Hansard, Thursday, 29 January 2015

1 Mr Seng Han Thong asked the Minister for National Development (a) what are the criteria for awarding tenders for the development of places of worship; and (b) whether a for-profit organisation is allowed to participate in the tender process for such developments.

2 Er Dr Lee Bee Wah asked the Minister for National Development (a) what are the current criteria to determine the winning bid of tenders for places of worship; (b) whether it is the practice to allow non-religious business entities to bid for such projects; and (c) whether the Ministry will review its criteria on who can qualify for such projects so that religious groups can have a fair chance to compete in the bidding.

3 Ms Lee Li Lian asked the Minister for National Development (a) how many commercial companies are operating in land zoned for religious use; and (b) what are the considerations used by the Ministry to award such land to commercial entities.

Mdm Speaker, may I have your permission to take Question Nos 1 to 3 together?

Yes, please.

Places of Worship, or PWs, serve the spiritual needs of our people and are essential community facilities. That is why the Master Plan has reserved and zoned specific land sites for PWs to be built. We tender out such sites to meet new demand and invite religious organisations to bid in such tenders. We have also opened such tenders to participation by companies. This is because some religious organisations form companies to enable and facilitate their ownership and development of such PW sites. This has been the practice since 1991 – that is some 24 years ago -- when state lands were put up for tenders for PW use. The assumption is that only companies affiliated to religious organisations would participate in such tenders.

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For each tender, the highest bid among eligible bidders will win, as this is a fair way to allocate the site. Since 1991, seven sites have been won by companies, all affiliated to religious organisations.

Until the recent case of the Chinese temple site in Sengkang, the Government has never awarded a PW site to a company that is not affiliated to a religious organisation. We now understand that the winning tenderer for this site, Eternal Pure Land Pte Ltd (EPL), is actually a private company without any religious affiliation. From what we know, the plan of the company is to run a commercial columbarium on the site. This is not in line with our plan for the PW site at Sengkang.

The Master Plan sets aside and provides sites for private columbaria. We have occasionally tendered such sites as "columbarium", but not as "place of worship". The tender documents are differently worded.

The Sengkang site is not intended for a commercial columbarium. HDB awarded the site to EPL, under the impression that the company is a vehicle for a religious organisation to build and own a Chinese temple.

We will ensure that the land is restored to the original plan of a Chinese temple. We are in discussion with EPL on how this can be achieved.

The intent of a Chinese temple was clearly stated in the Master Plan and the HDB's marketing brochures for their BTO flats there. Many temples provide an incidental columbarium service for their members and devotees. Whether the eventual temple in Sengkang will also provide such a service is a decision for the temple trustees to make. But to minimise disamenity to residents, there are clear URA planning guidelines for such ancillary facilities.

Late last year, we launched a review to improve our land tender process for places of worship, for example by tightening eligibility requirements for tenderers. We have been engaging religious groups on the review. The Sengkang temple case has highlighted the necessity for such a review. I will provide more information when the review is completed.

Mdm Speaker, may I ask the Minister what lessons can HDB and other Government agencies learn from this episode? Secondly, is it possible for URA, in its Master Plan, to indicate the possible sites for the development of places of worship; make it compulsory? And is it possible for it to be made compulsory for HDB to be specific in its future sales brochures to indicate a site meant for development of places of

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worship? A third question in Mandarin, please.

(In Mandarin): [Please refer to Vernacular Speech.] I would like to ask the Minister this: in the past development of Singapore, what experiences have we gained in the building of temples, churches, mosques in residential areas? Many of our residents believe that if they live near to a temple or places of worship, they will be blessed. Kong Meng San Phor Kark See Monastery has opened up to become a tourist site. In the case of Fo Guang Shan, they were able to be developed to provide both temple and columbarium services without any problems. Why is the development a problem?

Mdm Speaker, I thank the Member for the questions. One take-away for me from this episode is that times have changed and some of our tender procedures have not caught up with time. For example, for over 20 years, we would never have thought that a for-profit company would participate in a non-profit making venture like building and owning a Chinese temple. In this instance, the motivations of the successful bidder are very different. But having reached such a situation, I will find a way to try and unwind this.

The key point is, for that Sengkang site, we want a Chinese temple; and we will deliver that. For that Sengkang site, we do not want a commercial columbarium; and we would not have one. Members can be assured about this point.

As for reservation of PW sites, they are clearly marked in our Master Plan. Every five years, we review the Master Plan and when adjustments are needed, we publish those proposals and seek public consultation before we confirm them. So, there is full transparency. Likewise, HDB's BTO brochures are very clear. In this instance, for example, that the site would be reserved for a Chinese temple was clearly marked. There was no ambiguity about that. But I can understand some of the residents' unhappiness because of the possibility that there will be a commercial columbarium cropping up in their neighbourhood. I think those concerns are legitimate and reasonable.

We make a strong distinction between a commercial columbarium and an incidental columbarium service which is provided by temple or church. I remember that in Er Dr Lee Bee Wah's constituency, there is a church which has an incidental columbarium service. As Mr Seng Han Thong pointed out, temples like Kong Meng San Phor Kark See Monastery and Fo Guang Shan also provide a columbarium service. I visit Fo Guang Shan occasionally and I am impressed with their careful planning of the columbarium. Most temples hide them in the basement, so, it is dark and gloomy. But in this instance, they put it on Level 3 or 4. With sunlight coming in, it is bright and when you walk in, you do not feel uneasy about the

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columbarium.

In other words, there are ways to provide a good columbarium service without causing any kind of disamenity. I hope that answers the Member's queries.

I also asked about making it compulsory for URA and HDB to indicate specifically the sites for places of worship.

It is not necessary. We already do it as our Standard Operating Procedure (SOP).

Can I remind Members to address the Chair when you have to take the floor. Er Dr Lee Bee Wah.

Thank you, Mdm Speaker. It is not just the residents who are not happy. A lot of temples are not happy as well, since commercial companies were allowed to tender for the site. I would like to ask the Minister, since it is a commercial company which has the intention of setting up a columbarium, will the Ministry consider disqualifying this company and recalling the tender. By allowing a commercial company to build a columbarium and later on bringing in a temple, the nature of the operations is very different from a temple operating the place.

A second question is, moving forward, will MND disallow commercial companies to tender for religious land in the future?

Mdm Speaker, as I have indicated, a review is on-going. In fact, the review has been going on for several months. There are different kinds of religious organisations – a church's needs and a temple's needs can be quite different. We have done many rounds of consultation and the consultation will continue to see how best to tighten some of these tender rules to achieve our planning objectives. If we want a temple, we really get a temple, and not a commercial columbarium cropping up out of the blue. The review is ongoing.

The reason that triggers the review was not this incident in Sengkang. It was that we have got quite a bit of feedback from some of our temples and churches. When they take part in a tender, they often lose out to some other bidders whose congregation is much smaller and who already own an existing place of worship. So, they asked if the Government could build in additional criteria to ascertain needs rather than to simply award the tender to whoever has the deepest pocket. Often, the latter also has external links, being foreigners.

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And with deep pockets, they were more able to win the tender.

That was what triggered the review. As Members know, it is not easy to assess needs, especially when different kinds of religious organisations are involved, but we will find a way. We will seek religious wisdom. We will meditate on it.

Punggol East): Thank you, Mdm Speaker. It is good to hear from the Minister that that plot of land will still be a place of worship. One supplementary question: how can such an incident take place or be overlooked? What other safeguards are there in place to prevent it from happening again?

Mdm Speaker, as I have said, this is a case where, for many years, the tenders are open to commercial companies without problem. The assumption is that the companies are affiliated to some religious organisations and are a convenient vehicle for the religious organisations to take part in a tender and to execute a project.

In fact, some of us recall that the request to include commercial companies came from the religious organisations because some of them found it more convenient to do so. Because temples and churches are non-profit making, we just assume that profit-making companies would not be taking part in a non-profit making venture. That is how it came about.

Mr Seng Han Thong would know a very popular Chinese opera – Butterfly Lovers. It was in an era of old China when girls, unfortunately, were not allowed to join schools. But there was this young and beautiful talented lady, 祝英台, who wanted to study. So, she disguised herself as a boy and succeeded in attending the school for three years. The classmates just assumed that girls would not turn up. In hindsight, they asked why they did not suspect. They had noticed that the student looked a little girlish, but just brushed the thought aside as it would be too incredible. And "he" turned out to be a girl.

It is a similar situation here. The officials assessing the tender assumed that it must be a company affiliated to some religious organisation. Because they made the highest bid, it was awarded to them. But as I have said, we will find a way to forge a middle path forward. The key point is we will restore the planning objective.

Mdm Speaker, my first question earlier was since the company that tendered for this site is not a temple or a company set up by the temple, will the Ministry disqualify this tenderer and recall the tender, so that the temples, especially the smaller temples can take part in the tender and make it more affordable? Many say that if you allow the commercial company to tender such land, it would drive up the bid price and the smaller

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temples have difficulty in getting land.

Yes, that is the intent. We are in discussion with the company to see how we can restore this site to its original purpose. Their plan and our plan do not coincide. We are in discussion; I do not want to go into too much detail here. But we will find a way to restore this site to its original intent.

Mdm Speaker, the Minister had alluded to the fact that the intention of the winning bidder might not coincide with the state's land use planning. I would like to ask when the agency assessed the tender, would information about the parentage of the bidder and the fact that it was incorporated in Singapore only recently, not arouse some suspicion and prompted checks. Therefore, I ask the Minister what is the due diligence that was taken in assessing this tender and whether lessons learnt could be applied to prevent such instances from happening, not only just for religious sites, but other land use tenders as well.

Certainly, out of this incident, we have learnt some lessons, which Mr Seng also asked about just now. But as I have said, for a quarter of a century, we never had a for-profit company taking part in such temple tenders. Therefore, it never crossed the minds of the officials evaluating the tender. But it is not too late to unwind the situation.

Mdm Speaker, I would just like to ask about the issue of temples and religious organisations. Some of the temples and religious organisations in my constituency have bidded for a long time and have waited many years, but they have no choice and their hands are tied.

Since there is a review ongoing, can the Minister ensure they also look at the extension of lease for some of these religious organisations as well, and perhaps update us at the relevant time?

Madam, as I said earlier, the review was meant to look at larger issues and various aspects have cropped up. Shortage of land for PWs is indeed a real issue, because Singapore, unfortunately, is very handicapped as far as land is concerned. That is why in recent years, we have allowed existing PWs to intensify their land use so as to be able to meet the greater demand that they are now facing. We have reserved enough sites, but there is a need to intensify land use. We will bear the Member's points in mind.

Mdm Speaker, I thank the Minister for the clarification. One supplementary question: on the issue of transparency, one of the sticking points from the many potential buyers of flats was that the columbarium was seen to be a

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fine print. Moving forward, from URA's perspective or sales perspective, how does HDB plan to change this practice? Transparency is important. Any associated or incidental columbarium, or any other services that could be sensitive, should also be included in sales plans and booklets.

Madam, in this instance, there was no question of a lack of transparency. The site was clearly marked out as a temple. In fact, for completeness, the HDB put in a footnote to indicate that there may be a columbarium. We cannot assume that the temple will build a columbarium. I am closely associated with three temples which I visit quite regularly. Out of the three, two have a columbarium service. It is not all three; and not all zero. Some do and some do not. Even for this new temple that will eventually crop up when we re-tender, we will not know yet if they want to put up a columbarium service or not. We cannot make that assumption. But I think the unhappiness of the residents over the last few weeks was that they thought we were going to allow a commercial columbarium to be built there. And this is quite a different entity from an incidental columbarium service.

4 Er Dr Lee Bee Wah asked the Minister for Transport in the light of the recent underground train incident in Washington where one person died and more than 80 were treated for smoke inhalation after a wiring short-circuit (a) what safeguards are in place in our MRT system should this happen in our train tunnels; (b) whether there are rescue procedures to evacuate trapped passengers in a similar situation; and (c) whether simulated exercises have been held to test our readiness for such eventualities.

Mdm Speaker, let me assure Members of the House that our MRT system is designed to protect commuters in case of fire or smoke in the tunnels or trains. Our underground MRT stations and tunnels are equipped with smoke extraction and tunnel ventilation fans to expel smoke and to supply fresh air in the event of a fire. The materials used for our trains conform to strict fire safety requirements so that smoke emission and the level of smoke toxicity are minimised during any fire outbreak.

LTA's Code of Practice on Incident Management requires our rail operators to have plans to ensure passenger safety during emergencies and to ensure that their officers are trained to execute these plans promptly and efficiently. For instance, in the event of a fire or smoke in the MRT tunnel, the operators will have to alert SCDF immediately and route affected trains to the nearest station, away from the source of the fire or smoke. If passengers have to detrain onto the tracks, the operators are required to activate the tunnel lights and ventilation system to provide a safe evacuation path.

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The operators' readiness to handle such emergencies is tested regularly by LTA and relevant agencies, such as the SCDF and SPF, through checks as well as table-top and simulated exercises. For example, in August 2013, LTA conducted a joint exercise to test SBS Transit's readiness to respond to an incident of smoke in the tunnels of the North East Line. The learning points were then shared with the rail operators to improve their emergency preparedness.

5 Mr Baey Yam Keng asked the Minister for Trade and Industry under which Government agency's purview do the operations and safety of the Sentosa monorail come under.

Mdm Speaker, Sentosa Development Corporation (SDC) is the statutory board that oversees the operations and safety of the Sentosa Express. The operations of the Sentosa Express are managed by Sentosa Leisure Management (SLM), which is fully owned by SDC.

SLM outsources the maintenance of its trains and tracks to SMRT, which has a team of 16 professionals on site at the Sentosa Express Depot. The SMRT team undertakes routine preventive maintenance works, troubleshooting of minor issues as well as repairs of the trains and tracks. A technical team from SLM works closely with the SMRT team as well as the Sentosa Express' Original Equipment Manufacturer (OEM), Hitachi Asia Limited, to undertake a range of regular inspections as well as procure and replace parts.

Mdm Speaker, a few questions for the Senior Minister of State. I would like to ask: when SDC maintains or operates the monorail, what are the guidelines or regulatory requirements that it adheres to? Which Government agency in Singapore is responsible for enforcing or regulating that aspect? I note that SLM's reply in the Forum page that it is according to the required standards for railways in Japan. Does that mean that the Japanese authorities come and certify the monorail? Which is the Government agency in Singapore that is responsible?

My other question is about the 4 December incident where 61 people were stranded for four hours on the monorail: how do we prevent such an incident from happening again? Industry observers say that the system does not have a walkway that would enable passengers to be rescued easily. Will this pose a danger for passengers on the Sentosa monorail, and how can we further enhance this system?

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Madam, I thank the Member for the supplementary questions. Yes, it is true that the monorail system, Sentosa Express, follows the stringent requirements of the Japanese monorail system, which is not just used in Japan, but also in China and some Middle Eastern countries. With the OEM's recommended maintenance schedule and parts replacement, SLM working with SMRT carried out those inspections. Some of them are daily; some of them are weekly; others are at the longer intervals. SDC itself also commissions independent audits to make sure that operationally, it is safe and professionally managed. On certain aspects, for instance fire safety, they will have to comply with SCDF's requirements.

Let me explain a little further about the 4 December incident. For the monorail to run, there is a swinging arm on the monorail and there is a power line that is semi-embedded along the track to supply the power. This arm will have to be in contact with the power line in order to tap on power for it to move. As soon as there is no contact, the train will stop. Unfortunately, in this case, at one end of the terminal, at the Beach Station, the power line has lost some tensile strength. Over a period or a long time of use, the power line can be slightly dislodged, and that was what happened. So, when the train moved off, it entangled the power line and started to cause damages on both sides.

The first train suffered some damage; the subsequent train which was the one that carried the 61 passengers, got its arm dislocated and was stuck there. The passengers were safe; there was no fire. The train was made of non-combustible materials, both internally as well as the structure. A series of recovery actions started. The first thing that the train company SLM did was to send a rescue train to come in and bring the passengers away. Within the next hour, all passengers had moved on to the rescue train.

But the second problem, which was not expected, happened. After they transferred all the passengers to the rescue train, because it was on a slope, the new train could not have power to decouple from the stuck train, to move on. A week later, there was a series of enactment and study, and they figured that if they had increased enough power, the train could have actually moved off. On the instruction manual, it was recommended for them to use P1 gear, instead of P2. So, with simulation and so on, they discovered that that could be done.

What SLM, together with Hitachi, has done is to revise the manual and improved the design of the power line at both ends of the station, such that even if the power line gets weakened over time – because it is metal – there is some protection so that it will not be protruding externally to cause the damages.

I think they have taken reasonable steps to prevent such incidents from happening. Monorails all over the world do not, like MRT, have a tunnel where you have evacuation

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route, railing or steps on the side. With its kind of design, passenger load and its slow speed, we are reasonably confident that such an incident will not happen in future.

The four hours that the media referred to was by the time the last person was evacuated. Actually, the evacuation took place soon after. Because it was a one-by-one kind of operation, it took a while to get everybody – 61 people – out of the train.

6 Mr Zaqy Mohamad asked the Deputy Prime Minister and Minister for Home Affairs whether the Ministry will consider allowing alcohol sold in residential areas to be contained in only plastic or tin containers as a safety measure in the event of unruly behaviour or fights in the neighbourhood.

(for the Deputy Prime Minister and Minister for Home Affairs): Madam, we adopt a calibrated approach towards liquor licensing according to the public order situation in a locality. In general, liquor licences issued in both residential and non-residential areas carry similar basic licensing conditions.

However, where there are law and order concerns in a particular area or neighbourhood, the licensing authority may decide not to grant licences or, in some cases, impose special conditions such as disallowing glass bottles.

The Liquor Control (Supply and Consumption) Bill which was read for the first time in Parliament on 19 January will empower the licensing authority to take even more calibrated measures to actively manage law and order concerns arising from liquor consumption in neighbourhoods.

Can I ask the Minister a supplementary question? This is not a new concept in the sense that in the UK as well as in a few other places, they do regulate the use of glass bottles especially, and it is not just about riots or safety concerns but also about nuisance like people breaking the glass bottles in parks and neighbourhoods. I do have a lot of complaints from residents of glass bottles being used and these are often sold in nearby marts. Could we just restrict this to the marts in those areas near neighbourhoods, and could they, for example, sell liquor in plastic bottles or tin cans?

Madam, I thank the Member for his supplementary quetstion. In general, the licensing conditions can be modified to take into account the points that the Member has made. For example, in licensing for particular events, this has already been the practice where they impose certain conditions – whether to use plastic containers or others. The

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Police have also, for example, as reported in the media, worked on some ideas of using tin cans and so on, in the Tekka Market area. So, I think this is part of the process.

We have to just remember that the countervailing consideration is that it does have a bearing on the experience of the patrons and also the business considerations. We have to find a balance. But where the local conditions and situations demand a review, in order to impose certain conditions like these, we will certainly look into that. And I think the new legislation that is being proposed will enhance the range of levers that are available to the licensing authority in order to take more measured and calibrated steps to address some of these disamenities that the Member refers to.

7 Mr Alex Yam asked the Deputy Prime Minister and Minister for Home Affairs (a) whether the Ministry has detected any heightened threat to Singapore following our deployment of troops to support the coalition against ISIS; and (b) whether additional measures are required to address issues of self-radicalisation.

8 Mr Gerald Giam Yean Song asked the Deputy Prime Minister and Minister for Home Affairs (a) whether other countries share their terrorism watch-lists and no-fly lists with the Singapore Government; (b) whether individuals who are on other countries' watchlists are all denied entry into Singapore at our checkpoints; and (c) whether Singapore maintains its own terrorism watch-list and no-fly list and shares it with other friendly countries to enhance security cooperation.

Mdm Speaker, with your permission, may I take Question Nos 7 and 8 together?

Yes, please.

Mdm Speaker, our security agencies have good cooperation with their foreign counterparts. They regularly exchange information on the terrorism threat. This includes the reciprocal sharing of information on terrorists and terrorist suspects. Such exchanges take place within the framework of each country's laws and agreements or understandings with counterpart countries.

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We take stringent measures to protect ourselves from any individual, local or foreign, who poses a terrorism threat to Singapore; or who intends to use Singapore to carry out terrorism-related activities. This includes denying a foreign individual entry into Singapore.

While watch-listing and sharing watch-lists are important components of counter-terrorism measures, they cannot be fool-proof in preventing foreign terrorists from entering Singapore. All countries face the challenge of stopping so-called "clean skins" – that is, persons who have not previously attracted security attention and are therefore unknown to the authorities. This is compounded by the large number of individuals from many different countries – more than 15,000 in total – who have taken part in the armed conflict in Syria and Iraq, plus others who have been indoctrinated in extremist ideology or trained in violent methods elsewhere.

The case of Mehdi Nemmouche illustrates this problem. Nemmouche was a French national who had fought in Syria. He had travelled through Thailand, Malaysia and Singapore after leaving Syria enroute to Europe, where he went on to carry out an attack in Brussels, Belgium in May 2014, killing four people. He was hitherto not known to the security agencies and therefore had not attracted the attention of countries he travelled through. So, he was not on our watchlist.

Even if a traveller's name does not appear on a watch-list, Singapore, like other countries, reserves the right to deny him entry if he has no bona fide reason for entering Singapore. Singapore also subscribes to INTERPOL's Stolen and Lost Travel Documents database, which allows us to identify anyone who uses a lost or stolen passport to mask his real identity.

Mr Alex Yam asked if there has been any heightened threat to Singapore following our deployment of troops to support the coalition against ISIS. There is no indication of a heightened threat to Singapore specific to our support to the coalition against ISIS.

However, the violence in Syria and Iraq continues, and raises the overall threat level in every country. ISIS still attracts extremists and encourages its overseas supporters to carry out attacks on home soil using all means available. In the past six months alone, we have seen "lone-wolf" attacks in North America, Europe and Australia. The fact that "lone-wolves" are not part of a structured organisation makes it harder for the security agencies to detect and neutralise them.

A case in point is Man Haron Monis, an Iranian refugee who became an Australian national. Monis perpetrated the Lindt Café siege in Sydney in mid-December 2014, where two hostages were killed. This attack occurred even after Australia had raised its security

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posture and arrested several persons who posed a terrorism threat in Australia. France was also on heightened alert in January 2015 when the Paris attacks happened. Thus, there is no guarantee that similar attacks can always be prevented here.

Mr Alex Yam has rightly pointed out that self-radicalisation is a problem as it can lead to "lone-wolf" attacks. We have had instances of Singaporeans becoming self-radicalised even before the Syrian conflict. ISIS has, however, worsened the threat through its widespread and effective use of social media to radicalise and recruit foreign fighters and supporters.

Our community and religious organisations have put in considerable effort to counter the radical ideology of ISIS and the jihadist terrorists. They recognise the importance of tackling the problem ideologically, to complement security action by the authorities. There is growing international recognition of the need to deal upstream with the ideology that fuels jihadist terrorism. To contribute to this effort, we will be hosting the East Asia Summit Symposium on Religious Rehabilitation and Social Reintegration in April this year. The Symposium will share best practices among participating countries and build capability to counter the terrorists' radical ideology.

Apart from what the Government and community organisations can do, I would also like to emphasise the important role that members of the public play to help protect Singapore against terrorism, in particular self-radicalisation. Family and friends are best placed to notice changes in the people close to them. They should alert the authorities if they suspect that their relative or friend may be at risk of becoming radicalised. And they could be saving their relative or friend from harming themselves and from endangering others.

Our security agencies will continue to take the necessary measures to prevent a terrorist attack from happening here. However, as I explained earlier, there is no guarantee that these measures will always succeed.

From time to time, if there is specific, credible information of a threat, or if we assess the general threat level to have risen, we may need to temporarily raise our security precautions further. While we will strive to minimise inconvenience to Singaporeans, some disruption will be inevitable such as more stringent checks at our checkpoints and the public transport system, or at places or events where many people congregate. We hope Singaporeans will understand this as necessary trade-offs for greater security to protect our loved ones, while allowing life to carry on as normally as possible.

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But, if in spite of our best efforts, an attack does occur, the Government will respond robustly and decisively to apprehend the perpetrators, and neutralise all possible threats uncovered, to prevent further attacks.

At the same time, how Singaporeans respond to an attack is key. If people who are caught in an incident know what to do and react appropriately, they can help to save their own lives and the lives of others. Emergency preparedness training is therefore important.

It is equally important that we do not allow the terrorists to achieve their objectives – to sow mistrust, division and enmity between the different communities in our society, or to create fear to stop us from going about our daily lives.

Instead of becoming divided, Singaporeans should reach out even more to each other, to friends and neighbours, schoolmates, colleagues and across communities to strengthen our unity and social resilience. The violence committed by these radicalised individuals with extreme beliefs does not represent any particular group or religion and has no place in Singapore society. We should stand together resolutely as one people to condemn it and its ideology and perpetrators.

We should also carry on with life and not be cowed – take the train, go to school, carry on working, continue with your usual activities. Of course, take sensible and necessary precautions, such as looking out for and reporting suspicious persons or objects. By all of us responding calmly together as one united people, we can prevail over the terrorists and prevent them from paralysing and dividing our society.

Mdm Speaker, I thank the Deputy Prime Minister for his re-assurance. However, as we have seen from the recent Japanese hostage situation with regard to ISIS, threats can happen not just on our home soil but overseas as well. So, I have one supplementary question for the Deputy Prime Minister. Is he aware of any Singaporeans who are perhaps contractors in Syria, Iraq or Egypt, and does the Ministry have any specific recommendations for their safety?

We have advisories, of course, against people going to Syria and Iraq, particularly at this point in time. For Singaporeans everywhere, wherever they go to, as I have said, the general threat level around the world has risen and they should always take precautions and follow the guidance of security authorities in the countries which they are visiting or doing business in. That is the advice that I can give.

Thank you, Mdm Speaker. Can I ask the Deputy Prime Minister, to-date, how many individuals have been denied entry

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at our checkpoints because they were on terrorism watch-lists or no-fly lists?

Mdm Speaker, I am not able to provide Mr Gerald Giam with that information.

9 Mr Gerald Giam Yean Song asked the Minister for Law since 2001 (a) how many times have our Ministries, agencies and statutory boards, or Government-linked Companies (GLCs) applied to the Intellectual Property Office of Singapore (IPOS) for revocation of patents, registered trademarks or registered designs belonging to local intellectual property (IP) owners; (b) how many revocations have been granted; (c) what are the main reasons for revocation; and (d) how many complaints has the Government received from local IP owners about our Ministries, agencies and statutory boards, or GLCs infringing their IP rights.

(for the Minister for Law): Madam, there have been two revocation applications made since 2001. These were not made to the Intellectual Property Office of Singapore (IPOS) but in the High Court, in the context of counterclaims to proceedings.

The first case was Mobilestats Technologies Pte Ltd v Attorney-General. The plaintiff claimed in Court that the defendant had infringed its patent. The Court held that the plaintiff's patent was invalid and revoked it.

The second case was Yiap Hang Boon v Housing Development Board. The Court held that the patent was invalid and revoked it.

The Ministry of Law (MinLaw) and IPOS have not received any other complaints which allege that the Government has infringed the IP rights of local IP owners.

Mr Gerald Giam Yean Song (Non-Constituency Member): Mdm Speaker, I have four supplementary questions for the Senior Minister of State.

First, I understand IPOS has its own established process for parties to apply to revoke a patent. What are the considerations for Government agencies in deciding to go to the Courts instead of to IPOS to apply for revocation of patents?

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Second, does IPOS grant patents for inventions which are not patentable, meaning they are not new, they do not have an inventive step or do not have industrial applications?

The third question: the patent search and examination process is a highly technical and complex process to determine if an invention is patentable. It has taken years for IPOS to build up its patent search and examination capabilities. So, how much technical expertise do our Courts have to subsequently decide which patents that IPOS has granted are now invalid?

Lastly, I am sure the Senior Minister of State agrees that patents are very important to the entrepreneurship ecosystem in Singapore because they encourage inventors to invest time and money to develop their ideas and have the assurance that others will be prevented from using and profiting from their inventions. Have the recent cases of patent battles, including these two cases which the Senior Minister of State has mentioned, between entrepreneurs and Government agencies, affected in any way the confidence among businesses, both local and foreign, that Singapore is a good place to develop and launch their intellectual property?

Mdm Speaker, may I just clarify with Mr Giam on the first question? He referred to IPOS having its own processes and he asked what considerations were taken into account. But he asked the second question following that – not a separate question but pertaining to the first one – can I just understand his full question so that I can answer it appropriately?

The first question was regarding why the Government agencies would go to the Courts instead of going to IPOS to apply to revoke patents, since IPOS has its own patent revocation process. Why do they go to the Courts? The second question was—

That is fine. That was the part I needed to clarify.

With respect to the first question which was what considerations IPOS takes into account, the patent protection accorded varies from country to country. Patent protection in each country is granted by its patent office and most countries adopt the internationally recognised criteria of novelty, inventive step and industrial applicability to ascertain whether a patent should be granted. Each patent office conducts its own search and examination. The determination of whether an invention meets the criteria for obtaining a patent depends very much on the relevant body of knowledge and technology that the examiner is able to find in the public domain within the time available and his evaluation of the information found.

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With respect to the second part of that question, Mr Giam asked in what circumstances would Government agencies go to the Court instead of IPOS. As I had mentioned earlier, the two cases in question arose in the context of counterclaims.

With respect to the second question, Mr Giam asked whether IPOS would grant patents for inventions which are not patentable. As I mentioned earlier, each patent office will do its own search and examination. It will look at the criteria of novelty, inventive step and industrial applicability and ascertain whether, on the face of it, the patent can be granted. I should say, however, that all patents that are granted are potentially open to challenges by other parties. The grant of a patent does not guarantee that the patent will never be successfully challenged in Court since the patent office grants patents without the benefit of hearing arguments by other parties as to why a patent should not be granted. Recognising that it is not possible for a patent examiner to be aware of all the relevant body of knowledge and technology that is publicly available worldwide, patent systems in the world generally allow for the validity of patents which have been granted to be contested, and Singapore is no exception.

With respect to the third question, Mr Giam asked about the search and examination process. He mentioned that it was highly complex and he asked how much expertise the Court has to determine the validity of a patent. This is no different from any other subject matter brought to the Court which is of a technical or complex nature. In the usual course, the Court will have the benefit of the assistance of expert witnesses in order to do this.

In the fourth question, Mr Giam said that intellectual property is important to entrepreneurship and asked whether the recent cases would affect confidence in Singapore as a place for protection of intellectual property. As far as MinLaw is aware, it has not affected the confidence of investors and entrepreneurs in the intellectual property regime in Singapore.

10 Mr Zaqy Mohamad asked the Minister for Manpower (a) what are the measures to help middle-income, middle-aged workers above 50 years old who will see reduced personal CPF contributions that will result in higher personal income tax and inability to earn a higher interest on their retirement savings through CPF; and (b) whether the Ministry will consider enabling such persons to voluntarily contribute more into their CPF to reduce their personal income tax liabilities and enhance their retirement income.

Mdm Speaker, our objective is to ensure good employability for all Singaporeans. The CPF contribution rates for older workers

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above 50 were lowered in the past to do precisely that and, basically, to enhance employability for older workers. Why is that so? Seniority-based wage systems were common then, which discouraged employers from retaining and hiring older workers. The employment rates of older workers have since improved considerably although, by and large, when you compare older workers with younger workers, the employability of younger workers is generally higher than the older workers themselves. Good progress has also been made by tripartite partners in wage restructuring and other efforts to help them be employed and also to stay employed.

We have consulted our tripartite partners and reached consensus that the CPF contribution rate for workers aged 50 to 55 should be restored to the same level as younger workers. The increase in contribution rates has been phased in gradually to moderate the impact on business costs and take-home pay of the employees. Since September 2012, we have twice increased the CPF contribution rates for older workers aged 50 to 65, with the latest increase effective from 1 January this year. In particular, the CPF contribution rate for workers aged 50 to 55 has been raised by five percentage points since 2012, and is now two percentage points lower than for workers below the age of 50. We are now studying when to take the next step to increase CPF contribution rates for older workers.

CPF members who wish to voluntarily contribute more to their CPF can do so through the Minimum Sum Topping Up Scheme (MSTU) to build up their CPF savings for retirement. Members who top up their own Special or Retirement Account using cash can also enjoy tax relief of up to $7,000 per calendar year.

11 Assoc Prof Fatimah Lateef asked the Minister for Health (a) whether the amount that can be used under the Flexi-Medisave Scheme for the elderly is over and above the total amount that they can use under the Chronic Disease Management Programme; and (b) whether there will be a list of items, prescriptions, investigations, tests and procedures for which the Flexi-Medisave amount can be utilised for.

(for the Minister for Health): Mdm Speaker, from 1 April 2015, we are introducing a new outpatient Flexi-Medisave scheme for the elderly aged 65 and above. This allows them to use up to $200 of Medisave a year for outpatient medical treatment at the public sector Specialist Outpatient Clinics (SOCs), polyclinics and GP clinics participating in the Community Health Assist Scheme (CHAS). Together with the enhanced outpatient and drug subsidies for SOC, polyclinics and CHAS that were rolled out since 1 September last year, this means that the elderly will pay even less cash for their outpatient medical care.

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The $200 of Flexi-Medisave can also be used over and above other outpatient Medisave limits, such as the $400 annual limit for the Chronic Disease Management Programme, and the newly implemented $300 limit for outpatient scans.

Flexi-Medisave is meant to allow the elderly more flexibility in using Medisave for outpatient medical treatment. It is, thus, not restricted to a prescribed list. It will generally cover consultation fees, tests, drugs and other medical services needed to diagnose or treat a medical condition. However, to ensure prudent use of Medisave, Flexi-Medisave cannot be used for non-medical treatments, such as those for cosmetic or lifestyle purposes, or for non-essential items, such as retail skincare products. This helps to ensure that the elderly have enough Medisave for their healthcare needs during retirement.

Medisave is what Singaporeans have carefully saved up during their working years. Even as we continue to expand the use of Medisave, I would like to encourage all Singaporeans to use it wisely so that it is enough for their healthcare needs over a lifetime. MOH will continue to review Flexi-Medisave and Medisave use regularly, together with other healthcare financing policies, to ensure that outpatient care remains affordable to all Singaporeans.

One supplementary question, Madam. The Flexi-Medisave scheme can be used by an individual from his own account and it is also mentioned that it can be used from the spouse's account. I would like to ask the Minister of State if the Ministry can consider, in the review that is going to be continuously carried out, if they can use that $200 from their children's account or other family members' account because, sometimes, the spouses already have got depleted Medisave accounts and they themselves have medical problems.

Mdm Speaker, I would like to thank Assoc Prof Fatimah Lateef for the suggestion. At this point in time, Flexi-Medisave is only limited to the patients' as well as the spouses' Medisave account. We will take into consideration her suggestion in subsequent reviews.

12 Mr Baey Yam Keng asked the Minister for Health what is the rationale for not applying a fixed Medisave Minimum Sum by cohort, similar to the Minimum Sum for the Ordinary Account.

(for the Minister for Health): The Medisave Minimum Sum (MMS) is the amount a CPF member needs to set aside in his Medisave account to ensure adequate savings for his own and his dependants'

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healthcare expenses, including MediShield and ElderShield premiums, during old age.

The MMS needs to be adjusted yearly for healthcare inflation. With Singaporeans living longer and Medisave use regularly expanded, we must also review the MMS regularly to more accurately reflect how much elderly Singaporeans need for their healthcare expenses in retirement. To help Singaporeans save more, the Government has also helped to top up Medisave accounts through GST Vouchers and Workfare, and increased employers' Medisave contributions by one percentage point from the start of this year.

Last year, the Government appointed a CPF Advisory Panel to study ways to improve the CPF system to provide greater peace of mind and flexibility for Singaporeans in retirement. My Ministry will review the MMS, taking into consideration the healthcare needs of our current and future elderly and the broader changes to the CPF system. We will provide more details when our review is completed.

Thank you, Mdm Speaker. The Senior Minister of State has explained that the Minimum Sum for Medisave is adjusted for inflation reasons. But for the CPF Minimum Sum, there is no adjustment applied to cohorts that come after the Minimum Sum that is set for that year. I wonder whether that could also be applied.

My second question is: given the current adjustment on a yearly basis, does the CPF member keep on topping up the difference, or when they utilise part of the minimum Medisave and it falls below the Minimum Sum, would they have to keep on topping up the amount?

The next question is: for members who have comprehensive healthcare insurance policies, is it possible for them to apply for full or partial exemption of the Minimum Sum? Can the Ministry consider this because this should be akin to CPF where members with annuity plans can apply for partial or full exemption?

My last question is: with MediShield Life, where there is more coverage and also lower co-insurance rates, will this Medisave Minimum Sum be revised downwards?

With regard to the first question on why the Medisave Minimum Sum is not cohort-based, the design of the CPF Minimum Sum and the Medisave Minimum Sum is different.

The Minimum Sum is drawn down as a constant stream of fixed payouts from age 65 and it is fixed at age 55. You can compute the Minimum Sum in advance, fix it at age 55. And then, thereafter when it is drawn down fixed payments, you do not account for inflation

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thereafter.

But for the Medisave Minimum Sum, it is different because healthcare expenses are uncertain, as well as the fact that you can utilise your Medisave anytime for approved healthcare expenses. We have had to revise and review our Medisave Minimum Sum, adjust it for healthcare inflation on a yearly basis and also to regularly review it to take into account longer life expectancies, as well as new Medisave users, such as the upcoming Flexi-Medisave.

As I have said, we know the need for more certainty, more flexibility for Singaporeans in retirement, give them greater peace of mind. In line with the broader changes to the CPF system that we are making, we will also be reviewing the Medisave Minimum Sum and we will provide Members with more details when it is completed.

Regarding the second question about whether you need to top up your Medisave Minimum Sum when you utilise it, there is no need to top up the Medisave Minimum Sum in order to use Medisave for approved healthcare expenses. This is applicable for all ages. But if the member wishes to withdraw his CPF savings in excess of the Minimum Sum at age 55 or after age 55, he will first have to top up his Medisave to the Medisave Minimum Sum. Then, he can withdraw the excess CPF savings.

Subsequently, if he continues to work and he continues to contribute to CPF, then of course, he will have fresh Special Account (SA) and Ordinary Account (OA) amounts, as well as contribute to his Medisave. If he then wants to apply again to withdraw this excess cash savings, he would then have to again top up his Medisave Minimum Sum to the prevailing Medisave Minimum Sum, before he can withdraw.

Regarding the third question, which relates to, if you have a comprehensive insurance plan, then can you have partial or full waiver of Medisave Minimum Sum. As I have said, the Medisave amounts can be used for various approved healthcare expenses, not just inpatient bills, but also some outpatient approved chronic disease treatment, as well as new users – Flexi-Medisave, the upcoming one, as well as for outpatient scans from start of this year. And in addition, it can be used to pay healthcare insurance premium – MediShield and ElderShield. When you have an insurance plan, likelihood if it is an Integrated Shield Plan, you will pay part of it — at least part of it — using your Medisave. Basically, Medisave Minimum Sum is still required to ensure that the members have enough to pay for their healthcare expenses, including for healthcare insurance premium in their old age. There is no decision to waive this Medisave Minimum Sum.

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The last question is: because of MediShield Life, the implementation of MediShield Life, does it mean that you can do away with Medisave Minimum Sum? I have more or less given the answer in relation to question three. Even as we implement MediShield Life with better coverage protection for all, for life, so better benefits, there will be some increase in the premiums. And as I have said, your Medisave can be used to pay for these premiums.

In addition, we need to take into account healthcare inflation; we need to take into account new Medisave users and longer life expectancy which means that it is unlikely that healthcare expenses will go down — much as we will try to contain cost and healthcare inflation, working together with every individual Singaporean. So, it is unlikely, even as we review the Medisave Minimum Sum Scheme that we will adjust the Medisave Minimum Sum downwards.

13 Mr Gerald Giam Yean Song asked the Minister for Culture, Community and Youth (a) what will be (i) the one-time cost of implementing and (ii) the annual cost of maintaining the newly proposed "lay-and-play" natural grass turf solution in the National Stadium, over and above the $860,000 spent on the existing hybrid turf system and the $1.5 million spent on buying "growth lights"; (b) why this new turf solution has been chosen over an artificial grass pitch solution which can be more durable and cost effective to maintain; and (c) how the Government will ensure that Sports Hub Pte Ltd (SHPL) does not pass these additional costs to its tenants and end customers.

Madam, under the Project Agreement with the private consortium Sports Hub Pte Ltd (SHPL), the National Stadium has to be able to host a wide range of sporting events. When it became clear that the current pitch solution was not able to meet the demands for the events calendar for the National Stadium, SHPL did an extensive review and decided to go with a natural turf "lay-and-play" solution, meaning they grow the turf separately outside the stadium and they lay over the pitch. This "lay-and-play" solution was preferred over a fully artificial pitch because top sporting events and top teams in sports like football and rugby demand a natural turf.

The "lay-and-play" solution would involve, as I have mentioned earlier, growing the natural pitch under more conducive conditions of a nursery and then installing it at the National Stadium for such sporting events. The cost of implementing and maintaining the new turf is a commercial matter between SHPL and the parties it is contracting with. Under the terms of the Project Agreement, such costs are fully borne by the private consortium, SHPL, and not by the Government.

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The Member asked how the Government will ensure that SHPL does not pass the additional costs on to tenants and customers. SHPL has already made a public commitment that it will bear the full cost of the new pitch solution and will not pass on the costs to event organisers or end users and Sport Singapore will continue to keep a close watch on rentals, charges and ticket prices at the Sports Hub to ensure that this commitment is upheld.

Madam, I have five supplementary questions for the Minister. First, there were concerns from experts that if the natural grass is laid just a week to 10 days before an event, its roots may not have enough time to have the necessary penetration into the sub-base to provide a firm and solid pitch. This may cause the grass to slip and athletes could get hurt. How will these concerns be addressed?

Question two: artificial turf technology has improved significantly in recent years and there are now 459 artificial turf pitches around the world that have FIFA's two-star recommended mark for fields that ensure the highest playing performance for professional level football, including four in Singapore. Was serious consideration given for artificial turf to be used after the hybrid's turf solution failed and what were the reasons why it was rejected? Was it due to the public outcry against it when the idea was first reported in November last year?

Question three, were there any warranty clauses in the contracts with the original hybrid turf contractor to ensure that they pay for any remedies if they fail to ensure that the grass will grow properly?

Question four, moving forward, does the contract with the new natural turf contractor include warranty clauses, in case this, too, fails?

And lastly, while I know that SHPL is responsible for the service recovery, one can reasonably expect that it will need to find some ways to recover the cost of these failed solutions, which at latest count seems to be in excess of $2.3 million. Beyond assurances, are there any contractual prohibitions against SHPL recovering cost either directly or indirectly from tenants and customers, either now or in the future?

Madam, on the first point of the technicalities of laying the pitch, timing and so forth, that is something that I think is best left to the experts. There will be different views on this. SHPL is engaging an international turf company to work out the solution for this "lay-and-play" approach and I am sure they would be well advised on having adequate time to put the pitch in place.

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A "lay-and-play" solution is not something new. It has been done around the world in many stadiums and so there is very adequate experience and expertise out there for us to make sure that this is done properly. I am sure SHPL will consult the experts and Sport Singapore will also supervise to make sure that this is done properly.

On the second point about artificial turf and whether this has been considered, indeed, it was considered very carefully. As I had mentioned, SHPL did an extensive review of all the options including an artificial turf option. And the reason as I mentioned why it ruled out a fully artificial pitch is that, notwithstanding what the Member said about artificial turf gaining popularity around the world, there are still many top teams in football and rugby that will not play in an artificial pitch. That is the case today. If we had an artificial pitch, I doubt very much that we would have a Brazil-Japan match, for example, recently. I doubt very much that top rugby teams will play in Singapore.

The situation may change because the artificial pitch is getting better, the technology is getting better and acceptance is growing. We are not ruling it out completely and SHPL will continue to monitor. I am sure they will continue to assess whether this can be an option in the future.

On warranty clauses and remedies, whether with the existing or whether with the current provider or the new one, as I have mentioned earlier, these are commercial contracts between SHPL and its providers. It is left to commercial negotiations between SHPL and its providers.

On service recovery, I have already explained what SHPL has done. Contractually, SHPL has an agreement with Sport Singapore to deliver certain standards and that includes ensuring that the facilities and the pitch at the stadium are of a sufficient standard for international play. Sport Singapore will hold SHPL accountable to these outcomes. I think what is important, is, as I have mentioned, Sport Singapore has been engaging SHPL at the very highest level. They have met the Chairman of the company; they have even met the senior leaders or the equity owners of this project. It is the equity holders, not just the management company but the equity holders. All of the leadership and the people involved in this project have given us the promise that they will do their best to rectify the teething issues and they would do it at their own cost. They have given this promise not just to Sport Singapore, but publicly to Singaporeans, and we will hold them to account for this.

14 Mr Zainal Sapari asked the Minister for Communications and Information and Minister-in-charge of Muslim Affairs for 2014 (a) what has been the total amount of zakat collected by MUIS; (b) what is the breakdown of the allocation of zakat to the beneficiaries;

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and (c) whether any zakat is used to fund MUIS's operating expenditure.

Madam, zakat is not used to fund the Islamic Religious Council of Singapore's (MUIS) operating expenditure. MUIS funds its operating expenditure from its General Endowment Fund. The Fund has a number of income sources, including property, inheritance and investment income, and fees for services such as Halal certification. Zakat funds are not part of the General Endowment Fund and are separately accounted.

The amount of zakat collected in 2013 was $28.4 million. The collection for 2014 has yet to be confirmed through audit.

Zakat funds collected are channelled toward disbursements, provision of programmes and services, and their operating costs to serve the beneficiaries, in accordance to the eight categories or Asnafs prescribed by Muslim Law.

In 2013, about $11 million or 40% was disbursed to the needy through direct financial assistance and empowerment programmes. These empowerment programmes provide holistic intervention for zakat recipients to improve their employability and gain other life skills. MUIS helped 5,263 families in 2013 through direct financial assistance, which supplements the assistance provided by national schemes. MUIS also runs an Empowerment Partnership Scheme (EPS) to help zakat-receiving families achieve self-reliance. Since its inception in 2004, 595 of the 847 families on this scheme had successfully graduated from it and no longer require MUIS' financial assistance.

Madam, another 40% of the zakat in 2013 was used to support our mosques and madrasahs, through grants, programmes and funding for the training of madrasah teachers, mosque religious officers, volunteers and youth development officers.

The remaining zakat was used for dakwah, which is propagation, and public education, the development of Islamic education, and the funding of Amil administration – Amils are those who collect zakat – as well as assistance for Muslim converts.

I have two supplementary questions. First, given that there is an increase in the amount of zakat collected, what could have contributed to this increase in zakat collection? It is necessary for MUIS to identify what are the key success factors that led to the increase in zakat collection.

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Secondly, given the increase in zakat collection, will MUIS be reviewing either the income criteria to enable more needy families to benefit or the quantum given to needy families so that it would be of better help to them?

I thank the Member for the two questions. Certainly, there are many factors that would have contributed to the success of zakat collection in Singapore, but what comes to my mind are two possible factors. Rising affluence within the Malay/Muslim community is, in fact, a reflection of zakat collection. As more Malays do well professionally through the educational system, we will be able to increase wealth in the community. But more importantly, the awareness programme that MUIS has conducted for many years to show how zakat funds which have collected had been used, have resulted in a lot of Muslim professionals' willingness to step forward and show their generosity because everything that is collected from zakat goes back to the community. So, I think these are the two factors – mainly affluence and awareness of how the funds have been utilised.

The Member's second question was something which I have replied to earlier. We will continue to review the scheme, especially the criteria for low-income families — and I mentioned earlier that we have just revised it last year — and we will continue to do so recognising that not only do we have more funds but, at the same time, families may face difficulties, and there could be differences in terms of their income and cost of living. So, we will continue to do so because the real purpose of zakat is to benefit the community and we will continue to do so to make sure that no low-income families are left out from this scheme entirely.

A supplementary question, Mdm Speaker. I would like to ask the Minister if the recipients of the zakat donations are excluded from the regular assistance elsewhere, or can they also tap on the national schemes.

Again, as I have mentioned in my reply, the strategy that we have adopted is really to make sure that everyone who needs help tap on the national schemes because that is also something which they are entitled to. Zakat comes in to complement. But if for some reason or another, they are not entitled to some of the schemes, we will continue to assist them. There is a whole range of zakat assistance programmes from long term to short term. As I have mentioned in my response to the earlier supplementary question, we will make sure that no Muslim family who are in need will be left out, so we will do our best to assist them as much as possible.

Thank you, Mdm Speaker. I would like to seek one clarification from the Minister. I would like to know whether the zakat

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amount collected was disbursed fully on an annual basis.

The accounts will show that there will be instances where we may not be able to disburse entirely within one year, but the money will be kept in the zakat funds. Whatever it is, basically, it will always be kept in the zakat funds.

15 Mr Yee Jenn Jong asked the Minister for Education how many new non-graduates join the Ministry as General Education Officers each year from 2012 to 2014 and what percentage do these new teachers form as a percentage of all new teachers hired in those years.

(for the Minister for Education): Mdm Speaker, from 2012 to 2014, we have recruited a total of 663 non-graduates for the teaching service and they comprised 17% of newly recruited teachers over the past three years.

Thank you, Madam. I would like to thank the Minister of State for the reply. I would like to ask regarding the 17% figure, are they at the General Education Officer level or it includes other forms of teachers that are under some kind of supplementary schemes? And I would also like to ask, since MOE started drastically reducing the number of new teachers hired last year, does it mean that it will be more challenging for non-graduates to become General Education Officers moving forward?

Mdm Speaker, may I ask the Member to clarify his first question? What does he mean by "supplementary schemes"?

I understand that there are various teaching schemes, so this 17%, can I just clarify is specifically for General Education Officers?

We are talking about Education Officers. That is the figure that has been given. In terms of prospects for non-graduates who wish to enter the teaching service, I would like to highlight that when the Ministry of Education (MOE) recruits teachers, two factors are very important to us. First, would be mastery of academic content and the second one would be whether the person has the passion and the correct disposition to teach. Both factors are important. We will continue to focus on hiring graduates. We will also continue to bring in strong non-graduate recruits whom we believe will make good teachers.

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16 Mr Gan Thiam Poh asked the Minister for Trade and Industry what has been done and put in place so far to ensure that Singaporean university graduates will get quality and fulfilling jobs upon graduation in view of the Government increasing the percentage of graduates for each cohort from 25% to 40%.

Mdm Speaker, the Government adopts a two-pronged approach in its efforts to help our university graduates get good jobs. First, we keep our economy competitive and seek to capitalise on new opportunities in and beyond our region. We do this by growing knowledge-intensive industries that will provide good jobs, and also by pursuing sustained, productivity-driven growth in key sectors of our economy such as manufacturing, financial and business services. This allows our economy to grow amidst a challenging global environment and to create higher-skilled jobs for Singaporeans.

Let me illustrate how this strategy is implemented in manufacturing. As we all know, manufacturing remains a vital part of our economy, providing more than half a million jobs while contributing about a fifth of our GDP. To build up our industry capabilities in advanced manufacturing, we are helping businesses to adopt and leverage on new technologies in areas such as Additive Manufacturing and Robotics. This will transform the way our companies operate to create new growth and business opportunities, as well as diverse jobs that provide good career development potential for Singaporean graduates. These jobs will require deep skills and multi-disciplinary knowledge, and the ability to synthesise the two. One example is a manufacturing operations design specialist, someone who needs to be able to design the manufacturing process for new products, rather than just implement an existing procedure.

The second prong of our approach is to invest heavily in equipping Singaporeans with the skills to take on the jobs that we are creating. Ministry of Trade and Industry (MTI) works with Ministry of Education (MOE) and Ministry of Manpower (MOM) to identify the current and future skillsets required and design education and training programmes to equip Singaporeans with these skills. For example, our Institutes of Higher Learning have industry engagement platforms to ensure that their curricula and learning outcomes are mapped closely to the skills and capabilities required by industry. The SkillsFuture Council will also work with industry partners to develop Sectoral Manpower Strategies to identify future skills and set out strategies for developing these skills in our workforce.

The expansion of our publicly funded university cohort participation rate to 40% by 2020 has been designed to place an emphasis on applied degree pathways to create a diverse pool of graduate talent to meet the changing needs of our economy. We will

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continue to keep our economy competitive by pushing on with restructuring and our efforts to create good jobs. We will also continue to invest in education and training, including creating pathways for Singaporeans to upgrade their skills. However, it is equally important for Singaporeans to take ownership of their own career development and ensure that they develop the right skills and experience to make use of all these opportunities that are emerging.

I thank the Minister for the comprehensive reply. Will the Ministry also look at the aspirations of Singaporeans, especially the young? Will the Ministry make efforts to look for jobs that meet these aspirations?

Our approach is to create a competitive economy that creates the jobs that meet the aspirations of Singaporeans but, at the same time, we work under certain constraints. For example, we cannot have an economy that is, say, 50% financial services sector because 50% of our young Singaporeans want to work in the financial services sector.

We need a diverse economy and that diverse economy will include the various sectors that we already have built up competencies in and that we can continue to be competitive.

Thank you, Mdm Speaker. I would like to ask the Minister; for this 40% of graduates – does it take into account those who attend the private institutions and part-time degree courses, courses that the workforce may take on its own?

The 40% is the cohort participation rate in our publicly funded educational institutions. Today, if you look at our workforce, overall, about one-third are already graduates. But if you look at the young workforce, those below 30 years in age, almost 50% are already degree holders. So, the publicly funded cohort participation rate today is around 30%. But Singaporeans, particularly our Polytechnic diploma holders, aspire to be graduates and they go on to take courses on their own.

Similarly, as the Government's publicly funded cohort participation rate goes up to 40%, we can expect that they will be supplemented by others who will take up courses in private institutions. And, therefore, in our planning we expect the cohort participation rate for the young workforce to be much higher than 50%.

Mdm Speaker. I would like to ask the Minister for Trade and Industry for a clarification on whether there are any significant difficulties with the fact that in advanced manufacturing, for example, which he referred to, the preparation time that is needed to induct graduates into the workforce in those areas can be quite substantial. During the course of the preparation of graduates, the needs of the

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industry may have changed and may have advanced, how significant are these challenges in the adjustment between the two different streams – the demand for graduates on one hand in specific areas, and the supply on the other?

Of course, we do not indulge in state planning like in the Soviet Union but we try to create the supply in anticipation of our demand. With the Economic Development Board (EDB) attracting a constant pipeline – a regular pipeline of investments – we have some reasonable anticipation or idea of what jobs are needed. This is then fed back to our educational institutions and also in career counselling of the students so that we prepare the workforce for it. More specifically, before every company sets up its plant, EDB will have a dialogue with the company to see how they would grow their workforce and recruit the workers as the plant comes into operation. And many times, the company would train the workers in anticipation of their start-up, so we try to marry the process. But as the Member has rightly pointed out, this is a huge challenge and there will always be some mismatch along the way, but we try our best.

Order. End of Question Time.

[Pursuant to Standing Order No 22(3), written answers to questions not reached by the end of Question Time are reproduced in the Appendix, unless Members had asked for questions standing in their names to be postponed to a later Sitting day or withdrawn.]

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"to amend the Police Force Act (Chapter 235 of the 2006 Revised Edition), to make related amendments to the Fire Safety Act (Chapter 109A of the 2000 Revised Edition) in connection with fire forensic specialists, and to make consequential amendments to certain other written laws",

presented by the Senior Minister of State for Home Affairs (Mr Masagos Zulkifli B M M); read the First time; to be read a Second time on the next available Sitting of Parliament, and to be printed.

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

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

Madam, Prime Minister Lee announced in August 2013 during the National Day Rally that MediShield would be enhanced and renamed MediShield Life. This marks a significant shift in healthcare financing towards greater collective responsibility to give Singaporeans better peace of mind so that they need not face life's uncertainties alone.

This strategic shift is in line with the Healthcare 2020 Master Plan to keep healthcare accessible, affordable and sustainable over the long term. It is also a response to the feedback received during Our Singapore Conversation that Singaporeans want to come together as a community and nation, to better support the more vulnerable and needy, especially those who meet with unexpected shocks in their life journeys.

The MediShield Life Review Committee headed by Mr Bobby Chin was set up in November 2013 to review and make recommendations on the MediShield Life Scheme design and parameters, taking into account feedback from the public and key stakeholders.

After eight months of extensive public consultation and intensive study, the Committee submitted its report to the Government and the White Paper on the "MediShield Life Review Committee Report" was debated in Parliament in July last year. I am pleased that it received unanimous support from Members of this House.

As recommended by the Committee, MediShield Life will provide every Singaporean with better and lifelong protection against unexpectedly high medical bills, regardless of changes in their life or health circumstances. The key recommended enhancements include: (a) removal of the lifetime claim limit so that it will provide life-long protection; (b) increase the policy year and daily claim limits so that it will cover more; and (c) reduce co-insurance rate so that patients pay less especially for larger bills.

The Committee also recommended that MediShield Life should be universal for all Singaporeans with no exemption but appealed for the Government to bear the bulk of the

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cost of bringing those with pre-existing conditions under MediShield Life, and to provide the support needed to keep premiums affordable, especially for the vulnerable groups.

The Ministry of Health (MOH) has been preparing for the introduction of the MediShield Life Scheme and this Bill will provide the legislative framework for the establishment, governance and administration of the Scheme.

Mdm Speaker, I shall now highlight the main features of the MediShield Life Scheme Bill.

First, clause 3 of the Bill provides for the establishment of the MediShield Life Scheme and for the transition from MediShield to MediShield Life. It also provides for the Scheme to be administered by the CPF Board.

Clause 7 of the Bill provides for the current MediShield Fund to be renamed the MediShield Life Fund, and that all payments under the Scheme are to be met from the Fund. CPF Board, as the administrator for MediShield Life, is not liable for payments under the Scheme, and therefore cannot use other monies that it holds to meet the obligations under the Scheme.

In short, the MediShield Life Fund is to be a self-sustaining insurance fund supported by premiums it collects. All of us contribute to the Fund. Those who fall seriously ill get payouts from the Fund. This is the spirit of collective responsibility, but with strong support from the Government.

Up to two-thirds of the population are eligible for Premium Subsidies of up to 50%. Premium Subsidies are a permanent feature of the Scheme – which means that these subsidies will continue to be extended to Singaporeans who meet the criteria and will not be phased out over time.

Clause 8 of the Bill provides for the establishment of a MediShield Life Council, comprising up to 17 members. We have benefited much from the wide-ranging experience and professional expertise of the members of the MediShield Life Review Committee. I am confident that we will also benefit from the advice and guidance of the MediShield Life Council in the implementation and administration of the Scheme. The key roles of the Council are outlined in clause 8 of the Bill.

The Council will review the design of MediShield Life Scheme benefits and parameters regularly, consider appeals for Additional Premium Support, and decide on the approach and

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guidelines for the recovery of outstanding premiums.

The Council will be established by the time the Scheme takes effect. We are working through the details of setting up the Council and will release more information later.

Let me now turn to the issue of universal coverage under MediShield Life and the approach for bringing in those with pre-existing medical conditions.

The MediShield Life Review Committee consulted extensively on the issue of universal coverage. The vast majority of Singaporeans strongly supported bringing the uninsured, including those with pre-existing medical conditions, under MediShield Life. Many saw this as part of the move towards a more inclusive society. This will reduce the financial burden on these individuals by spreading the costs more evenly across the population. This is also aligned with views gathered from Our Singapore Conversation where Singaporeans expressed support for greater collective responsibility to help one another with unexpectedly large hospital bills.

Clause 3 of the Bill provides for the MediShield Life Scheme to apply to all Singapore Citizens and Permanent Residents (PRs). This enables those who are currently uninsured and those with pre-existing medical conditions to benefit from MediShield Life coverage. However, this also means that the Scheme will face higher costs, given the higher risks of these groups.

As noted by the Review Committee, while it would be fair that those with pre-existing medical conditions pay higher premiums to reflect the higher risks, we also need to ensure that the Additional Premiums would not be too onerous. On balance, the Review Committee recommended that: the Government bears the bulk of the costs of bringing in individuals with pre-existing medical conditions; these individuals with pre-existing medical conditions shoulder part of the costs by paying Additional Premiums of 30% for the first 10 years; and the rest of Singaporeans co-share a modest part in the spirit of collective responsibility.

Under the Scheme, a pre-existing medical condition is one that has already developed before an individual's insurance coverage begins. Those who fall ill only after their insurance coverage begins will not be considered to have pre-existing medical conditions and will therefore not need to pay Additional Premiums.

MOH is currently reviewing the list of serious pre-existing medical conditions, with specialist advice from clinicians, and will share more on the broad categories of such conditions later. Individuals who have to pay the Additional Premiums will be informed

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before the start of the Scheme.

I wish to assure Members and the public that we will adopt a fair and compassionate approach in the assessment for Additional Premiums. The key focus would be on serious pre-existing medical conditions that are likely to be life threatening or have high risk of future complications or recurrence, and therefore may require prolonged treatment. Singaporeans with these conditions will benefit significantly from the enhanced protection when they are covered under MediShield Life, as many of them would not have been able to get insurance coverage for their pre-existing medical conditions in the past.

Madam, having a serious medical condition is worry enough. Therefore, we want to make the process of identifying such individuals a more convenient one. Part 5 of the Bill allows MOH and CPF Board to do so by accessing individuals' information already existing in Government administrative databases and medical institutions. We hope that, through this, the majority will avoid having to undergo medical assessments or provide medical reports.

We understand that some Singaporeans may not be comfortable with us accessing their medical information. They may choose to decline MOH and CPF Board access to their medical information. However, if they do so, we will not be able to ascertain that they do not have pre-existing medical conditions and, therefore, they will have to pay the Additional Premiums under MediShield Life. Notwithstanding, they can submit the necessary medical reports and documentary evidence to certify that they do not have any pre-existing medical conditions or if they change their minds later, they can consent to the access of their medical information.

Mdm Speaker, let me now move on to MediShield Life premiums and payments.

With the significant benefit enhancements and provision of universal coverage under MediShield Life, premiums will have to increase to support the higher payouts. However, premiums will remain affordable for all Singaporeans through a variety of measures.

First, the Government will provide strong support in the form of various subsidies and support measures, to help Singaporeans with MediShield Life premiums.

For lower- to middle-income households, they will be able to benefit from MediShield Life Premium Subsidies. The eligibility criteria for the Premium Subsidies will be based on household monthly income per person and the Annual Value of one's residence. MOH will also take into account multiple property ownership, to better reflect the individual's financial circumstances, similar to the approach for other Government schemes such as the GST-

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Voucher (U-Save) Scheme.

Besides Premium Subsidies, the Government has also announced special subsidies and Medisave top-ups for all Pioneers. With these subsidies and top-ups, all Pioneers will pay less for their MediShield Life premiums than they would otherwise have to.

The Government will also provide Transitional Subsidies for all Singapore Citizens over four years, to help ease the shift from MediShield to MediShield Life.

Second, Medisave may be used to pay the full MediShield Life premiums. For the 94% of Singaporeans who are already covered under MediShield today, including those who bought Integrated Shield Plans, their existing Medisave payment arrangements will be retained. For those who wish to have another immediate family member to help with premium payments, they can request the Board to do so. These Medisave payment arrangements will be provided for under clause 4 of the Bill.

For children below the age of 21, clause 4 further provides for their premiums to be borne by their parents. Citizen babies born after 2012 can tap on the $3,000 Medisave grant under the Marriage and Parenthood Package to help pay for their premiums.

The one percentage point increase in employers' CPF contribution to Medisave accounts this year will also help to cover the increase in MediShield Life premiums for most Singaporean households.

For needy Singaporeans who need further help with their premiums even after these subsidies and support measures, the Government will provide Additional Premium Support on a case-by-case basis for their premiums.

Mdm Speaker, Premium Subsidies and support are a key feature of the MediShield Life Scheme.

The MediShield Life Review Committee recommended that the process of applying for subsidies should be as simple and convenient as possible so that those who need them will receive them. Many Singaporeans have also suggested that we simplify the application process to reduce the need to provide similar information to different agencies repeatedly.

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Therefore, Part 5 of the Bill allows MOH to do so by using individuals' information in Government databases, to check and compute Premium Subsidies for each individual. These facilitated eligibility checks will ensure that eligible Singaporeans are able to access MediShield Life Premium Subsidies as conveniently as possible, without having to apply individually and submit supporting documents.

While MOH will do our best to use the latest information, the outcome of the facilitated eligibility checks depends on information in the Government databases being up to date. We all know in our interactions with other Singaporeans that some Singaporeans may not have updated their NRIC addresses after moving to a new address. Some who have rented out their flats may not have updated their tenants' particulars as well. So, to help us compute your subsidy eligibility, we urge individuals to do their part by checking and updating their records.

Similar to the access to medical information, Singaporeans may choose not to participate in the facilitated eligibility checks so that the Ministry of Health and CPF Board will not access their information, but this means that they will not receive any Premium Subsidies as we will not be able to assess their eligibility. However, if you do change your mind subsequently, you can still apply later to be assessed.

I would like to assure Members that stringent safeguards are in place to protect the information from unintended or inappropriate use. First, only authorised persons will be allowed to access, use or disclose medical and financial information for specified purposes. They will be required to sign appropriate undertakings. Second, the Minister in charge of the agency that controls the information requested will have to approve the disclosure of that information and can impose appropriate terms and conditions. Third, clause 29 of the Bill makes it an offence for any person to access, use or disclose information about an individual obtained under Part 5 of the Bill without authorisation or the written consent of the individual concerned. Offenders may be punished with a fine of up to $5,000 or imprisonment of up to 12 months, or both.

Mdm Speaker, let me now address the issue of premium payments and recovery measures for the MediShield Life Scheme.

As MediShield Life is a universal and self-sustaining scheme, all citizens and PRs must play their part in paying their premiums on time, to ensure that the Scheme can continue to pay out the benefits and meet its commitments. To facilitate and assist Singaporeans in paying their premiums, a comprehensive framework of measures will be put in place, in addition to the subsidies and support I mentioned earlier.

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First, we will facilitate the process for other immediate family members to pay for your MediShield Life premiums if you do not have sufficient Medisave balance.

Second, for those who have missed premium payments due to insufficient Medisave balances, we will send regular reminder letters to alert them to top up their Medisave and to make use of alternative payment modes available.

Third, we recognise that there may be some who need further help with their premiums even after Premium and Transitional Subsidies. Some may not be aware of the help available or how to access it. We will put in place measures to help the vulnerable to ensure that those who are needy will receive help.

However, there may be a small group who refuse to pay their premiums, despite multiple notices and reminders, even though they have the means to do so. Their premium defaults will translate to bad debts to the MediShield Life Fund and lead to higher premiums for all Singaporeans.

The MediShield Life Review Committee had noted this and recommended that the Government adopt appropriate premium recovery measures and penalty to ensure social responsibility in the payment of premiums.

Let me emphasise that the premium recovery framework and penalty are directed at this small group of freeloaders who are wilful defaulters and do not contribute their share, even though they can afford to. It is necessary to have a set of firm measures in place to deter defaults and uphold the spirit of collective responsibility behind MediShield Life. This will ensure that the MediShield Life Fund remains sustainable and can meet its commitments to all Singaporeans. It also ensures that the debts of these freeloaders will not be unfairly shouldered by those who have paid their share responsibly.

This is similar to other countries with mandatory national insurance schemes which have also adopted strict enforcement measures, to ensure compliance and recover outstanding premiums.

Part 3 of the Bill provides for a robust premium recovery framework, with powers adapted from the existing income tax legislation. Whether it is MediShield Life premiums or taxes, they rely on the same principle of collective responsibility and there is a need to take a firm stance against those who are able to but refuse to play their part.

Clause 12 empowers a recovery body to appoint defaulters' agents such as banks and employers who can be required to pay defaulters' outstanding premiums from the

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defaulters' savings and salaries respectively.

If necessary, the recovery body may prevent those with outstanding premiums from leaving the country without paying them, as provided for in clause 16 of the Bill. Those who are notified about such a direction from the recovery body and yet choose to violate the direction will be committing an offence punishable with fine or imprisonment or both.

Clause 17 allows the recovery body to impose a penalty, not exceeding 17%, on outstanding premiums and any interest imposed on the outstanding premiums. This is aligned with the maximum penalty of 17% for income tax arrears. Let me clarify that the 17% is not a recurrent penalty. It is the total maximum penalty that can be imposed on a year's outstanding premiums. It acts as a deterrent for delaying payment and will go towards covering the enforcement costs of recovering premiums. Clause 11 allows interest to be imposed on outstanding premiums. This interest is not a penalty but to fairly reflect the opportunity cost to the MediShield Life Fund, which could have earned a return from investing the premiums to support payments from the Fund.

I assure Members that we will exercise discretion and impose interest and take the various recovery measures only in appropriate circumstances, when the defaulters wilfully refuse to pay their premiums despite multiple reminders and attempts to contact them and to help them over an extended period of time. The MediShield Life Council will provide direction on the broad approach towards premium recovery.

I would also like to clarify that late payment of premiums will not be a criminal offence.

IRAS and the CPF Board will be appointed as recovery bodies to help ensure that premium payment is made in a timely manner. This enables the Scheme to tap on their expertise and resources in administering these measures in an effective and sensitive manner.

Madam, let me conclude. MediShield Life is a major step to strengthen collective responsibility and give Singaporeans peace of mind. We discussed at length during the Parliamentary debate last year on issues ranging from the benefit features and premium affordability to Fund sustainability. The debate concluded with unanimous support for this significant shift in healthcare financing. We are taking another step now to make this a reality. The MediShield Life Scheme Bill will provide the legislative framework for this shift to take place and for the implementation and administration of the Scheme.

MediShield Life is a complex Scheme. We will step up our outreach efforts to explain the benefits of MediShield Life, how Singaporeans can receive subsidies and support for

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premium payments and to explain the effects of the Act.

Madam, the idea of MediShield Life goes beyond healthcare and insurance. It is in fact a reflection of the kind of society we want to build; a more inclusive society where we pool our resources together to help the vulnerable and the sick among us. And a more caring and progressive society, where those who are able play their part while those who are needy will receive more help. This MediShield Life Scheme Bill sets the framework not only for the introduction of universal coverage for all, but also for every Singaporean to play a part in nurturing an inclusive, caring and progressive society. Mdm Speaker, I beg to move.

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

Mdm Speaker, for a young nation such as ours, just now maturing gracefully into our 50th year of independent existence, we should be justifiably proud of what we have achieved in terms of safeguarding the health of our citizens. In terms of health outcomes, no matter what measure you look at, in many independent surveys around the world, Singapore has always ranked quite high. So, by any measure, we are a nation of healthy people. But healthy people do and can fall ill and, sometimes, they fall ill very seriously indeed. When this happens, this is where MediShield Life or any form of medical insurance steps in.

MediShield Life represents another significant step towards ensuring that Singaporeans have continued assurances with regard to their medical needs, specifically in the unfortunate event when they face a major illness. I warmly support this Bill, as I have done when the Scheme was first mooted and was later debated in Parliament last year.

I do have three areas with regard to this Bill for comment, consideration and clarification.

The first actually concerns the scheme itself rather than the Bill specifically and return to some lingering concerns about premium affordability. We appreciate the raft of measures to health affordability that the MediShield Review Council and later the Ministry of Health (MOH) has adopted, and which has just been detailed by the Minister in his opening speech earlier.

There are the Pioneer Generation subsidies and grants for our Pioneers. Aside from these, there is a further $4 billion being set aside for financial assistance, particularly for

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those with low income and who are in particularly vulnerable positions.

All Singaporeans, as I understand, will also benefit from Premium Subsidies for the first few years after the roll out of MediShield Life, so as to allow time to adapt to the moderate increases in premiums from the Basic MediShield. It is also reassuring to note that most Singaporeans will be able to pay for their premiums completely from their Medisave accounts alone.

Nonetheless, I do not think it would be unreasonable for us to ask the Ministry and the Government to consider expanding or increasing these subsidies, particularly for the vulnerable groups. And also for the majority of all other Singaporeans, I hope that the Transitional Subsidies Scheme can perhaps be looked at and extended beyond the first five years and perhaps even increased as this would soften the transition further for Singaporeans as they ease from MediShield to the universal scheme which is MediShield Life.

My second concern concerns the change from the MediShield or the Basic MediShield system to a universal single payer national insurance health scheme. Notwithstanding the availability of integrated plans by various private insurers, this represents a pivotal shift in the way healthcare is delivered and paid for in Singapore.

And although Singapore is well poised for this change as most Singaporeans already have MediShield and have MediShield accounts, from which they can service their premiums, the sustainability and affordability of such an ambitious scheme as MediShield Life will come under increasing pressure in the years to come, as our population grows older and our tax base shrinks, and also when medical technology becomes more expensive and perhaps if demand surges.

Our Government Parliamentary Committee (GPC) for Health has previously raised this issue about a need to more rigorously evaluate medical treatments and technologies, so that we can better control costs, and this perhaps can be better facilitated when we have a single payer system such as MediShield Life. In healthcare, as it is in many other aspects of life, expensive does not always mean better.

As a doctor in Government practice myself, I find that some patients still feel suspicious or short-changed when they are given a medication which they feel is significantly less expensive than what they feel it should be. Often, this can be easily explained because of Government subsidies or because the patent for the original drug has expired, or perhaps a cheaper but better drug has been found.

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Another example is that of patients requesting for complex scans when the need is not supported by medical evidence, or asking for the newest procedure when older ones are measurably more effective, more reliable and more affordable. This is as much a challenge of public perception as anything else, but it is a reality and it will, nonetheless, continue to put pressure on healthcare providers and subsequently upward pressure on medical costs.

Hence, I hope that the Minister could clarify a little bit further – I know he has already done so – on the roles and functions of the MediShield Life Council, as defined in clause 8 of the Bill. I understand that the Council will advise the Ministry on the parameters of coverage, and I hope that there will be robust mechanisms to evaluate what treatments are deserving of coverage, regardless of how much it costs. This ability to determine which treatment is allowed under the Scheme is already stipulated, as I note under clause 34(c) of the Bill.

What I am advocating is that whether a treatment is covered by the Scheme should be based on scientific merit and, if this treatment is actually effective, then the Scheme should endeavour to cover it, regardless of the cost. The strong safeguards that we need are necessary to guard against this moral hazard of over-consumption, whether it is from the demand side by patients, or from the supply side by healthcare providers.

My final point of clarification is a short one. I do know of many elderly residents, most of whom are Pioneers, who have never been covered under any medical insurance scheme and also have incomplete medical records. These residents or these citizens may sometimes encounter challenges going for a thorough medical review. I would like to seek clarification that these citizens can be automatically included in the scheme with the assumption that they have no pre-existing illnesses.

Finally, I would like to conclude with just a brief comment on what MediShield Life does not cover. While improvements in coverage for outpatient cancer treatment and also for kidney dialysis are very welcome indeed, various aspects of intermediate and long-term care still face challenges in financing. As raised on previous occasions, our ElderShield system is still limited in its benefits in terms of its scope and schedule, and I hope that the Ministry will continue to look into these areas, beyond MediShield Life, since there is a continuum of care from the hospital all the way back to the community.

MediShield Life is, indeed, many things; it is many good things, but it is not about abrogating our individual responsibility for our own health and the health of our loved ones, it is not about the complete freedom to utilise health services as we choose. But what it is about is to afford us peace of mind so that even as we take positive steps to safeguard our health, should a medical catastrophe strike us or our loved ones, then we can be assured that we will have the medical treatment that we need, regardless of our circumstances,

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young or old. With that, I support the Bill.

Mdm Speaker, I had spoken in this House last year during the debate on MediShield Life White Paper and voiced my support for it. As such, I am pleased that this Bill is now before us in this House for Second Reading, another step towards realising universal public health insurance in Singapore.

During my speech on the MediShield Life White Paper in July last year, I highlighted the need for affordable healthcare for all and how important it is for Singaporeans to collectively take care of one another as a show of national solidarity, on top of the 3M public healthcare financing system we have in Singapore. I had also described MediShield Life as a bold scheme and cautioned about the need to ensure its sustainability, given the significant and permanent financial commitments by both Singaporeans and the Government. Experiences by other countries such as Canada, US, Europe, Australia and Taiwan offered invaluable lessons on how the government's strong fiscal positions and people's conscientious premium contributions are important in sustaining a universal public health insurance scheme. Such a scheme brings great social good but if it cannot be sustained, then it will be a shame.

Therefore, I am pleased that the MOH has committed a significant and no doubt calibrated budget to provide various subsidies for Singaporeans, including permanent special subsidies for our Pioneers and additional Premium Subsidies for Singaporean households who may be facing financial difficulties. These subsidies help to relieve the financial burden from the expected rise in premiums and they would not have been possible without a strong fiscal position.

I also note that this Bill has set out penalties for those who wilfully defaulted on their premium payments. At first glance, the penalties appear harsh and some may even interpret it as the Government being gian lui (greedy for money). However, I do think otherwise as I believe it is just as important to put in place a mechanism to ensure that financially capable policyholders play their role and contribute. It is important for Singaporeans to pool our risks and take care of each other collectively. All Singaporeans contributing to the pool is a tangible action and demonstration of our strong sense of national solidarity and willingness to help our fellow countrymen. It is, to me, a test of our conviction towards building a caring and inclusive society. Therefore, while the Government should and can take on a large share of the healthcare financial burden, all of us still have a role to play. It is in this spirit that I agree to the need for penalties to be imposed on wilful recalcitrant defaulters and I stress "wilful recalcitrant defaulters".

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However, I do have some clarifications to seek on this.

There may be some members who have insufficient Medisave savings, likely self-employed and, for some reason, are too busy with work or have to travel overseas frequently. Hence, they may inadvertently have missed the premium payment notices sent to them. As such, I would like to ask the Minister how will MOH identify and decide if someone is a wilful defaulter? What parameters, specifically, will be used to define a wilful defaulter? If the member delays the payment beyond 90 days but shows reasonable effort to pay once he or she can, will the MOH give him or her, a second chance? While it is important to ensure that wilful defaulters do their part, I am also cognisant of the need to avoid penalties on Singaporeans who just need a little more time. Mdm Speaker, please allow me to continue in Mandarin.

(In Mandarin): [Please refer to Vernacular Speech.] Mdm Speaker, the Pioneer Generation Package introduced by the Government last year is warmly welcomed. Our pioneers are deeply relieved because the Package is a great help to reduce their medical expenses, especially for those who have not had income after retirement. The Pioneer Generation Package has eased their hesitation to see a doctor because of cost concerns. It is truly commendable.

Today's debate is on the MediShield Life. I have a few questions.

For those aged between 75 and 79 at 2014, they can receive a subsidy of $600 Medisave top-ups every year. This subsidy, together with the special premium subsidy under the Package, can fully pay for their annual MediShield Life premium until they are 83. This means that for quite a number of years, they do not have to pay anything out of their own pocket. But when they reach 83, they will suddenly find the need to pay for the additional premiums on their own, which can cause confusion. Besides, retirees will have less Medisave savings and cash as they get older. Some of them may have already exhausted their Medisave. I would like to ask the following questions.

First, among this group of Pioneers, how many are likely to be in this situation? Second, for these Pioneers who have financial difficulties, will the Government automatically give them additional subsidies so that they can continue to be insured and will not be worried about getting a ‘red slip'? This also applies to the Pioneers who are slightly younger than this age group and who may face a similar situation. Third, will the Government consider allowing this group of Pioneers, namely those aged between 75 and 79 last year, to be exempted from paying premiums altogether. After all, the difference between their Medisave subsidies and the premiums they have to pay is about $12 to $15 only.

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(In English): Mdm Speaker, in conclusion, I believe MediShield Life marks an important milestone in our public healthcare landscape. It helps Singaporeans to pool risks, share resources and defray large healthcare expenses. While helping to keep public healthcare affordable for all, it is also a tangible way for Singaporeans to demonstrate our solidarity as a nation and our conviction to building a caring and inclusive society. Hence, notwithstanding the questions I have raised, I fully support this Bill.

Mdm Speaker, this Bill gives effect to the MediShield Life Scheme, which was debated in this House in July 2014. It spells out the framework for the disclosure of an individual's confidential health and financial information, recovering outstanding premiums, and the offences and penalties for false declarations and claims.

I have several concerns to raise regarding the disclosure of information and the recovery of outstanding premiums:

First, on the disclosure of information described in Part 5 of the Bill. The Bill authorises certain "authorised persons", including public servants from the Central Provident Fund Board (CPF), the Ministry of Health (MOH) and public hospitals to tap into various Government databases to extract an individual's confidential health information for two purposes: One, to assess whether a person has pre-existing medical conditions for which premium loading may apply; and two, to assess the person's benefit claims under MediShield Life.

The Bill also permits these authorised persons to request for access, use or to disclose to other authorised persons the "means information" of an individual, which could include monthly income, information on assets, residential address and household composition.

My queries and concerns on this Part of the Bill fall into four categories: (1) the means testing process; (2) the extent of access, disclosure and use of confidential data; (3) the process and consequences of opting out; and (4) safeguards to prevent illegal disclosure.

First, on means testing. I understand the rationale for authorising the disclosure of health and means information is to facilitate the smoother and more seamless execution of the MediShield Life Scheme.

I raised the matter of means-tested Premium Subsidies in both my Adjournment Motion on healthcare affordability in November 2013 and during the MediShield Life White Paper

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debate last July. I had asked for Premium Subsidies to be provided automatically to households that have already undergone means-testing for other Government assistance schemes like the Community Health Assist Scheme (CHAS). I also asked for the appropriate level of Premium Subsidies to be automatically extended to all vulnerable groups of Singaporeans, without requiring them to apply separately. This is so that all individuals who are eligible for Premium Subsidies will receive them with minimal paperwork.

Can the Minister confirm if the provisions in this Bill will enable means-testing to be automated, such that individuals do not have to submit any additional forms to receive the Premium Subsidies?

If not, what would be the procedure for individuals to apply for Premium Subsidies, and how will MOH ensure that the process is simple and convenient, especially for the elderly, people with disabilities and those with lower levels of literacy? Given the very tough premium recovery measures in Part 3 of this Bill, it is even more critical that no one misses out on their Premium Subsidies, if they are eligible.

Next, on the use of confidential information. Will the Government be allowed to use any of the confidential information authorised under this Bill for purposes other than means-testing, premium calculations and benefit claims assessments? I note there are provisions under the Bill, including in clause 30, for the Minister to approve the access or disclosure of such information as he "considers appropriate". This gives very broad powers to the Minister and could potentially negate the protections spelt out in other parts of the Bill.

Can the Minister give some examples of what grounds he may consider to be appropriate for granting access or disclosure of confidential information that is not already covered in this Bill? Can these not be spelt out in the Bill instead of giving the Minister so much discretion?

Next, on opting out. For those who do not consent to sharing their confidential information, how will they opt out? Will the process be made simple and explained clearly to all persons, including those who have not yet expressed a desire to opt out? The Bill does not explain the procedure for opting out, but simply that it should be in "the manner determined by the Minister".

If individuals opt out, will they automatically have the full 30% premium load for 10 years imposed on them?

It is easy to assume that people all fall into one of only two groups: the first group being those who are willing to allow the Government to access their health and means information;

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and the second group, those who have medical conditions that they are trying to hide so as not to attract higher premiums. But there is a third group of individuals, those who have no medical conditions that warrant higher premiums, but still do not wish to give the state such wide-ranging access to their personal information. People in this group should not be penalised for wishing to maintain their privacy, neither should they be forced to make a Hobson's choice: either permit access to your data or pay higher premiums.

For individuals who are concerned about privacy, can the Government allow them to opt out from giving access to their health information, and then make a statutory declaration about their health status? If they declare that they have no relevant medical conditions, they would not be required to pay higher premiums. If they are untruthful in their declarations, then there are already penalties in this Bill and other laws that can be used to punish them and deter such behaviour.

I believe this would strike a fair balance between individuals' desire for privacy and the need to ascertain their health status for premium calculations.

Next, on safeguards. This Bill greatly increases the potential number of persons who will be authorised to access confidential information of individuals. We have seen examples in other countries where public officers who were given wide-ranging access to confidential information misused that information and even disclosed it publicly. We have also seen large organisations have their computer systems breached by hackers and suffer massive losses of confidential information, including health information of their employees or credit card numbers of their customers.

I note that there are penalties in the Bill for unauthorised disclosure. But it is not always easy to track down the source of a leak, and in any case, once confidential information is leaked, the damage would have already been done.

With the introduction in this Bill of such extensive authorisation to access confidential information, do the relevant agencies plan to significantly beef up the security of their computer systems to prevent unauthorised data access, either by external hackers or by disgruntled insiders?

Can the Minister assure us that authorised persons will be given access only on a strictly "need-to-know" basis, regardless of their seniority, and that the data in their possession is removed as soon as it is no longer needed?

I note that a new Cyber Security Agency (CSA) has been set up under the Prime Minister's Office (PMO). Will the security of confidential information covered under this Bill

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come under the purview of the CSA?

I now move on to Part 3 of the Bill: the recovery of outstanding premiums.

Under the Bill, those who do not pay their premiums could also be slapped with penalties of up to 17% of outstanding premiums and interest on late payments. Can the Minister elaborate on how the penalties will be computed and how soon after a default they will take effect?

The Bill empowers a "recovery body" to use methods of recovery of outstanding premiums similar to that used by the Inland Revenue Authority of Singapore (IRAS) to recover outstanding taxes. These include declaring any person or entity to be a "defaulter's agent", who could be one's employer, bank or tenant. The defaulter's agent will then be obliged to pay the premiums due from any salary, pensions or rent that he owes to the defaulter. Defaulters could also be sued.

I agree with the Minister that those who have the means to pay their premiums but fail to do so should be firmly compelled to do so. This is only fair to other policyholders who are contributing their fair share to ensure that the Scheme is sustainable and viable in the long term. However, can the Minister assure the House that the Government will not aggressively pursue individuals who default due to their genuine inability to pay?

I am not referring to the destitute, who can be helped by Premium Subsidies, but those who may not qualify for Premium Subsidies but still cannot pay, for example, individuals who have lost their jobs or cannot work due to illness. Can the Government allow for premium deferment for such individuals who may have temporarily run into hard times financially?

And lastly, if an individual continues to default on premium payments, will he ever lose his MediShield Life cover? I hope this will not be the case because it will call into question the universal nature of MediShield Life.

In conclusion, Madam, I support this Bill but have expressed a number of concerns about the disclosure of health and financial information, and the enforcement of the measures to recover outstanding premiums. I hope the Minister will address my queries in his round-up speech.

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Mdm Speaker, in any society, the medical need is the most important benefit that the Government can provide for its citizens.

I must applaud the Ministry for putting forward this Bill. Nevertheless, I have two concerns. Firstly, Singaporeans fear that whenever subsidies are enhanced by our Government, an increase in costs follows on the beneficiary – in this case, hospitals. Ministries should monitor the increase in hospital charges in all restructured hospitals. All cost increases should be justified. Costs should only increase with new technologies introduced or it is really necessary.

Secondly, the Bill has looked at all levels of society – the low-wage workers, the Pioneer Generation and those with financial difficulties. But there are few who may be doing well now and suddenly undergo retrenchment from company and meet many crises. Based on CPF records and others, it may be the middle income who require temporary needs or assistance. Medical social workers should look at his or her present status and try to assist him and should not use his household type or assets and possessions to judge his status.

I know a manager who was retrenched and found out later that he had advanced stage cancer. Medical social workers could not assist him because he stays in a 5-room flat and owns a car. His wife tried desperately to immediately sell the car or the house to continue the payment of medical bills. But it was a bit too late. And he too could not collect his CPF because he was only in his 50s.

I urge the Ministry to brief all medical social workers on this new MediShield Life.

I am happy to note that the Committee has looked at all aspects. It provides better protection, has affordable premiums and makes sure no one in society is left out and it is for life. It is on that, Mdm Speaker, I support the Bill.

Madam, the MediShield Life Scheme is the Government's response to one of the key anxieties of Singaporeans in an ageing society with increasing healthcare options and costs. I believe it is a game-changer in the national healthcare landscape in many ways; but especially in three areas – coverage for all, coverage for life and coverage with help.

Coverage for all. According to 2013 data, about 7% of Singaporeans were not covered under the MediShield scheme. That will change under MediShield Life. In the past, MediShield does not cover those with pre-existing medical conditions, whether they are

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born with it or acquired it later in life. In the past, about one in four in the Pioneer Generation were not covered under MediShield because they cannot work or cannot be reached or may have opted out. In the past, pioneers above the age of 90 were not covered under MediShield. MediShield Life will now cover all of them.

Coverage for life. In the past, MediShield protects members only up to a specific age with a lifetime claim limit of $300,000. With MediShield Life, they will now be protected for life, with no lifetime claim limit.

Coverage with help. Whilst premiums will increase, a slew of measures had been painstakingly put together by the MediShield Life team to allay fears of affordability. MediShield premiums can now be fully covered by Medisave, to avoid the need to pay upfront cash. There are also five types of subsidies that will kick in to ensure the affordability of premiums: one, Transitional Subsidies for all Singapore Citizens; two, Subsidies for Pioneers; three, Permanent Subsidies for premiums for the lower- to middle-income families and that covers two-thirds of Singapore households; four, Government's footing of the bulk of the costs to bring in those with pre-existing conditions; and five, additional support for those who need further help.

MediShield Life, to me, is a more appealing updated, more comprehensive and portable package that is personal and usable across all settings, whoever one's employer and station in life is. Let us support MediShield Life wholeheartedly.

Madam, MediShield Life, most of all, is not only about updating a national healthcare insurance scheme. It is the manifestation of the spirit of belonging to a country.

Basic healthcare coverage is an essential part of the safety net in one's life. Every citizen ought to be included and ought to have access to basic healthcare coverage and not just those who are accepted for access for coverage by insurance providers. The price to pay for that inclusion must be something that we, as the people of Singapore, must determine to pay. True, premiums will increase with this more comprehensive national healthcare insurance package. But we cannot say we are a Singapore family if we leave behind other members of the family when they get older, when they become health-wise vulnerable or when they are born with or later acquire disabilities through accidents or sicknesses.

I have sat through many dialogues including the "Our Singapore Conversations" where so many people spoke about having an inclusive country where the older and the disadvantaged will be cared for. But we cannot claim we want to be inclusive only in word and not in deed. We cannot lament about poverty or poverty lines if we do not support the move to pool our risks and ensure that those who are poor also receive universal basic

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healthcare for as long as they live; and those who are disadvantaged as well, in health.

Who knows if, one day, you or a loved one should land in circumstances that put you at risk of being excluded from healthcare because you are no longer young, healthy or financially able? Who knows if, one day, one of your loved ones is born or acquires some form of disability which a private insurer may not cover or cover only at a very high cost? Who, for that matter, would answer to the national call to have more babies if there is no guarantee that any Singapore baby, born in sickness or health, will have access to basic healthcare insurance coverage?

MediShield Life is Singapore society's response to the call to ensure that no one, now or later, is left behind as far as essential healthcare services are concerned. Whether we will use the service now or never, let us all support the scheme wholeheartedly and be proud that there is such a scheme in Singapore.

Let us also be patient and allow time for any gaps or administrative challenges in the scheme that may still need to be closed or overcome. These imperfections do not call for the baby to be thrown out with the bathwater.

In this regard, Madam, I would like to share three concerns commonly raised for Minister's comments and consideration. These concerns are, one, pre-existing conditions; two, defaulters; and three, sustainability of the scheme.

Concern one on pre-existing conditions. Madam, clause 4 of the Bill provides that persons who are deemed by the Board to have a pre-existing medical condition will be subject to premium loading. According to the Ministry, such persons will pay an additional 30% on top of the normal premium of an insured for 10 years; after which a normal premium is supposed to be applicable.

I understand that the bulk of the cost of bringing persons with pre-existing medical conditions into the common pool is already borne by Government; and that the additional 30% premium loading is a signal of co-ownership or co-sharing.

But the details of what might constitute a pre-existing condition and hence subject to premium loading, have not been published or explained in detail. And that is a cause for anxiety for at least two groups of Singaporeans.

One, special needs persons with lower medical risk. Madam, I have been asked by members of the special needs community if any person diagnosed with an intellectual disability or learning disorder or had spent time in a special school, would be automatically

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slapped with an additional 30% premium loading. Many of them, for example, the deaf, intellectually disabled or those with other learning disorders, may experience challenges at schools and workplaces that relate to their ability to learn, socialise and be included; but physically, health-wise, these persons may not be at risk of requiring more medical treatment or even hospitalisation than the rest of the Singapore population. Hence, the feedback is for persons with special needs who do not have adverse medical claim track record, should not be subject to the additional 30% premium loading.

The second group who are anxious are persons who are subject already or going to be subject to additional premium loading. Madam, as details on the subject of "pre-existing conditions loading" are not fully released, affordability for those with additional premium loading is a concern.

There is also ground fear that the return to a normal premium for these persons after 10 years will apply only to those who have good claims records for the initial 10 years. For those who are chronic or more severe, they worry, perhaps unfounded, that they will be made to continue to pay the same or higher premium loading. These are persons who are currently not covered, because they are born with congenital illnesses, or they have acquired chronic medical problems due to strokes or accidents, prior to the introduction of MediShield Life.

Being turned down, being rejected or being made to pay very high premiums was the experience of many of these people with pre-existing conditions in the current healthcare landscape. As many of them may not be employable and their families cannot support them for life, they seek assurance that the government of the day will always ensure affordability and find means to ensure that they are appropriately covered.

I therefore seek the Minister's consideration to codify the principles of MediShield Life's pre-existing conditions scheme. This is so that members will not be subject to the additional loading without good medical reasons; and so that premiums for those who are subject to additional loading will always remain affordable.

Concern two, on defaulters. Madam, the MediShield Life Bill has provided a full section, Part 3, clauses 11 to 18, on policies and practices relating to defaulters. I fully agree that since this is a shared scheme of collective responsibility, any member who can afford but wilfully does not pay up, should be subject to punitive measures.

Madam, for those who truly cannot afford, I seek the Minister's assurance that defaulters who cannot pay for good reasons, be treated with not only justice but mercy as well. I am referring to examples of members who live in bigger abodes whose Medisave

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could have been depleted as a result of serious illnesses or big hospitalisations or business failures or by the sheer fact that they are not employable due to disabilities or chronic illnesses. There may also be households where husbands simply cannot afford to top up the Medisave balances of their non-working spouses, in addition to topping up their own.

So besides treating these special defaulters with mercy, may I also suggest that MOH proactively work with MSF to develop a register of vulnerable persons such as these and pay special attention to them?

Perhaps a Special "Top Up My Medisave Fund" could be set up and the relevant Ministries could advocate for annual top-ups during Budget time and/or encourage philanthropists or members of the public to contribute to such a Fund and help them top up.

Concern three is on sustainability. To help Singaporeans with their MediShield Life premiums, the Government, we understand, will provide close to $4 billion over the next five years. Government is bearing the bulk of the cost of extending coverage to those with pre-existing conditions, Premium Subsidies, Pioneer Generation Subsidies, Transitional Subsidies, all these are borne by Government. All these are well thought out, very thoughtful and deeply appreciated.

But what happens after five years and the years after is important food for thought and discussion. Although Transitional Subsidies will no longer apply then, there is still the permanent bill for Premium Subsidies for the lower- to middle-income families and the Pioneer Generation Subsidies. Other factors will also come into play. With a new-found confidence by members that coverage is now for all and for life with no cap to life-time claim limits whatsoever, the potential of higher and over-consumption is real. With lower co-insurance payments by the insured, will there be a temptation to go for more lavish or boutique services and prescriptions? Added to this is, as most of us know, that by 2030, one in five will be 65 years and older, and almost a million people belong to that group.

So what can be done to mitigate the high possibilities of over-confidence, over-consumption, over-prescription that will lead to an escalation of healthcare expenditure and therefore premiums in the long term?

Can the Ministry set up a Work Group to look deeper into incentives to look after one's health; to educate Singaporeans on less costly but just as effective medical prescriptions and to develop solutions to reduce over-consumption of healthcare benefits?

On the supply side, where would future funding and revenue sources come from if healthcare costs are expected to rise? Even if we dip into the national coffer, is that a wise

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long-term strategy? A lot of these will have, of course, to do with the ability and the wisdom of the Government of the day; but still, Madam, it would be useful to hear the comments of the Minister on these potential longer-term issues, for the sake of those who come after us.

In conclusion, Madam, at last year's July discussion of the White Paper on MediShield Life in this House, Minister Gan spoke about the important blend of three body parts that would make this important scheme a successful reality. He says the Team needs to Listen with their Hearts, to know what are the worries of Singaporeans; to Think with clear Heads and to be Hands-on during implementation and delivery. The Bill has reflected that the Ministry has indeed deployed well their Heads and their Hearts. It is now the time for the most challenging part of the Scheme to ensure that the Hands now deliver.

I thank the Team for the excellent work, and I really look forward to a successful albeit a very challenging delivery of this important birth. I urge all Singaporeans to support the Ministry of Health's Team in this very important implementation phase and constructively help to explain, help to improve and help to make this Scheme work. With that, Madam, I support the Bill.

Mdm Speaker, MediShield Life has been debated extensively in the House and there was and is overwhelming support for the aim of universal healthcare insurance coverage for life, for all Singaporeans. We did not debate on whether the Bill goes too far.

This is quite noteworthy. In many parts of the world, the idea of a mandatory, compulsory or universal healthcare care financing framework brings out the worst possible rhetoric and posturing from the political right, with accusations of welfarism and socialism. In the United States, the debate over the Affordable Care Act was particularly heated in this respect. On the other hand, in a place like the United Kingdom, where there are proposals to introduce market and insurance mechanisms to the NHS, it has also drawn accusations about heartless capitalism from the left. Here, in Singapore, in debating and discussing the changes to MediShield that take it to the next level, MediShield Life, this has not been the issue. We take it as read that we can use insurance, co-payments and other tools of the market to achieve what is essentially a fairly socialist aim, that is, the provision by the state of accessible, affordable healthcare for all. The Government is not being attacked for a welfarist or socialist position, quite the opposite, there are many calls to do more, provide more help, reduce the financial burden even further. And the response has not been one of ideology, but rather the practical reality – everything we do has to be sustainable, we must not burden our children of tomorrow with the bill from the political promises of today. We have moved past ideology, and that is something to appreciate, to be grateful for, and to

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preserve.

Madam, the peace of mind, the security and the safety net provided by a universal, lifetime insurance plan, with no exclusion on the basis of pre-existing conditions, are considerable and will put to rest many fears, concerns and anxieties. There have been questions about the sustainability and financial viability of the scheme. These have been discussed, debated and answered, but, in truth, we will always need to keep a close eye on this, as health and healthcare expenditures are very unpredictable. In general, however, Singaporeans should have peace of mind that they are much better protected from large hospital bills.

I have a number of questions about MediShield Life.

My first is about the process of a Singaporean opting out of the information discovery and that can either be the healthcare issues or their means and wealth. This comes with a cost, as discussed, of the citizen having to bear a higher premium. My question is about the process of opting back in again. How often will this opportunity be available? On a yearly basis? On a rolling basis? Is there a minimum time period for which the citizen will have to pay the higher premium? When the citizen opts in again, it is appropriate that the administrators of the scheme will need to have access to healthcare data from the period during which the citizen had opted out, so that the risks of possible pre-existing conditions can be assessed properly. However, would the income, wealth and means data from the time period that the Singaporean had opted out of means-testing, be then available and be scrutinised when they opt back in again? I assume that there is only a need for the scheme to assess the citizen's means at that point in time, but could the Minister please clarify this?

Next, if I may draw your attention to clause 16, where significant powers of enforcement are granted to deal with defaulters from the scheme should they wish to leave Singapore. Essentially, this is to ensure that the scheme is truly universal and mandatory. I would like to contrast this with the situation of a non-Singaporean, who is struck by an unforeseen catastrophic illness and racks up a large bill at one of our public healthcare institutions, a bill they may not be able to pay. I realise that the comparison is not entirely appropriate as on the one hand, you have a national insurance scheme, and on the other hand, you have an operational cost recovery problem for the specific hospital. But if that bill remains unpaid, becomes a bad debt, as occasionally happens, this will affect the costs for our healthcare system, as the Minister has described, and lead to an increase of healthcare costs in general, and so, eventually, have an effect on the premiums.

Philosophically, from the issue of social responsibility, there is also the issue that we are mandating an appropriate financial burden to provide the healthcare insurance coverage for Singaporeans, without making the same requirement on non-Singaporeans who may utilise

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our healthcare infrastructure. In general, this will not be an issue and most will pay their unsubsidised bills in full and on time. But where unfortunate circumstances overtake these non-Singaporeans, they may not be able to pay, even if they intend to. In particular, I am concerned about the non-Singaporean dependants, for example, children and grandparents, who will not be covered by the employer of the primary pass holder. For the purposes of protecting the finances of our public institutions and in order to achieve parity with the requirement placed on Singaporeans, I would like to suggest that MOH consider mandating healthcare insurance for non-Singaporeans that are here for a prolonged period of time. This would not fall under the remit of MediShield Life, and so should not affect the risk pooling. It should be an entirely commercial insurance product, with no risk to the public finances, and it need not be comprehensive in terms of healthcare coverage. Essentially, there are two minimum options, either coverage for catastrophic large hospital bills, over a certain threshold, or to cover the repatriation of the person to their home country. But in order to drive this process, it needs to become required, mandated by law, rather than voluntary.

I am in no way suggesting that we need to close the doors of our emergency departments to non-Singaporeans, nor am I suggesting that we need to see documentary evidence of insurance pre-approval before providing timely and necessary care. At the frontline of public healthcare, we must still continue to provide help, care and treatment as needed, as soon as presented with a patient, as we have done. We should continue to allow non-Singaporeans to visit us and to utilise our excellent healthcare services, because that is the morally correct and human thing to do. But we should help to ensure that they can deal with the costs should something unforeseen and unfortunate happen, and that this should not be a burden on the finances of the Singaporean public institutions and, finally, to ensure that there are no loopholes for abuse.

Moving on to my last point, Mdm Speaker, I had previously spoken in the House about smoking cessation and the benefit this would bring to the health of our nation. I continue to believe that the best course of action would be to enact the Tobacco Free Generation Proposal, a ground-up initiative conceptualised here in Singapore, and rapidly gaining attention around the world, where individuals born in the year 2000 and later are prevented from purchasing cigarettes.

This does not fall within the remit of MediShield Life, but the shift to universal provision of healthcare insurance gives us an opportunity to reconsider the issue. The universality of the MediShield Life scheme and the attendant risk-pooling means that the problems of smokers are now all our problems. The impact of smoking-related diseases will increase the premiums for all Singaporeans, unless we continue to act to help people stop smoking. I applaud MOH and HPB and many other institutions for the hard work they do in this area, but more needs to be done, and I fear it will be many years before we can see the last case

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of smoking-induced cancer.

I have a suggestion. It would not be my first choice, but if we cannot achieve a tobacco-free generation through a legislative mandate, how about using the economics of MediShield Life to help drive the right behaviour? Specifically, if a person should be discharged, not admitted – you do not know what is happening to you when you are admitted – from a public hospital with a smoking related disease; thereafter, for all costs related to the same disease, should he not have to pay a larger proportion of the bill if he is still smoking? And how might we know that if he is still a smoker? There is a very simple test, called the urinary cotinine, using a urine dipstick to test for a substance that is a by-product of tobacco, which remains in the body for a week after smoking. If the individual's urine is positive, how about requiring them to pay a larger portion of the bill? If we do not have a mechanism like this, the true cost of that person's smoking is passed on to all Singaporeans as a result of increased healthcare expenditure. This method that I have suggested would not affect the premiums paid, nor would it deny a citizen access to healthcare. It would not affect the charges for healthcare prior to the first diagnosis of a smoking-related disease. But having been admitted for smoking-related diseases, this becomes a very powerful incentive to quit and if you are far-sighted enough, of course quit long before you have a smoking related disease. We have considered discounts, penalties, rewards and rebates as a means to shift behaviour in many other spheres of life, from purchasing goods and using power to parking. Why not use it as a mechanism to encourage people to give up smoking?

Mdm Speaker, in conclusion, the Jubilee Babies born this year will grow up in a society where they have automatic inclusion into a universal healthcare insurance scheme, allowing them affordable access to some of the best healthcare in the world. They will enjoy a public healthcare system that is robust, effective and sustainable. They will not believe there was ever a time when this was not available. They will not believe that there ever was such a thing as an exclusion criterion. The idea of being "uninsurable" will be unfamiliar to them. They will assume that universal healthcare coverage for life is the natural way such things should be done and they will not understand the anxiety their parents and grandparents had about growing old and not being able to afford healthcare. It is only good and right that we can remove this fear, calm this anxiety, and provide all Singaporeans the healthcare that they need. Madam, I support the Bill.

Thank you, Madam. This Bill sets out the legislative framework and powers for the implementation and administration of the MediShield Life Scheme. I support this Bill but I have several clarifications and concerns which I will elaborate as I move on.

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One, penalty for late payment of premiums. According to clause 11, interests may be imposed from time to time on outstanding premiums for that insurance period for those who default on payments. And in clause 17, a penalty may also be added on to the premiums and interests. I would like to find out under what circumstances will interest and/or penalties be imposed.

The total amount of penalties and interests imposed cannot exceed 17%. According to an online article from Channel News Asia, these recovery measures are meant to clamp down on wilful defaulters with the means to pay their premiums and are adapted from existing income tax legislation. On what basis did MediShield Life decide to adopt such measure from the income tax legislation and how is medical insurance premium comparable to income tax?

Will the insured lose their cover if the payment is still not recovered despite multiple reminders and interest incurred? I would like to assume that they would not, since this is a compulsory national insurance but, still, I would like to seek a confirmation. And if the insurance is indeed lapsed, is there a function to reinstate the policy?

Will this scheme allow premium holidays for insured who genuinely cannot pay for their premiums? These could be individuals who lose their job and stop contributing to their CPF Medisave. Some may argue that although the insured becomes unemployed, Medisave savings will be able to see them through the difficult period. However, let us not forget that there are individuals who are paying for the premiums of their children, spouse and parents from their own Medisave account.

Next, access to health information. An authorised person, certified by the Minister, can have access to an individual's health information or history. I can understand the need to have access for such information for the purpose of determining the loading factor to the premiums as stated in clause 27, subsection 1a. However, like many Singaporeans, I am concerned about how much information is available and accessible to those given the authority to assess the database. What security measures are put in place to ensure that the abuse of medical information is kept to the minimum?

An individual can choose to opt out of the system if he or she does not want to give such access to the Ministry. Once an individual is out, will all details be removed from viewing, or only partial information? Apart from not being able to enjoy premiums subsidies, what other benefits are they not entitled to? Will there be any implications to their claims? At which point of the application process would the insured be able to opt out?

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Third, underwriting process and pre-existing conditions. Like every insurance policy, an applicant needs to go through the underwriting process. I would like to find out how will this be done in the case of MediShield Life. Will this be individual or group underwriting?

One of the key features of MediShield Life is that it covers pre-existing conditions. Pre-existing conditions not currently covered under MediShield will have to pay an extra 30% in premiums for 10 years. Is 30% a standard rate for all pre-existing conditions, or is it a range of up to 30%, depending on the severity of the pre-existing conditions?

Next, the insured will pay normal premiums after the 10 years. Is this guaranteed or subject to claims and/or premium payment experiences? More details on what constitutes pre-existing are not available. What about a scenario such as an insured who was fully covered under MediShield, a few years down the road the insured took up a private integrated shield plan and had conditions to be excluded? Will such conditions be treated as pre-existing and will be required to pay more premiums under MediShield Life?

Lastly, for insured who are currently on private Integrated Shield Plans, their premiums are paid directly to the private insurers who will service the policyholders' needs. Private insurers will service all claims and sort out back-end arrangements with CPF Board to include any payouts from MediShield through the Central Claims Processing System, better known as CCPS. Since MediShield Life is replacing MediShield, am I right to assume that the current procedures remain unchanged? That is, the insured do not need to pay premiums separately? With that, I look forward to the Minister's responses. Thank you, Madam.

): Thank you, Madam. I speak in support of the MediShield Life Scheme Bill. I also declare my interest as the President of SPD and board member of SG Enable, both of which organisations serve persons with disabilities, that is, persons with pre-existing medical conditions. I am also personally interested, being currently subject to policy exclusions on grounds of my physical disability and being closely related to persons who are currently subject to policy exclusions or totally excluded from insurance cover.

I applaud the Government's move towards universal health coverage, erstwhile elusive. The MediShield Life Scheme marks another significant commitment by the Government towards greater acceptance and inclusion of persons with disabilities within our society. The Scheme promises to make significant social impact, but it comes with its corresponding costs and burdens and as such, we must be particularly careful in its enactment and execution.

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The nation's interest is served not simply by the introduction of this scheme but more by its acceptance by Singaporeans and its fair, effective and sustainable execution. With this in mind, I raise five issues for the consideration of the House.

Firstly, the scope and definition of "pre-existing medical conditions". Clarity, as much as is achievable, is important in this respect, given that premium loading will be applied based on the same.

I therefore seek clarification from the Minister on the following. I noted that the Minister did say he was going to share broad categories of the pre-existing medical conditions with members of the public. I also request that more details be given and also that criteria in assessing premium loading be shared and made transparent as well.

The MOH Factsheet states that those with "serious pre-existing conditions" would be liable to premium loading. Is it then correct to say that "non-serious" pre-existing medical conditions will not be subject to premium loading? And I see the Minister nodding so I suppose that is the answer, then, I do not have to ask any more. Thank you.

Noting the recommendation also of the MediShield Life Review Committee to exclude from the Scheme treatment for self-inflicted injuries and attempted suicide, will the Minister consider persons who suffer from self-inflicted injuries or who attempt suicide by reason of mental illness? Can this class of treatment be included under the Bill?

Noting also that the determination of a pre-existing illness and, therefore, the application of premium loading will have an adverse impact on any future application for insurance cover, will the Minister consider an appeal process whereby persons can make a direct appeal and have their conditions re-assessed?

Madam, the second issue that I would like to raise concerns the payment of premiums for persons above 21 years old who lack capacity within the Mental Capacity Act. These are the people who may not have donees, who may not have court-appointed deputies and who are above 21 years old. How will the Government ensure that premiums are paid? It would be onerous to require them to make an application to court or to require their caregivers to make an application to court just so that premiums can be paid. I would request the Minister to consider making provision for premiums to be paid by the donee, deputy, or in the absence of either, a parent or both parents of such an insured person.

Madam, my third issue concerns the application of section 59 subsection (6) and subsection (7) of the CPF Act, as sought to be amended under the Bill. Can the Minister clarify the application of the amended subsections to the MediShield Life Scheme? The subsections

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govern the appointment and the assignment of liabilities under the original MediShield scheme to appointed insurers. How is that going to be applied to the MediShield Life Scheme? Will private insurers be appointed, and if not, then why are the amendments sought to be made under the Bill? And if not, then why is the current section 56A of the CPF Act not to be repealed?

If private insurers are to be appointed to manage the Scheme, then I think there is great cause for concern insofar as sustainability, insofar as the protection of private data and those who insofar as, whether or not at the end of day, we could be held to ransom because there are just far too few insurers out there who can manage this Scheme for us.

I then move on, Madam, to the fourth issue which has been raised by my fellow Members on affordability and subsidies. I will not belabour the points that have been raised but I do want to thank the Government and the Minister for the re-assurance that persons who cannot afford to pay premiums will be assisted with that. I also, however, want to request the Minister to consider including additional criteria apart from income and household house value in assessing whether or not an insured person qualifies for Premium Subsidies. The reason is simple – anyone with a pre-existing medical condition would naturally have to spend a lot more in terms of treatment and in terms of other ancillary requirements, such as even transport costs. So, there would be other considerations and I hope that the Minister would take those other criteria into account.

Another point that has been raised by fellow Members is the issue of the importance of ensuring that medical costs do not soar as a result of the provision of insurance. After all, if I do not have to pay, why worry about spending?

Minister, I think I would like to share my thinking that the focus of the Bill is really on treatment, and cost is important, but cost is ancillary. So, while we should be careful about managing the costs, we must also be judicious in the way in which we are going to be monitoring the spending because we must not harness our doctors. They are the ones who know best how to treat, and so we must not have guidelines that tie their hands. I certainly hope that the Ministry would look into this, that even as we monitor, we will be judicious in our guidelines.

My final point, Madam, although not the least important, for the scheme to be sustainable in the long term, we need the Government to continue to honour this commitment. But, whilst we can legislate the proportions of contributions to the MediShield Life Fund and we can legislate how much the contributions are going to be, we cannot legislate empathy, and we also cannot legislate acceptance of persons within our community

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who have greater needs.

The people of Singapore must believe in this scheme and support it. It must emanate from within their hearts and minds. For this, we need the mindshare of the people and the heart-share of the people of Singapore. We cannot run the Scheme and legislate and force people to pay. We cannot talk about penalties and say, "Oh, you know, if they do not pay, what are we going to do? How strict are we, how stringent are we, how robust are we in enforcing?" It helps, it helps, and that is why I have not talked about penalty because, personally, I think it is important. But we must go out and we must explain to people as my hon colleagues have done, that it can happen to just any of us, and it is important for us to have this sense of collective responsibility.

The MediShield Life Scheme, as the Minister pointed out, is not just about insurance. It is also not just about premium loading, Premium Subsidies or penalties. It is about corporate responsibility. Undergirding the whole scheme is the higher ideal of a collective responsibility and societal cohesion. It is not about abuse; it is not about compassion; it is not about charity. It is about respecting the dignity of Singaporeans, in sickness or in health, and it is about us as a country.

During the "Our Singapore Conversation", many participants emphasised the need to bring back the kampong spirit. There has also been much feedback, from the ground and "Our Singapore Conversation", on the inadequacies in the provision for disadvantaged persons. How much more can be done; how much more should be done for the people in our community. I am personally heartened by such feedback because it shows that our people care for the disadvantaged in the community. So, I now call upon these ones who gave that feedback and these ones who believe in it to rally behind and to support the scheme, to go out and to be the ambassadors to other Singaporeans so that they, too, will rally behind and support the scheme.

This is our opportunity, by contributing to the pool of premiums, to play our part in ensuring that every Singaporean has access to medical care. This is our opportunity to show our kampong spirit, and to express our respect for the dignity of fellow Singaporeans. This is when Singaporeans walk the talk. The success or failure of the scheme, and, indeed, of our society, lies within our own hands. Mdm Speaker, on that note, I support the MediShield Life Scheme Bill.

Mdm Speaker, thank you for allowing me to speak on this "game-changing" Bill. The MediShield Life Scheme is a game-changer because it is

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exactly that – it completely transforms the coverage for healthcare insurance in Singapore, most importantly, because it is a universal system. For the first time ever in Singapore, everyone – regardless of age, income levels or health levels – will have access to coverage. What better way for our young nation to mark 50 years of its short history by showing that it has matured to embark on a universal system?

I have several points to make today that I feel will help strengthen the MediShield Life system. Allow me to make these points.

Firstly, access to data. Much has already been said, in this House and outside in the mainstream and social media, of the Bill allowing the Government unequivocal access to an individual's income and health records.

Although the legislation will allow those who find these powers intrusive with the choice to opt-out from having their information shared, I feel that this will be counter-productive to the aim of establishing a universal health insurance system in Singapore.

The idea of MediShield Life, in the first place, is to get everyone to enjoy a cost-effective medical coverage. So, why should we allow one to opt out of information sharing for means-testing and pre-existing illnesses only to incur the additional 30% cost loading? This is counter-productive in providing affordable healthcare when, in principle, the data already reside in one of the Government's databases or registered partner.

I do believe that we have established a reasonable trust level for Singaporeans to declare their income and health records today with the Government agencies, much like we do in our annual income tax submissions. This system is about collective responsibility and the majority helping to subsidise the costs, including the additional loading of 30%. As I understand from the Minister's speech earlier, that 30% loading is cross-subsidised by the rest. So, it is not equitable for some to simply opt out on information and load on the others.

I would also like to highlight a potential loophole. It is quite possible for someone here who has been seeking healthcare treatment outside of Singapore for a pre-existing condition to keep it undeclared and may even get away with it without being found out. I would like to ask the Minister how the Ministry plans to close this loophole.

To improve the integrity of the policy, I would also like to propose setting up a whistle-blowing access so that errant individuals can be identified. I am also supportive of stronger penalties should anyone be found to have declared false information so that it is a strong deterrence for errant behaviour. And this will continue to ensure the robustness and

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integrity of the system.

Many Singaporeans would already have existing private insurance coverage. This may not necessarily be just the higher-income Singaporeans but also, I think many of the middle-income Singaporeans who are also financially savvy to protect themselves and manage to work out premium payments from their monthly incomes. Such individuals may now end up paying double premiums and I am afraid this may prove to be taxing on them. Even though they can pay for their own MediShield Life premiums using their Medisave accounts and not affect their monthly disposable incomes, it is nevertheless a strain to pay for two policies at one time.

I would suggest that Singaporeans with existing policies be given a transitionary period to choose to exit their private insurance plans, especially those whose plans are maturing in the next few years or so. This group can either be given a grace period to complete their private insurance commitments before they officially come on board the MediShield Life or, perhaps, if they fall within the low-income bracket, their MediShield Life premiums can be subsidised during this transitionary period.

On the issue of affordable premiums, I think many Members of this House have spoken. But I would like to add on a few more points. I think the Government has done a lot to ensure that the premiums remain affordable for all Singaporeans. Through a mixture of Medisave payments, subsidies and financial assistance for those who still need more help, the Government has done its best to ensure that it may be difficult to default on premium payments.

On this point, I am particularly concerned with one group, which is the families who are supporting homemakers and young children, those who are unable to work due to chronic illness where the husband or the family members do not have enough to pay for others in the family for their MediShield premiums.

Can the Ministry provide more details on how it plans to assist this group and after how many months of default before the MediShield coverage is cut off? I hope that we monitor this vulnerable group over the next few years and keep track to make sure they do not fall off the scheme due to affordability concerns. Come 2019, when the transitionary subsidies fade out, the increase in premium payments then can be quite steep, especially if you are a low-income earner with some pre-existing ailments.

The strength of the MediShield Life system will be in its long-term sustainability, that is, for Singaporeans to remain on it for their lifespan. If more of them are going to find it difficult to keep up with the steep increase in premiums from 2019 onwards, then we may need to

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review to see how it can be made more affordable then.

I would like to suggest that the Government do a mid-term review before 2019 and identify those low-income individuals whose Medisave may fall short when the subsidies are phased out. For this group, the Government may wish to consider a Medisave top-up so that their risk of not meeting premiums is significantly lowered.

Among residents, there is also a common perception that with the Integrated Plan, one has to continue to pay two premiums rather than one. How does the Ministry plan to address this and how can we improve public understanding of this rather complex policy?

On the issue of pre-existing illnesses, for those with pre-existing illness conditions, the Bill stipulates that they need to pay 30% more on their premiums than others. On the one hand, this may be fair based on the principle of equity. If someone is going to draw more from MediShield Life, then they should be expected to pay higher premiums, and that is what private insurance plans are likely to impose as well.

I would like to propose that the Government review the requirement for low-income earners to pay additional premiums at a tiered level. So, what it can do is to look at alternative loading tiers for low-income earners, for example, paying a lower loading, and the high-income earners paying a different loading, and the medium income, perhaps, keeping your 30% loading, for example. Madam, I move on now to my Malay speech.

(In Malay): [Please refer to Vernacular Speech.] MediShield Life is a scheme that will benefit Singaporeans and permanent residents from all walks of life, not only as a form of protection, but it also brings relief to several groups like the needy and those with pre-existing conditions.

For the Malay community that is always concerned with health and healthcare cost issues, this scheme is a welcomed one. I suggest that the community study this scheme in detail and make use of it, even if they already have their own health insurance.

In this regard, I propose that the Ministry and related agencies increase efforts to explain to Singaporeans the details of MediShield Life so that everyone will be clear and everyone will understand it.

Their concerns in terms of affordability and subsidies that are provided must be addressed. The implementation of this scheme must be reviewed so that it will not burden certain groups too much, including those with pre-existing conditions.

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(In English): Mdm Speaker, on the whole, I support the Bill.

Madam, the proposed MediShield Life will address the fundamental issue of providing basic universal health insurance for all Singaporeans.

The transit from MediShield to MediShield Life may be a non-event for many Singaporeans due to Transitional Subsidies. But for two groups of Singaporeans, those with pre-existing conditions and those with pre-existing medical benefits, the impact of the new health insurance scheme could be significant.

For Singaporeans with pre-existing conditions, it means a lot to be able to buy health insurance for their pre-existing conditions finally, albeit at a higher premium. MediShield Life is taking a step in the right direction. I urge private insurers to ride on this and provide better coverage for those who need more benefits and to keep the additional premiums affordable since the underlying risk of covering someone with pre-existing condition is already underwritten by MediShield Life.

As for Singaporeans with pre-existing medical benefits, the transition to MediShield Life may not be so straightforward. This group includes people with private medical insurance plans and pensioners.

For those people with private medical insurance plans other than the integrated shield plans, it does not make financial sense for them to over-insure themselves with MediShield Life. These Singaporeans should be exempted from the scheme. They can opt to join the scheme anytime or when their private insurance coverage ends since premium is calculated based on age, annual value of their home, per capita household monthly income, and there is a 30% loading on premiums for those with pre-existing conditions.

I can understand the Government does not want Singaporeans to be saddled with large medical bills if they are underinsured. But this can be easily resolved by drawing up a list of approved private healthcare insurance plans in lieu of MediShield Life that would qualify Singaporeans for exemption.

Next, the impact of MediShield Life on the 32,000 pensioners needs to be spelt out clearly. The last time I spoke on this issue, I asked that these pensioners be given an option to opt out of MediShield Life as well. Although the Health Minister has assured this House that pensioners will not be worse off, I will repeat my call for pensioners to be given this

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option for good reasons.

In a news report last July, the Public Service Division (PSD) announced that 40% of these pensioners who are currently receiving 1% additional Medisave contribution will get another 1% when MediShield Life starts. This will certainly help pensioners who are on the Comprehensive Co-payment Scheme (CCS) cope with the transition to MediShield Life.

In the same report, it was mentioned that the other 60% of the pensioners who are on older medical benefit schemes, which "already provide better coverage than what MediShield Life will be providing," will have their premiums for MediShield Life paid for by the Government. The reports said PSD would be writing to pensioners with more details on MediShield Life by October 2014.

Madam, I wish to ask the Minister to share with this House the impact of MediShield Life on this group of pensioners whom PSD had said are currently receiving better coverage than what MediShield Life will be providing.

Apart from paying the premiums for these pensioners and their spouses, what about the deductibles under MediShield Life that they have to bear now?

For pensioners under the Fixed Amount of Ward charges scheme (FAW), their public hospital bills are capped at $8 per day. Would these pensioners and their dependants be paying the same rate under MediShield Life?

For pensioners and their dependants under the Co-Payment on Ward charges scheme (CPW), their co-payments for ward charges are capped at 20% and 50% respectively. For a hospital bill of $2,000, for example, these pensioners only need to pay $400 for themselves. How much would these pensioners be paying under MediShield Life since the deductible for a Class C ward is already $1,500 for policyholders aged 80 and below?

How would MediShield Life be better for these pensioners when PSD has acknowledged that it is not? And why would the Government want to go to great lengths to match the benefits of MediShield Life with what the pensioners are currently receiving when a simple solution is to let them remain status quo?

The MediShield Life Review Committee report has made reference to the Swiss experience on health insurance. The Swiss has mandatory health insurance but there are exemptions allowed for good reasons. Likewise, our MediShield Life Scheme should also allow exemptions, especially for pensioners and for very good reasons.

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One, pensioners have an existing ecosystem in the Government catering to their needs, including a comprehensive Medical Billing System for participating medical practitioners to file medical claims so that pensioners and their dependants do not need to pay the full fee upfront.

Two, this group of pensioners will never grow in numbers. Their percentage share of the insured pool is negligible and shrinking at the same time. Would it be so difficult to let this group of pensioners remain status quo and run its course?

I urge the Ministry to consider implementing exemptions for MediShield Life for these selected groups of Singaporeans as highlighted. Madam, I support the Bill.

Mdm Speaker, can I seek a clarification, please?

Yes, please.

Madam, if I heard correctly, the Member said that the Government had said that these pensioners would be worse off. Can I seek a clarification from the Member, please?

I did not say that these pensioners would be worse off. I read a report that was in the newspaper that says, and I quote, "In the same report, it was mentioned that the other 60% of the pensioners who are on older medical benefit schemes, which ‘already provide better coverage than what MediShield Life will be providing'." That was reported in the news.

Madam, can I ask the Member to please continue because I thought I heard after that, he said that the Government had said that pensioners would be worse off?

Okay. This is my speech: "The report said, ‘PSD will be writing to pensioners with more details on MediShield Life by October 2014.' So, I want to ask the Minister actually to share with this House the impact of MediShield Life on this group of pensioners whom PSD has said are currently receiving better coverage than what MediShield Life will be providing." That is what the report says in the newspaper.

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I just want to be sure, Madam, that the Member did not say that the Government said that pensioners would be worse off.

No, no, definitely not.

I am very much reassured, Madam, because in my response to him previously on pensioners, the Government had very clearly said those who are on the old medical schemes will continue to receive all the benefits that they currently have under the old medical schemes and that Government will pay for the MediShield Life premiums of these pensioners. And so, they will continue to have all the benefits that they currently have.

In fact, pensioners will have one important benefit with MediShield Life that they did not have previously. Previously, the spouse of a pensioner would cease to have medical benefits when the pensioner passes away. With the new MediShield Life, pensioners' wives will be covered by MediShield Life. I hope that the Member will help to reassure pensioners rather than causing them anxiety by raising issues which are not true.

Mdm Speaker, may I respond?

Yes, please.

What I raised are features that are in the pension plan now. They are not a figment of my imagination, concocted just to alarm pensioners. This is what they are getting now. If they are paying $8 per day – this is asking a question to the Minister whether under MediShield Life, they would be getting the same thing. These are not things that I concoct out of my own imagination just to alarm pensioners. I just want to seek clarification; if pensioners were to go on MediShield Life, what would they be expecting? Are they going to be expecting the same kind of payment? This is what I just want to seek clarification on.

Madam, the answer is yes. In fact, they would get more because if the pensioners pass away, their wives will continue to be covered under MediShield Life, something which the wives would not have had previously. So, the answer is yes, unequivocally yes. Pensioners who are on the old medical schemes will continue to enjoy all the benefits that they currently have under their old medical schemes. I think that was already very clearly stated previously. I hope that the Member, instead of raising red herrings, will help to reassure pensioners of this.

Yes, Mr Png?

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These are not red herrings, but these are benefits that the pensioners are receiving. Are these not the benefits that they are currently receiving? So, if they are, then I am just raising them, and asking them, "When you transpose that to MediShield Life, are they going to pay $8?" And if you say that it is, then yes, that should be quite clear then.

But then the thing is, in the previous reply, there were no mentions of how much they are going to pay for their medical bills under MediShield Life because there is a deductible. That is, $1,500.

Mdm Speaker, the PSD has communicated directly with all these pensioners, explaining to them that they will continue to receive the same medical benefits as they had before, and the Government will pay for their MediShield Life premiums. In fact, they will be better off, as I have explained, because their spouses would be covered by MediShield Life even after they pass on. I hope that the Member will help us to explain this to all the pensioners rather than causing alarm.

The point is this. Mr Png, you sought a clarification on pensioners. The Deputy Prime Minister, as Minister in-charge of the Public Service Division, has given that clarification, and I am sure that further clarifications would also be given by Minister Gan in his reply.

So, let us now move on. Dr Lim Wee Kiak.

Mdm Speaker, that the MediShield Life Scheme will formally be implemented this year is good news to many. The Scheme has created plenty of buzz since last year when it was first announced. Many of my residents are looking forward to the finalised details, mostly with anticipation, although some with a little trepidation.

The goal of MediShield Life is to ensure that the healthcare costs of every Singaporean and PR, from young to old, healthy and those with pre-existing conditions, regardless of income group, are all covered. This is a thoughtful scheme that closes up some of the existing gaps in healthcare safety net provided under our 3M health coverage system now, where no private insurance company would venture at times even at higher premiums.

In the medical profession, this scheme is of great interest to many of us as well. We have come across examples of patients struggling so much with medical bills that they have wanted to give up treatment. Or elderly residents who have confided that they were afraid