MENTAL CAPACITY BILL

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MENTAL CAPACITY BILL: Order for Second Reading read.

5.21 pm

The Minister for Community Development, Youth and Sports (Dr Vivian Balakrishnan): Mr Speaker, Sir, I beg to move, "That the Bill be now read a Second time."

[Mdm Deputy Speaker (Ms Indranee Rajah) in the Chair]: Our population is ageing and with ageing, unfortunately, the rate of dementia will also increase. At the age of 65 years, one in twenty of us may have dementia. By the time we are 75 years old, the incidence could be as high as one in 10. Maybe I will use the numbers in the Chamber as an analogy. If this Chamber was full and all of us were past the age of

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75, there could be as many as nine persons who would have some form of dementia. I think it is just a coincidence that there will be nine speakers on this Bill!

As we grow older and become frail, the fact is our dependence on other people will increase. In a

book entitled, "Tuesdays with Morrie" , the author Morrie Schwartz described this need quite succinctly. He says, and I quote, "It's like going back to being a child again. Someone to bathe you. Someone to lift you. Someone to wipe you."

Morrie Schwartz graciously accepted his need for others as his body wasted away from Lou Gehrig's Disease and he was unable to take care of himself. But sometimes, instead of the body wasting away, our minds may waste away first. And we may be unable to make decisions on our own and ultimately be unable to fend for ourselves. If any of us, unfortunately, was to reach that point, I am sure that we will feel much safer if we knew that the person whom we were going to depend on at that point in time was someone whom we had chosen when we had the capacity to choose – someone whom we could trust and rely on and someone who was willing to undertake that burden. The best time to choose that someone is now, before we lose our minds, before we lose our capacity. The question therefore is: can we do so under the current legal system? The short answer to that question is "not quite".

Today, a Committee of Person or Estate may be appointed by the High Court to manage the personal welfare and financial matters of those with 'unsound mind' and who are deemed to be incapable of managing their affairs. This is provided for under the Mental Disorders and Treatment Act, an Act which Parliament has just agreed to repeal. However, the problem with this prevailing

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legislation is that the appointment of the Committee of Person or Estate can only be done after an individual person has lost his mental capacity. In other words, you cannot plan in advance and, even worse, you cannot exercise a choice.

I am therefore introducing the Mental Capacity Bill to address this lacuna. We have studied the legislative frameworks of various countries, including the United Kingdom, Germany, Australia, and other countries closer to us in Asia, including Japan and Hong Kong. We have found the England and Wales Mental Capacity Act to be a comprehensive example, and we have modelled our Bill along their lines.

The Mental Capacity Bill puts in place a framework for proxy decision making. This framework sets out who can make the decisions on behalf of those who are mentally incapacitated, which includes persons with dementia, intellectual disabilities or brain damage. It also specifies the processes for doing so. Family members and caregivers who make decisions on behalf of those lacking capacity will be guided by this overall framework. And recognising that persons who lack capacity are specially vulnerable, this Bill provides safeguards against abuse by proxy decision makers.

Public consultation

This Bill is one that has taken a long time in gestating and it has been considered by staff in the Ministry of Law, Ministry of Health and the MCYS for almost a decade. Personally, it has been on my desk for almost three years and we consulted the public through a consultation exercise which began two years ago. So, we have taken our time to carefully and deliberately craft this Bill and make sure it suits our local conditions.

The consultation exercise included, in particular, consultation with social welfare organisations, legal, banking and medical

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sectors. I am very heartened that most Singaporeans and key stakeholders have welcomed the Bill as a timely measure in view of our ageing population and they have also provided useful feedback. We have evaluated all the feedback and we have also amended our original drafts so that we have come up with what I believe is a more appropriate Bill in its current form.

I would now like to draw the attention of the House to some of the main features of the Bill.

Lasting Power of Attorney

The Mental Capacity Bill will empower individuals to plan in advance. It creates a new statutory mechanism called the Lasting Power of Attorney (or LPA in short). With the LPA, individuals can choose, in advance, the person whom they would like to make decisions on their behalf, if and when they lose their capacity in the future. The designated proxy decision maker is known as the donee.

The LPA is a flexible instrument and individuals will be empowered to determine in advance the specific areas which their donee can make decisions for them. These areas may cover property and financial matters, as well as personal welfare matters, including healthcare matters. When the individual loses his mental capacity, his donee is sanctioned to make decisions on his behalf in the areas that have been pre-determined by the person. An individual can also appoint one or several donees who can act jointly or jointly and severally.

Under the Bill, we have provided that bankrupts will not be able to act as a donee for property and financial affairs. However, a person who is a bankrupt can act for personal welfare affairs. When we consulted the public on the exclusion

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criteria for donees, we received mixed reactions - some wanted us to be very safe and have a long list of exclusion criteria, yet, others said that these are personal decisions and we should let the individual decide who he or she wants to act as a donee, regardless of any previous convictions or financial embarrassment which an individual may be exposed to.

In the end, we decided to take what we believe is the right balance between protection and choice and we decided that we would draw the line only on bankrupts insofar as property and financial affairs are concerned. We do not want to be overly prescriptive and we want to allow Singaporeans the maximum choice to choose someone whom they trust to be their donee. But I would emphasise that you should consider very carefully the overall circumstances of the person whom you are intending to make your donee and to confer a lasting power of attorney to.

When individuals plan in advance, they may actually alleviate their loved ones of much stress later when they lose capacity. I will cite an example of one Madam Adeline Ang who is married with two sons. Some time ago, her husband was diagnosed with brain cancer, subsequently lost his ability to make decisions, and Madam Ang found that she then could not gain access to his bank account in order to even pay his medical bills. She was told she had to make an application to Court but she discovered that this process would be costly and sometimes cumbersome.

In the end, she chose not to go to court but that meant she had to struggle even more, to look after the husband, to get the necessary resources and also to look after the children. We believe having a Bill like this which allows pre-planning and pre-designation will lighten the burden in a significant way for future families in such

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circumstances. But having said that, I also want to say that we will not mandate that everyone must make such a directive and conferring a lasting Power of Attorney to someone else. This will be entirely voluntary. We are merely providing individuals with the means to do so if they wish to and this, therefore, is the attraction of the Bill. It is empowering, it is giving you a choice, and it allows you to plan in advance.

Court decisions

Sometimes, there will be people who did not plan or deliberately did not want to plan and to appoint someone as a donee. In such a case, there is an option of applying to the High Court when that person loses capacity, for a court decision on the person’s personal welfare or property and affairs.

The High Court will have powers which are listed in the Bill to make decisions on the control and management of the mentally incapacitated person’s property, carrying on the profession or business of the mentally incapacitated person and the execution, amendment or revocation of a will on behalf of that person.

Court made wills

Sir, allowing the High Court to make wills on behalf of a person who lacks capacity was a recommendation put up by the Law Society and one which I hesitated on initially. However, after consulting the experts involved in this field, I think this is something which we should provide for. Why? When a person who has not made his will and then subsequently loses his capacity, and if he has got a fair bit of assets that need to be distributed, and where it is apparent from his circumstances that the distribution of the assets according to the laws of intestacy – that means according to circumstances where no will is made –

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would lead to inappropriate, unfair or unjust outcomes, then there is an advantage in allowing an application to the High Court for the court to step in and decide in an objective and fair manner as to how these assets should be distributed in the person’s best interests, not necessarily in the best interest of the beneficiaries This, I believe, will clarify misapprehensions and prevent possible future disputes or tensions among family members. Family members can then focus on looking after the well-being of the mentally incapacitated person.

Deputies

For those who have not planned in advance, and where there is a need for ongoing decisions to be undertaken, the High Court can also sometimes appoint a deputy for the person who lacks capacity. This system is not unlike the current Committee of Estate or Person which we have in today's legislative framework.

This provision would be particularly useful for parents of children with intellectual disabilities. Let me explain this in greater detail. Very often, parents who have children with disability, mental or physical, have expressed to me that their greatest anxiety is what happens after they pass on. Who will look after their child? Who will look after him when he reaches adulthood? Who will take care? Who will make decisions? As a parent myself and, I think, as all of us here are parents, we can empathise with this great anxiety or fear of the future in such circumstances. This Bill would not be a panacea for their worries but it provides a framework which I believe will assuage some of their fears.

Let me explain how this will operate. Parents can apply to the High Court to appoint a deputy for their child. In the case where the child has reached the age of 21, the court may make the appointment if at that point in time the

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child is deemed to lack the capacity within the meaning of this Bill. In the case where the child is not yet 21, the court may still make the appointment if it considers likely that the child will continue to lack capacity when he reaches 21 years of age. In appointing a deputy for the child who has not reached the age of 21, the court must have regard to the principle that the appointment of his parents or guardian is to be preferred. The court also has the power to appoint successor deputies in the event that the parents pass away. When considering who should be the successor deputy for a child who has not reached the age of 21 years, the court shall have regard to the parents’ wishes. In other words, the parents can indicate who they want to act as their successor deputy and the court will have regard to their wishes. This, therefore, establishes a succession pathway for the care of the child with intellectual disability and we will work to make this process as efficient and simple and as affordable as possible to all parents in such circumstances.

Safeguards and protection

Sir, I have shared with the House the avenues provided under this Bill to appoint a proxy decision maker, either a donee or a deputy. In addition to providing these avenues, the Bill also guides proxy decision makers in the discharge of their duties. Let me, therefore, elaborate on some of these provisions.

Key principles

At the heart of the Bill is a set of key principles whose core tenet is that every individual must be presumed to have capacity unless shown otherwise. The Bill provides a two-stage test that must be applied in order to determine whether a person has the capacity to carry out an act or make a particular decision. It focuses on the particular time that the decision has to be made and on the

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particular matter to which the decision relates. This, therefore, allows the calibration of powers to be granted to appointed proxy decision-makers so that they will take into account, at all times, the extent of the person’s mental capacity.

As for those that lack capacity, decisions that have been taken on their behalf must be taken in their best interests. The Bill offers guidance on what constitutes best interests. One example would be in the case of making a decision with respect to the incapacitated person’s property. The Bill states that where there is a need to dispose of or settle a person’s property, the decision-maker must be motivated by a desire to ensure that the incapacitated person’s property is preserved as far as possible to maintain the incapacitated person during his life. This is to avoid some of the conflicts of interest which inevitably arise in such circumstances.

Statutory protection for informal caregivers

We also have provided for statutory protection for informal caregivers. These are people who are looking after people who are incapacitated but have not been designated formally as donees or deputies. As long as these informal caregivers perform acts in connection with the care and treatment of people with incapacity, in their best interests, and without negligence, then clause 7 of the Bill will provide these informal caregivers with protection against civil and criminal liability.

This requirement, and I want to emphasise this requirement, to act in the best interests of the mentally incapacitated person and without negligence, is based on existing common law principles. Caregivers should be assuaged that they

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would not be ‘criminalised’ nor face civil suits in their course of caring for the mentally incapacitated insofar that they were performing these acts of care and treatment in the best interests of the mentally incapacitated in good faith.

Excluded decisions

Having said that, Sir, there are some issues which we believe should be excluded and some decisions which proxy decision makers should not have a right to make. For instance, there are some decisions which are so sensitive, for example, the consent to marriage; consent to divorce; consent to sexual relations; sterilisation; adoption; renunciation of religion or change of gender. This Bill will also not affect the existing operation of the Human Organ and Transplant Act or the Advance Medical Directive (AMD) and where a person has already made an AMD, the AMD will prevail.

Criminalisation of ill-treatment

I am certain that the majority of us, if we are called upon to perform the role of a proxy decision maker, will do so sincerely and to the best of our ability but we should also be realistic and understand the vagaries of human nature. Some of us may have read in the newspapers, I think in May this year, of a wife who was appointed to the Committee of Person for her husband by the court. Her husband was incapacitated due to a work-related incident. She was appointed to manage the sum of money that was awarded to her husband as a result of the accident. I believe this was the Workmen's Compensation. Many of us would have been appalled to read that not only had the wife pocketed the entire sum of money for herself, she also locked her husband up at home without care while she went on to live with another man.

We want to deter such flagrant cases of abuse as far as possible. As a bulwark

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against abuse, this Bill will introduce a new criminalisation clause. Ill-treatment or wilful neglect of a mentally incapacitated person will be a criminal offence. Any caregiver, donee or deputy found guilty of such an offence shall be liable to imprisonment or a fine or both.

Office of Public Guardian

Sir, we will set up a new Office of Public Guardian. It will perform a range of functions that contribute to the protection of those that lack capacity. The Office will supervise and support court-appointed deputies. Families may approach the Office of Public Guardian for information on making the Lasting Power of Attorney as to what powers they could consider granting and what to consider when trying to choose who they want to act as a donee. We expect that the Office would be operational some time in the middle of next year.

Mdm Deputy Speaker, we cannot stop the ageing process and we cannot stop the fact that some of us will lose capacity in the future. But this Bill is to empower us to plan in advance, to try in some significant way to secure peace of mind even if we were to lose our minds in the future.

Mdm Deputy Speaker, I beg to move.

Question proposed.

5.42 pm

Mr Sin Boon Ann (Tampines): Mdm Deputy Speaker, I may be getting old but I assure the Minister that I am not yet suffering from dementia.

Madam, the Mental Capacity Bill is both timely and appropriate. Singapore is rapidly ageing. We are constantly reminded of the increasing number of elderly Singaporeans. With ageing, comes

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the reality that our mental faculty may not be as capable as before. For a fair number within our society there will come a time where they are no longer capable of assuming the mental ability and responsibility for their decisions.

Presently, the Mental Disorders and Treatment Act (MDTA) is the only significant piece of legislation that deals with people who are mentally incapable of looking after themselves. And we have just only this afternoon repealed this Act but it will come back in a different form. Unfortunately, the MDTA was drafted more for those who are mentally unsound than for those who are mentally incapable, in law at least, of making proper decisions. Although the MDTA may be applied to those who lack mental capacity to look after themselves, to have decisions taken on behalf of those who lack the capacity under the prevailing legislation may not always be appropriate, as the application of the Act carries with it the potential stigma, as we have heard earlier, of being labelled as insane by the community.

The present Bill, therefore, fills a gap in the legislation. It also simplifies and makes it possible for us to plan ahead to prepare for the day we no longer are able to make sensible decisions. With the passing of the Bill, Singaporeans can now draw up instruments in the form of Lasting Power of Attorney, or can now take comfort in the prospect of a court appointed Deputy who can eventually make decisions in their best interests.

I, therefore, applaud and welcome such moves by the Government to attempt to bring back some dignity in the lives of those who cannot look after themselves. However, I do have a few concerns that I hope Minister can shed light on.

It would be ideal for one to plan ahead to draw up Lasting Power of Attorney but

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I am not sure if the majority of Singaporeans will fully appreciate the benefits that this legislation seeks to bring to them. I suspect that as with wills and testamentary dispositions, most Singaporeans would either be ignorant of the matter, or will not appreciate it sufficiently to want to bother. Besides, even if they are prepared to draw up such an instrument, we may not have the right people who are sufficiently informed of their rights and obligations in duty to properly discharge their functions as guardians of such mentally incapacitated people.

In the absence of a Lasting Power of Attorney, concerned parties, as we understand, may still apply to court to get an order to appoint a Deputy to act on behalf of the person concerned. However, unless that person is a man of means, few would ordinarily want to take the trouble of making an application to court to get a Deputy appointed in the absence of a Lasting Power of Attorney.

Who will bear the cost of such application? The fact remains that a person who lacks the mental capacity to make decisions would have to rely on his family for his daily needs. What he may not be able to do, unless he has made prior arrangements, is to have contractual dealings with other parties. In many cases, families may just wait till the person passes away before dealing with his assets and properties. The prospect of going to court to make an application in most cases would just put many Singaporeans off. Unfortunately, unlike estate matters where properties of the deceased may be applied for the benefit of the beneficiaries, including the administrator, there may be fewer incentives for anyone to apply to court to act as a Deputy as there are added impositions on the person concerned without the obvious benefits. Sir, if the Act is to achieve the broader purpose for

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which it was designed, it should be made more friendly and less costly to implement and has a wider reach to all and sundry rather than just be confined to a few. What we certainly do not want is a legislation that is confined to the middle class and the well-heeled Singaporeans.

Secondly, much authority has been given to the Attorney or the Deputy in a court appointed case. These powers are wide ranging. Potentially, these persons may make decisions that harm the person concerned although these decisions are ostensibly made in his best interest. The Bill presently disallows persons who are bankrupt from acting on behalf of the incapacitated person in certain matters. However, the Act is silent as to persons with past record of criminal convictions, particularly those who have been convicted of violent or sexual crimes, fraud or dishonesty. I note that the Public Guardian, together with the Board of Visitors, is supposed to provide supervisory guidance on the conduct of the Attorney, which, for the purpose of my speech, also includes the Deputy appointed by the court. The question really is, whether this is sufficient to safeguard the interest of the person concerned. The Bill seems to be saying that a bankrupt is more dangerous than a convicted fraudster or a violent criminal. This seems like an anomaly and is rather presumptions. A person could be bankrupt for various reasons. However, the law unfortunately makes the presupposition that all bankrupts cannot be trusted to act in the best financial interest or property interest of the person who is mentally incapacitated.

Thirdly, the Bill entrusts the Attorney to behave properly in discharging his duties under the appointment. Currently, otherwise determined by the authorities, the law allows the Attorney to deal with the property and affairs of the incapacitated person. Such acts will be binding on the person whom the Attorney

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represents. While the Bill makes provisions for the oversight and supervision by the courts, the Board of Visitors and the Public Guardian, there should be rules to spell out the specific areas that these guardians should look out for. For instance, the Bill is silent on the question of whether or not, in the discharge of his duties, the Attorney ought not to be placed in a position where he is in breach of his fiduciary duty to the incapacitated person. As to what the nature of that fiduciary duty is, as I said earlier, or what is the nature of the conflict that the Attorney should not put himself into a position is very much dependent on the knowledge and maturity of the Attorney concerned. In this regard, I am not sure whether all who will be appointed Attorneys under a Lasting Power of Attorney will properly and fully appreciate the responsibilities that he now has to shoulder for his loved ones whom he is giving continuing care for. I do understand that under the present regime as proposed, there is a provision for the Code of Practice. I therefore would like to urge the Government that in drawing up a detailed Code of Practice, the Government would take into consideration a very detailed set of guidelines that will guide and supervise the Attorney or perhaps the Deputy in the discharge of his duties towards the incapacitated person.

Madam, in its implementation, much will have to depend on the public to have the good sense to know that delegating the authority to someone to make decisions on their behalf under certain circumstances is a very important and serious exercise. Much of his quality of life will depend on the Attorney to properly discharge his duties and to have the wherewithal to discharge it. Nonetheless, the introduction of the Bill is welcome as it provides a proper platform that is convenient and efficient in dealing with mental incapacity than that which is currently available. However, this is also one Bill that would require much public

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education and training if it is to be effective. I do hope that in this regard, the Government will put in place resources to properly and adequately prepare the public for it.

With that, Madam, I support the Bill.

5.50 pm

Ms Ellen Lee (Sembawang): Mdm Deputy Speaker, I will speak in Mandarin.

( In Mandarin ): [For vernacular speech, please refer to Appendix A.] The introduction of the Mental Capacity Bill is indeed timely as we anticipate and prepare for the imminent challenges of an ageing population coupled with longer life expectancy.

When the draft Bill was circulated for discussion, many groups of people from various non-governmental organisations and self-help groups were consulted. I can see from this Bill that quite a number of the recommendations have been included and feedback considered. I applaud MCYS for this.

The Bill has attempted to elucidate the meaning of "mental incapacity" and what is in the "best interests" of the donor and the various instances where decisions can be made on behalf of them. In short, the Bill has attempted to encapsulate comprehensively and make express provisions to cover the various possibilities where a person who lacks mental capacity has to make a decision.

This Bill will only be useful for our populace in so far and as long as the common man in the street understands the provisions of this new law when passed. In addition, the various useful recourses provided in this Bill must not only be understood but utilised and executed effectively to give full justification for its existence.

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As you can see from the recent front page newspaper reports, crimes against the older folks are on the rise. It is therefore imperative that this Bill provides security and has widespread use and reach amongst our people, especially the older folks, to truly prevent abuses and instances where their interests are not guarded due to them sustaining "mental incapacity". I therefore urge MCYS to take cognisance of the fact that communication and outreach are of paramount importance in the light of our greying population and the increasing trend of "mental incapacity" cases.

In short, I request MCYS, when embarking on issuing a Code or Codes of Practice for the implementation of this Bill when passed as law, to simplify the implementation processes so that the common folks would not find it too onerous.

*Cols. 175-176.

5.53 pm

Ms Denise Phua Lay Peng (Jalan Besar): Mdm Deputy Speaker, I rise in support of the Mental Capacity Bill and thank the Minister for this significant legislation. If executed well, this new Bill will make a real positive difference to many lives.

I will speak on three key points: (1) responses to the Bill; (2) its positive features; and (3) provide three suggestions for implementation.

The response to the Bill is mixed. One, professionals, especially the social service, legal and healthcare sectors, generally welcome the new Bill as it provides a comprehensive framework that reforms and updates the current Mental Disorders and Treatment Act (MDTA). The current Act is limiting in its scope and does not allow persons to plan in advance for a time when they may lose their

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mental capacity. Two, parents of special needs or disabled children appreciate the new Bill and thank the Ministry for this. In a 2006 Parent Workgroup Report on enhancing the financial security of persons with special needs, close to 100 parents and disability experts were engaged. The families' key fears were grouped into two main areas, namely, (1) financial and (2) caregiving arrangements when they are unable or no longer around to look out for their special needs children. And, three, other Singaporeans who either do not have or do not want to rely on their children and wish to plan in advance for their old age, I believe, also embrace the new Bill.

However, for the man in the street, the content of the Bill does not appear to be their concern. At a recent dialogue with my residents and grassroots leaders, I learnt that there is even concern that planning too early will (1) disrupt harmony amongst their children, and (2) encourage the abdication of filial duties of adult children who are not "appointed" to make financial and personal welfare decisions when their elderly parents lose their capacity. Hence, for the typical Singaporeans, there is a need for the Ministry to educate them so they can make informed options, instead of relying on their potentially false confidence that things will fall into place when the time comes or as the Chinese call this attitude, " chuan dao qiao tou zi ran zhi ", or as the song goes, " que sera sera , whatever will be will be".

As the new Bill is based on the British Mental Capacity Act passed in 2005 and came into force in 2007, Singapore is in a fortunate space to not have to reinvent the wheel. Positive new features were introduced in this new Bill. The Bill is comprehensive and protective of the person lacking capacity.

The new positive features of the Bill include the Lasting Power of Attorney

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that the Minister spoke about, a new regime for the appointment of a Deputy and even Successor Deputies for the person lacking mental capacity and the creation of the new Office of Public Guardian and Board of Visitors with accountabilities to safeguard the persons lacking capacity.

The new Bill is comprehensive and its authors took care to protect the person lacking capacity. Concerns raised in the UK experience were considered and, I believe, one of which was that lacking capacity need not be total and some people may lack capacity only in regard to some areas. For example, some people with disability may have no problems deciding what to eat and where to live but maybe unable to decide best on matters related to property and finance. Hence, the laudable provision of the Bill that persons participate as much as possible in any decisions made on their behalf.

To prevent abuse, limitations were also imposed on the powers of the Deputies and donees in matters such as the making of gifts, execution of wills, key decisions like sterilisation and the carrying out of life-sustaining medical treatment. These are good news and good features.

I want to move next to the point of similarities between the elderly and the disabled. In the same new Bill are provisions addressing what appear to be similar needs of the elderly and the "disabled". Both the elderly and the younger disabled at some time in their lives need someone to make decisions on their behalf and to look out for them and to look after them. The key difference is the time that it happens, the elderly are likely to take a longer time to reach the point of need but many elderly people do become less able and disabled at some stage. As the Minister had alluded to, we have nine people potentially in this House who could be afflicted with dementia. I

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believe that it is not just dementia we are talking about. Everyone in this House is potentially disabled.

And, indeed, the sooner we can see that some needs of the "disabled" and the "elderly" are not all that different, the sooner we can "mainstream" policies and services for the "disabled" in areas such as healthcare, employment, workfare, Medisave top-ups, MediShield, ElderShield scopes and coverages, tax reliefs for dependants, public transport and even housing.

Sir, it may be appropriate to even suggest that the Office eyeballing the needs of the elderly is also appointed to look into the needs of the younger disabled and identify common needs and strategies.

It has been said that behind every glamorous vision are a million plodding steps that need to be taken before the vision becomes a reality. Indeed, legislation alone is not sufficient and must be supported by practical guidelines and other initiatives to ensure that the Bill, if and when it is passed, does not become a white elephant.

The 2008-9 business plan of the UK Office of Public Guardian speaks of the reality of execution difficulties of the Mental Capacity Act, and I quote, "The implementation of the Mental Capacity Act 2005 in UK and the establishment of the Office of the Public Guardian is an ongoing challenge".

I therefore ask the Minister

to consider three suggestions to ensure that the Bill, when passed, will achieve its intended purposes. They relate to the need for:

(1) consultation in developing the Code of Practices;

(2) mass communication and education; and

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(3) integration of other pieces in a master plan for the elderly and the disabled.

Madam, the Code of Practices is a critical document provided in the Bill to provide further guidelines and illustrations on implementation of the Act. In the UK, this document issued by the Ministry of Justice is 302 pages long. I am not certain that the Singapore equivalent needs to be that long. However, I believe that time and resources must be applied to ensure that there are careful consultations during the drafting of the Code of Practices. This is to ensure that it is localised to our Singapore conditions and understood by all stakeholders, not just attorneys and lawyers.

In addition, a loss of capacity can be caused by an array of conditions, such as psychiatric illness, dementia, Alzheimer's disease, brain injury, learning disability and other neuro-developmental problems. In drafting the Code of Practices, medical and disability experts, social workers and so forth must be included to provide expert inputs to assessments of capacity and for appropriate care plans for the persons affected. Crucial dialogues must be held.

Because the Bill provides for a framework that is flexible and intended to be so, to ensure that individuals can participate as much as possible and to cover a range of possible scenarios for decision making, there is a real need for clarity for the purpose of day-to-day implementation.

What do we mean, for example, by terms such as "all practicable steps" in clause 3, "best interest" in clause 6, "minimum level of restraint" in clause 8, "reasonable price" in clause 9, and "reasonable expenses" in clause 24? All

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these in practice need clarification and guidance for those implementing the Act.

A comment often overheard regarding the Bill is that whilst it is a very good idea in principle, how will the Bill or the Act later become public knowledge and be understood and applied? Out of the 10 professionals whom I have sent the proposed Bill to last week, only one lawyer could fully comprehend the terminology, proposed features and implications of the Bill.

I, therefore, propose the development of a Communication Matrix that lists target groups according to their income and language proficiencies; how and where these target groups receive information; and matching communication strategies so that many people who need to can easily access the information needed to plan for their own futures and know where to get help. Communication has to go beyond the usual brochures, media releases and cartoon illustrations.

The Ministry has been proactive in recent years to address the needs of the ageing population and those who are at risk, eg, the disabled and the lower-income group. Many of us in the sector are encouraged and grateful by initiatives, such as:

(1) Council for Third Age;

(2) Enabling Master Plan for the Disabled;

(3) Trust Company for the Disabled;

(4) Financial Literacy campaigns;

(5) ComCare Funds for the needy;

(6) Community Foundations; and several others.

The new Bill cannot operate in a silo if it is to make a difference. There is a need to integrate the many pieces of effort and

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provide a clearer roadmap for Singaporeans planning for their future. Take, for instance, the Bill presupposes that there are sufficient financial resources available for persons to plan the future. But findings of the October 2006 AXA survey of 10,000 Singaporeans showed that most people do not have sufficient to retire and, in fact, have a "worrying disconnect with reality", as far as the resources they have for retirement are concerned. This lack of preparedness is further compounded in families with disabled children and, worse, in lower-income families with severely disabled children. The current "que sera sera, whatever will be will be" attitude towards the future is a potential time-bomb for a rapidly ageing population.

Thus, I would like to urge the Ministry to take the lead to integrate the many piecemeal initiatives to help Singaporeans, especially those who are ageing and/or disabled, to be more prepared for their future.

Develop a more user-centric, not agency- or Ministry-centric, map of services for easier navigation, so that those who are more able can equip themselves to make more informed choices for themselves for their future. The same map can be used by the appropriate Helping Hands in society to identify, eyeball and support those who are at risk due to their lower income or education.

Let us also continue to learn from others who have walked the journey before us in the UK, Scotland, Germany, Japan and the United States. In the UK, for instance, the Office of Public Guardian has already been set up with its own business plans and Key Performance Indicators (KPIs). We can avoid any potential pitfalls while localising our practices to align with our own Singaporean culture and values. We can

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even contribute, as we learn, to a bank of best practices to carers and practitioners in the rest of the world.

In conclusion, I would like to again thank the Minister and his team for this significant legislation.

Mdm Deputy Speaker, I support the Bill.