Singapore

Interview with Straits Times on public transport woes

The Straits Times did an interview with me last week about the performance of public transport since the last General Election, quotes of which were published on Saturday’s (3 May 2014) Insight article, “On track to solve public transport woes?”. Below is the full transcript of the interview.

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[Straits Times] In terms of train reliability, the disruptions in December 2011 were probably the turning point for the worse. 2012 saw the number of train delays hit a high, and according to LTA stats the number of delays and withdrawals came down last year. Some measures the Govt has implemented to tackle this include setting up joint teams with the operators post COI, and raising the maximum fine this year. What is your sense of rail reliability since 2011? Has the situation improved, stagnated or deteriorated, and why?

[Gerald] The number of delays lasting longer than 5 minutes may have come down last year, but this was from a high base of 396 in 2012 and 393 in 2011. The number of delays in 2013 was still higher than in 2010 and 2009. So I think it is still too early to declare victory.

Furthermore, I have often experienced trains stopping many times for less than 5 minutes along the way, resulting in the overall journey being significantly delayed. This has also been the experience of other commuters I have spoken to. Sometimes the statistics that the Government looks at don’t tell the whole story.

[Straits Times] Looking ahead, what needs to be done in to improve train reliability further?

[Gerald] It is usually cheaper to maintain a machine regularly than to replace a machine that has broken down because of poor maintenance. Our MRT system has suffered for years of under-investment in maintenance. It will take a massive re-investment in maintenance to restore reliability to acceptable levels. Beyond maintenance, technology and infrastructure needs to be upgraded to keep up with population and commuter growth. For example, I believe the multiple short delays during trips that I mentioned earlier are often due to the signalling system not being able to accommodate shorter headways (the distance or time between trains).

[Straits Times] In terms of crowding, have trains become even more packed since 2011? Any feedback you have gotten from commuters or residents about this issue?

[Gerald] I find that the train frequency during peak hours has increased slightly, but trains are often still not arriving fast enough to clear the continuous stream of people who are entering the station platforms. Once there is even a slight delay, the platforms would be overflowing with people. While MRT operators may have increased train frequency, there are also more commuters due to continued population increases. It is meaningless to tell commuters that trains are now arriving every 2 minutes instead of every 5 minutes, when they needs to wait for 3 full trains to pass by before being able to board a train.

[Straits Times] Some measures to ease train overcrowding include travel demand management schemes such as free travel and Insinc, as well as introducing express/parallel bus services under the BSEP. To what extent do you think these have been effective? And do you think the overcrowding situation will ease when the Downtown and Thomson lines open a few years down the road?

[Gerald] If we can find a way to spread out the commuter load away from peak hours, that would help ease peak hour overcrowding. However, I don’t think free travel or other incentives will make a significant impact. These will only work if most commuters have flexible working hours, which is clearly not the case now. More employer mindsets need to change to allow for more flexible working hours and telecommuting.

We also need to develop more alternative city centres so that commuters do not all head in the same direction at the same time, as this causes additional strain on the public transport network.

I hope overcrowding will ease with the opening of new lines, but keep in mind there will also be more commuters in the coming years because of an increasing population. Furthermore, many of the new lines are serving areas which previously had no easy access to MRTs. I think the main benefit of these new lines would be an increasing mode-share of commuters taking the MRT. It may not translate to less crowded trains along the existing lines.

[Straits Times] Do you think bus services have improved overall since the BSEP was rolled out, and to what extent? Why or why not?

[Gerald] I understand there has been an improvement in bus frequency along routes benefiting from BSEP, with some services seeing waiting times of 30 minutes reduced to 10 minutes. With $1.1 billion of taxpayer money poured into this programme, plus another $1 billion or so on the way (with BSEP 2), I think this is the least that commuters can expect.

[Straits Times] Are there any problematic routes you know of – whether in terms of being too crowded/very long waiting time/bunching – that need to be addressed?

[Gerald] I am not able to itemise every problematic route, but I am told that SBS services 225G and 225W from Bedok Interchange often experience very long queues, such that passengers at the back of the queue are not able to board the bus or have to squeeze themselves onto the steps of the bus entrance.

[Straits Times] Moving forward, what else needs to be done to improve the bus network? More bus priority schemes, moving more quickly to the contracts model, or even nationalization?

[Gerald] We need to prioritise the needs of public transport commuters over users of private transport. The former mayor of Bogota, Colombia once said that if all citizens are equal before the law, then “a bus with 80 passengers has a right to 80 times more road space than a car with one.”

With this in mind, I would like to see more all-day bus lanes to make bus journeys smoother and more predictable in terms of timing, even if it means taking away some road space from cars.

I think whichever public transport model we adopt must incentivise operators to place reliability, affordability and commuter comfort and convenience ahead of profits. I can’t see how this can be achieved with two operators that are profit-oriented and enjoy de facto monopolies on each of their routes. The PTOs’ profits should be used to lower fares and for maintenance and upgrades, not to distribute as dividends to shareholders. Alternatively, we should, where feasible, introduce genuine competition that will spur innovation and productivity improvements to lower costs and improve service quality. It is competition that spurs efficiency and productivity improvements, not the profit incentive as our Government leaders wrongly assume. PTOs cannot be allowed to keep their profits yet be shielded from competition, because the ones who will suffer are commuters, who come mostly from the middle and lower income groups.

Detecting aircraft that stray from flight path

I wanted to ascertain if suspicious aircraft can be effectively detected by our military radar and intercepted before they can harm our homeland. With just a tiny airspace surrounding our territory, there is little time to lose in completing the OODA loop (observe-orient-decide-act) to make the right decision in dealing with suspicious aircraft.

The startling revelation that Malaysian military radar tracked the missing MH370 flying across Peninsular Malaysia but did not sound an alarm, prompted me to ask this question of MINDEF. I wanted to ascertain if suspicious aircraft can be effectively detected by our military radar and intercepted before they can harm our homeland. With just a tiny airspace surrounding our territory, there is little time to lose in completing the OODA loop (observe-orient-decide-act) to make the right decision in dealing with suspicious aircraft. What is interesting is that these air defences were put to the test once before, although it is not clear what type of aircraft had wrongly entered our airspace.

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Mr Gerald Giam Yean Song asked the Minister for Defence whether the RSAF has measures in place to identify and be alerted to aircraft flying near Singapore which veer off their flight path so that they can be intercepted in time before they reach Singapore.

Dr Ng Eng Hen: The RSAF has a robust air defence system to monitor our skies and protect the sovereignty of Singapore’s airspace. Working closely with the Civil Aviation Authority of Singapore, the RSAF detects and identifies aircraft before they enter our airspace through its suite of radars.

If an aircraft veers off its flight path, a series of preventive measures will be triggered. First, air traffic controllers will communicate with the aircraft to verify its reason for veering off its flight path. If there are doubts regarding the intent of the aircraft or the aircraft does not adhere to air traffic control directions, RSAF fighter aircraft will be activated to intercept the aircraft. Ground-based air defence systems will also be activated.

On past occasions, the RSAF had responded swiftly to suspicious aircraft approaching our airspace. For instance, in 2008 when an unknown aircraft was detected heading towards Singapore, the RSAF activated our F-16 fighters to intercept and identify the aircraft, and the fighters escorted it till it landed.

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Source: Singapore Parliament Reports (Hansard)

Progressive Wage Model and Low Wage Workers

I asked the Acting Manpower Minister (on 14 April) how his ministry planned to bridge the gap between the 110,000 workers earning less than $1,000 per month (a figure I obtained from a previous Parliamentary question) and the 80,000 workers expected to benefit from the Progressive Wage Model, which will be applied to only the cleaning, security and landscaping industries.

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Mr Gerald Giam Yean Song asked the Acting Minister for Manpower how does the Government plan to raise the wages of local low-wage workers in industries other than cleaning, security and landscaping given that that there are around 110,000 employed residents in Singapore earning less than $1,000 per month (excluding part-time workers) and the enforcement of the Progressive Wage Model in these three industries is expected to impact only about 80,000 low-wage workers.

Mr Tan Chuan-Jin: I have talked about the need to raise the incomes of lower-wage Singaporeans for a few years now and we have been putting in place measures to do so. It requires a holistic and wide-ranging effort. As a key first step, we need to keep the economy healthy, competitive and vibrant so that a wide range of jobs is available.

Secondly, our tightened labour market helps to keep unemployment low and put some upward pressure on wages.

Thirdly, we have enhanced Workfare, which now supplements the incomes and retirement savings of more than 400,000 Singaporean workers earning less than $1,900, and encourages them to work regularly and up-skill. Through the Inclusive Growth Programme, low-wage workers benefit from companies’ productivity gains through higher wages. MOM has also raised the full-time equivalent (FTE) salary for full-time local workers from $850 to $1,000 in July 2013. The FTE salary is used to determine how many local workers a company has, as a basis to calculate the foreign worker quota that the company is entitled to. It also ensures that local workers are employed meaningfully, and are not paid token salaries just to pad the numbers.

However, it is important to also understand that raising incomes has to be based on productivity improvements, to be sustainable in the long-run. Mandating the Progressive Wage Model (PWM) to support wages at the very low end is a highly targeted intervention applied to specific sectors where there is a particular problem with the labour market, such as prevalent cheap-sourcing coupled with a lack of union representation for the workers. We are applying the PWM requirement through legislation in the Cleaning, Security and potentially the Landscape Sectors. But this legislation approach will not be appropriate for all sectors and occupations. A better approach for other sectors is NTUC’s on-going efforts to work directly with employers to develop progressive wage structures and career progression pathways for rank-and-file and even PME workers.

We also support the low-income earners through a range of other support schemes whether in the form of housing, medical and education subsidies.

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Source: Singapore Parliament Reports (Hansard)

Net Investment Returns Contribution

I asked the Finance Minister this question during the 14 April 2014 sitting of Parliament to find out if the Government had been using the full 50% of Net Investment Returns (NIR) to supplement the Budget, as is provided for in the Constitution. While it is widely assumed that 50% of the estimated long term annual returns from investing our reserves is contributed to the Budget each year, the Constitution actually allows for “up to 50%”, which means it could be less than 50%.

I asked the Finance Minister this question during the 14 April 2014 sitting of Parliament to find out if the Government had been using the full 50% of Net Investment Returns (NIR) to supplement the Budget, as is provided for in the Constitution. While it is widely assumed that 50% of the estimated long term annual returns from investing our Reserves is contributed to the Budget each year, the Constitution actually allows for “up to 50%”, which means it could be less than 50%.

Indeed, the Finance Minister revealed that the Government had in fact been using about 47% of NIR on average over the past 5 years. This works out to almost half a billion dollars less each year in the Budget than what the Constitution allowed for. However, for FY2014, the Government plans to top up the Budget with the maximum 50% of NIR.

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Mr Gerald Giam Yean Song asked the Deputy Prime Minister and Minister for Finance what percentage of the Net Investment Returns (NIR) on the net assets managed by Government of Singapore Investment Corporation (GIC), Monetary Authority of Singapore (MAS) and Temasek Holdings is contributed to the Government’s Budget as Net Investment Returns Contribution (NIRC) for each of the last five years, given that NIRC comprises up to 50% of the NIR on the net assets managed by GIC and MAS and up to 50% of the investment income from the remaining assets (which includes those of Temasek Holdings).

Mr Tharman Shanmugaratnam (Deputy Prime Minister and Minister for Finance): The Net Investment Returns (NIR) framework allows the Government to tap the investment returns of our reserves for budgetary spending in a sustainable way. Under the framework, the Government can spend up to 50% of the long-term expected real return from the net assets managed by GIC and MAS, and up to 50% of the net investment income from Temasek and other assets.

The Government generally budgets to take in 50% of Net Investment Return Contribution (NIRC) at the start of each Financial Year (FY). The actual NIRC taken in at the end of the FY may vary due to changes in the fiscal position and to differences in the actual outturn for the maximum NIRC compared to what was budgeted at the estimates stage.

From FY2009 to FY2013, the actual NIRC taken in has been close to the maximum 50%, with the Government taking in on average slightly above 47% of the NIRC. We expect to take in the maximum 50% of NIRC in FY2014, in view of an expected overall budget deficit.

The NIRC has been able to supplement the Budget by $7 billion to $8 billion annually. Our approach to taking in NIRC reflects a prudent approach to fiscal spending. We should spend to achieve desired outcomes, rather than spend to the last dollar available.

Further, our government spending needs will increase over time, and the NIRC will remain an important source of revenue over the long term. It is therefore vital that we spend in a disciplined way, and ensure sustained benefits from the returns on our reserves.

Source: Singapore Parliament Reports (Hansard)

Health screening (COS – MOH)

To encourage greater adoption of health screening, I propose that all Singaporeans who reach age 40 be provided with one set of free health screening tests for common chronic conditions and cancers under HPB’s Integrated Screening Programme. This should include the cost of the doctor’s consultation.

Parliament, 12 March 2014

Madam,

Age-appropriate preventive health screenings have been recognised as a cost-effective way to identify health problems before they develop further and end up being more costly to treat.

However, many are reluctant to undergo health screenings because of the inconvenience, cost or fear that it will reveal health problems, whose treatment may be beyond their ability to pay for.

More resources should be invested in promoting regular health screening on a wider scale. High risk groups should be identified and greater efforts should be made to reach out to them.

Subsequent health screenings should be provided at subsidised rates, and patients should be allowed to use their Medisave to pay for the remaining cost.

Having more Singaporeans in high risk age groups undergo regular health screenings could reduce overall health expenditure, as diseases are detected earlier, hence requiring less costly interventions.

MediShield Life

I would like reiterate my call for premium subsidies to be extended to all vulnerable groups of Singaporeans, including elderly persons with low savings and not only members of the Pioneer Generation; people with disabilities; those who have exhausted their Medisave; and those who already qualify for government financial assistance schemes like Medifund, Public Assistance, ComCare and CHAS (Community Health Assist Scheme).

Parliament, 12 March 2014

Madam,

I would like to make a few proposals regarding MediShield Life before it is introduced next year.

First, I would like reiterate my call for premium subsidies to be extended to all vulnerable groups of Singaporeans, including elderly persons with low savings and not only members of the Pioneer Generation; people with disabilities; those who have exhausted their Medisave; and those who already qualify for government financial assistance schemes like Medifund, Public Assistance, ComCare and CHAS (Community Health Assist Scheme).

Second, can the $70,000 annual claim limit be removed for MediShield Life? For the affected policyholders, it would be financially crippling if their insurance cover were removed when they reach the claim limit, since they would already have spent a lot of their savings on the co-payments. Fewer than 0.1% of policyholders reach the policy year limits each year. Continuing to cover them should not result in significantly higher claims or premium burdens, but would provide tremendous peace of mind for them.

Third, MOH should ensure that MediShield Life does not follow the practice of some private insurers, which sometimes reduce coverage after policyholders are diagnosed with the an illness, to prevent them from claiming again if they suffer a relapse. This should also apply to the Integrated Shield Plans that ride on MediShield Life.

Fourth, can we have better coordination of MediShield Life with private and company health insurance to ensure that they do not overlap? This will avoid unnecessary premium payments, which benefit no one but the insurers.

Properly incentivising providers (COS – MOH)

Can MOH explore alternatives to the current fee-for-service payment approach? Fee-for-service payment tends to give providers a perverse incentive to boost revenue by increasing patient throughput, rather than keeping patients healthy and out of hospital.

Parliament, 12 March 2014

Madam,

Traditionally, we contain healthcare costs by curbing patients’ demand for healthcare. We do this by making patients co-pay, so that they think twice before seeing the doctor or requesting for more diagnostic tests.

However, most times it is the doctors who decide on the course of treatment for the patients. Therefore healthcare providers, not patients, drive the bulk of healthcare spending. If we want to control costs, we need more focus on the providers.

Instead, MOH should better incentivise providers to contain the overall growth of healthcare costs across the continuum of care – from primary to acute to step down care.

Doctors and healthcare providers should be given greater financial flexibility to redesign care delivery, so that proven and cost effective services can be reimbursed. For example, we could reward providers for efforts to enhance patients’ medication compliance, monitor patients’ weight gain or blood sugar levels in their homes, or perform follow-up consultations using web conferencing.

Second, different providers should be better integrated and made collectively responsible for providing coordinated care for patients. GPs, acute hospital specialists and step down care professionals should be rewarded for cooperating and sharing information to improve quality and control costs, not simply by the volume or class of patients they treat.

Increasing adoption of telehealth (COS – MOH)

Given the cost savings, improved outcomes and improved patient satisfaction that telehealth has the potential to bring, the Ministry should look into ways to increase its adoption in Singapore.

Parliament, 12 March 2014

Madam,

Telehealth is a mode of healthcare delivery that uses technology to enable the remote diagnosis, consultation, treatment, education and care management of patients. It includes the use of home monitoring of chronic diseases, remote consultations between patients and providers, and videoconferencing between doctors in different hospitals.

Telehealth has the potential to reduce healthcare costs, increase the level of convenience for patients, and improve patient outcomes.

One key barrier to a greater adoption of telehealth is the absence of an agreed-upon reimbursement model. If doctors cannot get paid for telehealth consultations, they are more likely ask patients to come to the clinic for a face-to-face consultation. Similarly, if patients cannot use their Medisave or receive subsidies to pay for telehealth consultations, they would be more likely to choose to make the trip down to the clinic.

Given the cost savings, improved outcomes and improved patient satisfaction that telehealth has the potential to bring, the Ministry should look into ways to increase its adoption in Singapore.

These include providing the infrastructure and support to healthcare providers and patients in acquiring telehealth technologies, reforming reimbursement models for telehealth, and revising any legislation that unduly inhibits telehealth adoption.

Use of Medisave (COS – MOH)

The restrictions on Medisave withdrawals sometimes result in patients facing financial difficulties even though they still have balances in their Medisave accounts.

Parliament, 12 March 2014

Madam,

The restrictions on Medisave withdrawals sometimes result in patients facing financial difficulties even though they still have balances in their Medisave accounts.

Medisave should be allowed for all medically necessary treatment that is of proven value and is cost effective. MOH should greatly expand the list of approved outpatient treatments under the Chronic Disease Management Programme (CDMP). While 15 chronic diseases are now in the list, there are many others which are not, but which require long-term medication and frequent consultations, which can be very costly.

The expanded Medisave withdrawal list should be updated regularly by an independent panel consisting of doctors and healthcare researchers.

In addition, patients above age 75 should be allowed to use their Medisave without being subject to annual limits. This will ensure that they are not deterred from seeking treatment because of high cash payments.

Fare increases and quality of service (COS – MOT)

The PTC chairman acknowledged that service reliability needs to improve, but said that this issue should be kept separate from fare raises, which are to cover rising costs for operators. This is quite baffling for most commuters, myself included. In most service industries, customers will demand good service before they even agree to pay. But for public transport in Singapore, we seem to be expected to pay more just to get satisfactory service.

Parliament, 11 March 2014

Madam,

In January, when the Public Transport Council (PTC) approved hikes in bus and MRT fares, many commuters asked why fares were being raised when they had yet to see satisfactory improvement in service reliability.

The PTC chairman acknowledged that service reliability needs to improve, but said that this issue should be kept separate from fare raises, which are to cover rising costs for operators.

This is quite baffling for most commuters, myself included. In most service industries, customers will demand good service before they even agree to pay. But for public transport in Singapore, we seem to be expected to pay more just to get satisfactory service.

Can the Ministry consider revising the fare review formula to incorporate service reliability as one of its components? This will create is a direct link between service quality and fare adjustments, and will better align the incentives for transport operators with the interests of commuters.