Hansard, 2004-09-02

Under the provision of clause 2(d) of Article 46 of the Constitution of the Republic of Singapore, the following Member has 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 period stated: Name From (2004) To (2004) Ms Olivia Lum Ooi Lin 02 Sep 02 Sep

ABDULLAH TARMUGI Speaker Parliament of Singapore

[Mr Speaker in the Chair]

The following Question stood in the name of Mr Steve Chia Kiah Hong -

1. To ask the Minister for Foreign Affairs if he will (a) support Malaysian Prime Minister Abdullah Badawi’s suggestion that ASEAN should explore the possibility of having a common time zone, travel document and currency to boost the cohesion of the ASEAN people; and (b) outline how his Ministry plans to support this initiative to forge a more united ASEAN.

Question No. 1, Sir.

Mr Speaker, Sir, on a common ASEANtime zone, Members may recall that Senior Minister Goh Chok Tong, as Prime Minister, proposed that ASEAN leaders consider establishing an ASEAN Common Time Zone at the 5th ASEAN Summit in December 1995. SM Goh envisaged that theCommon Time Zonewould facilitate economic cooperation in ASEAN. The idea has since been under discussion by ASEAN, with Singapore supporting it strongly.

The idea of a common ASEAN currency was taken up by ASEAN leaders at the 2ndASEAN Informal Summit in December 1997. The idea has been studied by the ASEAN Common Currency Task Force and the IMF. It is a long-term issue that requiresdeep study and carefulevaluation given the diversity of ASEAN economies, the differing levels of development, and the stringent pre‑conditions required for a single currency.

ASEAN has also explored facilitating travel within the ASEAN region using a "smart card" concept. Former Prime Minister Mahathir raised this with then Prime Minister Goh in April 1998, to facilitate travel between Singapore and Malaysia. SM Goh suggested that Singapore and Malaysia could take the lead to facilitate travel within ASEAN. ASEAN officials have since formed a technical working group to look into the concept. Unfortunately, there has not been much progress. However, Singapore and Malaysia are continuing to discuss the idea.

Singapore supports all new ideas to make ASEAN more cohesive and competitive. But projects like a common currency are not easy to implement quickly as they involve a high degree of harmonisation of policies and systems. And this takes time.

Singapore supports Prime Minister Abdullah's suggestions as part of a series of initiatives that ASEAN should consider working on. Singapore’s hope is for the ASEAN Economic Community to be established as early as possible. Recognising that narrowing the developmental gap is essential, then Prime Minister Goh proposed the Integration of ASEAN Initiative. Singapore is committed to ASEAN integration and will continue working with Malaysia and other ASEAN members to achieve this.

Sir, first of all, how would Singapore position itself and what is the role that Singapore would play in pushing forward further integration of this concept of ASEAN?

It is completely in Singapore’s national interest to have an integrated ASEAN, so as to better compete against other regions like China, India, Latin America and Eastern Europe. Singapore has been a very active player in all projects to integrate ASEAN and create a common economic space. Last year, when the leaders met in Bali and issued the Bali Concord envisaging the establishment of an ASEAN economic community, Singapore was a very active player behind this idea.

Sir, can the Minister comment on whether the greatest obstacle to a common currency is, in fact, the possibility of the two countries coming closer together politically, just like the European Union?Our Constitution does not allow for a political union.

Sir, to create a common currency within ASEAN is a much more complex problem than that. The proportion of total intra ASEAN trade still represents a small minority of ASEAN's total trade with the world. We have a vested interest in adjusting our economic policies to developments in the advanced economies. Whether as a long-term objective we should work towards a common currency is an idea which should not be dismissed but should be worked on, explored, studied, and just kept in view. It is not something which can be done quickly without careful thought because there are a lot of implications, and they go well beyond Mr Chiam’s proposal over the years to have closer political cooperation between Malaysia and Singapore.

Sir, given the complexity of the process and the problem of ASEAN integration, would the Minister tell us how the integration process should be prioritised in terms of an agenda for the integration process so as to progressively work towards the integration?

Sir, I would say that the most important part of the ASEAN agenda is economic cooperation and creating a common economic space, so that foreign investors who come into ASEAN see ASEAN as ifit were one country for the purposes of trade, production, allocation of resources. The ASEAN Free Trade Area is intended to achieve that, but it applies only to goods. Tariffs are coming down. However, we have not yet tackled services with resoluteness and there are still many non-tariff barriers. So we have got to overcome all these impediments to free trade and the free flow of investments bit by bit. It is not easy because ASEAN countries are at differing levels of economic development. Singapore is the most ardent advocate because we already have a very free regime here, but we have got to, while servicing our own interests, be realistic and be respectful of our neighbours’ own difficulties.

2. Dr Amy Khor Lean Suan asked the Minister for Transport in view of the recent spate of accidents at MRT stations with open platforms (a) whether the operators have implemented any interim safety measures whilst more permanent solutions are being evaluated; (b) if so, what these measures are; and (c) what possible long term measures are being looked into.

3. Mdm Cynthia Phua asked the Minister for Transport in view of the accidents at MRT stations, (a) what measures are being taken by the relevant authorities to ensure safety of commuters; and (b) whether LTA will review the estimated 2-year time period needed to install the closed circuit television system at all MRT stations

4. Mr Steve Chia Kiah Hong asked the Minister for Transport what are the reasons for his and SMRT’s unwillingness to install cheaper options such as metal railings, instead of the S$280 million safety-door system, along the yellow lines at the edge of the MRT platform to prevent people from accidentally falling onto the track.

Sir, may I have your permission to take Question Nos. 2, 3 and 4 together?

Yes.

Sir, Dr Amy Khor and Mdm Cynthia Phua asked about the safety measures that have been implemented at MRT stations and those that are under consideration.

The Government has always taken a serious view on issues of public safety and I would like to assure the House that our approach to ensure commuter safety at MRT stations is no exception. Today, there are various safety measures in place at all MRT stations. These include Emergency Train Stop buttons at all platforms to allow commuters to stop the movement of trains. These buttons are also found at the Passenger Service Centres to allow station staff to perform a similar function. In addition, Emergency Phones located at all platforms allow commuters to speak with station staff during emergencies, and CCTVs enable the station staff to monitor the crowd situation at the platforms.

Our train operators have also been proactive in promoting and reinforcing station safety through the regular use of recorded voice and video messages. For example, commuters are constantly reminded not to stand beyond the yellow lines and not to rush to catch a departing train. Patrolling staff are also deployed on the platforms to help commuters who may be unwell, or to advise them to remain seated while waiting for the trains. In addition, train drivers have been instructed to sound the horn when the trains approach a crowded station. SMRT is also in the process of upgrading its CCTV system to incorporate recording features.

Sir, Mdm Phua asked if LTA will review the timeframe taken by SMRT to complete the CCTV system upgrade. I would like to assure Members that LTA has examined this issue. Given the complexity and scale of the upgrading works, the whole project will require another two years to complete. This ismainly becauseworks are carried out only during a 4-hour window at night, so asto minimise inconvenience caused topassengers.

Notwithstanding this, Iwish to inform the House that SMRT has given top priority to the CCTV cameras along the open MRT platforms which, unlike theunderground platforms, have no platform screen doors. As of 31st August 2004,CCTV cameras along the platforms ofall 35above-ground stations have been equipped with the recording feature.Completion of this first stage of the works will allow SMRT to better conduct any post-incident investigationwhen necessary.

Sir, with all these safety measures and ongoing upgrades, one may ask how do our safety standards compare internationally. In all our open platforms, yellow lines are drawn 60 cm away from the edge to demarcate the safety zone. This is twice the buffer provided for in systems such as the London Underground. Metro systems in cities like London, Paris and New York also do not provide platform screen doors, even in their underground stations. In this respect, Singapore has already gone beyond the standards set in other comparable networks by installing platform screen doors in all our underground stations.

Sir, I can fully understand the public reactions to the recent incidents, including the incidents at the Bukit Batok and Redhill Stations,whereby commuters were hit by oncoming trains after they fell onto the tracks. Some have suggested installing platform screen doors at all open platforms. Others, such as Mr Steve Chia, have noted that these options cost a lot and asked about cheaper options such as metal railings. I want tothank them for their suggestions and their concern for the safety of commuters. I have asked the LTA to work with the train operators to review the options available and study their cost-effectiveness, with a view to further enhancing commuter safety. In the interim, SMRT has increased staff presence at the open platforms to assist commuters and to remind them to stand behind the yellow line.

Sir, there has also been public feedback, including those who have spoken on the Media-Corp Talk-Back programme this morning, that we should deal with this issue sensibly. There is evidence, hearteningly, that the majority of Singaporeans are responsible and value the service that the SMRT is providing. Some members of the public have further pointed out that while the LTA and the operators can play their part, commuters should also take personal responsibility for their own safety when using the MRT system. Sir, I totally agree with them. The open platforms at the elevated MRT stations are like public roads where commuters exercise personal caution such as not standing too close to the edge and looking out for traffic. Likewise, at MRT stations, the public should observe and comply with the safety rules that have been put in place. For example, commuters should stay within the safety zone demarcated by the yellow lines on the platforms while waiting for the trains. If they are feeling unwell, they should take a seat or seek help from the station staff. With commuters conscientiously taking personal responsibility for their own safety, and operators exploring ways to improve safety standards, I believe we can collectively minimise the recurrence ofincidents.

Sir, abalance needs to be struck – any excessive installation of safety features and implementation of safety measures would ultimately exact a cost on the provision of transport services. This is something that the operators and the vast majority of commuters would want to avoid.

Sir, can the Minister of State let us know what are the causes of the four accidents and whether, after these accidents, any additional measureshave been taken?

Sir, it is unfortunate that the incidents have happened. Given that the investigations are ongoing, it would be premature to speculate on the causes of the incidents and on whether additional measures might have prevented them from happening. But in any case, allow me, Sir, to talk a bit about the measures as well as the context of these incidents.

First, let me begin by informing the House that LTA has in place an operating performance standard

which the operators are obliged to comply with. One of the indicators tracked is the passenger injury rate, and the standards stipulate that the cumulative passenger injury rate, which is for the firstaid cases only, should not exceed 0.4 per million passengers per year. So far, the operators have more than met the standards set.

Next, let us see the context in which these incidents have taken place. Since 1991, which is when the system was largely ready, there have been a total of 224 cases of unauthorised track access of which 12 were fatalities due to incidents where a commuter was actually hit by an on-coming train. A significant percentage of these fatalities were pre-meditated. While 12 is not a negligible number, and any death is one too many, the figure has to be viewed in the context of the 4.54 trillion passenger trips made during the system over the same period.

Let ussee this in comparison with the road-related incidents. For road traffic accidents, there are, on average, 900 accidents that result in injuries to pedestrians every year compared to four at MRT stations.This is despite the various physical measures that have been put up, such as road curbs, roadside railings, vehicle impact guard rails and bollardsat bus stops. The annual number of road fatalities has been in the range of 200 to 250.

So, in many ways, Singapore's pattern is similar to that of the other developed countries.

In fact, Sir, I am increasingly worried about the lack of due care that an increasing number of pedestrians exercise when using handphones while walking or, worse still, while crossing roads. There have been many near misses. So do we, therefore, ban the use of handphones while walking, as a preventive measure? This cannot be. The point is this: the importance of personal responsibility cannot be overstated.

Going on to the question of what are some of thepossible longer term measures under study by the LTA and the operators: the LTA and the operators are studying the effectiveness of the half-height railings used at some systems in other countries, but with lower capacities, and will evaluate a similar proposal for our system. The key issues under study are really how effective these systems are in enhancing safety at the MRT platforms and the cost implications.

Let me just briefly elaborate on the half-height railings. These are physical half-height barriers at the edges of the platforms with openings that are aligned to the positions of the train doors. LTA's preliminary risk assessment shows that the barriers will not bring down the risk of accidents at these platforms substantially. It can, nonetheless, help prevent those who may incidentally or unwittingly stray onto the tracks. A recent LTA study shows that such barriers have been adopted in two driverless automated people mover systems in the US and a monorail with driver in Kuala Lumpur, Malaysia. We note that the riderships of these LRT systems are much lower than our MRT system.

There are also many other safety considerations that would have to be addressed with the use of these half-height railings. For example, the barriers will need to be designed such that commuters will not sit on them and risk falling onto the tracks. Secondly, there will also have to be some distance away from the edge of the platforms to minimise the potential hazard of straying arms, inadvertently infringing onto the paths of oncoming trains. Thirdly, the space between the edge and the barriers can also become another potential hazard, if unwary passengers become trapped within the small space when the trains start to move, and this can happen to alighting passengers at crowded platforms or to passengers rushing to board a packed train.

Sir, finally, allow me to comment on the installation of platform screen doors. The overall lifecycle cost, which is in terms of the capital plus the operating and maintenance costs over 25 years, of retrofitting platform screen doors at all open station platforms would easily cost $200 million, depending on the height of the screen doors. Besides the high capital and maintenance costs which will have an impact on operating cost and, hence fares, there are also some technical constraints in retrofitting the sliding doors onto the existing station platforms. There will be considerable modifications to be done to the train signalling and control system to synchronise the sliding doors with the train doors.

Sir, I would like to ask the Minister of State whether she would agree that safety is paramount, regardless of inconvenience or cost. And I want to thank the Minister of State for giving the pros and cons of putting up barriers at the open platforms of MRT stations. But whatever the pros and cons, I think we need to consider it seriously and urgently, because there is a need to address this problem. It would be better, in my view, to err on the side of caution rather than to wait and see and prolongthe problem.

So what is your question, Dr Ong?

Sir, my question is: will LTA quickly considerputting up barriers atopen platforms?

Sir, I do not disagree with the Member in terms of the need to incorporate safety measures as far as possible, except to reiterate the point that a balance needs to be struck. Having said that, I would like to confirm that LTA and the operators are currently studying the provision of the half-height railings. In the meantime, SMRT will actually be mobilising as many operations staff as possible to assist in patrolling the more than 70 aboveground station platforms, particularly during the peak periods. Staff will actually be given whistles as well to remind commuters to wait behind the yellow lines. The public messaging system will also continue to be used.

But, Sir, all these would not have the same effect as the exercise of personal responsibility, and that remains the key point that I would like to leave with Members.

Mr Ang Mong Seng, last question.

May I ask the Minister of State on the number of accidents that happened in Singapore MRT stations over the last five years as compared to cities like Hong Kong, London and New York?

Sir, I do not have the details of the accidents that happened inthe other cities but suffice it to say that our numbers are a lot lower.

5. Dr Lily Neo asked the Minister for Health, in view of the recent survey by the National Heart Centre that shows one to two Singaporeans below 60 die from cardiac arrest every day, what actions is his Ministry taking to reduce this incidence and save lives.

Mr Speaker, Sir, the National Heart Centre recently conducted a study of post mortem cases to review the causes of sudden death among Singapore residents. This revealed that 220 persons between the ages of 18 and 60 years of age who died suddenly in 2003 had a cardiac cause of death. This means that the average number of persons under the age of sixty who die from sudden cardiac arrest each day is 0.6 and not one to two. Of course, this does not mean that there is a 0.6 death each day. What the numbers mean is that on some days there are no sudden cardiac deaths, on some days there is one death and occasionally there may be two deaths in a day.

What may be of more concern to Members of the House is the trend. Are things getting worse and are more young people dying from cardiac disease or is the trend showing improvement? I am happy to report that the statistics show that trend is one of improvement.

A review of the current trends of heart attacks and survival rates has shown that the overall rate of heart attacks in Singapore for those aged between 20 and 64 years has gradually declined over the past decade, at 2.3% per year. Additionally, with modern therapy, the death rate from a heart attack has also fallen, from 27.8% to 22.0%, giving an average decline of 2.6% per year.

Therefore, although coronary heart disease is the main cause of sudden death in this relatively young age group, taken in the context of the above statistics, it is clear that our investments made in our healthcare infrastructure and our healthcare system are saving lives.

At the hospital level, patients with heart attacks receive treatment in modern coronary care units, under the care of cardiologists. Clot busting drugs, angioplasty and stents open up the blocked arteries. Recent developments in drug treatment, including statins, result in improved survival outcomes. For the small numbers who still have life threatening heart rhythm problems after a heart attack, there are sophisticated implants called defibrillators that can save lives. My Ministry, through the recently introduced Medical Service Package (MSP), provides subsidies for all these cardiac implants.

Our ambulances are also equipped with automatic defibrillators, and our ambulance staff are trained in CPR (cardiopulmonary resuscitation). They ensure that patients seen with cardiac arrests are provided with prompt and effective therapy.

However, above all, the greatest benefit is achieved by taking preventive measures to reduce the incidence of coronary heart disease. Hence, the need to promote a healthy lifestyle. Singaporeans can avoid heart diseases with regular exercise, by stopping smoking and by having a healthy diet.

Mr Speaker, Sir, may I ask the Senior Minister of State, in view of the fact that measurable cardiovascular risk factors indices appear to have deteriorated in Singapore, whereas theepidemic of heart disease in England is heading downwards and the deaths from heart disease have fallen by a third, is there a need for us to re-examine and re-strategise our current practices in combatting cardiovascular diseases? Are we learning the experiences and best practices of other countries? Do we need to emphasise further on work health promotion and health screening to improve the health status of adult Singaporeans? Should there be more emphasison targeting high-risk groups? And, lastly, instead of just disseminating health messages, should we not now try to reinforce the benefits of healthy choices and better equip people with such choices?

Mr Speaker, Sir, I agree with the Member that we must constantly try to improve our healthcare services andreduce mortality rates from heart diseases, and we should constantly review all measures and see if improvements can be made. But if you look at it globally, in terms of health care, our life expectancy is now reaching into one of the top 10 in the world and our mortality rate from cardiac disease is also going downcompared tothe developed countries. So the Heart Centre and all the cardiology units in Singapore are making progress. And, of course, we will urge them to continue to improve their services.

6. Dr Lily Neo asked the Minister for Health (a) how will he address the concerns of Singaporeans on the affordability of healthcare costs, especially hospitalisation costs; (b) does he agree that "risk-pooling insurance" is a good consideration compared to "save and pay as we go" in financing healthcare; (c) if so, what are his action plans; and (d) will he ensure that any insurance plans implemented will be adequate for hospital needs of the majority and one that can also cater for the long term future medical needs.

7. Mr Zainudin Nordin asked the Minister for Health (a) what is the maximum limit for any person to buy a medical insurance policy under MediShield for protection in his old age; and (b) if a person can afford to invest in an additional insurance policy, will he be allowed to buy it under MediShield.

Sir, with your permission, I would like to take Question Nos.6 and 7together, as both are about medical insurance.

Currently, Medisave can be used to buy a catastrophic medical insurance policy. There are 15 approved medical insurance policies for Singaporeans to choose from. Withdrawal from Medisave to pay for the insurance premium is limited to $660 per year per policyholder. This withdrawal limit is more thanenough for the basic insurance product such as MediShield.

All the 15 insurance policies are competing insurance products; they are not complementary products. So buying one policy is enough. Paying for duplicated coverage brings no additional benefits.

That said, my Ministry is reviewing our policy governing catastrophic medical insurance. The objective of our review is partly to address the concern raised by Dr Lily Neo on the affordability of hospitalisation costs. Although our work is not yet finished, we have drawn the following six conclusions.

First, catastrophic medical insurance can play a useful role in helping to spread the financial risk of falling very sick and incurring a very large hospital bill.

Very few Singaporeans get hospitalised; at any point in time, only 1 in 800 Singaporeans does. Moreover, not every hospitalisation results in a very large bill. Because of heavy Government subsidy, only a minority with a catastrophic illness will end up with a very large bill. If the vast majority of Singaporeans subscribe to a catastrophic medical insurance policy, then the insurance premiums needed to pay for these very large hospital bills can be quite affordable. The premiums will certainly be very much less than if the patient is to self-insure and pay through his personal savings. This is of course the benefit of "risk-pooling", noted by Dr Lily Neo.

Second, national medical insurance plans are however not without problems. Experience elsewhere shows huge problems of over-consumption by patients and over-servicing by providers. And this is what we have referred to as the "buffet syndrome" of medical insurance. With the premiums being paid for, the financial burden has shifted to the insurer, resulting in both patients and hospitals losing any incentive to be prudent.

Third, the challenge is to maximise the benefits of risk-pooling while minimising the buffet syndrome. And one effective way is to exclude small payments from insurance coverage. Hence, outpatient treatment should be self-insured, paid out-of-pocket. Hospitalisation for most illnesses should also be self-insured and paid largely out of Medisave. We have had 20 years now of Medisave and most Medisave accounts are sufficient to cover such common hospitalisations, especially in class B2 and C where my Ministry will continue to subsidise heavily, up to 80% of the cost.

Fourth, the benefits of risk-pooling are greatest for coverage against catastrophic illnesses, like cancer, organ failure, which require prolonged hospitalisation and intensive treatment. These hospital bills, despite heavy B2/C subsidy, would be unaffordable to many families. Fortunately, the probability of falling very sick is low. And this is where a catastrophic medical insurance plan like MediShield comes in very useful. That is why we allow Medisave to be used to buy catastrophic medical insurance plans.

Fifth, MediShield has, however, been losing its effectiveness as a catastrophic insurance plan. All medical insurance plans have to be periodically reviewed and their parameters like premiums and benefits adjusted. Since its introduction 14 years ago, MediShield has largely remained unchanged. As a result, when a patient has a catastrophic illness and, let us say, incursa class C hospitalisation cost of $100,000, his bill, after subsidy, is about $20,000. As a policyholder of MediShield, he expectsMediShieldto foot the bulk of this bill. But MediShield today only covers about 40%, or $8,000. Many such class C patients do not have $12,000 in Medisave to settle their share of the bill.Hence, there is this public anxiety about large hospital bills. Part of the reason for this reduced effectiveness of MediShield is that its deductible level has not been adjusted. So instead of covering only the very large bills and covering them adequately, MediShield today covers too many bills, big and small, and covers them poorly. That is why we must return MediShield to its original purpose of only looking after very large hospital billsbut cover themadequately. To fund the additional benefits, premiums would have to be raised, especially since they have not been adjusted for over 12 years.

Sixth, while maximising the effectiveness of MediShield, we must also try to keep its premiums as low as possible. Ideally, MediShield should be compulsory for all Singaporeans. This will then ensure maximum participation with minimum distribution cost. Unfortunately, we have inadvertently compromised this principle by having private medical insurers compete with MediShield and, in so doing,fragment the risk-pool. Instead of one large MediShield risk-pool, we have today 15 smaller risk-pools, with correspondingly higher premiums than necessary. Not surprisingly, instead of competing to render better benefits at lower premiums, private insurers find it more profitable to pick and choose and draw away the healthy lives from the MediShield pool into their smaller pools. This is a phenomenon known as "cherry-picking" in the insurance industry. This must ultimately lead to the demise of MediShield, as its risk-pool becomes progressively older and sicker. MediShield has not yet reached this critical stage. But we must remove this cherry-picking and reverse the fragmentation of the MediShield risk-pool as soon as possible.

Over the next few months, my Ministry will conduct extensive discussions with the public, the insurers, the unions, the employers and all interested parties, to see how best to reform MediShield for the benefit of the majority.

May I ask the Minister whether any insurance element introduced by his Ministry should have the three essential tenets of a viable insurance scheme: firstly, national coverage with no one being left out; secondly, long-term sustainability to give Singaporeans assurance on their long-term medical needs; and, thirdly, ensuring that this scheme will givepeace of mind to all Singaporeans on their medical needs in public hospitals, regardless of medical conditions, albeit with deductibles and co-payment in place. May I ask the Minister whether MediShield in fact has failed in these three tenets? May I ask the Minister whether it is correct that, firstly, MediShield isan opt-out scheme with many most vulnerable being left out? Secondly, it has an age limit which does not serve us well in view of our ageing population and longer life span of Singaporeans. And, thirdly, it also has low annual and lifetime limit which defeats the purpose of assurance on health cost affordablilty. The Minister earlier said that he will keep MediShield to cover catastrophic illnesses. But that only constitutes 5%-10% of the hospital bills. How does the Minister expect Singaporeans to pay the rest of the 90%-95% of the hospital bills? Did he notagree that risk-pooling is a better method ---

Please keep your questions short, Dr Neo.

--- than save and pay as equal financing? Lastly, how does he reassure some Singaporeans who think that this MediShield revamping is another way of the Government taxing the people?

May I remind Members to keeptheir questions short, please? We have quite a few other Questions to deal with before the end of Question Time.

Mr Speaker,let me simplify the argument this way. What are we trying to do? Insurance is to really protect against financial disaster. Most of us buy life insurance because we worry that we may have a premature death. Ifyou buy insurance,at leastthe family will be taken care of, and likewise with medical insurance. So we buy medical insurance, not hoping to fall sick, but just in casewe are very sick, the bill is very large, at least financiallywe do not have this burden to worry about.Therefore, medical insurance can take various forms.We can look after all and sundry - large bills, small bills, outpatient, inpatient - and this is what we call in our tradecomprehensive medical insurance. And many countries do that. America is a typical example. Or we decide that, no,just focus on what we are most worried about. And if you ask me, I thinkwhatwe are most worried aboutare very large bills.With Medisave, in fact, for most bills, Medisave can cover. So if your bill is a few hundred dollars, or a couple of thousanddollars, do not worry,so long as you regularly contribute to Medisave. The fact is thatyou do not fall sickevery year and need to be hospitalised every year.

In fact, statistically, every year, only 10% of Singaporeans need to be hospitalised. So, on average, most ofus, over 10 years, we are hospitalised once. I am 52. I was hospitalised twice. So I am belowthe average, meaning that I am healthier, and I am sure most of you are like me too. But yes, there are people who are more sickly for various reasons,and therefore hospitalisation frequency may be higher. So the value of risk-pooling, which I totally agree with Dr Lily Neo. But itshouldbe appliedproperly.Because if you misapply it and try to cover all and sundry, you willface great difficulties like in the UnitedStates, and I am not making all these up. It is true.

There are abusesin the American insurance system likeover-consumption, in other words, frivolous claims. Having boughtan insurance, the insurer will pay and youdo not care. Any slightest sickness,you walk into the hospital, demand a bed, or whatever, because it does not costyou anything. Insurance will pay for it. Moreover,you get a medical certificate, andyou do not have to work. So this is one aspect of abuse. The other abuse is at the other end - over-servicing by the hospitals. It is what I call the "motor repair shop syndrome". You all know this. When you seea cargoing intoa repair shop, the first thinghe asks you is, "Are you insured?" If you are insured, you will likely see therepair shop put in anew bumper, repaint the whole car, and so on, because somebody is paying for it, and the consumer is not complaining. He gets thecar back almost brand new andrepainted. So this problem of over-consumption and over-servicing is real. Let usnot brush this aside. So, yes, I agree with Dr Lily Neo that we should begin to expand the role of MediShield, but let us do it with our eyes open and try to see how best to do it.

My prescription for Singaporeans about high healthcare costsis this: take a five-step approach. Step No. 1, avoid falling sick. How? Healthy lifestyle. So this Sunday, Prime Minister Lee is going to launch our National Healthy Lifestyle in a big way in Sentosa.This year, we are scaling it up, going extensively beyond the Ministry of Health to all public and private sectors, all Ministries, and I am glad the GPC, led by Dr Lily Neo, will also be there to be role models of healthy lifestyle.

Step No. 2, yes, sometimes we do fall sick,make sure you have a good family physician who will adviseyou on how best to look after your sickness. As primary healthcare in Singapore ismodest and inexpensive,pay for it out-of-pocket.

Step No. 3,bad luck, you are a little bit sicker, and you need to be hospitalised. Again, your family physician will be able to advise youtogo to thisor that hospital, see that particular doctor orspecialist.Most of the time, with heavy subsidy in Class B2/C, the hospital bills are very modest, a few hundred dollars, or couple of thousand dollars. With Medisave, there is no problem paying for it. If you are young

and have not started building up your Medisave yet, Medisave gives you an overdraft. You can pay for it later when you work. So, Medisave is enough to cover most hospitalisation bills.

Step No. 4, bad luck cases,when your bills are very large, that is when MediShieldought to come in, and that is why I have been focusing my mind on today's lack of effectiveness of MediShield, not by design, but because of lack of adjustments over the last 14 years. But better late than never.Let us reform MediShield and make sure it serves its original purpose well.

Step No. 5,really bad luck cases, ie, despite Medisave, MediShield, the bill is still too huge to cope. Do not worry, Medifund is thereto take care of this very small number of very unfortunate Singaporeans who are very sick. Medisave is completely wiped out, but Medifund is there to protect them.

With these five steps, Singaporeans can have peace of mind. But I need Singaporeans to do three things:

Step 1: Healthy lifestyle.

Step 2: Contribute regularly to Medisave. Employees have no problem. Self-employed,taxi drivers, hawkers, etc, please contribute regularly while you are young and healthy.

Step 3: Support me in my MediShield reform.

Sir, I just want to register my point to say that I agree with the Minister. We must definitely avoid over-consumption. I will elaborate later in my speech in the adjournment motion, but I would just like to urge the Minister tointroduce an insurance scheme that will solve the affordability concerns of Singaporeans.

May I ask the Minister: when the review is completed and we have a revamped and more effective MediShield scheme, would we accept those who have already opted out to opt into the scheme again, because I understand that there are more than 270,000 Singaporeans who have already opted out of the scheme?

I think a lot depends on whatyou mean by "opting out". If you have opted out of MediShield but into one of the 15 MediShield-like insurance, eg, IncomeShield, etc, I do not consider you as having opted out. You are still in the system. My worry is the small percentage of Singaporeans who completely opt out, who are not in any kind of scheme, then it is a bit troublesome, because I need to know what is your motivation for opting out. Again, using an analogy, it is like house fire insurance policies. All of us with properties buy some form of fire insurance. Insurers are most happy to insure you, but not while your house is actually burning. It cannot be that onlywhen you are sick and down thatyou start opting in. Then it is not fair to those who have not opted out,becauseyou suddenlydiscover you have cancer andthen onlystart subscribing to MediShield. We can take him but, surely, the premiums will need to be adjusted, to be fair to the majority who have stayed loyal to the scheme.

Miss Penny Low. Last question.

Sir, the Minister rightly said that insurance is for the purpose of covering financial disaster. But I think there are two components to the disaster. One is the new and increased medical bill, the other is the loss of income. It appears that the revamped MediShield scheme would remain largely an indemnity plan. Would the Minister consider adding an optional - and I emphasise "optional" - componentto provide a lump-sum or periodic payment to cover the loss of income, because some of these people who have catastrophic illnesses may be breadwinners to the family?

Mr Speaker, Sir, I always keep my options open. So, I consider all options. But let me just be candid upfront. "羊 毛 出 在 羊 身 上 (Yang mao chu zai yang shen shang)" - the English translation is "there is no free lunch". If you want more benefits, your premiums will also be larger. If you want less benefits, your premiums will be less. So, if you want to load your insurance policy with unemployment benefits because you are out of job so you need income support, then you are talking about a differentkettle of fish now. Should we have unemployment benefits nation-wide available? That is something I am sure my colleague, Dr Ng Eng Hen, would be most happy to engage with you. I stay focused on healthcare.

8. Mr Zainudin Nordin asked the Minister for Health in line with the Government’s call to Singaporeans to look at the region within a six-hour flight radius as their hinterland where they should be prepared to work, will the Minister consider allowing (a) Singaporeans to use their Medisave to pay for medical expenses should they fall ill while working in the said region; and (b) Medisave to be used by an account holder to enjoy the savings from seeking treatment from an internationally recognised medical specialist overseas.

Mr Speaker, Sir, the purpose of Medisave is to enable Singaporeans to help pay for their hospitalisation expenses, especially at old age. In order to keep the monthly contributions low, withdrawals from Medisave are capped at Class B2 rates. Hospitals and doctors are accredited, if their bills are to be eligible for Medisave withdrawals. My Ministry regularly audits them to ensure clinical standards are met and that the Medisave claims are in order.

As it will not be practical to subject foreign hospitals and doctors to our Medisave regulations, we do not allow Medisave withdrawals for elective hospitalisation treatment overseas. However, on a case by case basis, we have allowed Medisave to be used for overseas hospitalisation treatment when the treatment is an emergency and any delay may cause the condition to worsen.

9. Mr Low Thia Khiang asked the Minister for Manpower whether he will consider allowing Central Provident Fund members who have healthy CPF savings to top-up the CPF accounts of their parents who have exhausted their Minimum Sum savings.

Mr Speaker, Sir, children are allowed to top up the retirement accountsof their parents who must be aged 55 and above.The amounts that they can topup to is the Minimum Sum applicable to their parents. In order for the child to do so, the childmust have regrossed Ordinary Accountand Special Accountbalances of more than twice the prevailing Minimum Sum, and netbalances of more than twice the cash component.

Let me translate to this year's terms. In other words, for 2004, in order for a childto top up his parents' accounts, his own account must have more than $169,000 in their regrossed balance, of which $84,500 must be in cash. The reasons for these limitations are toensure that members, before they topup their parents' accounts, musthave sufficient savings for their own retirement needs before they help their parents. In addition to this, members can also make cash top-ups to their parents’ CPF accounts.

Sir, clarification. The Minister said that the parents must reach the age of 55. How about after 55? Can children be allowed to continue to top up the parents' Medisave accounts?

Sir, there are a number of conditions. Let me reiterate them.

Firstly, the parents must be 55 or older. In other words, the child can top up his parent's account any time after the parent is 55 or above.

Secondly, the childmustmeet minimum requirements and I have specified the amounts. If these conditions are satisfied, he can top it up.

Clarification, Sir. What about parents who have retired before the age of 55 and the children do meet the requirements? Can they top up their parents' accounts?

Sir, we have limited it to parents who are 55 and above.

What was the rationale for the age limit of 55?

Sir, the rationale goes back to what our CPF system was devised for.

Firstly, it was an individualised savings account. It is the safety net in our system. In other words, it is a specific feature in our system where you take care of yourself. So, first of all, we said that there must be a minimum balance before the person can top up his parents'accounts.

Secondly, we have limited it to parentsabove 55, particularly because, for many of them indeed, they are also working. The retirement age now is 62 and,even for those above 50, the re-employment rate is about 50%. So, many of them are still working.

So, this principle of saving for your own affordability, for your own retirement needs, continues to apply. Having said that, for the minority of CPF members who have large amounts,they are not many and we can work the numbers. In other words, very few children with parents below 55 have these balances. So, it is somewhat theoretical, but we can consider the hon. Member's proposals.

10. Mr Chiam See Tong asked the Minister for Manpower (a) what action does his Ministry take when it receives a written request from an employer to blacklist a foreign maid; (b) if a foreign maid is blacklisted, does it include debarment from working in Singapore; and (c) if it does, how long is the debarment.

Sir, all foreign workers, including domestic workers, must agree to abide by the work permit conditions if they choose to work in Singapore. When complaints are received and foreign domestic workers are found to havecontravened the work permit conditions, they are repatriated and debarred from working in Singapore. Appeals to re-enter Singapore are considered on a case-by-case basis.

How long does the Ministry of Manpower normally take to reply to a letter concerning a maid problem?

Sir, we will try to investigate immediately. But, based on records, most cases are concluded within six weeks.

I can point a case to the Senior Parliamentary Secretary. It is a case where the Ministry of Manpower took one year to reply to a letter. Is he willing to investigate on it and let me know the outcome?

If Mr Chiam could give me the details of the case, we will investigate andgive him a reply immediately.

Yes, I will let the Senior Parliamentary Secretaryhave the details and I hope to get an answer from him.

11. Dr Amy Khor Lean Suan asked the Acting Minister for Community Development, Youth and Sports why has Singapore not ratified the 1996 Stockholm Declaration and Agenda for Action which pledges a commitment to reduce child prostitution and child sex tourism.

Sir, the Government fully supports the intention of the 1996 Stockholm Declaration to protect children. As Singapore takes its obligations very seriously, we will examine the details of the Declaration carefully before making a decision on its formal adoption.

I would like to inform the Member that Singapore is already a party to the Convention on the Rights of the Child (CRC). This Convention reaffirms the intention of the Stockholm Declaration. It upholds the principle that every child has the right to special protection in situations of exploitation, such as child labour, drug abuse, sexual exploitation or sexual abuse, sale, trafficking and abduction.

There are very few cases of child exploitation in Singapore and we have adequate legislative provisions to protect our children. This robust legal framework is backed up by the tough enforcement stance we adopt against offences of child abuse and exploitation. It is also complemented by the many different kinds of social services available for children in need of protection.

Sir, I would like to ask the Parliamentary Secretary why is it that this Declaration, whichwas in 1996, has not yet been looked at for ratification?

Sir, as I mentioned earlier, we ratified the Convention on Rights of the Child in 1995. The spirit and broad principles of the Stockholm Declaration which came in 1996 are in line with those contained in the UN Convention on Rights of the Child.

Sir, the issues being deliberated by the relevant agencies are generally similar to those under the CRC, such asthe implementation and monitoring mechanisms, preventive strategies as well as protection of child victims. But we do realise also that the Stockholm Declaration focuses primarily on the exploitation of children. The commitments under the Stockholm Declaration are more specific. So, recognisingthe specificity of these issues presented under the Stockholm Declaration, we are currently looking into these specifics through consultation with relevant agencies. We are studying the commitments carefully and will make a decision in due course.

12. Miss Penny Low asked the Minister for Home Affairs what (i) are the common crimes committed at multi-storey car parks; (ii) is the trend of such crimes; (iii) measures are in place to counter car park crimes like theft, vandalism and mischief; and (iv) more can be done.

): Sir, the number of cases of seizable crimes committed at multi-storey car parks remains fairly stable, with around 1,000 cases in each of the lastthree years and 511 cases in the first half of this year. Thefts of motor vehicles and motor vehicle parts as well as theft from vehicles account for approximatelyeight out of every 10 cases.

Sir, vehicle owners play the most crucial role in preventing such crimes because it is their responsibility to ensure that valuable properties are not kept in the vehicle and visible to would-be criminals.

Car park owners and managers must also play their part. Some car park owners have put in place security measures such as improved lighting, closed-circuit television (CCTV) surveillance, and even deployed guards to patrol the premises. These are pro-active measures which I urge other car park owners to also adopt.

Police has an ongoing programme to educate vehicle owners on crime prevention measures, which include crime prevention talks and exhibitions. Police has also been sending out newsletters to residents to remind them to take precautions to prevent theft at car parks. Banners and signages have been put up to remind motorists to remove valuables from their vehicles and to secure their vehicles before leaving the car park.

In addition, the Police and the Neighbourhood Watch Zone volunteers conduct joint patrols to deter crime at car parks and HDB void decks. Police also works closely with grassroots organisations to formulate relevant Community Safety and Security Programmes (CSSP) to address various crime concerns.

Finally, we must recognise that aspolice officers cannot be everywhere at all times,the public can help by acting as the extended eyes and ears of the Police. Members of the public who see anything suspicious, whether in the car parks or in their neighbourhoods, should call the Police immediately.

I would like to ask whether the Senior Minister of State can define what are the seizable crimes. And if eight outof 10 casesare due to theft or breakage into vehicles, then whatare the other two out of 10? In the case of car park vandalism, especially in HDB estates, if all things fail, including Neighbourhood Watch Scheme, CSSP and so on,what else can be done to help protect safety and security of vehicle owners?

Sir, for the other seizable offences committed at multi-storey car parks, these include theft of bicycles, theft from persons, snatch thefts. These are some of the other examples. We can see that theftof vehicles, theft of vehicle parts andtheft from vehiclesconstitute a large percentage. That is the first point. The second point is, like I have said, the primary duty and responsibility lie with the car park owners. That is a key point, and that is why Miss Low will know that the Police has been very active, together with the National Crime Prevention Council, in introducing projects, for example, the muralproject,in Miss Low's ward as well as in Sengkang and Rivervale and Pasir Ris where the tagline is "Don't park your valuables in the car." There is another project which is initiated with URA and HDB where the coupons will soon have this tagline"Lock, look and leave".Whatever we do, there will be offences. So,you lock first, after you have locked, you make sure that you do not expose your cashcard ornotebook, and then you leave.

A lot has been done already, particularly to curb crimes in car parks. I think the grassroots are very active in doing this, for example, including initiatingCOP, citizens on patrol, and so forth. It is a situation where we can never eradicate crimes. Basically, my call isto car park owners. I think if they take this seriously upon themselves, thefts from cars will be reduced.

Sir, the Senior Minister of State is indeed right to point out that in Rivervale, Sengkang and Punggol areas, there have been quite a number of these campaigns. However, there has also been a spate of vandalism andI am not sure whether the figures have gone up because the Senior Minister of State has not given any figures on vandalism in multi-storey car parks in HDB estates. Ifit did, obviously these campaigns are insufficient to reduce or discourage vandalism. What other measures could be in place to help reduce these numbers and to protect the car owners?

Mischief cases are not seizable offences, so they are not captured in these figures. Indeed, there are offences concerning the scratching of cars, not just in multi-storey car parks, but everywhere else. This is one of those offences where if you are unfortunate, somebody fancies or does not like your car being so shiny, it will be scratched,that is no fault of yours in that case. I would expect that, in this instance, the citizens on patrol will help, or fellow car park owners keeping a lookout for suspicious characters around, because a person who comes around to scratch your car will not just come in a jiffyand go off. Normally, he will linger around. My last point is to be theeyes and ears of everybody, who is around everywhere, any time and, in particular, in that context, the multi-storey car park, because it is a confined space, people who do mischief there can be spotted if the grassroots are attentive.

Sir, in my division, we have found the use of surveillance cameras to bea very effective deterrent against petty crimes. Very often, for our residents, raising funds to cover the cost and expense of installing such cameras can be quite onerous and I have, in the past, in this House, asked the Government for some sort of subsidy, together with the fund-raising efforts of the residents, to install more of such cameras, particularly in the crime-prone areas like car parks. And I am sure, with an approach like this, it will help to reduce and deterpotential criminals from vandalising cars parked at public car parks, andalso instead of widening the category of seizable offences, whichwas suggested in the earlier round ofquestions.

Sir, certainly, having CCTVs installed will be one of the solutions but it cannot be the prime solution,otherwise we will have CCTVs in many places in Singapore. I am glad that Mr Sin Boon Ann has taken the initiative to install the CCTVs in his ward. I think he has managed to raise the funds by roundingup his residents, the town council chipped in andthe CDC also chipped in. It is an excellent example of a self-help approach which indeed we are encouraging on the ground. Police of course does its part, for example, by injecting funds to help residents carry out the CSSP activitieswhere the residents are involved. I think we should keep it at that. We should not use Police funds or Government funds to fund the hardware (CCTVs). Otherwise, everybody will be coming round to the Police and that may mean a dilution of available funds for what is the core of the matter, that is,community policing, which is working with the grassrootsin some of these activities.

Sir, I do not understand the logic. If , in the course of funding these programmes, it will help to reduce the crime rate, wouldthat not be helping the work of the Police as well? We are asking the Government for support here. We are not asking for a total subsidy, but just to help the grassroots along. I understand that technology has advanced somewhat to a point where the cost of acquiring these CCTVs is not very expensive. Would the Government reconsider this?

Sir, in the spirit of collaboration, all partners and parties should be involved. So each party should be involved in a way that it is best able to contribute, for example, getting the town council, the CDC or the HDB, for example, in HDB car parks to try to chip in. I think it is a wonderful way to do it. As for the Police, as I have said, in fact, we have done a lot already, where they can contribute inparticular areas, such asexhibitions, talks andhaving joint patrols. So let us all work together. Otherwise, it will not be a case of Mr Sin Boon Ann rallying the other parties to come forward with a solution. It is because we said no in this House, so he said, "All right.You said no, I will do it together with the other parties." He has come up with this solution. And since Mr Sin has done it and it is working for him,I think it is wonderful. He is able to find the funds forit.$2,000-$3,000 per camera is not much.For Miss Low and other MPs who may be having this problem, it is an opportunity for us, as MPs on the ground, to rally and find the best solution that works. But, as I have said, while CCTVs can be one solution, I think in all these offences, the person who suffers the crime and other people who are in the area must play their primary role. This is the message I want to reinforce today.

13. Ms Braema Mathiaparanam asked the Minister for Home Affairs (a) what is the policy on handling sex workers who are trafficked in by sex agents, in that are they seen as offenders or victims; (b) how many Singaporeans, in the last two years, have been caught as agents trafficking in women for the sex industry both here and abroad; and (c) whether it is time to up the punitive measures against traffickers caught in Singapore.

There aretwo categories of sex workers. The first category which forms the preponderantmajority of the cases that come to Police’s attention, comprises those who voluntarily work as sex workers. They are neither victims nor offenders as prostitution per se is not an offence in Singapore. They will be prosecuted only if they contravene our laws or if there is sufficient evidence that they have solicited for sexual services in public.

The other category comprises those who are forced or tricked into coming toSingapore to work as sex workers. The numbers in this category are very small. Since they are victims, they will not be prosecuted, unless they have committed some other offence. They will serve as prosecution witnesses against the agent who had brought them in. In the meantime, they are offered temporary shelter, psychological and emotional counselling as well as other forms of assistance. Since 2002, there have been onlysix substantiated cases of women forced or tricked into prostitution.

Sir, as to the number of Singaporeans, in the last two years, who have been caught as agents trafficking in women for the sex industry both here and abroad, the answer is no Singaporean has been caught. Neither does the Police have statistics of Singaporeans caught abroad, if any.

Substantiated cases of forced prostitution are very rare. In 2002 and 2003, there were 11 andseven reported cases of forced prostitution respectively but none was substantiated. Up till July this year,eight cases of forced prostitution were reported but onlytwo were substantiated. The agents, fromThailand and Sri Lanka, have been charged and convicted in Court.

Our laws against trafficking in women are very strict. For example, if the woman was below 14 years old or was forced against her will, the client who had sex with her could be convicted of rape. The agent who brought her in for this purpose could also be convicted of abetting the rape, and liable to imprisonment for a term of between8and 20 years and caning of at least 12 strokes if convicted.

The Penal Code criminalises the selling and buying of aperson below 21 years old for the purpose of prostitution. The penalty is an imprisonment term of up to 10 years, and a fine. The Penal Code also makes it an offence to assist in bringing intoSingaporeany women with the intent to sell her for prostitution. This is punishable with imprisonment of up to 10 years and a fine. The Women’s Charter also contains similar provisions on trafficking of women for prostitution and other related offences.

In summary, trafficking of women for the purpose of prostitution is not rampant in Singapore. There is no need to enhance the already punitive punishments.

Could I ask the Senior Minsiter of State how does the Police establish, during the course of investigations, whether a person is trafficked ornot? The second question is: in the case of the domestic workers who are later found to be trafficked, what would be the measures taken against the agent who first brought them in and was that substantial in regard to this particular case?

Sir, the first thing that the Police will do when they arrest a sex worker is to interview her to ascertain whether she had come in voluntarily or whether she has been traffickedor brought inagainst her will or being tricked into coming in.These facts are established upfront in the interview. Like I have said, agents who are found to have trafficked women into Singapore, meaningnot smuggled in with the consent or the assistance of the sex worker, but either tricked or forced, there are sufficient provisions in the Act to deal with them. Indeed, when these rare cases have surfaced, they have been dealt with.

Could I ask the Senior Minister of State on what kind of definitionare we working, wherePolice investigations are concerned, to establish whether one is a trafficked person? The second question is: what kind of training do our Police frontline officers have in this special area of trafficking where sex workers are concerned?

Sir, like I have said, it is quite clear. If the sex workers come in voluntarily - and many of them do -on a social visit pass, ply their trade and arecaught,then,of course, if they have not overstayed,they are sent back. But, if a person comes in and said that she was brought in - she may have come in legally, butwas tricked into coming here because the agent may have said she is coming here as a maid, for example, andshe laterfinds out that she is working as a sex worker -we will investigate to see whether the agent has committed the offence of fradulently deceiving her into coming in.

The third category would be if she comes, either voluntarily or tricked, andshe is threatened, or, in fact, sometimes even assaulted, into continuing being a sex worker, then the third definition "of being forced into prostitution" kicks in.

Our officers in the Anti-Vice Enforcement Unit are very experienced. The important thing is that they will interview the sex workers, who at that point in time will not be under any duress orpressure not to tell the truth.

14. Miss Penny Low asked the Acting Minister for Community Development, Youth and Sports if he will consider the merging of the Social Development Services (SDS) and Social Development Unit (SDU) so that the two organisations can share resources and programmes and reap economies of scale, while the members of both clubs enjoy a bigger selection of potential spouses.

Sir, I would like to thank Miss Penny Low for her suggestion. There are merits in her suggestion that if the Social Development Services (SDS) and Social Development Unit (SDU) merge, there would be economies of scale, and more social opportunities for members.

Currently, SDU and SDS do work together atMCYS. The staffmeet to share strategies and ideas on how to encourage social interaction amongst singles. They also collaborate on various programmes which are open to both SDU and SDS members.

Sir, 147,000 SDU and SDS members have married since the setting up of these two units. We are presently reviewing the functions and programmes of SDU and SDS in order to provide even better services to members and to achieve an evenhigher marriage rate.

Could I ask the Minister of State what is the rationale for having an SDU andSDS?

I am sure most of the Members understand the background. In our society we have different segments of people. In order to reach thetargeted group more effectively,we divided it into two groups at the beginning. Butthings developed, and there was more and more collaboration between these two groups. They sharestrategies, worktogether andeven sharedata. Lately, theytold me that they areusinga very advancedelectronic device known as "Blue Tooth". With it, you caneven know the potential partner you are going to meetwithin 20 metres, and it is up to youwhether or notto respond.

In the last few years, the staff really worked very hard with corporations,community clubs, grassroots organisations, CDCs, campuses and universities. They try to work together to targetdifferent groups and we do allow them to share information and programmes.I could see more collaboration would emerge.

Does the Minister of State have a breakdown on the success rate of SDU vis-a-vis SDS?

The SDS has a higher success rate. Like I said just now, out of the 147,000 marriages, 112,000 are from SDS and 35,000 from SDU. I am sure Members know that the number of graduates is also smaller. But,the most important thing is that we carried out a survey and the image has improved. More and more people are prepared to use SDU and SDS. But, we also have a segment of people who prefer to go through friends, relatives and colleagues. SoMembersshould render a helping hand and we hope toachieve more marriages.

Could the Minister of State tell us how much funding is provided to SDS and SDU and how many members SDS and SDU serve?

SDU now serves about 18,000 membersand SDS serves about 86,000 members.I do notice that SDU does have a higher operation budget than SDS. Besides direct service delivery, SDU forms strategic alliances with both commercial and community partners to promote marriages. While SDS gives direct services to members, SDU, besides giving services to members, also takes on the role of promoting marriages in Singapore. It also tries to promotefamily values, the importance of being a mother, parenthood, and so on. So, taking into considerationthe strategic planning andpromotional duties, they do incur additional budget. We would try to relook at this. Where resource allocation is necessary, we would look into it. When reviewing the whole thing, resource allocation is also one of the important areas.

Given our current national agenda on priority of marriage and procreation, and that the SDS serves a larger membership and has been very successful in matching couples, would the Ministry consider allocatingmore funding and resources to step up its efforts in picking the low-lying fruits without, of course, relenting its effort on getting the graduates to wed?

I thank the Member for her suggestion. Like I have said, the bottom-line is to have more marriages. So, I am surewe would review and look into the allocation of resources correctly.

I would like to ask the Minister of State whether she is aware that there is this trend in Singapore in that the male likes to marry down and the female likes to marry up - (上 �?,下 娶 shang jia, xia qu). So, if SDU and SDS are going to merge, would the graduate women who are singlebe further disadvantaged because the graduate men would have more opportunities to meet those with lower educational level and (下 娶 xiaqu) and we may end up with less opportunities for the single graduate women?

I did ask the officers and they told me that during the collaboration between SDU and SDS programmes, they do have this problem. While some of the graduate women were left at the corner,we also have less educated menleft at the corner too. So, like I said, we are taking a very pragmatic approach.I do understand the sentiments of theMember and we would look at what is the best way to address this issue.

Mr Speaker, could I ask the Minister of State again, please?I understand the rationale, but are we then merging SDU and SDS? I could not hear a categorical yes or no.Are we or are we not?

As I have said, we are reviewing the whole programme together. We need to study the issues and implications more carefully andnot rush into it.

In the light of that reviewing process, my question would be: as MCYS is the body that takes care of harmonising relationship, having an SDU and SDS, would it not then beentrenching class divides?

Both units are under the portfolio of MCYS, even though PA directly supervises the programmes. The strategies and policies are under the same unit. So we try to harmonise. LikeI said, when we review this programme, we would take into consideration all the Members' suggestions.

15. Ms Indranee Rajah asked the Minister for National Development (a) whether all available HDB rental units have been rented out; (b) if not, what is the number which has been rented out and the number which has not; and (c) which are the areas where there are still available rental flats

Mr Speaker, Sir, HDB lets out 1- and 2-room flats at heavily subsidised rents to low income citizen families under the Public Rental Scheme. As at 31st July this year, HDB has a stock of about 41,400 1- and 2-room rental flats availaible for letting. Of these, 37,400 or more than 90% are currently let out. The balance of 4,000 flats, slightly less than 10%, are located mainly in Ang Mo Kio, Bedok, Chai Chee, Bukit Merah and Toa Payoh. HDB will continue to avail its rental flats to low income families, as well as those who are facing financial hardship.

May I ask theMinister ofState whether, in view of the fact that there are some available rental units,MND would consider a review of the policy, whereby it does not allow rental of units to families whereone spouse is a Singaporean and the other is non-Singaporean, unless there is a Singaporean child. The reason I ask this is that usually you need a roof over your head to engage in the activity that would result in a Singaproean child. And, there are cases where there are low income families who come to see me with this difficulty, and it is a genunie hardship for them. So, I am wondering if MND would review that policy.

Sir, to qualify for a HDB rental flat the applicant must be a Singapore citizen and must have another family member who is at least a Singapore citizen or PR. So, households comprising a Singaporean citizen with a foreigner, who is a non-PR spouse, does not meet the minimum citizenship requirements to rent a flat from HDB. However, as soon as the spouse has obtained permanent residency status, or if the couple has a Singapore citizen or PR child, HDB would consider the application.

Sir, that does not answer my question, which really is that sometimes, in order to get achild,the family unit needs to have housing. So I was just wondering if the Ministry would consider a review of that policy.

There are many housing options that are available to them. If they can afford, of course, there is rentalhousing in the open market. HDB subsidies, as Members know, are very heavy for rental flats, and we would like to reserve them primarily for the benefit of Singaporeans. However, if there are very extreme cases of hardship, certainly HDB would considerthem. HDB would not leave people living in the streets, so to speak.

16. Mr Zainudin Nordin asked the Minister for National Development (a) under what grounds will the Government allow a waiver or variation of the current Housing and Development Board"s Ethnic Integration Policy; and (b) how many such applications have been received and how many were granted since this policy was implemented.

Sir, the Ethnic Integration Policy (EIP) was implemented in 1989 to promote racial harmony in public housing estates by preventing the formation of racial enclaves. The EIP ensures that each neighbourhood and block in an HDB estate has a good mix of residents of different races.

A large number of resale flats are transacted in the open market every year. Hence, most flat buyers should not have difficulty finding a flat of their choice. Similarly, most flat sellers should not have difficulty finding a buyer for their flat. Last year, HDB received about 400 appeals for waiver of EIP from flat buyers and sellers. As the EIP is a very important policyin maintaining racial harmony in Singapore, we have to apply it consistently.The EIP has worked well in forging ethnic integration in Singapore. We should not tinker with it.

I have been informed of HDB flats being left empty, sometimes for several years, because of EIP. My question would be: how do we balance the need to achieve EIP and, at the same time, reduce the wastage of resources like empty flats that could be easily occupied?

Sir, we have to be clear about the long-term policy objective of our public housing and EIP is one of them. It is not a small stone which we can just turn over. In fact, it is a bedrock. It is a bedrock upon which the racial harmony of Singapore rests. So, yes, although there are some vacant flats available, we must adhere to this policy. In fact, we must adhere to it very strictly and we should not compromise the long-term policy intent just because there are some holding costs of vacant flatsinvolved.

Sir, the Minister of State's point is well taken, but the fact remains that this policy has been in force for 15 years. The question is whether MND has actually reviewed to see whether this policy is still necessaryand what are the parameters it would be referring to inevaluating its usefulness going forward because the policy, as Mr Zainudin has pointed out,imposes costs on the HDB minority residents. May I askwhether the Ministry would infact review the need for such a policy?

The policy was introduced in 1989. Prior to that, about 28% of HDB neighbourhoods breached this EIP limit. Today, we have made some small progress, about 25% of HDB neighbourhoods breached the neighbourhood limit.

I think now, more than ever, whenterrorists and so forth are threatening to tearat our well intervowen social fabric, we must not give up this policy.We must not allow this vulnerability to be exploited. With Members' help, support and commitment, we can sell this policy.

3.00 pm

Order. End of Question Time.

[Pursuant to Standing Order No. 21(3), Written Answer to Question No. 18 on the Order Paperis reproduced in the Appendix*. Question Nos.17 and 19 have been postponed to the next available sitting of Parliament.]

Resumption of Debate on Question (1st September, 2004), "That the Bill be now read a Second time.". - [Senior Minister of Statefor Health].

Question again proposed.

Sir, I rise in support of this Bill.

Not many countries are able to venture into stem cell research in spite of the good that we all know it can bring. However, Singapore is well positioned to go into stem cell research. We have the infrastructure, international connections, legal framework and the human resource pool which is well-educated and of good quality. So we did the right thing to seriously look into this area. Having done so, we have to decide on important issues.

Many societies, including ours, are not comfortable with the cloning of humans. In fact, we find it abhorrent. As such, there is a need to distinguish legitimate stem cell research acceptable by society from development of human clones which is not acceptable. Prior to this Bill, the line has not been drawn. This Bill, therefore, serves the very important function of clarifying what is acceptable and what is not in Singapore. Just having this Bill passed into law, to my mind, is in itself a major significant step in the right direction.

Clause 5 of the Bill bans the implantation of any human clone in the body of a human or animal. Since reproductive cloning, as we know it today, requires implantantion of the embryo into a womb, this effectively prohibits the development of a human clone. Clause 7 prohibits against developing human embryo created other than by fertilisation of human egg by human sperm for a period of more than 14 days. In addition, clause 8 prohibits against developing any human embryo outside the body of a woman for a period of more than 14 days. I undersand that embryos less than 14 days old compose of undifferentiated cells. So the Bill allows for stem cell research to be done on these cells for as long as it takes and so long as the embryo is not further developed.

I understand that the 14-day point was recommended because it is at this time thatthe primitive streak appears. Many groups believe that human life begins to exist only later. Thus, clauses 7 and 8, read together, address our objections against experimenting with human life forms while allowing stem cell research.

Some groups believe that human life commences upon the creation of the embryo on the first day. I respect this view as much as we have to consider other views as well. One such other view is that if we take the route of this first-day view, then any stem cell research seems impossible. All its attendant good would be lost. Further, the difference really between the first-day group and the 14-day group is not one of principle. Both agree with the principle that we should stay away from work on human life forms, in the process of which life is experimented upon or even terminated at the sole discretion of a researcher. The difference lies in our different understanding or belief as to what constitutes the beginning of human life. And, moreover, the difference occurs not in clear and obvious areas but in fine abstract ones.

The Muslims in Singapore, on the other hand, after serious deliberations, find the 14-day cut-off point acceptable, but they do not make a firm position as to when human life is deemed to have commenced.

Sir, it is not possible to find an absolute solution to this. According to a Straits Times' report two days ago, even in the USA, they have yet to decide on this issue. Ironically, this indecision means that, at present, even reproductive cloning has not been banned yet.

I think our approach has been a balanced and sensitive one. The public was notified of the issues years ago. The Bioethics Advisory Committee was appointed in December 2000. I do not have the impression that we have rushed through this Bill. But for avoidance of doubt, may I ask the Minister whether he could say whether he is satisfied that ample consultations have taken place, bearing in mind that it touches on religious and ethical positions, and that sufficient efforts have been made to consult the different respective segments of our society? Nonetheless, it appears to me that the policies enunciated in the Bill adequately reflect the concerns and interests of our society in general.

This Bill is not a lengthy one. It spells outin broad and yet clear terms what is allowed and what is not. I think it is a correct first step. We are very new in this area, perhaps still in its embryonic stage. Much still needs to be done and learnt. I urge the Hon. Minister to monitor developments, subsequent to this Bill, very closely and make adjustments as they appear. I would like to ask the Minister whether he would delegate this task to a specific department or committee.

Lastly, I would like to thank the Minister and all those involved in the proceedings that culminated in this very short but very significant Bill.

(In Mandarin): Mr Speaker, Sir, I rise in support of the Bill before this House.

As of now, most countries in the world, including Singapore, have no clear laws banning the cloning of animals and plants. The research on such cloning aims at decoding genes by bio-engineering. At present, the research is confined to the laboratory. It does not encourage large-scale development because this would involve many issues. If not carefully handled, it may lead to a great calamity in the biological world.

Scientists are now able to clone some higher mammals such as cows and sheep. China has also announced a plan to clone the giant panda. But, there is still a long way before human beings can be cloned successfully. Research shows that the cloned animals have health problems and do not live long. Scientists have experimented on groups of cloned mice, putting them in identical living conditions, same diet and environment. After some time, they discovered that the life span and the health conditions of these white mice were different, despite identical genes and living conditions. Human beings arethemost developed amongst allmammals. This is because, apart from the mammalian characteristics, the most importantdifference is that human beingsare capable of logical thinking. Even if we could successfully clone human beings, like cloning another Ang Mong Seng or another Khaw Boon Wan, the cloned Ang Mong Seng or cloned Khaw Boon Wan may appear to be the same outwardly, but their thinking, intelligence, behaviour, likes and dislikes might be different. So it is difficult or even impossible to control the cloning of behaviour and thinking. This being the case, it will be meaningless and pointless to clone human beings.

Most people are of the view that human cloning is against nature, morals and religious principles. The cloned humans are notnatural creatures.

Under this Bill, the Minister may allow researchers to clone human embryos or to do research on a human embryo less than 14 days old and then destroy it afterwards. Many scientists and religious bodies regard an early embryo as merely a cluster of cells and not yet transformed into a human. I think that the Ministry of Health's permit for this kind of research is based on this understanding.

I would like to ask the Minister: when a woman is pregnant, from which day does the doctor start computing the foetus'gestation period? I have asked gynaecologists and obstetricians about the calculation of the 10-month gestation period. They told me that it is calculated from the date of the last physiological period. In other words, life begins from the very moment when the ovum is fertilised.

Many people and organisations opposed to cloning of human embryos are at the same time actively opposed to abortion. They believe that the life of a foetus begins from the fertilisation of the egg and any action to harm the foetus is unethical. Some religious bodies even hold the view that research on embryos is more inhuman than human cloning. This is because the procedure for embryo cloning is to deliberately create parts that can be used and destroy the embryo thereafter. I would like to ask the Minister to give a clearer definition for the number of days, especially the critical 14-day period, concerning the formation of a foetus.

A few months ago, South Korea announced that it had successfully cloned about 30 human embryos. This generated a stir in the world of science. In August this year, the United Kingdom approved embryo cloning. If we pass this Bill, we will become the third country in the world to have done so. Japan is also planning to pass a similar Bill.

I know there is great potential in such research. It will bring new hope for patients of many diseases. But stem cells need not necessarily be extracted from embryos, although such cells do have greater research potential. Stem cells can also be extracted from cell tissuesother thanembryos. We can encourage researchers to focus on the extraction or cultivation of stem cells from the blood of the baby's umbilical cord or blood taken from an adult.

According to my understanding, the United Nations will also review this issue. Life is priceless and if mankind can manipulate life, there is no guarantee that this technology will not be used by those with ulterior motives. I feel that the practice of deliberately creating a life and destroying it thereafter is a violation of life.

Sir, I hope the Minister will consider encouraging researchers to do research on stem cells from other alternative sources. On other prohibited practices, I feel that the Ministry of Health should also have clear legislation to ban the cloning of babies to extract their organs or cell tissues for transplantation and to ban the cultivation of human embryos in non-human bodies and to ban the sale of embryos. This is because these experiments are very unethical and violate the human life.

I would like to ask the Minister, apart from the punitive measures such as the $100,000 fine and 10 years' imprisonment, will there also be any adequate preventive measures and resources to stop such illegal activities?

Sir, in addressing the sensitive topic of cloning, I think this Bill underscores the balance that needs to be struck between, on the one hand, religious and societal perspectives

on the sanctity of human life and societal concerns about how such new realms of scientific researchare developed and its potential for abuse is curbed, and, on the other hand, managing it against the promise of new therapeutic outcomes which are pathbreaking and the potential economic spin-offs that can emanate from such discoveries, and even the process of research that will create the bedrock for such discoveries.

Sir, the potential benefits are considerable.Many speakers before me and the Minister himself have spoken at great length about the wide range of potential therapeutic outcomes that are possible from stem cell research for diseases which are, at least, atthis point seemingly incurable, like Alzheimer's, Parkinson's, and so on. So the potential to ease human pain and suffering is great. And stem cell technology and other research in areas like gene therapy and so on are at the forefront of such efforts.Although actual outcomes, in the clinical sense, may be five to 10 years away, the work that is done today will be the foundation for such pathbreaking discoveries; at the same time, the economic benefits are also substantial.Allow me to illustrate.

If I just take one particular disease, like Alzheimer's, the worldwide market for Alzheimer's drugs in 2003 was about US$1.3 billion, and it is expected to grow to about US$3 billion by 2008. Some of the key players in this business are, for example, large pharmaceutical companies like Pfizer and Eisai with the drug called Aricept, which has a market value of at least US$700-800 million. In the United States alone, there are at least four million patients who suffer from Alzheimer's. And that is just talking about one potential area of therapy and the Minister has also talked about other potential areas such as in diabetes and other disease conditions for which stem cell discovery can help. On the other hand, if you look at the concerns from the religious and societal perspectives, I think they stem from - no pun intended - profound views on the sanctity of human life, that the embryo deserves special status as a potential, if not actual, human being. And, therefore, stem cell research and any other research involving embryos must be set within a strict ethical and legal framework acceptable to Singapore society. Only that way can we ensure that human life - and potential human life - is always treated with dignity and respect in Singapore.

Sir, even those who support the idea of allowing science greater latitude want tobe assured. How would we ensure that such research will be responsibly and ethically conducted? What safeguards can be put in place to prevent the slide down the slippery moral slope, because the incentives to do so can be quite substantial? And I think how we manage this very delicate area is an essential part of our character as a society. By categorically banning and criminalising reproductive cloning, I think this Bill has, as many speakers have pointed out earlier,drawn a clear line and stated clearly our position on a matter of moral sensitivity and social reprehension. At the same time, the Bill has allowed for therapeutic cloning and with it, all potentially valuable research and work in this field. I believe this balanceis the correct one. As the Minister says, there is near unanimous support for the banning of reproductive cloning. And, therefore, I support the Bill. It is also consistent with the stance in countries like the United Kingdom and Australia. In the United States, the Bill to ban cloning is still pending approval in the Senate. But at the state level the position varies - some ban cloning entirely and others ban reproductive cloning only.

There are some questions however that remain, since we have left the door open for therapeutic cloning and embryonic stem cell research. Many have asked the question: why do we need to use embryonic stem cells? AsDr Amy Khor and Dr Lily Neo pointed out yesterday, there are other sources of stem cells - from adult stem cells, from the cord blood, and so on. I know the technical people talk about pluripotence and multipotence, and so on. The Minister is a doctor and a neurosurgeon at that. I believe he can give a more eloquent exposition, and I think Singaporeans need to hear the justification as to why we have chosen to allow embryonic stem cell research in Singapore.

The second question many have asked is: why must there be a need for therapeutic cloning? In other words, even if you accept that embryonic stem cell based research is essential, why must we allow therapeutic cloning? Again, I believe there are sound medical and scientific reasons, but these should be articulated in this House as part of the debate on this Bill. And I would like to hear from the Minister andthe Ministry theirperspectives on the justification for doing so.

The concern I have regarding this Bill, in a sense,is more about what the Bill does not talk about.The Bill has categorically made reproductive cloning a crime, and I think there is no dispute over that,but the question is: how will we manage the other tricky area of therapeutic cloning in Singapore? In the United Kingdom, for example, any research in public and private laboratories on embryos is subject to strict licensing requirements and it is overseen by the Human Fertilisation and Embryology Authority, which was established in 1990 by theeponymous Human Fertilisation and Embryology Act.

This Bill is silent on how we are going to deal with this vast area of therapeutic cloning, and it is not a trivial point, as the Minister would acknowledge, because therapeutic cloning can easily degenerate and become reproductive cloning. It is really the first step. So we have drawn the line at 14 days andwe stop them from implanting the embryo. But the point really is: how do you address the issue of therapeutic cloning? And I believe there are some merits in considering the UK approach and studying it in greater detail. Because it creates a register of bona fide researchers in this field,and any bona fide researcher should have no qualms about seeking licensing approval from the authorities to conduct legitimate research.At the same time, establishing such an authority will create an entity with the capability to monitor specific research projects andkeep track of general trends in this sector, whichare fast evolving and may well require periodic reviews of the legislation and any subsidiary regulation that arises to govern the space.

My question to the Minister is: how do we manage therapeutic cloning or any embryo-based research today? And going forward, given the fast-moving nature of this sector, how will we do so? Will we consider establishing an authority, as they have in the United Kingdom, for example? The second question I have is a more specific one. It is on why thefine has been kept at S$100,000. Sir, as I elaborated earlier, the monetary rewards in this space are vast. We are talking ofhundreds of millions, if not billions, of dollars, and I am talking of US dollars. We have capped our fine at S$100,000. It does not really communicate to me any deterrent value. So I presume it is symbolic in nature, which then begs the question: why do we have such a provision in the Bill at all?If we are serious about this, then we should have a fine, but leave it unlimited and leave it to the discretion of the courts to decide what isappropriate, based on the nature of the act. And I think that would go much further as a way of managing any kind of delinquent behaviour.

Sir, finally, I have a couple of operational questions. TheDirector of Medical Services has been tasked, I think, in this Bill with the whole area of enforcement. To the best of my knowledge - the Ministry of Health and the Director of Medical Servicesdo not have resources for such enforcement - I do not know what enforcement capability resides within the Ministry of Health. Andas this is a more technical area, obviously you cannot just sendthe average policeman to a laboratory. He needs to know what he is looking for and needs to be guided by technically trained people. So, I would like to ask the Minister: what resources will be made available to the Director of Medical Services so that he or she can fulfilthe responsibilities as required under this Act.

And, finally, what mechanism will the Ministry be putting in place - asmy colleague Mr Ahmad Khalis pointed out - to periodically review or, in fact, regularly review, the field and the developments against provisions in this and any other relevant pieces of legislation to ensure that Singapore remains appropriately positioned in this important area of scientific research.

Mr Speaker, Sir, this Bill seems to be necessary in order to prevent experimentation with human embryo cloning and to allow only the natural way of creating human beings. It could be argued whether this Bill is really necessary in Singapore today. Do we have a single case of abuse at all to warrant legislating on this controversial matter? Presumably, the introduction of this piece of legislation is for future deterrence.

Generally, the more popular view with normal human beings, including most scientists specialising in the field of stem cell research, seems to be that prohibition of human embryo cloning, based on scientific information available currently, seems necessary. However, my concern is whether the politicians in Singapore and of the world, and the scientific community in particular, are mixing morality ethics, religious leanings and scientific research and taking the safe way out by banning something we are not that familiar with. Have there been sufficient informed and independent enough discussion and debate with an open mind? I am not sure. Have there been opportunities given to the scientists to argue, without fear, in favour of research and experimentation with the cloning of the human embryo in the interest of scientific research and advancement?

The Government may well have studied papers, consulted experts and obtained scientific feedback from various advanced countries. Which countries did Singapore consult? Which scientific organisations, both local and/or foreign, have advised our Government for Singapore to come to the conclusion that human embryo cloning is to be outlawed? What are the views of different sectors of society on this sensitive matter? Has there been an exhaustive and critical feedback process put in place to get varied views from Singaporeans, for example, from religious groups, racial groups and the research and scientific community in Singapore and even abroad? In exploring the frontiers of scientific research and advancement, it is most crucial to have an open mind and to critically analyse scientific advances and experimentation, as long as the primary goal is to advance the cause of doing good and advancement of the human race. May I propose that this Bill, being innovative and far-reaching, be made available to the public for a thorough discussion by way of a parliamentary Select Committee? Through the Select Committee, varied views can be aired by our citizens and experts in this field. And Parliament and the Government

would be that much richer and wiser. We can then have an improved, well-informed and well-researched piece of legislation.

Stem cells are a kind of master cells that can grow into any kind of cell in the body. Research in this area is revolutionary in today's age. It may not be revolutionary in 10-30 years' time. We must explore the possibility of us being criticised in future that we were rather narrow-minded in legislating hurriedly on something that we are not that quite sure of. Those who favour such research would say that they are just trying to help people who are sick and really, that is an important focus for the advancement of the human race.

People are concerned about the ethical, moral and religious problems when it comes to cloning of human embryos. I believe this matter can be a big debate. But at the end of the day, I do not believemost people will favour cloning of human embryos. The Internetwebsites have a great deal of materials on human cloning, and I would like to quote some to give a flavour of the international debate that is going on, and I quote:

"A White House spokeswoman reaffirmed President Bush's opposition to human cloning. The President has made it clear that he is 100% opposed to any type of cloning of human embryos." said the spokeswoman for the President. The President supported the House legislation to ban human cloning which was passed overwhelmingly. The House of Representatives in USA voted to ban human cloning and set penalties of up to 10 years in prison and $1 million fine for those convicted of attempting to clone humans. The measure was never taken up by the Senate. So it never became law. I believe that is still the position,and I stand to be corrected.

One Senator hoped that the Senate could find a compromise that will allow some cloning research to continue without opening the door to the creation of human beings through clones. The Senate had to draw a line. So it is a resonable line.We can continue medical science and breakthroughs, without crossing the line into something none of us wants to see. These worksset the stage for human therapeutic cloning as a potentially limitless source of immune compatible cells for tissue engineering and transplantation medicine. Anotherquote,"Our intention is not to create cloned human beings but rather to make lifesaving therapies for a wide range of human disease conditions, including diabetes, strokes, cancer, AIDS, and neurodegenerative disorders, such as Parkinson's and Alzheimer'sdiseases." To describe the advances as a very primitive development, the Director of the Centre for Bioethics at the University of Pennyslvannia deemed it a significant one. "When you get to the point where you have made a human embryo even for research purposes, it is a line that is crossed." That is another quotation. The Medical Ethicist said an argument could be made for using the technology to create cells that could be used to treat diseases. If you could makecell lines from these creations and turn them into something that the body would not reject, that would be a wonderful breakthrough, in terms of being able to offer cures to people.

Just a few years ago, an Italian fertility doctor and a US researcher announced plans to clone humans. They said hundreds of couples had volunteered for controversial procedure. The announcement was criticised by officials inseveral countries, and the Italian authorities threatened to ban that doctor from practising medicine if he goes ahead with the experiment. Another organisation in USA moved his research into human cloning outside of the United States after being investigated by the Federal government. That organisation was founded by a member of a religious movement which believes extraterrestrial scientist created life on earth and that cloning is a way of achieving eternal life.

Many nations have either announced bans on cloning research or have legislation pending. I guess Singapore is one of them. The United States of House of Representatives voted to ban all human cloning. The legislation, supported by President George Bush, was passed by265 to 162 votes. In other words, it was not unanimous,60%-odd voted in favour, and whether that could go on to other kinds of cloning research.

But many scientists, patient groups and the biotech industry opposed the ban because it would outlaw cloning for reproduction as well as therapeutic cloning in which scientists make embryonic clones to get stem cells for potential disease treatments. Thus, our piece of legislation is modified in a way that itmay not cover all of these. Meanwhile, the Council of Europe's Convention on Human Rights and Biomedicine has introduced what it is believed to be the first international agreement banning human cloning. The measure called the Protocol on the Prohibition of Cloning Human Beings was drafted in the 1990s following successful attempts to clone mammals, particularly by embryo splitting and nuclear transfer. Twenty fourof the 43 Council of Europe States have signed the protocol. Elsewhere in Europe, a German Health Minister said a few years ago that she was opposed to human embryo cloning, while France adopted a draft law to ban human cloning in medical researchthat year. The French law will place severe restrictions on the use of frozen embryos created as part of a fertility programme but no longer needed or claimed by the parents for the purposes of medical research. Russia approved a five-year moratorium on human cloning, and these are some of the quotes I got from the Internet.

Sir, at the end of the day, this House, including myself, may well support this Bill, based on our gut feel. I really am not sure. Ten years down the road I may well feel happy that I have made this decision if we hear that in other countries there are problems related to human embryo cloning. On the other hand, a young scientist today who is eager to do all the cloning of human embryo research and might well feel he could solve a great deal of medical diseases might be disappointed with the passing of this Bill.

Mr Speaker, Sir, I support theBill and all its prohibitions. Given the current interest on the issue of cloning, it is important to keep in view the various and considerable concerns relating to the prospect of cloning. Ethicists, religious leaders and even Ian Wilmut, the creator of Dolly, the sheep, believe that we should "reject this proposed use of cloning" in humans. The caution raised to set clear guidelines for prohibition of cloning is understandable.

Many a time, due to the limitations of the human mind, great scientists may not foresee the long-term implications of their discoveries and inventions. For example, weapon of mass destruction - in the past, the explosive bomb and, nowadays, nuclear weapons -can be conceived as undesirable outcomes of a great scientific invention.

In the area of research involving human embryos and cloning, there are still controversies such as the status of human embryos. Are they live form? Are they potential human? Or are they just a mass of cells? Or issues such asthe point on the beginning of life. I think these would not be resolved easily. And I do not intend to dwell on them because I am not an expert. But in general though I feel that we should take a prudent approach. And we must, on the other hand, balance between an overly conservative approach that will stifle scientific progress and an overly permissive one that will give us undesirable long-term consequences.

Sir, I would like to comment on four areas that I think the Billmay not have addressed adequately. Firstly, I would like to talk on the issue of the creation of human embryo solely forresearch purposes.While the Bill explicitly bans the practice of "reproductive cloning of human" by the prohibition of placing human embryo clones into any human body or the body of an animal, and the prohibition of developing the human embryo clone for more than 14 days, the Bill does allow cloning of human embryo up to 14 days, I would like to know what is the rationale behind this. I presume that the reason is, as other speakers before me have alluded to,to allow the cloning of human embryo for other uses, such as therapeutic orresearch purposes.

At present, only very few countries, like the United Kingdom, allow scientists to create embryos solely for research purposes. Other countries, such as Belgium and Italy, have no laws yet becausethey also find it difficult to reach a consensus. Therefore, in these countries, everything goes. Some scientists can carry out experiments in Italy that would be banned elsewhere. In Canada, the Senate approved the Assisted Human Reproduction Act in March this year, addressing the human genetic and reproductive technologies.The creation of human embryos solely for research is not prohibited in Canada. However, research involving human embryos, including embryonic stem cell research, is permitted using embryos created but not used duringin-vitro fertilisation (IVF) procedures. The practice of using surplus embryos is also allowed in certain other countries, such as Finland and Belgium, and others are adopting the same position. Overall, we can observe a trend towards a certain liberalisation of these practices.

Sir, therefore, before the world can reach a consensus on this issue, I strongly urge the Ministry to adopt the middle path and to prohibit the creation of human embryos or human embryo clones solely for research purposes. This is also the position of the Council of Europe's Oviedo Convention.We should only allow human embryo research on surplus embryos for IVF procedures because they would otherwise be discarded anyway.

Secondly, I would like to comment on the practice of "therapeutic cloning" which has not been explicitly covered by the Bill. Sir, like other speakers have explained, the purpose of therapeutic cloning is to harvest stem cells compatiblewith the recipients so that they can be used to treat certain diseases without the problem of tissue rejection. Although there are promises of medical benefits for treating many diseases like Alzheimer's, diabetes, leukemia, using stem cells, we are still quite far away from the clinical application of these promised cures. My understanding is that in fact the research of stem cells at this stage is still very much focused on learning how to switch on these stem cells for their differentiations into the different types of organs. So therapeutic cloning, although the name implies that it is for therapy purposes, is not really therapeutic in that sense. It is still very much research based. Therefore, I would urge the Ministry to

have clear guidelines for what these so-called therapeutic cloning can be used. I feel that we should only allow therapeutic cloning of human embryos strictly for the purpose of treating specific serious medical conditions and only when they are proven clinically.

Thirdly, on the issue of genetic modification, the Bill has included in the definition of human embryo that "any life embryo that has an altered human genome as a human embryo". Therefore, I would likethe Minister to clarify whether it is implied in the Bill that genetic modification would be allowed because you definea human embryo as including those that have their genome altered. By that definition, they can also continue to go into full term. So, I would like this clarification of human genetic modification, because if the Minister intends to permit genetic modifications, then we have to be very cautious and to spell out what are permissible and what are not. Although theoretically we can intervene and modify the chromosomes to treat some hereditary diseases, it also opens up a Pandora's box that we may not be able to handle.

On the lighter side, we may say that in future we will allow parents to have designer babies, eg, today I want to have a baby who is tall, blond, with big eyes and an IQ of 150, just tick the options and you have them. But on a more serious note, I think it canbring the world a step closer to that of a brave new world. For example, supposedly, when the gene or genes that determine sexual orientation, if there are such genes, are located, the technology to alter the genome may also be used to either eliminate the zygotes of a particular sexual orientation, or a country or an individual might finance a programme similar to that of Nazi Germany, whereby humans were bred to maximise certain traits. Once the "super human" is developed,embryo cloning can be used to replicate this individual and, conceivably, produce unlimited numbers of the clones. The same approach could also be used to create a genetic underclass for exploitation, such as creating individuals with very sub-normal low IQs but who are good in doing certain tasks and to be exploited.

Fourthly, I would like to talk about a body to oversee this area of research.I notice that while the Director of Medical Services and his officers will be empowered to enforce the Bill when it is passed, there is no provision of an agency or body to oversee and regulate activities relating to research on human embyros, stem cells and so on.

Sir, let us look at other countries that have legislated in this area. I would just like to use a few countries for comparison. In Germany, their policies are more restrictive. British policies are the most permissive, while the Australian and Canadian policies are somewhere in between. As German laws ban a wide range of activities involving human gene, gamete or embryo research, as a result, they do not have a regulatory body to oversee these activities. On the other hand, the other few countries I mentioned, in the UK, they have a Human Fertilisation and Embryological Authority (HFEA), whose 18-member board decides what is permitted and what is not. The HFEA, as MrIswaran alluded to, requires that public and private institutions working on human embryos are licensed, and it can suspend or revoke the licence of non-complying institutions. Australia and Canada legislatively ban a number of widely condemned activities, leaving a more limited but still significant set of issues open for further consideration by their regulatory bodies. The Australian regulatory body is the National Health and Medical Research Council Licensing Committee. In Canada, under the newly-approved Act, they will have the Assisted Human Reproduction Agency of Canada.

Sir, the Bill on the table is somewhere in between. We are not so open, but we are also not as restrictive as in some countries. So, probably, we would also need to set up a national agency that is tasked to develop and oversee regulations covering these and other permitted activities. The agency shall be tasked to license, register, monitor, audit and regulate all individual scientists, doctors and researchers as well as private and public fertility clinics, research facilities and other institutions whose research or commercial activities involve human embryos or gametes.

Sir, with these comments and suggestions, I support the Bill.

Mr Speaker, Sir, I thank the hon. Members, Dr Lily Neo, Dr Amy Khor, Dr Chong Weng Chiew, Mr Ahmad Khalis, Mr Ang Mong Seng, Mr Iswaran, Mr Chandra Mohan and Dr Ong Seh Hong for their comments and for their support for this Bill.

Many Members were concerned that because we have not specifically banned therapeutic cloning, this maybe the thin wedge that leads to human cloning. Some members of the public also share this concern, especially because of the many sensational media reports about cloning. Dr Amy Khor mentioned a report about Dr Panos Zavos who claimed a few days ago that he had successfully cloned two dead people using cow embryos. There areothers who have made equally sensational claims. First, there was a Richard Seed, a physicist who volunteered himself for cloning and was going to clone himself. Then, there was an Italian doctor who was mentioned who has travelled around Europe with plans to clone a human, and announced that he intended to clone a person in the UK. The UK then passed emergency legislation to prohibit human cloning. Then, there is a journalist called Rael who started a religious cult and formed the company called Clonaid. He claims he met clones when an UFO landed in Canada and they had given him instructions to clone humans. Clonaid has announced that it has cloned a human called Eve, and there were even local media reports that Clonaid may clone Singaporeans and my Ministry was queried.

This Bill will unequivocally make it clear that we prohibit reproductive human cloning and that these self-promoters who want to promote human cloning are not welcome in Singapore for any activity that is related to human cloning.

There were questions asked about adult and embryonic stem cell research. Basically, stem cells are cells that have the potential to divide into any kind of tissue. Adult stem cells can do it, and embryonic stem cells can do it. Most scientists feel that research on all types of stem cells is necessary, but they believe that the potential for a cure is going to come from embryonic stem cells. This Bill has not mentioned therapeutic cloning, and therapeutic cloning is not being done in Singapore at this time. Why may therapeutic cloning be necessary in stem cell research?

Sir,how stem cells would be used to treat diseases is that the stem cells would be used to create cells that a person has a deficit in. These cells would then be given to that person. For example, a person who suffers from diabetes does not have the cells that produce insulin. Therefore, if we were to give him stem cells that convert into cells that can produce insulin, then his diabetes can be cured. But one of the problems would be that these cells may be rejected by the body. But if the make-up of the cell could be altered so that it is genetically similar to that of the recipient, then those stem cells, when given to the patient, will not be rejected by the patient. So, although the stem cell may originally have come from an embryo with a different DNA make-up, the stem cell that went into the patient has the genetic make-up of the patient himself. This process of changing the nucleus of the stem cells would constitute therapeutic cloning. And because it can be an essential part in the cure for many diseases, therapeutic cloning has not been banned in many countries.

Questions were asked whether there wereadequate consultations. The Bio-advisory Committee had been formed in 2000, and a special sub-committee to deal with this was formed in 2001, and this committee wrote to all the religious groups and professional bodies, including the Law Society - this is for Mr Chandra Mohan's information - to get their feedback. All this feedback was collated and published in its report. So, the opinions of everyone is in that report and a proper public consultation was done.

Mr Ang Mong Seng brought up a very important question: when does life begin? The answer to that is: no one has a consensus on it. This is an area in which people are guided by fundamental religious and moral beliefs, and there is a spectrum of views. There are those who believe that life begins at conception and others who believe that life begins much later. And I do not think it is possible to bring all these different religious views in this entire spectrum of views and merge them into a single view. Our position in the Ministry is that we respect everyone and their views. We have recorded their views and we will not force anyone who does not want to donate or be involved in stem cell research to be involved in stem cell research.

However, on the issue of human cloning, all groups are almost unanimous in banning this, because we do not want a world like that described in the Brave New World by Aldous Huxley where people are cloned and manufactured and we have the mass production of human beings, and we do not want such a world. So, in that area, everyone is in agreement, and that is what we are prohibiting in this Bill.

Just like people have a spectrum of views on when life begins, there is also a spectrum of views among countries with regard to legislation in this area. Dr Chong Weng Chiew has commented on the legislation in other countries, particularly the United States, and I would like to clarify some facts about the situation in the US because it is quite confusing there. In the United States, a Bill on cloning was passed in Congressbut was rejected by the Senate. So, at this point in time, the United States does not have a federal law that bans reproductive cloning. The law only prohibits the use of federal funds for research in this area. Some individual states have laws that prohibit the cloning of humans. But in the states where it is not prohibited, it may be legal for a scientist to clone a human as long as state funds are not used. Two states, ie, New Jersey and California, have specific legislation that allows therapeutic cloning. Internationally, at present, there are about 30 countries around the world that have already adopted national legislation or decrees that explicitly or implicitly prohibit reproductive cloning on human beings. When this Bill is passed, we will join these countries in prohibiting reproductive human cloning.

Of the countries that have legislation prohibiting reproductive cloning, about half prohibit therapeutic cloning and half do not. So, the legal position

in Singapore onstem cell research andcloning is somewhat similar to that in the UK and Japan. So we are taking a balance, middle of the road, very conventional approach in regulating stem cell research.

Members have also asked for proper enforcement of this Act. Dr Khor noted that Government institutions are not exempted from the provisions of this Bill.Currently, there is only one company in Singapore conducting research into human embryonic stem cells. Its stakeholders include EDB, NUS and the Monash University and it has complied with both the current PHMC Act in Singapore that regulates this area and the National Institute of Health's regulations in the US. That is why the US Federal Government allows the stem cells from this company to be used in US research laboratories. At this moment, no one is doing therapeutic cloning research in Singapore and no one has applied to do therapeutic cloning researchin Singapore.

A lot of people have asked me howwe are going to look at these embryos in the laboratory and decide whether they have crossed over the 14-day limit.I would like to clarify a little further on this issue. There is a scientific basis for drawing a moral line that research beyond 14 days should be prohibited. In natural fertilisation and development, the embryo starts as a cell with no specific features and then it just divides and divides for 14 days, andit is a tiny little ball of cells with no differentiation. On the 14th day of development,a linear indentation, called the primitivestreak, appears and this is the first sign of differentiation. That is the reason why most legislation uses this 14-day mark. But most research on embryos is actually done in embryos that have not gone beyond five days. In fact, it appears that no one can actually grow an embryo beyond seven days without implanting it into a womb. So there is a seven-day safety margin between what is possible in the laboratory and what would be illegal in the laboratory. Soone of the provisions in the Bill is to prohibit the implantation of cloned embryos into the womb of a human or an animal because without implantation, you cannot clone a human.

This does not mean that in the future, scientists cannot grow embryos to beyond 14 days in the laboratory. With the rapid evolution of science, this cannot be ruled out. And although there is one company in Singapore doing embryonic stem cell work now and no one is doing therapeutic cloning research, it is possible that in the coming years, there may be great interest in this area and we must be prepared to be able to regulate and control research in this area.

Today, the important measure that ensures that human cloning does not occur isthe registration and regulation of IVF facilities because this is where the embryos are. Currently, these facilities are regulated by the PHMC Act. And my Ministry has issued a set of quite detailed guidelines in September 2001. But the PHMC does not make human cloning an offence, nor does it prescribe penalties. It is being administered by the Accreditation Unit of the Ministry of Health. This Bill makes cloning an offence and prescribes penalties. This Bill also makes the Director of Medical Services responsible for the administration and enforcement of the Act.Clause 14 of theBill gives extensive powers to the Director to do this. Anyone who obstructs or hides relevant information is liable to be jailed for a year. My Ministry will work with the universities and other agencies to ensure that best practices are followed when monitoring and regulating research in this area. This Bill empowers the Minister to make regulations as necessary to give effect to the purpose of the Bill.So as thescience of this area evolves, as companies apply to do therapeutic research, we will introduce regulations based on the best practices of that time to ensure that all work being done is ethical.

Finally, with this Bill,we will deter people from attempting human cloning because of the stiff penalties for non-compliance. I agree with Mr Iswaran that $100,000 may not be much for a scientist or a big corporation. But going to jail for 10 years is a serious deterrent.It is not possible to attempt reproductive cloning without the involvement of a big team and every member of the team will be subject to criminal penalties if they are part of the team. And itis unlikely that a big team of criminal scientists and doctors can be assembled in Singapore and that they can conduct attemptedhuman cloning research without our knowledge. It should also be noted that so far, no one has been prosecuted under the legislation prohibiting reproductive cloning anywhere in the world and there has been no credible attempt to do this anywhere in the world, except for the much publicised claims by a few individuals which most scientists find not credible.

Dr Amy Khor had mentioned the Simon Shorvoncase. That episode shows that although an individual may be willing to cross the line and do wrong things, it is difficult to get the whole team to do so.In the Shorvon'scase, when Dr Shorvon crossed the line and conducted research that endangered patients, once his team members discovered that, they pulled out of the team and alerted the Ministry.So action was taken before any patients suffered from wrongful research. Because reproductive cloning requires a big team, it is unlikely that it can happen without detection.

Dr Lily Neo was concerned about the risks of bio-terrorism. Following the SARS' laboratory incident in September 2003, my Ministry has instituted a system of checks and enhanced bio-security at our laboratories. We are also working with the security agencies on this and a Bill on Bio-security is being drafted. We will soon bring the Bill to Parliament and there will be an opportunity for a full debate on the subject.

Finally, I would like to thank Membersfor their comments andsupport of this Bill.

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. - [Dr Balaji Sadasivan].

Bill considered in Committee; reported without amendment; read a Third time and passed.

Order. I propose to take the break now. I suspend the Sitting and will take the Chair again at 4.30 pm.

Sitting accordingly suspended

at 4.10 pm until 4.30 pm.

Sitting resumed at 4.30 pm

Order for Second Reading read.

Sir, I beg to move, "That theBill be now read a Second time."

The Bill before the House seeks to amend the Government Securities Act to change the borrowing limit from a gross basis to a revolving basis.

Currently, the borrowing limit under the Government Securities Act refers to the gross sum of all Government securities issued, regardless of whether they have been redeemed. The intention is to amend the Act to change the borrowing limit from a gross limit to a revolving limit, which will be based on the amount of securities outstanding. This is a more meaningful measure of Government’s outstanding liabilities and is consistent with the borrowing limit for treasury bills in the Local Treasury Bills Act, which is on a revolving limit.

The key provision of the Bill is in clause 2, which amends section 11 to provide that the borrowing limit refers to the aggregate amount borrowed and outstanding.

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. - [Mrs Lim Hwee Hua].

Bill considered in Committee; reported without amendment; read a Third time and passed.

Mr Speaker, Sir, I beg to move,

"That the Standing Orders Committee appointed under paragraph 4(a) of Standing Order 96 do consider and report on such amendments to the Standing Orders of Parliament which the Committee may deem necessary."

Sir, it is normal practice for the House to review and amend the Standing Orders from time to time to make sure that the business of the House is transacted as efficiently as possible. Members may wish to take this opportunity to submit their proposals on the amendments of the Standing Order to this Committee for its consideration.

As the Standing Orders Committee would be meeting soon, Members are urged to submit their proposals to the Committee by 9th September 2004, ie, a week's time.

Question put, and agreed to.

Resolved.

"That the Standing Orders Committee appointed under paragraph 4(a) of Standing Order 96 do consider and report on such amendments to the Standing Orders of Parliament which the Committee may deem necessary."

Mr Speaker, Sir, I beg to move,"That this House expresses its gratitude to Senior Minister Goh Chok Tong for his contributions and services to the nation during his tenure as Prime Minister."

(In Mandarin): Mr Speaker, Sir, Senior Minister Goh Chok Tong has been in politics for 28 years, and he was our Prime Minister for the last 14 years. His contribution to the nation and the assessment of the people of him can be summarised in the couplet appearing on the special feature on SM Goh published by the Shin Min Daily News. The couplet used the two Chinese characters "Chok" and "Tong" in his name as the opening. The couplet says:

作风清和， 民众爱戴

栋梁屹立， 国家隆昌

Meaning，"Gentle and amiable in style; Well-loved and respected by the people; Pillar of the Nation; Prosperity to the country."

I would like to give two examples to illustrate SM Goh’s gentle and amiable style and how he was loved and respected by the people.

Since 1996, NTUC has been awarding 100 model workers each year for their hard work. Over the years, workers who received the award from the hands of SM Goh Chok Tong included cleaners, bus drivers, taxi drivers, construction workers, shipyard workers, port workers, hospital workers, and daily-rated workers from various industries.

This Model Worker Award was SM Goh’s idea. In the Prize Giving Ceremony in 1996, he said, "We have national awards like the Public Service Medals for those who serve society. The private sector also recognises the outstanding businessmen and entrepreneurs with its own awards. But ordinary workers are often overlooked. It may be because their individual contributions are not big enough. Or it may be because, like bolts and nuts, they are often not noticed."

Pointing to the 100 bus drivers, taxi drivers and MRT workers present at the ceremony, he said, "Without them, the economy cannot function. Without them, our seaport and airport, our telephones and factories will not work. Without them, the public transport system will grind to a halt." These were words from the bottom of his heart. He meant what he said.

These low-income workers often thought that they were "useless". Having heard the encouraging words from the then Prime Minister, particularly when they saw their colleagues posing for photographs to be taken with the VVIP, and then they had the opportunity to go overseas for study tours, they feltthat they were not so "useless" but probably be "of some use" after all. When they came back from their overseas tour, they began to feel that they were "quite useful".

Giving a shot in the arm for the low-income workers, converting their "useless" mentality to "some use" mentality and then to "quite useful", is still relevant in today’s context. At present, we still have some older workers who feel that they are "useless", unable to find jobs. We must encourage them to go for training, and become useful workers.

In fact, some model workers had the opportunity to take a flight overseas for the first time in their life only after they had won the prize. Prior to that, the only way to go out of the country was to take a bus to Malaysia. Many workers were so proud to have shaken the hand of the Prime Minister that they told me they would not wash their hands.

Over the years, SM Goh has adopted a gentle and amiable style, winning the trust of the workers and the support of the union leaders. That is why the Government was able to implement CPF and wage reform during the past two years when we faced economic recession, in order to enhance the competitiveness of Singapore, thereby creating more job opportunities for our workers.

Let me give another example to show how the people loved and respected SM Goh. SM Goh told the media that, on the average, he would visit his mother once every two weeks. As his mother lived with his younger brother and sister, they would have the chance to have a family gathering whenever he made the visit. They would also have family gatherings during the Chinese New Year and on special occasions.

As the Prime Minister, he was so busy with all the national affairs, yet he would make special efforts to visit his mother every fortnightly, and had gatherings with his siblings. In the eyes of the residents, the filial piety exhibited by the Prime Minister was a kind of subtle education, withimperceptible influence on the ordinary citizens.

When he came to the HDB estate to visit his mother, some children who saw him coming would ask their parents, "Why is the Prime Minister coming here?" The parents would say, "He came to visit his mother." This is a living example of filial piety for the children to emulate.

The residents told me that whenever the Prime Minister came to visit his mother, he would greet them cordially. As a matter of fact, the Prime Minister who once lived in a HDB flat, was also the one who initiated the upgrading programme for the HDB estates. The Lift Upgrading Programme is mostwelcomed by the people, particularly the old folks. Theyare now very happy that they can now visit their children and friends even when they are staying in the top floors. Such convenience extended to the residents in general, and the old folks in particular, is also an expression of his care and concern for the people.

Now, let me talk about "Pillar of the nation and prosperity to the country".

SM Goh stands at 6’3" tall. He is certainly tall and big. When he first stepped into politics, due to his height and stature, he was immediately deemed to be arrogant. Some people thought that he was so tall and aloof that he appeared to be very arrogant. However, over the years, his amiable manner and pro-people image have completely changed the people’s impression of him, especially when they saw SM Goh standing tall among all the VVIPs attending the international forums such as APEC, ASEM, World Economic Forum, and consolidating Singapore’s ties with the various countries. They are very proud of him and deemed him to be the pillar of our nation.

In the past, people used to say that there is no diplomacy in the small nation. When MM Lee Kuan Yew was the Prime Minister, we made many friends and broke through this traditional belief. As a result, we became a small nation with a big diplomacy. SM Goh further expanded the diplomatic network and turned it into an economic network,so that our economic development will not be stifled just because of sudden changes in a certain region or country. This is indeed a pillar standing majestically.

In the past decade, we went through a financial crisis, avoided terrorist attacks, and conquered SARS. Now, our economy is beginning to recover, and SM Goh can go according to his original plans to pass the baton to Prime Minister Lee Hsien Loong. This is prosperity for the country.

SM Goh joined politics at a young age of 35. He is now 63. We notice that his dark, black hair has turned to silver and grey. His black spectacles have also turned to silver. His contributions to the nation, society and the people are here for all to see.

On behalf of the workers and the ordinary citizens, I would like to say a big "thank you" to SM Goh and to convey our most sincere greetings to him.

Senior Minister Goh Chok Tong, "We wish you good health, with ahearty look, and continue to make contributions to Singapore."

Mr Speaker, Sir, the desire of the fellow Members of Parliament to find the earlist opportunity in this House to express our thanks to Senior Minister Goh Chok Tong is unanimous. In fact, Dr Tan Cheng Bock, who is overseas on Parliament business, has asked me specificially to mention that he shares the sentiment and the feelings of Singapore on this occasion to thank Senior Minister Goh for his tremendous contributions as Prime Minister. I am sure Dr Tan would have much to say if hewas present in the House, given that he is a contemporary of the Senior Minister since secondary school and has served in Parliament together with Mr Goh since December 1980.

Further, the four of us have put our names down so that the motion could be moved in the four official languages to affirm the fact that as representatives of Singaporeans we speak with one voice on this motion.

Mr Speaker, Sir, when asked what they think of Senior Minister Goh, the responses from the people from all walks of life are consistent. Let me give two examples.

Mr Pang Kim Hin, former PAP candidate for Anson, characterised Mr Goh as a "people person". To him, Mr Goh is firm but, at the same time, open to others' human failings. Mr Goh is approachable, someone to whom you could pour out your problems and would get a sympathetic ear and not got clobbered in the process. With Mr Goh, one feels comfortable and accepted. In contrast, according to Mr Pang, his predecessor, Minister Mentor Lee Kuan Yew, is a no-nonsense person.Sir, this change in the leadership style is more in tune with the time. Mr Goh brings out the best in you because you want to, and not because you have to.

Another young lady told me that at theSeventh month festival last Sundayshe believed that Mr Goh has a passion for Singapore as he put his heart and soul into the job as Prime Minister.

Sir, I believe the image that will stay onpeople's mind when one thinks of Mr Goh would be the smiling Prime Minister, waving with his right arm raised, as he walked towards the lectern on National Day Rallies. It is an image that projects the persona of Mr Goh well: approachable, compassionate, caring and warm.

Sir, Mr Goh has immense capacity to listen to differing views without taking personal offence. As such, he encourages open and frank discussions. I still remember the MP caucus meeting where the topic was "The Next Lap: the Swiss 1984 standard of living by 1999". It was during the time when Coca Cola introduced the new Coke which, if you remember, failed miserably in the market place. At the meeting, I had the audacity to describe that slogan as a glass of cola which had lost its sizzle. The fact that Mr Goh did not take offence exemplified the Chinese saying"宰相 肚 里 能 撑 船 (Zaixiang du li neng cheng chuan)", which could be roughly translated to mean that "the Prime Minister has immense tolerance for criticism".

Indeed, Sir, Mr Goh, as a person, can be described as what you see is what you get. Those of us who have the privilege to work with Mr Goh know this. As a person, Mr Goh retains his roots after 14 years as Prime Minister. I gained an insight of the person when the topic of Singaporeans' consumption of personal hygiene products was discussed at one of the MPs' Tuesday lunches. Mr Goh disclosed that he still used a bar of soap for washing and bathing - not hand soap, not some of those fancy bath foams, when the sale of such products exceeded the sale of bar soap. Not only that, he continues to use the cake of soap until it is minuscule, a frugal habit he acquired as a child.

Sir, from such little things, one gets a true measure of the man. Indeed, he is a Prime Minister Singaporeans can readily identify with.

By his own account, Senior Minister Goh was a reluctant politician who gave up a successful career in the corporate world to become an MP. When his peers chose him to be Prime Minister, he was not the first choice of the then Prime Minister Lee Kuan Yew. I believe we still remember Mr Goh being described by Mr Lee Kuan Yew as being 'wooden' in his delivery of speeches. Thus, at times, one was not sure whether Mr Goh enjoyed the blessing of Mr Lee Kuan Yew, who remained as Secretary-General of PAP for a period after stepping down as Prime Minister.

Sir, Mr Goh wore his own shoes. At ease with himself despite the constant comparison with Mr Lee Kuan Yew, he was able to leverage on his personal attributes which turned out to be his strengths. And in so doing, he changed the whole tone of the Government after he became Prime Minister. Mr Goh succeeded in bringing Singaporeans from all walks of life, from all ethnic groups, closer together. More than all his achievements, Mr Goh leaves behind the legacy of openness which laid the foundation of a more dynamic and vibrant Singapore.

Sir, this tendency of Mr Goh, not seeking the limelight on his own but elected by his peers as their leader, was already manifested in his senior years in secondary school. This story was told to me by Mr Lim Jit Poh, a career civil servant turned well-known corporate figure. Mr Lim was a classmate of Mr Goh in Raffles Institution, back in 1958, close to 46 years ago, when Mr Goh and Mr Lim were in Form 5. At that time, education in RI was a six-year affair, from Form 2 to Form 6, or the equivalent of Secondary 1 to JC 2 in today's nomenclature. Sir, an interesting event occurred which, in retrospect, appears to be oracular.

In those days, Form 6 students typically provided the leadership for school societies. Mr Lim and his fellow students in Form 5, however, were a rebellious lot. They felt that they were equally good, if not better than some of theForm 6 students. In one society, the Historical Society, this group of friends fielded their Form 5 candidates and organised to get their candidates elected. This they could do readily as there were five classes in Form 5 whereas there was only one Arts stream in Form 6. Thus, the number was in their favour. What was different was that these rebels did not study history as a subject because, in those days, History was not offered and most of the better students were studying Science. Imagine a group of Form 5 students putting up young Mr Goh as a candidate, albeit a reluctant candidate, overthrew the sixth formers in the election of office bearers for the Historical Society. Sir, coincidentally, Prof. Jayakumar, DPM, a sixth former at that time, was a casualty of Mr Goh's popularity.

Upon assuming office, young Mr Goh proceeded to organise two speaking sessions on democracy. Sir, that was the era of self-government under the Rendel Constitution. The Society invited the then Chief Minister, Mr David Marshall, as well as the fiery Secretary-General of the Opposition party, the PAP, Mr Lee Kuan Yew, to speak to the students. The sessions were packed. Thus, according to Mr Lim, he was not surprised when Mr Goh was chosen by his peers to lead Singapore as Prime Minister. Despite his affability, or rather because of it, Mr Goh would emerge as the natural leader once he wins over your confidence.

Sir, even though Mr Goh did not seek the job of Prime Minister, once he assumed the responsibility, he devoted his heart and soul to it. The future of Singapore and the welfare of Singaporeans, especially Singaporeans from the lower income groups, became his foremost concerns. He governed with his head but ruled with his heart.

Senior Minister Goh's achievements as Prime Minister are numerous, and have been well documented by the newspapers during the run-up period to 12th August 2004. I do not intend to cover the same ground but, nonetheless, some mention would be appropriate.

In his 2004 National Day speech earlier this month, Mr Goh spoke of seven bountiful years and seven lean years during his tenure. In good times, he shared the wealth, opened up our political space and put in new organisations to unify us. Inbad times, he was generous to the needy, attentive to the unemployed, and worked tirelessly to help Singapore build up economic ties with other nations.

Sir, the first seven years produced bountiful harvests. In 1990, the per capita GDP was $27,950. By 1997, this had increased to $37,351. The average annual GDP growth during those years was 8.8%. Our average household income grew from $2,300 in 1990 to $3,600 in year 2000.

Between 1990 and 1995, purchasing power rose an average of 4.9%. The mid-1990s marked the high point of Singapore's consumer spending. The changing lifestyles of Singaporeans created an upbeat, hopeful and vibrant feel across the island.

Sir, all this was in line with the Government's Vision of 1999. In 1996, Mr Goh, in his usual homespun humour, pointed out the way lifestyles of Singaporeans were changing. In his National Day Rally Speech, he noted that people were turning to strawberries instead of pineapples, and observed that even NTUC FairPrice now sells sushi. But Mr Goh knew that at a time of plenty, there would still be those who need help within the community. Way back before any of his wealth-sharing policy was implemented, Mr Goh shared with the MPs his concerns on the trend of widening income gap between the higher-income groups and the lower-income groups in Singapore. It was at a time when the forces of globalisation wreaking changes were still not obvious to many people. At one lunch with myself and two other MPs, he talked about his concept of "negative income tax" as a way of income distribution to bridge the widening income gap. I believe this was the genesis of the various wealth sharing schemes such as Edusave, the various rebates and top-up schemes as well as the ESS shares. Of course, these goodies are popular. But I do not think this was what made him popular. What did was his concern for the lower income and the less fortunate ones amongst us.

Mr Goh knows that the best way to help them was not to rely on a faceless bureaucracy but on the grassroots leaders and self-help groups, and to give resources to volunteer organisations and empower local interest groups. Thus, in 1997, the Community Development Councils were set up. At the swearing-in ceremony of the first batch of Mayors, Mr Goh said, "The establishment of the CDCs is part of the process to build a tightly-knit, compassionate and self-reliant society." As a result, today, we have more young professionals participating in a new kind of volunteer community work with the CDCs.

Sir, the next seven years from 1998 to 2004 were lean years. First, South-East Asia was struck by the Asian financial crisis in 1998. Then followed September 11 terrorist attacks in 2001, and the economic recession aggravated by SARS.

To help the lower-income groups, as soon as the budget permitted it, Mr Goh announced in his 2000 National Day Rally that there would be a CPF top-up of between $500 and $1,700 to be given to Singaporeans. The first payment would benefit 1.9 million Singaporeans, and the second payment would be given out in early December 2001. By 2001, it was clear that many would miss out on this top-up, as they did not contribute the $100 required to qualify. In his 2001 National Day Rally Speech, one year later, Mr Goh announced that the 187,000 Singaporeans who missed out would be given a second chance. This demonstrated once again his flexibility and his genuine desire to help those who truly needed it.

By then, Sir, Singapore was in the second year of a recession. Factories were relocating and the unemployment ratewas atan all time high. The Economic Downturn Relief Scheme was implemented to assist those who lost their jobs on an urgent basis. This was a concrete, practical and compassionate way of helping Singaporeans.

Mr Speaker, Sir, during this period, Mr Goh also handled well some of the more divisive issues facing Singapore. For instance, the JI terrorist arrests, starting in December 2001 and continuing into September 2002, could have driven a wedge between the various races in Singapore. At that time, the newspapers reported that some Chinese Singaporeans would view any Muslim wearing a beard and a sarong with suspicion. Instead, Mr Goh seized the occasion to build a stronger bond between the races. He met with all the Malay Muslim leaders.

He instituted Inter-racial Confidence Circles in all wards as a new grassroots initiative. Sir, as a result, I believe that relationship between the races is now stronger than ever.

Mr Speaker, Sir, during his tenure as Prime Minister, his popularity increased year by year. He led the PAP from the low electoral popularity of 61% in 1991 to 65% in 1997 to the high of 75.3% in 2001. Still, few would view Mr Goh as the consummate politician. But it is political suicide to underestimate him - as Mr Chee Soon Juan learned painfully in the General Election of 2001. Chee Soon Juanhectored Mr Goh at a campaign walkabout in Jurong GRC, in front of television cameras, for all Singaporeans to see. As a result, the Jurong team polled the highest among the GRCs - 79.8% of votes, and the SDP became a spent force. In fact, in the General Election of 2001, some districts, with new PAP candidates, polled as high as 80%. Sir, Mr Goh has a long coat-tail that carried these new MPs into Parliament.

Sir, he achieved his popularity despite the numerous unpopular measures that had been implemented during his term of Government. For instance, bus fares cotninued to be adjusted from time to time, PUB bills went up, Town Councils' charges increased, medical bills increased as hospitals were corporatised, GST was introduced and later raised during his tenure. Bread and butter issues continued to irk the population. The interesting thing is that people blamed the Government and the civil service. Hardly anyone blamed Mr Goh. To me, that is the feat of a consummate politician. How did he do it? I think it is a difficult question. I do not know the answer, but perhaps I can offer some hints.

For instance, he mooted the idea of the Feedback Unit in 1985. He said:"I would like to encourage greater participation by Singaporeans in shaping the destiny of Singapore." Later, he also said: "Younger Singaporeans want to participate in determining the course of Singapore and we should encourage their participation." Apparently, this 1985 message is still valid as Prime Minister Lee also called for younger Singaporeans to step forward in his recent 2004 National Day Rally Speech.

The role of feedback is also given prominence in policy decision-making by his Government. Mr Goh, in his message to the book, "Building Bridges, the Story of the Feedback Unit" reaffirmed that, and I quote: "To govern effectively, the political leadership and public service must have their ears close to the ground. Feedback helps us to understand the concerns of the people."

Sir, it is clear to all that he implemented his policies with a heart. I remember how the Medifund scheme came about. At a debate in Parliament on the restructuring of Government hospitals, it was pointed out that such changes would impact Singaporeans already past their prime, who no longer had the earning power in the time remaining in their active life to save up for their medical care. The situation was indeed more grave for those who had already retired. To address these concerns, Mr Goh introduced the Medifund Endowment scheme in April 1993 with an initial capital of $200 million as a safety net.

Another example is that of the GST increase from 3% to 5%. When recession hit Singapore badly in 2003, it became an issue whether the Government should go ahead with upping the GST from 3% to 5% in one step or to 4%, followed by another 1% one year later. It is Mr Goh's concern for the lower income that swung the decision in favour of a two-step increase. His policies reflect his genuine concern for the lower income group.

Mr Speaker, Sir, from the feedback I got from the ground, Mr Goh is beloved by all Singaporeans, the old as well as the young, the rich as well as the poor.

Mr Goh has changed the way we live our lives, care for our parents and nurture our children. He has implemented wealth-sharing schemes such as the Edusave and Medifund. Together, they provide a comprehensive and yet reasonable welfare net for Singaporeans to ensure that they have access to good healthcare, even if they fall on hard times. More importantly, the Edusave scheme ensures that every child in Singapore would start from the same starting point in running the next lap.

Ultimately, Sir, the rootedness of Singaporeans is primarily a matter of the heart. In this respect, Mr Goh fundamentally changed the relationship between the Government and the people. Looking ahead to the time when Mr Lee Hsien Loong would take over as Prime Minister, most Singaporeans believed that the days of the gentler Government would be over, as they expected the new Prime Minister would pursue more hard-headed policies based on logic and less on the heart. Contrary to expectation, PM Lee chose to pursue the open approach of Mr Goh. Thus, indeed, the trend towards openness introduced by Mr Goh is entrenched. The legacy of Mr Goh lives on.

Mr Speaker, Sir, Singapore has benefited from his steady hand on the helm during the good times and bad. He became Prime Minister at age 49 and stepped down at 64. It is a tribute to the man who has devoted the most productive years of his life in the service of Singapore. I know he will say that he did not do this alone, and that he had a good team. But he was first among his equals, and he had the grace and the wisdom to tap the greatness of every member of his team.

In the depth of recession, Mr Goh, in his 2003 National Day Rally Speech, talked about being in the valley of gloom. He promised to show the nation "the way out of the gloomy valley and up into the sunny highlands". Typically of Mr Goh, he fulfilled his promise. Once achieved, he did not linger to bask in the glory but stepped aside so that a younger team, led by Prime Minister Lee, could take Singapore into the next phase of its development.

Sir, this is the hallmark of a great leader - a selfless leader, a leader that will endure in the hearts of Singaporeans for all time!

After 14 years of Mr Goh's leadership, we have emerged as a more united people. In his National Day Rally Speech of 2002, Mr Goh talked about Singapore thus: "This is home because we built it. Every Singaporean has given a part of himself, big or small, to the country. Singapore is the sum of our dreams, our fears, our sweat. It reflects who we are and what we want to be." These words still resonate with us.

Mr Speaker, Sir, I believe I speak for all Singaporeans when I say, "Thank you, Mr Goh. We love you." [Applause.]

Resolved,

That the proceedings on thebusiness set down on the Order Paper for today be exemptedat this day’s sitting from the provisions of Standing Order No. 1. - [MrMah Bow Tan].

Debate resumed.

(In Tamil): Mr Speaker, Sir, I wish to pay tribute to our Senior Minister Goh Chok Tong and thank him for his services to the country as Prime Minister.

The great poet Thiruvalluvar had described 2,000 years ago the four qualities of a good leader. In verse No. 382 of Thirukkural he had spelt out the four qualities: fearlessness or courage, generosity, wisdom and resourcefulness. A leader should have all these four qualities.

First, fearlessness: he should face any challenge without fear. Second, generosity: he should give generously when it is necessary. Third, wisdom: he should see what is good and what is bad in advance. Fourth, resourcefulness: perseverance.

Mr Goh is a leaderwith these qualities. Hecarried out his duties for 14 years very well. He performed the duties as a Prime Minister according to the "kural". Despite difficulties, his 14 years as Prime Minister were golden years in the history of Singapore. He gained the love and support of the people, and he earned their praise as well. In 1990 when he took over as PM, he said that he would strive to improve relations between the Government and the people. After 14 years, he has retired from his position with pride that he has fulfilled his promise. Now he has taken over as a Senior Minister. All Singaporeans would say that his humble approach is the best of his characteristics. That is why he is referred to as the People's Prime Minister.

Our former Prime Minister has always carried out his duties with the aim of providing a better life to Singaporeans. He wanted to uplift the lives of ordinary Singaporeans. He introduced the Edusave scheme so that all students would do well in education. He announced the Medifund and Eldershield schemes to help the elderly and the needy to cope with their medical bills. He implemented new schemes like Main Upgrading Programme, Lift Upgrading Programme and Interim Upgrading Programme to upgrade HDB flats. Above all, he also introduced the Hawker Centre Upgrading Programme. He gave benefits to the people according to our country's growth. The Economic Restructuring Shares and the Singapore bonus shares are some of the examples. He introduced the Renaissance City Plan to make Singapore a country where arts and culture flourish.Many new buildings for arts and culture, like the Esplanade theatre, the new museum and new cultural centres were erected during his period.In Singapore, he strived to enhance the bonding and unity among the people. Whatever the problem was, he put it across to the people in simple terms and got their cooperation and understanding.

During the 14 years when Mr Goh was Prime Minister, Singapore faced many challenges locally and globally: first, the Kuwaiti war; the Asian financial crisis in 1997;the terrorist attack in September 2001;the Afghan war; the Iraq war; domestic issues like SARS; the tension with the neighbouring countries and the activities of Islamic terrorists. Many such crises arose. Mr Goh found solutions to all these problems in his own style. He thought calmly and deeply and took measures and implemented policies that were necessary with Singapore's interest at heart. He enjoyed the support of all sections of the people.

Mr Goh was popular not only locally but also abroad. Mr Goh was well known as a sound politician and a wise thinker in the world arena. He was Singapore's foremost ambassador. He played a key role in setting up APEC and ASEM. He is also responsible for the good relations we enjoy with countries like India and China. When ASEAN was lacking direction and leadership, he provided the same. From 1997 to 1999, he provided guidance and strengthened the unity among ASEAN countries. He was responsible for the Free Trade Agreements that Singapore signed with several countries. And recently, he gave new ideas to improve relations between Asia and the Arab countries. As long as Singapore exists, his services will be remembered in the history of Singapore. I am happy he will continue to serve the country as Senior Minister. He has dedicated his life for Singapore and the people of Singapore. On behalf of all Singaporeans and myself, I thank Mr Goh. At the same time, I wish to thank Mrs Goh Chok Tong also who has helped Mr Goh in carrying out his duties.

Long live Mr Goh's great deeds! Long live his glory!

(In Malay): Mr Speaker,Dwight Eisenhower had once said, "A platoon leader does not get his platoon to go by getting up and shouting, ‘I am smarter, I am bigger, I am stronger. So I am the leader for you.’." He gets his men to go along with him because they want to do it for him and they believe in him.

That is themark of leadership. In a nutshell, this is how I see Mr Goh Chok Tong's style of leadership and his contributions to Singapore.

In his 14 years as Prime Minister, Mr Goh has initiated many important policies for the good of the people. Andhe was able toselleven the most difficult measures because he had gained the trust of fellow Singaporeans.

How did Mr Goh, the reluctant politician, win the confidence of the people? He did so by being himself. He did not set out to copy or be another Lee Kuan Yew. He had never said that he was smarter than all of us.

As the Prime Minister, he hadto steer Singaporethroughan economic crisisin the late 1990s. He haddiscussions with union leaders on how to get out of the recession. Eventually, he was able to persuade workers to accept a 10 percentage point CPF cut on top of other wage restraint measures. Just as we were about to overcome the economic crisis, we were faced with terrorist attacks, the Iraq war and SARS.Again, Mr Goh was able to galvanise Singaporeans to think as one peoplein dealing with the crises.

After each crisis, the trust between the people and Government became stronger. For this, we must thank Mr Goh Chok Tong for his inspiring leadership.

We, in the labour movement, have known Mr Goh for a long time. In 1977, soon after he was elected a Member of Parliament for Marine Parade, he was appointed the Director of the Singapore Labour Foundation. He then assumed the position as Chairman. As SLF Chairman, he did many things for the workers. Among the projects he started were the NTUC Pasir Ris Resort, a bursary award scheme for theeducation ofunion members' childrenand educational tour award scheme for model workers. Mr Goh also launched Medisave, MediShield and Medifund. He pledged that no one would be denied hospital care because he did not have money to pay for the treatment.

As the First Deputy Prime Minister, Mr Goh promised to build a special home for NTUC in the heart of thebusiness district as a "signal that the workers are equal to the employers and Government officials in contributing to the prosperity of Singapore." Later, as Prime Minister, he saw to it that the funds were made available for the NTUC to carry out this project. We, in the labour movement, are indeed happy that the building was completed in time for Mr Goh to officially open it in May, some months before he stepped down as Prime Minister.

As Prime Minister, he fully supported NTUC's efforts to upgrade the skills of our workers. When the Skills Redevelopment Programme was initiated by NTUC, Mr Goh Chok Tong's Government donated $100 million. And the NTUC Education and Training Fund, now stands at more than $60 million, thanks to a Government matching grant of $3 to every $1 raised by the labour movement.

Mr Speaker, Mr Goh is a true friend of labour. He gave us voice, dignity and an important place in society.

Last year, Mr Goh urged the Malay leaders to work together with the community to achieve its vision, like the Malay saying, "Together we go through thick and thin." This, in many ways, sums up the kind of support and commitment that he had given in helping to improve the status of theMalay community in Singapore. In 1994, he set the tone when he stressed that "it is the Government's hope that all races will progress and enjoy the fruits of Singapore's success, and that Singapore does not want to see anyparticular group left behind."

As Prime Minister, he had given tremendous support and encouragement to our community. He shared the dream of the Malay leaders to make the Malay community a "Community of Excellence".

He has a genuine concern for the well-being of the community and theirability to adjust to a competitive global economy. Often, he was frank and open in discussing issues faced by the community, whether it was for moderation in practising Islam or urging the community to deal effectively with issues arising from dysfunctional families. He even set targets for us to meet our educational achievements, and I am glad to say that we have not disappointed him.

Mr Goh Chok Tong strongly backed theestablishment of the Malay-Muslim Education Trust Fund to help the lower income Malay-Muslim families afford early childhood education.Mr Goh had done much in providing inter-racial harmony. He stressed that we must developthe sense of a Singapore family,that we are one people and that we sink or swim together as Singaporeans. Following the arrests ofsomepeople who were suspected to be members of Jemaah Islamiyah (JI), Mr Goh personally made a call to Singaporeans not to suspect fellow Muslims. Describing the JI as a group of misguided extremists, he urged Singaporeans not to misconstrue the evil deeds of the JIs as the teachings of Islam.

Mr Goh stressed that Islam is not under threat, that Muslims are free to practise their faith within the context of our multi-racial and multi-religious society, like other Singaporeans. He called on the people, Muslims as well as non-Muslims, to forge a better understanding of Islam as a moderate and rational faith. By his actions and words, Mr Goh had helped to maintain stability and injected confidence in the Muslim communityduringvery difficult and trying period.

Mr Speaker,by his own admission, Mr Goh had said that he was not a natural politician. He took up the challenge of leadership because he saw it as a duty. He came from a poor family and had benefited from our meritocratic system. So his political involvement was a way to repay society for what it did for him. For 14 years as a Prime Minister, Mr Goh was indeed the people's Prime Minister. Humble and kind, he showed true qualities of leadership for all of us to emulate.

On behalf of all Singaporeans, I would like to express my thanks to Mr Goh Chok Tong for his wonderful contributions to Singapore. His services will always be remembered.

Mr Speaker, Sir, it was during SM Goh's tenure as Prime Minister that I entered politics. And over the last three years of my involvement, I have come to appreciate more and more the enormous contributions that SM Goh has made to all of us in this House and to Singapore as a nation. Idecided to pen a few verses of appreciation, and beg the indulgence of Members, as I try to read this to you as slowly and as poetically as I can. Please be forgiving if your goose pimples erupt or the William Woodsworth in you cringes at what I say and how I say it. For this is my very first and perhaps may well be my last attempt in crafting poetry. So, here, it goes.

An ode to SM Goh Chok Tong:

They said you were there to warm seats

Instead you warmed our hearts

They said you were wooden

But with the artistry of the alchemist

The wood turned into gold

Many your accomplishments

People understand that your heart was with them

When death and grief shook our nation

Your calm and kindly leadership won with the people

Ring-fenced spectres that ravaged the land

Restored hope and gave consolation

We held our heads high as the world watched

And marvelled at this island of wonders

Through a shaking of foundation

The world grew smaller

You spurred us to sprout wings and fly

Into the regions and beyond

Triangles and bilaterals aplenty

We made a name for ourselves

Into the far-flung reaches of this globe

Merchants of an economic powerhouse

But it was to a home not a hotel we returned

To the ambience of familiar faces and the warmth of its pleasant places

You egged us on to open our mouths

And let looseour discontent

With the promise of harkeningears

Ripples of dialogue, not a homily

Groups focused, committees working

Alternative cries were heard

Except he who is marked as bounded out

Delicate matters of colour, of faith and of betrayal

Stirred your indignation

The weak you thought of

Helping those who could not help themselves

Enhancing assets, shares of the New Singapore

Redistributing wealth, levelling up

For you were once among the humble

And understand the common men

Singapore bohemian,taboos banished, busk not blemished

More freedom to express, more places to go

Bar top dancing, bungee in reverse, deviant no more

Heartware beyond hardware

Bonding hearts, building minds

Remaking, refreshing, reviewing

Nothing sacred

The baton now lies in steady hands

But deep foundations have been sunk

Upon which to build fresh dreams

And to crown them with realisation

One score and 19 years, adolescence passed

You helped your people grow.

Senior Minister Goh, thank you from the bottom of our hearts. [Applause.]

Mr Zainudin, you have an ode too?

Mr Speaker, Sir, after the ode, it would be difficult for me to equal. I rise to support the motion to express our gratitude to Senior Minister Goh Chok Tong for his contributions and services to the nation during his tenure as Prime Minister proposed by our fellow parliamentarians. I would like to thank him for shouldering the very heavy responsibilities as Prime Minister by sustaining and developing our country's peace and stability for the past 14 years. I thank him for his efforts that made Singapore a gentler and a more sophisticated place for all Singaporeans. I thank him for bringing our peoplecloser together.

Personally, as a Member of Parliament, he has always made me and my colleagues feel comfortable when approaching him. His height was well matched by his compassion for others, as he built upon the legacy left behind by Minister Mentor Lee Kuan Yew. He clearly demonstrated to the nation that the Government comprises people who care and listen. His leadership style brought the nation to another level. During some of the difficult periods when Singapore faced stormy days, which included the economic crisis, strained neighbourly ties, terrorist threats andSARS, SM Goh demonstrated his tenacity and calmness to show Singaporeans that, with sheer grit, determination and foresight, Singapore can surmount any seemingly impossible obstacles.

At this juncture, please allow me to read out some expressions of gratitude from my grassroots leaders. So many wrote in, but I have selected only three which showed how he is a role model, and I quote:

"You started to lead the nation at a time I was a teenager. My patriotism to the nation and the eagerness to serve my country was inspired by you. I owe to you for having made me feel that I belong to this nation and however small a part I play does count." - from Miss Susila Ganesan, Bishan North CCMC member.

"Thank you very much. You have taken good care of every citizen for the past years. We owe you forever. Good health and best wishes." - from Miss Helen Wee.

"My heartiest congratulations to you for your posting as Senior Minister. Thank you for your love, care and compassion you have shown to us. Your contributions will find a place in our hearts." - from Mr Ahmad Arifin.

I must take this opportunity to also say that, by way of example, SM Goh showed us how to live a more ethical and social, gracious life as Singaporeans. A particular incident comes to my mind. During a ceremony, when the Remaking Singapore Committee was submitting the report and recommendations to SM Goh who was the Guest-of-Honour, the event started with a sketch that was quite hilarious, and this was just before his speech. The sketch gently mocked the Singaporean way of doing things - the good and the not-so-good. It made fun of some of our silly habits, typical responses and inclinations. As SM Goh later got up to deliver his speech, he must have recalled some similarities of the speech that he was about to deliver and the issues raised in the sketch when he suddenly burst into laughter. He tried to compose himself again, but gave in to the guffaws as the rest of us laughed with him. To me, that moment was unbelievable. It made him even more endearing as a leader. I witnessed how he truly connected. His humility touched all of us that day, as he demonstrated the ability to laugh at ourselves as Singaporeans. He, of course, spoke to us finally and delivered his message in his own special way. Indeed, may it be known that he established his own connection with Singaporeans, not through a high-flown oratory but delivered in a rational simple anecdotal style, often using simple analogies, like positions in a football team, to explain complex things like his role in his Cabinet, and many more. His dulcet tones exuded sincerity and a willingness to hear out Singaporeans.

The less fortunate are often on his mind. During his tenure, SM Goh introduced new schemes to help Singaporeans. CPF top-up schemes, Singapore Shares, Edusave, Medisave and MediShied are just some examples. He took steps to ensure that every citizen has equal opportunities, and that our senior citizens are not forgotten. It was him who continues to push for young people to be brought into the Government. He also wanted to get the local residents to be more involved in the grassroots activities. In his early days, it was also him who tried and tested the Residents Committee concept and that has now proven to be a success.

Now, let us talk about the fun things that brought forth. He got everyone on their feet when he launched the first ever Singapore Swing, if you can recall, that began a new wave of letting down the hair as Singapore began to loosen up. What followed were big countdown parties and light-up ceremonies during festive seasons. Of late, he permitted bar-top dancing, though he could not quite understand what all the excitement was all about. Following this was bungee-jumping.

Over the 14 years, he made personal sacrifices and led by example. He brought upgrading programmes to HDB homes and made education compulsory for our young. He persuaded Singaporeans to accept tough decisions and taught us that, as long as the peoplework with the Government, the economy will thrive. He realises how small Singapore is as a country and decided to link us to the world. He took concrete steps to institutionalise this. He conceived the idea of the Asia-Europe Meeting (ASEM) in 1995 to forge links between Asia and Europe. He was responsible for Asia-Europe Foundation, and steps were also taken to connect us to Latin America and the Middle East. In all these, while at home SM Goh was busy bringing us all closer together as one people, one nation and one Singapore. He has painstakingly taught us that we must, and I quote: "Continue to share the same roof, the same walls, and the same foundation. We must. Otherwise, our home will fall apart." But he also says: "The condition for each room can vary. Not every room needs to be furnished to the same taste." Therein lies the versatility of Senior Minister Goh as a leader. Those words almost captured the essence of a man who held the hands of a young nation and led us steadily into the 21st century. Today, we, as a nation, are united as a whole, regardless of race or religion.

Sir, this year marks a new chapter in the pages of Singapore history. We have started on our next journey with a new captain at the helm. Mr Goh had handed over the leadership to Mr Lee Hsien Loong, a worthy successor of his choice. Our new PM is not new to us and he has more than proven his mettle. I am confident, like SM Goh, PM Lee will take Singapore to another level of advancement on the road of nation building. Our new Prime Minister, I believe, will build on the legacies of Minister Mentor Lee Kuan Yew and Senior Minister Goh Chok Tong, and I am confident that, one day, the future generations will be able to celebrate his legacy, just as we are doing so for Senior Minister Goh in this Chamber.

Mr Speaker, Sir, we can be confident that after SM Goh's wonderful 14 years of tenure as Prime Minister, Singapore will again, under PM Lee, become an even more vibrant and exciting haven. Ours will be a place where every Singaporean and everyone can call home, whatever the race, language or religion, and all this is by no small means we owe to Senior Minister Goh Chok Tong.

For that, I would like to thank you, Senior Minister Goh.

Mr Speaker, Sir, I am greatly honoured to be given this privilege to convey these few words sincerely from my heart to our Senior Minister Mr Goh Chok Tong, and I strongly believe that what I am going to say would be what the ordinary workers would express to him, if they were given the opportunity. Aseveryone of them cannot be here, so allow me to recap what the earlier speakers said and refocus on some exemplary things thathe has donefor Singapore. For a great leader, his character will be better understood during a crisis.He hasshown it during a crisis and let me elaborate on it.

Senior Minister, during your premiership, the nation experienced a period of strong growth as well as downturn in the economy which was not our own doing. That was the Asian financial crisis. Then came the SARS crisis whenhigh unemployment took place in the service sector. The impact on the labour movement was tremendous. During the financial crisis, you called for a CPF cut and, in 2003, you proposed a retuning of the CPF, knowing it would cause dissension. But you took that step, unpopular as it was, in order to save jobs. At that time, many might not have understood, but now all realise the necessity of such a move. Many jobs were saved and new ones were created. Workers gained confidence in you and the Government. The nation managed to ride the wave.

Then, when we were faced with the SARS epidemic simultaneously with an economic downturn, workers in the service sector had to make several sacrifices, and some even lost their jobs. But your sincere call to all Singaporeans to rally together and face the calamity, gave us the strength to overcome it. Financial help through Government agencies gavehelp to those who really needed it. As a union leader, many affected workers have expressed to me their gratitude for the assistance you provided. It is your personal approach leadership and a ready listening ear that give us the will to face whatever challenges that come. I can personally attest to this because you have many a time shown your concern and asked me about the workers' plight and problems.

During good times, you made it a point to share the wealth of the nation with all. And, in difficult times, you provided assistance to the needy, some of which I will reflect here. Under your administration, many schemes were initiated that were meant to help the ordinary workers and the lower income. Schemes, such as Medifund, Edusave, service and conservancy charge rebates, utility rebates, etc, were introduced. The Edusave Scholarship is also extended to the students in the Normal and Technical streams. It clearly showsyour vision for academic achievements for our future generations, that the opportunity should be there for all and not just for an elite few. By your concern and care for this group of children, you have given the assurance that they too are important and they have a role to play in the building of a nation.

At the same time, efforts were made by you and your administration to see that, irrespective of educational level and age profile of the ordinary worker, provision must be there for them to upgrade their skills. In these respects, funds, such as Lifelong Learning Fund, SRP Fund, etc, made it possible for workers to upgrade their skills and to remain employable. In particular, your offer of $3 for every dollar raised by the NTUC Education and Training Fund reflects your great support for the labour movement. Now there are abundant resources that a worker can be eligible for if he wishes to upgrade his skill. The end result is that we have been rated many times as theNo. 1 workforce in the world. This attracts investments to Singapore, hence creating jobs.

Another significant initiative that marks your attachment to the labour movement, as mentioned by my colleague, Mdm Halimah, and which all ordinary workers appreciate, is the promise that you made to NTUC to have a new office building right in the business district. Now that promise is a reality that stands tall -the NTUC

Centre atOne Marina Boulevard. I am not aware of any country in the world where the Prime Minister or any other leaders have extended such an exemplary gesture to the trade union movement. SM Goh, you stand above the rest, not by your high priorities.

Another key initiative introduced during your tenure of premiership is the introduction of NMPs in Parliament. Your objective of giving different interest groups the opportunity to voice their views in Parliament is laudable. These and other measures introduced, so that ordinary people can give their views and raise their concerns, speak volumes of your consultative style of governance.

Sir, SM Goh's service to Singapore and Singaporeans is like an ever-flowing river. It is impossible to condense it in a text. All I manage today is to just take a few drops from this river and sprinkle it here. Senior Minister, I humbly wish to express my gratitude to you for all the contributions you have made to all Singaporeans as a whole and to the nation. You have made this little red dot of ours a symbol of peace and racial harmony that the world should take it as an example.

Mr Speaker, Sir, as I sat there listening to the speeches by Seng Han Thong, Wang Kai Yuen, Ravindran, Halimah and the other MPs, I thought to myself that this motion is not really necessary. I am not used to hearing praises or tribute heaped on me, so I did feel a little awkward. Besides, Prime Minister Lee has already paid tribute to me -notonce, but twice - during his swearing-in speech and the National Day Rally. I thought that was more than enough and more than I deserved.

To be given the privilege and honour of serving my fellow Singaporeans is reward enough for me. Nevertheless, I thank all Members of Parliament for their warm sentiments and kind words in moving this motion. In many a country, Prime Ministers are often unceremoniously removed – sometimes by their own party colleagues. I am grateful that such a fate has not befallen me. I hasten to add thatmy success is also the success of my Cabinet colleagues and the MPs of my party. We have shared the responsibility and worked together in looking after Singapore.

Many Singaporeans have also saidkind words about me. I thank them. Let me add here that I could not have done my job alone and certainly not without the strong support of Singaporeans – young and old, men and women, Singaporeans from all walks of life. I cherish their warmth and encouragement. I appreciate their understanding when I had to take painful measures to solve our country's grave challenges.In some countries, tough policies would have been met with demonstrations and riots. Here, the people rallied behind the Government to overcome common problems. It is a joy working with Singaporeans and for Singaporeans. You can see the results – a peaceful, cohesive and thriving Singapore. As I have said before, thank you for walking the hills and valleys with me. My heart will always be with you.

Life has a strange way of leading you to places where you did not plan to go. Sometimes, you end up in a better place; sometimes, worse. I did not set out to be Prime Minister and, least of all, leave a legacy. I wanted to lead a simple and quiet life. Politics was not in my blood. I did not prepare myself for it. But I owed my country something. Without the Government bursary, I would not have been able to go to university. Without equal opportunities, I would not have been recruited into the Singapore Administrative Service or become the managing director of the national shipping line. Without a party that believes in planned and orderly leadership renewal, I would not have been invited to enter politics. Hence, when my peers and colleagues elected me to be their leader after the 1984 General Elections, I could not refuse to take on the responsibility. I knew it would be a tough job. But I am the product of a political culture which scours the country for good and able people to serve. I had to play my part for Singapore. And I wanted our children to continue to enjoy the peace, stability and prosperity which the first generation leaders had given us. So I took on the job of Prime Minister and gave it my best shot.

I am happy that I have made a contribution to Singapore. In this, I was fortunate to have a solid team of Ministers and MPs to help me. The PAP MPs play a critical role in helping the Party win elections to form the Government. Had the Party been fractious, had our Government been weak or had Parliament been packed with rowdy and cantankerous opposition members, we would have gone the way of many developing countries. I have watched how democracy is practised in these countries. It has not brought them the better life they hoped for their people. Their people remain mired in poverty while their politicians fight to serve themselves more than their country. It is not by chance that we have honest men and women in Parliament, and I include here the opposition MPs and the Nominated Members of Parliament as well. It is by the will of a group of honest men and women who believe in running a clean and honest Government based on meritocracy.

There are many individuals I should thank but I would like to highlight only two.

First, I would like to recognise Minister Mentor Lee Kuan Yew.As Senior Minister in my Cabinet, he was an invaluable member of my team. After he stepped down as Prime Minister, he made it his mission to ensure that the second generation leaders succeeded. He was honest in his critique and generous with his advice. He had a large databank of wisdom and experience and an international network of contacts built up over 31 years as Prime Minister, from which we drew and benefited. I found SM Lee an immensely useful, wise and trusted counsel.That was why I advised Prime Minister Lee Hsien Loong to retain Mr Lee Kuan Yew in Cabinet as Minister Mentor. MM is a national resource and too valuable an asset for Singapore to lose. I can tell you that fears that Prime Minister Lee will find it difficult to be himself because of his father’s presence in Cabinet are unwarranted. I have worked with both MM Lee and Prime Minister Lee for more than 20 years now. I know that PM Lee is his own man and that his father will not cramp his style or stifle his ideas.

The other person I would like to thank is Hsien Loong or Prime Minister Lee. As my Deputy, he was like my badminton doubles partner. He could smash and retrieve, which complemented my strengths in drop-shots and netplay. He was not only a most supportive and valuable deputy, but also a key Minister handling many jobs at any one time - having many balls in the air and not dropping them. He dealt with difficult issues like pulling Singapore out of recession and restructuring of the economy and financial sector. Just look at the holes he has left behind now that he has become Prime Minister. He has to retain the Finance portfolio and I have to cover the Monetary Authority of Singapore because the younger Ministers are not ready.

The political changeover has got off to a very good start. The new Prime Minister has connected well with the people with his swearing-in speech and his first National Day Rally. Most importantly, he has generated a new sense of excitement, especially amongst younger Singaporeans. We need a fresh burst of energy and ideas to break through the wall of challenges and seize the opportunities ahead of us.

I am optimistic about Singapore's future. I strongly believe that our future will be bright and exciting. Asiais on the move. Yes, there will always be challenges. But this is what makes life exciting and worth living. The brave will reap the rewards.

Singapore has succeeded because it has enjoyed good clean Government and capable leadership. ForSingapore to continue to prosper, able and committed men and women must come forward and dedicate themselves to the well being of their fellow Singaporeans. Prime Minister Lee has called on all Singaporeans to help him shape the future together, to build aSingapore for all Singaporeans. I join him in this call. Regard me as an example of what is possible in Singapore. Had I lived in another country with a different political system and philosophy, I would never have the chance to lead such a fulfilling life and make a difference to my country. I have done my bit forSingapore as Prime Minister and will continue to contribute in my new capacity. I call on the younger generation to do their part to makeSingapore an even more prosperous, secure and exciting home. Thank you, once again, for your support and kind tribute. [Applause].

Mr Seng, would you like to wrap up?

Sir, we have heard Senior Minister Goh's response. It is a typical Goh Chok Tong's response. He is humble. He mentioned that this motion is not necessary because he is not used to praises. Senior Minister Goh, we are not here to praise you. We are here to set on record your contributions to Singapore, to society and to all communities.

In fact, more than 30 of us had indicated our intention to speak on the motion. But due toparliamentary procedure, only seven of us had the opportunity to speak on the motion. I am sorry that opposition MPs did not indicate that they want to speak on the motion. We all spoke with genuine affection for Senior Minister. We delivered our speechesin four languages. But the message is clear, and there is only one message,that you are the people's PM and you will be loved by all Singaporeans.

Sir, may I, on behalf of the Members who have spokenin support of this motion, thank Senior Minister,in particular,for his sincere response. I agree with him that MM is our national resource. We always say that we have no natural resources.

Now we have national resources, and you, SM Goh,will add to our national resources.

Question put, and agreed to.

Resolved,

That this House expresses its gratitude to Senior Minister Goh Chok Tong for his contributions and services to the nation during his tenure as Prime Minister.

Resolved,

"That, at its rising today, Parliament do stand adjourned to a date to be fixed." - [Mr Mah Bow Tan].

Mr Speaker, Sir, I beg to move,

That Parliament do now adjourn.

Question proposed.

6.00 pm

Sir, may I beseech this House to look into healthcare financing in Singapore to ease the pain of healthcare expenses.

I am sure many Members of this House agree with me that our present system of Medisave where we save and pay as we go financing for healthcare is becoming less adequate to serve our needs. An individual's expenditure on healthcare is, to a large extent, unknowable, both in magnitude and timing. It is, therefore, intrinsically difficult for an individual to make financial provision for episodes of sickness.

Sir, healthcare affordability has been a major concern for many Singaporeans and their concerns will worsen with the expected escalating healthcare costs, in view of our ageing population and the rapid advances in medical technology. Our people would surely value arrangements that protect them from this uncertainty in expenditure. Thus, we need to make drastic changes here to ease the increasing burdens of the nation.

Sir, "risk-pooling" in healthcare finance should be given a bigger role in Singapore. Risk-pooling in healthcare finance is a system whereby collected healthcare revenues are transferred to the purchasing organisations. Pooling ensures that the risk related to financing healthcare interventions is borne by all the members of the pool and not by each contributor individually. Its main purpose is to share the financial risks associated with healthcare interventions for which there is uncertain need. It implies redistributive functions - from the healthy to the sick and from the productive to the unproductive stage of the lifecycle. The most important imperatives for risk-pooling are to establish appropriate and reliable systems of governance, to assure the collection and stewardship of finances and to ensure that providers are reimbursed appropriately. They imply the need for a long-term trust in the institutions of healthcare. I feel that, in Singapore, this role is best assumed by the Government especially for the mandatory national medical insurance.

In Singapore, the bulk of healthcare financing comes directly from households in the form of eitheruser payments or out-of-pocket fees and Medisave. In fact, the National Healthcare Expenditure or NHE proportion is borne two-thirds by the people or the private share and only one-third by the Government. Here we have a system where minor and higher cost risks have been separated and financed through different mechanisms. Individual medical savings accounts (Medisave) provide inter-temporal spread for some ambulatory and hospital expenditures, while a national catastrophic illness insurance scheme (MediShield) is supposed to cover prolonged and expensive treatments. MediShield, however, has failed in its functions. I shall elaborate on this later. Medisave involves no direct risk-pooling and although MediShield does pool risks, the effect, Sir, is less than satisfactory. The trend should be towards larger risk-pools than exist at present. In addition, there is a complex system of co-payments and deductibles, which involve direct out-of-pocket private payments. We should preserve our policy on deductibles and co-payments to ensure individual's responsibility and accountability on the sensible consumption of our healthcare. This will emphasise the principle of individual responsibility for one's own healthcare needs. We definitely must avoid the pitfalls of failed medical insurance in other countries that lead to the moral hazards of excessive consumption of healthcare resources or the "buffet syndrome". Fear of over-consumption can be minimised by adopting best practices.

MediShield pools risks minimally because it covers for catastrophic illnesses that constitute 5-10% of the hospital bills, while leaving a big gap of 90-95% of the rest of thehospital bills with no risk pooling. Sir, we need to close this loophole to ease the affordability of the majority of hospital bills, albeit with deductibles and co-payments in place.I favour solidarity principle reflecting objective securing universal coverage where risk-pooling is mandatory for at least basic public hospital bills. Risk-pooling for only basic public hospital bills without frills such asB and C class wards, will ensure affordable premiums for the majority. This will have the advantage of no Singaporean being left out, complete risk sharing across a nation with minimised variations in expected expenditure and avoiding inefficiencies and inequities associated with adverse selection such as cream-skimming and transaction costs. This will need good managerial control and coordination. Thenotion ofa compulsory risk-pool carries with it an implementation of a curtailment of individual choice as to the nature of the package of healthcare made available. Therefore, those who wish for the enhanced services should be allowed to secure a package of care in line with their preferences, for which they are willing to pay or supplement with privateinsurance, only after contributing to the mandatory basic pool.

The Minister for Health earlier in this House mentioned that he will keep MediShield, albeit returning it to its original purpose. How is MediShield going to solve Singaporeans' concern on the basic issue of medical cost affordability? Sir, that is my worry. I would like to share with this House the various flaws of MediShield and how it has failed to serve Singaporeans' medical needs.

MediShield is an opt-out scheme with many of those most vulnerable being left out. MediShield does not have good population coverage because it is available only to CPF account holders. Since only 59.6% of the labour force contributes to CPF, the other 40% of the labour force are not covered under MediShield. This does not take into account the proportion of the population not in the labour force. Of the three million CPF accounts, only 1.3 million are active. Sir, there are only 1.33 million MediShield and 0.3 million MediShield Plus accounts as of 31st March 2004.

Apart from only covering catastrophic illnesses, MediShield imposes low annual and life-time limit coverage which defeats the purpose of giving assurance to Singaporeans on the affordability of their medical needs in the public hospitals. Basically,MediShield coverage provides for the bare minimum and, in some cases, only covers a fraction of the actual cost of treatment. MediShield pays $150 a day for hospitalisation. It has a maximum claim limit of $30,000 per policy year and $120,000 in a lifetime. If this cap is used up, either in the year or in the lifetime, the individual cannot claim any more.

The Minister for Health earlier said that he would adjust the premium of MediShield and raise the annual and lifetime limit of MediShield. Sir, there are still other basic issues that are not addressed under MediShield such as the affordability of the majority of hospital bills and catastrophic hospital bills beyond the stipulated limits of coverage. The Minister said that he will keep the MediShield to cover catastrophic illnesses or 5-10% of hospital bills.This will be, effectively, not expanding the risk-pooling advantage of insurance and the majority of the hospital bills will still have to be paid out-of-pocket finance or Medisave.The burden of healthcare will be increasingly difficult to be served by Medisave, especially in ourincreasing ageing population and with the trend of smaller families to share the health burden of each family. Sir, even the non-catastrophic hospital bills can be heavy for many families for one episode, let alone many episodes of illnesses. For example, for B and C class wards, the 50th percentile to 90th percentile of each hospitalisation bill for asthma is about $1,000 and $2,800, and for non-catastrophicday surgery about $4,000 and $5,000, respectively.

MediShield's public risk-pool or financial viability is threatened with cream-skimming by private insurers. Several insurers have devised insurance products designed along the lines of MediShield. These insurers offer some differences. For example, the coverage is for longer than the 80 years offered by MediShield and the coverage also offers better claimable amounts. However, their insurance premiums are significantly higher. Private insurers, in maximising their profitability, have cherry-picked their customers - insuring mainly the low-risk group, the young and healthy and leaving the high-risk group, the old and infirm to MediShield. Sir, this begs the question whether, hereafter, is it not better for the Government to assume the bigger role in expanding our healthcare insurance rather than leaving this expansion to private insurers? Would not Singaporeans feel more secured to have their life-long medical insurance in the hands of the Government?

MediShield also has an age-limit coverage of 80 years which does not serve us well in view of our ageing population and the longer life-span of Singaporeans which is projected to increase further. This is all the more critical when usually it is in the last year of a person's life that the need for medical care is most acute. It is noteworthy that there were about 45,000 people aged 80 years and above last year.

Therefore, Sir, the present MediShield with all its deficiencies - the most pressing of which is the coverage for the majority of 90-95% of the basic hospital bills - leaves much to be desired. MediShield will need drastic overhaul if we were to keep it.

It will be most unfortunate if we repeat the past mistakes in our experience with MediShield. Time is pressing on, in view of the various factors mentioned earlier, for us to devise a viable insurance scheme that can look after the medical needs of Singaporeans in the public hospitals and their long-term medical needs to give that assurance and peace of mind. Here is our chance to make good this time, and I hope we can be bold, thorough and not leave undesirable gaps from this major review of medical insurance.

In a national public insurance scheme, the probability for our Government subsidising the premium, especially for the needy and/or non-working, must be on the cards. Sir, more attention should be paid to the less well-off in our society and, in view of our fast ageing population, it is better to help with a small outlay in terms of insurance premium and through risk-pooling at the outset than for the Government to carry the heavy burden later on.

In Singapore, the major providers of healthcare are Government-managed public hospitals. Nevertheless, attention should be paid to the uniform standard and levels of care in any chosen package of healthcare services and mechanisms in place to reduce supplier-induced demand. Block contracts have been introduced in other countries to reduce the incentives to induce supply.

Care should also be heeded to prevent the over-consumption incentives in the design of medical insurance. The claimable amount stipulation only with hospital stays will be such an example. Patients should not be encouraged to stay in hospitals due to the design of insurance for claim purposes as many illnesses can nowbe treated as day surgeries without hospitalisation. Some severe illness may not require hospitalisation such as cancer or strokes.

In our health insurance expansion planning, some incentives should be incorporated to rally Singaporeans towards keeping fit and healthy. The other issue in the health insurance expansion is to ensure coverage for Singaporeans when they are in dire need, such as when they are without jobs, and between jobs or portable medical benefits.

Ideally, medical insurance should also have the component of preventive medicine in order to prevent people getting more illnesses. One good example, Sir, is the control of the metabolic syndrome which has been estimated to be able to reduce national disease burden by 50%, making it the single most important syndrome to work on. The metabolic syndrome is made up of hypertension, diabetes, lipid disorders and obesity. Therefore, it will be good if two chronic diseases such as diabetes and hypertension affecting about 10% and 25% of the adult population, respectively, can be considered by some coverage to ensure good compliance and control so as to reducecomplications such as heart diseases, strokes and renal failure.

Our Government is funding about 30% of the total healthcare expenditure mostly through subsidising patients in public hospitals. It should be the Government's priority to fund disease prevention instead of just looking after end stage diseases. Government may consider it necessary to increase the scope of coverage to make it applicable to a wider population by keeping premiums affordable and also to take advantage of a larger risk pool to provide more comprehensive coverage.

Sir, in our efforts to help parents to raise families, one worthwhile consideration is on our pro-natalist importance where couples are insured for procreation anomalies such as complicated pregnancies, premature babies and infertility.

Lastly, I shall mention another of our present insurance scheme, ie, Eldershield. It was implemented about two years ago and is an insurance plan to help older people who have become disabled. This opt-out scheme will entitle a subscriber to draw $300 a month for up to five years if the subscriber is unable to carry out unaided at least three of the daily activities. Those eligible for claim are usually heavily dependent individuals who find $300 per month inadequate for their care. The time limit of five years is restrictive as many of the severely disabled usually have problems in recovery. Many of the elderly opted out of Eldershield as they cannot afford the high premium for their age group. Therefore, there should be a review on Eldershield.

Sir, in conclusion, I am glad that it is the Minister for Health's top priority to expand the insurance schemes and I hope to see good medical insurance schemes in place soon that can solve the healthcare affordability issues well and remove the concerns of Singaporeans on their healthcare needs hereafter.

Mr Deputy Speaker, Sir, I thank Dr Lily Neo for her adjournment motion on medical insurance. Her deep concern for Singaporeans' ability to pay for good medical treatment is well known. She has, in this House, expressed her concern on various occasions. And just earlier today, we had a fairly good discussionabout it.I too share Dr Neo's deep concern. How I wish it were possible to provide good medical careand to do it cheaply. But, alas, we all know that this is not possible.

I have seen Class C wards in a neighbouring country charging patients only a few dollars a day. But at what standard of care? On the other hand, I have seen in the United States a very high standard of medical care, but also very expensive. Just last month, one of my hospital colleagues sent me an email about her recent experience in a US hospital in Illinois. She was there on a study trip when she had a bout of abdominal pain and was admitted. The hospital kept her under observation forfive hours, gave her three bags of intravenous saline, a painkiller injection and two CAT scans to exclude appendicitis and cystitis. Her total bill was US$5,600 for five hours of observation, and that is almostS$10,000. Her two CAT scans cost her US$3,700, about S$6,400. Whereas our Class A rate in Singapore for the same scans would only be S$850, eight times cheaper. Knowing the business, her first instinct was to question the hospital on the outrageous bill size. Then she decided not to bother as she had bought a medical insurance policy upon arrival in the United States, andthe whole bill would be settled by the insurer.

This is the perverse outcome of a system that is fuelled by medical insurance. Having paid for the premium, you no longer worry about how big the hospital bills are. And as hospitals are largely reimbursed based on procedures and volumes, they have every incentive to service the patients to the hilt. This is particularly so since any under servicing which leads to mis-diagnosis might lead to a legal suit for medical negligence. So, as a result, the average American spends nearly US$5,000 in medical resources each year, more than the combined total spent on cars, TVs and computers. Consequently, insurance premiums are so high that over 40 million Americans are reportedly priced out and suffer the risk of having no insurance coverage and is now one of the issues in the American Presidential election. In Singapore, we took a different path. Rather than relying on one single source of funding for healthcare, we tap on multiple sources - Government subsidy, personal savings in cash, personal savings in Medisave, insurance, employer medical benefits, charity dollars. In this way, we do not put all our eggs in one basket and we reduce the adverse impact, if any, of a particular source of funding.

Likewise, in the provision of healthcare, we tap on multiple operators - public hospitals, private hospitals, community hospitals run by voluntary welfare organisations, and each one offering multiple levels of care - Class A,B1, B2, C wards. So Singaporeans have a range of services to choose from, depending on their means. But at the most basic level, we will ensure that our ClassB2 and Class C wards are of good standard and affordable. Affordable does not mean cheap. Affordable means leveraging on Medisave and MediShield, and ensuring that they are generally adequate to cover medical expenses, and those who run out of Medisave and MediShield cover will get support from Medifund as a last resort. It is against this backdrop thatI began this inquiry into the role of medical insurance. Dr Neo has argued on many occasions in this House for an expanded role. I agree with her. But when we broaden the role of medical insurance, let us be aware of the perverse effects. Medical insurance is not all roses. There are thorns here and there. The abuses of over-consumption and over-servicing are real and prevalent, and that is why my recommendation isthat we should never go for comprehensive medical insurance; in other words, insurance from first dollar up.

The Government will continue to subsidise medical treatments heavily in Classes B2 and C. So, for subsidised patients,this will be the first source of funding and, in fact, the largest source of funding. After Government subsidy, the balance of the bill should be paid with Medisave and out-of-pocket. For most hospital bills, there would be enough in Medisave. So, not to worry. But there are some very large hospital bills when medical insurance must kick in after a certain threshold in bill size has been crossed. This threshold is what the insurance industry calls a "deductible". To minimise the abuse of medical insurance and to keep premiums affordable, the deductible should not be too low. When MediShield was first introduced, the deductible at $1,000 then was an appropriate threshold. But as the deductible has not been adjusted over the last 12 years, the MediShield threshold is now too low relative to the current medical bill sizes. We should therefore raise the threshold to reflect current costs, and return MediShield to its original purpose of only looking after the very large bills but look after them adequately.

I thank Dr Neo for her commitment to healthcare issues and her continuing support of my Ministry’s work. We will consider all her inputs and and her points made just now. Time does not permit me to respond to them, and we will continue this discussion elsewhere. In fact, I have started discussions with the labour unions and with the insurance industry and I will continue to do so over the next few months. Let us strive to tap the benefits of medical insurance, but let us avoid the adverse effects that we see in countries like in the United States. Let us have the roses but, hopefully, we can avoid the thorns.

Resolved,

"That Parliament do now adjourn."

Adjourned accordingly at Twenty-Six Minutes

past Six o'clock pm to a date to be fixed.

WRITTEN ANSWER TO QUESTION FOR ORAL ANSWER NOT ANSWERED BY 3.00 PM

asked the Minister for Transport whether the designs for all new MRT stations, including those to be built along the Circle Line, will include in-built effective facilities for the disabled and elderly.

Ms Indranee asked whether all new MRT stations, including those along the Circle Line, would have facilities for the disabled and the elderly.

I am pleased to inform that all new MRT stations, including the Circle Line stations, will be equipped with facilities for the disabled and the elderly. These facilities include lifts, ramps, handicapped toilets as well as the Tactile Guidance System for the visually impaired.

All the MRT stations along the recently opened North East Line and Sengkang LRT are also equipped with such facilities. The accessibility of the entire MRT system will be further enhanced when the retrofitting works at the existing stations along the NS-EW Line are completed.