Hansard, Monday, 4 January 2021

1 Ms Tin Pei Ling asked the Minister for Communications and Information whether he can provide an update on the plan for live-streaming of Parliament proceedings and how this can be implemented in a way that mitigates concerns about its potential impact on the quality and tone of debates.

Mr Speaker, Sir, may I begin by wishing you and all Members of this House a happy and healthy new year.

Sir, the live-streaming of Parliamentary proceedings commences today. As we speak, this Sitting is being streamed real-time on MCI’s YouTube channel, which is accessible to all. There will be two live-streams: one with English interpretation of speeches made in vernacular languages, and one without. As with current practice, the full video of each live-stream will remain on MCI’s YouTube channel for a period of six months after the end of the Sitting.

All currently available avenues to access Parliamentary proceedings remain. These includes attendance in-person from the Strangers’ Gallery, online video clips uploaded within hours of the Sitting and the written records of the Hansard which are also available online.

These arrangements already give us the full benefits of transparency, accountability and accessibility. With live-streaming, members of the public will now also be able to watch proceedings in real time, without having to be physically present in Parliament. As I explained in September last year, the Government has agreed to this in view of the global and technological trends which have made online streaming more feasible and enabled legislatures around the world to live-stream their proceedings.

Even as we seek deeper engagement of our citizens through the live-streaming of Parliamentary proceedings, we must preserve the integrity and dignity of Parliament as a forum for serious debate on national issues.

The Member has asked how concerns over the potential impact of live-streaming on the quality and tone of parliamentary debates can be mitigated. Ultimately, it rests with all Members of this House, present and future, who must uphold the highest standards of conduct and decorum, as we engage in the cut and thrust of parliamentary debate.

Mr Louis Ng.

Thank you, Sir. Just one supplementary question. Could I just check whether there will be sign language available for the live-stream, as well?

Mr Speaker, I thank the Member for his question. At this point, we do not have the provisions for sign language. However, the English stream on YouTube will have auto-captioning available. In other words, that which has the translations of the vernacular as well. So, that will be our starting position in terms of how we make it more accessible for those who may be hearing impaired.

2 Dr Lim Wee Kiak asked the Minister for Health (a) what is the number of COVID-19 vaccines that have been secured for Singapore; (b) how will the vaccination programme be rolled out; (c) what is the earliest projected date to commence the programme; and (d) whether the vaccination be made mandatory for both Singaporeans and foreign residents.

3 Mr Lim Biow Chuan asked the Minister for Health (a) what are the measures taken by the Ministry to ensure that any vaccines for COVID-19 are appropriate and safe for Singaporeans; and (b) whether the Ministry has assessed all potential side effects of the vaccine.

4 Ms Foo Mee Har asked the Minister for Health (a) what are the details of the rollout plans for COVID-19 vaccination in Singapore; (b) how does the Ministry determine the safety and effectiveness of the various vaccines coming into the market; and (c) whether individuals who have been vaccinated will be given a "vaccination card" to facilitate identification that may be required from time to time.

5 Ms Sylvia Lim asked the Minister for Health (a) what criteria are used by the Health Sciences Authority (HSA) to assess COVID-19 vaccinations before approval for public use; and (b) what benchmarks for efficacy are used.

6 Miss Cheng Li Hui asked the Minister for Health regarding the COVID-19 vaccines (a) what are the potential side effects associated with the vaccines; (b) whether the extent and probability of side effects occurring are significantly different from existing flu vaccines; (c) what are the plans to deal with the severe side effects that can arise due to the administration of the vaccines; and (d) what recourse do Singaporeans have should they experience severe side effects.

7 Mr Chua Kheng Wee Louis asked the Minister for Health (a) what is the number of COVID-19 vaccine submissions that are in each phase of evaluation by HSA; (b) what is the number of doses of each type of COVID-19 vaccine that has been secured for Singapore; (c) what is the delivery timeline for these vaccines; and (d) whether individuals will be given autonomy to decide on the type of vaccine they will receive when more than one vaccine has been approved.

8 Ms He Ting Ru asked the Minister for Health what are the measures to assuage ground concerns about the safety of the COVID-19 vaccines.

9 Dr Tan Wu Meng asked the Minister for Health in view of certain COVID-19 infections having "high genetic similarity" of virus despite dissimilar countries of origin among persons who served Stay-Home Notice (SHN) at Mandarin Orchard Singapore, whether the Ministry will consider establishing capability for scaled-up rapid whole-genome sequencing (WGS) of virus from clinical samples including nose swabs, so as to complement existing WGS from cultured COVID-19 virus.

10 Mr Alex Yam asked the Minister for Communications and Information (a) whether any research is being done on public attitudes towards vaccination against COVID-19; and (b) how will the public communications strategy be formulated to engage residents across all demographics.

11 Mr Leong Mun Wai asked the Minister for Health considering that there is little change between Phase Two and Phase Three of the re-opening, what is the current strategy to progressively reopen Singapore until our borders are opened to foreign visitors.

12 Mr Murali Pillai asked the Minister for Health what measures will be put in place in Singapore to deal with the new variant of the COVID-19 virus that is reported to be spreading rapidly in the UK and parts of Europe.

13 Mr Lim Biow Chuan asked the Prime Minister (a) what is the reason for the delay in supplying the TraceTogether tokens to all residents by 14 December 2020; and (b) what is the new timeline for all residents to collect the TraceTogether tokens.

14 Mr Dennis Tan Lip Fong asked the Minister for Health (a) whether there will be a need to separate blood collected from donors who have and have not received COVID-19 vaccinations; and (b) if so, whether all necessary measures will be put in place ahead of the vaccine being introduced for use in Singapore.

Mr Speaker, as Minister Lawrence Wong and I will be making a Ministerial Statement in a short while, may I have your permission to take Question Nos 2 to 14 in our Ministerial Statement instead, so that we can provide the proper context to the replies?

Please do. Mr Christopher de Souza.

15 Mr Christopher de Souza asked the Minister for Home Affairs whether TraceTogether data will be used for criminal investigations and, if so, what are the legal provisions and safeguards in using such data.

Mr Speaker, the Singapore Police Force is empowered under the Criminal Procedure Code or CPC to obtain any data, including TraceTogether or TT data, for criminal investigations.

The Government is the custodian of the TT data submitted by individuals, and stringent measures are in place to safeguard this personal data. Examples of these measures include only allowing authorised officers to access the data, using such data only for authorised purposes and storing the data on a secured data platform. Under the Public Sector (Governance) Act, public officers who recklessly or knowingly disclose the data without authorisation or misuse the data may be liable to a fine of up to $5,000 or imprisonment of up to two years, or both.

Mr Christopher de Souza.

Sir, I thank the Minister of State for his response. In an investigation, there are suspects and there are witnesses. So, in the event that the TraceTogether information is used of a witness, would there be a possibility of deletion of this information, by virtue of its private nature, if the investigation does not yield anything or the investigation comes to a close? I am wanting to draw a distinction between the suspect and a witness.

Data will only be taken from the individual. In a criminal case where there is a suspect and a witness, we will extract the data from the witness. However, for individuals who are suspects or are under investigation, the data will not be extracted from them, for the purpose of security.

Mr Gerald Giam.

Sir, we all know that effective contact tracing is key to containing the spread of COVID-19 and that the more people use TraceTogether, the better. We should always be looking for ways to remove the impediments to voluntary adoption of the TraceTogether app. So, if people suspect that their TraceTogether data is being used for anything other than for contact tracing, would this not lead to a lower than expected adoption rate?

And I am sure that the Minister of State is aware that users can prevent the app from being used, for example exchanging proximity information, even if they have it installed. So, my question is, now that the Government has said that they might actually use the TraceTogether data for Police investigations, does this not violate the TraceTogether privacy statement, which says that any data shared with MOH will only be used solely for contact tracing of persons possibly exposed to COVID-19?

I thank the Member for the question. TraceTogether is conceived and implemented for the purpose of contact tracing and for fighting the COVID-19 pandemic.

We do not preclude the use of TraceTogether data in circumstances where citizens' safety and security are or have been affected. This applies to all other data as well. Authorised police officers may invoke the Criminal Procedural Code, as I had mentioned earlier, to obtain this data for the purpose of criminal investigation and for the purpose of protecting the safety and security of our citizens.

But otherwise, TraceTogether data is indeed to be used only for contact tracing and for the purpose of fighting the COVID-19 situation.

16 Mr Chua Kheng Wee Louis asked the Minister for Transport what has been the total amount of expenditure incurred to date by Singapore on the High Speed Rail project and what are the terms specified in the bilateral agreement in relation to compensation claims upon termination of the agreement by either party.

Singapore has incurred more than S$270 million for the Kuala Lumpur – Singapore High Speed Rail, or HSR Project. Some of these costs, such as for consultancy services, design of infrastructure and manpower to deliver the HSR Project, are abortive costs if the HSR Project does not proceed.

To date, Singapore has already received about S$15 million from Malaysia, arising from Malaysia’s request to suspend the construction of the HSR Project back in 2018 and up to May 2020. Subsequent to that, at the request of Malaysia, the HSR Project was further suspended until 31 December 2020. Malaysia has now decided not to proceed with the HSR Project. According to the terms of the Parties' agreement, Malaysia is obliged to pay termination compensation to Singapore. This will include various abortive costs but not land acquisition costs since the value of the land can be recovered.

The compensation amount for the termination and schedule for payment are specified in our agreement. In addition, there is a small component of miscellaneous abortive costs for the suspension of the Project requested by Malaysia that Singapore is currently verifying, before we send to Malaysia.

Due to Singapore’s confidentiality obligations under the HSR Bilateral Agreement, we are unable to reveal the exact terms in relation to the compensation for the termination of the HSR Project.

We look forward to continue to build good relations and work closely with Malaysia to improve connectivity in other ways, and in many other fields, for the mutual benefit of the people of both countries.

Mr Louis Chua.

I thank the Minister for his response to the question. I have got two supplementary questions. The first is, now that we know that the high speed rail has officially been cancelled, if the Minister can share with the Members of the House what were some of the substantive points of differences that cannot be breached that led to the cancellation?

And in relation to compensation, I note earlier in July 2018 that former Transport Minister Mr Khaw Boon Wan said that the total cost incurred back then was exceeding $250 million which is expected to exceed $300 million by the end of 2018. So, in relation to the expenditure already incurred, if Minister could share the details on what is the difference and whether or not we will be able to recover the full amount of the expenditure, excluding land acquisition costs, as the Minister had mentioned, and if so, when should we expect some form of conclusion on this?

Let me answer the Member's second question first. Then-Minister Khaw Boon Wan did mention the figure of S$250 million. He also mentioned that costs continue to be incurred and, therefore, it may reach S$300 million or so later.

Today, our expenditure is roughly S$270 million, less than what he had indicated earlier, because when the Project was suspended and we agreed to the suspension, we wound down the contracts and we maintained activity at a low level, which is why we did not incur as much as it was indicated earlier.

Will we be able to claim the full amount? The amount to be compensated, as I have mentioned, and the schedule for payment, these are specified in the agreements. So, it is a fixed amount specified in the agreements. Unfortunately, due to confidentiality obligations, I cannot disclose the amount. But we have started the process of compensation.

As for the first question, it is an important one – the substantive point of difference. Let me go back a little bit.

Singapore and Malaysia signed the HSR Bilateral Agreement – we call it HSR BA – in 2016. And that is after three years of negotiations to implement the HSR Project. Subsequently, both Parties signed two supplementary agreements relating to the suspension of the construction of the HSR Project. Both suspensions were at Malaysia's requests. So, the first supplementary agreement was signed in 2018, to suspend the construction of the HSR Project. The second, in 2020, extended the suspension period to 31 December 2020, with the explicit understanding that it would be the final extension. By then, it would have been extended by two and a half years.

I will refer to the HSR BA, subsequently amended by the supplementary agreements, generically as the "HSR Agreements" as a short form. So, the HSR Agreements are legally binding international agreements. Parties come to the table as equals, discuss the various terms, such as how to structure and implement the cross-border HSR Project, and the rights and obligations placed on both Parties. As Members know, this process involves understanding each other's concerns, addressing them, striking compromises and finding mutually acceptable common ground.

Singapore was fully committed to carry out our obligations under the HSR BA. But Malaysia felt that circumstances had changed, including due to COVID-19, and proposed several changes to the HSR Project.

Be clear about this, which is, Singapore was not obligated to agree to any of such changes because we had signed an agreement in 2016 already. But, notwithstanding, we considered them in good faith. But we were unable to agree to one particularly significant change proposed by Malaysia. This involved the removal of the Assets Company – in short form, we call it "AssetsCo" – which is the systems supplier and network operator of the HSR service between Singapore and Kuala Lumpur (KL).

Let me explain why. As the HSR is a cross-border service, it must be a single train system operating between Singapore and Kuala Lumpur in Malaysia. Because neither country has the expertise and experience in operating an HSR, we agreed, under the HSR BA, to appoint a best-in-class industry player through an open and transparent international tender to assume the role of the AssetsCo. Once appointed, the AssetsCo would supply the train system, operate the network, ensure that appropriate priority is given to cross-border HSR service vis-a-vis Malaysia's domestic service, and AssetsCo would be accountable to both countries, that is, Singapore and Malaysia.

To Singapore, AssetsCo is the centrepiece of the HSR Project. It is necessary to ensure that the interests of both countries are protected. This will minimise the possibility of future disagreements and disputes over the long duration of the Project, lasting decades. Singapore, therefore, informed Malaysia that the removal of the AssetsCo constituted a fundamental departure from the HSR BA and could not be accepted.

Malaysia has since decided to allow the HSR BA to be terminated. In these circumstances, it has to compensate Singapore, in accordance with the HSR Agreements. Now that the HSR BA has been terminated, Singapore is willing to discuss any new proposal on a KL-Singapore HSR from Malaysia in good faith, but starting from a clean slate.

Mr Saktiandi Supaat.

Mr Speaker, I thank the Minister for the answer to Mr Louis Chua's question earlier.

First of all, I would like to thank the MOT team for putting in a lot of good work done that led to an agreement after four years of negotiations. But, alas, Malaysia proposed changes to the agreement and it did not go through. But following up on the Minister's answer just now, also for the sake of transparency, can the Minister share why another extension of the bilateral agreement would not have been possible and whether a further extension would have allowed some room for further discussions to be made to reach an agreement?

Another question is whether Singapore is open to HSR-like projects in the future.

Thank you. As I have mentioned in my earlier clarifications, at the request of Malaysia, we suspended the Project for two years up to May 2020. And then, there was a second request from Malaysia to extend it until 31 December 2020, that is, another six months, which we were not obligated to agree, but we agreed to it. So, there were two extensions, at the Malaysians' requests and we agreed to it in good faith and in the spirit of good bilateral relations. But we cannot extend indefinitely and, so, for the second extension to 31 December 2020, both sides agreed that it shall be the final extension, and it is part of the agreements. So, I think there will have to be a finality to the suspension and extension of the Project. Having said that, there is a fundamental difference which I have explained earlier with regard to the removal of the AssetsCo.

Whether we are open to future discussions, of course, we are. But it should be on a clean slate, after we have settled the current HSR BA.

Mr Ang Wei Neng.

Thank you, Speaker. I thank the Minister for the comprehensive reply. I have two supplementary questions.

First, is there any impact of the cancellation of HSR on the Johor Bahru-Singapore Rapid Transit System (RTS)?

Second, what would be the impact of the HSR cancellation on the development of the Jurong Regional Centre? Although I have moved from Jurong GRC to West Coast GRC, but many of the West Coast GRC divisions are very close to the Jurong Regional Centre. I hope the Minister can give a good reply.

Thank you. The short answer to the first question is no. RTS is progressing well so far. The Johor Bahru side has broken ground; on our side, we will break ground soon and we hope the Project and the service can commence in 2026 as scheduled.

As for Jurong Regional Centre, let me assure the House that MND had started planning to transform Jurong as early as 2008. So, the Jurong Lake District is part of a broader effort to develop urban centres outside of our CBD and our city centre. The plans for Jurong Lake District, or JLD were, therefore, developed well before Malaysia proposed the current HSR Project in 2012. It was only much later, in 2015, that we decided to locate the Singapore terminus of the HSR in Jurong. The termination of the HSR Project, therefore, does not affect the overall impetus and vision for JLD, although some details may need to be adjusted along the way. When completed, this will be the largest commercial and regional centre outside of our city centre, bringing many jobs, business and recreation opportunities for Singaporeans and Singapore companies.

The land parcels that the Government has acquired are still needed to realise these plans. For example, the Jurong Country Club site will provide for new mixed-use developments and community facilities. The Raffles Country Club site is also still needed for the Cross Island Line's western depot and the Integrated Train Testing Centre. We will be able to realise the full potential of the land to benefit Singaporeans.

Mr Melvin Yong.

Thank you, Mr Speaker. I thank the Minister for his reply. I have two supplementary questions.

Prior to COVID-19, the Singapore-Kuala Lumpur air route was one of the busiest in the world, with more than four million passengers flying this route every year. The HSR Project was meant to shorten the travel time between Singapore and Kuala Lumpur from about five hours by air to just 90 minutes, and provide greater access to both cities.

My first question is, what is the impact of the HSR's cancellation on the attractiveness of Singapore as the region's premier air hub and on the SIA Group as a whole?

My second question is, how many staff at SG HSR Pte Ltd have been impacted by the project's cancellation and how many have already been redeployed to other job roles? Will these be made permanent? And what are the manpower plans for the remaining staff that have yet to be redeployed?

I think the Member just now meant five hours by car, not five hours by air.

Yes, not by air.

What is the impact of HSR termination by Malaysia on our aviation air hub? As I have mentioned earlier, there are some reasons given as to why the Project was terminated and the impact on air hub was cited in some media reports. But as mentioned, our main concern was the removal of the AssetsCo.

Having said that, Malaysia's new proposal to connect the HSR to Kuala Lumpur International Airport or KLIA means that HSR will share tracks with the express rail link to KLIA. The Express Rail Link is an existing train system, not an HSR, and runs at half the full speed of HSR. So, should we have proceeded, there would have been many technical issues to resolve. But having said that, the main concern for us was the removal of the AssetsCo.

Since the Member has asked about the impact on aviation, actually, without the HSR, the Singapore-KL aviation route will continue to ferry and transport many passengers, in fact, closer to five million than the four million number stated by the Member. But throughout this whole discussion, the status of our aviation hub due to the HSR Project has not been the key consideration. We knew that this Singapore-KL air corridor is the busiest in the world – 46 flights a day, almost five million passengers a year – a number that is almost equivalent to Singapore's residential population. But it is precisely because of this heavy air traffic between Singapore and KL that we believe that the HSR Project was viable, mutually beneficial and strategic for the long term. So, Singapore will always assess the cost benefit of such major infrastructure projects from a national and long-term perspective, and not just from the perspective of one company or one industry.

As for the Member's second question about manpower, 80 staff are affected. Out of the 80, 70 or so have been redeployed to LTA and the other 10, we are looking them. We are confident we can redeploy all of them in LTA or within the larger transport eco-system. There are many important projects that are happening, and there will always be a need for good people, such as those 80 people working on the HSR Project.

Mr Dennis Tan.

I thank the Minister for the response so far. I just have one question. What is the reasoning behind the Malaysian government's reason for the change on their position on the AssetsCo?

I thank the Member for the question, but I really cannot speak for the Malaysian government.

17 Dr Lim Wee Kiak asked the Minister for Health following the error in the Khoo Teck Puat Hospital laboratory test for cancer patients (a) how many patients suffered side effects arising from being given the wrong treatment; (b) how many were treated at private hospitals versus Government hospitals; and (c) what is the average cost of medication incurred by all these patients.

18 Ms Joan Pereira asked the Minister for Health with regard to the case of breast cancer patients at Khoo Teck Puat Hospital who may have received unnecessary treatment since 2012 due to inaccurate test results (a) what are the key revelations from the review of the process; (b) what measures have been implemented to prevent similar incidents; and (c) whether there have been cases of patients suffering from detrimental effects.

19 Dr Tan Wu Meng asked the Minister for Health with regard to cancers inaccurately classified HER2-positive by Khoo Teck Puat Hospital laboratory (a) how many patients (i) received unnecessary treatment and (ii) suffered significant or long-term side effects thereby; (b) what is the ensuing cost to affected patients; (c) what is being done to help these patients; and (d) what measures are taken to ensure fidelity of laboratory tests.

20 Miss Cheryl Chan Wei Ling asked the Minister for Health with regard to the incident at Khoo Teck Puat Hospital where breast cancer patients received unnecessary treatment since 2012 (a) why did subsequent follow-up checks on the patients over the years not pick up any misdiagnosis from the earlier test; and (b) whether there are regular audits of hospitals and medical clinics on laboratory protocols to identify lapses.

21 Ms Hazel Poa asked the Minister for Health what are the reasons for the wrong test results for cancer patients at Khoo Teck Puat Hospital and what measures will be put in place to ensure that such errors do not occur again.

Mr Speaker, Sir, may I have your permission to take Question Nos 17 to 21 together, please?

Yes, please.

Sir, on 19 November 2020, Khoo Teck Puat Hospital (KTPH) was informed by its laboratory that its immunohistochemistry (IHC) tests for Human Epidermal Growth Factor Receptor 2 (HER2) were producing higher-than-expected rates of positive results for breast cancer patients. Preliminary investigations by the laboratory suggested that some of the HER2 results may be inaccurate.

Following the incident, MOH has been working closely with KTPH to ensure that affected patients are provided with adequate support. KTPH has sent the samples of all patients, who have been tested HER2 positive since 2012, when HER2 testing first started in KTPH, to external laboratories for re-testing to determine how many have received inaccurate results. Preliminary investigations by the KTPH laboratory suggest that the inaccurate results could be due to a suboptimal staining process. The KTPH laboratory has since stopped in-house testing of HER2. MOH has also issued an alert to our other public healthcare institutions to conduct a quick review of their laboratory-developed IHC tests to ensure that positivity rates are within the acceptable range. Thus far, we have not received any reports of similar risks from other healthcare institutions.

KTPH's Department of Laboratory Medicine is subject to regular inspection by MOH as part of regulatory processes under the Private Hospitals and Medical Clinics (PHMC) Act to ensure that its laboratory facilities, systems and processes are in place to meet patient and personnel safety standards. In addition, the laboratory is accredited by the College of American Pathologists (CAP), where the last biennial inspections by peers were conducted in 2019.

As at 23 December 2020, 200 patients have been reclassified from HER2 positive to HER2 negative. Of these, eight patients were treated at private hospitals and 192 patients at Government hospitals. Eight patients are still pending retests. Joint care teams have been formed, comprising KTPH surgeons, histopathologists and the treating oncologists, to review the individual care plans for these affected patients, based on the change in their HER2 status.

KTPH and the treating oncologists are in the process of actively reaching out to these patients to conduct open disclosure and assess these patients for any potential side effects due to unnecessary treatment. The more common side effects include diarrhoea, chills and fatigue – these are usually short-lasting. About 3% to 4% of those who underwent HER2-directed treatment, for example, using Herceptin, may also experience heart problems. KTPH is also reviewing the bills of these affected patients. The portion of the bills which arose from the unnecessary treatment will be fully refunded. KTPH is also ready to provide any clinical and financial support to the affected patients including on-going or follow-on treatments, if any, which may be needed as a result of this over-treatment.

The National Healthcare Group has convened an independent review committee, comprising external experts from multiple relevant disciplines in the healthcare industry. The objective is to conduct a thorough evaluation of the incident, to understand better the lapses that have occurred and recommend appropriate measures to improve the process. This ensures that any system gaps are identified and addressed swiftly to prevent recurrence of similar incidents.

The committee's investigations are on-going right now and more time would be required to ensure a thorough review. NHG will provide an update when more information is available and these findings will be shared with the other healthcare institutions for improvement.

Dr Tan Wu Meng.

Mr Speaker, I start by declaring that I am a doctor who happens to be a specialist in medical oncology but I should also declare that my Clementi residents too follow the news. Some have also raised this issue with me, in my Member of Parliament capacity.

Sir, a number of residents have said this unfortunate situation should not have happened. But it has, and it is incumbent upon the authorities and the hospital to do the very best to support the affected patients in as holistic a way as possible and as compassionately as possible. Sir, I have two supplementary questions for the Senior Minister of State.

The first is that in terms of supporting the patients, will the relevant authorities bear in mind that patients who undergo unnecessary treatment as a result of this unfortunate situation, some of these patients will have had to make recurrent visits to clinic, recurrent visits for treatment involving time-off work, care-givers taking time-off work – all of these with possible financial implications as well as implications for job security in the current COVID-19 climate. And I ask, will the Ministry, together with KTPH, consider this compassionately and holistically in supporting the patients who have gone through this?

The second question to the Senior Minister of State is that even as the root cause analysis is on-going, can the Ministry assure us that we will also look at whether any areas of improvement may impinge on other immunohistochemistry tests that may have come out of that relevant laboratory?

Sir, I say this because pathology tests, immunohistochemistry tests – they are like the charts which guide sailors at sea, which guide the treating medical team, which guide the patient. And if there has been an issue with the charts for whatever reason, it is, of course, a concern for navigating the patient care journey and giving the relevant treatment. Sir, I raise these questions to the Senior Minister of State.

Mr Speaker, I thank the Member, Dr Tan, for raising these two questions that I am sure, must be on the minds of many patients and relatives who are cancer sufferers.

First, I must say that Herceptin treatment for HER2 positive patients usually is not so much of a monotherapy, that means on a standalone basis. Usually, it is in combination with other chemotherapy drugs for breast cancer. So, in other words, even in a HER2 negative patient, where you do not need Herceptin treatment, you will still require some chemotherapy to overcome breast cancer, and therefore, you will still have to come for recurrent visits, treatment, monitoring and testing by the managing oncologist. But we know that some of these can create a lot more anxiety, maybe a few extra visits that will be required for monitoring of side effects.

KTPH and the managing oncologists and doctors will take a compassionate approach to reassure, to also help these patients to overcome their disease and anxieties by keeping close communication with them through a more dedicated care team, especially those who are affected by the change in result status.

But I must also say that in this situation where the issue is more of a false positive, it does mean that some patients would have perhaps, over treatment. I think it is probably a preferred state than to have under treatment, especially when you have cancer. In this situation, HER2 testing has shown that some of them should have been classified as HER2 negative, meaning that actually the patient does have a better prognosis compared to those who are HER2 positive.

Overall, it is not necessarily a bad thing for the patients to be actually reclassified as HER2 negative on testing. KTPH has informed that any costs, as well as investigations that are done as a result of Herceptin treatment will be borne by the hospital and refunds will be given. So, I think that will go in some way to relieve some of the financial pressures and stresses that a patient has undergone.

On the second question of whether other immunohistochemistry tests would be reviewed; I think we must understand that immunohistochemistry testing is classified in most laboratories as a highly complex test. By highly complex, what I mean is that it is a test that is not quite the same as you drawing a blood test – pop it into the machine and the result comes up within a few minutes. It is not as simple as that. It is a multi-step process that has multiple steps of human intervention in the process.

First, as a tumour specimen is removed, what we call cold ischemic time – how soon the tumour, after it is removed from the body – gets put into a fixation, that means to fix the tissue in the chemical, usually it is recommended to be less than one hour. So, how the operating team in the Operating Theatre, not even the pathologist, just how the operating team handles the tissue – when do they take a specimen out, when do they call for the team to put into the solution; you must also put into the correct solution, otherwise if you put in the wrong chemical to fix the tumour tissue, that sample cannot be used for IHC staining.

Then, when it goes to the laboratory, how thick the specimen is sliced, what kind of stains are used, what kind of temperature that is done, what is the concentration of the stains being used, what is the choice of antibody and subsequently after staining, how the pathologists themselves grade the degree of staining. And the degree of grading or staining is what we call a semi quantitative method. It means it is not a "plus" or "minus", "yes" or "no". It is a gradation of degrees of staining just like when you look at your iPhone photos, and you try to adjust the contrast. Between two sets of persons looking at the adjustment, to you, this may look pleasing enough, dark enough, but to another person, this may be too light.

So, there is some degree of inter-observer variation which trained pathologists must then make the judgement call and say is this dark enough stain to be deemed as a positive 3+, 2+, 1+ or 0. So, it is semi-quantitative in that sense.

Therefore, you can appreciate that this being a very complex test, as in most other immunohistochemistry tests, will require multiple levels of validation. But I will also say that the reason why this issue was discovered is because the institutional processes within KTPH have allowed this to be picked up. Because being a multi-step process, if we depend on one single point to validate its accuracy, then it will be at a very, very high risk of failure at some point of time. But fortunately, because there is an institutional process through the Tumour Board – a multi-disciplinary review board looking at tumour outcomes, specimen and treatment, it was flagged up at the point of review that the positivity rate seems to be higher than expected. And that was what triggered the review.

I would say that the processes are there. We now need to look at which part of this process could have been strengthened further and that is the on-going review that the expertise team is looking at, at the moment. We will also use this chance to learn about some of the failures that may have happened in this multi-step process and help the laboratory to strengthen them for other immunohistochemistry tests as well.

Miss Cheryl Chan.

Thank you, Mr Speaker. I would like to ask the Senior Minister of State because my original questions were not being answered.

Actually, the main thing around it is this, because as the Senior Minister of State has said, all these patients had gone for recurrent visits to their respective doctors. Certainly, over the entire period of time, something must have been picked up even if the first diagnosis was supposed to be wrong. So, as the Senior Minister of State said, with all these specimens and also all the different processes that are in place, why was there not an earlier trigger? I think that is the key to the issue.

Sir, I thank the Member for asking this question. It is going to be a little bit technical but let me attempt to explain this in a way that most people can understand.

Inherent in any laboratory test, there is always a chance of false positivity, false negativity. That relates to the sensitivity and specificity of the test. In recent months, because of COVID-19, we have all been doing PCR testing, everybody is a little bit more attuned to the concept of why a certain test can give you a false positive and false negative result.

Immunohistochemistry test actually is fairly notorious for having this kind of risk because, as I said, it is semi-quantitative, so the staining process is like mixing poster colours. If any part of the mixing process – the process of processing the specimen by putting stains, dyes and counter-stains – is not done optimally, the key word here is "optimal", you can perform all the steps but if the timing is a bit off, maybe the concentration is off by a little bit, the kind of picture that comes out on the slide that the pathologist gets to look at, will be quite different in terms of contrast and stain.

If I may quote from a paper in Journal of Clinical Oncology published in 2015, a British medical journal, it gives a background that early studies using this technique to look at HER2 staining has shown high false positivity rate, as high as 19% – as high as 19% – in the early days when this test was started. Over the years, after 2007, when a stronger push by the professionals to put out guidelines, that false positivity rate has now dropped to about 6% or less, but it is still present; it is never going to be zero.

What we need to do, as in this instance, where the clinical practice within an institution does regular review of data accumulated over time; because to show that there is now an over-representation over time, you need to have accumulated enough caseload over a period of time, to show on a retrospective basis that after three years, five years, I accumulated 200 patients, 1,000 patients, and I aggregate the data and I realise, "Oops, it is actually more than 6%". Then, this is when it triggers a review.

But when you first start the test, you only have one case, two cases, three cases, there is not enough to do statistical analysis to tell you whether you are above or below the 6% mark.

So, I hope that gives a sense that it is not a complete failure of the system; it is inherent in the test and that is how a review process through a multi-disciplinary tumour board picks up any outlier conclusions to trigger a review.

Ms Hazel Poa.

I thank the Senior Minister of State for his reply. I have a few supplementary questions.

Firstly, while these errors were actually discovered in a review process, since the error actually started in 2012, why did it take so long to discover the errors? Is it a standard timeframe for enough statistics to flag up a possible error? Secondly, would the Ministry consider a second independent test for serious illnesses? The last supplementary question is about compensation to the victims. What sort of compensation is being considered and is a lifetime of free healthcare on the cards?

Sir, let me clarify the Member's misconception. When I said in my reply that KTPH is reviewing all the results from 2012, 2012 was taken at a point in which the test first started in KTPH. It does not mean that all the results going back to 2012 are erroneous. So, in that sense, KTPH is being prudent and careful, super kiasu, going back all the way to when the test first started. It may well be that the errors could have occurred in the last three months or six months.

I think the key point usually is when the reagent has been changed. A different brand of reagent or a different provider of the reagent could usually be the starting point of why the protocol or the test conditions were no longer as optimal as they should be.

But going back to 2012 when the test first started was really trying to be comprehensive and to be careful, to make sure that we do not miss anybody in the process. It does not mean that the test was erroneous from 2012. The results of the review are still on-going, so I do not want to prejudge the review process from the experts. Let us wait for the experts to look at all the results going back to 2012 and then decide at which point, what step of the process that could have been where the error occurred.

When it comes to the question of whether you are going to get compensation, as I said earlier, any treatment cost due to the treatment arising from a positive HER2 results, in other words, usually treatment with Herceptin as the drug, the cost of the drug likely would be refunded. Any investigation or tests or treatment of any related complications as a result of, say, Herceptin, would also be refunded as well. But to then say that this translates to a lifetime of compensation, I think that would be a little bit too far a thing to stretch because most of the complications, if any, or most of the side effects relating to the treatment, are transient – diarrhoea, a bit of fever, a bit of chills. They do not have long-term consequences, they are not long-lasting and we have to take that in the correct context of medical treatment.

I hope that answers the Member's questions.

Ms Hazel Poa.

I also had a question about a second independent test for serious illnesses.

I take that as a general question which in any form of medical diagnostics, if the clinician is unsure that a particular test alone cannot give you a high degree of probability of predicting a positive diagnosis or presence of an illness, then it behoves clinical judgement to call for a second test. But immunohistochemistry is a specific unique test. It does not necessarily mean that an alternative is available. Although in the literature, there are other alternative tests that could be done but we have to consider that against the time needed to do it because that could delay treatment, and also whether that brings on unnecessary costs.

That, I think, we should leave it to the experts to come up with the process guidelines on what is a testing algorithm to decide for Herceptin-related treatment.

Dr Lim Wee Kiak.

Thank you, Mr Speaker. I think the Senior Minister of State also have not fully answered my Parliamentary Question regarding, how many patients were actually involved and how many patients have MOH engaged in the first place currently now that are affected by this particular error. Currently, what measures have been taken to ensure the well-being of the patients, both psychologically as well as physical health? I would also like to know what was the average cost of the medication, of this particular medicine that was just mentioned. Because the Senior Minister of State did not mention anything about the costs; he just mentioned that it will be refunded but I am not sure what is the actual cost.

I do have a patient, who is my resident in Sembawang GRC, who saw me at my Meet-the-People Session. She was very worried when she saw the news; she said she is one of them. When I asked her whether has MOH contacted her, she said not yet. So, she was asking me what legal help can she now seek. So, I would like to ask the Senior Minister of State what avenues do affected patients have to seek compensation for such an error?

Sir, the anxieties of patients are quite understandable, especially when they read about this in the news.

I would want to give assurance and say that if you have not been contacted by your oncologist, it means you are okay. Those who are affected, as I said in my reply, 200 patients so far have been reclassified from HER2 positive to HER2 negative. In other words, these 200 patients from a poor prognosis tumour now has a better prognosis tumour, because HER2 positivity codes for a poorer prognosis to begin with.

Therefore, it needs the managing oncologists to go on a one-to-one with any of these patients whose status have been reclassified, to do a detailed conversation on their own clinical prognosis, what is the stage of the tumour, what treatment has already been given in the past, what will be the on-going treatment needed.

Not all patients, I must say, who have been tested HER2 positive be it now or previously, will go on to Herceptin treatment because it is a treatment decision that is guided by the needs of the patient, not just by the test alone. There are some patients for which the body may be too frail; even if you are HER2 positive, you may not receive Herceptin treatment. On the other hand, there are recurrent tumours where the oncologist feels that you have reached end of line, you will still require Herceptin treatment as a last resort, even though it may not be the first line in some other cases.

The decision matrix is not a straightforward one. For patients who may be affected, it is best to seek your oncologist's advice. But if you have not been contacted specifically for this, it means that you are okay, your status remains as it was from the last conversation with your oncologist.

The cost will vary from institution to institution. I do not have the exact numbers right now because it also depends on how many doses, how long the duration of treatment each patient got, and also different body size of patients may require different dosages to begin with. So, that is something that we cannot generalise; it is probably quite individual. That is why the dedicated care team from KTPH, especially the oncologists, will have to reach out to affected patients one by one and go through the conversation in a detailed manner.

Ms Joan Pereira.

Thank you, Speaker. I thank the Senior Minister of State for his reply. In addition to the physical side effects that many of these patients might have suffered, some of them might suffer panic attacks, anxiety attacks. So, would Khoo Teck Puat Hospital be able to support medical costs relating to mental health?

Sir, I think it is best we leave such a assessment and decision to the managing joint care team together with the patient. A panic attack or anxiety episode can occur with or without cancer, can occur with or without treatment. There can be a myriad of factors involved. But the joint care team will deal with the patients with compassion and find a way to help them overcome this current hurdle they are facing.

22 Ms Nadia Ahmad Samdin asked the Minister for Sustainability and the Environment (a) how often do NEA and SFA conduct checks on the hygiene of food stalls and catering licensees; (b) whether these have been affected by the circuit breaker measures; and (c) what steps are taken to work with food stall licensees to improve cleanliness and hygiene standards when such stalls are faced with licence suspensions.

The formation of the Singapore Food Agency (SFA) in April 2019 has brought together all food-related functions under a single agency to enhance regulatory oversight of the entire food supply chain. All food establishments, including food stalls and caterers, are licensed by SFA and required to comply with SFA’s licensing conditions and regulatory requirements. These include maintaining and cleaning their stalls regularly, ensuring that workers who handle food have attended and passed the requisite food safety courses, and having proper infrastructure in place to safely prepare, handle and sell food.

SFA conducts routine inspections to ensure that the food safety regulations are adhered to. The inspection frequency is guided by the risk profile of the food establishments, which is based on the premises type, nature of food sold, food handling process and compliance track record. SFA also conducts ad hoc inspections in response to feedback received from the public. From April 2019 to March 2020, SFA conducted more than 47,000 inspections on food stalls and caterers, which was on average about twice per food stall or caterer over this period.

During the circuit breaker period, the total number of inspections conducted temporarily decreased as some food establishments had ceased their operations. SFA resumed its usual frequency of inspections after the circuit breaker period.

In February, when we started detecting COVID-19 cases in Singapore, my Ministry launched the SG Clean campaign to rally all Singaporeans to keep Singapore clean. As part of the campaign, we introduced sanitation and hygiene checklists for food establishments which highlighted key practices to safeguard food safety and reduce contamination risks. SFA and NEA also issued joint advisories and stepped up engagement efforts with food establishments on the importance of ramping up cleaning efforts to safeguard public health. Such engagement efforts and food safety checks continued during the circuit breaker period, when critical food services were allowed to remain open for takeaway and delivery services, to ensure food safety for consumers.

SFA also ensures that food establishments that have breached any of the licensing conditions are aware of the rectifications needed to comply with them.

SFA will inform licensees of the necessary corrective actions whenever a food safety lapse is detected during an inspection.

In the case of a suspension, all food handlers must also re-attend and pass the Basic Food Hygiene Course (BFHC) before they are able to resume work at the premises. The BFHC equips food handlers with relevant food safety and hygiene knowledge, including proper food handling and good personal hygiene practices. All appointed food hygiene officers working in suspended premises will also be required to re-attend and pass the Singapore Workforce Skills Qualifications Conduct Food and Beverage Hygiene Audit course to ensure that they remain properly trained to be able to continue to oversee and enhance the food safety standards of the premises.

SFA will also carry out a re-inspection after the suspension has been lifted to ensure the food establishment has rectified the lapses.

Ms Nadia Samdin.

Thank you, Speaker. I thank the Minister for her response. Since the circuit breaker, we have seen an increase in the use of food delivery services, I have two supplementary questions.

Will the Ministry consider looking into guidelines to mandate F&B merchants on food delivery platforms to display the relevant grades or awards obtained under the Food Hygiene Recognition Scheme (FHRS) so that customers are aware and have access to the information? And secondly, whether food delivery riders are regulated or fall under the FHRS and if so, how?

Mr Speaker, I thank Ms Nadia for the supplementary questions. She has given us some food for thought. At the moment, the grade of the food establishments is not listed on the delivery platform, we will consider her suggestion when we next review our food safety framework. At the same time, the delivery personnel are not licensed under our food safety framework as well. Similarly, we will consider her suggestions when we next review the framework.

23 Ms Nadia Ahmad Samdin asked the Minister for Sustainability and the Environment (a) beyond beach clean-ups, how is marine trash (including both micro and macro debris) cleaned off the coasts of Singapore to keep our blue spaces clean; and (b) what are the most common types of (i) micro debris and (ii) macro debris found on our shores.

The bulk of our beach litter is marine debris brought in by natural tidal conditions. NEA cleans our recreational beaches twice a day during the Northeast and Southwest monsoon periods, when the amount of marine debris increases. During the rest of the year, the beaches are cleaned daily or four times a week depending on the location.

The most common micro- and macro-debris encountered along our shores are styrofoam, film and hard plastic fragments, with some variation in the volume and distribution of macro-debris due to seasonal monsoons.

We can all do our part to keep our beaches clean. This includes demonstrating social responsibility by not littering, as well as supporting beach clean-ups, especially during the monsoon periods. This will help maintain a pleasant and safe environment for beachgoers and wildlife, and preserve the beauty of our shores.

Mr Louis Ng.

Thank you, Sir, and I thank the Minister for the reply. Could I ask whether MSE is studying whether there is micro-plastic in our local seafood that is bred in the kelongs in Singapore waters? Secondly, I think we do a lot of beach clean-ups and it really is never-ending. I am just wondering whether we can go a bit upstream, work with our neighbouring countries and support some of their waste management and waste disposal plans?

Mr Speaker, I would like to thank the Member for the supplementary questions. SFA will ensure quality and safety of our food regularly and they do inspect on a regular basis. Specifically, with regard to kelong and micro-plastics, I will have to come back to the Member and I will encourage the Member to file a Parliamentary Question if he is interested in this topic.

I do agree with him. With each tide, each day, each monsoon season, marine litter is washed ashore. Indeed, I think we are very, very grateful to many of the community groups that have been conducting beach clean-ups. Some of the Members here have joined them and would appreciate the enthusiasm and the commitment these groups have demonstrated.

We do actively participate at the regional as well as the global arenas. We are active in ASEAN. We participate, we agree, we sign on to declarations to stop and act on marine litter. We are also actively conducting courses for the officials on this issue about tackling waste and managing litters. So, we will be an active member regionally as well as globally. This is a topic that I think is receiving a lot of attention and we will continue to play a constructive and responsible part globally.

24 Mr Chong Kee Hiong asked the Prime Minister (a) with the increasing need to use Singpass, what measures are in place to ensure privacy and security for users, especially senior and vulnerable citizens, when they depend on third parties who are tasked to assist them to navigate online services and enter their IDs and passwords; and (b) whether the Government will consider maintaining more alternative avenues, such as physical counters, for the elderly to avail of such services without the need for Singpass as they have difficulty keeping up with the pace of digitalisation.

25 Mr Gerald Giam Yean Song asked the Prime Minister with the discontinuation of the OneKey token from 1 April 2021, how will GovTech ensure that (a) all residents who do not own a mobile phone will be able to access Government e-services using Singpass, given that a local mobile phone is required for the Singpass two-factor authentication (2FA) process; and (b) notwithstanding the introduction of Multi-User SMS 2FA, whether alternative 2FA methods can be provided to enable residents with no mobile phones to login with Singpass independently, without the assistance of a third party.

Mr Speaker, with your permission, may I address Question Nos 24 and 25 on behalf of the Prime Minister.

Yes, please.

Mr Speaker, we are committed to building an inclusive Smart Nation, one where nobody is digitally excluded.

Members would be aware that the key element for the delivery of digital services is to get digital identity right. In the case of Singapore, our national digital identity is expressed through Singpass.

For the well over 90% of people in Singapore who have access to a smartphone, I think all of you, particularly in this House, would use Singpass through Singpass Mobile. And I would take a bet, that most of us who use Singpass Mobile have forgotten our password, because we depend on the biometric features of our smartphone to not only authenticate but also to act as a two-factor authentication system. So, these two questions really relate to the minority of Singaporeans who do not have a smartphone. You will also recollect that in the old days – I said old because it is quite many years ago – Singpass consisted of a user ID and password. This was not secure enough. Therefore, we introduced a two-factor authentication system.

The two-factor authentication system, the second factor was delivered either through an SMS or through a token – we called it the OneKey token. The challenge with delivering an SMS is that it requires someone to have a phone, otherwise the SMS message with the one-time password will not reach you. Or to use a token. The token will be phased out and the last day of use will be 31 March 2021.

Therefore, these two questions relate to the small minority of people without a smartphone, without a mobile phone and for whom, the use of the token as a second-factor authentication will not be available from the first of April this year.

I want to emphasise, that when we design our digital services, we design them to be accessible, secure and convenient. We therefore have to have this assurance that after 31 March this year, these services will continue to be available for everyone just as they have been today.

So, let me explain how we are adapting our system. The first thing is, many Members of this House may not be aware of this new system we have rolled out called facial verification. This allows users who do not have a mobile phone to log into the Singpass system without the help of a third party. And they do so by using an Internet-enabled computer with a web camera, webcam for short. The webcam allows the computer to scan your face, the system then verifies that against the biometric information that the Government has on all of us through ICA. That means, it verifies against the face on record that we use for Identity Card or our Passport. This allows people to log on and to authenticate to Singpass even if they do not have a smartphone. But that requires a webcam.

So, the next supplementary question you would ask, what about those who do not have access to a computer with a webcam? The answer is that if you do not have access to such a device you can access it through kiosks which the Government has rolled out at selected public locations. These locations include all CPF Service Centres, IRAS Taxpayer and Business Service Centre, Our Tampines Hub's Public Service Centre, Geylang East Public Library – I am just going through a list but this list is going to keep expanding. So, in other words, even if you do not have a computer with a webcam, do not worry there is still a physical counter which you can access.

The next point I would make, is that the other modification we have introduced is what we call Multi-User SMS two-factor authentication, in which users can opt and nominate to have their SMS one-time password sent to another Singpass user who has a mobile phone. This allows a resident – remember without a smartphone – without a mobile phone, to continue to access services with the help of a trusted family member. For this mode to work, obviously, the key word is trust. And our system has to make sure that it also protects privacy and security.

How do we do that? Before the nomination of a trusted party is activated, there is a strict process for us to ensure that we have verified identities of both persons, the nominator and the trusted party, explain to them the use of these and to obtain – very importantly – obtain consent. I would also emphasise that the person who is nominated would only get the one-time password. That person does not have access to the services which the actual user is logging on, does not have access to the information or the transactions that the actual user is transacting in.

The next point is that we will provide help for all those who need it so that there will always be able to have access and skills for an increasingly digitalised environment. Basically, we have to put our money where our mouth is and ensure that no one is excluded simply because of lack of resources. For instance, we have the Home Access scheme, which subsidises broadband connectivity and a smartphone or a tablet for lower income households especially focused on low-income seniors. Our low-income seniors can go to a SG Digital community hub to apply for support under the Mobile Access for Seniors scheme, which offers eligible seniors a subsidised smartphone and a mobile plan. The subsidised smartphone starts from as low as $20, the mobile plan from as low as $5 a month. And I am sure if someone cannot afford that, if they see their local Member of Parliament, we will find ways to help people. So, do not worry about access to equipment or devices.

But actually, the greater challenge is skills – digital skills and that is why we have the SG Digital Office, which is supporting seniors to pick up these skills, including the most important skill, is how to use Singpass Mobile. And again, if you have observed the digital clinics in our community clubs, you will notice that that is almost 101, the first lesson which is provided. For those who need it, we will also provide in-person support at the 55 SG Digital community hubs at our community clubs and libraries islandwide and at PA's Tech Connect initiative and Integrated Public Service Centres.

Finally, for those who truly require a physical means to access public services, we will make sure that physical counters remain available.

Whilst the Government is working towards the digital delivery of all Government services, we will also ensure that everyone always has access to all these services.

Mr Gerald Giam.

Mr Speaker, the Minister has said that the people who are not able to use Singpass right now because of the phasing out of the OneKey token are in the minority, which is true. But many in this minority are the elderly, the less educated and the disabled. So, although they are a minority, they must not find themselves excluded because of the phasing out of this OneKey token.

For example, face verification can be done only if the user is physically present at these counters that the Minister has explained. However, residents who are physically disabled will find themselves having difficulty visiting the counters. I understand that there are other methods of logging in but none of these fully replace the OneKey token which allows users to log in independently without the mobile phone.

So, will GovTech consider introducing other 2FA methods that do not require users to have a mobile phone or be physically present at counters?

Secondly, I also note that several locations like the IRAS Service Centres will have the counters that provide the Singpass face verification. Can such counters also be extended to all Social Service Offices (SSOs) because many residents who visit the SSOs are not tech-savvy but they need to log into the Singpass to retrieve supporting documents like CPF statements and HDB statements?

And, lastly, will residents without a recent photo on record at ICA be able to be matched by the face verification algorithm?

I thank the Member for the questions. But, in fact, that is precisely the point. I have gone to great lengths to explain how the system will work, even without access to a smart phone, without access to a mobile phone and how you can either have someone else whom you rely on as a trusted party to be the mediator of the second factor authentication as well as a new method which we call facial recognition.

My point is that we totally agree with you that we must make sure no one is excluded, that no one is worse off in the face of the inevitable progress of digital technology.

I also want to reiterate the point that I made earlier that the key thing actually is not hardware or devices, it is really trust, confidence, digital literacy. And for this, I think I will also say – and I think from all Members' experience – hand-holding is necessary. And that is why the SG Digital Office and the more we can roll that out on the ground, accessible, so that someone is there to hold your hand and explain and teach the person, the better. So, you have my assurance that we will continue to roll this out. And the Member's suggestion on Social Service Offices, I think we will look at it. This is part of the delivery of Government services at the retail level.

What was the Member's third point? Sorry, I want to make sure I answer him accurately.

Thank you. I was asking for residents without a recent photo on record, how will the Government be able to match by the recognition algorithm.

Yes, thank you. That is a valid point. I think Members will also now realise why ICA has been fastidiously reminding people at a certain age to update photos so that the photo on record is a recent one. And I would also add, because Singaporeans are quite well travelled at least until 2020 came along, if all of you were to log on to your Singpass Mobile now and look at your National Digital ID, you will realise that that photograph has been updated to your latest passport photograph.

But, nevertheless, your point is valid, we need to make sure we have got updated photos. I would also add this additional point. That the digital systems actually are fairly robust and are able to identify, even if we have got more eye bags, wrinkles and grey hair on our visages.

Mr Chong Kee Hiong.

I am glad to hear Minister say that physical counters will still be around to help those who really do not have the skill sets to do it, and also to minimise the risk. They want to do it themselves rather than relying on someone to key in the Singpass password for them. So, my first supplementary question is, is there a timeline where physical counters would be phased out?

My second question is, how would the Government ensure that the private sector also maintains access to services which do not require Singpass, especially for the senior citizens. Because I get feedback from citizens, senior citizens that to open a bank account now, going to the counter with an identity card is not good enough. They still need to go through the Singpass route.

Thank you. Those are two very salient supplementary questions. Is there a timeline to phase out physical counters? If you ask me, I would believe there is no timeline to phase out physical counters because there will always be a need for some contact, some hand-holding, some training, some engagement.

Now, how and where the physical counters are expressed on the ground, will vary with time. Today, the common ones we are all used to is community clubs, libraries and other suggestions. I think that list would evolve but I do not see the time when we will eliminate all physical counters and human-to-human interactions.

Your next point was on the private sector. And here, this is another important question because the example that you cited – opening a bank account, it used to be that you showed up at the bank with your IC or your passport and maybe if you had, for those of us old enough to have a POSB account with stamps and all that, there was a track record, and it seemed quite seamless to open a bank account.

Actually, that same capability is available today but banks have also had to keep up with the times, both in terms of the digital possibilities which have opened up as well as the dangers of fraud and impersonation in the new world. That is why you will find that today, most banks, in fact all our local banks, when you actually are opening a new account, will try their best to get you to also use Singpass. The reason why they want to use Singpass is because of this other module which we call "MyInfo". Which means the Government as the ultimate custodian or a source of truth of trusted data that "I am who I am; I exist; my details, address and so on and so forth". You realise many times now, you do not need to keep filling up forms repeatedly because the private sector wants to have access with consent to those fields of data which the Government verifies and that is why the banks today would prefer that you use Singpass Mobile and that you authorise them so that they can get the data that they need in a way which they feel is more accurate.

So, the point I am trying to make is that these are possibilities which emerge because we are a Smart Nation, because we use the digital tools available. But even as we do this, we must make sure nobody gets left behind. And that is why the focus on training, on hand-holding, on physical counters to get people past this hurdle. Thank you for that very important point.

26 Miss Cheng Li Hui asked the Minister for Education in light of the recent study on children of divorced parents faring worse than their peers from intact families (a) what support is available to such children in the schools; (b) whether schools can offer deferments and temporary financial waivers with the goal of encouraging such children to complete their studies; and (c) whether teachers are made aware of the family situation of such children so that they can provide motivation and show more sensitivity during school lessons.

Mr Speaker, our schools monitor the well-being of students affected by divorce and other issues closely, and provide social, emotional and learning support for those in need. When the school is informed of a change in parents’ marital status by either the parents or the students, the teachers will check in with the students and assess their needs to decide what support is appropriate and necessary.

For students who exhibit emotional distress or social and behavioural changes, or where there is a need for counselling support, School Counsellors and Student Welfare Officers in school will provide individual counselling or group programmes for the students. They may also make referrals to community agencies such as Family Service Centres and Self-Help Groups to provide wrap-around support to the students and their family.

Students who require financial support can apply for the MOE Financial Assistance Scheme (FAS) to meet essential school expenditure such as school and miscellaneous fees, textbooks and school uniforms, and transport and meal subsidies. There is also school-based financial assistance to provide further support for students who need additional aid.

While updates on marital information is based on voluntary disclosure by parents to schools, the teachers will look out for any changes in the behaviour of their students and follow up with these students and their parents when there is a cause for concern.

Miss Cheng.

I thank the Minister. Will the Ministry also consider doing a study on children of divorced parents who have done well to understand how they have negated the challenges? And two, do the Counsellors also hand over the cases from Primary to Secondary schools for the more vulnerable ones, such as those on the UPLIFT programme?

Sir, I thank the Member for the questions. On the study of children of divorced parents who are doing well, I think it is very important for us to do that because if you look at the outcome of the recent study, whilst it is indicative that there could be some less favourable responses or outcomes of children of divorced parents, there are significant number of children of divorced parents who have done well, too. Certainly, divorce alone is not a causal factor to the outcomes of children. There are many factors – it is dependent on the way the divorce happens and on the support level given by parents post-divorce and throughout the lives of their children. It is really useful to understand the children of divorced parents who have done very well. And amongst us, I am very sure we all know that. I would encourage MSF to work together with MOE to venture into studying deeper with reference to children with positive outcomes and to look at factors that have made it possible for these children to have succeeded.

The second question is really whether we transfer information of children who have had challenges in Primary school, moving on to Secondary school. Prior to this, there is always this tension on whether we want to give children a fresh start when they get into Secondary school.

There are two schools of thought. One school of thought really is: we want to give them a second chance, a fair chance, even if they have had situations in Primary school, whether they had disciplinary problems, or issues in schools. When they start Secondary school, we want them to have a fresh start so that teachers do not see them with a certain mindset, a certain lens.

But we also understand that it is useful to transfer some of the information. What MOE has done now is to allow school leaders to have sight of some of these Primary school children who may have had some challenges while they were in Primary school, but not all teachers. School leaders will be able to make a determination. It is more about having sight of some of these students who come to the Secondary schools, not necessarily to make a judgement on them; more indicative. Should the child show some indication of challenges early, the school leaders would then be able to alert the school personnel, like the School Counsellors and the Student Welfare Officers, as well as some of his teachers, to be able to help the child.

From MOE's perspective, every child's well-being is of paramount concern, not just in terms of academic pursuits but also their emotional and social well-being.

Order. End of Question Time.

Ministerial Statement. Minister for Health.

Mr Speaker, Sir, thank you for allowing me to give an update to Members on the COVID-19 situation and, specifically, on our plan to vaccinate our population. Minister Lawrence Wong and I will address earlier Parliamentary Question Nos 2 to 14 and Question Nos 15 to 18 for Questions for Written Answer from today's Order Paper, as well as questions filed by Members of Parliament for future Sittings.

With your permission, I may also call upon my other colleagues to address supplementary questions that may follow, as we work as a team under the Multi-Ministry Task Force.

Sir, it has been almost a year since we had our first case. We have come a long way. We strengthened our healthcare system, enhanced our contact tracing capability, expanded our testing capacity and introduced safe distancing measures. All these efforts work together as a multi-layered defence system to keep us safe from COVID-19.

With the continued support and sacrifices of everyone in Singapore, we have brought the situation under control and kept community transmissions low. We have now moved into Phase Three and are making steady progress towards a new normal.

However, this is not the moment to be complacent. Globally, daily infection numbers and deaths continue to rise in many countries, constantly setting new records, including countries that had been successful in containing their outbreaks previously. We have also seen the emergence of new variants that appear to be more transmissible and have had to tighten some of our border restrictions as a precaution.

We must, therefore, be prepared that, despite best efforts, new infections will still occur here from time to time. We face the continuing risk of new clusters and outbreaks and the danger of a new wave of infections getting out of control. This will be the new normal for a long time to come. That is why we still need to keep up our multi-layered defence. In fact, we must further strengthen it as we continue our journey through Phase Three.

Vaccination is a new line of defence we must put in place. Vaccination is a critical shield to protect us and our loved ones against COVID-19 even as the global situation remains volatile. It will also be a key enabler, allowing us to return to normalcy.

The Expert Committee on COVID-19 Vaccination – comprising professionals in infectious diseases, immunology and other relevant fields – has studied the available data on the vaccine, reviewed the reports from the Health Sciences Authority (HSA), deliberated at length and considered carefully safety and efficacy aspects of the Pfizer-BioNTech vaccine. The Committee has concluded that the vaccine meets the safety and efficacy requirements of the World Health Organization and other international regulatory authorities as well as that of our own HSA. It recommended that everyone who is medically eligible should be vaccinated so that Singapore can achieve as high a level of vaccination coverage as possible. Vaccinations should, however, be voluntary. The Government has accepted these recommendations in full.

A high level of vaccination coverage will maximise protection for the population and minimise the proportion of persons still susceptible to COVID-19. This will, in turn, reduce the risk of large outbreaks and continue to keep community cases low and allow us to further reopen the economy and resume more normal, social activities.

We received our first shipment of vaccines from Pfizer-BioNTech at the end of last year. Our first vaccinations were conducted at the National Centre of Infectious Diseases last week. This is an important milestone and we are beginning to see the light at the end of this very long tunnel.

Dr Lim Wee Kiak and Mr Louis Chua asked about the number of vaccines that we have secured. I am not at liberty to disclose the specific quantity ordered due to commercial sensitivities and confidentiality undertakings in our advance purchase agreements with the vaccine manufacturers. However, I can assure Members that we have secured enough vaccines for all Singaporeans and long-term residents in Singapore. A team headed by the Head of Civil Service led the efforts and undertook this very urgent, complex and difficult task.

The vaccines will arrive in Singapore in batches, given high global demand, especially from countries with high rates of infection. Pharmaceutical companies will also need time to scale up vaccine production and distribution. Following the first shipment of the Pfizer-BioNTech vaccine at the end of last year, we are expecting more deliveries in the next few months, including from Moderna and Sinovac. If all goes according to schedule, we will have enough vaccines for everyone by the third quarter this year.

As recommended by the Expert Committee, we will prioritise vaccinations of groups that are most at risk. This is also consistent with the World Health Organization's guidance and similar to what other countries are doing. We will, therefore, begin with the healthcare workers and staff working in the healthcare sector as they work in direct care of patients or in supporting roles. We will also prioritise COVID-19 frontline and other essential personnel, including swabbers hired by the Health Promotion Board, staff working at Government Quarantine Facilities, Community Care Facilities and dedicated Stay-Home Notice Facilities.

We plan to start vaccinating our elderly and those at greater risk of severe disease from COVID-19 infection starting from February 2021, beginning with seniors aged 70 and above. We will also prioritise others who are in jobs or settings where risk of super-spreading events is high, such as the construction, marine and process sectors, including migrant workers. Thereafter, we will progressively broaden our vaccinations to include other Singaporeans and long-term residents who are medically eligible.

As more vaccines are approved for use, we will adjust our vaccination programme, depending on the vaccine supply as well as the disease epidemiology at that point in time.

The national effort to vaccinate the population will require considerable resources to implement. This is one of our key focus areas this year.

The last time we did a vaccination of this scale was in 1959, in response to an outbreak of smallpox where slightly over one million people were vaccinated. The scale of the current effort is larger but we are also much better prepared. We started planning for this very early on. We have put in place end-to-end processes to meet the cold-chain logistics requirements – from delivery and receipt at the airport, through to storage and then transport to vaccination sites – so that the quality and efficacy of the vaccines are not compromised.

While our healthcare workers are receiving their vaccinations within their healthcare institutions, we are concurrently readying clinics and vaccination centres for others to be vaccinated when it is their turn. Prior bookings will be necessary, given the cold-chain requirements at the vaccination sites and multi-dose vials of the vaccines. It will also ensure operational efficiency and minimise individual wait times. More information on how to make the booking will be provided later.

We encourage everyone to come forward for your vaccination when your turn comes so that we can increase our coverage as soon as possible. We should also bear in mind that some vaccines, such as the Pfizer-BioNTech vaccine, will require two doses, 21 days apart, and it will take up to another 14 days after the second dose to achieve maximum protection against the virus.

At the same time, we will test our systems thoroughly before ramping up to ensure that vaccination operations proceed smoothly and patient safety is not compromised.

There were several questions from Members, including Ms Foo Mee Har and Ms Sylvia Lim, on the safety and efficacy of the vaccines. These concerns are understandable, given the extraordinary speed at which the COVID-19 vaccines have been developed and brought to the market. The speed achieved is the result of a strong and concerted global response to a major pandemic rather than a compromise of safety standards.

Let me assure you that the safety and well-being of Singaporeans is the top priority in our vaccination efforts.

First of all, the vaccine must be approved by HSA. Under HSA's Pandemic Special Access Route (PSAR), HSA's scientific and clinical experts apply strict international standards to assess COVID-19 vaccines to ensure that they meet the stipulated high standards of quality, safety and efficacy. These standards are the same as those used for full vaccine evaluations except that long-term data from clinical trials will only be evaluated later as the data becomes available.

The data that has been reviewed includes those from pre-clinical studies done in laboratories, clinical trials on human volunteers, manufacturing and quality controls as well as the on-going experience with the actual use of the vaccines.

The assessment and recommendations for the vaccines are also reviewed by HSA's Medicines Advisory Committee and Panel of Infectious Diseases Experts.

HSA will only allow a COVID-19 vaccine to be used if it is assessed to be sufficiently efficacious and safe for use and only if the benefits of the vaccine are assessed to outweigh the risks of any potential adverse effects from the vaccination. HSA has put the Pfizer-BioNTech vaccine through this rigorous review process and has authorised its use. The Moderna and Sinovac vaccines are also currently undergoing the review process.

Following HSA's approval, the independent Expert Committee appointed by MOH has also reviewed the clinical data on the safety and efficacy of the Pfizer-BioNTech vaccine and has been briefed by HSA on the full range of considerations in granting interim authorisation. The Expert Committee concurs with HSA – that the vaccine is suitable for use in Singapore, for persons aged 16 years and above, for the prevention of COVID-19.

In assessing the suitability of vaccine candidates for specific population groups, the Expert Committee took into consideration four key criteria – vaccine safety, vaccine efficacy, vaccine tolerability and data adequacy of clinical trials.

The Expert Committee has assessed that the Pfizer-BioNTech vaccine demonstrated a high vaccine efficacy of 95% in reducing symptomatic COVID-19 disease among persons aged 16 and older and its safety profile is consistent with that of other established and registered vaccines used in immunisation against other diseases.

Mr Melvin Yong asked whether there is any data to show that the current COVID-19 vaccines are effective against the new strain seen in the UK and Europe. Mutations occur in viruses naturally and different strains can emerge from time to time, especially in a long-drawn pandemic. While this B.1.1.7 strain from UK does appear to be more transmissible, there is currently no evidence that current COVID-19 vaccines are less effective against this strain.

Experts have said that it is unlikely that mutations would impact effectiveness of current vaccines.

Vaccine producers such as Pfizer-BioNTech and Moderna have also come forward to reassure that their vaccines should protect against the B.1.1.7 variant, and are undertaking studies to formally confirm this. MOH will evaluate the data as it emerges and review our vaccine strategy and border measures, if necessary.

Miss Cheng Li Hui, Mr Lim Biow Chuan and others have asked about potential side effects. Both HSA and the Expert Committee have studied the data, from clinical trials as well as actual experience from vaccinations carried out in other countries. They have factored this into their evaluation before granting authorisation or making a recommendation on the use of COVID-19 vaccines.

Based on data available today, people who receive the Pfizer-BioNTech vaccine may experience side effects such as pain in the injection site, fatigue, fever, muscle aches, or headaches. These are similar to side effects for other established vaccines and they usually resolve on their own in a few days.

As with all medications and established vaccines, there is a small risk of very rare but serious adverse events that may occur post-vaccination, including allergic reactions.

HSA and the Expert Committee have therefore recommended that those with known severe allergies should not be vaccinated. All vaccine recipients should also be observed on-site for 30 minutes post-vaccination, so that any severe allergic reactions such as anaphylaxis can be detected and treated promptly.

MOH will also introduce a vaccine injury financial assistance programme to provide support for persons who suffer a serious adverse event that is assessed to be related to COVID-19 vaccines administered in Singapore. While we expect few to need this, the programme will give a greater peace of mind for those taking the vaccination. Further details on the programme will be provided in due course.

In addition, HSA requires vaccine manufacturers to submit new information continually for active review. HSA and the Expert Committee will also continue to monitor and review the efficacy and safety of COVID-19 vaccines in the local population and internationally. This includes data on specific population subgroups such as those below age of 16, persons with immunosuppression, or pregnant women that were excluded from initial clinical trials. HSA and the Expert Committee will also look at long-term safety data to detect rare and severe adverse events, and study the durability of protection provided by the vaccines. This on-going monitoring is the norm expected for any vaccines that first come into use.

Mr Dennis Tan asked whether there will be a need to separate blood collected from donors who have and have not received COVID-19 vaccinations. There is no need to do so. The COVID-19 vaccine does not cause infection.

While the COVID-19 vaccination will be voluntary, we strongly encourage everyone who is medically eligible to get vaccinated when the vaccine is offered to you. This will not only provide protection to yourself, but also indirectly protect those who cannot be vaccinated due to medical reasons. This collective protection would be more effective the more are vaccinated. In turn, we can keep the number of cases low, minimise the stress on our healthcare system, ensure that those who are ill get the treatment that they need and allow us to return to normalcy sooner.

Some may feel that there is no urgency to get vaccinated given the current low number of community cases and the local situation is under control. We must not be complacent or wait till an outbreak and then rush to be vaccinated. We have seen a few community cases in the last few days, which shows clearly that there are hidden cases among us. We are also seeing new variants that are more contagious. Any of these cases has a risk of sparking a major outbreak as we have seen in other countries. The best time to vaccinate is now. If people wait until an outbreak has happened to get themselves vaccinated, it will be too late – both to protect themselves and to prevent the outbreak in the first place.

As the Prime Minister has said, we have every confidence in our experts and the process that has been put in place. The Prime Minister and our Cabinet colleagues, including myself, will lead on this. We will be getting vaccinated as early as possible when our turn comes.

To ensure access to the vaccine, COVID-19 vaccination will be free for all Singapore Citizens, Permanent Residents and long-term residents in Singapore, which includes Employment Pass, S Pass, and Work Permit holders, Foreign Domestic Workers, and Dependent Pass, Long-Term Visit Pass and Student Pass holders – totalling about 5.7 million people. This excludes Short-Term Visit Pass holders, such as tourists.

I understand Mr Yip Hon Weng would like to know whether those who are not vaccinated will have their job scopes reviewed, in order to reduce exposure to the virus. In most instances, redeployment of non-vaccinated employees is unlikely to be necessary, unless there is a resurgence of local cases. But all workers should continue to take the necessary precautions such as mask-wearing, and where required, donning of Personal Protective Equipment or PPE, and undergoing Rostered Routine Testing or RRT. That said, there may be specific cases such as researchers or laboratory staff working directly on the COVID-19 virus or those who face very high risk of exposure to infected individuals. MOH and MOM are reviewing the issue of vaccination of workers in such workplace settings and will provide further advice later.

Ms Foo Mee Har asked if individuals will be issued vaccination cards after receiving the COVID-19 vaccination. Every person who is vaccinated will receive a physical vaccination card and this will help remind them of their appointment to return for their second dose, indicate clearly which vaccine was administered and provide brief post-vaccination advice. In addition, any person who is vaccinated will have their record updated in the National Immunisation Registry, and individuals will be able to check their vaccination status digitally.

Mr Louis Chua asked if individuals will be given a choice of vaccines when more than one has been approved for use. The allocation of vaccines will largely be based on medical indications of the different vaccines and the suitability of the vaccine for the different population groups, as well as availability of the vaccines. Any COVID-19 vaccine that is approved for use will have to meet the stringent safety and efficacy requirements. Therefore, it is not necessary to allow individuals to have choice of vaccines, which will unnecessarily complicate the already complex vaccination programme. Anyway, in the immediate term, only the Pfizer-BioNTech vaccine has been approved for use. So, there is no choice.

Mr Alex Yam and Ms He Ting Ru asked about our public communications strategy. Government agencies have been using various channels to understand public sentiments on the COVID-19 vaccines, including ground outreach and surveys. Our findings showed that more than half – close to 60% – say they would get vaccinated if a vaccine becomes available in Singapore. About a third were more cautious, saying they would prefer to wait for more data before deciding.

We will continue our efforts to reach out to our population to explain the importance of vaccination and to assure them of the safety and efficacy of the vaccines we are using. I hope parliamentary colleagues will also help to share the information with your constituents.

I would also like to urge everyone to refer to official or credible sources of information and not to forward unconfirmed or untrue information. For example, there were claims that six people had died due to the Pfizer-BioNTech vaccine during clinical trials. However, the facts are that only two of the six individuals were given the vaccine and the other four were given the placebo. Investigations revealed that there was no causal relationship between the vaccine and the two individuals’ deaths. Spreading such misinformation undermines our efforts to protect Singapore and Singaporeans against COVID-19.

Let me conclude. We have come a long way in the past year. We have been through the circuit breaker. Many have missed their vacations for the whole year. We have had to learn and manage with safe distancing measures when we are out and about. It is only through everyone’s concerted efforts that local transmission is now low in Singapore. However, the global situation is still far from under control.

Vaccinations will be a key enabler for us to return to normalcy. We have secured enough vaccines for the whole population. Every vaccine will meet all our safety and efficacy requirements before being approved for use. And I strongly encourage all Singaporeans and long-term residents to get vaccinated when the vaccine is offered to you, to protect yourselves and your loved ones.

This will be the key focus of the MTF over the next few months. Let us all do our part, so we can overcome and emerge stronger together. [Applause.]

The Minister for Education will be making a related Ministerial Statement. I will allow Members to raise points of clarification on both Statements after this Statement. Minister Wong.

Mr Speaker, Sir, our key priorities for the year are to implement the vaccination programme smoothly and to continue with our re-opening plans safely while keeping the infection under control. Minister Gan has just given an update on our vaccination plans. Let me now elaborate on our other areas of focus and what we should be prepared for over the coming months.

We have worked hard together over the past year to get to where we are today. It has not been an easy journey. We have been tested severely. We have put in place some very tough measures. I thank everyone for cooperating with them and taking them in your stride.

In a crisis like this, we have learnt to expect the unpredictable. You can have the best laid plans. But new issues will inevitably crop up and some things will go wrong. What matters most at the end of the day is our ability to rally and work together, to adapt along the way and to regain our footing after setbacks.

That is how we were able to bring things under control, keep community transmission low, and move to Phase Three on 28 December last year. It is a careful acknowledgement of our state of readiness to resume more activities in a controlled manner. The specific adjustments from Phase Two to Phase Three may not seem like a lot. Indeed, in his Parliamentary Question (PQ), Mr Leong Mun Wai said there’s “little change”.

But let us not trivialise these hard-won gains. They are the result of the efforts and sacrifices by many people over the course of the year.

Importantly, we are not out of the woods yet. We cannot afford to relax and let our guard down. As Minister Gan highlighted just now, the global situation continues to escalate rapidly.

Cases continue to climb in many countries, including in places which had previously established good control over the virus. In Singapore, in recent days we have already seen two family clusters. Marine workers went on board ships, they got infected and they spread the virus to their family members, including their spouses and children. One of the children had a school-mate who visited the home and was infected. Fortunately, this happened during the school holidays, so they had limited contact with other students. But it is a sobering reminder of how easily new infection clusters can break out. it only takes one super spreader event to spark another major outbreak, so we must continue to stay alert and vigilant.

The emergence of new viral strains that may be more infectious, such as the B.1.1.7 variant, is indeed very worrying. And I share the concerns raised by Mr Murali Pillai and Mr Melvin Yong.

Where necessary and practical, we will tighten our border restrictions to limit importation risk. For example, from the UK and South Africa we have introduced additional testing and requirements, as well as restricted the number of travellers. We have also recently tightened the testing regime and safe management measures for those working in the aviation and maritime sectors, as they are the ones who are most likely to be interfacing with travellers and crew from overseas.

For example, for air crew who have layovers in higher risk countries, we are testing them more frequently after they return to Singapore and requiring them to self-isolate for a few days. Likewise, we are doing a one-time sweep to test all marine workers and we are increasing the frequency of testing for marine workers going on board vessels. We are testing them every seven days instead of 14 days.

This is not the first time we have picked up new strains of the virus. Nor will it be the last.

The fact is that the virus has always been mutating, and will continue to do so. Other new strains will continue to emerge. We do not know what their cumulative effects will be like. So, we will have to constantly monitor the latest developments around the world, review the data and evidence, and update our measures accordingly.

With the virus raging around the world, we clearly cannot afford to freely open our borders at this time. But neither can we close ourselves completely from the world and simply stop all flights or ships coming to Singapore. Trade and travel are our lifeblood. This is an existential issue for us because we do not have the luxury of a hinterland to depend on.

Therefore, we take a calculated risk-based approach in managing our borders. Minister Ong Ye Kung recently made a Ministerial Statement on this. So, I will just reiterate the key points.

To facilitate essential business and official travel, we have established special travel arrangements with certain countries and territories. We control the number of travellers on these schemes tightly, and we require the travellers to stick to a controlled itinerary and strictly limit interactions with the wider community.

For example, we have a Fast Lane between Singapore and six provinces and municipalities in China, established in June last year. Miss Cheng Li Hui asked how many have taken this up. Around 500 travellers have arrived from China under this arrangement. Since early November, we have also allowed short-term Chinese visitors to enter Singapore via the Air Travel Pass.

In order to promote both Singapore’s economic interests and our status as a global business and transportation hub, we will continue to negotiate and formulate additional travel arrangements with other like-minded countries or regions while ensuring that public health is not compromised.

Recently, we also announced a new travel lane, called Connect@Singapore, aimed at a limited number of business, officials and high economic value travellers coming to Singapore for short-term stays. As it would not be practical for these travellers to serve a 14-day quarantine, we manage the risk by placing a “bubble wrap” around these travellers. So, the travellers will only stay at dedicated facilities and will not be allowed into the community. They will also undergo regular testing and observe all prevailing safe management measures.

Besides these special travel arrangements, we have, on a daily basis, a far larger number of travellers who are returning Singaporeans, PRs and long-term pass holders. There is also a continued flow of new migrant workers coming in, mostly construction workers and foreign domestic helpers. We need them to build our homes and infrastructure, and to support the care-giving needs of our families.

For these returning residents and essential workers, we allow their inflow on a controlled basis, but we require those who are from higher risk countries to serve a 14-day Stay Home Notice or SHN at dedicated facilities. They will be tested at the end of their SHN. Travellers from countries with new virus variants will serve their SHN at designated hotels to further minimise the risks of spread. This system ensures that we are able to tightly ring-fence imported cases and minimise the risk of leakage into the community.

Since 18 November, we have required all non-citizen and non-PR travellers from higher risk countries or regions coming to Singapore to take a pre-departure test within 72 hours prior to their departure. We have not required this of citizens and PRs because we do not want to place additional barriers for them to return home if they have urgent need to do so. Additionally, as paediatric testing services may not be so easily available in some countries, those aged six and below are also exempted from this pre-departure test. But through the SHN, we ensure that community transmission risks are minimised for these travellers, even in the absence of a pre-departure test.

So, in response to Mr Gerald Giam’s query, between 18 November and 27 December last year, there have been over 12,000 travellers, including citizens and PRs, from higher risk countries and regions who entered Singapore without pre-departure tests. So far around 100 or 0.85% have tested positive. Importantly, none of these cases has resulted in local transmission.

We recognise that our containment measures depend on good management of the hotels which are used as SHN facilities. We make sure these facilities have strict protocols in place to segregate persons on SHN from all other guests. These include placing them in segregated blocks, wings or floors, clearly demarcating their route of movement and instituting regular cleaning and disinfection regimes.

Persons on SHN are not allowed to use common facilities in the hotels. Once there is a confirmed case, comprehensive contact tracing and ring-fencing of contacts, including staff working in SHN facilities, will be done to prevent further transmission. And any links between confirmed cases from the same facility will be thoroughly investigated.

Even with the multiple layers of safeguards, the risk of leaks, though small, remains. And the recent incident at Mandarin Orchard Hotel is a case in point, as Mr Ang Wei Neng highlighted.

Based on our preliminary investigations, there had been no breaches in SHN protocols at Mandarin Orchard Hotel. But investigations suggest that infection protocols can be improved, for example, through better crowd regulation as well as having good ventilation systems to circulate more fresh air. We will continue to work closely with all SHN hotels to ensure that infection prevention protocols are robust.

As an additional safeguard, all hotel staff in contact with SHN individuals will henceforth be placed on a 14-day rostered routing testing regime or RRT.

Monitoring genetic information of the virus in Singapore’s COVID-19 cases has been important in uncovering the Mandarin Orchard Hotel incident and is required to detect any importation of new COVID-19 strains into Singapore.

Specific to Dr Tan Wu Meng’s question regarding whole-genome sequencing in Singapore, this is an established capability within the National Public Health Laboratory or NPHL. Where possible, whole-genome sequencing can be performed rapidly and directly on clinical samples of COVID-19 positive cases. However, in samples that have low viral loads, it may be necessary for the virus to be cultured before the sequencing can be done. We will continue to assess available and emerging laboratory technologies so we can improve our capabilities and enhance our responses.

One important issue is whether we can relax our border measures for persons who are vaccinated. We are studying this issue very carefully. As mentioned earlier, the main benefit of the vaccine is that it offers protection to the vaccinated individual. It is likely that the vaccination can also reduce the risk of transmission of the virus. But at present we still do not know the extent of the reduction.

There are several on-going studies on the effectiveness of vaccines in reducing transmission risk and we are monitoring these very closely. To Ms He Ting Ru’s question, if there is clear evidence that transmission risks can be lowered significantly, then we will certainly consider some relaxation to the SHN regime for vaccinated travellers.

But for now, we will continue to take a more cautious approach. In other words, vaccinated travellers will continue to be subjected to prevailing border measures and SHN requirements. We will fine-tune our approach over time, once we have understand the effect of the vaccine better.

Of course, border measures are just one part of our overall system of defence against the virus. Within our community, we must continue to adopt a calibrated approach towards resumption of activities in Phase Three and minimise the risks of any further flare-ups during this period.

The tools for us to do so are not new – we have repeatedly emphasised them throughout the past year, but I think they bear repeating as we begin this new year because memories are short, as we all know.

First, we must uphold safe management measures. Under Phase Three we can go out in larger groups of eight people. By all means, use the opportunity to catch up with family members and loved ones. But please do so responsibly and in accordance with prevailing rules and restrictions.

Unfortunately, there are a few who persist in pushing their luck and disregarding the rules. We have stepped up checks over the festive period. Firm enforcement actions have been taken and will continue to do so against any such breaches.

Let us also not forget some of the basic measures that we have put in place. All the good practices that we have emphasised and cultivated over the past few months remain very important – wearing a mask, practising good hygiene, washing of hands regularly, not using your hands to touch your face. Remember we talked about all these repeatedly at the start of the outbreak last year. Let us not forget them. They are simple but still very effective.

Second, testing remains important and we are continuing to deploy more tests as widely as possible, so that cases can be detected quickly.

Anyone who sees a doctor with acute respiratory infections or flu-like symptoms will be advised to take a PCR test. On average, we have tested more than 14,000 individuals every week in December last year, through this surveillance mechanism. That was how we picked up several of our recent cases. So, it is very important for anyone who feels unwell to see the doctor immediately. And if the doctor advises you to be tested, please comply with the doctor’s instructions.

For those engaged in higher risk activities, we are putting them on a rostered routing testing regime or the RRT. This already applies to workers in the construction, marine and process sectors, as well as to airport and marine workers, and now to staff in the SHN hotels, as I mentioned just now.

Beyond the RRT, we undertake special testing operations from time to time to do a sweep around specific areas or groups of individuals, whom we assess to be at higher risk of transmission. Over the past few months, we have done such tests amongst staff of nursing homes, hawkers, as well as bus and taxi drivers. This month, we will be testing the students staying in our University hostels.

We have also been stepping up the use of antigen rapid tests. They are useful as a pre-event measure for larger scale activities. They are also a very good complement to the PCR tests which are more sensitive but take longer to obtain results. The costs of these rapid tests have been coming down. The first of such rapid test kits administered in Singapore cost about $80 per person. That is not just the test itself, but also the operation and manpower costs. Now, it is possible to do this for under $50 per person, and the cost is likely to come down further.

Over time, we can expect more innovative rapid test kits that are cheaper, faster and more convenient to administer. These will enable us to test more extensively and conveniently, to detect positive cases and protect our population more comprehensively.

When we first deployed testing in a significant way, I know there were concerns amongst certain groups. Some thought it would be a hassle. Others were worried that there would be a stigma associated with being identified for testing. But I hope by now we can all appreciate and understand the reasons why testing is important and necessary.

Frequent and widespread testing is a critical enabler, which we intend to ramp up over the coming months. We must all start getting used to the idea of regular testing being a part of our lives during this pandemic period.

Third, we will continue to strengthen our contact tracing capabilities. Despite our best efforts at safe management measures and testing, we know that cases will still slip through from time to time. That is why we need to be able to quickly identify and trace the contacts, and ring-fence the clusters.

The TraceTogether and SafeEntry Programme has been, and will continue, to be a key part of our contact tracing operations. Before TraceTogether or TT, we had a good contact tracing system but it was manpower intensive. It worked well for SARS, but not for COVID-19, where the virus spreads much faster, well before the onset of symptoms and even in cases who themselves remain asymptomatic. In the past it took two days for us to interview an infected person, establish all of his close contacts and then get in touch with these people and put them on quarantine. Two days. That was too slow. Today, with TT and SafeEntry, we are able to do all this in a matter of hours.

Once we identify the contacts, we test them immediately, at the start of their quarantine. For those who are positive, we in turn get their TT data to identity their contacts and then, initiate the tracing process. In this way, we try to get ahead of the virus and contain clusters before they get any bigger.

Our ability to do all of these is not just because of the TT programme. It is fundamentally because of the confidence and trust that Singaporeans have in our system – the way we handle the data, the way they go about doing contact tracing.

I thank everyone for their cooperation and support because this has enabled our contact tracers to do their work and to keep cases under control.

To date, we have spent around $10 million on developing both the TraceTogether app and SafeEntry system. Mr Gerald Giam asked if the cost is justified. Well, the results speak for themselves – TraceTogether has stopped the transmission of the virus in many instances and has helped save many lives. So, I have no doubt about the cost-effectiveness of the programme.

Of course, in developing the programme, we remained mindful of the need to ensure value for money. For example, Mr Dennis Tan had filed a question on whether we could work on a rechargeable version of the TraceTogether tokens. Doing so would inevitably increase the cost and also the time needed for manufacturing. Instead, we have designed the tokens using off-the-shelf components where possible to minimise manufacturing complexity, time and costs.

More than 4.2 million people or around 78% of Singapore residents now participate in the TraceTogether programme. And we certainly encourage an even higher take-up. Not all of them use the token. Quite a number, around two million or slightly less than half, just use the TraceTogether app on their phones. I am one of them because I think that if I have the token with me, I quite likely to lose it. So, I just use my phone and that works well for me. But we recognise that some people want the tokens and that is why we made them available and distributed them across all the Community Centres or CCs.

Given that the TT app was easily available, we had initially not expected such a strong demand for the tokens. On the supply side, there were also some delays in the manufacturing schedule. That is why, as mentioned by Mr Lim Biow Chuan, we were not able to complete the distribution of the tokens across all the CCs. We have been steadily building up the inventory of the TraceTogether tokens and will soon be able to resume distribution in the CCs that are currently closed. As announced previously, we will also be distributing the tokens to school students who have not yet collected them, through the schools.

After everyone who needs a token has had a chance to collect one, we will put in place the requirement to use TraceTogether only at the SafeEntry checkpoints. In other words, we have what we call TT-only SafeEntry where the SafeEntry checking in/checking out is done either through the app or the token. We will give further information on this once the details and timelines are firmed up, and will provide adequate advance notice to all the affected establishments, so that they can gear up and prepare.

Mr Speaker, 2020 was undoubtedly a difficult year, but we can take heart that we have learnt and grown tremendously in our abilities to cope with the virus.

I thank everyone who has worked so hard and made many sacrifices to get us to where we are today. Our healthcare workers and frontline officers – contact tracers, safe distancing ambassadors, our swabbers, enforcement officers, immigration and security officers, airport workers, our SHN operators – have all been working hard round the clock. There are also many who have contributed; many unsung heroes all over Singapore doing their part.

Toward the end of last year, Minister Gan and I held a simple appreciation event – in accordance with all safe distancing rules, of course – to thank the people involved in setting up the COVID-19 Community Care Facility. This is at the Expo and Big Box.

Members will recall this was a pivotal moment in our fight against the virus. At the peak of the pandemic, we had more than 1,000 cases per day, and our healthcare system was at risk of being overwhelmed. The team came together from both the public and private sectors. In the spirit of SG United, they got the facility up and running in a matter of days. They truly made the impossible possible.

Now, we have stood down the facilities at the Expo and Big Box because we do not need them for now. I told the team we will do our best to avoid calling on them again. I think they were quite relieved to hear that. But I was also very heartened when they said, "Don't worry, if the need arises, we will be ready to respond anytime".

That is the indomitable spirit that gives me confidence in our fight against COVID-19. We must not allow this prolonged vigilance to wear us down. We must not falter; we must not weaken or tire. Let us approach the new year with the same spirit of fortitude, solidarity and unity that we had shown over the past year. Let us finish the job and complete our mission together. [Applause.]

Dr Tan Wu Meng.

I thank the Ministers for their Statements. I would like to ask one clarification to highlight a group of individuals who may well benefit from expedited access to the COVID-19 vaccine. These are Singaporeans who serve Singapore overseas. Often in jurisdictions where COVID-19 may be very prevalent and even with the best protective measures, they may come face-to-face with a COVID-19-infected person during their overseas duties. These include our public officers at overseas missions, whether from MFA, MTI or MINDEF.

Another related group would be our national sports women and sportsmen, some of whom may be training overseas, some of whom may be back home in Singapore right now, like one of my residents, but at the same time worried about what will happen when they return overseas for studies, when they go overseas to train, and may again come face-to-face with a COVID-19-infected person while flying Singapore's flag.

So, I would like to ask the Ministers what is the policy approach that will be taken to support Singapore Public Service officers and our Singaporean sportswomen and sportsmen who represent us overseas, often in jurisdictions where COVID-19 is running rampant?

Thank you. I would like to thank Dr Tan for his questions and clarification. In fact, these are issues that the Multi-Ministry Taskforce is discussing. We are also consulting the expert committee on vaccination on how to deal with the various priorities. As I mentioned earlier, the key priority today is to focus on healthcare workers because they are at the frontline and they are dealing with the patients and some of them could be, in fact, infected with COVID-19. So, our priority is to first protect the healthcare workers, ensure they can continue to preserve our healthcare system.

Secondly, we look at those who are at a high risk of a severe outcome, should they be infected. This includes vulnerable seniors. Therefore, this is the second group that we will be focusing on.

Beyond this, we are also looking at different categories of people including key entities like our military, our Police force, which are very important in ensuring law and order, and national security, as well as our foreign representatives, our embassies overseas, particularly in countries where there is a high prevalence of COVID-19. They are protecting Singapore's interests and we should find ways to protect them as well.

So, all these are factors that will be taken into consideration. But as the Member pointed out, there are many groups and many of them are also facing challenges. We do want to protect them as much as possible. So, the key really is to expand our vaccination as quickly as possible to cover as many people as possible. If it is your turn, please come forward and get vaccinated, do not wait. This is the only way for us to protect individuals as well as to protect one another.

I take the Member's point that there will be different groups that have an interest and that require protection. We will see how we can manage our vaccination programme to meet their needs. But bearing in mind that the priority is still to protect our healthcare system, our healthcare workers and the next priority are the seniors, who are vulnerable to severe outcomes.

Dr Lim Wee Kiak.

Thank you, Mr Speaker. Let me thank both Ministers for the Statement. The pandemic itself is a war. When we first saw the first shipment of the vaccine that arrived in Singapore with Minister Ong receiving at the airport, we were very happy.

But, subsequently, we were a little bit disappointed with the speed of the roll-out of the vaccine. In fact, in Canada, during the Christmas period, they closed the vaccination centre and they were being slammed, "Why did you close the vaccination centres during Christmas?" They should be speeding on now to quickly vaccinate as many people as possible. As from today, Israel has already vaccinated 12% of their population.

Initially, I was hoping that Singapore should be the first country in the world to get the whole country vaccinated. If any country can do it, Singapore can do it. We can show the world. Because we are small, we are fast, we are efficient, we are organised. If this is a war, I would say that vaccination, initially, I was hoping it would be made mandatory. Of course, the Government has chosen to make it voluntary.

I know that vaccination is a personal choice, but it has public consequences. I certainly urge everyone to be vaccinated as soon as possible. So, I hope that the Ministers now can consider rolling out this vaccination programme faster than what we are talking now. Because as it is now, I am not sure what are we waiting for. We should be vaccinating more people now. In fact, I hope that the healthcare workers should be vaccinated within the next two weeks and it should be completed as soon as possible.

Next, I would also like to ask when will the Speaker, Deputy Speakers and the Members of Parliament be vaccinated.

First, let me thank Dr Lim Wee Kiak for his enthusiasm and his strong support for our vaccination programme. In fact, I do agree with him. Our objective is to roll out our vaccination programme as quickly as possible, but we have to bear in mind that we have limited supplies, we need to progress based on the supplies that we can receive.

Secondly, I must also stress that we did not rest over the Christmas or the New Year. The key reason for our approach is to adopt a cautious one because vaccination is a very complex process, particularly bearing in mind that we need to ensure the ultra cold-chain is intact to ensure the quality and efficacy of the vaccine will not be affected. So that is one.

Next, we also want to make sure the safety of those who are receiving the vaccination, making sure that there is a proper queuing system, they are registered properly, and data are captured accurately. It is quite a complex situation. We conducted a trial recently, last week. And we will be rolling out full-scale vaccination for the healthcare workers.

Hopefully, soon we will be able to make it available to Speaker as well as Members of Parliament. It is important that we also roll out for the rest of Singaporeans. So, I agree with Dr Lim and I am equally anxious to cover as many Singaporeans as possible. I look forward to Members to help support our effort and to convince your constituents to step forward when their turn comes for the vaccination.

Ms Sylvia Lim.

Thank you, Mr Speaker. I have two clarifications for the Minister for Health. The first is whether the Health Sciences Authority or HSA works with any threshold for efficacy before it approves any vaccine. I read, for example, that in the US, the regulators need a minimum efficacy threshold of about 50%. Does HSA have some minimum threshold that it works with before considering approving any vaccine? So, that is the first question.

The second clarification concerns HSA's approval of the Pfizer-BioNTech vaccine. HSA has announced that it is actually an interim authorisation and that further data – probably longer term data – will need to be submitted by the manufacturer before the vaccine can be given full registration. So, I would like the Minister for Health – for public consumption – to explain what additional information the manufacturer needs to submit in order to get full registration for the Pfizer-BioNTech vaccine. Thank you.

Thank you. First, on the question of efficacy threshold, it is true that WHO and the US, have a threshold of 50%. We, too, have a minimum threshold of 50%. But I think that the efficacy threshold has to take into account the potential risk that the vaccine may create, the potential risk of adverse incidents, as well as other factors. So, it is not a clear-cut threshold that once it is 50.1%, we will approve it. If there is greater uncertainty, then we will require a higher level of efficacy for us to be assured of the benefits versus the risks.

We also have to take into account the current situation of the pandemic. If it is a very severe pandemic, then it is important for us to ensure that we vaccinate our population as quickly as possible and, therefore, we may have to accept a lower threshold of efficacy. If the pandemic is less severe – low mortality and so on, we may require a higher level of efficacy. Basically, it is a balance of benefits and risks. So, it is a holistic assessment that HSA's experts will have to take into account in coming to a conclusion whether or not it will be approved for use. It is not just a single number.

Secondly, Ms Sylvia Lim asked about the meaning of "interim approval" and what long-term data we are looking at. Because this vaccine has been made available only in recent months and it has only been applied for a couple of months, we still need to monitor how it is applied in real life. Manufacturers are required to report any adverse incidents that happen so that we can keep track of the performance of the vaccine on the ground as well as the potential risks that it may carry.

We need to do this continuously for a prolonged period of time – usually one year, two years or maybe longer – so as to give us assurance of the long-term effect of this vaccine. This is part of the reason why HSA has not given a full authorisation because a full authorisation will require these long-term data to be available before we do so.

But in view of the pandemic that we are facing today, HSA has given an interim approval for the use of this vaccine, accepting the fact that long-term data will only be available in the long term and we will need to continue to monitor and to make our assessment in the long term.

Ms Foo Mee Har

Thank you, Speaker, and thank you, Ministers, for the comprehensive responses. I have two supplementary questions.

First, we take comfort from Minister Gan's report that Singapore has secured sufficient supplies for the entire Singapore local population and that vaccination is anticipated to complete by the third quarter of 2021. I would like to ask the Minister: what are the risks of Singapore not getting delivery of our vaccine orders even though we have secured them – whether they will be delivered as we compete with other nations to get hold of the vaccines? That is the first supplementary question.

The second supplementary question is, testing has been a key requirement for travel under COVID-19 conditions. I would like to ask the Minister whether the Government will add vaccination in the future as a qualification for travel and perhaps even for employment in certain occupations or engagement in certain social activities. Particularly, also related to this question on vaccination, how would vaccination be featured in the upcoming World Economic Forum (WEF) to be hosted in Singapore in May?

Thank you. On the delivery of our advance order for vaccines – there is always a risk of non-delivery or a delay in delivery. So, we are in close contact with our manufacturers that we have entered into contract with and we are monitoring their delivery schedule, and if our vaccination programme has to be adjusted.

We are also looking forward to more vaccines being approved so we have alternatives. We want to make sure that we diversify our sources of vaccines so that even if one shipment is delayed, we have access to other supplies. This way, we ensure that we have adequate vaccine supplies for the whole of Singapore.

With regard to the questions on travel, I will leave them to my Co-Chair to respond.

Mr Speaker, it is important that we look at vaccinations as just part of the broader suite of measures that we have to protect ourselves, including safe management, testing and contact tracing. Vaccination is not a silver bullet. It is just part of that overall system.

As I have mentioned just now, we are still assessing the extent to which vaccinations can help reduce transmission risk. We know when you get vaccinated, you are protecting yourself. You do not know how much you can protect others. Yes, there will be some beneficial impact but what is the extent? It is still under consideration. So, until we understand the effects of the vaccine, I think we will not be able to make any changes to our measures, be domestic or travel measures.

But if the results indicate that vaccinations do offer protection to others, then, clearly, we can make some adjustments.

What are some of the adjustments that are possible? For example, if there is a concert being held today, typically, under today's rules, we would require a pre-event test for everyone going to the concert. Potentially, if you have been vaccinated, we might say: well, someone who has been vaccinated need not take such a pre-event test. That is conceivable.

Subsequently, if we have, again, more evidence, we might say, for travellers, well, you do not need a vaccination to travel but, if you are vaccinated, you travel and you come back, I might consider the extent to which I impose the Stay-Home Notice (SHN) conditions or the number of tests you are required to take. These are also possible. So, those are the things that we are looking at and these are all being studied very carefully

For purposes of the WEF event which Ms Foo highlighted, well, if the travellers come in on a vaccine and if we have the data and evidence, then, indeed, we can review the requirements that we impose on these travellers. Otherwise, the basic arrangements for the WEF event will be through existing prevailing measures. For example, we will bubble wrap a facility. We will put the travellers under frequent testing to ensure that they are safe. We will have safe management measures in place. All of these measures are still effective and we should still continue to rely on them.

Mr Louis Chua.

Mr Speaker, I have two follow-up supplementary questions for the Minister.

Firstly, I understand that because of commercial sensitivities, the exact number of doses of vaccines cannot be shared but, perhaps, the Minister can share with us, in aggregate, the number of doses that have been secured to give people the assurance that there is more than sufficient. As alluded to by Dr Lim Wee Kiak as well as Ms Foo Mee Har, I think you will also give Singaporeans comfort to know of the expected delivery timeline of when they will be able to be vaccinated in the rest of the year.

The second question is also a follow-up question to what the Minister has said in terms of individual autonomy to choose the vaccines. For people who are within the same category, for example, who are Singaporeans, who are male and of a certain age, what is the approach or process by which the vaccine is being administered, given that should there be more than one that has been approved? Would the Ministry provide the up-to-date information as to the different side effects, efficacy rates as well as various clinical trial data for people who are being administered a particular vaccine to have a sense of these are?

Thank you. I thought I have answered the question on quantity. I will not be able to give a specific number but suffice to say that we have secured a sufficient quantity for the whole population. Our strategy is also to ensure that we have a portfolio of vaccines and not just rely on a single supplier. Today, we have approved the Pfizer-BioNTech vaccine and we are continuing to evaluate two other vaccines that I have mentioned in my speech.

With regard to the second question, I am not quite sure what the question was about. How do we administer the vaccine if there are different types? As I have mentioned, it will be based on the assessment. If there are significant contra-indications for a specific vaccine that, say, for example, is not suitable for young children and another vaccine is suitable, then we will use the vaccine that is suitable for young children, depending on the indication that is provided by the manufacturer.

But if the indications are similar, then it will also depend on the availability of the vaccines at the point in time, whichever stock is available. So long as we are able to administer them, we would use the vaccine that is available to us. The key is that whatever the source of the vaccine, all of them must meet our safety efficacy requirements. From a safety and efficacy point of view, they should be treated similarly.

But at the same time, as the Member has pointed out, we do provide information on these vaccines. I think HSA's assessments are published, reports are available and the manufacturers also shared a lot of details with regard to the potential side effects of these vaccines and I have mentioned some of the side effects in my Statement earlier.

Mr Alex Yam.

Thank you, Mr Speaker. I thank the Ministers for their Ministerial Statements.

With regard to my question, the answer provided by the Minister earlier is that, based on the recent surveys, over 60% of Singaporeans were prepared to be vaccinated. I would like to ask the Minister three follow-up questions.

One is: this figure of 60% "satisfactory" to the Multi-Ministry Taskforce (MTF), should it be higher, because we had mentioned that we should be looking at above 70% vaccination rate?

Second question is: as more vaccines come on stream or are approved for use in Singapore, the sentiments with regard to different vaccines – will that also be similarly surveyed?

Thirdly, on when these additional vaccines come on stream. Anecdotally, over the weekend, as I was speaking to residents as well as family members, quite a number of older Singaporeans seemed to indicate a preference for CoronaVac, which is the vaccine that is developed by Sinovac, which is not using the new technology. For some reason, they indicated that it is because it is older technology, it is more established. If it comes on stream, they would like to choose to have that.

If, in the event that, at the time that they are assigned to take their vaccinations and these other variants of vaccines are not available and they reject the current vaccines, how soon, when new vaccines come on stream, will they be eligible to be vaccinated?

Thank you. Let me say that we hope that more than 60% of Singaporeans – in fact, ideally, everybody in Singapore – should be vaccinated. Therefore, regardless of whether it is 60% or 70%, we must work hard to try to get the last person to get vaccinated. The Government alone cannot do this. We need everyone to chip in to help – the professionals counselling your patients and their family members to get vaccinated and Members of Parliament going down to the ground, persuading their constituents to step forward and get vaccinated.

I think we want to push the coverage to as high as possible a level, so that we provide protection especially for those who cannot be vaccinated because of medical conditions and/or for various reasons; and there are some for whom the vaccine may not be effective because effectiveness is 95% for the Pfizer-BioNTech vaccine.

Therefore, we need to protect them by making sure that all of us are vaccinated to the extent possible. I urge Members to continue to help us to share this message that we want to encourage Singaporeans to step forward to get vaccinated.

With regard to Sinovac or any other vaccine that has not been approved, my advice is, do not wait for them because we do not know when they will be available and we also do not know whether they will be approved at all. Because until we have the full information, until we have completed the review, I cannot assure you that these vaccines will be available in the short term or even in the long term. So, let us not depend on something that is far away. Focus on what we have today, that is the Pfizer-BioNTech vaccine and get vaccinated. When additional vaccines are available, we will share the details with Singaporeans including the safety efficacy data and everything.

We aim to be as transparent as possible, even side effects, adverse events, we share with everyone so that we can all collectively make an informed decision. So, I think it is important to be transparent, so that we can maintain the trust between the Government and the people and so that we can embark on this vaccination programme together as a country.

Mr Dennis Tan.

Thank you, Mr Speaker, Sir. I thank the two Ministers for their Ministerial Statements. Minister Lawrence Wong made some comments in respect of the Parliamentary Question I filed for tomorrow's sitting. Essentially, I have asked whether the Government is considering or working on a rechargeable version of the TraceTogether token and whether battery replacement for the current version will be provided without charges.

I would just like to see some clarification from the Minister following his comments. Does it mean that the Government will provide free replacement of the current token, free replacement with similar models, not a rechargeable version when the battery runs out, say after six months? I read the literature that the battery will last about six months.

My second clarification is, has the Government already computed at this current non-rechargeable version, if supplied free of charge to all Singaporeans, will cause the Government less in the longer term as compared to a rechargeable version? And this is not forgetting the environmental costs arising from the current model.

Mr Speaker, we had indeed considered these factors on whether or not to have a battery or rechargeable version. I think if you consider the imperatives of what we had to do – roll out the token very quickly and get it distributed in a short time – there is no question, we have to use a version that allows us to use off-the-shelf components. We do not have to incur more costs. We do not have to incur greater complexity in manufacturing. So, that was very clear.

In terms of battery replacement, yes, for the tokens that we have today, the batteries will need to be replaced and we will put in place an implementation process to facilitate that for free, for everyone. Some of it can be done through a simple replacement. Depending on the version of the tokens, because there are different versions. Some of them can be done just through true a simple replacement of the battery, you need not do a one-for-one swap. In other instances, it may be easier to do a one-for-one swap.

But we have indeed taken into consideration all of these factors including the fact that with the current model, you may need to do a one-for-one swap, but we overall still think that this approach, given the circumstances, given the urgency of rolling out the tokens, was a better approach.

Mr Lim Biow Chuan.

Sir, many of my residents have expressed concern about the speed of the development of the vaccine. And the Minister's assurance was very helpful in allying their fears. Sir, I wish to ask the Minister for Health, I recall that in the 1950s and 1960s, there was this wonder drug thalidomide, which had severe side effects for pregnant women. So, let me ask the Minister, what assurances are there that, there would not be adverse side effects which may show up perhaps a few years later, especially for pregnant women.

Another clarification which I wish to ask Minister Lawrence Wong is about the TraceTogether token. Sir, I hear what Minister had said about residents collecting tokens, even though they have apps in their smartphones. I feel bit disconcerted because I feel that for residents to collect them and keep them as a reserve, is really quite a waste of resources. And the literature, as the hon Mr Dennis Tan had said, states that the battery runs out in six months and you will be given a free replacement of the battery. If it is damaged, there will be free replacement of the token. If you lose it, there will be a first free replacement as well.

I feel that we should encourage our residents not to waste resources like this. Use the app if they have it in a smartphone and for those who do not have the smartphone, then yes, we want to encourage them to adopt this TraceTogether programme by collecting the token. But certainly, for those who have smartphones, I hope that the Minister can reconsider and ask those with smartphones to not collect or not seek a replacement when the battery wears out.

Sir, let me address the first question on the long-term side effects for pregnant women. Minister Lawrence Wong can deal with TraceTogether token.

In my speech, I explained that specifically for pregnant women, because the data is insufficient for the time being, therefore, we have advised pregnant women not to be vaccinated for the time being. We are continuing to do research to study the effects on pregnant women. The manufacturers are doing that. As data emerges, we will look at the data and reassure ourselves whether it is safe for pregnant women to take the vaccination. That is a safety precaution we are putting in place.

They are also looking at indications even from a short-term reaction to see whether they are likely to have long-term effects on a pregnancy. These are the part of the scientific work that is on-going. Rest assured that HSA as well as the Expert Committee will take into account all these data before recommending vaccinations for pregnant women.

Mr Lawrence Wong.

Sir, I just want to say I fully agree with Mr Lim Biow Chuan. Thank you for making the plug for the app. For those who have smartphones, there is really no need to collect the token. I have not collected my token. I do not see a need to collect my token either because I am quite happy using my app.

So, we will continue to strongly encourage everyone with the app – use the app. We will try to make the app more useful, add more features and hopefully, when we do that, it will further tilt the balance and encourage more people in favour of using the app as opposed to the tokens.

But to the extent that Singaporeans want to collect the tokens, I think we do want to make them available, reduce any anxieties associated with the roll-out of to TraceTogether-only SafeEntry and that is why we are doing this one time distribution. We will complete that soon and then, we will transit, as I said, to this new phase of having TraceTogether-only SafeEntry.

I share Mr Lim's concerns and I would strongly encourage all of us to put the message out to our residents, the app is just as effective perhaps even more effective when new features are added on, so, please use the app.

Mr Leong Mun Wai.

Mr Speaker, I thank the Ministers for giving us so much information today. To the Minister for Education, I like to clarify that I am not trivialising the effort that the Government has put in from bringing us from Phase Two to Phase Three. However, I am also reflecting some sentiments of many Singaporeans that since there is not much change from Phase Two to Phase Three, we would like to know a longer roadmap whereby we will get closer to the pre-COVID-19 situation. Although it is a new normal, we would like to see this new normal to be far more liberal than before.

So, we would like to know – we would like the Minister to enlighten us on that. Some areas that perhaps we would like to ask is that, one, if we attain a certain level of vaccinations, are we going to open up? Two, if we attain a certain level of testing capability, especially in the rapid test capability, are we going to open up? Three, can we upgrade further the way we use our tracing technology?

For example, just now we were talking about the token, why the Government actually introduced token when we could have push everybody into smartphone, in the first place? So, there are all these questions that on the mind of many Singaporeans. And to open up, can any of these conditions be satisfied or a combination of these conditions will allow us to be closer to the full opening up?

It would be useful not to repeat some of the questions that have been answered, please. Thank you.

Mr Speaker, Mr Leong reflected the sentiments, he says that people have, that these changes from Phase Two to Phase Three are not very meaningful. But in fact, in fact, when you go from five to eight, in groups of five to groups of eight, you are adding a lot of risk. Particularly, if one person goes out multiple times, each time a group of eight persons eating, dining, visiting, you are adding a lot of risk. So, I would say, "Don't sweat the small stuff".

It may appear small but these are significant moves that we are making. I think people do appreciate that they can meet in larger groups, meet with their family members, meet with their loved ones and every time we make one step forward, relax a measure, we are adding risk and all of the risk, do add up.

So, it is not just simply saying, "The situation looks very good, let's all keep opening up, let's keep opening up." But each time we make a move, we have to be very sure that we have the tools and the enablers to keep the infection under control.

With regard to these different tools on testing, on tracing, we have already reached quite a high level. We have reached the desired capacity of testing that we wanted to build up. We have the capacity to test more frequently and we are going to do more, using rapid test. We have 78% of people in Singapore on TraceTogether. It is already a very high percentage, probably the highest in the world on a contact tracing system; and we will still try to get a higher rate. So, on these, we are doing quite well.

The one thing that can allow us to open up more is vaccination. But we will only be able to get people vaccinated, a significant number of people vaccinated, as we said, by the third quarter of the year. So, between now and the third quarter of the year, let us not rush to make big changes and big relaxations. We have to do this in a controlled manner, recognising that the risks are there and the virus is raging everywhere in the world. There are new strains emerging. So, let us do this in a very controlled, careful, calibrated manner.

Even after we have had a lot of people in Singapore being vaccinated, it does not mean that everything is over. Because no country is safe until everyone in the world is safe and it will take some time for the whole world to get vaccinated.

So, yes, getting all of us in Singapore vaccinated is important. It will enable us to move further in terms of relaxation of measures for travel, for our own resumption of activities within Singapore. But if your hope is to get back to a pre-COVID-19 sort of normal, I think we still have to be circumspect and we still have to be realistic. The virus is still going to be raging in many other parts of the world, vaccinations will take time to distribute to every country, to everyone in the world. So, we have to be prepared to live with COVID-19 for quite a while.

Assoc Prof Jamus Lim.

Thank you, Mr Speaker. Let me start by thanking both Ministers for not just the update but their hard work, and, indeed, the work of all Government Ministries and agencies. It has been a long road to get us here and I, for one, feel very thankful. I have two clarification questions that should be very quick to answer.

The first is, given that the endorsement for the usage of the vaccine is only for those over 16 and, understanding that, access is voluntary, would it be possible for those under 16, if they wish, to be able to do so, be vaccinated?

The second question is, if I could clarify the definition of residents able to obtain the vaccination, would this generally include LTVP, Employment, Work Pass holders?

Sir, for the second question, it is in my speech. So, I think I have answered the question, in order not to waste time for the House.

On the first question, I would strongly discourage those below 16 to volunteer for vaccination, primarily because the initial clinical trial did not include those below 16. So, if you do take the vaccine, you will be taking a risk. And I am sure my healthcare professionals would not be in a position to give you a vaccine that has not been authorised for use. So, I would say, please, do not get vaccinated if you are below 16.

We are monitoring. The trials are on-going, manufacturers are continuing to trial on the people below 16. When the data is available, and we are able to verify that they are safe and efficacious for those below 16, we would roll it out for those below 16.

Mr Darryl David.

Thank you, Mr Speaker. I thank both Ministers for patiently and thoroughly explaining the process to us. I would like to ask one clarification which is related to what I think Minister Lawrence Wong said earlier about, for whatever reason health – emotional, psychological – should individuals choose not to get vaccinated, is there any possibility that they could, therefore, end up being excluded from certain activities, from certain places. I think Minister mentioned that they might have to take more thorough tests but I think this was raised to me by a couple of my residents and they said they might choose not to take the vaccination, "Will I be stopped, say, for example, going to watch a movie? Will I be stopped from going to school? Will I be stopped from doing certain things if I do not get vaccinated?"

If Minister could, perhaps, clarify this and give the assurance that, perhaps, the Government will not go down this path? It would be useful, I think, for those who do not get vaccinated to know.

Mr Speaker, as we have highlighted before, without a vaccination, there will be all the various measures that are in place – whether it is testing, whether it is safe distancing, whether it is, you know, tighter control around a particular venue. These are all the prevailing measures that we are used to. They will continue.

When vaccination comes in, we may relax some of these requirements. Many of us are not vaccinated today except for the healthcare workers. But we can do many activities subject to prevailing guidelines, prevailing safe distancing measures.

The idea is that when you get vaccinated, perhaps some of these measures can be relaxed. And we are studying what are the potential changes and adjustments that we might allow and consider.

So, it is not going to be a situation where we say, "No, you can't do this." But it is more likely to be a situation where vaccination will allow you some benefits in terms of activities, in terms of being exempted from certain requirements. Exactly what these are, as I said earlier, it is under study and when we have the data, evidence, when we are clear about what changes are possible in our guidelines and measures, we will put that out to the public.

Minister Gan Kim Yong.

Just to add to Minister Wong's comments. From MOH's point of view, at the moment, that is not the important question to ask. The important question, the important issue is to please get vaccinated. So, do not worry too much about what if you are not vaccinated. Focus on encouraging your constituents, "Please go ahead and get vaccinated." Reassure them that we have gone through thorough assessment on the safety and efficacy of the vaccines. We encourage all of you to get vaccinated when your turn comes.

Mr Gerald Giam.

I thank the Ministers for their Statements. I have clarifications on travel and vaccinations.

I am concerned about the increase in the imported cases. Can the Minister clarify which categories of travellers are excluded from the Pre-Departure PCR Test. I believe he only mentioned Singapore Citizens, PRs and children under six and below? Did all the 12,000 travellers who entered Singapore without a Pre-Departure PCR Test, fall under these categories and, of the 100 imported cases who did not have a Pre-Departure PCR Test, were any of them supposed to have had the test but did not do so?

On vaccinations, since our vaccine programme has already started with healthcare workers, to give the assurance to everybody, including healthcare workers, that the vaccine is safe, should not our senior public servants, including Ministers, already have been vaccinated by now? So, this is not a cheeky question but I believe it will give Singaporeans more assurance to take the vaccine.

And, lastly, is HSA evaluating the Oxford-AstraZeneca vaccine which was already approved by the UK on 30 December?

Mr Speaker, the categories of people who do not require to take the Pre-Departure Tests are spelt out publicly – Singaporeans, PRs who are returning home, children. Those are the key categories. So, I have not looked at the data in great detail but, based on the information we have put out, that the 12,000 which I cited, would largely comprise of these visitors or these returnees.

But as I have highlighted and emphasised, whether someone does a Pre-Departure Test or not, so long as they come into Singapore from a high-risk country, we subject them to a quarantine, SHN. It is quite tight and we make sure that these cases, if they were to emerge, are isolated and ring-fenced and do not leak into our local community. That is the more important point. And we have continued to do so.

There was a second question with regard to our senior public servants and the politicians, whether we should take the lead. In fact, we will be taking the lead. As the Prime Minister has said, he will be among the first when his cohort comes. At the same time, we also do not want to be accused of jumping the queue, that we go ahead of the others. Therefore, we have to manage the process to ensure that the first priority is given to the healthcare workers because they are exposed and they are at risk. Every day, they see the patients and care for the patients, they themselves are exposed to potential infection. And therefore, the priority must be given to the healthcare workers first and we are focusing on that. Among the healthcare workers, Prof Leo Yee-Sin who is the CEO of NCID, was among the first batch to get vaccinated. That is how she demonstrates her leadership and confidence in the vaccine.

So, I think when our turn comes, I am sure all my colleagues would be very happy to step forward to get vaccinated.

Mr Christopher de Souza.

Mr Speaker, first, let me say that I am pro-vaccine. We have learned quite a lot about new strains or mutations across the globe. Look at UK. My question is, does this vaccine we have subscribed to anticipate resistance to future strains or are we to get further vaccinations over and above what we have subscribed to? So, is this a moving target, over and above what we are going to get vaccinated for?

Thank you. We will continue to monitor the mutations of the virus. I think the scientists around the world are watching and monitoring carefully. As I mentioned in my speech, mutation happens from time to time. In fact, it happens quite regularly as the virus, basically, is like a photocopying machine so it copies itself and every time it makes copy, it will be slightly different from the version previously. There will be some specks here and there, some dots here and there that are different. That is how photocopying works.

By and large, up to today, there has not been evidence to show significant shift in the severity of the virus or the impact on the effectiveness of the current vaccines that are being approved or reviewed in Singapore. So, we continue to monitor.

It is possible that one day, the virus may mutate and we may need to modify our vaccine in order to respond to the new virus. With the current vaccines that have already been developed, I think it will facilitate the development of the new vaccines if it becomes necessary to respond to new strains of the virus, particularly, with the platform of mRNA, it is much easier for us to replicate, to produce new vaccines in response to variations or mutations in the virus.

Mr Leon Perera.

Thank you, Mr Speaker, Sir. I thank the two Ministers for their detailed Statements. Just three supplementary questions for the Minister for Health.

In regard to where the vaccines will be administered, can we take it that they will be administered at polyclinics, public hospitals? Will GP clinics also be involved? Will every effort be made to ensure that the vaccines can be administered in locations that are close to where people are living in diverse locations across the country?

The second question is, will every effort be made to bring the vaccination process to elderly Singaporeans who are in nursing homes, senior care centres and so on, who may not exactly be very ambulatory?

And, thirdly, just to follow up on the question that my colleague Mr Gerald Giam asked, I do not believe it was answered. Is the Government evaluating the Oxford-AstraZeneca vaccine as well?

Thank you. I think there are quite a number of vaccines that we are currently evaluating. I would not be at liberty to go into details of which are the vaccines that we are evaluating.

It also depends on the data that we are able to get. HSA has now adopted a progressive rolling review approach. As and when data is made available, publicly or bilaterally from the manufacturer, we review them and we get ourselves updated as much as possible so that when the application is made by the manufacturer for the vaccine to be registered, we will then be ahead of time to be able to make a quick assessment, rather than to start from scratch. Therefore, we do this rolling review approach in order for us to speed up the approval process.

So, I would say that most of the vaccines that are currently being developed, HSA has been keeping a watch on them, and is assessing and reviewing the data as and when they become available. As and when the vaccine has applied for registration, we will then go into a full swing evaluation. I would not be able to share what are the vaccines that have applied, beyond the three that I have mentioned earlier.

The other question that where would vaccination sites be, I would say that we will generally take into account accessibility and convenience for those who are receiving the vaccination. For the healthcare workers, most of them will receive the vaccination within their healthcare institutions. They have an existing system to vaccinate their staff and we will tap on those.

For the general public, we will set up vaccination centres across the island. We will also tap on the polyclinics that are available, operating today, but bearing in mind that the polyclinics also have their usual patients that they need to attend to. So, we would not be able to squeeze everyone into the polyclinics for vaccination and that is why we also will need vaccination centres.

We will also be working with private General Practitioners (GPs) clinics to help us to administer the vaccine, especially for those who are less mobile and will need to get to a clinic that is nearby. We will work with the private clinics as well.

Having said that, we have to bear in mind that this particular vaccine – the Pfizer-BioNTech vaccine – is quite challenging to handle. As you are aware, it requires ultra cold-chain, minus 80 degree Celsius and it needs very careful handling during the administration of the vaccine to the individual. It is not so easy to make it available conveniently at all the private clinics. We will need to work with specific clinics and specific chains as well as work with specific, selected vaccination sites so that we are able to construct the infrastructure that is needed for this extra cold-chain storage and administration.

For nursing homes and senior care centres – yes, we will make special arrangements to make sure that we are able to vaccinate them because many of them are not mobile. We are planning to set up mobile vaccination teams that will be deployed to some of these nursing homes and senior care centres to provide vaccination services for them.

Order. End of Ministerial Statements. Introduction of Government Bill. Minister for Communications and Information.

[(proc text) "to amend the Electronic Transactions Act (Chapter 88 of the 2011 Revised Edition) and to make consequential and related amendments to the Bills of Lading Act (Cap. 384) and the Contracts (Rights of Third Parties) Act (Cap. 53B)", (proc text)]

[(proc text) presented by the Minister for Communications and Information (Mr S Iswaran) read the First time; to be read a Second time on the next available Sitting of Parliament, and to be printed. (proc text)]

[(proc text) Order for Second Reading read. (proc text)]

Mr Speaker, I beg to move, "That the Bill be now read a second time."

The Payment Services Act, or PS Act, came into force in January last year. Since then, payment services have continued to evolve rapidly, with innovative activities and new business models emerging. One significant development is in the area of digital payment tokens, or DPTs. These are cryptocurrencies – such as Bitcoins – which are not denominated in any currency but can be used as a form of payment.

The speed and cross-border nature of such DPT activities carry higher inherent money laundering and terrorism financing or ML/TF risks. They need to be regulated and service providers need to carry out proper customer due diligence and monitoring of transactions.

Global standards setting bodies, regulators and policy makers around the world are focused on addressing these risks. As a major financial centre and fintech hub, Singapore has played an active role in shaping international standards, including at the Financial Action Task Force, or FATF, which sets standards for combating ML/TF.

The Monetary Authority of Singapore (MAS) is therefore enhancing its regulatory framework and updating the PS Act to keep pace with changes to international standards and to better mitigate ML/TF risks related to DPTs.

MAS has conducted a public consultation on the Bill and noted the broad support from respondents. MAS has considered the feedback received and, where appropriate, has taken them into account in finalising the Bill. The Bill makes amendments to the PS Act in three broad areas.

First, mitigating ML/TF risks. Under the PS Act, MAS currently regulates service providers dealing in DPTs and facilitating the exchange of DPTs where the service provider comes into possession of monies or DPTs. These are common business models of DPT service providers that operate in Singapore.

The scope of the PS Act will be expanded under this Bill to confer on MAS powers to regulate service providers of DPTs that facilitate the use of DPTs for payments and may not possess the monies or DPTs involved. The FATF standards term these service providers as virtual asset service providers.

In regulating these virtual assets service providers, the Bill will expand the scope of DPT services in the PS Act to include the following three activities: one, facilitating the transmission of DPTs from one account to another; two, custodial services for DPTs; and three, facilitating the exchange of DPTs where the service provider does not come into possession of the moneys or DPTs involved.

The Bill will require an entity that provides any of these services as a business in Singapore to be licensed and subject to rules and regulations set by MAS in subsidiary legislation. This will help minimise the risk of DPT service providers being exploited by criminals to launder illicit proceeds or hide illicit assets.

The Bill will also pre-emptively address ML/TF risk that is outside of the DPT space. The Bill will broaden the definition of cross-border money transfer service to include facilitating transfers of money between persons in different jurisdictions where money is not accepted or received by the service provider in Singapore. That way, such service providers will come under the regulatory ambit of MAS even if the monies do not flow through Singapore.

The second set of amendments provides MAS with powers to impose measures on DPT service providers to ensure better consumer protection and to maintain financial stability and safeguard the efficacy of monetary policy.

The risks to consumers are not significant currently because of the relatively low usage of DPTs in Singapore today. However, user adoption of DPTs could gain traction quickly as the industry comes out with products to attract customers. We have seen recent development of new forms of DPTs which values are pegged to stable assets to gain users' confidence. It is therefore important for MAS to be able to respond to market developments and address new risks in a timely manner.

The Bill will enable MAS to impose user protection measures on DPT service providers when necessary. This could include, for example, requiring a DPT service provider to segregate customer assets from its own assets. This will augment current powers that allow MAS to require DPT service providers to safeguard customer money from loss in the event of insolvency.

MAS will also be empowered to impose additional measures on certain DPT service providers to maintain stability in Singapore's financial system, safeguard the efficacy of the monetary policy or where it is in the interest of the public to do so. The scope of this new power is necessarily broad so that MAS can respond flexibly and swiftly in the fast-moving DPT landscape. MAS will consult the public and the industry when drafting subsidiary legislation on the specific measures.

Finally, the Bill will make three other miscellaneous amendments to the Act.

Firstly, the PS Act currently accords protection to consumers, whether they are payers or payees, during a domestic money transfer. As financial institutions are sophisticated entities that can protect themselves, the Act carves out the situation where a financial institution is part of the transaction. However, that means that an individual involved in a domestic money transfer transaction with a financial institution is not accorded protection under the Act. The Bill will therefore broaden the scope of protection of the PS Act to carve out only situations where both payer and payee are financial institutions.

Secondly, only major payment institutions providing services like e-money issuance are currently required to safeguard customer money. With the fast-evolving landscape, user protection concerns associated with other types of licensees can also arise. The Bill will thus allow MAS to prescribe, where necessary, additional classes of licensees conducting specific payment services to be subject to the requirement to safeguard customer money.

Thirdly, the PS Act today requires an individual to use reasonable care to ensure that any information he or she provides to MAS under the PS Act is not false or misleading in any material particular. The Bill will clarify that this general duty of care applies to all persons, whether or not the person is an individual.

Mr Speaker, Sir, this Bill will enhance the regulatory framework for payment services in line with global regulatory standards and will allow MAS to be nimble and responsive in addressing various risks in the payment landscape. Mr Speaker Sir, I beg to move.

[(proc text) Question proposed. (proc text)]

Mr Louis Ng.

Sir, the proposed amendments in this Bill will expand anti-money laundering and counter-terrorism financing regulations to cover more categories of payment service providers. The list will include those providing services centered on Digital Payment Token (DPT) and those facilitating cross-border money transfers where the money does not pass through Singapore.

I agree with this step. The fight against money laundering and terrorism financing is the fight to make sure that crime does not pay. This mission, by necessity, must include all players of our finance industry.

Before I continue, let me thank MAS for conducting a public consultation which shaped the proposed amendments we see today. Public consultations help us formulate better policies and I hope MAS will continue this good practice.

I have three points of clarification to make on this Bill.

My first point is about anonymity in our payment eco-system. In its public consultation, MAS made clear that this Bill will obligate DPT service providers to conduct customer due diligence to guard against money laundering and terrorism financing.

These requirements mean that short of peer-to-peer trading, there is no way to trade cryptocurrencies in Singapore anonymously. This removes one benefit of cryptocurrency, which is its anonymity.

I will say, first, that I fully agree with the intent of this Bill – bad actors must not be allowed to use Singapore's financial system for their purposes. But cryptocurrency's quest for anonymity is perhaps one we can empathise with. Today's world is plagued by compulsive tracking. You cannot access any digital services without someone storing every little bit of information about where you are, what you do and who you are.

Today's world is also plagued by massive data leakages and malicious hackers. A month does not go by before some company we know spills our private information and order history into the wild.

Having sought the views of the public and the industry, can the Minister share whether MAS has reached a final policy stance on whether it envisions providing any space for anonymised financial transactions in Singapore?

My second point relates to user protection. The Bill provides powers for MAS to enact regulations on licensed DPT service providers. Many of the regulations pertain to the DPT service provider's maintenance of and safeguarding of assets belonging to users.

I support these powers. User protection is essential. It helps keep our financial system stable and it protects the assets of Singaporeans.

As part of its efforts to protect users, will MAS consider introducing other forms of user protection measures? In particular, will MAS consider regulating DPT servicer providers to ensure they do not engage in misleading or deceptive conduct concerning their offerings?

DPTs are fresh, different and interesting. Service providers will likely latch onto these qualities when marketing to unsuspecting consumers. Regulating how DPTs at an earlier point when they are marketed to consumers would complement regulations at a later stage on money management by service providers. After all, it will be harder to defraud or otherwise harm a customer who knows what they are getting themselves into.

My third point relates to the illegal wildlife trade. This Bill expands our regulatory scrutiny of international money transfers and that is a good thing.

In this spirit, I ask that we work more closely with financial institutions to ensure that their internal controls can accurately identify signs of illegal activity, particularly when it comes to illegal wildlife trade. This is not a new idea from me. It is a best practice recommended in a June 2020 report by the Financial Action Task Force (FATF), titled "Money Laundering and the Illegal Wildlife Trade".

I quote, "There is a need for both the public sector to share additional information with reporting entities, including feedback on [suspicious transaction reports] filed, and for reporting entities to review whether current internal controls against money laundering from the illegal wildlife trade are in line with identified risks... Where competent authorities have shared information, financial institutions have been able to incorporate this into their transaction monitoring systems and, in turn, provide richer intelligence for [law enforcement authorities]."

My team spoke to some employees of local financial institutions who monitor transactions. They agreed with this recommendation. Some shared their concerns that they may only receive generic responses from the authorities with regard to the suspicious transaction reports they file. This creates two problems.

One, the employees do not know whether the signals they are looking out for are relevant or not. The feedback from the authorities with regard to the suspicious transaction reports is not specific enough to motivate meaningful operational changes.

Two, the employees have little information on the status or outcomes of Government investigations. This means they struggle to take internal follow-up actions to adjust the risk levels of these clients. Better feedback will help our Government get more relevant reports as well as help financial institutions take strong internal actions against bad actors.

Industry experts say the same thing. At a seminar held by the Association of Certified Anti-Money Laundering Specialists (ACAMS) last October, the panelists from the industry noted that there has not been sufficient focus on the financial aspect of tackling the illegal wildlife trade.

Will the Government consider sharing feedback with greater details when financial institutions do provide suspicious transaction reports, including on the illegal wildlife trade? To ensure that its feedback is relevant, will the Government also consider holding discussions with ground staff at financial institutions to assess the efficacy of its existing feedback?

Sir, notwithstanding my clarifications, I stand in support of the Bill.

Mr Speaker, Sir, in recent years Singapore has built up its reputation as a fintech hub. To preserve that, we have to ensure that our regulations strike the right balance between carefully managing risks and encouraging innovation.

In 2018, Singapore was the second most popular country in the world for ICOs, and as of November 2020, 234 blockchain companies were operating in Singapore. E-money has also received high adoption rates here and our consumers need to be protected. Seventy-seven percent of Singaporeans already used digital wallets, though there is still much room for improvement in the adoption of digital payments, as my Parliamentary colleague, Mr Louis Chua Kheng Wee we will expand on. We have to ensure consumer confidence has not misplaced. Trust in people is earned, not given. Trust in business is also earned and this is where a sound regulatory framework plays a crucial role.

The Payment Services (Amendment) Bill is a step in the right direction of proactive regulation of the payment space. Sir, I shall focus the remainder of my speech and raising questions and suggestions in relation to the attributes of proportionality and possibility and transparency in relation to the Bill.

I declare my interest as the CEO of a Research Consultancy that undertakes work in the fintech space, among other sectors.

Firstly Sir, I shall speak on the expanded definition of DPT service provider in this Bill. The expanded definition of DPT service provider will capture more activities, but more guidance is needed from MAS as to what constitutes certain activities such as, control, inducing and arranging. The expanded definition of DPT service provider will capture entities who offer token custody services or entities will market or advertise token sales. Such entities will have to be licensed and regulated to the same extent as a token exchange.

While it is laudable that the Payment Services Act or PSA is amended to greater meet the Financial Action Task Force or FATF standards, it maybe onerous for certain payment service providers to meet the same licensing requirement despite posting different or lower levels of risk. Here, I would like to note in passing, that my parliamentary colleague, Assoc Prof Jamus Lim will be making a similar argument in the context of the moneychangers actor and small businesses.

Sir, the PSA licensing regime currently requires DPT service providers to meet relevant MAS requirements on cyber hygiene, periodic returns, business conduct disclosure and communications as well as annual audit requirements, amongst others. However, a token marketer or token custodian such as, a wallet service provider, for example, may not pose the same risks as a token originator or a token exchange to warrant such regulation by the MAS PSNO requirements.

Specifically, for a token marketer limb E of the proposed inclusion, states that an entity who induces a person to buy or sell a DPT ought to be regulated, although this entity may not come into possession of the DPT at all. While some marketing may be performed by a DPT custodian, other entities such as, for example, a professional public relations company asked to design or execute an ICO campaign or even a blogger writing about hot ICOs, may conceivably be caught in the net. What then is the purpose of requiring such an entity to meet periodic returns and our audit requirements if they are merely in the service of marketing a token and might it be too onerous for such an entity to meet the whole suite of MAS PSNO requirements?

Also, industry feedback suggests that the definition of arranging or inducing an individual to enter into a transaction is vague. Perhaps, the Minister could provide further clarifications on the exact types of activities that fall within the definition of "arrange" or "induce". On token custodians, there are also concerns from stakeholders in the DPT space that the definition of control in the proposed limbs F through H is somewhat vague. While MAS had clarified that I quote, "A DPT service provider will have control of a DPT if it has the ability to control access to any DPT or to execute transactions involving the DPT", further regulatory guidance as to what this control exactly is, would be helpful.

I would also suggest that MAS consider in the fullness of time offering relaxation on MAS requirements, for entities who pose less of a threat. For example, relaxing the audit requirements or periodic returns requirements for a token advertiser.

Next, Sir. Current companies who one, have a capital markets licence, and two, provide a token custody service must still hold a payment service licence with an exception available, if a token's function is merely incidental to the business of that payment service provider. In the prior crypto wave in 2017, companies who dealt in digital tokens were required to hold a capital markets licence if such tokens resembled security or shares. Now, these companies have to also hold a major payment institutional licence or standard payment institutional licence under the PSA, if the tokens that they custodise hold the payment function. Perhaps, more guidance and defining incidentality would be helpful for entities to make an assessment as to whether a token's payment function is merely incidental to its core business function of providing custodial service.

In addition, Sir, it is unclear who the onus is on to determine whether a token is a DPT or not. Whether that falls on the custody service provider to assess whether a token it seeks to custodise is a DPT thus having a payment function warranting a licence application, or whether it falls on the token originator to warrant that its token is not a DPT and thus the custody service providers have no need to apply for a PSA licence. For example, must a wallet service provider conduct its own analysis as to whether a token that it seeks to custodise falls under the definition of a DPT under the PSA or whether it may carry out its custody service, as long as the DPT provider is already a licence entity?

Perhaps, there should be further consideration as to whether the PSA should provide an exemption for custody service providers in the event that the token issuer is already licensed. This is to prevent unnecessary dual licensing.

Secondly, Sir, I would like to speak on how the perception of increased regulatory powers by MAS may spark fears of over-regulation and potentially excessively stifled innovation, especially among smaller players. The amendment Bill before us provides additional powers to the MAS to, firstly, impose user protection measures on certain DPT service providers; and secondly, impose additional measures on any DPT service provider or class of DPT service providers by way of subsidiary legislation.

While consumer protection is an important concern, feedback from the industry, especially smaller firms, suggest that this is a cause for concern by them. For instance, the proposed amended section 21(A) may be too onerous in the view of some in the industry. It should be borne in mind that excessive regulation could curb entrepreneurship in a sunrise industry and crowd out smaller players and start-ups leaving only the bigger players to dominate. This in turn would be bad for entrepreneurship and innovation in the longer term. I would like to ask what steps would be taken by MAS to ensure that smaller companies and new entrants to the industry are able to meet these enhanced regulatory standards.

Thirdly, Sir, the expanded definition of cross-border money transfer services raises questions in terms of its enforceability and benefits for Singapore, in terms of congruence with other competing jurisdictions. This amendment Bill expands the definition of cross-border money transfer service to require licensing of service providers like brokers in Singapore that actively facilitate cross-border money transfers between entities in different countries, although monies are not accepted or received in Singapore.

Under the current PSA, such providers are not covered. While it is laudable that Singapore is taking the lead on cross-border regulation of VASPs and adopting FATF recommendations, there are two concerns. Firstly, this may be difficult to monitor and enforce if the flow of money is from one foreign country to another foreign country. How does the Government intend to monitor and enforce this?

Secondly, while I acknowledge that this amendment is necessary to uphold the reputation of Singapore as a trusted financial hub, it is unclear if other countries are doing the same with regard to monitoring the movement of illicit funds or suspicious transactions with regard to DPTs from Singapore to a third country or vice versa.

While according to an FATF review and I quote, "Twenty jurisdictions advised that they have extended their regime to include value-added service providers or VASPs conducting operations from their jurisdiction", the review did not appear to identify the specific jurisdictions or provide specific details about these regimes. Furthermore, the review then noted that such a diversity in approach and I quote, "may present challenges in identifying which VASPs are regulated by each jurisdiction".

In respect of other jurisdictions specifically, for instance, there do not appear to be similarly expansive definitions, which have been implemented or proposed with regard to cross-border money transfers in Hong Kong or the Cayman Islands, even though these jurisdictions have proposed to enact or have enacted legislation in connection with the FATF guidelines. Hence, I would like to ask if the MAS will, going forward, monitor the extent of international regulation of VASPs in line with the FATF recommendations and calibrate the onerousness of our own regime in line with what is being done internationally, with an eye to our competitiveness.

Fourthly, Sir, I would like to speak about the need for greater transparency and less of a black box approach in the payment service licence application process. The payment service licence process required for firms covered under the PSA is perceived by some industry players as a completely black box. Many companies reportedly find themselves stuck on the waiting list for long periods.

Moving beyond a completely black box approach to a greater degree of transparency, could provide more support to viable businesses to get licence and go to market faster. It may also enhance Singapore's attractiveness as a fintech Hub. While MAS does provide some basic criteria, for example, base capital requirements, fit and proper requirements of shareholders and employees, no entity is familiar with the actual determining factors that make or break a licence application.

Companies may apply for exemption status to continue operating on a small scale for six months while waiting for the licence but cannot scale up during that time. These companies also struggle to account to their investors or shareholders and their future plans and as a result, go into hibernation or may leave the country.

There are 366 firms who applied for exemption from holding a licence under the PSA for specific payment services for a specified period while waiting for their licence. And there are likely even more in the pipeline, namely those who directly applied for the licence without seeking exemptions, those who are still seeking legal advice and have not yet applied, and those who will only apply after this amendment passes. For example, DPT marketers and custodian service providers. There are 439 firms who currently hold the payment licence.

While it is understandable that the full licensing criteria cannot be disclosed due to the risk that some applicants may game the system, as it were, this has to be balanced against the need for some transparency, so as to enhance Singapore's attractiveness as a fintech hub.

With that in mind, I would like to ask the Minister for information regarding the proportion of successful applicants to total number of applicants and the average duration companies have had to wait for an outcome.

I would also like to ask if the MAS would consider providing:

a clearer fixed timeline and process including an appeal process so applicants know when to expect an outcome;

more resources to help innovative businesses understand and navigate the licencing process. For instance, project innovate by the UK's financial conduct authority targeted support to innovative businesses in navigating the FCAs at the authorisation process. This achieves good results. Firms coming through this programme in the UK are being authorised on average 40% faster than the standard applicant.

I note that the MAS launch the payment Regulatory Evaluation Programme in 2019, meant to assist payment service providers and seeking legal advice from registered Singapore law practises relating to the PSA. This entails a sample questionnaire for potential applicants to approach law firms with, and the list of legal practitioners who can provide advice in relation to the PSA, but it does not provide targeted support like what is being done in the UK. Furthermore, this programme will cease in January 2021, one year after the PSA has come into force and the transitional period has ended; and

I would like to ask if the MAS can provide high-level guidance on the criteria determining approval or rejection of a licence.

Order. I propose to take a break now. I suspend the Sitting and will take the Chair at 5.35 pm.

Sitting accordingly suspended

at 5.15 pm until 5.35 pm.

Sitting resumed at 5.35 pm.

[Deputy Speaker (Mr Christopher de Souza) in the Chair]

[(proc text) Debate resumed. (proc text)]

Assoc Prof Jamus Lim.

Mr Deputy Speaker, the proposed amendments in the Payment Services Act of 2019 takes a number of important steps to accommodate new innovations in payment systems and services. The very fact that an amendment is needed so soon just one year after the enactment of the original Act demonstrates the speed by which technological developments can render even the best laid legislation rapidly obsolete or, at the very least, struggling to catch up.

While I understand the premise behind the proposed amendments with regard to scope to essentially ensure adequate regulatory coverage of the Bill to all MAS licensees, I wish to raise three cautionary points, all related to potential unintended consequences.

Before I proceed, I wish to declare that I am the Chief Economist (Emeritus) of a homegrown investment advisory firm, which had previously been involved in payment services.