INFECTIOUS DISEASES BILL

Order for Second Reading read.

4.09 p.m.

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

The control and prevention of infectious diseases into Singapore have been regulated by the Quarantine and Prevention of Diseases Act of 1915, the Leprosy Act of 1949 and the Diphtheria Immunization Act of 1962. The purpose of this Bill is to bring the provisions of the old Acts under one cover and at the same time to provide more effective measures against the spread of infectious diseases. The need for this Bill is substantiated by the outbreak of two epidemics in 1975 - a malaria epidemic and a typhoid epidemic. Investigations showed that the outbreak of malaria in the Whampoa area was due to a single patient who had been infected by the disease when he was outside Singapore.

As facilities for travel become easier and immigration controls are more relaxed, it becomes essential for Singapore to be vigilant against the importation and spread of infectious diseases in the Republic. At present, diseases which must be notified by medical practitioners include cholera and typhoid, plague, smallpox, yellow fever, chicken pox, diphtheria, leprosy, malaria, poliomyelitis, tuberculosis and typhus. Under the provisions of this Bill, the schedule of notifiable diseases has been widened to include infectious hepatitis, encephalitis and venereal diseases, Although private doctors are required to notify cases of venereal diseases, they do not have to reveal the names and particulars of their patients. The reason for such a step is to encourage infected persons to seek treatment by their own doctors as early as possible. In this way, it is hoped that the spread of sexually transmitted diseases can be voluntarily kept under control without patients being fearful that they will be publicly embarrassed.

The control of infectious diseases within Singapore will be administered by the Director of Medical Services, whilst the prevention and introduction of such diseases, in particular cholera, typhoid, malaria and dengue haemorrhagic fever, into Singapore will be administered by the Commissioner of Public Health in the Ministry of the Environment.

Clause 20 of the Bill empowers the Director of Medical Services to prohibit any person from carrying on any occupation, trade or business if in doing so he will cause the spread of the disease.

Members of the House are aware of the "Combat Infectious Diseases Campaign" carried out in September this year, during which the public attention was focussed on tuberculosis, food-borne diseases, malaria, dengue haemorrhagic fever, leprosy and venereal diseases. The campaign has been successful in educating the public into the causes and effects posed by these diseases.

Apart from legislative measures, I believe that an educated and well-informed public is a more important factor in controlling the outbreak of epidemics and assure a high standard of health in Singapore.

Question proposed.

Mr Conceicao: Mr Speaker, Sir, I rise to speak in support of the Bill. To describe the introduction of this Infectious Diseases Bill as timely might well be the understatement of the year. This piece of legislation is really long overdue as the existing Quarantine and Prevention of Diseases Act which this Bill seeks largely to replace was first introduced in 1915. Many of the references in the original Act are therefore completely out of date, even to the extent of retaining quaint colonial overtones.

For example, in the section in the old Act devoted to the interpretation of terms, much space is taken by reference to animals, carcass, cattle, dairy, fodder, litter, and so on.

Dr Toh Chin Chye: Corpse!

Mr Conceicao: Yes. Again, oddly, an immigrant in the old Act is characterised as

'(a) any person not being a first or second class passenger arriving in the waters of Singapore in a ship with the intention of landing in Singapore;

(b) any person arriving at any local area n Singapore as a third class passenger in a train;'

Apparently at that time they did not believe that first and second class passengers could transmit infectious diseases. Or again,

'(c) any person arriving at any local area .n Singapore on foot in a bullock-cart, hire gharri ...'

and so on. For the benefit of the younger members of this House whose experience may not have included acquaintance with the term "gharri", it means horse cart. This Bill, therefore, seeks to replace an old outmoded colonial piece of legislation with something more related to our present circumstances.

Although some of the classic diseases which the old piece of legislation was particularly exercised over. such as small-pox and plague, have been virtually eliminated we must always keep our defences up against the risk of introduction of infectious diseases from outside Singapore. Though we do not have immigrants arriving on foot, in bullock-carts or in gharries (we have emigrants going out with forged passports!), modern modes of transport and the large influx and movement of tourists and those on business have made Singapore one of the busiest crossroads of international travel in the world. There always remains the risk of diseases being introduced without prior warning.

Modern international traffic is so intensive that it is not possible to set up any kind of cordon sanitaire of the good old days. Quarantine laws have therefore to be updated in keeping with contemporary conditions. For, not only do we have the better known infectious diseases to guard against, but there are also new exotic but nonetheless very dangerous viral afflictions, outbreaks of which have been noted in one or two countries, both developed and under developed. Powers to tackle such diseases, even if these ailments are not presently subject to international health regulations, have been incorporated in this Bill.

We should remember. Mr Speaker, Sir, that Singapore is one of the healthiest countries in the world where environmental conditions are concerned and we should continue to keep it that way. Our people are provided with safe drinking water, modern sanitation and a clean environment. The inculcation of better standards of personal hygiene and public health has been part of the continuing public education programmes of the relevant Government departments, programmes that have been carried out at community centres and through mass campaigns and in other ways. Where infectious diseases have occurred sporadically, our constant vigilance and effective surveillance have paid dividends in early detection and immediate action and treatment to ensure that the diseases are brought under control quickly.

It has often enough been stated that our best assets and prime resources are people. It is important that every effort be made to safeguard their health and protect them from avoidable infection: this especially so in view of the fact of the close relationship between our relatively high standard of living and our achievement in the field of public health. I am sure Hon. Members who have recently so enthusiastically played their part in the "Combat Infectious Diseases Campaign" will support fully this move to update the laws relating to the control of infectious diseases.

However, as the Minister has pointed out, it is not enough merely to pass laws and implement them at the official level. For the effect of laws to be successful, it is necessary to have the full cooperation of the population. Although the ensurance of clean water supply and modern sanitation to households have eliminated many of the common infectious diseases such as cholera, some enteric diseases are still prevalent. Therefore, standards of personal hygiene have yet to be raised higher and should there be any unfortunate infection occurring, prompt reporting from the public and medical practitioners, and general public alertness are equally essential for halting the spread of infectious diseases, for notification is one of the keystones of our programme of protection of our people against infectious diseases.

Dr Toh Chin Chye: Mr Speaker, Sir, I have nothing particularly to add to what the Member for Katong has said except to thank him for the historical references that he has made. It sounds amusing in these modern times. I am glad I am receiving his support.

Question put, and agreed to.

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

The House immediately resolved itself into a Committee on the Bill.-[Dr Toh Chin Chye].

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