VOLUNTARY STERILIZATION (AMENDMENT) BILL

Order for Second Reading read.

6.16 p.m.

The Minister for Health (Mr Chua Sian Chin): Mr Speaker, Sir, I beg to move, "That the Bill be now read a Second time."

In 1969, when I moved the Second Reading of the Voluntary Sterilization Bill in this House, I say, inter alia, that the Bill together with the Abortion Bill and the Singapore Family Planning and Population Act of 1965 would be a "charter to liberate women from unwanted pregnancies". I have also stated that during the operations of the Act a critical assessment would be made of its effectiveness.

Both the Abortion Act and the Voluntary Sterilization Act have been in operation in the last two years. Experience gained has shown that the Abortion Act has been operating smoothly and fulfilling its purpose. Since its coming into operation till the end of December 1971, about 5,300 abortions have been carried out. The vast majority of the abortions were done on women with unwanted pregnancies who have a large number of children and belong to the low income group. The Abortion Act can be said to have more than fulfilled the objectives for which the Act had been passed. The same, however, cannot be said of the Voluntary Sterilization Act. During the same period, only 1,639 sterilizations were carried out. This is a pity since sterilization is the best method of family planning for those who completed the number of children they want.

From the figures I gave a moment ago, it can be said that the number of abortions performed was more than three times the number of sterilizations over the same period. This is because the demand for sterilization has been hampered by a number of restrictions in the Voluntary Sterilization Act. Some of these restrictions are connected with the procedure in applying for sterilizations; others with the conditions that have to be satisfied before sterilization can be approved under the Act. It is, therefore, considered desirable to amend the Act suitably so that it will serve its purpose well, namely, to make sterilization, as a method of family planning, easily available to as many men and women who come within its ambit. Hence, the present Bill before the House.

Under the Voluntary Sterilization Act, every applicant has to appear before the Eugenics Board for an interview. This is a mandatory provision of the law as it stands, and the Board has no discretion in the matter. The purpose of the interview is to explain to the applicant the meaning and consequences of sterilization. The reason underlying this provision is that every applicant should be clearly aware of the steps being taken so that he or she will not enter into it unknowingly, or under false ideas nor frivolously - to be regretted when it is too late at a later date.

Sometimes good intentions have a way of achieving unexpected results. But one of them might have been foreseen. This is that many of the applicants find it an embarrassment to present themselves before the Board for the interview. Many have refused to attend the interviews after they had made their applications. How many more have not made applications for sterilization because of this requirement will never be known. Because of this one reason, this important method of contraception for family planning is not as popular as it should be.

There are other reasons too, which make the rigid requirement for the interview undesirable, one of which is that hardship is caused to those applicants in the lower income group (the large majority of applicants are in this group) who live away from the City, particularly in the rural areas, in that they have to take time off from work, perhaps losing a day's wages and spend money on transport to attend the Board's interview at the Kandang Kerbau Hospital. As a result of this compulsory interview, the Board has, to meet regularly to deal with all applicants. In view of the large number of applicants received - about 150 a month - the Board at present meets weekly. It is, therefore, considered desirable that the question whether an applicant is to be interviewed by the Board or otherwise be left to the Board's discretion and provision to this effect has accordingly been made in the Amendment Bill. In other words, the Board will decide on the basis of the information contained in the application whether a person should be called for interview or not.

Every applicant whose application for sterilization has been approved and who is not required by the Board to appear for an interview will be notified by post. As a safeguard and to enable the applicant to have a full medical explanation, he or she will be provided with a leaflet, in the appropriate language, explaining the meaning and consequences of sterilization so that he or she will be fully aware of the step intended to be taken. This leaflet has, been prepared in four languages and has been in use since December 1970. In this connection, I would like to mention that the staff of the various hospitals and maternity and child health clinics, where most applicants go t& get application forms, will continue to give an explanation of the meaning and, consequences of sterilization to the applicants as they have been doing hitherto.

Under the Act, at least 30 days are required to elapse between the date of the application and the date sterilization is to be carried out. This is intended as a safeguard in case the applicant changes his mind, when it would have acted against the basic purpose of the law. The need for such a long waiting period has been criticised. Many are. unable to understand the need for the delay. Indeed, many applicants have indicated a desire to be sterilized immediately after the Board's interview. It is known that some women became pregnant during the waiting period. An amendment to shorten the waiting period from 30 days to 7 days has, therefore, been made. The safeguard is retained, only the period between the approval and when the sterilization operation can be carried out has been shortened. There can be no undue haste in taking this important decision, yet it should not be unduly long.

At present one of the conditions that every applicant must satisfy before the Board will authorise treatment for sterilization is that he or she must have at least three children. In other words, the present position is that parents who have decided that their family is complete with two children cannot benefit from sterilization and would have to adhere to other contraceptive methods for the rest of their lives. It is an undesirable hardship on the marriage partners. It is inconvenient and can be expensive, and further, other contraceptive methods are not 100 per cent effective and there is the ever-present fear of an unwanted pregnancy. After looking into this matter very carefully, it is considered that there is justification in liberalising the law in this regard. Accordingly, the present requirement of three children has been reduced to two and the Bill gives effect to this.

Further, it is also provided that where there are exceptional circumstances, the Board may approve sterilization in the case of an applicant with one living child. The "exceptional circumstances" may be on medical, therapeutic or environmental grounds. The last mentioned ground includes the financial and social circumstances of the applicant. Any application under this head will naturally be scrutinized by the Board with the utmost care, and approval would be given only if the Board is satisfied, having regard to all the circumstances, that there is real justification. Each case will depend on its own merits.

The present law allows the Board to approve sterilization in the case of a person under 21 years of age if he is suffering from hereditary illness that is recurrent, mental illness or epilepsy, and if his parent or guardian consents to it. This precludes unmarried persons over 21 years of age and married persons of any age from applying for sterilization if they are suffering from these illnesses. The Bill seeks to remedy this. deficiency.

At present, the Eugenics Board has no powers to appoint committees for any general or specific purpose or to authorise them to do any specific act or carry out any specific function. Such powers have been provided for the Termination of Pregnancy Authorization Board under the Abortion Act. It is considered that there is a need for similar powers for the Eugenics Board. Clause 2 of the Bill gives effect to this.

Mr Speaker, Sir, I have dealt with the main amendments proposed in the Bill and have explained why they are necessary. I would, however, like to assure the House that the existing safeguards enshrined in the principal Act remain, and these are -

(a) that the authority of the Eugenics Board will continue to be required to authorise sterilization;

(b) that sterilization will not be carried out against a person's, will, in each case, the consent of the person concerned being necessary;

(c) that sterilization will be carried out only in Government hospitals or in approved institutions;

(d) that sterilization will be effected only after a period of seven days has elapsed following the Board's approval of the application, giving sufficient time for a change of mind;

(e) that no medical personnel will be obliged to carry out sterilization if it is against his, conscience.

Mr Speaker, Sir, I beg to move.

Question put, and agreed to.

Bill accordingly read a Second time and committed to a Committee of the whole House.

The House immediately resolved itself into a Committee on the Bill.-[Mr Chua Sian Chin].

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