VERIFICATION OF HEALTH CARE SUBSIDY OF GOVERNMENT POLYCLINICS AND PUBLIC HOSPITALS

3.52 pm

The Minister for Health (BG George Yong-Boon Yeo): Mr Speaker, Sir, I beg to move,

That this House

(a) adopts the Report of the Select Committee on Verification of Health Care Subsidy of Government Polyclinics and Public Hospitals, contained in Parl. 5 of 1996, and endorses the Committee's findings that

(1) the figures for the fees charged by polyclinics and private GPs and the average bill sizes in private and public cospitals, which the Minister for Health provided to Parliament on 15 March 1996, were correct;

(2) the subsidy levels for services provided by polyclinics and public hospitals, as provided by the Ministry of Health,were also correct; and

(3) Mr Ling How Doong and the Singapore Democratic Party (SDP) had not been able to provide any objective data to substantiate their claim that "health care costs are hardly subsidised at all"; and

(b) regrets the attempt by Mr Ling How Doong and the SDP to mislead Parliament and members of the public about Government subsidy of health care.

Today's debate comes at the end of a long but necessary journey which began when the SDP published an article in the New Democrat 1996 Issue No. 1 entitled "The Truth about Health Care Costs". The article claimed that "health care costs are hardly subsidised at all". Mr Ling How Doong, the Chairman of the SDP, repeated the allegations in this House on 11th March 1996 during the Budget debate.

As the Minister for Health, I understand and share the public concern that health care in Singapore should always be kept affordable. It is the responsibility of the Government to ensure that all Singaporeans have access to good quality basic health services at affordable prices, and to ensure that no Singaporean is ever denied health care because of his inability to pay.

Whether Mr Ling and the SDP genuinely believed in the allegations they made or were merely exploiting public concern for political purposes, I was duty bound to clarify the matter. Therefore, during the Committee of Supply debate on 15th March 1996, I explained at some length why the analysis by Mr Ling and the SDP on health care costs and subsidies was wrong. I circulated three tables in this House to give the actual picture. One table compared polyclinic and GP charges for acute and chronic conditions, while the other two tables showed the total and daily average hospital bill sizes in public and private hospitals. I asked Mr Ling to retract his allegations and offered to convene a public committee should he refuse to do so. Although Mr Ling was not present in the House that day, he would have read in the newspapers of what I said.

Far from retracting their allegations, the SDP welcomed the formation of such a public committee. In a statement on 18th March 1996, the SDP Secretary-General, Dr Chee Soon Juan, said, "The Minister for Health Mr George Yeo had challenged the SDP to a public committee hearing to verify the figures on health care cost published in the latest issue of The New Democrat. The SDP welcomes the challenge (and) looks forward to taking part in such a public committee hearing." That being Mr Ling's and the SDP's position, I proposed to this House that Parliament convene a Select Committee to verify the health care subsidy of Government polyclinics and public hospitals on 21st March 1996.

Mr Speaker, Sir, some Singaporeans have asked me why the Government did not simply ignore the wild allegations of Mr Ling and the SDP. But had the Government not reacted, the allegations would have grown wilder over time. A few Singaporeans might even misinterpret the silence of the Government as confirmation that the allegations are true. Mr Ling and the SDP would then have been encouraged to exploit other public concerns for their own ends. Hence, I had no choice but to ask Parliament to convene the Select Committee in order to establish the truth and put it beyond doubt that health care costs in Singapore are heavily subsidised.

Although it meant a lot of work for officers from the Health Ministry and public hospitals, I welcomed the public scrutiny. The Ministry of Health has nothing to hide. That the Government provides substantial health care subsidies based on cost is a matter of fact. The Ministry's affairs have always been conducted openly and professionally. I was confident that the Ministry's position would withstand the public scrutiny and emerge stronger.

Mr Speaker, Sir, there are two parts to my motion. The first is for this House to adopt the Report of the Select Committee and to endorse the Committee's findings. On this part of the motion, I would like to make two points. First, the Committee's findings are based on hard data which have been reproduced in the Report. And second, the facts and figures in the Report have been independently verified by the Auditor-General and are free from material errors. The accounting methods and standards adopted by the Ministry of Health and the restructured hospitals are in line with generally accepted accounting principles.

In view of this, I do not intend to discuss the basis for the Committee's findings in detail today. Everything is in the Select Committee's Report. The facts and figures speak for themselves. The conclusion is absolutely clear: There is substantial Government subsidy of health care in polyclinics and public hospitals; and Mr Ling and the SDP had no basis at all for making their allegations.

This leads me to the second part of my motion which is to regret the way Mr Ling How Doong and the SDP tried to mislead Parliament and members of the public. Mr Speaker, Sir, I feel strongly about this. As elected Members of Parliament, we are under an obligation to the people of Singapore to be honest in our deliberations and to uphold the integrity of the House. Mr Ling and the SDP have not behaved honourably. They said they wanted to "hold the Government accountable to the people for its claims on health care subsidies". But in the end, it is Mr Ling and the SDP who must be held accountable to the people for the cynical way in which they exploited a public concern to achieve their own purposes. As Members know full well, Mr Ling is the Member who alleged in this House that there was no cost-based subsidy in health care. He is also the Chairman of the SDP which alleged in The New Democrat that "there is hardly any subsidy at all in health". It was therefore natural for us to expect that Mr Ling would be a key player in the Select Committee's work. Unfortunately, this was not the case.

Mr Ling not only failed to shed light on the issue, he obfuscated it. His flips-flops over the course of the Committee's deliberations are by now well known to Singaporeans. Not only did Mr Ling not assist the Committee in its work, he often refused to look at the facts or listen to the arguments. Instead, he kept insisting that he was right based on what he described, rather frankly, as his own "simplistic" approach. The Committee had to spend time at each meeting, however, to nail down Mr Ling's latest position. Just when we thought that some progress had been made, Mr Ling would change his position again. And no doubt to avoid giving his final position, Mr Ling absented himself without any apology at the Select Committee's last session when we discussed the Report to be presented to this House. The draft Report was sent to him a few days earlier.

Mr Ling's last position to the Select Committee was that he never doubted that the Government spent substantial amounts on health care. He proclaimed that his principal disagreement had all along been with the Government's definition and use of the term "subsidy". To be sure, Mr Ling's definition of "subsidy" is quite extraordinary. He said the term "subsidy" could only be used "when it is a first party's money expended on a third party. When people's money is being used for the benefit of the people, it is not subsidy." Mr Ling said that if taxpayers' money was used, it would never count as "subsidy". It was sad to see the way Mr Ling retreated to this rather ludicrous position. Instead of acknowledging the facts, Mr Ling tried to play word games. Had he stated from the beginning that his principal disagreement was with the Government's definition and use of the word "subsidy", it would not have been necessary for us to convene the Select Committee. A good dictionary would have settled the matter, and shown conclusively that he was wrong.

The SDP's behaviour was equally dishonourable. The SDP jumped at the offer of a public committee to debate the issue of health care subsidy. Yet they came to the Select Committee with a written representation which was riddled with misinformation, inaccuracies and errors. Confronted with the facts, they claimed that they made a typographical error in a crucial statistic central to their arguments.

As the verbatim reports show, and they run into hundreds of pages, the SDP had no intention of ever engaging in an honest dialogue on health care subsidy. They were uncooperative and evasive from the start. They refused to discuss the facts and persisted in prevaricating. As a result, it took the Committee a total of 14 hours to establish beyond doubt that the SDP's allegations were baseless and that they had tried to mislead us by misrepresenting key data.

Mr Speaker, Sir, such behaviour cannot be condoned by Parliament if we are not to lose our honour in the eyes of Singaporeans. As Members of Parliament, we are duty-bound to defend and uphold the Constitution of Singapore. We cannot allow Parliament to be mocked or trifled with. I was forced to lodge a formal complaint with the Speaker about the thoroughly objectionable behaviour of the four SDP members who appeared before the Select Committee. That matter has since been referred by the Speaker to the Committee of Privileges. As my complaint is presently before the Committee of Privileges, the second part of my motion today regretting the behaviour of the SDP excludes the specific charges I cited in my complaint against the four SDP representors for they are being separately dealt with by the Committee of Privileges.

Mr Speaker, Sir, I asked my officials to estimate roughly how much it cost the Government to convene the Select Committee. The ballpark figure they gave me was well over half a million dollars. This included manpower resources provided to the Select Committee by the Parliamentary Secretariat, the Ministry of Health and the Auditor-General's Office.

We had to bring in the Auditor-General because of the way Dr Chee Soon Juan, the Secretary-General of the SDP, had cast aspersions on the integrity of the civil service. He said "looking at some of the figures and some of the things that the MOH has said give us reason to be highly suspicious of figures." Dr Chee claimed that there was "a pattern here of overcharging, of overstating the charges." Mr Ling was there when Dr Chee said those words. Mr Ling did not contradict Dr Chee when those charges were made. For this reason, we had to call in an independent body to audit the Ministry of Health. I would like to record here the gratitude of the Select Committee to the Auditor-General and his staff for their good work. They laboured long hours into the night and over weekends, and testified before the Select Committee without fear or favour. And both Mr Chiam See Tong and Mr Low Thia Khiang praised the Auditor-General for the professional way in which he and his staff carried out their work.

Mr Speaker, Sir, while we had to spend much time and resources on the Select Committee to get at the truth, the effort was very necessary. The truth must be known in order that Singaporeans do not lose faith in their institutions and in the system of public administration in Singapore. The Select Committee has been able to settle the issue of health care costs and subsidies conclusively. Ironically, the stones which Mr Ling and his SDP colleagues wanted to throw have fallen on themselves. It is therefore more in sorrow than in anger that I ask Members to regret this shameful attempt by Mr Ling and the SDP to mislead Parliament and members of the public on the very important issue of health care subsidy.

Question proposed.

Mr Loh Meng See: Mr Speaker, Sir, I rise to support the motion standing in the name of the Minister for Health.

Sir, you chaired the Select Committee on the Verification of Health Care Subsidy of Government Polyclinics and Public Hospitals. We had a number of very long sessions. We heard several representors including that from the Singapore Democratic Party. In retrospect, the work of the Select Committee is not without beneficial outcomes.

The SDP had wanted to "hold the Government accountable to the people for its claims on the health care subsidies". They accused the Government of "a pattern of overcharging, of overstating its charges". They had cast serious aspersions against the integrity of the civil service. However, Mr Ling and the SDP forgot the dictum that those who live in glass houses do not throw stones.

The allegations of Mr Ling and the SDP could not stand. Instead, the Ministry of Health officials have proven once again that they could be relied upon to administer Government policies effectively and judiciously. The Health officials are thoroughly professional in their work, ready and able to withstand public scrutiny any time.

I am glad that the Government has lived up to its promise to the people of Singapore that health care will always remain affordable, especially for the lower income groups. The Medisave, MediShield and Medifund Schemes are available to help Singaporeans who are in need of financial assistance for medical treatment.

What was noteworthy were the confusing and contradictory views expressed by Mr Ling How Doong at the sittings of the Select Committee. There appears to be one Mr Ling in the Select Committee and a different Mr Ling outside when speaking to the press.

Even his understanding and definition of the term "subsidy" was changed over time. It started with below cost subsidy and not below market subsidy, and finally, subsidy refers only "when it is a first party's money expended on a third party ... the use of taxpayers' money is not subsidy".

At the first Select Committee sitting on 8th July 1996, Mr Ling conceded that there were "market rate" subsidies, agreeing that the Government hospital fees were lower than that of the private hospitals. He also agreed that the subsidy was "substantial".

On 2nd August 1996, Mr Ling again conceded this time that "cost subsidy" exists, and that the Government hospital and polyclinic fees were charged below cost. Having conceded that there were below market and below cost subsidies, Mr Ling must explain why he chose to come up with the nebulous and extraordinary definition that "when people's money is being used for the benefit of the people, it is not subsidy". It is important that Mr Ling clarify this, as I am sure the constituents of Bukit Gombak will wonder whether the terms he uses in the Bukit Gombak Town Council are any different from those used by the other Town Councils in Nee Soon Central, Potong Pasir, Hougang or the PAP Town Councils.

Sir, the other beneficial outcome of the work of the Select Committee was we got to know Dr Chee Soon Juan and the other officials of the SDP in greater depth. We know from experience that there are individuals who are very impressive when we meet them for the first time on short encounters. We only know their character and true colours in subsequent longer meetings. When we engage them in serious discussions and debate, we know whether they are consistent and honourable men of principles. Fortunately for us, the Singaporean public did not learn too late.

Dr Chee Soon Juan, when asked for the first time on 15th July 1996 the source of his data on Government health expenditure which plunged from 27% in 1989 to 5% in 1990, said he was not sure of the source of his information. Dr Chee subsequently told the Committee on 12th August 1996 that he had the copy of the Asian Survey article with him on 15th July. But later he changed his position to say that he had a copy with him, but it was in his files at home. Having personally observed his actions and listening to what he said, I could not help but to conclude that he was not telling the truth.

Mr Wong Hong Toy said he was the one who calculated the figure of 25%. It became clear that it should have been in Dr Chee's book "Dare to Change" published in 1994. I saw quite clearly Mr Wong's reaction when Mr Kwan Yue Keng mentioned about seeing the chart in Dr Chee's book without prompting. Mr Wong's body language suggested that Mr Column 694 Kwan has let the cat out of the bag. Mr Wong clearly understood English and really did not need an interpreter but used this as an excuse for not correcting the figure in the chart purported to be calculated by him.

Mr S. Kunalen calls himself the Head of Research but did no research. It showed to Singaporeans to beware of someone who inflates his status for which he is not. In reply to my query in the Select Committee, Dr Aline Wong, who is a University Professor, said she would give the research paper a "Fail" mark even for the first degree undergraduate paper, let alone a Ph.D thesis.

The SDP is made up of a group of disparate people. There is no teamwork. Singaporeans should be forewarned if the SDP ever says they are putting up a team in a GRC for elections. SDP should be asked: how is it that with the four representors each did not know what the other is doing?

Mr Ling How Doong and the SDP have mocked the honour and integrity of Parliament. Their intentions have all along been sinister. I join the Minister to express my displeasure for their inexcusable acts in misleading Parliament and the public on the important issue of health care subsidy. We should not allow again precious resources of the state to be used to look into such frivolous and wild allegations. The resources could have been used to help more patients for which the SDP claimed they were championing but obviously they do not.

Mr Ling How Doong: Mr Speaker, Sir, let me first clarify that the speech I made in Parliament in respect of health care cost was not a repetition of what was published in the New Democrat. You would recall that I had, in fact, told the Select Committee that I made this issue in January 1992, immediately after the general election. It is in the Hansard. Members can always check that. In fact, I have a copy here. Actually, it is on 15th January 1992. Immediately after the 1991 general election, I had already raised this issue. I raised this issue at most of the election rallies. So for Members to say that I want to cash in on political ground is all wrong. Why should I? Immediately after the 1991 general election, I raised the same point again in Parliament.

Before I proceed, I propose to go through the speech I made in Parliament in respect of the health care cost. This is what I said on 11th March 1996 [Hansard, Vol. 65, Col. 872]:

"Mr Speaker, Sir, I would urge the Government to do more for the poor and the disadvantaged. There ought to be more subsidies in medical treatment, ward charges and operation fee for the poor. As it is now, the amount of subsidy is just not sufficient. I suspect [I used the word "suspect"] that the so-called subsidy by the Government is not below cost subsidy but below market price subsidy. Let me cite an example. If you go to a polyclinic, you pay $7 per visit excluding medicine. Formerly, you may have paid $12 including medicine. It varies. So you can say, on average, you probably pay $13 to $14 per visit to the polyclinic. But if you visit a private practitioner, you pay about $16. But you must not forget that when you go to a private clinic and they charge you $16, the doctor must have made at least 50% from there. He must have made $8 from there. So the actual cost is only $8." Further down, it reads [Hansard, Vol. 65, Col. 873]:

"If the Government is serious about subsidy, the subsidy should be below cost and not below market price.

I cite a simple example. In Singapore, C class ward charges are $25 per day, excluding food, toilet paper, medicine, etc. For a C class ward, the Government claims that they subsidise 80%. So without subsidy, it comes to $125 per day. If you compare with a private ward outside - we have a number of hon. Members here who have clinics outside - you will find that for $180, you stay in a two-bedded ward with an air-conditioner, telephone and TV. So is this subsidy? In a private hospital, in a four-bedded ward, you pay $157, with air-conditioner, colour TV, etc. Bearing in mind all the infrastructure and equipment, everything in the hospital is paid for from the taxpayers' money. Therefore, when you talk of subsidy, the Government should [I use the word "should"] make sure it is below cost subsidy. It is very easy to work out this way. If the private hospital charges $200, how much do they make from the amount? If they make $100, that means their cost is $100. So if members of the public are asked to pay $80, that means the subsidy is $20. It is very simple. We do not have to go beyond that. The Government should do that. Then I agree that it is really subsidising Singaporeans."

You have observed in my speech that there are two matters. Firstly, assertion of fact and, secondly, expression of an opinion. Expression of an opinion can never mislead. Why I say it is an assertion of fact I will come to it later on. If I am expressing an opinion, how could I mislead with an opinion? I will give you a simple example. I tell you the sky is blue. But you say, "No, it is not blue." Am I misleading anybody? Because you have eyes to take a look at the sky itself, it cannot be misleading. How can it be misleading? You have eyes to see for yourself. I could be colour blind. So the term "mislead" is not appropriately used here. You would notice that in my speech, I dwelt on two points. The first point is ward charges, and the second point is charges at polyclinics. I dwelt on these two points only.

Let me come to my point on charges at the polyclinics. It is an assertion of fact. This is simply because, as I have told the Select Committee, I had been to three different doctors. I was charged $16 per visit on three occasions, and this was why I stated it was $16. That was my point. It is an assertion of a fact. Because I have personally experienced this. That is why I say $16 per visit. Compared to the Government polyclinic charge at $10, $12, $13, I am not far off the mark. Again, I expressed my view to say that of the $16, the private practitioner could have made $8. Thus, if the Government polyclinic charges $10, it is above the amount to be charged. That is the first point.

The second point is in regard to ward charges. As regards ward charges, for Tan Tock Seng Hospital, a 40-bedded dormitory type of ward with no air-conditioners and no television, the cost is $140 per day. In fact, I have brought this to the attention of the Select Committee. I have got the tariffs from the Mount Alvernia Hospital where it is stated here, "for 2-bedded ward with air-conditioning and television, the cost is $180, and for 4-bedded it is $135, and for 6-bedded with air-conditioning, it is only $100." How would you reconcile the charges of a C class ward with 40-beds to that of Mount Alvernia Hospital? That explains away whether there is subsidy or not. You can compare these two hospitals and you will know whether there is subsidy or not.

The next point I would come to is what is stated in the New Democrat. In the New Democrat, in the article "The Truth about Health Care Costs", there are four items there. The PAP Government claims that it costs $225 for a C class bed per day at a Government hospital, 40 beds per ward, with no air-conditioning, telephone or private bathroom. Of this, it tells Singaporeans that the cost is subsidised by 80%. But a B class ward, 4-beds with air-conditioning, telephone and private bathroom in a private hospital like Gleneagles, Mount Alvernia, East Shore, etc. costs $160. Yet there is no subsidy in these hospitals. Consultation charges at Government polyclinics, plus medication, cost $14 to $17. Consultation charges at private GP clinics, plus medication, cost $15 to $18. Yet the PAP Government claims that there is an 80% subsidy at Government polyclinics. Health care costs are hardly subsidised at all. For example, beds in a B2 ward in Tan Tock Seng Hospital are more expensive than the same class beds at Balestier Medical Centre. Indeed, the PAP Government says that it is subsidising 20% of B2 beds. I would like to draw your attention that of the four items there, the last one, health care costs are hardly subsidised at all. These apply to bed charges. It applies to the last item. It started off by stating that health care costs are hardly subsidised at all. For example, it states that it is confined to bed charges.

BG George Yong-Boon Yeo: Can I ask the Member a question?

Mr Speaker: Are you giving way to the Minister?

Mr Ling How Doong: No. Can I finish? Because I do not want my trend of thought to be disturbed.

Now I propose to go, one by one, to justify what is stated in the article "The Truth about Health Care Costs", as I have done in respect of my own speech in Parliament.

The Parliamentary Secretary to the Minister for Information and the Arts (Encik Mohamad Maidin B P M): Mr Speaker, Sir, are we debating on the motion or are we going through something which I thought should have been dealt with by the Select Committee?

Dr Aline Wong: It has already been dealt with.

Encik Mohamad Maidin: I am not sure whether this is appropriate, Sir.

Mr Speaker: I think I will allow Mr Ling to continue.

Mr Ling How Doong: Let me tell the hon. Member that apparently he did not even understand the motion. Do you know what is the motion about? The motion clearly states, in case you do not understand:

"(3) Mr Ling How Doong and the Singapore Democratic Party (SDP) had not been able to provide any objective data to substantiate their claim that "health care costs are hardly subsidised at all"; and (b) regrets the attempt by Mr Ling How Doong and the SDP to mislead Parliament ...". If I explain this item by item, I can prove that there is no such thing as misleading Parliament. You are objecting to me ---

Encik Mohamad Maidin: The point is that this matter was discussed at the Select Committee. Why was it not clarified and made clear that you did not try to mislead the public and Parliament?

Mr Ling How Doong: You have read the whole Select Committee Report. You have noticed that all these items were there. I am here trying to explain that from my speech there is no such thing as misleading Parliament. So I am here to justify, item by item, that there is no such thing as misleading Parliament or members of the public. Therefore, I need to go through all of them, item by item.

Mr Speaker: All right, Mr Ling. I recognise that you need to defend yourself.

Mr Ling How Doong: Thank you, Mr Speaker, Sir.

Mr Speaker: But may I remind you that you only have 30 minutes to do so and I know you have a lot to say. So I suggest you carry on quickly.

Mr Ling How Doong: I will come to the first part of the motion that the PAP Government claims that it costs $225 for a C class bed per day at a Government hospital. I am trying to relate to you how this came to be in our New Democrat. I cannot do better than by going through with you excerpts from the hearings of the Select Committee.

BG George Yeo, the Minister for Health, asked this question. The representor was asked to clarify the first part of the New Democrat. The PAP Government claims that it costs $225 for a C class bed per day. That was the question put to the representor and was asked by BG George Yeo. So an answer was given. This was from a hospital bill of one of the patients. The hospital bill was handed in. And it was stated in that hospital bill that the cost of a C class ward is $225. Being satisfied with how the SDP came to this figure, BG George Yeo continued from there. I merely read out from what he had said [para. 425]:

"Your point in making the statement that C class bed costs $225 is that the Government is not telling Singaporeans the truth, that the cost of health care is subsidised by 80% in C class wards. That is the conclusion in that paragraph. I acknowledge that we made a mistake, that Tan Tock Seng made a mistake in putting down $225. In fact, it should have been $140." Clearly, if there was falsehood in this particular statement, the falsehood originated from the Government because we merely copied from the hospital bill. And if, in fact, this statement is misleading, it was the Government which had misled us and the members of the public. We just copied from the hospital bill. And having been satisfied that the cost of a C class ward in Tan Tock Seng Hospital ought to be $140, instead of $225, this is what BG George Yeo said in the Select Committee hearing [para. 433]:

"Mr Chairman, Sir, I am not saying that the SDP had no basis for putting down $225 for a C class bed, because there was in fact an instance where this had happened, it was a mistake, for which we are sorry, and that was the only point I wanted to make. I just wanted to establish where the SDP got its data from. Because if the data were from someone else, apart from Mr Kow, I would have worried, that there was another such case. But since he told me that Mr Kow, I feel quite comforted that he was referring to the same case. In fact, when Mr Kow was here, I apologised to him on behalf of the Health Ministry for having given him the wrong number." Now I go back to this sentence again: "Because if the data were from someone else, apart from Mr Kow, I would have worried, that there was another such case." And it was further adduced during the Select Committee hearing that this was an isolated case. But let me assure this House that it was not an isolated case. I would refer you to the excerpt further down there. It was not an isolated case. It was not the case of only one bill with the amount wrongly stated to one patient. I will go further down and show that. You will see that when Mr John Chu was questioned, the Government admitted that the amount of $225 stated in the bill was a mistake. Government admitted that it was a mistake. So I followed up with my question [para. 839]:

"During the period 1994, could there be similar mistakes of this nature where you put down there as $225 per day? Could there be similar mistakes in 1994?" His answer was that:

"Mr Chairman, if I may seek clarification. What do you mean by "similar mistakes"? I cited an example [para. 840]:

"For example, in Sunny Kow's case, the full charge was supposed to be $140 but it was reflected in the bill as $225. So could there be other bills for a C class ward, instead of $140, you put $225? Could there be other similar bills?" His reply was this:

"As I mentioned earlier, this number is fed into the computer and for all bills, regardless of whether it is C or A, it shows $225." It was fed into the computer and it was generated for a period of time. It could be hundreds or thousands of bills. Why? Because further down there, BG George Yeo said [para. 842]:

"... They have made a mistake. That mistake probably resulted in errors in many bills issued during that period." "Many bills issued during that period." I have answered the first point. That was a mistake by the Ministry. It was not by us.

Now we come to the second part regarding the private hospitals' charges.

BG George Yong-Boon Yeo rose ---

Mr Speaker: Mr Ling, would you like to give way to General George Yeo.

Mr Ling How Doong resumed his seat

BG George Yong-Boon Yeo: Mr Ling, on this specific point of Mr Sunny Kow, since many Members would not be familiar with the details of his case, can you tell the House how much Mr Sunny Kow in fact paid for his C class bed?

Mr Ling How Doong: I would like to make it very clear, to be fair to everyone here, that the quibbling is not so much as to the actual cost. In fact, I made it very clear that the quibbling is over the question of cost. It is a question of cost. Because we are all the time talking of subsidies. So whether it is $225 or $140, Sunny Kow still paid $19. He still paid $19 for the charge, which is the standard charge.

BG George Yong-Boon Yeo: Mr Speaker, Sir, I would like to ask Mr Ling whether the error affected the amount Mr Kow had to pay.

Mr Ling How Doong: No.

BG George Yong-Boon Yeo: Did it affect any other patient whose bill contained that similar error in the amount that he had to pay?

Mr Ling How Doong: I have not seen the other bills. I assume that it must be the same, $19.

BG George Yong-Boon Yeo: Mr Speaker, Sir, I think it is clear that Mr Ling is quibbling.

Mr Ling How Doong: Now you look at my speech and the article printed in the New Democrat. Because the Government has claimed that it is paying so much subsidies, what would be the impression or perception of the members of the public? Instead of $140, you are saying that it costs $225. Members of the public will say, "My gosh! I have been subsidised to such an extent. The cost is $225. I pay only $19." That, to me, is very dishonest.

BG George Yong-Boon Yeo: Mr Speaker, Sir, if I were to answer this later, Members would not be able to follow the mathematics. Can I ask Mr Ling, as a proportion of $140, what is $19?

Mr Ling How Doong: I do not think one should or can draw a comparison. Of course, of $225, if you pay $19, the subsidy is higher. But it is an impression given to members of the public that you spend so much money and you pay so little. That is the point.

BG George Yong-Boon Yeo: Mr Speaker, Sir, I think Members now have a sense of the flavour of the Select Committee. $19 out of $140, which was the rectified amount, is 86%. Government only claims that C class wards are subsidised 80%. But, in fact, based upon the corrected actual amount, it is 86%. If it was upon the erroneous amount of $225, it would have been much higher. But Government only claims 80%. It is a very material percentage, Mr Ling.

Mr Ling How Doong: But you must consider earlier on what I have said in this House. We even questioned the $140 cost by bringing in the tariffs from Mount Alvernia Hospital. For Tan Tock Seng Hospital, a 40-bedded ward, no air-conditioner and no television, you said the cost is $140. And I had cited earlier the charges of Mount Alvernia Hospital. It is clearly stated how much is a two-bedded ward. For Mount Alvernia Hospital - I just have to repeat here - 6-bedded ward, air-conditioned, colour TV, $100 per person; 4-bedded, it is $125. We even compared with a 4-bedded ward. Are you telling me a 40-bedded ward in Tan Tock Seng Hospital, no air-conditioner, no TV, costs $140, while a 4-bedded ward in Mount Alvernia Hospital costs $125?

BG George Yong-Boon Yeo: Mr Speaker, Sir, I have to record an objection to the line Mr Ling is taking. We had before the Select Committee officials from the Ministry and from the hospitals. We had the Auditor-General to audit the various accounts put up. Mr Ling had full access to ask them the questions he now asks me. He did not ask of any of them those questions. Why is that, Mr Ling?

Mr Ling How Doong: The Government says that the cost for Tan Tock Seng Hospital is $140 a day. I have the tariffs from Mount Alvernia Hospital. Is it not a comparison? For a layman, he just takes a look at it, makes a comparison and comes to the inescapable conclusion whether there is subsidy or not.

BG George Yong-Boon Yeo: Mr Chairman, Sir, I think this really proves the point that we are making. Mr Ling is now suggesting that the figures for Tan Tock Seng Hospital are cooked up, that the $140 are not the real costs, that we were somehow misleading him and members of the public as to the true cost of providing a C class bed. He had ample opportunity during the Select Committee hearings to ask the officials and to ask the Auditor-General to check the numbers to make sure that $140 was inflated. He did not. Why is that?

Mr Ling How Doong: As I said, I was just comparing Tan Tock Seng Hospital's charges for a 40-bedded ward. I was just comparing. [Interruptions.] I brought this up in the Select Committee hearing. This is not the first time that you have heard of this. I will give you a simple example.

An hon. Member: Why did you not tell the Auditor-General?

Mr Ling How Doong: I will give you an example. You go to a sundry goods shop, for example, you will find identical goods there. One is $16, and the other is $14. Must I ask him? A layman takes a look and he will know it is $2 more expensive than the one which costs $14. You do not have to go beyond that. Anyway, my point is this. Why I am bringing all this up is simply this. If you look at the motion, it says that the SDP and I are trying to mislead Parliament. You read my speech and my backup of what I said. As I said, firstly, it is an assertion of fact. Secondly, it is an expression of opinion. How could these things mislead anybody? That is my point. So I am labouring on all these things. It is ironical that when hundreds or even thousands of bills are printed with the mistake of "$225", the Government just exonerates and clears itself by saying that it is a mistake. But when we said it is a mistake, no, this is fabrication, prevarication. I really do not understand. And when I said something, you said it is misleading. I really do not understand. So I would seriously want to hear from any Member of this House telling me which part of my speech could mislead this House or the members of the public. I would like to hear that.

BG George Yong-Boon Yeo: Mr Speaker, Sir, I would like to ask Mr Ling when he said earlier, referring to the SDP's New Democrat, that when they said health care costs are hardly subsidised at all, they were referring only to bed charges. Does Mr Ling remember that after the first Select Committee meeting on 8th July, Dr Chee Soon Juan issued a statement asserting the SDP's position that health care costs are hardly subsidised at all without qualification and Mr Ling also issued a statement confirming that his position and the SDP's position are identical. Do you remember that, Mr Ling?

Mr Ling How Doong: Mr Speaker, Sir, may I clarify here? I have stated earlier what I said in Parliament. There are two issues - ward charges and polyclinic fees.

An hon. Member: Mr Ling, you want to deal with fees?

Mr Ling How Doong: Yes, of course. What I am saying is that in both The New Democrat as well as my speech, we only dealt with the ward charges as well as the fees at the polyclinics. As I said earlier, I expressed my view in the sense that I had seen three doctors and I was charged $16. I was also of the view that probably the doctor made $8 from there. So the actual charge was $8. On that assumption, the Government should charge less than $8 in order to be considered as a subsidy, as you call it.

BG George Yong-Boon Yeo: Mr Speaker, Sir, I think here we see it again. Just a moment ago, Mr Ling told us that when the SDP said health care costs are hardly subsidised at all, they were only referring to bed charges. So he brought us this thing about Mount Alvernia's bed charges compared to Tan Tock Seng Hospital. But Mr Ling had conveniently forgotten that not long after the first Select Committee meeting, both the SDP and he issued statements confirming their allegation that health care costs are hardly subsidised at all, statements which Mr Ling told us earlier that he remembers.

Mr Ling How Doong: I have just explained that I went to see three private doctors and they charged me $16. If they made $8, and the Government is charging $10-$12, is it not more than what the private clinics are charging?

BG George Yong-Boon Yeo: Mr Speaker, Sir, I think this is quite a grahic illustration of prevarication. Can I also ask Mr Ling, Mr Speaker, Sir, whether he remembers seeing tables during the Select Committee meeting showing the charges, bill sizes for admissions to Tan Tock Seng Hospital versus private hospitals and bill charges by disease conditions? Does Mr Ling remember those tables?

Mr Ling How Doong: I really do not understand this line of going forward and backward. My answer is a very simple one. I have already told you that I had seen three doctors and they charged me $16. And I am of the opinion that they made $8. Is it not that simple? As I said, if you study my speech carefully, it is an assertion of fact as well as an expression of opinion. I am expressing an opinion. Rightly or wrongly, it is up to you.

An hon. Member: There is something wrong.

Mr Ling How Doong: As I said, rightly or wrongly, I am merely expressing my own opinion.

Mr Speaker: Would you like to resume your speech, Mr Ling? There is no more clarification. You have the floor.

Mr Ling How Doong: I merely just want to repeat here. It is stated in the motion, "... regrets the attempt by Mr Ling How Doong and the SDP to mislead Parliament." I would like to hear from any of the Member pointing out which part of my speech has actually misled Parliament. That is all.

Mr Wong Kan Seng: Nothing more to say.

Mr Ling How Doong: I have said more than enough to exonerate myself.

Dr Aline Wong: Mr Speaker, Sir, for those of us who were Members of the Select Committee and for members of the press and members of the public who have watched the proceedings, I think this appears to be so much deja vu. We really should not be replaying in the House the whole proceedings of the Select Committee again. We are here to debate the Report. We are here to shed further light on the issue and Mr Ling at this moment is intent on saving his own skin.

Let us be clear. He is the Chairman of the SDP. He is responsible for the SDP's newsletter, The New Democrat. He is responsible for the written submission of the SDP to the Select Committee and what has he got to say about this. Yes, there could be something like assertion of facts, but facts can be proven wrong. Figures have been given by SMA and the charges by polyclinics have been verified by the Singapore Medical Association which is an independent professional body. Opinions can be misleading, especially if they are based on wrong facts. So if we carry on like this, 14 hours of debate and hundreds of thousands of dollars spent on the hearings, then they have come to nothing.

We knew it was so difficult to make progress with Mr Ling at the Select Committee meetings. Every single step forward, there were two steps backward. At the end, he claimed that there was no such thing as subsidy. His definition of "subsidy" is so strange that nobody will understand him. If the Opposition wants to engage in a constructive debate with the Government, rightly over an issue which concerns public health care costs, surely, there must be some common starting ground. He said that he meant one thing but we meant another. How can we talk? The common understanding of subsidy is so well-defined in the dictionaries and yet his final position was that there was no such thing.

I just want to share with the House some impressions I have of the proceedings of the Select Committee without going over the details of our examination or inquiry again, especially my impression of the representation made by Dr Chee Soon Juan and the SDP. As I said, Mr Ling is the Chairman of the SDP. He should take some responsibility for the submission of the SDP. But here, I am not speaking only as a Member of the Select Committee, but also speaking from years of experience in teaching and researching at the National University of Singapore. What disturbed me was the shoddiness of the written representation submitted by the SDP to the Select Committee. Since the SDP welcomed the formation of the Select Committee and said it was looking forward to taking part in the public hearing, one would expect that the SDP would take the whole exercise seriously and present a credible case to challenge the Government's position. What came about was a big disappointment. The written representation submitted to the Select Committee was full of factual errors. The various charts that formed the backbone of the SDP's allegation were very poorly prepared with obvious and gross errors in the headings and contents.

Chart 1 was crucial to the SDP's allegation. It was supposed to show that the Government health expenditure as a percentage of total Government expenditure had declined over the years since 1970. There were four points on the graph corresponding to the years 1970, 1985, 1989 and 1990. The chart showed a drastic drop between 1989 and 1990, from 27% to only 5%. This drastic drop in a matter of one year would have caused any researcher to take a very close look to find out what were the reasons behind this and whether there could have been any computational errors. Unfortunately, Dr Chee did none of that. I recall that we at the Health Ministry ---

Mr Ling How Doong rose ---

Mr Speaker: Order. Dr Wong, would you like to give way to Mr Ling to make a clarification?

Dr Aline Wong resumed her seat.

Mr Ling How Doong: I think what she is saying now amounts to sub judice because the four representors of SDP are coming before the Committee of Privileges. She is going into the whole thing. I think it is wholly improper. We should wait until the hearing by the Committee of Privileges to decide on this because she is going into the whole thing now. That is my view. I will leave it to the Chair to decide on this. I think we should leave it to the Committee of Privileges.

Mr Speaker: I will just remind Members not to make any specific reference to the actual complaint which is before the Committee of Privileges. But if the Member is not making any reference to the complaint, then she is free to carry on. Dr Wong.

Dr Aline Wong: Mr Speaker, Sir, I am just analysing the way the chart is structured and presented from the point of view of what research should be like. I am making a judgment on a piece of research. As a researcher, I think I have a right to say what I think is the quality of the research.

The drastic drop in a matter of one year would have caused any researcher to take a very close look to find out what are the reasons behind this and whether there could have been any computational errors. I recall that we at the Ministry of Health were extremely perplexed by Chart I. Our officials had to conduct a very time- consuming research on Dr Chee's chart. What are his sources? Is there any misquotation? Is there one source, or are there several sources from which figures are plucked out of context? What we found was quite astonishing. First, he used M. Ramesh's article which he quoted as his only source to obtain the 1985 and 1989 figures. The figures for 1970 and 1990 were not contained in Ramesh's article. The 1970 figure was apparently lifted from either a 1991 or 1993 article by Mukul Asher, but Dr Chee did not acknowledge this source.

Finally, he superimposed his own computation for 1990 to show a steep plunge which he claimed prove his case that health care cost is hardly subsidised at all. It was only after many attempts that the Ministry officials finally succeeded in reconstructing Chart I, errors and all. It is like a piece of detective work. It was no mean feat, no mean task, and no one imagined that the figures for Chart I were derived by combining two incompatible time series in one equation. These two incompatible time series were: one based on current prices and the other based on 1985 prices. Also, M. Ramesh never explained his methodology in his article, but surprisingly, Dr Chee managed to reconstruct his wrong methodology successfully. I find it very amazing that Dr Chee was ingenious enough to reconstruct the incorrect method. But it never occurred to him that he should check his computation for 1990 to verify the trend against an extension of time series data between 1991 and 1994. The data has already been published. As a researcher, I would have gone to take a look at what lay beyond 1990 in order to see whether the sudden drop in 1990 was in accord with the trend or not. So he did not do his work right. I am speaking as someone who has experience with research and think that this piece of work should have been presented with all serious intention and deliberation, because the SDP knew very well that it was coming before a Parliamentary Select Committee. I was quite disappointed with the quality of the research.

As for Mr Ling, my impression of his attitude at the Select Committee is that actually a lot of the times he was not really paying very much attention to the proceedings of the Committee. It was only when he was pushed and asked to answer questions that he really had to face the facts, so to speak, and what you see on the television snippets are those moments that he was asked to answer questions.

As the Minister had already indicated when the Auditor-General gave his reports and so on, Mr Ling did not ask questions. When the Health Ministry came and gave their representation, he kept on asking only about Sunny Kow's case.

Mr Ling How Doong rose ---

Mr Speaker: Dr Wong, do you want to give way to Mr Ling?

Dr Aline Wong: No. As he said, he had said enough. In the end, Mr Ling claimed that he had never doubted that the Government spent substantial amounts on health care and he said his principal disagreement had been only with the definition of subsidy. I have already touched on this point. I would like to conclude that personally I am quite disappointed with the exercise, but the exercise need not be seen as a futile one. I think for those Singaporeans who are interested to follow the detailed presentation and the statistics, they know how in detail costs and subsidies are calculated, that we have always done things according to internationally recognised accounting principles, that the Auditor-General verified the figures and so on. Singaporeans can rest assured that there is nothing to hide, as far as the Ministry of Health is concerned.

Again, I would like to remind Mr Ling that he himself is a Member of the House. He has every right to raise questions about health care subsidies in this House and we would never hide from his questions. Why is there the need to take this outside the House and cause all these things to happen?

Mr Speaker: Yes, Mr Ling.

Mr Ling How Doong: I raised the health care issue during the parliamentary debate. That is the first point. The second point is, in my view, opinion can only be wrong, but it cannot be misleading. The third point is, she asked why I never raised questions. This is because I was a Member of the Select Committee. I was not a representor. But if you have listened to her, what she said was that I was pushed to answer.

The Deputy Prime Minister (BG Lee Hsien Loong): Why did you not ask questions?

Mr Ling How Doong: No, I cannot just be giving an answer when no question was put to me. She said, "Mr Ling had to be pushed to give an answer." But I was a Member of the Select Committee. So it is only when you asked that I answered. I cannot just go round like I am a representor.

BG Lee Hsien Loong: But did you ask?

An hon. Member: You can also ask questions.

Dr Aline Wong: Can I ask Mr Ling, as Chairman of the SDP, was he not interested in finding out what was going on and finding an answer to his questions?

Mr Ling How Doong: Can you repeat your question again?

Dr Aline Wong: Mr Ling just said that he answered only when he was asked questions because he was only a Member of the Committee. He was not a representor. But as Chairman of the SDP, surely he must be interested to find out whether his position and his party's position was accurate and correct, and therefore he should have asked the representors some questions himself.

Mr Ling How Doong: As I have said earlier, my speech was made during a parliamentary debate. To me, there was nothing wrong with my speech. I went further to justify why I said those things and it was an assertion of fact plus an expression of opinion.

BG Lee Hsien Loong: What is your opinion today?

An hon. Member: Colour blind.

Mr Ling How Doong: Sometimes colour blind, sometimes no. As I have said before, I used the term quite often during the election. I said, "The PAP is a chameleon." During election time, it changes colour. It becomes Father Christmas. I have said that before. I am glad that you remind me of that phrase.

Encik Mohamad Maidin: At least you are not colour blind.

Mr Ling How Doong: I have already given, towards the end of the Select Committee, my interpretation on the question of subsidy. To me, in Southeast Asia the only country that can safely claim to have subsidy is in Brunei. They do not pay income tax. Royalty from oil and petroleum is being dished out to help the poor and needy. That is my point.

An hon. Member: Insurance company.

Mr Ling How Doong: If I can go further, I should say that even the insurance companies are subsidising all their policy holders. For example, you pay $30 premium for an insurance and if you happen to fall ill, you go to a hospital, they will pay you $300 to $500. That is subsidy.

Encik Mohamad Maidin: Mr Speaker, Sir, a Member of Parliament went to the clinics three times and he was charged $16 each time. He suspected the doctors made $8 per visit. The Government clinic charges $10. So he came to the conclusion that there was hardly any subsidy at all. The Member came to Parliament and made a speech. His New Democrat published that it was hardly subsidised at all, and based on his assumption, based on agak agak, the Member was not only wrong but he was trying to mislead Parliament and obviously trying to mislead the public. I think that was the point he asked. I think he had just told us very clearly that he had tried and made attempts before, based on agak agak. How can Mr Ling tell us in this House today that he is not trying to mislead Parliament and the public?

Mr Ling How Doong: I said earlier, based on my deduction that he made so much, and how could you say that I am misleading. As I said, it is an opinion. It is not an assertion of fact to say, "No, Government is charging the public."

Encik Mohamad Maidin: So you made accusation not based on facts. It is not facts, right?

Mr Ling How Doong: No, it is on fact. What is the fact? Would you want to know? I repeat one more time. I went to see three doctors. Is it not a fact?

Encik Mohamad Maidin: I said the same thing. You visited three doctors.

Mr Ling How Doong: Yes. But the point here is, you tell me, how does the Statistics Department go around collating all these statistics?

Encik Mohamad Maidin: That is a different approach.

Mr Ling How Doong: No, the same principle is applied here.

Encik Mohamad Maidin: I do not think they go to meet ---

Mr Ling How Dong: They go to the market place, check ---

Mr Speaker: Order. Mr Maidin, can we have one person speaking at a time

Mr Ling How Doong: Mr Speaker, Sir, he has given me the floor. He interjected me half-way.

Mr Speaker: Yes, that is why I am reminding him to sit down to allow you to continue.

Mr Ling How Doong: Thank you, Mr Speaker, Sir.

Mr Speaker: Have you finished, Mr Ling?

Mr Ling How Doong: Like the Statistics Department, for the cost of living, in fact, it was stated in the press that they sent their members out, go to the market place, take a sample of the various vegetables and see how much, then they come to the conclusion that the price has remained stable or has gone up. Mine is the same way.

Encik Mohamad Maidin: From what I know, normally the Department of Statistics, after they have done a sample survey to date, would compare with the previous survey. They do not agak agak that they have made $8 profit. How can you use that as a basis to come to the conclusion, as the Chairman of SDP, that health care cost was hardly susbsidised? That is what you told us earlier. I wonder whether the Member would like to clarify how he arrived at $8. It took more than agak agak. I do not know. Would he like to reply?

Mr Ling How Doong: If you calculate - in fact, this was done by the SMA - that a doctor needs to see 40 patients a day to make ends meet and he charges, let us say, $20, do not say $16, the overhead is $6 or $7, and he does not make $8 per patient, he cannot survive. You can calculate. With 40 patients a day, if he does not make $8 per patient, he cannot survive. There is no way. It is a very simple, logical way of deduction from there.

Encik Mohamad Maidin: Sir, I cannot clarify, verify or ask the doctor or during the Select Committee meeting. Anyway, Sir, may I be allowed to speak in Malay so that I do not have to engage in a direct debate with Mr Ling?

Mr Speaker: Mr Maidin, please continue. You have started in English.

Encik Mohamad Maidin: Sir, it all started exactly seven months ago when a very serious allegation was made by Mr Ling and his Party. Because it was a very serious allegation, we went through all this process of forming a Select Committee and adopting the Report, and all the way through there was clear and indisputable evidence that there was Government subsidy and up to 80% for C class wards and many others. But the sad thing is today we hear that because of this baseless allegation, and because Mr Ling does not understand the meaning of "subsidy", the Government and Parliament had to spend up to half a million dollars just to clarify and make sure that the public is aware that the allegation is not only wrong, but based on very funny and unbelievable reasoning. We went through the entire process, many hours of work, planning, thinking, preparing from up to eight meetings from 17th May to 24th September, and another session today. Altogether 10 Members of Parliament were involved, which include the Speaker, two Ministers and one Senior Minister of State. On top of that, officials from the Ministry of Health, Auditor-General's Office, Singapore Medical Association and many others, even members of the public, were involved. We sought their views because this issue is of great public interest. There were nine submissions and finally this 620-page Report of the Select Committee.

Sir, it started as an allegation, a serious one, made in this House that health care cost in Singapore was hardly subsidised. In the end, we found out Mr Ling did not understand the word "subsidy" and had his own way of interpreting and defining the word "subsidy".

Sir, I think the Select Committee had been very kind in saying that had we found out earlier or had Mr Ling earlier clarified that he had a different definition of the word "subsidy", we need not go through all this. I do not believe Mr Ling does not understand the word "subsidy". I think he had done so purposely to throw new light, to twist along the way, and trying to outdo the debate. Because throughout the Select Committee proceedings, it was clear that there was indisputable evidence about such subsidy. Up to now, in fact, everywhere in the world, when we visit many parts of Malaysia, in the kampungs, ulu places, kampung folks know the word "subsidy", and many of them do not go to school.

An hon. Member: Bomohs.

Encik Mohamad Maidin: They were not even lawyers. Even the bomohs understand the word "subsidy". Sir, in the past, the Member for Bukit Gombak had used the word "subsidy" many times without any special meaning, without any new interpretation to the word. And finally when it came to this, he changed and tried to side-step the main issue.

Sir, I suspect that the whole idea of accusing the Government, of trying to undermine the system and the civil service over this issue was the fact that there was rumour sometime earlier this year about a possible general election in 1996. So based on what had happened, I suspect that Mr Ling and his party have tried to mislead not only Parliament, but the people of Singapore, by way of discrediting the Government and trying to make capital gains through this exercise.

Sir, I think Mr Ling and his party suspected that Singaporeans could easily be misled, because of the way they change facts and figures. Now these proceedings of the Select Committee help me to understand why more than two years ago, the Secretary-General of the SDP published a book Dare to Change, because they dare to change many official figures, whether it is the health care report or any other thing, in order to mislead the public. This came out during the proceedings of the Select Committee.

Sir, at the end of the day, I hope Singaporeans will realise that some people are willing to do many unbelievable things in order not just to mislead the public but also to make capital gains. But I hope, and I believe, their effort would backfire at the coming general election.

Sir, I support the motion.

Mr Ling How Doong: Clarification, Sir.

Mr Speaker: All right.

Mr Ling How Doong: Mr Speaker, I have already told this House earlier on that I said the same thing in 1992, immediately after the general election, and I spoke again at a parliamentary debate. Why is he now suggesting that because the election was around the corner, I whipped up this sort of thing? The other point is this. When I spoke in Parliament, anyone of you could have spoken up that what I was saying was not true. There was no reply in this House. How many of you were here? Why? I spoke in Parliament, at the right forum, and none of the Members deemed fit to reply to what I had said. If Members thought it was misleading, it was falsehood, how come there was no response from any of the Members here when I spoke in Parliament?

Encik Mohamad Maidin: Sir, I remember I had engaged Mr Ling before in a debate when he made some accusations about health care in Singapore. Maybe we should refer to Hansard and check. By the way, Sir, I would like to clarify. When he spoke about subsidy in 1992, did he have the same meaning then and now? Or was it different then and now? Did he have a different definition or the same? Because he never said, before the end of the Select Committee hearing, that he had a completely different meaning for "subsidy".

Mr Ling How Doong: That is not the issue. The issue is in reply to his allegation that I only said it because an election was round the corner. I prove him wrong because 1992 was immediately after the 1991 general election. I brought up the same subject matter. So it is my duty as an elected representative that I have been bringing this matter up, not only during the two occasions, ie, the debate on the President's Address and the Select Committee, but I have been bringing this up at most of the election rallies.

Encik Mohamad Maidin: Sir, raising an issue is not the same as when Mr Ling is asking a question. Raising an issue is not the same as changing facts and figures in official Government documents and statistics, in order to mislead the public to show that health care cost is hardly subsidised. He has done that.

Mr Ling How Doong: You read my speech. My speech is the subject matter of this motion today. Where in my speech had I changed the data and figures? Point out to me.

Encik Mohamad Maidin: I am referring to SDP, Sir.

Mr Ling How Doong: You look at the motion: "regrets ... Mr Ling How Doong and the SDP ...".

Encik Mohamad Maidin: Sir, as I have explained, you go to a clinic, pay $16 bill, you agak-agak $8 profit. You are misleading the public, Mr Ling. And you are doing it today.

Mr Speaker: Order, order. I think we are repeating ourselves here. Encik Othman Eusofe.

Encik Othman bin Haron Eusofe (Marine Parade GRC): Mr Speaker, Sir, I will be very brief.

Firstly, I support the motion moved by the Minister for Health. The Report of the Select Committee on Verification of Health Care Subsidy of Government Polyclinics and Public Hospitals has given conclusive evidence that health care is heavily subsidised and that that subsidy is a cost and not a market rate subsidy. And the Auditor-General has conducted an independent, detailed and thorough audit of the Ministry of Health's data in accordance with the auditing guidelines which are issued by the Institute of Certified Accountants of Singapore. The two Opposition Members on the Select Committee, Mr Low Thia Khiang and Mr Chiam See Tong, have recognised the audit by the Auditor-General as thorough and professionally done. So I think there should be no doubt that the Government health care delivery system is therefore effective and fair.

[Mr Deputy Speaker in the Chair]

5.25 pm

Encik Othman bin Haron Eusofe (Marine Parade GRC): Sir, Mr Ling and the members of the SDP had made very serious allegations. A Select Committee was formed. They were given a chance to prove the allegations. But I think they did not take their work seriously. And that is an important lesson here for us, that is, whenever we elect Members of Parliament, Singaporeans must be sure that the Members of Parliament are competent and they have high standards of performance and integrity. I think, in this particular case, Mr Ling had shown what a disappointment he is and I am sure members of the public will take note of the poor conduct of the members of the SDP during the Select Committee proceedings. This is a very important point which I just like to take this opportunity to say - that we should make sure that the Members of Parliament that we elect are honest and competent men who can provide Singaporeans with good leadership, men who have integrity and committed to the interest of Singaporeans.

Dr Ow Chin Hock (Leng Kee): ( In Mandarin): Mr Deputy Speaker, Sir, the blue sky may be the subjective description by the poets and the artists, but whether it is a rainy day or a sunny day is an objective statement of fact. We must not fail to distinguish between the black and white.

Our debate today is to go to the root of the matter and discuss a very serious issue, that is, whether or not the Government has subsidised health care to look after our people and, if so, what is the amount of subsidy and what is the percentage of the subsidy. It is a very serious matter; it is not a matter of opinion.

Mr Deputy Speaker, Sir, I support the motion standing in the name of the Minister for Health, BG George Yeo, and I also support the adoption of the Select Committee Report. In this Report, there are a few very important data:

First, the Government's health care subsidy rose from $431 million in 1990 to $1,065 million in 1995, and the per capita subsidy had also increased from $159 to $356 during the same period of time, as shown in Table I.

Secondly, in 1995, the Government's subsidy for class C patients per day in the public hospitals, including Tan Tock Seng Hospital mentioned by Mr Ling just now, was between 59% and 82% of the daily average cost. For B2 patients, the daily subsidy was between 62% and 73% of the daily average cost, much higher than the subsidy given to the A class and B1 class patients, as shown in Table 5.

Thirdly, the net Government health expenditure, as a percentage of national health expenditure, rose from 22% in 1990 to 28% in 1995. The net Government health expenditure as a percentage of GDP also rose from 0.6% in 1990 to 0.9% in 1995 (Chart I and Chart II).

Mr Deputy Speaker, Sir, the Select Committee Report had verified that all the figures on medical fees and charges presented by the Minister for Health to Parliament on 15th March were all correct. The Report further verified the figures on the Government's health care subsidy as presented by the Ministry of Health. Apart from the subsidies to the public hospitals, particularly the C class and the B2 class wards, and the polyclinics, the Government also provides three types of protection safeguards in health care for the people, that is, Medisave, MediShield and Medifund. No Singaporean will be denied medical treatment just because he is poor and cannot afford it. This is the Government policy and a personal pledge by the Prime Minister.

However, Mr Ling How Doong, on 11th March 1996, told Parliament, and The New Democrat 1st issue, 1996, alleged that "health care costs are hardly subsidised at all by the Government". They distorted the facts but are unable to present any data to support their arguments. At the same time, in the Select Committee meetings, Mr Ling kept on changing his stand based on his own interpretation of the concept of subsidy. His definition of "subsidy" is not only "extraordinary" as observed in paragraph 21 of the Report, but is indeed ridiculous ( ). In economics, so long as the fee or average revenue per unit is lower than the average unit cost, there is subsidy. But Mr Ling had presented various views on the definition of "subsidy" ( ), is it because of his personal ignorance that he could not understand this concept, or was he trying to distort the definition to confuse others?

Chee Soon Juan and the three other representors from the SDP were unable to present any data in Committee hearings to support their allegation that "health care cost was hardly subsidised at all by the Government." Chee not only did not point out the source of the reference articles, but also quoted the findings out of context. Further, he had deliberately fabricated data. For example, he gave the figure for the Government's share in the total national health expenditure in 1990 as 5%. When confronted by the Minister for Health, he just dismissed it lightly by claiming that it was a typographical error where the digit "2" was left out. There is a world of difference between 25% and 5%, even a primary school student knows that. As Dr Aline Wong said, Chee, as a former academic, should check carefully figures he quoted from the articles and reports of scholars, and he should clearly cite the sources of his references. However, he and the SDP research team members had not only failed to observe the general principles and minimum requirements of research, they even resorted to quoting findings out of context and fabricated data in an attempt to confuse the people. This is most regrettable.

The conduct of the SDP's representors at the Select Committee hearings infringes on the privilege of Parliament, and possibly an act of contempt of Parliament. The Minister for Health has already lodged a formal complaint to the Speaker, and the matter has now been referred to the Committee of Privileges. It is not proper for me to make further comment on the matter here. But through the second part of today's motion, we want to solemnly and seriously warn Mr Ling How Doong and the SDP that Parliament will not tolerate the ways they conducted themselves with the attempt to mislead the public. It will also send a signal to prevent others from repeating the same mistake.

The Select Committee has spent a lot of time, effort and money to discuss the issue of Government's subsidy on health care in Singapore. What are the effects of the proceedings of this Select Committee? I believe there are two effects: On the one hand, the Select Committee positively had verified the Government's health care subsidy and presented data to effectively rebut the misleading allegations by the SDP. On the other hand, the hearings of the Select Committee had also indirect but positive significance: Firstly, it confirms the transparency of our policies. Any policy or issue can be raised in Parliament to query the Government departments concerned or to debate on the issue so that members of the public would understand the objectives, the rationale of the policies, and the problems encountered in the implementation of these policies. At the same time, groundless allegations can be rebutted, and rumours can be refuted. The Government's style of getting to the root cause of the matter, and its determination to show that "facts speak louder than words" ( ) is once again reflected here.

Secondly, to maintain the dignity of Parliament. Parliament is the paramount legislative body of the Republic of Singapore. As Members of Parliament, regardless of our party affiliation, either from the ruling party or from the Opposition party, we must observe the code of honour. Otherwise, we are not fit to be Members of Parliament, and representatives of the people. When we debate on our national issues, we must present correct figures and facts, and put forward our arguments objectively. Otherwise, we will fall short of the mandate from the people ( ).

Dr Tan Cheng Bock (Ayer Rajah): Mr Deputy Speaker, Sir, I have earlier given my name to speak. But I realise that my speech contains remarks that could be interpreted as being prejudicial to the Committee of Privileges' hearing. I therefore choose not to speak today but I will speak at a later date.

Mr Peh Chin Hua (Jalan Besar GRC): ( In Mandarin): Mr Deputy Speaker, Sir, I support the motion standing in the name of the Minister for Health, BG George Yeo.

In my view, when we want to doubt or negate any matter, we must have sufficient grounds and evidence to prove our argument, but not to fabricate data or to make use of specious arguments to deceive oneself as well as others. I agree with Mr Maidin that we do not wish to have agak-agak MPs, neither do we like to have blur-blur MPs. The SDP had, on several occasions, made use of the erroneous figure of 5% instead of the 25% to represent the Government's health expenditure in terms of the total Government expenditure, in order to discredit the Government, and then claimed that it was a "typographical error". It is more than that. It cannot be simply dismissed as a typing error, as claimed by Dr Chee, to cover up at the last moment. Personally, I feel that this is similar to the fallacious argument of baima fei ma [ ] (a white horse is not a horse) popularly used in ancient China. The SDP consistently uses this sophist tactic to mislead the people, in order to achieve its political objective.

Sophism is very famous in China. I have here a book entitled "Complete Book on Sophism" which sets out more than 500 tricks in sophism. The sophist tricks used by the SDP are, according to my reckoning, not more than 10 types. Let me illustrate how the representatives of SDP had made use of some of the tricks mentioned in this book during the public hearings of the Select Committee and in the statements issued by the Party, in attempts to conceal the truth and distort the facts, in order to mislead Parliament, and even the public.

First, let me look at the Chapter on Sham. According to this Book, people who deploy this tactic generally make use of specious reasoning, just like what Mr Ling did just now. For example, the book says, "Water can drown people. People who practise sophism will tell you that since water can drown people, the water in a tea cup can also drown people." Such specious reasoning may sound seemingly logical, but it is in fact a very irresponsible argument to deceive others. Another argument is that anyone who intentionally kills another person shall be sentenced to death. The act of execution is also intentional killing. Therefore, the executioner should also be sentenced to death. This type of sophism is ridiculous and irresponsible. Yet, the SDP has been using them over and over again, at the public hearings of Parliament, at election rallies, and in the SDP's party organ. Their purpose is to create a sham to mislead people. For example, in the recent public hearings of the Select Committee on Health Care Subsidy, the SDP, in order to make people believe what they said in the past that "people in Singapore can die but cannot afford to be sick", they persistently argued that the health care cost in Singapore was hardly subsidised at all by the Government, and that the people could not afford the medical expenses in Singapore, in order to gain political capital.

In fact, in our society, the Government has taken upon itself the responsibility to look after the poor who could not afford to pay for their medical treatment, by setting up Medifund. In Singapore, no one is denied good medical care and treatment just because he cannot afford to pay for it. Such a thing does not happen in Singapore. I can cite you an example in my own constituency. Certain poor people in my constituency were admitted to the hospital for medical treatment and surgical operations. They could not afford to pay the hospital bills. As their Member of Parliament, I appealed on their behalf to the hospital to waive the payment, and they were all given free and proper medical treatment. You can read the articles and see the photographs on pages 85 to 95 of Petir, our Party organ. These are all records of true incidents.

The SDP also likes to use another trick in sophism known as touliang-huanzhu [ ] (steal the beams and pillars and replace them with rotten timber) as described in page 87 of this book. In other words, it is to perpetrate a fraud. The book says people who use this trick would consciously or unconsciously use one concept to replace another concept in the process of arguing and reasoning. Let us look at how the SDP "steals the beams and changes the pillars". When Dr Chee Soon Juan and the representatives of SDP talked about the national health expenditure as a percentage of the GDP, they used the same tactic. They gave the figure as 0.8% and claimed that they were quoting from a figure given by NMP Dr Soin. As a matter of fact, the figure quoted by Dr Soin referred to the net Government health expenditure as a percentage of the GDP, as the actual figure of the national health expenditure as a percentage of the GDP is 3.1%. Substituting 3.1% by 0.8% is a classic example of "stealing the beams and changing the pillars" to confuse the people.

There is another example in the book to help us understand how the SDP made use of a sophist trick of "stealing the beams and changing the pillars". It says, a customer went to a coffee shop and asked the shopkeeper for a chashao bao (steamed pork bun). Before he paid for it, the customer said that he would like to exchange the bao for a cup of coffee. After drinking the coffee, he wanted to go off without paying for the coffee. The shopkeeper asked him for the money, but he said, "I traded a bao for the coffee." The shopkeeper said, "But you did not pay for the bao either" He replied, "I did not eat your chashao bao, why should I pay you for it." I think, by listening to Mr Ling this afternoon, and all that was being said by the representatives of the SDP, you will find that they are more or less the same as described in the book.

Dr Chee and the SDP are very fond of the trick known as moxuyou [ ] (equivocation) as described on page 51 of this "Complete Book on Sophism". The book says, moxuyou means "maybe there is". "Maybe there is" does not mean "there is". It cannot be taken as conclusive evidence to form a basis for argument. If one uses "maybe there is" as a basis to assert his argument to be true, then that is truly sophism. From 25% it can be changed to 5%. So, you can just equivocally find a number and fit it in. That is moxuyou .

In their argument, they are also fond of using the trick of zhi lu wei ma [ ] (calling a stag a horse). Like what he said just now, "I believe it is right, but whether you believe it or not is another matter." "If I, Ling How Doong, a Member of Parliament, believe that this horse is a stag, you do not believe it is a stag but believe that it is a horse, then it is your business. However, I, Ling How Doong, a Member of Parliament believe that it is a stag." According to page 124 of the book, "calling a stag a horse" means to deliberately misrepresent, confusing right and wrong, confounding black and white - normally referring to improper or unjust words and deeds.

Jiewai Sheng Zhi [ ] (digression) is another sophist trick frequently used by the SDP. Please refer to page 131 of this book. The basic characteristic of this trick is to create a lot of side issues to evade the main issues in order to confuse and mislead people. An issue which was originally clear and defined is brought to an awful mess of confusion through the introduction of many irrelevant side issues. Just now, Mr Ling said that the sky was blue and whether you believed it or not was not his business. I immediately turned to this book, and on page 54, it was there. A question was posed, " Chang'an (the capital of China in the Han and Tang Dynasties) or the sun, which is farther away from us?" The answer was Chang'an. Because, I could see the sun but I could not see Chang'an. So, Mr Ling can tell you, "When I stand in the middle of the road, I could see the sun but I could not see Johor Baru. Therefore, Johor Baru is surely farther than the sun." Just now, he said the sky was blue. Later on, he may stand up and say he can see 12 suns above the roof of Parliament House (referring to12 spot lights above the roof of Parliament House.). Such digression or sophist argument is irrational, unreasonable, and arbitrary.

The SDP representatives thought that their ways of arguing would be appreciated by the people of Singapore. They thought they were very clever in the way they argued. In fact, this is a cunning and irresponsible way of arguing. If the people of Singapore want to know more about sophism, episodes of sophism which are more interesting than the tricks used by the SDP, they should read this book. They can learn about a very famous sophist by the name of Zheng Xi, in the time of the Warring States in China, 560 B.C. The tricks used by the SDP are far inferior to the tactics mentioned in the book. It is a far cry from what was mentioned in this book!

I am very disappointed with the Member for Bukit Gombak, Mr Ling, for repeatedly going back on his word, during the public hearings of the Select Committee. First, he admitted and then denied that the Government had subsidised on medical cost in Singapore. He said that the money used by the Government on the people's health care cost came from taxpayers' money and therefore could not be known as subsidy. That the Government had subsidised is an undeniable fact. The Government's money is the people's money. The Government is just a trustee of the people's money.

We all know that Singapore is a small country with no natural resources, and is therefore very vulnerable. Mr Ling said that the people in Brunei do not have to pay income tax. But, he forgot to mention that Brunei has a lot of oil underneath its soil. I think if Singapore has a lot of oil, then we can also consider doing so. But, the fact is, Singapore has no oil, no natural resources, no water. So, without a good Government and a group of responsible and upright political leaders, to effectively look after the people's money, if there is a problem in the way the Government manages the people's finances resulting in massive unemployment, people being unable to earn a living, cannot afford to purchase a HDB flat, then whose responsibility is it? Are you saying that it is the fault of the people?

Therefore, a responsible Government will surely take great care and exercise prudence in using the people's money or subsidising them. I do not know whether it has occurred to Mr Ling and the representatives of SDP that they have already indirectly wasted a lot of our people's money. Take a look at this very thick blue book - the Select Committee Report. Together with the proceedings of the public hearings, as the Minister has said, some few hundred thousand dollars had been wasted. Just imagine, the manpower and resources involved before, during and after the public hearings! If we could save on this, we could have helped how many poor people in Singapore! The Minister and senior officials of the Ministry of Health could have made use of their time in a better way to plan and work towards better health care services for Singapore in future, to the benefit of the people.

As Members of Parliament, we have the responsibility to censure such irresponsible behaviour, particularly the use of such cunning specious arguments to distort the facts in order to mislead Parliament and the public. As the Minister for Health, BG George Yeo, had said, Parliament should never be turned into an arena for child-play. The function of democracy depends upon Parliament and Parliament should therefore be accorded the highest dignity and respect from the people. Facts speak louder than words. The SDP's attempt to twist the facts to mislead the people will not be accepted by the people of Singapore.

I therefore support the motion.

BG George Yong-Boon Yeo: Mr Deputy Speaker, Sir, I would like to thank the Members who have spoken for supporting the motion before the House.

Let me also reiterate that the second part of the motion to regret Mr Ling's and SDP's attempt to mislead Parliament and members of the public should exclude the charges I have made in the complaint to the Speaker regarding the behaviour of the four SDP representors when they appeared before the Select Committee because, as Mr Ling said, they would be, in a sense, sub judice and something that we should be mindful of.

There are two limbs to the motion: one, to verify that there is indeed substantial Government subsidy of health care in polyclinics and public hospitals. I think that has been established beyond doubt. Because Dr Chee had cast doubts, we opened every drawer and every cupboard in the Health Ministry for audit. It is very important that the officials in the Health Ministry enjoy the trust of Members and the trust of all Singaporeans, because the officials of the Health Ministry and the hospitals perform a very important job, which is to provide the best health care system in Singapore which we can afford to have. And the trust of ordinary Singaporeans in their good faith and in the integrity of the health care system is absolutely important.

My officials worked late into the night and I had to meet them from time to time to keep their morale going. The auditors were putting a lot of pressure on them to produce this data and that data. I told them that this is a very important test of the Ministry, that if we acquit ourselves well, then we can go back to our mission of looking after the health of Singaporeans. I told them that it was an effort worth making. I told them, "Look, you might have to work late. You might have to work over the weekends, but do it and do it well, because it is for the good of the Ministry and the good of Singapore." They rose to the challenge and I am very proud of them.

The fact that health care costs in Singapore are heavily subsidised is a matter of fact. It should really not surprise us in this House because every year during the budget debates we vote hundreds of millions of dollars for this purpose. If there were no health care subsidy, then where did all the money go to? But because allegations were made, and Mr Ling and the SDP refused to retract those allegations despite data provided to this House, and in addition, cast aspersions on the data, we had to have a Select Committee and this debate. But I hope we can get it behind us so that all of us can go back to our jobs, the officials, doctors, nurses, making sure that we provide the best health care system possible for Singaporeans, which Singaporeans deserve to have.

It does not mean that the more we subsidise the better. We are proud that we have a good health care system. We are proud that those who cannot afford health care at full cost are subsidised. We are proud of our polyclinics. We are proud of our B2 and C class wards. But it is not our objective to have the polyclinics take over the primary health care sector. They provide only about 20% of the primary health care sector. They perform a specific purpose. They look after those in the lower socio-economic classes in Singapore. They do a good job. That is fine. The rest of us, including Mr Ling, we go to see GPs who can be just downstairs or nearby, and they provide a very good service. The market operates on supply and demand and prices are set by the market. That is a good system. So it does not mean that while we debate that health care in Singapore is indeed heavily subsidised, we are saying that the more health care subsidy the better. Not at all. Indeed, in many countries, too much health care subsidy or health care subsidy wrongly applied, can bring the whole system down, which is why we try to build in as many safeguards as possible into our system in Singapore to ensure that the subsidies go to those who need them; that there is little moral hazard and that those who can afford to pay should bear a share of the burden. That is very important.

Over the years, we have built up quite a sophisticated health care system offering both public and private services and choices, ensuring those who cannot pay are fully covered through Medifund; ensuring those who are poorer enjoy huge subsidies in B2 and C class wards; and ensuring those who are rich who can afford the full cost of health care services enjoy a choice between private and public facilities. Our health care system has earned a certain amount of praise from people who are overseas, even from professional journals like the Lancet, which published an article earlier this year giving us quite fulsome praise. It does not mean our health care system is perfect. We have still got many things to do. There are many problems to be solved and it is a constant challenge. But let us have a debate, which is honest, which looks at the facts and which takes full cognizance of the pitfalls of a health care system that is overly socialised or subsidised. I think that is the straightforward part of the motion, which is that the health care costs in Singapore are heavily subsidised.

The second limb is to regret the attempt by the SDP and Mr Ling to mislead us and members of the public. I moved this second limb without any pleasure, not to gloat, but because it is wrong to exploit public concern for narrow political purposes. Mr Ling said that he was only offering opinions. He never tried to mislead us. But even today, in this debate, he tried to mislead us repeatedly. He talked at length about errors in the bills produced by Tan Tock Seng Hospital. But until I pressed him, he conveniently left out the fact that whatever the error, it did not affect the amount which the patient had to pay, not Sunny Kow, not any other patient who received an error in his bill. Even after correction, those patients who were in the C class wards were subsidised 86%. We never claimed in this House or anywhere else that we subsidised C class patients by more than 80%, which we could have. But we did not. It is not something for us to exploit politically. But it was a material fact which Mr Ling conveniently chose not to mention until I asked him. He talked about the bed charges at Mount Alvernia Hospital and how cheap they were relative to bed charges in public hospitals. I do not know how Mount Alvernia Hospital calculates its bed charges, whether in fact it deliberately charges certain items lower than cost as loss leaders. But it does not matter. What matters at the end of the day is how much the patient has to pay.

During the Select Committee, we produced a comprehensive set of data, comparing what patients have to pay for various conditions in public hospitals like Tan Tock Seng Hospital and SGH and in private hospitals like Mount Alvernia, Mount Elizabeth, Glenealges Hospitals. There was no doubt whatsoever that for all disease conditions, Singaporeans pay far less, even A class wards, in public hospitals than in private hospitals. Those tables are in the Report from the Select Committee to you. Again, Mr Ling did not mention it. He only talked about bed charges. Of course, he presents it in a very disarming way. He says, "Oh, my approach is a simplistic one. I see the doctor, GP, three times, $16. So do not blame me if I jump to the wrong conclusion." It may be artfully disarming, it may have even created some mirth, provided some entertainment, but I think it is more than that. I think in that selective suppression of relevant data, Mr Ling was trying to mislead us. Of course, he is very good at word games, at talking about how in his earlier speeches to this House he used words like "I suspect", "I was not sure", "I thought". Then he said opinions cannot mislead.

Mr Ling How Doong: In my speech in Parliament.

BG George Yong-Boon Yeo: But even today, he tried to wriggle away from another position by saying that when the SDP in the New Democrat talked about health care costs not being subsidised, they were referring only to bed charges, until I had to remind him that both he and his party separately issued statements, making it clear what they meant. At least on four to five occasions today, Mr Ling had again tried to mislead us. So I do not think there is any doubt at all what he and his party had been trying to do.

If it were not such a serious matter, I think we could have just laughed it away or shrugged it off. But health care, and health care cost in particular, is a very serious matter. It affects all of us. It affects every family in Singapore. We worry about it for ourselves. We worry about it for our parents and grandparents. We worry about it for our children and grandchildren. At the end of the day, however we subsidise or cross-subsidise or charge, Singaporeans have to bear the health care burden of Singaporeans. Americans are not going to help us. Malaysians are not going to help us. Others are not going to help us. We have got to help ourselves. And what we want is to provide the best health care for Singaporeans at the least cost. Because if the burden is too heavy, however we cut it, it must at the end of the day affect the competitiveness of our economy, and that we cannot afford. In America today, it is 14% of the GNP and still rising. 14% - that is more than our health, education and defence budgets combined. It is fortunate that they have got large parts of their economy which are highly productive and very competitive in the world. And even so, 14% is not a light burden to carry.

We know our population is ageing, we know how easy it is to incur health care costs when we are old. We all have parents, uncles, aunts whom we have got to help bear this burden. And if we are not careful, health care costs can not only impoverish entire families, they can bankrupt entire societies. It is an issue of great concern, and must be of great concern, to all Singaporeans and to all of us as Members of Parliament. And we must try our very best, work our hardest, to create a system in Singapore which is competitive, which offers choices, but which at the same time makes sure that no one is left by the side, left dying on the streets. And there are none in Singapore who are left dying on the streets. We all know that. Even compared to cities like Tokyo, Washington, London or Paris, if you look at the bottom 10% of society, they are better treated from the health care point of view. We have not done too badly. We have not done too badly at all. But it is a continuing challenge because we all want the best for ourselves and for our parents and our children.

But in order for Parliament to pass laws which help us get the best system for Singaporeans, we must have the facts, we must acknowledge the facts, and we must have honest debates, based on the truth, not based on opinions, not based on assertions about the colour of the sky.

There were parts of our exchange with Mr Ling today which had a certain Alice-in-Wonderland quality about it, where words mean what we want them to mean. If you were telling stories to children, that is fine. But we are not telling stories to children. We are talking about how to look after the sick and the dying. So words must have meaning, and words must not mislead.

Question put, and agreed to.

Resolved,

That this House

(a) adopts the Report of the Select Committee on Verification of Health Care Subsidy of Government Polyclinics and Public Hospitals, contained in Parl. 5 of 1996, and endorses the Committee's findings that:

(1) the figures for the fees charged by polyclinics and private GPs and the average bill sizes in private and public hospitals, which the Minister for Health provided to Parliament on 15 March 1996, were correct;

(2) the subsidy levels for services provided by polyclinics and public hospitals, as provided by the Ministry of Health, were also correct; and

(3) Mr Ling How Doong and the Singapore Democratic Party (SDP) had not been able to provide any objective data to substantiate their claim that "health care costs are hardly subsidised at all"; and

(b) regrets the attempt by Mr Ling How Doong and the SDP to mislead Parliament and members of the public about Government subsidy of health care.