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Editorial

Singapore to require 24,000 more nurses in next 8 years, faces challenges to attract and retain experienced staff

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Singapore Health Minister Ong Ye Kung told Parliament on Wednesday (5 Oct) that Singapore will need more nurses by 2030 as Singapore ages (‘24k more nurses, healthcare staff needed by 2030 as S’pore ages‘, 6 Oct 2022).

“They number 58,000 now and MOH (Ministry of Health) estimates that this will need to grow to 82,000 by 2030,” said Mr Ong in his closing speech on the debate on the Healthier SG White Paper in Parliament.

This means MOH will need 24,000 more nurses in the next eight years, about 3,000 per year on the average.

The Health Minister “pointed out that by 2030, one in four Singaporeans will be aged 65 and above, and said that nurses, allied health professionals and support care staff are needed to operate hospitals, clinics and also eldercare centres.

Mr Ong took the opportunity to point out that since there simply are not enough local nurses available, Singapore will have to rely on more foreign nurses.

“If we want to take care of our seniors and the sick, if we want to reduce the workload of healthcare workers, we must expect foreign healthcare workers to play a bigger role in the coming years,” said Mr Ong. “This is especially so in areas that are facing a bigger manpower crunch, like aged care or palliative care.”

But he assured the House that there has been no exodus of local nurses, and that efforts are afoot to raise the intake of nursing students locally to 2,300, from 2,100 currently. That is, an increase of 200 more locals per intake.

Nominated Member of Parliament and breast surgeon Tan Yia Swam then suggested giving permanent residency to foreign nurses and Mr Ong said MOH is supportive of this.
Presently, Singaporeans and permanent residents make up about 72 per cent of Singapore’s pool of registered nurses and 63 per cent of enrolled nurses. The rest are foreigners.
In his closing speech, Mr Ong again underlined the urgency to attract foreign nurses, who are critical in making the aged care system work.

In fact, MOH already put up a tender through its subsidiary last month (Sep 2022) looking for recruitment agencies to provide services for a period of two years to hire nurses and nursing aides from overseas. The closing date for the tender is 2 weeks from now:

 

Uphill Challenges For Singapore To Attract And Retain Top Talents Nursing

Similar to issues faced by Singapore in attracting top talents for junior doctors in fierce competition against OECD countries such as the United States, Australia and the United Kingdom, nurses too is a profession much sought for by developed countries, especially in light of the issue of aging population.

As Mr Ong clarified in his speech, there was no mass exodus of local nurses amidst the COVID pandemic but the attrition of foreign nurses has gone up.

“From about 8.9% in normal years, to 14.8% in 2021. This is where there is record high attrition, at least over past few years.” said Mr Ong.

Recognising the heightened international competition, Mr Ong said, “We know the main reason, and Dr Tan Yia Swam talked about it – which is that the pandemic has increased the demand for nurses all over the world, and our foreign nurses are being poached by other countries. They go to New Zealand, Australia, the UK, the UAE etc.”

According to data from OECD for countries such as Australia, UK, New Zealand and US, the top source countries for their foreign-trained nurses come from Philippines and India. One reason being nurses from these two countries would likely be able to communicate in English.

While in Singapore, other than the Philippines and India, it also taps on countries such as Malaysia, China and Myanmar for nurses.

In a 2005 report, each year, about eight per cent of nurses leave, and seven per cent of them enter Singapore based on information from the International Council of Nurses (ICN). This figure corresponds with the figure provided by Mr Ong in his speech on 5 Oct.

The report further notes that the 8 per cent of nurses who leave the country are mostly foreign nurses on employment contracts, not Singaporean nurses.

“Filipino nurses, in particular, tend to move to other countries such as the U.K., the U.S. or Canada upon completion of their employment contracts. According to the Ministry of Health, the attrition rate of foreign nurses in 2005 was 23 per cent. Singapore seems to serve as a stepping stone for these Asian nurses who wish to migrate to other destinations with the expectation of bigger and better compensation packages.”

As to whether such sentiments are still present, a report produced by Lien Foundation in 2019 on Long-term Care workers in Singapore, had interviewees say:


So just how much is the difference in wages between nurses in Australia and Singapore?

On top of differential wages from other developed countries, there is also a difference in work environment and culture. Again we use results obtained from Lien Foundation’s report as a superficial comparison between countries. While the figures used for long-term caretakers are not indicative of the primary care environment but it gives some basis for comparison between countries.

Mr Ong said in response to questions filed by MPs back in August, “Even as we prioritise the well-being of our nurses, we appreciate the reality of their work, which is to deliver timely and quality patient care. The Ministry is working to ensure there are sufficient nurses on the ground. In fact, the registered stock of nurses over the past few years has remained stable, with a slight increase from around 42,800 in end 2019, to 43,000 in end 2021. Local nursing intakes have also increased from around 1,500 in 2014 to around 2,100 in 2021 to ensure that there is a stable inflow of nursing manpower into our healthcare system.”

While Mr Ong is optimistic about the increase of nurses with the figures that he cited, the reality might be far harsher when we consider the number of nurses leaving employment — both local and foreign — against those that Singapore hires on a yearly basis. This is especially so when Singapore intends to hire 3,000 nurses per year to increase the base number of nurses to another 24,000, which is 67,000 if we used the figures in 2021.

If Singapore does not wish to become a nursing ground for potential hires of OECD countries — although it already is in a way — and to retain its new recruits, more needs to be done urgently to ensure that nurses feel well-taken cared for and that they have a career prospect in the country regardless whether they are local or foreigners.

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Editorial

Lim Boon Heng’s misleading claims & omission in July ST interview on Income-Allianz deal

In a July 2024 interview, Lim Boon Heng praised the proposed Allianz acquisition of Income Insurance, but subsequent revelations from Minister Edwin Tong raised concerns about misleading claims and non-disclosure, particularly regarding the planned capital reduction and its impact on Income’s social mission.

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In a July 2024 interview with The Straits Times, Lim Boon Heng, chairman of NTUC Enterprise, framed the proposed acquisition of Income Insurance by German insurer Allianz as a positive development.

The former People’s Action Party minister, who is also the chairman of Temasek Holdings, emphasised the deal’s potential to strengthen Income’s competitiveness and enable it to fulfil its social mission more effectively.

However, Culture, Community, and Youth Minister Edwin Tong’s 14 October 2024 ministerial speech uncovered inconsistencies in Mr Lim’s statements, particularly regarding the planned capital extraction, casting doubt on the broader implications of the transaction.

While Mr Lim’s remarks focused on the benefits of Allianz’s majority stake, Mr Tong’s detailed disclosure in Parliament revealed significant concerns over the deal’s financial and social impacts, leading to the government’s intervention to block the transaction in its current form.

Misrepresentation of Income’s Social Mission

In the July interview, Mr Lim assured the public that Income’s social mission, which has historically supported low-income and vulnerable communities, would remain intact even after Allianz’s acquisition.

Lim noted that commercial companies worldwide had adopted similar values, suggesting that Allianz would likely uphold Income’s mission of “doing well to do good.”

He also reassured Singaporeans that the partnership would not compromise Income’s involvement in national insurance programmes.

However, Mr Tong’s ministerial statement revealed that the deal involved a significant capital reduction of S$1.85 billion within three years of the acquisition.

This planned extraction, which had not been disclosed publicly by Mr Lim or NTUC Enterprise, cast serious doubt on Income’s ability to continue fulfilling its social responsibilities.

During its corporatisation in 2022, Income had emphasised that the shift from a cooperative to a corporate entity was necessary to build a stronger capital base and ensure long-term sustainability.

Furthermore, NTUC Income, Singapore’s only insurance cooperative, was corporatised in 2022 into Income Insurance Limited “to achieve operational flexibility and gain access to strategic growth options to compete on an equal footing with other insurers locally and regionally.”

Shareholders were assured at the 2022 annual general meeting that NTUC Enterprise would remain the majority shareholder of the new company post-corporatisation, a promise that was not honoured in the proposed deal.

The proposed capital reduction directly contradicted these earlier justifications, raising concerns about the deal’s real motivations.

Lack of Transparency on Capital Optimisation Plans

In Mr Lim’s interview, there was no mention of Allianz’s post-transaction capital optimisation plans, which Mr Tong later disclosed.

These plans included freeing up capital for shareholder returns, which fundamentally altered the nature of the deal.

Workers’ Party MP for Sengkang GRC, He Ting Ru, questioned why NTUC Enterprise decided to proceed with the sale despite knowing about the capital extraction. She highlighted the difficulty of reconciling the withdrawal of capital with the goal of strengthening Income’s financial base, especially given its social mission.

Mr Tong responded by stating that the capital withdrawal needed to be seen within a broader context. He explained that even with the capital reduction, NTUC Income would still meet regulatory capital adequacy requirements.

Nevertheless, Mr Tong emphasised in his speech that the government’s decision to block the deal was not based solely on financial factors but also on concerns about governance and the lack of structural protections to ensure that Income could continue to pursue its social mission under Allianz’s majority ownership.

Second Minister for Finance Chee Hong Tat also clarified that the Monetary Authority of Singapore (MAS) had not approved the proposed capital reduction plan, leaving key questions about the deal unresolved.

Contradictions on Income’s Financial Needs

Mr Lim’s portrayal of the Allianz-Income deal as essential for shoring up Income’s finances was contradicted by Mr Tong’s revelations.

He had pointed to Income’s struggles with its capital adequacy ratio (CAR) during past economic downturns as justification for seeking a majority shareholder.

However, Mr Tong noted that the planned capital extraction undermined Income’s long-term financial sustainability.

The lack of transparency over the capital reduction drew sharp criticism from Non-Constituency Member of Parliament (NCMP) Leong Mun Wai of the Progress Singapore Party (PSP).

During the 14 October parliamentary session, Leong expressed shock over the revelation of the planned capital extraction, which had not been disclosed to the public during discussions about the deal.

He argued that this critical financial condition should have been made public from the outset.

“This information should be available to all Singaporeans,” Leong said. “For the last few months, we were under the impression that the information provided was complete. Now, we learn about capital extraction, which is a very important condition of any financial deal.”

Leong expressed his dissatisfaction with how the deal had been communicated to the public, stating, “I’m surprised, I’m shocked, and I’m very unhappy today that this important condition was not disclosed to Singaporeans when we were all discussing this deal.”

He pressed the government for accountability, asking, “Who is responsible for not disclosing this information? Can the government give a commitment that it will pursue responsibility in this matter?”

Despite the various misleading or non-disclosed elements in NTUC Enterprise’s and Income Insurance’s communications, Mr Tong is of the view that no one deliberately misled the public.

PSP NCMP had questioned whether action would be taken against those responsible for misleading the public and government. In her speech, Poa highlighted that the deal contradicted earlier representations made during Income’s corporatisation and called for greater transparency.

Mr Tong, however, rejected the suggestion of deliberate misinformation but acknowledged that the government had concerns about whether Income could continue to serve its social mission after the capital reduction.

Was Lim Boon Heng Misleading?

While Mr Lim’s statements in the July interview painted a positive picture of the Allianz-Income deal, subsequent revelations by Mr Tong and MPs He Ting Ru, Hazel Poa, and Leong Mun Wai have raised significant concerns about the financial and social impacts of the transaction.

The planned capital extraction and lack of transparency over key financial conditions suggest that important details were withheld from the public.

This leaves an important question: Did Lim Boon Heng’s statements mislead the public, or was it a matter of differing interpretations of the deal’s long-term impact?

As more details emerge, the public will have to decide whether NTUC Enterprise’s leadership was fully transparent or whether key aspects of the deal were deliberately downplayed. What do you think?

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Editorial

CNA’s one-sided POFMA coverage ignores key opposition and independent voices

[Editorial] Channel News Asia’s recent article on POFMA is marred by a lack of balance and transparency. By failing to engage key stakeholders and overlooking the challenges of contesting POFMA orders, the article skews public perception, reinforcing state narratives while ignoring critical perspectives.

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Channel News Asia’s (CNA) recent article, “Views stay divided on POFMA five years on, but has it helped in tackling fake news?” on the Protection from Online Falsehoods and Manipulation Act (POFMA) is presented as a  balanced reflection on the law five years after its enactment after a very controversial parliamentary process.

However, the article raises significant concerns about its lack of objectivity, transparency, and the selective representation of public sentiments toward the law.

Given CNA’s ownership by the Singapore government through Temasek Holdings, these concerns highlight the limitations of state-funded media in critically evaluating government policies. In Singaporean terms, this article shows how “ownself check ownself” literally “cannot make it”.

Lack of Transparency in Claims

The article claims that CNA reached out to “several recipients” of past POFMA orders to discuss their experiences.

Yet, after cross-checking with numerous POFMA recipients, it appears that only two individuals confirmed being contacted.

Crucially, major targets of POFMA orders, such as The Online Citizen (TOC), Kenneth Jeyaretnam, and the Singapore Democratic Party (SDP)—all of whom have been frequent recipients of POFMA correction directions—were not approached for comment.

This was confirmed by the above and also by Worker’s Party’s Yee Jenn Jong and Progress Singapore Party’s Leong Mun Wai,

This omission distorts the narrative, leaving out key perspectives from those who have been most affected by POFMA, casting serious doubts on the objectivity of the article as a whole.

Moreover, when contacted for clarification on who among POFMA recipients was reached out to, the article’s author did not respond.

This lack of transparency further undermines the credibility of CNA’s claim that it attempted to consult multiple stakeholders. By selectively omitting arguably the most important voices, the article fails to provide a comprehensive view of how POFMA has been applied or received.

Selective Representation of Public Sentiment

CNA’s portrayal of public sentiment toward POFMA is similarly problematic.

The article claims that “a majority” of those interviewed agreed with the necessity of the law to combat falsehoods.

However, this assertion seems at odds with the article’s reception on social media—or, more specifically, its absence online.

CNA chose not to post the article on its usual primary social media platforms, opting instead to post it only on Telegram.

This unusual choice suggests CNA may have anticipated criticism of the article’s narrative and sought to limit public engagement. This does not speak to confidence in the assertion that the “majority” of those interviewed agreed with the law unless the interviewees were restricted to a very narrow echo chamber.

Even on Telegram, the response was overwhelmingly negative, with 372 users disliking the post versus 70 expressing approval.

While this is not a representative sample of the entire population, it directly challenges the article’s claim that most people support POFMA.

The negative reaction on Telegram further undermines the argument that public sentiment is largely in favour of the law, particularly when the CNA itself avoided posting the article where public scrutiny could be more visible and objectively documented.

TOC also posted a survey on Facebook asking if people were in support of the law, with the majority saying no. We recognized the limitations of the survey and did not try to claim to present a balanced view of the law but rather an estimate of public perception based on an open, transparent survey.

The Hidden Costs of Challenging POFMA

One of the most misleading aspects of CNA’s coverage is the Ministry of Law’s (MinLaw) claim that the lack of challenges to POFMA orders indicates that recipients knew they were spreading falsehoods.

This interpretation ignores the significant financial, emotional, and legal barriers to challenging POFMA orders.

It also ignores the fact that while the majority of POFMA recipients have not formally challenged the orders in court, many of them published statements disagreeing with the correction directions that they were forced to carry.

To get some idea about how onerous a formal legal challenge to a POFMA direction, just visit the instruction page to learn how to go about filing a POFMA appeal; simply looking at the fees and potential costs involved is intimidating enough.

The fees listed also do not include the cost of hiring a lawyer to represent the individual or entity in court. While you can represent yourself in court, based on TOC’s experience, you would be facing three trained legal professionals arguing against you, which would be very challenging, to say the least.

The reality is that for many, complying with a POFMA order is the path of least resistance, especially when the alternative is public embarrassment, legal intimidation (if they cannot afford a lawyer), and the financial burden of a court battle.

TOC, which has filed the most court applications against POFMA with three applications and received the most directions at 15—more if you include Gutzy Asia’s directions—stopped contesting some of the more recent orders not because it admitted to spreading falsehoods but because the legal process is too onerous and costly.

Because of the way the law is written, challenging a POFMA order is, in most cases, less about proving truth or falsehood but rather about how government ministers frame their statements as being false.

The “multiple meanings” rule taken to be the yardstick by which statements are judged under POFMA presents a huge challenge to anyone making a statement as it would imply that any statement has to take into account varied interpretations beyond the original intent of the statement maker. This legal quagmire deters even those with legitimate cases from fighting back.

A prime example is Terry Xu’s case, where he challenged a POFMA order issued by Minister of Home Affairs and Law K Shanmugam in 2023.

Despite Mr Shanmugam’s statement in parliament that no costs would be imposed on individuals who contest POFMA orders, the Attorney-General’s Chambers (AGC) tried to obtain legal costs from Xu.

The court ultimately rejected AGC’s claim and ordered the AGC to pay Xu S$2,500 in costs for the failed application.

This particular incident highlights the intimidating legal environment surrounding POFMA challenges, where even promises made in parliament appear to be disregarded by government agencies.

Following the Court of Appeal’s ruling that one must establish a prima facie case that the alleged falsehood is true (in other words, that the burden of proof falls on the person who has allegedly made the false statement rather than on the Minister), TOC also had to withdraw its appeal against the POFMA correction direction regarding Ho Ching’s salary after the AGC threatened to seek costs.

It would have been challenging for TOC to contest the case, as the claim originated from a Taiwanese media outlet, which TOC merely reported on. Notably, the Taiwanese media outlet itself was not issued a POFMA correction direction.

This situation highlights a double standard, where media reporting on the government’s claims is not required to verify their truthfulness, given that POFMA directions do not apply to statements made by the government.

It also exemplifies the apparent arbitrariness of the POFMA process, a point that may have been hinted at in the CNA article but was not explored in depth.

A Skewed Perspective on POFMA’s Application

The CNA article also skirts around the fact that POFMA disproportionately targets opposition figures, activists, and independent media outlets.

It briefly notes that nine out of fourteen POFMA cases in 2023 involved opposition members or political candidates but fails to explore the implications of this statistic.

Instead of engaging with the criticism that POFMA is used selectively to suppress dissent, the article repeats MinLaw’s assertion that the process is rigorous and impartial.

However, selective enforcement is a real concern.

For example, the repeated use of POFMA against opposition figures and activists raises questions about whether the law is being applied fairly as promised against threats to public safety or as a tool to stifle political opponents of the ruling People’s Action Party (PAP).

By failing to address these concerns, CNA’s article gives the impression that POFMA’s application is fair and just and above reproach, which does not align with the experiences of those who have been most affected by it.

The article also fails to address how POFMA directions have predominantly been issued by a particular minister and his ministries.

If POFMA were intended to address falsehoods more broadly, one would expect a more even distribution of applications across different ministries, rather than the clear disparity seen in the statistics. (refer to TOC’s documented directions here)

CNA’s Reporting Reflects the Limitations of State Media

CNA’s article on POFMA misses the opportunity to provide a balanced and transparent evaluation of the law’s impact.

Given that CNA is state-owned and funded by Temasek Holdings, its coverage is naturally aligned with the government’s narrative, which explains the lack of critical engagement with the law’s flaws and controversies.

Rather than providing a platform for meaningful debate, CNA’s reporting reinforces the government’s position on POFMA while excluding key voices from the conversation.

Moreover, the decision to limit the article’s visibility on social media raises concerns about CNA’s willingness to engage with public criticism in general.

Ultimately, CNA’s coverage reflects the broader limitations of state media in critically analyzing government policies.

By failing to engage with all relevant stakeholders and presenting a one-sided view of POFMA, CNA’s reporting risks becoming an echo chamber for official government positions, rather than a platform for balanced, independent journalism.

With the SPH Media Trust also coming under the government’s financial umbrella, Singaporeans are at risk of being deprived of critically important news analysis due to this dominance by a one-sided official narrative.

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