Assoc Prof Daniel Goh Pei Siong (Non-Constituency Member): Mdm Chair, it is expected that the demand for palliative care at home will double by 2020 to more than 10,000 patients. However, some reports suggest that the current supply of nurses providing home-based care may not be sufficient to meet the expected increase in demand. Several providers of home nursing care are employing foreign nurses on foreign domestic work permits. This could compromise the quality and development of home-based care in Singapore. Furthermore, the 10,000 patients only refer to those needing palliative care.
I would like to raise two suggestions for the Ministry to consider in their efforts to expand home-based care service and raise standards.
Assoc Prof Daniel Goh Pei Siong: Mdm Chair, primary healthcare at general practitioner clinics should be seen as a form of preventive healthcare to arrest the development of illnesses before they escalate to the needs for costly hospitalisation. Costly, that is, to the public purse and the public, given universal hospitalisation insurance or MediShield Life.
The monthly household income per member capped to qualify for Community Health Assist Scheme or CHAS subsidies should be raised from $1,800 to the prevailing median monthly income from work for an individual which stand at $3,900 in 2015. This is so that retirees who live with their working children, who are themselves parents, are not excluded. This would also provide some relief for the children of the retirees, who belong to the sandwiched middle-income group. Another benefit is that this would provide support for and promote multi-generational households, where the elderly would not be disincentivised to live with the children and grandchildren.
Assoc Prof Daniel Goh Pei Siong: Mdm Chair, the harmful effect of excessive sugar consumption has led to Britain recently introducing a sugar tax. Singapore, like the UK is experiencing an ageing population and the prevalence of obesity and heart disease. There are also local characteristics to the problem as Asians are at a higher risk of developing type 2 diabetes and in fact over 10% of adult Singaporeans are currently diabetic and is the second highest proportion in the developed world. It will therefore appear that we should seriously consider a sugar-tax.
Assoc Prof Daniel Goh Pei Siong (Non-Constituency Member): Chairman, Sir, Ministry's ComCare Annual Report reported that the number of recipients of ComCare Short-to-Medium Term Assistance increased from over 11,000 beneficiaries in Financial Year 2012 to over 27,000 beneficiaries in Financial Year 2014. I believe this is due to the expansion of the eligibility for Short-to-Medium Term Assistance in 2012 and 2014, and also the greater outreach effort by Social Service Offices.
It is good that ComCare is reaching more Singaporeans in need. Nevertheless, all else being equal, the effectiveness of Government's efforts to help Singaporeans in need should be reflected in a decline of the number eligible for assistance. We should be worried if the number of beneficiaries continue to climb when the eligibility criteria stays the same.
I would like to propose the Ministry set up a Mentoring Programme for the recipients of ComCare Short-to-Medium Term Assistance. Recent studies show that asset and cash transfers to the poor are more effective when the recipients receive two years of counselling and training to use the assets and cash in ways that will help them to graduate from poverty
Assoc Prof Daniel Goh Pei Siong (Non-Constituency Member): Mdm Chair, the NEA reported that in 2014, less than 13% of food waste was recycled and over 680,000 tonnes had to be incinerated. This number is only going to grow with our increasing population and given the prosperity of the population and the Singaporean culture of eating out.
Recently, NEA announced the launch of a two-year onsite food waste recycling pilot at two hawker centres at Ang Mo Kio and Tiong Bahru. This is a good move. But for an urgent problem, it is insufficient.
Assoc Prof Daniel Goh Pei Siong (Non-Constituency Member): Mdm Chair, as we move towards a car-lite Singapore and improve our public transportation system to make it as cost-effective, reliable and comfortable as it was before, more individuals would choose to travel by bus and train rather than drive. However, it would take a generation to wean cars from our culture. For some, owning a car would remain an aspiration or a status symbol. For many others, owning a car is felt as a necessity, especially young families
Assoc Prof Daniel Goh Pei Siong (Non-Constituency Member): Mdm Chair, more than 200,000 people is estimated to be providing regular care to family and friends in Singapore. This number is expected to rise as the number of elderly more than double by 2030.
A Duke-NUS Medical School survey found that fewer than 5% of care-givers interviewed used individual support services such as home nursing and respite care programmes. Care-givers are becoming a vulnerable group themselves while they care for their vulnerable loved ones. They face emotional stress, lack of social support and immediate and long-term financial burdens. This is worst for specialised care-givers who have to care for loved ones with specific illnesses, for example, care-givers for elderly with dementia, care-givers of people with mental illness and parents of children with special needs.
Assoc Prof Daniel Goh Pei Siong (Non-Constituency Member): Thank you, Madam. Mdm Chair, no matter how meritocratic our education system is, no matter how well trained our teachers are, there will be inequality in two areas. There will be students coming from under-privileged backgrounds who will need closer attention and motivation, and there are teachers who are by nature more caring and motivated to go the extra mile, change the lives of their students.
I ask that the Ministry consider establishing a "Teach for Singapore" Programme to match exceptionally motivated teachers to under-privileged students. This will be modelled after the US' "Teach for America" and the UK's "Teach First Programmes", both of which have good track records in improving educational outcomes for under-privileged students. We should, of course, make specific adaptations to the Singapore context.