Gerald Giam

Debate on the Prevention of Human Trafficking Bill

Sir, the provisions for victim protection and assistance in the Bill need to be strengthened further. There are two key reasons why this is necessary. First, it is the right thing to do for victims of human trafficking. Many victims would have suffered horribly in the hands of their traffickers, and may be in a state of shock, misery and disorientation in a foreign land. As a developed country, Singapore should do all it can to lessen their physical, mental, emotional and financial burdens while they assist in investigations and await the trial of their victimisers.

Mr Deputy Speaker,

Human trafficking is a gross human rights violation and a moral atrocity. According to International Labour Organization (ILO) estimates, there are at least 2.4 million trafficked persons around the world at any given time, with 56% of these in the Asia-Pacific region. Yet there are only a few thousand convictions of traffickers every year. Most victims are not identified and consequently never receive justice for the damage and hurt inflicted on them. Disturbingly, human trafficking remains a low-risk enterprise with high returns for traffickers. The ILO estimates that profits generated from human trafficking are as high as US$32 billion every year.

The United Nations (UN) points out that almost every country in the world is affected by human trafficking, whether as a country of origin, transit or destination for victims. The US State Department said in its 2014 Trafficking in Persons Report that Singapore is a destination country for women and girls from China, India, and parts of Southeast Asia who are victims of sex trafficking, and a transit country for Cambodian and Filipino men subjected to forced labour on fishing vessels that stop at Singapore ports. The report stated that many foreign workers here have assumed large debts to recruitment agencies in both Singapore and their home countries, making them vulnerable to forced labour, including debt bondage. The report further said that some foreign workers reported confiscation of their passports, restrictions on their movement, illegal withholding of their pay, threats of forced repatriation without pay, and physical and sexual abuse, which are all potential indicators of trafficking. The Government has responded to this report, saying that it remains of the view that the US needs to adopt a more objective methodology in future reports.

Last year, there were 53 reported cases of sex trafficking and 49 reported cases of labour trafficking in Singapore. Of these, only seven have been prosecuted, while investigations for most of the other cases are ongoing.

Human trafficking is covered under UN Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children. The Protocol came into force in 2003. Singapore is neither a signatory nor party to this Protocol, although it has ratified the UN Convention against Transnational Organized Crime, which is the parent convention to this protocol.

Singapore currently does not have a dedicated anti-trafficking law; this Bill will be the first. Currently, human trafficking is covered by several different pieces of legislation such as the Women’s Charter and the Children and Young Persons Act.

This Bill represents progress in acknowledging the problem of human trafficking in Singapore instead of conflating human trafficking with other crimes such as human smuggling or illegal migration as used to be the case. It also makes an attempt to move beyond the perception that the bulk of human trafficking offences are related to sex trafficking and sexual exploitation, and acknowledges that labour trafficking is also a problem.

The main focus of this Bill is to criminalise trafficking by imposing penalties, and stepping up enforcement efforts to weed out traffickers. There are also some provisions for victim protection and assistance.

The Inter-Agency Taskforce on Trafficking in Persons was set up in 2010, and is co-chaired by the Ministry of Home Affairs and the Ministry of Manpower. The Taskforce came up with the National Plan of Action in 2011 which aims to combat human trafficking through the “4Ps” framework of prevention, prosecution, protection and partnership.

In this Bill, of the 4Ps, prevention and prosecution feature strongly; protection of trafficking victims is provided for but is lacking in some areas; while partnership is largely absent. My speech will focus on the victim protection and assistance measures in the Bill.

Trafficking victim assistance and protection

The Bill has some provisions for protection and assistance to victims. Clause 18 protects victims of sexual exploitation by providing for in camera court proceedings, and a publication gag order to prevent the identification of victims. Clause 19 empowers the Director of Social Welfare to provide victims with assistance, including temporary shelter and counselling services, as he or she considers “practicable and necessary” in the circumstances of the case. However these are provided administratively at the discretion of the Director.

Second, strengthening the protection and assistance framework would encourage more trafficking victims to come forward to report their plight to the authorities. As human trafficking is a clandestine activity, there is often no paper trail and the prosecution relies heavily on the cooperation of victims to report and testify against suspects. In the absence of a strong victim protection and assistance framework, trafficking victims may decide that they are better off suffering in silence or may be reluctant to cooperate fully with authorities. This will make it harder for the authorities to hunt down traffickers and for prosecutors to secure convictions. Traffickers will then be able to brazenly continue with their evil deeds, and harm even more innocent victims.

There are several ways the victim assistance and protection framework can be improved. First, in addition to shelter and counselling, Clause 19(1) should also mention that victims should be provided with food and healthcare.

Second, victims should be allowed to work during the time their case is ongoing. Most foreign workers who leave their home countries and come to Singapore, do so to seek better work opportunities. The fear of not being able to carry on working while they undergo a lengthy court case, which may last up to three years, could discourage victims from coming forward, as most have families back home relying on their remittances and many would have incurred hefty debts to come to Singapore. While temporary employment is currently permitted where merited, this is done on a case-by-case basis. There is no public mention of the criteria and merits used to determine this. This will result in a degree of uncertainty for victims who are deciding whether or not to report trafficking.

Third, genuine victims should be assisted to safely return to their country of origin without unreasonable delay after the conclusion of the trial. One of the initiatives proposed in the 2011 National Plan of Action (NPA) by the Inter-Agency Taskforce was to “facilitate the re-entry and return of victims to their home countries” after conducting a review of provisions to allow this. The review was due to be completed in 2013 , but this provision is nowhere to be found in the Bill. May I ask if the review been completed and what its conclusions are?

Fourth, victims should also be given access to legal aid and representation. They should also be provided with information on the criminal and administrative proceedings related to their cases, including advice on pursuing civil action against their traffickers to obtain compensation.

Fifth, the courts should study if it is possible to allow victims of human trafficking to attach civil claims to the criminal case, as many will not have the means to take out separate civil lawsuits. As brought up by Ms Sylvia Lim in this House earlier this year, traditional criminal proceedings are aimed at punishing the offender, while the victim usually receives no compensation for injuries or losses from the crime. I would like to suggest that Singapore could consider a scheme practiced in the Netherlands, which allows trafficking victims to attach a civil claim to a criminal case, so that the criminal court can decide on claims at the sentencing stage.

And sixth, with respect to victim protection, the Bill should clarify that trafficking victims will not be prosecuted for offences committed by them, if such offences are a direct consequence of their situation as trafficked persons. Without an assurance that they will not suffer repercussions for speaking out, many may opt not to report their abuse.

Some may argue that providing strong victim assistance and protection could incentivise false reporting. I think this fear is overstated. As a matter of principle, we should not compromise the interests of the vast majority of genuine victims in our attempt to prevent a small minority of false reporters.

A clear definition and guidelines of what constitutes trafficking will help prosecutors and investigators correctly classify trafficking cases based on their circumstances. Genuine trafficking victims should be spared from prosecution. To provide the necessary deterrence, those who engage in wilful false reporting should be prosecuted. This is already provided for under Clause 20 of this Bill.

Other suggestions

Apart from victim assistance and protection, I have several more suggestions on how this Bill and its subsequent implementation could be enhanced to better meet its objectives.

First, after this law is enacted, there needs to be sufficient public education provided to foreign workers, employers and members of the public who may come into contact with trafficked victims. This is so that they will all be more aware of their rights and responsibilities under this law, and report violations when they occur.

Second, the penalties for human trafficking under Clause 4 of this Bill should be enhanced further, given the terrible nature of the crime and the fact that human traffickers often make a tidy profit off their victims. Clause 4 specifies a penalty of up to 10 years imprisonment, a 100,000 dollar fine and caning for the first offence. In comparison, under Proposition 35 which was passed in the state of California in the US to enhance penalties for human trafficking, the maximum fine is 1.5 million US dollars and prison sentences of 15-years-to-life.

Third, the Government should reveal how it plans to measure the success of anti-trafficking efforts following the passing of this Bill. The Government should conduct benchmarking studies every few years to measure the scale of the problem, and how effectively we are rooting out trafficking. The methods, data, and findings should be made available to the public.

And lastly, the fourth “P” in the anti-trafficking framework – partnership – is not mentioned at all in the Bill. Partnership with civil society and cross-border cooperation is a key tenet of a broader anti-trafficking strategy. Human trafficking is a problem that has to be tackled simultaneously on different fronts, and there has to be effective collaboration between different organisations and governments for this to succeed.

Conclusion

Mr Deputy Speaker, this Bill is a step forward in tackling the serious and extensive problem of human trafficking in the world. However, in order for the Bill to achieve its intended objective, the 4P’s of prevention, prosecution, protection and partnership need to work hand-in-hand. We cannot over-rely on prevention and prosecution. Greater protection and assistance to victims of human trafficking is both a moral obligation and a practical imperative to securing more convictions.

The key success indicator of this legislation is if it enables the authorities to identify more victims, to prosecute and convict more culprits of human trafficking, and lower the incidence of this heinous crime. Once this Bill is passed, I urge the Government to expeditiously sign and ratify the UN Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children.

Sir, I support the Bill.

Retirement adequacy and low take-up rate of Lease Buyback Scheme

Mr Gerald Giam Yean Song asked the Minister for Manpower whether there is any evidence to support the Ministry’s view that the low take-up rate for the Lease Buyback Scheme among eligible home owners may be a positive sign that most seniors have other forms of support and are adequately provided for in retirement, as opposed to any shortcomings in the design of the scheme, lack of awareness of the scheme or other reasons.

Parliamentary Question on 8 October 2014

LINK BETWEEN RETIREMENT PROVISION ADEQUACY AND LOW TAKE-UP RATE FOR LEASE BUYBACK SCHEME

Mr Gerald Giam Yean Song asked the Minister for Manpower whether there is any evidence to support the Ministry’s view that the low take-up rate for the Lease Buyback Scheme among eligible home owners may be a positive sign that most seniors have other forms of support and are adequately provided for in retirement, as opposed to any shortcomings in the design of the scheme, lack of awareness of the scheme or other reasons.

Mr Tan Chuan-Jin: Most seniors have various sources of financial support in retirement. Based on the findings of the latest Household Expenditure Survey, a retiree household in 2012/2013 received $1,740 of non-work income on average a month. The sources of income include monthly payouts from CPF, contributions from family members, rental income and investment income. Results from the National Survey of Senior Citizens 2011 also indicated that about two-thirds of senior citizens received income transfers from their children.

Many of our seniors today also have savings in their housing assets which have appreciated significantly. A typical retiree household who owns a three-room or a four-room flat has $300,000 or $400,000 worth of net equity in the flat respectively. The Government has introduced schemes such as the Lease Buyback Scheme (LBS) to provide Singaporeans with additional options for unlocking the savings in their flats to supplement their retirement income if they wish to do so. Seniors who have other forms of financial support might not see the need to take up LBS, or they may choose to move to a small flat or rent out rooms in their flats instead. One in 10 elderly households aged 55 and above sublet a room or the whole flat. These are alternative monetisation options for those who prefer to bequeath their flats to their children.

There is ongoing interest and enquiries about the housing monetisation schemes which indicate awareness of these options, but not all enquiries translate to actual applications. Nonetheless, the Government will continue to study ways to improve the range and features of housing monetisation schemes to ensure that they meet the needs of our seniors while providing flexibility to suit different preferences. MND and HDB recently announced enhancements to the LBS, which include extending LBS to 4-room HDB flats, relaxing the top-up requirement to the CPF for households with two or more lessees, and having the flexibility to choose the amount of lease to retain. These enhancements were made in response to feedback on the LBS. We will continue to take in feedback for future reviews.

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Source: Singapore Parliament Reports

Special access for Indian businesses under CECA

Mr Gerald Giam Yean Song asked the Minister for Trade and Industry if he will provide an update on the Comprehensive Economic Co-operation Agreement (CECA) negotiations and, specifically, whether India is entitled to special access to Singapore’s labour market or banking licences under the terms of CECA.

Parliamentary Question on 8 October 2014

UPDATE ON SPECIAL ACCESS FOR INDIAN BUSINESSES UNDER BILATERAL FREE TRADE AGREEMENT

Mr Gerald Giam Yean Song asked the Minister for Trade and Industry if he will provide an update on the Comprehensive Economic Co-operation Agreement (CECA) negotiations and, specifically, whether India is entitled to special access to Singapore’s labour market or banking licences under the terms of CECA.

The Minister for Trade and Industry (Mr Lim Hng Kiang): Mdm Speaker, the India-Singapore Comprehensive Economic Cooperation Agreement (CECA) entered into force on 1 August 2005. CECA provides for reviews to examine issues related to the Agreement. The first review was completed in 2007 and the second review is on-going.

CECA has increased trade and investment flows between India and Singapore. Bilateral trade grew from S$16.6 billion in 2005 to S$25.5 billion in 2013. Foreign Direct Investment (FDI) from India into Singapore grew from S$1.3 billion in 2005 to S$20 billion in 2012. This has helped to create good jobs for Singaporeans.

CECA serves to bring conveniences to businesses by allowing temporary entry on both sides for certain categories of persons, including business visitors, professionals, and Intra-Corporate Transferees.

Under CECA, Singapore agreed to grant three bank licences with Qualifying Full Bank (QFB) privileges to Indian banks, subject to the prudential requirements of the Monetary Authority of Singapore (MAS). Two Indian QFBs, namely State Bank of India and ICICI Bank, have been approved to date. At the same time, India agreed to allow the three Singapore banks to open a total of 15 bank branches in India and 11 branches have been approved so far.

Mr Gerald Giam Yean Song (Non-Constituency Member): I have two supplementary questions, Madam. I understand that India is claiming that our Work Pass framework, which has been tightened in recent years, somehow violates CECA, or they are saying that they are entitled to allow more workers to come in here. So, can the Minister share with us his interpretation of what India’s claims are?

Secondly, can the Minister also share Ministry of Trade and Industry (MTI)’s position on this, and also give us an assurance that the Government will stand up to pressure from the Indians to allow more of their nationals to work here?

Mr Lim Hng Kiang: Under the Free Trade Agreements (FTAs) that we negotiated, there is an exchange of preferential treatment. In India’s case, in CECA’s case, one of the privileges we extend to India was to create greater conveniences for business people to move between the two countries, Singaporean businessmen to India, and vice versa.

One category is Intra-Corporate Transferees. That means if you got employees that you have employed and you are setting up a business in Singapore, we facilitate the transfer of your corporate employees to help you set up and run the business.

Under the General Agreement on Trade in Services (GATS) in World Trade Organization (WTO), we grant such Intra-Corporate Transferees, say five years. In India’s case, we allow them to do so for eight years. These are the kind of privileges.

All these privileges do not deviate from our right to apply measures to regulate the entry as well as a temporary stay. So, the overall immigration and employment rules that we regulate have to be maintained. But where the special privileges are negotiated in the FTA, then, of course, the counter-party will enjoy those privileges. And we will follow these rules strictly.

Mr Gerald Giam Yean Song: Madam, I understand the point about the privileges. My question is, are we granting them all the privileges that they are entitled to under the CECA, or are they saying that we are not granting them enough? If it is the latter, would that mean that, effectively, the Indians are asking for more Work Passes for themselves?

Mr Lim Hng Kiang: The privileges are clearly delineated in the FTAs and in CECA. As I had explained just now, say, for example, Intra-Corporate Transferees, if the Indians dispute that we are not giving them eight years as we agreed, then they can refer the case to us and, ultimately, there is a dispute settlement process.

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Source: Singapore Parliament Reports

Fees charged for transit wards in hospitals

Mr Gerald Giam Yean Song asked the Minister for Health (a) which public hospitals charge patients for (i) temporary beds in tents; (ii) beds in the corridors outside the wards; or (iii) beds in the ward corridors but not in ward rooms; (b) how all these rates differ from beds in the ward room; and (c) whether stays in temporary beds in tents and in the corridors, outside and inside the ward, qualify for Medisave use or MediShield Life claims.

Parliamentary Question on 8 October 2014

USE OF MEDISAVE FOR PATIENTS IN TRANSIT WARDS OF ACCIDENT AND EMERGENCY DEPARTMENTS IN HOSPITALS

The following question stood in the name of Mr Zainal Sapari —
10 To ask the Minister for Health (a) what is the average length of time that a person will be in the transit ward of the Accident and Emergency Department of a public hospital before getting a bed at the subsidised wards; and (b) whether the Ministry can allow patients who are in transit wards to use their Medisave for payment during their stay there.

11 Mr Gerald Giam Yean Song asked the Minister for Health (a) which public hospitals charge patients for (i) temporary beds in tents; (ii) beds in the corridors outside the wards; or (iii) beds in the ward corridors but not in ward rooms; (b) how all these rates differ from beds in the ward room; and (c) whether stays in temporary beds in tents and in the corridors, outside and inside the ward, qualify for Medisave use or MediShield Life claims.

Mr Zainudin Nordin (Bishan-Toa Payoh): Question No 10.

The Minister for Health (Mr Gan Kim Yong): Madam, may I take both Question Nos 10 and 11 together.

Mdm Speaker: Yes, please.

Mr Gan Kim Yong: Madam, for 2013, the median time for admission to a ward from the Emergency Department was about 2.5 hours.

Patients at the Emergency Departments are prioritised and attended to based on the severity of their conditions. While patients wait to be admitted to an inpatient bed, they will continue to receive medical treatment, nursing care, clinical monitoring and other services, as well as meals that they may require during this transit period. Their safety and care remain the focus of our care teams at the Emergency Departments.

During the transit period, patients would be charged for services that have been rendered. Medisave and MediShield can be used for these charges if the patients are subsequently warded, subject to the prevailing daily and other limits, and the number of inpatient days of stay.

We have received appeals and queries earlier about the computation of Medisave and MediShield claims for patients who received treatment before their inpatient beds were ready. Some hospitals commence inpatient charges only when the patients are transferred to a ward and taken care of by the inpatient team. Ward charges are not imposed during the transit period at the Emergency Department and, consequently, the transit period does not count towards the inpatient days in the computation of Medisave and MediShield claims. Other hospitals consider patients as inpatient once they are taken care of by the inpatient team, even during the transit period. The time during this period contributes towards the length of stay and patients will benefit from higher claims for Medisave and MediShield.

We are reviewing these two ways of computation to see how we can streamline the practices across public hospitals to minimise confusion.

Mr Gerald Giam Yean Song (Non-Constituency Member): A few supplementary questions. I think the Minister basically has said that different hospitals have different practices right now. Can the Minister clarify which are the hospitals that do charge for the temporary beds and which are those that do not?

For the hospitals that charge for the temporary beds, do they charge at the same rate as for beds inside the wards or do they have a discounted rate? The patients on temporary beds are already putting up with a fair degree of discomfort and inconvenience. Would the Minister agree that as long as the bed is not inside the ward, and inside a room, that they should be eligible for a lower rate, and should be allowed to use their Medisave and MediShield where eligible, as well as receive all the C Class ward subsidies? Thank you.

Mr Gan Kim Yong: Madam, I thank the Member for the questions. Firstly, he asked which are the hospitals that charge for temporary beds in the transit area. The Changi General Hospital and the Singapore General Hospital consider the patients as inpatients once they are taken over by the inpatient team and, therefore, their stay during the Emergency Department after they have been taken over by the inpatient team will be charged according to the wards.

He also asked whether there are different rates charged. When the patients are transferred to the ward, they receive the same level of care and treatment as all other patients. So, generally, they will be subjected to the same charges that are imposed at the respective wards, whether they are B2 or C Classes. But some hospitals do exercise some flexibility, taking into account the environment and whether there is a need to help the patients. So some hospitals do offer reduced charges for some of these wards, taking into account various factors.

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Source: Singapore Parliament Reports

Bus announcements for visually-impaired commuters

Asked the Minister for Transport whether LTA will consider using technology to equip (i) bus stops with audible announcements of arriving bus service numbers; and (ii) buses with on-board announcements of approaching bus stops to better enable visually-impaired commuters to travel more independently, safely and conveniently.

Parliamentary Question on 8 October 2014

BUS ANNOUNCEMENTS TO ASSIST VISUALLY-IMPAIRED COMMUTERS

Mr Gerald Giam Yean Song asked the Minister for Transport whether LTA will consider using technology to equip (i) bus stops with audible announcements of arriving bus service numbers; and (ii) buses with on-board announcements of approaching bus stops to better enable visually-impaired commuters to travel more independently, safely and conveniently.

Mrs Josephine Teo (for the Minister for Transport): … Mdm Speaker, LTA is already in the process of developing a central bus management system which will be capable of relaying real-time information to and from buses and bus stops. This system will be implemented progressively from end-2015 and completed in 2017. At that time, we will have announcements of the next bus stop, for example broadcasted on buses, or delivered in a more targeted way through smart-phone applications and other devices. Today, however, the bus operators have separate fleet management systems and do not have the necessary infrastructure and systems in place to support such announcements.

In the meantime, LTA will continue to work with the bus operators to ensure that bus captains are trained to offer persons with disabilities the assistance they need to travel safely and reliably.

Mr Gerald Giam Yean Song: I really appreciate the assurance by the Senior Minister of State that this system would be rolled out. Can I clarify that with this new fleet management system, it will mean that there will be audible announcements on all buses and will that extend to the bus stops as well to announce the incoming buses so that the visually-impaired commuters will be notified of the incoming buses.

Mrs Josephine Teo: Mdm Speaker, the Member’s clarification is a useful one. Audible announcements being broadcasted on buses is fairly straightforward because only the people in the buses will hear them and so it does not cause much disturbance. For audible announcements at bus stops, it is something that we have to consider more carefully. The reason being that some of the bus stops are located quite near to people’s homes. At busy times of the day where the buses are arriving at a bus stop, sometimes on a continuous basis, can you imagine what it means for people who are living in homes quite near these bus stops?

That is something that we have to look at quite carefully. Now, there are only a very small number of cities in the world that have attempted audible announcements at bus stops and where they have done so, it has not been comprehensively implemented. There are only selected bus stops where they will introduce these audible announcements. What we also know is that typically the preference is for push button, on-demand type of announcements so that visually-impaired persons if they require these announcements can access them. However, these announcements are not made at all times of the day and as and when every single bus arrives.

Those are some of the issues that we will have to look into. But, as I said earlier, in today’s context the infrastructure and systems are not even in place to support such audible announcements at bus stops. We will have to let this new system be implemented and then we will at the same time look at how audible announcements can be made feasible at bus stops as well as on buses.

Mr Gerald Giam Yean Song: I thank the Senior Minister of State again for the reply. Is it technically impossible to do it or is it just the noise problem? Because I believe all the SMRT bus stops already have visual announcements of the incoming buses. So I do not see why that technology cannot be extended to audible announcements.

Secondly, I do not think the announcement needs to be that loud because visually-impaired commuters would tend to have more sensitive hearing so it does not have to be so loud that it disturbs the residents nearby. And, perhaps, the Ministry could consider some other alternatives. One is to have tactile announcements that use touch rather than sound to announce the incoming buses.

Thirdly, I think what some cities do is that the buses themselves have an announcement when it pulls into the bus stop to inform the commuters about what bus number that is. From my conversations with the members of the visually-impaired community this is a more pressing need than the announcements on board the bus. They could be at an empty bus stop and not have anyone to ask what the next bus number is. They have told me that even when the bus arrives and they ask the bus driver, sometimes the bus driver just gives a nod or shakes his head. So, to the visually-impaired commuter there is no response. I hope the Ministry can look into this. Thank you.

Mrs Josephine Teo: We certainly will. Thank you.

Er Dr Lee Bee Wah: I would to ask the Senior Minister of State since we are buying a new fleet of buses, can we order the buses in such a way that the door is right at the back, so that commuters when they move into the bus, will move towards the back of the bus straightaway? I think the design of the bus will help commuters in moving towards the back of the bus.

Mrs Josephine Teo: Mdm Speaker, I do not see how this has got to do with audible announcements but we thank her for her suggestion. We will take a look at that.

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Source: Singapore Parliament Reports

Size of MediShield reserves

Asked the Minister for Health (a) what is the size of the MediShield Fund’s reserves as at 31 December 2013; and (b) what is the percentage of the reserves that support (i) claims incurred but not yet submitted or paid; (ii) claims not yet incurred but expected to be paid in the future; (iii) continuing claims which have a long tail; and (iv) future premium rebates.

Parliamentary Question on 4 August 2014

Mr Gerald Giam Yean Song asked the Minister for Health (a) what is the size of the MediShield Fund’s reserves as at 31 December 2013; and (b) what is the percentage of the reserves that support (i) claims incurred but not yet submitted or paid; (ii) claims not yet incurred but expected to be paid in the future; (iii) continuing claims which have a long tail; and (iv) future premium rebates.

Mr Gan Kim Yong (Minister for Health): The MediShield Fund’s reserves were at $1.7 billion as at 31 December 2013. The reserves support scheme liabilities that include policyholders’ claims as well as premium rebates to help policyholders with their premiums in their older ages.

Of the total reserves set aside, currently about two-thirds support ongoing and future claims while the rest support future premium rebates. The portion of the reserves that support premium rebates is expected to rise in future with the move to distribute premiums more evenly over policyholders’ lifetimes under MediShield Life, so that net premiums after the premium rebates rise less steeply in old age.

MediShield liabilities and reserves are reviewed annually in line with established actuarial principles. The MediShield Fund accounts are audited annually by an independent auditor.

Impact on Govt’s new bus contracting model on SMRT and SBST

Asked the Minister for Transport (a) what are the reasons for having SMRT and SBS Transit continue running nine out of 12 bus contract packages without a competitive tender in the initial period of the new bus contracting model even after their Bus Service Operating Licences (BSOL) expire on 31 December 2016; (b) whether during this initial period SMRT and SBS Transit will benefit from being paid the service fee with no fare revenue risk while not being subject to competition for their nine negotiated packages; and (c) when does LTA expect to put out a competitive tender for all 12 bus packages.

Parliamentary Question on 4 August 2014

Mr Gerald Giam Yean Song asked the Minister for Transport (a) what are the reasons for having SMRT and SBS Transit continue running nine out of 12 bus contract packages without a competitive tender in the initial period of the new bus contracting model even after their Bus Service Operating Licences (BSOL) expire on 31 December 2016; (b) whether during this initial period SMRT and SBS Transit will benefit from being paid the service fee with no fare revenue risk while not being subject to competition for their nine negotiated packages; and (c) when does LTA expect to put out a competitive tender for all 12 bus packages.

Mr Lui Tuck Yew (Minister for Transport): The move to the Government contracting model is a major shift, involving more than 270 bus services across the country. The LTA is therefore adopting a gradual approach by tendering three packages initially while retaining the current operators in the remaining nine packages. This is to ensure a smooth transition and minimise the risk of disruption to bus services and inconvenience to commuters. A gradual transition provides time for new operators to become familiar with our market, and for LTA to refine and improve on the tendering and handover processes for each successive tender.

The Bus Service Operating Licences (BSOL) of SMRT and SBST will expire on 31 August 2016. At that time, the nine packages that they will continue to run will also move to a Government contracting model. Since the service standards for these nine packages will be similar to that of the three tendered packages, we can use returns from the competitive tenders as a reference for our negotiations with the operators on the nine packages. Contracts for the nine packages will vary in duration and we will continue to gradually move more of them in phases towards competitive tendering when the contracts expire. We expect more than half of bus packages to be competitively tendered by the early 2020s, and the rest thereafter.

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Source: Singapore Parliament Reports (Hansard)

Delay of Ng Teng Fong General Hospital and increased patient load

Asked the Minister for Health with regard to the delayed opening of the Ng Teng Fong General Hospital and the addition of 150 beds to existing hospitals to cope with the increased patient load

Parliamentary Question on 8 September 2014

Mr Gerald Giam Yean Song asked the Minister for Health with regard to the delayed opening of the Ng Teng Fong General Hospital and the addition of 150 beds to existing hospitals to cope with the increased patient load (a) whether NUH, SGH and CGH have the infrastructural capacity to cope with the additional 150 beds that are unplanned for; (b) whether the bed additions to these hospitals will be permanent or temporary, (c) what proportion of these beds will be housed in corridors or temporary structures such as tents; and (d) whether the hospitals have the ready manpower to absorb the additional strain to ensure that patients will still be able to receive high standards of care.

Mr Gan Kim Yong (Minister for Health): CGH’s additional beds have been planned as part of the CGH-SACH Integrated Building for which works started in 2012. The new Integrated Building will progressively open from end 2014 and will have over 280 beds when fully open in 2015. CGH has been ramping up its manpower in preparation for this planned expansion.

In addition, about 150 beds will be added in NUH and SGH to cope with any surge in acute care demand. As new facilities such as the NUH Medical Centre, the Academia and the National Heart Centre have been completed, the space in existing buildings has become available for new uses. These additional beds will be housed in renovated spaces within the existing hospitals as part of their plans to remodel and refresh their facilities. None of these additional beds will be housed in temporary structures. As JurongHealth and Sengkang Health had recruited staff in preparation for the opening of NTFGH and running of Alexandra Hospital (AH), there is also sufficient manpower in the system to operate these additional beds safely.

Care programme for rape victims

Asked the Deputy Prime Minister and Minister for Home Affairs regarding the Victim Care Cadre (VCC) programme which trains members of the public as victim care officers to provide direct moral support to victims of rape.

Parliamentary Question on 8 September 2014

Mr Gerald Giam Yean Song asked the Deputy Prime Minister and Minister for Home Affairs regarding the Victim Care Cadre (VCC) programme which trains members of the public as victim care officers to provide direct moral support to victims of rape (a) when did the programme start; (b) what are the selection criteria for VCCs and whether these include personnel from groups that are already providing victim care support; (c) what kind of training have the VCCs undergone; (d) to date, how many VCCs have been trained and certified; (e) how many victims have received support from VCCs; (f) whether all victims of serious sexual crimes who make police reports are assigned VCCs; and (g) whether VCCs are allowed to accompany victims through all medical examinations , police interviews and court processes and, if not, whether they can be so allowed.

Mr Teo Chee Hean (Deputy Prime Minister and Minister for Home Affairs): The Police have implemented the Victim Care Cadre (VCC) pilot project in June 2014 to provide care services to victims of serious sexual crimes. It offers an additional avenue of help to victims, and complements the Child Protection Service programme offered by the Ministry of Social and Family Development. The Police also work closely with the Ministry of Education, the National Crime Prevention Council, crisis support groups and medical social workers to provide additional victim care.

VCC volunteers must be at least 21 years of age, possess relevant qualifications and experience in counselling, psychology and/or social work. Suitable candidates are required to undergo a training programme conducted by trained psychologists. To date, 15 volunteers have been appointed under the VCC programme.

Upon activation by the Police, the appointed volunteer will respond to the assigned victim, providing emotional and other support according to the needs of the victim. The consent of the victim is required before a volunteer is assigned. Appointed volunteers are not allowed to sit in during Police interviews to ensure proper conduct of the interviews and for confidentiality reason.

Police will be evaluating the VCC pilot project in June 2015 upon completion of the 1-year trial.

Impact of removal of medical fee guidelines on healthcare costs

Asked the Minister for Health (a) whether the removal of the Singapore Medical Association’s (SMA) Guidelines on Fees (GOF) in 2007 has resulted in more competitive medical consultation and procedure fees in the primary and specialist healthcare sectors; (b) if so, what is the evidence of such price competitiveness and, if not, whether the removal of the GOF has directly or indirectly contributed to healthcare inflation; and (c) whether the Ministry plans to introduce legislative amendments to override the Competition Commission of Singapore’s concerns about fee guidelines and allow the guidelines to be re-introduced to help contain healthcare inflation.

Parliamentary Question on 8 September 2014

Mr Gerald Giam Yean Song asked the Minister for Health:

(a) whether the removal of the Singapore Medical Association’s (SMA) Guidelines on Fees (GOF) in 2007 has resulted in more competitive medical consultation and procedure fees in the primary and specialist healthcare sectors;

(b) if so, what is the evidence of such price competitiveness and, if not, whether the removal of the GOF has directly or indirectly contributed to healthcare inflation; and

(c) whether the Ministry plans to introduce legislative amendments to override the Competition Commission of Singapore’s concerns about fee guidelines and allow the guidelines to be re-introduced to help contain healthcare inflation.

Mr Gan Kim Yong (Minister for Health): The Ministry of Health (MOH) has been monitoring healthcare charges in the private sector. Between 2007 and 2013, based on a sample of 10 common procedures, the increases in the median Surgeon Fees at the major private hospitals ranged from 3.2% per annum (for Hip Replacement Surgery) to 9.7% per annum (for Heart Bypass Surgery). Similar increases were seen at the 75th percentile level. The overall healthcare inflation rate was 3.4% per annum over the same period.

Our samples do however show more variation in the rates of increase for charges above the 75th percentile level. This wider variation may reflect underlying differences in case complexity, individual patient conditions, or different charging practices among doctors. It is therefore difficult to determine the direct impact of the GOF on fees.

Nevertheless, MOH has been working towards facilitating greater price transparency to help both patients and doctors make informed decisions. Since 2003, MOH has been publishing Total Hospital Bills for common conditions at both public and private hospitals. On 1 September 2014, MOH published information on the Total Operation Fees for 65 common procedures at public hospitals. We will continue to explore more avenues to provide useful information and guidance to doctors, patients and their families.

Healthcare costs also rise as a result of the ageing population. As we grow older, we tend to consume more healthcare services which in turn drive up demand and costs. The increasing use of more expensive new technologies in diagnostics and treatment may also drive up healthcare costs. MOH has recently introduced Health Technology Assessment for medical devices to ensure they are both clinically- and cost-effective. We are also working with the public hospitals to set up Medical Device Committees to ensure rational selection and utilisation of these devices.