TR EMERITUS

SGH Patient's daughter: No proper monitoring of patient My mother recently fractured her right hip and underwent an operation at the Singapore General Hospital (SGH). The operation was a success but my mother subsequently had diarrhoea and tremors in her hands. She also complained of pain in both legs, and her right eyelid could not be raised. Her condition worsened after she was discharged. A general practitioner examined her and suspected she had stroke. So my mother was admitted again to SGH. The specialists wanted her to be tested for stroke, chest infection and cancer, and put her through a whole battery of tests. My family did our own research and suspected she was suffering an overdose of thyroxine, as she was displaying the typical side effects. Her medical tests also showed an extremely high level of the drug. We suggested that the dosage be reduced but the doctors continued to prescribe 100 microgrammes daily, which was double her normal dosage, until we warned the hospital that a complaint would be lodged. When we questioned the specialist, she admitted she did not see my mother after the operation and was unaware of her symptoms. Once the dosage was reduced, my mother's general well-being improved significantly, all her symptoms disappeared and all the tests turned out negative. We are disappointed by the treatment she received as the many tests she underwent could have been avoided had there been proper monitoring for possible side effects caused by her medication. Why was there no subsequent monitoring when an unusually high dosage of a drug was prescribed? And when blood tests or other investigations are carried out, should there not be follow-ups on results that are beyond the normal range? Julia Lim Kiat Bee (Ms) SGH's reply: Medical management was appropriate, says hospital As Ms Julia Lim Kiat Bee's mother needed surgery, medical pre-operative tests were carried out to determine the appropriate management, given her pre-existing conditions. Based on the patient's thyroid function test results, it was necessary to increase the dosage of thyroxine to optimise her condition for surgery. The operation went well and the patient was closely monitored until her condition stabilised. Although further tests were recommended post-surgery to evaluate the patient's thyroid status, her family asked for her discharge and follow-up by the patient's regular doctor in another hospital. The patient was promptly assessed for her symptoms upon re-admission. Our doctors found no evidence of thyroxine overdose and this was conveyed to her family. We understand the family members' anxiety over their mother's well-being, and assure Ms Lim that medical management was appropriate throughout the hospitalisation. Chia Shi-Lu (Dr) Acting Head, Department of Orthopaedic Surgery Singapore General Hospital Goh Su-Yen (Dr) Head, Department of Endocrinology Singapore General Hospital * Both letters appeared in ST Forum (17 May). Related: Who is right – TTSH or patient’s son?  Read More →

16 May 2012 PRESIDENT'S ADDRESS FOR OPENING OF 2ND SESSION OF 12TH PARLIAMENT OPENING OF PARLIAMENT – MAY 2014 PRESIDENT’S ADDRESS Pledging Ourselves to a Better Singapore President Tony Tan This Session of Parliament opens at an important moment in our history. Next year, we celebrate our Golden Jubilee. For 50 years since Independence, we have built our homes together, raised families, and helped one another as friends, neighbours and compatriots. Despite long odds, we have not only survived, but prospered. Every Singaporean can take pride in this as we celebrate as one people. At 50, we are still a young nation, with great promise ahead. Just as our pioneers overcame formidable obstacles with grit and determination to build today’s Singapore, we too must create our Singapore of tomorrow. Our work continues – to build a fair and just society, regardless of race, language or religion; to achieve happiness, prosperity and progress for our nation. These are the founding ideals in our Pledge, which we must always uphold. In the second half of this Twelfth Parliament, my Government pledges to work with all Singa­poreans to address the concerns and aspirations of our people and build a better future: ·         We will strengthen safety nets to help the vulnerable and elderly cope with the vicissitudes of life ·         We will enhance retirement adequacy to give greater assurance and peace of mind to all Singa­poreans. ·         We will support strong families and communities, so that values such as empathy, filial piety, respect and mutual help continue to be part of our lives. ·         We will create the conditions for every Singaporean to enjoy a better quality of life, with improved transport options, more recreational spaces and rejuvenated neighbourhoods for all to enjoy. ·         We will create more opportunities for working adults to have a fulfilling career, to keep learning all their lives, and to realise their dreams and aspirations. ·         We will enable young Singaporeans to fulfil their potential, pursue their dreams, and follow their interests in diverse fields. My Government will pursue new strategies to achieve these goals. Our environment has changed, and so must our approach to nation building. We will chart this journey together with all Singaporeans. We have heard from the many citizens who participated in the OSC (“Our Singapore Conversation”). We will give substance to these voices, and set out a new way forward for ourselves and our nation. Keeping Pathways Upwards Open to All First, we will keep pathways upwards open to all Singaporeans, regardless of background or family circumstances. Singapore must remain a nation of opportunities for all. Those who do not succeed at first should have a second chance, indeed must always have the chance to try again. We want an open and inclusive society, where all have opportunities to learn, and to earn our own success; where we respect fellow Singaporeans, regardless of social status, for the worth we see in everyone; and where we interact informally with one another free of rigid social hierarchy. Our education system must uphold this ethos. This means inculcating empathy and respect from young, and fully developing everyone’s abilities in a meritocratic society. We are investing more in pre-school education, to help those who are born with less get to a good starting point, and give them every chance to achieve their full potential. We recognise that competition in our schools is keen, especially at milestones like Primary 1 registration or the PSLE. We will continue to improve the system, so that no single point in our education will wholly determine our future. We will ensure that every school is a good school, and offer more opportunities for students to hone their interests and talents across many fields. We will go beyond academic success, to imbue our young with practical skills, good character and sound values that are just as important in life. Beyond primary and secondary school, we will create diverse and flexible options to cater to students’ different abilities and pace of development. The ASPIRE committee is exploring ways to create more opportunities for ITE and Polytechnic students. We are also expanding university places, and introducing new degree programmes in our 5th and 6th autonomous universities – SIT and UniSIM – with a stronger focus on practical application. But education must continue beyond our ITEs, polytechnics, and universities. Through lifelong learning, the Government will help our workers upgrade skills and develop expertise in every vocation, and stay abreast of changing industry demands. This is critical because jobs are changing faster, and knowledge is becoming obsolete more quickly. We will focus not only on low-income workers, but middle-income Singaporeans and professionals, managers and executives (PMEs) too. We are strengthening our system of Continuing Education and Training (CET), including the two new CET Institutes – the Devan Nair Institute in Jurong, and the Lifelong Learning Institute in Paya Lebar. Sharing Singapore’s Success; Strengthening Social Safety Nets Beyond equal opportunities for fulfilment, every Singaporean should enjoy a fair share of our nation’s success. We will strengthen our social safety nets, not only to give all Singaporeans peace of mind, but also to share the fruits of progress more widely, especially with the lower-income and vulnerable groups. Promoting home ownership remains a key strategy. Home ownership has made an enormous contribution to levelling up our society. It has enabled Singaporeans, especially the lower-income, to build up significant assets, and have a tangible stake in Singapore’s progress. No other country in the world has done this. The Government will continue to keep housing affordable for all Singaporeans, and help low- and middle-income households to own their HDB homes, and build up a nest-egg for retirement. We will also develop new housing options to encourage extended families to live closer together, and strengthen our family bonds and ties of kinship. We will ensure affordable and quality healthcare for all Singaporeans. We have enhanced the Community Health Assist Scheme (CHAS), expanded the use of Medisave, and increased subsidies for outpatient care. MediShield Life will give all Singaporeans, including those with pre-existing illnesses, better lifelong protection against high medical bills. The MediShield Life Review Committee is finalising the details of the scheme. We will ensure that the premiums will be affordable for all. We will pay particular attention to vulnerable Singaporeans, including low-wage workers and our elderly. We will strengthen social safety nets beyond home-ownership and Workfare. We will also do more for our elderly. Singaporeans are living longer. To ensure that they have enough for their financial needs in their golden years, we will improve the existing CPF savings and CPF Life annuity schemes, and develop more options for Singaporeans to unlock the value of their homes in their retirement. But as we do more for the vulnerable, the poor and the old, we must also give people the means and the incentives to help themselves. Singa­poreans believe that personal responsibility and effort are essential to their dignity and self-worth. This was the pioneering spirit that built the Singapore we see today. Let us preserve this spirit, even as we strengthen social safety nets and give Singaporeans more confidence to face the uncertainties of life together. Our New Pioneers and Community Action Government spending will increase over the next decade and beyond, especially on social programmes. We have to ensure that our social spending can be sustained, and that we have enough revenues to balance our budget. But at the same time, government spending, by itself, does not create a wealthier, a better or a happier society. It must be matched by individual and community effort and initiatives. Active community involvement engages the human spirit, provides personal fulfilment and strengthens our collective well-being. This is how we will build a nation for tomorrow, a home where we feel a sense of responsibility for one another, and not just a sense of entitlement to the benefits of citizenship. Endearing Home, Fulfilling Lives Singapore cannot be just a marketplace in the global economy. For every one of us, it is first and foremost our home: where we sink our roots, raise our families and share life’s ups and downs together with one another. Singapore must be a home that endears, with an active citizenry dedicated to creating our shared future. A good home reflects the best of its people. We must keep Singapore a place where people of different races, religions and backgrounds live harmoniously together, and where we embrace one another as fellow Singa­poreans, working together for a common purpose and a shared future. We also have new immigrants and foreigners amongst us, who contribute to our society and economy. Let us treat them with graciousness, kindness and fellowship, even as we expect them to respect our values and our Singaporean way of life. This spirit will enable us to progress and prosper together. A good home provides an environment for people to thrive. We will create a living environment where all Singaporeans enjoy a better quality of life. We will continue to upgrade our HDB heartlands and neighbourhoods, connect them to a more extensive and convenient transport network, and integrate them into a web of green corridors and waterways, as well as sports and leisure facilities. We will also enrich our lives through vibrant arts and cultural pursuits. As our city becomes increasingly complex and diverse, the demands on amenities, infrastructure and resources will rise. We will make full use of new technologies to develop sustainable and innovative solutions that improve our lives. We will make Singapore a Smart Nation: enabling safer, cleaner and greener urban living, more transport options, better care for the elderly at home; more responsive public services and more opportunities for citizen engagement. Upholding Constructive Politics To achieve all these ambitious goals, it is crucial to maintain constructive politics that puts our nation and our people first. Politics lives off robust debate and passionate argument. But in many countries, the hurly-burly of politics has resulted in short-term populist measures, and sometimes gridlock and paralysis. This sort of politics will weaken Singapore. We should continue to have vigorous debates on the challenges facing our nation, and be prepared to take necessary and bold decisions for our future. It is important for us to do so, to have the best ideas and best leadership for Singa­pore. Everyone should join in the debates, understand the issues, share their views and argue their positions. Sometimes these debates will stir great passions, but we cannot allow our differences to pull us apart. So while we may have differing views, all sides must take a long-term perspective for the common good. And once the debate is settled, we must come together again, to move ahead as one united people. Adapting to a Changing Environment This is how we have continued to adjust and adapt to changes in global competition, the limits to growing our labour force, and to the evolution of Singapore society. The Government made major shifts over the last decade, to build a more inclusive society and to transform our economy. We introduced ComCare and Workfare to take care of our needy as well as our low-wage workers. We embarked on a multi-year plan to raise skills and productivity, create quality jobs and raise incomes for Singaporeans. In recent years, the Government has made further moves. We sped up housing and public transport programmes to address urgent needs. We implemented parenthood and immigration policies to ensure a sustainable population where Singaporeans form the heart and strength of our nation. We slowed the inflow of foreign workers, while being mindful to maintain a vibrant economy to create opportunities and jobs for Singaporeans. With social issues becoming more pressing, we introduced the Wage Credit Scheme and the Progressive Wage Model to help raise wages. Our plans for the future reflect our determination to keep adapting, improving and upgrading ourselves. But amidst these changes, some things remain constant: Singapore will always be a small country, constantly navigating dangers and threats in an uncertain world. Recent events in Ukraine, as well as tensions and maritime disputes nearer home in East and Southeast Asia, remind us that we must never take our safety and security for granted. We need effective diplomacy to safeguard our interests abroad, cooperate with other countries, and earn respect around the world. We also need a strong SAF and Home Team to protect our homes and families. Our NSmen have the spirit and resolve to defend our nation, and provide us with that sense of security to pursue our dreams. They deserve our support and recognition: the Committee to Strengthen National Service will propose ways to do this. Our Best Years Lie Ahead In December 1965, a few months after independence, President Yusof Ishak opened the First Parliament of the Republic of Singa­pore. President Yusof expressed our hopes for Singapore to become a “tolerant society, multi-racial, multi-lingual, multi-religious, welded ever closer together by ties of common experience.” This remains at the heart of what we stand for – a strong Singaporean identity, in a diverse and plural society. Our Golden Jubilee will be an occasion for us to re-dedicate ourselves to building a better Singa­pore. Our pioneers had a dream of what Singapore could be. They fought for our independence, and toiled for our success.  They succeeded in large measure, and created in Singapore something special and precious for all of us to enjoy. The Pioneer Generation Package is a sincere expression of appreciation for their sacrifices and contributions. But the best way to honour our pioneers is to uphold this same pioneering spirit – to dream and fight for Singapore. We must be stewards of our pioneers’ success, and leave behind a better Singapore than we inherited. We, and especially our young, must take the torch, run faster and further, and keep Singapore’s light burning bright. Our best years lie ahead. We have not overcome all our challenges, but we are determined to do so, and we will. Singapore remains a home that brings out the best in us. By recognizing our collective destiny, by finding fulfilment in building our home and nation, we can continue to progress and prosper. As we approach our 50th anniversary of independence, let us pledge ourselves anew to build a better, brighter Singapore. Source: www.istana.gov.sg/content/istana/news/speeches/2014/president-s-address-for-opening-of-2nd-session-of-12th-parliamen.html  Read More →

(GENEVA, Switzerland, 16 May) – A vote on Sunday to establish a minimum wage of $25 an hour would make mostly immigrants here in agriculture, housekeeping, and catering among the world's highest paid unskilled workforce. The vote comes after hundreds of fast-food workers walked off their jobs in many U.S. cities and in more than 30 countries on Thursday in a protest for higher wages. If the Swiss proposal passes, the country would have the highest minimum wage in the world. But some who would be eligible for the higher wage worry that it may do more harm than good. Luisa Almeida is an immigrant from Portugal who works in Switzerland as a housekeeper and nanny. Almeida's earnings of $3,250 a month are below the proposed minimum wage but still much more than she'd make in Portugal. Since she is not a Swiss citizen, she cannot vote but if she could, "I would vote 'no'," she says. "If my employer had to pay me more money, he wouldn't be able to keep me on and I'd lose the job." Almeida's concern illustrates the dilemma that faces the movement to have governments and not the market decide how much people should be paid at a minimum. Forcing employers to hike wages means they must cut expenses to accommodate the higher labor costs. That often means less hiring, or some firing. But Patrick Belser, Senior Economist in the Wage Group of the International Labor Office in Geneva says the initiative could work. "International experience has shown that minimum wages can prevent labor exploitation without any negative effect on the economy," he said. Yet, Besler worries that a minimum wage of $4,500 a month "is probably a little too high. "If it is accepted, the effects on employment would have to be carefully monitored, and a mechanism for social dialogue should be created to discuss its effects and possible future adjustments of the rate," he said. Currently, Switzerland does not have a minimum wage law. Industry-specific pay scales are determined by employment contracts or collective bargaining agreements between employers and trade unions. However, 90% of Swiss workers earn well above the proposed minimum and are already among the highest paid in the world. According to government statistics, the average household income in Switzerland is about $6,800 a month; in the USA, where the minimum wage is currently $7.25 an hour, the average household monthly income is roughly $4,300, Census Bureau figures indicate. Referendums are a unique feature of Switzerland's unique brand of social democracy, which gives citizens the power to shape policy over the government. Any individual or group can challenge existing legislation or force a vote on a new issue by collecting 100,000 signatures on a petition. Read more: www.usatoday.com/story/news/world/2014/05/16/swiss-minimum-wage/9166687  Read More →