Means testing in acute care vs community hospitals

Mr Gerald Giam Yean Song asked the Minister for Health (a) whether means testing for patients at community hospitals and other step-down care facilities employs a different set of criteria from means testing for acute care hospitals; and (b) if so, what are these differences.

Parliament

Parliamentary question asked on 17 January 2012:

Mr Gerald Giam Yean Song asked the Minister for Health (a) whether means testing for patients at community hospitals and other step-down care facilities employs a different set of criteria from means testing for acute care hospitals; and (b) if so, what are these differences.

Mr Gan Kim Yong : Means-testing is used to determine a patient’s eligibility for government subsidies, taking into account his ability to pay. It helps the Government to be more targeted in channelling government subsidies to those in greater need.
The intermediate and long term care (ILTC) sector which includes community hospitals and nursing homes uses per capita family income as the criteria for means-testing. This is an equitable basis as it takes into account the patient’s family circumstances. For example, a sole breadwinner supporting his wife and children would require more financial support than a bachelor earning the same level of income and who has no dependants. On the other hand, an elderly patient who has no family support is less able to pay for his bills than another who is receiving financial support from his children.

In the acute hospitals, we have adopted a simpler means test based on a patient’s individual income from work, and does not take into account the rest of the family members. If the patient is economically non-active, the means-test will be based on the annual value of his residential property. This is more practical and easier to administer given the much higher patient volumes and short stays at acute hospitals. However, hospitals do have the flexibility to assess the patient based on the per capita family income approach similar to that used in ILTC sector, if specific patients feel that the simplified approach based on individual income is disadvantageous to them.

Deregulation, market competition and taxi fares

Mr Speaker, the fact remains that each time ComfortDelgro raises their fares, all the other companies follow suit. Does the Minister agree that this is a clear indicator that there is insufficient competition in the taxi market? And if so, in the absence of sufficient competition, will the Ministry of Transport (MOT) consider re-introducing some form of fare regulation?

Parliament

Parliamentary Question asked on 17 January 2012:

Mr Gerald Giam Yean Song asked the Minister for Transport (a) what measures has the Government put in place to ensure a sufficient level of competition among taxi operators; (b) whether these measures are adequate; and (c) whether further measures to ensure greater competition for the benefit of consumers will be implemented in the near future.

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Parliamentary Questions: COI on MRT service disruptions

Mr Gerald Giam Yean Song: To ask the Minister for Transport whether the Committee of Inquiry on the MRT service disruptions will be investigating the regulatory structure and processes that are currently in place to ensure that MRT operators maintain high maintenance and safety standards; and (b) whether the Committee will be tasked to look into not just the recent major disruptions on the North-South line but also service disruptions on all MRT lines in the last two years.

My Parliamentary question answered on 16 January 2012:

Note: I had filed this question a week before the Minister’s statement to Parliament on 9 January 2012.

Mr Gerald Giam Yean Song: To ask the Minister for Transport whether the Committee of Inquiry on the MRT service disruptions will be investigating the regulatory structure and processes that are currently in place to ensure that MRT operators maintain high maintenance and safety standards; and (b) whether the Committee will be tasked to look into not just the recent major disruptions on the North-South line but also service disruptions on all MRT lines in the last two years.

Mr Lui Tuck Yew:

I had explained the Committee of Inquiry’s (COI) Terms of Reference at length in my statement to this House last week. To reiterate, the COI will establish the technical, systemic and other causes that may have contributed to the disruptions, and make recommendations to minimize a recurrence of the incidents of 15 and 17 December based on their findings. This would include assessing whether the current regulatory regime is sufficiently robust.

As I had also mentioned, convening a Committee of Inquiry is a serious matter. The extent and severity of the service disruptions on 15 and 17 December, and the potential safety risks that they posed are what warrant an independent inquiry into the causes of the disruptions. Nonetheless, if there are previous incidents or events that may be relevant or had contributed to the events of 15 and 17 December, the COI has both the latitude and the obligation to consider them. It is not intended that the COI look at the smaller unrelated events as that would only dilute its focus.

I hope that this sufficiently addresses the Member’s concerns.

Speech in Parliament on Ministerial salaries debate

Mr Speaker, I support some of the proposals in the White Paper, including the removal of pensions and the introduction of the National Bonus. However, I fundamentally disagree with the top-down approach of benchmarking Ministerial salaries to top income earners, as well as the principle of paying out huge bonuses to political leaders.

This is the speech I delivered in Parliament today during the debate on Ministerial salaries. Click here to watch the video.

Parliament

Mr Speaker,

Thank you for giving me the opportunity to take part in this debate.

Like my honourable colleague, Mr Chen Show Mao, I believe that the White Paper’s approach of benchmarking Ministerial salaries to the top income earners is fundamentally flawed.

The proposed benchmark pegs entry-level Ministers’ salary to three-fifths of the median income of the 1,000 highest earning Singaporeans. This group represents the top 0.06% of Singaporean income earners. It presents no significant shift from the previous 2/3 M48 formula, which pegged Ministers’ salary to two-thirds of the median among a small group of 48 professionals, comprising top bankers, lawyers, MNC chiefs and others.

This new formula still benchmarks Ministers’ salary against the richest of the rich, reflecting an approach that appears to be based on a number of questionable assumptions:

Firstly, it assumes that Ministerial talents should be first looked for among the highest income earners. The Paper states that the benchmark “reflect(s) the calibre of the people which Singapore needs for good government”.

Secondly, it expects most Ministers will be parachuted in from the top echelons of the private sector, rather than going through the paces of first being elected as MPs, gaining experience on the ground, before being promoted to junior ministers and finally full Ministers.

Thirdly, it assumes that potential Ministers are often reluctant politicians, who consider entering politics to be a sacrifice and a burden, rather than a privilege to serve the nation, and they therefore need to be coaxed with monetary incentives before stepping forward.

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Parliamentary Questions (16 January 2012)

I have filed one question for the Health Minister and two for the Transport Minister for the Parliamentary sitting on Monday 16 January 2012. I will also be making a speech during the debate on the Ministerial Salaries during the sittings between 16 and 18 January. Look out for the video on the CNA website.

I have filed one question for the Health Minister and two for the Transport Minister for the Parliamentary sitting on Monday 16 January 2012.

1. To ask the Minister for Health (a) whether means testing for patients at community hospitals and other step-down care facilities employs a different set of criteria from means testing for acute care hospitals; and (b) if so, what are these differences.

2. To ask the Minister for Transport (a) what measures has the Government put in place to ensure a sufficient level of competition among taxi operators; (b) whether these measures are adequate; and (c) whether further measures to ensure greater competition for the benefit of consumers will be implemented in the near future.

3. To ask the Minister for Transport whether the Committee of Inquiry on the MRT service disruptions will be investigating the regulatory structure and processes that are currently in place to ensure that MRT operators maintain high maintenance and safety standards; and (b) whether the Committee will be tasked to look into not just the recent major disruptions on the North-South line but also service disruptions on all MRT lines in the last two years.

Source: Parliament Order Paper

I will also be making a speech during the debate on the Ministerial Salaries during the sittings between 16 and 18 January. Look out for the video on the CNA website.

Appointment and removal of MRT CEO

Mr Gerald Giam Yean Song asked the Minister for Transport (a) whether LTA has to date exercised its power to impose conditions relating to the appointment, re-appointment or removal of MRT operators’ CEO, chairman or any of its directors; and (b) what criteria does the LTA use to decide when to impose such conditions.

I asked this question in Parliament on 9 January 2012.

Mr Gerald Giam Yean Song asked the Minister for Transport (a) whether LTA has to date exercised its power to impose conditions relating to the appointment, re-appointment or removal of MRT operators’ CEO, chairman or any of its directors; and (b) what criteria does the LTA use to decide when to impose such conditions.

Mr Lui Tuck Yew (part of Ministerial Statement):

19. Mr Gerald Giam has asked if LTA has to date exercised its power to impose conditions relating to the appointment, re-appointment or removal of MRT operators’ CEO, chairman or any of its directors, and about the criteria that LTA uses to decide when to impose such conditions. Decisions relating to the changes of these key appointments in the company are initiated by the company or (in the case of the chairman and directors) the shareholders, and cannot be unilaterally imposed by LTA. However, under LTA’s current licences, operators must seek LTA’s approval for the appointment, re-appointment or removal of any director or the Chairman of its Board of Directors. While LTA has veto powers over the appointment of the operators’ Board, these are generally intended to be used as a last resort against clearly unsuitable nominees, and to date, LTA has not found it necessary to exercise this veto power.

20. One of the questions that needs to be answered is whether the regulatory regime is sufficiently robust. Together with the COI’s more holistic findings, the Government will thoroughly review the regulatory and penalty framework and its oversight over the operators’ maintenance regimes to strengthen it where necessary.

(Source: Ministry of Transport website, 9 January 2012)

Alternatives to constructing the North-South Expressway

Mr Gerald Giam Yean Song asked the Minister for Transport (a) whether other options were studied by the Ministry before it decided to build the North-South Expressway (NSE); (b) if so, what were the options and what were the reasons for building the NSE instead of pursuing these other options; and (c) whether the Government had considered the feasibility of adding a second level to the existing Central Expressway instead of building a new expressway.

This was my question in Parliament on 9 January 2012 about the North-South Expressway, which has necessitated land acquisition, affecting many home owners:

Mr Gerald Giam Yean Song asked the Minister for Transport (a) whether other options were studied by the Ministry before it decided to build the North-South Expressway (NSE); (b) if so, what were the options and what were the reasons for building the NSE instead of pursuing these other options; and (c) whether the Government had considered the feasibility of adding a second level to the existing Central Expressway instead of building a new expressway.

Mr Lui Tuck Yew:

The North-South Expressway (NSE) is a high capacity road link to connect people in the northern regions of Singapore to the city centre. It will serve to relieve congestion along major road corridors and to better distribute traffic on our expressway network.

Many Singaporeans will benefit directly from the NSE as their travel time between the north and the city centre is expected to be reduced by up to 30%. The NSE will also create new connections currently not available on our expressway network. For example, motorists travelling on the Pan-Island Expressway (PIE) towards Changi can connect to the city centre with the planned PIE/NSE interchange. Without the NSE, congestion on the Central Expressway (CTE) and major roads along the North-South corridor, such as Thomson Road, will build up with expected residential growth in the north and employment growth in the city centre.

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Acquisition of properties in Rochor area

Mr Gerald Giam Yean Song asked the Minister for National Development whether any consultation was done with residents and business owners before the decision was taken to acquire the HDB blocks, private properties and shops in the Rochor area (including Rochor Centre) to build the North-South Expressway.

Question I asked in Parliament on 9 January 2012:

Mr Gerald Giam Yean Song asked the Minister for National Development whether any consultation was done with residents and business owners before the decision was taken to acquire the HDB blocks, private properties and shops in the Rochor area (including Rochor Centre) to build the North-South Expressway.

Mr Khaw Boon Wan:

The North-South Expressway (NSE) is a major road infrastructure that connects the north and north eastern sectors of the island with the city centre. LTA has conducted very thorough studies to identify the best possible alignment taking into account engineering requirements while minimising the need for land acquisition.

Whilst the best efforts have been put in to minimise land acquisition, the Government will still need to acquire some land in the highly built-up Rochor area, in order to construct the NSE. Other than Rochor Centre, small portions of the landscaped areas of Golden Landmark, Gateway and The Plaza are also being acquired within the Rochor area for the NSE construction.

We were unable to consult those potentially affected by the road proposal prior to its announcement because such information is market sensitive.

Immediately following the announcement of the full alignment of the NSE on 15 Nov 2011, HDB explained the acquisition and relocation package to affected flat owners and shop tenants personally through door-to-door visits. Affected property owners will receive market value statutory compensation. Affected HDB flat owners at Rochor Centre will also receive assistance to relocate to a replacement property, while the shop tenants will be given clearance benefits.

Compensation for Rochor residents

Mr Gerald Giam Yean Song asked the Minister for National Development what is the compensation that the residents of the flats in the Rochor area affected by the upcoming land acquisition will receive if they choose not to relocate to the new flats in Kallang.

Parliamentary question asked on 9 January 2012:

Mr Gerald Giam Yean Song asked the Minister for National Development what is the compensation that the residents of the flats in the Rochor area affected by the upcoming land acquisition will receive if they choose not to relocate to the new flats in Kallang.

Mr Khaw Boon Wan:

All HDB flat owners at Rochor Centre will be compensated for their existing flats based on the prevailing market values as at the date of announcement of the acquisition, i.e. 15 Nov 2011. This is regardless of whether they decide to take up the new replacement flats in Kallang. The market value will be assessed by a qualified and professional private valuer licensed by the Inland Revenue Authority of Singapore after a thorough physical inspection of each flat.

On top of the market compensation, all the flat owners will be paid reasonable expenses, which comprise a removal allowance as well as stamp and conveyancing fees to buy a comparable replacement flat.

They are also given a relocation package, similar to those offered under the Selective En bloc Redevelopment Scheme (SERS). They will be assured of a new replacement HDB flat in the vicinity of Kallang MRT station, which they can purchase at subsidised prices frozen as at 15 Nov 2011 and will further enjoy a 20% price discount (up to $30,000) if eligible.

If they choose not to relocate to the new flats in Kallang, they may apply for a new flat elsewhere under HDB’s public sales exercises and enjoy the same relocation benefits, including the price discount. Alternatively, they may choose to sell their existing flat with the relocation package in the resale market, which will typically fetch a premium above the compensation. With the sale proceeds, they may then find alternative accommodation on their own.

Media reports:

Public sector doctors leaving for private sector

Mr Gerald Giam Yean Song asked the Minister for Health what is the average age of public sector doctors leaving for private practice and how this figure compares with that of ten years ago.

Question asked in Parliament on 9 January 2012:

Mr Gerald Giam Yean Song asked the Minister for Health what is the average age of public sector doctors leaving for private practice and how this figure compares with that of ten years ago.

Mr Gan Kim Yong:

The average age of doctors leaving the public healthcare clusters for private sector increased slightly from 35 years old in 2001 to 36 years old in 2010. This is an estimate based on doctors who had indicated ‘joining private sector’ or ‘personal reasons’ as their reasons for leaving and excluded doctors who left due to transfer within public sector, retirement, contract lapse, termination of service, change of occupation, going overseas, family or health issues as well as those who did not put down any reasons.

Media reports: