Vulnerable Adults Bill

Order for Second Reading read.

2.52 pm

The Minister for Social and Family Development (Mr Desmond Lee): Mr Speaker, I beg to move, "That the Bill be now read a Second time."

With your permission, Mr Speaker, may I ask the Clerks to distribute an A4 copy of an infographic on the Vulnerable Adults Bill?

Mr Speaker: Please do. [A handout was distributed to hon Members.]

Mr Desmond Lee: Thank you. Sir, this Bill seeks to protect individuals, 18 years and older, who cannot protect themselves from abuse, neglect or self-neglect, because of a mental or physical infirmity, disability or incapacity.

In the course of our work as Members of Parliament, we would have come across households seeking help and assistance, as they juggle the many roles expected of a family: breadwinner, caregiver to elderly parents, and parents to young or teenage children. It gets harder when elderly parents lose mental capacity because of dementia or become bedridden because of illness. Double the challenge if they have children with disability or special needs to provide for.

Through various schemes and programmes, we want to better enable our families as they carry out their caregiving roles as the first line of care and protection for their vulnerable members. Indeed, one of the key priorities for the Ministry of Social and Family Development (MSF) and the Ministry of Health (MOH), both now and in the years ahead, is to enhance support for the elderly and people with disability and special needs, and to better enable their family members and loved ones to carry out their roles as caregivers.

From time to time, we hear about sad cases where elderly persons or persons with disability or special needs are abused or neglected. Currently, we have in place a network of community and social service agencies which support families through social intervention, such as counselling, case management and case monitoring.

Take the case of "Mdm Chua". It is not her real name; we will not use any real names in this Chamber on this topic. Mdm Chua is a 68-year-old lady with early-stage dementia. When neighbours spotted Mdm Chua wandering around the estate with bruises on her arms and around her left eye, they alerted the Family Service Centre (FSC). The FSC found out that Mdm Chua’s daughter would beat her mother every time Mdm Chua soiled herself or left the stove on. When social workers contacted the daughter, she expressed remorse for using force against her mother. We found out that the daughter’s anger stemmed from her frustration and stress. Not only was she coping badly with her mother’s failing health, she also needed to care for her own son who has special needs. The daughter agreed to participate in counselling and assistance programmes to help her manage Mdm Chua’s failing mental and physical health.

To provide the daughter with caregiver respite, the FSC also persuaded another of Mdm Chua’s daughters to step in to care for Mdm Chua on weekdays. Assistance was also given to help her care for her son, who had special needs. Since our involvement, there have not been further incidents of violence reported to date.

Cases, such as this, remind us of the complexity of family relationships, and the crucial role that family and community intervention plays in helping vulnerable individuals.

But Singapore’s population is rapidly ageing. Today, more than 450,000 Singaporeans are 65 and above. In 12 years, by 2030, one in four will be aged 65 and above; that is more than 900,000 elderly individuals. The number of residents living alone is also projected to increase to more than 80,000 in 2030.

Our changing demographics impact our household structures. And this can complicate family dynamics. In our midst are vulnerable Singaporeans who may not be able to care for themselves, as they have physical or mental infirmities or disabilities. Some of these vulnerable individuals may not be able to depend on their families to provide adequate care for them; others may not even have family members or friends to rely on.

While our adult protection framework has functioned well, there are instances where family and community interventions may not be effective. Since MSF’s Adult Protective Service (APS) was established in 2015, the number of referrals to MSF has increased. On average, we have handled about 110 cases annually involving vulnerable adults 18 years and above, though not all of these cases eventually required our intervention. Our experience, validated by feedback from our stakeholders, indicates that family matters are never clear-cut, never black and white.

Caregivers who abuse vulnerable adults may themselves be victims of difficult circumstances and be under tremendous stress. They are sometimes unable to control their emotions, which may cause them to hurt vulnerable adults or other family members. One of the cases where MSF had to intervene involves “Sam”, again not his real name. Sam is a 29-year-old young man with Attention Deficit Hyperactivity Disorder (ADHD), autism and an intellectual disability. Sam is an only child and lived with his elderly parents. However, his parents were not able to understand his condition and, hence, care for Sam. Sam’s father would hit him to try and control his behaviour. This resulted in severe cuts and bruises on Sam, all of which required medical attention. But Sam’s behaviour also caused his father a lot of stress. When MSF spoke with Sam’s family members, they mentioned that Sam’s father had entertained thoughts of killing his son and then ending his own life. Sam’s father refused assistance and therapy for himself and his son, insisting that Sam be medicated to control his behaviour. Given the high risk of Sam being hurt again, Sam was placed at a facility that was equipped to address his care needs.

In cases like this, the Government must take a proactive approach and intervene early, as any delays may lead to further harm, or worse.

Sir, I am, therefore, putting the Vulnerable Adults Bill before the Members of this House to seek their support to strengthen the existing adult protective framework. The Bill will allow the Government social services to intervene, assist and protect vulnerable adults when social work-based family and community interventions are inadequate. It will complement other existing laws that protect vulnerable individuals, such as the Women’s Charter and the Mental Capacity Act.

We hope to achieve two objectives. First, we want to ensure that we have the ability to move quickly to protect and support vulnerable adults as well as their caregivers, when the need arises; and second, we want the protection for vulnerable adults to be effective.

In drawing up the Bill, we consulted our community partners and public agencies. Together, we reviewed cases where vulnerable adults were abused, neglected or self-neglected themselves, and discussed how best to calibrate the powers that the Bill should give. This was an important exercise that we did not want to rush, as we should not be excessively intruding into the sanctity of the home and eroding the autonomy and responsibility of the family.

During our consultations, we received strong support for the Bill. I met our community partners earlier this year and the draft Bill was finalised, and I was encouraged by their continued strong support. I would like to thank all stakeholders who provided valuable insights. We have studied these views carefully and incorporated them into the Bill where appropriate.

Before I go into the main provisions of the Bill, I would like to assure Members that the Bill does not and must not replace the social work that supports vulnerable adults and their caregivers. Social work intervention is, and remains, the main form of external intervention in such cases. This Bill, if passed by Members, should be a law of last resort; state intervention through the exercise of statutory power into the family for family matters will be applied judiciously and only when necessary. This is because personal care arrangements are largely matters for individuals and families to decide on. This Bill does not seek to supplant or diminish the role of the family and community.

Sir, let me now bring the House through the main features of the Bill, which fall broadly into four categories. Members can refer to the sheet that I passed around which gives a broad summary of the rest of my presentation, so I hope it is useful.

So, four categories: first, the scope of the Bill and the guiding principles that underlie our intervention; second, MSF's ability to intervene and protect vulnerable adults; third, I will talk about Court orders that will enhance the protection and support for vulnerable adults and their caregivers; and, fourth, I will talk about community involvement in protecting vulnerable adults. I will start with the first, which is the scope of the Bill.

First, the Bill protects vulnerable adults and explicitly sets out the guiding principles underlying state intervention. Clause 2 of the Bill defines a vulnerable adult as an individual, aged 18 or older, who because of mental or physical infirmity, disability or incapacity, is incapable of protecting himself from abuse, neglect or self-neglect. For individuals above the age of 16 but below 18, we are looking to amend the Children and Young Persons Act (CYPA) to extend statutory protection under the realm of the Child Protective Services, which is the sister agency of the Adult Protection Service (APS).

Since its formation in 2015, MSF’s APS has seen a range of vulnerable adult cases involving abuse and neglect. “Abuse”, under the Vulnerable Adults Bill, refers to physical, emotional or psychological abuse. “Abuse” also includes any conduct or behaviour which causes an individual to fear for his safety or well-being, or unreasonably deprives, or threatens to unreasonably deprive, him of his liberty of movement or well-being. Hence, an individual who excessively controls another individual’s day-to-day life and social relationships and, as a result, causes the individual to suffer adverse emotional health effects, may be regarded as having abused that individual. A vulnerable adult may also require protection if he has been neglected. “Neglect” refers to the lack of provision of essential care to an individual, to the extent of causing or being reasonably likely to cause injury or pain. Not providing food, clothing, medical aid, lodging, supervision and other necessities of life are examples of neglect.

A vulnerable adult may also neglect himself. “Self-neglect” refers to the failure of an individual to perform essential tasks of daily living, such as eating, drinking and seeking medical aid. Vulnerable adults may, as a result of self-neglect, live in grossly unsanitary or hazardous conditions, suffer from malnutrition or dehydration, or suffer from untreated physical or mental illness or injury.

Since 2015, APS has seen close to 50 cases of such self-neglect. Many do not have families to care for them. Take Mr Wong, for example. Mr Wong, again, not his real name, is an 85-year-old elderly man who lives alone. He has diabetes and has developed diabetic-related wounds on his feet. When community workers found him, he had not bathed for months. He did not keep his medical appointments despite running out of medication and was not able to take care of the wounds on his feet. As a result, maggots had infested the wounds on his leg and he required urgent hospitalisation. But despite repeated engagements by community workers and by our social workers, Mr Wong refused to be admitted to a nursing home or a hospital. MSF persisted, and found his step-daughter. Together, they persuaded him to accept medical care in his home, after getting assurances that his leg would not be amputated.

APS also managed to get help for Mr Wong to manage his swollen legs and to monitor his condition. As of today, nursing staff from a social service agency visit Mr Wong weekly to clean his wound and this has reduced the stench of rotting flesh from his right leg. Three meals are delivered daily to him. Each week, staff from our Senior Activity Centre visit him. They also arrange for a doctor to see him whenever necessary. Mr Wong’s step-daughter also plays her part, dividing her time between work, her own family and children, and looking after Mr Wong. We are supporting her with caregiver support to help her cope. Cases like Mr Wong's highlight the need for adult protection legislation that will provide Government social services with powers to better support these vulnerable adults.

When drafting the proposed definitions, we wanted to ensure that the Bill complements, but does not supplant, existing laws and support networks. Certain scenarios are, therefore, not covered. For example, an individual who is physically abused by a family member, but who is capable of protecting himself – in other words, he does not meet the vulnerability threshold under the Bill – may instead apply for a personal protection order (PPO) under the Women’s Charter. Individuals with suspected mental illness, who are not vulnerable adults, may also be assisted under the Mental Health Care and Treatment Act (MHCTA), if their behaviour places them at risk of harm.

Next, clause 4 of the Bill sets out the five key principles that guide how we will exercise and carry out the duties or exercise the powers under this Bill. The powers of the Bill are intrusive into the family and, hence, must be exercised within limits and with the right intent. We have, therefore, embedded these key principles in the Bill, to balance the need to protect a vulnerable adult with his right to autonomy and self-determination. So, what are these principles?

First, when we exercise the powers or perform the duties under the Bill, it must be to protect vulnerable adults from abuse, neglect and self-neglect. The Bill is not intended to solve community disputes, nor remove persons from their homes just because they may be perceived by their family members or by neighbours to be a nuisance. We will intervene if we assess that doing so is the only way to protect the vulnerable adult. That is first.

Second, we recognise that a vulnerable adult with mental capacity is generally best placed to decide how he wishes to live, and whether or not to accept any assistance. The Bill does not seek to override an individual’s freedom of choice nor coerce individuals to behave in a certain manner. MSF will seek an individual’s consent before intervening. Having said that, there may be circumstances where we should intervene, even though the vulnerable adult has mental capacity and refuses to accept protection. Such intervention will only take place in extreme cases involving the safety and protection of the vulnerable adult.

Third, we must consider the previously expressed views, wishes, feelings, values and beliefs of a vulnerable adult who lacks mental capacity, where reasonably ascertainable. MSF will, as far as possible, respect an individual’s choices and beliefs when we intervene.

Fourth, we must intervene and assist in a manner that is less restrictive of the vulnerable adult’s rights and freedom of action. In order to do this, MSF will work closely with the vulnerable adult and involve his family and caregivers, where possible.

Fifth, the welfare and best interests of the vulnerable adult must be the paramount and first consideration.

Sir, I will now move on to MSF's ability to intervene and protect vulnerable adults.

The next category of provisions sets out the state’s powers. Cases, such as Mr Wong, which I referred to earlier, illustrate why it is crucial for MSF to have powers to enter private premises, assess and, if necessary, remove a vulnerable adult. The Bill will only be effective if it allows us to intervene quickly to prevent further harm to the vulnerable adult.

So, Part 2, Division 1 of the Bill empowers MSF to enter private premises, to assess a person whom we suspect to be a vulnerable adult, if we have reason to believe that the individual has suffered from, is suffering or is at risk of abuse, neglect or self-neglect. In severe cases, the vulnerable adult may no longer be safe within his place of residence or home. Under clauses 10 and 11, MSF may remove vulnerable adults from their residence and commit them to gazetted care facilities, or to the care of a fit person. This allows swift assistance to be rendered to the vulnerable adult while other care arrangements are worked out. MSF must apply for a Court order within 14 working days after the removal, unless the vulnerable adult is earlier permitted to return to his residence. This requirement was included because we recognise that placement can significantly impact the vulnerable adult’s way of life.

I wish to assure Members that committals to these care facilities will only be done as a last resort, for an appropriate duration, until the vulnerable adult can be safely reunited with his family. To ensure the vulnerable adult’s well-being and safeguard his health, MSF may require him to be treated by a registered medical practitioner or registered dentist before or during his stay in these care facilities. Once committed to a care facility, the vulnerable adults must be protected from further harm. So, clause 19 requires the care facilities to undertake security measures to ensure the safety and protection of the vulnerable adults residing within their premises, while clause 20 empowers MSF to establish a Review Board to ensure that proper care plans are in place for the vulnerable adult. The Review Board will also advise MSF on whether a vulnerable adult can be discharged when the period of committal ends.

By and large, the Bill is premised on the vulnerable adult’s autonomy to make his own decisions. That said, our experience working with vulnerable adults is that there are exceptional circumstances where we may have to intervene to ensure his safety despite his refusal to consent to intervention. This includes instances where the vulnerable adult refuses to consent to assistance because he is under duress or undue influence. Clauses 7 and 10 will, therefore, allow MSF to apply for a Court order to assess and commit a vulnerable adult to a care facility, where a vulnerable adult with mental capacity refuses assistance. Let me explain our considerations for this.

First, during our consultations, some stakeholders highlighted actual cases where they were unable to help a vulnerable adult, because he refused to accept their assistance. Some of these adults were abused or neglected until the day they died.

Second, we looked at other countries which have longer experience with vulnerable adult legislation. Some of these jurisdictions have laws that allow a vulnerable adult’s stated wishes to be overridden. For example, in Scotland, the Adult Support and Protection Act permits the state to intervene despite a vulnerable adult’s refusal to consent, if there is evidence that the adult is unduly pressurised, and there are no other reasonable steps that can be taken to prevent further harm to that adult.

Similarly, in British Columbia, Canada, the state can intervene, without the vulnerable adult’s agreement, to remove an adult, provide them with emergency health care and take any other emergency measures necessary to protect the adult, if the adult is suffering from abuse or neglect. The state can do this if it is of the view that it is necessary to act without delay, in order to preserve the life of the adult; prevent serious physical or mental harm to the adult; or protect the adult’s property from significant damage or loss.

Like the adult protection laws in these countries, our Bill will similarly allow MSF to intervene despite a vulnerable adult’s wishes, if it is necessary to protect him and ensure his safety. But, as a safeguard, we will get a Court order to do so.

Ensuring the vulnerable adult's welfare and best interests is paramount. However, we must also hold abusers accountable for their actions if they are culpable. Clauses 26 to 29 empower MSF to investigate offences under the Bill. And to deter people from harming vulnerable adults, clauses 40 and 41 make related amendments to the Penal Code and Protection of Harassment Act respectively to enhance the maximum penalties of specific offences by up to one and a half times if these acts are committed against the vulnerable adult. This aligns with the enhanced penalties for Penal Code offences against domestic workers who are also a vulnerable group.

Clause 42 also amends the Women's Charter to enhance the penalties for breaches of the Women's Charter, Personal Protection Orders (PPOs), to maintain parity with the Bill. These enhancements receive strong support during consultation.

I will now move on to the orders that the Court may make to protect vulnerable adults and support their caregivers.

Clause 14 empowers the Family Justice Courts to make intervention orders to protect vulnerable adults from further harm. The need to apply for a Court order serves as a safeguard against excessive statutory intervention. When considering whether to make orders and what orders to make, the Court must have regard to the same five principles in the Bill that I have articulated earlier. But it may also take into account any other relevant matters it deems fit. There are three categories of Court orders. First, Core Protection Orders. These Core Protection Orders protect the vulnerable adult from any third party who may cause him to suffer from abuse or neglect. It includes Restraining Orders, Exclusive Occupation Orders, and orders prohibiting a person from visiting or communicating with the vulnerable adult.

Second, Alternative Placement Supervision Orders, and what are these? These orders ensure that the vulnerable adult is relocated to a safe environment. The Court may order a vulnerable adult to be committed to a care facility for a specified period of time, or order that the vulnerable adult be placed under the supervision of an appointed person. This appointed person may include a protector or an approved welfare officer.

Third, the Court can also make other protection and intervention orders, including orders to make the vulnerable adult's residence a safe living environment, and an order requiring the vulnerable adult or any other person to attend counselling or any such programmes as directed by the Court. This includes the power to order a vulnerable adult or any other person, including a caregiver who may have caused the abuse or neglect to go for counselling or training and get additional support.

Some vulnerable adults may face difficulties applying for such Court orders on their own. So, clause 12 allows approved welfare officers to apply for Core Protection Orders. More importantly, clause 12 preserves the role of the family as it also empowers family members, including a vulnerable adult's donee or deputy, to apply for protection orders. By donee, I refer to a person who has been appointed by the vulnerable adult under a Lasting Power Attorney (LPA) to make decisions on his behalf for his personal welfare, property and financial affairs, if and when he loses mental capacity. And by deputy, I refer to a person appointed by the Court to make such decisions on the vulnerable adult's behalf if he no longer has mental capacity to decide for himself and did not make an LPA earlier.

Our aim is to help every vulnerable adult to turn to the love and care of his family eventually. So, I would like to come back and talk about Sam, that 29-year-old young man whose father had hit him in order to control his behaviour.

The Bill, if Members support it, will allow Sam to be placed in a care facility, where he will receive the support necessary for him to manage his condition and recover from physical abuse. Having Sam temporarily away from his home may also provide respite for Sam's parents. MSF can then continue to engage Sam's father and ask that he attend therapy and counselling sessions to help him better understand and care for Sam and, if he refuses, we can try to apply to Court for an order requiring him to go for such counselling or other such programmes that the Court deems necessary as an added push.

The Bill allows us to calibrate the level of intervention necessary for each case, through a combination of statutory orders as well as social work interventions. This complements our existing adult protection system which seeks to support both the vulnerable adult as well as their family and caregivers.

Finally, I will now explain how the Bill enables our wider community to play a bigger role in preventing family violence and the abuse and neglect to vulnerable adults.

Members will recall the sad and tragic case of Ms Annie Ee. Ms Ee was a 26-year-old intellectually disabled waitress who left home because she wanted to work and be independent. She stayed with people whom she believed were her friends. Unfortunately, she was severely abused by her flat mates and eventually passed away. This was a horrible and tragic case.

While the Bill will allow the state to step in to protect individuals like Ms Ee, none of the intervention powers in this Bill will be meaningful unless those who meet and interact or come across vulnerable individuals like Ms Ee step forward and raise the alarm bells for community agencies and the authorities to intervene.

For example, in the case of Mdm Chua, in the first example I gave, her neighbours saw bruises on her arm and around her eyes and promptly sounded the alert. Our FSCs were, therefore, able to enquire about the circumstances and alert us to take action.

We have, therefore, included clauses in the Bill to strengthen the roles of both the family and community. Specifically, clause 23 protects people who report such cases to the relevant authorities. These whistleblowers will be protected from civil and criminal liability, as long as they had acted with reasonable care and in good faith. They will also not be regarded to have breached any professional etiquette or ethics. This will protect professionals, such as doctors, counselors, lawyers and so on.

Clause 22 also places restrictions on the publication of information identifying a vulnerable adult. Any information that may lead to the identification of a vulnerable adult cannot be published or broadcast. This is to safeguard a vulnerable adult's privacy and allow him to recover; this privacy will also allow the vulnerable adult and the family to focus on repairing their relationship.

That said, clause 24 allows the disclosure of confidential information relating to a vulnerable adult to MSF, and by us to any other Government agency, statutory body, Police Officer or prescribed person or body. This would include MSF's community partners, such as our Family Violence Specialist Centres (FVSCs) and FSCs, as well as medical and healthcare professionals. This is to ensure that swift action can be taken by different agencies to protect the vulnerable adult, hold perpetrators accountable, and ensure that appropriate assistance is provided to their families.

MSF recognises that working with vulnerable adults sometimes requires submitting of difficult professional judgements. If we want those who work with vulnerable adults to carry out their duties diligently and professionally, we must provide them peace of mind. So, clause 34 protects anyone performing a function or exercising powers under the Vulnerable Adults Bill from legal liability, so long they have acted in good faith and with reasonable care. Such protection is extended to any member of the Review Board, any person appointed by Court, and any person working in the care facilities. However, protection will only be afforded if they act professionally and responsibly. Mr Speaker, allow me to say something about the Bill in Mandarin.

(In Mandarin): [Please refer to Vernacular Speech.]: Our population is ageing rapidly. By 2030, about one in four Singaporeans will be aged 65 and above. As our demography changes and more individuals, along with their caregivers, age, more may face abuse, neglect and self-neglect.

The Vulnerable Adults Bill will better protect vulnerable adults living in our midst.

Under the law, when caregivers did not take good care of the vulnerable adult in their family, the relevant authorities will have the power to intervene by appointing suitable family members to care for the vulnerable adult. Family members may also apply for Court orders to prevent a perpetrator from having access to the vulnerable adult for his safety.

Individuals will be protected from legal liability, when they whistleblow and report alleged harm caused to a vulnerable adult or perform their duties to help a vulnerable adult. Such protection is given to anyone in the community who has acted in good faith, including professionals, family members, neighbours and members of the public.

Only where necessary, MSF will intervene to protect vulnerable adults, as a last resort. Where family and community intervention has failed, MSF may enter a vulnerable adult's premises, assess his condition and relocate him for his safety. To deter abuse and neglect, the law provides for heavier penalties for offences committed against vulnerable adults.

Mr Speaker, caring for family members is never easy. At times, it can, understandably, be overwhelming.

We want to tell those caregivers who face challenges that you are not alone. We recognise the stresses you face. Partners in the community, such as FSCs, stand ready to support you. Based on your family’s needs, they may provide counselling and support and, if required, link your family with agencies like the Agency for Integrated Care (AIC) or SG Enable. There, your family members may benefit from care services for vulnerable seniors or persons with disabilities, such as day care or residential services. Those of you who are caregivers may also receive respite care services so that you may take a break from your caregiving duties.

In order to care for our loved ones, we must also exercise self-care. Let us not wait until we are distressed and unintentionally harm those whom we love. While helping others, do reach out to seek help early if you yourself need help. Mr Speaker, I will now conclude my speech in English.

(In English): Mr Speaker, Sir, the Bill will only be effective if each and every one of us in the community continues to play our part. We must look out for the safety of vulnerable people and extend warmth and a helping hand to families who care for their vulnerable family members. But the abuse and neglect of vulnerable adults are not a private matter and must not be tolerated. Everyone, including family members, neighbours, community leaders, employers and healthcare professionals, have a role to play to prevent vulnerable people from being abused, and to stop it if it happens.

So, let us step forward to break the silence by reporting suspected cases of abuse, neglect and self-neglect. Beyond the Bill, MSF will continue to facilitate the community's efforts in reaching out to vulnerable adults. We will reinforce our existing help networks, such as our Social Service Offices' local networks and the Community Network for Seniors programme, to better reach out to vulnerable adults and their caregivers. Even as we operationalise the Bill, we will continue to work with families, professionals and volunteers to strengthen the care networks across the community. Together, we can all do our part to keep an eye out for the most vulnerable members of our society. Mr Speaker, I beg to move.

Question proposed.

Mr Speaker: Ms Denise Phua.

3.30 pm

Ms Denise Phua Lay Peng (Jalan Besar): Mr Speaker, Sir, I stand in full support of the Vulnerable Adults Bill. This is a Bill that has been in the making for a long time and aims to protect vulnerable adults in our midst from abuse and neglect. The comprehensiveness of the Bill is testament to the diligent and good work put in by the MSF team.

My work with some of the vulnerable adults reminds me of the usefulness of the Bill. I have an elderly resident, a second-hand goods seller who hoards his entire rental flat and corridor with goods that he picks up in trolleys that he took from the nearby supermarkets. With the flat completely filled with old goods, he sleeps instead at the void deck or the staircase nearby and incurred the resentment and wrath of his neighbours. His hygiene and daily living habits become a great concern to the people around him. He refuses help except for the money he receives from passers-by who thought he was begging. And his social worker and his only nephew are at their wits' end.

I have another resident who suffers from mental illness, with violent tendencies. Her husband refuses to send her for treatment or supervise her well-being. Neighbours who were physically threatened by her could not get assistance by the Police who claim there is nothing they can do until the neighbours get physically hurt first.

Sir, these are but real-life examples that can be added to the unfortunate case of the intellectually disabled Ms Anna Ee whom the Minister has mentioned was tortured to death by her flat mates.

With the rapidly increasing numbers of elderly Singaporeans, the number of persons diagnosed with special needs, and the increasing number of persons with mental illnesses in a highly urbanised society like ours, the Vulnerable Adults Bill will provide the final safeguard to protect persons, such as them.

Sir, I would like to seek the Minister's clarification in several areas.

First, on the big picture. As there is a current slew of many legislation and services which covers the same target group of vulnerable adults that the Minister has mentioned, can the Minister explain how the proposed Bill will complement exactly at the operational level existing Adult Protective Services and legislation, such as the Mental Capacity Act and the Women's Charter? How will practitioners on the ground or even members of the public learn, understand and interpret and apply the various provisions to assist persons who are vulnerable?

Second is on balancing the state's right to enforce versus the citizen's right to choose. The Bill, in general, accords power to the Ministry which then appoints a director or protector, as stated in Part 2 of the Bill, such that the state can exercise the power to assess, enter premises, obtain information, remove and commit the vulnerable adult to a place of care and protection, sometimes against his will, if the state so decides.

Mental incapacity falls upon a continuum of severity from mild to moderate to severe. And there are also varying degrees of abuse, neglect by another person, or even self-neglect, which are all criteria applied in identifying a vulnerable adult in the Bill.

I would like to seek clarification from the Minister on when and how the state actually decides that an intervention is in order and not a violation of a vulnerable adult's basic human rights? Hence, in the case of the elderly second-hand goods dealer I shared earlier, who appears not to have totally lost his mental capacity and yet showed serious signs of self-neglect, I am interested to know the course of action that the Ministry would undertake to support him. How does the Bill balance the tension between state enforcement and a citizen's right of choice under such circumstances?

My third area of seeking clarification is on placement decision. Sir, clause 11 of the Bill commits the vulnerable adult, upon removal by the state, to be placed under temporary care and protection in an assigned place or under a "fit person". In the event that a vulnerable adult is removed and placed in the gazetted care facility, what measures are taken by the Ministry to ensure that that these places of abode are suitable, dignified and staffed by persons who are properly trained to handle, especially the vulnerable elderly and/or the very severely disabled, some of whom would need specialised and expert care?

Fourth, on the role of the community. Since the formation of the Adult Protective Services by the Ministry, I understand from somewhere I read that the data is that about 250 cases were identified, largely involving adults with intellectual and physical disabilities, psychiatric conditions and illnesses. This is a small number – those who are supported in this way – compared to the universe of, I am sure, a much larger pool of adults who are potentially vulnerable. So, are there any robust ongoing strategies to engage and equip the community, including neighbours, grassroots leaders, medical, social, Police and disability groups, so that suspect vulnerable adults in their midst are identified and supported earlier and not till damage is done either to themselves or others?

Without strong community support, many of these adults would fall through the cracks and remain unidentified until something tragic happens. So, legislation is, hence, only a small part of the solution.

To this end, Sir, I recommend that the Ministry seriously consider the formation of a National Vulnerable Adults Support Services Association, similar to that started elsewhere in the world, such as the US. The association should aim to help organise, educate and train local residents and partners, community partners on the ground, to identify and support vulnerable adults in each private or public residential zone in Singapore. It can form local care groups, much like the cell groups that we commonly find in Christian or Buddhist organisations.

It can play the role of an integrator, a social service integrator, to provide a tighter coordination of the many diverse voluntary welfare organisations (VWOs) specialising in disabilities, elderly and mental health support organisations, FSCs, Residents' Committees (RCs) and other security and social support agencies. The association can also look at providing scalable upstream and downstream services to meet the diverse needs of the ever-changing and enlarging population of vulnerable adults. With such an association, many more adults with varying degrees of vulnerability would be able to then receive the needed support upstream in their neighbourhood.

In conclusion, Sir, let me end off with a story of two vulnerable adults, two men with special needs, whom I personally know.

John, not his real name, was a young man who had severe autism. He was living with his very protective mother who also had special needs. Mom, his sole caregiver, rejected treatment for John, sometimes refusing to send him to school when he was younger. Mom was also very insistent on doing things her way, often verbally abusing and avoiding the agency staff who tried to assist. John's life was prematurely ended when he fell to his death, reportedly trying to climb out of the flat he was locked in. We wept when we paid respects at his funeral wake.

Another man I know with a developmental disability had a better fate. He is a resident whom I found during my house-to-house visits as a Member of Parliament. Er Ge, as he is now fondly known, was locked up in his rental flat as well whilst his elder brother went to work. Fearing for his safety and well-being, my grassroots and I approached the nearby PeaceConnect Senior Activity Centre. The Centre and many of its volunteers then offered him daily daycare services even though he was only in his 30s when we found him and not exactly a senior citizen. Today, Er Ge has a whole community supporting him in a day centre and a very vibrant social life at least, compared to me. His brother could even become a volunteer after work because of this respite that he now gets.

I share this tale of the two men to highlight the usefulness of the Vulnerable Adults Bill in the case of John; and the importance of community support in the case of Er Ge.

Sir, as rightly pointed out by the Minister, the Bill is only a tool of final resort to offer protection for the vulnerable adults amongst us, albeit an important one. Unless we seriously organise and harness the potential of the community around them, these adults will not be found nor liberated. So, Sir, with that, I fully support the Bill and thank the Ministry for this Bill.

Mr Speaker: Ms Sylvia Lim.

3.39 pm

Ms Sylvia Lim (Aljunied): Mr Speaker, Sir, this Bill seeks to give the state certain powers to protect adults from abuse, neglect and self-neglect, and focuses on adults who are not able to protect themselves. Nobody can quarrel with such an aim.

Even as our intentions are noble, our perception of what is in the vulnerable adult's best interest may not accord with theirs. There is a Bible passage that literally captures the powerlessness that older people feel as they become more dependent on others. In the Acts of the Apostles, Jesus is recorded as saying to his disciple Peter: "When you were younger, you used to dress yourself and go where you wanted, but when you grow old, you will stretch out your hands, and someone else will dress you and lead you where you do not want to go".

In this regard, I endorse the fundamental principles set out in clause 4 of the Bill. Clause 4 provides that in exercising any of the powers under the Bill, a vulnerable adult must be respected and have the right of self-determination and not be subject to any unnecessary restrictions on his rights and freedom of action.

While I support the rationale for the Bill, there are a few aspects of the Bill that concern me, which I shall summarise as follows.

First, what will be the division of work between the Ministry under this Bill and the Office of the Public Guardian?

Second, what is the rigour of assessment to be applied before the state decides to intervene to change a person's living arrangements? I am worried about possible Government overreach, causing unnecessary institutionalisation of vulnerable adults, which, itself, would have harmful effects.

Third, would the definitions of "abuse", "neglect" and "self-neglect" in the Bill inadvertently discriminate against the poor?

I raise these issues so that the Ministry can clarify, in order to have greater public understanding of how the Bill will operate. In addition, I will touch on some areas that need further attention to enable vulnerable adults to live fuller lives.

First, division of work under the Bill and the Office of Public Guardian. Under the Mental Capacity Act, the Public Guardian's Office was set up to perform certain functions vis-à-vis mentally impaired persons. These functions include supervising the way donees and deputies perform their duties under Lasting Powers of Attorney and Court Orders. The Public Guardian is tasked with looking into complaints about donees or deputies who do not act in the person's best interest, either in managing his personal welfare or his property and affairs.

When this Bill is in place, there will be some overlap when it comes to a vulnerable adult's personal welfare. I assume that this Bill will tackle the cases where there is no donee or deputy appointed. But the Bill also covers cases where there are donees and deputies, as seen, for example, in clause 6. The question then arises: should there be a case involving donees or deputies that requires state intervention, to whom should a complaint be made? Is it to the Director of Social Welfare under this Bill, or to the Public Guardian under the Mental Capacity Act, or can both be pursued concurrently?

Additionally, the Bill does not cover abuse of a vulnerable adult's financial assets. Where there are donees or deputies appointed, a complaint can be made to the Public Guardian that the donee or deputy has acted in bad faith. But if there is no donee or deputy, the Ministry has stated that the Police would investigate any criminal offences reported. While the criminal justice system is geared towards punishment, how does one undo or reverse financial transactions, so as to restore monies or properties to the vulnerable adult? One can always apply to Court if one has the means. But what if a person does not have the means or does not have any family member to do so? How would this be resolved?

My second point is about the rigour of assessment and the risk of Government overreach. In discussing this area, my concern is about mentally impaired persons and the state's power to remove a vulnerable adult from his current residence. The state can do this if the person is assessed to be suffering from abuse, neglect or self-neglect.

I believe that the Government would not wish to be over-zealous in exercising such powers. Earlier, in the Second Reading speech, the Minister did reaffirm that social work interventions would basically need to be exhausted first before the Bill will be triggered. Indeed, excessive intervention will harm the vulnerable adults and also be an unreasonable burden on public resources.

To this end, the state's power under the Bill is correctly limited. According to clause 4, a vulnerable adult's views must be respected if he is able to make his views known. Clause 4(b) states that where he has mental capacity, he is generally best placed to decide how he or she wishes to live and whether or not to accept any assistance. Even where he lacks mental capacity, clause 4(c) makes it clear that his views, whether past or present, wishes, feelings, values and beliefs, where reasonable ascertainable, must be considered.

Sir, ascertaining the wishes of a person with dementia can be tricky. From my personal experience with family members and constituents with dementia, dementia is not a static condition. There are good days and bad days, with moments of lucidity when the person seems to think normally. Dementia patients may speak clearly at times, but do they always understand the implications of the wishes they are expressing?

Sir, I would be slow to support the institutionalisation of dementia patients even if things are not ideal at home. Being institutionalised generally comes with a loss of pride and a loss of autonomy, having to live by an institution's rules. Dementia patients can be very agitated and difficult to handle in unfamiliar environments or when surrounded by strangers. Moving such a person from his home to an institution would likely be very damaging to the person's psychological and emotional well-being.

What rigour of assessment will be used before such drastic intervention will be triggered? What standard of care do we expect from caregivers when they care for vulnerable adults?

We usually see caregivers being spouses or children, who love their family members deeply. However, caring for dementia sufferers is onerous, exhausting and physically risky. Spouses are often elderly and frail themselves. Caregivers may also have other obligations, such as work or caring for other family members. And earlier, I think the Minister gave an example of a Mdm Chua and I think her family fits this description which I have just made. Such caregivers are often not medical or healthcare professionals. By what yardstick will they be assessed if a complaint is made?

In this regard, there are somewhat wide definitions in the Bill about what amounts to abuse, neglect and self-neglect.

According to clause 2, a vulnerable adult may be considered to be abused if he is subject to physical, emotional or psychological abuse, is subject to domination or has been unreasonably deprived of liberty of movement or well-being. This raises some pertinent questions.

For instance, if a caregiver decides not to bring the person out because she cannot manage him in public, is that an unreasonable deprivation of liberty? As for being unreasonably deprived of well-being, the illustrations in clause 2 also need closer scrutiny. Let us take illustration (b). It states that if a caregiver does not dress the adult after bathing her and leaves her unclothed in a room with windows open that can be seen by neighbours, that amounts to depriving a person of her personal dignity. While the modesty of the individual certainly needs respect, there could be valid reasons why the caregiver left the adult as such after a bath. For instance, it could be that the caregiver needed some time to prepare medicines that need to be applied on the person's body. Perhaps, the caregiver needed to attend to an urgent phone call or other task. Illustration (c), too, is worth noting. It speaks of a caregiver who refuses to allow a vulnerable adult to receive visitors. But what if the caregiver did so because the adult had reacted badly to visitors in the past, shouting at them and even pushing them away? What if the visitors are young children, who might be traumatised to witness such behaviour?

Before the state exercises its drastic powers of intervention, I would expect that a case-by-case and subjective assessment would have to be made.

Next, does the Bill risk inadvertent discrimination against the poor? How will the definitions of "abuse", "neglect" and "self-neglect" impact poor families or individuals? For instance, we sometimes see multigeneration families living in small rental flats. Will a vulnerable adult sleeping on a mattress without a proper bed be considered "neglected"? What if the vulnerable adult would benefit from certain treatment which requires payment, but he does not have the means to pay for it? For instance, there are psychiatric drugs to treat aggression, but some of these drugs are not subsidised and are costly, especially when prescribed long term. Will the vulnerable adult be considered neglected if the family cannot afford such treatment?

How will the Government approach such cases? I am not saying that the Bill intends to discriminate against the poor, but could this be an inadvertent result?

Finally, Sir, some areas for review.

The Government has been increasingly active in addressing issues, such as ageing and mental health. For instance, the Government has enabled parents of disabled children to access a simplified, low-cost procedure to be appointed as deputies when their children reach adulthood.

Another scenario I have come across is that of adults who lose their mental capacity later in life and have modest bank balances. From time to time, they also receive some top-ups from the Government, which go into their bank accounts. Because of their lack of capacity, they are unable to sign documents and family members are unable to access those monies for their medical treatment or upkeep. With small balances like, say, $5,000 or $10,000, it does not make sense for family members to fork out, say, $6,000 in legal fees to apply to Court to be appointed deputies, especially when the money has to be paid upfront by them. Can the Government look into how the process of deputyship in such cases can also be streamlined and made cost-effective?

My next point is about increasing the social space for vulnerable adults to engage in public activities. Sir, we have made concrete efforts to introduce barrier-free access for those who have physical disabilities. In the case of mental impairment, however, there is less public understanding of the condition.

Families with dementia sufferers tend to limit their social lives, due to the discomfort caused in public by the odd behaviour of their family members. Families often reduce or even avoid outings. This is an area that we can all continue to work on. With greater public understanding of dementia and its manifestations, society can show kindness and support towards families and individuals stricken with mental illness and be more welcoming and understanding towards such families. Public education efforts can be stepped up to increase awareness of conditions like dementia, and I agree with the Minister that all of us can play a part in this.

Finally, if institutionalising a vulnerable adult is unavoidable, how can we cushion the transition to institutional life? The institutions involved could make life more bearable by little gestures to preserve the person's individual identity and autonomy. For instance, instead of requiring residents to wear a uniform, could they be allowed to don their own clothing? Could residents be encouraged to have a space to place family photographs and other effects from home? These seemingly small gestures will go a long way to reassure the individual in an unfamiliar institutional environment.

[Deputy Speaker (Mr Lim Biow Chuan) in the Chair]

Sir, in summary, I am in support of the Government's efforts in this Bill to plug a gap in protecting vulnerable adults. As mentioned earlier, the powers given in the Bill need to be judiciously used, so as not to result in Government overreach and unnecessary separation of vulnerable adults from their family and home settings. There is also room for improvement to give vulnerable adults the assurance that society as a whole understands their plight and sees them as integral members.

Mr Deputy Speaker: Ms Chia Yong Yong.

3.52 pm

Ms Chia Yong Yong (Nominated Member): Sir, may I declare my interest as President of the Society for the Physically Disabled (SPD), and board member of SG Enable, both serving vulnerable persons.

The Vulnerable Adults Bill seeks to safeguard vulnerable adults from abuse, neglect or self-neglect. Everyone has the right to live in safety, free from neglect, abuse, free from fear and coercion. This is so, whether the person is powerful or vulnerable, or has or does not have mental capacity.

This Bill has been a long time coming, and I am glad it has finally come. It is a good start, but I am sure the Minister will agree with me that there will be more to be done to protect vulnerable adults. This Bill has been a long time coming because it touches on sensitive matters – a person's right to live where he chooses; a person's right to be cared for; a family's right to care for a vulnerable adult. But when we enter into sensitive family spaces, we can expect to deal with deep-seated family tensions and grievances, strong and overwhelming family dynamics, family reputation; strong ties of love, loyalty, kinship and obligation, feelings of guilt, resentment, contempt, financial challenges, emotional and relational dysfunction, misguided action or inaction. And, very often, many, if not all, in one set of relationships.

So, understandably, the Government does not want to be interventionist. And, understandably, my hon colleague, Ms Sylvia Lim, also cautioned quite wisely against a judicious exercise of power. And yet, we need to strike a balance -- a balance against the right of another person to act, as opposed to the need to protect the vulnerable. And this balance must be prudent and yet bold, and it must be struck in favour of protecting the vulnerable. If I may share that this may well be a difference in perspectives.

A few years ago, someone shared with me from the social service sector that in the earlier years, when there were voices calling for transport concessions, there were people in the social service sector serving people with disabilities who opposed those voices. In their view, it was the dignity of people with disabilities that mattered more, that, by virtue of upholding that dignity, we should not concede and ask for transport concessions. Strangely, the person then shared that when the Government announced these policies, and they consulted people with disabilities, the people with disabilities said they wanted it. So, it just could be a matter of perspective. Is it not? We could be professionals and we could be very well-meaning and say we want to preserve your dignity. But if I am a vulnerable person, maybe, I want more to be protected. By this, I suppose a balance and an assessment that the Government and the professionals have to assess, have to make. But again, I urge it must be struck in favour of protecting the vulnerable.

Let me now come back to the issue of sensitive family spaces. When a "stranger" enters into any family space, he or she will be confronted with the question: "who are you?" What it really means, in our context, is: "what right have you to interfere in my family matters?" What right do you have?

Currently, not much right. Hence, social workers, support service providers and Government offices, while actively engaged on the ground to assist and support vulnerable adults and their families, are hampered in their attempts to protect such adults – not much right. It is not much that can be done and, hence, we welcome this Bill.

Take another step back. Nobody in our right mind or heart will ask, "what right have you to protect the vulnerable adults?" But we should not, indeed, be surprised that family members will demand, "what right have you to interfere in my family matters?"

And that is, in fact, a fair question, and that is a question that must be answered by this House now, unequivocally. We must answer this question clearly and unequivocally by, firstly, setting out clearly the scope of the protection for vulnerable adults. Anyone whose circumstances do not fall within the scope of production, will not be able to claim such protection. So, I think it has got to be clear in our minds that we must have a Bill that is broad enough to protect. The protection must be sufficiently significant to an adult.

Secondly, we must empower the Director, protector and others to act boldly and courageously to protect vulnerable adults without fear of complaints, fear of having to put out so many reports to explain their decisions. Despite section 34, clarity on the scope of protection and a strong adherence to the principles set out in section 4, will empower the Director and such other persons to act boldly and courageously to protect the vulnerable person.

And thirdly, persuading the community that each person has a role to play in the protection of vulnerable adults.

These three questions we must answer unequivocally today.

Sir, a vulnerable adult is defined as an individual who is 18 years of age or older, and is, by reason of mental or physical infirmity, disability or incapacity, incapable of protecting himself or herself from abuse, neglect or self-neglect.

Let me, first, address the scope of protection but I will address the first two issues together – the issue of the definitions and the empowerment of the Director and the protectors. Both issues relate to the scope of protection, and I will share my views as to what I think the limitations in certain definitions are and state my proposals for amendments. In the interest of time, however, I will not repeat the definitions word for word, and I seek the indulgence of hon Members to refer to the Bill as I speak.

Sir, "abuse" has been defined to mean: (a) physical abuse; (b) emotional or psychological abuse; (c) conduct or behaviour by A that in any other way controls or dominates B and causes B to fear for his or her safety or well-being; or (d) conduct or behaviour by A that unreasonably deprives, or threatens to unreasonably deprive, B of B's liberty of movement or well-being.

Sir, "emotional or psychological abuse" is further defined. But I have to admit I am not comfortable with the word "mean" or "means" in that definition. It limits the definition as opposed to the word "includes". When I read the definition of "emotional or psychological abuse", together with the illustrations, I believe, Sir, that the question is left open as to whether non-action, such as indifference or just complete inaction in treatment constitutes emotional or psychological abuse. I hope the Minister can clarify.

I move on to the definition of "Neglect". It means the lack of provision to the individual of essential care, to the extent of causing or being reasonably likely to cause personal injury or physical pain to, or injury to the mental or physical health of, the individual. Again, the word "means", is very limiting, as opposed to "include".

Next, "self-neglect". Also, it means the failure of an individual to perform essential tasks of daily living to care for himself, resulting in the individual suffering certain prescribed consequences or conditions.

At this point, I would like to propose that the Minister consider amending the three definitions by replacing "means" with the word "includes". This amendment broadens the scope of protection and empowers the Director with clarity, confidence and courage in the exercise of his powers to protect vulnerable adults.

With reference to the definition of "self-neglect", there are also other limitations. In order for the requirement of "self-neglect" to be fulfilled, the failure of the individual to care for himself or herself must result in the individual: (a) living in grossly unsanitary or hazardous conditions; (b) suffering from malnutrition or dehydration; or (c) suffering from an untreated physical or mental illness or injury.

The three consequences are extreme. At least one of the three must occur before the Director can intervene. In other words, the Director cannot intervene to protect the individual until something extremely terrible has happened. That should not and cannot be the intention of the Minister. Certainly, it should not be condoned or be the intention of this House. The Director should have the power to intervene if the failure to care for oneself could reasonably be expected to cause any of those three consequences.

In addition, I would also propose that the word "grossly" be deleted from (i) of the definition. It is bad enough to live in unsanitary or hazardous conditions. We should not require such living conditions to be gross in order to justify intervention. The deletion of the word "grossly" will also remove ambiguity as to whether “grossly” qualifies only "unsanitary" or qualifies "hazardous" as well.

Sir, as I said earlier, definitions are important. The narrower the definitions, the narrower the scope of protection. I urge the Minister and this House to consider my proposals.

I now move on to three aspects of the protection.

Firstly, the removal of the vulnerable adult from his place of residence for "assessment". This is provided for under section 6. However, again, the definition of "assessment" seems somewhat limited to me. It is not clear as to whether psychological assessments are included. I would be grateful if the Minister can clarify. If, indeed, "assessment" does not include psychological assessments, then I urge the Minister to consider amending the definition to include the same.

Notwithstanding that there may be many non-legal triggers for the protection of a vulnerable adult, assessment itself is an important trigger. Beyond re-examining the definition of "assessment", we should also re-examine the requirement for a Court order where a vulnerable adult, notwithstanding his or her mental capacity, refuses, under coercion, to give consent for his or her removal for such assessment.

Sir, given that I have similar considerations and arguments in relation to section 6 and section 10, I would like to make my submissions on both sections together.

For the ease of recollection by Members, section 10 empowers the Director to remove a vulnerable adult from the place where the vulnerable adult is residing or staying if the Director is satisfied on reasonable grounds that the vulnerable adult has experienced, or is experiencing or is at risk of, abuse, neglect or self-neglect. Unfortunately, it also requires an order of Court where a vulnerable adult, notwithstanding possessing mental capacity, refuses to give consent for his or her removal.

Two important considerations from the basis of my submissions on the inadequacies of section 6 and section 10.

One, where the individual or vulnerable adult does not give consent, but is also not acting freely, for example, where he or she refuses consent for fear of reprisals from or unhappiness of caregivers or of family members.

Secondly, there is also a spectrum of abilities in reasoning and judgement. Under the Bill, mental capacity is used in the same sense as under the Mental Capacity Act. This leaves a large group of persons who may have inadequate reasoning faculties, but who may not lack mental capacity under the Mental Capacity Act, for example, those with low intelligence or suffering from certain spectrum of Autism Spectrum Disorder (ASD), or in the early stages of dementia.

In both groups, the lack of financial independence, lack of social support network, and emotional attachment to familiar people, the Stockholm syndrome, may increase their dependency on their family members or increase their fear in reporting. We know that it is common for caregivers who refuse medical assessment. This is a problem that we need to address. We cannot assume that these two groups of people do not require protection simply because they have refused to give consent.

I support the provisions, in fact, that the Director may, without the consent of the relevant donee or deputy, assess a vulnerable adult without mental capacity, recognising that some donees or deputies are themselves abusers.

But, here, the two groups of persons whom I referred to above are no less vulnerable than those who lack mental capacity. In fact, they could be more vulnerable simply because they have the capacity to consent. And should they give consent or should they in any way intimate fear or convey simply a need for protection, they are more likely to be held to account by their abusers, caregivers and family members. The abuse or neglect may intensify. The family alienation may deepen. The fear of the vulnerable adult is thereby accentuated.

I have noted that the Bill provides for the Director to make an application to the Court for the vulnerable adult to be removed, whether for an assessment under section 6, or for removal under section 10. I submit that the Director should be given broader powers than to be constrained in this manner. My reasons follow from my analysis as to how a Court order may be obtained for the assessment of an individual or a vulnerable adult.

In a Court application, first, the Director must make the application to the Court.

Second, the Director must (a) satisfy the Court that, on a balance of probabilities, the individual or vulnerable adult has experienced, or is experiencing or is at risk of, abuse, neglect or self-neglect; and (b) persuade the Court that such an order for assessment is necessary for the safety and protection of the individual or vulnerable adult.

If the Director is able to satisfy both requirements, should he not be empowered, in the first instance, to remove the vulnerable adult for the protection of the vulnerable adult? Any concern as to whether the Director may be acting too intrusively may be addressed by amending section 11(1)(b) as well as related provisions accordingly.

If I may, I would also like to share an additional concern in relation to the removal of the vulnerable adult for assessment. Section 7(1) provides that the Director is not required to exercise any power under section 6 if consent is refused by the vulnerable adult with mental capacity. Making the application to Court becomes discretionary. In other words, the Director may also choose not to make an application to Court.

Mr Deputy Speaker: Ms Chia, you have one-and-a-half more minute.

Ms Chia Yong Yong: Thank you, Sir. As such, I would propose the amendments that I have suggested, and I would also like to ask that the Minister consider other amendments; consider provision of facilities to cater to the needs of vulnerable adults. I also ask that we not be shy to exercise and to apply for powers of exclusion of the abusers.

If I may also add, the role of the community cannot be underestimated. The case of Annie Ee and other unfortunate cases tell us that there will be many out there in the community who would have fallen through the gaps. Neighbours play an important role. They have, in some cases, played a critical role in saving someone. So, I urge neighbours, it is better to report to save a life or even a family, than to report to retrieve a body. I support the Bill.

Mr Deputy Speaker: Mr Louis Ng.

4.12 pm

Mr Louis Ng Kok Kwang (Nee Soon): Sir, the Vulnerable Adults Bill has been a long time in the making, with the public consultation on a draft Bill having been conducted nearly two years ago. The Bill is a welcomed piece of legislation to protect some of the most vulnerable in society but also raises difficult questions of the role the state should play in intervening in the most intimate of relationships, and in interfering with decisions and preferences of an adult on matters of their own care. The long period of gestation for the Bill reflects the delicate process of balancing protection and respect for individual autonomy and freedom.

I stand in support of the Bill and the principles set out under section 4, which articulates the restraint and proportionality that should guide the exercise of the extensive powers under this Bill.

I have a few points of clarification on the scope of protection offered by the Bill, the mechanisms for checks on the exercise of powers, and measures for protecting vulnerable adults beyond those set out under the Bill.

My first point really is what I started this speech with. Why did it take so long to introduce this Bill? What were the various considerations or challenges MSF faced in introducing this important Bill?

Next, under the Bill, a vulnerable adult is defined as an individual who is 18 or older. Can the Minister clarify the rationale for setting 18 years old as the lower age limit for a vulnerable adult? The Children and Young Persons Act protects individuals who are under 16. What are the forms of equivalent legal protection and recourse available to those who are between 16 and 18?

Next, sexual abuse is not listed as a type of abuse under section 2(1). Instead, "physical abuse" is defined to include coercion or attempts at coercing an individual to engage in sexual activity. This definition of sexual abuse as being a subset of physical abuse is too narrow because not all sexual harassment is physical. For instance, vulnerable adults may be subject to verbal sexual harassment not amounting to coercion in engaging sexual activities. Can the Minister clarify the rationale for subsuming sexual abuse under physical abuse, and also clarify how verbal sexual harassment will be dealt with under the Bill? Further, would the Minister consider introducing or including sexual abuse as an independent head of abuse?

Similarly, the definition of "abuse" under section 2(1) does not include financial abuse. There is also a lack of provisions in the Bill that address financial abuse of vulnerable adults. Financial abuse, such as financial exploitation, is a significant problem faced by vulnerable adults and is a form of elder abuse recognised by MSF. A 2014 survey conducted by Trans Family found that 29% of elderly mistreatment in Singapore involves financial exploitation. There appears to be a gap in the current legal framework for addressing financial abuse and exploitation of vulnerable adults.

For instance, finance-related offences under the Penal Code, such as theft, extortion and cheating, may not be sufficiently nuanced to address financial exploitation in the context of an existing relationship of trust or dependency. Protection orders under the Women's Charter does not extend to financial abuse. The definition of ill-treatment under the Mental Capacity Act, which protects mentally incapacitated elders from ill-treatment by their caregiver or donee or deputy does not include financial abuse. Will the Minister consider extending the ambit of the Bill to protection against financial abuse in the future? What are the current legal protections available to vulnerable adults subject to financial abuse?

Next, the Director and protectors have extensive discretion and powers under the Bill. Caregivers may legitimately worry about disruption and interference in their lives, such as the possibility of entry into their homes and premises. Excessive intervention may also further strain relationships between elderly parents and their children. These extensive state powers must thus be exercised with great restraint and proportionality. Can the Minister clarify what mechanisms exist for review and oversight of the powers granted to the Directors and protectors?

Would the Minister consider instituting a formal approval or reporting process for the most intrusive powers exercised by the Directors and protectors? This would include the powers to remove an individual for assessment without consent, to enter premises, to remove a vulnerable adult from their place of residence and to require medical treatment. Can the Minister also clarify the instances where the Director or protector need not seek a donee or deputy's consent before assessing or removing a vulnerable adult under section 6(2) and section 10(2)?

Given that cases of abuse, neglect or self-neglect often occur outside the public eye, effectiveness of the Bill, as the Minister has mentioned, is contingent on detection and reporting of such cases. Will training be provided to frontline staff to sensitise them to indicators of abuse, neglect or self-neglect? I understand that Social Services Offices and other community partners can call MSF to report cases of vulnerable adult abuse, but vulnerable adults who are not in contact with community partners may fall through the cracks. Would the Minister consider setting up a public hotline under the Adult Protective Services for reporting vulnerable adult abuse, as has been done with the MSF Child Protective Services Helpline?

Further, can the Minister clarify the ways in which the Adult Protective Services are similar or different from the Child Protective Services? Will every case of vulnerable adult abuse be reported to the Police? There is an existing mechanism under section 8 of the Mental Health (Care and Treatment) Act that allows a Magistrate to investigate a report from any person or Police Officer that a mentally disordered person is not under proper care and control or is ill-treated or neglected. Can the Minister clarify how this provision will operate in relation to the Bill?

Lastly, can the Minister also share the plans for ensuring successful reintegration and adequate care of vulnerable adults when they are returned to their homes from place of temporary care and protection?

Sir, clarifications and suggestions for Ministry's consideration notwithstanding, I stand in support the Bill.

Mr Deputy Speaker: Mr Seah Kian Peng.

4.19 pm

Mr Seah Kian Peng (Marine Parade): Sir, protecting vulnerable adults treads a fine line between respect of dignity and compassion for the vulnerable. The Vulnerable Adults Bill is a timely and necessary creation to address the needs of a rapidly ageing population, and to bolster our existing legal frameworks.

We have spoken much about bold ideas, but less about real action. This is an example of a small but significant change that we can make. A change that is literally a matter of life and death for thousands of older Singaporeans. The urgency and scale of the problem cannot be denied. By 2030, over 900,000 residents in Singapore will be aged 65 and above, and an increasing number will be living alone, from 31,200 in 2012 to 83,000 in 2030. Sir, I believe the number of adult abuse and neglect will increase going forward.

The law, as it currently stands, is inadequate insofar as the state lacks the authority to intervene. For example, the state has been unable to enter the homes to render timely assistance to vulnerable adults who might be abused by their caregivers or are in a serious state of self-neglect, if the owner of the home refuses them permission to enter. The case of Mdm Ee, a 79-year-old single woman who lives alone, shows us this in real life. She is mentally incapacitated – a schizophrenic – and she has no next-of-kin. She rebuffs all attempts at treatment and intervention from healthcare professionals and social workers alike. Meal delivery services were also ignored as Mdm E left delivered meals at her gate. Hence, the risk of self-neglect is very high. The mentally-ill elderly who live alone, such as Mdm E, are prone to untreated falls and illnesses and may not have ready access to food.

Another case shows how timely this proposed Bill is. Mrs A, she is an 81-year-old woman suffering from dementia and is incapable of activities of daily living. She was abused physically, emotionally and psychologically by her 87-year-old husband who himself is prone to violent outbursts. They used to stay together alone and away from their adult children. But their children's fear of the father made them unable to supervise the elderly couple, leaving Mrs A without any protective figures at home.

The new Bill allows for such cases of self-neglect and abuse, which usually also involve uncooperative or non-communicative vulnerable adults, to be addressed efficiently, without the need for lengthy and unproductive negotiations with either the aggressor or the victim. Assessments of mental capacity can be enforced, the power of entering a vulnerable adult's premises can be exercised and, most importantly, there is a power to remove the vulnerable adult from the premises and to a safer place. This Bill allows us to act pre-emptively to protect vulnerable adults against caregiver abuse and neglect, and victim self-neglect.

Mr Deputy Speaker, Sir, I wanted to point out a few ways in which I believe we can make this Bill better.

What is missing from this Bill? My first suggestion is to implement a mandatory reporting system for all stakeholders involved in providing care and services for vulnerable adults. Stakeholders, such as medical and social workers, AIC, the Police and perhaps even finance professionals, could be legally obliged to report suspected abuse as long as they have reasonable grounds to believe that a vulnerable adult has been neglected or abused.

The underlying principle is that with a group of people as vulnerable as those considered here, those who are unable or unwilling to voice their pains, worries and concerns, it is wiser to be wrong than sorry; it is better, in my opinion, to err on the side of caution, because under-reporting of abuse is likely to be the norm.

The difficulty, as is always the case, lies in the details – who is required to report? Do we restrict the obligation to care professionals or should we include neighbours, friends and family members? What about finance professionals? Which types of abuse must be reported? Should less-tangible forms of abuse, such as psychological and emotional abuse, be covered? Would it be overly onerous to penalise the third party for non-reporting of such less tangible abuses? What about financial abuse, which my fellow Parliamentarian Mr Louis Ng just talked about? What sanctions will be imposed for failing to report, taking into account the bystander effect, that witnesses of abuse are more reluctant to shoulder the burden of reporting if there are other witnesses?

Lessons can perhaps be drawn from overseas jurisdictions. Washington has a mandatory reporting requirement in cases of elder financial abuse, though relatives, friends and neighbours are exempted from this obligation. Likewise, the state of Illinois imposes an obligation to report on "includes employees of the state of Illinois who provide medical or rehabilitation services to adults, law enforcement officers and social service workers" to guard against elder financial abuse.

More fundamentally, we must strike an acceptable balance between protection and intrusion into personal affairs, taking into account Singapore's cultural norm of non-interference.

It is my view that the Bill, which already protects whistleblowers, can be tweaked to include mandatory reporting and yet protect these stakeholders from liability arising from provision of such information or breaches of any code of professional conduct. Penalising the willfully blind heightens stakeholder awareness of their wards' vulnerabilities and improves oversight over the welfare of vulnerable adults. The social need for adequate protection of the most vulnerable amongst us charges us with a moral duty to find this balance, regardless of how difficult it is.

My second suggestion is to consider including financial abuse of vulnerable adults under the ambit of this Bill. Fellow Parliamentarians, such as Dr Lily Neo and Mr Chia Yong Yong, and professors, such as Prof Chan Wing Cheong, and non-government organisations (NGOs), such as the Association of Women for Action and Research (AWARE), have repeatedly raised this concern. And again, Mr Louis Ng just raised this as well.

As it currently stands, the proposed Bill only includes physical, sexual or emotional/psychological abuse. But financial abuse can be as devastating as other forms of abuse and neglect. They can also be precursors to physical abuse. As AWARE observes, financial abuse is "often accompanied by threats of physical violence, and compounds the vulnerability of a victim to further abuse and neglect".

Vulnerable adults, due to their physical or mental infirmities, are less able to safeguard their financial security, or may be held hostage by their live-in caregivers, or lack the financial resources to take civil action. We are well-aware of cases of over-trusting parents who part with their assets out of love for their children, children who subsequently forsake them, whether due to a lack of filial piety or disagreements in the family. Too many cases. Too many sad cases.

Other cases include deceiving or coercing an elderly parent to sign a will or deed or taking money from them without providing support in return. Furthermore, financial abuse is under-reported, due to its subtle, non-tangible nature. In fact, one-in-three cases of elder abuse involved financial abuse as well, according to a 2014 study by Trans Safe Centre.

Including "financial exploitation" under the definition of "abuse" in the Bill would, I believe, be a good starting point in securing the financial interests of vulnerable adults. The definitions used in other jurisdictions, such as in New York, Washington and Illinois, can potentially be transplanted with modifications. Some US states even go so far as to impose a mandatory reporting obligation on professionals who are aware of elder financial abuse.

In fact, this is not the first time that the financial interests of the vulnerable have been debated in this House. The Maintenance of Parents Act, passed in 1996 and amended in 2010, allows elderly parents who are unable to maintain themselves adequately to apply for an order to have their children sustain him or her financially. The Bill tabled before us today gives us the opportunity to act more pre-emptively; to treat the scourge of financial exploitation at its root.

Instead of ensuring that the vulnerable receives financial maintenance after the act of abuse has taken place, is it not more effective to remove the threat in the first place? Such pre-emptive action ensures that whatever financial resources that the vulnerable adult still possesses are not taken away by abusers.

As some points of clarification, this pertains to the issue of cost: who bears the costs of intervention under the Bill? For example, who pays for the permanent care or relocating of the vulnerable adults? Would it be from the vulnerable adult's Central Provident Fund, or the abuser or the Government? I think this point was raised by the National University of Singapore Centre for Biomedical Ethics, and I agree that some clarification would be good.

Mr Deputy Speaker, Sir, I have argued that there is a case to be made for mandatory reporting and the inclusion of financial abuse into the Bill. As is often said, a society is judged by how it treats its weakest members. The Bill, in combating the social ill of the abuse of vulnerable adults, not only meets the changing needs of Singaporeans – its ageing population, falling birth rates and elders who live alone – but also affirms the values of the Singapore that we all know and are proud of.

The Vulnerable Adults Bill must recalibrate our traditional aversion to interventionistic laws, against the reality of the everyday lives of older Singaporeans on the ground. It should not be an obstacle against protecting the highly vulnerable, whether they be children or adults, exceptions must be made where called for. The welfare of vulnerable adults is one such instance. Mr Deputy Speaker, Sir, I support the Bill.

Mr Deputy Speaker: Assoc Prof Daniel Goh.

4.31 pm

Assoc Prof Daniel Goh Pei Siong (Non-Constituency Member): Deputy Speaker, Sir, there is broad support for this proposed law from the social services sector and the public, and I would like to echo the support. It is an important instrument of last resort to be used to safeguard the well-being of vulnerable individuals facing abuse.

I personally witnessed a case where multiple Government and social service agencies were scrambling to intervene to safeguard an elderly woman's well-being after community and family interventions have failed to rescue the mentally incapacitated lady from self-neglect. The crux of the problem was who had the power to compel the lady to accept assessment and assistance. It took years to finally get help to the lady in need which had, in the meantime, caused much distress to the family and the neighbours.

I have three points to raise about the Bill. But before I raise these points, I would like to ask an important question of clarification. MSF first mooted the Vulnerable Adults Bill in 2014, and it was said that the Bill would likely be enacted in 2015. That did not happen and the public consultation on the Bill took place in 2016. Almost two years have passed since and we are here at the Second Reading of the Bill. This is a wait of three years.

Every year, we see about 200 reported cases of abuse of seniors and people with disabilities. This is sufficient reason, in itself, for the urgency of the Bill. The frequently asked questions accompanying the public consultation documents for the Bill stressed that the rate of abuse of vulnerable adults is relatively low and that the Bill is important to keep this rate low as the Singapore society ages and the number of senior citizens increases to 900,000.

The ageing society is also cited as the impetus for the Bill in the other documents. While the ageing society is the crucial context, I believe the central motivation of the Bill should not be about keeping rates low as the society ages. It should be about reducing abuse to the minimal and safeguarding vulnerable adults in all cases of abuse regardless of the societal context because one abuse is one too many and should be stopped. In other words, the motivation and the spirit of this law should be more humanistic and less bureaucratic in the sense of measuring abuse in terms of a key performance indicator.

Therefore, this rate of three years for the Bill to be tabled needs to be accounted for. There must be a good reason or good reasons for the delay. The Minister said we should not rush this Bill in his speech. I hope the Minister could elaborate.

Let me move on to the three points I would like to raise for the Bill.

The first point is about the definitions and the scope of the Bill. It is very good that the principle in clause 4 states that, "In all matters relating to the administration or application of this Act, the welfare and best interest of the vulnerable adult must be the first and paramount consideration" has been added to the Bill after public consultation. This is the most important principle. It signals that the main motivation for the Bill is not about keeping abuse rates low, but in protecting the basic human dignity of the weakest members of our society.

However, there appears to be two gaps in the definition. A vulnerable adult is defined in the Bill as an individual aged 18 and above who is incapable of protecting himself from abuse, neglect or self-neglect due to physical or mental incapacity.

Our young persons aged between 16 and 17 are left in no-man’s-land in terms of protection from abuse or neglect. This means that close to 200,000 individuals each year entering what is arguably a very emotionally volatile phase of growth as late teens would neither be protected under the Bill nor under the Children and Young Persons' Act, which defines young persons as under 16 years of age.

The second gap is that the definition of abuse does not include financial abuse when the vulnerable adults' resources are being exploited by perpetrators for their financial gain or personal benefit. While financial abuse is not as physically apparent as other forms, it is equally harmful to the vulnerable adult's well-being and best interest.

Feedback during the public consultation phase highlighted these two gaps. MSF responded to the feedback by implying that the two gaps are covered by other laws. Regarding older young persons, MSF stated that the Women's Charter provides protection for victims of family violence of all ages, and that there are many services and programmes on the ground catering to older youths. However, the whole point of having the Bill is precisely to give MSF protectors the powers to intervene to stop the abuse when family and community interventions have failed.

The Women's Charter does not provide these important powers of last resort. It will be tragic if, because of this definition handicap, MSF protectors would have to wait for two years to intervene to rescue a young person aged 16 facing abuse by reason of physical or mental incapacity. Therefore, would the Minister consider amending the definition of vulnerable adults to lower the age to 16 years, or amending the Children and Young Persons Act to cover young persons who are up to 17 years of age?

Regarding financial abuse, MSF stated that the Police can investigate financial offences under the Penal Code, and the Office of Public Guardian can apply to Court to suspend or revoke the powers of a vulnerable adult's donee or deputy. However, financial abuse is much more insidious and hidden. And it often involves elements of psychological and emotional abuse.

With all due respect to the abilities of the Police and the Office of Public Guardian, they are not as well-equipped as the MSF protectors and the powers under the Bill to investigate, detect and assess incidents of financial abuse. Again, the whole point of having the Bill is to enable the MSF protectors to intervene to stop the abuse and harm caused to the vulnerable adults, which is something the Police and the Office of Public Guardian cannot do.

The second point I would like to raise for the Bill is that while the statutory powers of intervention should generally be deemed as powers of last resort compared to the family and community interventions, there is scope and justification for some of the powers to be deemed as intermediate powers. What I mean by this is that the MSF protectors should be allowed to exercise some powers of the Bill while family and community interventions are ongoing so that the latter – the family and community interventions – could be supported and enhanced. This pertains to the powers of getting information of the suspected vulnerable adults, entering private premises to assess well-being, and compelling vulnerable adults to receive medical or dental treatment.

Of course, these powers have to be assessed judiciously so as not to compromise family and community interventions. The power to remove and relocate the vulnerable adults should remain the power of last resort.

Would the Minister comment on how these powers would be operationalised and exercised vis-à-vis the family and community interventions on the ground?

At this point, I would like to go back to the question of financial abuse. If, in the course of an investigation and ongoing family and community interventions, it is discovered that the vulnerable adult is facing financial abuse in having his or her resources exploited for the perpetrators personal benefit, what recourse does the MSF protector have to intervene to protect the vulnerable adult? Can the MSF protector refer the case to the Police or the Office of Public Guardian? Would the evidence be sufficient to bring charges against the perpetrators for fraud or dishonesty offences and the process be quick enough to stop the harm being done to the vulnerable adult?

I am asking this because the Office of Public Guardian can only apply to Court to suspend the powers of the donee or deputy if the donee or deputy has been charged for a financial offence.

There is one more issue I would like to raise with regard to intermediate powers. This is regarding situations where vulnerable adults face economic abuse in not having their needs being met because of the lack of financial support from family members. The power to remove and relocate the individual under the Bill may actually not be in the best interest of the vulnerable adult as she may benefit more in residing and receiving care in their own home.

It appears that the intermediate power is needed here. I am not keen to suggest that the MSF protector be empowered to apply on behalf of the vulnerable adult for maintenance from his/her children under the Maintenance of Parents Act as I am instinctively wary of quipping state intrusion into the prerogatives of the family. But what other intermediate recourse is available to MSF officers?

The third and last point I would like to raise about the Bill is the connection and potential overlap with the provisions in the Women's Charter catering to the protection of victims of family violence. While this Bill appears to be motivated by the need to especially protect the vulnerable elderly from the risk of abuse in an ageing society, the definition of vulnerable adult is broad enough to encompass victims of family violence, particularly family violence of the most egregious kind. Whilst spousal victims of family violence are most likely not in the first instance, be it the mentally or physically incapacitated, in many cases of egregious abuse, spousal victims, and most of them being women, become mentally incapacitated because of sustained abuse, and are incapable of protecting themselves from further abuse.

I would like to seek the Minister's clarification, therefore, on whether the Bill does, in fact, cover victims of family violence, and whether the MSF protectors are effectively empowered to intervene in cases of family violence under this Bill. If, in fact, it does, then I would like to ask the Minister what the division of labour and powers would be like in the provisions in the Women's Charter and in the Bill. I am asking this because there could be quite a lot of confusion on the ground after the enactment of the Bill. Social service agencies and concerned whistleblowers may choose to report incidents of family violence to MSF for more immediate intervention under the Bill instead of the more laborious route of helping victims to apply for Personal Protection Orders (PPOs) from the Court.

I am personally in favour and open for spousal victims of family violence who have become mentally incapacitated by abuse to be deemed as vulnerable adults so that they can receive the needed assistance from MSF.

On the other hand, I am concerned that MSF resources could be stretched and overwhelmed if MSF officers have to investigate even a proportion of family violence cases to determine whether intervention under the Bill is warranted. One compromise could be for the law to be amended to allow immediate family members of victims of family violence and perhaps selected social service agencies, the Police and MSF protectors included, to apply for PPOs on behalf of victims. The idea is to avoid concerned family members and friends of victims of spousal abuse expecting and going for the nuclear option of removing the victims from their homes unless it is absolutely necessary to do so.

Deputy Speaker, Sir, I believe the Bill would become a landmark law in our legislative history. It has far greater ramifications and the express intentions to keep abuse rates low in an ageing society. In fact, the Bill has raised, and the Act will continue to raise, many issues regarding human dignity and human rights and the role the state plays to protect and provide for the more vulnerable members of our society. The conversations and debates should be welcomed and embraced because I think they will push us forward as a people grappling together with the issues of human vulnerability.

Already a number of cases of abuse of neglect and self-neglect have made headlines recently and sparked intense discussions. This Bill is timely and actually somewhat delayed. Nevertheless, I support the Bill and look forward to tracking closely the effectiveness of its implementation on the ground.

Mr Deputy Speaker: Mr Henry Kwek.

4.42 pm

Mr Kwek Hian Chuan Henry (Nee Soon): Mr Deputy Speaker, I rise in support of the amendment. I would also like to put on record my thanks to the MSF officers who work very hard to not just care for the needy, but also proactively consult VWOs as we change the law.

Members from the VWO sector whom I spoke to are supportive of this amendment. It strengthens how we protect our seniors, especially during a crisis. I especially appreciated the part about protecting whistleblowers because we do need our community to come in and tell the state when people most need help.

Today, I would like to propose two things: how we can better stay in touch with vulnerable adults prior to a crisis which requires intervention; and how we can minimise the number of vulnerable adults through the Lasting Power of Attorneys (LPAs), by getting as many Singaporeans as possible to predetermine their caregiving arrangements in the event of a mental incapacitation.

Let me touch on the first point. A collaboration between MSF and Silver Generation Office (SGO) can go far for us to stay in touch with vulnerable adults regularly. I understand that the Government has a database called the Developmental Disability Registry (DDR) to track our vulnerable adults and children. This database likely contains a large percentage of them. But it is possible that some of them are not captured in the database.

To improve on this matter, during regular SGO’s outreach to seniors, a small group of vetted and well-trained Silver Generation Ambassadors (SGAs) can be assigned to visit the vulnerable adults already in the registry. These SGAs can refer them to social workers, if necessary, and also update the registry.

In addition, when other SGAs chance upon any vulnerable adults or children in their outreach session, they can also include that information into the registry. SGO’s involvement will go very far to help us in the know about every vulnerable adult or children in Singapore and, in doing so, can potentially forestall some of the tragedies involving vulnerable adults later on.

Next, I will speak about getting Singaporeans to do up their LPAs. With our ageing population, there will many more adults who, through illnesses or accidents over their lives, grow dependent on their family and friends. If these adults get mentally incapacitated, their caregivers could have difficulties mobilising enough resources to help them. Without a strong support network, some of these mentally incapacitated Singaporeans will become vulnerable adults.

We should tackle the problem upstream, by encouraging all Singaporeans to create LPAs, which identify and authorise a "donee" to act on his/her behalf, including on financial matters, when he/she is mentally incapacitated.

Should no LPA exist after mental incapacity sets in, there are still options to deal with it, but it gets complicated. Family members and friends can apply to be Court-appointed deputies, which is time-consuming and costly. MSF's new Community Kinship Service pilot can get social workers to be Court-appointed deputies and, therefore, take charge. But most of us here in this Chamber would agree that MSF's limited resources should focus on only the most pressing of cases.

Therefore, to minimise the number of vulnerable adults ahead of the coming Silver Tsunami, LPAs play a major part. I have assembled a team of lawyers and community leaders to think about this issue. We believe a major LPA adoption drive is necessary and would like to propose three steps.

One, integrate the LPA into relevant Government processes. This will give many Singaporeans the chance to think through this issue and make a decision and draw up their LPAs. For example, the Immigration and Checkpoints Authority (ICA) can insert the LPA process automatically within the 55-year-old identity card re-registration process as well as passport renewal for Singaporeans over 45 years old. The Housing and Development Board (HDB) can insert the LPA process within all deed transfers and name insertions for people above 55. MOH can get hospitals to advise moderate to high-risk and senior patients to get LPAs and offer that process in major hospitals.

Two, we can minimise the cost of LPAs. The current cost is not costly, but to get mass adoption of LPAs by seniors and retirees, we can try to bring down the cost even more. MSF can extend the waiver of LPA application cost. At pre-selected Government offices issuing large numbers of LPA certifications, we can include an onsite team of certifiers, that is, lawyers, doctors and psychiatrists. And the benefit of this is that we can then offer out bulk-contracts for these certification services to further reduce the cost from lawyers, doctors and psychiatrists. Another option is for us to train civil servants who know about these issues to act as certifiers at key locations.

Our third point is that we need to communicate extensively. We can explain about LPAs through videos in different languages. These videos can be made and screened on television, within cinema and online. SGO can explain the importance of LPAs to seniors, and we can also communicate the importance through various community health screenings.

I am sure a big push will increase the LPA numbers and we must monitor the adoption very carefully. However, if the situation does not improve within a few years, I hope we can consider even more decisive steps. One is to make LPA mandatory. The other way is to revise our Mental Capacity Act to include a "default LPA". By "default LPA", it means having the law to automatically determine the right person to take charge, in the absence of an LPA made voluntarily.

Talking to my team of lawyers and community leaders, the tricky part of the default LPA option is how the law should determine the donees. The most obvious way the law can determine the donee is to use the succession rules from the Inter-Succession Act. But even if we go down that path, we need to consider whether the default donee should be an individual, or a group of natural heirs with collective responsibilities. And if there are collective responsibilities, how should responsibilities be divided up, and how do we reconcile the difference in views and motivations among the natural heirs in the process? So, this is quite tricky.

If we go down the path of default LPAs, it would also be good for us to clarify the powers of donees with regard to utilising the assets of the donors. This could include clear guidelines on what constitutes reasonable cost for medical and long-term care of the donors and caregiving of the donor's direct dependants.

I understand that Minister Desmond Lee has set up the Committee to Review and Enhance Reforms in the Family Justice System (RERF) recently to review family law issues. Perhaps, the Committee can take the lead to explore the default LPA issue very carefully in consultation with the lawyers, the legal community and the people sector, so that we can have at least one additional option to minimise the number of vulnerable adults. But, of course, the first logical no-regrets move we should do is to push for the mass adoption of voluntary LPAs.

To conclude, I warmly welcome and support the amendments. With stronger laws in place, I hope we can improve how we care for our vulnerable seniors. Moving forward, I also hope we can focus on the urgent task of minimising the number of vulnerable seniors, and one good way is to get all Singaporeans to write up their LPAs.

Mr Deputy Speaker: Ms Thanaletchimi.

4.51 pm

Ms K Thanaletchimi (Nominated Member): Mr Deputy Speaker, Sir, I am heartened that the Bill will further strengthen the Government's ability to intervene to protect the vulnerable adults who may have fallen through the cracks of family, friends and community support and subjected to abuse and neglect. Such individuals may include the elderly, as well as persons with disability and special needs. It is about time that the Vulnerable Adults Bill is set to complement existing laws that address violence, maltreatment and abuse against vulnerable adults. Therefore, I rise in support of the Bill.

Sir, however, I have the following clarifications in two broad areas of the Bill, that is, one, empowering state intervention and, two, relocating of vulnerable adults. On empowering state intervention, I have the following four questions.

An "adult" is defined as 21 years of age in the majority of Singapore's laws. How has the age of 18 been decided in this Bill? As the Children and Young Persons Act covers children below age 14, and this Bill covers persons from 18 and above, how would the vulnerable persons between ages 14 and 17 that are not covered under this Bill be supported?

Two, how do we first establish early identification of this group of vulnerable adults?

Three, how can MSF take on a more active than reactive role when it comes to identifying vulnerable adults? I am sure most of us remember the case of 26-year-old Annie Ee Yu Lian, who had intellectual disabilities and suffered torture at the hands of a trusted couple. Eight months of agony and suffering, and yet no one knew – no one even suspected that something was wrong. What more can we do? How else can we educate Singaporeans to look over one another and be bold enough to report? Is there any other hotline to report suspicion as many may hesitate to report to the Police as it is not yet known to be a fact that such abuse is taking place in the first place? Moreover, some may want to report but do not want their identity to be known for fear of souring their relationship with neighbours, relatives or friends. Can MSF do more to create awareness amongst the public, riding on SG Cares, which is a national movement to support the efforts in building a more caring and inclusive society?

Four, even if a deputy or donee has been appointed, their consent is not required for the power to assess, power to remove and for the medical care to take place as stated in sections 6(2), 10(2) and 18(3) of the Bill. Under the Mental Capacity Act, however, their consent is required for medical care. Will this cause a conflict?

On relocating vulnerable adults, I have the following question. MSF is given the mandate to arrange for temporary care location. Who would be responsible for the cost of care and any other costs, such as those requiring medical attention deemed necessary by professionals?

Notwithstanding the above clarifications, I am optimistic that with the support and cooperation of Singaporeans at large, complemented by robust law and SG Cares initiatives, we can minimise or perhaps eliminate such inhumane abuse and exploitation inflicted upon vulnerable individuals who trust the very people that cause them pain.

Mr Deputy Speaker: Ms Joan Pereira.

4.55 pm

Ms Joan Pereira (Tanjong Pagar): Mr Deputy Speaker, Sir, I rise in support of this Bill. Having encountered vulnerable adults and their families in my Henderson Dawson Division, I feel this Bill is very timely. There are more people who live longer lives but not always able to care for themselves for one reason or another and becomes vulnerable adults.

I am pleased to note that the Bill aims to provide a safe environment for whistleblowers to report abuse and suspected abuse to the authorities. One common reason the neighbours and even relatives and co-workers do not lodge reports is because they are afraid that they will be identified. So, confidentiality is important. But this will pose a challenge under certain circumstances if the authorities decide to take the abuser to Court where evidence from witnesses are required. One solution would be for the Court to allow voice evidence recorded by Police as admissible in Court, without disclosing the names/addresses. Or it could be a video recording, but the face of the witness be blurred out to protect the identity of the witness. What is most crucial is that the evidence deduced from the whistleblower, and evidence thrown up in the Police investigations, such as the injuries sustained by the victim, are the critical factors in the case in convicting the accused person(s).

Second, abuse and neglect often occur when the caregivers are at wit's end. We all would know how difficult it is to handle individuals when they suffer from mental distress. The person may refuse to eat, bathe, take medication, may throw tantrums, create a ruckus and disturb his or her neighbours.

Let me share an example from my Henderson Dawson Division. On some days, as early as 5.00 am, my resident – let us call him Mr S – gets up and yells vulgarities very loudly. Mr S lives with his spouse, and the family puts in effort to get him treatment and to take his medication. The spouse does her best to make sure Mr S takes his medicine regularly and the VWOs assist when she cannot. However, it is not working out and she has sort of given up. Meantime, the neighbours suffer along with the family. Thankfully, the neighbours are understanding and compassionate. Still, there is a need to find a solution.

However, a lot would depend on what resources there are available to the family. Hospitals would not keep an individual in the ward unless there is a medical need to do so. Caregiving homes and hospice care may be out of reach for some and some fall through the cracks as they do not meet the per capita income for Government help but are unable to afford on their income level.

Here is where the family members need help. It is a real dilemma for them. The family members must work, yet the distressed person needs their care and attention. I would like to propose that MSF set up a platform where a family/caregiver who needs help can turn to for assistance or guidance. The ComCare hotline is very visible to residents. I propose that this hotline extends its scope to help families to point them to the right organisation. It would help to lighten their load to know who and where they can get help to meet their needs. An intervention by a Government agency can save the distressed individual from being relegated from being a loved one to becoming a burden to the family. Once they are seen as a burden, then that is where the person becomes vulnerable to abuses of all kinds.

There are many cases where because of the pull between filial piety and financial affordability, the relationship between husband and wife becomes strained, or relations between brothers and sisters become strained. Accusations and finger-pointing create quarrels and you see a family divided. And worse, the vulnerable adult is abused because the family is unable to find a solution to care for him/her. I hope that in cases where MSF has to intervene, it will weigh the family's circumstances so that the action taken will not result in the breaking up of family ties. I know it is heart-wrenching for the family. No one wants to "abandon" their loved ones.

Lastly, although this Bill is targeted at vulnerable adults, similar problems can be observed in children with health problems requiring extensive care, as well as their parents, caregivers and neighbours. Similar intervention and help should also be extended to such families. Sir, I support the Bill.

Mr Deputy Speaker: Dr Lily Neo.

5.00 pm

Dr Lily Neo (Jalan Besar): Mr Deputy Speaker, Sir, I stand in support of the Vulnerable Adults Bill. I have always been concerned about the vulnerable adults and have, since 1999, raised the issue on better protection of our vulnerable adults and, especially the abused seniors. I have spoken about the predicament of vulnerable adults being abused and have beseeched our Government to better assist them at least nine times in this House. I am glad, indeed, that MSF will soon put into law to better safeguard the vulnerable adults.

Over the years, during my speeches on this topic, I have raised the issues of neglect of the vulnerable, physical abuse resulting in injuries, emotional trauma, psychological anguish, deceit of funds and financial abuse. I am glad most of these are now covered in this Bill. However, this Bill does not cover financial abuse, as mentioned by other Parliamentarians earlier. We need to address financial abuse in these vulnerable adults. Let me elaborate.

As mentioned by my Parliamentary colleague Mr Seah Kian Peng earlier, a 2014 study by Trans Safe Centre, a charity that specialises in tackling elder abuse, showed that about one in three involved a senior who had been financially abused. With each passing year, the growing numbers of seniors will reach 900,000 by 2030. Many of them would have some savings from their long working years and they may be subjected to financial abuse. This will be an increasing problem with time. I have heard residents and patients relating to me that they had to give in reluctantly to their difficult children who might be drug abusers, ex-convicts or gamblers when they demanded money from them. The seniors said they were afraid of their children; scared of their tantrums, tempers and abusive words if they did not give in. There were also stories of unpaid borrowings by children, deceit in transferring of HDB ownership and so on. Thus, this Bill is not complete with the omission of the financial abuse issue.

During one of my house visits, I saw one debilitated senior on her bed through her house gate. She was too weak to even sit up or talk to us. The home was in an unhygienic state. Her gate was locked by her only son when he left to work early in the morning and would only come back late at night. I considered it as a case of neglect, either due to circumstances or willfully. But the senior would not complain as she was too afraid to lose whatever she had left and had resigned to her fate. Thankfully, we managed to find her son and persuaded him to allow us to assist with his mother's daily needs and medical needs henceforth. I hope this Bill will enable individuals like this to be identified early and help rendered before it is too late.

The role of the community is important to better protect the vulnerable adults. Extended families and neighbours are usually the first to know of the vulnerable adults at risk. Publicity and raising awareness on this topic and information on the kind of assistance available are thus very important.

I welcome Part 4 of clause 23, which provides protection to whistleblowers for providing the information on abused or neglected cases. This clause protects whistleblowers from liabilities. This fact must be well publicised to encourage more people in the community to report. In publicity materials, tips on what to look out for will be useful to further raise the awareness. Such relevant information includes poor hygiene, malnutrition, dehydration, physical injuries like bruises and fractures, unexpected injuries, mental trauma, depression as well as social isolation.

The people in the community, the family and friends as well as the neighbours, and the frontline personnel, such as medical doctors, nurses and social workers, play an important role to ensure the success of this Bill when it is enacted. In our society, there is a strong disapproval of abuses, especially so on the vulnerable. I hope MSF will spare no effort in facilitating the community to play their part in our responsible and caring society. There is a need for easy one-stop reporting and good follow-up provided by MSF. The convenience of a designated 24-hour hotline to call for reporting on information will be useful. I hope that with this Act and the good execution efforts by MSF, we can prevent another case of Ms Annie Ee who died from the injury of frequent abuses over a long period.

May I ask the Minister whether this Bill goes far enough in creating a criminal offence for the abuse or neglect of a vulnerable adult? Does this Bill send a strong signal to the perpetrators on their wrongdoings? Now that there is this Act, we need to have a deterrence to ensure that family members do not push their dependants away to MSF by causing neglect. Otherwise, perpetrators can walk away from their responsibilities, if they know that they can get away easily.

Under Part 3, clause 19(1) and (2) of this Bill, the Minister is empowered, by notification in the Gazette, to designate any premises in Singapore as a place of temporary care and protection for the care of vulnerable adults from abuse, neglect or self-neglect. I welcome this. In many cases of abuse, the best way to end their plight is to remove the vulnerable from their homes and place them at designated facilities that can provide better support and care. May I ask MSF what are these places and whether we have such avenues and such facilities available before enacting this Bill. We have to make sure that the vulnerable are not worse off with our intervention. I also hope that MSF will ensure that the vulnerable adults at risk receive as much information on their alternate care and assistance available to them. The fear of the unknown, away from their familiar environment and the fear of losing whatever little care and support they are getting may prevent the vulnerable adults at risk from giving their consent for interventions involving removal and out-of-home placements. This is especially so for the seniors at risk.

Under Part 2, clauses 5 and 6, this Bill empowers the Director or a protector to assess an individual or a vulnerable adult to be assessed by a qualified assessor. May I ask the Minister if the assessors can do both the physical health assessment, such as detecting malnutrition and body injuries, as well as mental assessments, to detect mental anguish, trauma and depression? Every assessment can only be complete with both physical and mental well-being taken together. Will these assessors be at hand on the enactment of this Bill?

I hope that MSF will implement this Act thoroughly to ensure its success. Areas of priority are good publicity, getting the buy-in from the community and enough personnel that will carry out their duties diligently. The success of all these will save our vulnerable adults from unnecessary pain and suffering and this is only rightly so in our inclusive caring society.

Mr Deputy Speaker: Dr Intan Mokhtar.

5.10 pm

Dr Intan Azura Mokhtar (Ang Mo Kio): Mr Deputy Speaker, Sir, thank you for the opportunity to speak on this Bill. As we intensify our efforts in being more inclusive and providing for the less fortunate and the vulnerable, this Bill is timely which seeks to provide for the safeguard of vulnerable adults from abuse, neglect or self-neglect. In the course of our daily interactions with others in our community, we would have come across adults who are deemed vulnerable, either because they have some form of special need, or because of age, they suffer from illnesses or conditions that diminish their ability to remember or communicate effectively, such as dementia, aphasia – which is an impairment of the ability to speak because of stroke –or multiple sclerosis, among others.

A few months back, a female resident, Ms N, came to see me at my Meet-the-People session, panicky and in tears. Ms N shared that her elderly father, whom she said had dementia, was missing and that she received a call from a Home for destitute persons informing her that her father was there. Apparently, he was found begging on the streets and could not recall where he lived. When Ms N went down to the Home to try and bring her elderly father home, she was told that she could not do so as the Home would need to get the go-ahead from MSF before they could release her father. She managed to talk to her father whom she said appeared scared and had suicidal thoughts. I managed to get in touch with MSF through Minister Desmond Lee and, with the Minister's kind help, managed to get Ms N's father released from the Home within the next few days. I must extend my sincerest gratitude, on behalf of my resident, for the Minister's timely intervention and assistance in this case.

While that incident turned out well for Ms N and her father, the reality remains that there will be adults among us who may not recall who they are or where they live, or who may do things that can compromise their safety or the safety or others. These are the vulnerable adults who live amongst us. There needs to be a better framework and set of laws to manage how we are able to provide for them and ensure their well-being and safety, as well as that of others around them.

While I generally support the intents of this Bill, there are some clauses within the Bill which I seek clarifications on.

First, for clause 3(2), it is mentioned that the Director may appoint any public officer with suitable qualifications and experience as protector under the proposed Bill. What qualities are needed before a public officer can be appointed as a protector? What are the functions and powers of the protector? How is the protector different from the Director? Is the protector a deputy to the Director? Or is the protector supposed to play the role of a counter-check to the Director or enforcement officers to ensure, for example, that the safety of the vulnerable adult is ensured, or that excessive force is not meted on any vulnerable adult that is being removed from a place that exposes that adult to abuse, neglect or self-neglect?

Second, for clause 6(1)(d) and clause 10(2), it is stated that the Director or protector may remove a vulnerable adult from the place where that vulnerable adult is residing or staying for the purpose of an assessment, with or without the consent of that vulnerable adult, their donee or deputy. To what extent can the Director or protector ensure this vulnerable adult is to be removed? What if the vulnerable adult becomes hysterical or has an emotional breakdown or a meltdown and starts to protest? How will the Ministry manage this delicate balance between state intervention and individual rights and choices?

Third, for clause 10(5), the Director or protector may use such force considered necessary to remove the vulnerable adult. Will physical force or coercion be used against this vulnerable adult? Who will provide that counter-check against the use of excessive physical force or coercion against a vulnerable adult? Will there be a standard engagement procedure employed when dealing with such adults, where engagement, communication and cajoling are applied first and foremost? What if the vulnerable adult in question turns violent? What will be done then?

Fourth, for clause 11(1)(a), in having removed a vulnerable adult, the Director or protector must commit the vulnerable adult to a place of temporary care and protection or to the care of a fit person. Similarly, for clause 19(1), the Minister may designate any premises in Singapore as a place of temporary care and protection, or as a place of safety for the care and protection of vulnerable adults. What would be these places of temporary care and protection? Are they in hospitals? Or are they in specific VWOs? Will family members be allowed visitations? How long will the vulnerable adults be committed to such places of temporary care and protection? And in terms of "fit persons", how are the competencies and qualities of these "fit persons" defined? Will there be considerations of prior interaction or relationship to the vulnerable adult in question, so as to ensure some level of familiarity or comfort? Will there be considerations of prior relevant experience or similar language ability to the vulnerable adult, so as to ensure minimal miscommunication?

Fifth, for clauses 20(1) and 20(2), a "proper care plan" has to be in place for a vulnerable adult. What are some criteria of the "proper care plan" for vulnerable adults? Will this "proper care plan" be made in consultation with family members should the vulnerable adult be committed to a place of temporary care and protection? Would the Review Board or Director or protector be the one to review or audit this "proper care plan" on a regular basis to ensure adherence?

While there are many causes and levers for intervention in the case of vulnerable adults among us, there are equally as many sensitivities in calibrating the balance between state intervention and individual rights and choices. Mr Speaker, Sir, notwithstanding my request for clarifications from the Ministry, I support this Bill.

Mr Deputy Speaker: Ms Rahayu Mahzam.

5.16 pm

Ms Rahayu Mahzam (Jurong): Mr Deputy Speaker, Sir, I would like to take this opportunity to laud the efforts that have been done to present this Bill to Parliament. As my other colleagues have said, this has been a long-awaited Bill, with many hoping to see more teeth in legislation to help safeguard vulnerable adults from abuse, neglect or self-neglect. I understand that for far too long, social workers have been left frustrated with the inability to take action in situations where they feel that more could be done. I note the great balancing act that needs to be put in place to ensure that while we do what we think is necessary for the group that cannot help themselves, we do not inadvertently trample on individual rights and liberties.

Therefore, although personally, I share the sentiments of some of my colleagues who feel that the Bill could extend to protect against issues like financial abuse, I appreciate the caution with which we proceed on this Bill. I hope that the Ministry would review the matter further and consider other recourse available to the elderly in this respect.

For the purposes of this speech though, I would like to focus on the implementation of the Bill. In my humble opinion, for this Bill to be effectively administered and for the true spirit of the Bill to be embraced, we need to ensure that there are appropriate support, resources and manpower in place to respond to the circumstances that would arise in the course of enforcement of this Bill. I, therefore, have some clarifications to make.

Firstly, I would like to understand who would form the team of qualified assessors on the ground. What would be the requirements of these assessors and would there be specified training given to them?

Secondly, I note that there would be instances where the vulnerable adult would have to be taken away from the care he or she has. Do we have sufficient manpower, support and spaces like the care facilities that the Minister referred to, to ensure that the care of these vulnerable adults, temporary or otherwise, is seamless and comprehensive? Further, what are the measures or support framework in place to ensure reconciliation with families where appropriate? I know that the Minister had earlier shared that Court orders could be made to direct family members to attend counselling. Are there other mechanisms to assist with reconciliation and appropriate follow-ups with the family members?

Thirdly, I believe that the cases that would fall under this category would be complicated and potentially emotionally and logistically challenging. The social welfare officers need to be trained in various aspects. They should be equipped with skills in dealing with, for example, violent relatives, they need to understand the Court processes and also have greater depth in dealing with and recognising psychological on top of physical harm. Are all our officers fully trained and equipped to handle various circumstances? I would be grateful if the Minister could shed some light on the matters I raised. Notwithstanding my request for clarifications, I support this Bill.

Debate resumed.

Mr Deputy Speaker: Minister Desmond Lee.

5.20 pm

Mr Desmond Lee: Mr Deputy Speaker, I thank Members who have spoken passionately on this Bill. Let me now take some time to respond to the Members' queries.

Some Members suggested identifying vulnerable adults early, to ensure their well-being, to be as proactive as possible. Ms Thanaletchimi and Ms Denise Phua asked what the Ministry of Social and Family Development (MSF) can do to educate our stakeholders and Singaporeans generally, to report suspected abuse cases that they come across.

Sir, this Bill will be effective only if all of us play an active part. Let me elaborate.

First, everyone should actively report suspected cases of abuse, neglect and self-neglect. MSF launched a three-year "Break the Silence" campaign in late 2016 to encourage open conversations about family violence, including abuse of vulnerable adults, to urge bystanders to action. We went onto social media, we went onto radio, television (TV), cinema screens, outdoor media and roadshows to campaign for greater public awareness that family abuse is not a private matter and cannot be tolerated. And, Sir, this has gone some way to shape public attitudes towards family violence.

Last year, one in three callers to our hotline who reported family violence matters were do-gooders, such as neighbours, friends and passers-by. This is an increase from one in five, prior to the campaign.

MSF has also been training community partners and grassroots volunteers. They are on the ground and can help us detect formerly "invisible" cases. We will continue to step up on our efforts in this area, as the work of public education and capacity building can never end. The whistleblower clauses in this Bill will support both of these efforts.

Second, we want frontline staff in relevant agencies to be well-trained and equipped to identify cases of abuse, neglect and self-neglect. These include our Family Violence Specialist Centres (FVSCs) and Family Service Centres (FSCs) as well as medical and healthcare professionals. To Mr Louis Ng's question on their training, MSF has established protocols and training platforms that equip them to handle and detect family violence. These include training modules at the Social Service Institute on identifying and managing vulnerable adults.

MSF is also building on our existing Integrated Family Violence Manual, which agencies rely on to guide their intervention into family violence. This manual will soon also cover the safety of vulnerable adults – so, work in progress. To more effectively identify and help vulnerable adults, MSF is currently working with our community partners to co-develop relevant Standard Operating Procedures (SOPs) and assessment guides.

Third, the Government must provide avenues for easy reporting and react quickly to reports that come in. Ms K Thanaletchimi, Mr Louis Ng and Ms Joan Pereira asked about a public hotline where people can report abuse and neglect of vulnerable adults. Mr Louis Ng also asked if every case of vulnerable adult abuse will be reported to the Police for action.

So, who should the public call if they come across suspected cases? They can alert the nearest FSC, they can call any of the three FVSCs set up by MSF, the numbers for both are available on our website, or they can call MSF's ComCare Hotline at 1800-222-0000.

Where there are immediate safety concerns or danger to a vulnerable adult, the public can call the Police.

But not every case of harm to vulnerable adults may necessarily warrant Police involvement, at least from the get go. Where the safety concerns are not so clear or immediate, our FSCs and FVSCs will first look into the matter and alert us at MSF if state intervention is necessary and then we will move in together.

Mr Seah Kian Peng suggested implementing a mandatory reporting system for stakeholders who interact with suspected vulnerable adults. We did consider this. But we decided against it for now for two reasons.

First, professionals have expressed to us concerns that mandatory reporting laws, such as this, especially in a family violent situation, may prevent abusers from seeking help for themselves or their victims, as they fear being taken to task.

Second, we understand that mandatory reporting laws in overseas jurisdictions have led to over-reporting, many of which were also unsubstantiated. So, we prefer, for now, to assure people who step forward, through whistleblower protection. So, let us see how it goes.

We will also be developing protocols and guidelines, similar to those used in the child protection sector, to educate professionals and the public on when, how and who to report such cases to. So, for those Members who are familiar with the Child Protection Scheme, there is a Child Abuse Reporting Guide which we share with our network, preschools, schools, clinics, the Police, medical professionals, hospitals, and using methodical approach, guide them on what to look out for, what to ask and what information to get and who to report to. So, we are looking at the same protocol for adult abuse.

Ms Denise Phua recommended forming a National Vulnerable Adults Support Services Association. It sounds very much like our Community Network for Seniors where we rely on community and partners and people on the ground to form networks to look after seniors and, in this case, to look after vulnerable adults. We thank her for her suggestion and we will certainly explore this in greater detail.

Mr Deputy Speaker, I now turn to questions relating to the scope of the Bill.

Mr Louis Ng and Assoc Prof Daniel Goh asked why the Bill only protects vulnerable adults aged 18 and older. How about legal protection for those above 16 but below 18, since the Children and Young Persons Act (CYPA) only covers individuals below 16?

First, vulnerable individuals, aged 16 to 18, have some protection under existing legislation, such as the Women's Charter. The Women's Charter protects individuals, regardless of their gender and age, from family violence. A personal protection order (PPO) may be applied for under that Act on behalf of the vulnerable person.

Secondly, and could be more importantly, as I have mentioned in my earlier speech, we are reviewing the CYPA in order to extend the statutory protection to those above 16 but under 18 under the Child Protection Framework as opposed to the Vulnerable Adults Framework.

A number of Members, including Dr Lily Neo, asked why the Bill does not cover financial abuse. Indeed, many of the Members have come across cases where parents have provided for the children, sold their homes and helped their children buy their new homes only to find themselves ejected out of those homes, or to be financially abused in any other case. I agree with Assoc Prof Daniel Goh that cases of financial abuse often involve elements of psychological and emotional abuse. So, where financial abuse occurs alongside other forms of abuse and neglect that are already covered under the Bill, the state can intervene.

There are also some other levers in place to deal with financial abuse against vulnerable adults. In cases where vulnerable adults have been exploited by caregivers, we often do see other family members, such as children, stepping forward to put a firm stop to this. If need be, our social work agencies can nudge next-of-kin to act. So, the family can take action to resolve financial abuse within their own families.

But in cases where the vulnerable adult lacks mental capacity and the alleged abuser is a donee appointed under an LPA or a deputy appointed by the Court, the Public Guardian may seek a Court order to suspend or revoke his powers to make decisions on the vulnerable adult's behalf, to prevent further abuse. Criminal charges or criminal investigation are not the only ways by which the Public Guardian can apply to Court to take action, again in cognisance of other facts, such as the donee or deputy not acting in the best interest of the elderly person, including financially abusing the elderly person. In fact, family members can also make such an application to Court.

If the vulnerable adult lacks mental capacity and has no family members, a deputy may be appointed by the Court to manage his property and affairs as well as his personal welfare matters. Under our upcoming Professional Deputies and Donees Scheme which will commence in the second half of this year, a professional deputy can be appointed by the Courts to step in. The professional deputy will be subject to the same requirements as any other deputy.

If the caregiver who financially abuses the vulnerable adult is neither a donee nor deputy, MSF and our partners will carry out social work interventions and assessments to look at what the situation is about. We may ask the Public Guardian to step in to ask for the Court to appoint a deputy to look into the vulnerable adult's financial situation. Again, this is also open to next-of-kin to do so, to solve this problem within the family. If there is suspicion that offences have been committed, and the Police will also investigate.

So, for now, the Vulnerable Adults Bill's focus is on physical and emotional abuse. Let us gain more experience in operationalising this vulnerable adult protection framework, while we continue to study the complex issue of financial exploitation among family members. We have ideas. Members have raised ideas to us in the course of this debate and the recent Motion on protecting our seniors and, of course, in many other debates and other platforms. As I said, we have some ideas. Let us continue to look at them and, at an appropriate time, we will bring it to this House.

Mr Louis Ng asked why the Bill does not define sexual abuse as an independent head of abuse, and how it considers verbal sexual harassment.

Sexual offences are covered under the Penal Code, for example. If there is conduct or behaviour that coerces or attempts to coerce an individual to engage in sexual activity, this is "physical abuse" under the Bill, and action can be taken. For verbal sexual harassment, this can fall under "emotional or psychological abuse".

Ms Chia Yong Yong asked why the definitions of "emotional or psychological abuse", "neglect" and "self-neglect" are definitive, as compared to the definition of "physical abuse" which is non-exhaustive.

This is by design. Physical abuse already has a limiting factor, in that the abuse must be physical in nature. There is unlikely to be largely differing views on what would constitute physical abuse. This is less clear for emotional and psychological abuse, neglect or even self-neglect. There may be differing opinions among professionals as well as members of the public on what these would constitute. These definitions are, therefore, crafted definitively, to provide as much clarity and certainty as possible on who the powers in the Bill apply to, and limit our discretion on how these terms are interpreted.

Ms Chia Yong Yong also asked why psychological assessment was not included in the definition of "assessment" under the Bill. The current definition of "assessment" allows interviews and examinations to be conducted to determine a person's mental state. This allows psychologists or psychiatrists to interview and examine a vulnerable adult to ascertain if there are any psychological concerns.

But, Deputy Speaker, let me take a step back from all the points that have been raised, whether on financial abuse or on the definitions of abuse, neglect or self-neglect, and assure Members that these scope the statutory powers that we can exercise under the Bill. The FSC, FVSC and our Adult Protective Service (APS) and our Rehabilitation and Protection Group (RPG) units in MSF are not prevented from social work interventions, reaching to the family, reaching out to the community, reaching out to neighbours, reaching out to the vulnerable adult because of the scope of definitions in this Bill. If there is a concern, our community and social work agencies and MSF will respond with social work as our primary tool, but as far as the exercise of these intrusive statutory powers are concerned, then we are limited by the definitions under the Bill. So, I hope Members understand that these definitions and the scope of the Bill do not prevent us from acting as we have always done, both now and in the past.

Ms Denise Phua asked about how the Bill will complement existing services, including that by APS. Dr Intan Mokhtar asked about the qualities required of protectors and their roles under the Bill. Sir, APS will assist the Director of Social Welfare in exercising powers under the Bill. Protectors will be our senior officers in MSF's APS who have suitable qualifications and experience to handle vulnerable adult abuse, neglect and self-neglect cases.

Mr Louis Ng asked about the similarities and differences between APS and Child Protective Service (CPS). The principles guiding APS and CPS' work are similar in that the best interest and welfare of the vulnerable adult and child respectively must be paramount. Beyond the distinct age groups each Service looks after, APS' work requires them to look into the vulnerable adult's mental capacity so that the client's right to self-determination is upheld as far as possible.

This leads me to Ms Denise Phua and Ms Sylvia Lim's question on how MSF decides when to intervene, and the rigour of our assessment, particularly when we remove a vulnerable adult. I agree with both of them that mental incapacity is a continuum, and that mental capacity is not a black-and-white concept. Indeed, there are good days and there are bad days.

Mr Speaker, under the Bill, MSF may intervene so long as the adult is suffering or at risk of abuse, neglect or self-neglect, and has physical or mental infirmity that renders him incapable of protecting himself. This will be confirmed by a qualified assessor who can conduct physical and mental capacity assessments or it might be different assessors would have come in together and do the assessments.

Assessing the mental capacity of a vulnerable adult is important because, as far as possible, an adult with the capacity to make decisions should do so. To ensure that we protect his right to participate in the decision-making process, MSF has been working with our partners to develop a mental capacity assessment form. This form sets out certain requirements and checklists that will determine if a vulnerable adult lacks mental capacity. For example, if the vulnerable adult is unable to understand information that is relevant to the decision at hand, to retain that information or to communicate his decision to others, then he will be considered as lacking mental capacity.

On Ms Denise Phua's example, where the vulnerable adult has mental capacity but shows signs of self-neglect, MSF can intervene to protect him from further neglect.

On Ms Sylvia Lim's examples, MSF will not remove a vulnerable adult without assessing the situation holistically. Where a caregiver is willing and able to look after the vulnerable adult but lacks the skills to provide adequate support, we will help him enhance his caregiver skills, instead of removing the vulnerable adult. We will invoke removal only when the vulnerable adult's safety and well-being have been compromised or are at risk. Neither will we remove a vulnerable adult because his family members do not have financial means to provide care. In such cases, we will work with our social service agencies and other agencies to provide assistance to the family.

Ms Sylvia Lim had given examples of cases where a person fulfills the example in the illustration but in her view and certainly in mine, I should not invoke a removal of the adult, for example, if the vulnerable adult is unclothed after a bath but the caregiver needs to go and prepare some medication, for instance. This would not be the way in which APS and our agencies act. It would involve concerns being raised; it would involve interviews, talking to the caregiver, talking to the family members, talking to the neighbours, speaking to the community, speaking to the vulnerable adult. It is not a case of looking at a snapshot of facts that within these 10 seconds, what you did and, therefore, I come and use these powers. It cannot be so. That would not really be within the ambit of how we do social work.

And as I mentioned in my opening speech, we will be judicious in how we exercise the powers under this Bill. When we identify a vulnerable adult, the default, where possible, should be to rely on social suasion with the support of his family and the community, because that approach is often more effective and sustainable, internalised by the vulnerable adult and the family. Only when this is ineffective, will we rely on the Bill.

Sir, Members asked about MSF's powers to intervene despite the vulnerable adult's refusal to accept this assistance. On the state's power to remove, Ms Chia Yong Yong said that MSF should be able to remove a vulnerable adult for assessment of placement if there are reasonable grounds to believe that an adult is withholding consent due to some form of coercion. Other Members felt that we should be more judicious in the exercise of powers.

Again, as Ms Chia Yong Yong has rightly pointed out, it is a matter of perspective, whether you are focusing on the needs of the vulnerable adult or whether you are concerned about whether there is statutory overreach. In fact, both are valid concerns and we want to strike the right balance, avoiding overreach while ensuring that the first and paramount interest is that of the vulnerable adult, as enshrined in clause 4 of the Bill.

I agree that a vulnerable adult’s right to self-determination should be respected. And that is why we hardwired this as one of the key principles in the Bill, and also why there are safeguards in the Bill against unnecessary intervention.

But there may be exceptional situations where intervention may be necessary even when the vulnerable adult has mental capacity and refuses assistance. As Ms Chia Yong Yong highlighted, there may be instances where the adult is under duress or pressured by their loved ones to refuse external assistance. I also mentioned the case of Mr Wong earlier, the elderly man who refused admission to a hospital or nursing home to treat his diabetes and wounds. There is a real risk that Mr Wong's life will be in danger in the future, if the state cannot intervene. That would not be right.

So, where the need arises, MSF has built in a safeguard. We can only intervene in such a situation after a Court order has been obtained. Where there are reasonable grounds to believe that a suspected vulnerable adult is withholding consent because of coercion or undue influence, for example, we will bring this to the Court's attention. The Court can then make an order for MSF to intervene to protect the vulnerable adult. If there are concerns whether it is expeditiously enough, especially where the case is particularly urgent, then there are provisions in the Bill that allow ex-parte application.

Dr Intan Mokhtar asked if engagement and communication should be applied first before we invoke the law to remove a vulnerable adult, while Assoc Prof Daniel Goh asked if MSF can exercise some of its powers under the Bill while family and community interventions are ongoing. Allow me to reiterate that family engagement and social work intervention by community partners, supported by MSF, will be the principal response to cases involving vulnerable adults. But statutory intervention and family or community interventions are not mutually exclusive and there may be times when a combination is necessary.

To Dr Intan Mokhtar's questions on how a vulnerable adult will be removed from his place of residence, if this is necessary, MSF is currently developing its SOPs to guide the actions of officers when dealing with vulnerable adults, including removal from their homes, where understanding and training are absolutely key.

To ensure that the experience does not traumatise the vulnerable adult, MSF will engage the help of support persons, which may include social workers, psychologists and community partners who have interacted with the adult, to assist with this removal. Friends and close family members may also be present as a form of assurance and support for him.

Some Members raised questions about care facilities and arrangements for vulnerable adults. First, Dr Intan Mokhtar and Dr Lily Neo asked which premises will be gazetted as places of temporary care and protection and how long a vulnerable adult would reside in these premises. Some existing residential care facilities, such as some of the adult disability homes and sheltered homes, will be gazetted as places of temporary care and protection and places of safety. A few medical facilities may also be gazetted to cater to situations where the vulnerable adults have clear medical needs. These facilities are intended to protect vulnerable adults who cannot remain safely in their place of residence, while allowing them to receive appropriate care.

The choice of gazetted care facilities and period of committal will depend on a vulnerable adult's care needs. However, places of temporary care and protection are only meant to house vulnerable adults for an interim period, so that investigations can be carried out and longer-term care plans made. Therefore, the length of stay in these premises will generally not be longer than six months. Again, this depends on specific circumstances of the vulnerable adult and the family or lack thereof.

Second, Ms Denise Phua asked whether these facilities and staff are equipped to care for vulnerable adults. These facilities have experience providing for residents who are vulnerable and have in place suitable standards of care to provide for their care and protection. As I have said earlier, MSF is also working with frontline officers of relevant agencies to ensure that they have the capabilities to provide support to vulnerable adults under their care.

Third, Dr Intan Mokhtar also asked how the competencies and qualities of a "fit person" are defined, and about the care plan that will be put in place if a vulnerable adult is committed to a facility. "Fit persons" are individuals or organisations whom the Director of Social Welfare thinks are competent to provide care and protection to the vulnerable adult. The main consideration as to whether one qualifies to be a fit person is whether he has the ability to provide the necessary care and protection to ensure the vulnerable adult’s safety and allow him to recuperate. Hence, a fit person could actually be a family member or a friend who is willing and able to care for the vulnerable adult. As for care plans, MSF will put them in place to ensure that the vulnerable adult receives the care and protection he requires while in the facility. The care plan sets out a care and recovery framework based on a comprehensive assessment of the vulnerable adult’s social, mental and physical state. MSF, together with a Review Board comprising professionals, will review these plans regularly.

Fourth, Dr Intan Mokhtar asked whether family members are allowed to visit vulnerable adults in gazetted facilities. Indeed, they are allowed and encouraged to do so. But there are exceptions. For instance, a Court may issue an order preventing the alleged perpetrator of abuse or neglect from visiting or contacting the vulnerable adult. MSF may also limit the contact between the vulnerable adult residing in gazetted facilities and individuals if such contact does not serve the best interest of the adult. Again, all these need professional assessments. Ms Sylvia Lim also provided several suggestions to help vulnerable adults adjust to their new environment. I note her suggestions and we will explore these ideas with the management of the facilities to ensure that these vulnerable adults feel safe and comfortable even while they are there.

Fifth, Ms Thanaletchimi and Mr Seah Kian Peng asked who will bear the costs of the care of a vulnerable adult. Families are primarily responsible to provide for their vulnerable members. Hence, if families have the means, the costs of placement and any other services or treatment of the vulnerable adult requires should be borne by them. But we recognise that not all families can provide for their vulnerable family members. In such instances, the state will pay for the temporary placement of these individuals in gazetted care facilities and related costs that may be incurred to ensure the vulnerable adult’s well-being. Let me assure this House that a vulnerable adult's or his family's inability to pay for such services will not be a barrier to him receiving the necessary intervention, treatment and care.

Sixth, Mr Louis Ng and Assoc Prof Daniel Goh asked about reintegration of vulnerable adults with their families. It is not ideal for a vulnerable adult to stay in a care facility for the long term. We will engage both the vulnerable adults and their families to establish safety and care plans at home. The vulnerable adult will only return home after we deem it is safe for him to do so. We will then work with a community agency to monitor the case and provide necessary support, until it is assessed that no further risks exist. I agree with Assoc Prof Daniel Goh that the Government must exercise restraint before interfering with family prerogatives with regard to a vulnerable adult’s personal care arrangements. Where possible, MSF will help facilitate the family in caring for their vulnerable members. This may include the provision of social support.

Several Members, including Ms Denise Phua, asked about the Bill’s interface with other legislation. The Bill complements the existing legal framework that protects vulnerable individuals. As the Bill covers a wider scope of vulnerable individuals, there will inevitably be some overlap. But the Bill will, ultimately, strengthen the current framework by allowing MSF to take a more proactive approach to protecting vulnerable adults. MSF can only do our work when we have the support of the community. We will work with community partners to put in place robust protocols. If practitioners based in the community are unsure, they can approach MSF and we will advise them on the best approach to take in relation to that particular case. This already happens on the ground and will remain so, going forward.

I now move to Ms Sylvia Lim’s question on whether a complaint against a donee or deputy should be made to the Director of Social Welfare under the Bill, or to the Public Guardian under the Mental Capacity Act (MCA).

The Bill overlaps with the MCA in that both protect vulnerable adults who lack mental capacity. But both Bill and the Act complement each other and strengthen the protection afforded to these vulnerable adults. The Vulnerable Adults Bill allows the state to intervene swiftly to assess and remove a vulnerable adult to safety and apply for the necessary Court orders to ensure his protection. The MCA then allows the Office of the Public Guardian to intervene, by applying to Court if the powers of the vulnerable adult’s donee or deputy need to be suspended or revoked to prevent further abuse of the adult and, if necessary, another deputy brought in, or a professional deputy, as the case may be. Where such incidents occur, it actually does not really quite matter to whom the complaint about the donee or deputy was made. MSF, including our APS and the Office of the Public Guardian, will have to assess each complaint holistically before determining the next steps.

Ms Thanaletchimi asked if there is any conflict between the MCA and the Bill. Let me clarify that under the Bill, a doctor or dentist may administer the medical or dental treatment to a vulnerable adult, despite the existence of an appointed donee or deputy, if the doctor or dentist is of the view that such consent from the deputy or donee cannot be obtained within a reasonable time; or that such consent is unreasonably withheld by the donee or deputy. While a donee or deputy appointed under the MCA can give or withhold consent to treat a vulnerable adult, the MCA actually already allows for doctors or dentists to override the donee’s or deputy’s decision. This occurs when the person providing healthcare reasonably believes that treatment is necessary to prevent serious deterioration of the adult's condition.

A similar principle now applies in the Bill. MSF has sought to limit a deputy’s or donee’s powers to consent or refuse treatment for the vulnerable adult under the Bill, as there may be situations where the donee or deputy cannot be contacted in time, or – and this is pertinent – the donee or deputy is the abuser of the vulnerable adult and, thus, out of fear or some other reason, may refuse to give consent to treatment. In such situations, we have allowed for treatment to be administered, as withholding treatment would, in such circumstances, go against the best interests of the vulnerable adult.

Mr Louis Ng asked how the Mental Health (Care and Treatment) Act (MHCTA) will operate in relation to the Bill. Not all vulnerable adults will fall under MHCTA.

First, not all vulnerable adults suffer from mental disorders. Some of the vulnerable adults that APS sees today may only suffer from physical disability or infirmity but not mental disorder.

Second, not all vulnerable adults should be admitted to a psychiatric institution when found to be suffering from ill-treatment or neglect. Some, with mental disorders, may benefit more from living in a gazetted care facility or with a fit person, and may even be able to live alone, as these arrangements may better meet their care needs. Again, it is very specific to the individual's case. Others may actually be able to live alone and just require protection from the perpetrator. In such cases, a protection order may be applied for to ensure the vulnerable adult’s safety.

Assoc Prof Daniel Goh asked about the interface between the Vulnerable Adults Bill and the Women’s Charter. The Women’s Charter protects individuals of all ages from violence committed by family members. In cases of family violence, individuals can apply for a protection order against the perpetrator under the Women’s Charter. But we recognise that there may be situations where victims of family violence, after prolonged or intense abuse, may become physically or mentally incapacitated, or both. The Bill will be invoked as these victims may no longer be able to protect themselves. As I have mentioned earlier, the public as well as community agencies can approach MSF and we will review all reports holistically.

Ms Joan Pereira raised the issue of caregiver support. I agree with her that caregiver support is important. Caregivers can face tremendous stress caring for vulnerable family members and, indeed, family matters which involve family violence and abuse are not always black-and-white. In the case of Sam, which I described earlier, the vulnerable adult is a 29-year-old man who is both a victim but, in a way, also the cause of the tremendous stress on the part of his father.

Let me briefly sketch out the options available for caregivers, and I encourage all Members of this House to return to your communities and help share this information to those who need it. For caregivers of vulnerable seniors, they can reach out to the Agency for Integrated Care (AIC) as they provide coordinated support to families with vulnerable adults and help them to access care services and schemes. Caregivers can call AIC's Silver Line, 1800-650-6060. This is the AIC's Silver Line for information on referrals to services. Caregivers can also approach the AICareLinks at hospitals and their office at Maxwell Road. These are one-stop resource centres for caregivers to get information and advice on the appropriate services for their loved ones. There are several support services that the Government has put in place for vulnerable adults and their caregivers.

First, we have centre-based care services where seniors can receive care during the day. This includes day care, dementia day care and day rehabilitation services.

Second, respite care options are also available so that caregivers can take a break. They can opt to send their family members to eldercare centres for a few hours on weekends so that caregivers can recharge. For caregivers who need a slightly longer break of several days to a few weeks, they can tap on nursing home respite care.

Third, the Caregivers Training Grant supports caregivers, including foreign domestic workers, to enhance their caregiving skills.

Fourth, Foreign Domestic Worker Levy Concessions are also available for those who need to hire a domestic helper at home.

For caregivers of persons with disabilities, they can also reach out to SG Enable.

Support for caregivers range from day care to long-term residential care. They include the Drop-in Disability Programme – these are centres located within the community that provide social activities to higher functioning persons with disabilities who are able to travel to the centre independently for a few half-day sessions per week. Day Activity Centres (DACs), which are day programmes to equip persons with disabilities with daily and community living skills and provide care relief for caregivers. Adult Disability Hostels (ADHs) are available as alternative housing arrangements for adults with disabilities who do not require institutional care but are unable to live with their families. And VWO Transport Subsidies are also available for persons with disabilities who need to take dedicated transport provided by VWOs to access care services.

Sir, the effectiveness of Singapore’s adult protection framework is dependent on the strength of our family units in Singapore and the support of the community. Mr Henry Kwek asked how we can better stay in touch with vulnerable adults. MSF remains committed to working with families and community partners to build capabilities and competencies to support vulnerable adults and to detect abuse or neglect. Therefore, while we seek to operationalise the Bill, the Government has already been working on strengthening the social-health integration framework.

First, as part of SG Cares, MSF will strengthen the role and capabilities of our Social Service Offices (SSOs) over the next five years. We will build even tighter networks with Government agencies, FSCs, SSOs, VWOs and other community partners to improve work processes and share information relating to the needs of our seniors and persons with disability that will help close the gaps in the adult protection landscape.

Second, MSF has transferred our functions under the Senior Cluster Networks, such as the Senior Activity Centres (SACs), Cluster Support, Caring Assistance from Neighbours (CANs) and other programmes, such as befriending services, over to MOH. This will allow MOH to bring a host of preventive health and healthcare services that will twin the social support provided by the SACs to seniors in rental precincts and studio apartments. These include exercises and nutritional programmes, chronic and functional screening, as well as nursing posts set up at the SACs to help seniors better manage their health conditions.

Third, with the merger of the Silver Generation Office (SGO) with AIC, SGO has trained our Silver Generation Ambassadors (SGAs) to proactively reach out to, and identify both social as well as health risks and needs among our elderly, and encourage seniors to step out of their homes to participate in preventive health screening and active ageing programmes to draw them away from social isolation.

Fourth, MOH will expand the Community Network for Seniors island-wide. Through this effort, AIC links up different Government agencies and community partners to sew up care across both the health and social domains for seniors, especially those living alone. In particular, AIC works with various community-based organisations and grassroots organisations to recruit and train befrienders to look out for seniors living alone in the community. Where SGAs or grassroots leaders identify vulnerable seniors, AIC will coordinate both social and health support from various Government agencies and community partners to help them and, there, the SSOs and the Silver Generation officers will work very closely on the ground in the local communities. This includes financial assistance, aged care services and health services. Similarly, if persons with disabilities are identified to have unmet needs, they will be linked up to the relevant agencies, such as SG Enable.

Finally, the social care and health care aspects of aged care have become integrated to support seniors, especially those who are frail and/or have weak social support. For example, MOH has integrated home and day care packages, as well as home medical, home nursing, home therapy and home personal care services, to support seniors more holistically so that they can age in place. MOH has also expanded senior care centres into Active Ageing Hubs (AAHs) which not only provide day care and day rehabilitation to frail seniors but also seek to engage seniors who are healthy in active ageing programmes. With this framework in place, the Government will be able to tap on the skills and the networks in different sectors to ensure a more robust support system is in place for vulnerable individuals.

Mr Henry Kwek called for a stronger push for LPA adoption to prepare our society for potential loss of mental capacity. I agree. The Office of the Public Guardian has embarked on a Business Process Re-engineering (BPR) exercise precisely to enable us to be future-ready in protecting our seniors who may lose mental capacity. One key objective is to see how we can move towards universal adoption of LPAs in a citizen-centric yet efficient manner and adopting a life stage approach. An interagency workgroup has been formed to do this, and will consult the public and stakeholders, and I will ask the workgroup to work and study Mr Kwek's ideas further.

Finally, Ms Sylvia Lim suggested that MSF look into streamlining the application process of deputyship to make it less costly and to make it more expeditious. The Family Justice Courts, the Ministry of Law (MinLaw) and MSF had convened the Committee to Review and Enhance Reforms in the Family Justice System (RERF) in January this year. One of the tasks that we have assigned them is to see how the deputyship application can be made simpler, more affordable and accessible, especially for straightforward and uncontested cases. More details will be provided when the Committee finalises its recommendations.

We will also continue exploring ways to ensure that the vulnerable among us are supported. Where eligible, a vulnerable adult could be supported under the Community Kin pilot, where VWOs can apply for a Court order to manage small and specific sums of an adult’s money for his day-to-day needs. This will enable the vulnerable adult to remain in the community with assistance from existing care networks, rather than have to be prematurely institutionalised.

Assoc Prof Daniel Goh and Mr Louis Ng have asked why it took three years for the Bill to be introduced. This Bill involves intrusive statutory intervention in the realm of family and personal matters, so we did not want to rush this. Indeed, as a Member has pointed out – was it Assoc Prof Daniel Goh – this Bill heralds more conversations in the future about the extent to which external state power should be brought into the realm of the family to enable, intervene and support. So, this is not just a Bill that involves operational details. It does involve quite a lot of that. But also very fundamental questions that we have to debate both internally and with our stakeholders. We had to consult our stakeholders extensively and review how past cases were handled to see where the law needed to come in. We also studied overseas jurisdictions.

In drawing up the Bill, we had detailed discussions with public agencies and community partners, such as our FVSCs, FSCs, SSOs, hospitals, the Police, the Courts and so on, on implementation, on SOPs – and work is still in progress on that front – capabilities, resourcing and training, not to mention the philosophical discussions that we have to have with various partners who are concerned about whether the Bill was sufficiently interventionist or whether it is overly intrusive. And, of course, during all this time, it was not the case that vulnerable adults were not supported and abuse left unattended. Social work intervention by our FSCs, FVSCs, SSC Cluster support, our APS, RPG, Office of the Public Guardian, AIC and the Police continues, as they have always been doing. With this Bill, we hope to be able to add on to that framework with the suite of powers that we are seeking your support on.

Mr Deputy Speaker, while the Government invests efforts to strengthen the adult protection framework, we will only succeed in protecting vulnerable members if we work with our stakeholder and the wider community. I thank Members and I seek your support for this piece of legislation.

Mr Deputy Speaker: Ms Sylvia Lim.

6.06 pm

Ms Sylvia Lim: Sir, I have a clarification for the Minister about his earlier explanation about why the cut-off age for the purposes of this Bill is set at 18. I think he mentioned that the Government is reviewing raising the age in the Children and Young Persons' Act from 16 to 18. I would like to have his confirmation as to whether this decision, in principle, has already been decided that it will be done, that the age will be raised from 16 to 18, or is the Government still thinking about whether this should be done.

Mr Desmond Lee: I thank the Member for the question. We want to ensure that there is seamless protection for both children and vulnerable adults. The CYPA is being reviewed for a range of possible amendments, including this increment of the age to close that gap. And this is something that we will do.

Mr Deputy Speaker: Mr Seah Kian Peng.

Mr Seah Kian Peng: Just a clarification for the Minister. The Minister mentioned in response to my suggestion for mandatory reporting that overseas jurisdictions showed that there was a case that when you have that, it leads to over-reporting. I concede that could happen. But why I proposed that was because I felt it is better to err on the side of caution. If there is no mandatory reporting, we will suffer the other consequence that there will be under-reporting. I also note that the Minister said, therefore, he is relying more on whistleblowing. That being the case, I would urge the Minister and the Ministry to really step up so that this whistleblowing awareness is a lot heightened because I am worried that under-reporting will lead to real consequences for the vulnerable adults.

Mr Desmond Lee: I thank the Member. Indeed, as I have said earlier, a mandatory scheme was, indeed, considered by MSF. We discussed this with our partners. There was considerable concern by professionals as to the efficacy and necessity of a mandatory reporting scheme. So, we adopted this where we strengthen and expand our network of care. Just like in child protection and adult protection, you also have to rely on a wide range of partners, both the community services, as well as professionals in healthcare and elsewhere that we share with them the importance of reporting suspected cases of abuse, that we guide them on what to look out for. As I have said earlier, there is a child abuse reporting guide.

We will do the same for adult abuse, neglect and self-neglect so as to uplift the capabilities and awareness of all our frontline stakeholders who are nodal points in this important community-based network to look out for vulnerable adults and children. So, let us put this whistleblower framework in place. Let us continue to strengthen our partners' awareness and their understanding that this is actually a very important role that they have to play in addition to the primary function, whatever that may be, and let us see if we can identify more cases that might be previously invisible. But as I have said, for now, we are not going to implement a mandatory scheme. But let us look at it in the future.

Mr Deputy Speaker: Ms Chia Yong Yong.

Ms Chia Yong Yong: Sir, I seek two clarifications from the Minister. Firstly, in relation to the financial protection of vulnerable adults, the Minister mentioned that he is considering certain steps to be taken. So, I would like to understand a little more about what steps will be taken. Will the Government also be prepared to look into amendments and steps to overturn even established principles of law, such as presumption of advancement and so on, for the protection of vulnerable elderly persons?

My second clarification relates again to the definitions which I had earlier submitted were far too narrow. The Minister clarified that by scoping the definitions, there is greater clarity for the exercise of the powers by the Director. On the other hand, the scoping of the definitions also means that the Director may be less able to exercise discretion. So, I would like to know how the Director would be able to balance considerations of protection and also in relation to applications for expedited orders.

Mr Desmond Lee: The Member had given some very useful ideas at the last Motion debate on seniors. If I recall, there were five ideas that the Member had raised. We are studying each and every one of them. Members, over the course of debates in the last few years, have also raised concerns about financial abuse of the elderly and abuse of parents financially. This is something that we continue to look at.

There are existing frameworks, such as the Commissioner of Maintenance of Parents and the Tribunal for the Maintenance of Parents. We are looking at all possibilities. It is a complex matter. Members who come across cases where even though an elderly constituent comes to tell you that he has been financially abused, when you offer some suggestions, they would not want to act on them. They want your listening ear. They do not want services to come in, they do not want you to report to the Tribunal for the Maintenance of Parents. They do not want the FSCs to get involved. It is a complex family and personal matter. But it is not a trivial matter, and I am sure Members will continue to look at possible solutions.

As to the point about whether long-established principles we are prepared to overturn, we will look at what can work and what will be acceptable.

The other question is about the scoping of definitions. Indeed, the Member has articulated that kind of balance we have had to strike between on the one hand having clarity and giving assurance that these interventionist powers will be limited to a very clearly defined scope and, on the other hand, always fearing that if you scope things too definitively and do not have discretion, for example, if the definition does not say "it includes" but it is not definitive, it includes other things as well, that you might just miss that opportunity to act in that one right case as it is. We want the best of both worlds actually. But I think we have drafted the definitions with sufficient breadth and yet need to assure the community and members of the public that there will be some clear definition that we operate on. So, let us develop experience operationalising these powers and then we can continue to review whether there are gaps that need to be plugged in the future.

Question put, and agreed to.

Bill accordingly read a Second time and committed to a Committee of the whole House.

The House immediately resolved itself into a Committee on the Bill. – [Mr Desmond Lee.]

Bill considered in Committee; reported without amendment; read a Third time and passed.