The Kwong-Wai-Shiu Free Hospital (Transfer of Undertaking and Dissolution) Bill

Order for Second Reading read.

3.33 pm

The Minister of State for Health (Dr Lam Pin Min):Mdm Speaker, I beg to move, "That the Bill be now read a Second time."

Mdm Speaker, before I begin, I would like to acknowledge Mr Patrick Lee, Chairman of Kwong Wai Shiu Hospital, Mr Leong Sin Yuen, Board member, and Dr Ow Chee Chung, CEO of Kwong Wai Shiu Hospital, who are here with us today to witness the deliberations on the Kwong-Wai-Shiu Free Hospital (Transfer of Undertaking and Dissolution) Bill.

Mdm Speaker, the Kwong-Wai-Shiu Free Hospital, or "Kwong Wai Shiu" for short, was established in 1910 under the Kwong-Wai-Shiu Hospital Ordinance (the Ordinance) to provide needy immigrants from the Kwong-Chau, Wai-Chau and Shiu-heng prefectures of the Canton Province of China with free healthcare. Since its establishment, Kwong Wai Shiu has played an important role in providing quality care to patients in Singapore. It has expanded the scope of its services significantly over the years, and currently operates a nursing home, a senior care centre, a Traditional Chinese Medicine Centre, and provides home care services.

Demand for healthcare services is expected to grow as a result of Singapore's rapidly ageing population. Not only do we need to add capacity, especially in the Intermediate and Long Term Care (ILTC) sector, we will need to also build up strong providers to deliver affordable, quality care.

Service providers like Kwong Wai Shiu will have an increasingly important role to play in serving needy patients and leading the way to innovative solutions. To better position itself to meet the future challenges, Kwong Wai Shiu is expanding its capacity and capability.

Kwong Wai Shiu is doubling its capacity at its current Nursing Home with the redevelopment and expansion of its facility at this site. The new Nursing Home, which will also house a Senior Care Centre, will be completed later this year. When fully opened, it will have more than 600 beds and will be the largest nursing home facility in Singapore.

Kwong Wai Shiu's upcoming Active Ageing Hubs in the vicinity of its current Nursing Home will also support our seniors to age in place. The Active Ageing Hub is a new concept we are trying out as part of the Action Plan for Successful Ageing. It is a one-stop centre for our seniors, where they can participate in active ageing programmes, and receive care services at the same place if needed. The centre can also provide assisted living services such as housekeeping and grocery shopping to seniors living nearby.

As Kwong Wai Shiu enhances its services and infrastructure to cater to the changing health needs of our population, it will also need to keep up with the times and ensure the hospital is well-positioned to support its mission to serve all Singaporeans. It is thus timely for Kwong Wai Shiu to review its organisational framework, which is currently set out in the Ordinance, and modernise its corporate and governance structure.

The Kwong Wai Shiu management therefore sought MOH's support to repeal the Ordinance, and establish the hospital as a Company Limited by Guarantee (CLG) similar to other Voluntary Welfare Organisations (VWOs), for the following reasons.

First, the current Ordinance has not been substantively amended since its enactment. As a result, its provisions have become antiquated, and are impeding Kwong Wai Shiu's development and growth as a modern healthcare provider. For example, before Kwong Wai Shiu can dispose of any immovable property, it is currently required to first seek the leave of the High Court, and serve the application on the Attorney-General. This unduly hampers Kwong Wai Shiu's ability to efficiently manage and control its assets and property to respond to the changing needs of Singapore and ensure that the hospital's activities remain relevant and viable.

In comparison, assets of modern charities and IPCs are usually governed by their boards, and these charities and IPCs are not required to routinely obtain the leave of the High Court and to serve the application on the Attorney-General when disposing of their immoveable property.

Another example is the requirement for Kwong Wai Shiu to follow the Chinese Lunar Calendar for the submission of its accounts to the "Secretary of Chinese Affairs", a position which no longer exists today.

Second, the Kwong Wai Shiu management wanted to improve and strengthen Kwong Wai Shiu Hospital (KWSH)'s overall governance and corporate accountability framework. The Ordinance is not fully compatible with the guidelines recommended in the Code of Governance for Charities and IPCs. For example, the Ordinance does not include guidelines pertaining to board governance, as well as the avoidance of conflicts of interests.

As a CLG, Kwong Wai Shiu will be governed by a constitution which contains such guidelines. This will ensure that Kwong Wai Shiu will continue to operate in a sound manner, and assure its donors and members and the public that its funds and assets are responsibly managed.

Last, and most fundamentally, the Ordinance limits the scope of Kwong Wai Shiu's operations and beneficiaries. The Ordinance restricts Kwong Wai Shiu's role to provide hospital services for "indigent persons connected with the Kwong-Chau, Wai-Chau and Shiu-heng prefectures of the Canton Province of China", hence the name "Kwong Wai Shiu Hospital".

In reality, Kwong Wai Shiu has gone beyond this limited scope and has long been serving the general public, regardless of race, religion and dialect. The breadth of Kwong Wai Shiu's current activities is worthy and welcome, and it is opportune that the formal limitations imposed by the Ordinance are removed in support of its noble and beneficial activities.

Mdm Speaker, I shall now highlight the main features of The Kwong-Wai-Shiu Free Hospital (Transfer of Undertaking and Dissolution) Bill - hereby referred to as the Kwong Wai Shiu Bill. The Kwong Wai Shiu Bill will allow Kwong Wai Shiu to modernise and strengthen its corporate structure and provide flexibility in managing its assets and its operations. The CLG, named "Kwong Wai Shiu Hospital", was incorporated last year and has been registered as a Charity and obtained IPC status as of 18 July 2016. The Commissioner of Charities, and specifically, the Ministry of Health as the Sector Administrator for healthcare charities and IPCs, have been identified as the supervisory regulatory authority for Kwong Wai Shiu.

The Bill will transfer all the assets, rights, and liabilities of Kwong Wai Shiu to the new CLG. The new CLG will be governed by the Companies Act. A new constitution has been established for the CLG, under which there are clear guidelines for governance and the avoidance of conflicts of interest. A board of directors will oversee the management of the CLG. As a result of the modernisation, Kwong Wai Shiu will have greater flexibility to expand its charitable activities, thereby further benefiting the broader community and public.

The transfer will take place after the Kwong Wai Shiu Bill comes into force. Upon the transfer, all records, legal rights, and obligations of the former Kwong Wai Shiu will be transferred to, and assumed by, the CLG.

This includes staff employment − the continuity of the staff's employment, and the terms and conditions of their service, will not be affected by the transfer to the CLG. Likewise, Kwong Wai Shiu's rights, powers, duties, and liabilities as an employer will be transferred to the CLG. As such, the Kwong Wai Shiu Bill will not have any adverse impact on Kwong Wai Shiu's employees. Kwong Wai Shiu has also engaged its union − the Manual and Mercantile Workers' Union − and I understand that the union is supportive of the new corporate structure. Kwong Wai Shiu has also engaged its internal stakeholders including employees and board members.

I would also like to highlight that the hospital's operations will not be affected and patients are unlikely to experience any inconvenience or any adverse changes as a result of the transition.

Mdm Speaker, I will now conclude. The objective of the Kwong Wai Shiu Bill is to support Kwong Wai Shiu to modernise its corporate structure, and place the hospital in a stronger position with greater flexibility to provide healthcare services to Singaporeans, while ensuring transparency and accountability. I hope that Members will support the Bill. Mdm Speaker, I beg to move.

Question proposed.

3.42 pm

Mr Thomas Chua Kee Seng (Nominated Member): Madam, in Chinese.

(In Mandarin): [Please refer to Vernacular Speech.] Mdm Speaker, the Kwong Wai-Shiu Hospital was established in 1910 and already has 106 years of history. The Ministry of Health supports the hospital in moving in step with the times, to abolish those antiquated regulations, and to widen the scope of its charitable affairs, hence raising the Bill for the transfer of undertaking and dissolution. I support this move.

Kwong Wai-Shiu Hospital provides affordable healthcare services to those with chronic conditions regardless of race or religion, supplements the Government's healthcare policy, and is an important charitable organisation in the private sector. During the colonial times, a group of Cantonese businessmen founded Kwong Wai-Shiu Hospital. They provided free hospitalisation and clinical consultation for Cantonese immigrants, and looked after the poor and needy clansmen. Although 100 years have gone by, times have changed, and Singapore has already gained independence for more than 50 years, the content of this legislation had never been amended.

I met up with Mr Patrick Lee, Chairman of Kwong Wai Shiu Hospital and its senior management, to get a better understanding of the situation. After listening to them, I was deeply moved. Actually, from 1974 onwards, Kwong Wai Shiu Hospital has already provided healthcare services for Singaporeans of all races; the hospital has also established an inpatient centre, rehabilitation centre, and community hospitals, to look after the needs of low-income elderly patients. Being a large Institution of a Public Character (IPC), the hospital's operations have already fulfilled the conditions required of an IPC. After the expiry of Kwong Wai Shiu's land lease in 2010, the Urban Redevelopment Authority and the hospital authorities came together for an earnest discussion, and came to an amicable solution of letting it remain at the original location. It gave the board more confidence in making long-term development plans.

There are many other charitable hospitals of this kind. Motivated with passion, regardless of race or religion, they provide long-term nursing care for the elderly and more vulnerable groups of people, and demonstrate the merits of an inclusive society. I am really pleased to note the Government's support for Kwong Wai Shiu Hospital. With our rapidly ageing population, more and more elderly people require care. Kwong Wai Shiu Hospital is in the process of trying out something new, to help the elderly grow old amidst familiar surroundings. This is a worthwhile experience to promote.

With the joint effort of the government and the private sector, Kwong Wai Shiu Hospital will enter a new phase of development. The Ministry of Health gives great support to the hospital in terms of its policies and regulations, while the hospital's management team will be unified in dedicating financial resources and energy in the expansion. This spirit of moving ahead with the times is exemplary and should be emulated by many social groupings and charitable organisations. The operational capital of these charitable hospitals relies on donations from society, and I earnestly hope that every member of society could continue to support the hospital.

This successful experience could be replicated in other areas. Due to changed circumstances, the original objective behind establishing many civic organisations has changed significantly. In particular, for some trade associations, the entire industry has to undergo restructuring. I hope that more Government agencies and trade associations could be inspired by the example of Kwong Wai Shiu Hospital, and enable more moving stories to be written.

3.48 pm

Mr Gan Thiam Poh (Ang Mo Kio): In Mandarin.

(In Mandarin): [Please refer to Vernacular Speech.] Mdm Speaker, just as my Parliament colleague has just mentioned, the Kwong-Wai Shiu Free Hospital (KWSH), has cared for many low-income families since its establishment in 1910. The hospital provided Singaporeans with good medical services and contributed much in terms of charitable and healthcare services. When it started, it provided both Traditional Chinese Medicine (TCM) and Western Medicine services, a first for Singapore. In the early days, it also provided maternity services and treated communicable diseases.

I am glad to see that the hospital has evolved its services over time. Today, it operates a nursing home, a day rehabilitation centre, a TCM centre, and provides homecare services. I understand that it is even going out into the community to provide healthcare talks and mobile health screening for the elderly.

KWSH has always played an important role in caring for the indigent. Even today, nursing home residents who are unable to foot their bills can still receive funding from KWSH's charity funds.

Mdm Speaker, when I was young, I used to live at a rental block opposite the hospital and it has left a deep impression on me. Thinking about the hospital brings back many vivid memories. When I was young, like many other residents, I visited the clinics there for treatment. KWSH's the low fees have benefited me, my family and my neighbours. I am glad to see that the Government has decided to keep the hospital and allow it to continue to do charitable work and help the low-income families. I am very happy to see that and I am also very touched.

Although in the early days, the hospital's main purpose is to care for immigrants coming from Kwong-Chau, Wai-Chau and Shiu-heng prefectures of the Canton Province of China; in fact, it has also already been caring for people from other dialects or races. Even though I am not a Cantonese, I am a Hokkien, I have also benefitted from the hospital.

Whilst it serves all Singaporeans, KWSH has also had the special support of the Chinese community. The hospital has many volunteers helping them in their programmes. The volunteers add much warmth and friendship to the lives of the hospital's residents. These volunteers are called the "Kopitiam kakis". They chitchat with the residents, share stories and sing songs with them, just like in a Kopitiam.

Even though KWSH's Ordinance was outdated, it has been able to achieve all this. I note that the Ordinance is not fully compatible with the guidelines recommended in the Code of Governance for Charities and IPCs.

With the new Bill, KWSH will have more flexibility to help more low-income Singaporeans regardless of race or religion. This will remove the limitations imposed by the Ordinance regarding KWSH's beneficiaries and allow it to adopt a modern governance structure. While KWSH had earlier made the right decision to broaden its scope of services to patients regardless of race, language or religion, it is appropriate that the mandate of the hospital, as reflected in its governing document, be updated in line with our national values. Changes to its governance structure will also be in the interest of KWSH's donors and beneficiaries as the Hospital will have greater transparency and accountability in fulfilling its mandate. Moving forward, I hope KWSH will contribute even more to healthcare services in Singapore following the repeal of this Ordinance.

I am glad that the Government has supported the upgrading of the hospital though part of it is affected by the land acquisition for development. The upgraded hospital will help support our aging population and patients with chronic diseases. The hospital has an important role to play and I hope it will continue to receive support from public. .

I would like to thank the Ministry for connecting the Bendemeer MRT station to the hospital, which will provide much convenience for the public to gain access to the hospital. I would also like to take this opportunity to thank our seniors, the pioneer generation and the public for their support over the years, with which KWSH is able to make continual success in Singapore.

I support this Bill. Thank you.

3.55 pm

Mr Louis Ng Kok Kwang (Nee Soon):Madam, the Kwong Wai Shiu Hospital has contributed its services for years, serving Singapore since 1910. As it transitions into the next phase of its development, I am heartened to see that it continues to serve the public in the spirit of charity.

As I learn about its makeover to be re-opened as Singapore's largest nursing home, I am assured of our Government's focus on our elderly, and to ensure that they are being well cared for. I was impressed with the amount of effort and planning put in to ensure that it is not just any nursing home, but one which bucks the trend, and sets higher standards for all new nursing homes in Singapore.

Madam, while I stand in support of this Bill, I would like to take this opportunity to seek a few clarifications. I understand the MOH has funded the expansion of the Kwong Wai Shiu Hospital, can I ask if it will also be providing the funding for the operations of this new entity?

Secondly, I was going to ask about the transfer of employees, which the Minister of State has clarified, but could he confirm that all existing employees will be directly re-employed by the new entity?

Thirdly, referring to clause 4(1) which states that the trustees and committee members have been involved in the hospital's operation for many years, building up valuable relationships with stakeholders. Will they still be able to contribute after leaving or will they be invited to serve in the new Board?

Finally, I refer to news reports announcing that the new 12-storey facility will be completed in 2017. Could the Minister of State provide an update on whether or not we are on track for the date of launch?

Madam, I also take this opportunity to share a few comments on Singapore's Action Plan to raise our capacity to provide for our ageing population.

I understand that the Kwong Wai Shiu Hospital is unique in its approach. For example, it will be a one-stop shop for services ranging from TCM to specialised wards to treat dementia. It is also not gated, and members of the public can enter freely to use its services.

There will be other innovative functions, such as a "haze management zone" and a "memory street" on every floor to help the elderly retain their memories. This is an excellent step forward in the design of nursing homes, and I hope that all new nursing homes will also model this approach.

I also understand from nurses on the ground that one of the key issues faced is the lack of available beds for patients with higher acuity of care in nursing homes. For example, this includes patients who require tracheostomy care. Such patients are often left to wait for available beds for up to a year while in the acute hospitals.

Another category of patients is those undergoing haemodialysis. Many have been rejected from nursing homes and families find it difficult to cope as there are few options available.

I hope this issue would be taken into consideration and new nursing homes will be able to accommodate those with acute conditions as well. Madam, the above comments notwithstanding, I stand in support of this Bill.

3.58 pm

Dr Lam Pin Min: Mdm Speaker, allow me to respond in Mandarin first.

(In Mandarin): [Please refer to Vernacular Speech.] Mdm Speaker, first, let me thank Mr Thomas Chua, Mr Gan Thiam Poh, Mr Louis Ng who have expressed their appreciation to the Kwong Wai Shiu Hospital (KWSH) for its contribution to healthcare in Singapore and voiced their support of the Bill.

Indeed, KWSH has played an important role in developing our healthcare system. As one of Singapore's oldest charitable healthcare institutions, KWSH has cared for the sick and needy for more than 100 years since it was established. It has continuously developed and evolved its services to cater to Singaporeans' healthcare needs. In the early days, KWSH responded to national needs by providing maternity services and treating communicable diseases such as Tuberculosis, and even continued its operations during the Japanese occupation. To ensure that it could care for Singaporeans regardless of race, language or religion, KSWH also went beyond its Ordinance and opened its doors to all Singaporeans in 1974.

In recent years, KWSH started to provide additional services such as speech therapy, cancer rehabilitation, and home care. I understand that KWSH also actively engages the community through mobile health screening, public health talks, and active ageing programmes.

As mentioned by Mr Thomas Chua, KWSH has been innovating to help seniors age well in a familiar environment. The Active Ageing Hubs that I earlier mentioned, is a good example of KWSH's efforts. In addition, Kwong Wai Shiu is also collaborating with the Academy of Chinese Medicine (ACMS ) to provide better care services for the elderly. The ACMS will be part of Kwong Wai Shiu's new integrated hub concept to provide better Traditional Chinese Medicine (TCM) services, and to more Singaporeans. This platform pulls together several streams of services, including the TCM clinic, to support seniors with varying needs and help them to stay well within the community.

Kwong Wai Shiu and ACMS will also jointly work on research study and training programmes to benefit clients and the Traditional Chinese Medicine (TCM) industry.

As mentioned by Mr Gan Thiam Poh, it is to Kwong Wai Shiu's credit that they have managed to adapt over time despite being constrained by its antiquated Ordinance. I commend Kwong Wai Shiu leadership for having the foresight to look ahead, and push for these changes to their corporate structure so that they are able to move more quickly and confidently in future, to meet future challenges. MOH is happy to support them in these efforts.

The Members have also raised various comments and questions on the Bill. Let me address the various comments and questions addressed by them.

I was heartened to hear Mr Gan Thiam Poh's affirmation of Kwong Wai Shiu's efforts in helping patients in need over the years. Indeed, Kwong Wai Shiu has a team that evaluates cases submitted by Medical Social Workers. Those who are assessed to be in need will be assisted using Kwong Wai Shiu's charity funds. Apart from helping indigent patients, I understand that Kwong Wai Shiu also caps its nursing home inpatient fees to ensure that they remain affordable for Singaporeans. This is also why it is important for Singapore to have VWO care providers - they have a passion to serve, and can harness the joint resources of the community to help patients in need.

Kwong Wai Shiu has promised me that it will continue to fulfil its mission in providing healthcare services to the sick and poor in Singapore regardless of race, language, or religion, and continue serving the community with passion.

I am confident that they will be able to fulfil their objective of serving the community for the next 100 years.

(In English): Mdm Speaker, Mr Louis Ng queried as to how the new entity will be funded and operated. He also asked for clarifications as to how the transfer of employees from the existing Kwong Wai Shiu entity, to the new entity, will take place. I would like to reassure Mr Louis Ng that the transition to the new entity is purely a change in Kwong Wai Shiu's corporate structure and does not affect its operations. As mentioned earlier, under this Bill, all records, legal rights, and obligations of the former Kwong Wai Shiu will be transferred to, and assumed by, the new CLG, in a seamless manner. This means that the "new" Kwong Wai Shiu will continue to run its nursing home, and receive the same funding from MOH to care for its clients. In line with this, Kwong Wai Shiu's employees will simply become employees of the new entity, with their employment terms unchanged.

I am glad that Mr Louis Ng raised the question on whether Kwong Wai Shiu's trustees and committee members will still be able to contribute to Kwong Wai Shiu after the transfer to the new entity. Kwong Wai Shiu's trustees and committee members have been closely involved with its operations for many years, and contributed significantly to its strong track record in community service. I understand from Kwong Wai Shiu that the trustees and committee members have been invited to serve on the new Board and that most have agreed to do so.

I am confident that the Board members will continue to lead and guide Kwong Wai Shiu as it expands its mandate and infrastructure. I would also like to take this opportunity to update that the new 12-storey facility is on track for completion in end-2017.

Lastly, I would like to thank Mr Louis Ng for his suggestion to consider the possibility of nursing homes accommodating patients with higher care needs. MOH is currently looking into this, and we will share more details in future.

Mdm Speaker, let me conclude. The Kwong Wai Shiu Bill will modernise Kwong Wai Shiu's corporate structure and put Kwong Wai Shiu in a stronger position to respond to future challenges. At the same time, Kwong Wai Shiu will also have greater flexibility to continue providing quality healthcare services to Singaporeans.

Moving forward, MOH will continue to work closely with Kwong Wai Shiu, as well as other like-minded partners to continue improving the accessibility and quality of ILTC care for Singapore. Together, we will make Singapore an ideal place to age gracefully in. I call on Members of the House to give their support to the Kwong Wai Shiu Bill.

Question put, and agreed to.

Bill accordingly read a Second time.

Dr Lam Pin Min:Mdm Speaker, as the Bill is, in your opinion, a hybrid Bill, in accordance with the provisions of Standing Order 68(1), the Bill will be referred to a Select Committee.

I beg to move, "That the Select Committee on The Kwong-Wai-Shiu Free Hospital (Transfer of Undertaking and Dissolution) Bill consists of Mdm Speaker as Chairman and the following Members:

(1) Dr Chia Shi-Lu,

(2) Ms Chia Yong Yong,

(3) Miss Cheryl Chan,

(4) Mr Christopher de Souza,

(5) Mr Gan Kim Yong,

(6) Dr Lam Pin Min,

(7) Mr Low Thia Khiang."

Question put, and agreed to.

Resolved, "That the Select Committee on The Kwong-Wai-Shiu Free Hospital (Transfer of Undertaking and Dissolution) Bill consists of Mdm Speaker as Chairman and the following Members:

(1) Dr Chia Shi-Lu,

(2) Ms Chia Yong Yong,

(3) Miss Cheryl Chan,

(4) Mr Christopher de Souza,

(5) Mr Gan Kim Yong,

(6) Dr Lam Pin Min,

(7) Mr Low Thia Khiang." - [Dr Lam Pin Min]

Mdm Speaker: Order. I propose to take a break now. I suspend the Sitting and will take the Chair at 4.30 pm.

Sitting accordingly suspended

at 4.08 pm until 4.30 pm.

Sitting resumed at 4.30 pm.

[Mdm Speaker in the Chair]

5.55 pm

Order for Third Reading read.

The Minister of State for Health (Dr Lam Pin Min): Mdm Speaker, I beg to move, "That the Bill be now read a Third time."

Madam, at the Second Reading in January this year, the House committed The Kwong-Wai-Shiu Free Hospital (Transfer of Undertaking and Dissolution) Bill to a Select Committee.

The Select Committee received one written representation, which was assessed not to directly concern the subject matter of the Bill. The Kwong-Wai-Shiu Free Hospital has also expressed its support for the Bill.

The Select Committee has considered the Bill and has only made textual alterations to the Bill to reflect the change in citation year from 2016 to 2017. The Committee's Report was presented to Members of the House on 15 February 2017.

In conclusion, the passing of the Bill will enable Kwong Wai Shiu to modernise its corporate structure and place the hospital in a stronger position, with greater flexibility to provide quality healthcare services to Singaporeans while ensuring transparency and accountability. Mdm Speaker, I beg to move.

Question put, and agreed to.

Bill accordingly read a Third time and passed.