Wednesday, 13 March 2013

Parliament Highlights - 12 Mar 2013

Committee of Supply Debate: MOH, MOT, MEWR

6 more hospitals, lower medical bills
Govt to boost facilities and pay bigger share of health-care costs
By Salma Khalik, The Straits Times, 13 Mar 2013

SIX more general hospitals and up to 14 more polyclinics will be built by 2030 as the Ministry of Health (MOH) ramps up facilities to meet growing demands of a larger population that is fast greying.

The Government will also pay a greater share of health-care bills, up from the current 30 per cent to 40 per cent or more, said Health Minister Gan Kim Yong yesterday.

Speaking during yesterday's parliamentary debate on his ministry's budget, Mr Gan said the major health-care financing review the ministry is currently undertaking also aims to increase insurance coverage for Singaporeans.

With both Government and insurance taking on a bigger share of health-care costs in future, people should be able to use less cash or Medisave balances to meet their health-care bills, he said. This will give people "peace of mind", even as health-care costs continue to go up.

Mr Gan outlined these major moves in a speech that touched on immediate improvements to the health-care system as well as longer-term fundamental shifts.

Outlining the thinking behind the review, Mr Gan said the current system - consisting of government subsidies and the "3M" framework of Medisave, MediShield and Medifund - has served Singapore well so far, but needs strengthening.

The idea is to "reduce the impact of rising health-care costs on Singaporeans, especially the lower- and middle-income", he said.

But the ministry will also look carefully at how to better utilise any additional spending, added Mr Gan.

"Today, the bulk of our subsidies go towards hospitals, where the cost per episode is high," he noted. "As our population ages, delivery of health care will increasingly extend beyond hospitals."

More targeted help can be given to alleviate the high cost of outpatient care and long-term care, he suggested, as well as preventive care that will keep Singaporeans healthy and out of hospital.

Another key area up for review is Medisave.

The MOH is studying if it can expand the list of outpatient treatments, medical screenings and vaccinations that are Medisave-deductible, as well as increase the $400 annual cap on the outpatient use of Medisave.

The challenge is to make sure that such changes do not result in the elderly having insufficient Medisave for their needs in the future, warned Mr Gan.

"If we calibrate carefully and put in place some safeguards, I believe we can allow greater flexibility in the use of Medisave to reduce out-of-pocket costs, without jeopardising the future," he said.

A third area for review is MediShield, the national insurance policy designed to help Singaporeans meet large inpatient bills.

The ministry will see if the scheme can be expanded to offset a higher proportion of costs, while keeping premiums affordable.

"We will also have to address Singaporeans' concerns about exceptionally large bills that go beyond the current cap on MediShield claims," he added.

Detailing other measures to help manage health-care costs, Mr Gan said Medifund, which disburses help to the poor, will get an injection of $1 billion, increasing available funds by at least 20 per cent to $120 million a year.

He also drew applause from the House as he removed a $3 fee that is charged each time a patient draws on Medisave to pay for outpatient treatment.

No more $3 admin fee for using Medisave
By Poon Chian Hui, The Straits Times, 13 Mar 2013

PATIENTS will no longer have to pay a $3 administrative fee each time they use Medisave to pay for medical treatment.

The announcement by Health Minister Gan Kim Yong yesterday was greeted with applause in Parliament, and comes on top of other measures to trim out-of-pocket payment.

For instance, Medifund will be extended to polyclinics and the National Dental Centre, and drug subsidies will be expanded to cover another 17 drugs, including second-generation insulin for diabetes.

The $3 fee has been imposed since Medisave started in 1984 to cover the cost of processing each claim. But it has received flak for making patients pay to use their own money. From April 1, the Ministry of Health (MOH), following a review, will absorb the transaction fees fully, said Mr Gan.

"I understand that this fee may pose a burden on patients, especially the lower-income, or those who need to use their Medisave frequently to pay for chronic disease treatment," he said.

One such patient is Mr Yeow Sun Wah, 73, who visits Bedok Polyclinic every two months for diabetes and hypertension check-ups. Each time, part of the $50 bill is paid for by his Medisave, which has been dwindling since he gave up his $2,000-a-month driver job to be a road sweeper eight years ago.

With a monthly salary of just $450, even a few dollars go a long way. "Every day, I spend only $2 on lunch," said Mr Yeow, who is single. "If I eat $3 meals, I won't have enough money left."

Meanwhile, wheelchair-bound retiree Koh Siew Hoon, 91, will be able to tap Medifund for her visits to Ang Mo Kio Polyclinic when the rule kicks in this June.

The former babysitter, who has problems ranging from high cholesterol to failing eyesight, is among 20,000 patients that SingHealth Polyclinics and National Healthcare Group Polyclinics help yearly through their internal assistance schemes.

SingHealth Polyclinics said the number of patients to whom it gives financial aid has risen by 11 per cent since 2011.

Similarly, the National Dental Centre has been helping more of such needy patients from its own budget: from 683 in 2009 to 837 in 2011. They come for treatments such as extractions and dentures.

With more drugs added to the Standard Drug List and Medication Assistance Fund, patients can also recover better, say doctors.

Most drugs on the list are capped at $1.40 per week for subsidised patients being treated at public health institutions.

The fund helps patients pay for costly medication.

One new addition is Alteplase, which costs a hefty $2,500 for a single injection. It is given within 4 1/2 hours of a stroke.

But it is the only approved medicine effective for patients after suffering an ischemic stroke, said National University Hospital's neurologist Vijay Kumar Sharma.

Going forward, Mr Gan said MOH will study if Medisave can be further liberalised as part of a review of health-care financing.

National University of Singapore's health economist Phua Kai Hong suggested placing a cap on the number of visits and charges to prevent any abuse and over-utilisation if the scheme is to be expanded. "Medisave should not be the sole tool to finance all healthcare needs."

Plans for health-care expansion 'on track'
Staffing up by 8%; hospital and nursing home beds being added
By Salma Khalik, The Straits Times, 13 Mar 2013

SOME 3,700 health-care workers joined the sector last year, helping to keep on track the Government's plans to expand both manpower and facilities up to 2020.

Health Minister Gan Kim Yong said yesterday that represented an 8 per cent increase in staffing, even as the demand for hospital beds climbed steadily by 4 per cent a year for the past five years.

Much of this increase is due to an ageing population, since demand by foreign patients has remained a stable 2 per cent.

Mr Gan said that, on average, and even with government subsidies, a 65-year-old spends three times the amount a 45-year-old does on hospital care.

The high demand has also been driven by "significantly better and more accessible" health care. More advanced medical treatments and technologies have become more common and achieved better outcomes for patients, he said.

In the short term, Mr Gan said the National University Hospital (NUH) will add 79 more beds this year. There will also be another 100 community hospital beds and over 500 more nursing home beds by the end of the year.

The NUH's new medical centre, which opens in July, will increase the number of specialist outpatient clinics and day surgery operating theatres.

The opening of four more community hospitals and two general hospitals by 2020 will give Singapore 4,100 more hospital beds.

That is about 10 per cent or 400 more beds than projected in the Healthcare 2020 masterplan, announced last year.

Mr Gan also announced the setting up of three more community health centres, in Bedok, Jurong East and Tiong Bahru, later this year. The pilot was launched in 2011 in Tampines. It has proven popular with GPs, who can send their patients there for support services they do not provide, such as diabetic eye screening.

As for recruiting more health-care workers, Mr Gan said the priority is "to grow our local health-care manpower supply". But foreign health-care workers will still be needed, to help meet "health-care needs, add diversity to the sector and help develop our capabilities in various clinical specialities", he said.

The Ministry of Health (MOH) will also invest more in training by giving $50 million more to institutions this year so they can "enhance their capacity to deliver good quality clinical training".

Beyond 2020, Mr Gan anticipates the need to build four more general hospitals and six to eight more polyclinics. The MOH is studying regional demographic profiles to decide the locations.

For the rest of this year, Mr Gan said he will pay greater attention to two areas.

One is to enhance the quality of elder care by setting guidelines and standards for nursing homes.

The other is to improve access and affordability of services so older patients can be cared for at home. Home nursing, home medical and personal care services will be expanded.

Elderly patients often have needs which encompass not just the medical but possibly also the social and financial. The Centre for Enabled Living will become part of the Agency for Integrated Care, so they need turn to only one place for help.

Mr Gan also gave an update on the Community Health Assist Scheme (CHAS). There are now 250,000 people with CHAS cards, which allow them to receive treatment at GP and dental clinics while enjoying government subsidies.

Nursing homes must meet revised criteria for licence
By Melissa Pang, The Straits Times, 13 Mar 2013

NURSING homes will soon have to meet clearly defined criteria in areas ranging from fall prevention to financial management before they can get a licence.

The new standards, which build on existing regulations and will be introduced by 2015, are aimed at improving the way the elderly are cared for, said Minister of State for Health Amy Khor yesterday.

First, clinical-care aspects such as oral hygiene, continence management and fall prevention are more clearly spelt out rather than simply implied.

Second, more attention will be devoted to the social and emotional well-being of nursing home residents, in terms of respecting their dignity and improving communication with staff and family members.

Finally, operators must meet organisational excellence standards in human resource and financial management, requirements which stem from a belief that "good care must be underpinned by good governance", said Dr Khor.

Singapore has about 60 nursing homes that are run by voluntary welfare organisations and private operators.

A draft of the new measures has been prepared by a committee made up of nursing-home operators and health-care professionals. The ministry will discuss the improvements with operators, she added.

While MPs welcomed the change, Dr Chia Shi-Lu (Tanjong Pagar GRC) was worried that it would raise costs for patients.

Dr Khor said a significant increase in costs is not expected, as the new guidelines build on existing good practices at nursing homes. She gave the reassurance that her ministry would keep a close eye on the impact of the change and ensure fees remain affordable.

With Singapore's ageing population set to triple by 2030, Dr Khor also touched on other initiatives for the silver generation in her speech during the debate on her ministry's budget.

For example, constituencies that wish to initiate elder-friendly towns with features like rest stops can receive up to $80,000, as the Government wants to fund five to 10 more "City For All Ages" projects over the next three years.

The project is currently being piloted in Marine Parade, Bedok, Whampoa and Taman Jurong.

Caregivers will also get help under another pilot project.

The Health Ministry will work with a few nursing homes to set aside some beds for respite services.

Caregivers who need a break can put their elderly in nursing homes for between seven and 30 days a year and enjoy a subsidy of up to 75 per cent, subject to means testing.

Finally, an industry-led committee will be formed to review and chart new standards for the development of home care and identify and develop services to meet unfulfilled needs.

Dr Khor said: "Our goal is simple - for our seniors to live happy and fulfilling lives, and to age gracefully."

Two free health jabs for kids at polyclinics
By Melissa Pang, The Straits Times, 13 Mar 2013

SINGAPOREAN children can get two vaccinations for free at polyclinics from June this year.

The jabs will shield them against some common and preventable childhood infections.

One is a 5-in-1 combination vaccine that protects against haemophilus influenzae type B, diphtheria, tetanus, whooping cough and polio.

The other is the hepatitis B vaccination.

Also, Medisave can be used for all vaccinations on the National Childhood Immunisation Schedule, up to a cap of $400 a year.

The list of free vaccinations now includes those against tuberculosis (BCG), and measles, mumps and rubella (MMR).

The changes were announced yesterday by Parliamentary Secretary for Health Muhammad Faishal Ibrahim.

Only two recommended vaccines under the national vaccination programme are not free: the pneumococcal conjugate vaccine and human papillomavirus vaccine.

Minister of State for Health Amy Khor said the cost of breast cancer screening for about 15,000 low-income women will be slashed.

From this Sunday, those who are eligible will pay up to $2 for a mammogram, compared with the existing subsidised rate of $50.

The mammogram will be done at the X-ray centres of participating polyclinics.

The Women's Health Advisory Committee - it comprises a committee of 14 women leaders who help refine health programmes for women - and the Health Promotion Board will work with voluntary welfare organisations as well as the private sector to help cover the screening costs.

Breast cancer screening will be made more accessible too.

A mobile mammogram screening service will be expanded to include more estates.

Ferrying services will also be organised at selected estates to take women to the screening centres.

What price peace of mind for Singapore's patients?
By Chua Mui Hoong, The Straits Times, 13 Mar 2013

THE eureka moment in yesterday's debate came at 6.05pm, when Mr Low Thia Khiang stood up near the end of debate on the Health Ministry's budget.

Debate on health-care spending has long focused on the need to curb soaring costs, and the need to set in place a sustainable framework for paying for health care, especially as people's expectations of medical care rises, and as the population ages.

In Parliament yesterday, MPs Lam Pin Min and Lily Neo were among the speakers who referred to Singaporeans' anxiety over affordability of health care.

Health Minister Gan Kim Yong responded to MPs' concerns about rising health-care costs by saying: "There is a strong desire among Singaporeans for greater peace of mind - the assurance that I will be able to afford health care when my family and I need it, whether now or when I grow old. We take these concerns to heart. We want Singaporeans to be confident that they can always afford the care they need."

Mr Gan's speech mentioned peace of mind four times in all. He repeated the promise made in the Feb 22 Budget that the Government will raise its share of national health expenditure - from one-third to about 40 per cent. The rest is paid by insurance, employers and patients, the latter via Medisave or cash. The change aims to reduce the amount people pay in cash.

The pledge prompted Workers' Party leader Mr Low, long a champion of greater government spending on health care, to observe with a smile: "I'm happy to note that the Ministry of Health (MOH) has shifted its focus and mindset from how to avoid health-care expenditure escalating, to how Singaporeans can have peace of mind in health-care needs, especially for those who have little Medisave in their account."

Mr Low's observation hit the nail on the head. The People's Action Party Government is undergoing a Copernican revolution in mindset. From viewing health- care cost as a fiscal liability to be minimised, it now views it as a fiscal responsibility it must bear, to relieve the burden on patients. This is the right view, even if it is one that the Government has come to too slowly for some.

The current health financing system exposes individuals to the risk of financial ruin from ill health of themselves or their loved ones, if they run out of Medisave, exceed MediShield claim limits and run out of savings.

The MediShield basic and premium plans are meant to pool risks. But the current MediShield model insulates the insurer from taking on excessive risk by allowing the insurer to exclude pre-existing medical conditions from coverage. MediShield payouts are also capped. In this way, the patient faces unlimited financial liability for his illness, while the insurer's risk is capped.

This is a perverse outcome of a national health insurance scheme whose aim by definition is to pool risks to reduce the individual's risk of financial ruin from medical costs. As Mr Gan noted, many would have heard stories of Singaporeans with exceptionally large bills and wondered: What if that happens to me?

The review of health-care financing promises to relook the much-vaunted 3M system and to review subsidies. MPs were quick to offer suggestions. One top call by MPs like Ms Tin Pei Ling, Ms Lee Li Lian and Mr Patrick Tay is to relax Medisave use to include more outpatient treatments, including dental care. Others want more subsidies, for example, for dialysis (Mr Yeo Guat Kwang).

Deciding what government money will pay for is certainly one important part of the review.

But another big part is to look at improving the role of insurance and risk-pooling. Here, the Government has to play the role of strict referee. Insurers are profit-oriented and will want to maximise profits by cherry-picking - reject sick patients and accept only well people into their insurance plan to minimise payouts.

But leaving out sick people who most need insurance isn't a good outcome for society. Hence, regulation of insurers is essential to limit cherry picking. Some countries require insurers that want to offer a national health insurance plan to take on people with pre-existing medical conditions after one year.

In Singapore, there is no such requirement, leaving many middle-aged and older folk with past illnesses uninsured or underinsured. (Disclosure: As a cancer survivor and MediShield upgrade reject, I fall into this category.)

Some countries require health plans to guarantee renewal so the insurer can't cancel your coverage the year after you are diagnosed with an illness.

It would be a travesty if companies like Aviva, AIA, Prudential, Great Eastern and NTUC Income make millions for being allowed to offer national insurance plans that ride on MediShield, but leave out a large segment of the population who need coverage.

During debate on the Ministry of Transport's budget yesterday, MP Lee Bee Wah noted that public transport operators are profitable and give dividends to shareholders, yet service standards are below commuters' expectations. She asked pointedly: "Where have all the millions gone?"

That's something to be borne in mind in the review of health- care financing. Increasing subsidies is all very well, but may just end up adding to the takings of health-care providers in the form of higher fees, or insurers in the form of reduced payouts, unless these are also regulated.

Incentives to ensure buses run on time
By Christopher Tan, The Straits Times, 13 Mar 2013

AFTER years of wielding the stick to get bus operators to improve service standards, the Government is changing tack - with carrots.

A bus quality incentive framework it is launching mirrors a carrot-and-stick approach taken by other cities to ensure buses pull up at each bus stop at designated times, not later or earlier.

Transport Minister Lui Tuck Yew told Parliament yesterday that the Land Transport Authority (LTA) "aims to trial this scheme on some 25 services, or about 10 per cent of bus services, towards the end of this year".

Singapore has long relied solely on a penalty system, which will become far more severe from next month, with bus operators facing fines of $100,000 a month per breach, up from $10,000.

And until now, standards were measured at the point when buses left a depot or terminal. There were no measures to ensure they reach bus stops punctually.

The plan is one of two new initiatives that revealed the Government is willing to try almost anything to improve the lot of public transport commuters.

The other is free travel. Mr Lui said his ministry is looking "seriously" at this novel approach to ease the peak crush between 8.30am and 9.30am.

"What we are still studying is whether we should simply increase the current 50-cent discount substantially to say, $1, or to go all the way to make it free," said Mr Lui.

"If we can get even 10 to 15 per cent of commuters in the peak period to travel up to an hour earlier, we would achieve a very perceptible improvement in commuters' daily travel experience."

Previous plans to nudge people to travel before the peak have largely been ineffective. The latest 50-cent discount reduced the peak load by 3 to 4 per cent.

The two radical moves come on the back of a third consecutive drop in public transport satisfaction in a survey done by UniSIM. Last year's poll showed 88.8 per cent of commuters were satisfied with standards - down from 90.3 per cent in 2011, 92.2 per cent in 2010 and 93.8 per cent in 2009.

Meanwhile, bus and train rides have increased by about 25 per cent to more than 6.1 million a day since 2009.

Mr Lui said long-term plans are in place to expand the capacity of the rail system to meet the demand of a growing population by 2030. But steps are being taken to accelerate interim measures.

Yesterday, he said most of the 550 additional buses promised in the Bus Service Enhancement Programme will be on the road by end-2014, instead of 2016 as previously targeted. "I would like to assure Singaporeans that dealing with the needs of our commuters 'here and now' is the key focus for my ministry, even as our longer-term infrastructure plans are rolled out," he said.

Transport consultant Bruno Wildermuth welcomed the scheme to improve bus punctuality. "This lapse is so common of late that it's pathetic," he said. "It's about time."

More bus lanes and bigger stops
Bus priority schemes to be expanded to boost speeds and reliability
By Royston Sim, The Straits Times, 13 Mar 2013

THE Government will spend $50 million over the next two years to give buses more priority on the roads, in a bid to improve bus speeds and reliability.

It will do this by expanding several existing bus priority schemes, such as adding more bus lanes, and enlarging bus stops.

Transport Minister Lui Tuck Yew announced this in Parliament yesterday as he laid out measures that his ministry will take to improve Singapore's bus network.

Some 30km of bus lanes will be added to the current 178km of normal and full-day bus lanes here. These are reserved for buses during certain times of the day.

The Mandatory Give Way to Buses Scheme, which works like a yellow box near busy bus bays, will be put in place at an additional 150 locations islandwide.

So far, more than 200 bus stops are under this scheme.

The number of bus hubs - longer bus stops that allow several buses to pick up and drop off passengers at the same time - will also be quadrupled from the existing 10 to 40, said Mr Lui.

Enforcement of these bus priority schemes will be ramped up as infringements cause delays for buses, he added.

There were 35,739 bus lane offences last year. Offenders can be fined $130.

In response to questions from several MPs, Mr Lui also said he plans to speed up a $1.1 billion plan to enhance bus services by two years. The Bus Service Enhancement Programme (BSEP) was meant to increase the bus fleet by 800 buses, or 20 per cent, over five years until 2016. The bulk of it will now be brought forward to the end of next year.

But, he added, much depends on whether operators SBS Transit and SMRT are able to recruit enough bus drivers in a tightening labour market.

Giving an update on the programme since its launch last September, Mr Lui said that 90 buses have been added so far to improve 50 existing services and start five new routes.

Another 190 of 550 buses funded by the Government under the plan will be delivered this year.

Private bus operators will also be tapped to boost services,given that the two operators' resources are "already very stretched", he said.

Six more express bus services will be tendered out to private operators under a new City Direct programme from next quarter, and will start from early next year. These services will serve towns closer to the city, such as Ang Mo Kio and Bedok. They will run during peak hours on expressways into the city in the morning and back in the evening.

This will bring the total number of parallel bus routes under the BSEP from eight to 14. Mr Lui hopes nine of the 14 routes will be run by private operators. To date, only two have been launched - run by SMRT and SBS Transit.

From the third quarter of this year, tenders will also be called for buses to ply short routes in housing estates to take residents to MRT stations during peak hours.

Mr Lui hopes these shorter services, also to be run privately, can be implemented next year.

Transport economist Michael Li from Nanyang Business School called the enhanced bus priority "a step in the right direction".

The measures will definitely improve commuting time, he said.

In the longer term, the authorities could also explore how to reduce the length of bus trips, possibly by revamping the bus network, he added.

"When the distance between A to B is too long, there are a lot of variables and it's difficult to follow the schedule set," he said.

Top 10 moves to improve public transport
- Reward system for bus operators that meet punctuality standards.
- Free travel being considered to flatten morning peak on MRT.
- Bulk of new buses financed by Bus Service Enhancement Programme to be on the road by the end of next year, instead of 2016.
- 30km more of bus lanes within the next two years, bringing the total to 210km.
- Another 150 bus stops to come under mandatory Give Way to Buses Scheme within the next two years, bringing the total to more than 350.
- Plans in place to reduce rail breakdowns further, with operators facing significantly higher penalties.
-Encourage more companies to allow staff flexible working hours, work-from- home option, and shower facilities for those who walk, jog or cycle to work.
- Rail capacity to rise significantly to cope with demand from a population of up to 6.9 million by 2030.
- 200km of sheltered walkways within 400m of train stations and bus interchanges.
- Increase train frequency during "shoulder" periods before and after peak time.

MPs want more steps to ensure punctuality of buses, trains
Govt announces reward-and-punish plan to spur reliability of bus services
By Jermyn Chow, The Straits Times, 13 Mar 2013

SEVERAL MPs yesterday wanted more action to be taken to ensure that buses and trains stick to their schedule and arrive on time.

Ms Foo Mee Har (West Coast GRC) asked for bus operators to be held more accountable while Mr Gan Thiam Poh (Pasir Ris-Punggol GRC) and Dr Lily Neo (Tanjong Pagar GRC) said commuters want their buses and trains to arrive regularly.

Announcing the Government's plan to improve the reliability of bus services, Transport Minister Lui Tuck Yew said yesterday during the debate on his ministry's spending for the new financial year that the Government will offer cash incentives to operators who ensure their buses are punctual.

The move is part of the Quality Incentive Framework, which will also penalise operators if buses arrive later, or even earlier, than scheduled. It will go on a trial run later this year and will involve about 25 bus services, or 10 per cent of all services.

Operators will be given specific targets on how long commuters should expect to wait at bus stops. This departs from the current Quality of Service standards, which focus on the interval between the departure times of buses from the terminal, among other things, instead of when the bus arrives at a bus stop.

In explaining the need for change, Mr Lui said operators have to be "a lot more busy, a lot more prescriptive" when monitoring and guiding the movement of buses, even as they are running on the roads.

To reduce bunching and long gaps between consecutive buses, operators need "to ask the buses to speed up or slow down where appropriate, or even to introduce some buses mid-stream when warranted," added Mr Lui.

He expressed the hope that the reward-and-punish plan will address MPs' calls for more reliable bus services.

Mr Lui also assured MPs that his ministry will "spare no effort" to address commuter woes.

Together with the near-term measures to build up capacity, he said he is focused on tackling the "here-and-now" needs of commuters, even as long-term infrastructure plans are being rolled out to ease road congestion and increase public transport ridership.

"We can cope...I am confident that there will be more than enough capacity to meet demand over the long-term."

In cities such as London and Seoul, similar reward-and-punish schemes have helped to improve bus punctuality. 96 per cent of Seoul buses arrived on time in 2011, up from 85 per cent in 2005.

In London, passengers waited only an extra one minute for their buses last year.

Transport economist Michael Li from the Nanyang Technological University said operators who get the incentives should reward their drivers. "It's a shared responsibility... Drivers are the key people who have to navigate on the congested roads to arrive on time. They must see the benefits."

Responding to the news, commuters last night said that the cash incentives for buses may work only if the roads are less congested. "No amount of incentives can improve punctuality when the roads are clogged up and buses are stuck in traffic," said marketing executive Lim Chong Wei.

The 30-year-old, who takes a bus every morning from his Bedok home to his office in Kallang, said: "I often have to wait up to 25 minutes when the bus is supposed to come at 10-minute intervals during the morning peak hours."

NEA to step up action against littering
By Grace Chua, The Straits Times, 13 Mar 2013

THE National Environment Agency (NEA) will step up enforcement efforts to combat littering but community action is still needed, said Second Minister for the Environment and Water Resources Grace Fu yesterday.

Responding to MPs' queries on littering and public cleanliness, Ms Fu said more NEA enforcement officers will patrol over a longer period of time, with their time spent out and about increasing from 24,000 man-hours a month to 35,000.

There will also be more surveillance cameras installed at littering hot spots.

For example, a pilot scheme trains video cameras on Jiak Kim Bridge and McCallum Street. These send the NEA alerts when litter is detected.

And 10 high-rise litterbugs have been caught on camera since the NEA started monitoring apartment blocks on camera in 2011.

Higher penalties for littering are also being considered, said Ms Fu.

Now, the maximum court fine for recalcitrant offenders is $1,000 for the first conviction, $2,000 for the second and $5,000 for the third, but these could all double.

But she added: 'We need everyone to help us make the transition from being a 'cleaned' city to a 'clean' one', by fostering stronger anti-littering social norms, starting community efforts in places like Bishan, Nee Soon South and Bedok to encourage residents to pick up litter, and training volunteers to reach out to those they see littering.

Meanwhile, to manage Singapore's waste, recycling schemes will be piloted, the second phase of Semakau Landfill developed and the Deep Tunnel Sewerage System Phase 2 built, said Environment and Water Resources Minister Vivian Balakrishnan.

For instance, early data from dual-refuse and recycling chutes at some new HDB flats shows these may increase recycling rates, he said.

Replying to Nominated MP Faizah Jamal's query on how projected population increases might affect the Semakau Landfill, he said work would start on the second phase of the offshore landfill next January and be completed in early 2015.

'We're not going to run out of space,' he said.

The landfill can meet Singapore's waste disposal needs till 2035 and its first phase is set to be filled to ground level by 2016.

Singapore is also building a new incineration plant and tapping the energy it produces by burning waste, Dr Balakrishnan said, while work will start on Phase 2 of the Deep Tunnel Sewerage System.

The 18km-long tunnel will run under western Singapore to channel used water to an upcoming water reclamation plant in Tuas.

The first phase, at 48km, was completed at the cost of $3.65 billion in 2008 and runs from Kranji to Changi.

Concerted drive to make roads less polluted
By Royston Sim, The Straits Times, 13 Mar 2013

THE Government will roll out several measures to improve air quality on the roads.

It will implement a scheme to encourage owners of older vehicles to retire them earlier and upgrade to newer, more environment- friendly models.

Minister for the Environment and Water Resources Vivian Balakrishnan said yesterday that an Early Turnover Scheme will be set up to incentivise a switch to vehicles that meet the Euro 5 emissions standard.

He noted that existing old diesel vehicles remain a major source of pollution.

There are about 38,000 old diesel commercial vehicles of pre-Euro or Euro 1 emissions standards with substantial PM2.5 emissions bought before Jan 1, 2001, he said.

The National Environment Agency (NEA) and Land Transport Authority will provide more details on this scheme in the next two months.

Dr Balakrishnan added that, from Jan 1 next year, the test standard for diesel vehicles will be tightened from 50 Hartridge Smoke Units to 40. The NEA will ramp up its enforcement against smoky vehicles on the roads.

Standards for motorcycle emissions will also be raised.

Dr Balakrishnan said there are more than 143,000 motorcycles on the roads, mostly of Euro 1 standard. From October next year, the emissions standard for all new motorcycles will be raised to the Euro III standard.

These new motorcycles will emit less than a fifth of the pollutants compared to the current fleet, he noted.

The Motor Traders Association (MTA) mooted a proposal akin to the Early Turnover Scheme last November.

In a paper, the MTA proposed cash grants be given to encourage owners of old commercial vehicles to switch to newer ones.

It called for a one-off incentive payment of at least $10,000 per replacement of a pre-Euro 4 vehicle with a model that meets Euro 4 or higher standards.

Still, during last month’s Budget speech, the Government announced that commercial vehicle owners would have the option to extend their Certificate of Entitlement for a further five years.

It said this was to ease their cash flow and provide flexibility.

Rentals for hawker stalls cheaper now
Decision to scrap minimum-price policy has led to lower tender bids
By Feng Zengkun, The Straits Times, 13 Mar 2013

HAWKER stalls have become cheaper to rent following a policy change in March last year, said Environment and Water Resources Minister Vivian Balakrishnan yesterday.

Previously, those who bid for a stall at a food centre had to pay a minimum price set by the National Environment Agency (NEA).

But this requirement was scrapped last year in a move to lower costs for would-be hawkers. 'This has generally led to falling tender prices,' said Dr Balakrishnan.

Between March and December last year, more than half of the 282 stalls put up for tender were snapped up at prices below the previous minimum rents for those stalls, according to NEA figures.

One stallholder put in a rental bid of $20 a month for a cooked food stall - and got it.

The stalls in the more popular food centres, however, got bids of up to $4,200 a month in rent.

Three-quarters of the 282 stalls had been vacant for more than three months.

Almost 2,000 of them had bought 20-year leases on their stalls between 1994 and 1997. Some said they feared that when the leases expire between next year and 2017, they would face much higher market rents. But Dr Balakrishnan said those who were on a subsidised rent scheme before they bought their stalls will be put on the scheme again.

He also gave an update on the 10 new hawker centres to be built by the Government in the next five years.

Five of them - including one in Yishun and another in Bukit Panjang - will be ready by 2016.

When they are completed, the minister said rents will fall. He said: 'Increasing supply will exert downward pressure on rents in hawker centres and other food outlets.'

Dr Balakrishnan also disclosed that social enterprise NTUC Foodfare will manage Bukit Panjang’s new hawker centre because it was the only group with enough experience when it was appointed in June last year.

But he added: 'I look forward, now that we have at least another nine hawker centres in the pipeline, to seeing who else puts up their hand and enters this field.'

Separately, Second Minister for the Environment and Water Resources Grace Fu announced a new requirement for caterers, who must submit food safety management plans to the NEA from June next year.

Last year, caterers had the highest rate of food poisoning, with 19.3 incidents per 1,000 outlets reported. In contrast, food retail outlets licensed by the NEA had only 0.8 incidents per 1,000 outlets over the past three years.

THE Budget AND MY hawker stall
By Feng Zengkun, The Straits Times, 13 Mar 2013

Mr Tan Chin Leong, Bak kut teh seller

FOR a lark, Mr Tan Chin Leong bid $166 a month to rent a hawker stall in Berseh Food Centre at 166, Jalan Besar.

But to his surprise, even though rentals at the centre usually go for at least $700 a month, he won the auction in June last year.

The bak kut teh seller said: 'I didn't expect to get it, but it turns out I'm not even the luckiest.

'Someone else just got a stall here for $158 a month.'

Mr Tan, 57, and his colleague were among two of many hawkers to benefit from the National Environment Agency's (NEA) decision in March last year to remove its requirement for minimum bids for hawker stalls.

It wanted to lower costs for those wanting to join the trade.

The NEA said that out of 282 stalls rented out between March and December last year, 155 or more than half were auctioned at prices below their previous minimum rents.

Mr Tan, who has been a hawker for decades, said: 'Having a lower rent means more options. We can work fewer hours if we need to, or offer lower prices when things are bad.'

He said he had previously paid thousands of dollars for a stall at a coffee shop.

His stall is now open between 11am and 7pm each day, and he sells various bak kut teh dishes at about $4 each.

Mr Tan declined to comment on his monthly earnings, but said that he can pocket up to $300 a day when the customer traffic is brisk.

'Of course, whether you can earn also depends on the place and whether it's popular. Sometimes this place also doesn't have that many people,' he said.

Budget 2013

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