The following is the maiden speech by NCMP Gerald Giam (Debate on
Presidential Address) in the 12th sitting of Parliament:
Mr Speaker, thank you for giving me the
opportunity to make this, my maiden speech to this House.
In his address to Parliament, the President gave a broad outline of this
Government’s goals for the next five years. The Government says it wants “every
Singaporean worker to hold a skilled, well-paid job; every family to live in an
affordable, comfortable home; every young person to develop himself fully and
pursue his dreams; every senior citizen to stay active and to live with
These are bold goals which my colleagues and I in the Workers’ Party will
hold the Government accountable for over the next five years.
Sir, today I would like to focus on three areas that many senior citizens,
families and workers have pressing concerns about. They are healthcare, public
housing and public transport.
Mr Speaker, the axiom, “it’s better to die than fall ill in Singapore” has
been heard time and again—twice during this debate alone.
Many Singaporeans, especially the elderly poor, worry greatly about falling
ill. They are concerned not just about the painful treatment they will have to
go through, but more often about the high costs involved, and the financial
burden they may place on their struggling children.
In Singapore, government subsidies make up only a quarter of total health
Out-of-pocket expenses, employer benefits and private insurance make up most the
The much vaunted “3Ms” of Medisave, MediShield and Medifund pay for less than
10% of total healthcare expenses
the lion’s share of which comes from Medisave, which is really patients’ own
savings. MediShield is a self-funding insurance scheme, which members pay
premiums to join. These premiums rise as they grow older. They also have to fork
out large deductibles and co-insurance before receiving pay-outs, and coverage
ends at age 85.
The Government will say that we have Medifund. But Medifund is subject to
extremely stringent means testing and the disbursements are not exactly
generous. In 2009, an average of $1,029 was given to less than 24,000 in-patient
This represented just 5% of the total hospital admissions that year.
For seniors with no income and little savings, the burden of healthcare is
shifted to their children. In 2005, 60% of the elderly had their medical bills
paid from their adult children’s Medisave accounts
This is a very high percentage, and is in fact a departure from the principle of
“self-reliance”. If these patients’ children are also low-income
earners—as is often the case—the Government is merely shifting the burden of
poverty within the pool of the poor.
Basically we are asking one disadvantaged group to pay for another.
The Government seems very reluctant it to take on a larger financial
responsibility for caring for our senior citizens. Instead, it hides
behind the mantras of self-reliance and filial piety to justify its relatively
low expenditure on healthcare for the elderly.
Self-reliance is good in principle, but when a patient has exhausted his own
savings and has to rely on his own struggling family members, then we as a
society are not being fair to both the patient and his family.
The Ministry of Health claims to provide universal health coverage to
but I believe we are still some way from that. The World Health Organization
defines universal health coverage as having a healthcare financing system that
provides all people with access to adequate healthcare services without
suffering financial hardship paying for them.
If we are to achieve this goal, we need to expand the coverage of MediShield
and reduce the over-reliance on direct payments by patients at the time they
need the care
To fund this, we need to strengthen the current forms of prepayment and
risk-pooling, and provide assistance to those who cannot afford the premiums,
like housewives and the elderly. All this points to a need to perform some major
surgery on MediShield.
Mr Speaker, for some time now, our public hospitals have been running at near
full capacity, with bed occupancy rates often exceeding 90% for Tan Tock Seng
Hospital and over 85% for National University Hospital. Khoo Teck Puat Hospital,
which opened just last year, was supposed to ease the crunch. But it too has
been running at almost 85% capacity for the past month. The Royal College of
Surgeons in the U.K. has advised that bed occupancy rates above 82% put patients
at an increased risk of infection
It was reported in the Straits Times on 30th
August this year that
hospitals in Singapore are facing such
a severe crunch in beds that
some are “borrowing” space from other nearby organisations to house their
How did we get into such a situation?
Between the year 2000 and 2010, our population has seen an increase of 26%,
mostly through immigration. The number of hospital admissions has seen an
increase of 15% in this same period. However, not only have the number of
hospital beds not kept pace with population growth, but they have actually
during this period. In the past decade, there has been a 7%
drop in the number public sector hospital beds, according to the Department of
Two years ago, the then-Health Minister admitted, that on hindsight, his
ministry made a mistake by not building a new hospital two years earlier.
Recently, the Health Minister floated the idea of bringing forward the opening
of Sengkang Hospital, currently scheduled for 2020. I support this move, but
this is still a long time to wait, and by that time, our population would have
increased even more.
What is left unanswered is why this self-proclaimed “far-sighted”
Government failed in the past 10 years to build our healthcare infrastructure to
keep pace with population growth and an ageing population.
Government instead overly fixated on the near-sighted
goals of boosting
economic growth by increasing our population?
Housing shortage and
Mr Speaker, I would now like to address many Singaporeans’ concerns about the
public housing situation in Singapore.
In the past 10 years, the HDB has grossly undersupplied new housing units to
the market. According to figures from the HDB, between 2001 and 2009, an average
of just 7,700 new flats were built each year
This was far short of the average annual resident household growth figure of
24,280 since 2005.
Even when the population surged from 2007 onwards because of the
liberalisation of our immigration policies, the Government failed to react by
building more flats for our people. Instead, they permitted more cash rich
foreigners to purchase almost any types of private property, which increased
their prices, and pulled up HDB flat prices, since the two are linked.
This combination of low supply and high demand resulted in a severe housing
shortage, causing a sharp and sustained rise in property prices. HDB resale flat
prices are now 92% higher than they were 10 years ago
This has not only caused much distress for many Singaporean families, but has
also created a potential asset bubble which could severely damage Singapore’s
economy in a downturn.
The Government finally awoke from its slumber this year and ramped up the
supply of Built-to-Order (BTO) flats to an expected 25,000 this year and another
25,000 next year. This is a move in the right direction. However, BTO flats do
not solve the immediate housing problem, because it takes up to three years
before the new flat owners get their keys. In the meantime, many are still
without a home of their own.
Despite the bumper launches of BTO and Sale of Balance Flats (SBF) this year,
we still saw the third-quarter HDB Resale Price Index shoot up 3.8% over the
previous quarter. The cooling measures that the Ministry of National Development
put in place earlier this year do not seem to be having their intended effects
on the resale flat market.
The Government has gone some way in reducing the housing problems for
first-timer couples, but not for singles, divorcees and those who need to
downgrade to smaller flats because of financial difficulty. We need to find a
way to help these people who are caught in between the policies. In particular,
more measures need to be put in place to cool down the resale HDB flat
The HDB market, whether direct or resale, cannot simply be left to
market forces. As a provider of this public good, the Government must step in to
ensure that the welfare of its citizens comes first.
Mr Speaker, please allow me to share some longstanding concerns about public
transport in Singapore.
In March this year, just before the General Election was announced, SMRT and
SBS Transit said they would add 590 additional MRT train trips. This was
expected to ease the squeeze on trains. However, many regular commuters will
testify that trains now seem even more crowded than ever. The recently opened
Circle Line may improve the situation nearer the city, but for those commuting
from the suburbs like Sembawang or Simei, finding room to board the trains will
still be a challenge.
One key factor that affects the train loads is the waiting time. I understand
that the current signalling systems on the ageing North-South and East-West
lines allow for maximum train arrival intervals of about two minutes without
compromising commuter safety.
If trains really
arrived once every two minutes, the overcrowding
problem would not be so severe. Unfortunately, this is seldom the case. Outside
of the narrow window of about half an hour on weekday mornings and evenings, the
frequency drops to three to five minutes, or more. This results in trains
arriving packed with passengers, making it impossible for many of those on the
platform to board. As a daily commuter myself, I often have to wait for
two—sometimes three—trains to pass by before I can board, during morning and
evening rush hours.
Sir, if the Government is serious about encouraging our people to drive less
and use more public transport, it must give priority to tackling the
overcrowding problem on trains. The solution lies not only in building more
lines, but making better use of the existing lines by increasing train frequency
and maintaining that high frequency for longer periods, especially during peak
Why can’t the MRT operators maintain a train interval of two minutes from 7am
to 9am, and from 5pm to 8pm? Is it because of technical constraints, or because
it will increase their costs and reduce their profits?
Under the current profit-maximising model, operators are incentivised to cut
costs and service levels, just to maintain their high margins. Their duopoly
position in the local market reinforces this behaviour.
It is time for the Government to demand that these operators provide
a higher level of service to commuters, even if it reduces their profit
Mr Speaker, whether in healthcare, public housing or public transport, the
Government has gone too far down the road of pursuing free market efficiency,
often to the detriment of the elderly and low wage workers.
At a time when our citizens are exposed to heightened risks in the form of
global competition, increased economic volatility, rising inequality and wage
stagnation, the Government is exposing them to even more competition from
foreigners. Our workers are told to be “cheaper, better, faster”, more
self-reliant and less selective about their jobs.
This regressive transfer of risks from government to citizens must
count as one of the PAP Government’s biggest policy failures in the last
The demographic, social and economic changes of the 21st
demand a rethink of how much a government should provide for its people, and how
much we can reasonably ask our citizens to provide for themselves.
Mr Speaker, we are at the dawn of a new era in the history of our nation. The
phrase “new normal” has often been used to describe this new political reality.
Now with more Workers’ Party members in the House, some pundits wonder if we
will be a constructive, or destructive party in Parliament; will we help build
our country, or be obsessed with tearing down our political opponents? This is
related to some of Mr Lee Yi Shyan’s concerns earlier. I believe our party’s
track record in Parliament answers these questions.
Having more Workers’ Party MPs does not change our rational and responsible
approach to politics. We want to be a force for good in our country—to help to
uncover solutions, not add to the problems.
However, it takes two hands to clap. The responsibility for ensuring fair and
constructive debates, in and out this House, rests not only on the Opposition,
but also on the Government. I hope that debates in this House will not just be
about winning the argument or scoring political points, but leveraging on the
arguments, and counter-arguments, to elicit better policy outcomes.
This will ultimately benefit Singaporeans, who put us here to serve them.
Thank you, Mr Speaker.
Weizhen Dong, The Singaporean medical savings accounts model and its
, Journal of Public Health, 4 July 2006, p211 (3). See also
Piya Hanvoravongchai, Medical Savings Accounts: Lessons learned from
, World Health Organization, 15 October 2002, p11
Ministry of Health, Medical Endowment Scheme Annual Report 2009/2010
Parliamentary reply, 17 Oct 2005
Michael Barr, Comparative Health Policy in the Asia-Pacific
Ministry of Health,
WHO World Health Report 2010, p9.
, p14. WHO recommends direct payments of not more than 15 to
Salma Khalik, Public hospitals ‘borrowing’ ward space
, Straits Times,
30 August 2011.
Department of Statistics, Yearbook of Statistics Singapore 2011
HDB Annual Report 2009/2010, Key Statistics, Building Statistics, p2.
Department of Statistics, Population Trends 2011
, p22. See also “Glut
unlikely, but Policy Risks Remain”, Citigroup Global Markets report, 26 June
HDB Resale Price Index (RPI), comparing 3Q 2001 RPI with 3Q 2011 (flash