NMP Dr Tan YS: Closing speech for Healthcare motion 10/05/23

Delivered on 10 May 2023. PLEASE CHECK AGAINST DELIVERY

Thank you, Sir. First, I thank Minister Ong. Okay, maybe not so angry anymore, after all your kind words. If you are going to stay 10 years like Mr Gan, then I will continue to advise and help for 10 years.

Sir, I am very heartened by the strong support for the Motion.

First of all, I thank all my fellow NMPs in attendance who have each shared their insights into how healthcare can be supported in their various sectors. This is the kind of fresh ideas that we need to have a synergistic whole.

Next, I thank all Members for their various speeches covering a wide range of topics in relation to support for healthcare, namely: (a) recruit, reskill and retain healthcare workers; (b) fair pay, reasonable working hours; (c) financing and business needs; (d) better IT systems; (e) taking a firm stand against bullying and harassment; (f) emphasis on prevention and primary care; (g) legal protection and support; and (h) looking after vulnerable groups, in particular, children, the elderly, migrant workers and the differently-abled.

However, I must address some of the points that the Member Mr Leong brought up yesterday. I appreciate his points about reviewing MediSave but I urge him to have in-depth discussions with MOH to better understand the current funding and to help in future reviews if necessary.

MediSave and MediShield Life have been extensively and rigorously reviewed to ensure that the majority of Singaporeans and Permanent Residents can afford medical care when they opt for subsidised wards in restructured hospitals. If any of you know residents in financial distress, please direct them to an experienced medical social worker who will be able to further advise on additional available subsidies.

I also need to seek clarification from Mr Leong on his comment that, I quote, "drug prices should not be marked up unreasonably for non-subsidised patients to cross-subsidise subsidised patients."

Firstly, is there have evidence of this happening? Secondly, what is the definition of an "unreasonable" mark-up?

If I can use another food analogy other than chicken rice, a can of soda can be sixty cents at a budget grocery mart, $1.30 at a super mart, $1.60 at a coffee shop, $3 in a restaurant and $5 in a hotel. How much is a reasonable mark-up for medications?

Patients who are not subsidised will be patients who opt in for A or B1 class, or foreigners. I, as a doctor, would think that allowing market forces to determine costings are fair. Would Mr Leong also want taxpayers to pay for everyone?

I also thank the political office holders from different Ministries for your assurance and commitment to support healthcare.

I thank Senior Parliamentary Secretary Eric Chua in advocating for sports across different Government agencies and active community engagement. Parkour aunties like myself rejoice. No more Police chasing us off.

Minister of State Gan Siow Huang has also given an overview of how teaching on exercise and healthy eating is integrated at all levels of education.

I thank Senior Minister of State Janil Puthucheary and Minister Ong Ye Kung for their detailed and candid replies in recognising complex problems of manpower, IT and financing.

The professional bodies will continue to work closely with MOH in resolving issues within healthcare, especially those that pertain to training and working hours. Honestly, only clinicians truly understand the delicate balance needed. I am glad that we are all aligned in this – that healthcare has to be a whole-of-Government effort.

In my closing, I come full circle, back to "Why". Why do we stand up to advocate for a cause? To leave behind a better world than the one we were born in.

Recent news regarding the next round of NMP applications has again raised some criticism. I believe the NMP role has given an ordinary citizen like myself the chance to voice opinions at a national platform. Ordinary, because I am a struggling working mother in the sandwiched generation. Ordinary, because I also fear and worry about my children's future. What kind of Singapore will my children grow up in?

Fellow MPs will appreciate how hard it is to prepare for a speech. It is not just simply coming up to the microphone and saying some fancy words. There is background research, sticking to the timing before getting scolded by the Speaker or Deputy Speakers; and speaking the truth – in a palatable way and driving home a point.

I commented before – we are all talking a lot, but who is listening? Is the public listening?

The livestreaming only has 400 plus viewers, usually. A few people will deliberately make funny clips of our mistakes or slip-ups. And yes. Once I get over the embarrassment of my own, I have to say, it is actually very funny, so, thanks for making us laugh!

But the people I am really speaking to are fellow citizens who share my interest in the larger good of Singapore, the citizens listening in and considering policy.

Maybe some of you are civil servants. Singapore has 150,000 public officers who report to the Government, not to any one political party. I rephrase for emphasis. Civil servants are individuals who would have their own different political beliefs and alignments. They serve the people of Singapore.

Blindly supporting or opposing any political party or mocking NMPs for being mouthpieces or puppets or blaming the Government for everything – I ask you, is it logical? Does it serve anyone?

Before reacting and speaking, consider three points: one, is it true? Two, is it necessary? Three, is it kind? If the answer is no to any of the above, maybe it is better not to say.

I am sure that many of you have friends who are in healthcare. Do speak to them and understand the problems we face. Create your own small little informal think tanks and brainstorm on how to solve larger healthcare issues.

For all the people listening in, whether you are working in Ministries, whether you are an ordinary citizen like myself, I hope that you will also think of ways to ensure that healthcare gets the support it needs and prioritise your own healthcare needs.

We now live in a rapidly changing and volatile world. Look at how COVID-19 brought the world to a standstill for three lost years. Look at the Ukraine war, the US bank collapses. Overnight, the world changes. Nothing is new. History repeats itself – maybe in a much faster cycle than before.

The modern person has to be able to adapt to a world where answers may be less obvious, where there is no rulebook or 10-year-series to refer to. There may be no single right answer and choices will have trade-offs.

Should war ever come to Singapore, should there be an apocalypse, we will need warriors, we will need leaders. But I tell you, we will need people who know how to look after others, people who know how to stop bleeding, prevent infections, deliver babies, how to grow food, how to get clean water – any kind of knowledge to ensure that we survive.

But are we building up on useful knowledge or frittering our time away on social media in mindless entertainment?

I see patients and the medical treatment algorithms are actually quite simple. There is a breast lump. It needs to be checked. But frequently, emotional stress gets in the way. This manifests as hesitation, fear, worry and even anger at me – "Why is there a lump?"

I understand but it is not easy to process the onslaught of negative emotions. Healthcare workers, teachers, drivers – all frontline service workers, in fact – have received the brunt of a lot of negative outpouring of emotions.

This is our society now. A pressure cooker. People being unhappy in their daily lives without even realising it, feeling irritable, snappy, overly critical, worried about everything and feeling unable to cope.

I repeat a point from my previous speech. Recognise mental health issues in yourself or your loved ones. If you suffer from anxiety or anger management, do not take it out on your healthcare worker. Do not take it out on others. Get help from a mental health professional.

Even though I am a breast surgeon, I cannot just operate on the cancer. I have to consider the patient in her whole entirety. Her overall health – does she have other medical conditions that impact her surgery and recovery? Her preferred language – does she fully understand what I am saying? Is she making a true informed decision? How is her personality like? Her social network? Is she going to be well supported at home and at the workplace or will she forgo care because she perceives that others' needs come before her?

The surgery itself is simple in expert hands. It is helping the patient to overcome all these other emotional and mental barriers to seek health and to eventually be on the road to recovery – that is the challenge for which I call for a global change and a whole-of- Government support.

I thank everyone who has taken part in the debate and I emphasise. First, walk the ground, get real feedback and acknowledge problems in healthcare. Second, continue education at all levels of engagement. Third, cross-collaborate across Ministries, across industries, across the public-private divide.

Humans have short memories. Let us learn from the mistakes of the past so that we do not repeat it. People care only when things affect them. Help me and make everyone care.

Finally, breaking formal protocol, I want to thank Shahirah, Samad, Lian Pin, Mark, Janet, Joshua, Hian Teck and Hsing Yao. Thank you all for your friendship. It has been an eventful and fun NMP journey.

To all MPs from both sides of the House, I am glad for the chance to get to know you all as people and real humans, not just as public figures on your posters. This is my last speech in this Chamber. The next time we meet again, it may be when I complain to you at Meet- the-People sessions.

I thank you all – both sides of the House – for your service to Singapore. If I may, I will pray for wisdom and kindness for you as you all continue to debate meaningfully on issues to guide Singapore safely through future challenges.?