Debate on MediShield Life – Keeping Healthcare Cost Manageable

(I delivered this speech on 8 July 2014 during the debate on MediShield Life)

Madam Speaker, I welcome the move to improve protection against large hospital bills and against expensive chronic treatments, as well as to cover those with pre-existing conditions. My colleagues have touched on and will be touching on various aspects of MediShield life. I wish to speak today about keeping healthcare costs manageable.

 

The Committee reported that in the recent five years, our total healthcare spending has risen close to 10% each year on average. Medical inflation has been rising much faster than inflation in general. The healthcare industry has little incentive in itself to contain costs. If this medical inflation trend continues, it can be worrying as to how much MediShield Life’s premiums will be in future, as well as the cost of smaller medical bills which are not covered by MediShield Life.

 

The report touched on some areas that the government can look into to contain costs. First, I’d like to understand how we can keep claims reasonable. I’d like to see a robust framework to detect inflated or frivolous treatments by healthcare professionals. Inflated claims can come in the form of prescribing treatments beyond what the patients need or from the over prescription of drugs. How will the government track claims to ensure that even as we strengthen our insurance framework, we will not have inflated claims and unnecessary treatments that will push up healthcare costs, as we have seen that happened in many other countries?

 

Another way to keep costs manageable is for people to stay healthy. That’s easier said than done. Many in Singapore today are already not healthy, being diagnosed with chronic illnesses. For example, 11.3% of Singaporean adults are diabetic. 1 in 3 people are currently diabetic by age 70. A recent study by NUS Saw Swee Hock School of Public Health forecasted that by 2050, Singapore may have as many as 1 million diabetics, with 1 in 2 being diabetic by age 70. [1] Around 24% of adults in Singapore now have high blood pressure (hypertension). [2] What’s needed will be to prevent those with chronic illnesses from developing complications. Diabetes itself is not scary, but it can lead to kidney failure, or the patient becoming blind or needing amputation. A person with high blood pressure may feel healthy, but the ailment can develop into stroke or a heart attack if the situation is not controlled.

 

Our lifestyles are increasingly becoming unhealthy. We can put more effort to focus on those that are already diagnosed as unhealthy and invest in preventive care for them. We need to give the best care possible and to monitor the proper taking of medication to prevent complications from developing, which will be life threatening and are very costly to treat. While we currently already have schemes like CHAS and various subsidies for medicines, it is frightening to note that we now have four new cases of kidney failure every day[3] and two cases of limb amputations are performed each day due to diabetic foot complications[4]. We should constantly monitor the schemes to see how they are working and what else can be done if the results are not as good as what we want them to be.

 

Drugs are another area for cost control. I am also concern about the potential impact that the Trans-Pacific Partnership Agreement (TPP) may have on the cost of drugs. TPP is currently being negotiated between 12 countries which include Singapore. Many negotiating countries have raised concerns about the Intellectual Property (IP) rights chapter in the TPP which reportedly seek a much more stringent level of IP protection than the WTO’s (World Trade Organisation) standards. Fears are that these new rules will strengthen the drug monopoly of big US pharmaceutical companies by altering existing patent laws in their favour[5]. The Medishield Life Review Committee has recommended using generic drugs as far as possible to lower costs. We will need to guard against the TPP drastically changing IP rules that may delay drugs becoming generic.

 

Next, on electronic health records.  I believe information transparency will allow the government to monitor the performance of healthcare providers and to track if appropriate and cost effective treatments are provided. Readily available comprehensive medical data will allow the government to better manage cost across the entire healthcare sector. This is especially so for the private sector, which the Committee had highlighted concerns about “high professional fees” in the private sector.

 

Some 10 years ago, the Ministry of Health made it as one of its priorities for the healthcare sector to adopt ICT for health and to set up a common Electronic Medical Record system. Much has been invested in the National Electronic Health Record system (NEHR) and international experts have been brought in to implement the system. I understand that today, a version of the system is used in the public healthcare sector. However, the vast majority of those in the private healthcare sector and those run by VWOs are not yet adopting the system.

 

For NEHR to help better manage the industry efficiently and effectively, I think it will be necessary to have the private sector and VWO health providers adopt the National Health Record system. We should have all healthcare providers on board the same system. This will let patients have the choice to move to other healthcare providers with full portability of records. The information will allow the government to measure the performances of healthcare providers and if necessary, to even effect changes to payment models, such as to pay for health outcomes rather than just on treatments.[6] I like to know if there are timelines in place for NEHR to be used industry wide.

 

Healthcare has been a laggard in the exploitation of ICT. As we move to provide wider healthcare coverage for all Singaporeans through MediShield Life, how will NEHR play a role in providing more efficient healthcare?

 

Also on technology, telehealth or telemedicine offers opportunities to enable the diagnosis, consultation, treatment, education, care management and self-management of patients remotely.  Telehealth can include the home monitoring of chronic diseases, time sensitive assessments in accident and emergency (A&E) departments by medical specialists in another hospital, video conferencing between patients and health providers, and store-and-forward technologies such as for X-Rays and photographs to be captured and transmitted for analysis by doctors later and remotely.

 

Expanding the use of telehealth has the potential to reduce healthcare costs, increase the level of convenience for patients, and improve patient outcomes over traditional methods. Home monitoring of chronic diseases has been shown to lead to reduced hospitalisations.  A patient in the A&E department can receive care by videoconferencing with a specialist in another hospital and thus may save a transfer to that hospital. Telehealth can provide timely care for stroke patients who may have difficulties travelling to hospitals. [7]

 

I understand telehealth is currently being piloted in Singapore. We will need to move to an agreed-upon reimbursement model. If doctors cannot be compensated for tele-consultations, they will likely fall back on the traditional mode of getting patients to visit them in their clinics. If patient cannot use Medisave or be covered by insurance for telehealth, they may opt not to have telehealth even if it can be more suitable for them. I’d like to see greater adoption of telehealth through better infrastructure and changes to reimbursement models or regulations that inhibit telehealth.

 

Finally, the Committee has recommended that the government build up capabilities to evaluate the cost-effectiveness of medical practice, technologies and drugs. I wish to understand what measures have the government put in place to ensure that new practices, technologies and therapies that are cost-effective in achieving a good treatment outcome are covered by Medishield Life? What will be the measures used to define cost effectiveness? What will be the frequency of such evaluation so that good treatment methods can be covered as soon as practical? Will there be a formal institution that will be set up to make these decisions in a transparent manner and to evaluate appeal on decisions? For example in the United Kingdom, the National Institute for Health and Clinical Excellence (NICE) is government-funded and exercises independent and binding decision-making on what the health service needs to offer[8]. Crucial to the Institute’s independence is its transparency in decision-making. The academic research, industry input, patient advocates’ filing, demographic and epidemiologic data that go into the decision-making process are freely available.

 

In conclusion, MediShield Life is a step in the right direction to ease the worries of Singaporeans on large healthcare bills. I hope the government will examine all ways possible to contain healthcare inflation so that healthcare will be affordable to all.

 

Madam Speaker, I support the motion.

 

———————————– References ————————————

[1] http://www.straitstimes.com/breaking-news/singapore/story/1m-diabetics-2050-singaporeans-get-older-fatter-20121002

[2] http://www.myheart.org.sg/article/about-the-heart-and-heart-disease/statistics/risk-factors/77

[3] http://news.xin.msn.com/en/singapore/sdollar70m-needed-to-support-kidney-patients-nkf-1

[4] http://www.annals.edu.sg/pdf/39VolNo6Jun2010/V39N6p472.pdf

[5] http://www.citizen.org/Page.aspx?pid=5325&frcrld=1

[6] http://www.nytimes.com/2007/05/17/business/17quality.html?pagewanted=all&_r=1&

[7] http://cchpca.org/sites/default/files/Fiscal%20Impact%20of%20AB%20415%20Potential%20Cost%20Savings%20from%20Expansion%20of%20Telehealth_0_0.pdf

[8] http://www.nice.org.uk/About/Who-we-are

Time to review priority for Primary 1 registration for community leaders

 

Last Thursday (12 June 2014), it was announced that parents who become grassroots volunteers will have to do at least two years of grassroots work and not one year as was the case previously, to qualify for getting priority for their children in the Primary 1 registration exercise. They will also be restricted to schools in the constituency where they live. The changes were announced by the People’s Association (PA) in a circular sent in April 2014. It was reported that the PA had reviewed the scheme and felt it was still “relevant” in promoting collaboration between schools and the community. The report stated that the changes were made to ensure that only “deserving” grassroots leaders and district councillors would benefit.

I think it is time to totally review this scheme. I had spoken on this issue a few times in Parliament, the records of which I have extracted and appended below.

The stated reason for this privilege is to promote collaboration between schools and the community. While I think it is relevant that there should be collaboration between schools and the community, it is questionable how many community leaders have actually been actively doing so. If the intention is really such, there can be a change to the rule. The principal of the school that the community leader is applying for priority entry for their children into, must endorse that the community leader is actually actively involved in collaboration projects with the schools for a sustained period. Right now, it appears that this is not the case from the reply given by Senior Minister of State, Ms Indranee Rajah to my question on 13 May 2013 (see below).

Anyone who wishes to serve as a community leader should serve voluntarily. I fail to see how active service to the community but not to the school will actually “promote collaboration between schools and the community.” By attaching various benefits to service as a community leader, it may distort the meaning of community service. The reason stated by the PA that “only deserving grassroots leaders and district councillors would benefit” seem to imply that these leaders must receive various benefits for their service.

 

 ————— Extracts from Singapore Parliament’s Reports ————–

1. Priority for Primary 1 Registration (13 May 2013)

http://sprs.parl.gov.sg/search/topic.jsp?currentTopicID=00000108-WA&currentPubID=00000021-WA&topicKey=00000021-WA.00000108-WA_1%2Bid-d0092b7e-8fb7-4aa8-a342-5c6f5a1a6329%2B

Mr Yee Jenn Jong (Non-Constituency Member): Thank you, Mdm Speaker. Earlier in her reply, the Senior Minister of State mentioned that the community leaders are important to build the bond between the schools and the community. I would like to ask if the Ministry has done any survey to see how many community leaders have actively contributed to the schools that their children are enrolled in, and if it can be a criterion for community leaders to have first made specific contributions to the schools before they are being considered for priority.

Ms Indranee Rajah: I am not aware of any survey. I do not have that information at the current time. If the Member would like to file a specific question on that, I can check. But currently, the criterion is based on contribution to the community, as opposed to contributions specifically to the school. Contributions specifically to the school would be under the parent volunteers scheme or on the Advisory Council of the school. But with respect to the community leaders’ contribution, it is contribution to the community.

 

2. COS 2013 – Ministry of Education (13 March 2013)

http://sprs.parl.gov.sg/search/topic.jsp?currentTopicID=00079140-WA&currentPubID=00079143-WA&topicKey=00079143-WA.00079140-WA_4%2Bbudget%2B

Primary One Admission

Mr Yee Jenn Jong: Madam, while MOE wants every school to be a good school, there is great disparity in results between schools. The highest and lowest medium PSLE T-scores amongst schools last year are 247 and 160 respectively, a difference of 87.I feel community leaders need not be given priority. Being a community leader for the purpose of getting into top primary schools does not gel with the spirit of community service. With the change, we can have a better mix of students of different social backgrounds in our schools, allowing better integration among pupils.

I hope MOE can better spread resources across schools, reduce class size and review the need to centralise gifted students into top schools, then it may not be as much stress over which primary schools to enter.

Mr Lee Kuan Yew had observed that admission to primary schools is based on the social class of parents. Six out of 10 pupils in six of the top primary schools live in private houses. But it is useful to review the primary one admission system. It is a stressful process for some; shifting house and doing volunteer work to get their children into top schools. I agree that priority should be given to those with siblings already in the school for the sake of convenience. Beyond that, we can consider a system with higher balloting chances for alumni, school volunteers and those living near the school. But it need not guarantee their position over others like in the phase system today.

 

(3)  Priority for Primary One Registration Based on Active Community Leadership (13 AUG 2012)

http://sprs.parl.gov.sg/search/topic.jsp?currentTopicID=00077817-WA&currentPubID=00077751-WA&topicKey=00077751-WA.00077817-WA_2%2BhansardContent43a675dd-5000-42da-9fd5-40978d79310f%2B

Mr Yee Jenn Jong asked the Minister for Education with regard to the priority granted for Primary One registration based on active community leadership by the child’s parents (a) what constitutes active community leadership; (b) how many children have gained admission to primary schools yearly based on this priority over the past five years; and (c) whether the Ministry plans to review the necessity for this priority.

Mr Heng Swee Keat: Under the current Primary One (P1) Registration Framework, current serving committee members of the Residents’ Committee (RC), Neighbourhood Committee (NC), Citizen’s Consultative Committee (CCC), Community Club Management Committee (CCMC) and the Community Development Council (CDC) are eligible to register their children under Phase 2B as active community leaders. To qualify as active community leaders, the People’s Association (PA) requires the community leaders to serve actively in these Committees for at least one year prior to the P1 registration exercise.

While active community leaders can choose to register their child under Phase 2B, there is no guarantee that they will be successful in obtaining a place in their school of choice if the number of applications in Phase 2B exceeds the number of places in a school. In the last five years, an average of 330 children, or less than 1% of the primary 1 cohort, were admitted annually under the active community leaders scheme.

The Ministry regularly reviews the P1 Registration Framework, taking into consideration the feedback received after every exercise.

Education and Social Mobility

I delivered this speech in Parliament on 27 May 2014 as my response to the President’s Mid-Term Address.

Madam Speaker, I will be speaking on education and social mobility. I wish to declare that I own businesses that provide services and products to schools.

Education is a key factor for social mobility. It is often presumed that access to education will ‘level the playing field’ for students of different backgrounds, thus creating an environment where individual merit can be identified and rewarded. Indeed it has been so for a good number of Singaporeans as our country moved from third world to first in a relatively short time.

Today, I wish to warn of dangers that can compromise our ability to achieve social mobility through education.

First, is a danger of education perpetuating class stratification, instead of leveling the playing field. It has been acknowledged both by politicians and scholars that entry into ‘branded’ schools in Singapore is a reflection parents’ social class than of student merit.[1]

Entry into the more prestigious and popular primary schools is based strongly on factors such as the location of the family home and parents’ connections to the school. Former Minister Mentor Mr Lee Kuan Yew had observed that admission to primary schools is based on the social class of parents. In a parliamentary reply in 2012, it was revealed that only 40% of the students in six of the most popular primary schools live in HDB flats. This contrasts greatly with 80% of all primary school students residing in HDB flats. MOE had replied that this reflected the mix of residential housing in the vicinity of these 6 schools. Given the current primary 1 admission rules, it will mean that those in the higher social classes will continue to have preferences to enter popular schools.

A second worrying data that suggests the reproduction of class is the profile of the Public Service Commission (PSC) scholarship holders. In 2008, the PSC revealed that 47% of the PSC scholarship recipients that year lived in HDB flats, and 53% lived in private housing. This is an over representation of private housing as up to 85 per cent of Singaporeans live in HDB flats.

Another set of data that also shows class stratification is the profile of students entering universities. In response to a parliamentary question from Member Sylvia Lim in 2008[2], it was revealed that students from 5-room flats and private housing were more likely to enter university (see table below). MOE tracked the 1990-1992 Primary 1 cohorts until they reached ages 22 to 24 in 2007 in order to ascertain levels of university participation according to household types.

Housing-type Distribution of the 1990-1992 SC/PR P1 Cohorts

Housing-type Distribution of the 1990-1992 SC/PR P1 Cohorts

According to MOE, “1 of every 8 undergraduates comes from poorer families who live in 1- to 3-room flats. When compared with the distribution of households of Primary 1 cohorts, students whose parents are more successful are more likely to make it to university.”[2] From the data, only 13% of those living in 1 to 3-room HDB flats made it to university although they had formed 23% of their primary 1 cohort. In contrast, 19% of those in private housing made it to university when they had formed only 12% of their primary 1 cohort.

MOE’s reply stated that “Admission to our publicly funded universities is strictly on the basis of merit. All those who qualify will have a place, regardless of socio-economic status.” However, the definition of ‘meritocracy’ is premised mainly on good examination results which, in turn, do not reflect structural disadvantages that working class families may face such as not being able to afford good tuition or academic enrichment classes.

Taken together, these trends should compel us to critically examine how we can strengthen education’s role as a key facilitator of social mobility. I will list a few areas for review.

First, there are subtle trends of class stratification within the education system. The practice of dollar-for-dollar topping up of the Child Development Account (CDA) is one such example. Here, parents who allocate more funds to their child’s CDA will get more public funds than parents who cannot afford to allocate as much. This is up to $6,000 each for the first two children, $12,000 each for the third and fourth child, and $18,000 each for the fifth child and beyond. Such a practice has the effect of rewarding higher income households while withholding funds from lower income households. The CDA is often used for pre-school education costs and therefore gives a leg up to children of higher income families. Yesterday, I was quite alarmed to hear from the Senior Parliamentary Secretary Mr Hawazi Diapi that since 2001, only 64% of the CDA budget allocated was actually used. No breakdown was provided by the SPS yesterday, but it will not be surprising to anyone that the lower income group who should be using this scheme for their children’s education are not drawing on the CDA budget.

I wish to propose that the funds be allocated to the CDA automatically and that the quantum be standardized to $10,000 for each child. Parents can have the option of topping up the CDA up to $10,000 for each child, if they so wish, to earn higher interest offered by the CDA, as a way of earmarking savings for the child’s education.

Second, I repeat my concern that student care facilities in schools should expand at a faster rate. Student care is an excellent way to help weaker students through care and coaching programmes within the school, before or after school hours. Demand is very strong across all schools that offer such services. Even with the expansion planned by MOE, more than 1/3 of all schools will still not have school-based student care services by 2016.

The impact is felt most strongly by young families where both parents need to work and alternative care at home or from the extended family is lacking. The demand for student care mirrors the strong demand for child care facilities which had caught the government off-guard and for which we are now rapidly ramping up the supply of places and teachers. We need to put more attention and resources into student care right now. By re-assuring parents that every school will have sufficient and affordable student care places within the school, many young parents could be more reassured to have more children and the need for private tuition will be reduced.

Next, I wish to reiterate a proposal I have presented several times since I entered this House. We currently have a competitive system that relies mainly on academic results to sort students into secondary schools and academic streams. While MOE has repeated stated that ‘Every school is a good school”, parents know which schools and which academic streams are most desired. Secondary schools are today highly differentiated and resourced differently. This has created a huge billion-dollar-a-year private tuition industry for those who can afford to seek additional help to give their children the boost to their academic results to get into the desired schools. A disproportionate effort is being spent on chasing academic scores over and above other forms of educational development.

I hope to see pilot neighbourhood schools offering 10-year integrated programme from primary one to secondary four, or even from kindergarten to secondary four. These schools will allow for holistic development of students without the distraction of high-pressure sorting and streaming examinations. It will allow students of mixed abilities to develop together in the same school throughout the 10 years in an environment that is more representative of our mix in society and in real life.

We also need to constantly guard against developing gap in resources between schools and between programmes. The widening income gap amongst Singaporeans has manifested itself in a variety of ways. So-called ‘branded’ or ‘elite’ schools which have larger alumnus or networks may be able to offer more expensive and more comprehensive learning programmes than neighbourhood schools.

I wish to also reiterate my call for smaller class sizes, especially in primary schools. Most schools in Singapore have a class size of around 40, while Primary 1 and 2 classes have 30 students. This is large compared to the OECD’s average of 21 per class. MOE has constantly emphasized that teaching quality is more important than going for smaller class sizes. I agree that teaching quality is important. However, it does not mean that we cannot move towards having general class sizes that are smaller.

With falling birth rates, it appears from MOE statistics that the cohort of students in primary school is getting smaller each year. In 2012, there were nearly 49,000 students in primary 6, versus less than 39,000 students per level in primary 1 and in primary 2; a difference of 10,000 students a year [3]. In contrast, the number of teachers is increasing. The Education Service has grown from under 30,000 in 2009 to 31,800 in 2012 and is projected to grow to 33,000 by 2015 [4]. I understand some of the increases have been and will be used by schools to decide how the teachers will be flexibly deployed in specific situations, such as for Learning Support Programmes and sometimes to have two teachers in a class of 40.

The best time to do the planning for smaller class sizes is now. With increasingly smaller student enrolment, we may not need a lot more teachers than what MOE had already planned for. We can start to move towards smaller class sizes, say starting at 30 students per class from primary 3 and 4, and then gradually moving towards that ratio for primary 5 and 6. This would also necessitate some re-design of the physical infrastructure in schools to have more classrooms.

The smaller class size will also allow teachers to better understand individual students, which will be essential as we move towards a more holistic character and values-based education system. It will also help make classroom management easier for teachers, who may otherwise not be able to pay attention to the weaker students. In my COS speech last year, I had cited studies which noted that large class-size reductions can have significant long-term effects on students’ achievement, and these effects seem to be largest for students from less advantaged backgrounds.

Finally, I like to add my thoughts on the topic of constructive politics which the President has spoken about. I am all for constructive debate in a contest of ideas, conducted with decorum. I believe that debate should be measured and not personal. At the same time, I believe that there should be an environment where politics is seen to be fair and where important institutions are independent so that we can encourage the development of constructive politics.

I do not mean constructive politics just in this House, as the Speaker had observed that ‘we do have quite a constructive Parliament.’ As the Secretary-General of the Workers’ Party Mr Low Thia Khiang had said yesterday, to achieve constructive politics in a diverse and open society, everyone across society has their part to play.

Since I had started my speech on the topic of education, I like to repeat a call I had made in my maiden speech in this House, which is to have Political Education in schools so we can train up a new generation to be more able to participate in constructive politics.

Political education can be about learning how to handle diversity and disagreement in views. It can help students understand our constitution, the role of various institutions, citizenry rights and obligations, as well as the rationale behind these rights and obligations. It can provide them with platforms to air their views on policies and learn how to handle differences in opinions.

Our education system should allow students to engage deeper into subjects where there are ambiguity, where there are not always clear right and wrong answers. Such education programmes can help our future generation be more confident to deal with the diversity of views in the public spaces when they grow up. This will allow Singapore to move towards more constructive debates in politics as the country matures.

Thank you.

———-
1. http://newshub.nus.edu.sg/news/1102/PDF/IMMOBILITY-st-16feb-pA25.pdf
2. http://www.moe.gov.sg/media/parliamentary-replies/2008/04/social-mobility-through-univer.php
3. MOE Education Statistics Digest http://www.moe.gov.sg/education/education-statistics-digest/files/esd-2013.pdf
4. http://www.moe.gov.sg/media/parliamentary-replies/2012/04/target-class-size-in-primary-a.php and Ibid.

3rd Anniversary of GE2011

It’s the 3rd anniversary of GE2011 today and supposedly mid of current term. I randomly googled and found this video (http://www.youtube.com/watch?v=OfIguU1mVIY) which summed up my rollercoaster emotions after 2 months of hard campaigning as a then-newbie. So many people came along the way to help an inexperienced politician. We started with just 2-3 persons walking daily in the first week after I was selected to lead the thrust into Joo Chiat, and it grew into a fairly large team by the end of the campaign. So many residents encouraging us along the way, getting our share of brick-brats, old friends that I found again and many new friends made, and the 5 kg I lost through the daily door-to-door house visits (Alas, the 5 kg was gained back too quickly afterwards and in the wrong places too :>).

Polling day was a mix bag of emotions: Casting my vote at St Pats first thing in morning, then moving from station to station to encourage my polling agents, bumping into residents after their voting who cheered me on, and the tense 2 hours of counting. Up one moment, down the next, and not knowing the results for certain until the last numbers were in. I was asked if I wanted a recount, because it fell just at the allowed 2% limit. I knew it was quite fruitless as I had witnessed the counting and it was impossible to have a 2% error, but we called the recount anyway just to be absolutely certain.

Then began the long drive from Victoria JC counting station to Hougang where we were to assemble for the final results with WP supporters. The two months of events and words in the daily gruelling campaign kept playing through my mind in the 30-min drive: What I could have done better that would have changed the result and the hopes of people which I could not fulfil. One that kept flashing through my mind was that of the retired teacher who phoned me a few days before polling to say “I have been voting for many years with my head. I now believe I must be true to my heart. I am a retiree. I wish to give you something but I have nothing to give. I can only give you my vote.” She was voting for the opposition for the first time. Hers and the hopes of many I met along the way weighed heavily on me as I delivered the short speech in that video, choked with sadness that I had to disappoint them.

I was glad though that the day ended with the major breakthrough of a GRC going to the opposition for the first time, that supposedly impenetrable fortress designed to keep the opposition from playing any big role in local politics. It led the way to two more consecutive by-election victories for the WP subsequently.

Enough of recollections on this GE2011 anniversary morning and back to the long work to build for the future.

MSF – KiFAS and Student Care

I delivered the following two speeches today during the Committee of Supply debate on Ministry of Social and Family:

Sir, I refer the Minister to the KiFAS portion of my Budget speech. I am puzzled that after review, KiFAS can only be used on kindergartens operated by MOE and Anchor Operators. Those that qualify for KiFAS form less than half of the some 500 kindergartens here. More than 95% of qualifying centres belongs to just PCF. Other than PCF and MOE centres, are there actually any other existing centres that are KiFAS approved today?

There are many good kindergartens, some with long history, like the ones my siblings and I attended some 40 to 50 years ago. KiFAS should apply to all registered kindergartens, just like its sister scheme, CFAC. CFAC can be used on all childcare centres. MOE saw it fit to support aided schools with religious affiliations. This government has pride our recent Budgets for being inclusive. I believe we can be more inclusive to allow more, if not all kindergartens to be KiFAS-supported.
 
 
Student Care Centres

Sir, we have seen a huge rise in the demand for child care. Of late, the government has put a lot of resources in this area.

However, I do not see the same being done for student care.  The same young working parents that use childcare services will need student care for their children, at least for the first few years of school.

Commercial SCCs are unattractive to run given the high cost of rent and lack of government support, compared to childcare. MSF website listed 207 student care centres, of which a good number are tuition or childcare centres. These may take a very small number for student care, if at all, as their other operations are generally more profitable. Good student care services could eliminate the need for tuition. Is the current supply of student care places sufficient for our increasing needs?

Student care operations are also not subjected to the ministry’s supervision for quality, unlike childcare. SCCs are not required to be licensed and are not subjected to regular checks by MSF. Their staffs need not attain minimum qualifications and training.

I urge the government to extend better funding and resource support to this sector, create more places, work with MOE to have SCCs in all schools, and to provide closer supervision of the quality of operations.


MOT – Bicycle Safe Singapore

I delivered the following speech during the MOT Committee of Supply debate on 11 March 2014:

YJJ Cycling to BridgeMadam, two months ago, I did a day-long cycling trip through San Francisco (SF), on a working weekday, from the bustling financial and shopping areas to the Golden Gate Bridge and back. It was a refreshing experience. Even in the busy downtown, there were clear bicycle lanes marked out for cyclists. Where there were no dedicated bicycle lanes, the slow lane was marked as a shared lane between motorists and cyclists. Motorists that were on the shared lane followed behind us. In some suburbs without any marked lanes, motorists waited patiently for us to cross the road junctions. They kept a safe distance when overtaking us.

Bicycles were allowed onto trains and subways. There were shared bicycle kiosks in many parts of the city where one could book out a bike and return it at another kiosk. It is no wonder that many in SF commute to work by cycling.

There are other examples of bicycle friendly cities. In Copenhagen, cycling is already the most popular mode of transport and the city has set even ambitious cycling KPIs, such as for bicycling to capture 50% of all modes of transport to school or work. The city has dedicated lanes and special short cut paths for cyclists. It takes a whole-of-city approach to encourage cycling by reducing travel time on popular routes and made roads safer and more comfortable for cyclists.

I acknowledge that the government has implemented some cycling paths and plans to have more. Having experienced San Francisco, I hope the government can set even more ambitious targets to make cycling safer and more comfortable here so many more can use it as a preferred mode of transport. We can start with new towns by having more dedicated bicycle lanes on roads and to have a more aggressive national campaign to cultivate respect for the roads between cyclists and motorists.

MEWR – Transboundary Haze Pollution

I delivered the following speech during the MEWR Committee of Supply debate on 10 March 2014:

Sir, the haze is at our doorstep again. Singapore has been affected by recurring haze episodes resulting from land and forest fires in Indonesia since 1991, with last year being the worst ever. These had an adverse impact on our tourism, economy and the health of our people.

I had previously in this House, called for legislation to empower our authorities to punish those found guilty of transboundary haze pollution in Singapore through their deliberate actions, even when committed outside of our shores. I am glad to see that the ministry is contemplating a bill to this effect that can impose criminal and civil liabilities on guilty entities. While some may argue that it is hard to impose our rights outside of Singapore, we should bear in mind that many of the large plantations have operations in Singapore or are public-listed here. We want to do business with companies that are responsible.

Many Singaporeans desire to know if the products they buy have been produced through illegal land clearance. While the fines may not seem large, the proposed legislation will now empower our government to have the means to take legal actions in our own courts against offenders. Such actions will signal to our consumers whose products they should and should not support. It will also signal to the region of our determination to solve this perennial problem and can hopefully spur other countries to enforce actions on offenders as well.

MOE COS – Learning opportunities for NSFs

I delivered the following speech during MOE COS debate today.
Sir, last year, NUS announced a 3-month online plus 3-month campus learning programme for incoming undergrads who have completed NS. The programme qualifies for academic credits.[1]
Last month, NTU went one up. Its online courses allow anyone to earn credits and transfer these to NTU if they enroll as an undergraduate later.[2]
MINDEF has initiated a Committee to Strengthen National Service (CSNS). Amongst other things, it is looking at how skills picked up during NS could be recognised in civilian life. An example is the Swiss allowing the transfer of skills or leadership positions in the military into credits in universities.[3]
Online learning is now widely used everywhere. We can marry the ideas started by the universities and what MINDEF is looking at, by having more programmes to engage NSFs in continuous learning.
A Straits Times’ article last year highlighted that more NSFs are studying part-time, but with private providers.[4] NSFs will have varying degree of free time. Online can let them pace themselves and learn even whilst in camp.
Our schools can look at courses that expand on what NSFs are learning in their vocations. MINDEF has gone high-tech. Universities can offer courses such as computing, telecommunications and engineering that explore the technology behind the weapons and tools that NSFs use. Management schools can engage them in leadership and soft skills.

MOE COS – Tertiary Students Internship

I delivered the following speech during MOE COS debate today.
Sir, I have taken interns in my companies for the last 13 years, from secondary to tertiary students. I made it a point to expose them to real-life work, as relevant as possible to their training, skills and interests.
Internship is an important part of tertiary training, as the Minister had just said. This will become even more so when we run practice-based universities. Even research universities need to develop meaningful internships to allow their students keep abreast of industry needs. Countries like Germany have strong internship programmes. Often, graduates continue to work for the companies they interned in. Research know-hows from German universities have also strengthened the technical capabilities of companies, often through internship and apprenticeship links.
Madam, there may develop a gap between the number of interns and the availability of meaningful internship places as we increase our tertiary intake. From my experience, I also found differing intensity of engagement by education institutions and by their supervisors with companies like mine.
Internship can be an effort beyond the institutions. It can be at the country level. We can identify technical skills needed in priority sectors and help inject these capabilities into local companies to make them global players. The government can work with larger companies to identify those prepared to commit a minimum number of internship places with real-world projects, and support companies by funding an internship manager. This manager can mentor interns and even guide them while they work part-time from their schools on projects initiated during internship. This will allow companies to assign longer and realistic internship projects and tap on academic supervisors to guide students in research.
By building deeper engagement, it will raise the bar for internship across the country and foster closer links between the industry and research done in tertiary institutions.

MOE Debate – School-based Student Care Centres

I delivered the following speech during MOE COS Debate today.
Madam, there are now 80 School-based Student Care Centres (SSCs). While this is an increase since 2011, SSCs is available in just over 40% of primary schools here.
The number of student care places outside of SSCs will continue to reduce as operators find it commercially unattractive to run these due to high rental costs. Operators prefer to offer child care services which are better funded by the government or run tuition centres. The demand for student care services has increased just as it did for childcare services. The best place to run such centres is in the schools, where students need not move out of the school and the operators can best coordinate with the teachers to follow up on homework and learning. Schools’ facilities in single-session schools are not fully ultilised after school hours. If facilities are offered at token rents to operators, MOE can negotiate for lower fees and higher quality programmes. It will also reduce the need for tuition, benefiting children from disadvantaged families.
MOE did not provide figures for my PQ on the waitlist in SSCs. So I did a random check on 12 SSCs, both in new and in mature estates. I found that all, ALL have NO vacancies, with one having over 50 children on the waitlist! The demand is very strong. I like to see MOE aim for 100% of all primary schools to have SSCs as soon as possible. Existing operators that run community-based centres will likely be interested to move their operations into schools to avoid high rents and can pass the savings on to parents. I hope MOE and MSF can make this into an urgent priority.