5 Jul 2021 SPEECH ON MENTAL CAPACITY (AMENDMENT) BILL

1. Mr Speaker, Sir, I support the Mental Capacity Bill amendments which allow LPAs to be drafted and amended and submitted via OPG Online. Through interactions with Yio Chu Kang residents, I have encountered problems due to an absence of LPA.?

2. Most recently, a resident, Mr K, came to see me at a Meet-the-People session. His father suffered from advanced dementia and was in a nursing home. Mr K wanted to sell off his father's flat to pay for his father's nursing home charges. However, he was unable to do this. His father did not execute an LPA when he was mentally capable of doing so. As such, Mr K was stuck in limbo. To obtain legal permission, he would have to apply to the Courts to be appointed as a deputy. This is both costly and time-consuming. I have proposals in three broad areas to enhance the Bill further.

3. First, Mr Speaker, Sir, we should make the process even more convenient for residents. I noted that the requirement for the donor to appear before the LPA certificate issuer, or CI, is retained. While I understand the rationale, this safeguard of meeting in person still presents a challenge to donors who have mobility problems. I hope that the Government can look out for this group of donors. Perhaps the Silver Generation Office can be roped in to do house visits. They can help to make clarifications and arrange for a CI to certify the LPA in the comfort of seniors' homes. Some medical practitioners and law firms already offer house visits. OPG should consider including those who provide such options on their websites and in the directory of CIs.?

4. We should also consider having the process authenticated using digital fingerprints. Banks and hospitals are already doing this for their forms and transactions. This will be useful for residents who may have suffered from a stroke and have difficulty signing physical documents, or those who are illiterate among our elderly.

5. Next, Mr Speaker, Sir, along with increased convenience, we need to make sure that there are sufficient safeguards in place. With digitisation, a growing concern is the rising trend of data leaks. In this case, we are looking at potential leaks of highly personal information. It could leave donors vulnerable to online fraud or blackmail. How will the Government safeguard our data in the event of a cybersecurity breach? How can donors be assured that they will not be left to their own devices to navigate the associated issues?

6. Separately, there was public feedback for the OPG to assist healthcare professionals and providers to retrieve the LPA and donee's contact information in a timely and cost-efficient manner. Currently, healthcare practitioners may login via SingPass to the OPG's e-services portal to make a search request. The search results indicate whether the patient has made an LPA and the relevant details of the donee. As the LPA will now be digital, can an LPA be automatically updated on the National Electronic Health Record system? This is so that in the event that an LPA needs to be activated, the healthcare professional need not wait two working days and pay $20 just to know who to contact.

7. I note that as part of the additional safeguards for donors, the Public Guardian may interview the donor. The Public Guardian may disclose to the donor the number of LPAs for which his or her prospective donee has already been appointed, or intends to be appointed. This is in the scenario if there is suspicion that fraud or undue pressure was used to induce a donor from making an LPA or appoint a particular person to be his or her donee.

8. Beyond this, another suggestion would be to make it mandatory for donees to notify the OPG of their intention to exercise their authority before doing so. This is to better protect donors from abuse. Requiring the donee to notify the OPG can act as a road bump to make some potential abusers think twice.

9. Checks and processes could also be added to look into cases where a Singaporean with living blood-related family members decides to appoint an unrelated person as his donee. There were 21,000 LPAs registered in 2020. Currently, 90% of donees are immediate family members. Still, that leaves 10% of them, or about 2,100 donors in 2020 alone, who have unrelated donees.

10. According to the recent population census, more people are choosing to remain single. Some married couples are opting to go childless. As such, we will likely see more Singaporeans choosing unrelated donees due to the lack of younger relations to count on.

11. Having such checks may prevent fraud incidents like the high-profile Madam Chung's case in 2016, who appointed an unrelated former tour guide from China as a donee. The 2020 edition of LPA Form One requires the donor to specify the relationship of the donee to the donor. This helps to alert the OPG should an unrelated donee be appointed. Hence, OPG should institute precautions when such unrelated donees are appointed, especially when LPA applications involve vulnerable groups.

12. Lastly, Mr Speaker, Sir, we should do more with regard to awareness and outreach to make sure more residents know about this important process. Under PAP Seniors Group, we will be rolling out LPA awareness talks to the public, encouraging more people, especially younger Singaporeans, to make their own LPA.

13. I wish you to circle back to a point I made when I spoke on the Electronics Transaction (Amendment) Bill earlier this year. Digitisation is merely an enabler. We should review the fundamentals of the LPA application process to ensure that is user-centric. Although the LPA is for adults above the age of 21, statistically, elderly Singaporeans are more vulnerable to mental incapacitation. We should, therefore, continue to focus our efforts on seniors. Advanced Care Planning, or ACP, is a critical component of ageing. The LPA may be important in ensuring that ACP is properly implemented in tandem.

14. Unlike the ACP, which is non-binding, an LPA is a legal document that appoints donees. Should one have already made an LPA, it would be ideal and advisable for one's donee and the nominated healthcare spokesperson to be the same person. This is to avoid possible disagreements when making healthcare decisions on one's behalf. I hope that the Government will look into incorporating ACP options into the LPA drafting process on the electronic system.

15. MSF could work with MOH to encourage all general practitioners (GPs), especially those who are concurrently qualified CIs, to proactively provide packages of LPA and ACP to their patients. Both Ministries should also build an integrated process from the Social Service Agencies, or SSAs, to the healthcare institutions to encourage this effort. SSA officers should be trained to provide this service. In the hospitals and polyclinics, they should actively highlight LPA and ACP matters to their patients.

16. OPG should also have a central hotline to provide support for all the GPs and SSAs. LPA consultations should be made more accessible in various languages and dialects. Likewise, the new online LPA service should be made available in four languages. Extending this further, we should take a whole-of-Government approach for outreach and awareness. Offer LPAs to everyone who is above 30 years old, like CareShield Life. We should start early because the risks of stroke and dementia are higher as we age. MSF should also work with CPF Board to see whether we can incorporate the process of reviewing one's nomination for CPF as well as LPA.

17. In conclusion, Mr Speaker, Sir, the LPA is a critical legal document. Whilst moving towards making the LPA process through OPGO more convenient is in the right direction, we need to make sure safeguards are in place and encourage greater outreach and awareness. This will benefit all Singaporeans. Mr Speaker, Sir, I support the Bill.