment programmes every evening from 10.00 pm to 11.00 pm Singapore time. From 1st January, SBC's English News will be broadcast from 10.00 pm to 10.30 pm and can therefore be carried "live" on satellite. For the other half hour, documentaries and entertainment programmes will alternate in English, Mandarin and Malay. It will be possible to receive the service over a wide geographical area from Shanghai to Darwin. SIF will encourage hotels and condominiums which serve Singaporeans to pull down the signal from Palapa and include it in the TV menu. This will be our first foray into satellite broadcasting. We will look for other opportunities as we gain experience and confidence.

asked the Minister for Information and the Arts, in view of the surpluses accumulated by the Singapore Broadcasting Corporation as revealed in its 1992/93 Annual Report, whether the SBC will increase its budget allocation for non-profit making programmes, such as public education and cultural programmes and, if so, what percentage of its budget will be allocated for these purposes.

SBC has always given importance to programmes serving national objectives. Non-profit programmes consist of Public Service Broadcasts (PSBs) and locally produced dramas. Besides public education and cultural programmes, PSBs also include sports, children's programmes and all Malay and Tamil broadcasts. In FY 93, the cost of PSBs and locally produced dramas came to 71% of SBC's total budget. PSBs and locally produced dramas on television make up 49% of SBC's total TV transmission hours. SBC will continue to raise the quality and quantity of PSBs and locally produced dramas. For example, it will increase the number of English and Chinese news bulletins next year. SBC will also be producing English dramas on a regular basis and at some cost, because it is important to reduce our dependence on Hollywood. As announced earlier, SBC will be increasing the transmission hours of Malay programmes, including extending the daily Malay news from 20 to 30 minutes. SBC 12 will extend daytime transmissions and introduce children's educational programmes. Channel 12's cultural offerings will also be increased. SBC will be announcing details of these improvements next month. At present, SBC's deficit for non-profit programmes like PSBs and local dramas is met from licence fees and an annual grant from the Government. SBC does not use the surpluses it has built up to fund these programmes, as this would affect its future effectiveness. These surpluses are not large compared to its investment needs. SBC will spend them on upgrading and expansion, for example, the new Bukit Batok facility which will cost well over $100 million. SBC needs more studios and production facilities. It is planning to develop an overseas production facility in China. SBC must also prepare for digital audio broadcasts, and later on, high-definition television. SBC's long term challenge is to upgrade its channels to enable them to compete and retain viewers when new channels proliferate as a result of satellite and cable television. When SBC is corporatised into separate companies, a new regulatory authority will be established to be called the Singapore Broadcasting Authority (SBA). Among other things, SBA will determine the amount of public service broadcasts and locally produced dramas needed and subsidise television and radio companies accordingly. SBA will get its revenues for this purpose from licence fees and the Government.

May I ask the Minister whether efforts will be made to improve the quality, instead of just the quantity, of the broadcasts, especially on Channel 8. Currently, there is a serial on gambling and anti-social activities, such as drinking, to solve social problems have also been promoted.

The pressure to increase quality is ceaseless, not least because the competition is relentless. As to whether anti-social themes should be introduced on TV dramas, I think we have to strike a balance between being realistic and being moralistic. We want to maintain a certain moral tone on our television programmes, and to have messages which further the cause of our social development, but we cannot over-moralise on television because that is the quickest way to kill interest. Drinking, prostitution and gambling are part of the drama of life. Unless these are inter-woven into the dramas of SBC, SBC's dramas would not be interesting and will have very low viewership.

asked the Minister for Labour what are the latest trends of employment of foreign workers by the various sectors of our economy and their long-term economic or social impact and whether the Government is considering any changes to its foreign worker policy to counter any undesirable trends.

Sir, the demand for foreign workers varies from economic sector to sector. In the manufacturing sector, despite advances in technology, more higher value-added investments and redistribution of labour-intensive operations to the region, the foreign worker population has remained largely stable since 1990. In fact, there has been a slight pick-up in employment of foreign workers in the manufacturing sector since the early part of this year. The marine sector is currently facing a slowdown in business. Nevertheless, the foreign worker population in the marine sector has been increasing since the middle of this year. The domestic maid population also continues to increase, although the increase has been moderated by the higher levy of $300 per domestic maid which was introduced since 1st April 1992. The strong growth in the service and construction sectors has resulted in heavy demand for more foreign workers. In particular, the construction sector benefitted from the liberalisation of the dependency ratio from 1:3 to 1:5 foreign workers since November 1992. Sir, in the longer term, we must achieve more capital intensive, higher technology and higher value-added economic enterprises. This is the only solution to maintaining our competitiveness with a base of only three million Singaporeans. We cannot hope to compete in the labour intensive industries against our neighbours with far larger population bases. The emergence of India, Vietnam and the PRC as market-oriented economies makes it even more urgent for us to move away from cheap-labour activities. Already the impact of having more than 200,000 foreign workers in Singapore is being felt, such as the difficulties of housing the foreign workers and the problems created when they congregate in certain parts of Singapore. 1.30 pm

Order. End of Question time. [Pursuant to Standing Order No. 21(3), Questions Nos. 14 and 15 have been postponed to the sitting on 11th November 1993. Written answer to Question No. 13 on the Order Paper is reproduced in the section, 'Oral Answers to Questions Not Reached' (Cols. 993 - 994).]

Mr Speaker, Sir, as you know, I have on the Order Paper the Second Reading of four Bills standing in my name. But I would like to take the Legal Profession (Amendment) Bill at a later time, that is, after the conclusion of the debate on the motion on Affordable Health Care. Therefore, Sir, I beg to move, That item 5 on the Order Paper today be taken after item 7.

Question put, and agreed to. Resolved, That item 5 on the Order Paper today be taken after item 7.

Order for Second Reading read.

Mr Speaker, Sir, I beg to move, "That the Bill be now read a Second time." Sir, let me deal with the major provisions of the Bill. First, powers to deal with prohibited immigrants. Sir, clause 13 empowers the Controller of Immigration to compel an aircraft or vessel (or another aircraft or vessel of the same company) to take on board a prohibited immigrant which that aircraft or vessel had brought to Singapore. The powers include preventing an aircraft or vessel from leaving Singapore if its captain fails to comply. Sir, why do we need these powers? It is because we have actually had instances where foreign airlines have brought passengers into Singapore en route to another country and having failed to proceed onwards, they had tried to dump them in Singapore. The current penalties for such contravention will be enhanced to a fine of not less than $5,000 and not more than $10,000 or imprisonment for a term not exceeding 12 months, or to both. The amendment to section 31 enables the Controller to remove a prohibited immigrant to any port or place designated by the Controller. With these amendments, we will be able to remove the prohibited immigrants more quickly and effectively. Next, provisions requiring employers/harbourers of an illegal immigrant to screen the immigration status of such person. Sir, until a recent decision of the Chief Justice in February 1993, we have experienced considerable problems in prosecuting employers of illegal immigrants and overstayers. Under section 57(1)(e) of the Immigration Act, a person commits an offence if he employs an illegal immigrant or overstayer. In several cases, when an employer was charged with such an offence, he was able to get an acquittal by simply arguing that he was shown a copy of a work permit by the foreign worker, even though it turned out that the work permit was forged. In February this year, the Chief Justice in a High Court case of Naranjan Singh vs. Public Prosecutor, on appeal from the magistrate court, ruled that section 57(1)(e), read with section 57(8) of the Act, shifts to the offender the burden of proving that they did not know that the workers they employed were illegal immigrants. The Chief Justice said in his judgement that "to allow an employer to evade the section by shutting his eyes to the immigration or employment status of his foreign employee, would make proper control and enforcement impossible. It cannot be placing too onerous a duty upon employers in Singapore to require them to screen their foreign workers before employing them to ensure compliance with immigration policy and the law." As this is only a High Court decision, it is only binding on the lower courts. We therefore propose to amend the Immigration Act to provide expressly for this approach. This is the purport of clause 21(e) which adds new subsections (9) and (10) to section 57. For consistency, the new law would also apply to harbourers of illegal immigrants and overstayers. The proposed section 57(9) and (10) seek to require a person charged with employing or harbouring an illegal immigrant or overstayer to prove that he had exercised due diligence by checking the passport or travel document of the illegal immigrant or overstayer and that after checking the passport or travel document, he has reasonable grounds to believe that the illegal immigrant or overstayer was in possession of a valid immigration pass or permit if his defence is that the illegal immigrant or overstayer had such a pass or permit. Sir, we will always have foreigners coming here illegally to work so long as there are unscrupulous employers who believe that there are loopholes in the law in their favour. In fact, the Controller of Immigration has informed me that the problem of illegal immigrants and overstayers working illegally is resurfacing. A strong signal must be sent to these unscrupulous employers. The amendment will remove the inherent difficulty in prosecuting employers of illegal immigrants and overstayers. Next, provisions which empower the Controller to deal with certain permanent residents. Sir, the Act currently does not give the Government adequate powers to deal with permanent residents (PRs) who, for example, have been convicted of offences in that it does not empower the Controller to impose additional conditions on the entry permits of such PRs. The vast majority of PRs are of course law-abiding and, in fact, only a handful of PRs are convicted of offences each year. But these amendments are necessary to provide Government with wider latitude in dealing with PRs who have come to adverse notice. Currently, we can either allow the PR to retain his status without any conditions or we must revoke the PR status of a PR who has been deemed to be a prohibited immigrant and expel him. Although, as I said, the number of such PRs who commit offences or engage in undesirable activities is small, the Government's hands should not be tied. In some cases, it may be too harsh to revoke the PR status of a PR, especiall if he has family roots and ties here. The amendment in clause 5 will empower the Controller of Immigration to warn them and impose certain additional conditions on such PRs so that they need not be expelled if there is no need to. If these PRs breach the new conditions, their PR status can be revoked. Finally, provisions concerning judicial review. Sir, the grant of PR or immigration facilities to a foreigner are essentially matters within the purview of the Government. Those decisions are based on immigration policies based on national interest. Clause 15 of the Bill inserts a new section 39A to clarify that the Courts cannot substitute their decisions for the Executive's decisions in matters relating to immigration unless it is on ground of non-compliance with any procedural requirements. The intention of this amendment is that the merits of the immigration decision, that is, whether it is right or wrong, cannot be reviewed. This is to avoid a situation where the Courts can frustrate Government's decision to expel aliens under the Act or other immigration decisions concerning aliens. Illegal entry and overstaying are problems which affect many countries. Singapore is also faced with this problem. But we must have full powers to deal with such offenders and when they are apprehended, to prosecute them and expel them after they have served their punishment. In some cases where we have caught overstayers or illegal workers and we want to repatriate them, they have brought legal action or threatened to do so claiming they have a right to stay on for various reasons. We cannot allow this. In other countries like the United Kingdom, the Courts there have developed the doctrine of legitimate expectations of aliens and have deployed this doctrine to overturn some of the decisions of the Executive concerning aliens. It is our intention that this should not happen in Singapore. Sir, I beg to move. Question proposed.

Mr Speaker, Sir, I rise to support the Bill. I would like to briefly comment on only two aspects of this Bill. Firstly, section 57(1)(e). Sir, this section refers to the responsibility on persons harbouring or employing foreigners. While I agree with the spirit of this amendment, mainly that they must show due diligence by checking the passport, I would like to differentiate between friends and relatives on the one hand, and employment agencies and employers on the other. In the latter case, that is, employment agencies and employers, the client or the prospective employee will expect to have all his documents checked, including, of course, the passport. Therefore, there is no sensitivity involved. However, in the case of friends and relatives, asking for their passports and checking the passport for the date of expiry of stay may become a very sensitive issue. I hope that the Minister will advise his officers to exercise discretion in the case of friends and relatives. The Ministry could also assist those cases asking for an extension of stay by informing the head of the household of the expiry date of the stay. Sir, next on the question of permanent residents. It has always been our policy, both economic and social, to welcome permanent residents who can contribute to the economic well-being of Singapore. As the economy matures and globalises, more foreigners will come. Some will find Singapore an attractive place to stay and apply for PR. Others may sink in deeper roots when they are married to Singaporeans. Some may decide to take up Singapore citizenship, while others may not want to for various reasons or are unable to do so. If, for some reasons, a PR contravenes the law, under existing provisions, the Controller would have to revoke the PR. This is a very drastic step, especially if the PR has a Singaporean spouse and children. I make this statement on the assumption that the offence is of a minor nature or a technical matter. I would expect that if it is a major offence, eg, murder or drug trafficking, their PR status will be revoked. I agree with the Minister that the vast majority of PRs are responsible people and persons of good standing. I therefore welcome this amendment.

Mr Speaker, Sir, I need to address only the point that Dr Arthur Beng made about the new amendment in respect of harbouring illegal immigrants. Let me assure him that the fear that he has is not one that we need be troubled by very much because, firstly, that is not the problem that Immigration has. The problem that Immigration has is really with those who are employed illegally by employers who in many cases are also the ones who give them food and shelter. Secondly, if you look at the definition of the word "harbouring" in the Immigration Act, it means "to give food or shelter and includes acts of assisting a person in any way to evade apprehension". Therefore, Immigration and the Attorney-General's Chambers will really charge a person for the offence of harbouring only if there is some intentional act of providing food and shelter, in other words, with the knowledge that the recipient is an immigration offender, although there is a presumption clause to aid the prosecution. The third point I want to make is that this particular amendment before us today, new subsections (9) and (10) to section 57, only applies where the accused person raises the defence that he had seen a work permit or pass. Why do we craft this amendment in this way? Because we have several cases where the prosecution lost in the courts where the employer, before the Chief Justice's decision, was successfully able to say in answer to the charge of illegal employment that his worker produced a document which was a work permit. But later on, it turned out that the work permit was forged. The Immigration's position is that that is not enough for an employer to discharge his onus. All he needs to do is to ask of the potential employee, "Let me have a look at the passport." And that will make it clear whether he has authority to stay in Singapore, whether that authority has expired, and so on and so forth. I thank him for his concern in any case. I will impress upon Immigration the point raised by Dr Arthur Beng.

Question put, and agreed to. Bill accordingly read a Second time and committed to a Committee of the whole House. The House immediately resolved itself into a Committee on the Bill. - [Prof. S. Jayakumar]. Bill considered in Committee; reported without amendment; read a Third time and passed.

Order for Second Reading read.

Mr Speaker, Sir, I beg to move, "That the Bill be now read a Second time." This Bill will amend the Economic Expansion Incentives (Relief from Income Tax) Act, which I will refer to as EEI Act in short. It is to put into effect four tax changes which were announced in the 1993 Budget Statement. I will describe each of the tax changes in turn. Use of Accumulated Losses and Capital Allowances The first tax change, on how much accumulated losses and capital allowances may be used, will apply to post-pioneer companies. These are companies which have two types of income after their pioneer period tax exemptions have expired and these two types are income taxed at a concessionary rate under the post-pioneer incentive of the EEI Act, and other incomes taxed at the normal corporate tax rate. In other words, pioneer companies, after their pioneer incentives have expired, may enjoy a post-pioneer incentive for some part of the activity, in which case they will have two types of income, ie, income under the post-pioneer incentives as well as the normal income which will be taxed at the normal corporate tax rate. The two types of income are accounted for separately since they are taxed at different rates. Losses and capital allowances which are not absorbed during the post-pioneer tax concession period are at present allowed to be carried over in full after the tax concession period. For example, if a post-pioneer company enjoying a tax concession of 10% has, by the end of its tax concession period, accumulated a loss of $100 in its approved trade, it can use that $100 loss to offset $100 of its income after the tax concession has expired, and that income after the tax concession period has expired, of course, will be taxed at the normal 27% corporate tax rate. The tax reduction is therefore $27 since the normal tax rate is 27%. When you have a loss of $100, you get a reduction of $27, instead of $10 because, in fact, that loss was incurred at the time when the company was enjoying a 10% tax rate. So in fact he should only enjoy a $10 loss. Therefore, as announced in the Budget Statement, an adjustment factor will be applied whenever unabsorbed losses and capital allowances of a post-pioneer company under one tax rate are used to set off against the income under another tax rate. This adjustment factor is equal to the ratio of the first tax rate to the second, and this is introduced in clause 3 of the Bill. The effect of such apportioning by the ratio will be in the example that I just gave, that the tax reduction will be $10 instead of $27. A similar provision has recently been introduced in the Income Tax Act, in respect of companies granted tax incentives under the Act and thus have incomes which are taxed at different rates. Extending the Tax Relief Period for Warehousing and Servicing Companies Incentives The second change relates to extending the tax relief period for Warehousing and Servicing Companies Incentives. This second change is to make extendable the tax relief period under the Warehousing and Servicing Companies Incentives Scheme. The incentives currently provide for a fixed tax relief period of five years for a warehousing or servicing company intending to incur expenditure of not less than $2 million in fixed assets. During the five years, half of the company's qualifying income will be exempt from tax. From past experience, however, the EDB has found that five years is not long enough to encourage the company to make such large capital investments. It does not also provide any incentive for the company to expand further after the initial incentive period is over. Therefore, the EEI Act is being amended to allow the Minister to extend the tax relief period by further periods of up to five years at a time, subject to such terms and conditions as he may impose, and this is in clause 4 which inserts a new subsection in the EEI Act. Modification to the Overseas Investment Incentive Third, modification to the Overseas Investment Incentive. This third change is an amendment to the Overseas Investment Incentive. This particular Incentive is aimed at encouraging investments in approved overseas investment companies for the purpose of acquiring technology for use in Singapore or for gaining access to overseas markets. It allows the capital losses incurred by an eligible investor in an approved overseas investment, after two years and before the 9th year, to be deductible against the investor's domestic income. One requirement under the present law is that every overseas investment must be done through a Singapore-incorporated company specially set up for the purpose. Investors' feedback is that this requirement of setting up a company specially for this purpose is cumbersome. Therefore, clause 5 of the Bill will insert a new section in the EEI Act to provide for the deduction of losses incurred by an approved eligible investment company on the sale of any share or in the liquidation of an overseas investment held directly by it. Under this additional arrangement, any gain from the disposal of shares or liquidation of the overseas company made after two years and before the 9th year will be treated as trading income and be subjected to tax if any capital loss had been allowed deduction. However, any such gain in excess of the losses already deducted will not be taxed. To put it in simpler terms, since we are allowing the losses to be offset, then the profits will also have to be taxed. But they will not be taxed in excess of the losses already allowed. Introduction of the Overseas Enterprise Incentive The fourth change is the introduction of a new incentive called the Overseas Enterprise Incentive. This Incentive will be given to encourage more Singapore companies to venture abroad to develop the external dimension of the economy. Currently, income derived from overseas investments may be exempt from tax under the Income Tax Act on a project-by-project basis. The new Overseas Enterprise Incentive will grant an approved enterprise, called the Overseas Enterprise, up to ten years of tax exemption on the basis of its qualifying income from qualifying activities. In other words, we define it by activities, not by projects. So there can be a number of projects under the same activity and if it is an approved activity, then it will enjoy tax exemption. This will facilitate the Overseas Enterprise's overseas investment decisions and the remittance of foreign income. It will give companies greater tax certainty in planning their overseas ventures because it need not obtain approval for each and every overseas project separately. Clause 6 introduces a whole new Part XIIIB to the EEI Act to effect this new Incentive that I have just described. It will allow the Minister to approve a Singapore-incorporated and resident company as an Overseas Enterprise if he is satisfied that the overseas investments or projects of the company will enhance the economic or technological development of Singapore. To be eligible, the company must be at least 50% owned by Singapore citizens and permanent residents. Additional Changes In addition to the four changes that I have just described, there is a need to fine-tune the existing pioneer incentive. There is a distortion in the treatment of capital allowances for pioneer companies under the present Act. Under the Act, as presently in force, a pioneer company is deemed to have permanently ceased its old trade or business at the end of its tax relief period and to have commenced a new trade or business on the next day. Thus, for a pioneer company whose tax relief period expires in the middle of the year of assessment, it must set off one year's full capital allowance against its pioneer income for that year of assessment. Companies have made representations that this distorts the income of the pioneer company in its final year of tax concession and also the income of the company in its first year after the tax concession. There is a tax disadvantage for them. Clause 2 of the Bill thus inserts a new subsection to permit companies to apportion capital allowances in the year of assessment in which their pioneer status ended in the midst of the year, as if the old trade or business had not been deemed to have ceased. In other words, if the pioneer period ends on 30th June, then only half needs to be accounted for, and the other half will be taken up in the post-pioneer activity. Mr Speaker, Sir, the proposed amendments to the EEI Act will enhance and provide new incentives to facilitate overseas investments by Singapore companies, and also improve and update existing incentives for the inflow of foreign investments into our domestic economy. Sir, I beg to move.

Question put, and agreed to. Bill accordingly read a Second time and committed to a Committee of the whole House. The House immediately resolved itself into a Committee on the Bill. - [Mr S. Dhanabalan]. Bill considered in Committee; reported without amendment; read a Third time and passed.

Order for Second Reading read. 2.00 pm

Mr Speaker, Sir, I beg to move, "That the Bill be now read a Second time." Sir, the main aim of this Bill is to remove the practical difficulties in applying the existing presumption in section 17 of the Act arising from a recent Court of Criminal Appeal decision known as Lee Ngin Kiat v Public Prosecutor. If I may explain, section 17 of the Misuse of Drugs Act states that where a person is proved to have had in his possession more than a stipulated quantity of any of the controlled drug specified therein, he is presumed, until the contrary is proved, to traffic in that controlled drug. In Lee v Public Prosecutor, the Court of Criminal Appeal held that where the prosecution seeks to rely on such a presumption clause to charge a person for trafficking in a controlled drug, to enable the accused to rebut the presumption, the prosecution must state in the charge the exact manner in which the accused had intended to traffic, ie, whether he had intended to sell, give, administer, transport, send, deliver or distribute that controlled drug without lawful authority or offer to do any one of these acts. Sir, section 17 was introduced by Parliament to deal with the situation where a person was caught in possession of a certain quantity of a controlled drug which is clearly meant to be used for trafficking. But as he was arrested before he could have the opportunity to carry out his intended act of trafficking, there is no other evidence to show that he had intended to traffic in that controlled drug. Therefore, while we respect the Court of Criminal Appeal's decision in that specific case, such a ruling is inconsistent with the intention of Parliament in enacting section 17. To further explain, if the prosecution is able to produce evidence of how he had intended to traffic in that controlled drug, then there will not be a need for the prosecution to invoke the presumption at all. Furthermore, such a ruling is impractical in such cases, because in those cases the only evidence that the prosecution can prove is the act of possession by the accused of a controlled drug in excess of the quantity specified by section 17. It is therefore impossible for the prosecution to specify the manner in which the accused had intended to traffic the drugs in his possession. We will have to read the mind of the accused. For the prosecution in these circumstances to specify the intended mode of trafficking in the charge will be most arbitrary. The Bill, therefore, gives effect to Parliament's intention in enacting the presumption in section 17 which has always been that when a person has been proved to be in possession of a controlled drug beyond a certain amount, he is presumed to possess the drug for the purpose of trafficking and should be dealt with as if he has committed the offence of trafficking in that drug. Once the presumption is invoked, there is no need to show the overt act of trafficking which he had intended to do. Consequently, there is also no need for the prosecution to specify the particulars of his intended act of trafficking in the charge. To remove the uncertainty and practical difficulties caused by the case of Lee in applying the presumption, clause 3 of the Bill seeks to insert a new subsection (2) to section 5 of the Act to provide that a person who is in possession of a controlled drug for the purpose of trafficking commits the offence of trafficking in that drug. Correspondingly, clause 4 seeks to amend section 17 to provide that where a person is proved to be in possession of a controlled drug in excess of the quantity specified under the section, he is presumed to be in possession of the drug for the purpose of trafficking. The presumption is rebuttable by the accused showing that his possession of the drug was not for the purpose of trafficking but for some other purpose, eg, for his own consumption. To some extent, we are reverting to the wording in the Act before our 1989 amendment. Sir, the other provisions of the Act deal with new definitions of controlled drugs. I must ask the Members' indulgence to bear with me as I take them through these provisions because they are quite technical in nature. Sir, we have taken the opportunity in this Bill to revise the definitions of some of the controlled drugs in the Act to put them on a more practical and scientific basis, especially opium and cannabis resin. These new definitions were arrived at after consultations with the Attorney-General and the experts in the Department of Scientific Services (DSS). First, opium. The current definition of opium only refers to its physical attributes, namely, that of a "coagulated juice obtained from any plant from which morphine may be produced." In practice, besides physical examination of the substance suspected to be opium, the chemists in the Department of Scientific Services also conduct a chemical test on the substance to test for the presence of morphine and any one of four other main alkaloids, namely, narcotine, codeine, thebaine and papaverine. As these alkaloids are only present in opium and not in any other natural product, the presence of these alkaloids will confirm that the substance is opium. According to the experts in the DSS, this is a more scientific way of proving opium and is a universal method adopted by chemists in other countries. Clause 2(b) of the Bill therefore seeks to amend the definition of "opium" to read as follows: ''opium' means any substance containing, in any quantity, morphine and one or more of the following, namely codeine, narcotine, papaverine or thebaine, but does not include poppy straw which is not mixed in any such substance.' Proof that a substance is opium as defined will henceforth be based on a scientific basis. This new definition will also do away with the need to define opium to include raw, prepared or medicinal opium in the First Schedule to the Act. However, it is necessary to exclude "poppy straw" from the definition as trafficking in poppy straw (which also contains small amounts of morphine and any one of the four main alkaloids) in whatever quantity is not a capital offence under existing laws. For the purpose of capital offences involving opium, the existing weight of 1,200 grammes of opium (as newly defined) will be retained but it will be qualified by a new condition that the amount of morphine found therein should be more than 30 grammes. This new condition is consistent with the existing capital offences for other controlled drugs containing morphine under the Second Schedule. Next, cannabis. Cannabis is currently defined under the Act to mean "any part of any plant of the genus Cannabis from which the resin has not been extracted, by whatever name it may be designated". In practice, the DSS relies on three types of tests to prove that the substance seized is cannabis as defined. First, there is a visual examination to establish the physical appearance and characteristic odour of cannabis. Next, a microscopic examination is carried out to detect the presence of resin, cystolithic trichomes and non-cystolithic trichomes which are unique to cannabis. Lastly, chemical tests are carried out to detect the presence of tetrahydrocannabinol and cannabinol. These are the two main alkaloids, I am told, which distinguish cannabis from other hallucinogenic drugs. We have been informed by DSS that they are also the psycho-active ingredients in the plant which causes hallucination. These alkaloids can be found in other parts of the plant (except the roots) which do not contain resin. In view of this and on the advice of the DSS, my Ministry proposes to amend the definition of cannabis to remove the misconception that cannabis is a controlled drug only if resin is present in that part of the plant. Clause 2(a) of the Bill seeks to amend the definition of "cannabis" as follows: "`Cannabis' means any plant of the genus Cannabis, or any part of such plant, by whatever name it is called." It is not necessary to provide for tetrahydrocannabinol and cannabinol to be included in the definition because, according to DSS, the plant material cannot be considered as being of the "genus cannabis" without their presence. Next, cannabis mixture. The Central Narcotics Bureau has detected some cases in which cannabis was trafficked in mixed form, ie, the plant is broken up and mixed with other vegetable matter such as tobacco. Currently, this does not attract the death penalty. To deter traffickers from trafficking in large amounts of cannabis in this form, a new capital offence will be created for this type of drug. As the amount of cannabis in such a mixture does not usually fall below 50%, it is proposed that for the purpose of capital offences, trafficking in a cannabis mixture should be in amounts of more than 1,000 grammes (as compared to more than 500 grammes in the case of cannabis alone). This will give an allowance of 500 grammes for any non-cannabis material in the mixture. For this purpose, clause 6(c) of the Bill amends the Second Schedule to provide for capital punishment for trafficking in more than 1,000 grammes of cannabis mixture. To be consistent with the penalties provided for other types of drugs, the same clause also provides that trafficking in between 660 grammes and 1,000 grammes of cannabis mixture will attract a penalty of between 20 and 30 years of imprisonment and 15 strokes of the cane. Consequently, clause 2(a) of the Bill seeks to introduce a new definition of "cannabis mixture" as follows: "`Cannabis mixture' means any mixture of vegetable matter containing tetrahydrocannabinol and cannabinol in any quantity." As explained earlier, tetrahydrocannabinol and cannabinol are the two main alkaloids distinguishing cannabis from other hallucinogenic drugs. Detection of these two substances by the DSS chemist is sufficient scientific proof that the substance is cannabis mixture. Finally, cannabis resin. Because of the reasons I have stated concerning the psycho-active ingredients in the cannabis plant being tetrahydrocannabinol and cannabinol, we are therefore adopting the same scientific approach. Clause 2(a) of the Bill amends the definition of cannabis resin accordingly. In concluding, Sir, these amendments will clarify both the intention of Parliament with respect to the matters I have mentioned and enable the courts to give full effect to Parliament's intention. I wish to emphasize that the amendments will not have retrospective effect and will not affect any cases pending trial in the Courts. Sir, I beg to move. Question proposed.

Mr Speaker, Sir, I rise in support of this Bill. Sir, if we follow closely news reports on drugs and its associated problems on the world scene, we cannot but feel shivers down our spine when we reflect on the untold miseries and havoc it is causing to many countries in the world. The fact remains that the drug menace is ever present over the horizon threatening the well-being of society if it is allowed to go unchecked. We in Singapore are indeed blessed to have tough and stringent laws to keep the supply of drugs under control. In addition, our enforcement agency, the Central Narcotics Bureau, must be commended for making this possible with their relentless efforts and ongoing vigilance for which there must be no let-up, mindful that drug traffickers and drug couriers are using new and more sophisticated methods in smuggling drugs. Despite our mandatory death sentence, drug dealers still continue to use Singapore for their nefarious activities. We must not forget that Singapore's proximity to the Golden Triangle will always make us vulnerable to the drug menace. Coming back to the Bill, Sir, I would like to touch on the proposal to re-word the presumption clause under section 17. If I could recall, this presumption clause was last amended in 1989. Sir, I am not a lawyer but, as the Minister has mentioned, the current re-wording of the clause will make it almost similar in wording as spelt out in the Act prior to the 1989 amendment. As such, Sir, I would like to seek the Minister's clarification on this matter.

Mr Speaker, Sir, to touch on the specific point raised by Mr Zulkifli, as I have mentioned in my Second Reading speech, to some extent, we have reverted to the wording in the pre-1989 position where the wording was also similar for the purpose of trafficking. In 1989, we changed it to overcome some problems in one or two cases. The difference between this present drafting and the pre-1989 drafting is that although there was a presumption in the 1973 legislation up to 1989, at that time, apart from the presumption, there was no substantive offence written into the law of possession for the purpose of trafficking. Now, we have, in a sense, tried to plug that loophole by not only having the presumption clause, but also having created a substantive offence of possession for the purpose of trafficking. I would like to be able to say, and to assure the House, that there will be no further amendment to the Misuse of Drugs Act. But although we have sat down with the draftsman and we believe that we have overcome the problems, we must get the law in tandem with the evolution of case law. From time to time, it is unavoidable that where we find that case law develops in a manner which runs counter to the intention of Parliament, we may need to fine-tune the legislation, but I hope that it will not be necessary for a long time to come.

Question put, and agreed to. Bill accordingly read a Second time and committed to a Committee of the whole House. The House immediately resolved itself into a Committee on the Bill. - [Prof. S. Jayakumar]. Bill considered in Committee; reported without amendment; read a Third time and passed.

Order for Second Reading read. 2.20 pm

Mr Speaker, Sir, I beg to move, "That the Bill be now read a Second time." The Bill seeks to amend the Probation of Offenders Act (Chapter 252) to provide the Courts with the power to grant probation, or an order of absolute or conditional discharge, for young offenders who have attained the age of 16 years but have not attained the age of 21 years at the time of their convictions for their offences, notwithstanding that the offences concerned are punishable with specified minimum or mandatory minimum sentences. In addition, such young offenders must also not have been previously convicted of an offence that is punishable with a specified minimum, or mandatory minimum sentence. Sir, the Probation of Offenders Act, as it now stands, can apply to any offence except for those offences where the sentence is fixed by law. The proposed amendments are necessary in view of the decision by the Chief Justice on 30th June 1993 that the Courts have no power to grant probation to offenders convicted of an offence where a mandatory minimum sentence is prescribed for that offence. The Chief Justice had ruled that the Court's discretion to make a Probation Order cannot over-ride the intention of the legislature in providing for specific sentences to be meted out for specific offences. He ruled that the words "fixed by law" appearing in section 5(1) of the Probation of Offenders Act apply to mandatory minimum sentences. Sir, the Chief Justice's decision is correct. In granting probation to an adult offender in cases where the law specifies a mandatory minimum sentence, a Court would be defeating the intention of Parliament when it enacted mandatory minimum penalties for such offences. The Probation of Offenders Act applies only to offenders above 16 years of age. Juvenile offenders below 16 years of age are dealt with under the Children and Young Persons Act. What is of concern to us are the young offenders in the age group of 16-21 years. There are two points which we need to bear in mind. First, my Ministry's experience with young offenders on probation shows that 94% were first offenders. About 84% of those granted probation complete it successfully. What is significant is that for young offenders who had committed offences involving mandatory minimum sentences and who had been granted probation, 81% of them successfully completed their probation. Second, when an offender is sentenced with a custodial sentence, the sentence stands as a conviction in his or her record. On the other hand, if an offender is placed on probation, it will not be deemed as a conviction for the record. For young offenders, this will greatly facilitate their rehabilitation within the community. Young offenders are more likely to be in school or higher institutions of learning or at early stages of employment. By placing them on probation, we allow them to continue with their education or employment. Furthermore, they will benefit from the personal care, guidance and supervision of a Probation Officer. It will give them the opportunity to turn over a new leaf, and become a responsible member of society. This amendment will allow those who are deemed suitable by the courts to be put on probation. Only those with relatively stable family backgrounds, good school or employment records, and no previous delinquent traits are considered for probation. I have no doubt that the courts, which have always been careful and selective when considering offenders for probation, will continue to do so. Sir, I beg to move. Question proposed.

Sir, I cannot support this amendment to the Probation of Offenders Act. My objection is in clauses 2(a) and 3(a). Firstly, it is in respect of the age limit. A young person between 16 and before attaining the age of 21 and without a previous similar conviction can only get probation under this Act. This age is taken on the date of conviction. I think that it would be more proper if this age, especially the upper limit of 21 years, should be taken at the date of the offence. We can think of many situations where a person has committed an offence and he has not been apprehended for some reason, or he has gone away, or sometimes, although he has been arrested, police investigations take a long time and he has exceeded 21 years; or on other occasions where he has committed the offence, but there was very late reporting. So in all these situations, we can envisage that the upper age limit would have been exceeded, and therefore he would not be able to get a probation order or an order of discharge if this amendment comes about. For these reasons, I would suggest that it would be fairer if the age of 16 but not having attained the age of 21 years be taken at the date of the commission of the offence, rather than on the date of conviction. The other objection to this amendment is the upper age limit. We have seen many court cases in which an offender, even on attaining the age of 26 years, comes from a good family background and there is a chance of rehabilitation. He has got proper training and he is on his way to turning a new leaf. It is still possible to rehabilitate that person, especially in our Asian society where the family is so supportive, even at the age of 25 or 26 years. So I say it would be fairer if, instead of taking the upper limit at 21 years, the upper limit is increased to 25 years. In 1984, the Penal Code was amended to take away the discretion of the Judge in sentencing because mandatory minimum sentences were imposed. At that time, in the debate, the Minister did mention that if there was a deserving case where an offender had committed an offence in which a mandatory minimum sentence should be imposed and the accused person was a deserving case, there was still this provision that he could still be given a probation or a discharge. But now with this amendment, I think the chances of getting a probation, where there is a mandatory minimum sentence to be imposed, are almost nil. So that escape route, where there is a deserving case, there is no possibility of making a probation order.

Mr Speaker, Sir, I rise to support the Probation of Offenders (Amendment) Bill. First, I must stress that I firmly believe that criminals who committed serious offences such as robbery, extortion, housebreaking, should be severely dealt with by the law. Therefore, I fully support the provisions that are in place in the Penal Code for mandatory minimum sentences for such offences. We must send the right signal to those would-be criminals that if they commit such offences, the full impact of legal sentence must bear on them and that they are old enough to be responsible for their own action. The message must be that crime does not pay, and this is how Singapore has always maintained one of the lowest crime rates in the world. However, I realise that some of these young offenders who committed offences which attract mandatory minimum sentences may not really be callous in nature. They may be offenders without delinquent traits. To impose such harsh punishments may be inappropriate and counter productive. More importantly, we would lose all opportunities to rehabilitate them within the community. I am satisfied that juveniles between the age of seven and 16 years would continue to benefit with probation as well as they will be dealt with under the provisions of the Children and Young Persons Act and they are not affected by the Chief Justice's ruling. My real concern is those young offenders between the age of 16 and 21 years. Although it is debatable whether they are to be considered juvenile and not as adult offenders, we must realise that many of them are still growing up and could have got involved in crime as a result of various mitigating factors and circumstances, like peer influence, peer pressure and the desire to seek thrills and excitement or even given in to a weak moment of impulse or greed. When such a young offender under 21 years of age, without criminal traits, comes from a relatively stable family and personal background, for example, with a good school record and employment history, he should be a candidate to be considered for probation, especially when he knows that he is wrong and shows determination to repent. He should be given all the help under probation. I disagree at this point that the age, as suggested by the Member for Potong Pasir, should be raised to 25 years old, because I think there must be a certain bar for such consideration. If we were to raise it to 25 years old, then what about 30? Are you saying that those who are 30 years old are not repentant and that they are not rehabilitative? So I would stick to the age of 16 to 21 years. Sir, appropriate supervision and personal care by the probation officer can have a salient effect on such young offenders. I must commend the Minister for his goodwill and understanding in providing a chance to young offenders to redeem themselves through probation and introducing the amendment, so that the Judge and Magistrate can have the discretion to decide on a case-by-case basis. I am extremely pleased to note that the success rate of young adult probationers completing supervision without further trouble is good - as high as over 80%. Nevertheless, I would request the Minister to carry out a survey on those who will benefit from the amendment, so as to find out what percentage of such young offenders steer clear of trouble during their probation period.

Sir, I would like to thank the Member for Hong Kah GRC, Mr Kenneth Chen, for his support for the Bill. Sir, I would definitely ask my officials to monitor those who are granted probation to see what are the effects of the probation on them in terms of their rehabilitation. With regard to Mr Chiam's two points, first, I would like to clarify that only offenders who are guilty or who have been convicted of serious offences are denied probation, ie, they are convicted and sentenced with a mandatory minimum sentence and therefore they are denied probation. Sir, these are for very serious offences, like rape, robbery, being part of a syndicate in extortion, and so on. For the other lesser offences they are still eligible for probation. Sir, with regard to his point that the age limit should be considered at the point of the offence rather than on the date of conviction, we had taken that point into consideration when we were reviewing the amendment and we looked to the United Kingdom for guidance. We studied the experience and the legislation in the United Kingdom. What we found was that in the UK they have stuck to this definition, which is the date upon conviction. I think there are good reasons for that. This is to ensure that those young offenders who commit serious offences are not given the incentive to go into hiding for as long as possible. Here, if they commit a serious offence and the Police are looking for them, the incentive is for them to really come out as quickly as possible, give themselves up and be subjected to the court's decision as quickly as possible. I think that the UK's practice has been a time-proven one. Since most of our laws are adapted from the UK model, it is wise that we stick to the UK practice. Sir, the second point is that the upper age limit be moved higher to 25 years. As I have explained just now, this applies to offenders who have committed very serious offences. In granting probation, we have taken into consideration the fact that the young offenders are likely to be less mature, more easily misled by companion, and therefore we give them the benefit of the doubt and grant them probation. Sir, it will be difficult for us to assume that those above 21 years are still immature. In fact, with modern education, I would say that most people in their late teens are already fairly mature. But, nonetheless, we have used 21 years as a cut-off point and I would urge the House to stick to this age limit of 21, rather than move it higher, because there must always be a cut-off point. The key point to take into consideration is this. Is 21 the appropriate age where a person is mature enough to be responsible for his own action, especially when he is committing a very serious offence?

Sir, can I get a clarification from the Minister? He says that the Ministry has looked into the UK's experience and decided to stick to the age of 16 to 21 years. But I am sure the UK has not got so many mandatory minimum sentences in their criminal law, as we have in Singapore. The 1984 amendment covered a wide range of offences and sometimes even for petty offences the Judge has to impose a mandatory minimum sentence. And sometimes where there is a mandatory minimum sentence and the offence is not that serious, there is a good case to give a probation order. Under this amendment, I think it is going to be very difficult.

Sir, the point that we must remember here is that only offences which are very serious in nature carry mandatory minimum sentences, eg, rape, robbery. The less serious offences do not normally carry a mandatory minimum sentence. Therefore, those who commit less serious offences are still eligible for probation. We are talking here of offenders of serious offences. Mr Chiam has mentioned that he has read the Hansard with regard to the amendment to the Probation of Offenders Act in 1984. The Minister at that time, Mr Chua Sian Chin, had stipulated the six categories of offences which carry mandatory minimum sentences.

Sir, can I get a clarification? The Minister refers to the 1984 amendment and the debate on it. If he will remember, in fact it was, I think, the hon. Member, Mr Chandra Das, who pointed out that even a youngster who stole a hubcap of a motorcar was subject to a mandatory minimum sentence, because it was part of a motor vehicle. And in such a case, if there is an amendment here and his age is slightly over 21, he will not get the chance to have a minimum sentence or if he repeats that similar offence. It is not a serious offence. It is only a hubcap of a motorcar.

Sir, as I stated just now, there must be a cut-off point somewhere. Yes, if he is a youngster, 16-17 years old, who is caught stealing a hubcap, he is entitled to probation. But, of course, if he goes into hiding, he may not be. But the point that Mr Chua made at that time also was that the prosecutor had the flexibility of charging that offender under a different legislation but he need not charge him if that person was really of good character with no previous delinquent traits. The prosecutor can charge an offender under a different provision which does not carry a mandatory minimum sentence. So the flexibility is still there.

Question put, and agreed to. Bill accordingly read a Second time and committed to a Committee of the whole House. The House immediately resolved itself into a Committee on the Bill. - [Mr Yeo Cheow Tong]. Bill considered in Committee.

Clause 1 ordered to stand part of the Bill. Clause 2 -

Sir, I beg to move, (1) In page 2, line 8, to leave out "shall not", and insert "may". Sir, this amendment, together with the next amendment, which I shall shortly move, is of a drafting nature. This is to make the section easier to read by avoiding the use of the double negatives "shall not" and "unless". Amendment agreed to. Amendment made: (2) In page 2, line 9, to leave out "unless", and insert "if". - [Mr Yeo Cheow Tong].

Sir, I beg to move, (3) In page 2, lines 13 and 14, to leave out "the same offence", and insert "any such offence referred to in this proviso, and for this purpose section 11(1) shall not apply to any such previous conviction". Sir, the expression "same offence" is ambiguous and can give rise to various interpretations. This amendment will make it clear that to qualify for probation, the young offender must not have any previous conviction for an offence which carries a specified minimum sentence or mandatory minimum sentence. Sir, under section 11(1) of the Probation of Offenders Act, probation is not deemed a conviction. This amendment will make it clear that young offenders who have previously been convicted for an offence carrying a specified minimum sentence or mandatory minimum sentence and who have been granted probation shall not be eligible for probation should he or she commit a second offence carrying a specified minimum sentence or mandatory minimum sentence. Amendment agreed to. Clause 2, as amended, ordered to stand part of the Bill. Clause 3 -

Sir, I beg to move, (1) In page 2, line 22, to leave out "shall not", and insert "may". Sir, the amendments being proposed to clause 3 are similar to those proposed for clause 2 and are being proposed for the same reasons. Amendment agreed to. Amendments made: (2) In page 2, line 24, to leave out "unless", and insert "if". - [Mr Yeo Cheow Tong]. (3) In page 2, lines 28 and 29, to leave out "the same offence", and insert "any such offence referred to in this proviso, and for this purpose section 11(1) shall not apply to any such previous conviction". - [Mr Yeo Cheow Tong]. Clause 3, as amended, ordered to stand part of the Bill. Bill reported with amendments, read a Third time and passed.

Order. I suspend the Sitting and will take the Chair again at 3.15 pm. Sitting accordingly suspended at 2.49 pm until 3.15 pm

Sitting resumed at 3.15 pm

Order for Second Reading read.

Mr Speaker, Sir, I beg to move, "That the Bill be now read a Second time." Sir, the Bill consolidates into one law fire safety provisions in various other legislation such as the Fire Service Act, the Building Control Act and the Petroleum Act. At the same time, it also introduces new provisions for more effective enforcement of fire safety standards. Before I go into the provisions, may I make a few general remarks as to why the Government attaches importance to the enforcement of fire safety standards? Sir, in many countries, fires in urban areas have caused disasters resulting in the loss of many lives and severe damage to properties. We read about such disasters regularly in the media. In January this year, a fire in a Taipei restaurant killed 33 people and injured 21 others, which was believed to be Taiwan's highest death toll in a single fire. What was the cause? Apparently it was the locking of emergency exits. In May this year, a fire in a factory in Thailand, believed to be the world's worst factory fire in history, claimed 210 lives. It was reported that this building had no proper emergency exits and that the alarm system failed to activate, resulting in the workers in the building not being warned of the fire outbreak. Perhaps these disasters could have been prevented or the terrible consequences reduced if fire preventive measures had been taken. Such illustrations underline my Ministry's concerns and drive home the need to constantly review fire safety standards and the powers available to the authorities to deal with fire hazards to protect lives and property. The need for effective fire safety legislation, I would say, is much more acute for us in Singapore where our urban areas are among the most densely populated in the world. We have a very high concentration of high-rise buildings - hotels, shopping complexes and offices. Many of them house hundreds if not thousands of persons at different times of the day. For example, the buildings in Shenton Way during the weekdays and in Orchard Road during the weekends are packed with people at all times. While we have been spared the wrenching agony of a major fire disaster, there should be no mistake: we become very vulnerable if we are not vigilant. Our fire safety legislation must not only prescribe minimum safety standards but also ensure that these are implemented, complied with and effectively enforced. May I make another point? While the Government can legislate strict building and fire safety codes and enforce them, the prevention of a towering inferno situation in Singapore actually calls for active cooperation of all parties concerned - building owners, building management, Government and everyone who resides in these buildings or who works in them. May I now turn to the provisions of the Bill which is modelled largely after the Building Control Act? The new provisions of the Bill are based on local as well as foreign legislation which are modified to suit our own circumstances. References to the local and foreign laws on which the Bill is based may be found in the comparative table set out at the end of the Bill. First, I will deal with the powers for abatement of fire hazards in Part II of the Bill. These are new provisions which give powers to the Commissioner of the Singapore Civil Defence Force (SCDF) to deal with fire hazards. Fire hazards can exist in many forms, the most common being obstruction of escape routes and overcrowding. In fact, we are very concerned over the problem of obstruction of escape routes. Restaurants, discotheques and departmental stores frequently ignore the dangers they cause by blocking corridors with their merchandise or by locking their emergency exits. The managements choose to lock their emergency exits sometimes, according to them, to guard against theft, unauthorised entry, shoplifting or perhaps prevent people from leaving without paying their bills. Another problem is overcrowding which frequently occurs in entertainment outlets like discotheques. In many of these outlets the number of persons present far exceeds the permitted capacity. All these are very dangerous and irresponsible acts. Members must have read of other instances where a lot of people have died in entertainment outlets when fires have broken out. In establishments where such problems exist, the Civil Defence Fire Safety Bureau does carry out enforcement measures, but unfortunately with very little success, because the law presently is inadequate, both in terms of deterrent penalties and the requisite powers. Consequently, such outlets have flagrantly disregarded the safety of their patrons in order to maximise profits. The Fire Safety Bureau has been grappling with these problems for many years, but until and unless we change the law, we will never be able to resolve the problems. Clauses 13 to 16 of the Bill give the Commissioner of Civil Defence Force the following powers to deal with fire hazard in any premises: (a) Requiring the owner of any premises to abate the fire hazard found therein within a specific period. (b) Initiating steps to abate it where the person responsible for the fire hazard cannot be found. (c) Where the notice to abate a fire hazard is not complied with and where there is immediate or substantial threat to life or property, for example, in an emergency, the Commissioner can take all necessary steps to abate the fire hazard. This includes removing or seizing property that constitutes a fire hazard. He can also order the owner to close the premises for up to 72 hours if there is no other way to ensure the safety of the people in the premises; and apply to the Court to extend the closure of the premises for such period as is necessary to enable steps to be taken to abate the fire hazard. (d) In all other non-emergency cases where there is non-compliance with his notice or where he is of the view that the fire hazard is likely to recur, the Commissioner has to apply to a Court for a fire hazard order requiring the owner to abate the hazard, prohibiting him from using the premises in any manner that may result in fire hazards. Next, I turn to the provisions concerning the role of the building managements in Part III of the Bill. We all know that in Singapore we have a very large number of high-rise complexes which are frequented daily by a large number of persons. These buildings may be designed with adequate means of escape and equipped with sophisticated fire-fighting and fire-detection systems. But such measures are only effective if escape routes are kept free of obstruction, if occupants know what to do in the event of a fire, and if the fire safety equipment are properly maintained. But the trouble is that the fire safety systems in some buildings are not well maintained, for example, fire doors have been wedged open, fire extinguishers and hose reels found not serviceable and valves to rising mains damaged and so on. In some cases, the staff and occupants are ignorant of evacuation procedures. Thus, if there is a real fire situation, the resulting confusion and inability of these equipment to work will easily lead to the loss of many lives. Therefore, building owners and managements can and should be required to do more for fire safety. For these purposes, clauses 21 to 23 of Part III of the Bill require the building owner or occupier, ie, the building management, of the designated larger, high-rise commercial buildings to: (a) formulate fire emergency plans and conduct regular fire drills to ensure that occupants are familiar with all the escape routes and can be evacuated in a speedy and orderly manner in the event of a fire; and (b) appoint qualified Fire Safety Managers to assist the building owner or occupier in ensuring that fire safety systems in the building are well maintained and fire emergency plans are properly formulated and exercised. The buildings that will be affected by these provisions are hotels, places of entertainment and public resort, offices and hospitals where there is a large number of visitors and occupants. Similar requirements are found in the fire safety laws of many countries such as Japan, Canada and the United States. If I may touch on the other provisions, the prior approval of the Commissioner of Civil Defence is required for any works in a building which involve the installation of fire protection and fire-detection systems or the use of combustible materials which affect the means of escape. Appeals against the decision can be made to the Minister who may seek advice from an Appeals Advisory Board. The penalties under the existing Petroleum Act have not been revised for more than 30 years. Fines for offences will be increased to deter non-compliance and the fines will be comparable to those under the Building Control Act. For more effective enforcement against offenders, the Bill will provide for simpler prosecution procedures and for the confiscation of stocks and equipment. There are also provisions to enable the Commissioner of Civil Defence, with the approval of the Minister, to farm out specific functions of the Fire Safety Bureau to qualified persons such as architects and engineers registered with the Board of Architects or the Professional Engineers Board. Initially, only inspections of buildings for the purposes of issuing fire safety certificates will be farmed out to qualified persons. More functions may be farmed out in future if feasible and if there is a need. In conclusion, Sir, may I reiterate the main concern behind this Bill in these simple terms. If we want to avoid a large-scale high-rise fire, then we must ensure that small fires are stopped at their incipient stage. Better still, prevent any fire from breaking out at all. This calls for increased vigilance and effectiveness in fire prevention, fire detection and fire fighting. We can succeed in this only through the concerted efforts of everyone concerned, whether it be the Civil Defence and its Fire Safety Bureau, the professionals for inspecting the plans, the building owners or the general public who inhabit, reside or work in the building. These new provisions seek to provide the Fire Safety Bureau and the Civil Defence with the necessary powers for more effective enforcement of these fire safety standards. With these additional powers, the Civil Defence will have the means, working together with these other parties, to curb and prevent fire hazard situations which endanger public safety. Sir, I beg to move. Question proposed.

Mr Speaker, Sir, this Bill is a significant development towards further improving fire safety standards in Singapore and therefore I rise in support of it. Sir, Singapore today is dotted with skyscrapers and to ignore sound contingency plans to deal with major fire disasters affecting high-rise buildings will only imperil the lives of our citizens. However, to-date, we have been fortunate that our Civil Defence Force has a good track record of fighting fires and protecting people and property. But it is essential that close monitoring is done to ensure buildings, be they old or new, are fitted with adequate fire safety features. Sir, under this Bill, building owners are required to employ a trained Fire Safety Manager to maintain fire safety standards, ie, people who are trained through special courses conducted jointly by the Civil Defence Force and the Ngee Ann Polytechnic. In this respect, I understand that to qualify to pursue the course one must have a minimum of three GCE 'O' passes, including Science and Mathematics. Because of this requirement, there is much anxiety on the part of personnel who are currently performing fire safety duties but who do not possess the necessary paper qualifications that they may lose their jobs. Although some are given an opportunity to undergo the course they are made to understand that they will not be given a second chance should they fail to make it the first time. Sir, I would like to seek the Minister's clarification in order to alleviate this fear. Another concern which I wish to highlight, Sir, is that presently, in most public buildings, the personnel engaged to look after the fire safety aspect come from people like Chief Engineers, Maintenance Managers or Chief Security Officers. In other words, they are doubling up as Fire Safety Managers whilst performing their full-time jobs. While this pool of people may have successfully undergone the Fire Safety Course, in reality, there will hardly be any opportunity for them to face a real life situation and thus there is a likelihood that they may lose their competency as they are not professional fire fighters. Could the Minister therefore enlighten this House as to what measures can be taken to counter this? Sir, a final point I wish to raise is the perception within some quarters that this Bill unnecessarily shifts the burden of responsibility on to the shoulders of building owners. With the appointment of Fire Safety Managers, it is foreseen that the building management, in particular, the Fire Safety Managers, will be subjected to a lot of questioning in the event that there are heavy casualties resulting from a fire outbreak. As for me, I am clear as to what the Bill is designed for, and would appreciate the Minister's comments on this matter. Sir, I support the Bill.

Sir, first of all, I welcome the support of Mr Zulkifli. What I need to respond to is his questions on Fire Safety Managers (FSMs). First, his concern that there is some anxiety. Actually, the course is about 2-3 months. When I was briefed on it by my officials, I recall that it is not a difficult course. In fact, the pass rate is more than 95%. So the persons who did not make it constituted a very small number. In any case, this small number of people who did not pass will be given a second chance to sit for the test again. So let me assure him that the Civil Defence Fire Safety Bureau will not take such a rigid approach in implementing this measure. As I said, the pass rate is very high and I am told that more than 90% of the buildings which are to be covered in the initial phases of the Fire Safety Management System already have such Fire Safety Managers trained to take up the job. His second point is that because many of these persons to be appointed as Fire Safety Managers are in fact also doubling up in other capacities, such as security officers and so on, and since they will not be confronted with actual situations, I gather his point is that they may not be as sharp in the duties expected of them. I do not think this is so because even if a real fire does not occur in the premises where they are working, there will be enough expected of them as Fire Safety Managers, for example, they will have to give an annual report to the Fire Safety Bureau on what they have done in the building, what is the training given to the staff, what is the status of the checks on fire safety equipment, fire protection system, and whether they have any fire drills and so on. In the case of a Fire Safety Manager who does not give such a report or gives a report saying that nothing was done, then I would expect the Fire Safety Bureau of the Civil Defence to look at it as a warning bell and to find out what is going on. Although it is true that the FSMs will be doing other work, it is not true that their role as a Fire Safety Manager will become so mundane and with so few responsibilities that they will not be taking the job seriously. Thirdly, I do not agree that this Bill is to shift the responsibility of the Fire Safety Bureau of the Civil Defence. In other words, passing the buck, so to speak. Yes, we do want to involve others in the prevention of fire hazard and to prevent a major towering inferno situation. We want to involve the developer who is developing a building. We want to involve the management of a highrise building after the building is built. We want to involve everyone who works in it, whether he is a manager, a secretary, a clerk or a typist. Because if a building is built and has met all the specifications, a year later, when you have moved in the furniture, equipment, curtains, drapes, and the management, residents and workers of that building do not play their part, then the role of the Fire Safety Bureau and Civil Defence is really to come and put out the fire. Our approach is, let us not wait to put out the fire. Let us prevent the fire from starting out in the first place. In order to do that, you must involve those who are residing in the building and are responsible for its management. I do not think, in all fairness, that it can be said to be shifting the burden of the Fire Safety Bureau. It is to involve the community and the owners and managers of the building. If we do not do that, and if I did not introduce this Bill, then Government will be failing in its duty.

Question put, and agreed to. Bill accordingly read a Second time and committed to a Committee of the whole House. The House immediately resolved itself into a Committee on the Bill. - [Prof. S. Jayakumar]. Bill considered in Committee; reported without amendment; read a Third time and passed.

Resolved, That the proceedings on the remaining item of business be exempted at this day's sitting from the provisions of Standing Order No. 1. - [Dr Lee Boon Yang].

3.37 pm

Mr Speaker, Sir, I beg to move the Motion* standing in my name. *The Motion reads as follows: That this House endorses the principles and approaches set out in Paper Cmd 16 of 1993 on "Affordable Health Care" as the basis for Government policies to contain health care costs and to keep good basic health care affordable to all Singaporeans. Sir, we have a healthy population. Our health education and disease prevention programmes include measures to maintain high standards of water, food and a clean environment. These have resulted in a people whose health measures very favourably with those of the developed countries. Because we have put our efforts in the right areas and put the emphasis on personal responsibility in health care, we have attained high standards of health by spending only 3.1% of our GDP on health care. This is low compared to the US which spends 14% of GDP on health care, Germany which spends 8%, and Canada 9% of GDP. However, the pressure for health expenditure to increase in the future is very strong. Between 1980 and 1990, expenditure on health care grew at 12% per annum compared to the GDP growth of 10%. Our population is getting more affluent. Expectations are rising. People are putting more emphasis on the quality and value of life. At the same time, the population is ageing. All these must lead to demand for better and more medical services. We must get our philosophy on health care right and pursue national health policies which prevent over-supply, dampen demand and keep cost increases in check. We must build upon our present sound approach to medical services and health care costs and reinforce the system to cope with the pressures of an ageing population, rising manpower costs and advances of new expensive medical technology and drugs. Otherwise, we too would be sucked into the same problems of exploding health costs faced by the United States and the countries of Europe. In Singapore, primary health care is provided by our general practitioners in the private sector and by our Government polyclinics. Private sector GPs cater for 75% of the demand for primary health care. They charge reasonable rates which most people can afford. Patients who cannot afford GPs can turn to Government polyclinics where charges are even lower, or where the truly indigent receive services free. Singaporeans are quite satisfied with the level, quality and cost of primary health care. Their health concerns centre around what will happen to them when they fall acutely ill and need to be hospitalised or need other special attention. The White Paper deals mostly with secondary and tertiary health care, though it also covers other aspects. Most of the concerns of people centre around the affordability of secondary and tertiary health care - affordability of the individual, the family, the employer and the community at large. I know many people feel that it is wrong for a person to be only allowed the medical care that he or she can afford. It offends their sense of equality and humanity. They would rather the same medical treatment be available to all regardless of income. This is a compassionate and understandable sentiment. But however compassionate we are, we cannot wish away the cost of medical care. The Government accepts that health care should not be a commodity that is available only to those who can afford it. But neither is it a public good that should and can be provided without limits and without regard to affordability. Regardless of how health care is financed, it is the people who ultimately pay for the health service. A person can buy an insurance policy to cover his medical needs. The premium that he pays will reflect the full cost of health care shared among all those in the scheme. The more he uses the insurance cover, the higher the premiums will be. A worker can get his employer to pay for his medical benefits. But the employer will pay them out of the total amount that he is prepared to pay for labour, so it comes out of the wages of labour. If the Government pays, it comes out of the taxes paid by the people. Ultimately, the people pay. We cannot avoid linking the standard of health care to affordability of the individual and society. The Government undertakes to provide every citizen with the health care that he needs. However, this cannot be an absolute right or an unconditional entitlement. It must be subject to certain conditions. Among them: (1) It must be confined to a defined basic health care package, and not cover unlimited amounts of medical services. (2) It will not be for free. The citizen must pay for at least part of the health care he uses, unless he and his family are absolutely destitute and unable to do so, despite having contributed to Medisave and participated in MediShield. (3) It must not prevent those who want more health care than the basic package, and are prepared to pay the full cost themselves, from obtaining it. Members in this House in previous debates have asked for a clear definition of what is meant by good basic medical care. What is in the package and what is not in the package? The basic health package will be defined by the Ministry of Health. It is difficult to list in detail everything which goes into this basic package. In broad pragmatic terms, the basic health package is what is already available in the polyclinics and the B2 and C Class wards of Government subsidised hospitals. But the exact type of treatment available will vary from illness to illness and the stage of the illness. A full description of what is basic health care package would fill a volume on its own. A few fundamental principles will shape the basic package:- First, it will incorporate good up-to-date medical practice. Second, it will give patients medically essential and cost-effective treatment of proven value for illness. Third, the treatment will be delivered without frills, that is, the use of space and other physical amenities will be very economical and the nursing staff to patient ratio will be adequate. Fourth, the treatment will be by trained personnel of qualified doctors, specialists and other medical staff working as a team. Fifth, the treatment will use appropriate diagnostic and treatment facilities; drugs provided will be from a standard list which is more extensive than that recommended by the World Health Organisation. And lastly, the treatment will include use of intensive care unit beds. Intensive care unit beds are not classified by classes and are open to patients purely according to medical need. This basic package will not include treatment for certain conditions. For example, it will not include cosmetic surgery or cosmetic dentistry other than for burns and injuries or those that are required on medical grounds. It will not include sex change operations, IVF treatment, organ and bone marrow transplants (other than kidney transplants). These excluded treatments account for less than 0.1% of the cases dealt with in the unsubsidised wards. Experimental drugs not of proven value and other high cost investigations and treatment where effective cheaper alternatives are available, will also be excluded. Doctors have treatment protocols to guide them in treating individual patients. In some situations, ordering more investigations and treatments will not improve the patient's quality of life significantly or change the outcome. Examples are treatment of incurable diseases where there is no chance of survival, or using life support systems to prolong death. Under the basic package, patients in these situations will be treated humanely, be relieved of pain and suffering, made comfortable and allowed to retain their human dignity. The basic package cannot be fixed for all time. The Government will continually review and revise the basic package to take into account medical progress such as new drugs, procedures and equipment, and social and economic progress. A large part of basic health care will be provided in the polyclinics and by hospitals which receive Government subsidies. All subsidised hospitals will compete with each other on price and quality, even though some of them will have specialist departments which the others will not. When hospitals are not subject to market forces, the potential for waste and inefficiency is enormous. Competition will improve their services and make them more responsive to market signals. But free competition alone will not guarantee us an optimal health service. Health care is an example of market failure. The Government must intervene directly to regulate key aspects of the health care system to prevent over-supply of medical services and dampen demand. In health care, supply creates its own demand. More supply and more competition does not always lead to lower cost or better services. More supply can actually increase demand and cost because of the nature of the consumer. The consumer who pays the bill, that is, the patient or a member of the family, is usually worried, under great emotional stress and is in no position to weigh the advice of doctors and make a rational choice based on the likely efficacy of the treatment and on his ability to pay. The consumer is often uninformed or misinformed, and naively believes that the more expensive the doctor, drug or procedure, the greater the likelihood of a cure. If the family is paying, their love, filial piety, and loyalty can be called into question if they do not agree to order the most expensive or latest procedures. This situation opens the door for health care providers to order more tests, procedures and expensive drugs. Often the patients or relatives themselves may request for these because they have read somewhere or heard from someone about these new medical developments. It is not mere chance that countries with more doctors, especially specialists, tend to spend more on health care. Government must therefore not only define the basic medical package. It also has to prevent over-supply of medical services by regulating the supply of doctors, specialists, beds in subsidised hospitals and the establishment of specialist and sub-specialist disciplines and the purchase of expensive high-tech equipment. These are described in the White Paper. In keeping with the primary mission of subsidised hospitals to provide for the lower- and middle-income groups, all subsidised hospitals will have C Class wards to serve the most needy Singaporeans. A minimum of 65% of the beds will be B2, B2+ and C Class beds. There will be some unsubsidised wards, Class A wards, not exceeding 11% of the total beds in these hospitals. These will be for patients who want more personalised care, creature comforts and non-essential services, and are prepared to pay the full cost for them. Patients in Class A wards pay the full cost not only of the extras, but also the full cost of the basic essential medical care. I know that some people are uncomfortable that patients in Government and restructured hospitals can get medical care beyond the basic package by paying more. They are especially unhappy that in the same Government or restructured hospital, patients in Class C wards should have spartan facilities, while others in A Class wards enjoy more privacy and creature comforts. They prefer everyone, rich or poor, to have exactly the same standard of medical care. This is a natural, egalitarian, human instinct. But, unfortunately, complete equality of treatment is neither realistic nor desirable. Logically, there are only two ways for everyone to receive exactly the same medical treatment: either the Government must not allow anybody to obtain more medical treatment than the basic package, or else the Government must provide everyone with all the medical treatment he or she wants, without limit. The first is an unnecessary and unjustifiable infringement on the personal freedom of individuals. The basic package only defines what the Government will subsidise and make affordable to the population as a whole. If a patient wants medical treatment which the Government does not consider basic, and the Government will not pay for, why should we stop the patient from getting it if he is prepared to pay for it? What moral right do we have to stop him? We will not make other Singaporeans better off by preventing a well-off patient from getting extra or better treatment. If a patient wants more nursing attention, a private room of his own instead of an open ward, or additional medical tests to confirm a diagnosis which is not really in doubt, and he is prepared to pay for it in full, who is the Government to say no? Even granted this, some may still question whether the extra service should be provided in Government and restructured hospitals. If it is not provided in these hospitals, patients can go to private hospitals. If we disallow Singapore hospitals or private hospitals in Singapore from providing such services, patients can travel abroad for treatment. From the point of view of the C and B2 Class patients, it is better in fact for the Government and restructured hospitals to have A Class patients because A Class patients provide a check on the quality of the doctors and the quality of the hospital. These patients are prepared to pay the full cost in the hospital, even though they can afford alternatives like going to a private hospital. If only subsidised patients go to the Government or restructured hospital for treatment, we do not know whether they are going there because the service is good, or because there is no alternative. But if some patients want to be admitted to these hospitals for non-subsidised treatment, then we can be more confident that the hospitals, specialists and staff are competent, and that the hospital is providing good service. We still need to make sure that these specialists and staff are not neglecting the subsidised patients in favour of the non-subsidised patients, but that is a management problem which we can solve. The second alternative, that is, providing everyone with all the medical treatment that he or she wants, will bankrupt us. Where do we draw the line? Should hospital in-patients receive four-star hotel treatment? Can every routine operation be done by the top surgeon? Should every patient who complains of a headache be given a CT scan? The list is endless and unaffordable. In every other area of life, people accept that there is a difference between the essentials and the extras and luxuries. There is a big difference between a healthy square meal and a gourmet dinner. People accept that only the well-to-do can afford a gourmet dinner. There is a difference between a 3-room HDB flat and an Executive flat. People accept that only those who are better off can afford an Executive flat. Medical services cannot escape the same logic. We need to also ensure that subsidised hospitals keep their costs, and hence their charges, down. Under normal market conditions, we can, after determining the subsidies to the hospital, leave it to competition to keep prices down. But as I explained just now, such self-regulation by market forces does not work because of market failure. Even with Medisave, which is the patient's own savings, patients are more ready to spend their Medisave balances than if they had to pay cash. Hospitals can, therefore, pass higher costs to patients by prescribing more tests and treatments than necessary, or by simply raising charges without losing patients. The Ministry of Health will therefore control the revenue per patient day by class of ward, by specialties (for example, oncology cases will have a higher cap than paediatric cases), and by type of hospitals (tertiary hospitals will have higher caps than secondary hospitals). The hospital's revenue, comprising subsidies and the charge to patients, cannot exceed this cap. If it does, the Government will recover the excess. This will encourage hospitals to keep their charges down without restricting too tightly how much they can charge individual patients. Hospitals which reduce their costs can keep their savings and improve their services. Those hospitals which cut costs and reduce service or quality to unacceptable levels will lose patients and will earn less fees as well as less subsidies. But those which strike the right balance between cost control and service will attract more patients and earn more fees and subsidies. Let me now come to financing. How patients pay for health care is an important part of any health care system. Note that the operative term is how, not who pays. Who pays is quite clear. As I have explained earlier, no matter who pays for health care in the first instance, the burden is ultimately borne by the people. The real issue is not who pays, but how and when the payment is made. We must have a system that encourages people to use health care economically and encourages health care providers to minimise inefficiency, minimise costs and prevent over-servicing. Under Medisave, individual savings form the core of the system. Government subsidies and catastrophic insurance, that is, MediShield, play supporting roles. Patients pay part of the costs at point of consumption. This applies even to the heavily subsidised C Class wards. Patients who demand higher levels of service must pay more. This ensures that they use medical services only when they really need to. We thus avoid the danger of unlimited demand for "free" medical services. The disadvantage of relying exclusively on savings to meet health care costs is that individuals will need to save more for their medical expenses than they are likely to spend because they must be prepared for unexpected contingencies. High Medisave also increases the temptation for patients to draw more on these balances than they absolutely need to. As I pointed out just now, patients are more prepared to spend their Medisave than if they were to pay cash although the Medisave balances are their own money. This is why our Medisave system has an insurance component in MediShield. It is catastrophic health insurance incorporating deductibles and co-payments, ie, deductibles in that the insurance cover starts only after the patient has spent a certain amount, and co-payment in that even after the insurance cover becomes effective, the patient has to share part of the cost. For those who have exhausted their Medisave and MediShield or for some good reason cannot even pay C Class rates, Medifund provides a safety net. Medisave, MediShield and Medifund, together with the Government subsidies, ensure that no Singaporean is deprived of medical care. Private medical insurance policies generally do not provide for deductibles and co-payments. They also do not restrict what health care providers can charge. Fortunately, the market in private medical insurance is small. But it is growing rapidly. We should act now to guide the growth of the market in the right direction. In the meantime, we can improve our MediShield system in various ways. We can extend the benefits package of MediShield to provide more cover for Class B2 and C treatment by reducing somewhat the deductible amounts. We can also introduce MediShield II for those who want increased daily reimbursement rates so that they can afford higher class wards. MediShield II will be a voluntary opt-in system, unlike the present MediShield which is an opt-out scheme. When the private sector insurance policies have the same safeguards as MediShield, we can allow people to use Medisave to pay the premiums of approved private insurance schemes. The White Paper also proposes that employers who provide medical benefits to their employees should contribute additional amounts to the employee's Medisave in lieu of part of the medical benefits in kind. We will encourage but not force them to do so. The Government, as the largest employer, will set the example. The Minister for Finance will present the medical benefits package for civil servants. Now, let me say something about Medisave in the private sector. Many patients in the private hospitals use Medisave to pay private hospital and specialist fees. We want the private sector to play an increasing role in health care though Government subsidised hospitals will be the dominant component in our health care system. This is why we are limiting A class beds in subsidised hospitals to 11% of the beds in these hospitals. Government will also encourage private sector hospital development by selling suitable sites for such purposes. But we need to have some control on the private sector charges as the private and public sector markets are interlinked. The public sector has had to increase the salaries of its doctors and other medical staff, partly because incomes in the private sector increased steadily, especially after Medisave was introduced and widened the gap between the earnings in the private and public sectors. This contributed to the overall rise in health costs. We, therefore, have to control private sector fees and charges when Medisave is used. We will work out schemes to limit balance billing of Medisave patients by private hospitals and doctors. This will be the private sector equivalent of the revenue cap system in the subsidised hospitals. There will be a limit on how much cash patients can be asked to pay over and above the payment from Medisave. 74% of the patients treated by private hospitals and doctors use Medisave to pay part of their bills. Income from Medisave patients constitutes 50% to 60% of private doctors' total earnings (I am talking about doctors who service hospitals, not the GPs who cannot draw on Medisave). Limits on balance billing should, therefore, be quite effective in keeping down fee and cost increases in the private medical sector. If the patient does not use Medisave and pays the entire bill in cash, the limit will not apply. But patients, we know, are more restrained when they have to pay in cash and will, therefore, resist high charges more strongly. We did not invent this idea of limits on balance billing. Germany and Japan have similar schemes to control private sector charges. We will take some time to develop a comprehensive system of limits on balance billing but a start will be made some time next year. Research and development. Our health policy emphasises primary health care, a good basic health package for all at the secondary and tertiary level at affordable prices and sustained cost control measures at all levels. Cost consciousness must become a deep part of the culture of our health care givers. Our research and development efforts in medicine and training of doctors must be consistent with and subordinate to the national health policy. Ever since the establishment of the Medical School in 1905 in Singapore, the medical profession has attracted the best minds in Singapore and the then Malaya. It is not surprising, therefore, that the quality of our medical service is the best in the region. It is also natural for the medical profession and for Singaporeans to expect us to be in the forefront when introducing or testing new medical procedures and drugs, and to be a leading centre for medical research and development. In the past, before the current explosion in experimental medical work, our society could bear the cost of such ambitions. The majority of the population was deeply suspicious of hospitals so that experimental work in hospitals did not result in an immediate demand for more services. The situation has, however, changed. Our population is now alert to the latest medical advances, however tentative, in the medical world. A short report in the newspapers of some new work results in immediate inquiries and demand for the same type of treatment, whether it is a new treatment for cancer, or a new surgical procedure for heart patients. Research with clinical implications, therefore, results in an immediate demand for more health services. If we want to maintain our excellent health care system and continue to attract some of our brightest students to study medicine, then we must carry on doing medical research and development. But we should focus more sharply on research with cost effective practical applications and research which can help improve the health care system. We must not be too ambitious to be at the cutting edge of medical technology. We can also do more theoretical research, like that done in the Institute of Molecular and Cell Biology, which is significant research, but has no immediate impact on the demand for health care services. But we should be very careful in undertaking research in areas not within the basic health care package. For example, we should leave it to other countries with more resources to experiment in organ transplantations. The White Paper proposes the establishment of a National Medical Research Council which will approve, oversee and coordinate medical research which has clinical implications. The content and emphasis in medical education too must be in line with the national health policy. Undergraduate training must emphasise primary health care, not high-tech medicine. The aim must be to train students to be good family doctors. In postgraduate and specialist training, the aim should be to meet the service needs of the public sector hospitals. The National University of Singapore will work together with the Ministry of Health and the Singapore Medical Council to keep undergraduate curriculum current and relevant. The Ministry of Health, together with an Advisory Committee on Medical Specialists, will regulate the training of specialists. Mr Speaker, Sir, there was a time, not so long ago, when few Singaporeans dared to venture into a hospital. To be sent to hospital was considered by many to be a death sentence. A more educated and affluent people now know the value of early attention and treatment. Fears and inhibition about hospital treatment have diminished. People know more about the latest treatments and advances in medical technology, though often their knowledge is partial and even distorted. All these will raise the demand for health care. We must learn to spend the money that we set aside for health care wisely. The Government undertakes to make a package of essential and effective treatment available to all, not for free, but at affordable prices. It will institute various measures to keep down national health care costs. But the responsibility rests on each of us, as individual Singaporeans, to do all that we can to stay healthy, to save to pay a share of the cost of treatment when we fall ill, and to spend these savings wisely. We have a good health care system. The proposals in the White Paper will improve it further. Singaporeans must be sensible about what they can expect from the health care system. Then the Government can manage the system rationally, and not dodge tough choices which are unavoidable. That way, we avoid the awful trauma that the developed countries are going through to reform their health care systems and make them affordable to society. Question proposed.

( In Mandarin): Mr Speaker, Sir, I rise in support of the Minister for Trade and Industry's motion. Giving birth, getting old, falling sick and dying are the inevitable processes of life. A person who is healthy and full of energy will not only increase his productivity and competitiveness but also enjoy a fulfilling and meaningful life and, therefore, people are very concerned about their health and the cost of health care. The health of Singaporeans has made very remarkable progress in recent years. Based on the average life expectancy, infant mortality, control of infectious diseases, we are not far behind the standards of advanced countries, some of which we have overtaken. At the same time, many people still feel that medical costs seem to be mounting all the time. Not only the private hospitals have adjusted their fees upwards, Government and restructured hospitals have also increased their fees in order to meet the increasing costs and to prevent a brain drain. Some people feel that it is the responsibility of the Government to account for the rising cost of medical fees. But I think when people talk about this issue they are very emotional. They do not quite understand the circumstances that have led to this situation and they listen to hearsay and follow what others are complaining about and blame the Government. The other reason is that between 1984 and 1989 there were no fee adjustments in Government hospitals. In April 1989, there were adjustments in the ward charges, surgical fees and other fees. In August 1990, Alexandra, Kandang Kerbau, Tan Tock Seng and Toa Payoh Hospitals also adjusted their fees upwards and quite substantially. At that time, soon after the implementation of the restructured hospital scheme, to increase efficiency, to simplify administrative procedures and to enhance services, I think the intention was good. But before efficiency was raised, the new rates of fees were already applicable. So some people had the preliminary impression of restructured hospitals that before they could get the benefits, they had suffered from the disadvantages. Since 1990, the Government decided to adjust the fees annually in order to prevent substantial increases over a longer period. I think this is the correct way. In order to ensure that we have an affordable health care service, the Government has published this White Paper to deal with the various objectives, which are as follows: (a) To nurture a healthy nation by promoting good health. (b) To promote personal responsibility for one's health and avoid over-reliance on state welfare or medical insurance. (c) To provide good and affordable basic health services. (The Minister has already explained the meaning of basic health services.) (d) To rely on competition and market forces to provide health care service and to raise efficiency. (e) To intervene directly in the health care sector, when necessary, where the market fails to keep health care costs down. This shows the basic principles and the right direction of the Government to make everybody responsible for his own health. I think we should be very calm and try not to be emotional in drawing the wrong conclusions. I hope that after the debate in this House, people in Singapore will have a better and more comprehensive understanding of our health care system. On market forces, theoretically, free market and competition are closely related with the two following features: First, we have a lot of buyers and sellers in the market and the individual buying and selling are very small which cannot influence prices. Secondly, there is no restriction on buyers and sellers and they understand the market price and related matters. I think Dr Ow has already told me this. Nobody can monopolise the prices if there is a balance between supply and demand. President Kennedy of the United States said previously that the free market is not only a more efficient determinant than the best central planning agency, it is also a pillar of the US democratic system. If the free market system is that good, then there would not be so many economic problems in the US. There will not be a wide gap between the rich and the poor and there would not be any inflation in the US. To ensure that, as the Minister has said, the patients do not know the good and bad points of medical treatment and they have no time to choose which hospital, which expert or specialist to see. I think the moral and ethics of doctors are important factors that will determine medical costs. So I hope that the Medical School in Singapore, in addition to inculcating and imparting the medical expertise, should also inculcate the correct attitudes and moral values to relieve people from pain and suffering in the service of society and for the benefit of mankind. I hope that the subsidised Government hospitals will, through competition, increase service quality and lower operating costs. I think these two are conflicting factors. If you want to improve the quality, you must have more medical, administrative and other staff. But the increase in staff means more expenditure and that will increase operating costs. On the contrary, if the Government wishes to save money by cutting down staff, then the workers will have a heavy responsibility. Morale will be down and the quality of service will also be affected. So between the two factors, I think it is a great challenge for the hospitals to maintain a balance. I hope that the Government hospitals or subvented hospitals should pay attention to improving the quality of service and should not be quibbling too much about cost savings. I think it is very easy to measure the financial performance of a hospital. But if you pay too much attention to financial performance, I think the quality of service will be affected. The Public Works Department, the PUB and other Government agencies have very good performance under monopolistic situations. It is also because of the right attitude of the people and the management of these statutory boards that they are very competitive. I think these are more important. According to the White Paper, Mr Speaker, Sir, A class beds should not exceed 9% of the total number of beds in the whole country or 11% of subvented hospitals and the individual subvented hospitals should not have more than 13% of A class beds. This measure is to ensure that the middle and lower income groups have affordable basic health care. I think it is a correct move. But in subvented hospitals, I think this percentage should be further reduced. The reasons are: (1) Those who can afford A class beds can go to the private hospitals. (2) Subvented hospitals now face the problem of manpower shortage. To increase the number of A class beds will further aggravate the manpower shortage situation. (3) The more A class beds there are, the faster will the B and C class beds reach the point of saturation, and some of the patients may be transferred to A class beds. On community hospitals, I think Mr Chandra Das also said sometime ago that the number of A class beds should be further reduced in community hospitals, because such hospitals are set up to provide affordable health care services and A class beds are not affordable. Workers' welfare and Medisave. The employers do not want their employees to over-use their medical benefits. So the Government is taking the lead to provide extra contributions to Medisave in lieu of medical benefits for the new civil servants. I think this measure to encourage employees to take care of their own health will enable those who are paying attention to their own health to have more Medisave balances in their accounts. This is a good measure but we should look further into it because it may be unfair to some people. For example, those who are involved in road accidents will have to be hospitalised, and they may have to be operated on several times. It does not mean that they are over-using their medical benefits. The 2% cap may be used to buy medical insurance but they will still have to pay out of their own pockets. Those people who have hereditary diseases such as diabetes need more medical care. It is not because they do not care about their own health. It is because of their own hereditary reasons and not because they neglect their health. So they need medical care. So the question of how these costs could be distributed fairly should be looked into further. I endorse the Government's view that everybody must be responsible for his own health. But for some other diseases such as heart diseases, diabetics, and with more and more such cases around, I think we should pay attention to them. According to a survey of the Ministry of Health, 10% of our students have high cholesterol levels and 15% of the students are overweight. It is because they eat more meat, but if you inculcate good eating habits from young you could prevent a high level of cholesterol, excess blood sugar and prevent high blood pressure. I think we must pay attention to this. The Ministry of Health and the Ministry of Education have worked out a scheme to encourage people to take care of their diet by eating less sugar and drinking more water. I think this is a very good way of looking after the health of people. But apparently, the White Paper has not dealt in detail about preventive health care. I think the Ministry of Health might already have something in mind. I hope that this can be published in due course. Prevention is better than cure. Before the situation gets out of hand, we should think of preventive measures, and this is consistent with the style of the Government. The White Paper is a good example. Apart from strengthening our health care system, a more important message is that every Singaporean must be responsible for his own health. Good eating habits, moderate living, healthy lifestyle, are important things that our people must look into.

Sir, I must commend the Ministerial Committee for presenting an excellent and comprehensive White Paper on Affordable Health Care. It is an extremely complex issue and the Committee has shown deep insight in the magnitude of the problems associated with our health care system. Against the backdrop of ever increasing health care cost and the limited human resources, not to mention the constant higher expectations from the general public, the White Paper analyses systematically the problems we face in the health care system with pragmatism and compassion, and examines all possible options and proposes a framework to put in place an effective, workable and fair health care system for all the Singapore citizens. But its rationale and analytical approach to the subject, though comprehensive and systematic, may not necessarily find immediate acceptance from the average Singaporeans who always have an in-built fear and apprehension towards the extent of health care that they can receive when they have the misfortune to fall ill. Furthermore, health care has always been and always will remain an emotional issue. It is this emotional dimension that causes judgment to be impaired, resulting in the health care system in some countries getting totally out of control. The White Paper addresses all aspects of our health care system, right from health care philosophy to medical treatment and training. Today, I would like only to focus on the subject of basic medical care. I have chosen this particular subject because I feel that it would generate the most concern as it is an aspect of health care that affects almost everyone at one time or another. It is important to ensure full understanding and acceptance. The White Paper has examined in detail the basic medical care in terms of need and cost affecting treatment that an average patient requires. It defines what basic medical care is all about and proposes a basic package of affordable health care, not by inclusion, but rather by exclusion. It includes almost 99.9% of medical treatment available and excludes items like cosmetic surgery and dentistry, sex operations and in-vitro fertilisation treatment, organ transplant, artificial appliances other than the most basic models for heart, hips, knees, etc, experimental drugs and all high cost methods of investigation. If one inspects the proposed medical care package rationally, one can understand fully the reasons for such conclusion because medical treatment is not an exact science and there is no limitation to how far one can go in seeking out the various treatments available, whether proven or experimental. It is obvious that such treatments cannot be given to everyone due to the immense cost and also, in some instances, the futility of such treatments. However, in time of sickness, the affected person, or those dear to him or her, would often not use rationale to make decision. They are usually in a highly emotional state of mind. For example, if there is the slightest chance, no matter how remote, for a terminally ill patient to be cured by experimenting with highly expensive and untested treatment, chances are that the patient as well as those in the immediate family would clamour for a try, and it is very difficult at that point of time to convince them that this is not included in the basic medical package and therefore will not be provided unless the patient pays for it. As we so often say, one cannot equate life with cost. How then can we overcome this emotional demand without sounding uncaring and cruel? It is the responsibility of the Government to ensure that everyone has to learn to accept that there is such a thing as cost constraint in medical care. It is not only a question of affordable health care for the individual. More importantly, we must have an affordable health care system for the nation. We cannot let a few isolated cases to cause our whole health care system to collapse. I must re-emphasise that this basic health care package refers to only Government subsidised medical treatment. The individual is not prevented from seeking whatever level of health care treatment he wishes provided he pays for himself. The Government also has the obligation to assure the general public that the basic health care package is made available to everyone irrespective of whether he is rich or poor. In turn, every citizen must understand that although the level of quality of medical treatment should generally be equal, the degree and comfort of services can vary. Very often when we hear of a complaint being made against a doctor or hospital, we assume that it is made against the medical treatment received. In actual fact, a great percentage of them are actually against the degree of comfort and services received, and not the quality of medical treatment. These are two completely different issues. A patient staying in Class C ward and a patient staying in A1 ward and having the same sickness would probably require the same length of time to be cured. The fact that those C class patients would have to wait longer for the nurses to attend to them or have to endure a noisier and hotter environment would not in any way make the illness any worse. They may suffer a bit more discomfort, but the quality of medical treatment must remain more or less at par between the patients of those two wards, and this the Government should ensure. As I have emphasised earlier, this is a very emotional subject. It may not be easy to bring across the rationality of such a decision on defining what constitutes basic health care. It is further complicated by the fact that medical science is not an exact science and there are lots of imponderables and probabilities that even the best of doctors or specialists may not be able to come to the same conclusion. Therefore, in borderline cases where a doctor has to make the decision as to whether a certain treatment can be considered basic or not they can generate disagreement and dissatisfaction. This will no doubt cause a lot of controversy in the future. While one should be caring and understand the plight of those who have fallen ill and that of the relatives and loved ones, the Government must take a firm stand in implementing a long term affordable health care system. We have seen numerous examples of countries, both developed and developing countries, grappling with their health care systems, some of them on the verge of collapse, and we cannot fall into the trap of being over-benevolent and let our emotions cloud our judgment. Once again, I commend the Committee for putting up this White Paper. I am sure the Ministry would continue to make adjustments and improvements to the system. The tremendous progress and changes in the field of medicine necessitated these adjustments. Who knows that what is considered basic today may be just routine tomorrow. But at this point of time the Government must assure all its citizens that they will have an effective, efficient and affordable health care system. It is hoped that our citizens will be able to take care of themselves as much as possible, but should they be unfortunate to fall ill, they will be given the best possible health care.

Singapore as a Medical Centre Singapore would like to be a medical centre and to succeed in this task, we need a number of specialists in a number of specialised areas. For each specialty, we need to have many specialists in order to provide breadth and depth of knowledge in the field. Over the last few years, we have, by and large, succeeded in this task. This is shown by the number of patients from the region coming to Singapore to seek medical treatment. This is much to the credit of the doctors in Singapore as well as the people who plan the scheme. More specialists means more referrals by general practitioners When a general practitioner suspects that the patient suffers from a serious illness, it is very likely that he will refer the patient to a specialist. This is to enable him to get a second opinion. It is also to ensure that he has the benefit of the advice of properly trained specialists in order to help him with the diagnosis. If no specialists were available, then his conscience is clear. But if a specialist is available, the GP may find it unconscionable not to seek that advice. This is good for the practice of medicine, it would also contribute to the rise in medical expenses. Specialist Equipment Sir, specialist equipment is another area. When specialists are available, they would install specialist equipment. When the specialist equipment is available, specialist tests would be prescribed. A doctor would find it difficult not to prescribe tests that are available in order to get all the information that he can get hold of for the purpose of a complete diagnosis before treatment. When more tests are being prescribed, the cost of medical treatment would therefore rise. Some of these medical equipment are very expensive and their capital cost would have to be recovered by means of usage fees and so the cost of medical tests and procedures will also increase the cost of medical attention. Many family members would also want specialist treatment GPs are not the only people who would like their patients to be subject to specialist treatment. From time to time, a patient is sent for specialist treatment when the family members think that it is a matter of duty, perhaps their love for the patient, to send the patient for specialist treatment and to get the best possible attention available. Often this is out of a sense of filial piety, even though in some cases the condition of the patient may not be all that hopeful and the cost of specialist treatment may be beyond the means of the family. But many of them would feel that their conscience will not be clear if a specialist is available and his help is not sought for their sick or dying parent. Choosing the Specialities In the process of becoming a medical centre, let us choose the specialities carefully. It is clear that in trying to become a medical centre, we have inadvertently and perhaps indirectly raised the cost of medical treatment in Singapore. I am not saying that Singapore should not be a medical centre. May I suggest to the Health Ministry that we restrict the number of specialities that the Government would like to subsidise and encourage in the hospitals funded by the Government. There are many reasons for these. For example, there is a finite number of people in Singapore who can become doctors. And among them, there is even a smaller number who can become specialists. With just three million people, there is a demographic limit to the number of people who can realistically become specialists and we simply do not have enough men to man so many specialities. Many of this talent ought to be channelled to other areas in Singapore because these other sectors also need a fair share of talent. Summary To summarise, Mr Speaker, Sir, the development of Singapore into a medical centre has inadvertently increased the cost of medical treatment. I urge the Government to control this by restricting the number of specialities that it would promote and subsidise, leaving the private sector to promote other specialities if the market demand is there. On this note, I support the motion.

Mr Speaker, Sir, reading the White Paper on Affordable Health Care was like de javu. My views on health care are in many ways similar to that advocated in the White Paper.

4.46 pm The Ministerial Committee has produced an excellent report on the macro aspects of creating an efficient health care system, keeping basic health care accessible to all and containing long-term health care cost and Government subsidies. I believe that it is a step in the right direction. However, I would like to make comments on certain areas. Firstly, health care philosophy. The five fundamental objectives spelt out in the Government's approach to health care philosophy are sound. However, I think that there is one other important objective that should be added to the Government's health care philosophy, that is, to avoid over-subsidy of health care services and to educate the public on the true cost of health care. We should not be too liberal in subsidising health care services, but we must be liberal in ensuring that those who are unable to afford basic health care services will not be denied of basic health care services. By over-subsidising health care, not only will consumption of health care be increased but it will also distort the true cost of health care. Our present system of health care subsidy in the subvented hospitals at the macro level is not reflected at the micro level. For example, a B2 patient may in effect be subsidised substantially more than 65% of his cost if he requires more investigations. Hence, a patient who, because of his medical condition, requires extensive x-ray investigation, including a CT scan costing a few hundred dollars, may only have to pay a maximum of $50 for all these tests throughout his entire stay in hospital. Likewise, a B2 patient with cardiac disease who requires multiple electrocardiograms, cardiac ultrasound scan, treadmill tests, ECG monitoring costing, say, more than $500, may not have to pay more than $20 for all his tests. In fact, a subsidised B2 patient once remarked that it was ridiculous that a cardiac ultrasound scan is charged only $20 when an electrocardiogram is also charged $20. It seems ironical that a cardiac ultrasound scan which takes a highly trained technologist half an hour to an hour to do on a machine, which costs a few hundred thousand dollars, is charged the same cost as an ECG which can be done by an unskilled technician in 10 minutes on a machine that costs a few thousand dollars. In line with the objectives spelt out in the White Paper, the Government should take steps to address this issue of over-subsidy. The system perhaps should be revised so that patients should pay a percentage of the true cost of the service or tests provided rather than a flat rate. Those who consume more should pay more and those who consume less should pay less. Hence, those in subsidised wards who use more services should not receive more subsidies than those who use less. If the true cost of health care is distorted, it will be detrimental to our health care system. An elderly gentleman I met along a corridor of an HDB block expressed great unhappiness about his hospital bill. He was admitted to a subvented hospital for a surgical procedure and his gross hospital bill was more than $1,000. However, after all the Government subsidies were accounted for, he had to pay about $200. He was unhappy not because he had to pay about $200, but he was indignant that the gross bill was more than $1,000. He felt that it was ridiculous that the bill should be such, even though he stayed in hospital for about a week and had undergone a surgical procedure. He was unable to appreciate the true cost of health care. We must not have a generation of Singaporeans growing up not appreciating the real cost of health care or they will not appreciate the health care subsidies given by the Government. Hence, in whatever way health care subsidies are given, the real cost of health care should not be distorted by over-subsidy. There must be not too big a gap between the real cost and the cost paid by the consumer. Singaporeans must understand that if they want a high quality of health care, health care cost will increase. For example, in the past when dialysis was not available, if you had renal failure, the ultimate cost was death. However, now dialysis is widely available, but it is also costly. So if we take away high-technology medicine, who is to lose out? I think that the rich can always go overseas and seek treatment, but the average Singaporeans will face problems. So sometimes it is very difficult to have good quality medicine and cheap medicine. Secondly, I would like to say a few words about basic health care. I am glad that the White Paper has tried to give some form to this nebulous term of basic health care. In principle, I agree with the broad definition given in the White Paper. However, some of the principles are completely sound and logical but do not give health care givers clear directions at the ground level. For example, no one will dispute that basic medical care excludes extravagant efforts to keep gravely ill patients alive using high-technology equipment, regardless of their quality of life and prospects of recovery. However, in practical aspects, what does it mean? Does it mean that a young man with a disease affecting his muscles, resulting in his inability to breathe properly, we should put a tube in him? Because if you put a tube in him and put him on a ventilator, he will otherwise be well. But if we do not put a tube in him, he will die. If we do not put a tube in him, is that passive euthanasia? So these are very difficult questions for practitioners on the ground. Perhaps at the national level, or at hospital level, ethical committees should provide clearer direction. If a patient's family insists on high-technology measures against doctor's advice, will he be automatically converted to non-subsidised status, because such measures are not part of the basic medical package? These questions need to be answered. I support the recommendation that employers contribute more to Medisave in lieu of traditional benefits. If both outpatient and hospitalisation benefits are converted to increased Medisave contribution, the Government may perhaps want to consider allowing the use of Medisave for outpatient care with some caveats. To prevent unnecessary administrative burden and abuse, the use of Medisave for outpatient services should be linked with some conditions: (1) It must be a co-payment scheme; (2) There must be a ceiling for the amount withdrawn over a certain period, perhaps, monthly; (3) It should only be allowed for outpatient treatments which are relatively more costly; and (4) There should be a cap on the amount to be charged for the services provided. In other words, you should limit the balance billing. I also support the establishment of MediShield II, and the development of the private health insurance. However, health insurance in Singapore must not evolve in the direction of the US where doctors, instead of being trusted for their expertise, are expected to call an 800 number and get approval for even basic medical procedures from a total stranger sitting in an air-conditioned office miles away. The US system promotes over-consumption and over-supply of services. Any private insurance scheme should involve some form of co-payment. I also support the concept of balance billing. However, this is something that needs to be looked at carefully. The bill often contains not only the doctor's fee, but there usually is a two-component fee: one, the hospital facility fee; and two, doctor's fee. And in planning to limit balance billing, all sectors should be considered separately so that all sectors will contribute to this effort to limit balance billing. Also, each inpatient visit by each doctor may be different. In other words, we may have to differentiate between the charges by the doctor for different types of visits. A 10-minute routine visit at nine o'clock in the morning for a routine round cannot be equated with an one-hour stay in an intensive care unit for an extremely ill patient. Thus, there may be a need to have different scales for different types of visits. At the end of the day, what does it mean for the man-in-the-street? I think the message to them is that there will be an affordable basic health care package. But we must educate the public that if they want to continue to have good quality health care, health care cost will increase. Ensuring that the increases remain affordable will require efforts by the Government, hospitals, health care providers, and most importantly, the man-in-the-street himself. At the end of the day, the man-in-the-street must understand that although, at most times, health care is good and cheap, occasionally it will be good but expensive. I support the motion.

( In Mandarin): Mr Deputy Speaker, Sir, over the past few years, medical cost has been going up all the time. Although the Government has increased its expenditure on health care, the rates of subsidy have been reduced, eg, from 85% to 84% for Class C beds, and this will be further reduced to 80%, and from 73% to 71% for Class B2 beds in 1992. This will be further reduced to 65%. The concern of Singaporeans is that after the privatisation of Government hospitals, hospital fees will be further increased. With this trend going on, Singaporeans, especially those in the lower-income group, will one day be unable to afford these medical expenses. Although the Government has, after the last General Election in 1991, introduced the Medifund scheme to assist the lower-income people who are unable to pay for their medical expenses, most of the people in the lower and middle-income groups are unable to avail themselves of the benefit of the Medifund. The ever-increasing medical cost has remained a serious problem. This White Paper brings forth some recommendations on how to control the continuous rise in medical cost. This is indeed very appropriate and relevant. First of all, I would like to deal with the Government's philosophy on the provision of health care to our people. The Government feels that everybody must be responsible for his own health, and should not rely on the Government's welfare service or medical insurance. Of course, I agree with the Government's emphasis on a healthy lifestyle to encourage more people to exercise regularly to keep themselves fit and healthy. A mentally and physically healthy person is a valuable asset of the country. However, this does not mean that when somebody falls sick and needs medical care, he must be held responsible for having fallen sick. Nobody wants to fall sick in order to enjoy the Government subsidy. Falling sick is something which cannot be helped. Because of his sickness, he has to worry about how to raise the money to pay for his medical expenses. This is really something which breaks his heart. The provision of medical care is the responsibility of the Government, in the same way that it is the responsibility of the people to pay tax, or to serve in national service. So the Government cannot push the responsibility on to the people. Secondly, the Government is relying on market forces and free competition to improve service and efficiency. The White Paper recommends the overall control of medical service, including the number of doctors and charges of private hospitals, etc. But on the rise of medical cost, it talks about free market forces and cost-effectiveness. The role played by the Ministry of Health is to regulate the rise in medical cost. Government hospitals are privatized to conform to the principle of free economy. On the one hand, the Government wants to have overall control on the medical service market but, on the other hand, when medical cost escalates, it puts the blame on market operation in a free economy. Now, it has come a stage when everyone has to be held responsible for his own sickness. What really is the Government up to? Mr Speaker, Sir, let me now deal with the contents of the White Paper. First, the basic medical care package. The Government says that it will be unrealistic to make the basic medical care package rigid and inflexible, and the items in the basic package will be reviewed from time to time. I presume that when the Government reviews the package, it is done with the view of increasing the items of medical services in the basic package, and not to reduce them. In my view, if the Government is unable to allow Medisave to cover all the items, then you might as well list out all the items that are to be excluded. Apart from pages 23 to 24, all the basic items should be included in the package. I feel that the general principle of the package must be that wherever lives can be saved by the provision of any service, then it must be included. To save life is very noble. Secondly, the payment of medical expenses. The Government's basic pay package applicable only to Class B2 and C patients. However, certain major surgical operations are not available to Class C patients. They have to upgrade to B2 class in order to avail themselves of these operations, and hence pay 35% of the cost. Sir, 35% of a major surgical cost is certainly very substantial. If hospital charges keep on going up, then they will become a great burden to the people. The Government's solution is the use of the formula CPI plus X to control the rise in the cost of medical expenditure. How much is X? What will be the actual fees to be collected - $10, $100 or $1,000? Thirdly, the Government plans to increase the contributions to Medisave. The question here is: Will the percentage increase affect the ability of the people to buy properties, to own shares, etc? Will this not be contrary to the Government's philosophy sharing national wealth? Fourthly, the Government is encouraging employers to offer more contribution to the Medisave account in lieu of the traditional medical benefits. The question here is: Will this not lead to the employees losing their existing medical benefits? Does it not mean that, with this increased contribution, employers will no longer be responsible for the medical benefits of the employees? The White Paper mentioned that we too should explore ways to make greater use of medical insurance. I am of the opinion that health insurance is a matter that the government must further explore and look into. In order to ensure that the people have the money to pay for their medical expenses, the government encourages more money to be paid into Medisave account. This is not a long term solution especially when the medical expenses are supposed to be fixed byu market forces and the government refuses to spend more to offset rising medical cost; how much Medisave is enough is an uncertain X factor. With a lot of money frozen in Medisave, will it not run against the Government's principle of cost-effectiveness? Overall, the White Paper expounds the Government's motive in providing medical care. In other words, the people must be held responsible for falling sick. Free market forces must be used to determine medical expenses. Is this the so-called responsibility of the Government, the PAP Government, to the people?

( In Mandarin): The Government has the responsibility to provide affordable health care to the people. This is undeniable because people have been paying taxes. Even those who do not pay taxes, or are paying little taxes, have also laboured for the good of the nation. Therefore, the State has the responsibility to look after their health. Even those handicapped people are also our compatriots. The Government has the responsibility to look after them. Our Government has enough reserves, it should spend more on housing, education and health care, especially for those poorer people. Of course, we do not want people to depend too much on the Government, but nobody wants to fall sick and be admitted to the hospital just to enjoy the Government's subsidy. This point has just been made by Mr Low Thia Khiang, the MP for Hougang. When a person falls sick, he and members of his family will have to worry about the medical expenses. Although the Government says that it has subsidized health care, most people are still very concerned about the high medical and health care costs. I hope the Government will pay attention to the three following points: (1) Health care for the senior citizens; (2) The high cost incurred by patients suffering from serious and complicated diseases; and (3) Ways to reduce health care costs. Let me talk on these three points. First, the health care cost to the senior citizens. Because of the changes in society and because of the Government's land acquisition policy, some elderly people, who do not have children or whose children do not have the means to support them, will have problem once they fall sick. If they do not have savings, they will not be able to afford the medical expenses. Many elderly people are jobless and do not have CPF nor Medisave. These people need the help from the Government. Secondly, the patients who are suffering from serious and complicated diseases. They may be small in number, but these are people who require treatment with high-tech medical skills and equipment. They will have great problems in paying for such high medical cost. The Government should find some ways to help these patients to lessen their burden. Thirdly, how to reduce medical costs? How are we going to avoid excessive expenditure on health care? For example, we should not readily resort to expensive, high-tech facilities. The Health Ministry should also consider holding more exhibitions in the HDB housing estates so as to educate people on the importance of keeping a healthy body. Indirectly, this will go a long way to reduce health care cost. On the other hand, we should also restrict the medical fees charged by the private hospitals. Industrial diseases should be looked into also. The Government should raise the salaries of nursing staff to attract more people to join this noble profession. Minor cases can be managed by the nurses instead of the doctors. In this way, we can save on medical fees, or health care costs. But more importantly, the Government should not privatise all its hospitals. Health care is a public service to be provided by the Government. The Government should not, on the slightest excuse, privatise all its hospitals. Once the hospitals are privatised, the fees charged by these hospitals will be raised. Now that we have strong financial reserves, we should not privatise all the hospitals even if the hospitals suffer a deficit. The Government should continue to subsidise these hospitals. The Government should make use of its budget surpluses to subsidise the hospitals. Although the Government says that those who cannot afford to pay for their medical expenses can apply for waiver of medical fees, this will result in delay in getting treatment. The Government should think of a more efficient way to make it easier for these people to apply for waiver of medical fees. The White Paper emphasises on the effective ways to cut down health care cost and that people should be responsible for their own health. This is a correct policy. However, I am of the opinion that, apart from the suggestions in the White Paper, the Government should listen to feedback from the people on health care, to understand better the plight of the elderly people and to give more subsidies on their medical fees. 5.13 pm

Mr Deputy Speaker, Sir, I rise to support the motion standing in the name of the Minister for Trade and Industry, Mr S. Dhanabalan. The many debates in Parliament in the last few years culminating in the White Paper on Affordable Health Care show clearly that the health of Singaporeans remains a high priority of the PAP Government. The White Paper sets out clearly the health care philosophy of the Government and its commitment that good health care will remain accessible and affordable to Singaporeans. Sir, the recent tragedy of AIDS-tainted blood in Germany is a useful lesson for us. In our drive to contain medical cost increases, the quality of medical care should never be open to jeopardy. In our effort to economise on medical cost, we should not risk a nightmare of disastrous consequences. The disaster in Germany shows that it may take years to uncover the grave and irresponsible error and system failure if no checks are in place. By the time it is found out, irreparable harm had been done to the innocent people. We cannot be complacent but to remain vigilant. I would like the Minister for Health to assure this House that in Singapore we handle all medical cases with care and that the exposure to accidents of the kind reported will not happen and that Singaporeans shall have no fear because their health and safety are in safe hands when undergoing medical treatment in Singapore. We in the GPC on Health are happy that the Government has taken pains to define what universal good basic health care is. Our people are already enjoying comprehensive and quality health care. In today's B2 and C class wards, Singaporeans are being treated by well-trained and qualified doctors. Sir, Dr Michael Lim just now asked the Government not to give over-subsidy. I hope that the Government does not take his cue to reduce the subsidy for Singaporeans going into the B2 and C class wards. I think our concern is that the subsidy will be further reduced and, if possible, we will ask the Government to increase the subsidies for the B2 and C class ward patients. The Government has assured us that the basic medical package will be constantly reviewed and expanded from time to time to take into account medical progress and improvement in the socio-economic status of our people. It is advisable and wise for us to go for results and to spend only on essential medical treatment of proven value that enhances the patient's health and quality of life. There are innumerable health care needs but the resources available are limited. We therefore should opt for cost-effective treatment that yields the best outcome possible. Sir, one item in the White Paper that concerns many people is the exclusion of "unwarranted effort to prolong life and delay death" as part of the basic medical package. There are some who view this as a step towards the practice of euthanasia or mercy killing in Singapore. I am sure that this is not what the Government has in mind even though the Straits Times editorial of 25th October 1993 seems to indicate that "Singaporeans are being prepared for the day when conditions would be rendered acceptable for the plug to be pulled on those patients for whom, in the doctors' judgment, nothing more can be done." Here, I wish to state my position on this issue. I would not agree to euthanasia or mercy killing. We have no right to take away another person's life, not even the person himself. Sir, in the GPC, we also have the views of the senior citizens. What cheered me is the comment of Mr Lye Thim Fatt at the meeting the GPC (Health) had with the Resource Panel. Mr Lye is the Chairman of the People's Association Senior Citizens' Club Co-ordinating Council. According to him, senior citizens, especially the elderly in their 70s, do not favour the use of expensive life supporting equipment in ICU wards to prolong life and delay death. They take a philosophical view that when their time comes to leave this world, they wish to die with dignity, comfort and in peace. He thinks that it is the children who would be more inclined to ask for such life support equipment to save the parent when taken gravely ill. They normally take the decision on behalf of the parent out of filial piety. Perhaps the White Paper's mention of this delicate and sensitive matter may serve to bring the discussion out in the open among family members. I agree with Mr Lye' suggestion that the hospital doctors be properly trained and be ready to counsel the young next-of-kin on the possible outcome of any treatment, given the medical condition of the patient, before coming to the decision on the medical care to be given to the patient. The children can then be reassured that they have done their utmost for the parent in the most difficult circumstances when having to make the decision one way or another. Next, Sir, I come to the standard drug list. The basic medical package also provides for a standard drug list based on World Health Organisation's (WHO) recommendation. However, the perception seems to be that they are of inferior quality as WHO connotes drugs suitable for the less developed third world countries. The President of the Pharmaceutical Society of Singapore, who is a member of the GPC (Health) Resource Panel, told us that the standard drug list provided by subvented hospitals and polyclinics is in fact much longer than those recommended by WHO and are of higher quality. But, Sir, maybe because of certain medical conditions where first-line drugs are needed for cancers and heart ailments, they are expensive no doubt, but they are very much needed, the Ministry should consider including some of them as soon as possible. Therefore, Singaporeans should not worry about the quality of drugs being dispensed at Government pharmacies. The other interesting item in the White Paper is the need for Government intervention in the structure of the health care industry and the regulation of the health care system. Mr Low Thia Khiang just now made some comments about the contradiction between having free competition on the one hand and Government intervention on the other. I think it is only right that the Government intervenes, because the Government has chosen to intervene particularly where it wants to concentrate its resources on the subsidised patients in the B1, B2 and C class wards, focusing on the middle and lower income groups. I hope that the Government will constantly review the total number of beds in the different class wards so that the public will always have a choice according to their affordability. The changing demographic profile of our population and the disease pattern mean that adjustments will have to be made to the number of beds in the different class wards to meet the demand of the day. In the area of health financing, Sir, I subscribe fully to the principle that the individual patient pays his own medical bill. Mr Low Thia Khiang suggested earlier that when a person falls ill, it is total Government responsibility. I think the Government should only come in in cases where the individual cannot help himself rather than to make it that anyone who falls ill, it is the Government's full responsibility to take care of every one. I think we should go for the exception rather than the norm. There would be exceptional cases of those unfortunate few, because of their serious medical condition, that will impose severe financial burden on themselves and their family members. And it is right that the Government has started the Medifund scheme to be the source for such people needing help from the State and I think the Medifund scheme has been a boon to all these people. Sir, there is a group of retired senior citizens who have depended on their life-long savings to keep them going. Because of the small CPF savings in the earlier years and Medisave accounts being non-existent, these retirees, having exhausted their CPF savings, are very afraid to incur high medical bills that impose a heavy financial burden on their children. Here, the family support is crucial and important. But there are those whose children are not well-off and these people have tremendous difficulty in looking after and supporting their aged parents. I hope that this will be taken into account when the hospital administration assesses genuine cases requiring additional subsidy or waiver of hospital fees. This group of elderly Singaporeans has contributed much in the past by laying the foundation for Singapore's present-day growth and prosperity, yet they are put in the undeserved plight because of the unfortunate circumstances in the old days of colonial government and early independent Singapore. The Medifund Committee should be more sympathetic and accommodating to these Singaporeans in need. It is right that we focus on the large majority of our population who are gainfully employed. It is good to make a start now to encourage personal responsibility on one's own health, especially among the younger members of our working population. With a cap on companies claiming for tax deduction on medical expenditure at 2% of the payroll and the medical bills of most companies fall below the 2% level, it is timely for employers to revise their medical benefits scheme to incorporate incentives for medical cost containment and strengthen their business competitiveness. Sir, the issue and challenge is how to make the transition phase in the switch-over more palatable to the affected employees. Staff and workers need to be assured that there will be no cut-back in their existing medical benefits. The medical benefits can be frozen at the present level with no further enhancement without co-sharing between management and staff. If employers wish to introduce co-sharing now, it would be only fair that financial incentives be given in exchange for co-sharing. I would ask the employers to first make a careful and detailed study on their own companies' past experience on medical expenditure and the number of cases involved so that the revised medical benefits scheme worked out could be perceived to be fair and reasonable to all parties concerned - the employer, the union and the individual staff. For those few unfortunate cases where the staff have been receiving medical treatment, the employers should endeavour to help find a cure first before putting them into the revised medical benefits scheme, or to work out some scheme to accommodate these staff who are having a medical condition. Sir, I come to medical insurance and MediShield. Because of the unpredictability of a major illness befalling any one of us, Medisave savings may not be sufficient to pay for the sudden, unexpected catastrophic illness. The financial burden would be made worse when companies no longer pay in full or in part the medical bills incurred. I would urge the Government to get the CPF Board to quickly extend medical insurance coverage under MediShield. Such extended MediShield coverage will come in handy in instances of sudden and unexpected major illnesses. However, as MediShield is not likely to cover those living to the ripe old age beyond 70 years old, Medisave and other savings will still be needed to pay the sizable medical bill usually incurred in the last 1-2 years of a person's life. With regard to the supply of doctors and hospitals, I support the Government's move to regulate the supply of doctors and hospitals. I welcome the fixing of a minimum 65% of the number of B2 and C class beds in subvented hospitals and 9-11%, depending on how you look at it, allowed for the A class beds. This demonstrates to whom the subvented hospitals are mainly to serve. I agree with the Minister's explanation on the need to retain a fair number of A class beds in subvented hospitals to ensure that service quality is maintained. As for the number of doctors, we have been assured that there will be an adequate supply. Here, I think the key word is "adequate" supply, never mind the number, but they should be adequate, and 40% among the doctors being specialists. With the changing population profile and disease pattern, the type and number of specialists in demand will also change over time. For example, geriatric medicine will grow in importance to care for the increasing number of elderly Singaporeans. On balance billing, I agree to the limit imposed through balance billing in the charging of patients using Medisave accounts by private sector doctors and hospitals. It is right to use the cost of effective treatment as the basis for balance billing as a way to protect the interest of the patients. I think the yardstick must be what is the cost for effective treatment of the patient as the basis. We should not allow it to be over-lucrative for private sector specialists to affect the specialist in the subvented hospitals who would then want to leave Government service. We would want to retain and continue to attract very good doctors and specialists working in subvented hospitals. It is not how much that one earns that matters. But if the differential in earnings becomes too wide between the private and public sector specialists, it gives rise to the feeling of their worth not being recognised working in public sector hospitals. It is therefore right for the Government to recognise this problem and to use balance billing to correct the anomalies in earnings of medical professionals in the two sectors. We have heard that because of balance billing the private specialists' income will likely drop. This should be welcomed by all of us, because it means that the patient will be charged less for treatment. I must say that from time to time I am quite disappointed to hear medical practitioners mentioning about cutting corners in service because of the lower fees that they are able to charge. I think that is certainly not the hallmark of the medical professionals. As specialists, with the personal reputation to uphold, I am confident that they will maintain the high standard of medical service even if the rate of fees has fallen. We want our doctors and specialists in subvented hospitals to concentrate on the work of treating and healing the patients. Once there is stability in the medical professional manpower, excellent medical service delivery will be maintained. Sir, the last item is Medical Fee Council. For too long, there has been the overly high dependence and over-reliance on medical experts to influence and decide on health care delivery policies and issues in Singapore. As has been evident from public discussion and comments on the White Paper, the consuming public, though the most affected, are not as vocal as those from the medical community. It is not surprising as the private sector hospitals and medical professionals have vested interest. It is about time that opportunities were given for greater involvement and participation of consumer representatives. They should be given positions in the Medical Fee Council to represent the interest of the large consuming public. The consuming public has been at the receiving end of decisions made on health standards affecting them. If the consumer representatives are part of the decision-making process, there would be greater confidence in the objectivity and rationality of the decisions made. Once the decisions have been made and accepted, it is a matter of public education and information dissemination to rally the public behind in support of the exercise to contain medical cost increases. We all have a part to play to continue with this happy state of affairs in making health care affordable and accessible to all Singaporeans. I would like to thank the Ministerial Committee for making the contribution for all Singaporeans. Sir, I support the motion.

Sir, may I clarify the part of my speech which Mr Loh Meng See quoted.

All right.

I did not say that patients should not pay if they can afford to. In my speech, I am objecting mainly to the Government's philosophy to make the individual to be responsible for his sickness and treat health care purely as a consumption item.

If Mr Low disagrees, can he state his position on it? Either the person is responsible or not responsible. Is he saying that a person is not responsible for his own medical condition?

Sir, a person can be responsible for his own health by doing exercise or whatever, but it does not mean that he wants to get sick. On the one hand, a person can be responsible for his health. But how can a person be responsible for his own sickness?

Even if he is unfortunate enough to fall sick, if he can afford it, should he not be made to pay for it?

I did not say that he should not pay for it, if he can afford it. The question is, you cannot treat that as a kind of responsibility. If he cannot afford, the Government should pay for it. You cannot treat that as consumption, and say, "Because you are a consumer, you pay." To me, health care is a need.

Am I correct to understand from Mr Low that he agrees that if a person can afford to pay he should be responsible enough to pay for his own medical bill to look after himself?

Sir, may I get confirmation from the Member that a person cannot be responsible for his own illness? An hon. Member: Why not?

How? Even if you exercise the whole day, you can still fall sick. How can he be responsible?

When I was listening to Mr Low just now, I was also equally confused. I am glad that he has thrown a little bit of light. But I think there is still quite a bit of darkness in front of me. Is he saying that even when a person has taken all the necessary efforts, for example, he has paid attention to all our healthy lifestyle messages, exercise everyday, and he still falls sick, if that person can afford to pay his own medical bills, the Government should still intervene to pay his bills for him?

No.

So what you are saying is that those who can afford to pay their bills, they should pay, but those who cannot afford, Government should intervene to assist them to bear their hospital bills if they deserve it.

But it is not a personal responsibility. Let us make it clear. It is the individual's responsibility to keep himself healthy. If he can afford to pay, he pays. But it does not mean that when a person falls sick, it is his own responsibility to fall sick.

I agree with Mr Low that when a person is sick, sometimes it is not because of his own responsibility.

Yes.

That statement, I accept. But, of course, if he gets sick because he smokes, drinks and does all kinds of things -- An hon. Member: He gets AIDS!

Yes, he gets AIDS. But for those who fall ill for various reasons, whether self-imposed or otherwise, he agrees that if they can afford to pay, they should pay, but where they genuinely cannot afford to pay, Government should provide some form of assistance.

AIDS is not necessarily self-inflicted.

Resolved, "That this Debate be now adjourned." - [Mr S. Dhanabalan].

Resumption of debate, what day?

Tomorrow, Sir.

So be it.

Resolved, "That Parliament do now adjourn." - [Dr Lee Boon Yang]. Adjourned accordingly at Eighteen Minutes to Six o'clock pm

asked the Minister for Labour what are the latest trends of employment of foreign workers by the various sectors of our economy and their long-term economic or social impact and whether the Government is considering any changes to its foreign worker policy to counter any undesirable trends.

The demand for foreign workers varies from economic sector to sector. In the manufacturing sector, despite advances in technology, more higher value added investments and redistribution of labour-intensive operations to the region, the foreign worker population has remained largely stable since 1990. In fact, there has been a slight pick-up in employment of foreign workers in the manufacturing sector since the early part of the year. The marine sector is currently facing a slowdown in business. Nevertheless, the foreign worker population in the marine sector has been increasing since the middle of the year. The domestic maid population also continues to increase, although the increase has been moderated by the higher levy of $300 per domestic maid introduced since 1st April 1992. The strong growth in the service and construction sectors has resulted in heavy demand for more foreign workers. In particular, the construction sector had benefitted from the liberalisation of dependency ratio from 1:3 to 1:5 foreign workers since November 1992. In the longer term, we must achieve more capital intensive, higher technology and higher value-added economic enterprises. This is the only solution to maintaining our competitiveness with a base of only 3 million Singaporeans. We cannot hope to compete in the labour intensive industries against our neighbours with far larger population bases. The emergence of India, Vietnam and the PRC as market-oriented economies makes it even more urgent for us to move away from cheap-labour activities. Already the impact of having more than 200,000 foreign workers in Singapore is being felt, such as the difficulties of housing foreign workers and the problems created when they congregate in some parts of Singapore. My Ministry will continue to monitor the situation. Where demand has risen and there are sound economic reasons to allow more foreign workers into Singapore, we will adjust the dual mechanism of dependency ratios and foreign worker levy to regulate the growth in foreign workers.

asked the Minister for National Development, in respect of each contract for public housing awarded by the Housing and Development Board in 1984, what were (i) the financing and overhead costs and (ii) the professional and supervisory fees, as percentages of the total construction costs.

HDB awarded some 60 contracts for public housing in 1984. Detailed information on the financing/overhead and professional/supervisory costs for each contract awarded 9 years ago, in 1984, is no longer maintained by HDB. All these costs, however, would have been well within the market equivalents. For example, interest on Government loans for the construction of flats for sale was 6% p.a. in FY 84/85, as compared to the prime lending rate of 9.4% in that year. HDB's professional/supervisory costs have also been historically stable at around 4% to 5%.

asked the Minister for Communications whether any special arrangements can be made for Singaporeans above the age of 21 who are studying or working abroad to apply for Singapore Telecom Group A shares so that they too can have a share in the economy of Singapore.

To cater for Singaporeans who were overseas, the CPF Board operated a special service to authorise the Board to apply for the Group A shares on their behalf. Members had only to fill up and submit a special Authorisation Form available at all CPF offices, by the close of the Singapore Telecom share offer. This special service was announced in a CPF Board press release dated 10th September 1993. Many Singaporeans who were going overseas filled up these special Authorisation Forms and returned them to the CPF Board before leaving the country. Others collected the Authorisation Forms on behalf of their relatives or friends who were working or studying abroad. As at the close of the Singapore Telecom share offer, a total of 18,117 completed Authorisation Forms were received.

asked the Minister for Education what happened to the 8.8% of the pupils who did not pass their Primary School Leaving Examination (PSLE) in 1992.

In the 1992 PSLE, 5.2% of the cohort (ie 2053 candidates) was retained. Another 1398 candidates (3.6% of the cohort) who were too old to be retained in primary schools were invited to join the Institute of Technical Education. Of those who were retained, 2022 sat for the 1993 PSLE.

asked the Minister for Education (a) why there are substantially more female students than male students in the Arts and Commerce streams in secondary schools; and (b) whether this indicates that more Science classes have to be made available in the girls' schools?

Students at the upper secondary level are required to study 5 core subjects comprising English Language, Mother Tongue, Elementary Mathematics, a Humanities subject and a Science subject. In addition, they may, according to their ability and inclination, offer at the GCE `O' level examinations, 1 to 4 elective subjects taken from among the Arts, Commerce, Science and Technical groups of subjects. Among the students taking the 1993 `O' level examination, girls comprise 50% of the candidature in the Science stream, 61% in the Arts stream, 63% in the Commerce stream and 20% in the Technical stream. There are as many girls as boys in the Science stream. There are more girls in the Arts and Commerce streams and fewer of them in the Technical stream. The situation reflects the different choices made by boys and girls. However, the percentage of girls to the Technical stream has risen from 11% in 1990 to 20% in 1993 and may increase further as more girls take up Technical Studies at the lower secondary level. (b) There are enough classes in the 16 girls' schools to cater to students with an aptitude for Science. This year, 68% of the 116 `O' level classes in these schools are Science classes.

asked the Minister for Education what percentage of the individual Edusave accounts has been utilised by students in 1993 (up to the latest convenient date) and what is the number of students (as a percentage of the cohort) who have utilised their accounts.

For the first 9 months of this year, 47,000 students have utilized their Edusave money. This represents 14% of the number of students with Edusave accounts.

asked the Minister for Education whether his Ministry is making a concerted effort towards a more balanced and gender equitable representation of male and female roles in the writing of textbooks and, if not, why not.

The Ministry makes a conscious effort in the writing of its instructional materials not to stereotype sex roles. This is reflected in packages such as Home Economics, Civics and Moral Education and the Languages. However, certain roles in society have traditionally been male or female because they are more suited to either sex. It would be unrealistic and unwise to present them otherwise, pretend that differences do not exist, or attempt to change the natural state of affairs by rewriting textbooks.

asked the Minister for Community Development what is the role and function of the Women's Welfare Service Unit and what has it done so far?

The Women's Welfare Unit was set up as a Unit under the Family and Social Support Branch of the Ministry on 1st April 1990. The Unit functions as a direct point of contact for women in distress or in need of assistance. They can either call at the Unit in person or use the Unit's toll-free hotline. Officers of the Unit discuss with the women their problems and help them to decide on appropriate solutions. Where necessary, they are referred to other government or welfare agencies for appropriate assistance. Between April 1990 and September 1993, more than 3,500 women called at the Unit seeking assistance for domestic and marital problems such as divorce and separation, assault, conflict with in-laws and spouse leaving marital home. In addition, for this year alone, about 2,000 calls were received from women on the Unit's hotline. They sought information and advice on personal and family problems. The Unit has also compiled and published a Directory of Services for Women. The Directory has been circulated to grassroots organisations and community and voluntary welfare organisations which come into contact with women who have problems or who are in need of a social service. Information pamphlets on socially relevant issues affecting women such as Violence at Home, Assistance for Single Parents and Services for Unwed Mothers have also been produced and distributed by the Unit.