The following is Part Two of a two-part response to Senior Minister Goh Chok Tong’s remarks on 4 September (see here) where he urged S'poreans to see things in perspective and to think of the poor.
Leong Sze Hian –
In almost every survey done on the elderly and the poor, one of their greatest concerns was the affordability of healthcare.
In this connection, I refer to media reports (“Full house at Khoo Teck Puat Hospital” , ST, Jul 25) that the new Khoo Teck Puat Hospital has been full since it opened recently, and that the bed crunch has been so bad in the past couple of years that non-urgent surgery had to be put off, beds placed along corridors and hours spent waiting for an available bed.
According to the Department of Statistics’ Yearbook of Statistics 2010, the number of hospital beds in Singapore, has hardly changed - from 11,742 to 11,663, from 1999 to 2009.
The number of hospitals only increased by one, from 28 to 29.
During the same 10-year period, the population grew from 3.96 to 4.99 million.
Although the Health Mnistry has said that Singapore will not be caught out by a shortage of hospital beds again, even with the net increase of about 400 beds after the expected opening of the 700-bed Jurong General Hospital before 2015, and the closure of the 300-bed Alexandra Hospital, the total number of hospital beds is only expected to be about 12,613, even after adding the 550 beds from Khoo Teck Puat Hospital.
If not for allowing Medisave to be used for hospitalisation in 12 approved hospitals in Malaysia, since March this year, the shortage of hospital beds may be even worse.
At the current annual rate of growth in the population, at 1.1, 11.5 and 4.8 per cent, respectively, for Singaporeans, permanent residents and foreigners, and the long term target of a 6.5 million population, the shortage of hospital beds may not go away soon.
Perhaps what we may need to do is to spend more on healthcare, as I understand that Singapore’s healthcare spending to GDP is only about 4 per cent, with about 2 per cent of GDP on public healthcare spending in 2008.
In contrast, our neighbour, Malaysia, spent 4.8 per cent of GDP on healthcare in 2008.
The Singapore Tourism Board has been promoting Singapore as a medical tourism destination, with medical tourists to Singapore growing to 646,000 in 2008.
About half of Singapore's medical visitors come from Indonesia, with the other 30-40 per cent coming from Malaysia and the Middle East. The remainder comes from Russia, China, the Philippines and Vietnam.
Also, more will be done to help Singapore meet its target of attracting 1 million medical tourists a year by 2012.
So, since the number of hospital beds did not increase over the last 10 years, and with the population increasing by 1.03 million plus another 646,000 medical tourists, is it any wonder that the waiting time for poorer Singaporeans seeking medical treatment, may be getting longer?
Billions in investment based on “gut-feel” decisions?
With all the constant rhetoric over the years about helping the poor, what about the billions of investments that we made? How much thought or analyses were made on what some of these billions could do for the poor?
I refer to media reports ("Why Temasek took China project", Business Times, Jul 3) about Senior Minister Goh Chok Tong’s remarks that for Singapore’s industrial projects in Suzhou and Tianjin, on the government-to-government side, we did not do any economic feasibility study, and that we just felt in our guts that this was something good to do to engage China and that we could make it work.
Given that these were investments in the billions, I am rather surprised that we did not do any economic feasibility study.
What is perhaps even more alarming may be that this is only revealed now after decades, by way of a casual remark by the Senior Minister.
Are our billion dollar investments now still being made based on “gut” feel?
As we contemplate investing in other cities, perhaps now is a good time to evaluate what is the return on investment on our first Suzhou Industrial Park venture.
It may also be instructive if we evaluate our US$1.9 billion investment in Shin Corp which the Thai Government has indicated a keenness to buy back, PT Indosat and Telkomsel which have been deemed to have violated anti-trust laws in Indonesia, SingTel-Optus which at one point was estimated by analysts to have an estimated expected write-down of $8 billion, the US$5.4 billion investment in Dao Heng Bank which at one point had an estimated goodwill impairment of S$1.13 billion, etc.
I think we may be able to learn a lot from the above, with a view to learn from the lessons and not repeat the mistakes in the future.
Specifically, how and why have we failed in respect of regulatory, market, competitive and business intelligence, and privileged insights, in Mergers and Acquisitions’ (M &A) terminology, in our M & A activities?
On a brighter note, at least Temasek's latest RMB 2 billion (S$400 million) investment through its subsidiary, Singbridge International, in the joint-project "Sino-Singapore Guangzhou”, to build the "China Knowledge City", which is on the suburban area of Guangzhou city in southern China, had the benefit of the feasibility study done by the Keppel Group which signed the initial agreement in March 2009, before Singbridge's takeover of the 50:50 joint project between Singapore and China.
Having said that, we should still ask: Could we not have used these billions to help the poor instead, especially given that S'pore's income gap is among the widest in the world? Or, and if indeed these investments have been successful, how have they benefited the poor and the low-income?
Additional input by Andrew Loh.