ESTIMATES OF EXPENDITURE OF SINGAPORE FOR THE FINANCIAL YEAR 1ST APRIL, 1998 TO 31ST MARCH, 1999

Order read for consideration in Committee of Supply [3rd Allotted Day].

[Mr Speaker in the Chair]

Head O (cont.) -

Resumption of Debate on Question [12th March, 1998],

"That the sum to be allocated for Head O of the Main Estimates be reduced by $100." - [Dr Ong Chit Chung].

Question again proposed. 12.38 pm

The Minister for Foreign Affairs (Prof. S. Jayakumar): Sir, may I continue with my response to the various points raised yesterday. When we adjourned, I was responding to Dr Ong Chit Chung's question on the United Nations. The second point he had raised on the UN was with regard to our candidature for the United Nations Security Council for the non-permanent seat. He asked me for a progress report.

Members will recall that Singapore presented its candidature for the non-permanent seat in the Security Council for the period 2001 to 2002. The elections for that particular vacancy will take place in the year 2000 and, if elected, we hope that we can bring a constructive and useful perspective, shall I say, a small state perspective, to the UN Security Council. It is an important perspective because a majority of the United Nations members are small states. Participating in the UN Security Council will also allow Singapore to learn first-hand how the UN Security Council operates, both in its formal session as well as in the consultations. Since we became a member of the United Nations in 1965, we have never served in the UN Security Council which of course, in a sense, is at the very heart of the UN system. So far, Singapore is the only declared candidate for the Asian group seat for the year 2001 to 2002. Our candidature has been endorsed by ASEAN countries and many other countries, both from within the Asian group as well as outside the Asian group, have expressed their support for our candidature in writing.

We recognise that within our limited manpower and financial resources, Singapore can do only so much at the United Nations. But let me assure the House that we will continue to do our part as a responsible member of the UN system and as a member of the international community. And that is one of the reasons why we have sought the non-permanent seat in the Security Council.

If I may, Sir, proceed to the other points which were raised yesterday and not answered. First, I will take the various comments which were made on Singapore-Malaysia relations by Dr Ong Chit Chung, Mr Chiam See Tong, Mr Hawazi and a few others. First, to recap the events since we last discussed the situation in this House. When we recall our last discussion in this House, it was in the context of still fairly strained relations between our two countries. But on that occasion, I did say that there were some encouraging developments to indicate that relations were slowly getting back to normal. I would say that since then there have been further significant developments in our bilateral relations.

Members will recall that in September last year, the Malaysian Customs commenced stringent checks on lorries ferrying goods from Malaysia to Singapore and vice versa. An adverse effect of this move was the chronic vehicular congestion at the Causeway that lasted up to one month or so. Fortunately, the situation eased soon after the two Prime Ministers met at the Commonwealth Heads of Government Meeting in Edinburgh in October 1997 and they agreed that both sides should see how this problem should be resolved early.

What are the recent developments? Since the two Prime Ministers met in October, they have met on three separate occasions, once in January and twice in February, the latest being 16th February when Prime Minister Goh visited Malaysia in Kuala Lumpur. Prime Minister Goh's visit to Kuala Lumpur was significant in that it took place against a backdrop of the regional economic downturn which has been described as the worst crisis faced by the region since the Second World War. In this regard, our Prime Minister's visit was a useful opportunity to continue with his earlier discussions with Prime Minister Mahathir, the earlier discussions being held a few weeks prior to that in February as well as on 20th January. These discussions were focused on how Singapore and Malaysia could cooperate closely in all possible areas for mutual benefit.

Sir, the interests of Singapore and Malaysia are closely intertwined, particularly in the economic area. The contagion effect of the regional financial crisis has underscored this and emphasised the fundamental interdependency between regional countries and the need to cooperate. Our Prime Minister's visit, I believe, reflected the readiness of both Singapore and Malaysia to work towards realising the full potential in our bilateral relationship based on the principle of prosper-thy-neighbour.

Sir, the discussions between Prime Minister Goh and Dr Mahathir took place in a warm and friendly atmosphere. And on the whole, the visit was useful for both Singapore and Malaysia because both sides can now build on this for even closer relations. I believe, Sir, that this is a direction in which Singapore-Malaysia relations should continue to develop.

The outcome of the discussions between the two Prime Ministers is reflected in a joint communique which was issued at the end of our Prime Minister's visit. That joint communique spells out several areas of proposed cooperation between the two countries, including financial and economic cooperation. It serves also to highlight the commitment by both sides to redouble efforts to resolve several outstanding bilateral issues, such as the long-term supply of water to Singapore, the development of Malayan Railway land in Singapore as well as the dispute over Pedra Branca. As stated in the joint communique, the agreements reached between the two Prime Ministers have laid a firm foundation for both Malaysia and Singapore to cooperate closely in the future. We hope that progress can be made on the outstanding issues. This will help to maintain the momentum in bilateral relations. So in response to the questions posed by Dr Ong Chit Chung and others on bilateral relations, I would say that bilateral relations are back on track, and this is evident from the joint communique. 12.45 pm

However, I do not wish to mislead Members into believing that we have solved all the problems. There are still issues that remain to be solved. These issues cannot be solved overnight. However, I believe that our Prime Minister's visit and the discussions between the two leaders have indeed laid a good foundation for further progress to be made on the outstanding bilateral issues. And as Prime Minister Goh said to the press after the visit, it was a useful visit. In this improved atmosphere and common desire to enhance cooperation, both sides, I believe, can now better manage bilateral relations.

I have noted what Mr Chiam See Tong has said about the possibility of an economic union between Singapore and Malaysia, a point which he had made previously when he spoke in the debate on the President's Address last year. I understand the basic thrust of his proposal, which is that he recommends closer economic cooperation between Singapore and Malaysia. And as Members are aware, the joint communique issued after the Prime Minister's discussion has indeed mentioned that Singapore and Malaysia will intensify efforts to cooperate in the areas of banking and finance, and all possible areas. Efforts are also under way to encourage mutual investments in the key economic sectors of both countries. This will make Singapore and Malaysia stakeholders in each other's prosperity, to cite the sentiments in the communique

I think Members in this House should also know that ASEAN is now working towards establishing a free trade area (AFTA) by the year 2003. At the moment, this is a current priority. However, as for Mr Chiam's proposal of an economic union, and I am no expert on this matter, I have no doubt that my colleague, the Minister for Trade and Industry, would take note of this and give it consideration within the broader context and desire of closer economic cooperation with Malaysia. But we must remind ourselves, as Prime Minister Goh said last year in his reply to Mr Chiam, that such cooperation, of course, takes two willing parties.

On the progress of various items in the communique, the officials from both sides, I believe, will meet in the course of the next few weeks to follow up on the various items in the communique.

Mr Chiam made reference to the question of the water supply. This has also been dealt with by Minister Lee Yock Suan yesterday, when winding up on the Ministry of Trade and Industry. To that, let me just add that, as reflected in the joint communique, Dr Mahathir had agreed that Malaysia would undertake to continue the supply of water to Singapore beyond the expiry dates of the existing 1961 and 1962 water agreements. This general undertaking will be confirmed in an agreement to be signed within sixty days from the issuance of the joint communique. Officials from both countries, I understand, will be meeting in Kuala Lumpur on or around 9th April to discuss this matter.

We had originally sought a full water agreement with specific terms and conditions. Achieving a full-fledged agreement with Malaysia on extending the existing water agreements beyond the present expiry dates of 2011 and 2061 would help not only in dismantling a psychological barrier between our two countries, but replace it with a new framework of cooperation for mutual benefit. However, Dr Mahathir indicated that he was unable to agree to a full-fledged agreement at this point of time. He said that he would also need time to get the backing of state governments, as water is under state control.

Sir, lacking a firm agreement that sets out explicitly and comprehensively the terms and conditions for the supply of water beyond the present terminal dates, we will have, of course, to continue to intensify our efforts to find new sources of water supply. This is something, as mentioned on other occasions in this House, we have been actively doing over the years, even though water is not of immediate issue for us. Currently, desalination, of course, remains one salient option among several that are being explored.

Let me now turn, Sir, to the comments and questions raised by colleagues on Singapore-Indonesia relations. I would first speak generally about bilateral relations since the House last met in the Committee of Supply. I would say that bilateral relations generally are close and good. Our ties with Indonesia have been built on a strong foundation based on common interest in many spheres. Relations in the past year have been strengthened by regular exchanges of visits. Our Prime Minister and President Suharto have kept up their regular meetings to discuss various issues. In August 1997, some of our Members of this House visited Indonesia in conjunction with their independence day celebrations. This is a good reflection of the broad-based relationship between the two countries.

There have also been concrete examples of close bilateral cooperation. One clear example was the difficult joint search-and-rescue-cum-recovery operations in the aftermath of the SilkAir MI 185 tragedy at Palembang in December last year. It was heartening to see cooperation from the ministerial level to the local authorities on the ground. And the tragedy, while I believe we certainly would have wished it had not taken place, had brought our two countries and people closer.

But taking the situation as at present, we must recognise that Indonesia is going through a difficult patch. They are facing economic problems and a currency crisis, problems of drought, shortage of food supplies, medicine, etc, and there have also been reports of sporadic unrest. However, general law and order have been maintained.

Sir, we, in Singapore, must understand and empathise with these difficulties that the Indonesians are experiencing. We are concerned about the difficulties they face and we will do our best to help them overcome their difficulties. As the Prime Minister has said, it is impossible for Singapore to close our eyes or fold our arms and ignore the problems of our neighbours. We should see these problems in perspective. Taking into consideration factors such as their sheer geographical size and large population, Indonesia would need time to tackle the financial crisis and stabilise its economy.

The Indonesian government has to handle many competing priorities, especially during the current economic difficulties. But the problems the Indonesian government faces are not insurmountable. There are two reasons why I say this. First, President Suharto has begun his new term as President and he remains in control of the situation. We are confident that he will make some tough decisions to resolve the current crisis. As Prime Minister Goh said in his letter to congratulate President Suharto which was published recently, "Indonesia had faced overwhelming difficulties and widespread poverty in the past. But through President Suharto's strong will and leadership, Indonesia overcame them."

The second reason is that the international community has come forward to assist Indonesia to stabilise its economy and ameliorate some of the impact of the financial crisis. Yes, there may be differences in how the problems could be resolved, but I believe that all concerned parties want to see Indonesia recover from this crisis by adopting the most realistic and rational solutions.

Sir, in today's world, we see a series of cross border linkages bringing countries closer together. Strengthening these regional or global linkages will be beneficial for economic development. In that regard, Indonesia is a vital link in that chain for the region and for Singapore. Indonesia is a key strategic player in the region. A politically stable and economically sound Indonesia is therefore important. It is important not only for Singapore, it is important for ASEAN, it is important for the rest of the region and beyond.

It is with these considerations in mind that Singapore has offered a contribution of US$5 billion loan to Indonesia, as part of the IMF package. Prime Minister Goh has also proposed a multi-lateral trade finance guarantee facility for Indonesia. This proposal is awaiting responses from countries to which the Prime Minister has written, including the G7 countries US, Canada, Japan, UK, France, Germany, Italy, as well as Australia, Brunei, China, Malaysia, the Netherlands.

However, our assistance alone would not be effective. It is therefore important that we work with international and regional institutions such as the IMF, the World Bank, the Asian Development Bank and other countries to assist Indonesia in its economic recovery. We are a small country. Our assistance is within the constraints of our resources, and our US$5 billion loan package and our PM's proposal of a multi-lateral trade finance guarantee facility for Indonesia should be seen in that light. But Singapore can play a catalytic role in proposing workable ideas and getting others to join in doing more to help Indonesia. In other words, we try to play a supportive and constructive role alongside other countries to help restore confidence to Indonesia and to the region. I hope that with the international collective will and cooperation, Indonesia and the rest of the region will emerge out of the regional economic crisis even stronger.

I now turn to Dr Tan Boon Wan's comments about the principle of non-interference, and how do we tackle transnational problems that affect various countries. I would respond that we should and indeed we have always abided by the principle of non-interference in the internal affairs of other countries. It is a principle that we should always uphold. But this does not preclude countries from helping one another or formulating new mechanisms, and this was a point Dr Tan Boon Wan asked about new mechanisms. It should not prevent us from formulating new mechanisms to ensure that problems like the haze or the currency crisis do not recur. In this respect, steps have already been taken. On the issue of the haze, for example, Members have heard my colleague, the Minister for the Environment, recently tell the House that the ASEAN Environment Ministers had met to look for ways to solve the problem. Similarly, in the regional financial situation, ASEAN leaders had met in December to discuss the issue. A leaders' statement was subsequently issued.

More recently, Singapore has offered its assistance to which I have referred. Other ASEAN countries have similarly provided assistance. The ASEAN countries have jointly sought solutions to the crisis. Under the Manila Framework, six ASEAN countries Brunei, Indonesia, Malaysia, Philippines, Singapore and Thailand together with other Asia-Pacific countries such as US, China, Korea, Hong Kong and Australia have agreed, as Members would have read in the press, on the need for a regional surveillance mechanism for early detection of problems.

Sir, there are indeed mechanisms for regional countries to deal with such problems. But to be realistic, I must admit that we cannot guarantee that such problems would not recur as there are so many factors and causes involved. On its part, Singapore will work with the other countries to see how these mechanisms can be strengthened in the future. 1.00 pm

Now, I turn to the two related questions asked by Mr Shriniwas Rai about MFA's policy of diplomatic relations. He urged that we have diplomatic relations with as many countries in the world as possible. It is very difficult to disagree with the objectives that he urges upon the Ministry of Foreign Affairs. Presently, Singapore has established diplomatic relations with some 149 countries. I would say our considerations for establishing diplomatic ties are three-fold: first, sometimes we are approached by another government to establish formal diplomatic ties. Second, to do so is consistent with our policy of cultivating a constituency of support from countries which are responsive to our interests at the UN and other international forums. Third, where we do not have significant bilateral relations with other governments, there is merit in cultivating relations.

But I should explain to Mr Shriniwas Rai that in today's world of diplomacy, the formality of entering into diplomatic relations is really not a condition precedent, i. It is not an obstacle or a bar to having interactions and having to conduct various relations with those countries. In other words, it is a formality that does not prevent visits, discussions and so on. There are many ways in which this interaction with other countries can be achieved, trade and economic linkages, people-to-people contact and mutual support in international forums. So the fact that we may not have formal diplomatic ties with some countries has never precluded us. Indeed, many of the Foreign Ministers and other leaders have come to Singapore, and some of them are from countries where we do not have formal diplomatic ties. I am not sure whether Mr Shriniwas Rai had in mind the formal act or whether he meant actually establishing a diplomatic presence, which is of course a different thing altogether.

Since 1990, Singapore has formalised diplomatic relations with some 52 countries. At the same time, we have developed ties with many other countries with which we have not established the formal act of diplomatic relations.

He asked about roving ambassadors. But in asking that question, he was cognisant of the fact that, as a small country, with a developing foreign service, we just cannot have resident ambassadors in many parts of the world. So we establish a non-resident ambassadors or roving ambassadors scheme as a means of expanding our diplomatic representation abroad. When we appoint non-resident ambassadors, we do so after careful selection of suitably qualified candidates. I take his point that we should try to expand and build on this roving ambassadors. We will try to do so, but before the Government appoints more non-resident ambassadors, we must ensure that we have the candidates who can adequately and effectively represent the interest of Singapore in the country of accreditation. I should say that since 1991 we have appointed 14 non-resident or roving ambassadors, and between the 14 roving ambassadors they cover 37 countries in Asia, Europe, Latin America and Africa and the Pacific.

Mr Simon S C Tay (Nominated Member): Sir, I am obliged to you for your permission to join in the discussion of the Ministry of Foreign Affairs' budget. My cut relates to the United Nations. Specifically, it is a suggestion to increase Singapore's financial contributions to United Nations and UN agencies.

Sir, Singapore has risen in international profile. It has demonstrated increasing political leadership internationally, commensurate with our economic development in the last decades. The respect and success for our small nation has arisen because of our pertinence, or relevance, and our competence. It is also, largely due to the Ministry of Foreign Affairs in representing us abroad. The United Nations has been emphasized by this Government as having a central role in giving a voice to smaller states like ours. And Singapore, from my observations, has paid a constructive, helpful and supportive role at United Nations and other international fora. There is every good reason for Singapore to aim for a non-permanent Security Council seat in the UN. Support, of course, Sir, has many aspects, including financial, which I am emphasising today. I respect that our first contribution must be in work and ideas. I come to my question: should we contribute more on finance?

Clearly, Singapore has had a good record in paying up on our asscessed contributions. I turn then to our record in voluntary contributions. In reply to a question I submitted at a previous sitting, the Ministry of Foreign Affairs has kindly given us a 10-year series of how much Singapore has given to United Nations organisations. Sir, to sum up the table, which is in the records of Parliament, baseding on the last 10 years, in 1988 we gave the figure of US$305,230 only to one institution, United Nations Development Programme. Ten years on, we gave US$390,000 to three organisations, again the bulk of US$300,000 to the United Nations Development Programme. Sir, these figures are not adjusted for inflation and I think they show consistent, but if I may say, stagnant contribution, which is no longer commensurate with our increase in international standing, our scope, the way we play, and our ambitions over the last 10 years.

I do not believe that this financial year will see an increase. Hence, my cut. My proposal is that the sum should be increased to agencies whose work is relevant to us, or that we support in principle. This is not a legal obligation but, if I may say, a moral expectation of what countries should do as they rise in international standing and economic progress. Developed countries, as the Minister knows, set a target of official assistance at 0.7%. I am not saying that figure should apply to us. But I do urge the Minister to consider setting a base and then perhaps to increase it yearly according to our own growth.

Also, my cut relates to the idea that specific agencies should be better supported, in particular the United Nations Environment Programme. Nothing is given in terms of voluntary contributions to this programme. This programme is much less funded than the United Nations Development Programme, which we largely gave to. Yet, UNEP is of growing relevance to the international community and Singapore.

Sir, last year, Singapore joined in the four-country initiative for the environment under the leadership of Chancellor Kohl of Germany. With these other three countries, Singapore has joined in calling for UNEP to play a larger role. UNEP is also providing assistance to have an international conference in Singapore that will focus on model cities of which I and others believe Singapore is a good example. UNEP has already provided assistance for the regional seas' programme, which Singapore benefits from, being a major port in this area. Very recently, the new Executive Director of UNEP has called for this institution to play a central role in organising international attention and action on the regional haze pollution, a problem that affects us.

With that, Sir, I urge the Minister to consider that Singapore should increase voluntary financial contributions to the United Nations as a whole, and United Nations agencies, especially UNEP.

Mr Shriniwas Rai: With your permission, Sir, may I seek two clarifications from the Minister.

I think the House agrees with the Minister's assessment of the situation with Malaysia. I think Mr Chiam's suggestion is worthy of consideration and we should seriously consider it. Perhaps the Government may want to set up a Ministerial Committee to study how we could bring about an economic union, provided the Malaysians are of the same mind. In the interest of both countries, we should start afresh.

I am aware of the Prime Minister's regular visits to Malaysia. So are the Foreign Minister and other Ministers. Could we institutionalise these visits? We are coming to a stage where we do not have many Ministers in the Malaysian Cabinet who have studied in Singapore. There are younger Ministers who have never been to either a Singapore school or university. So it is important, both for the governments and the civil servants, to have regular dialogues. As neighbours, we may have our problem, but we should look at the long term perspective in the interest of both countries.

Prof. Jayakumar: First, let me reply to Mr Simon Tay. There are various ways in which you can look at the extent of our contributions to United Nations organisations, whether mandatory or voluntary contributions. The way Mr Simon Tay has looked at it, he thinks it is not adequate and not commensurate with our position or status and he, therefore, calls for an increase in contributions. But in case he believes that our contributions are inadequate, I would present a different way of looking at it. The fact is, firstly, we have over the years increased our contributions. But when we contribute, we do so not in order to solve the financial problems of that particular international organisation but, more importantly, to demonstrate Singapore's support for that organisation for what they are doing and it is more symbolic of support and hopefully will trigger other countries to do so. Really, large contributions have to be made by other countries. Let us remember that we are a small country and we have to be realistic as to how much we can actually contribute to international organisations.

If you look at the 1997 UN handbook, there are more than 37 organisations within the UN system, and if you look at the Year Book of International Organisations, there are some 13,600 international organisations. Clearly, it is not possible for us to make contributions to so many organisations. So our approach is: be selective, do what we can within our resources, and the objective is to show support for the UN system and for those organisations. In that sense, we have traditionally made voluntary contributions to a number of UN related IOs, including the UN Children's Fund, the UN Fund for Women and the UNDP. We have gradually increased it over the years. It may not be of the frequency and the magnitude that Mr Simon Tay would want. But I believe we have demonstrated Singapore's willingness to contribute to the international community as a country that is mindful of our role and willing to perform our role as a responsible member of the UN. But to look at it really, we must not forget that we also make contributions in other forms, which are very difficult to quantify. But if you ask the Ministries and the Ministry of Finance, they can quantify it in terms of costs. Our participation in UN related activities like peace-keeping operations, that is an important contribution. But again, this is to show support for the system.

Mr Simon Tay just now referred to the fact that we are holding workshops, seminars and conferences. Indeed, we do hold conferences. For the past three years, I have been guest-of-honour at seminars and workshops hosted in Singapore, for example, on peace-keeping. There are certain costs involved in hosting that seminar. I am sure that if I add up all the costs, hospitality, the reception we have given and the local transportation costs for all these conferences and workshops, they can add to these figures, which I have not done so. But it is a relevant factor. It again shows our support. In terms of showing our willingness to perform our role, because we have done comparatively better than some other developing countries, let us not forget our technical assistance programmes. Of course, it is not a programme for contributions to international organisations, but it shows your foreign policy stand, and under our Singapore Cooperation Programme, which is bilateral, as well as through schemes which we tie up with other organisations and countries, including the UNDP, World Bank, and so on. 1.15 pm

To-date, we have trained some 6,000 participants from 92 developing countries, under various types of training programmes. I think this is an important part of your foreign policy objective. How else do you support the UN system? Because that is the way I look at it - contributions to support the UN system. I think we contribute to the UN system by paying our contributions on time. And I hope Mr Simon Tay will sometimes make a call for bigger nations, whom I will not mention specifically, to pay their contributions on time. For 1997, we paid US$1.7 million as our excess contribution to the UN's regular budget, and US$314,000 to the peacekeeping budget. Our voluntary contribution to UN-related international organisations was about US$317,000. Is it a lot? Is it a little? It depends on how you look at it. It was a 27% increase from our contributions in 1996. Another US$182,000 was made to non-related international organisations. Our participation in peacekeeping operations is about S$159,000. And the Singapore Cooperation Programme, which I referred to, amounts to S$10 million.

Therefore, if you look at it in financial terms, Singapore's contribution, voluntary and mandatory, just as administered by the Foreign Ministry - I emphasise that because some other Ministries have similar programmes - was in the tune of some S$15 million for 1997. As I said, other than MFA, we have contributions to the UN Environment Programme. I take note that Mr Simon Tay would like this to be increased. In 1997, we contributed US$15,000.

But apart from these contributions, I should also mention there are specific funds, such as the UNEP Trust Fund for East-Asian Seas. For 1998, we contributed US$10,000. And I am told that the National Parks Board has also contributed S$15,000 to the Convention on Biological Diversity. Primary Production Department has contributed $10,577 for the Convention on International Trade in Endangered Species of Wild Fauna and Flora. I do not know what else can be discovered from the other Ministries. But the point I want to make is, again, that, yes, we can increase our contributions but we always have to bear in mind our position and our resources. And I think within the constraints of our small size and limited resources, we have not done badly in terms of our contributions to the UN system.

On Mr Rai's comments on the economic union, I have nothing further to add than what I have said to Mr Chiam, and I have taken note of it.

As to institutionalising links, there are various shapes and forms in which countries can conduct relations. And I think between Malaysia and Singapore, it is very fair for me to say that the different Ministries and different agencies have very good contacts with each other. The Ministers have good working relations, not just with the Foreign Ministry, but also with the communications, as well departments like the Police and Immigration under the charge of my colleague, the Minister for Home Affairs. This has evolved over a period of years. Do we want to change it and have some institutional system? Some countries have what they call joint commissions which meet annually at specific dates. So there are various forms. I think from my viewpoint, as Foreign Minister, I am open to suggestions. But I will pay emphasis to the substance and results, rather than form. You can have form. But it will be a pity if we have the form and elaborate structures, tremendous numbers of meetings, but at the end of the day, very few results. So let us go for the results, whatever the form may be.

Dr Ong Chit Chung: Sir, may I thank the Minister for his full replies and wide-ranging responses to our many questions. In particular, we wish to join the Minister in hoping for the best and also working towards closer Malaysia-Singapore relationship and closer Singapore-Indonesia relationship too.

On that note, Sir, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

The sum of $161,490,000 for Head O ordered to stand part of the Main Estimates.

The sum of $53,242,300 for Head O ordered to stand part of the Development Estimates.

Head Q -

The Chairman: Head Q - Ministry of Home Affairs. Amendment No. (1), Mr Chng Hee Kok.

Mr Chng Hee Kok (East Coast): Sir, I beg to move,

That the total sum to be allocated for Head Q of the Main Estimates be reduced by $100.

Sir, my subject is on illegal immigrants. Of late, illegal immigrants and overstayers have been making the headlines in the local media. Just this morning, on the front page of The Straits Times, there is a report of some 200 illegal immigrants of various nationalities who were apprehended. The problem is not confined to Singapore. There are continuing reports on this similar issue in Malaysia almost on a daily basis. This morning, The Straits Times showed most graphically the situation in Malaysia headlined, "Foreigners caught in garbage truck". They even come in garbage trucks. The following article also reported that Malaysia is urging Indonesia to act on this issue, as presumably a large number of illegal immigrants in Malaysia are from Indonesia.

With the tightening up in Malaysia, combined with the slowdown in the economies of neighbouring countries and the increasing number of unemployed, the problem in Singapore looks set to get worse. This is worrying. As the economy in Indonesia is set to decline, going by press reports, the problem must be contained. Whilst the success of the police raids is commendable and comforting, the substantial number of illegal immigrants apprehended in the last few police raids, in fact, means that this is just the tip of the iceberg. There must be a large pool of illegal immigrants and overstayers in our midst.

Although Singapore is not a large island, the coastline is long and one can imagine the difficulties the Police must be facing in trying to stop the tide of those seeking to enter Singapore illegally. I have no doubt that the Police is doing its utmost to contain or arrest the problem. On the legal side, employers must be educated that this is a serious problem and that one should not encourage illegal immigrants by employing them. Despite hefty penalties, there are employers who are prepared to flout the law. On enforcement, the Police should be well equipped with manpower and equipment, especially in the seas, to prevent illegal entry. Once they land on shore in Singapore, and in our midst, the chance of detection and apprehension diminishes.

I am sure all Members support me when I say that the Home Affairs Ministry should get a higher vote, if necessary, to implement programmes to counter this problem. The Minister may like to assure the House and Singaporeans on the steps being taken to contain this problem.

Mr Ong Kian Min (Pasir Ris): Sir, the current financial turmoil and economic crisis are forcing many people from our neighbouring countries to flee hyper-inflation, severe food shortages and unemployment which are affecting them in their own land. They may be attracted to Singapore which is only a short boat ride away. In the early hours of 24th February, 12 suspected illegal immigrants were arrested in the waters off Changi. The police spokesman stated that this was the largest number arrested at sea for trying to enter Singapore illegally from the south. The Police also reported that the total number of illegal immigrants caught at sea for the first two months of this year stands at 39, compared to 84 for the whole of 1997. This number seems incredibly small compared to the numbers reported in Malaysia where 3,971 illegal immigrants were arrested in a three-week period last month. No doubt, Malaysia is a bigger country with a longer coastline, swampy coastal marshes and deserted shorelines which all serve as good landing points. But I wonder whether, apart from the relatively small number who has been arrested so far, there were other illegal immigrants who have managed to avoid arrest and slip through our surveillance net to land on shore.

Sir, we need to formulate a comprehensive and effective approach to prevent, detain, and deal with such economic migrants. We must formulate a realistic approach in anticipation and in the event of a mass exodus of illegal immigrants from our neighbouring countries. Are we able to cope should large numbers of foreigners turn up in our waters? If we are to arrest and imprison them, can our prisons house and feed all of them?

Sir, I believe the problem should be approached from at least four different angles. The first is to nip the Taikongs, or boatmen, who exploit the desperation of these foreigners by smuggling them to Singapore for a fee. If found guilty, they should be given heavy deterrent penalties, including jail terms, caning, confiscation of their boats, so as to cut off the provision for this ferry service and to deter others from offering it. We might pity the illegal immigrant who is often driven by deprivation and turmoil back home to risk venturing overseas. But no pity should be given to the boatmen who seek to profit from the desperation of others.

Second, surveillance of our coastlines and onshore patrols must be stepped up. This requires the coordinated efforts of the Police Coast Guards, the Navy and the Immigration Department.

Third, citizens should be vigilant and look out for illegal immigrants in their neighbourhoods. Any suspicious characters should be reported to the Police for their identification to be verified and, if found to be not in order, to be arrested. If large numbers of foreign workers are known to be congregating in any particular place in Singapore, combined operations should be mounted to check on them and round them up. And those who have come in illegally or have overstayed should be dealt with accordingly.

Fourth, residents who harbour and provide refuge for illegal immigrants should be severely punished. We have to also track down illegal immigrants who make use of make-shift accommodation in the nature reserves and other deserted areas. To address this problem, a combined operation by the Police, and perhaps the army, should be launched to flush them out.

Sir, the crisis and turmoil in the region would inevitably lead to more illegal immigrants trying to land on our shores. We should not think that that is not a big problem as the number arrested so far is small. Many might have slipped through. I believe this problem is potentially serious and warrants a concerted multi-pronged approach to deal with it effectively. 1.30 pm

Mr Kenneth Chen Koon Lap (Hong Kah): Sir, in addition to the usual illegal immigrants we have from time to time from the traditional foreign workers market, we can expect a big influx of illegal immigrants for the next few years from our neighbouring countries who have been badly affected by the current economic turmoil. It will no doubt cause a great strain to the Police Department's resources to deal with this situation as Singapore is an island and the task of patrolling our shores would be much more difficult.

As illegal immigrants not only cause social problems, but more importantly, they will present security problems that involve the safety of all Singaporeans, I hope the Ministry can take early preventive measures to tighten security and coordinate with perhaps the armed forces who can patrol the outlying areas and the forest areas, the navy who can help to patrol our shoreline, and other law enforcement agencies like the Immigration Department could tighten control of the influx of these immigrants to prevent anyone from entering Singapore illegally.

For those who may have slipped through our first line of defence, I suggest that, apart from continual raids or even intensified vigilance on construction sites, factories and other workplaces, the Police Department can work with the various grassroots organisations, especially the Neighbourhood Watch Groups to alert residents in the HDB estates to notify the Police as soon as they detect any strangers who behave suspiciously and, more so, speak no local languages. They should also send continuous reminders to contractors and factory operators of the serious consequence if they are found with illegal workers. This is perhaps the most effective way to minimise illegal immigrants to Singapore because if they cannot find work here, there is no reason for them to take the risk of being caught. I hope the Ministry can give the assurance and enlighten us on what other plans it has to keep Singapore a safe and peaceful place for all of us to live in.

Assoc. Prof. Chin Tet Yung (Sembawang): Sir, other Members in the House have already spoken about the expected influx of immigrants from neighbouring countries. Today, we have heard that over 300 illegal immigrants have been picked up in one operation alone last night.

Yesterday, The Straits Times reported a story from Newsweek that an official from a neighbouring country made the remark that even if 10 million people were to leave for neighbouring shores in their boats, they will not be stopped. That is a very scary statement. Even if 1% of that 10 million were to gain entry into Singapore, we would face very serious problems. Crime control measures may have to be increased to levels as yet unknown and could adversely affect our social life. I believe that all of us in this House would very much like to know what are the steps that are needed to ensure that this does not happen. Do we have the resources? More importantly, do we have the will to deal firmly and sternly with those who intend to come in illegally?

It may be very difficult to be strict. We naturally sympathise with those who are in extreme distress. We remember the anguish of the world for the Vietnamese boat people. It is natural to want to help people in distress. But I believe that in Singapore, we have to stand firm. We already have around 450,000 foreign workers who are working here legally. Land and resources are in short supply. Frankly, I believe we have no choice. I have every confidence that the Minsiter would be in a position to assure us that effective steps would be put in place to control the influx of illegal immigrants into Singapore, dealing with them firmly but decently. Singaporeans would need to know why we need to take such firm steps. Quite simply, it is to preserve our way of life, to protect all that we have worked for over these years, that is, in short, what is at stake.

The Minister for Home Affairs (Mr Wong Kan Seng): Sir, I would like to reply to this question of illegal immigrants raised by four Members first, because I think it is a very important topic for all of us in today's climate where there is a regional economic downturn and that there is a fear of potential influx of illegal immigrants. But, first, I would like to assure Members that the Home Affairs Ministry is fully aware of this problem and has been dealing with it for some time. I also want to thank Mr Chng for his support for a higher vote for the Ministry of Home Affairs. I think my colleague in the Finance Ministry will hear him loud and clear and, hopefully, his plea would be answered.

At the outset, let me first say that Singapore welcomes all foreigners to come here to work, visit, play or even to study. But they must come through legal channels. "Legal channels" mean they must come with proper papers and travel documents. When they come here for a visit, they apply for a social visit pass. If they work here, they apply for an employment pass, a work permit or other documents, such as a student pass if they want to study here. If they come in with these documents, we will endorse their stay here. Then, lawfully, they will be residents in Singapore. For those who want to come in by other means, then I think it would be very difficult for them not to be detected.

Sir, we have taken and will continue to take a very tough stand against all the illegal immigrants and overstayers, and I group all these people as immigration offenders. These immigration offenders could also include their smugglers, the Taikongs, as mentioned by Mr Ong Kian Min. There are also , or the harbourers (the ones who allow them to live in their homes) or the employers of these people who give them jobs.

Let me explain why we cannot afford to be lax or kind to these illegal immigrants. Singapore is a very small country with limited natural resources. We therefore cannot allow people to come here just to stay and work illegally. They will pose a very serious and grave national, social and security problem for us. We therefore have enacted very tough laws to deal with these illegal immigrants and overstayers. We will enforce these laws vigorously which we will apply equally to all nationalities regardless of where they come from. If they come here illegally or prolong their stay here illegally, we will deal with them.

The punishments prescribed under our laws are very severe. For example, illegal immigrants will be imprisoned up to a maximum of six months and will be given a mandatory three strokes of the cane. Overstayers will also be imprisoned up to six months, and if they overstay for more than 90 days, they will also be subject to a minimum of three strokes of the cane. We will be deliberately tough on those who smuggle in the illegal immigrants, the Taikongs, the people who employ them, harbour them or give them accommodation. These smugglers will be punished with imprisonment of not less than two years and caned a minimum of three strokes. Those who harbour and employ illegal immigrants will be jailed for a term not less than six months and fined a maximum of $6,000. But for those employers who employ more than five immigration offenders, whether they are overstayers or illegal immigrants, they will be imprisoned not less than six months and fined not exceeding $6,000 and caned. Since we amended the Immigration Act in 1989, many employers have been caned. In fact, since we tightened this up in 1996, seven employers have been caned.

Sir, for the same reason that we are a small country with limited natural resources, Singapore is also not in a position to accept anyone who claims to be a refugee, whether he is an economic or a political refugee. We could otherwise be overwhelmed by the sheer numbers of people who want to come here and claiming themselves to be refugees. Therefore, anyone who enters Singapore's territorial waters illegally will be regarded as an illegal immigrant and he will be treated accordingly. If they come in through to our waters illegally, we will try to stop them. If they refuse to stop, then we will have no choice but to use force to stop them. Prof Chin asked whether we have the will to do so. Yes, let me assure him that we have the will and the Police Coast Guard (PCG) will have the will to stop these people from coming in.

Sir, in the past, we have been kind enough to agree to take in Vietnamese refugees with third country guarantees for resettlement. And for years, we were saddled with them because these third countries which agreed to resettle them did not honour their guarantees. Eventually, when the camp had to be closed, these Vietnamese had to be sent back. We have learnt our lesson and we will no longer accept any refugee even if a third country promises to resettle them.

Sir, let me give Members some idea of how serious the problem is by quoting the following numbers. In 1997, 13,910 immigration offenders, of whom 7,600 were illegal immigrants, were arrested. In 1996, 14,260 immigration offenders, of whom 5,710 were illegal immigrants, were arrested.

Although the number of immigration offenders arrested as a whole dropped by 2.5% in 1997, the number of illegal immigrants arrested during the period has gone up from 5,710 in 1996 to 7,600 in 1997. This is because Singapore Immigration tightened up the entry requirement for some nationalities. Of the illegal immigrants arrested in 1997, the top five nationalities came from China, that is, PRC, Indonesia, Myanmar, Thailand and India. In other words, not all came from the South, that is, Indonesia. The number of illegal immigrants has gone up significantly mainly through Malaysia. They came across the Straits of Johor.

More than half or 53% of the illegal immigrants came in from the sea, 46% came in by land and less than 1% claimed that they came by air. For those who came by land, in 1997, nearly 400 illegal immigrants sneaked in through the Woodlands Checkpoint by hiding in lorries, while about 200 hid themselves in the car boots. And many more came by speed boats over the Straits of Johor.

Sir, joint efforts are needed between the Singapore Police and the Malaysian Police to tackle this problem. The Singapore Police has sought the Malaysian Police's cooperation to stem out this illegal immigration problem. Both the Police Forces have already met and discussed the problem and they have exchanged information on the syndicated operations and the staging points where both forces can cooperate to weed out these illegal entries. We hope that the Malaysian government will take this problem seriously and deal effectively with the syndicates which smuggle illegal immigrants into Singapore from Johor, just as the Malaysian government is very concerned about the Indonesian illegal immigrants and they have taken up with the Indonesian government to solve this problem. The Malaysian government knows the seriousness of the problem they face with illegal immigrants from other countries, especially from Indonesia.

As this illegal immigrant problem is likely to get worse, I have asked the Police and the Singapore Immigration to be even more vigilant and to step up their enforcement action. Let me now outline or explain what these actions are.

Increased Vigilance

Like some Members pointed out, our first line of defence is our coastal front where we will enhance our patrols by the Police Coast Guard. The Police Coast Guard will do this with radar surveillance systems. That will help to detect all those who come by sea all round our island. I think some Members may have seen this on television a few weeks ago. The radars on board the PCG can detect any penetration of illegal immigrants on vessels from the sea. PCG also has land based radar stations to supplement the patrol boats and we will buy more patrol boats to increase the detection of these illegal immigrants. Police has also stepped up shore patrols and set up observation points, as some Members suggested, along the coast and at landing areas. Police Land Divisions are also deploying more men to patrol the illegal immigrant landing points. The Police Coast Guard has also increased deployment of its patrol boats in the Johor Straits and in the Straits of Singapore. The police has also stepped up intelligence gathering, because we just do not act without information. 1.45 pm

While the Ministry empathizes with these poor hungry people who want to come here to work illegally, and they risk their lives to come a long way, we cannot afford to allow them to come in. Our primary responsibility is to safeguard the safety and security of all Singaporeans, and not let anyone come and remain here illegally to work, as they will pose a serious social and security problem for us. All illegal immigrants will ould be arrested, prosecuted, punished and repatriated. We will press for deterrent sentences against the immigration offenders, especially the people who smuggle them in.

Enforcement Actions

Police and Immigration have been conducting operations to arrest illegal immigrants and overstayers. Some Members have read about this in the papers in the last few days. Checks and raids have been conducted regularly at congregation points, construction sites, workplaces and even forested areas, because they could be a good hiding place for criminals. Police have also set up road blocks to sieve out immigration offenders. Lodging houses are also being targetted and harbourers will be prosecuted. An island-wide operation was conducted just a few days ago which resulted in the arrest of 91 illegal immigrants and 124 overstayers of various nationalities. Another island-wide operation lasting two days also resulted in the arrest of more than 200 illegal immigrants and overstayers. We will ask the courts for maximum sentences for these employers, harbourers and immigration offenders.

Let me assure Members that Police and Immigration will continue with their relentless effort in enforcement against these immigration offenders, and we will flush them out as quickly as we can.

Tighter Border Control

Foreigners, who come to Singapore and who fit the profile of suspected illegal workers, will not be allowed to come into Singapore. In 1996, 97,710 such people who fit the profile of suspected illegal workers were denied entry into Singapore. In 1997, 92,400 such people were not allowed to come into Singapore. Police and Immigration will be more vigilant now in monitoring all our border entry points. The monitoring at checkpoints at the Causeway, Tuas, land checkpoints, seaport and the airport will all be stepped up.

Police and Immigration will also intensify the checks at these checkpoints to detect the smuggling of illegal immigrants by vehicles. Let me give Members an idea of what the numbers are of those who were so detected. In 1997, 26 illegal immigrants and 11 smugglers were arrested, and 13 vehicles seized at Tuas and Causeway checkpoints. Vessels carrying illegal immigrants will be stopped by force, if necessary. And iIf they try to evade arrest despite being told to do so, then the Police Coast Guard, as I said, will use force to stop them. If they are arrested, these vessels will be confiscated and they will be disposed of or destroyed. In 1997, last year, 30 such vessels were seized together with 255 illegal immigrants arrested.

Tightening of Visa Control

Immigration also imposes visas to address the overstayer problem for some years, and visas have been imposed on people coming from countries such as the People's Republic of China and India. Last year, we also imposed visas on people coming from Myanmar and Bangladesh. We will consider imposing visas on other nationalities if they pose a serious overstaying problem here.

Sir, given the regional situation, it is in the interest of all Singaporeans that we continue with our very strict and tough stance against immigration offenders. The Police, Immigration and the other agencies in the Home Team and indeed members of the public can also help us and we will spare no effort to detect and deal firmly with immigration offenders.

The Home Team will closely monitor the situation, take the necessary actions, adjust the strategies and deployment and stay on top of the situation. This will help to ensure the safety and security of Singapore.

Mr Chng Hee Kok: Sir, the salary structure of the Police Force was adjusted last year. This is good news for the police officers already in the force and is certain to attract more capable men and women into the force. I am pleased to read in the press recently that the prison's recruitment exercise attracted an unprecedented number of applicants. I hope that from this wider and better pool of applicants to choose from, the prison authorities and the Police Force as a whole will be able to recruit higher calibre officers.

Sir, earlier, I spoke about the problem of illegal immigrants, which has been answered by the Minister, and the need to have the necessary equipment to stop this problem at our coastline. Investing in high-technology equipment will complement and supplement the limitations of human resources, as they can give early warning and pinpoint the locations with accuracy. With the economic crisis in the region, the waves of illegal immigrants, as the Minister and other Members have said, will foreseeably be more frequent and intense.

We all know that technology is also making great progress and white-collar crimes have become increasingly more complex and complicated. There was a report recently that some FBI agents in the US are equipped with laptop or notebook computers to help them fight crimes, and they have achieved some measure of success.

Sir, the investment in equipment and the changing climate of crime entails that the quality of our law enforcement officers must continue to rise to match the changing circumstances. There is also a compelling need to operate across departments and Ministries, as issues become more complex. Joint operations require well thought out plans and coordination to ensure a greater degree of success. Therefore, it goes without saying that the quality of leadership is crucial in such operations.

I shall be pleased to hear the Minister elaborate on some of his Ministry's plans to improve the quality of our law enforcement officers.

The Chairman: Mr Chng, you can go on to your next topic.

Mr Chng Hee Kok: Sir, Singapore has been rated as one of the safest cities in the world. Singaporeans can take pride in our police force for making this possible. Recent reports on the crime statistics show that crime has been declining despite a number of cases of serious crimes in the first two months of this year.

However, as the economic conditions appear to be less favourable this means it is bad news for crime. The reported rise in illegal immigrants also spells bad news. Illegal immigrants without gainful employment are good targets for crime. Since the beginning of this year, the spate of break-ins seems to be on the increase, as the press reports go. Most of them involve burglary in landed properties and in most of these, the burglars were armed. This is most worrisome, as it shows that these armed burglars come prepared and their victims were subdued. In other words, criminals are getting more desperate. On 4th March 1998, three condominium units in Seletar Hills were burgled. Even condominiums which have some measure of security are not safe when it comes to crime.

There is every possibility of the crime situation getting worse this year. Besides increasing law enforcement measures, public education must also be stepped up. The recent spate of burglaries may be avoided if the owners had been more vigilant and if security systems had been installed. Educating Singaporeans and reminding them to improve on security measures should be an on-going effort, but they do have their limitations as it is human behaviour to think that bad things only happen to others.

Apprehending criminals in housing estates is much more difficult because of the size and location of these houses in the estates. Greater police presence may not be the most effective way of preventing break-ins.

I would like to ask the Minister to elaborate on what steps have been taken to strengthen the existing measures and whether the police could do more to contain this problem.

Mr Kenneth Chen Koon Lap: Sir, at a recent press conference, the Criminal Investigation Department assured the public that the number of murders, 15 in total, in the first two months of this year is not unusually high. In fact, there were two periods at the peak which exceeded the total of January and February this year, ie, between October and November 1994, there were 15 murders, and between September and October 1993, there were 16 cases.

This is of little comfort because in the past years, the average yearly number of murders was 45 cases. It works out to be an average of four murders a month. During the first two months of this year, the total number well exceeded the average. And if this is seen together with last year's trend, it shows that, although the number of crimes committed is lower, what is significant is that the reported cases for murder and rape cases increased. It is indeed an area for great concern as these are the two most feared and serious types of crime. The recent two brutal double murders really shocked all Singaporeans. One of these murders occurred in my constituency. In fact, the whole neighbourhood was really shaken.

Whatever the causes, it is not something that we should consider not out of the ordinary, as has been stated by the Criminal Investigation Department. We should never be complacent just because we have achieved a lower crime rate and Singapore is perceived to be a very safe place for us to live in. While I compliment the police department for doing an excellent job in keeping the crime rate low, I would request the department to put in greater efforts to address our concern, especially in the case of murder and rape.

Mr Ong Kian Min: Sir, first of all, I am very happy to note that the total expenditure for the Ministry of Home Affairs in FY 97 increased over actual FY 96, and a further increase of $104 million has been budgetted for FY 98. I fully support the need to build up and maintain a credible and effective Home Team. The Home Team has done an admirable job in bringing down the crime rate which has declined for the past nine years, with some types of crimes registering record lows.

Singaporeans and foreigners alike appreciate our safe streets. This is an important element in making Singapore one of the most livable cities in the world and the best home for our people. It is also one of the positive factors which top foreign talents consider when deciding to relocate themselves and their families to Singapore. Therefore, in addition to our emphasis on defence, education and development of our economic infrastructure, I would strongly support our emphasis on maintaining and enhancing public security in Singapore. Just like a credible defence force, an effective Home Team cannot be created and developed overnight. It requires long-term commitment and investment in manpower, hardware, software, expertise and new technology. 2.00 pm

Although our crime rates have dropped over the past nine years, we must not be complacent. Because, I believe, our Home Team will face particularly tough challenges in the face of the on-going regional economic crisis. There is a real danger that crime and violence may escalate under the present difficult regional circumstances. In addition to the problem of illegal immigrants which I have raised earlier, an increase in crime may be due to one or more of the following reasons:

First, the impact of the crisis on our local population is profound. Singaporeans, especially the younger generation, are used to enjoying years of strong economic growth and appreciating asset values. Generally, we have benefited from the good years and there is no denying that there is a sizable proportion of Singaporeans who have grown accustomed to the creature comforts of the good life, some even to the point of being extravagant.

Suddenly, they are now faced with a slowdown and the real possibility of a decrease in asset values, loss of jobs and a reduction of income. In the light of this slowdown, they should make adjustments to their lifestyles and trim expenditure. But some may succumb to temptation or pure greed and some may be forced by severe financial difficulties to take the easy route to money through crime.

Second, Singapore is a very open country. Last year, there were more than 6 1/2 million tourist arrivals. Many will come genuinely looking to enjoy our beautiful country, seeking job opportunities or to trade. But there will be some foreigners who come here with the intention to commit crime and those who, while they are here on a legitimate purpose, turn to crime when the opportunity presents itself. These foreigners take the chance, secure in the knowledge that they are anonymous in this country and can flee quickly and easily without notice. Therefore, more in the areas of crime prevention, encouraging members of the public to report and arrest criminals, and fast police response to the scene of crime must be done to arrest and address this potential problem.

Sir, we should not take our low crime rates for granted. The police force and other Home Team agencies need resources to constantly upgrade their establishment, their expertise, and operational capabilities to prevent, deter and solve crimes. We must do our utmost to support the building and maintenance of an effective Home Team so that our streets and homes will remain safe in the midst of the on-going regional crisis and beyond.

Assoc. Prof. Chin Tet Yung: Sir, personal security, both in the home and outside, is a major concern for everyone. Safe streets, safer homes. Singapore is fortunate. We on the whole do have safe streets and safer homes. But recent robberies and murders highlighted by the press have led many with the feeling of unease, particularly in the housing estates affected. It often translates into an emotive issue. At grassroots level, Members of this House would have inevitably been approached by residents wishing to be assured of a higher level of security. That is understandable. What is not often stressed enough, however, is that the war against crime is not just fought by the Home Team, the uniformed services. It requires the support of the very people they are duty bound to protect. The man-in-the-street must participate actively in crime prevention. The more the public is aware of the need to cooperate and be crime conscious the less crime there will be. Public awareness has to be improved.

Last year, the Minister announced a new plan to restructure the coverage of the Home Team in Singapore. A pilot project was started, I believe, and we are anxious to hear how the new NPC/NPP combination has worked out. Is it likely that in this year we can expect the restructuring to go on? If so, which areas would next benefit from the new methods of policing?

I believe too that there is a need, given the manpower shortage in the services, to give more thought to the use of electronic surveillance equipment in Singapore. It was found in studies abroad that where there were surveillance cameras in place crime has fallen. Cameras have often helped also in identifying culprits and the like. I would urge the Minister to consider installing such equipment, not just, for example, inside MRT stations, but also in the surrounding areas where there are usually pedestrians who may be walking home late at night. Indeed, it may be appropriate in due course to extend such camera surveillance to housing estates, especially in areas that are isolated, such as in blocks bordering parks or roads.

Sir, the control of crime calls for collective action. The Home Team must help citizens protect themselves. Crime can cast a dark shadow over a large group of people, the victims, the relatives, the bystanders, the people in the vicinity and neighbours. Singapore takes a very hard line, rightly so, in dealing with criminals, and for that we do have a very safe environment.

At the end of the day, internal security is every bit as important as our defence from external threats. Total defence should cover the work of the Home Team as well.

Mr Wong Kan Seng: Sir, let me first deal with Mr Chng's question about the training of the Home Team officers on the use of high-tech equipment. Let me assure him that we are very aware that we need to keep in touch with the changing times and, as a result, the Ministry has embarked on a number of acquisitions of high-tech equipment. Therefore, we will definitely pay a great deal of attention in training our officers on the use of high-tech equipment. Over the next few years, in fact, the Home Team will take a quantum leap in the use of information technology (IT) and other high-tech systems to help the Home Team in its enforcement efforts. I can assure Members that the Home Team officers will be properly trained in the use of these equipment. For example, all our police recruits are now trained in the use of command and control mobile data terminals that are needed for front line policing during their basic training. Recently, 550 immigration officers were also trained in the handling of sophisticated IT systems, namely, the Tuas network infrastructure, the entry and exit control upgraded system, the immigration automated clearance system and the automated character recognition system at the Tuas Checkpoint to facilitate Singaporeans and other users of the checkpoint to clear the checkpoint as quickly as possible.

The Civil Defence Force, for example, also uses training simulators to train its staff our people on fighting LPG leakages and fires, flashovers and hazardous materials. They use these simulators to enhance training realism.

Another target for the Ministry is to make the use of personal computers more universal within the next two to three years. This we do through the intelligent desktop project and it will help us to attain the goal of 100% computer literacy for all our officers over the next few years. With all these on-going measures, we will work together to ensure that our senior and junior officers are trained, quality personnel who will be able to handle high-tech equipment and systems well into the 21st century.

On Mr Chng's and Mr Kenneth Chen's concern about the crime situation in Singapore, in particular Mr Chen's concern about the CID's comments recently that the number of murder cases is not unusual, let me first assure him that CID is not taking the matter lightly, and they do not find the number acceptable. But what they are trying to put out is the fact that, "yes, indeed, we have a number of murders over the last two months. Let us take this in proper perspective and not be unduly alarmed by it, but at the same time not to be complacent about it".

The CID actually compared the figures with previous years' figures and found that the figures, are no doubt high. But they are not really unusual, and they have given some numbers. For example, in 1993 and 1994, there were 15 and 16 murder cases just over two consecutive months. Eventually, we found the cause of those murder cases and since then we have no more such problems. But I agree with Mr Chen that the past record of high murder rates is not a good reason for us to feel comfortable about the situation. For the families of those who were murdered, our sympathies and condolences are certainly with them.

But all these 13 cases in the first two months of this year were unrelated. We do not have a serial murderer on the loose. The murders are not concentrated on any particular geographical area. The victims come from different backgrounds and the reasons for their being murdered differed from one to another.

Mr Chen has expressed concern that the public sense of well-being and security may be affected because of the economic downturn and more crimes like these murders may be committed. He wanted to know how many of these were due to economic reasons.

CID has assessed that none of the 13 murders in January and February were the result of the economic downturn. In three out of the 13 cases, the perpetrators actually killed the victims in order to facilitate robbery, and the reasons for robbery could be many. The rest were either crimes of passion or isolated cases of fights and disputes. If these people could not settle the disputes, force was used and as a result people die. In 1996, seven of the 31 cases of murder involved robbery, as did eight out of the 37 in 1997.

What is the police doing about the increase, and whether the number of murders will be further increased this year, as Mr Chng has asked. The year has not run out yet. I hope the number will not be large and it is still too soon to tell. But we know in 1997, there were 37 murder cases compared to 31 in 1996. But these were actually quite low figures compared to previous years, for example, between 1990 and 1995, we had between 42 and 58 murder cases. The number fluctuates from year to year. Five of the 13 cases committed this year have already been solved and CID told me that they were making good progress in the remaining cases and they are confident of solving more of them soon.

Mr Chng is also concerned about the recent spate of reports of robberies or house-breaking incidents in private housing estates. Yes, indeed, there are some reports about house-breaking. Whether we have more of such cases, again in 1998, I would say that it is too soon to tell. But in 1997, we had 42 such cases of private estate house robberies compared to only 17 in 1996. So we can see that there is an increase in house-robbery cases between 1996 and 1997. Again, there is no particular reason to explain this increase and neither is there a sign that the trend will continue.

Mr Chng has asked what steps police will be taking to deal with the problem. The police told me that: Firstly, they have set up a Fast Response Task Force to respond quickly to apprehend the suspects when the cases occur. But again that depends on the residents and the people who were affected to report the commission of crime as quickly as possible.

Secondly, they have deployed temporary police posts to areas which are affected by the robberies in order to project a higher police profile and visibility.

Thirdly, they have intensified the crime prevention activities with the residents; and

Fourthly, they have helped the residents form Neighbourhood Watch zones.

Like some Members have said, I would like to stress also that crime prevention is not the sole responsibility of the police. All of us play a part. We must do our share and we must help to keep crime at bay. Although the crime rate has been declining every year for the last nine years, we must not be complacent and think that wethey will not be a target for criminals.

There are indeed many measures which residents, the home owners themselves, whether they live in a HDB estate or in a private condominium or landed property, can take in order to make the homes more secure. For example, they can install good quality locks or alarm systems. And iIf they have an alarm system, for goodness sake, please switch them on when they are needed. I know quite a number of these private residential properties have alarm systems, but, unfortunately, they were not turned on when the criminals and the robbers went into the house. Even when they leave their homes, residentsthey should take the necessary precaution of securing the home by closing the windows and doors, shutting the grilles and so on, and not like in one instance, where I read in the papers, they just left things as they were and walked out of the home, thinking that everything would be fine. The worst thing you can do is to tempt the robber or any perpetrator who may want to commit a crime, passing by your home and finding it is so unprotected and giving him an opportunity to commit a crime. Those living in private condominiums or even in landed properties can help to form Neighbourhood Watch Groups. In fact, I think it is good for them if they can form Neighbourhood Watch Groups not just for protection of their own homes, but also for the purpose of building neighbourliness. At, at least theyyou get to know theiryour neighbours. And Iif they see suspicious characters lurking around, I think they should report them to the Police as quickly as possible, and the Police will respond. 2.15 pm

The Police, in fact, is going around helping to form Neighbourhood Watch Groups. In the past few years, they had formed 8,000 such groups in the private housing estates, including condominiums. And I would urge all those living in private estates, condominiums, landed property, to form NWGs as quickly as possible. The Police will help them if they are asked. The Police will also work very closely with the Community Development Councils and other grassroots organisations to come up with measures to see how we can make the place where we live more safe and more secure, and they will jointly come upout together with a Community Focused Plan, which I will elaborate later on, on how to get the community more actively involved in crime prevention. So actually it is a very simple, very commonsensical thing to do. Everybody should take extra care and precaution, and play histheir part to help keep crime rates low and not be complacent, especially during this period of economic uncertainty.

Mr Ong Kian Min has made many complimentary remarks on the Home Team officers. I am sure they are very pleased to hear that. And I want to thank him for his support. I agree with him fully that home security and safety is as important as our external defence. Because if our home is not safe, people do not feel safe walking the streets and do not feel safe going out, I think we willare be just prisoners in our own homes, which the residents of some countries experience. ThenAnd I think no investors would want to come here. One of the reasons why many investors want to come to Singapore is that they feel that Singapore is indeed very safe, where they can work, and bring up their children too. And I can assure Mr Ong that the Home Team will continue to remain very vigilant in fighting crime and safeguarding our national security.

Prof. Chin asked what has happened to the Neighbourhood Police Centres which we announced last year and what actions we are going to take in the next couple of years, and whether we could use more electronic surveillance equipment. Let me report to the House that the pilot phase of the Neighbourhood Police Centre (NPC) scheme, which was launched on 1st October last year in Queenstown, indeed, has progressed very well. The residents in Queenstown are quite happy with the results so far. The Queenstown NPC is doing well in ensuring the safety and security of the neighbourhood. Now Queenstown NPC is a one-stop centre providing a wide range of police services. Response time has also improved. There are more frequent patrols, and crime reports receive immediate and better on-scene investigations.

Although some NPPs are now closed after 11.00 pm, because there was not much demand and the place was rather quiet in those NPPs, the presence of police officers on the ground has actually not reduced. In fact, the presence of police officers has actually been increased on the ground. Patrol man-hours have increased by 13%, for instance. The number of quick response teams has also increased from five to seven during the peak hours between 6.00 pm and 1.00 am. And anyone who comes to the NPP, which is closed after 11.00 pm, can have quick and easy access to the Police through the Emergency Communication System installed at the particular NPP.

Since the Queenstown NPC was set up, crime victims in that area are now better and faster served. Instead of passing through a chain of investigators, from NPC officers, divisional officers, and so on, now the crime victim is served immediately by the NPC officer who is a front-line officer dealing with the entire on-scene investigation process. As the NPC officers are better trained and now have greater authority in crime investigation, they can also process the case much faster. For example, now most of the on-scene investigations attended to by the NPC officers are processed within 40 to 45 minutes, compared to about double the time previously.

The NPC has also enabled the Police to forge a stronger community participation, a partnership in the fight against crime. For example, the NPC has joined hands with the Tanjong Pagar-West Coast Community Development Council to organise wholesome activities for youths who are at high risk of becoming juvenile delinquents. The second storey of the Alexandra NPP will be converted into a centre for counselling of wayward youths. In December last year, the Queenstown NPC and the Citizens' Consultative Committee jointly organised a Queenstown Family Day with the twin objectives of increasing social interaction and raising crime prevention awareness amongst the residents.

All these service improvements are quite apparent and clear to the residents. A telephone service audit, conducted by the Quality Service Unit of Clementi Police Station recently, revealed that the residents served by the NPC were very happy with the services received. There were no adverse comments from the respondents. And crime victims who were served by the NPC officers responded that the standard of investigation was good.

Prof. Chin was asking whether, with the cut in the budget, our NPC roll-out plan would be affected or not, and what would be the roll-out plan for the next few NPCs.

Let me say that the Clementi Police Division will have its full complement of NPCs, with the addition of three new ones in Jurong East, Clementi and Bukit Merah by April 1998. But due to the tighter budget situation, the roll-out of other NPCs will be staggered over a slightly longer period of time, compared to what was originally planned. The entire NPC programme will now be completed by June 2001, instead of July 2000. So it is about 11 months of delay. This slight delay in the physical infrastructure will not mean a delay in the transfer of the experience and knowledge gained from operating the NPC scheme. The Police will proceed to transfer the lessons learnt and experiences gathered from the operational NPCs.

Sir, the Police Force has been successful in keeping crime rates down for nine years. Crime rate has become quite low and the people feel quite safe now to walk the streets. The Police will continue to keep the vigilance. But, again, let me say this: that the community has a part to play in keeping its own living environment safe and secure. The community cannot depend solely on the Police for its safety and security. People can take a proactive stance by forming Neighbourhood Watch Groups or Zones, for example.

One major initiative that we are now actively responding to is to strike a stronger partnership between the CDCs and the Home Team. Safety and security are at the heart of the community's well-being and an integral element in the self-help building process. As such, I believe the Home Team can help the CDCs achieve their aim of greater community ownership of civil affairs, especially in safety and security issues.

The Home Team plans to help each CDC develop a Community Focused Plan (CFP) to involve the community in safety and security issues. The CFP is basically a plan for joint proactive community and Home Team initiatives, programmes and projects, which are tailored to meet the safety and security needs of that particular community. The CFP will provide a more structured, focused and coordinated approach for the Home Team to help CDCs engage and mobilize the community to take responsibility for their own needs.

To start with, the CFP will focus on police issues. Activities that will form part of the CFP, for example, could include crime prevention, road safety, community-based problem solving and victim support. After about six months into the CFP, the activities could be extended to include other Home Team issues such as fire prevention, civil defence education, emergency drills, preventive drug education, care for the families of those who are incarcerated and helping those who are released from prisons to reintegrate into our community.

I can assure the CDCs, the Chairmen and Mayors, that the Home Team will spare no efforts to help make this joint venture a success.

Prof. Chin is also concerned about new towns and whether the Police will take an interest in the new towns or not. I can assure Prof. Chin that Police take an interest in all areas which are prone to crime. If there is a serious problem, the Police will attend to it. If not, Police resources will be diverted to places where it is most needed. In the case of Sembawang, particularly in the place where Prof. Chin is in charge of, from the data I know, I think it is a very safe place. Compared to national statistics, I think that area where Prof. Chin is in charge of has one of the lowest crime rates in Singapore.

Mrs Lim Hwee Hua (Marine Parade): Sir, early this month, the Police reported that juvenile crimes showed a smaller increase of 1.8% to 2,147 youngsters arrested in 1997. The moderation is due mainly to a drop in the number arrested for fights in public and the Police noted that the banning of tea dances may well have well checked such incidence. What is disturbing is the rise in stealing offences by youths, as such acts are probably a manifestation of an underlying problem - a lack of self-esteem and the need to seek attention. What is equally disturbing from a separate analysis of trends in recent years is the increase in more violent crimes and a higher female participation rate.

Sir, the small increase in overall youth crime of 1.8% in 1997 is not cause for celebration as juvenile delinquency remains a social problem, one that concerns parents, schools and society at large.

Currently, a multi-organisation approach, involving the Police, MCD, schools, home and the community, is in place to tackle juvenile delinquency, both in terms of corrective and preventive measures. However, to avoid overlapping and poor monitoring, especially of recalcitrants who might slip through the cracks, either a single agency should be set up or an existing agency be made responsible for the coordination and follow-through of all efforts, in an exhaustive manner, to help delinquents and even teens-at-risk. This agency should ideally facilitate an exchange of information between the different implementing bodies, perhaps through the creation of a central database. The focus should be on youths as individuals, and this agency should ensure that all efforts are made to help them rehabilitate. Would the Minister consider putting in place such an arrangement?

Mr Kenneth Chen Koon Lap: Sir, early last year, the problem of juvenile delinquency had often been highlighted. Concern for the deteriorating situation had caused several measures to be introduced, one of which was the banning of teenagers under the age of 16 to attend any tea dances. Assistance also is sought from grassroots organisations to organise more activities for youths to keep them out of problems. Teacher-cop was also introduced to the schools which I understand has worked very effectively. Since then, not much has been reported on the activities of juvenile delinquency. But of late, again, there have been some cases of gang fights being brought to our notice. Only a few days ago, a teenager was brutally attacked by a group of youths. So it appears that all is not well with our youths. I would therefore like to ask the Minister to give us an update on the situation and inform us whether more measures would be introduced to address the problem.

The Chairman: Mr Choo.

Mr Choo Wee Khiang (Jalan Besar): I am not speaking.

The Chairman: Prof. Ho. 2.30 pm

The Minister of State for Home Affairs (Assoc. Prof. Ho Peng Kee): Sir, I thank both Members for speaking on juvenile delinquency. Let me first respond to Mr Chen who has asked the House for an update on the juvenile delinquency situation.

Sir, the number of juvenile offenders arrested rose steadily from 1,205 in 1990 to 2,574 in 1995. We managed to reduce the number to 2,110 in 1996. Last year, it rose slightly by 37 to 2,147. Sir, the increase was due to a higher number of unlawful assembly cases as well as property-related cases, such as shoplifting and robbery. There were, however, some encouraging signs. For example, the number of juvenile student offenders fell slightly from 1,782 in 1996 to 1,749 last year. The number of juveniles arrested for rioting, an area of concern which we focused on last year, fell by 30%, from 216 in 1996 to 154 last year. Nevertheless, I agree with Mr Chen that the situation still has to be very closely monitored because the numbers are still unacceptably high.

Sir, as alluded to by both speakers, in particular, Mrs Lim, juvenile delinquency is indeed a complex, multi-faceted problem. And the number of arrests alone may not tell the full story. The reasons why a juvenile turns to crime are diverse and complex in nature. These may include ineffective parenting, parental neglect, boredom, undesirable peer influence, greed, the desire to do the unconventional, or a combination of these factors.

Dealing with the problem effectively requires the coordinated efforts of various Ministries and agencies, such as MCD, MOE, the Police, the National Youth Council (NYC), the courts and voluntary welfare organisations. Each must do its part, maximising its own expertise and tapping resources in its respective fields. But Mrs Lim's suggestion for a single agency to be set up to deal with juvenile delinquency is one way to go, but will not be the most effective one.

Sir, in our view, a better approach, one that we have taken, is for the various Ministries and agencies to continue doing what they are best at, and for a single body to steer and coordinate their efforts so as to avoid duplication and to derive the greatest synergy. The Inter-Ministry Committee on Juvenile Delinquecy (IMJD), which I chair, was set up in April 1996 with this objective in mind. It has MPs and social work professionals on board with representation from MHA, MCD, MOE, AG's Chambers, the Juvenile Court, NYC and the National Council of Social Services. NYC provides the secretarial support.

As I informed the House in July last year, during the Committee of Supply debate, IMJD's approach is to, first and foremost, prevent youths from drifting into delinquency; secondly, take strict enforcement action against those who create law and order problems; and finally, provide rehabilitation opportunities for those who are amenable to change. MOE leads in preventive education, Police leads in enforcement efforts, and MCD leads in the rehabilitation of juvenile offenders.

The IMJD acts as a catalyst for multi-agency initiatives. It provides a platform for the agencies to exchange experiences and share knowledge. The Committee also identifies gaps in our matrix of measures and makes recommendations as to how these gaps may be filled, all of which functions Mrs Lim has rightly pointed out are very important. Since its formation in 1996, the Committee has coordinated about 20 measures on prevention, enforcement and rehabilitation which were mounted by the various Ministries and agencies.

Let me give you one example. One example is the StreetWise Programme that was implemented in October last year. This 6-month programme aims at imbuing life skills in youths who have drifted into gang activities through close supervision, night curfew, counselling, and other developmental training. To do this, IMJD has pooled together resources of the Police, MCD, NYC, VWOs and the courts. Another example which Mr Chen has mentioned is the Honorary VSC - teacher officer scheme where IMJD acted as a catalyst to synergise Police and the schools.

This multi-pronged approach is an effective one, one that has produced some results but, like I said, we have to continue to work at it. However, Wwhilst juvenile delinquency is under control, we cannot be satisfied with the results so far. As mentioned by both Mrs Lim and Mr Chen, all involved, including not just Governmental agencies, but and many people, indeed parents and the community in general, must press on by working together to reduce the numbers. Hence, in July last year, Police took several new measures - - it appointed 11 teacher officers as Honorary-VSC Senior Officers, itthey set up a Police Caution Cases Guidance Programme, together with MCD, and stepped up preventive education. Other partners in the IMJD have also launched new initiatives, such as peer mediation by the courts, Community Service Orders by MCD, promotion of mentoring schemes by NYC and issuance of guidelines on discipline by MOE. These are just some examples.

Mr Chen asked what else will be done. This year, we will assess these measures to see how their effectiveness can be further enhanced. Also, IMJD will consider new measures. For example, IMJD will discuss with Community Development Councils and see how they can help to reach out to youths, especially those who are out of school. Other areas where CDCs' involvement can be explored are in enlisting more volunteers, forming mentor groups and helping parents and youths understand each other better. At the rehabilitation end, Prisons will strengthen its reformative training Pprogramme. Likewise, I understand that MCD will strengthen its Boys' Home Pprogramme.

But Mrs Lim suggested setting up a single agency to trackp delinquents so that problematic juveniles can be identified for early monitoring and assistance. She suggested something like a central database. I am happy to inform Mrs Lim Hwee Hua that an Inter-Agency Work Group chaired by MCD, with representation from MHA, MCD, MOE, MOH, the Subordinate Courts and NCSS, has been set up to develop a centralised inter-agency database on juvenile pre-delinquents and delinquents. The participating agencies will transfer information on cases to the centralised database, which they can then tap on an on-line basis. This will facilitate the sharing of records for investigation and monitoring purposes, so that the necessary pre-emptive steps can be taken to help delinquents who need assistance.

But Mrs Lim in her speech also mentioned her concern about female juvenile delinquency. First, the numbers. The number of female juvenile offenders arrested actually fell from 737 in 1995 to 611 in 1996 and 582 in 1997. More than 80% were arrested for theft and related crimes, such as shoplifting. The number of female juveniles arrested for rioting in 1997 also decreased by 50% from 76 in 1996 to 38.

However, even with 1997's reduced figures, the numbers arrested are still double the 267 female juveniles arrested in 1991. Therefore, rightly, we are concerned. The efforts of the IMJD agencies may therefore have arrested the sharp rise in the early 1990s, but we must never assume that the decline of arrests over the last two years will continue. More importantly, the raw number of arrests may not fully reflect the peculiar charactistics of female juvenile delinquency, or indeed, its extent.

IMJD's comprehensive package of measures covers both female and male juveniles. What we will do in order to better understand the profile of juveniles who riot, their backgrounds, their motivation, their reasons, and so forth, is that IMJD has commissioned a study on juvenile fighting and rioting. We want to examine actual cases to look into the backgrounds, like I said, and the reasons for rioting and also whether or not they are aware of the possible consequences of their actions. The study will be completed by year-end and will provide useful inputs to agencies such as MCD, Police and NYC. One focus of this study will be on female delinquents. Female teenage delinquents may have problems peculiar to them as a group, and the study will bear this in mind.

Mr Kenneth Chen Koon Lap: Sir, the recent drug bust resulting in the arrest of seven drug traffickers is certainly a feather in the cap for the narcotic officers. In fact, a number of successful cases in recent months have been highlighted with large amounts of prohibited drugs being recovered. Unfortunately, this success story brings with it more worries than comfort. Because, if there is still such a great need for the supply of these drugs, then one can conclude that there must be equally greater demand. Therefore, I would like to know from the Minister why, despite our all-out efforts to combat this social menace and the heavy punishments we impose on drug traffickers, there are still so many drug trafficking cases. Would the Minister enlighten us on the latest number of new cases of drug addicts? Are they on the increase? And what about the repeated cases? If so, does it mean that our rehabilitation programme is not effective as we have anticipated?

I understand that the repeated drug addicts are subject to caning. How effective has this form of punishment proved to be? I also understand that these drug addicts are being treated with a drug called Naltrexone. Since this is a very expensive drug, has it been found to be cost effective and how is the recovery rate after they have taken this drug?

Mr Chng Hee Kok: Sir, last year, I raised in the Committee of Supply debate the issue of privatisation of non-essential law enforcement services. Sir, the Police Force, or Home Team, despite the new salary structure will continue to face manpower shortage. A police officer is a highly skilled and trained person. He needs to understand the law, how to apply the law, trained as a diplomat as he is in contact with the public and, at the same time, he must be physically trained to apprehend wrong-doers or perpetrators. Hence, the non-essential jobs outside the scope of the work of a police officer should be done by another agency or perhaps be privatised, for example, the role of the Traffic Police officer in issuing car park violations. This is not a Police function. Will the Minister highlight to the House the progress made in this area of privatisation of services?

Assoc. Prof. Chin Tet Yuing: Sir, our Traffic Police is a familiar and frequent sight on our roads and expressways. The officers maintain road discipline but other Members of the House have indicated or will indicate there is some concern over the rising number of accidents and other moving offences. The installation of red light cameras and speed cameras no doubt help in general traffic control. But we do seem to need more officers on highways to ensure a greater degree of compliance to traffic laws. Indeed, the existence of two types of traffic officers may give rise to some confusion. For example, those officers under the LTA are concerned principally with offences relating to overloading of trucks, emission violations or unlawful modifications to vehicles and motorcycles. They do not seem terribly interested in speeding cars or trucks. 2.45 pm

The Traffic Police, on the other hand, are responsible for the general conduct of drivers on the roads. I wonder whether it is not time to consider merging these officers, not physically but as a group, into a single body of men and women charged with the duties of enforcing all laws relating to vehicular traffic and rules of the road. Such officers could be trained specifically for the control of traffic and vehicles and for the investigation of road accidents, which is really quite different from investigating other crimes. Unless someone deliberately runs another down with an ulterior motive, road accidents are usually the result of carelessness more than anything else.

This brings to mind the training of the officers themselves. It seems unnecessary to train traffic officers for the general investigation of crime. If the officers are recruited specifically for traffic control, their training can, in fact, be faster and they can be put on the roads quicker to assume duties. The training can also be more focused. Criteria for recruitment may also change.

What all this leads to, if I may venture to suggest, is that it seems to be appropriate for the Traffic Police to come perhaps under the Land Transport Authority, although I wish to assure the Minister that far from it for me to suggest that he relinquishes part of his authority. It is a suggestion that it may be better for the Traffic Police to come under the Land Transport Authority, which already handles many duties relating to the road system in Singapore.

On the whole, I am sure that Members in the House will want to know whether there are steps taken to rationalise the regulatory agencies with regard to land transport in Singapore.

Mr Kenneth Chen Koon Lap: Sir, with all the traffic measures such as the introduction of speed traps, red light cameras, speed cameras, demerit points and the extremely heavy fines imposed on traffic offenders and the LTA's constant efforts to improve our road design and conditions, the number of traffic accidents still remains high, especially fatal accidents. I would like to ask the Minister whether the Traffic Police could make a study on the main causes of the various accidents that occur. Is it due to speeding or reckless driving? Or is it due to the lack of skill and experience of the drivers?

I understand that there is a high percentage of motorcyclists involved in traffic accidents. At times, I marvel at the dare-devil way motorcyclists weave their way through motorcars at high speed on expressways. I wonder whether they realise how close they are from encountering fatal accidents every time they do so. I would like to ask whether the Traffic Police would consider lowering the speed limit for provisional drivers and motorcyclists if they are found to be usually involved in the many traffic accidents. I hope that the Traffic Police Department can take the necessary measures to monitor the situation so that our roads can be made safer and unnecessary loss of lives can be kept to the minimum.

Mr Wong Kan Seng: Sir, first, let me deal with Mr Kenneth Chen's comments about the drug situation and whether all these success stories in the raids mean more worries because more people are still out there waiting to be caught. He heard that there are still more traffickers, because more people are demanding drugs and therefore the situation has not got better.

Let me assure him that CNB is also equally concerned about the drug situation, and that is why it hasthey have gone all out to take enforcement actions against people who perpetrate the use of drugs, traffic in drugs or take drugs. But let me assure him that the drug situation in Singapore is under control. We do not have as serious a problem as in many other countries. Just for his information, the number of drug addicts arrested has actually fallen from 6,160 in 1994 to 4,750 in 1997. The relapse rate of drug addicts has also improved. The relapse rate means that people who took drugs and after a period, they went back to drugs. This has also improved. It has declined steadily from 81% in 1994 to 56% in 1997.

But one indicator whether we are getting more drug addicts or not is the arrest of the number of arrest of new drug addicts, ie, people who are arrested for the first time. The number of new drug addicts arrested also registered a decline. Compared to 1996 when we arrested 1,420 new drug addicts, last year, only 1,130 new addicts were arrested.

Other indicators such as the continued high price and low purity level of heroin also confirm that the drug situation in Singapore has actually improved. The heroin purity level dropped to an all-time low of about 3-4% in 1997, compared to 7% in 1996. What this means, according to CNB, is that the drug suppliers, people who supply drugs to the addicts, are finding it more and more difficult to get drugs and therefore they reduce the purity level of heroin in the phials supplied to the addicts.

Sir, we have kept the drug situation under control through a multi-pronged strategy of preventive drug education, tough laws, strict enforcement, rehabilitation and after-care. The National Council Against Drug Abuse (NCADA), the Central Narcotics Bureau, the voluntary organisations, all work very closely together with the schools, the youth organisations, to organise preventive drug education talks. Anti-drug seminars, exhibitions, advertising campaigns are also conducted regularly to raise the public's awareness about the dangers of drug consumption. CNB has also kept up very heavy pressure on traffickers and abusers. In 1997, CNB mounted a total of 46 major operations which crippled 26 drug trafficking syndicates, and resulted in 2,150 arrests. It also conducted a total of 110 raids and checksed on night entertainment outlets last year. As a result of these raids, 200 people were arrested for ecstasy abuse, while two nightclub entertainment outlets had their operating hours actually reduced for allowing their patrons to use the place for drug taking. These raids serve as a very strong signal to the nightclub entertainment operators that it is their responsibility to help keep their premises drug free.

The Ministry will not let up on the strong enforcement actions against the traffickers and abusers. So far, just this year, three major operations have been mounted against the syndicates and four dragnet operations were also mounted against the abusers. 93 and 457 offenders respectively were arrested in these operations.

As some Members may have read in the papers in the last few days, Operation Phantom, which CNB mounted over the last few days, saw the biggest heroin haul from a single syndicate in its history that resulted in the seizure of more than 47 kg of heroin which is worth more than $2 million in the market. We also confiscated 116 phials of liquid ice as well as small amounts of cannabis and other kinds of drugs. A total of 29 suspects were arrested, of whom 10 may face the capital charge.

Since 1996, I have spoken several times of the Government's intention to take very tough measures against hard-core opiate addicts. Unlike what Mr Chen has understood, we have so far not caned repeated addicts when we send them to court. The law has not come into force yet. But the law will come into force when the new amendments are made in this Parliament some time later.

For these hard-core addicts, if they are convicted, they will be sentenced to a long term imprisonment of up to 13 years and 12 strokes of the cane. Feedback from the prison officers indicate that these announcements alone have had an impact on the DRC addicts. This is shown, for example, in the declining number of third timer and above addicts in the DRC. The number of third timer and above addicts fell from 2,850 in 1995 to 2,010 in 1997. In other words, fewer of the hard-core addicts are now under detention in the DRCs as a result of these announcements.

Rehabilitation and after-care is an integral part of the Ministry's multi-pronged approach towards fighting drugs. Our rehabilitation programme provides treatment and after-care support, and also employment opportunities for the released addicts. Under the community-based rehabilitation programme (CBR), more than 500 inmates have been emplaced on the Naltrexone programme since 1995. Mr Kenneth Chen asked about the success of the Naltrexone programme. It is too early to say how successful it will be, because the assessment time , which is the completion rate, is not due yet. It will only be in June this year. It is only after , after two years of being on the Naltrexone programme, that we will know whether or not they will go back to drugs. But so far, after completing one year without any breach of conditions, we have seen that more than 80% of them are still on the programme. This is a marked improvement compared to the 50% completion rate for the rehabilitation programme before June 1995.

Under the CBR programme, addicts are also released into the community, eg, into half-way houses to continue with their rehabilitation programme in a more supportive environment. Agencies such as SANA and SCORE are also providing counselling and aftercare services to these ex-addicts.

Providing employment opportunity is also an important aspect to the successful rehabilitation of the drug addicts. Agencies like SCORE have a number of schemes to help these addicts inculcate in them a strong work ethic and instill confidence and discipline in them, so that they can remain in the workforce. So far, 14,000 inmates and ex-inmates have benefitted from the SCORE's job placement services.

What sort of problems do we face in tackling this drug addict situation? The Government and its agencies and the non-Government agencies face two main challenges in tackling this problem. Firstly, they need more active volunteers to assist in the after-care of these discharged inmates. However good the rehabilitation programmes are, these programmes will not succeed unless the organisations have enough volunteers and counsellors who are dedicated and committed to the rehabilitation cause to implement these programmes. Secondly, the community must be prepared to re-accept into its ranks the ex-addicts who genuinely want to turn over a new leaf and give them a second chance. Ex-addicts who have strong support from their family members and their friends are those who are most likely to kick off the habit. Changing social prejudices and attitudes would take time, but it is something that we must continue to work at to help the ex-addicts successfully re-assimilate into our society. 3.00 pm

On the privatisation of services, Mr Chng said that police officers should not waste their training by doing things which are not germane to their training or mission. Let me assure him that the Police always reviews its services to make sure that the services itthey performs are in line with itstheir mission, and if they are not, itwe will find other agencies who are most capable of doing them. Since we train officers to a high level of efficiency and proficiency, we do not want them to perform non-essential functions which are not police functions. Then the police officers who are freed from all these non-essential functions can spend more time on crime prevention, investigation and maintaining law and order. For example, the Traffic Police has already privatised the towing of illegally parked vehicles to private contractors. ItThey no longer tows these vehicles away. The driving centres are also now privatised. Police used to run athe driving centre, but this has now been privatised. For big organisers who want to organise big events which involve a lot of people and they need crowd control, unless it is absolutely necessary for the purpose of maintaining law and order and the police hasve an interest in it, like a national function, we will also ask these organisers to employ their own guards to safeguard the place.

The police will also be reviewing other types of services to see whether they can be transferred to other Ministries or other agencies. For example, noise pollution. I know that from time to time residents would ring up and say, "This construction site is making a lot of noise. My neighbour is making a lot of noise. Please come and stop them from making noise." The police will not do that in future. The police will rightfully pass this on to the right Ministry to tackle noise pollution from construction sites. We also know that from time to time people will call up the police and say, "So and so urinates in the lift. Please come and arrest him." That again the police will also in future not do, and it will consider asking the town council or whoever that is the rightful authority to take over this task. For illegal parking in void decks, as Mr Chng said, weyou do not need a fully-trained police officer to book people for parking illegally. We will also consider passing this function to the right people. As I said, the police will continue to review its roles and functions to ensure that they stay focused on crime prevention and maintaining law and order.

Prof. Chin has asked about the Traffic Police department and whether the Singapore Police Force is really the right place for the Traffic Police to be sited in. He has presented a number of good reasons why the Traffic Police should be merged with the LTA. I am not averse to that. In fact, some time ago, I did study this and I did put up such a proposal to the Ministry of Communications and they declined. I think they have good reasons not to do it. I have decided to leave the matter be. But if the Ministry of Communications decides to take this over, I have no objection. I will leave it to them. But if Prof. Chin thinks that it is better to do so, I suggest he also takes it up with the Minister for Communications.

Mr Kenneth Chen is concerned about the traffic accidents and the number of traffic accidents that he reads about in the newspapers. He is concerned whether the Traffic Police has studied the causes of these accidents and whether it is due to the training of the drivers or due to speeding, or whatever reason. He has suggested lowering the speed limits for probationer drivers and motorcyclists. Let me just quickly give him some statistics on the causes of accidents.

In the year 1996 and also in 1997, the major cause of accidents is speeding, which accounts for at least a quarter of the number of accidents. The other causes are careless driving, inconsiderate driving and so on. Whether it is due to training or not, we know that when we go for training we obey all the rules and everything the instructor tells us. Sometimes, after we have passed, some of us do forget some of the rules that we have learnt and decided to take short cuts. I think all of us were taught not to speed. I am sure many of us do. All of us were taught not to beat the red light. I am sure that some of us also do. So really the responsibility is that of the driver.

But whether there is a serious concern about the number of accidents or not, certainly we are very concerned. Of the number of accidents we had last year, 257 people died as a result of road accidents and that number is slightly more than the previous year of 225. Of these 200-odd fatalities as a result of road accidents, about 110 of them are either motor-cyclists or their pillions. We are also very concerned about the motorcyclists because, of this number of fatalities of motorcyclists and pillion riders, about one-third of them are Malaysians who come here to work or visit people.

Certainly, his suggestion about lowering the speed limit by motorcyclists and also by probationary drivers can be studied by the police. But let me tell him that I have also asked them to do this some time ago and they have told me that it is really not so practical to enforce a lower speed limit for motorcyclists. You must be on the road all the time to be on the watch-out to make sure that they do not speed, and then you can book them. If you do not see them, they will be speeding anyway. Not just motorcyclists but also motor cars. So basically, we are talking about enforcement and to do this we need to have other means of helping the Traffic Police, particularly the mobile squad, in tackling this problem of speeding. One of the things that we will do is the installation of more speed cameras on our expressways. We have installed quite a number of speed cameras already and more such speed cameras will be installed.

The Traffic Police will continue to have campaigns to educate our motorists. and mMany campaigns are organised right through the year, whether they are drink driving campaign, don't drink and drive at the same time, don't speed, be more courteous, and so on. In a few months' time, we will organise another speed management campaign to raise the awareness of the motoring public of the dangers and consequences of speeding. But one effective way of dealing with people who speed is really to raise the penalty for speeding in terms of raising the demerit points and probably even raising the fines. The police is studying this. If, instead of 6 points for a particular offence or 9 points for a particular offence, thesey were to be increased the demerit points, then moreit will take the motorists will be taken off the road sooner than under the current system. The Traffic Police is also reviewing the Road Traffic Act to make sure that they are in line with the current problems that we face. If the law needs to be amended, we will certainly amend the law to make sure our roads remain safe for everybody, not just motorists but also pedestrians who form a significant group of people being killed on our roads.

The Chairman: Order. I propose to take the tea break now.

Thereupon Mr Speaker left the Chair of the Committee and took the Chair of the House.

Mr Speaker: Order. I suspend the Sitting and will take the Chair again at 3.30 pm.

Sitting accordingly suspended at 3.09 pm until 3.30 pm. Sitting resumed at 3.30 pm

[Mr Speaker in the Chair]

Debate in Committee of Supply resumed.

[Mr Speaker in the Chair]

Head Q (cont.) -

The Chairman: Amendment No. (1), Mr Ong.

Mr Ong Ah Heng (Nee Soon Central): (In Mandarin): Sir, according to the crime statistics released by the Police, last year's crime rate dropped by 5%, the 9th successive year of drop in crime rate. This is indeed something we can be proud of.

The Police Force plays a very important role in ensuring our internal security, just as the armed forces ensure our protection against invasion from outside. Once our internal security is threatened, not only will our people's daily lives be affected, the foreign investors will also be scared away. Therefore, the job of the Police is very important and very challenging. For this reason, while we need to attract talented people to join the Police Force, we must also find ways and means to recruit and retain the capable, experienced and dedicated policemen to keep up the good work of the Police Force and to ensure that the crime rate is kept under control.

Sir, at the moment, if young people who reach the age in which they are liable for national service join the regular police force, they will be exempted from national service after five years. If we are unable to retain these experienced police officers after they have completed five years of service, then we will have a rather serious problem at hand. We are losing experienced police officers. The Police Force will have to recruit new officers and train them afresh. Training will take quite a period of time, and the operations of the Police will surely be affected. What we are worried is that more and more young people are enrolling in the Police Force as an alternative to national service. As soon as they have completed their mandatory period of service, they will leave the Force. Recruits with `O' level passes who have not completed their national service, get a starting pay of $1,350. On the other hand, those who go for 2 1/2 years of full-time national service in the army are paid some $200 to $300. So from the financial point of view, it is very attractive for these national servicemen to join the Police Force, because they can get better pay. But the question is: after five years, how do we retain them in the Police Force, and make them take Police as a life-long career? If we cannot retain them, then the Police Force will face the question of manpower shortage every year.

Sir, I feel that the Police can consider the following suggestions:

Firstly, apart from adjusting the pay for the Police officers, we must also increase various kinds of allowances, eg, shift allowance, children's education insurance or dependants' allowance. Police officers will not have to worry about their families when they carry on their duties.

Secondly, we must extend the five-year Police service bond in order to be eligible for exemption from national service. I understand in the recruitment exercise last year, for the 700 vacancies, there were only 300 applicants. About 88% of them were more interested in exemption from national service than service in the Police. So if we extend this five-year qualifying period for exemption from national service, then we will be able to attract those people who are genuinely interested in joining the Police Force rather than those who are only using the 5-year stint as a means to avoid national service. In this way, the Police will be better able to do their long-term planning for manpower and training.

Thirdly, we know that the retirement age for junior officer is 45. I know that many junior officers who have reached the retirement age do not want to remain in the Police Force. Our retirement age at the national level is 60, and will be extended to 62. I think retiring police officers at 45 years is a waste of manpower. The Police should review the conditions of service and to persuade those with a good service record to continue serving in the Police Force. They can put in another 17 years of useful service to the Police Force.

Sir, we all know that the Police job is a very challenging one. Our security, our children, our family's security are all dependent on the Police officers. They are the pillar of our social order and discipline. We need capable and experienced officers to stay in the Police Force to lower our crime rates and to ensure our safety and security. But when they enforce their duties, they have to risk their lives. So we must give them better pay and better care. I think this is something worth our consideration.

Mdm Claire Chiang See Ngoh (Nominated Member): Sir, I would like to ask the Minister if a central database on spousal violence and child abuse cases is now set up within the operation unit of the Police Force. I am not referring to the archival database on dysfunctional families established by MCD nor the quantitative large-scale data survey that they are collecting at this point. I am referring to operation data which will enable police officers to better protect victims with children, at the same time closely monitor perpetrators' violent behaviour. This idea was first mooted by the Ministry in 1995.

The police operation data is important for four reasons: (1) clearly establishes patterns of criminal behaviour over time on where, when, what and how the crime was committed; what age groups, ethnic groups and kind of dangerous weapons used.

(2) Capturing data helps guide intervention, policy formulation, as well as identify the appropriate security measures and case management decisions. Let me give an example. If we only know the total number of rape cases and not indicate the age groups of the victims, we may be misguided in the way we plan our community crime prevention programmes. If the age groups of victims are older, a community-based prevention campaign, with the support of all forms of media, is more suitable to help increase awareness of this threat. To combat teen rape, however, the target should be aimed at school teenagers and street youth gangs. Teachers and youth groups have to be mobilised to talk to school teenagers about threats and self-protection. In police training, soliciting information from a teenager is a different experience from investigating an adult victim. The police therefore needs to know the trend and focus their training in developing different sets of interviewing skills.

(3) Enhance coordination with FSCs. With the amendments to the Women's Charter now implemented and the setting up of island-wide networking loop initiated by MCD and MHA, police officers now have additional network channels, through FSCs, to enforce case management. It will be helpful if the data captured by the Police could be electronically e-mailed to select FSCs appointed by MCD to take in police referrals on spousal violence and child abuse. Then together, both FSCs and the Police can reinforce protection to the families.

(4) Similar cross-checks on victims and their case history can be effectively achieved by electronically linking up the island-wide Police network of NPCs and NPPs to guarantee fast response to, and close monitoring of, high-risk individuals.

I seek the Minister's urgent attention to this matter for the purpose of enhancing policy formulation and enforcing good practices.

The Chairman: Would you like to move on, Mdm Chiang?

Mdm Claire Chiang See Ngoh: I would like to ask the Minister in the planning for the Community Focused Plan to assure effective community intervention programmes, if he would consider employing social workers in the Police Force, as done in the courts, hospitals and schools, for the following two reasons:

One, cross-boundary skills enhance police enforcement duties in difficult family disputes such as spousal violence and child abuse; similarly, in traumatic cases like rape. The argument is, by combining the efforts of the social workers and police during investigation in such cases, both groups can add value to the assessment of the case by offering varying imports gathered from their respective training. This effort is particularly helpful in cases where criminal evidence cannot be established, yet expert opinions are needed to help assess the risk levels of families in crisis.

The job of the Police is not merely to prosecute but to protect. Where prosecution evidence is lacking, protection to victims must still be assured, and I argue it takes a trained skill from a counselling background to observe the signs and cues of potential hurt faced by the family members. By reinforcing the criminal processes with psycho-socio inputs during investigation, we help to moderate the too often cited criticism that the Police, in the handling of family cases, is too focused on prosecution procedures and less on victim protection. In rape cases, in particular, the victim is in traumatic state. By clearly establishing the investigation roles of police enforcement officers and police social workers, the former to adopt a line of questioning to establish facts on the act of violence and the latter to restore the emotional state of the victim through a counselling line of questioning, two sets of information can be examined in parallel for a more judicious appraisal and judgment of the case. Over time, social workers and police officers, working under one institution and guided by the standard operating procedure, could develop an understanding of their complementary roles of police and social workers throughout the investigative process, and then establish a shared foundation for criminal investigation work in family and rape cases.

The second reason is, at the community level, with the implementation of the amended Women's Charter last year in areas of spousal violence management, police officers now will collaborate with social service agencies in a networking loop to refer victims for counselling. Within the framework of this new operation guidelines, Police social workers can play a key role of being the networker and liaison case workers with FSCs. In a way, the Police social worker becomes an institutional broker by increasing police awareness and usage of community services and promoting police-community relationships.

Sir, these are not new ideas. They have been tested in other countries. The shortage of social workers is a definite challenge. But if we should let the market of supply self-regulate, the Police Force may pick up the professionals who decide to leave the social service sector. Anyhow, if we recognise this principle as good in itself, we should lead the way and find solutions.

I hope the Minister will study this idea and let it germinate to assess its applicability in our context. 3.45 pm

Mr Simon Tay: Sir, my cut concerns the Registry of Societies which comes under the Ministry. My cut starts from the call by the Prime Minister in this House last year for a civil society, that the Government's wish and vision for Singapore in 21st century is to have a strong people sector with self-responsibility by citizens, self organisation by citizens, andkeeping self-help from many helping hands. I think this is pertinent this year when we look at the coming bad times.

Sir, people need to organise for a common cause. Societies, clubs and associations need an institutional framework. Article 14 of our Constitution gives them the fundamental right to assemble and associate and the laws provide that without registration as a lawful society, they may be guilty of illegal assembly or other offences.

Sir, the present laws do allow citizens to register as societies with the Registrar of Societies. But the present laws also give a very wide discretion to the Registrar of Societies whether to register them. Clause 4 creates exceptions for issues, such as security and national interest. I do not urge that these principles are wrong. These principles are right. But the law, as it stands, does not allow for delay in registration almost indefinitely, and it gives a very wide discretion to the Registrar and the Ministry based on the possibility that something might go wrong, not a reality. As an example, if I may draw from my own experience with the Roundtable of which I am a member, it took this society two years to be registered.

Sir, the actual number of such delays in registrations may be small but I believe there is a perception among citizens that there could be many obstacles into registering societies. For example, it has been observed in some reports by international NGOs that there are no human rights societies in Singapore. And this is clearly an ill perception because Singapore, in recent years, has acceded to human rights treaties and has in its Constitution, fundamental liberties.

So my cut proposes to suggest to the Minister that it is timely to change the laws and change the functions of the Registry, ie, to keep the discretionary powers of the Registrar to the minimum, to set a time limit for the Registrar to respond yes or no. A, and it is my hope that registration of societies, clubs, this people sector, would become automatic for Singapore citizens with a minimum of discretion, such as you are not a bankrupt or suffer from some other basic disqualifications. This analogy for automatic registration is not without precedent. It can already be done for the registration of private companies, for businesses. Should not the people sector be as free as businesses?

Sir, in making the suggestion, I am still mindful that a society once registered would still be subject to other laws on security, public order, etc. This is not a situation of free licence. It is merely to give a licence to register. Perhaps, the role of the Registry of Societies should be changed to one that is more supportive and nurturing rather than policing, one that is like the National Council of Social Services, supporting charities. The Registry of Societies should, in my view, allow, promote and facilitate civil society groups.

Sir, there are already many obstacles to self-organisation by citizens - time, work and other exigencies. The Minister and the Ministry would help us move towards civil society in the 21st century Singapore by allowing the registration of societies to be amended in the way I have suggested.

Mr Wong Kan Seng: Sir, first, let me answer Mr Ong Ah Heng's question about extending the minimum term of engagement of those national service liable persons who serve in the Police Force. NS liable persons are allowed to serve not just in the Police Force but also in the Singapore Armed Forces as well as the Singapore Civil Defence Force. The minimum period is really five years, that is, about double their NS full-time liability. The minimum term of engagement (MTE) for Police was reduced from eight years to five years to attract more of such NS liable persons to join the Police Force. In the past, we had eight years. I think the results were not that good and that is why we decided to bring it down to five years.

These MTE police officers play an essential role in ensuring the safety and security of Singapore and their contributions are no less than those who serve the full-time NS in the SAF, the Police or the Civil Defence. They have chosen to serve their extended period as regulars in order to fulfil their full-time NS obligations. But when they leave after five years of the MTE, they will be liable as operational ready NSmen and their training which they receive while in full-time regular Police Force will not be wasted because they will still have to do their NS while in the Police.

Contrary to Mr Ong's impression that many of them left the service after five years, the statistics do not seem to show that. Between 1984 and 1992, an average of 67% of those who served their NS under the MTE scheme remained with the Police Force. I think that is a pretty good retention rate. Many of those who did not stay on decided to go for further studies or have found other jobs, which is quite natural for Singaporeans. If they want to find something else to do, they will do so. So I do not think there is a need therefore to extend the MTE beyond the five-year period. A better approach would be to encourage these officers on the MTE scheme to remain by offering them a more fulfiling job, enlarged job, better training, more satisfying opportunities for career advancement and give them competitive terms and conditions which we have recently done. Hopefully, with all these measures, they will remain with us. But even if they were to leave, it is no loss because they will continue to be liable for NS under the law.

Mr Ong's suggestion about rehiring those junior officers who retire at the age of 45 is already being done. For oOfficerss whose performance is good, we will ccontinue to re-employ them on contract. So long as they are operationally efficient and continue to be able to do their best, we will give them a job.

Can I just deal with the point which I forgot to answer Prof. Chin just now about electronic surveillance in HDB estates, car parks, void decks, and so on. We do not see a major need in this area. But I know that in some HDB estates, they already have such security systems. In Bedok, for example, there is a system where the residents can help to monitor themselves. But if there is a need and the community feels that there is a need, the Police will help them set up such a system. The Police will not be able to invest resources and money in setting up the system. But in places where we have a large congregation of people from time to time and we need to find a way to effectively police the area, the Police is considering having a mobile surveillance system. For example, in Little India or in places where large crowds of people gather, the Police is thinking of buying the mobile surveillance system to help them with the Police work. I will leave it to Prof. Ho Peng Kee to answer the other questions.

Assoc. Prof. Ho Peng Kee: Sir, first, let me take NMP Mdm Claire Chiang's point. Mdm Chiang asked if a central database on family violence cases can be set up. I am pleased to inform her that the Ministry of Community Development is leading a task force, comprising representatives from MHA, Police, Ministry of Health and the National University of Singapore to develop a central database on abused victims and family violence cases. The online database will not only facilitate research into family violence cases but will also assist frontline officers from MCD, Police and the Health Ministry in the operational work. I think this was her concern. It should not be just an archival database, but one where the parties can tap online to help them in their work. I understand that MCD has established the basic requirements of the database and will commence its study on the systems design soon. Police will do its part in the context of this Committee and I will ask them to bear Mdm Chiang's points in mind.

The other suggestion that she made is whether MHA could consider employing social workers in the Police Force. Sir, our response is that it is not really necessary for Police to employ full-time social workers as cases requiring social work expertise occur sporadically. Police is nevertheless prepared to consider making arrangements with voluntary welfare organisations to have social workers on a standby basis to assist Police as and when needed. Instead of Police employing social workers full time, a better approach and a more effective one in the longer term is for Police and social workers to develop a good and close working relationship with one another. I am glad that, and indeed this has been so. T, this collaboration and synergy has evolved steadily, especially overfor the last three years, and I believe with Mdm Chiang playing a part in bringing this about. Police and social workers now cooperate and coordinate closely with each other at both policy formulation and ground operation levels. At the policy level, the Director of Operations of the Singapore Police Force chairs the Women and Family Violence Committee, comprising members from MCD, MOH and VWOs, such as the Singapore Council of Women Organisations and the Society Against Family Violence. The Committee sets out and reviews the work processes of various agencies involved in managing family violence. It also serves as an avenue to explore new strategies to handle family violence.

On the ground level, medical social workers refer suspected abuse cases to police officers stationed in hospitals. Police officers also work with social work counsellors when investigating rape, juvenile delinquency and family violence cases. Police have also worked out guidelines to deal with family violence cases jointly with relevant agencies, such as MCD and the VWOs.

Mdm Chiang talks about the Community Focused Plans that the Minister for Home Affairs has mentioned earlier on. Every Neighbourhood Police Post (NPP) is linked to a Family Service Centre to which the NPP can refer victims of spousal violence for counselling and conflict resolution. But besides responding to cases, managing the scene of incident, investigating and prosecuting offenders, the police officers also advise victims of spousal violence on the courses of action available, such as the taking out of Personal Protection Orders from the courts. In addition, Police can arrange for the victim and the offending party to undergo conflict resolution and recommend recalcitrant cases for court action. This is one of the refinements Police has made in dealing with family violence crimes and victims of such crimes, something again introduceddone over the last two to three years.

Mdm Chiang talks about the need for police officers and social counsellors to understand each other's mindset so as to be able to effectively work together. She is probably also aware that police and social workers conduct cross- training programmes for one another. For example, Police has conducted lectures for social workers and MCD staff on police procedures and handling of family violence cases. Likewise, the Society Against Family Violence has conducted workshops for police officers to equip them with the relevant knowledge and skills in dealing with abuse cases, such as family violence. Such cross-training has helped the police and social workers to better understand each other's role in handling of family violence cases.

Sir, we feel this is a better approach. To find ways to strengthen these working ties between police and social work agencies. It produces all the benefits that Mdm Chiang has talked about, and more, better synergy and complementarity can be found this way than by the Police Force employing its own social workers. This approach, we feel, taps diverse community expertise in different ways of counselling and fosters community involvement and ownership. 4.00 pm

Sir, let me now respond to Mr Tay's point as to whether or not the Registrar of Societies' discretion can be kept to a minimum. First, let me say that the objective of the Societies Act is to ensure that groups which may pose a threat to public order and national security interest are not allowed to establish themselves in Singapore. I am sure Mr Tay agrees with that objective.

The Registrar of Societies does not really have a wide discretion to reject applications. Under the Societies Act, the Registrar can reject an application when the group is likely to be used for unlawful purposes, or for purposes detrimental to public peace, national security or national interest. But let me assure Mr Tay that the Registrar exercises this discretion judiciously and will continue to do so. And indeed this springs from Article 14 that he talked about. Article 14(2)(c) also mentions the need for parameters.

Mr Tay brings up the point about delay. I think it is a point taken. In fact, MHA has been monitoring this. As Members know, MHA has been asking its agencies to serve the public better and, certainly, we have asked them to facilitate applications. Sometimes, of course, delays are caused because when the ROS makes inquiries, the applicants take some time to come back. So it is not entirely the fault of the Registry. I think it is a point well taken. We will certainly take that into account. And indeed we have acted on it as shown by because of a recent measure that we introduced. Now, the Registry of Societies provides applicants with a draft constitution based on model rules, because some applicants may not be very clear as to how to proceed to apply. The Registry would readily approve any application which adopts the draft model constitution provided as long as the society is not set up for unlawful or unacceptable purposes. Any proposed society which feels that its application has been unfairly treated may appeal to the Minister for Home Affairs for further consideration.

Sir, this approach that we have adopted does not really run counter to efforts to build an active civil society. In fact, it can be said that this approach really keeps at bay those groups whose formation will pose a threat to the interests of an active civil society.

Mdm Claire Chiang See Ngoh: The on-line database that was set up by MCD has taken some time to realise. I would like to know whether the Police itself has its own operation database. How is it tapped and whether we can get information from it when we need? That is my first question.

Assoc. Prof. Ho Peng Kee: This on-going project was not really a recommendation of the Ministry of Home Affairs. I think in her speech, she said that we had suggested it. It was a recommendation of the inter-Ministry work group on family violence chaired by the then Deputy Secretary (Home Affairs) made in December 1995. And then a task force was set up under MCD because the committee felt that MCD was the best agency to drive this project. The delay was caused partly because, originally, it was conceived as an archival type of database - which I am sure Madam Chiang agrees would not be of much use - and then it was to converted it into an operational database and that delayed it somewhat. Let me assure Madam Chiang that the project will now proceed at a clip. Like I said, the police will do its part to input whatever information that it can and then I am sure this collective effort of all the agencies in building up this database will advance the cause of victims of family violence in Singapore.

Mdm Claire Chiang See Ngoh: My question is: at the current moment, how is the Police keeping its operation database on family violence cases and child abuse? Do you have your own Police operation database?

Assoc. Prof. Ho Peng Kee: Yes, we have our own.

Mdm Claire Chiang See Ngoh: Sir, for the last 4-5 years, since 1992, I have been coordinating training classes for the Police on rape, and it is through that experience that I have learnt about the challenges between social workers and the Police Force. And that is precisely why I am suggesting employing social workers in the Police Force because of the turfs and the institutional barriers which have been established. Even as I walk in with all my front-line agencies to the training, I feel the "we" and "them" boundary. Although we try very hard to merge our mindsets and try to use the best of our competencies to investigate and manage a case, nevertheless, the police feel that we are so different. But for five years, I think we have achieved a certain level of rapport and I thank the Minister for giving us that opportunity to get entry. If we cannot get social workers in, as he has suggested, could the police then look into the training curriculum and inject more components on counselling principles and the rest of it?

Mr Simon Tay: Sir, first of all, I am very heartened to hear from the Minister of State that there is an on-going attempt to speed up the process of the Registry of Societies. I want to know whether there is a set goal. Assuming that the group, of course, responds duly, how quickly would the ROS take to complete the whole process?

Assoc. Prof. Ho Peng Kee: To some extent, it will depend on the objectives and purposes of the society. I think if there is any delay, it would be caused more in terms of the ROS examining the objectives of the society. We, like I have said, have asked the ROS to have its own parameters, its timeframe. We monitor these goals very carefully. There are set timeframes.

Mr Shriniwas Rai: Sir, further to what my friend, Mr Simon Tay, has asked, I think Singaporeans, by and large, would be grateful to hear of the announcement by the Minister that it would take a shorter period. In cases where people pose no security risk to the State, would there be a framework, say, within six months? Because I find that it is easier to get other societies registered in Singapore within three months. Why not cases of civil societies which are going to contribute to the growth of civic societies in Singapore? The example of two years is unbelievable. I know the Ministry is trying to reduce it. But if all the relevant information is given, could the Minister of State assure the House what is a fair timeframe to work on?

Assoc. Prof. Ho Peng Kee: Sir, it depends on the nature of the application, but I think 3-6 months would be a fair timeframe to work on.

Mr Chng Hee Kok: Sir, before I withdraw my amendment, I shallwould like to bring the Minister back to the question of privatisation of services. Since the Ministry of Communications is not taking over the Traffic Police, will ould the Minister still consider that perhaps the issuance of notices for illegal parking may be privatised or transferred, let us say, to the HDB or URA which have car park wardens who can be trained to do such a job?

Mr Wong Kan Seng: For illegal parking in HDB estates, the HDB wardens are already doing that. If it is illegal parking along our roads, we will have to look at the Road Traffic Act and find a way to delegate or empower other groups to do the job. We are looking into that.

Mr Chng Hee Kok: Sir, with the reassuring note of the Minister on the efficacy and efficiency of the Home Team, I am quite sure that we all can rest much easier now. On this note, I beg leave to withdraw my amendment.

Amendment, by leave, withdrawn.

The sum of $1,131,351,310 for Head Q ordered to stand part of the Main Estimates.

The sum of $898,425,200 for Head Q ordered to stand part of the Development Estimates.

Head P

The Chairman: Head P Ministry of Health. Amendment No. (1), Mr Bernard Chen.

Mr Bernard Chen (West Coast): Sir, I beg to move,

That the total sum to be allocated for Head P of the Main Estimates be reduced by $100.

Sir, the issue of the supply of doctors and nurses to meet increasing demand for health care in Singapore has been raised many times in this House. The White Paper on health care has spelt out the strategic direction which will establish Singapore as a quality medical centre, not only for our people but also for those who may come to Singapore to seek medical treatment.

The success of this programme depends critically on the number and quality of the medical staff we can harness. Increasing enrolment in NUS and the Ministry's move to attract foreign doctors and nurses in the last few years will go some way to meet this demand. Would the Minister inform the House the progress made in meeting these targets?

The regional economic difficulties have prevented many people from the countries in the region to seek treatment in Singapore. I understand that some hospitals which cater to foreign patients have already taken steps to downsize the facilities. And doctors who look after foreign patients have also reported some heavy losses in business. The question, of course, is whether the present downturn is temporary and would, therefore, not affect the longer-term demand. Can the Minister comment on the impact caused by this current drop in demand?

Mr Goh Choon Kang (Maarine Parade): (In Mandarin): Sir, over the past few years, private hospitals havemedical practice has developed quite rapidly in Singapore. Some of these hospitals medical practitioners have already evolved into medical groups and they are continuously expanding their scope of practice. One of these groups has even become a public-listed company. I feel that the development of private hospitals medical practice may result in some brain drain of Government doctors and nurses to the private sector, causing acute shortage of medical staff in the public and restructured hospitals. The Chairman of the GPC for Health has already mentioned that admission for medical students in NUS is quite restricted. This may be another reason for the shortage of new supply of doctors. Apart from all this, I think there may be a question of income gap and the work pressure, etc., which have resulted in the migration of Government doctors and nurses from the Government hospitals to the private sector.

Sir, in our GPC's visits to the polyclinics and hospitals, we discovered that one of the clinics which was supposed to be staffed by 12 doctors had only 7 on duty, a shortage of 5 doctors. The same situation applies to nurses. I think this may be a question of social status, remuneration, workload, etc. We should seriously look into the situation and try to find some solutions to resolve the matter. Otherwise, there may be some negative results or undesirable consequences.

Firstly, for existing doctors, I think their workload is much too heavy, and at the same time, this in turn may affects their morale too. Secondly, there will be a longer waiting time for ppatients. And finally, oOn the whole, the quality of medical service will be adversely affected. I understand that the total number of doctors has been increasing every year. For example, in 1987, we had 2,940 doctors. In 1992, we had 3,960 doctors. Last year, we had 4,916 doctors. In 1987, the doctor/patient ratio was 1:940. In 1992, it was 1:800. In 1997, it was 1:760. I believe that by the year 2010, our target is 1:650. What plans do we have in hand to train more doctors or to have more doctors?

In terms of nurses, right now we have about 14,000 nurses. But by the year 2000 we will need another extra 3,000. So I would like to know whether the Ministry of Health has any measures to solve this problem of shortage in nurses.

Right now, our medical infrastructure is very advanced and quite good. We have a New Changi Hospital, and the new Tan Tock Seng Hospital is already under construction. To develop Singapore into a regional medical centre or medical hub, I believe we have all the necessary hardware. But in terms of software, there is still room for improvement. Can the Minister please tell us what plans the Ministry of Health has in place to resolve all these problems? 4.15 pm

Dr Lily Neo (Kreta Ayer-Tanglin): Sir, it seems that there is an enigmatic exodus of doctors from our public hospitals every year. This has led to a shortage of doctors and a vacuum of continuity in terms of teaching from the seniors to the juniors in these hospitals. We should try and clear this problem promptly, especially when our healthcare facilities are in the midst of rapid change for the better. Before going on further, I would like to state that I am a doctor in private medical practice and do not have any direct or pecuniary interests in this matter.

Firstly, the shortage of doctors in the public sector has to be resolved. This shortage means over-working the doctors in the hospitals. Job-satisfaction is lost and morale is diminished. This, Sir, is not fair to the doctors and is also not good for the patients. The quality of care that we expect in our hospitals may not be maintained, let alone improved, under these circumstances. Unsatisfactory work-terms must be the reason for the often-mentioned exodus of doctors from Government service for private practice. What are the problems facing the doctors here? Perhaps the following factors ought to be looked into:

(1) Unmatched long and tedious working hours in relation to remuneration. Well, this will always be a stumbling block for the public service. However, it should be the easier of the problems to resolve, and it should be resolved in conjunction with a whole new attitude towards the healthcare service in Singapore.

(2) Uncertain prospects for their future in the public sector. The consideration of a lower income potential together with the fear of being phased down at a time when the energies are lower for striking out in the private sector, may be a reason for people to leave public service sooner than later. Perhaps the solution here may lie with softening the line of demarcation between the private and the public sectors of our health service. Allow the more senior doctors a choice for proportioned and responsible commitment in both sectors if they wish.

(3) The medical officer dilemma. What options are there for the senior medical officers? If not private practice as a general practitioner and if not into a specialist trainee post, what is there which the public sector can offer on a longer term basis? There is a need for some sort of career enhancement in this aspect. Perhaps, a new work schedule, a new pay scheme and a new hospital status could create a new mindset and a new breed of doctors. If more medical officers can be induced to stay back because they can see a worthy future as a career medical officer, there will be a resultant positive effect. There will be less on-call nights, less pressures in not being speciality trained, less urgency to leave for full-time general practice. In this latter aspect, perhaps the more senior ones may also be given a choice for proportioned and responsible private sector as partners or as locums in the GP clinics.

Secondly, the often lamented vacuum of continuity in the teaching of junior doctors by the more senior ones in the hospitals can worsen. The teaching and training of our junior doctors needs to be maintained or our standard of healthcare will be severely compromised. The deficiency of capable teachers can only be resolved if:

(a) the system allows for more scope and better rewards for those who like to teach and to do research, and

(b) more senior doctors who need to explore their prospects in full-time private practice are obligated to contribute a certain amount of their time towards the public sector.

Sir, we are a small and unique nation. We are more amenable to change things for the better, of course, without disrupting the lives of too many people. In terms of healthcare, I feel that to further integrate the public and private sectors and to have them functioning cohesively, would be a worthwhile change for our people.

Mr Choo Wee Khiang (Jalan Besar): Sir, let me first commend the Minister for Health for having taken prompt action to meet both the short-term and anticipated long-term shortfalls in healthcare manpower. I note that the intake of medical students into NUS was increased from 150 to 180 last year, and will be further increased to 200 this year, so as to meet the increased long-term demand for doctors as our population grows older. I also note that our public sector hospitals have been actively recruiting foreign-trained doctors and nurses in order to supplement our local supply of healthcare professionals and meet the current shortages.

However, I learn from recent press reports that the regional economic crisis has been taking its toll on the healthcare institutions. Private sector hospitals have reported decreases in their occupancy rates. I have also read of private sector specialists who say that they are seeing fewer foreign patients now than they used to.

Sir, in view of the fact that overall the demand for healthcare services appears to have declined, I would like to ask the Minister for Health whether his Ministry is rethinking its long-term strategy and projections for the supply of doctors and nurses in Singapore.

Firstly, will the increase in the local supply of doctors and nurses result in an oversupply, in view of the current economic climate?

Second, does the Ministry of Health have any plans to reduce the foreign intake and recruitment of both doctors and nurses? If not, foreign doctors and nurses may end up competing with our local doctors and nurses for work when overall demand for health care goes down.

I hope the Minister will clarify these two points.

Mr Bernard Chen: Sir, in the past several years, we have seen an increasing number of specialised medical centres being established. We have now in our midst the National Heart Centre, National Eye Centre, National Skin Centre, the new KK Women and Children's Hospital, just to name a few. There is logic in setting up these centres, as they concentrate specialised expertise under one roof, which should also help to lead to better treatment and facilitate research. There are, however, two effects which need to be addressed. First, how do we reconcile treatment by these centres and those currently done in other general hospitals? While we can say, for instance, that the paediatric cases can be handled by the KK Women and Children's Hospital, how do we deal with specific paediatric cases which have to be handled in the other general hospitals? The same, for example, can go for heart cases, especially when the patient has multiple illnesses and cannot be wheeled from one hospital to another. How do we ration the manpower required to handle the treatment in different places?

Second, the standalone facilities with their sparkling new facades and very tasteful designs will give an impression of high cost treatment. In reality, specialist treatment, of course, will cost more. It will be helpful if the Minister can give an explanation on this and assure the public that the treatment costs at these centres are fair and reasonable and, if higher, whether they can be justified by higher value-added service?

Sir, can I go on to the next topic?

The Chairman: Yes.

Mr Bernard Chen: On the school health programme, early this year the GPC for Health visited the Institute of Health, which implements the school health programme. I must say that we are very impressed by the comprehensive range of services rendered to our school children, especially in respect of preventive health care. I believe that the school health programme is little known to the public outside the schools. The contribution of the staff involved should be properly recognised. I think it will be good if the Minister can give a brief account of the school health programme that is being implemented at the moment and inform our people the good work that is being done.

Encik Ibrahim bin Othman (Bishan-Toa Payoh): Sir, I join my Chairman in commending the School Health Service for having a very good and comprehensive health programme for our students in schools. The major types of health programmes, namely, health screening, immunisation programme and health education ensure that our school children are well looked after and they grow up to become healthy citizens.

Sir, presently, our school children undergo screening at Primary 1, Primary 6 and Secondary 4. These health screenings assess their nutritional status, their growth and development, their vision and any other health problems. These assessments, I believe, are very useful, as we can detect early any health problems faced by our children, and thereafter we can take remedial measures.

I wish to ask the Minister whether the Ministry has any plans to conduct yearly health screening for our school children. If not, could the Ministry perhaps consider having additional screening at these Primary 3 and Primary 4 levels and also at Secondary 2.

Sir, one of the health problems amongst children is myopia. I wish to ask the Minister whether the Ministry has any health education programme to advise our children on myopia so as to prevent more of them becoming myopic. Further, Sir, I wish to ask the Minister whether the School Health Service screens students in our junior colleges and institutes of technical education. If not, could the programme be extended to them too?

Mr Choo Wee Khiang: (In Mandarin): Sir, we always say that for the nation to be strong we must have strong people. We always say children are the future masters of the nation. We all know that we must have a healthy body and a healthy mind in order to get things done in the best possible manner.

In Singapore, have we done enough to develop ourselves into a nation of healthy people? This is a big question, particularly on the health of our children. Every year we invest a lot of money on education. However, are we spending enough on the health of our children? When I look at our little boys and girls running about in my constituency, many of them are chubby and cute. But a few years later, when they grow older, they have a good chance of turning fat and overweight. Obese school children seem to be a common sight nowadays. If we are going to spend so much money on education, yet unable to cultivate our children into boys and girls, then we would have lost the meaning of our total education.

I am told that when children are overweight, they are less fit, and the majority of overweight children are not doing well in their studies. So we should do something about it. Looking after the well-being of the children is also a responsibility of the Government. While giving them a good living environment, we should likewise give them strong bodies so that they could learn and grow up to be useful citizens of Singapore.

Every year, the Ministry of Health is spending only $11 million on school health services. Assuming that there are half a million school children, we are spending only about $22 per year on each student. I feel that this amount is grossly inadequate. So I would like to ask the Minister for Health what plans has the Ministry to ask for more funds for their officers to provide better preventive health service to our students. For example, I heard that in many schools, they are engaging some medical and physical education experts to guide the teachers and students on ways of healthy living. In this respect, the Ministry of Health should help by providing more resources for the schools to improve the general health of the students. 4.30 pm

The Minister for Health (Mr Yeo Cheow Tong): Sir, first, I would like to thank the MPs who have spoken. On the first cut, four MPs have spoken on manpower supply of doctors and nurses. Mr Bernard Chen has asked for a report on the progress that we have made in meeting the manpower targets, in terms of supply of doctors and nurses. And he is also wondering what is theits impact of from the current downturn in foreign patient load. Mr Goh Choon Kang has asked what are the plans for solving the manpower shortages that we are facing in both doctors and nurses. Dr Lily Neo is also worried about the exodus of doctors and wants to know what we are planning to do, whilst Mr Choo Wee Khiang is also concerned about the downturn in the economy and impact on the private sector, and what we are doing to reduce the intake of foreign doctors and nurses.

Sir, these are different perceptions from different angles. I would like to assure Mr Bernard Chen that the steps that I mentioned last year in this House for increasing the manpower supply are being taken. The first step, of course, is very important - increasing the intake of medical students from 150 a year to 180 in the 1997 intake. But I think it will be also useful for me to briefly recap the four key factors underpinning medium to long-term health manpower projections, because, unless we keep these in mind, we will not be able to appreciate what the Ministry is doing.

Sir, first, is that patients' expectations will continue to increase. Singaporeans are better educated, and they are better informed. Increasingly, doctors tell the Ministry that patients and their families insist on being told exactly what is the diagnosis, what is the treatment being rendered to them, and what are the implications of the treatment. This communication programme is a very good one. But, unfortunately, it is also very time-consuming and therefore it will increase the need for doctors in the years to come.

Secondly, aging population. With the number of elderly increasing, the demand for doctors from the elderly population will also increase.

Thirdly, medical research. This is also related to what Dr Lily Neo has said. It is important that we focus also on medical research in our medical institutions. This will allow us to remain at the forefront of medical development as well as to ensure that we are able to maintain a high standard of medical care.

The fourth is, of course, foreign patient load. It has gone down now. But I think once the regional economies recover, the foreign patient load will also rebound.

Sir, the first three factors are definitely not affected by the downturn and, therefore, we should continue with our present programme to increase the supply of doctors. The impact of the economic turmoil, in fact, in terms of the Ministry's manpower supply, has in fact been positive. The resignations of specialists from the Government hospitals has, in fact, declined slightly. For example, last year, in February and March, the two months, we lost a total of 14 specialists. This year, for the first two months, that loss has been reduced to eight. So I think the trend is quite encouraging.

In terms of actual plans to address the shortfall, whichat Mr Goh Choon Kang has asked for, I would like to break this into three different categories which are very important: the medical officers (MOs), the specialists, and the nurses.

For MOs, last year, I announced the improvement in terms of service. We have implemented that. We have adjusted their salaries, we have adjusted their pay scales. We have also improved the work environment. Last year, I mentioned about the night calls being very onerous. We have reduced the number of night calls from between eight and 10, to six now. So it is a significant reduction. Furthermore, we have also tried to match the postings of the medical officers with their interests. So if a person would prefers to work normal office hours, then we try to make sure that the person is posted to a polyclinic which operates during the normal office hours. If a person has a certain interest in, let us say, the elderly, then we also try to make sure that we are able to give the postings that fit in with that particular doctor's interest. And I believe that if we can do this better, it is not always possible to match perfectly, but if we can improve on the matching, then I think the long-term ability to make the job more interesting for the MOs concerned would be there, and therefore the long-term ability to retain them would also be there. Of course, we are recruiting talent from abroad. The healthcare sector in that respect is following what the other sectors of the economy have had to do - recruit talent from abroad. And I must say that the recruitment results have been encouraging. We embarked on that last year.

I am happy to inform the House that last year alone we managed to bring back and recruit a total of 160 medical officers and housemen. In previous years, we were only able to get about 50 a year. So last year, with the concerted efforts, we have tripled the results. I do not think we can maintain this level, because what we did was in reaching out. We are also able to reach out to Singaporeans who were already working abroad and therefore we brought them back. That pool will dwindle in years to come. What is also interesting is that one-quarter of the 160 are non-Singaporeans. So, in fact, we have been able to widen our talent pool. And as a result, we have managed to reduce the shortfall in the medical officers. The shortfall now is a very manageable 61.

We will continue to encourage Singaporean doctors to return. We will continue to have regular dialogues with our medical officers to understand what interests them and help them to do their career planning. And I believe that with this concerted effort, we will be able to continue holding on to more MOs and therefore reduce the shortfall in the coming years. Once we are able to do that, then I think the problem that Mr Goh Choon Kang brought up just now, that in the polyclinics that he visited, with a planned manpower of 12 doctors, we were only able to supply seven - . I think if we are able to hold on to more MOs, we would be able to ensure that the polyclinics will be fully manned in the next few years.

Specialists - this is a very crucial group, because specialists do not only provide service but, as pointed out by Dr Lily Neo, the senior specialists are also teachers of our future generation of doctors. Therefore, it is important that we try to retain the better ones of the senior specialists. But having said that, I want to also ask the House to remember that there will always be a turnover of doctors and specialists in the hospitals because if we have, let us say, 200 doctors graduating each year, and we train half of them as specialists, it is not possible for our public sector to retain all the 100. So it is good, in fact, to have some turnover to ensure that the public sector is not bloated and also to ensure that the private sector is not stifled.

The public sector, as at the end of 1997, is still short of 70 specialists. The figure is an improvement over the year before. At the end of 1996, we had a shortage of 84 specialists. We were short of 84 specialists. So it is an improvement. And, again, the existing shortage is mainly in two areas - anesthesia and diagnostic radiology.

As a short-term measure, we are asking the restructured hospitals to continue recruiting from abroad to make up for the shortfall. And we are also reaching out very actively to the private sector to encourage those who are practising in the private sector to devote some time in the public sector institutions, do some service, conduct some teaching, and if they are interested in research, we are also very happy to involve them in our research activities.

In terms of retention, it is not possible for the public sector to pay the same amount as what private sector specialists can earn. In fact, we have not paid close to what they are able to earn in the private sector. But because of the need to ensure that the better ones are retained, it is important for our payment system to ensure that our leading lights are able to earn more and that the gap between what they can earn versus what they can potentially earn, if they went out to the private sector, will be closed or reduced. This is something that we are looking at very actively now and I think we should be seeing some change in the coming months.

As for the overall environment, it is something that we are also looking at actively - how to make sure that the teaching is more meaningful, more satisfying, and also how to ensure that we have adequate research funds for them. Because at the end of the day, this is what distinguishes institutional practice from private sector practice - the teaching and the research. In terms of research, we are now making available more funding for research and we are asking the hospitals to set aside protected time to enable those doctors who are interested in doing research to actually conduct the research work.

I believe that with all this, we would be able to better retain an adequate number of specialists to serve in the public institutions.

Sir, nurses - the shortfall is still very significant, unfortunately. Last year, we managed to increase our nursing manpower by 400. But, unfortunately, the shortfall has increased from 6% to 8%. And this is because the opening of the Kandang Kerbau (KK) Women and Children's Hospital and the New Changi Hospital have resulted in an increased demand for nurses. We have opened more wards and therefore the two hospitals have had to recruit more nurses.

The national shortfall in nurses is expected to be about 1,300 between now and the year 2000. What are we doing to resolve this problem which has been with us for a long time? Sir, first, we are intensifying efforts to promote nursing as a career of choice. As you all know, there are tremendous career opportunities available now to our young girls and boys, and nursing will have to make a strong bid for their attention and a strong bid for their decision. So we are doing career talks and exhibitions. And I think the results over the past two years, in terms of enrolment in the diploma course in the polytechnic, had been encouraging.

We are also recruiting from abroad for the time being. It is very essential. Because it takes three years to train a nurse. Shortage is with us now. Service is being affected. We need to recruit progressively. And last year, in 1997, we had one of our biggest recruitment drives. We managed to recruit 800 nurses from abroad. They mostly come from the Philippines, India and, to a small extent, China. 4.45 pm

Sir, over the longer term, we are also looking at the fundamentals. To achieve that, we are now carrying out a strategic review of the nursing profession. The objective is how to make the profession, as a whole, more attractive, more challenging, more satisfying. We have set up a task force in November 1997 to look into this and we expect the task force to complete its work by the end of May.

Sir, let me now move on to the next cut by Mr Bernard Chen. He asked how do we reconcile the treatment in the national centres versus other hospitals and his concern as to whether the medical centres will in fact result in higher costs and therefore higher fees for patients. Sir, in order to discuss the first point on how we reconcile the treatment, let me first explain that the national centres are not meant to replace the existing departments in each of the hospitals, for example, the National Heart Centre. The National Heart Centre will coexist with the Heart Department in NUH and in fact will provide support to the other hospitals, in terms of providing expertise and working with them on their patients who have heart problems. For most cases, because Singapore is very compact, the existence of a national centre will not impact on the safety of the patient. Let us say a patient has a very serious heart attack and requires a bypass. Because Singapore is so small, even if a person is staying in the eastern part of Singapore, it will only take about 20 minutes to go by the highway. In the meantime, the paramedics would be able to stabilise the patient. And if the patient decides to go to, let us say, New Changi Hospital which should be the nearest, the hospital staff there would be able to stabilise him and get ready for a bypass operation, if need be, in the Singapore General Hospital or NUH. So the centres will coexist. But more importantly, the centres will allow us to optimise the use of our limited resources.

Singapore, having a small population, also implies that the rarer and more complex cases would be fewer. Rather than having these rarer and complex cases split over several centres and each centre not having enough of the critical mass to develop the expertise, what we will do is we will now be able to coordinate and ensure that these more complex and rarer cases are centralised in one centre so that the chances of developing in-depth skills will be better improved. What we are also doing is that we are reaching out to the private sector practitioners as well as practitioners in other hospitals and encouraging them to come forward and be dual- appointed. This means they can have their appointments where they are but also receive another appointment at the national centre so that those who are interested and have some expertise in treating those more complex cases can also now come to the national centre and have the advantage of a bigger patient load. So it is a win-win situation for both the specialists involved as well as the patients who have such conditions. Also, it will help the profession greatly. Because by having the leading specialists being affiliated to the centre, we will also be able to upgrade the standing of the profession as well as better facilitate and coordinate the development programmes for that specialty. It would also enable us to come out with, what you call clinical pathways, ie, for certain complex conditions as well as other commonly encountered medical conditions, a guideline on how that condition should be best treated. In this way, the patients will get the best possible treatment and hopefully the most cost effective as well.

Will the centres result in more costly treatment? Sir, the answer is no, because already at the present moment, the fees charged in these centres are exactly the same as those charged in the other restructured hospitals. But of course sometimes the perception could be that the patient goes in and the bill size is a lot bigger. But that is because patients going to the nationalmedical centres tend to be patients with more complicated conditions and therefore they are subjected to more tests and the result is a higher bill size. But the point is that if they had gone to an existing department, the same tests would probably have had to be conducted. So in terms of costs, the answer is no. If you are able to now consolidate the pool of expertise and come out with more cost effective treatment protocols, over the long term, we should be able to see a better control on our healthcare costs.

Sir, I would now like to ask my Senior Minister of State to reply to the last part.

The Senior Minister of State for Health (Dr Aline K. Wong): I would like to thank Mr Bernard Chen, Mr Ibrahim Othman and Mr Choo Wee Khiang for their interest in the school health programme. As Mr Bernard Chen said, this part of the work of the MOH is not very well known. In fact, thisits work has been very much taken for granted.

The school health programme is one of the strategies to achieve our Ministry's mission to promote good health and reduce illness. The health promotion and preventive health programmes reach out to children when they are young and they help to lay a firm foundation for good health. This would bring long-term benefits to the population. MOH will continue to place great emphasis on such programmes.

The School Health Service (SHS) reaches out to about half a million students in our primary and secondary schools, junior colleges, Institutes of Technical Education and Sspecial Sschools. Mr Ibrahim Othman asked whether the School Health Service covers the junior colleges and ITE. My answer is yes. They are already included in our programme. The SHS provides three major types of health programmes for the students: health screening and follow-up care, immunisation, and health promotion and education. These programmes are conducted in the schools by visiting school health teams and are also provided at the Student Health Centre at the Institute of Health.

Health screening. A full medical examination is given to our students at Primary 1, Primary 6 and Secondary 4, as noted by Mr Ibrahim Othman also. They are given to students at these levels by doctors and nurses who assess their nutritional status, that is, to see whether they are overweight or underweight, to see whether they are growing and developing at the appropriate pace, to check on their eyesight and on any other health problems. In addition, Primary 1 students also undergo hearing tests. Primary 4 students are given a spinal screening in order to exclude a curved spine and students at all the levels are given an annual vision test. These medical examinations and screenings are given at important stages of the child's development. It is not necessary to give a full medical screening every year. This is the opinion of the medical profession. Students who are identified with health problems are referred to the Student Health Centre for further assessment and follow-up management.

At the Student Health Centre, there are clinics for students with nutrition and weight problems, eye and hearing problems, growth and development and adolescent problems as well as heart and spine conditions. Visiting specialists to the SHS will attend to the more complex cases. If students still require further assessment and management by specialists, they are referred to the appropriate hospital department. After the health screening, feedback is given to the schools. So if there are certain students in the school who require special attention or exemption from some school activities, such as PE, then the principal would be notified.

Immunisation. The school health teams visiting the schools administer immunisations against the major communicable diseases including diphtheria, tetanus, polio, measles, mumps, rubella and tuberculosis, according to the Childhood Immunisation Schedule. About 95% of the students are covered.

Health promotion and education. The School Health Service also carries out a lot of health education activities on leading a healthy lifestyle, on eye care, personal hygiene and other topics. The school health teams work with the schools in health promoting activities, such as the school environment, canteen or tuckshop and also on parent education. For some years now, MOH has also assisted the Ministry of Education to incorporate health education into the school curriculum.

Sir, our students are generally healthy. The school health programme has greatly contributed to this happy state of affairs. However, among our school children, myopia and obesity are still common health problems. In fact, in 1997, about 48% of the students have shortsightedness and 12% of the students are assessed to be overweight. What do we do about this? We educate the students, the parents, the teachers and the public on these two health problems. Our strategy for control is to prevent, detect and also correct the problems at the early stage.

For myopia, MOH has set up a Vision Care Committee and this Committee has drawn up guidelines on measures that can be taken by various organisations to prevent myopia. And based on this Committee's guidelines, MOE has embarked on a programme to ensure better lighting in the classrooms. All primary schools have also introduced the eye relaxation programme and this is being extended to the secondary schools as well.

As for obesity, MOE, as you may be aware, has for a number of years implemented the Trim and Fit scheme which emphasises physical activities and proper nutrition. Within the school health service itself, we have now a Nutrition Clinic which runs a structured obesity management programme for students who are moderately or severely overweight. We also plan to conduct an education programme for parents of moderately and severely obese children because, very often, the parents themselves pamper their children. They are not necessarily convinced and during school holidays, they feed them with all kinds of junk food. As a result, children will come back to school gaining weight again. So we are trying to educate the parents also.

The SHS is able to do all these programmes and keep our school children healthy at a budget of $11 million per year through careful planning and efficient scheduling of activities. In health care, more spending does not necessarily equal to better care or better outcome. In fact, I think for $22 per pupil, we have done so many marvellous things. We will continue to maximise our resources and study ways of providing a high standard of preventive health care for our students. We may also consider extending such health promoting activities to the pre-school age group because some of the health problems like myopia and obesity also affect them.

Mr Bernard Chen: I am assured by the Minister's remark about the need for continued facilities in the hospitals for specialised treatment. But in our visits to the hospitals, there was some concern expressed that too much emphasis would be placed on the centres, and hospitals like the New Changi Hospital or the upcoming Tan Tock Seng Hospital would give up these traditional specialised facilities. I hope the Minister will look into making sure that everyone gets a fair share of things. 5.00 pm

On the question of obesity, I understand that in some schools, school children have been asked to forgo food and drinks during recess time. Instead of having a bowl of noodles, they have to exercise. Apparently, some parents are a bit anxious that their lovely children are prevented from having their bowl of soup or noodles. I do not know whether this is the right way to go about things. Maybe that is better for them.

Mr Choo Wee Khiang: Sir, I would like to ask the Minister whether there is a brain drain problem in terms of foreign recruited doctors and nurses. Is there an contractual agreement between ourselves and the foreign recruited doctors? Because I am worried that after having a short stint in Singapore, they learn a lot from our medical services and then leave somewhere for good. I am actually concerned about it.

Secondly, are there records to show that foreign recruited doctors have left after a short stint of service in Singapore?

As regards obesity, I wonder whether the Minister will consider sending booklets on obesity to hawkers and fast food operators to tell them what have they done to our young people. Twelve out of 100 is actually a very serious thing.

An hon. Member: The parents should not send them there!

Mr Choo Wee Khiang: Okay, send the booklets to parents also.

Mr Sin Boon Ann (Tampines): Sir, a point of clarification before the Minister answers the question. I think the earlier remark made was that we recruited 160 doctors in our recruitment drive overseas, of whom a substantial number were Singaporeans. Will the Minister please clarify on the number of Singaporeans who qualified as doctors from overseas? How many of them actually failed to gain admission to our local university in the first place?

Mr Yeo Cheow Tong: Sir, first, on the point brought up by Mr Bernard Chen that some of the hospitals are concerned that their traditional specialist areas may be jeopardised. There are two different types of acute hospitals. One is the tertiary hospitals which would be mainly SGH and NUH, where we have a significant number of specialties available in those hospitals plus super specialisation. And we also have the regional hospitals which reach out to the broad general public. The aim, as has been spelt out in the 1993 White Paper on Health Care, is that in view of our compact size and in view of our small manpower and patient pool, it is important for us to ensure that, on the one hand, we do not over provide; and, on the other hand, have such a dispersion of specialties that each of the departments now ends up with a sub-optimal patient load. Therefore, the regional hospitals, like New Changi Hospital, Tan Tock Seng Hospital and, Alexandra Hospital, will continue to have general departments of medicine and surgery, and they will also continue to have an ability to focus on one, two or three specialties.

It does not mean that they are going to stagnate there, because the population profile would change over time and, together with that, the change in the medical condition and the demand for medical care. For example, heart. New Changi Hospital (NCH), at the moment, does not have a heart department, because in terms of the present supply of service, both SGH and NUH, together with the private sector hospitals, are adequate. But we are prepared to let the National Heart Centre (NHC) provide some supporting services in NCH and allow NCH also to develop some service up to a certain level of complexity, ie, check-ups, perhaps even some interventional work, but definitely not by-pass operation. So we have to balance, on one hand, the aspirations of the doctors and hospitals; and, on the other hand, we have to balance against the national interest, which is how to make sure that we do not unnecessarily duplicate both expertise and equipment which are very expensive. So it is a continuing balancing game that we have to play.

Mr Choo Wee Khiang asked about the brain drain, whether we have a contractual agreement and are we seeing a lot of foreign doctors leaving. Is he talking of bond-breakers?

As regards contractual agreements, I believe most of the doctors are recruited here and offered contracts over a certain number of years. So there are normally contractual agreements binding them.

Should we worry about the brain drain? I think it is a toss up. If we are worried about the brain drain and we do not go out to recruit foreign doctors, then we end up with an ever bigger shortage here, which must impact on the quality of care and result in long waiting queues of patients. Our experience has been that most of the foreign-trained doctors do sink their roots here after a few years, because the practice of medicine is a very personal thing. After practising here for a few years, they develop close links with a certain group of patients and it does not make sense to give up that goodwill which they have built up over the years. So many of them do sink roots and settle down here.

Mr Sin Boon Ann has asked about the 160 doctors that we recruited last year. Three-quarters of them are Singaporeans. That means 120 are Singaporeans. As regards whether we know how many of them were trained abroad because they could not get into NUS, unfortunately, I do not have the information.

Dr Lily Neo: Sir, can I make one clarification? Can the Minister tell us whether the hospital doctors are now given the correct recognition and time to do research and teaching?

Dr Tan Cheng Bock (Ayer Rajah): Sir, I just like to ask the Minister how many of the 160 doctors who were recruited were from the approved list of medical schools.

Mr Yeo Cheow Tong: Sir, in response to Dr Lily Neo's question, whether our senior doctors are given adequate R&D time, unfortunately, since R&D has not been a major focus in previous years, we were unable to give protected time to many of those who were interested in research. Our plan now is to recognise that research is an important pillar of institutional practice and therefore we would ensure that funds are available to enable those who are really interested in research to have enough protected time to conduct research and enough funding to employ supporting staff to help him or her in the research project.

Dr Tan Cheng Bock asked whether the 160 doctors recruited last year are from the recognised medical schools. The new schedule was effective end-1993. So anyone who enrolled in those medical schools before end-1993 will still qualify. Since this is 1998, and they were recruited in 1997, I assume that they had enrolled in the medical schools under the old schedule, before the new deadline took effect.

[Mr Deputy Speaker in the Chair]

5.10 pm

Dr Tan Cheng Bock: Sir, if we are so short of doctors, would the Ministry then consider expanding the approved list of medical schools, so that we can have a bigger intake of doctors? The present list is quite narrow. Does the Minister like to expand that list?

Mr Yeo Cheow Tong: Sir, as I explained last year, since the list was drawn up on certain assumptions that, on the average, we are enrolling about 50 Singapore students under that list of approved institutions, we should spend some time observing what is the actual outcome. Our preliminary findings are that, in the first two years alone, since the new schedule took effect, the approved medical schools have already been taking in about 50 students a year. Our expectation would be that in the coming years, the enrolment of Singapore students in those schools is likely to pick up. And, therefore, the enrolment will actually exceed what we have projected in our manpower planning.

At the same time, we have already proceeded to increase the intake in NUS; the 180 this year which will be increased to 200 this year. And if the need arises, we will be quite happy to discuss with NUS on the possibility of increasing the intake further. But let us spend some time to watch the trend before deciding what to do again.

Mr David T. E. Lim (Aljunied): Sir, may I ask a follow-up question on the specialisation of hospitals? The New Changi Hospital when it was built, I think it had provision for paediatric facilities. As I understand it, these are not going to be used for the time being, but they would be concentrated at the new Kandang Kerbau Hospital.

In the case of paediatrics, I can understand if a child has a hole in the heart that having a specialised team might provide better care. But if a child falls down and breaks a bone and needs to be hospitalised, having a hospital nearer to the community may be more convenient to the parents. I would like to ask the Minister whether he would consider allowing some paediatric facilities still at New Changi Hospital, because it will serve the catchment out in the eastern part of Singapore.

Mr Choo Wee Khiang: Sir, I would like to seek clarification from the Minister. Foreign-trained doctors actually come from the recognised institutions. But I do not think nurses fall under this category because we recruit nurses from all over the world. I just wonder whether, as a result of recruiting so many nurses from overseas, our service standards will be affected or impaired.

Mr Yeo Cheow Tong: Sir, Mr David Lim asked whether we could consider allowing NCH to have a department of paediatrics. As I mentioned just now, Singapore is an extremely compact country. On the PIE, from one end of Singapore to the other, it takes about 45 minutes. I think now with the road expansion works that are going on, once they are completed, the travel time may be even shorter.

The concern here is that, as I have stated, how do we make sure that we do not end up dissipating our limited resources with a balance? When NCH was planned, it was very clearly pointed out to the hospital that the existing Toa Payoh Hospital departments will be transferred to the New Changi Hospital, and that the development of new departments there, especially departments of specialties, will have to be approved by the Ministry. This is because if, left to themselves, every hospital will want to have the whole complete range of specialties plus, if you have that piece of equipment, they will say, "I better have one too." That is the surest formula to a high cost type of healthcare system. We have learnt from the other countries how to avoid that and how to ensure that there is enough central control on development while giving each hospital maximum flexibility and autonomy to operate efficiently within their areas of purview. 5.15 pm

Sir, in terms of paediatrics, it is an on-going request from NCH. Our reply to NCH is, "Let the consolidation of paediatrics in the new KK Hospital be completed first." If need be, once KK Hospital has settled down, I am sure KK Hospital will be very happy to provide a satellite operation in NCH. So in due course that will be done.

As for nurses, because of the large number of foreign nurses here, as I have stated just now, 12% are foreign nurses. Has the large number of foreign nurses here jeopardised our service standards? I would like to assure Mr Choo Wee Khiang that the Singapore Nursing Board takes a very cautious approach. Before we embarked on a recruitment of foreign nurses, we consulted the professionals oin the Board and they came out with their conditions and standards. Not only that, they also went to the key countries of recruitment to get acquainted with the key teaching institutions so that they understand what are the methodologies, the curriculum and, more importantly, the actual practice of teaching what is claimed in that nice little booklet which all institutions give out. So we have gone through the quality audits. Not only that, when the nurses come to Singapore, we counsel them. The Singapore Nursing Board also conducts a test on their competency and, quite often, this takes the form of a written test. So there are a lot of stringent requirements in place already to ensure that our high standard of medical care is not in any way compromised.

Dr Tan Cheng Bock: Sir, I think what Mr David Lim wants is an assurance from the Minister that in the case of a paediatric emergency, could the New Changi Hospital at least take care of that patient for just that emergency period and later you can do the transfer? I think he must give the Singaporeans staying in that area the assurance that in such an emergency, a hospital of that size must at least be able to take care of that sort of emergency, and not let the poor fellow run all the way to KK Hospital. Am I right, Mr David Lim?

Mr David Lim: May I add on a word or two first. I thank Dr Tan for speaking on my behalf. I am not a doctor, so I do not know this matter as well as he does. Actually, I take it from a more practical point of view. I must declare my interest. New Changi Hospital is in my ward. I have spoken to my constituents and they had been looking forward to this. It is so much more convenient for them. Although Singapore is small and it takes 20 minutes to get from Simei, where the New Changi Hospital is, down to KK Hospital by car, it takes much longer by public transport. It is much more difficult for young parents who may have other toddlers to tag along to make that trip. So it is just to serve the community better and not for the hospital administrators, not so that the hospital can have one more feather in its cap, but more for the benefit of the people who live out in the east.

Mr Yeo Cheow Tong: Sir, let me respond to the two points. Dr Tan was speaking on behalf of Mr David Lim. I do not know whether I should reply to Dr Tan or Mr Lim. Let me assure Dr Tan that all emergency cases are stabilised in the receiving hospital before they are transferred to the hospital with the relevant expertise, whether it is paediatrics, a head injury or a heart condition.

As I have mentioned to Mr David Lim, this will be done in due course. Give KK Hospital a chance to consolidate what it is doing. I am sure that the CEO and the doctors of KK Hospital will be very happy to spread their wings.

Mr Goh Choon Kang: (In Mandarin): Sir, in 1993, we set up Medifund. To the poor people it is a very important fund because people who really cannot afford the medical fees will be able to apply for grants from this Medifund. The fund also ensures that no citizen in Singapore will be deprived of medical care just because he cannot afford to pay for the medical fees.

In 1995, there were over 40,000 applicants. In 1996, there were 56,000 applicants. Last year there were around 50,000. Funding from Medifund came to about $10 million. According to the statistics, more than 90% of the applications were approved. But I understand that many citizens still do not know of the existence of Medifund, or they do not know how to go about applying for the fund. Many of them approached their MPs for assistance. Generally, all the PAP MPs know how to assist them. I am not sure about the Opposition Members.

In fact, these people can apply directly to the hospitals. They can also apply for Medifund through the CDC. I hope the Government can step up the publicity on Medifund for the benefit of the ordinary citizens.

The second thing I want to point out is that since 1993 the Government has already injected $600 million capital grants into Medifund. Because the fund is financed from the interest earned from the capital grant, the capital will not be used up. In 1993, it was $200 million, and from 1994 onwards it was $100 million per year, making a total of $600 million. This year, no grant is provided because of financial difficultiesturmoil and economic slowdown. I hope the Minister can give us an assurance that in future years when the economy improves, the Medifund will continue to be topped up.

Mr Sin Boon Ann: Sir, the Medical Endowment Fund or Medifund is an endowment fund set up in 1993. The initial contribution of $200 million was made by the Government, after which an additional $100 million was added to the endowment fund by the Government for each of the following three financial years, bringing the total endowment fund to $500 million. The purpose of the Medifund, Sir, is to assist needy Singaporeans to pay for medical care.

I believe Medifund is the most obvious expression of the promise by the Government that no Singaporean will be deprived of healthcare for lack of financial means.

Sir, I note from the latest annual report of the Ministry of Health that there were about 58,000 applications for Medifund assistance and of which 99.4% were approved. The total amount of Medifund help given amounted to $12.4 million. Unless I am wrong, most of the applications for Medifund assistance came through screenings carried out by hospital social workers. If true, some measure of screening would already have been carried out by the medical social worker and the figure of 0.6% of the applicants who were unsuccessful may be higher.

My question to the Minister is whether medical social workers at hospitals screen potential applications before they apply for Medifund assistance. If so, whether there were many potential applicants who were turned away at that stage, with the result that there could be a higher figure than the 0.6% as listed in the annual report.

My second question, Sir, is whether the Ministry will consider making the process of applying for Medifund assistance more transparent so that applicants can know in advance what criteria apply and whether there are avenues available for an appeal to be made in the event that he or she is unsuccessful.

Dr Lily Neo: Sir, at the moment, the use of Medisave is limited to payment of expenses in the acute-care general hospitals. The use of Medisave should be extended to bona fide MOH-approved nursing homes.

Sir, I would like this House to consider the following often mentioned factors:

(a) We are now expecting people to live longer, even beyond 80 years of age. As such, there will be an increasing number of patients with chronic illnesses and most of them would be requiring mainly, if not, only care in nursing homes. Using Medisave and MediShield would certainly ease the heavy burden tremendously.

(b) Obviate the need for some patients opting for the more expensive hospital beds. The general preference of most Singaporeans using Medisave instead of cash is indisputable and understandable. Just so that the bill may be paid through Medisave, an acute care bed is wasted and at higher cost too.

(c) The general and even the community hospitals would have lesser problems at discharging the less critical cases. The patients and their families would be happier because there is, at least, some sort of continuing care made available to them.

Sir, in view of the above considerations, may I urge the Minister for Health to look into this matter.

Sir, may I continue with my next cut on affordability?

The Chairman: Yes, carry on.

Dr Lily Neo: A crucial dilemma which many of our people, especially in their old age, may face in the future will be the effects of having insufficient funds to meet the cost of health care. This can happen in spite of the Medisave and the MediShield schemes which we have in place even as of now. This is due to the fact that people are going to be living longer and healthcare costs are undoubtedly going to be higher. Furthermore, we do not have in place the kind of financial support needed by the increasing numbers of chronic sick in those institutions where, at the moment, Medisave and MediShield cannot be used.

Sir, this problem has to be looked into now and we must come up with the solutions in good time. The Medifund, set up by the Government not too long ago, is one step in the right direction. However, further steps must be taken or we will need huge increases in Medifund and other subsidies, at the expense of the next generation, to cater for the progressive demands of good healthcare for all. This can become a problem so large that the undue economic burdens placed upon the Government and the future taxpayers become untenable. Will we always have the economic success to guarantee that no Singaporean will be denied of medical care due to the lack of means? Are we prepared to become a healthcare welfare state? No. 5.30 pm

Just one episode of severe illness requiring intensive care and recuperative stay in hospital can cost more than $10,000 even at current C-class bed charges. For those with chronic illnesses, substantial amounts of money may be needed for fairly frequent long term hospital stays. Sir, at the moment the total amount of Medisave which our CPF members need to set aside is $20,000. If these CPF members are also covered by MediShield, they can claim a maximum of $20,000 per policy year and $80,000 per lifetime. This means we can have one category of people having, at best, access to $100,000. We have also to consider two other categories, those who cannot accumulate enough Medisave and those who are already retired, both of which not having that much access. Now, if people are going to be living maybe 20 years beyond their retirement age, the very finite amount of $100,000 from their combined Medisave and MediShield, for future use, may not be enough even at current rates. As healthcare cost, in dollar terms, will definitely increase, there will be heavy dependence on the children's funds or the Medifund. It is not good to leave such a legacy for our children and country.

Is having more Medisave the solution? I do not think so. For a start, the majority of people would be reluctant to put more money aside through compulsory savings. Should we raise the MediShield coverage? This is a possibility. But, it is likely that this expenditure may just overburden the subscribers. It is unlikely that any simple increases in payment will go down well with the people.

Sir, I propose that we consider MEDICARE as a further counter before turning to Medifund for help. The difference between MediShield and MEDICARE is that the latter will be insurance derived from a co-payment scheme with the Government and it will be cost-index linked. Perhaps such co-payments may be made by the children on behalf of parents who are near or past retirement age. These features should make this health insurance more acceptable to the people and they could be persuaded to take up this extra expenditure. Sir, the main point here is for us to have enhanced health insurance for our people at affordable rates and to spare the use of Medifund for the truly deprived.

Making the public aware and more responsible for their own healthcare will be the key to successful implementation of healthcare planning for the future. While the three `Ms' (Medisave, MediShield and Medifund) can take care of almost all our needs, complacency and allowing things to remain status quo cannot guarantee us affordable healthcare in the longer term.

Mr Choo Wee Khiang: (In Mandarin): Sir, I agree with Dr Lily Neo. What she said is reasonable and she has a valid point. She actually looks at the long-term point of view. But I am looking at what is immediately in front of us.

Right now, we are facing a regional financial and currency crisis. To many people, it is a very sudden and hard blow because they really do not know what hit them. In this economic turmoil, many countries around us have to tighten their belts and some countries, I believe, have told their government departments to cut down on expenditure. I know of one country in Southeast Asia where even the Ministry of Health was ordered to cut down on expenditure. It is an across-the-board cut of, say, 12% to 15%. Under the circumstances, the quality of their health care service will surely be affected.

In Singapore, our Budget is a prudent one. But at the same time, I hope that in the exercise of prudence in our Budget, we will never, never neglect the healthcare for our people. We should not cut down on our healthcare expenditure. This is because, crisis or no crisis, nobody wants to fall sick. However, should somebody fall sick at this time of crisis, of course, he hopes to be able to get the appropriate treatment in time. At the same time, when he is receiving his treatment, he also hopes that he can afford to pay for the medical fees and expenses that follow.

I hope that our Singaporeans will not say, "Don't fall sick in Singapore. It is more expensive to fall sick than to die!" I hope the Minister for Health can assure that this is not the case. During this turmoil, when we are tightening our belts, we are cutting down on our expenses. At the same time, our Singaporeans, especially the lower-income people, can be assured that their medical care and medical treatment will not be affected by this current turmoil. I hope the Government can step forward to assure these poor Singaporeans that notwithstanding the turmoil, they can continue to afford and enjoy good healthcare services in Singapore.

Mr David Lim: Sir, the point which I wanted to raise concerns the standards of nursing care, a question that my colleague, Mr Choo Wee Khiang, has already touched on. However, I would like to elaborate. Before I do so, I would just say that the standard of healthcare overall in Singapore has risen over the years and that this is due in no small measure to the dedication of the doctors, the nurses, the administrators; indeed, all the people who work in this industry. But it is a manpower intensive industry. And because of this, we do need people to get the job done.

The Ministry of Health has over the last few years brought in foreign nurses to meet the current shortage that we have in nursing staff. And this has given rise to a number of concerns:

(1) Some foreign nurses speak little or poor English. Although they may be able to read, their grasp of conversational English is poor. This makes patient-nurse communication difficult, at best, and suspect from time to time. The concern raised is that miscommunication over critical issues, such as medication, may result in harm to the patients.

(2) Some nurses may not be exposed to the same level of technology in their home countries. Here the concern is that they may not be using medical equipment properly, and may make mistakes in setting up the equipment or devices. This may lead to erroneous test results, or to wrong treatment.

(3) Another concern, which may or may not be due only to the employment of foreign nurses, relates to lost records. I have heard some complaints of medical records being misplaced or lost. For example, patients have been told that their test records are missing, and they have to redo the tests all over again. This cost is not just in time to redo the tests, but also the trauma of the patient and the time lost in treating the illness.

Sir, we welcome foreign talents to work in Singapore because they create even more opportunities for Singaporeans. Each job they hold means that several other Singaporeans will also have jobs. And indeed we cannot have excellent hospitals, world-class hospitals, without nurses, and without the nurses our best doctors would not be performing surgery here but they will perform surgery in London or in Houston.

It is therefore not whether we should have foreign talents or not, but rather how we ensure that standards are not eroded. I would be grateful if the Minister would update this House on the number of foreign nurses in Singapore, and the measures which the Ministry is taking to ensure that standards are maintained, not only at the point in time where they bring them into Singapore but whether there is an ongoing system to monitor their performance and to ensure that they are effective and up to the mark.

Finally, I would like to ask the Minister whether the hospitals keep statistics of lost records, how serious this problem is, and whether steps are being taken to invest in better record-keeping systems.

Dr Michael Lim Chun Leng (Cheng San): Sir, I wish to declare that I am a doctor in private practice. Over the last few years, the Ministry of Health has spent much effort and resources in building new hospitals and medical centres to its credit. However, what makes the medical centre or a hospital a good one is not just the physical building or what machines it has, but more importantly, these institutions should be judged by the standard and quality of healthcare provided.

It is time that the Ministry made an objective assessment of the quality and standard of health that is given to all Singaporeans who use public health institutions. In the front-line we have our polyclinics where very often, doctors and nurses are overloaded with work. It is time for the Ministry to do a clinical audit of the outcome and standards of care provided at our polyclinics. Many of the lower income families, less well-off Singaporeans, and our senior citizens use the heavily subsidised services. It is important that we provide an acceptable quality of care for these patients. How many patients with high blood pressure have normal blood pressure after being treated at the polyclinics? How many diabetic patients have well controlled blood sugar levels after being treated at the polyclinics?

Good control of common medical ailments, like high blood pressure and diabetes, will reduce the incidence of more serious diseases, like stroke and heart diseases. The Ministry can only realise its objective of providing a high quality of medical care if the large majority of patients with common ailments are well managed. Hence, it is time for the Ministry to do a clinical audit on the standards of care provided in polyclinics. It can then identify areas of weaknesses, for example, if there are insufficient medical staff, and overcome these problems.

At the hospital level, patients who are seen at the Accident and Emergency Department may have to wait for long periods before being admitted to the hospitals. My residents have seen me to complain about the long waiting period for transfer to the wards after being seen at the Accident and Emergency Department. Despite the serious illness that their relatives have had, no beds could be found in the subsidised ward and they had to wait for several hours. While waiting at the Emergency Department for a long duration, no definitive care was administered. Unfortunately, for two of my residents, their relatives died shortly after admission to the hospital. I think this is a major weakness in our hospital system which needs to be addressed.

There are several potential options which the Ministry may want to consider:

First option: to admit subsidised patients who have serious illnesses and require urgent attention to the first available bed, even though it may mean having a subsidised patient lodging at a paying bed and being charged at subsidised rates. This should not only apply after office hours but throughout the day.

Second option: to have the ward medical team come to the Emergency Department to review and treat patients while they are waiting for transfer to the hospital ward.

Or perhaps a third option: to have a team of doctors at the Emergency Department who are sufficiently well trained and whose primary role is to initiate treatment and do the necessary investigations while the patient is awaiting admission to the ward.

There should perhaps also be a classification system for admission. Patients who are very ill and require urgent attention should perhaps be classified as "priority one" patients, and these patients must be attended to within a stipulated time-frame. Patients who are ill and require hospital admission but do not require attention so urgently should perhaps be classified as "priority two" patients. Perhaps it is time to have ISO standards for delivery of medical care.

Upon admission to the hospital, again, there are other new dilemmas. For example, in Singapore General Hospital where virtually all the departments are very specialised departments and there is no real general medicine department, there is a dilemma for the doctor at the A&E department as to which department to admit the patient to, if he has multiple-problems. And when the patient with multiple problems get admitted to the ward, will the doctors be so focused with their own specialty that they do not pay adequate attention to other specialties? For example, if a patient with breathlessness is admitted to the ward and has a heart problem but gets admitted to the Chest Ward, will it be such that the doctors are so focused on the chest problems that the heart problems are missed totally? I think these and other issues have to be addressed by the Ministry. Yes, it is good to have new hospitals and new machines but I think, most importantly, we must have a high standard of medical care. Only by delivering a good quality of medical care, can Singapore lay its claim to be a Centre of Medical Excellence.

Can I continue, Sir?

The Chairman: Yes. 5.45 pm

Dr Michael Lim Chun Leng: Sir, in the last few years, the Ministry has spent significant amounts of money in developing new hospitals and specialist centres. However, in some hospitals, the occupancy rate for paying beds is not high. For example, I have had the opportunity to visit some of my grassroots members who have been hospitalised in the Kent Ridge Wing of NUH and I was surprised that the place was rather quiet. Not too long ago, it was publicised in the newspapers that there were plans for building a hospital wing near NUH where Johns Hopkins Hospital will be involved. I am concerned that we may be building more than is necessary. Residents have given feedback that it is not unusual to wait for long periods for admission to subsidised ward. But it is often not too difficult to get admission to paying wards. Is there a misallocation of resources resulting in insufficient subsidised beds andby an excess of paying beds? Our hospital facilities should be used efficiently and perhaps the redistribution of beds and allocation of resources will help to overcome some of these bottlenecks in our public healthcare system.

As these medical institutions are built with public money, it is important that we reassure the public that whether they are subsidised or paying patients, they will not be disadvantaged in getting access into our public medical institutions. Hence, in the development of our health facilities, the Ministry must take into account the demand for subsidised services. In this economic downturn, it will not be unexpected that more Singaporeans will use subsidised healthcare services. If there is an increased demand, will the Ministry be making adjustment in our healthcare facilities to meet this increased demand? If adjustments are being made, can the Minister let the House know what active measures will be taken to meet this demand?

Mr Yeo Cheow Tong: Sir, first, let me address the questions raised by Mr Goh Choon Kang. Mr Goh Choon Kang has expressed his happiness with the work and outreach of Medifund but he is concerned that there are no additional top-up grants to the endowment fund this year. He would like the Ministry to ensure that when the economy recovers in future years, there will be top-ups to the endowment fund.

Sir, the decision not to top up the endowment fund this year was actually taken after very serious consideration. If the need had arisen for top-ups, I think we would have scrounged around and argued very strongly for top-up. The fact is that Medifund is actually quite well endowed now. We have $600 million and this gives us an annual income of about $21 million and, as pointed out, the outlay of Medifund a year comes to about $10 million. So that means we currently have enough revenue flows to more than meet the needs of the poor in Singapore. And even with the economic downturn, I think we have enough of a cushion there. But I would like to assure Mr Goh Choon Kang that once the economy improves, we will of course put in our bid for Medifund to be further topped up.

Mr Sin Boon Ann asked two questions. First, whether the medical social workers actually do brisk screening of Medifund applicants and, if they did, would the success rate (he mentioned 99.4%) still be correct, or would the figure be actually lower? And secondly, he asked the Ministry to publicise more widely to the public what are the avenues of appeal for those people who have applied for Medifund support but have been turned down.

Sir, let me answer the first point. Do medical social workers screen potential applicants? To qualify for Medifund, there are some simple criteria. Firstly, the patient must be a Singaporean. Secondly, the patient must be either a B2 or class C inpatient, or if an outpatient, similarly, he must be a subsidised patient or someone who is using the polyclinic services. Thirdly, he has to show that he cannot afford to pay for the hospital bills that have been levied on him. Very simple criteria. If he meets those criteria, he is then referred to the Hospital Medifund Committee for assessment.

The last point is the one which I think may sometimes pose a problem. Can they afford to pay the hospital bills? What the medical social workers would do then is to review the Medisave balances. If there is enough Medisave balance, the point is that they should then use their Medisave balance first before appealing for Medifund. In any case, the Hospital Medifund Committees are made up of grassroots leaders and being grassroots leaders, and having very close connection to the people on the ground, the members tend to err on the side of generosity which is why we have such a high success rate. Now that the CDCs are also involved, I think the outreach would be even better.

How can we help to publicise the avenues of appeal? Sir, as pointed out by Mr Goh Choon Kang, one common avenue of appeal is really the MPs. And I have from time to time enquired of my MP colleagues as to whether their residents are facing any problems in getting Medifund help. I am quite happy to report that no MP, including Mr Low Thia Khiang, has told me that his residents have had problems getting Medifund support. Usually, if they face any problems, they will go to the MP and the MP will make an appeal. So far, the Committees have been very supportive of the MP's' appeal.

In terms of publicising the avenues, we will continue to do that at the hospital level. Now that the CDCs are involved, we will work with the CDCs on how to further publicise the fact that Medifund is available and if they face any problems, they can either go to their own MP or grassroots organisations for support.

Dr Lily Neo talked about Medisave and the ability of patients to afford the healthcare charges even with Medifund, MediShield and Medisave. Sir, I will take her two questions together. First, whether Medisave is adequate and, second, whether we can extend Medisave to nursing homes and other long-term care services. Sir, Medisave has been a very well thought-out scheme, not just in terms of helping Singaporeans to have a savings fund, but also the contribution rate and the maximum limit for Medisave account. Studies have shown that the average adult aged 21 will require approximately 55 days of hospitalisation from the age of 21 to the end of his life. Of course, that is an average. You are going to get the outliers. In any case, based on the 95th percentile of B2 hospital bills, we have computed that the life-time expenditure in today's dollars would amount to only $27,000 if he uses B2 class facilities. If he uses A, B1 or private sector services, I think the figure would be much, much greater.

So the key to affordability is that patients should use the type of service that they can best afford. If they are in the lower income group with low Medisave contributions, please use B2 or C class ward. It is for that reason that we have implemented a very rigorous financial counselling programme at the hospitals so that patients who are going for A or B1 class ward are told of what to expect in terms of the bill size and are asked to rethink again. If they do not think they can afford that bill size, then they can seek to downgrade to either a B2 or C class ward.

So the Medisave limit of $20,000 is adequate and the MediShield limit of $80,000, that is, the basic MediShield coverage, is more than adequate for a patient who uses B2 and C class services even with a catastrophic illness. It is more than adequate. But, again, of course, for those who tend to use higher class wards, the MediShield limit will not be adequate. In which case, I will encourage such patients to upgrade themselves to a higher level of coverage by either going for MediShield Plus which is available and should cover A and B1, or seek private sector coverage. You have the NTUC Income which provides a very comprehensive range of catastrophic insurance packages as well as other insurance companies. So if you get the appropriate coverage, it would be enough. But if you use a lower coverage to cover a higher cost service like in the private hospitals, then of course it would not be adequate.

Medicare. Sir, as I have explained, the higher level coverage is already available, and I would hesitate to set up another system under the Government when the private sector is already providing the higher coverage for those who prefer a higher level of service.

Dr Neo is also very concerned about the elderly who require long-term care or those who require long-term care. I agree with her that this is a real problem for the future, especially with the increasing number of elderly and the larger proportion of the elderly amongst our population. Sir, whilst there are some elderly who do require long-term care, fortunately, the vast majority of elderly are well elderly and do not require long-term care even till their last few days. There are people who remain very healthy right to the very end and then they die within a very short period of time. Studies have also shown that only 2% to 3% of the elderly will require institutional long-term care, such as nursing homes or community hospitals. Unfortunately, any institutional care is costly. Even for VWO homes that are able to offer subsidised charges, the average charges of between $600-$800 a month would mean a very heavy burden to many families. 6.00 pm

Sir, the point is that even if we extend Medisave to long-term care, whatever Medisave funds they have will be quickly depleted. A person who now retires at the age of 55, if he has a lot of Medisave balances, he still needs to retain $15,000 in his Medisave account. If he goes into a nursing home and pays, say, $600 per month charges, that $15,000 would not last him very long. So that is not the solution.

We have to think of a different approach and it is towards this end that I am also chairing an inter-Ministryerial committee on health care for the elderly. One of the things that we are looking at is how to come up with an alternative funding mechanism for the minority who require long-term institutional care. How do we, in the first place, help to avoid long-term institutional care? How do we keep the sick elderly at home where his medical outlays will be minimised? That is really our focus, keep them at home, support them with a lot of home-based services, so that we limit those who require expensive long-term institutional care to the minimum. If we are able to do that, the scheme we come out with for financing will also be easier to resolve. The committee is looking at that now and I will announce the details when the study is completed in the coming months.

Mr Choo Wee Khiang also spoke about Medifund. He was saying that he hoped that the citizens of Singapore had better not fall sick or they may die. Sir, the first part is correct. I think all Singaporeans should always say, "I better not fall sick." But it cannot be a prayer, because keeping yourself fit and healthy is something which requires an active effort on the part of each and every one of us. This is the message and the intent of our Healthy Lifestyle programme. This is to encourage Singaporeans to have a healthy lifestyle, to invest in their own health so that they do not fall sick. But if they do fall sick, first of all, we have a health care system which will continue to give them a high standard of care, even though our economic growth may have slowed down this year.

The health budget, I am happy to inform him, has gone up, despite the tight budgetary constraints. Our health budget actually went up by 7.7%, in terms of our operating budget. With this increase, we would be more than able to retain the current subsidies of 80% subsidy for a Class C patient, 65% subsidy for B2, 50% for B2-plus, and 20% for Class B1. For the polyclinics, we will be able to retain the current subsidy target of 50%. I can assure Mr Choo that the support programmes are being maintained and will be in no way affected by the downturn.

Mr David Lim has asked about the standard of nursing. He is concerned about the impact of foreign nurses, but he recognises that they are an important factor; in fact, they are indispensable in our current context. He has asked about the current numbers. What are the measures to ensure standards are maintained? Do we have an on-going system of monitoring standards? And, lastly, lost records. Let me answer them one by one.

As regards the number of foreign nurses, we have a total of 1,800 foreign nurses in Singapore. Of these 1,800 nurses, 83% are working in the public sector. The vast majority are in the public sector and they comprise about 17% of the total public sector nurses. Therefore, considering that today we have an 8% shortage, if we did not have the foreign nurses, can Members imagine the hospitals running with a 25% shortfall of nurses. Some services may be even decimated because of that. There will be long queues for operations and for admissions. So foreign nurses have helped to relieve the shortage.

Yes, we do face certain problems. Some of them do not speak proper English and therefore they have problems communicating with some sector of the population. It is a problem which, I think, the hospitals are familiar with. Because even in Singapore, being a multi-racial society, we also have nurses who can speak English but may not be able to speak another of the national languages, or dialects. Then what the hospitals try to do is to ensure that there is a good mix so that there is some mutual help that takes place in terms of helping to communicate with the patients.

He was also concerned about the nurses not being exposed to the sort of high-tech equipment that we have. The hospitals are aware that the foreign nurses come from societies with different cultural backgrounds, different languages and perhaps even different clinical practice. Therefore, what the hospitals have done is to set up orientation and in-house training programmes for the new foreign nurses whenever they join the hospitals. And because the foreign nurses are recruited in batches, it is quite easy for the hospitals to conduct such training programmes. The in-house training will also include orientation, in terms of use of the sort of equipment that are available in the department that they are being sent to.

The hospitals also closely supervise and monitor their performance to ensure that nursing standards are being maintained The feedback is that, from time to time, some nurses cannot fit in, and the hospitals have had no choice but to come to some mutual agreement on how to terminate their service. This is also being done.

He has asked about lost records. We do have lost medical records and I think it is inevitable with the large number of patients that our system is coping with. Fortunately, improvements have been made. The number of lost records in 1990, for example, amounted to 1.7% of all patient load. As at the end of last year, they have dropped to 0.0003% in SGH, ie, almost no lost records, to a high of 0.4% in Tan Tock Seng Hospital. So improvements have been made but I think more can be done in the other hospitals.

What they are looking at now is a programme to computerise record keeping. This has already been looked into for X-rays and the ordering of medical tests. It has already been introduced in some of the hospitals and they will move on to the taking of clinical notes and patient diagnosis.

Lastly, Dr Michael Lim has talked about the clinical outcome studies. I will let Dr Aline Wong answer that.

He has talked about the A&E long waits. Sir, I agree with him that some patients have had to wait at least 4-5 hours before being transferred to the relevant wards during the peak hours. But I want to assure him that the hospitals have in place a rigorous triage system where patients with serious and emergency conditions are transferred, immediately after they have been stabilised, to the wards. For such cases, quite often, the A&E doctors would even ask the ward doctors to come down to help in providing that preliminary treatment before they are transferred to the wards.

70-80% of those requiring admissions from the A&E department do have to wait, but most have only to wait a short while. This is because, since the subsidised wards are all very heavily occupied, the bed management can be a bit of a problem, ie, they have to maybe move patients around, or sometimes ensure that patients who are being earmarked for discharge that day are actually being discharged, even though the family members may be hesitant to take them home. I am sure Dr Lim is familiar with this problem since he has worked in the public hospitals before. In any case, we are looking into that.

In terms of the facilities, he brought up the problem of high occupancy rate in the B2 and C wards and asked what are we doing about that. Sir, the occupancy rates of the B2 and Class C wards have been going up steadily over the years. For example, for Class C, in 1992, the occupancy rate was only 75%. But last year, the occupancy rate has crept up to 93%, and 93% means that it is full house.

Class B2 is still manageable. It is very high but still manageable, at about 87%. The demand for Class B2 has increased because, as I have stated just now, we are doing financial counselling. So more patients are now opting for B2 and C than they would have otherwise. Secondly, we are also having significant numbers of long-stay elderly patients. They should actually be transferred to a nursing home or to a community hospital, just like that step-down care capacity is not adequate at the present moment. So they are being lodged by their families in the hospitals. Of course, we have patients who should be discharged but whose families refuse to bring them home. These are things that we have to grapple with and we will have to be more stringent in terms of discharging those who are well enough to be discharged regardless of whether the family is ready to take them or not. Otherwise, patients will suffer by having to wait even longer in the A&E departments.

We are now reviewing the occupancy levels in the restructured hospitals and, if need be, after ensuring that the patients are being discharged properly, after helping them to be admitted into nursing homes and all that. If the demand is still there, if the occupancy is still that high, I think we have no choice but to make available more B2 and Class C beds.

The situation in nursing homes and community hospitals should improve because in the next three years, we will be increasing the nursing home beds by over 2,000, ie, an increase of 45% and we will be increasing the community hospital beds by 74. I think in the next two years or so, we should be seeing a significant improvement in the occupancy rates as well. 6.15 pm

Dr Aline Wong: Sir, a very short response to Dr Michael Lim's concern about the quality of care in our Government polyclinics and the issue of clinical audit.

Actually, oOver the years, many measures have been introduced to ensure quality care to patients in our polyclinics. We have developed standardised clinical protocols for use in the polyclinics for the management of patients with different conditions including diabetes and hypertension.

Since 1994, we have established an annual audit programme for different medical conditions, including the common chronic illnesses such as diabetes and hypertension. These audit procedures are drawn up with reference to international guidelines. Since 1994, we have had clinical audit.

Dr Lily Neo: Following what Minister Yeo said earlier on the alternative minority institutional care scheme for the elderly and chronic sick, in fact, it was in my speech earlier that I was trying to give an answer to that group of people who did not have enough Medisave and therefore, having this scheme where there is a co-payment between the Government and the patient to help this group of people. I hope the Minister will really look into it and maybe he could understand better what I was trying to say.

Now, on preventive healthcare service. "Prevention is beter than cure" is an adage all and sundry knows. Promoting preventive care as the way to go is accepted by the majority of healthcare providers. Failure of preventive care will call for more palliative treatment and laborious nursing of end stage progression of illnesses This is most unrewarding. Not only does it eat into people's well-being, but it also eats into people's pockets.

Are we in Singapore doing enough in this respect? The answer is "No". Could it be that we are still very much caught up in the stage of coping with curing illnesses and the priority for preventive healthcare had to be compromised? Sir, we really have to redouble our efforts in promoting preventive healthcare if our nation is to maintain our high healthcare standards and to contain our low healthcare costs well into the next century.

The Public Health Service does provide health screening and some preventive care for our school children. It has been rather successful in this area and this is commendable. However, it is a very different story in the area of the general workforce, the elderly and the womenfolk. It is this area that we are concerned about.

At the moment, only 13.6% of the Ministry of Health budget is allocated to Primary Health Care and Preventive Health Care. There are only five people in the Public Health Department doing promotional work on preventive care for the elderly and womenfolk in the whole of Singapore. Another five are catering for the needs of the whole mass of the workforce. This is really inadequate for promoting healthy lifestyles to the whole country.

Sir, I would like to suggest that we embark on a mass public education programme on preventive healthcare. There is a need to promote the idea of personal responsibility for one's own health and the ways of attaining and maintaining good health. Health screening tests, on a regular basis, should be made available, especially to the poor and the elderly who are most in need but the most deprived. We can conveniently reach a target group making use of the numerous day care centres for the elderly; we can organise mass programme at the community centres and we can increase awareness that such tests are available at the island-wide and well-scattered polyclinics. We already have a very good network of helpers, like the grassroots leaders and other caring residents who can help to reach out to the people.

We will also need to provide training for facilitators in the community who have the direct and continuing contact with the primary target groups. These facilitators may be the nurses at the polyclinics, community leaders of their community centres or the personnel officers in the various large companies. We need a more consistent island-wide systematic approach to promote different aspects of healthy living and preventive care. These activities may include items like (a) having trained personnel going around perhaps on a monthly basis to the different community centres or day care centres to advise the elderly and the womenfolk , and (b) having another group covering the community at work at their working places.

The Community Development Councils, the community centres and the corporate establishments should participate in the logistics and planning to reach out to the people. Incentives and other aids should be given to them. We should help the private companies realise that such programmes will enable them to have healthier workers leading to enhanced productivity as well as providing their staff with essential health screening tests conveniently and at affordable prices.

Mr Low Thia Khiang (Hougang): (In Mandarin): With the aging population, there are more and more elderly people in our society. Many of these old people suffer from various chronic diseases, such as senile dementia and other problems. They are unable to look after themselves. Although they stay with their children, more often than not, their children would be working outside and therefore unable to look after the old folks. The problem is getting more serious nowadays, as the number of old people rises. Although there are home nursing serviceshomes presently available to cater for these old folks, these serviceshomes are run on a private commercial basis. Their fees are high, and quite beyond the reach of the lower middle income groups. Only a small number of such services are provided by charitable organisations.

I hope the Government will provide inexpensive home nursing care for these people so that they can stay in their home and need not go to the nursing home.

As for the nursing homes run by the charitable organisations, I understand there are many elderly people waiting to be admitted. I would like to know how many elderly people are on the waiting list and whether the Government has plans to increase the number of nursing homes.

Mdm Claire Chiang See Ngoh (Nominated Member): Sir, we currently have very well established treatment centres, but we are less successful at integrating appropriately rehabilitative patients into the society.

I have a few questions. I shall rush through them because of a lack of time. First, there are no established half-way houses for the mentally ill. This is very important, Sir, because this is a transitional period where they will learn social skills and work skills. A period of six to 12 months is very important for them to be adjusted and to feel supported in a home-like environment.

Second, in Singapore, some advocates have queried whether the Ministry should lead in the development of a broad range of psycho-socio rehabilitation programmes. Let me clarify for Members.

Unlike Woodbridge Hospital which administers medicine to the patients, the psycho-social rehabilitation programmes actually look into the community resources and identify ways to maximise the resources and help patients lead fulfilling independent lives. At this point, a large part of this initiative comes from the community and the query is: is this a good strategy that there is very little supervision from the Ministry of Health?

Third, the VWOs are very frustrated by the efforts in setting up community mental health services because when they write to HDB for void decks, their reply is always, "Sorry, it is not suitable." When they re-suggest new void decks for their applications, again it comes back to them and say, "Sorry, it is not suitable." Can the Government help by listing the void decks to the VWOs as to which is more suitable in the first place?

Lastly, some neighbourhoods and residents do not like the idea of VWOs setting up mental services in their neighbourhood because property sales will go down, and their property value will also go down. Is this still true? How can the Government help to correct this social stigma?

Dr Tan Cheng Bock: Sir, I shall be as brief as I can, although I have a lot to say.

Sir, the Home Nursing Foundation, if Members remember, was started by Dr Toh Chin Chye many, many years ago. It has a good mission and that was to take care of the sick at home, and I think they have done a very good job. But I am just wondering whether we should look at the Home Nursing Foundation again and see whether we could expand its modalities of care.

At the moment, I think the Home Nursing Foundation takes care of the recently discharged hospital cases by dealing with simple nursing and perhaps some counselling. But I am wondering whether we could expand this modality of care. Because if we watch our population pattern, we are getting older, and diseases like diabetes and hypertension are more common, and disabilities will set in, especially when they reach the age of 65 and above. We know all these are coming. So what do we do? I would propose that at least we must have some proactive programmes on the part of the Home Nursing Foundation.

The Minister has just mentioned about preventive care. I agree with him, and I have always asked this House to put more money into the primary health care portion rather than put so much money into hospital care. But, unfortunately, I lost the battle. The Government is putting up huge hospitals. But this expansion of the modalities of care would involve actually going to the homes. How do we manage diabetic patients at home? How do we manage hypertensive patients at home? These are challenges that I would pose to the Home Nursing Foundation: how are they going to have programmes to handle all these?

To do this, I would propose that the Home Nursing Foundation should actually go along with the allied health care services that are provided by some societies, like the diabetic society, cardiac society. Or the rheumatic society. Of course, these societies will come in and they can work out programmes as to how to manage patients, maximising related to the various societies' expertise so that there will be a good exchange of information and management skills. To be effective, we actually need a proper, if possible, standalone building, for the Home Nursing Foundation.

The Chairman: Order. Dr Tan, you are making a very important point. But do you want a reply?

Dr Tan Cheng Bock: Okay, I will summarise my speech. Most important, they must give funding. If they do not have funding, the Home Nursing Foundation will not be effective and the CDCs will be very happy to work along with the Home Nursing Foundation to achieve what I want to say.

Mr Goh Choon Kang: (In Mandarin): Sir, my question is very simple. According to my understanding, the Ministry of Health is planning to register now going about with the registration of acupuncturists. May I ask the Minister to update the House on the for a progress reportprogress?

Dr Aline Wong: Sir, I have only about five minutes. I really do not know how I could manage to answer one by one in a satisfactory manner. But if I can, I would like to give the last speaker the first response.

On acupuncture, the Ministry of Health has adopted a phased approach to the regulation of the Traditional Chinese Medicine Practices (TCMP), ie, first, we have a phase of self-regulation by the TCM community initially, and followed by statutory regulation at a later stage. MyThe Ministry of Health intends to register acupuncturists in the year 2000. This is in accordance with the recommendation of the Committee on Traditional Chinese Medicine. At present, there are about 1,070 acupuncturists practising in Singapore. Many of them have practised for a long time and many practise on a part-time basis.

To protect the interest of the public and to raise the standard of practice of acupuncturists, my Ministry's approach is to ensure that applications for registration should meet a uniform, acceptable standard of competency. To this end, a set of training requirements and a common qualifying examination will be established to ascertain whether applicants meet the prescribed standard. Those who pass will be registered.

As the Member may well be aware, there is now a standardised 6-year part-time diploma course on TCM, which is offered by the major local TCM training institutions. The acupuncture training offered by this course will be the benchmark training requirement for eligibility to sit the common qualifying examination. New graduates from this course will be deemed to have met the training requirement in acupuncture and will be eligible to sit for the qualifying examination.

During the transitional period, however, we will give consideration to existing acupuncturists who possess sufficient training and experience. Each application for registration will be assessed. Those who possess suitable qualification and experience will be exempted from the acupuncture common qualifying examination, either in part or in full. For those who do not possess sufficient experience or training, they will be required to attend upgrading training courses and to sit for the common qualifying examination.

We will encourage a local professional TCM body to organise and administer the qualifying examination with the help of foreign TCM experts in setting the questions and the passing standards. We will also encourage the major local TCM schools to run the upgrading courses.

The above framework for registration of acupunturists will ensure a uniform and upgraded standard of practice of acupunture in Singapore. 6.30 pm

Now let me move on to Dr Lily Neo's point. I think I cannot agree with her more that we should put a great deal of emphasis on preventive care. Are we doing enough? She said, no. I beg to differ with her. We try to do as much as we can. We would try to do more. But it is a matter of judgment at this point whether within the resources we have, we are doing enough. In fact, we are doing a lot, and I really I would like to find out from her wherehow she gotets the figures of only five people within the Primary Health Department in MOH doing preventive health work for the elderly, and only five to cater to the entire workforce.

I must emphasise that when you work with the community, it is not just the number of MOH officers that matters. We work with the community organisations. We work through the professional organisations. We work through the women's organisations. And it is through this outreach that we can reach all sectors of the population. But I agree with her entirely that preventive healthcare is a very good strategy that will raise the health of our nation and reduce healthcare cost in the long run.

Mr Low Thia Khiang asked about home nurses. In fact, the Home Nursing Foundation has been in existence for more than 20 years. It has been doing very good work. Last year alone, it had carried out 45,000 visits to homes to do home nursing for patients. This is a charitable organisation. It is not a commercial organisation. And patients are charged according to their affordability to pay.

As for the waiting list, yes, we are right now short of nursing home beds. In the past six years, the Ministry of Health has worked with the voluntary organisations and we have built quite a number of nursing homes that have increased our capacity by a great deal. In the last six years, we had built eight VWO nursing homes. At the At present, we have 4,700 nursing home beds. Another 11 nursing home projects are in the pipeline. With the completion of these projects, they will add another 2,100 beds and the total number of beds by then would be sufficient to meet our needs by the year 2000.

Mdm Claire Chiang talked about the significance of the psychosocial -socio programmes. I understand what she means and I thank her also for sending me some reading materials. I think the concrete expression of this approach would lie in so-called half-way houses. There are at the moment a few half-way houses, one run by the Ministry of Health and a few run by VWOs. The Ministry of Health does work with them. There are visiting psychiatrists who work as honorary ordinary cconsultants to these half-way houses. So tThey provide the professional or medical cover. They also give professional consultancy to these homes. So it is not entirely true that our Ministry does not supervise their work, or has no inputs.

I agree with her that we need to work more in this direction to provide for the number of mental patients we have in our midst and who, after they have been stabilised, after they have gone through this steady state, need some kind of rehabilitation in order for them to be reintegrated into society.

As for social stigma, I am afraid iit is very unfortunate that in our society there is still quite a bit of social stigma attached to mental illness. That is why my Ministry has put a great deal of emphasis on mental health education in public education to raise public awareness and also to educate the public on the facts about mental health and how early detection and management, and so on, would help the patients.

Finally, Dr Tan Cheng Bock talkeds about the need for an enlarged role for the Home Nursing Foundation. I also agree with him. I can see that the Home Nursing Foundation can play a much more proactive role in the community. It is doing a very, very good job. But I think it can still extend its reach much more through partnership with community-based organisations, including the CDCs. And if Dr Tan Cheng Bock, being a member of the CDC, would like to work within the Home Nursing Foundation, the Ministry of Health would be fully behind him.

Mr Bernard Chen: Sir, I beg leave to withdraw my amendment.

Amendment, by leave, withdrawn.

The sum of $1,012,292,140 for Head P ordered to stand part of the Main Estimates.

The sum of $251,062,000 for Head P ordered to stand part of the Development Estimates.

Head R -

The Chairman: Head R - Ministry of Information and the Arts. Amendment No. (1), Mr Chew.

Mr Chew Heng Ching (East Coast): Sir, I beg to move,

That the total sum to be allocated for Head R of the Main Estimates be reduced by $100.

Sir, some 1 1/2 years ago, the Government mooted the idea of having a large scale National Exhibition as part of a larger exercise on National Education to inform, educate and remind Singaporeans about our history, our roots, and on how our country came about.

While National Education is taught in schools, the National Education exhibition was meant to educate the general public, the young, the middle-aged and the old, across all sections of our society. This subject of National Education exhibition was raised last year at the Committee of Supply debate on MITA, but no decision was reached as to when the Government will hold the exhibition.

Sir, in the light of recent developments in the region and the impending social unrest that may unfold in our neighbouring countries, I think it makes it even more pressing now to have this National Education exhibition. Singaporeans need to be made more aware of our unique position in the region, the need for sensitivity as regards race, language, religion and culture, and the challenges that will face us in the years ahead.

May I therefore ask the Minister when will this exhibition be held, and if it would be held after all, and if he would elaborate on the details of this exhibition?

Dr Yaacob Ibrahim (Jalan Besar): Sir, the thrust of our National Education programme has been to create a sense of awareness among our young about how this country of ours came into being. I understand that schools and tertiary institutions have already embarked on a variety of programmes and projects with their students.

Sir, I am also concerned about the need to introduce NE to the general population. In this regard, could the Minister enlighten us on the efforts thus far taken by his Ministry to bring the message home to the general population?

Sir, this effort is all the more important during this very difficult time. I echo the sentiments of my Chairman, Mr Chew. During the recent debate on the Budget statement, I spoke about the need for Government to do little things to calm the financial jitters of the average Singaporean. Now is the time perhaps for us to consider big things to reinforce the message of unity among our population. We have heard of the need to rally Singaporeans so that as a nation, we can ride out this economic storm which is blowing our way. We do not know how this storm will develop. Will it become a typhoon or will it just fizzle out into a tropical thunderstorm?

We do not know and we cannot take any chances. Hence, I would urge the Minister to consider ways in which we can reinforce our sense of rootedness to Singapore. What can be done to placate our anxieties and yet strengthen our cohesion as a people?

I wonder, Sir, if the time is not right for us to also consider roping in the efforts of private groups in this endeavour. Could we not mobilise groups at the ground such as those affiliated with the People's Association, arts groups, media, and other concerned individuals to work together on programmes and activities that will strengthen our sense of belonging and cohesion? Private groups are well placed to reach out to a wide audience through their varied and fresh perspectives, diverse fora and activities. Let us not restrict our efforts such that we end up inadvertently writing off some groups in our country. To encourage private groups, we may want to consider putting aside some funds for them to conduct activities related to National Education. Let us tap all available resources to build a nation with a strong sense of self. This is a time for us to re-double our efforts to ensure that the small man in the street, small community groups and other concerned individuals are involved in, and contribute to nation building.

Mr Chew Heng Ching: Sir, the Programme Advisory Committee (PAC) and the Advisory Committee on Chinese Dramas and Variety Shows (ACCESS) have recently submitted their reports and made numerous observations and recommendations to further improve our TV programmes. I am sure MITA will seriously look at how best to implement some of these recommendations.

Sir, I rise to seek clarification from the Minister over the longer term objectives of TCS and TV12 in Singapore. There has been some concern that there appears a growing imbalance of programming in favour of entertainment over current affairs on air in these stations. Most glaringly, viewers have found that the recent SilkAir MI185 tragedy was more widely covered by foreign stations than our own TV stations.

Sir, we are aware that our domestic television stations are driven by commercial interest as they have to remain viable and yet play a nation-building role, and it is not easy. However, in view of the scarcity of resources in a small country, like Singapore, it appears that increasingly with competition posed by cable TV (SCV), there may be a duplication of resources if TCS adopts a strategy to keep up with the type of entertainment programmes that SCV also caters for. Furthermore, it will be beneficial for Singaporeans who wish to take a greater interest in current and national issues to be able to access specifically to programmes that cater to them more specifically in these aspects. So it must be in the national interest, therefore, to optimise our limited resources by channelling less of TCS' resources towards entertainment and perhaps leaving SCV to do the entertainment programmes, and more resources made available to TCS towards nation-building.

In the light of this, I would like to ask the Minister if MITA has plans to really review the focus and the directions of TCS and TV12, so as to reduce the potential drain in resources from the duplicative nature of the present state of competition posed by SCV to these stations.

Mr Shriniwas Rai: Sir, before I proceed, I need a clarification from you. I see some Members addressing you as the "Chairman", some as "Deputy Chairman". For the benefit of the younger Members of this House, would you please say which is the correct form?

The Chairman: Whether the cat is black or white, it still catches the rat. But, anyway, the correct form is "Chairman".

Mr Shriniwas Rai: Thank you, Sir.

Sir, I think I have to admit, and other Members will admit, that the quality of the TCS programmes has improved. Viewers now have greater opportunity of also switching to Cable Vision. This imposes on our station a greater responsibility. I am concerned specially with the news and current affairs because Cable Vision has got far better inputs and many members of the public, I know, sometimes prefer to watch these programmes. Only when it comes to Singapore, they want to watch our station. I think this is sad. We should try to improve the standard. I am not being critical. I think it is in the interest of Singapore that our station is watched by everybody because CNN and other stations cannot carry the message of nation-building which my friend, Dr Yaacob Ibrahim, has emphasised, our station can. In this respect, I would urge the Minister to take an interest in this area and to improve on it.

Sir, take the example of parliamentary reports. It is shown 15 minutes after the News. I think it is rather late. We should have it a bit earlier so that school children will know what is happening. For the last few days, Parliament has been sitting for hours, yet in 15 minutes, I think in fairness to TCS, you cannot convey the message. I know the Minister may reply, "Oh, there is no audience." I think that is not the question. The audience can be built up. Even if the audience is not there, the people who are going to watch are important people in the society, and for their interest I think we should try to enlarge, reorganise the programme, and also change the time.

The Chairman: Order. It is 6.45 pm.

Thereupon Mr Deputy Speaker left the Chair of the Committee and took the Chair of the House.

BG George Yong-Boon Yeo: Mr Deputy Speaker, Sir, I beg to report that the Committee of Supply has made further progress on the Main and Development Estimates for the financial year 1998/1999, and ask leave to sit again on Monday, 16th March, 1998.

Mr Deputy Speaker: So be it.