ANNUAL BUDGET STATEMENT

[Mr Speaker in the Chair]

Debate resumed.

Mr Zainul Abidin Rasheed (Aljunied): Mr Speaker, Sir, practically all Singaporeans know we face uncertain times. Obviously, difficult times too. But the degree differs. And this can be seen in the way many of the unemployed and the retrenched behave. Contrary to what hon. Member, Mr Low Thia Khiang, said earlier, jobs are still available - plenty in fact - but not the ones many of the retrenched or the unemployed are waiting for or willing to accept.

They give many and varied reasons why they chose not to accept the jobs matched or assisted by the CDCs, for example. Among them: "Money no enough"; "Jauh lo - distance. How can I work in Jurong? I stay in Punggol, you know?"; "No shift, please"; "Weekend free, can or not?"; "Admin job only, OK?" These are some of the responses that we got from many of those who actually came forward to seek help.

We can understand the low salary as being a not strong enough pull, especially when a person, having benefited from the high wage policy and earning about $1,800-$2,000 after working for about 10-15 years suddenly finds himself retrenched, with two kids in school and has recently upgraded to a 4- or 5-room flat. Thus, for someone like him - and there are many of them - the $1,000 salary, with a take-home of about $850, in the mind of such a person, surely "money no enough". But after months of waiting, surely it is better to grab the $850 rather than no money at all, except for the interim assistance from Government, which is less.

Mr Speaker, Sir, the CDCs try. Nearly 5,000 applied for assistance last year at the North East CDC, out of which 65% were matched, but only 14% placed with jobs. From the macro job fairs held with the help of the Ministry of Manpower to a more focused Compassvale locality and industry-based job fair, the CDC tried and tried. It never gave up. Even the GRC-based approach was taken, through Pasir Ris-Punggol, for better focus, with geographical considerations taken into account. Temporary employment through Town Councils too for those in arrears, pioneered by Pasir Ris-Punggol Town Council, thanks to the hard work by its Chairman, the hon. Member, Mr Charles Chong. The scheme is now extended to Tampines and Aljunied Town Councils.

Mr Speaker, Sir, times are bad, all right. My CDC officers now tell me that there has been a change in attitude lately. More of those who came to seek help are less choosy. More desperate perhaps, savings dry up, relatives' help not as forthcoming, and more are even prepared for training and retraining. Before, it was difficult to convince them to go for training and retraining, they were thinking that the Government, with its past track record, would be able to turn the economy around in no time, and they would go back to their old jobs. I personally know of cases of those who, having worked as policemen, firemen, water boat men or tug boat men, did not see themselves in alternative work. They wanted to work in the same jobs till retirement. They are proud of the work they did, and they were good workers indeed. But those jobs are no longer available. This is the structural unemployment which the Government has been trying to prepare Singaporeans for, especially in terms of training and retraining. But some, perhaps many, did not take heed.

Mr Speaker, Sir, the CDC experience shows how we have tried and how sad sometimes the stories can be. They serve as a reality check as to how difficult times can be, especially for those in need. As hon. MP, Mdm Cynthia Phua, said yesterday, many have to tighten their belts.

This, Sir, reminds me of an anecdote, more like a joke. There was a time during the Cold War days when China used to provide a lot of financial aid to many African countries. One day, Chairman Mao got very upset because these satellite countries were getting spoilt. He decided to give them a dose of reality check. He sent them a note:

"Comrade, yes, times are bad, but we cannot go on like this depending on others for help all the time. We must each do our part. Tighten your belts."

Then came one reply:

"Comrade Mao, you are right. We agree. We must tighten our belts. Yes, Comrade, please do send the belts."

Mr Speaker, Sir, the situation faced by many of our retrenched and unemployed is no laughing matter. Much of the interim assistance given out has been exhausted, and even those forced to take lower paying jobs are now faced with loans and arrears beyond repair. Money owed to Singapore Power for electricity and water has led to many now living without those amenities. I do not have the numbers, but perhaps during the Committee of Supply, the relevant Ministry would be able to give us an update. But this situation must have dented the level of self-confidence and self-esteem in many of those affected.

I dare say that many of those caught in this predicament are victims of their own situation and financial mismanagement. They will say that it is easy for people like us to say that. Nevertheless, their problems are real and they need urgent help. I dare not, however, say that we must provide more of Government assistance to get them out of the deep hole. Welfarism is not the way out. But how do we fare as Government and fellow Singaporeans in the face of these needy cases? The number of fellow Singaporeans hauled to court for bankruptcy, for example, must have risen, desperate and not knowing how to save themselves. All these will certainly have an impact on their self-confidence.

When the number of those affected is large enough, either from a social and low income group or, worse, a particular race - as a significant percentage of those affected are Malays and Indians - the problem becomes more acute. There is a need to look at this problem of financial squeeze in the short term while we pursue to prepare them to overcome their predicament for the long term through education and training.

Mr Speaker, Sir, the hon. Member, Dr Wang Kai Yuen, earlier this morning described the situation in three words: Jobs, Jobs, Jobs. I agree. But may I add that the solution is in a 4-letter word, an abbreviation: JELL. It is not a signal for a short cut nor a quick fix. But, indeed, it is to emphasise a longer term view for the future. JELL stands for Jobs, Employability and Lifelong Learning. This is also the approach at the North East CDC.

I am therefore happy to welcome the decision by the Government to establish a statutory board in charge of Lifelong Learning and Training. MOM, NTUC, CDCs, self-help groups and voluntary welfare organisations will tell us that there are serious hurdles to overcome for training and retraining. The untiring efforts shown by MOM and other complementary agencies must continue and should bear fruit. The Government, the Ministry of Finance in particular, should not leave any stone unturned here to provide the infrastructural and financial help needed to give the new board a fighting chance to succeed and to excel.

The mindsets and attitude problems on the ground are real. It could be as innocent as senior workers - those 45 and above - not wanting to attend classes for perceived fear of holding back others, to the more serious ones like those having mental blocks to upgrade, especially with computer training. The not-so-young 45 and above, concept of retirement - for a long time pegged to the 55-year mark - needs redressing, and their grey mindset about-one-job whole-life career too needs sensitive overhauling. Counselling for second and alternative careers needs to be looked at carefully as there is a serious shortage of counsellors working on the ground, whether at MOM, CDCs or VWOs.

On a related but important new frontier, the Government's call for more entrepreneurs deserves closer scrutiny by all for the opportunities they come with. More can be done to upgrade and expand opportunities and open up new fronts for employment. We have often heard that not enough was done to support the nation's call for our budding entrepreneurs. From the stories we read or heard or saw in the media, the new budding - and now more successful - entrepreneurs did it on their own steam. That is what entrepreneurs and entrepreneurship are all about.

Nevertheless, I personally believe that we could do a lot more to sow the seeds for more entrepreneurial flowers to bloom. While we would want to see more local entrepreneurs to succeed, creating employment in the process, I feel that it is equally important for the Government to nurture the spirit of enterprise in as many Singaporeans as possible.

With your indulgence, Mr Speaker, Sir, the North East CDC believes so. We start young, even at primary schools. In fact, the need to instill the spirit of enterprise should cover all age groups. Like at the North East CDC, the Students Middle Aged and Senior Citizens (SMS) approach will provide opportunities wide enough for all to realise their potential for entrepreneurship and being enterprising. Our national efforts at promoting entrepreneurship should also cover as wide and as deep an area as possible.

In short, jobs, JELL and entrepreneurship should provide us the glue that would bind the people together in good or in bad times. Economics, or livelihood, after all, is the best bond for social cohesion.

It is easy to say that the Government should and could do more but this is also an opportunity for us, the people, to ask ourselves: what have we done more to help ourselves and the economy in these uncertain times? Yes, the Government must and will have to take the lead but the people must also have the will to learn and unlearn many times around what holds for the future economy and the challenges of uncertainties.

Let us not swallow the Oliver Twist culture for more hook, line and sinker unthinkingly. Instead, more Singaporeans should stand up, fighting for - in the words of SMS, Mr Khaw Boon Wan - a 'more than good' chance to be the best through a competitive culture called ERC - Enterprising and Resourceful Culture.

Sir, I support the motion in the name of the Minister for Finance.

Dr Jennifer Lee (Nominated Member): Mr Speaker, I would like to draw attention to two big areas of concern for Singapore, both of which relate to our demographics - our aging population and our declining fertility.

The Budget addresses both subjects to varying degrees - the aging population and the changes to the CPF contribution rates, and in the measures to enhance older workers' employability. With regard to fertility, there is one solitary item, tax exemption, for employer subsidised childcare benefits - not much, but perhaps just a signal that the issue is not being forgotten. For today, I will touch only on the first subject, leaving my observations on our pro-family efforts and policies for the Committee of Supply debate to come.

The Member for Marine Parade GRC, Mrs Lim Hwee Hua, spoke yesterday on the need for us to totally review our concept of retirement and the way that CPF is structured, against the background of CPF withdrawal age of 55, retirement age of 62 and life expectancy of 78, and the rapidly evolving patterns of employment as companies compete in the globalised economy. Many Singaporeans have come to realise, with considerable consternation, that what they had been taking for granted or assumed that somehow CPF would take care of their retirement needs has been an illusion.

In 1998, the Inter-Ministerial Committee on the Aging Population found that only 24% of those turning 55 had $60,000 in their Minimum Sum cash portion. Now the ERC estimates that even of new account holders contributing for a full career span at current CPF rates, only 50% would achieve the targeted $80,000 Minimum Sum for the cash portion of $40,000. The Government has taken steps to limit the ceiling on CPF withdrawals to be made for property purchases, and the DPM has announced that the rate of contribution to the Special Account will be raised in steps over the next three years towards addressing the shortfall. But even with these, it is anticipated that only 60% of account holders will reach the target Minimum Sum level. Further, this target amount translates into an income stream of something like $600 per month, assuming a 4% interest rate for a period of 16 years, taking retirement at 62 and life expectancy at 78. Thus, recognising that this amount may not be adequate and, indeed, the ERC has recommended that the Minimum Sum should be subsequently raised beyond $80,000. But truly, how much will we be able to do and, if anything, at what pace?

In addition, another major deficiency of the CPF model in catering for Singaporeans' retirement needs is that the system currently leaves out some significant groups of people - the self-employed, workers in the informal sector and home-makers - whose contributions are not attributed economic value and are not included in its cover. As the latter group is largely women, who will in all probability outlive their husbands, their financial security in old age will be precarious.

The ERC has taken the approach in its recommendations that CPF should cater for the 10th to the 80th percentile of the income spectrum. Now, this approach makes eminent sense, as indeed the top 20% can very well look after itself and, truly, the bottom 10% would have so little put aside through regular contribution rates - as well as did every dollar that they earned to meet their immediate day-to-day expenditures - that it does not make sense to have them make an employee contribution at all.

However, implicit in this recommendation is that there will be 10% of the population who will have no financial provisions for their post-retirement needs. This is a very significant number. Just some months ago, the Minister for Community Development and Sports, in answer to a question on the financial assistance schemes available, shared that in the financial year 2001, almost 15,000 beneficiaries were helped. But on examining the details of the numbers, one finds that the majority of these were either in interim short-term assistance schemes or for very specific purposes, such as student care fee assistance, and only 2,773 were beneficiaries under the main Public Assistance System. Compare this number to a full 10% of the population of workers as they reach retirement age. The DPM has mentioned in his Budget speech the need for Government to focus its social assistance in the future on only the truly needy. It appears that this group of truly needy may be a very significant number.

How has Government planned to provide for this bottom 10% in their retirement? Is the intent to simply gear up, so that more people will come under the current assistance schemes, coupled with continuing to depend on families to step in the breach, as is the present practice and expectation? Is this realistic, considering the trends of family formation that we are currently experiencing? Given this scenario of the lack of any savings at all for the bottom 10%, the full-time home-makers not catered for in the CPF system, the anticipated inability of 40% of CPF account holders in the future to meet the Minimum Sum target, and indeed the likely inadequacy of that sum to generate enough monthly income to maintain a desired living standard, it seems to me that a critical part of the solution must be the continued employability and employment of older workers.

Many of us must be looking to being employed well beyond our current expectations, not only to keep active and engaged, but also to generate some continuing income to supplement what we have been able to put aside as savings. In this, the Government has been very active and very visibly putting its money where its mouth is, so to speak, with generous funding invested in the Skills Redevelopment Programmes since 1996 and, more currently, in the People-for-Jobs Traineeship Programme. The $0.5 billion that Government has just deposited into the Lifelong Learning Fund in financial year 2002 to bring it to $1.5 billion to date will generate $16 million of interest income to continue to support the skills upgrading and retraining programmes. This is truly a commitment that few governments anywhere else would make and something which Singaporeans should not take for granted. But Government's willingness to generously fund skills upgrading and retraining alone is not enough. Workers and employers need also to play their part.

On the workers' part, while some are still refusing to accept the reality of Singapore's changing environment and its implications and impact on them personally - as just been recounted by Mayor Zainul Abidin Rasheed - I believe that there are many more people now who are much more willing to adjust their expectations and to try new jobs in sectors that they may not have considered attractive enough previously. There are jobs that are available, if all parties are willing to give it a try.

Besides creating new jobs in new sectors, we have some 900,000 non-Singaporeans working in our midst. While we welcome them and know we will continue to rely on them far into the future, there are many sectors, like healthcare, for example, where employers would welcome, with open arms, willing locals to fill positions, so that we can moderate the ratio of local to non-local employees. The Government has put in the money to support reskilling workers. Workers are now more willing to give the schemes a try and to moderate their expectations. Now, employers must also be willing to overcome their prejudices and mindsets to hire these mid-career recruits.

I would like to share a success story, not only to encourage workers currently looking for a break in the dark clouds that they can take heart, but more so to encourage employers to engage in some enlightened self-interest. It is about our experience in KK Hospital with a group of new recruits who underwent three months of training in the National Skills Standard for healthcare attendants. In fact, in the HMI training programme that my NMP colleague, Dr Gan See Khem, had established, they are a small group and they have been with us for just two months. But I have been tracking their progress and I am confident enough that they will be long-term employees with us to share our story with the House.

We started with 10 recruits, mostly in their 40s from varied backgrounds - clerical, secretarial, production operations, storemen. They are now deployed in frontline positions in our wards, clinics and operating theatres. Frontline jobs in healthcare institutions are very tough work. You are on your feet most of the day in constant patient contact and service, going on shifts. I can tell you that this group has had some tough time adjusting, but they are very determined and very committed to making this endeavour work.

On the hospital's part, each of their supervisors had been briefed as to making an extra effort to help them settle in, to be available to help, either to coach or to assist, just to provide encouragement. We started with 10, we have lost three, who are unable to make mainly the physical adjustments. The remaining seven, however, their reports on them, both from the recruits themselves, as well as their supervisors, is that they have got through the adjustment period and are now functioning very comfortably in their assignments. In fact, they have been given top marks by the supervisors for attitude and performance. I think 7 out of 10, a 70% retention rate, is pretty good, and I am very happy with the outcome.

This group of 40-somethings is a shining example of what is possible with reskilling, good attitude, commitment and the willingness to stick it out through the initial adjustment to a new work environment. The moral of the story is that effort is most certainly required on the part of the workers, and on the employers, in paying attention to job fit, some orientation and instructions on the job and attention from supervisors in helping the new mid-career recruit to settle in and adjust. This did not take a huge effort or commitment of any additional resources on the company's part, mainly just some additional attention from supervisors in the initial period. For that the hospital has gained a bunch of enthused, committed and stable staff.

I see in these tough times an opportunity to redesign jobs and to fill vacancies with mature and stable workers. Not all sectors are in the doldrums and I would like to take the occasion to encourage employers in those sectors that are in good shape to engage also in what is not at all altruistic, but distinctly in their own self-interest, as I believe the returns are well worth the efforts.

I have shared one story of one group in one organisation. We must share all other success stories that there are, big and small, to talk about what is possible and workable and viable. But beyond spreading the good word, we need to do more, to urgently accelerate the process, getting companies over preconceived ideas of the capabilities and commitments of older workers. Exhortation and proselytising would only get us that far. I would like to therefore suggest that it may be a worthwhile investment to incentivise employers to hire older workers by offering tax offsets against the cost of employing these re-skilled older recruits, but for a limited period only of, say, 3-5 years, as the intent is purely to get them pass the existing immediate prejudices and mindsets. Once employers have had the opportunity to get past the initial scepticism, I am sure that they will have enough positive experiences with older workers that sweeteners would no longer be necessary in the long run. No doubt, details of such a scheme will have to be worked out to prevent gaming and abuse.

Government has already shown the importance it places on addressing the problem of structural unemployment and enhancing the employability of older workers in the generous funding it continues to direct towards skills upgrading and retraining programmes. This investment in reskilling would go to waste if employers do not respond in sufficient numbers. I believe a concerted effort to incentivise companies for a limited term to hire older reskilled workers would be well worth the money spent.

There are other significant factors in the total picture of enhancing the employability of older workers. The two most important that have been discussed often before are moving away from a seniority-based wage system and portable medical benefits. We have been discussing moving away from a seniority-based wage system since the 1980s. As recommended by the ERC, we really need to act much more expeditiously on this.

With regard to portable medical benefits, the Deputy Prime Minister has offered both a bit of a carrot and a stick in the budget. But the question is: is this enough, and how can we move this along faster? Both Members, Halimah Yacob and Heng Chee How, have also spoken on this.

Finally, while the manufacturing sector continues to be very important to us, many of the jobs that are available, and will be available, are in the services sector. Singaporeans need to change yet another mindset - that of the attitudes towards work in serving others and accord such honest labour the respect that it deserves. This would facilitate the transition we need to make.

With that, Sir, I support the motion.

Dr Lily Neo (Jalan Besar): Mr Speaker, Sir, I stand in support of the motion raised by the Minister for Finance. I would like to especially welcome his Ministry's acceptance of the recommendations by the Economic Review Committee on focusing to make Singapore the regional hub for new areas like healthcare, education and creative industries.

Sir, I have some time ago raised the notion in this House that Singapore becomes the regional medical hub. This idea is not new; the implications are not unknown. We have, indeed, been there, but balked each time. I hope that this time this idea will not be thwarted again, lest we lose the chance.

Sir, Malaysia and Thailand have been making up ground in healthcare services by leaps and bounds. In 2001, the Thai's Bumrungrad Hospital alone saw 225,000 foreign patients; much more than all the hospitals in Singapore put together. Treatment like open heart surgery, once considered beyond the abilities of many hospitals, is something most hospitals in Malaysia and Thailand offer today, at a fraction of the costs charged here. Both Malaysia and Thailand have declared their intention to go for a bigger slice of the healthcare pie in the region. Both these countries have the advantage of lower costs and the marked difference in costs is driving large numbers of cost-conscious patients from the region away from Singapore.

What are the serious questions encountered from this idea of making Singapore into the regional medical hub that caused key players to abandon it in the past? First, the fear of spiralling cost of healthcare. Second, "the demonstration effect", which is the effect of increasing demand from the local populace expecting the services being offered to foreign patients at full-fee paying prices and perception of inequality.

On the point of spiralling costs, having more full-paying foreign patients, apart from giving a spin-off effect for our other services by having more visitors to Singapore, may be a source of subsidy rather than a cause of rising healthcare costs for local patients. Sir, there is a need for a mindset change here. Getting more foreign patients paying full rates help hospitals in operating costs and may moderate the need for future hospital fees hikes.

It is more cost effective and sensible to share expertise and expensive equipment in Singapore, especially in the very specialised fields like liver transplants and gamma-knife facilities. There is not a sufficient pool of patients to support these areas from our population of 3 million people. Super specialists will get more patients to keep their skills and improve on them. This will benefit both the local and foreign patients in the end.

Mr Speaker, Sir, the present scheme of blurring the private and public sectors by allowing private specialists to come back to public hospitals as visiting consultants and allowing public hospital specialists to practise in the private sector will minimise the ill-effects of doctors leaving the public sector for more lucrative returns in the private sector. There are enough specialists, especially in the private sector, to cater for both local and foreign patients. Private hospitals today are running at less than half capacity.

Spiralling healthcare costs are inevitable the world over. Having foreign patients here will have a cushioning effect rather than a worse-off effect in this respect. Sir, the real reasons for our inevitable rising healthcare costs are the increasing expectations of patients, the Government's assurance that our public healthcare system is the best, the demographic variables of population growth and age structure, the changing epidemiological patterns of diseases with a shift towards chronic degenerative conditions requiring intensive and longer-term care and the rapid advances of complex capital-intensive technology.

On the point of perception of inequality, consensus must be reached through more informed discussion and public education. Assurance must be given on good affordable and basic healthcare to all Singaporeans. Sir, the demand in medical care could be moderated by the suppliers themselves. Since consumers cannot exercise their sovereignty in purchasing the appropriate amount and level of medical care in most cases, they are invariably dependent on the expert judgement of the providers. Hence, to address this issue, healthcare providers can be subjected to the audit of an effective watchdog body with a system of checks and balances and healthcare providers should be bound by ethical codes of conduct. Public hospital A-class beds should be limited to not more than 13%. A further measure may be the requirement of the public hospital providers to follow prescribed fair allocation of time for local populace as against foreign patients.

What are the challenges facing this path of being the medical hub of the region? Sir, I feel the following areas are worth elaborating.

Singapore's healthcare services are high in costs and fees in comparison to about half in Malaysia and about one-third in Thailand. In this respect, I applaud the Economic Review Committee's recommendation to ensure adequate supply of land at institutional rates for medical hub developments. Singapore may have lost the edge to Malaysia and Thailand for many low-end medical treatments and Singapore should aim for high-end medical treatments such as transplant surgery, complex heart surgery and other complicated or advanced surgeries. There must be concerted efforts by service providers to contain and keep healthcare prices more competitive. Sir, I feel that integration of the private and public sectors is the way forward to maximise our resource pool, to have better economies of scale, to contain costs and to avoid duplication of services.

Sir, there is a need for mindset change here by the Government to treat these two sectors as one entity to achieve our aim of being competitive globally. I therefore welcome the Economic Review Committee's recommendations on the establishment of a responsible healthcare consumer forum for greater transparency on pricing and clinical practice norms and the introduction, selectively, of subvented healthcare at private facilities to help generate economies of scale in the private sector and enable them to provide more cost-competitive services.

Sir, Singapore has a very good reputation as a centre of medical excellence and our healthcare professionals are recognised for their high quality and efficiency. We need to have more structured aggressive marketing of this fact. Both the private and public sectors must undertake this in a coordinated manner. Remembering that there is increasing protectionism of local healthcare services in other countries, joint-ventures with reputable big names within the region to form strategic alliances may be necessary. Other areas worth considering should include offering incentives and recognition to healthcare professionals, strengthening international professional associations and enhancing networking with regional healthcare providers. China is a country with a huge potential demand for healthcare services and is a new market that needs our immediate attention.

Sir, in order to have the upper edge, there is a need for innovations and an ability to predict future trends. For example, with the trend towards an ageing population, there will be an increase in the incidence of chronic diseases. Thus, a greater focus on strategies in eldercare and health promotion as well as development of treatments for chronic diseases should be encouraged. A good example would be the recent improved surgical procedure by our local doctors on reshaping the heart to give patients with chronic heart failure a new lease of life. For nearly two-thirds of patients who are waiting, often in vain, for a new heart, this new procedure is a solution. This procedure costs a third of the price of a heart transplant and thus gives us the extra advantage with regard to foreign patients.

Sir, our "research culture" had not been great and "clinical research", especially, was never the emphasis. Our public hospitals' priorities are driven by maximising immediate returns. Clinicians, especially the specialists, are incentivised to treat as many patients as possible; they become too preoccupied with the routines and are required to tend to maximal numbers of patients. That leaves them with little or no time to teach the juniors, let alone spend time on research. A lot of changes at our institutions are required to promote, identify and support the different aspects of clinical research. Research activities on the world-wide prevalent diseases should be expanded expeditiously. One good example is the research on prevention, early diagnosis and drug therapies to combat coronary heart diseases.

Sir, in order for Singapore to remain competitive, we need to pay attention to the training of the future generation of our healthcare providers. Only by continuing to invest heavily on our undergraduate and postgraduate medical education will we ensure that our doctors will be competent and conversant with the new developments in medical sciences. Thus, our investments on the Health Manpower Development Programme ought to be enhanced. The learning of medicine is an apprenticeship; one cannot be a good doctor just by reading textbooks. We must encourage those who are willing to teach and those who are willing to learn by providing them with the opportunities.

Sir, it is worthwhile to include the extension of the service hub to become a training hub, as this will boost our aim of being a medical hub in the region. This will have the effect of promoting collaboration with doctors in the neighbouring countries and of gaining their acceptance of us. Training is a great professional relationship creator. The goodwill and mentorship will continue long after the training period is over. Word of mouth is the most effective form of advertisement of our medical capabilities. It would be far more effective than any advertisement campaign, which might earn the wrath of the authorities in our neighbours. There is also a need for the public sector to involve the private sector as partners of the training and service hub. Only then could we have optimised our strengths as a medical hub in the region.

Innovative packaging with other products such as insurance, travel arrangements, hotel and shopping needs should be facilitated to make it more attractive for consumers to come here. The various service sectors will no doubt benefit when the consumers decide to come. A coordinating body that plans and complements the different services to meet the needs of end-users in a mutually consistent way should be formed.

Sir, while I am supportive of most of the Economic Review Committee's recommendations on promoting Singapore as the regional medical hub, I do have a differing view on their recommendation on reviewing the regulations in the Public Hospitals and Medical Clinics Act, with a view to relax restrictions on responsible institution-based advertising locally and abroad. Sir, ethical issues have always been of paramount importance in the conduct of our medical profession, especially with regard to advertising or medical services. There is already provision for limited and responsible advertisement locally by individuals and an even wider provision for public institutions.

Advertising abroad is restricted by the enacted laws of the foreign countries, thus forbidding others to advertise in their countries. The gamma-knife incident a year ago is a good case in point. The Malaysian doctors viewed the promotion of this new modality to a group of doctors and the public in Kuala Lumpur by a Singaporean doctor to be ethically unacceptable and indeed lodged a complaint to the Singapore Medical Council. Indeed, there were formal complaints lodged with the Singapore Medical Association in the past by neighbouring medical associations that Singapore doctors and private hospitals advertised their medical services in the newspapers and the Yellow Pages of the neighbouring countries. The complainants felt this was distasteful and unethical.

Sir, the concerns arising from relaxing advertisement locally by individuals will be the creation of unhealthy demands for certain services by locals rather than attracting foreign patients. The possibility of boosting unnecessary local consumption and over zealous advertisements may also mislead the public. Liberalising advertisments locally may degenerate into enticement or persuasion of the public to use medical services for maximising profits of the doctor.

Sir, I do hope that the Finance Minister would consider my suggestions on making Singapore the regional hub for healthcare.