|
PARLIAMENTARY DEBATES
SINGAPORE
OFFICIAL REPORT
ELEVENTH PARLIAMENT
| PART I OF FIRST SESSION |
VOLUME 82 |
The House met at
1.30 pm
PRESENT:
PERMISSION TO MEMBERS TO BE ABSENT
(2007)
(2007) Ms Ellen Lee
Mr Masagos Zulkifli B M M
Mr S Iswaran
Mr Tharman Shanmugaratnam
Miss Penny Low
Mr Teo Ser Luck
Dr Vivian Balakrishnan
Mr Cedric Foo Chee Keng
Mr Lee Yi Shyan
Mdm Ho Geok Choo
Mrs Lim Hwee Hua
Dr Lim Wee Kiak
Mr Wee Siew Kim
Assoc. Prof. Dr Yaacob Ibrahim
Mr Zainul Abidin Rasheed
Mr Ong Kian Min
Mr Seng Han Thong
Mr Ang Mong Seng
Mr Michael Palmer
Mr Alvin Yeo
Mr Chan Soo Sen
Dr Balaji Sadasivan
Mrs Yu-Foo Yee Shoon
Mr Hawazi Daipi
Mr Inderjit Singh
Mr Charles Chong
Ms Jessica Tan Soon Neo
RAdm (NS) Lui Tuck Yew
Mdm Cynthia Phua
Mr Lim Swee Say
Mr Yeo Guat Kwang
Mdm Halimah Yacob
Dr Ong Seh Hong
Mr Sam Tan Chin Siong
Dr Fatimah Lateef
Dr Lily Neo
Mr Lim Hng Kiang
Dr Ng Eng Hen
Assoc. Prof. Ho Peng Kee
Mr Gan Kim Yong
Mr Sin Boon Ann
Mr Raymond Lim Siang Keat
Mr Teo Chee Hean
Mr Liang Eng Hwa
Dr Muhammad Faishal Ibrahim
Mr Lee Hsien Loong
Assoc. Prof. Koo Tsai Kee
Mr Abdullah Tarmugi
Mr Mah Bow Tan
Ms Lee Bee Wah
Dr Lee Boon Yang
Mr Zainudin Nordin
Mr Matthias Yao Chih
Prof. S Jayakumar
Dr Ahmad Mohd Magad
Mr Goh Chok Tong
Mr Khaw Boon Wan
Mr Arthur Fong
Mr George Yong-Boon Yeo
Mr Lee Kuan Yew
Mr Seah Kian Peng
Ms Grace Fu Hai Yien
Mr Heng Chee How
Ms Eunice Elizabeth Olsen
Mr Gautam Banerjee
Prof. Thio Li-ann
Dr Lam Pin Min
Dr Amy Khor Lean Suan
ABDULLAH TARMUGI
Speaker
Parliament of Singapore
Column No : 922
Mr Speaker: I have to inform hon. Members that I have on 15th November 2006 communicated to the President the Address agreed to by Resolution of this Parliament on 14th November 2006.
Column No : 922
Mr Speaker: On 14th November 2006, Parliament resolved in accordance with the Fourth Schedule of the Constitution of the Republic of Singapore that there shall be nominated Members of Parliament (NMPs) during the term of the present Parliament.
The Special Select Committee was constituted on 15th November 2006 and its Report was presented to Parliament on 12th January 2007 as Parl 1 of 2007.
The Special Select Committee nominated the following nine persons to the President for appointment as NMPs:
Mr Gautam Banerjee;
Ms Cham Hui Fong;
Mr Edwin Khew Teck Fook;
Dr Loo Choon Yong;
Assoc. Prof. Kalyani K Mehta;
Ms Eunice Elizabeth Olsen;
Mrs Jessie Phua;
Mr Siew Kum Hong; and
Prof. Thio Li-ann.
On 18th January 2007, President S R Nathan, by Instruments of Appointment dated 18th January 2007, appointed the nine Members as NMPs for a term of two and a half years with effect from 18th January 2007.
The Nominated Members are present today to take their seats. They will now take their oath or affirmation of allegiance.
Column No : 923
Column No : 923
The following Members took and subscribed the Oath of Allegiance, or made Affirmation of Allegiance, in the order below (in group):
Mr Gautam Banerjee (Nominated Member of Parliament);
Ms Cham Hui Fong (Nominated Member of Parliament);
Mr Edwin Khew Teck Fook (Nominated Member of Parliament);
Dr Loo Choon Yong (Nominated Member of Parliament);
Assoc. Prof. Kalyani K Mehta (Nominated Member of Parliament);
Ms Eunice Elizabeth Olsen (Nominated Member of Parliament);
Mrs Jessie Phua (Nominated Member of Parliament);
Mr Siew Kum Hong (Nominated Member of Parliament); and
Prof. Thio Li-ann (Nominated Member of Parliament).
Mr Speaker: My congratulations to the new Members! I welcome them to Parliament and look forward to their participation in the proceedings of this House.
Column No : 924
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1. Mdm Halimah Yacob asked the Minister for Health if he will provide an update to the House on the MediShield and ElderShield reviews and when these reviews will be completed.
The Minister for Health (Mr Khaw Boon Wan): Sir, both reviews of MediShield and ElderShield are on-going. I hope to complete the reviews within the next few months so that we can have them implemented this year. There will be many rounds of public consultations during the review so that we can forge the best solutions for Singaporeans.
The basic MediShield reform is more straight-forward. We did one last year which has brought about many benefits. The industry structure is now sustainable. Cherry-picking has been eliminated. MediShield has regained its financial viability. Patients with large bills have benefited from larger payouts, with co-payment reduced from 60% to 40% of hospital bills. They have saved thousands of dollars.
But 40% is still high for many patients. Preliminary soundings suggest that Singaporeans are prepared to pay higher premiums for greater MediShield payout, provided the premium increase is not too big. Our actuary consultant is helping us in the review.
In addition, we are reviewing the deductible imposed on the private MediShield enhancement policies. The current level of $3,000 may be too high and there is scope to reduce it by $500 or so. We will settle the details within a month or two. This will particularly benefit the middle income group who use the private unsubsidised wards.
As for ElderShield, this is a four-year-old scheme launched in 2002 to provide some basic financial protection for Singaporeans with severe disabilities. It is contractually bound for a review and renewal by September this year. So we will conclude the review within the next few months and be clear on what to do come September.
Our actuary consultant has been on this assignment for a few months now but it is a complicated review. I hope to achieve clarity by next month so that we can discuss more of this in this House.
Dr Lily Neo (Jalan Besar): Sir, supplementary question on MediShield. Could I ask the Minister whether he is concerned about the 30% of Singaporeans who are not covered under MediShield? How does this group of people pay for their high hospital bills as many of them, in fact, belong to the less well-off group? If the Minister is going to reply that they can apply to Medifund to pay for their bills, then may I ask him how long will the present Medifund last, taking into consideration the increasing life expectancy of the majority and the fast ageing population?
Lastly, may I ask the Minister whether MediShield can only be claimed through hospitalisation as many illnesses can now be treated under day-surgery? Should we not heed to prevent over-consumption incentives in the design of medical insurance?
Mr Khaw Boon Wan : Sir, I am certainly as concerned as Dr Lily Neo and, rightly so, because if you stay out of insurance thinking that you will never fall very sick, then when you are hit with a major illness, life will be rough on you. As for the 30% uninsured - I thought it was 25% but I cannot remember the figure but it is a significant minority - not necessarily all of them belong to the lower income group. I have looked at some of the data and there are those in the middle-class and many of them are housewives of middle-income families. My message remains the same: please buy insurance for your spouse. Most of them are female who are not working and they look after the family, so as husbands, please look after them and buy them insurance. But a large number are children who are not yet in the workforce. Because they are young, their insurance is actually very low. I remember it is only about $30 a year. Please buy insurance for your children as well. They may be young and fit, but you never know, when something happens and you want to buy insurance, they may be excluded because of pre-existing illness. It is far better to sign them on when they are young and healthy.
I think we have discussed this in this House several months ago. A large number of them are young and below 20 years old. We will eventually catch up with them because once they start working and contribute to CPF, we have a way of reminding them. But it is the spouses whom some husbands may have forgotten, but please sign them on.
As for the adequacy of Medifund, certainly with ageing, the demand will grow and that is why every year, around this time, I will be reminding the Minister for Finance to top up Medifund, if possible. There is an immediate target to double it to $2 billion and I am sure the Minister for Finance will be sympathetic.
Mdm Halimah Yacob (Jurong) : Mr Speaker, Sir, after the review, I would like to ask the Minister whether he will give an assurance that MediShield and ElderShield will continue to remain affordable to Singaporeans, in particular, since the Minister has announced that premiums will be reviewed.
My second question is what will be done to assist older and lower-income Singaporeans who do not have enough Medisave savings to take care of their healthcare needs and also to pay for their MediShield premiums.
My third question is to ask the Minister whether he will review the upper limit imposed on Medisave funds because once it reaches a certain amount it will roll over into the Ordinary Account. Will the Ministry be reviewing the upper limit imposed on the Medisave account?
Mr Khaw Boon Wan : Sir, I can certainly assure the Member that affordability must be one of the key elements in the design of the 3M system because, if it is not affordable, what is the point. It may be a good plan on paper but if most people are excluded, then it does not serve any purpose. That is the reason why in the last MediShield reform, I sought advice from Members and I remember Mdm Halimah and Dr Neo gave me very good advice that the premium increase should not exceed single digit which limits it to about $10 a month. That is why we designed the last MediShield reform that way. But once you are limited by $10 per month, the payout is also limited and that is why I was not able to bring the co-payment down from 60% to 20% which was the target I set out to do. But, never mind, we achieved quite a good outcome in reducing it to 40% and this year I hope that the public, at least based on the people whom we have spoken to during the focus group discussions, will find it reasonable to have another round of increase of a few dollars a month and, hopefully to bring co-payment down to 20%, if possible. The various computations are actively being done now. I hope this is something that we can achieve and we can discuss this next month.
On the inadequacy of Medisave for the elderly, whenever the budget allows it, we have some top-ups for the elderly. I am looking forward to the Budget Statement next month. Hopefully, there is some good news for us too.
Dr Lily Neo: Sir, a supplementary question on ElderShield. But before that, the Minister did not reply to the question on whether MediShield can be claimed without hospitalisation. On ElderShield, may I ask the Minister whether the take-up rate is small and whether he will look into this issue? May I also ask him whether he will look into the tenure and amount of ElderShield payout? Is $300 per month for a totally dependent elderly not too little, even for subsistence?
Lastly, could he also look into the unaffordable premium for ElderShield for the elderly?
Mr Khaw Boon Wan: I think the limitations of the current ElderShield have been voiced by Dr Lily Neo and Mdm Halimah and a few MPs before and I have taken note of those criticisms. They are valid and that is why the design of the revised ElderShield will take some time.
Roughly, what I have in mind, which we can discuss more next month is this: obviously the society is not homogeneous and there are people who find $300 per month helpful, but there are also people who find $300 per month too little for the premium they have to pay. Like in the case of MediShield, what I have in mind is to restructure it so that there are various plans and, obviously, they come with different prices, and it is up to Singaporeans to choose which plan they think is reasonable, and then subscribe to it.
As to the acceptance of ElderShield, I am quite glad that the last few times when I looked at the subscription level - because we have a system now, whenever Singaporeans reach the age of 40, a notice will go out to them to encourage them to sign on - those who objected and said, "No, I don't want to sign on.", I think it is down to about 10%. So, in terms of flow, 90% of Singaporeans who reach 40 are signing on to ElderShield. I think that is good and there is a better understanding of the need of such a severe disability plan. But I am quite sure, after reform, if we do a good job of it, many more will find it even more acceptable.
As regards the MediShield for non-hospitalisation or day surgery, I thought it covers.
Dr Lily Neo: Medisave covers.
Mr Khaw Boon Wan: Only Medisave? I have to refresh my memory on this point. Is the Member quite sure that day surgery is not covered by MediShield?
Dr Lily Neo: Not for MediShield.
Mr Khaw Boon Wan: I suppose, like all things, if you want it to cover more, then the premiums have to go up too. So it is one of those things that we always have to find a balance. But the key point is to make sure that at least on hospitalisation, the additional $10 premium increase must be able to cover. If indeed day surgery is not covered then I think the reason must be this: because this is not a routine general health insurance, it is a catastrophic illness insurance, that is, it is for the very sick who requires hospitalisation and typically may require prolonged stay in ICU. So, for day surgery, probably that is why there is no coverage.
Mr Speaker: Mdm Halimah, last question.
Mdm Halimah Yacob: The Minister did not answer my last question. I asked whether he would consider raising the upper limit as currently imposed on Medisave account, instead of allowing it to roll over because there is now more need for funds on the part of the individual.
Mr Khaw Boon Wan: I am sorry for missing this out. Yes, I am sympathetic on this particular issue. Mdm Halimah has raised it before. I have voiced my support for this. The ultimate decision lies with the Minister for Manpower because CPF comes under him. But I will continue to lobby for raising it. I think it is still academic at this stage because most people have not quite crossed that level. But we will look at the data and see when it is a good time to raise it, provided there is acceptance by the other Cabinet Ministers as well.
Column No : 930
2. Dr Lim Wee Kiak asked the Minister for Health (a) what is the average amount of Medisave a Singaporean has upon reaching the retirement age of 62 years; and (b) following the higher withdrawal limit for Medisave, if there has been a corresponding increase in the utilisation of private paying wards in the restructured hospitals.
Mr Khaw Boon Wan: Mr Speaker, Sir, as at end-2005, Singaporeans aged between 61 and 65, have an average Medisave balance of $11,700. So it is about $12,000. This can cover about 10 normal episodes of Class B2 hospitalisations.
On 1st April, 2006, we raised the inpatient withdrawal limit for Medisave from $300 to $400 per day of hospitalisation. The purpose is to help Singaporeans cope with their hospitalisation cost, particularly for those who choose to stay in the unsubsidised wards.
Prior to this, Medisave covered, on average, 67% and 52% of the Class B1 and Class A/private hospital bills respectively. After the change, the Medisave coverage has increased to 76% and 57% respectively, reducing the patients’ out-of-pocket expenses. The change has also benefited patients in Class B2/C. They can now use Medisave to pay for more than 95% of their bills. So, it is practically the full amount.
Dr Lim asked if the change has led to more patients in restructured hospitals opting for private wards. The evidence based on five months of data does not support such a view. I am glad that patients have remained prudent in their choice of wards in accordance with what they can afford. This will help conserve their Medisave balances for their future needs.
Dr Lim Wee Kiak (Sembawang): Mr Speaker, Sir, I would like to ask the Minister for Health whether the current amount in the Medisave is enough, keeping in mind that we are liberalising and allowing Medisave to be used for more chronic illnesses. So for a person having diabetes at 40 years old now, or hypertension as well, the question is whether there will be enough Medisave by the time he actually retires.
Mr Khaw Boon Wan: Indeed, I am very concerned about this particular topic because $11,000 or $12,000 is a five-digit figure, but it is not a big number, bearing in mind that you have many years to go. With medical science, life expectancy is growing every decade by a year or two. So, really, people should look at Medisave carefully and try to conserve, and that is the reason I have to be the very unpopular gatekeeper now and then when Members put up their hands and say, "Please, can I use Medisave for this and for that?", I have to always bring them back to the original purpose of Medisave, which is for costly hospitalisation. So when it is for outpatient treatment, a few dollars, or even if it is tens of dollars, please pay for it out of your pocket and conserve the amount in Medisave for the old age, especially at the time when you will not be working. That is why it took us 20 years after we introduced Medisave to decide to make a major change, which is from inpatient to outpatient, but even then to restrict it to 4 chronic illnesses and we have to restrict it carefully. We have started it for four diseases. Implementation so far has been smooth. It is a little bit of leap of faith. If all patients follow, comply with the instructions of their doctors and manage their chronic illnesses while they are still mild, the hope is that we can avoid very costly complications 20 or 30 years down the road. So, on a life-time basis, hopefully, you save money and not just deplete your funds. That is why for the extension of this scheme to other illnesses, we restrict it to those where there are clear-cut disease management protocols and not just for any kind of outpatient treatment. Because if it is purely consumption without any impact on the future health, then I think we should not do so.
Dr Lim Wee Kiak: One last supplementary question. Since the Medisave is mainly used for hospitalisation as well as more serious disease, the question is, for the poor, they cannot really afford the amount of money to use for health screening. Will the Ministry consider in the future or near future to allow Medisave to be used for health screening, especially for the poorer population so that they can detect their disease at an early stage to avoid costly treatment later on?
Mr Khaw Boon Wan: Health screening is a most interesting topic. It covers a wide field. There are a lot of self-interested parties with personal interest at play when they push for certain kinds of screening. For one, some of those esoteric health screenings cost hundreds, if not thousands, of dollars to pick up things which often the patient would die before that thing kills him. That means he dies of something else and not because of that. Because the scanning technology is now so advanced, you can pick up all sorts of things. Nobody is perfect and we have all kinds of problems with us in the body but we may not die of those things, but die of something else. But if you pick it up, and the US begins to coin a term called "pre-disease", you are in fact healthy people, but if you are pre-diseased, you are pre-diabetes, you are pre-whatever, it merely caused you so much anxiety and, of course, along the way some of the hospitals may come in to say, "Do this, do that." And because in the US, they allow advertising of prescription drugs, you are just making the population hypochrondriac. And when they go to the doctor, they ask, "Please prescribe this, please prescribe that.", and the money just run out but, at the same time, their health does not improve.
So, for screening, please take it with, shall I say, "a pinch of salt". All I know is some of the most effective health screenings which really make sense, which really prolong life and improve health are rather inexpensive, which is, what is your blood pressure, your cholesterol level, and those basic tests are really very cheap which most people can afford. If you cannot afford it, as MPs, as organised by Dr Lily Neo for many years, we do it on a community level and we can help subsidise them. But for those esoteric $600 or $700 type of screening, if you feel that it will benefit you, please pay for it yourself and do not look to me for subsidy or for Medisave to be used.
Column No : 934
3. Ms Ellen Lee asked the Minister for National Development (a) whether a 30% subsidy is in fact true of all HDB flats bought direct from the HDB; and (b) how does the HDB explain the magnitude of the loss in value to some first-time buyers of new flats which had a purchase price of $320,000 to $350,000 in 1996-1998 but which value had dropped to $290,000 to $320,000 since 2004.
The Minister of State for National Development (Ms Grace Fu Hai Yien) (for the Minister for National Development): All new HDB flats are sold at a subsidised price, below the market value. The extent of subsidy varies with flat-type and market conditions. It is not a fixed percentage.
HDB flat prices are subjected to market forces. They move up or down depending on demand and supply factors similar to private properties. It is possible therefore for the prices of HDB flats to fall below their purchase price even with a subsidy. This was what happened when the property market suffered a severe downturn after the Asian Financial Crisis. Without the subsidy, the diminution in value would have been even greater.
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4. Mr Zaqy Mohamad asked the Minister for National Development (a) will the Ministry review the limits on the maximum income for the purchase of subsidised flats from the HDB; and (b) whether, in the HDB’s measure of affordability, it takes into account families which have illnesses to bear or aged parents to support, whether living with them or not.
Ms Grace Fu Hai Yien (for the Minister for National Development): The household income ceiling for the purchase of a subsidised flat by first-time flat buyers is $8,000 per month. For extended families buying a subsidised HDB flat to stay together, they will enjoy a higher household income ceiling of $12,000 per month.
The income ceiling is necessary to ensure that the Government’s limited public housing subsidies are given to those who need them more. It is already generous, as eight out of 10 Singaporean households will satisfy this income ceiling.
Families whose household income exceeds the income ceiling can buy resale HDB flats. Those with monthly household income of up to $10,000 can buy a new Executive Condominium (EC) unit with an EC Housing Grant.
Nonetheless, we recognise that there may be cases deserving special consideration. For example, the household income may exceed the income ceiling only marginally. Or although the household income exceeds the income ceiling, the family is in financial difficulty due to prolonged costly medical treatment needed by a family member. As it will not be possible for HDB to set a meaningful income ceiling that covers all extenuating circumstances, HDB exercises flexibility on a case-by-case basis to allow deserving cases to purchase a subsidised HDB flat.
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5. Dr Teo Ho Pin asked the Deputy Prime Minister and Minister for Home Affairs if he will update the House on counter-terrorism measures taken by the authorities on vehicles transporting hazardous materials on our roads.
The Senior Minister of State for Home Affairs (Assoc. Prof. Ho Peng Kee) (for the Deputy Prime Minister and Minister for Home Affairs): Sir, the threat of terrorists using hazardous material (hazmat), such as flammable materials or hazardous chemicals, for terror attacks is real. For example, on 11th April 2002, terrorists drove a truck carrying liquefied natural gas and ignited the cargo in front of a synagogue in the Tunisian island of Djerba, killing 21 and injuring 30 tourists. Currently the use, manufacture, storage and trade of hazmat are regulated by agencies such as the Singapore Civil Defence Force (SCDF) and the National Environment Agency (NEA). Companies and individuals must adhere to safety and security standards stipulated by these agencies. In addition to safeguarding the hazmat while it is in situ, ie, during storage, the protection of hazmat has been extended to its transportation to minimise the possibility of its being used as a moving terrorist weapon.
A number of measures have been implemented to regulate the transportation of hazmat in Singapore. Let me set these out:
First, hazmat vehicle drivers must pass security screening and a one-day emergency response course conducted by accredited institutes before they are issued with a Hazmat Transport Driver Permit (HTDP) by SCDF.
Second, vehicles must either be licensed by either SCDF or NEA before they can be used to transport flammable materials or hazardous substances respectively.
Third, foreign-registered vehicles transporting hazmat are checked at Tuas Checkpoint before they are allowed entry into Singapore.
Fourth, hazmat drivers are required to adhere to regulated routes and transportation timings.
Fifth, to further minimise the possibility of a terror attack using a hazmat vehicle within the Central Business District (CBD), vehicles that need to travel into the CBD are only allowed to enter through three designated entry points at Anson Road, Lavender Street and Newton Circus where they are checked.
Sir, in addition, the GPS-based Hazmat Transport Vehicle Tracking System (HTVTS) was implemented on 1st July 2005 to track the movement and location of all local and foreign-registered hazmat vehicles transporting bulk quantities of licensable toxic or flammable materials to prevent the possibility of terror attacks using hazmat vehicles as weapons of mass destruction.
These vehicles are monitored on a real-time basis round-the-clock by SCDF's Control Room to ensure that drivers comply with the prescribed requirements. Any violation such as deviation from approved routes would trigger an alarm at SCDF's monitoring console. At the same time, the horn and hazard warning lights of the errant vehicle will be activated. When the alarm is activated, the Hazmat Transport Vehicle Tracking System (HTVTS) operators will verify with the company involved to ascertain the nature of the violations, eg, transportation of hazardous cargoes outside of the regulated transportation routes or hours without prior approval from SCDF. If a violation is unable to be verified through the company concerned, the operators will activate SCDF's Enforcement Bikers and Police's Fast Response Cars, if necessary, to intercept the errant vehicle.
Currently, whilst the tracking system can detect an errant hazmat vehicle, it cannot immobilise the vehicle to prevent a determined terrorist from driving it into a target. We now have plans to roll out the progressive installation of immobilisers on these hazmat vehicles that would enable SCDF to remotely activate them to stop the vehicles by shutting down the engine safely. We will implement this plan over a one-year period, starting from April this year.
Dr Teo Ho Pin (Bukit Panjang): Sir, may I ask the Minister whether the present water tank trucks which actually carry potable water for watering plants will be classified under hazmat vehicles because these vehicles can be easily stolen and refuelled with hazardous materials and pose as a security threat?
Assoc. Prof. Ho Peng Kee: Currently, about 680 vehicles are licensed and these are vehicles of three metric tons or more, because they carry hazardous materials like chlorine and flammable materials like acetylene or butane. These are the ones that are the target and focus of this regulation, not water-carrying trucks.
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6. Dr Fatimah Lateef asked the Deputy Prime Minister and Minister for Home Affairs if he will give an update on Subutex abuse since Subutex’s classification as a controlled drug was implemented in August 2006.
Assoc. Prof. Ho Peng Kee (for the Deputy Prime Minister and Minister for Home Affairs): Sir, buprenorphine (which is the active ingredient in Subutex) was made a Class A controlled drug under the Misuse of Drugs Act on 14th August 2006. Between 14th August 2006 and 31st December last year, CNB arrested a total of 347 persons for Subutex-related offences. Of these, 150 Subutex abusers were sent to the Drug Rehabilitation Centre (DRC) for treatment, 55 abusers were imprisoned under the Long Term Imprisonment regime, and 102 persons were sent to Prisons as they were found to have either trafficked or possessed the drug. As for the remaining 40 persons, 22 were given a warning and 18 are pending further investigations.
Since the implementation of tougher measures to counter Subutex abuse, I am happy to report that the situation has improved significantly. To prevent the influx of illicit supply of the drug, CNB is maintaining a watchful eye at the checkpoints as well as on the ground situation. CNB has not detected any signs of a black market emerging and the number of Subutex tablets seized monthly is not high. Between 14th August 2006 and 31st August 2006, 512 Subutex tablets were seized. Although about 1,000 Subutex tablets were seized in September 2006, this is attributed to a single seizure of 884 Subutex tablets, which is the largest consignment seized so far. 319 tablets and 590 tablets were seized in October and November last year respectively. In December 2006, only 79 tablets were seized.
Feedback from the public also suggests that the Subutex abuse situation has improved. I am sure Members of Parliament who monitor the grounds will know this. Since September 2006, the monthly number of calls and other feedback from the public on Subutex abuse have declined. We believe that CNB's strong enforcement action has led to a decline in public concern over Subutex abuse.
CNB's intelligence indicates that, while it is likely that a small proportion of Subutex abusers may attempt to illicitly access the drug, the vast majority of ex-Subutex abusers have very likely managed to overcome their Subutex dependence. Thus, CNB's enforcement actions have helped to contain Subutex abuse. Nevertheless, CNB will continue to keep a close watch on the Subutex abuse situation and will press on with vigorous enforcement efforts to detect and deter illicit drug activities, taking firm action against both drug traffickers and abusers alike.
Ms Sylvia Lim (Non-Constituency Member): Sir, since August 2006, based on the information released by the Central Narcotics Bureau on its website, it appears that there have been several operations in which significant amounts of heroin had been seized. And I would like to ask the Senior Minister of State whether he thinks it is possible that there has been a displacement effect from Subutex now that it is controlled and such abusers switching instead to heroin.
Assoc. Prof. Ho Peng Kee: Sir, as I have reported, our assessment is that there has been no displacement effect. Firstly, the number of heroin abusers who have been arrested has remained low. Yes, there was some increase in 2006 over 2005, but not significant in terms of the numbers. So that is the key point. Otherwise, you will find the vast number of Subutex abusers on the CARDS system, more than 3,000, if the supply of Subutex is hard to come by, then they would have gone for heroin. But despite vigorous enforcement action, and this is something that CNB has not compromised on just to have nice figures, the number of heroin abusers arrested has not shot up dramatically. The price of heroin on the ground has also remained constant because if the demand is high, the price will go up. These are figures which CNB will monitor very carefully. As for seizure of drugs, I think the number can go up and go down. I think there will be those who may try to bring drugs into Singapore of whatever volume and the bringing of drugs and the seizure of drugs in themselves do not suggest the deterioration of the ground situation.
Dr Fatimah Lateef (Marine Parade): Sir, can I just find out the utilisation rate for the Subutex voluntary rehabilitation programme and the take-up rate since it has been implemented and, also, if the Minister has the data for the ratio breakdown?
Assoc. Prof. Ho Peng Kee: About 3,000 persons signed up for the Subutex programme. Of these, about 2,500 turned up for the first consultation, and about 1,600 completed the medical detoxification phase. So not all have signed up. But I think what is heartening is that of the number of Subutex abusers who were arrested, not more than 170 were people who had gone for the SVRP programme. In other words, a large majority who went and completed it were not arrested subsequently for Subutex abuse. So that is heartening.
Mdm Halimah Yacob: I wanted to ask the Senior Minister of State what is the success rate of the rehabilitation programme because there have been newspaper reports that there have been drop outs of this Subutex rehabilitation programme.
Assoc. Prof. Ho Peng Kee: I think we can only go on the figures of the arrestees, the number of Subutex abusers who have been arrested, since we began the programme in August 2006. As I said in my main answer, only about 350 persons have been arrested for Subutex-related offences over the past four or five months. So that signals that when Subutex was legal, people went for it because it was legal and it was accessible. But when the message was sent that Subutex would be illegal and that you should kick whatever habit you may have, whether it is heroin or other related drugs, in a way we have always said should be done, which is zero tolerance, I think the message went to the ground. So that is the current situation.
Mr Low Thia Khiang (Hougang): Sir, why was Subutex not classified as a controlled drug earlier? Why wait until there was widespread abuse, then the Government decided to take action? Secondly, I wonder whether it is a wise decision for the Government in the first place to allow Subutex to be used legally in a way to counter the impact of heroin drugs.
Assoc. Prof. Ho Peng Kee: I think this point has been answered before, principally by the Minister for Health whose officers are in charge of bringing drugs into Singapore as prescription drugs. This was done in 2002. I think the officers at that time felt that this could be part of the overall scheme to help heroin abusers kick the habit. And, indeed, when it was introduced in Singapore, already six countries had it. So it was done. To the credit of the Government, we did not just do it and leave things as they are because we monitored the ground. When CNB fed back to MHA that there was abuse on the ground, steps were taken to try to arrest the situation, not immediately by making it a controlled drug but by various measures taken. For example, the CARDS system was started whereby all abusers of Subutex were required to register and this online registry was made available to doctors so that they would know if the abusers doctor-hop. A protocol was started, clinical practice guidelines where doctors were taught and informed, workshops were conducted to tell them what is the proper way to administer Subutex. When these measures were implemented and still did not stem the tide, we felt that we should do more and in a sense reversed the decision and hence we made Subutex a controlled drug.
Mr Zaqy Mohamad (Hong Kah): I would like to go back to the question earlier whether heroin was a substitute for Subutex. If we look at the trend the other way around where Subutex became a substitute for heroin, does the Ministry see any other substitutes? I do not think that they would go to a more expensive substitute but to a cheaper alternative. Do we see a trend with substitute drugs, apart from Subutex, now that we have clamped down on Subutex?
Assoc. Prof. Ho Peng Kee: We do not want to use a drug-substitution approach. This episode shows us that that is not the approach to take. We are, of course, monitoring other drugs. For example, Dormicum is one drug we are monitoring. But unlike Subutex, Dormicum has also other medical uses. It is used for pre-surgery anaesthesia. It can be used to help people who cannot sleep. So, we do not want to just always make a drug a controlled drug when it is abused. The best way is to monitor, work within the framework and make it controlled, if need be.
Just one other point on my previous answer. The Minister for Health is on record saying that it was a matter of poor judgement on the part of the Ministry of Health for having introduced Subutex. So it is already very widely explained in the media. There is nothing to hide. But to give the Government credit, when we realised that it should not have been done in the first place, we took remedial actions clearly, decisively and, most importantly, as a Government, multi-agencies working together.
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7. Mdm Ho Geok Choo asked the Minister for Manpower (a) how will a 3% increase in CPF contributions impact the business competitiveness of Singapore; and (b) if the fruits of Singapore’s economic growth can be passed on to workers through their variable wage component instead of raising the employer’s CPF contribution.
The Minister for Manpower (Dr Ng Eng Hen): Mr Speaker, Sir, the NTUC proposed the CPF increase. The Government is still consulting various stakeholders, including unionists, employers, workers and other relevant agencies on the proposed CPF increase. It would be premature to speculate on the actual increase, if any, but we agree with Mdm Ho that the impact on our overall business competitiveness should also be a factor for consideration.
Mdm Ho also asked if we should increase workers’ variable wage component instead of the employer's CPF contribution. CPF increases and rewarding workers through a higher variable wage component are not mutually exclusive options. It does not need to be "either or". You can do both. Our view is that, if the economy continues to do well, an increase in employer CPF rates may be appropriate, as a structural change to benefit all workers.
Mdm Ho Geok Choo (West Coast): Mr Speaker, Sir, I would like to ask what is the Ministry's view with the following observation. Where economists have warned of divergent growth patterns between different businesses and income groups and that a dual economy may emerge, with businesses catering to the global market seeing robust growth whilst, on the other hand, companies serving local markets are lagging behind because private consumption growth is slow. I would like to ask how and how else can the Government help equalise this disparity for businesses and incomes.
Dr Ng Eng Hen: Mr Speaker, Sir, I thank Mdm Ho for her question. She is asking for two sets of situations. One set is for workers. In fact, she is quite right. The low-wage workers, if we increase the CPF for them, they would be more costly to employ and they might find problems in employability. If we increase, for example, the employees' CPF, obviously they will have less in take-home pay. I think that is why there is merit in NTUC's suggestion that, for this group of workers, we actually reduce both, and that is something we are seriously considering, ie, reduce the employees' CPF so that their take-home pay is increased, and reduce the employer's CPF so that they cost less to hire.
Of course, then something has to be done if we did do that to match the reduction in CPF, and this is where Workfare comes in and this is an active area that we are consulting various agencies. For various companies, Mdm Ho is saying, "Yes, some companies are doing well and there is a global demand for my goods, but certain companies that are looking at domestic demand may not be doing very well." And we agree that the CPF is a blunt tool. Even when we reduced it, there were companies that were doing well post-SARS. We recognise and, therefore, it is important to consider two general points.
One, that we should do it only when the economic forecast is sustained and projections are good. Two, the actual increase, if any, should be able to allow a majority of companies to respond to it, as well as to look at other budget measures which may be helpful to these companies which are usually the SMEs.
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8. Mdm Halimah Yacob asked the Minister for Manpower, considering that only four in ten Singaporeans had the mandatory Minimum Sum savings in their CPF accounts in 2005 and a survey result released in February 2006 showed that only one in ten actively saved for retirement, what more can be done to help enhance Singaporeans’ retirement security.
Dr Ng Eng Hen: Sir, about four in ten active CPF members who turned 55 in 2005 met the Minimum Sum of $90,000.
One reason for this is that members were and are able to withdraw 50% of their CPF balances when they turn 55, before they set aside the Minimum Sum. In other words, previously we said, "Even if you did not, you could withdraw an amount of your CPF." If we had not allowed that, 60% of active members would have met this Minimum Sum.
This is the reason why the Government had announced in 2003 that the Minimum Sum should be gradually increased, and the 50% withdrawal rule will be progressively phased out starting from 2009. These changes will help Singaporeans to set aside more funds for their retirement.
Besides changing the withdrawal rules, the Government will help Singaporeans to enhance their retirement security in a number of other ways.
Firstly, the Government will help older Singaporeans keep their jobs and stay longer in their jobs so that they can earn more and put more into their CPF.
Secondly, we will find ways to help CPF members enhance the returns on their CPF savings. In February this year, the CPF Board has tightened the criteria for admitting funds into the CPF Investment Scheme (CPFIS) in order to improve the quality of funds in CPFIS. In other words, we set out a number of criteria, both on expense ratios and fund loading charges as well as how they perform. So, we are using two levers. One is information, ie, to put out the information on how the funds perform. We rank them in terms of their expense ratios, as well as set benchmarks for how much they can charge.
Finally, the CPF Board will continue to educate CPF members on ways to improve their retirement adequacy. We are working with market players to provide members with better information about their investments, educating members so that they can make informed investment decisions, providing online financial tools and reaching out to Singaporeans through seminars and road shows on the need for retirement funding. The most recent road show at the HDB Hub in September 2006 attracted 92,000 visitors. So Singaporeans are actively engaged, and I take it that they want to learn also how to plan their retirement. We will also work with the Housing and Development Board to encourage the prudent use by members of CPF for housing.
Mdm Halimah Yacob: Sir, I would like, firstly, to ask the Minister whether, in the Minister's view, the Minimum Sum that members can withdraw after 62 is sufficient to take care of their retirement needs. Secondly, the Minister alluded to the fact that there is a study that is going on to look into how to enhance the returns to members' CPF contributions. When will that study be completed and its recommendations made and put in place? Thirdly, are there any proposals to look into how to help Singaporeans make use of their flats or assets to convert them into cash to make use of them for their retirement income?
Dr Ng Eng Hen: Sir, I thank Mdm Halimah for bringing up those salient questions, which give us the opportunity to touch on them.
The Minimum Sum, as it is called, is the minimum sum, ie, minimum enough for substantial living and let me translate it into monetary terms. If we assume a 20-year lifespan from age 62, the average life expectancy now at age 62 for males is 81 and that for females is 84. For females, 84 minus 62 is 22 years. If we translate so many in dollar terms, ie, about $90,000 over 20 years, we get the amount. That is the amount that we think is adequate for subsistence living. That is why it is called the Minimum Sum.
The second point which Mdm Halimah asked is whether we are considering a variety of plans to enhance the retirement savings for members and when the study would be completed. Sir, the study is on-going. But even as we are looking at various aspects, we have moved. Some of the changes the CPF Board has made in terms of tightening entry of funds and dictating maximum expense ratios were as a result of this study. There was a proposal put that the CPF Board should consider itself as an aggregating body to put out funds. That is a little bit more complex and it has taken us a while. We are still consulting various stakeholders. The issues are risk-tolerance and educating members, which the industry tells us is not that easy. No matter how much we educate members, some do make wrong decisions in investments. In any framework where we liberalise the investment framework, members must be willing to live with that risk.
There was a third point, on the monetisation of assets. As the Prime Minister mentioned, the majority of Singaporeans have assets. Even the lowest 20% of households have a positive equity of $138,000. This is a significant asset that we can help them monetise and have an income stream. It is an added revenue for their retirement. I think the Minister for National Development is actively studying these options in terms of how we can provide options that allow our elderly to monetise.
Dr Lily Neo: Mr Speaker, Sir, could I ask the Minister what is the total amount of members' balances in the CPF presently? How are members' funds being invested and what are the returns of such investments? How are the CPF rates of return being protected against the current rates of inflation? Can there be better returns to members, especially during retirement, to address the issues of longevity and inflation risks? Lastly, could the Minister look into the CPFIS scheme, ie, the early withdrawal scheme, to see whether such funds should be centrally managed, instead of leaving them to individual choice, for better return outcomes for members?
Dr Ng Eng Hen: Sir, as I mentioned, these are active suggestions that we are looking into. But we cannot run away from one cardinal principle on investing, ie, higher returns come with greater risks. So, if a member wants to put in his funds which may have a projected higher return, he has to live with the fact that he may also lose money in the short term. That is why the current framework, which pays 4% for the SA and the MA accounts, is risk-free, the Government bears the risks. Members, if they want to, for example, could invest in the CPFIS. Unfortunately, as our results show, about three-quarters of them do not make good investment decisions and fail to outperform CPF's interest rates.
Mdm Lily Neo asked whether we should invest on behalf of members. That is a good suggestion. It allows us to aggregate the sums and reduce the expense ratio. But the problem we are still grappling with is one of investment risk. Even though I may do it cheaper for you, ie, at a lower amount, if the stocks go down and there is a loss of money, there is a risk that we will have to factor in. So, we are looking at all these issues. Currently, at the 4% interest risk-free rate on SA and MA, I think it is quite reasonable, given the current conditions of the market.
Dr Ahmad Mohd Magad (Pasir Ris-Punggol): Mr Speaker, Sir, the Supplementary Retirement Scheme (SRS) has been indeed one of the vehicles used to enhance Singaporeans' retirement security. May I ask the Minister to please explain why the maximum contribution cap on the SRS declines each year instead of going the other way round?
Dr Ng Eng Hen: Sir, that is a very good question best answered by the Minister for Finance.
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9. Ms Lee Bee Wah asked the Minister for Trade and Industry in view of the large investments involved in, and the high profile of, the two Integrated Resorts (a) if mechanisms have been put in place to monitor the work-in-progress to ensure compliance with the contract awarded; (b) if he will provide an update on the work-in-progress with regard to these two projects; and (c) what recourse is there if the companies fail to meet their contractual obligations, such as completion deadlines.
The Minister for Trade and Industry (Mr Lim Hng Kiang): Sir, the obligations of the Integrated Resort (IR) operators are clearly outlined in the Requests for Proposals and the Development Agreements. The two IR operators are contractually bound to deliver the overall IR concept and all the components of the IR as detailed in the accepted proposal. Any changes to the accepted proposal would require the Government's approval.
Furthermore, the IR operators must start construction within three years and complete the construction within eight years from the date of the signing of the Development Agreement. They also have to incur 100% of the development investment within three years from the first issuance of the casino licence, or eight years from the date of signing the Development Agreement, whichever is earlier.
If the IR operators fail to meet their contractual obligations, the Government reserves the right to forfeit the security deposit, which is 5% of the development investment, or about $200 million for each IR. If necessary, the Government can also repossess the IR land.
Let me assure Members that while we have put in place robust safeguards, the IR operators themselves have every incentive to complete their projects on time and on budget. The two IRs have an exclusivity period of only 10 years, and every month of delay translates to not just substantial revenues forgone, but also interest costs incurred for the IR operators. The cost of delay will thus be high especially given the large investments involved.
The Government will continue to closely engage with the two IR operators to ensure the successful implementation of the IRs.
Ms Lee Bee Wah (Ang Mo Kio): Sir, now that Singapore has awarded one of its biggest projects on Sentosa to a Malaysian company, can the Minister please inform the House whether he expects that Singapore companies will find themselves more welcome when they invest in Malaysia, especially the south Johore economic zone?
Mr Lim Hng Kiang: Sir, we awarded the IR to the Malaysian company entirely on the merits of their proposal. And we hope that our neighbours - Malaysia, Indonesia, whichever country - will welcome Singapore investors on the merits of their investment proposals. I think this is the best way for an enduring and sustaining relationship. Of course, with more economic contacts with our companies, the economic linkages and the people-and-people linkages will help facilitate relationship between us and our neighbours.
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10. Mdm Ho Geok Choo asked the Minister for Trade and Industry (a) what is the increase in the number of small and medium enterprises (SMEs) in the last five years and which industries do they belong to; (b) what contributions do they make to the Singapore economy; and (c) what are some of the more pressing needs of these SMEs and how are they being helped.
Mr Lim Hng Kiang: Sir, between 2000 and 2004, the number of small and medium enterprises (or SMEs) increased by about 13,000. Today, we have some 133,000 SMEs in Singapore, which make up 99% of all our enterprises. About 94% of our SMEs belong to the service and commerce industries, with the remaining 6% in manufacturing . SMEs contribute some 42% of our GDP and employ 56% of our workforce.