Debated in Parliament on 3 Nov 2014.
Order for Second Reading read.
Mdm Speaker, I beg to move, "That the Bill be now read a Second time."
Mdm Speaker, since the Government first announced the Pioneer Generation Package, many Pioneers have started to enjoy the healthcare benefits provided to them.
In July this year, 440,000 Pioneers received their Medisave top-ups which can be used to meet medical needs or medical insurance expenses. For many Pioneers, these top-ups have come on top of the annual GST Voucher – Medisave top-ups paid to seniors aged 65 and above.
In September alone, which was the first month since Pioneers received their PG cards, there had been about 317,000 Pioneer visits to Specialist Outpatient Clinics (SOCs), Community Health Assist Scheme (CHAS) clinics and polyclinics which qualified for special subsidies on consultation and treatment. The Pioneers’ bills at the subsidised SOCs and polyclinics will be reduced even further when subsidies for their medication come into effect in January next year.
We also introduced the Pioneer Generation Disability Assistance Scheme (PioneerDAS) where eligible Pioneers can receive monthly cash supplements. As of end-October 2014, about 14,000 Pioneers are benefiting from PioneerDAS.
Next year, all Pioneers will also receive additional subsidies to help pay for their MediShield Life premiums when the programme comes into effect. This will ensure that all Pioneers get to enjoy the enhanced benefits of MediShield Life, including the many Pioneers today who are not insured under MediShield.
The Pioneer Generation Package will provide these healthcare benefits to Pioneers for the rest of their lives. This support is on top of the substantial healthcare benefits that the Government already provides for all Singaporeans and which have been continuously enhanced. To ensure that funding for the Package is available beyond the current term of Government and regardless of the state of the economy, the Government will set up a
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Pioneer Generation Fund.
Mdm Speaker, although the Pioneer Generation Package was only introduced earlier this year, awareness levels are relatively high. A survey by MCI showed that about eight in 10 Pioneers are aware of the Pioneer Generation Package. This is a significant improvement from just six months ago.
Senior Minister of State for Health, Dr Amy Khor, and I chair a Taskforce comprising members from the public and private sectors to reach out to Pioneers. Since its formation in April 2014, the Taskforce has rolled out various communications and outreach efforts on the Pioneer Generation Package, such as through TV interstitials, radio segments and print advertorials and even at getais, in both the official languages and dialects. This complements the letters and welcome packs mailed to Pioneers.
The People's Association and its Grassroots Organisations have, together, held more than 800 dialogues and briefing sessions on the Pioneer Generation Package. Many community organisations, such as MENDAKI and CDAC, have also stepped forward to spread awareness about the Pioneer Generation Package.
We are mindful, however, that even with these outreach efforts, it can be challenging for Pioneers and their caregivers to fully understand the Pioneer Generation benefits they stand to enjoy. Many Pioneers are not familiar with online resources or prefer face-to-face explanations which also allow them to seek clarifications.
We have, therefore, set up a Pioneer Generation Office to gather and train a group of volunteers called Pioneer Generation Ambassadors. These Ambassadors will visit the homes of our Pioneers to explain the Package to them and answer their queries. The Pioneer Generation Ambassadors' engagement is intended to be sustained and ongoing so that the Pioneers will always have a contact point whom they can approach if they have questions about the Pioneer Generation Package. The programme has just started in Nee Soon, Tampines and East Coast and will be introduced progressively to other constituencies.
Let me now turn to the Bill itself, which provides for the establishment of the Pioneer Generation Fund and its administration. As stated in Budget 2014, the Government will set aside $8 billion to meet the full cost of the Package. With accumulated interest over time, we estimate this amount to be sufficient to meet the projected cost of the Package, which is slightly over $9 billion.
Mdm Speaker, I shall now highlight the main features of the Bill.
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Part II of the Bill sets out the purposes for which monies in the Pioneer Generation Fund may be used. It places the general responsibility for the management and administration of the Fund on the Minister for Finance and provides for the presentation of annual financial statements and Auditor’s report to Parliament.
Part III of the Bill defines the eligibility criteria for an individual to be considered a Pioneer and outlines the benefits which Pioneers stand to receive as part of the Pioneer Generation Package. The benefits include annual top-ups to the CPF Medisave Account; MediShield Life premium subsidies; extra subsidies for outpatient treatment and cash grants under the Pioneer Generation Disability Assistance Scheme.
Part III also provides for the powers of the Appeals Panel and how appeals may be made. The Panel may determine a citizen of Singapore to be a Pioneer provided that the person is born on or before 31 December 1949. As stated in Parliament on 8 September 2014, it was recognised, after extensive deliberation, that for any age criterion, there will be those who marginally fall short of the criterion. The Panel thus decided that it was not feasible or fair to allow age-related appeals without extending the new age criterion to all Singaporeans. This is why the Bill provided that the Appeals Panel will only be looking at citizenship-related appeals.
Parts IV and V of the Bill contain general provisions, including the power to make regulations for carrying out the purposes and provisions of the Pioneer Generation Fund Bill and the proper conduct of officers and entities exercising functions under the Bill. Any decisions of the Appeals Panel made prior to the passing of the Bill are also taken as valid, so that the Panel could grant Pioneer status to those who have successfully appealed earlier.
Madam, the purpose of the Pioneer Generation Package is to recognise our Pioneers' contributions in developing Singapore. As Prime Minister Lee Hsien Loong has said, it is "a special package for a special generation" who have built up Singapore to what it is today. The Package reduces the medical expenses of Pioneers, enables them to save more for their other needs and thus helps their family members as well. Mdm Speaker, I beg to move.
Question proposed.
Madam, this Bill is one that provides reassurance for our Pioneers, of our commitment to care for them, no matter what our future economic or fiscal outcomes are. It also provides for peace of mind for themselves
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and their families. It is, indeed, a generous move on the part of the Government.
A central focus of this Fund is the various healthcare subsidies and assisted payment plans, without means testing. This is appropriate for the thrust of this Bill and the Fund because, when surveyed, our seniors and Pioneers have voiced rising healthcare costs and the ability to pay for their medical management and treatment as two of their top concerns and challenges.
A clarification, Madam: the term "healthcare provider" under clause 2 is defined as "any organisation providing one or more health services in the course of business". Can I ask if we should consider defining this with greater clarity or specifics? This is because the PG card, for example, can only be utilised in Government restructured hospitals as well as private entities, such as GP and dental clinics with the CHAS logo. The benefits and subsidies are not applicable when the Pioneers seek treatment at a private healthcare institution or healthcare provider. This can be critical, as leaving the definition generic and non-specific can lead to misinterpretations and confusion with consumer as well as Pioneer utilisation decisions. Of course, there are mentions in the Bill of public schemes and public authorities, but I feel that it should be a bit clearer.
Pertaining to the Fund and its funding: the Government has provided the seed funding for this and will monitor and regulate the funds. Can the Minister outline what other sources of income, donations, support and fund-raising can be utilised to augment this fund? Also, for interested parties, donors and sponsors, how do they go about doing this?
Another clarification with regard to clause 16: many of the disbursed funds will be through portals like Medisave, MediShield Life. For outpatient claims and other claims, how will the Ministry regulate this? Will there be some maximum claimable limit set, for example, annually, or will it be on a case-by-case consideration? This is not really very clearly defined and outlined and, in my interaction with the community and in the many dialogue sessions we have had, many Pioneers and their families have been asking for some clarity on this as well.
Next, for Pioneers who are in detention, for example, in prisons and also being incarcerated long term, how are they able to utilise their PG card and Pioneer status subsidies? Some family members have been asking for clarification on this as well. How about those who have been institutionalised, such as the Pioneers in nursing homes and old folks homes? How do their families practicalise their claims and utilisation?
Madam, whilst the majority of our Pioneers are delighted and happy and they welcome the package, how do we reduce misuse? I hesitate to use the term "abuse" as I feel these
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cases are really unintentional and result more from a misinterpretation of information or the lack of information.
I have had some feedback from dental clinics. For example, some Pioneers had gone down to get their dentures done and were apprised of the cost by their dentist and even paid some of the downpayment as well. The mould had been prepared but they defaulted and then they came back to ask for reimbursements which created some misunderstanding and some problem as well with the clinic. This, of course, adds to the costs of dental practice, as we understand, not forgetting also taking up the time of AIC and MOH staff to follow up and investigate as well. Many of these issues can, I feel, be sorted out with better communication and use of clear signages and explanations at the clinics. I would appreciate the Ministry's inputs as well on this.
Also, Madam, such a package requires sustainable, impactful communications to educate the Pioneers and their families. I have to congratulate the Government on the many initiatives that have been put forth for this. One group of personnel though that I feel we can strengthen and align better with will be our frontline counter staff at Specialist Outpatient Clinics, GPs and dental clinic assistants. These are the people who will be our "ambassadors of the Pioneer Generation Package". The interaction that they have with the Pioneers will colour the perceptions of the Pioneers about the package. Therefore, we need to update and brief these personnel so that they have a very good and in-depth understanding of the utilisation processes.
I have actually encountered several elderly who have developed a negative view of this extremely good package, which is really unfair, because they were told by some of these frontline staff to go back and forth, to go back to their GPs, for example, to get assessments done for disability claims and so on and so forth. If we can simplify it for them and do it under one roof, that would certainly make it easier for our Pioneers. Indeed, simplification and streamlining processes for the Pioneers will have the positive impact that is intended.
As one of the Pioneer Generation residents in my constituency told me, she really felt that this package made her feel the real meaning of 家有一老, 如有一宝, which essentially means if you have a Pioneer or a senior in your home, it is really like having a valuable gem at home. Well, she interpreted it to me and said that it is like the Government is treating them as though they are valuable gems of the country, of the nation, and they really feel appreciated.
Madam, this Bill reflects the honour and privilege we accord our Pioneers, the generation that built Singapore. They more than deserve this. Thank you very much and I
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support the Bill.
Mdm Speaker, thank you for allowing me to speak on the Pioneer Generation Fund Bill. This Bill is, by far, one of the boldest and most generous initiatives undertaken by the PAP Government in looking after the welfare of our senior citizens.
This fund is set up with a noble aim to recognise and thank each and every of our Pioneer Generation Singaporeans for their contribution in making Singapore what it is today. This Fund will greatly alleviate theirs and their families’ anxiety and concerns on healthcare bills as they live out their golden years.
Since September 2014, many of our 450,000 Pioneer Generation Singaporeans had experienced a significant reduction in their healthcare cost. Many, who did not qualify for the Pioneer Generation Package, came to see me at my Meet-the-People session (MPS) to appeal for inclusion in view of the benefits experienced by their Pioneer Generation friends.
In last Friday's Straits Times article, it was reported that many seniors who have not seen a dentist in a very long time are finally getting their teeth checked and fixed. Some 24,000 PG seniors visited the dentists with their PG Card in hand.
Currently, the large healthcare discounts for the Pioneer Generation are almost in full swing except for the subsidies of medicines and premiums for MediShield Life. Nonetheless, members of our Pioneer Generation are generally happy with the benefits of the PG Package.
The total cost of the PG Package in nominal terms will be slightly over $9 billion, and, with the accumulated interest over time, it is projected that the Pioneer Generation Fund will be enough to pay for the full cost of the package. Hence, sustainability is an important consideration with this package. With the multi-faceted subsidies to benefit 450,000 members of the Pioneer Generation, the Government will need to fulfil its obligations to those eligible for life.
Our Pioneer Generation seniors can also be assured, knowing that the Government has prudently set aside the full amount of the PG Fund now to ensure the sustainability of this package. This is a guarantee that Singapore will honour the commitment made to them, regardless of future economic or fiscal circumstances. In doing so, our budgets in subsequent years can be freed up to meet future needs and challenges without burdening future
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generations.
What is clear is the need to ensure the PG Fund is well governed, prudently utilised and effectively deployed to achieve the desired outcomes for our seniors. We should also guard against being too bureaucratic or conservative in its application, resulting in an overtly under-utilisation of the PG Fund.
Several factors, however, can accelerate the utilisation of the PG Fund, threatening its adequacy. In 1990, the life expectancy of Singaporeans was 75 years, but, today, it is 82. The World Health Organization placed Singapore fourth in the world with the global average age of 70 years. Our citizens are able to enjoy longer longevity where a large part is credited to a world-class healthcare system and greater awareness of a healthy lifestyle. Should there be a breakthrough in science and medicine that enables us to live much longer, more PG Fund will be needed.
Mdm Speaker, I would also like to call for more transparency in healthcare costs for medicine and treatments. We need to avoid indiscriminate pricing by healthcare providers, which may have a double-whammy effect on making healthcare more expensive for our seniors and accelerating the depletion of the PG Fund.
Notwithstanding the Finance Minister’s pledge to ensure the benefits of the PG Fund do not run out, how can we ensure that the cost of living, especially healthcare costs, is insulated from spikes in an inflation? Singapore is a small country with highly porous borders and we are highly susceptible to global economic factors. At the moment, our inflationary rate is manageable, but there is no guarantee that external forces, such as the excessively high price of oil, would not result in the cost of living in Singapore spiralling upwards.
We have, for many years, achieved Budgetary Account balances, with some exceptions, mostly in surpluses. However, it is a known fact that with many rebates, close to 70% of Singaporeans do not pay income tax. Our Government's revenue has for some years now been dependent on indirect tax for income. Thus far, we have been fortunate to achieve fiscal surpluses. But, as more pressure builds up on providing social support, as well as the need for maintenance and replacement of existing infrastructures, our people need to be assured that the Government would not take the route of increasing direct income tax or other indirect taxes to raise revenue to fund demand for similar generous social measures.
Mdm Speaker, the PG Package and its many wonderful provisions reminded me of the traditional Chinese delicacy of 盆菜. This dish takes hours and hours of preparation, served in a large earthen pot. At every layer, it is stuffed with delicious delicacies. But, for the country, this is both a source of celebration and concern. Concern because, even in the face
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of one of the worst global financial meltdowns in 2009, we had had to utilise $4 billion of our country's reserves.
This year alone, we are introducing various social programmes costing many billions. Moreover, the funding of the PG Fund is drawn from our Net Investment Returns of our reserves, and the source of the latter is dependent on prudence, governance and strong economic growth. Although the approach is one of prudent fiscal spending, for a small economy like Singapore, we are highly susceptible to shifting global external conditions beyond our control. The question is whether Singapore can continue to enjoy the trade winds of good investment yields from its reserves.
Mdm Speaker, we need to avoid well-intended good policy marred by poor execution. In this regard, we have introduced many measures that go to the heart of easing the living of all Singaporeans as much as possible, sparing no effort or funds. Many members of the Pioneer Generation may have little or no education, are monolingual and ignorant of current affairs. Thus, it would be a shame if people do not understand how they can benefit from all the goodness and benefits of the PG Package.
I must add that the Government has embarked on an aggressive and comprehensive outreach and communication plan to reach out to as many of our PG seniors and the public as possible. It is good to do a stock-take and see how effective this has been and what more can be done.
Mdm Speaker, the PG Package has been a popular policy with the recipients. This is evident as more than 100,000 of the PG members have started using their cards in just over two months. On the ground, during my interactions with my residents, many are appreciative and commented that the PG Package benefits are good. During my MPS, I have received appeals from seniors to be included even though they missed the qualifying criteria.
Many argued that they, too, have contributed to the building of Singapore. Some naturalised citizens, too, want to be included on grounds that they have been in Singapore for longer than their citizenship status. Although clauses 13 through 15 addressed the issue of who qualifies, as well as the appeal process, I hope for more transparency in the deliberation of the appeal. On what grounds would exceptions be made on these appeals?
Mdm Speaker, the crux of the issue is for members of the Pioneer Generation who need help to be able to receive them as quickly and seamlessly as possible. This is the basic issue that we have to address. The Government had spared no effort and resources in trying to get the message of the PG Package down to the recipients. We, therefore, owe it to ourselves, as well as the Pioneer Generation Singaporeans, to avoid hiccups and delays in the delivery,
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such as subsidies in medicine and premiums for MediShield Life. With this, I support the Pioneer Generation Fund Bill.
Mdm Speaker, I speak in support of the Pioneer Generation Fund Bill. I also declare my interest: I am the President of SPD, a voluntary welfare organisation which falls within the definition of "healthcare provider" under the Bill, and a board member of SG Enable.
Madam, the principle of honouring our Pioneers and caring for this special group in their senior years is right and laudable. The healthcare-related needs of seniors intensify with age. It is, therefore, good and timely that greater attention is paid to such needs. An important component would, naturally, be financial assistance.
It is heartening that the healthcare-related schemes announced to-date by the Government under the PG Package do not require means-testing. By such, the PG Fund is rendered more accessible to Pioneers.
In this context, it is noted that clause 3 of the Bill states the purpose of the Act as "to recognise and honour the participation and sacrifice of Singapore's Pioneers in the development of Singapore by providing to them who are now elderly and are or may be in need of financial relief, assistance or other support to meet their healthcare costs, and other costs of living in Singapore." The Explanatory Statement to the Bill is similarly worded.
Madam, I would like to draw the attention of the House to the phrase "and are/or may be in need of financial relief". This phrase suggests that for a scheme to qualify for funding under the PG Fund, the disbursement of monies or provision of benefits to any Pioneer must be subject to means-testing or differentiation on the ground of financial need. If so, a scheme that benefits Pioneers without the requirement for means-testing would not qualify for funding under the PG Fund. That would be inconsistent with the declared intentions that the announced healthcare-related schemes should be drawn from the PG Fund because the current announced schemes do not require means-testing.
To address the foregoing concern, as well as concerns as to whether a Pioneer participated and made sacrifices in the development of Singapore, the language in clause 3 may be amended by replacing "them who are now elderly and are or may be in need of" with simply "Pioneers". This would remove doubts as to whether the PG Package healthcare-related schemes, as announced, are eligible for funding under the PG Fund and would also grant the Government greater flexibility in designing and qualifying future schemes under
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the PG Fund. I do recognise that there are other possible interpretations of clause 3. But I would suggest that we should make a plain reading plain.
Madam, I support the provision under section 13(3)(c), which provides that a verification application for an individual under mental incapacity may be made by a donee under a lasting power of attorney. I would request that in the drafting of the regulations, a verification application may also be made by a Court-appointed deputy.
In relation to section 18 of the Bill, Parliament may also wish to consider the need to reserve a power or discretion to exclude or restrict any Pioneer or class of Pioneers from receiving benefits under the Act where it is expedient in the public interest, particularly in view of the stated purpose of the Act. This power or discretion may be incorporated into section 18(2).
Madam, allow me to now move on to some practical issues.
In as much as the intention is to make the PG Fund accessible to Pioneers, we need to take a holistic approach between schemes under the PG Package and other existing schemes. We should make accessibility to all these schemes as seamless and painless as possible. For example, whilst one common Functional Assessment Report is utilised for schemes administered by AIC, Sg Enable, SNTC and HDB, the form of the report states that it is, I quote, "NOT valid for claims under ElderShield and the Interim Disability Assistance Programme for the Elderly (IDAPE)". With due respect, I fail to see a compelling reason, notwithstanding that ElderShield and IDAPE are administered by insurers, to subject the elderly to different functional assessment exercises for a similar assessment outcome. Would the Government consider rationalising the Functional Assessment Report requirements?
We should bear in mind the challenges enroute to obtaining such assessment reports. There are transport and other logistical challenges, such as how to go, who to accompany; there are cost constraints, such as taxi fare, caregiver to take leave, sometimes no-pay leave, payment for costs of assessment and certification; waiting time to obtain appointments, waiting time at the relevant clinics. It can be very debilitating for the patient and caregiver. Let us not make our Pioneers whom we wish to honour and their caregivers who are already under tremendous stress, undergo multiple assessments unnecessarily.
On a similar note, I would, therefore, request the Minister also to clarify if there would be requirements for periodic reassessment after an initial functional assessment has concluded that a disability is permanent or likely to be permanent.
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In relation to PioneerDAS, the FAQs state that the sums disbursed under PioneerDAS may be used to pay for any expenses, at the discretion of the Pioneer. The Pioneer may also nominate a caregiver who is at least 18 years old to receive the payments. I have two concerns, which apply to all disbursements under the PG Fund. The first is that the Pioneer may be vulnerable and subject to undue influence. The second is that the minimum age of a caregiver who may be nominated to receive the payments should be raised to above 18 years. The minimum age would be an arbitrary number, I agree, but the relevant authorities would be in a good position to assess what an appropriate uniform minimum age would be, with discretion granted to the various scheme administrators to make exceptions as the circumstances may warrant. Pioneers should also be strongly encouraged to nominate suppliers and service providers to receive the relevant funds received from the PG Fund. This would reduce the risks of dissipation, which may otherwise leave the Pioneer deprived of the funds.
Under PioneerDAS, the FAQs also state that if a Pioneer passes away, the caregiver is required to submit a death certificate. Potentially, disbursements can continue to be made for as long as the death certificate is not submitted. Instead of relying on the diligence or good faith of the caregiver and the claw-back provisions, the registration of the death of a Pioneer could be immediately uploaded onto the scheme administrator's system through the Registry of Births and Deaths.
The FAQs also state that the Pioneer and his caregiver may nominate different bank accounts for different schemes. So, you could have a Pioneer with different bank accounts for PioneerDAS, ElderShield, IDAPE and the Foreign Domestic Worker Grant. We are concerned that the potential number of bank accounts would result in greater difficulty for the Pioneer to monitor and track transaction trails. I would, therefore, also urge the Government to rationalise payments into a single account, regardless of whether the schemes are administered by the public, voluntary or private sectors.
Having said the above, I would also like to urge my fellow Singaporeans to recognise that the responsibility should not be the Government's alone. It must be a family and community effort. Honouring our Pioneers does not lie in dispensing funds alone. It lies in according them respect and dignity. They should not be viewed as a burden to our community, but as valuable members of our community and, where applicable, as role models and mentors for the younger generation.
It is as frightful to be aged and lonely as it is to be aged and poor. The role of the family is something which no Government or VWO can assume. Loneliness is not a condition that the Government or a VWO can relieve. Love is not something that the Government or a VWO can give.
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As we consider, debate upon and execute various Government schemes for Pioneers, I urge each Singaporean to examine our roles in relation to the Pioneers, seniors, people with different or special needs and others within our families and community.
We, who have seniors in our families, are we willing to assume responsibility for them? We, who have seniors in our neighbourhood, are we willing to be neighbours to them? We, who are employers, are we willing to engage and employ our seniors on fair terms? Are we willing to redesign the work scope and workspace to accommodate their needs whilst tapping on their experience? We see our seniors taking public transport, working in public places. Should we be kind and gracious to them? Do we even notice them? Or do we think that someone else will?
It is not a scheme or package that makes a country kind and gracious. Yes, that sets the tone. But it is every individual – you and I. Singaporeans. The young today will be aged one day. The able-bodied will slowly suffer functional disabilities. It is not someone else’s problem. It is our problem. We are the ones who determine the type of community we live in and the type of community we will live in in the future. The Government has set the tone for us in this Bill. The question now is: what will we, the common folk, do?
Our Pioneers merit special treatment. They made extraordinary sacrifices to build families under unfavourable conditions. Born before 1949, there was barely any real opportunity to secure any education or home. They grew up among the ravages of unemployment and socio-economic disadvantages in the 1950s and 1960s. CPF was started only in 1955. Neither was there a real opportunity to build up savings with their meagre salaries.
The true benefits of economic progress were enjoyed by the younger generations born after them. Our healthcare system has prolonged their life expectancies. Our education has made it hard for them to participate in the labour force. Even our modestly-priced public housing in the initial years was beyond the reach of many low-skilled workers. Some have been displaced from their agricultural livelihoods to make way for public housing, industrialisation and infrastructure. In other words, they were displaced to make way for our future.
This Fund is but a token of appreciation to recognise their past. We, their children, benefited from our economic progress built on their past and their sacrifices. We must work together with the State to galvanise more efforts to provide the seniors and the Pioneers with a dignified twilight.
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Mdm Speaker, on that note, I support the Pioneer Generation Fund Bill.
Senior Minister of State Josephine Teo.
Mdm Speaker, I thank the Members, Assoc Prof Fatimah Lateef, Mr David Ong and Ms Chia Yong Yong, for their support of the Pioneer Generation Fund Bill. As I speak, I am trying to look through my reading glasses. I am beginning to experience what it is like to cope with seniority. So, what Ms Chia, in particular, says about the challenges that our seniors, our Pioneers faced, I cannot say I relate to completely but I am beginning to experience it and it resonates with me.
I would like, Mdm Speaker, to respond to each of the Members' points. In order to organise this, I will respond to Assoc Prof Fatimah's points first, then Mr David Ong's and Ms Chia's, if that is permitted.
So, let me start with Assoc Prof Fatimah who had a question on how certain groups of Pioneers, such as those who are currently incarcerated or those who are in nursing homes, can benefit from the Pioneer Generation benefits.
Pioneers who are incarcerated already receive medical care provided by the Singapore Prison Service and, so, do not require subsidies for outpatient treatment while in prison. However, they will still receive the Medisave top-ups and receive premium subsidies for MediShield Life when it is implemented.
Pioneers in nursing homes are eligible for the same benefits as all other Pioneers, on top of the Government subsidies that they may receive for long-term care. Like other Pioneers, they can get the Medisave top-ups and the subsidies for outpatient treatment, which are useful if and when they are referred to the specialist outpatient clinics for treatment. Those with moderate to severe functional disability will benefit from the Pioneer Generation Disability Assistance Scheme (PioneerDAS), which I introduced earlier, which can be used to support the cost of long-term care.
We have also reached out to our nursing home providers to inform them how to facilitate their patients' applications for PioneerDAS. And when MediShield Life is implemented, they will also receive special subsidies for Pioneers and have insurance coverage in case they are hospitalised.
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Assoc Prof Fatimah is right to point out that Pioneer benefits do not apply to all clinics and settings and has asked whether we need to clearly define the term "healthcare provider" under section 2 of the Bill. The list of healthcare providers that disperse Pioneer Generation benefits will be gazetted under section 19 of the Bill. We also intend to put up this list of healthcare providers online so that members of the public can check against this list.
The important point is how Pioneers can more easily identify the healthcare providers where Pioneer benefits are available. In this regard, I am pleased to share with Members that, in fact, the CHAS GPs and subsidised SOCs have all been provided collaterals, such as standees, and encouraged to display these collaterals prominently so that Pioneers can see clearly that benefits are available to them. I think something visual, big and prominently located is easier for the Pioneers to identify. So, that is what we will continue to encourage the healthcare providers to do.
The PG Fund has been sized so that it is sufficient to cover the projected costs of the entire package. So, there is really no need for individuals and organisations to donate to the Fund. We encourage them instead to donate directly to charities or platforms, such as the SG50 Care and Share Movement. The impact of the donations will be doubled with the matching grants from the Government. This will provide additional resource support for the good work of our community organisations which directly help the vulnerable elderly. Monies in the PG Fund will be invested with the Government, which will pay a fixed return to the Fund annually. This is the same for other funds, such as the Goods and Services Tax Voucher Fund.
Assoc Prof Fatimah also asked whether there is a maximum claim limit under the package. As Members are aware, there are existing rules on how much a Member can withdraw from his CPF Medisave Account or how much he can claim via MediShield Life. The same rules apply to Pioneers. However, there is no cap to the number of years a Pioneer may claim the PG Package benefits because the Government is committed to providing them to all Pioneers for as long as they live.
Moving on to Mr Ong's points, he raised four main ones.
First, he emphasised the need to ensure that the PG Fund is well-governed. Let me assure Members that the Fund is subject to the same stringent governance structure already in place for other similar funds. It will be audited annually and its financial statement will be presented to Parliament every year.
Second, Mr Ong highlighted the concern of indiscriminate pricing of medicine and treatments by healthcare providers, especially where there are subsidies which are very
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attractive. Madam, I believe that the vast majority of doctors are conscientious and take it upon themselves to always act in the best interests of their patients. Nonetheless, MOH closely monitors the claims submitted by the CHAS GPs and will not hesitate to call on clinics to account for exceptional claims. Let me add, too, that, as patients, we have to be careful to avoid asserting undue pressure on doctors by seeking treatment or medication excessively.
Third, Mr Ong is right to remind us that there could be unexpected or external factors that may lead to accelerated depletion of the Fund. We have, therefore, included a buffer for inflation and also taken into account utilisation due to the ageing demographics of Pioneers when sizing the Fund. But his broader point about the need to contain healthcare cost increases is an important one and there are three key strategies, as mentioned by Deputy Prime Minister Tharman during his Budget round-up speech earlier this year.
First, we must rebalance the structure of our healthcare system to shift from an over-concentration of treatment in acute hospitals even when treatments can be effectively delivered through primary care or step-down care providers.
Second, we must ensure that we have the right incentives for healthcare providers, doctors and individuals and we must avoid over-prescription by ensuring that treatments are clinically necessary and cost-effective.
Third, all of us must take responsibility for maintaining healthy lifestyles and utilise healthcare services prudently. This is a long-term effort and we will all need to do our part to control healthcare costs.
Finally, Mr Ong asked about the Appeals Panel criteria. For citizenship-related appeals, the Panel has been considering the relevant factors of each case. These factors include whether the appellant had been in Singapore in the early years of Independence, demonstrated clear efforts to sink roots in Singapore and had obtained Singapore citizenship shortly after the 1986 cut-off date.
On age-related appeals, the Panel had deliberated on the matter extensively and it was a very difficult debate. It recognised that, for any age criterion, there will be those who marginally fall short of the criterion. Some appeals pointed out that they actually missed out the 31 December 1949 criterion by a mere few hours. So, the Panel has decided that, as difficult as it is, it was not feasible or fair to allow age-related appeals without extending the new age criterion and to all Singaporeans. In other words, shift the line completely. It is decided that it is not feasible to do so and, so, the Bill reflects these decisions accordingly.
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Let me now turn to Ms Chia Yong Yong's points. Ms Chia has asked to replace the line, I quote "them who are elderly and are or may be in need of" from section 3 of the Bill with "Pioneers" should this give the impression that the PG benefits will be means-tested. The Government does not intend to introduce means-testing to the PG Package. The intent of the Package is to honour and recognise the contributions of all Pioneers in nation-building, regardless of their financial status. As such, they receive similar special benefits, on top of healthcare subsidies which the Government already provides for all Singaporeans.
Let me assure Ms Chia and Members that section 3 is an acknowledgement that our Pioneers are likely to be less well-off and be in need of greater assistance. It is meant to reflect a fact and not to signal the Government's intent to restrict Pioneer benefits to the financially needy. So, I want to make that clarification and I hope that Ms Chia would be willing to accept this clarification, which is also a matter of record in this debate.
Ms Chia had a suggestion to provide for a verification application for an individual under mental incapacity to be made by a Court-appointed deputy under section 13(3) of the Bill. The Appeals Panel has operated for a while under the current provision and it has not encountered such an instance. Nonetheless, we understand where Ms Chia is coming from and we will keep the suggestion in view. I can also give Members the assurance that we will exercise flexibility when it comes to accepting appeals on behalf of persons with mental incapacity. The intent is to evaluate the appeals on their own merits than the way in which they are received. Yes, there is a provision in the Act but I can give Members the assurance that we will be willing to exercise flexibility in accepting appeals.
Ms Chia has also suggested that we consider the need to reserve discretion to exclude or restrict any Pioneer or class of Pioneers from receiving benefits under the Bill, where it is expedient in the public interest to do so. There is actually no need for us to reserve this discretion as the PG Package is a commitment by the Government to all Pioneers that they will receive these benefits for life. Such a clause would be counter to this intention.
Ms Chia raised several very useful points on the PioneerDAS, ElderShield, Interim Disability Assistance Programme for the Elderly (IDAPE) and the Foreign Domestic Worker (FDW) Grant. She is right that we should endeavour to make access seamless. Her point also underscores the challenges that the Government faces when introducing new schemes and the tremendous effort that needs to go into their implementation, so as not to confuse citizens and make it seem as though they have to jump through multiple similar hoops in order to access the benefits. Now, they are very important feedback that we should rightly share with MOH in whose purview these schemes lie and which will need to be involved in making the improvements. So, I give Ms Chia and Members the assurance that we will take it up with MOH and we will explore ways in which we can ensure that the implementation
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process makes access to the scheme more seamless.
Once again, I thank Members for their very thoughtful comments and for their support of the Bill. In closing, I could not help but be struck by Ms Chia's speech, especially the second half. I think she said something that I have felt for a very long time, ever since I began serving as a Member of Parliament. She said, if I may quote, that "loneliness is not a condition that the Government or a VWO can relieve. Love is not something that the Government or a VWO can give". She is very right. And in the passing of this Bill, I also join her in calling on all Singaporeans to work together with the state to galvanise more efforts to provide the Pioneers with a dignified twilight. Mdm Speaker, I beg to move.
*Question put, and agreed to.*
*Bill accordingly read a Second time and committed to a Committee of the whole House.*
*The House immediately resolved itself into a Committee on the Bill. – [Mrs Josephine Teo].*
*Bill considered in Committee.*
[Mdm Speaker in the Chair]
Clauses 1 to 2 inclusive ordered to stand part of the Bill.
*Clauses 3 to 17 – (proc text)]
Ms Chia, I understand that you have an amendment to move to clause 3. Do you have a copy of the amendment in writing and are copies available for distribution?
Yes, Madam [A handout was distributed to hon Members]. Madam, I beg to move,
In page 6, line 12 and 13, to leave out the words "them who are now elderly and are or may be in need of" and insert the word "Pioneers".
The hon Member has indicated that she would like to move an amendment to this clause and the amendment has already been distributed to Members. As inadequate notice has been given of this amendment, it is subject to the consent of the Chair and the general assent of Members present. I give my consent.
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Let me now turn to Members of the House. Are hon Members agreeable to the amendment to be moved? Can I have an indication from hon Members whether you are agreeable to the amendment to be moved by Ms Chia to clause 3, an indication of yes or no? Can I have a louder sense of whether it is an indication of a yes or a no?
Hon Members indicated assent.
Mrs Teo, do you wish to say something?
Mdm Speaker, with your permission, I would like to humbly request Ms Chia to reconsider tabling this notice of amendment. As I have explained in my response speech to the Member's comments during the Second Reading, the intent of the Pioneer Generation Fund Bill is really not to restrict the benefits at all. The line in which she referred to in section 3, in fact, is merely a statement of a fact. This clarification would already stand part of parliamentary records.
As to the proposed amendment to clause 18(2), in fact, it would restrict the provision or benefits to the extent that was not intended by the PG Package. We do not think that it is necessary to insert the words "or if the Minister deems it expedient in the public interest to so declare". In other words, we do not think there is any need to give the Minister this power to exclude any particular group of Pioneers or any Pioneer from enjoying the benefits. So, I just want to make that clarification.
Ms Chia, do you wish to reconsider or do you intend to proceed with your amendment?
With Mdm Speaker's permission, if I could just clarify my motivation to move this amendment. I have heard the Senior Minister of State. I think, all the more, if the intention is that we do not wish to conduct any means-testing, that we should remove any doubt that financial need may be a criterion in any scheme that is to benefit under the Fund.
This is to avoid any argument subsequently that a scheme had been improperly administered because it fell outside or did not satisfy clause 3 because there was no requirement for financial differentiation. I would urge the Senior Minister of State to consider and advise me accordingly.
Mrs Teo, do you wish to respond?
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Yes, Madam. In fact, in section 3, it more or less falls within the preamble of the Bill. In the preamble of the Bill, we described the intent of the Bill. In describing the intent of the Bill, we provided the background as to why the Government has decided to put forward a package that would provide relief to Pioneers in their twilight years. It is meant to focus on supporting them in their healthcare expenses.
One of the reasons that we provide for putting up the PG Package is to record the fact that in the earlier years of nation-building, many of our citizens would not have been in a position to save very much or to accumulate balances that would help them in their retirement years. And that is primarily because their wages were not very high in those years. So, it is really intended as a provision of a background and I think it has to be read in that context. That is why I reiterate and really hope that Ms Chia can take it from that perspective.
Thank you, Senior Minister of State. I do apologise, but I would like to put this to the House. Thank you, Mdm Speaker.
Ms Chia, please move your amendment.
Chairman, I beg to move, "In page 6, lines 12 and 13, to leave out the words "them who are now elderly and are or may be in need of" and insert the word "Pioneers".
Amendment negatived.
Chairman, point of Order. As you have indicated, Madam, the notice for amendment came very late. It really has not given us enough time to consider this. I wonder if it may be possible to put this to a vote at a later time, possibly tomorrow, because we are likely to have to sit tomorrow.
Mrs Teo, assent has already been given to move it, but Members have not agreed to the amendment. There has been a strong endorsement to say "No" to the amendment. So, assent was given to move it, but the amendment is not accepted because the majority of the Members of the House do not agree to the amendment.
Clauses 3 to 17 inclusive ordered to stand part of the Bill.
Ms Chia, you have also given an indication that you intend to move an amendment to clause 18. Would you like to indicate your amendment?
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Madam, in view of the explanation given by the Senior Minister of State, I would not move the amendment. And I apologise to the House for the late notice.
Clauses 18 to 28 inclusive ordered to stand part of the Bill.
Mdm Speaker, with your permission, if I may just touch on the earlier proposal by the Member, Ms Chia, on clause 3. Although the Bill would be passed, I think we want to make a note that we will still take a look at the Bill again and, if it is possible to do so, introduce a Notice of Amendment. So, I just wanted to put that on record.
Bill reported without amendment, read a Third time and passed.
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