MOH: MediSave use for outpatient treatment

Committee of Supply debate, 5 March 2021.

MediSave withdrawal limits

Many seniors suffer from chronic conditions which require extended care that can be very expensive. Most outpatient treatment is not covered by Medishield Life, and access to Medifund is only available to the very low income. The use of Medisave is subject to annual withdrawal caps. This can have the undesirable effect of discouraging seniors from seeking early treatment. 

Can MOH allow MediSave withdrawals for the treatment of all chronic conditions, not just those on the Chronic Disease Management Programme list, to ensure that no one is excluded just because they suffer from a less common chronic condition. 

Can MOH remove annual withdrawal limits on the use of MediSave for patients over 60 who have a balance of at least $5,000 in their MediSave accounts?

This can be rolled out at polyclinics, restructured hospitals and CHAS clinics, where tight procedures are already in place to ensure that only medically-necessary treatment is prescribed.

Senior Minister of State Koh Poh Koon responded to my cut, but did not announce any further liberalisation of the use of MediSave. Following the ministers’ responses, I raised further clarifications:

What is the Ministry’s main concern about allowing greater use of Medisave in polyclinics, SOCs and restructured hospitals? I know MOH is worried about the premature depletion of patients’ Medisave. However Medisave can only be withdrawn for medically-necessary treatment.

The risk of doctors in these public institutions over-treating is minimal. Patients there also have little discretion to demand unnecessary treatment.

On the flip side, patients do retain the discretion to skip treatment to reduce OOP payments. This will impact the success of their treatment and may cost both the patient and the government more in the long term. 

Can MOH re-consider how prudent it still is to restrict the use of Medisave in public healthcare institutions?

The SMS responded that MOH is open to further liberalisation of the use of MediSave. His full reply will be published in the Parliament Hansard.

Workplace sexual harassment

Workplace sexual harassment

Minister for Home Affairs and Law K Shanmugam made a ministerial statement today (5 March 2021) outlining MHA and MinLaw’s efforts to protect victims of hurt and sexual crimes. After his statement, I sought the Minister’s clarifications on MinLaw’s efforts to protect victims of workplace sexual harassment, which is also very serious.

An Aware-Ipsos survey in Nov 2020 found that 40% of workers in Singapore said they had been sexually harassed at the workplace but only 3 in 10 of them officially reported it. Many were reluctant to report their harassment because of the fear of not being believed or being blamed for bringing it upon themselves.

I asked Minister Shanmugam:

Has the Government done any victimisation surveys of its own to uncover the extent of workplace sexual harassment in Singapore and, if so, what are its findings?

Are there plans to table legislation to oblige employers to prevent and address workplace sexual harassment?

I know TAFEP has issued a Tripartite Advisory on Managing Workplace Harassment, which is quite comprehensive. However, this is only an advisory and not a statutory requirement. Employers can choose to ignore them.

I also understand that we have the Prevention of Harassment Act (POHA). However that requires the victim file for a court order, which may be too onerous for them.

Would it be better to give the TAFEP advisory more teeth?

Among his replies, the Minister said that where it concerns employers’ obligations to deal with workplace sexual harassment, this falls under the purview of Ministry of Manpower. He invited me to file a Parliamentary Question for MOM, which I will.

MOT: Commuter-centric public transport

Committee of Supply debate, 5 March 2021.

Commuter-centric public transport

Efficient and convenient public transport is vital to achieving many national priorities. It allows HDB to build more flats away from the city; it enables workers to travel to further-out workplaces; and it helps us reach our climate change goals.

I sold my car five years ago and now make most of my trips by bus and MRT. I have not regretted this decision and highly recommend it to others who can afford not to drive.

Improving the commuter experience can convince more people to take public transport — reducing both traffic congestion and carbon emissions.

How can we nudge more people towards going car-lite? I have a few suggestions:

First, reduce the amount of walking needed during the journey. Singapore’s tropical weather is not conducive to walking outdoors for long distances while dressed up for work. Transport planners should keep this in mind when planning the location of bus stops and the routes of feeder bus services. For example, some of my HDB and condo residents living along Bedok Reservoir Road do not have a direct feeder bus to the nearby Bedok North MRT and have a rather long walk to and from the station.

Second, construct more covered linkways from housing estates, including private condominiums, to transport nodes. Covered linkways can influence a commuter’s decision whether to brave the elements or take private transport. 

Third, reduce crowding on trains and buses so that commuters have a more comfortable ride with better safe-distancing. I hope MRT operators will also stop removing seats from their train cars, because we commuters like sitting during our rides!

And fourth, continue to make our roads and public transport more accessible for people with disabilities. I had earlier suggested how we should use tactile signals to enable visually-impaired commuters to cross roads late at night. I look forward to that being implemented.

MOE: Foundation subjects in primary school

Committee of Supply debate, 3 March 2021.

Foundation level subjects

In primary school, students may take a combination of Standard and Foundation Level subjects based on their strengths and choices. 

However, many students and parents may not be aware that, for the purpose of Secondary 1 posting, even a perfect score at the Foundation Level maps to a Standard Level Achievement Level (AL) of only AL 6. In contrast, students taking Standard Level subjects can achieve AL 5 if they score just 65%. A higher AL translates to a poorer PSLE score.

If parents opt for their child to take a Foundation Level subject after P4, it will be an uphill climb to get back to Standard Level in P6.

Poor grades in school are seldom a full reflection of the student’s abilities. The quality of instruction they receive and their home environment make a big difference. Some students simply need more encouragement and guidance to do better academically.

What are the objective and subjective criteria that schools use to determine the student’s Subject Level combinations?

How are parents, including those who may be less educated, made fully aware of the impact that taking Foundation Level subjects will have on their children’s PSLE scores?

How do schools ensure that late-bloomers have a fair chance of taking Standard Level subjects at the PSLE, despite their poor exam performance in P4 and P5?

MND: Temporary development levy

Committee of Supply debate, 4 March 2021.

Temporary development levy

The Temporary Development Levy (TDL) is a tax payable when permission is granted for a temporary enhancement of land value. The TDL can amount to tens of thousands of dollars payable by a small business every year, and can form a significant proportion of their business costs.

Tenancy agreements seldom specify who is responsible for paying the TDL, and tenants are often in a weaker bargaining position vis-à-vis their landlords when the TDL is levied. Often, the tenant is unaware of the TDL until they receive the bill, and would not have factored this into their business expenses. It can be inequitable if the tenant bears the full TDL, because the landlord also benefits from the enhancement of land value by being able to charge a higher rent to the tenant.

Could URA require that all change of use applications include an undertaking from the applicant that the TDL had been discussed between landlord and tenant?

Second, for some industries, URA grants Temporary Permission (TP) for only one year at a time. This can result in widely fluctuating TDL payable every year, making business planning difficult.

Can URA provide businesses more certainty by giving them a choice of TP of between three and five years, to better align with typical commercial tenancy agreements? This will allow tenants to negotiate equitable rental contracts with their landlords and make other business plans.

Lastly, some businesses have lamented to me that their TDL far exceeds their business revenue, especially during the pandemic. If businesses are unable to pay the TDL, they might have to close down, leading to losses for themselves, their landlords and their employees. The Government will also lose out on tax revenue. 

Can URA consider giving such businesses rebates or deferments of their TDL?

MOM: Progressive wage model

Committee of Supply debate, 2 March 2021.

Progressive wage model

The progressive wage model (PWM) currently covers three industry sectors: cleaning, security and landscaping. It will cover the lift and escalator maintenance sector by 2022 and there are now discussions to implement PWM in six more sectors.

Based on MOM labour force data, apart from the aforementioned sectors, there are still more than 80,000 Singapore citizens and permanent residents aged 15 years and over working in other sectors, earning a gross income of less than $1,000 per month. These include 27,300 in transportation and storage, 10,900 in public administration and education, 8,000 in manufacturing, and 7,400 in health and social services. If we include those earning less than $1,500 per month, the numbers more than double.

Can the Minister share whether MOM has plans to roll out PWM to these sectors and, if so, what are the broad timelines for doing so?

The NTUC wants to look at a vocational PWM for lower-wage occupations like clerks, general machine operators and electricians. How does MOM plan to implement PWM for these vocations given they cut across multiple sectors? What levers will MOM use to impose wage, training and career progression requirements, in the absence of licensing conditions?

Finally, DPM Heng said that the Government’s aspiration is for every sector of the economy to have some form of progressive wages. Moving forward, how will the Government roll out the PWM differently, so that it can be implemented at a quicker pace and made universal? Which processes and requirements will be streamlined or removed, to ensure a faster rollout?

MOE: University cohort participation rate

Committee of Supply debate, 3 March 2021.

University cohort participation rate

Every year, around 9,000 students graduate from private education institutions offering degree courses in Singapore, while thousands more study in universities overseas. Apart from the few who obtain scholarships, most of these students have to pay full tuition fees for their studies.

This can cost them between $8,000 and $30,000 a year at local private education institutions — which vary considerably in instructional quality and resources — and an average of $33,000 annually in overseas universities. These are enormous financial commitments for them and their parents.

In contrast, their peers in local autonomous universities (AUs) spend around $8,200 annually for a non-medical degree after benefiting from tuition grants.

Many polytechnic graduates feel the pressure to get a degree because of better job and salary prospects as they compete in a globalised job marketplace, even in Singapore.

The cohort participation rate in local autonomous universities last year was 42%. Can our AUs continue to open up more places, raising the target cohort participation rate to 50%? This will allow more deserving Singaporeans who want to attend the AUs to tap on the Tuition Grant Scheme and benefit from the high quality of education offered by our AUs.

MinLaw: Resolving neighbour disputes

Ministry of Law Committee of Supply debate, 2 March 2021

Resolving neighbour disputes

Neighbour disputes are some of the most thorny issues in public housing estates. 

Residents often contact the Police, HDB, town councils or their MPs to seek assistance. Avenues like the Community Mediation Centre (CMC) and Community Disputes Resolution Tribunal (CDRT) are available, but many residents seem less keen on using them because of administrative hurdles and perceived ineffectiveness.

Can there be a more streamlined, efficient and effective process available to residents at the first instance?

The CMC could be that avenue, but it first needs to be given more resources and teeth.

First, when a resident chooses to lodge an application for mediation, the CMC should mandate that both parties be present at the mediation; it should not be voluntary.

Second, the CMC should be staffed with full-time, professional mediators to mediate cases. This can also help to boost their authority in the eyes of the disputing parties.

Third, agreements must be binding on all parties. If violated, the complainant should be able to use it to file a case with the CDRT for a fast-tracked application for an injunction.

And fourth, the Government should publicise the CMC more, so residents know that they can contact the CMC, before they call the Police or HDB to settle their disputes.

I believe if these proposals can be implemented, the CMC will provide a more streamlined avenue for residents to seek a resolution to their disputes, and relieve the burden of mediating neighbour disputes on agencies like the Police.

MTI: Helping SMEs attract local talent

Committee of Supply debate, 2 March 2021.

Helping SMEs attract local talent

SMEs face many challenges in attracting and retaining local talent. There is sometimes a bias against working for SMEs in favour of MNCs, GLCs and the Civil Service. Many SMEs try their best to attract local talent, for example by offering competitive salaries, but with mixed results.

We need to help our SMEs attract more local talent if we are to nurture globally competitive home-grown firms. I propose three ways to help them achieve this.

First, in both the classroom and at home, teachers and parents could encourage our young people to broaden their career aspirations and widen their definition of success. Not every child needs to aspire to be a doctor, lawyer, banker or government scholar. Many SMEs provide incredible opportunities to learn different skills and take on multiple roles.

Second, there needs to be a rebranding of SMEs as employers of choice. We have many local enterprises made good. We could do more to profile SMEs both in the media and also as business case studies within classrooms.

Third, Enterprise Singapore could assist more SME managers to adopt modern management practices. They could be provided easier access to certified executive coaches, who can provide one-to-one guidance on improving their management approaches. 

I believe all this could help our local SMEs become more attractive workplaces for Singaporeans to work in, and enlarge SMEs’ talent pool.

I delivered this “cut” during the Committee of Supply debate in Parliament on 2 March 2021.

MHA: PR for foreign spouses and children

This is a “cut” I delivered during the Committee of Supply debate on the Ministry of Home Affairs’ budget on 1 March 2021.

PR for foreign spouses and children

Around one in three marriages in Singapore is between a Singaporean and a non-Singaporean. Currently foreigners married to Singaporeans can apply for a Long-Term Visit Pass (LTVP) or LTVP+. LTVP+ provides access to additional benefits like subsidised healthcare and permission to work. However, LTVP+ is not the same as permanent residency (PR) in terms of benefits.

PR is much more difficult to obtain. Of the many Singaporeans I meet at my Meet-the-People Sessions who are appealing for their foreign spouses’ PR applications, the overwhelming majority of them are from lower income groups, with spouses from countries like China, Vietnam or Indonesia.

Are economic considerations and educational qualifications given more weight than family ties in determining PR application outcomes? If so, this would disadvantage the low-income.

May I suggest that for PR applicants who have a Singaporean spouse, child or parent, family ties should be the primary consideration for approval of their PR. Their close kinship with Singaporeans makes them part of the Singapore Core and we as a society should try to integrate them into our fold.