QUOTA ON FEMALE MEDICAL STUDENTS

5.40 pm

Dr Kanwaljit Soin: Mr Deputy Speaker, Sir, I have laid claim to speak on the motion for adjournment today on a matter which many Singaporeans believe is of some importance. I ask for your indulgence and of the remaining hon. Members to prolong the sitting of this House. The matter, Sir, which I am referring to is the presence of a quota for female medical students, and I would like to make a fervent appeal to the Minister to abolish this quota.

Since 1979, a quota of 33% for females has existed for entry into the medical school. This means that the intake of female medical students into the medical faculty is restricted to one-third of the total intake and no more. The total medical enrolment in 1993 was 771, of which 522 were males and only 249 were females. The female percentage therefore constitutes less than one-third of the total. In spite of this, the surprising fact is that out of 13 people, up to 1993, who obtained an MBBS (Hons) degree, which is only given for exceptional academic performance, seven are females and only six are males.

Since 1979, a lot of water has passed under the proverbial bridge. And as our Deputy Prime Minister has said, the world has changed. Our GDP has increased from $6,700 in 1979 to $22,000 in 1993. Our female labour force participation rate has increased from 42% to 52% in the same period. Singapore has gone regional and has become a successful hub city. Fifteen eventful years have gone by and each year, many disappointed parents and their intelligent and hardworking daughters have continued to be discriminated against entry into medical school and they have stood by in sadness, helplessness and anguish while being lectured on the advantages of living in a meritocratic society.

The conditions which prevailed in 1979 and which prompted the institution of the quota have changed many times over and are hardly applicable today, but yet, unfortunately, we have not reviewed the policy.

In 1979, the following reasons were advanced for imposing the quota:

The first reason given was that female doctors shunned speciality training and preferred outpatient work and are thus considered less productive than male doctors.

In 1979, nearly 85% of the outpatient doctors were females. Since then, this percentage has dropped tremendously and females are no longer concentrated in the outpatient sector. In 1992, 39% of the female doctors were providing primary health care as compared to 34% of the male doctors. So 39% females, 34% males. 32% of female doctors provided specialist care as compared to 40% of male doctors. 32% females, 40% males. 24% of the female doctors were medical officers under training as compared to 23% of the male doctors. 24% females, 23% males. So all these figures for male and female doctors are pretty close, signifying that there is not much difference in the career paths of male and female doctors now. Thus, the statement that females prefer outpatient work no longer holds.

The second reason that was given in 1979 was that female doctors do not continue to work after graduation and thus are wasting the taxpayers' money on medical education. This is also no longer valid. In 1979, the attrition rate of female doctors was 15-20%. This was the figure quoted by Dr Toh Chin Chye in Parliament in March 1979. Today, the figure has changed completely. The numbers for both sexes are very comparable. In 1989, the female attrition rate was 3.4%, and for males, 3.5%, hardly any difference. In 1990, it was 5.1% for females and 3.5% for males, an insignificant difference. In 1991, it was 4.7% for females and 2.6% for males, again, hardly significant. And in 1992, the female attrition rate was 5% and the male attrition rate was 3%. Hence, we see that the difference between the attrition rates of male and female doctors over four years is hardly significant, unlike the picture in 1979.

Also, for the last 10 years or so, doctors have been bonded to work for the Government upon graduation. Singaporean doctors are bonded for five to eight years and scholarship holders serve a longer period. This is only fair as the Government spends about $300,000 on each doctor's undergraduate training and the bond is to ensure that the taxpayers' money is not wasted. If the doctor, male or female, wishes to have an early release, the applicant has to pay the outstanding sum of the bond back to the Government. Thus, the second argument that female doctors are wasting the taxpayers' money is also no longer valid and no longer true. In 1979, there was no bond and the female doctor could stop working. Now, she can only exercise this choice, like her male counterparts, if she pays back the bond. All the medical students are fully aware of this stipulation and know what they are in for when they apply to study medicine in NUS.

Thus, the reasons for which the quota was instituted no longer stand, but the quota still stands. Is it not time for the Minister to review this anachronistic policy? I am sure that as a good policy maker, the Minister will understand the need for this change and abolish the quota.

Here, I would like to illustrate my point with a story. When Maynard Keynes was criticised for changing his policy stand, he had this reply for his critic, and I quote:

`When circumstances change, I change too. What do you do, sir?'

If the Minister needs any further reasons to change the policy, let me also try to provide them. When our family planning policy was first enunciated in the second half of the 1960s, the slogan was "Boy or girl, two is enough". Countless Singaporeans heeded this advice and only had two children. Even if they came from traditional families and wanted sons, they enacted their part of the social contract and obeyed the Government's edict and did not go on trying to have sons even if both their children were daughters. Now, are we trying to tell all those parents who were responsible citizens that they cannot maximise the potential of their children if they happen to be daughters? That was not part of the bargain as far as they knew.

Secondly, I am sure that the Minister knows that the medical quota is against our Constitution which is predicated on equality and equal protection of the law, especially when the matter concerns an institution, namely, the university, which is supported by the taxpayers. Not only does this practice offend the letter and the spirit of our Constitution, but it is also against our ethos of building a society based on justice and meritocracy. Here, I would like to quote the Minister for Education, Mr Lee Yock Suan, himself. This is what he said on 12th March, 1993 with regard to the admission of candidates into the medical course, and I quote:

'In the selection process, aptitude and suitability for the course as assessed by the interview are taken into account together with the "A" level performance. The selection is based entirely on merit.'

I appeal to the Minister to consider heeding his own words and abolishing the quota which relies on sex and not on merit.

The Minister for Education (Mr Lee Yock Suan): Mr Deputy Speaker, Sir, I think it is getting late, and so I do not want to go into a very long debate on this issue. I will give a very brief and to-the-point reply.

As Dr Soin has said, since 1979, the intake of female medical students into the National University of Singapore has been limited to one third of its total intake of medical students, and this is because of two main reasons. Firstly, women doctors, particularly, after marriage, cannot be assigned duties as freely as male doctors. Secondly, a significantly higher percentage of female doctors do not work or work part time. The policy was announced in a press statement in March 1979 and is reviewed regularly.

In 1988, 32.8% of female doctors, as compared to 8.7% of male doctors in the Ministry of Health, its restructured hospitals and NUH, were deployed in positions which did not involve irregular working hours. The 1988 Singapore Medical Council register showed that the proportion of female doctors who did not work or who worked part time was three times that of their male counterparts - 16.3% for females and 5.4% for males. The difference between these figures and Dr Soin's figures is that my figures include the part-timers. I think Dr Soin only mentioned those who stopped work.

Last year, the figures still showed that 23.3% of female doctors, as against 12.4% of male doctors in the Ministry of Health, its restructured hospitals and NUH, were deployed in positions which did not involve irregular working hours. The 1993 Singapore Medical Council register also indicated that 15.6% of female doctors, as compared to 6% of male doctors, did not work or worked part time. There is, therefore, no need to change the existing policy despite the very strong appeal by Dr Soin.

As she has mentioned, it costs about $300,000 of taxpayers' money to train each medical graduate at NUS. It takes five years and the annual operating cost alone is about $60,000, or three times that of arts and science graduates. Therefore, we should make sure that the money is put to best use with minimum wastage.

She also mentioned the point that this quota of one third is against the Constitution. I have asked the University this and they have checked with their lawyers. They have been advised that it is not against the Constitution. If Dr Soin disagrees, she can put this to a test in a court of law. The University must have proper requirements and qualifications for its students, and certain jobs are more suitable for men than for women. So they have this rule which is not against the Constitution.

As I said, the essential difference between her figures and mine is that a lot of the female doctors worked part time. For example, in 1993, of the female doctors, 11.2% were working part time, as compared to 2.8% for male doctors. So in percentage terms, four times of female doctors were working part-time as compared to male doctors. This represents an under-utilisation of a very valuable resource. In the case of doctors not working, in 1993, 4.4% of the female doctors were not working as compared to 3.2% of male doctors. So if you add up both the part-timers and those not working, for females, it was 15.6%, as compared to 6% for males. So I think the reasons that were given in 1979 still remain valid, and I have no intention to change the policy.

Dr Kanwaljit Soin: Sir, can I ask a point of clarification?

Mr Deputy Speaker: No, you have no right of reply.

Question put, and agreed to.

Resolved,

That Parliament do now adjourn.

Adjourned accordingly at Five Minutes to Six o'clock pm.